UCLA Entrance Exam [Airway] UPDATED
ACTUAL Exam Questions and CORRECT
Answers
Hyperventilation - CORRECT ANSWER - Pt is breathing too fast, exhaling too much CO2
Side effects of hyperventilation - CORRECT ANSWER - Increased PH level in body, tingling
in extremities, tachycardia, dizziness
______ is a form of respiratory drive in which the body uses oxygen chemoreceptors instead of
carbon dioxide receptors to regulate the respiratory cycle. "Backup System" to control breathing.
COPD pt's. - CORRECT ANSWER - Hypoxic drive
Signs and Symptoms:
- Progressive SOB
- Increased ALOC
- Neck vein distention
- Tracheal deviation - CORRECT ANSWER - Condition: Tension Pneumothorax
Upon discovering an open chest wound, you should:
A:prevent air from entering the open wound.
B:immediately reassess the patient's ventilatory status.
C:quickly cover the wound with a porous trauma dressing.
D:begin assisted ventilation and prepare for transport. - CORRECT ANSWER - A) Prevent air
from enteringthe open wound.
Immediately upon discovering an open chest wound (ie, sucking chest wound), you must take
immediate action to prevent air from entering the wound. This is most effectively accomplished
by applying an occlusive dressing or similar material to the wound. A porous (non-occlusive)
,trauma dressing will not prevent air from entering the wound. Tape three sides of the occlusive
dressing and closely monitor the patient. If worsened respiratory distress and signs of shock are
noted, a tension pneumothorax is probably developing, and you must release pressure from the
pleural space by lifting up the unsecured portion of the occlusive dressing.
You are assessing a young male who was stabbed in the right lower chest. He is semiconscious
and has labored breathing, collapsed jugular veins, and absent breath sounds on the right side of
his chest. This patient MOST likely has a:
A:hemothorax.
B:pneumothorax.
C:ruptured spleen.
D:liver laceration. - CORRECT ANSWER - A) hemothorax
Reason:
You should suspect a hemothorax if a patient with chest trauma presents with shock, especially if
the injury was caused by penetrating trauma. Hemothorax occurs when blood collects in the
pleural space and compresses the lung, resulting in shock and respiratory compromise. Other
signs include collapsed jugular veins (due to low blood volume), labored breathing, and
decreased or absent breath sounds on the side of the injury. A pneumothorax (air in the pleural
space) is also associated with difficulty breathing and unilaterally decreased or absent breath
sounds; however, the jugular veins are usually not collapsed. If excessive air accumulates within
the pleural space, however, pressure will shift across the mediastinum and affect the uninjured
lung (tension pneumothorax); if this occurs, the jugular veins may become engorged (distended).
Splenic injury is unlikely; the patient's injury is on the right side and the spleen is on the left. A
liver laceration can cause severe shock; however, it is not associated with unilaterally decreased
breath sounds or labored breathing.
A 45-year-old male was stabbed in the left anterior chest. He is conscious, but restless. His skin
is cool and clammy, his blood pressure is 90/60 mm Hg, his respirations are rapid and shallow,
and his heart rate is 120 beats/min and weak. Further assessment reveals that his breath sounds
are clear and equal bilaterally and his jugular veins are distended. In addition to giving him high-
flow oxygen, you should:
,A:cover the stab wound with an occlusive dressing, support ventilation as needed, and transport
rapidly.
B:control the bleeding from the stab wound with a sterile porous dressing and reassess his vital
signs.
C:suspect that the patient has a tension pneumothorax and notify the trauma center as soon as
possible.
D:perform a detailed physical exam at the scene to ensure that you locate and treat less obvious
injuries. - CORRECT ANSWER - A) cover the stab wound with an occlusive dressing,
support ventilation as needed, and transport rapidly.
Reason:
Your patient has signs of a pericardial tamponade, a condition usually caused by penetrating
chest trauma. In a pericardial tamponade, blood collects in the pericardial sac; this prevents the
heart from filling during the diastolic phase, causing a decrease in cardiac output and blood
pressure. Signs of a pericardial tamponade include muffled or distant heart tones (difficult to
assess in the field); a rapid, weak pulse; hypotension; jugular venous distention; and a narrowing
pulse pressure (difference between the systolic and diastolic blood pressures). A tension
pneumothorax is unlikely in this patient; his breath sounds are clear and equal bilaterally.
Treatment for a pericardial tamponade includes ensuring adequate oxygenation and ventilation,
covering the chest wound with an occlusive dressing (cover all open chest wounds with an
occlusive dressing), controlling any external bleeding, and transporting rapidly. Pericardial
tamponade is a life-threatening condition that requires definitive treatment at the hospital.
Nocturnal Dyspnea - CORRECT ANSWER - PND is a sign of congestive heart failure and
often strikes one or two hours after the person with heart failure has fallen asleep.
Specifically, dyspnea, "refers to the sensation of difficult or uncomfortable breathing,"according
to the National Center for Biotechnonoly Information. However, Dyspnea is not the same as
hyperventilation which consists of short, quick breaths and an inability to get one's breath.
Dyspnea can also be associated with exertion.
PND occurs by a fluid build up in the lungs entering the alveoli (air sacs) while a person sleeps.
The alveoli are responsible for oxygen and carbon dioxide exchange from the blood. During the
day, the fluid is retained in the legs. At night, while sleeping, the body resorbs this fluid resulting
in an increase in total blood volume and blood pressure leading to pulmonary hypertension or
, edema. Many patients, without realizing the congestive heart failure nature of these symptoms
naturally counteract these symptoms by sleeping on several pillows or sleeping while sitting up.
One explanation for the onset of symptoms is that the left ventricle is starting to fail and is
unable to keep up with the performance of a perfectly healthy right ventricle. Other theories
according NCBI, include "decreased responsiveness of the respiratory center in the brain and
decreased adrenergic (adrenalin-fueled) activity in the myocardium (heart muscles) during
sleep."
Common Causes of PND
- Chronic Obstructive Pulmonary Disease (COPD): a group of lung conditions including chronic
bronchitis and emphysema that affects the lungs' ability to function normally.
-Cor Pulmonale: "An acute strain or hypertrophy [abnormal enlargement] resulting from disease
of the lungs or of other blood vessels." (Dictionary.com)
- Heart failure
- Hypertensive heart disease
- Obesity (which aggravates
Upper Airway [6 components] - CORRECT ANSWER - All anatomic airway structures
ABOVE vocal cords. Includes nose, mouth, jaw, oral cavity, pharynx and larynx
What are the 3 major functions of the upper airway? - CORRECT ANSWER - Warm, filter
and humidify air as it enters the body through the nose and mouth
Muscular tube that extends from the nose and mouth to the level of the esophagus and trachea? -
CORRECT ANSWER - Pharynx (throat). Composed of the naso, oro, and laryngopharynx.
ACTUAL Exam Questions and CORRECT
Answers
Hyperventilation - CORRECT ANSWER - Pt is breathing too fast, exhaling too much CO2
Side effects of hyperventilation - CORRECT ANSWER - Increased PH level in body, tingling
in extremities, tachycardia, dizziness
______ is a form of respiratory drive in which the body uses oxygen chemoreceptors instead of
carbon dioxide receptors to regulate the respiratory cycle. "Backup System" to control breathing.
COPD pt's. - CORRECT ANSWER - Hypoxic drive
Signs and Symptoms:
- Progressive SOB
- Increased ALOC
- Neck vein distention
- Tracheal deviation - CORRECT ANSWER - Condition: Tension Pneumothorax
Upon discovering an open chest wound, you should:
A:prevent air from entering the open wound.
B:immediately reassess the patient's ventilatory status.
C:quickly cover the wound with a porous trauma dressing.
D:begin assisted ventilation and prepare for transport. - CORRECT ANSWER - A) Prevent air
from enteringthe open wound.
Immediately upon discovering an open chest wound (ie, sucking chest wound), you must take
immediate action to prevent air from entering the wound. This is most effectively accomplished
by applying an occlusive dressing or similar material to the wound. A porous (non-occlusive)
,trauma dressing will not prevent air from entering the wound. Tape three sides of the occlusive
dressing and closely monitor the patient. If worsened respiratory distress and signs of shock are
noted, a tension pneumothorax is probably developing, and you must release pressure from the
pleural space by lifting up the unsecured portion of the occlusive dressing.
You are assessing a young male who was stabbed in the right lower chest. He is semiconscious
and has labored breathing, collapsed jugular veins, and absent breath sounds on the right side of
his chest. This patient MOST likely has a:
A:hemothorax.
B:pneumothorax.
C:ruptured spleen.
D:liver laceration. - CORRECT ANSWER - A) hemothorax
Reason:
You should suspect a hemothorax if a patient with chest trauma presents with shock, especially if
the injury was caused by penetrating trauma. Hemothorax occurs when blood collects in the
pleural space and compresses the lung, resulting in shock and respiratory compromise. Other
signs include collapsed jugular veins (due to low blood volume), labored breathing, and
decreased or absent breath sounds on the side of the injury. A pneumothorax (air in the pleural
space) is also associated with difficulty breathing and unilaterally decreased or absent breath
sounds; however, the jugular veins are usually not collapsed. If excessive air accumulates within
the pleural space, however, pressure will shift across the mediastinum and affect the uninjured
lung (tension pneumothorax); if this occurs, the jugular veins may become engorged (distended).
Splenic injury is unlikely; the patient's injury is on the right side and the spleen is on the left. A
liver laceration can cause severe shock; however, it is not associated with unilaterally decreased
breath sounds or labored breathing.
A 45-year-old male was stabbed in the left anterior chest. He is conscious, but restless. His skin
is cool and clammy, his blood pressure is 90/60 mm Hg, his respirations are rapid and shallow,
and his heart rate is 120 beats/min and weak. Further assessment reveals that his breath sounds
are clear and equal bilaterally and his jugular veins are distended. In addition to giving him high-
flow oxygen, you should:
,A:cover the stab wound with an occlusive dressing, support ventilation as needed, and transport
rapidly.
B:control the bleeding from the stab wound with a sterile porous dressing and reassess his vital
signs.
C:suspect that the patient has a tension pneumothorax and notify the trauma center as soon as
possible.
D:perform a detailed physical exam at the scene to ensure that you locate and treat less obvious
injuries. - CORRECT ANSWER - A) cover the stab wound with an occlusive dressing,
support ventilation as needed, and transport rapidly.
Reason:
Your patient has signs of a pericardial tamponade, a condition usually caused by penetrating
chest trauma. In a pericardial tamponade, blood collects in the pericardial sac; this prevents the
heart from filling during the diastolic phase, causing a decrease in cardiac output and blood
pressure. Signs of a pericardial tamponade include muffled or distant heart tones (difficult to
assess in the field); a rapid, weak pulse; hypotension; jugular venous distention; and a narrowing
pulse pressure (difference between the systolic and diastolic blood pressures). A tension
pneumothorax is unlikely in this patient; his breath sounds are clear and equal bilaterally.
Treatment for a pericardial tamponade includes ensuring adequate oxygenation and ventilation,
covering the chest wound with an occlusive dressing (cover all open chest wounds with an
occlusive dressing), controlling any external bleeding, and transporting rapidly. Pericardial
tamponade is a life-threatening condition that requires definitive treatment at the hospital.
Nocturnal Dyspnea - CORRECT ANSWER - PND is a sign of congestive heart failure and
often strikes one or two hours after the person with heart failure has fallen asleep.
Specifically, dyspnea, "refers to the sensation of difficult or uncomfortable breathing,"according
to the National Center for Biotechnonoly Information. However, Dyspnea is not the same as
hyperventilation which consists of short, quick breaths and an inability to get one's breath.
Dyspnea can also be associated with exertion.
PND occurs by a fluid build up in the lungs entering the alveoli (air sacs) while a person sleeps.
The alveoli are responsible for oxygen and carbon dioxide exchange from the blood. During the
day, the fluid is retained in the legs. At night, while sleeping, the body resorbs this fluid resulting
in an increase in total blood volume and blood pressure leading to pulmonary hypertension or
, edema. Many patients, without realizing the congestive heart failure nature of these symptoms
naturally counteract these symptoms by sleeping on several pillows or sleeping while sitting up.
One explanation for the onset of symptoms is that the left ventricle is starting to fail and is
unable to keep up with the performance of a perfectly healthy right ventricle. Other theories
according NCBI, include "decreased responsiveness of the respiratory center in the brain and
decreased adrenergic (adrenalin-fueled) activity in the myocardium (heart muscles) during
sleep."
Common Causes of PND
- Chronic Obstructive Pulmonary Disease (COPD): a group of lung conditions including chronic
bronchitis and emphysema that affects the lungs' ability to function normally.
-Cor Pulmonale: "An acute strain or hypertrophy [abnormal enlargement] resulting from disease
of the lungs or of other blood vessels." (Dictionary.com)
- Heart failure
- Hypertensive heart disease
- Obesity (which aggravates
Upper Airway [6 components] - CORRECT ANSWER - All anatomic airway structures
ABOVE vocal cords. Includes nose, mouth, jaw, oral cavity, pharynx and larynx
What are the 3 major functions of the upper airway? - CORRECT ANSWER - Warm, filter
and humidify air as it enters the body through the nose and mouth
Muscular tube that extends from the nose and mouth to the level of the esophagus and trachea? -
CORRECT ANSWER - Pharynx (throat). Composed of the naso, oro, and laryngopharynx.
