Correct Answers with Rationale 2024.
A 75 y/o F complains of a sudden onset of right-sided chest pain and dyspnoea.
She is recovering from a recent hip surgery. What should you suspect?
a. hypotension
b. pneumonia
c. pulmonary embolism
d. myocardial infarction
c. pulmonary embolism
Typically the result of a clot that has formed in a lower extremity with poor circulation.
Hip surgery requires a pt to be immobilised for an extended period of time which can
permit a clot to form in a distal portion of an extremity. The sudden, unilateral chest pain
in the lung with the clot. Any lung tissue distal of the clot will not allow for adequate O2
exchange.
An 18 y/o M is cyanotic and complains of sharp chest pain and difficulty
breathing (dyspnoea) after lifting weights. Vital signs are BP 110/66, P 88, R22.
What is the most likely cause?
a. acute myocardial infarction
b. tension pneumothorax
c. spontaneous pneumothorax
d. pulmonary embolism
c. spontaneous pneumothorax
Performing strenuous activities can, on occasion, cause a collapsed lung (spontaneous
pneumothorax). He has stable vital signs so you should suspect a spontaneous
pneumothorax. If he had been hypotensive (88/40), you should suspect that the
spontaneous pneumothorax had developed into a tension pneumothorax.
A 53 y/o M is sleepy, diaphoretic, difficult to arouse, and breathing 8 times a
minute. What should you suspect?
a. respiratory distress
b. respiratory alkalosis
c. respiratory arrest
d. respiratory failure
d. respiratory failure
This rate is too slow and the fact that he is sleepy and difficult to arouse shows that he
, is in respiratory failure. An adult with a respiratory rate of 8 is too slow for adequate gas
exchange.
What are the small sacs at the end of the airway that are responsible for gas
exchange?
a. bronchioles
b. carina
c. trachea
d. alveoli
d. alveoli
The use of accessory muscles and nasal flaring are signs of what type of
breathing?
a. laboured
b. obstructed
c. normal
d. shallow
a. laboured
The use of accessory muscles is a sign of respiratory distress or failure. Nasal flaring is
the body's response in effort to increase the size of the airway and attempt to draw in
more air with each breath. Expect to initially see an increased respiratory and heart rate
with laboured breathing. As the pt begins to tire, the respiratory rate and quality will
begin to decrease, which worsens the problem.
An unresponsive 43 y/o M is cool, pale, diaphoretic, and breathing 6 times a
minute. Which device should you use to administer O2.
a. BVM
b. NRM
c. simple face mask
d. NC
a. BVM
He is unresponsive and breathing too slow. This is a "sick" pt and assisting his
ventilations should be the first intervention. You can increase his respiratory rate with a
BVM, which is why it is the most correct choice.
An alert 32 y/o F complains of difficulty breathing. She speaks in 2-3 word
sentences and has an O2 saturation of 92%. What should you do?
a. obtain vital signs
b. apply high-flow oxygen
c. assist her with her metred dose inhaler
d. assist ventilations with a BVM
b. apply high-flow oxygen
She is alert and her respirations are still effective without the need for assisting