When assessing a 3-year-old male in respiratory distress, the EMT should recognize “see-saw” breathing when he observes:

movement of the chest and abdomen in opposite directions.

alternate breathing through the nose and mouth.

retraction of the muscles between the ribs.

up-and-down motion of the head as the patient breathes.

The mother of a 5-year-old female states that her daughter has been “sick” with a sore throat and fever for several days. The mother became concerned tonight and called 911 because the child was “making funny noises” and could not breathe. Your assessment reveals a lethargic, well-developed child sitting upright and with high-pitched tracheal noises when she breathes. Of the following, what is the priority action?

Administering supplemental oxygen

Placing an oropharyngeal airway

Inspecting the airway with a tongue depressor

An alert and oriented 45-year-old female patient is complaining of shortness of breath. Although her respiratory volume and rate are satisfactory, you note cyanosis in her fingertips. Which one of the following should be your next action?

Administer supplemental oxygen.

Assist respirations with the bag-valve mask.

Place a nasopharyngeal airway and assist respirations.

Move to the stretcher for immediate and rapid transport

A 67-year-old male patient is complaining of shortness of breath. The patient cannot remember how many times he used his inhaler prior to your arrival. Which of the following should be your next action?

Call medical direction for advisement. B) Assist the patient in the self-administration of his inhaler. C) Transport the patient to the hospital. D) Auscultate the lung sounds and administer the inhaler if you hear wheezing.

Assist the patient in the self-administration of his inhaler.

Transport the patient to the hospital.

Auscultate the lung sounds and administer the inhaler if you hear wheezing

A confused, lethargic, and nonverbal 50-year-old female has altered mental status. You are told she has a history of chronic obstructive pulmonary disease (COPD). The primary assessment reveals a breathing rate of 6 per minute and cool, clammy skin with cyanosis around the lips. Which of the following should be your next action?

Assist respirations with positive pressure ventilation.

Administer oxygen by nasal cannula at 15 lpm.

Administer oxygen by nonrebreather mask at 15 lpm.

Sit the patient up, assess lung sounds, and obtain a blood pressure

Within minutes of administering Proventil (albuterol) to a patient through her metered-dose inhaler (MDI), she is breathing easier and states that she feels much better. An Emergency Medical Responder on scene asks you how the medication in the MDI helped the patient. Which one of the following responses would be most appropriate?

“The medication in the inhaler relaxes and opens up the small airways in the lungs.”

“The medication travels to the brain and forces the respiratory rate to increase.”

“The medication in the MDI relaxes the throat, allowing more oxygen to enter.”

“The medication is an anti-inflammatory and decreases swelling in the lung tissue.”

Medical direction has ordered you to assist a patient in taking his metered-dose inhaler (MDI). After placing his lips on the mouthpiece, which one of the following instructions would be most appropriate?

“Please inhale slowly and I will administer the medication.”

“Please hold your breath and I will administer the medication.”

“Please inhale, then hold your breath, and I will give you the medication.”

“Please exhale, hold your breath, and I will administer the medication.”

You are assisting a patient in taking her metered-dose inhaler for the first time. Which one of the following statements about the side effects of the medication would be most appropriate?

“You may feel anxious and your heart rate may increase.”

“You will probably not even remember taking the medication.”

“You may experience a runny nose and increase in saliva.”

“The medication may cause you to become very tired and fatigued.”

After you administer a medication through a metered-dose inhaler (MDI), it is important that the patient:

hold her breath for several seconds.

exhale as forcefully as possible.

At a health fair, a patient informs you that she has just been prescribed a metered-dose inhaler (MDI) for her asthma. She states that she is confused about how to take the medication when needed. Which one of the following statements about the MDI would be most appropriate for you to make?

“It is important to shake the inhaler vigorously before taking the medication.”

“Take it every 4 hours around the clock, even if you feel fine.”

“Make sure to store the metered-dose inhaler in your refrigerator.”

“You should only take the medication after calling your doctor.”

You are administering a medication through a metered-dose inhaler (MDI) using a spacer. Which one of the following actions would be most appropriate?

Administer the medication into the spacer and then have the patient inhale.

Instruct the patient to inhale slowly just prior to the medication being placed in the spacer.

Administer the medication into the spacer and then have the patient exhale.

Instruct the patient to exhale slowly as you place the medication into the spacer.

Your medical director’s written protocol instructs you to obtain on-line medical direction prior to assisting a patient with a metered-dose inhaler (MDI). Given this protocol, you must contact:

an emergency physician prior to assisting with the MDI.

the patient’s family doctor before assisting with the MDI.

the medical director after assisting with the MDI.

no one; physician direction is not required when assisting with the MDI.

You have been called for a patient who is complaining of shortness of breath. On scene you find the 41-year-old woman sitting upright in bed with nasal flaring and wheezing. A metered-dose inhaler (MDI) is lying on the nightstand next to her. To assist her with the MDI, which of the following criteria must be met?

The MDI must be prescribed for the patient.

The pulse oximeter reading must be less than 90%.

High-concentration oxygen must be administered first for 5 minutes.

The patient must display altered mental status.

You are called to a motor vehicle collision. A 26-year-old female states that she was unrestrained and struck the steering column with her chest after the car she was driving struck another from behind. She is somewhat confused, and complaining of chest pain and difficult and painful breathing when she inhales. Her airway is patent and her breathing is adequate. Assessment of the radial pulse reveals it to be rapid and very irregular and weak. She has cyanosis in her nose and finger tips. Her breath sounds are clear and equal and skin moist and pale. She informs you that she suffers from asthma and has a metered-dose inhaler (MDI). What is your best action in treating this patient?

Assist the patient with her MDI.

Transport in a position of comfort.

You have been called for a 2-year-old male who is sick and having a difficult time breathing. On scene, you find the patient in his mother’s arms. He appears to have labored breathing and skin that is warm to the touch. What additional assessment finding would you recognize as the most serious?

Grunting noise heard as the child exhales

Continual crying accompanied by a fever of 99.4°F

Respiratory rate of 28 breaths per minute

Slight abdominal movement with breathing

A 6-year-old female is in respiratory distress and will not keep the nonrebreather face mask on her face. In this situation, the EMT should:

have the mother hold it near her face

secure the mask with tape to her face.

start positive pressure ventilation.

immediately transport without oxygen therapy.

On scene, you find a 2-year-old male in significant respiratory distress. He is responsive to verbal stimuli and exhibits noisy respirations through an open airway. His breathing is shallow at a rate of 44 breaths per minute. His pulse is rapid. Assessment of the skin shows it to be cool and diaphoretic with cyanosis to the extremities and around the mouth. What is the immediate priority for this patient?

Start positive pressure ventilation.

Insert an oropharyngeal airway.

Apply oxygen through a pediatric nonrebreather mask.

Move to the ambulance for immediate transport.

You have been dispatched for a young child with difficulty breathing. As you enter the apartment, which one of the following scene clues would best indicate that the patient is experiencing a problem in her upper airway?

Stridorous noises with inspiration

A 4-year-old boy in respiratory distress is sitting upright in bed and drooling. His mother states that he has been complaining of a sore throat throughout the day and tonight became severely short of breath and started drooling. He is alert with adequate breathing. His skin is hot to the touch. Vital signs are pulse 132, respirations 28, and SpO 2 90% on room air. Which one of the following is your first action in caring for this child?

Insert an oral airway and start ventilations.

Suction the airway of secretions.

Use a tongue depressor to inspect for a foreign body obstruction

Following a call in which you treated a pediatric patient suffering from croup, a new EMT who is in orientation asks you how you can differentiate croup from epiglottitis. Which one of the following responses would be most appropriate?

“The child with epiglottitis typically drools; the child with croup rarely, if ever, drools.”

“The swelling associated with epiglottitis typically decreases with exposure to cool air; the swelling with croup does not.”

“Epiglottitis is accompanied by a cough; croup is not associated with a cough.”

“Croup is typically associated with wheezing; epiglottitis is typically associated with crackles in the lungs.”

A 911 call was placed for a 3-year-old child with difficulty breathing. On scene you note that the child is upright with slight stridor upon inspiration. He is alert and breathing at a rate of 30 breaths per minute. His skin is warm and dry, and his radial pulse strong and regular. His breath sounds are clear and equal. His mother states that he has been fine all day until 15 minutes ago when he was playing with friends in the playroom and suddenly started having difficulty breathing. As an EMT, you should suspect which of the following conditions?

Foreign body airway obstruction

Croup (laryngotracheobronchitis)

A son has called 911 for his father, who is having difficulty breathing. On scene the 81-year-old patient is lethargic and lying on a couch in the living room and is in obvious respiratory distress. He is confused, but has an open airway. His respirations are 30 per minute and his skin is extremely diaphoretic with cyanosis in the fingertips. At this time, the EMT should:

start positive pressure ventilation.

suction the airway of secretion.

assess the patient’s breath sounds.

determine the patient’s past medical history.

When assessing a patient complaining of shortness of breath, which of the following actions should the EMT perform first?

Assess the adequacy of a patient’s breathing.

Ascertain whether the patient has used an MDI.

Get the patient’s SpO 2 to 100%.

Determine the cause of the shortness of breath.

You are treating a patient who states that he has been short of breath for the past month. Tonight, his breathing just “got too bad” and he decided to call 911. The 67-year-old male is alert and oriented and has a patent airway. He is breathing 24 times per minute but appears to have an adequate tidal volume. His pulse is strong and regular, and his skin is warm. Vital signs are: pulse 92 beats per minute, respirations 22, blood pressure 128/66 mmHg, and SpO 2 93% while on home oxygen at 2 lpm. What instruction would you give to your partner regarding this patient’s care?

“Let’s try 3 liters of oxygen through a nasal cannula.”

“He seems pretty stable; we can refer him to his family doctor.”

“Why don’t we see how he tolerates a nasal airway?”

“Let’s go ahead and put him on 15 lpm of oxygen.”

A confused and cyanotic patient is breathing 8 times per minute with poor chest rise and fall. What instruction would you give your partner about the respiratory care of this patient?

“Ventilate him at 10 to 12 times per minute and superimpose your ventilations over his.”

“Only deliver a ventilation with the bag-valve mask when he breathes.”

“Be sure to deliver your ventilations with the bag-valve mask in between his breaths.”

“Since he is breathing, let’s go ahead and put him on a nonrebreather mask with 15 lpm of oxygen.”

As you enter the living room of an adult patient who called 911 for shortness of breath, you observe the patient sitting upright in a chair with a panicked look on her face, struggling to breathe. Her breathing rate appears to be fast and tidal volume poor. You can hear rhonchi from her lungs without the aid of a stethoscope. Once at her side, you initial care should be to:

establish her rate of breathing

When assessing an adult patient with difficulty breathing, what sign or symptom would be of most concern?

Rate between 20 and 24 breaths per minute

You are having a hard time getting the past medical history of a patient who is short of breath. Which one of the following pieces of information would lead the EMT to believe that the patient has a history of chronic lung disease, such as emphysema or chronic bronchitis?

Her chest is “barrel” shaped.

Her respirations are tachypneic.

You have been called to a residence for a patient with altered mental status and shortness of breath. On scene an Emergency Medical Responder meets you and states that he believes the patient had a stroke and is unresponsive. As you enter the room, you see the patient lying in bed with snoring respirations. Oxygen at 15 liters per minute has been applied. Your immediate action when you reach the patient’s side would be to:

perform the head-tilt, chin-lift.

place a nasal airway and suction.

start positive pressure ventilation.

determine if the patient has a pulse.

You realize the EMT is properly ventilating an unresponsive adult male patient when he:

delivers each breath over a 1-second period.

ventilates smoothly at a rate of 24 breaths a minute.

flexes the patient’s head as ventilations are administered.

allows 2 seconds between each ventilation.

A 71-year-old female is complaining of the sudden onset of shortness of breath and rapid breathing. She also states that she is experiencing some chest pain that seems to worsen when she takes a deep breath. The primary assessment shows her to be alert and oriented with a patent airway and rapid breathing that is adequate. Her pulse rate is 92 per minute and her blood pressure is 116/68 mmHg. When obtaining a history, which statement made by the patient should raise your suspicion that the patient may be experiencing a pulmonary embolism?

“I had foot surgery five days ago.”

“I think that I may also have a fever.”

“I just started a new blood pressure medication today.”

“I had a headache earlier and took an aspirin.”

Respiratory System

Authored by Jennifer Immediato

Other

11th Grade

Used 16+ times

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91 questions

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MULTIPLE CHOICE QUESTION

30 sec • 1 pt

Which are not considered adventitious breath sounds

Clear bilaterally

rhonchi

wheezing

crackles

MULTIPLE CHOICE QUESTION

2 mins • 1 pt

Trouble breathing, swelling of the face or tongue and fainting are signs of ...

Heart attack

Stroke

Severe allergic reaction

Nosebleed

MULTIPLE CHOICE QUESTION

30 sec • 1 pt

When arriving on scene of a person being stuck by lightning you find they are unresponsive, not breathing, and does not have a pulse. You should:

assess them for skin burns

immediately attach the AED

begin one-rescuer CPR

MULTIPLE CHOICE QUESTION

45 sec • 1 pt

3-year-old girl swallowed a piece of hard candy and it lodged in her throat. She is having diﬃcultly breathing. You hear abnormal sounds when listening with your stethoscope. What sound might you expect to hear?

Rales

Stridor

Snoring

Wheezes

MULTIPLE CHOICE QUESTION

45 sec • 1 pt

Your patient used a metered-‐dose inhaler prior to your arrival. It provided relief from his asthma symptoms. This is because the medication inhaled came in contact with the:

oral mucosa

trachea and main bronchi

bronchioles

alveoli

MULTIPLE CHOICE QUESTION

30 sec • 1 pt

A patient suddenly has difficulty breathing and has audible inspirations that sound like wheezes. She is suffering from:

Chronic bronchitis

Emphysema

Asthma

Left-sided heart failure

MULTIPLE CHOICE QUESTION

30 sec • 1 pt

Family directs you to a bedroom where a 62-year-old male is in respiratory distress. During the scene size-up, which of the following most strongly suggests that the patient suffers from a chronic respiratory disease?

A) Furnace turned on high with humidifier running

Bottles of aspirin and nitroglycerin on nightstand

Patient in chair in tripod position

Smell of cigarettes in house

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Respiratory System

Which are not considered adventitious breath sounds

Trouble breathing, swelling of the face or tongue and fainting are signs of ...

When arriving on scene of a person being stuck by lightning you find they are unresponsive, not breathing, and does not have a pulse. You should:

3-­year-­old girl swallowed a piece of hard candy and it lodged in her throat. She is having diﬃcultly breathing. You hear abnormal sounds when listening with your stethoscope. What sound might you expect to hear?

Your patient used a metered-­‐dose inhaler prior to your arrival. It provided relief from his asthma symptoms. This is because the medication inhaled came in contact with the:

A patient suddenly has difficulty breathing and has audible inspirations that sound like wheezes. She is suffering from:

Family directs you to a bedroom where a 62-year-old male is in respiratory distress. During the scene size-up, which of the following most strongly suggests that the patient suffers from a chronic respiratory disease?

Family directs you to a bedroom where a 62-year-old male is in respiratory distress. During the scene size-up, which of the following most strongly suggests that the patient suffers from a chronic respiratory disease?

What is the most common cause of cardiac arrest in infants and children?

When assessing a 3-year-old male in respiratory distress, the EMT should recognize “see-saw” breathing when he observes:

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3-year-old girl swallowed a piece of hard candy and it lodged in her throat. She is having diﬃcultly breathing. You hear abnormal sounds when listening with your stethoscope. What sound might you expect to hear?

Your patient used a metered-‐dose inhaler prior to your arrival. It provided relief from his asthma symptoms. This is because the medication inhaled came in contact with the: