Nurs Chapter 09 Questions Part 3

61. Prior to applying a nonrebreathing mask on a patient, you must ensure that the: A. one-way valve is sealed. B. flow rate is set at 6 L/min. C. reservoir bag is fully inflated. D. patient has reduced tidal volume. Answer: C Question Type: General Knowledge Page: 351 62. At a flow rate of 6 L/min, a nasal cannula can deliver an approximate oxygen concentration of up to: A. 24%. B. 35%. C. 44%. D. 52%. Answer: C Question Type: General Knowledge Page: 352 63. The nasal cannula is MOST appropriately used in the prehospital setting: A. when the patient cannot tolerate a nonrebreathing mask. B. if the patient’s nasopharynx is obstructed by secretions. C. if long-term supplemental oxygen administration is required. D. when the patient breathes primarily through his or her mouth. Answer: A Question Type: General Knowledge Page: 352 64. The main advantage of the Venturi mask is: A. the ability to adjust the percentage of inspired oxygen when caring for a critically ill or injured patient. B. the use of its fine adjustment capabilities in the long-term management of physiologically stable patients. C. that it does not contain an oxygen reservoir, so the same percentage of oxygen can consistently be administered. 18 D. the ability to adjust the amount of oxygen administered to the patient by increasing the flow rate on the regulator. Answer: B Question Type: General Knowledge Page: 352 65. A 51-year-old female presents with a sudden onset of difficulty breathing. She is conscious and alert and able to speak in complete sentences. Her respirations are 22 breaths/min and regular. You should: A. administer 100% oxygen via a nonrebreathing mask. B. insert a nasal airway in case her mental status decreases. C. perform a secondary assessment and then begin treatment. D. assist her breathing with a bag-mask device and 100% oxygen. Answer: A Question Type: Critical Thinking Page: 353 66. What occurs when a patient is breathing very rapidly and shallowly? A. Minute volume increases because of a marked increase in both tidal volume and respiratory rate. B. Air moves primarily in the anatomic dead space and does not participate in pulmonary gas exchange. C. Air is forcefully drawn into the lungs due to the negative pressure created by the rapid respirations. D. The majority of tidal volume reaches the lungs and diffuses across the alveolarcapillary membrane. Answer: B Question Type: General Knowledge Page: 354 67. As the single EMT managing an apneic patient’s airway, the preferred initial method of providing ventilations is the: A. mouth-to-mouth technique. B. one-person bag-mask device. C. manually triggered ventilation device. D. mouth-to-mask technique with a one-way valve. 19 Answer: D Question Type: General Knowledge Page: 354 68. You and your partner are treating a 66-year-old man who experienced a sudden onset of respiratory distress. He is conscious but is unable to follow simple verbal commands. Further assessment reveals that his breathing is severely labored and his oxygen saturation is 80%. You should: A. attempt to insert an oropharyngeal airway. B. assist his ventilations with a bag-mask device. C. apply a continuous positive airway pressure (CPAP) device and monitor his breathing. D. apply high-flow oxygen via nonrebreathing mask. Answer: B Question Type: Critical Thinking Page: 354 69. Which of the following statements regarding positive-pressure ventilation is correct? A. Positive-pressure ventilation allows blood to naturally be pulled back to the heart from the body. B. With positive-pressure ventilation, more volume is required to have the same effects as normal breathing. C. To prevent hypotension, the EMT should increase the rate and force of positivepressure ventilation. D. Unlike negative-pressure ventilation, positive-pressure ventilation does not affect the esophageal opening pressure. Answer: B Question Type: General Knowledge Page: 355 70. How does positive-pressure ventilation affect cardiac output? A. There is no effect on cardiac output because positive-pressure ventilation is the act of normal breathing. B. It decreases intrathoracic pressure, which facilitates venous return to the heart and increases cardiac output. C. It causes pressure in the chest to decrease, which increases stroke volume and cardiac output. 20 D. It increases intrathoracic pressure, which decreases venous return to the heart and causes a decrease in cardiac output. Answer: D Question Type: General Knowledge Page: 355 71. You are ventilating a 40-year-old uninjured man who is apneic but has a pulse. When your partner reassesses his blood pressure, he notes that it has decreased significantly from previous readings. You elevate the patient’s legs, but this action has no effect. You should: A. reevaluate the rate and volume of your ventilations. B. perform a head-to-toe assessment to look for bleeding. C. increase the volume of your ventilations and reassess his blood pressure. D. ensure that you are delivering one breath every 3 to 5 seconds. Answer: A Question Type: Critical Thinking Page: 355 72. You are performing mouth-to-mask ventilations with oxygen connected and set at a flow rate of 15 L/min. What percentage of oxygen is your patient receiving? A. 45% B. 55% C. 65% D. 75% Answer: B Question Type: General Knowledge Page: 356 73. You and your partner are caring for a critically injured patient. Your partner is controlling severe bleeding from the patient’s lower extremities as you attempt ventilations with a bag-mask device. After repositioning the mask several times, you are unable to effectively ventilate the patient. You should: A. begin ventilations using the mouth-to-mask technique. B. hyperextend the patient’s head and reattempt ventilations. C. continue attempted ventilations and transport immediately. D. suction the patient’s airway for 30 seconds and reattempt ventilations. 21 Answer: A Question Type: Critical Thinking Page: 356 74. Which of the following statements regarding the one-person bag-mask device technique is correct? A. Bag-mask ventilations should be delivered every 2 seconds when the device is being operated by one person. B. The C-clamp method of holding the mask to the face is not effective when ventilating a patient with a bag-mask device. C. Adequate tidal volume is often difficult to achieve when one EMT is operating the bag-mask device. D. The bag-mask device delivers more tidal volume and a higher oxygen concentration than the mouth-to-mask technique. Answer: C Question Type: General Knowledge Page: 358 75. Despite your attempts to coach a conscious young female’s respirations, she continues to hyperventilate with a marked reduction in tidal volume. You should: A. restrain her and provide ventilatory assistance. B. insert a nasopharyngeal airway and give oxygen. C. explain to her that you will assist her ventilations. D. ventilate her at the rate at which she is breathing. Answer: C Question Type: Critical Thinking Page: 359 76. All of the following will help minimize the risk of gastric distention when ventilating an apneic patient with a bag-mask device, EXCEPT: A. delivering each breath over 1 second. B. ensuring the appropriate airway position. C. ventilating the patient at the appropriate rate. D. increasing the amount of delivered tidal volume. Answer: D Question Type: General Knowledge Page: 359 22 77. Which of the following is the MOST reliable indicator of adequately performed bagmask ventilations in an apneic adult with a pulse? A. 20 breaths/min being delivered to the adult B. decreased compliance when squeezing the bag C. an adult’s heart rate that is consistently increasing D. adequate rise of the chest when squeezing the bag Answer: D Question Type: General Knowledge Page: 360 78. On which of the following patients would it be MOST appropriate to use the flowrestricted, oxygen-powered ventilation device? A. an 8-year-old female with respiratory failure B. a 21-year-old male with traumatic cardiac arrest C. a 38-year-old apneic female with blunt chest trauma D. a 59-year-old male with chronic obstructive pulmonary disease (COPD) Answer: B Question Type: General Knowledge Page: 360 79. How does CPAP improve oxygenation and ventilation in patients with certain respiratory problems? A. It forces the alveoli open and pushes more oxygen across the alveolar membrane. B. It pushes thick, infected pulmonary secretions into isolated areas of the lung tissue. C. It decreases intrathoracic pressure, which allows more room for the lungs to expand. D. It prevents alveolar collapse by pushing air into the lungs during the inhalation phase. Answer: A Question Type: General Knowledge Page: 362 80. CPAP is indicated for patients who: A. have signs of pneumonia but are breathing adequately. B. are unresponsive and have signs of inadequate ventilation. C. have pulmonary edema and can follow verbal commands. 23 D. are hypotensive and have a marked reduction in tidal volume. Answer: C Question Type: General Knowledge Page: 362 81. You are ventilating a patient with a stoma; however, air is escaping from the mouth and nose. To prevent this, you should: A. thrust the jaw forward. B. seal the mouth and nose. C. ventilate with less pressure. D. thoroughly suction the stoma. Answer: B Question Type: Critical Thinking Page: 366 82. A 37-year-old male has an apparent foreign body airway obstruction. He is conscious and alert and is coughing forcefully. His skin is pink, warm, and moist. The MOST appropriate treatment for this patient includes: A. a series of back blows and chest thrusts. B. finger sweeps to remove the obstruction. C. performing a series of abdominal thrusts. D. encouraging him to cough and transporting. Answer: D Question Type: Critical Thinking Page: 366 83. While eating dinner, your partner suddenly grabs his throat and has a panicked look on his face. He has a weak cough, faint inspiratory stridor, and cyanosis around the lips. You should: A. encourage him to cough as forcefully as he can. B. deliver up to five back blows and reassess him. C. place him in a supine position and open his airway. D. stand behind him and administer abdominal thrusts. Answer: D Question Type: Critical Thinking Page: 366–367 24 84. Which of the following is NOT a possible cause of airway obstruction? A. relaxation of the tongue B. aspirated vomitus C. shallow breathing D. foreign objects Answer: C Question Type: General Knowledge Page: 367 85. You are ventilating an apneic woman with a bag-mask device. She has dentures, which are tight-fitting. Adequate chest rise is present with each ventilation, and the patient’s oxygen saturation reads 96%. When you reassess the patency of her airway, you note that her dentures are now loose, although your ventilations are still producing adequate chest rise. You should: A. remove her dentures, resume ventilations, and assess for adequate chest rise. B. attempt to replace her dentures so that they fit tightly and resume ventilations. C. leave her dentures in place, but carefully monitor her for an airway obstruction. D. remove her dentures at once and increase the rate and volume of your ventilations. Answer: A Question Type: Critical Thinking Page: 368 25