Name: __________________________ Date: _____________



1.
Which of the following factors will cause a decreased minute volume in an adult?
A.
shallow breathing
B.
increased tidal volume
C.
respirations of 20 breaths/min
D.
slight decrease in respiratory rate


2.
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


3.
Central chemoreceptors located in the medulla provide feedback to increase the rate and depth of breathing when they sense:
A.
slight elevations in carbon dioxide or a decrease in the pH of the cerebrospinal fluid.
B.
slight decreases in carbon dioxide and an increase in the pH of the cerebrospinal fluid.
C.
decreased levels of oxygen in the blood and an increase in the pH of the cerebrospinal fluid.
D.
increased levels of oxygen in the blood and a decrease in the pH of the cerebrospinal fluid.


4.
What is the minute volume of a patient with a tidal volume of 500 mL, a dead space volume of 150 mL, and a respiratory rate of 16 breaths/min?
A.
5,600 mL
B.
6,000 mL
C.
7,400 mL
D.
8,000 mL


5.
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.


6.
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.


7.
In the presence of oxygen, the mitochondria of the cells convert glucose into energy through a process called:
A.
perfusion.
B.
respiration.
C.
aerobic metabolism.
D.
anaerobic metabolism.


8.
The leaf-shaped structure located superior to the larynx is called the:
A.
epiglottis.
B.
vallecula.
C.
cricoid ring.
D.
thyroid cartilage.


9.
If ventilation is impaired, carbon dioxide levels in the bloodstream will increase. This condition is called:
A.
acidosis.
B.
hypoxia.
C.
hypoxemia.
D.
hypercarbia.


10.
Which of the following patients should you place in the recovery position?
A.
a 19-year-old conscious male with a closed head injury and normal respirations
B.
a 24-year-old unconscious female who overdosed and has a reduced tidal volume
C.
a 31-year-old semiconscious male with low blood sugar and adequate breathing
D.
a 40-year-old conscious female with a possible neck injury and regular respirations


11.
A patient who is suspected of being hypoxic and is breathing adequately should be given supplemental oxygen with a:
A.
nasal cannula.
B.
nonrebreathing mask.
C.
bag-mask device.
D.
mouth-to-mask device.


12.
The actual exchange of oxygen and carbon dioxide occurs in the:
A.
bronchioles.
B.
alveolar sacs.
C.
apex of the lung.
D.
pulmonary capillaries.


13.
Which of the following would NOT cause a decrease in tidal volume?
A.
shallow breathing
B.
deep respirations
C.
irregular breathing
D.
agonal respirations


14.
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.


15.
Proper technique for suctioning the oropharynx of an adult patient includes:
A.
continuously suctioning patients with copious oral secretions.
B.
suctioning while withdrawing the catheter from the oropharynx.
C.
removing large, solid objects with a tonsil-tip suction catheter.
D.
suctioning for up to 1 minute if the patient is well oxygenated.


16.
When testing a mechanical suctioning unit, you should turn on the device, clamp the tubing, and ensure that it generates a vacuum pressure of more than:
A.
100 mm Hg.
B.
200 mm Hg.
C.
300 mm Hg.
D.
400 mm Hg.


17.
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.
D.
It increases intrathoracic pressure, which decreases venous return to the heart and causes a decrease in cardiac output.


18.
An unconscious patient found in a prone position must be placed in a supine position in case he or she:
A.
requires cardiopulmonary resuscitation (CPR).
B.
begins to vomit.
C.
regains consciousness.
D.
has increased tidal volume.


19.
Which of the following oxygen flowmeters is NOT affected by gravity and can be used in any position when attached to an oxygen cylinder?
A.
vertical-position flowmeter
B.
Bourdon-gauge flowmeter
C.
ball-and-float flowmeter
D.
pressure-compensated flowmeter


20.
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.


21.
Which of the following patients is breathing adequately?
A.
a conscious male with respirations of 19 breaths/min and pink skin
B.
a conscious female with facial cyanosis and rapid, shallow respirations
C.
a conscious male with respirations of 18 breaths/min and reduced tidal volume
D.
an unconscious 52-year-old female with snoring respirations and cool, pale skin


22.
A ventilation/perfusion (V/Q ratio) mismatch occurs when:
A.
ventilation is inadequate due to a traumatic injury or medical condition, which results in an impairment in pulmonary gas exchange.
B.
a disruption in blood flow inhibits the exchange of oxygen and carbon dioxide in the lungs, even though the alveoli are filled with fresh oxygen.
C.
ventilation is compromised, resulting in the accumulation of carbon dioxide in the bloodstream, alveoli, and the tissues and cells of the body.
D.
a traumatic injury or medical condition impairs the body's ability to effectively bring oxygen into the lungs and remove carbon dioxide from the body.


23.
In contrast to inhalation, exhalation:
A.
requires muscular effort to effectively expel air from the lungs.
B.
is a passive process caused by increased intrathoracic pressure.
C.
occurs when the diaphragm lowers and expels air from the lungs.
D.
is an active process caused by decreased intrathoracic pressure.


24.
The physical act of moving air into and out of the lungs is called:
A.
diffusion.
B.
ventilation.
C.
respiration.
D.
oxygenation.


25.
The MOST serious complication associated with using a nasopharyngeal airway in a patient with trauma to the head or face is:
A.
fracturing the septum.
B.
damaging the turbinates.
C.
penetrating the cranium.
D.
causing severe bleeding.


26.
Which of the following statements regarding oxygen is correct?
A.
Oxygen cylinders must always remain in an upright position.
B.
Oxygen is flammable and may explode if under high pressure.
C.
Oxygen supports the combustion process and may cause a fire.
D.
Oxygen is most safely administered in an enclosed environment.


27.
Inhalation occurs when the:
A.
diaphragm and intercostal muscles relax and cause an increase in intrathoracic pressure.
B.
diaphragm and intercostal muscles ascend and cause an increase in intrathoracic pressure.
C.
diaphragm and intercostal muscles contract and cause a decrease in intrathoracic pressure.
D.
diaphragm ascends and the intercostal muscles contract, causing a decrease in intrathoracic pressure.


28.
Which of the following is a late sign of hypoxia?
A.
anxiety
B.
cyanosis
C.
tachycardia
D.
restlessness


29.
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.


30.
Which of the following structures is contained within the mediastinum?
A.
lungs
B.
larynx
C.
bronchioles
D.
esophagus


31.
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.


32.
Gas exchange in the lungs is facilitated by:
A.
adequate amounts of surfactant.
B.
water or blood within the alveoli.
C.
surfactant-destroying organisms.
D.
pulmonary capillary constriction.


33.
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.


34.
The process of exchanging oxygen and carbon dioxide between the alveoli and the blood of the capillaries is called:
A.
external respiration.
B.
cellular metabolism.
C.
pulmonary ventilation.
D.
alveolar ventilation.


35.
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 positive-pressure ventilation.
D.
Unlike negative-pressure ventilation, positive-pressure ventilation does not affect the esophageal opening pressure.


36.
The primary waste product of aerobic metabolism is:
A.
lactic acid.
B.
pyruvic acid.
C.
carbon dioxide.
D.
adenosine triphosphate.


37.
The hypoxic drive—the primary stimulus to breathe for patients with certain chronic respiratory diseases—is influenced by:
A.
high blood oxygen levels.
B.
low blood oxygen levels.
C.
low blood carbon dioxide levels.
D.
high blood carbon dioxide levels.


38.
On which of the following patients would it be MOST appropriate to use the flow-restricted, 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)


39.
With a good mask-to-face seal and an oxygen flow rate of 15 L/min, the nonrebreathing mask is capable of delivering up to ______% inspired oxygen.
A.
70
B.
80
C.
90
D.
100


40.
A 19-year-old female is found unconscious by her roommate. Your primary assessment reveals that her breathing is inadequate. As you insert an oropharyngeal airway, she begins to gag violently. You should:
A.
continue to insert the airway as you suction her oropharynx.
B.
remove the airway and be prepared to suction her oropharynx.
C.
insert the airway no further but leave it in place as a bite block.
D.
select a smaller oropharyngeal airway and attempt to insert it.


41.
Without adequate oxygen, the body's cells:
A.
rely solely on glucose, which is completely converted into adenosine triphosphate (ATP).
B.
cease metabolism altogether, resulting in carbon dioxide accumulation in the blood.
C.
begin to metabolize fat, resulting in the production and accumulation of ketoacids.
D.
incompletely convert glucose into energy, and lactic acid accumulates in the blood.


42.
Hypoxia is MOST accurately defined as:
A.
low venous oxygen levels.
B.
a decrease in arterial oxygen levels.
C.
an increase in carbon dioxide in the blood.
D.
inadequate oxygen to the tissues and cells.


43.
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.


44.
A nasopharyngeal airway is inserted:
A.
with the bevel facing the septum if inserted into the right nare.
B.
into the larger nostril with the tip pointing away from the septum.
C.
with the bevel pointing downward if inserted into the left nare.
D.
into the smaller nostril with the tip following the roof of the nose.


45.
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%.


46.
Which of the following structures is NOT found in the upper airway?
A.
larynx
B.
pharynx
C.
bronchus
D.
oropharynx


47.
In which of the following patients would the head tilt–chin lift maneuver be the MOST appropriate method of opening the airway?
A.
a 24-year-old male who is found unconscious at the base of a tree
B.
a 37-year-old female who is found unconscious in her bed
C.
a 45-year-old male who is semiconscious after falling 20 feet
D.
a 50-year-old male who is unconscious following head trauma


48.
To select the proper size oropharyngeal airway, you should measure from the:
A.
corner of the mouth to the earlobe.
B.
center of the mouth to the posterior ear.
C.
corner of the mouth to the superior ear.
D.
angle of the jaw to the center of the mouth.


49.
The nasopharyngeal airway is MOST beneficial because it:
A.
can effectively stabilize fractured nasal bones if it is inserted properly.
B.
is generally well tolerated in conscious patients with an intact gag reflex.
C.
effectively maintains the airway of a patient in cardiopulmonary arrest.
D.
can maintain a patent airway in a semiconscious patient with a gag reflex.


50.
A 71-year-old male is semiconscious following a sudden, severe headache. There is vomitus on his face and his respirations are slow and shallow. The EMT must immediately:
A.
insert a nasopharyngeal airway.
B.
perform oropharyngeal suctioning.
C.
apply oxygen via a nonrebreathing mask.
D.
assist the patient's ventilations with a bag-mask device.


51.
You have inserted an oral airway and are ventilating an apneic woman with a bag-mask device. She suddenly begins regurgitating large amounts of vomit. You should:
A.
perform a finger sweep of her mouth.
B.
insert a nasal airway and then suction her mouth.
C.
roll her onto her side and remove the oral airway.
D.
remove the oral airway and suction her oropharynx.


52.
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.


53.
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.


54.
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.


55.
An adult at rest should have a respiratory rate that ranges between:
A.
8 and 15 breaths/min.
B.
10 and 18 breaths/min.
C.
12 and 20 breaths/min.
D.
16 and 24 breaths/min.


56.
Each cell of the body combines nutrients and oxygen and produces energy and waste products through a process called:
A.
respiration.
B.
ventilation.
C.
metabolism.
D.
oxygenation.


57.
The pressure of gas in a full cylinder of oxygen is approximately _______ pounds per square inch (psi).
A.
500
B.
1,000
C.
1,500
D.
2,000


58.
Tidal volume is defined as the volume of air that:
A.
is moved through the lungs in a single minute.
B.
moves into or out of the lungs in a single breath.
C.
remains in the lungs following a complete exhalation.
D.
is forced into the lungs as a result of positive pressure.


59.
The MOST significant complication associated with oropharyngeal suctioning is:
A.
oral abrasions from vigorous suctioning.
B.
hypoxia due to prolonged suction attempts.
C.
clogging of the catheter with thick secretions.
D.
vomiting from stimulating the anterior airway.


60.
The purpose of the pin-indexing system that has been established for compressed gas cylinders is to:
A.
ensure that the correct regulator is used for the cylinder.
B.
help you determine what type of oxygen regulator to use.
C.
prevent destroying or stripping the threads on the cylinder.
D.
reduce the cylinder pressure to a safe and more useful range.


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