PARAMEDIC EXAM STUDY PREP - AIRWAY AND BREATHING TEST
WITH THE FULL COVERAGE
Avchildvinvrespiratoryvdistressvmayvgruntvasvthevchildvbreathes.vThisvisvavresultvofv
(A)vincreasevtidalvvolume.
(B)vanvincreasedvrespiratoryvrate.
(C)vcreatingvpressurevtovhelpvmaintainvopenvairways.
(D)vanvindicationvthatvthevchildvisvtiredvandvwillvprogressvtovrespiratoryvarrest.v-
vcorrectvanswer-
C.vGruntingvinvolvesvexhalingvagainstvavpartiallyvclosedvglottis.vThisvcreatesvpressurevto
vhelpvmaintainvopenvlowervairwaysvsimilarvtovpursed-
lipvbreathingvinvadultsvwithvCOPD.vThisvshortvlow-
pitchedvsoundvisvoftenvmistakenvforvwhimperingvandvsuggestsvseverevhypoxia.
Respiratoryvacidosisvisvcausedvbyv
(A)vanvexcessvofvbicarbonate.
(B)vexcessvcarbonvdioxidevretention.
(C)vavlossvofvbicarbonate.
(D)vexcessvcarbonvdioxidevexcretion.v-vcorrectvanswer-
B.vRespiratoryvacidosisvisvcausedvbyvexcessvcarbonvdioxidevretention.
Scenario:
Youvarevusingvanvend-
tidalvcarbonvdioxidevdetectorvasvavtoolvtovassistvforvpropervendotrachealvintubationvplace
ment.
Question:v
Thevabsencevofvcarbonvdioxidevinvexhaledvairvindicatesvthevendotrachealvtubevhasvbeen
(A)vplacedvinvthevrightvmainstemvbronchus.
,(B)vcorrectlyvplacedvinvthevtrachea.
(C)vplacedvinvthevesophagus.
(D)vplacedvinvthevleftvmainstemvbronchus.v-vcorrectvanswer-
C.vThevabsencevofvcarbonvdioxidevlikelyvindicatesvthatvthevendotrachealvtubevhasvbeenv
placedvinvthevesophagus.vVerifyingvcorrectvendotrachealvtubevplacementvisvabsolutelyv
essential.vETCO2visvonlyvonevmethodvtovassistvinvverification.
Scenario:v
Youvarevusingvanvend-
tidalvcarbonvdioxidevdetectorvasvavtoolvtovassistvforvpropervendotrachealvintubationvplace
ment.
Question:
Yourvnextvactionvisvtov
(A)vdeflatevthevcuff,vpullvthevendotrachealvtubevbackv2vcm,vandvreassessvplacement.
(B)vsecurevthevendotrachealvtubevandvconfirmvcorrectvplacementvbyvauscultation.
(C)vinflatevthevdistalvcuffvwithv7-10vccvofvairvandvsecurevthevendotrachealvtube.
(D)vremovevthevendotrachealvtubevandvprovidevseveralvventilationsvpriorvtovattemptingvi
ntubationvagain.v-vcorrectvanswer-
D.vThevendotrachealvtubevisvlikelyvplacedvinvthevesophagus.vYourvnextvactionvisvtovremo
vevthevendotrachealvtubevandvprovidevseveralvventilationsvwithvsupplementalvoxygenvpr
iorvtovattemptingvanothervintubation.
Whichvofvthevfollowingvdrugsvisvusedvforvrapidvsequencevintubation?
(A)vVecuronium
(B)vSuccinylcholine
(C)vLidocainevandvatropine
(D)vAllvofvthevabovev-vcorrectvanswer-
D.vAllvofvthevabove.vVecuroniumvisvavcommonvnondepolarizingvneuromuscularvblocker.v
LidocainevisvcommonlyvusedvinvRSIvtovpreventvdysrhythmiasvassociatedvwithvstimulatio
nvofvthevglottisvassociatedvwithvintubation.vAtropinevisvoftenvadministeredvtovdecreasevth
evincidencevofvbradycardiavassociatedvwithvthevadministrationvofvsuccinylcholine.
Youvarevcalledvforvav54-year-
oldvwomanvwhovisvunconscious.vYourvassessmentvrevealsvthevpatientvtovbevapneicvandv
pulseless.vInitialvmanagementvofvthisvpatient'svairwayvshouldvinclude
(A)vassistedvventilationvwithvavbag-valvevdevicevatv6-10vLPM.
(B)vassistedvventilationvwithvavnonrebreathervmaskvatv10-15vLPM.
(C)immediatevnasotrachealvintubationvandvventilationvwithvavbag-valvevdevice.
(D)vinsertionvofvanvoropharyngealvairwayvandvventilationvwithvavbag-valvevdevice.v-
vcorrectvanswer-
D.vOfvthevchoicevlisted,vinsertionvofvanvoropharyngealvairwayvandvventilatingvwithvavbag-
valvevdevicevisvthevbestvanswer.v(A).visvincorrectvbecausevitvutilizesvavnonrebreathervma
skvtovassistvventilations.vnonrebreathervarevnotvdesignedvforvorvcapablevofvassistingvven
, tilations.v(C).visvincorrectvbecausevanvapneicvpatientvcannotvbevnasotracheallyvintubate
d.
ThevEsophagealvTrachealvCombitubev(ETCT)vandvthevpharyngotrachealvlumenvairwayv
(PTL)varevsimilarvbecausev
(A)vneithervrequiresvassessmentvforvaccuratevplacement.
(B)bothvrequirevmanipulationvofvthevheadvandvneckvforvinsertion.
(C)neithervisvinsertedvblindly.
(D)vNonevofvthevabove.v-vcorrectvanswer-
D.vNonevofvthevabovevarevcorrect.v(A).visvinvcorrectvbecausevbothvdevicesvrequirevasses
smentvforvaccuratevplacement.vWithvthevPTLvyouvbeginvventilationvthoughvavshortvtubev(
thevonevwithoutvthevstylet);vwithvthevCombitube,vyouvbeginvventilationvthroughvavlongerv
bluevtube.vIfvchestvrisevandvpresencevofvbreathvsoundsvarevnotvobserve,vyouvmustvswitc
hvimmediatelyvtovthevothervventilationvportvandvreassess.v(B).visvincorrectvbecausevbothv
arevinsertedvinvthevneutralvpositionvandvnovmanipulationvofvthevheadvandvneckvisvrequire
dvforvinsertion.v(C).visvincorrectvbecausevbothvdevicesvarevinsertedvblindly.
Breathvsoundsvsuchvasvcracklesvandvrhonchivthatvarevnotvnormallyvheardvarevdefinedvas
v-----vbreathvsounds.v
(A)vbronchial
(B)vadventitious
(C)vvesicular
(D)vbronchovesicularv-vcorrectvanswer-
B.vAdventitiousvbreathvsoundsvarevconsideredvabnormalvsoundsvsuchvasvcracklesvandvr
honchi.
Whichvofvthevfollowingvcorrectlyvdescribesvthevflowvofvairvfromvoutsidevthevbodyvintovthevt
rachea?
(A)vNose,vnasopharynx,vlaryngopharynx,voropharynx,vlarynx,vtrachea
(B)vNose,vnasopharynx,vlarynx,vlaryngopharynx,voropharynx,vtrachea
(C)vNose,vnasalvcavities,vnasopharynx,voropharynx,vlaryngopharynx,vlarynx,vtrachea
(D)vNose,vnasalvcavities,vlaryngopharynx,vnasopharynx,voropharynx,vlarynx,vtracheav-
vcorrectvanswer-
C.vThisvisvavsimplevanatomyvandvphysiologyvquestion.vThevnose,vnasalvcavities,vnasoph
arynx,voropharynx,vlarynx,vandvtracheavcorrectlyvdescribedvthevflowvofvair.
Youvarevcalledvforvanvunresponsivev29-year-
oldvman.vBystandersvreportvhevhasvbeenvdrinkingvheavilyvallvday.vAssessmentvrevealsvt
hevpatientvtovbevresponsivevonlyvtovpainfulvstimuli.vHisvbreathingvisvshallowvatvavratevofvf
ourvtimesvpervminute.vHowvwouldvyouvmanagevthisvpatient?
(A)vNasalvcannulavatv2-4vLPM
(B)vSimplevfacevmaskvatv4-6vLPM
(C)vNonrebreathervmaskvatv10-15vLPM
(D)vBag-valvevdevicevwithvavreservoirvatv10-15vLPMv-vcorrectvanswer-
D.vBreathingvmustvbevsupportedvwithvavbag-valvevdevicevwithvsupplementalvhigh-
WITH THE FULL COVERAGE
Avchildvinvrespiratoryvdistressvmayvgruntvasvthevchildvbreathes.vThisvisvavresultvofv
(A)vincreasevtidalvvolume.
(B)vanvincreasedvrespiratoryvrate.
(C)vcreatingvpressurevtovhelpvmaintainvopenvairways.
(D)vanvindicationvthatvthevchildvisvtiredvandvwillvprogressvtovrespiratoryvarrest.v-
vcorrectvanswer-
C.vGruntingvinvolvesvexhalingvagainstvavpartiallyvclosedvglottis.vThisvcreatesvpressurevto
vhelpvmaintainvopenvlowervairwaysvsimilarvtovpursed-
lipvbreathingvinvadultsvwithvCOPD.vThisvshortvlow-
pitchedvsoundvisvoftenvmistakenvforvwhimperingvandvsuggestsvseverevhypoxia.
Respiratoryvacidosisvisvcausedvbyv
(A)vanvexcessvofvbicarbonate.
(B)vexcessvcarbonvdioxidevretention.
(C)vavlossvofvbicarbonate.
(D)vexcessvcarbonvdioxidevexcretion.v-vcorrectvanswer-
B.vRespiratoryvacidosisvisvcausedvbyvexcessvcarbonvdioxidevretention.
Scenario:
Youvarevusingvanvend-
tidalvcarbonvdioxidevdetectorvasvavtoolvtovassistvforvpropervendotrachealvintubationvplace
ment.
Question:v
Thevabsencevofvcarbonvdioxidevinvexhaledvairvindicatesvthevendotrachealvtubevhasvbeen
(A)vplacedvinvthevrightvmainstemvbronchus.
,(B)vcorrectlyvplacedvinvthevtrachea.
(C)vplacedvinvthevesophagus.
(D)vplacedvinvthevleftvmainstemvbronchus.v-vcorrectvanswer-
C.vThevabsencevofvcarbonvdioxidevlikelyvindicatesvthatvthevendotrachealvtubevhasvbeenv
placedvinvthevesophagus.vVerifyingvcorrectvendotrachealvtubevplacementvisvabsolutelyv
essential.vETCO2visvonlyvonevmethodvtovassistvinvverification.
Scenario:v
Youvarevusingvanvend-
tidalvcarbonvdioxidevdetectorvasvavtoolvtovassistvforvpropervendotrachealvintubationvplace
ment.
Question:
Yourvnextvactionvisvtov
(A)vdeflatevthevcuff,vpullvthevendotrachealvtubevbackv2vcm,vandvreassessvplacement.
(B)vsecurevthevendotrachealvtubevandvconfirmvcorrectvplacementvbyvauscultation.
(C)vinflatevthevdistalvcuffvwithv7-10vccvofvairvandvsecurevthevendotrachealvtube.
(D)vremovevthevendotrachealvtubevandvprovidevseveralvventilationsvpriorvtovattemptingvi
ntubationvagain.v-vcorrectvanswer-
D.vThevendotrachealvtubevisvlikelyvplacedvinvthevesophagus.vYourvnextvactionvisvtovremo
vevthevendotrachealvtubevandvprovidevseveralvventilationsvwithvsupplementalvoxygenvpr
iorvtovattemptingvanothervintubation.
Whichvofvthevfollowingvdrugsvisvusedvforvrapidvsequencevintubation?
(A)vVecuronium
(B)vSuccinylcholine
(C)vLidocainevandvatropine
(D)vAllvofvthevabovev-vcorrectvanswer-
D.vAllvofvthevabove.vVecuroniumvisvavcommonvnondepolarizingvneuromuscularvblocker.v
LidocainevisvcommonlyvusedvinvRSIvtovpreventvdysrhythmiasvassociatedvwithvstimulatio
nvofvthevglottisvassociatedvwithvintubation.vAtropinevisvoftenvadministeredvtovdecreasevth
evincidencevofvbradycardiavassociatedvwithvthevadministrationvofvsuccinylcholine.
Youvarevcalledvforvav54-year-
oldvwomanvwhovisvunconscious.vYourvassessmentvrevealsvthevpatientvtovbevapneicvandv
pulseless.vInitialvmanagementvofvthisvpatient'svairwayvshouldvinclude
(A)vassistedvventilationvwithvavbag-valvevdevicevatv6-10vLPM.
(B)vassistedvventilationvwithvavnonrebreathervmaskvatv10-15vLPM.
(C)immediatevnasotrachealvintubationvandvventilationvwithvavbag-valvevdevice.
(D)vinsertionvofvanvoropharyngealvairwayvandvventilationvwithvavbag-valvevdevice.v-
vcorrectvanswer-
D.vOfvthevchoicevlisted,vinsertionvofvanvoropharyngealvairwayvandvventilatingvwithvavbag-
valvevdevicevisvthevbestvanswer.v(A).visvincorrectvbecausevitvutilizesvavnonrebreathervma
skvtovassistvventilations.vnonrebreathervarevnotvdesignedvforvorvcapablevofvassistingvven
, tilations.v(C).visvincorrectvbecausevanvapneicvpatientvcannotvbevnasotracheallyvintubate
d.
ThevEsophagealvTrachealvCombitubev(ETCT)vandvthevpharyngotrachealvlumenvairwayv
(PTL)varevsimilarvbecausev
(A)vneithervrequiresvassessmentvforvaccuratevplacement.
(B)bothvrequirevmanipulationvofvthevheadvandvneckvforvinsertion.
(C)neithervisvinsertedvblindly.
(D)vNonevofvthevabove.v-vcorrectvanswer-
D.vNonevofvthevabovevarevcorrect.v(A).visvinvcorrectvbecausevbothvdevicesvrequirevasses
smentvforvaccuratevplacement.vWithvthevPTLvyouvbeginvventilationvthoughvavshortvtubev(
thevonevwithoutvthevstylet);vwithvthevCombitube,vyouvbeginvventilationvthroughvavlongerv
bluevtube.vIfvchestvrisevandvpresencevofvbreathvsoundsvarevnotvobserve,vyouvmustvswitc
hvimmediatelyvtovthevothervventilationvportvandvreassess.v(B).visvincorrectvbecausevbothv
arevinsertedvinvthevneutralvpositionvandvnovmanipulationvofvthevheadvandvneckvisvrequire
dvforvinsertion.v(C).visvincorrectvbecausevbothvdevicesvarevinsertedvblindly.
Breathvsoundsvsuchvasvcracklesvandvrhonchivthatvarevnotvnormallyvheardvarevdefinedvas
v-----vbreathvsounds.v
(A)vbronchial
(B)vadventitious
(C)vvesicular
(D)vbronchovesicularv-vcorrectvanswer-
B.vAdventitiousvbreathvsoundsvarevconsideredvabnormalvsoundsvsuchvasvcracklesvandvr
honchi.
Whichvofvthevfollowingvcorrectlyvdescribesvthevflowvofvairvfromvoutsidevthevbodyvintovthevt
rachea?
(A)vNose,vnasopharynx,vlaryngopharynx,voropharynx,vlarynx,vtrachea
(B)vNose,vnasopharynx,vlarynx,vlaryngopharynx,voropharynx,vtrachea
(C)vNose,vnasalvcavities,vnasopharynx,voropharynx,vlaryngopharynx,vlarynx,vtrachea
(D)vNose,vnasalvcavities,vlaryngopharynx,vnasopharynx,voropharynx,vlarynx,vtracheav-
vcorrectvanswer-
C.vThisvisvavsimplevanatomyvandvphysiologyvquestion.vThevnose,vnasalvcavities,vnasoph
arynx,voropharynx,vlarynx,vandvtracheavcorrectlyvdescribedvthevflowvofvair.
Youvarevcalledvforvanvunresponsivev29-year-
oldvman.vBystandersvreportvhevhasvbeenvdrinkingvheavilyvallvday.vAssessmentvrevealsvt
hevpatientvtovbevresponsivevonlyvtovpainfulvstimuli.vHisvbreathingvisvshallowvatvavratevofvf
ourvtimesvpervminute.vHowvwouldvyouvmanagevthisvpatient?
(A)vNasalvcannulavatv2-4vLPM
(B)vSimplevfacevmaskvatv4-6vLPM
(C)vNonrebreathervmaskvatv10-15vLPM
(D)vBag-valvevdevicevwithvavreservoirvatv10-15vLPMv-vcorrectvanswer-
D.vBreathingvmustvbevsupportedvwithvavbag-valvevdevicevwithvsupplementalvhigh-
