PRACTICE EXAM QUESTIONS WITH CORRECT ANSWERS RATED A+ - EMT

Which of the following would MOST likely occur if an adult patient is breathing at a rate of 45 breaths/min with shallow depth? A) The volume of air that reaches the alveoli would increase significantly. B) Minute alveolar volume would increase due to the rapid respiratory rate. C) Most of his or her inhaled air will not go beyond the anatomic dead space. D) The lungs would become hyperinflated, potentially causing a pneumothorax. - C) Most of his or her inhaled air will not go beyond the anatomic dead space. Feedback: Minute alveolar volume, the amount of air that reaches the alveoli per minute and participates in pulmonary respiration, is affected by tidal volume, respiratory rate, or both. If the respiratory rate decreases, tidal volume must increase to maintain adequate minute alveolar volume. Conversely, if tidal volume decreases, the respiratory rate must increase accordingly. However, if the respiratory rate is extremely fast, especially if the depth of breathing is shallow (reduced tidal volume), most of the inhaled air will only make it to the anatomic dead space (ie, trachea, larger bronchi) before it is promptly exhaled. As a result, minute alveolar volume will decrease, resulting in inadequate pulmonary respiration and hypoxia. For this reason, patients with rapid, shallow breathing often require ventilation assistance. Pulmonary hyperinflation would not be an issue in a patient with exceedingly fast breathing and reduced tidal volume because very little air is actually reaching the lungs. Patients with a hypoxic drive: A) may hypoventilate if given low concentrations of oxygen. B) are stimulated to breathe by low oxygen levels in the blood. C) rarely become cyanotic because of high blood oxygen levels. D) are accustomed to low levels of carbon dioxide in the blood. - B) are stimulated to breathe by low oxygen levels in the blood. Feedback : Patients with chronic respiratory diseases (eg, emphysema) maintain decreased levels of oxygen and increased levels of carbon dioxide in the blood. The sensors in the brain become accustomed to this. Unlike in a healthy person, whose primary respiratory drive is influenced by increasing carbon dioxide levels in the blood, the primary respiratory drive of a patient with a chronic respiratory disease is influenced by low levels of oxygen in the blood (hypoxic drive). Cyanosis is common due to chronic hypoxemia. Some patients with a hypoxic drive may hypoventilate if given high concentrations of supplemental oxygen, although this is highly uncommon. High-flow supplemental oxygen may fool the brain into thinking the body has sufficient oxygen, causing it to send fewer signals to the diaphragm and intercostal muscles. A 50-year-old man presents with crushing chest pain that suddently began about 30 minutes ago. He is diaphoretic and anxious. The EMT should: A) obtain baseline vital signs. B) apply supplemental oxygen. C) administer chewable aspirin. D) perform a complete physical exam. - C) administer chewable aspirin. Feedback : Aspirin (up to 325 mg) has clearly been shown to reduce mortality and morbidity from acute myocardial infarction (AMI) and should be given as soon as possible to patients with suspected cardiac chest pain (unless they are allergic to aspirin). Not all patients get oxygen, even those experiencing AMI. Give oxygen if the patient is hypoxemic (oxygen saturation less than 94%). Clearly, it is important to perform a physical exam and obtain vital signs. Of the interventions listed, however, aspirin administration has the highest priority in this patient. Which of the following would MOST likely occur if an adult patient is breathing at a rate of 45 breaths/min with shallow depth? A) The volume of air that reaches the alveoli would increase significantly. B) Minute alveolar volume would increase due to the rapid respiratory rate. C) Most of his or her inhaled air will not go beyond the anatomic dead space. D) The lungs would become hyperinflated, potentially causing a pneumothorax. - C) Most of his or her inhaled air will not go beyond the anatomic dead space. Feedback : Minute alveolar volume, the amount of air that reaches the alveoli per minute and participates in pulmonary respiration, is affected by tidal volume, respiratory rate, or both. If the respiratory rate decreases, tidal volume must increase to maintain adequate minute alveolar volume. Conversely, if tidal volume decreases, the respiratory rate must increase accordingly. However, if the respiratory rate is extremely fast, especially if the depth of breathing is shallow (reduced tidal volume), most of the inhaled air will only make it to the anatomic dead space (ie, trachea, larger bronchi) before it is promptly exhaled. As a result, minute alveolar volume will decrease, resulting in inadequate pulmonary respiration and hypoxia. For this reason, patients with rapid, shallow breathing often require ventilation assistance. Pulmonary hyperinflation would not be an issue in a patient with exceedingly fast breathing and reduced tidal volume because very little air is actually reaching the lungs. Patients with a hypoxic drive: A) may hypoventilate if given low concentrations of oxygen. B) are stimulated to breathe by low oxygen levels in the blood. C) rarely become cyanotic because of high blood oxygen levels. D) are accustomed to low levels of carbon dioxide in the blood. - B) are stimulated to breathe by low oxygen levels in the blood. Feedback : Patients with chronic respiratory diseases (eg, emphysema) maintain decreased levels of oxygen and increased levels of carbon dioxide in the blood. The sensors in the brain become accustomed to this. Unlike in a healthy person, whose primary respiratory drive is influenced by increasing carbon dioxide levels in the blood, the primary respiratory drive of a patient with a chronic respiratory disease is influenced by low levels of oxygen in the blood (hypoxic drive). Cyanosis is common due to chronic hypoxemia. Some patients with a hypoxic drive may hypoventilate if given high concentrations of supplemental oxygen, although this is highly uncommon. High-flow supplemental oxygen may fool the brain into thinking the body has sufficient oxygen, causing it to send fewer signals to the diaphragm and intercostal muscles. A 50-year-old man presents with crushing chest pain that suddently began about 30 minutes ago. He is diaphoretic and anxious. The EMT should: A) obtain baseline vital signs. B) apply supplemental oxygen. C) administer chewable aspirin. D) perform a complete physical exam. Feedback : Aspirin (up to 325 mg) has clearly been shown to reduce mortality and morbidity from acute myocardial infarction (AMI) and should be given as soon as possible to patients with suspected cardiac chest pain (unless they are allergic to aspirin). Not all patients get oxygen, even those experiencing AMI. Give oxygen if the patient is hypoxemic (oxygen saturation less than 94%). Clearly, it is important to perform a physical exam and obtain vital signs. Of the interventions listed, however, aspirin administration has the highest priority in this patient. - C) administer chewable aspirin.