Paramedic Exam Study Prep - Airway
and Breathing Questions & Answers
A child in respiratory distress may grunt as the child breathes. This is a result of
(A) increase tidal volume.
(B) an increased respiratory rate.
(C) creating pressure to help maintain open airways.
(D) an indication that the child is tired and will progress to respiratory arrest. - ANSWERSC.
Grunting involves exhaling against a partially closed glottis. This creates pressure to help
maintain open lower airways similar to pursed-lip breathing in adults with COPD. This short low-
pitched sound is often mistaken for whimpering and suggests severe hypoxia.
Respiratory acidosis is caused by
(A) an excess of bicarbonate.
(B) excess carbon dioxide retention.
(C) a loss of bicarbonate.
(D) excess carbon dioxide excretion. - ANSWERSB. Respiratory acidosis is caused by excess
carbon dioxide retention.
Scenario:
You are using an end-tidal carbon dioxide detector as a tool to assist for proper endotracheal
intubation placement.
,Question:
The absence of carbon dioxide in exhaled air indicates the endotracheal tube has been
(A) placed in the right mainstem bronchus.
(B) correctly placed in the trachea.
(C) placed in the esophagus.
(D) placed in the left mainstem bronchus. - ANSWERSC. The absence of carbon dioxide likely
indicates that the endotracheal tube has been placed in the esophagus. Verifying correct
endotracheal tube placement is absolutely essential. ETCO2 is only one method to assist in
verification.
Scenario:
You are using an end-tidal carbon dioxide detector as a tool to assist for proper endotracheal
intubation placement.
Question:
Your next action is to
(A) deflate the cuff, pull the endotracheal tube back 2 cm, and reassess placement.
(B) secure the endotracheal tube and confirm correct placement by auscultation.
(C) inflate the distal cuff with 7-10 cc of air and secure the endotracheal tube.
(D) remove the endotracheal tube and provide several ventilations prior to attempting
intubation again. - ANSWERSD. The endotracheal tube is likely placed in the esophagus. Your
next action is to remove the endotracheal tube and provide several ventilations with
supplemental oxygen prior to attempting another intubation.
, Which of the following drugs is used for rapid sequence intubation?
(A) Vecuronium
(B) Succinylcholine
(C) Lidocaine and atropine
(D) All of the above - ANSWERSD. All of the above. Vecuronium is a common nondepolarizing
neuromuscular blocker. Lidocaine is commonly used in RSI to prevent dysrhythmias associated
with stimulation of the glottis associated with intubation. Atropine is often administered to
decrease the incidence of bradycardia associated with the administration of succinylcholine.
You are called for a 54-year-old woman who is unconscious. Your assessment reveals the patient
to be apneic and pulseless. Initial management of this patient's airway should include
(A) assisted ventilation with a bag-valve device at 6-10 LPM.
(B) assisted ventilation with a nonrebreather mask at 10-15 LPM.
(C)immediate nasotracheal intubation and ventilation with a bag-valve device.
(D) insertion of an oropharyngeal airway and ventilation with a bag-valve device. - ANSWERSD.
Of the choice listed, insertion of an oropharyngeal airway and ventilating with a bag-valve
device is the best answer. (A). is incorrect because it utilizes a nonrebreather mask to assist
ventilations. nonrebreather are not designed for or capable of assisting ventilations. (C). is
incorrect because an apneic patient cannot be nasotracheally intubated.
The Esophageal Tracheal Combitube (ETCT) and the pharyngotracheal lumen airway (PTL) are
similar because
(A) neither requires assessment for accurate placement.
(B)both require manipulation of the head and neck for insertion.
(C)neither is inserted blindly.
and Breathing Questions & Answers
A child in respiratory distress may grunt as the child breathes. This is a result of
(A) increase tidal volume.
(B) an increased respiratory rate.
(C) creating pressure to help maintain open airways.
(D) an indication that the child is tired and will progress to respiratory arrest. - ANSWERSC.
Grunting involves exhaling against a partially closed glottis. This creates pressure to help
maintain open lower airways similar to pursed-lip breathing in adults with COPD. This short low-
pitched sound is often mistaken for whimpering and suggests severe hypoxia.
Respiratory acidosis is caused by
(A) an excess of bicarbonate.
(B) excess carbon dioxide retention.
(C) a loss of bicarbonate.
(D) excess carbon dioxide excretion. - ANSWERSB. Respiratory acidosis is caused by excess
carbon dioxide retention.
Scenario:
You are using an end-tidal carbon dioxide detector as a tool to assist for proper endotracheal
intubation placement.
,Question:
The absence of carbon dioxide in exhaled air indicates the endotracheal tube has been
(A) placed in the right mainstem bronchus.
(B) correctly placed in the trachea.
(C) placed in the esophagus.
(D) placed in the left mainstem bronchus. - ANSWERSC. The absence of carbon dioxide likely
indicates that the endotracheal tube has been placed in the esophagus. Verifying correct
endotracheal tube placement is absolutely essential. ETCO2 is only one method to assist in
verification.
Scenario:
You are using an end-tidal carbon dioxide detector as a tool to assist for proper endotracheal
intubation placement.
Question:
Your next action is to
(A) deflate the cuff, pull the endotracheal tube back 2 cm, and reassess placement.
(B) secure the endotracheal tube and confirm correct placement by auscultation.
(C) inflate the distal cuff with 7-10 cc of air and secure the endotracheal tube.
(D) remove the endotracheal tube and provide several ventilations prior to attempting
intubation again. - ANSWERSD. The endotracheal tube is likely placed in the esophagus. Your
next action is to remove the endotracheal tube and provide several ventilations with
supplemental oxygen prior to attempting another intubation.
, Which of the following drugs is used for rapid sequence intubation?
(A) Vecuronium
(B) Succinylcholine
(C) Lidocaine and atropine
(D) All of the above - ANSWERSD. All of the above. Vecuronium is a common nondepolarizing
neuromuscular blocker. Lidocaine is commonly used in RSI to prevent dysrhythmias associated
with stimulation of the glottis associated with intubation. Atropine is often administered to
decrease the incidence of bradycardia associated with the administration of succinylcholine.
You are called for a 54-year-old woman who is unconscious. Your assessment reveals the patient
to be apneic and pulseless. Initial management of this patient's airway should include
(A) assisted ventilation with a bag-valve device at 6-10 LPM.
(B) assisted ventilation with a nonrebreather mask at 10-15 LPM.
(C)immediate nasotracheal intubation and ventilation with a bag-valve device.
(D) insertion of an oropharyngeal airway and ventilation with a bag-valve device. - ANSWERSD.
Of the choice listed, insertion of an oropharyngeal airway and ventilating with a bag-valve
device is the best answer. (A). is incorrect because it utilizes a nonrebreather mask to assist
ventilations. nonrebreather are not designed for or capable of assisting ventilations. (C). is
incorrect because an apneic patient cannot be nasotracheally intubated.
The Esophageal Tracheal Combitube (ETCT) and the pharyngotracheal lumen airway (PTL) are
similar because
(A) neither requires assessment for accurate placement.
(B)both require manipulation of the head and neck for insertion.
(C)neither is inserted blindly.
