NREMT FINAL EXAM: AIRWAY,
RESPIRATION, AND VENTILATION
QUESTIONS AND ANSWERS
A 65-year-old male who has a history of congestive heart failure is slumped in a chair
not responding to you. His wife tells you that his difficulty breathing started an hour ago
and has been getting worse. He is tachypneic, and you auscultate rales in all fields. You
should first:
A. assist his ventilation.
B. administer oxygen by non-rebreather mask.
C. apply CPAP.
D. assess his vital signs. - Answer-A. assist his ventilation.
Patients who have chronic bronchitis may have which of the following?
A. Persistent productive cough, thickening of walls of bronchioles, excessive mucus
production
B. Increased sensitivity of lower airways to irritants, bronchospasm, edema
C. Destruction of alveolar walls, distention of alveolar sacs, reduced area for gas
exchange
D. Acute infectious disease, lung inflammation, pus-filled alveoli - Answer-A. Persistent
productive cough, thickening of walls of bronchioles, excessive mucus production
A 70-year-old male has difficulty breathing. When assessing him, which of the following
should influence your decision to assist his ventilation with a BVM?
A. A decrease in his mental status
B. An SpO2 below 90% on room air
C. An increase in his respiratory rate
D. A history of COPD - Answer-A. A decrease in his mental status
You are assisting the ventilation of a 57-year-old female who is in respiratory failure.
Her initial vital signs were P 102, R 32, BP 142/84, and SpO2 was 88% on room air.
After five minutes of assisted ventilation, her vital signs are P 96, R 18 assisted with
slight chest rise, BP 108/80, and SpO2 is 95% on oxygen 15 L/minute by BVM. You
should:
A. decrease the tidal volume of your ventilation.
B. increase the tidal volume of your ventilation.
C. increase the oxygen flow rate.
D. decrease your ventilation rate. - Answer-D. decrease your ventilation rate.
An 86-year-old female who has a history of emphysema complains of chest pain. Her
initial SpO2 was 92% on home oxygen by nasal cannula, 3 L/minute. You administered
oxygen by non-rebreather, 12 L/minute. Her SpO2 is now 100%, and her chest pain is
resolved after aspirin and nitroglycerin administration. You should next:
,A. discontinue oxygen administration.
B. switch to a simple face mask.
C. decrease the flow rate to 6 L/minute.
D. transport her. - Answer-B. switch to a simple face mask.
Which of the following prevents the over-inflation of the lungs during normal respiration?
A. Cushing reflex
B. Baroreceptor reflex
C. Chemoreceptors
D. Stretch receptors - Answer-D. Stretch receptors
Which of the following sounds indicates an upper airway obstruction in a child who is in
respiratory distress?
A. Rales
B. Wheezes
C. Stridor
D. Rhonchi - Answer-C. Stridor
A 16-year-old female complains of a runny nose and a low-grade fever. She has a burst
of rapid coughing with an inspiratory whooping sound. While she is coughing her skin
becomes cyanotic. After she stops coughing her skin color
returns to normal. You should suspect:
A. pneumonia.
B. pertussis.
C. rubella.
D. tuberculosis. - Answer-B. pertussis.
What causes the prolonged expiratory phase of the respiratory cycle in a patient who is
having an asthma attack?
A. Bronchiole constriction
B. Pulmonary venous hypertension
C. Thick, sticky mucus production
D. Ruptured blebs - Answer-A. Bronchiole constriction
A 64-year-old male is having an asthma attack. Which class of medication can help
improve his alveolar ventilation?
A. Beta2 agonist
B. Beta1 antagonist
C. Beta1 agonist
D. Beta2 antagonist - Answer-A. Beta2 agonist
A 47-year-old male complains of difficulty breathing, and he cannot stop coughing. His
conjunctivae are pale and moist. He has a 40 pack-year smoking history. You should
first:
A. administer oxygen.
B. assess his vital signs.
, C. collect a sample of his phlegm.
D. determine his past medical history. - Answer-A. administer oxygen.
Which of the following respiratory conditions in children over 2 years old has similar lung
sounds to an infant who has bronchiolitis?
A. Asthma
B. Pulmonary edema
C. Pertussis
D. Pneumonia - Answer-A. Asthma
A 77-year-old female complains of difficulty breathing. She tells you she has had a
productive cough for several years. You auscultate coarse rhonchi in the bases of her
lungs. You observe her mucous membranes are cyanotic. Her vital signs are P 96, R 26
and labored, BP 148/92, and SpO2 is 88% on home oxygen 3 L/minute by nasal
cannula. You should:
A. rapidly transport her to the hospital.
B. administer oxygen by non-rebreather mask.
C. assist her ventilation with a BVM.
D. increase the oxygen flow rate to 4 L/minute. - Answer-B. administer oxygen by non-
rebreather mask.
A febrile 69-year-old male complains of body aches and decreased appetite. He tells
you he has had the flu for a week. His skin is cyanotic and diaphoretic. You auscultate
rhonchi and decreased lung sounds over his left lower lung. His vital signs are P 102, R
26, BP 116/90, and SpO2 is 91% on room air. You should suspect:
A. pneumonia.
B. influenza.
C. septic shock.
D. pleurisy. - Answer-A. pneumonia.
Why can pulmonary embolisms cause a V/Q mismatch?
A. They block bronchiole airflow.
B. They block bronchial airflow.
C. They block pulmonary venous blood flow.
D. They block pulmonary arterial blood flow. - Answer-D. They block pulmonary arterial
blood flow.
Why would a 46-year-old male who inhaled steam from a malfunctioning boiler have
stridor in his upper airway and wheezes in his lower airway?
A. Steam can irritate both upper and lower airways causing bronchoconstriction.
B. Steam can burn both upper and lower airways causing edema.
C. Steam can irritate the upper airway causing bronchoconstriction and burn the lower
airway causing edema.
D. Steam can burn the upper airway causing edema and irritate the lower airway
causing bronchoconstriction. - Answer-B. Steam can burn both upper and lower airways
causing edema.
RESPIRATION, AND VENTILATION
QUESTIONS AND ANSWERS
A 65-year-old male who has a history of congestive heart failure is slumped in a chair
not responding to you. His wife tells you that his difficulty breathing started an hour ago
and has been getting worse. He is tachypneic, and you auscultate rales in all fields. You
should first:
A. assist his ventilation.
B. administer oxygen by non-rebreather mask.
C. apply CPAP.
D. assess his vital signs. - Answer-A. assist his ventilation.
Patients who have chronic bronchitis may have which of the following?
A. Persistent productive cough, thickening of walls of bronchioles, excessive mucus
production
B. Increased sensitivity of lower airways to irritants, bronchospasm, edema
C. Destruction of alveolar walls, distention of alveolar sacs, reduced area for gas
exchange
D. Acute infectious disease, lung inflammation, pus-filled alveoli - Answer-A. Persistent
productive cough, thickening of walls of bronchioles, excessive mucus production
A 70-year-old male has difficulty breathing. When assessing him, which of the following
should influence your decision to assist his ventilation with a BVM?
A. A decrease in his mental status
B. An SpO2 below 90% on room air
C. An increase in his respiratory rate
D. A history of COPD - Answer-A. A decrease in his mental status
You are assisting the ventilation of a 57-year-old female who is in respiratory failure.
Her initial vital signs were P 102, R 32, BP 142/84, and SpO2 was 88% on room air.
After five minutes of assisted ventilation, her vital signs are P 96, R 18 assisted with
slight chest rise, BP 108/80, and SpO2 is 95% on oxygen 15 L/minute by BVM. You
should:
A. decrease the tidal volume of your ventilation.
B. increase the tidal volume of your ventilation.
C. increase the oxygen flow rate.
D. decrease your ventilation rate. - Answer-D. decrease your ventilation rate.
An 86-year-old female who has a history of emphysema complains of chest pain. Her
initial SpO2 was 92% on home oxygen by nasal cannula, 3 L/minute. You administered
oxygen by non-rebreather, 12 L/minute. Her SpO2 is now 100%, and her chest pain is
resolved after aspirin and nitroglycerin administration. You should next:
,A. discontinue oxygen administration.
B. switch to a simple face mask.
C. decrease the flow rate to 6 L/minute.
D. transport her. - Answer-B. switch to a simple face mask.
Which of the following prevents the over-inflation of the lungs during normal respiration?
A. Cushing reflex
B. Baroreceptor reflex
C. Chemoreceptors
D. Stretch receptors - Answer-D. Stretch receptors
Which of the following sounds indicates an upper airway obstruction in a child who is in
respiratory distress?
A. Rales
B. Wheezes
C. Stridor
D. Rhonchi - Answer-C. Stridor
A 16-year-old female complains of a runny nose and a low-grade fever. She has a burst
of rapid coughing with an inspiratory whooping sound. While she is coughing her skin
becomes cyanotic. After she stops coughing her skin color
returns to normal. You should suspect:
A. pneumonia.
B. pertussis.
C. rubella.
D. tuberculosis. - Answer-B. pertussis.
What causes the prolonged expiratory phase of the respiratory cycle in a patient who is
having an asthma attack?
A. Bronchiole constriction
B. Pulmonary venous hypertension
C. Thick, sticky mucus production
D. Ruptured blebs - Answer-A. Bronchiole constriction
A 64-year-old male is having an asthma attack. Which class of medication can help
improve his alveolar ventilation?
A. Beta2 agonist
B. Beta1 antagonist
C. Beta1 agonist
D. Beta2 antagonist - Answer-A. Beta2 agonist
A 47-year-old male complains of difficulty breathing, and he cannot stop coughing. His
conjunctivae are pale and moist. He has a 40 pack-year smoking history. You should
first:
A. administer oxygen.
B. assess his vital signs.
, C. collect a sample of his phlegm.
D. determine his past medical history. - Answer-A. administer oxygen.
Which of the following respiratory conditions in children over 2 years old has similar lung
sounds to an infant who has bronchiolitis?
A. Asthma
B. Pulmonary edema
C. Pertussis
D. Pneumonia - Answer-A. Asthma
A 77-year-old female complains of difficulty breathing. She tells you she has had a
productive cough for several years. You auscultate coarse rhonchi in the bases of her
lungs. You observe her mucous membranes are cyanotic. Her vital signs are P 96, R 26
and labored, BP 148/92, and SpO2 is 88% on home oxygen 3 L/minute by nasal
cannula. You should:
A. rapidly transport her to the hospital.
B. administer oxygen by non-rebreather mask.
C. assist her ventilation with a BVM.
D. increase the oxygen flow rate to 4 L/minute. - Answer-B. administer oxygen by non-
rebreather mask.
A febrile 69-year-old male complains of body aches and decreased appetite. He tells
you he has had the flu for a week. His skin is cyanotic and diaphoretic. You auscultate
rhonchi and decreased lung sounds over his left lower lung. His vital signs are P 102, R
26, BP 116/90, and SpO2 is 91% on room air. You should suspect:
A. pneumonia.
B. influenza.
C. septic shock.
D. pleurisy. - Answer-A. pneumonia.
Why can pulmonary embolisms cause a V/Q mismatch?
A. They block bronchiole airflow.
B. They block bronchial airflow.
C. They block pulmonary venous blood flow.
D. They block pulmonary arterial blood flow. - Answer-D. They block pulmonary arterial
blood flow.
Why would a 46-year-old male who inhaled steam from a malfunctioning boiler have
stridor in his upper airway and wheezes in his lower airway?
A. Steam can irritate both upper and lower airways causing bronchoconstriction.
B. Steam can burn both upper and lower airways causing edema.
C. Steam can irritate the upper airway causing bronchoconstriction and burn the lower
airway causing edema.
D. Steam can burn the upper airway causing edema and irritate the lower airway
causing bronchoconstriction. - Answer-B. Steam can burn both upper and lower airways
causing edema.
