NREMT
Exam Prep
(600+ Practice Questions)
Answers with Rationales
This Document Description:
This document contains a collection of
617 verified multiple-choices questions
and Correct answers with Rationales.
Ideal for exam preparation and concept
reinforcement.
,1. Your team is performing CPR on a 68 year old male. You are assigned the
airway. When ventilating him, you should
A) ventilate him once with a BVM every 15 seconds.
B) use a two person ventilation technique.
C) ventilate him once when CPR stops after 30 compressions.
D) use a BVM that can refill in 3 seconds.
Correct Answer: B
RATIONALE
The two-person ventilation technique tends to provide better ventilations because one
rescuer can focus on the mask seal while the other squeezes the bag. Ventilations are
delivered at a 30:2 ratio for adult CPR, you wouldn't ventilate 4 times/minute (every 15
seconds) and there isn't a need for a BVM to refill in 3 seconds.
2. A 6 year old male has a fever and difficulty breathing. He is anxious, sitting in a
tripod position, and complains of a sore throat. You should suspect
A) rubeola.
B) pertussis.
C )esophagitis.
D) epiglottitis.
Correct Answer: D
RATIONALE
Epiglottitis is the best answer. Pertussis is whooping cough and there is no indication of
that characteristic cough. Rubeola is measles which causes skin rashes. Esophagitis is
much less likely to be seen in this patient.
3. A 52 year old male complains of sudden onset of shortness of breath. He has
some right-sided chest pain. He tells you he thinks he has some odd type of flu
because two days ago he flew home from Asia. His vitals are P 108, R 18, BP
102/84, and SpO2 is 86% on room air. You should suspect
A) pulmonary embolism.
B) cor pulmonale.
C) pneumonia.
D) Asian encephalitis.
,Correct Answer: A
RATIONALE
Lack of movement is a leading cause of pulmonary embolism, and this patient just
completed a long airline flight from Asia. Encephalitis (brain swelling) causes a
headache, not chest pain. Pneumonia could be possible, but it's less likely because he
is not coughing, doesn't complain of fever, and he has a stated report of long-distance
travel which likely led to venous obstruction. Cor pulmonale is right-sided heart failure,
and these vital signs and his history don't fit with that disease.
4. The sign you should assess which indicates a child in respiratory distress has
transitioned to respiratory failure is a change in the
A) depth of sternal retractions.
B) level of consciousness.
C) intensity of wheezes.
D) ability to speak in full sentences.
Correct Answer: B
RATIONALE
Respiratory distress progresses into respiratory failure when a child has an altered level
of consciousness. A child can be in distress and speak in one- or two-word sentences.
Sternal retractions occur in respiratory distress. Cessation of wheezes is a concern and
may be seen when the level of consciousness changes, but cessation alone does not
represent respiratory failure. The key differential between distress and failure is a
change in the level of consciousness.
5. Relaxation of smooth muscles that cause relief of symptoms associated with
asthma is influenced by
A) alpha adrenergic medications.
B) beta-adrenergic medications.
C) glucocorticoids.
D) anaphylactoids.
Correct Answer: B
RATIONALE
You should not administer or assist a patient in taking any drug without knowing its
mechanism of action. Beta 2 drugs relax the smooth muscles of the bronchi. Alpha
,drugs mostly cause vasoconstriction, glucocorticoids are steroids which protect cell
walls, and there is no type of drug called anaphylactoid.
6. Which of the following findings indicates a condition where air is trapped in the
lower airways?
A) Rhonchi
B) Rales
C) Wheezes
D) Pleural rub
Correct Answer: C
RATIONALE
Wheezes are caused by airflow through the narrowed lower airways (terminal
bronchioles) in asthma which traps air in the alveoli. Rhonchi are caused by airflow over
congestion (secretions) in the larger airways (bronchus) in conditions like pneumonia or
chronic smokers. Rales are caused by the alveoli reinflating in congestive heart failure.
A pleural rub is caused by the pleural lining rubbing together when there is
inflammation.
7. A 25 year old male complains of shortness of breath over the past four hours
after playing soccer. His chest expansion is normal and he has no chest wall
pain. You hear diminished breath sounds over his right upper thorax. His vital
signs are P 106, R 18, BP 126/84, and SpO2 is 92% on room air. You should
suspect
A) spontaneous pneumothorax.
B) pulmonary embolism.
C) costochondritis.
D) pleuritis.
Correct Answer: A
RATIONALE
He most likely suffered a spontaneous pneumothorax. Exertion during exercise of a
young male, (likely thin in body structure), that causes diminished breath sounds on one
side are the clues. A pulmonary embolism is unlikely in a young person who was
exercising. Costochondritis presents with chest wall pain. Pleuritis presents with chest
pain that dissipates when the patient holds their breath
,8. A 2 year old female who has had a cold for the past two days now has frequent
barking coughing. Her skin is warm to touch. She has inspiratory stridor, and her
SpO2 is 98% on room air. When transporting her, you should prepare for
A) emesis.
B) respiratory arrest.
C) sepsis.
D) airway obstruction.
Correct Answer: D
RATIONALE
You should know that whenever you hear stridor, partial airway obstruction is present
and soon could lead to complete airway obstruction. Airway obstruction would then lead
to respiratory arrest. Emesis and sepsis are poor choices in this situation.
9. An 8 year old female who has a history of asthma self-administered her
metered dose inhaler prior to your arrival. Her vital signs are P 96, R 16, BP
108/78, and SpO2 is 94% on room air. You auscultate her lung sounds over the
lower lobes and should expect to hear
A) wheezes.
B) rhonchi.
C) bronchovesicular sounds.
D) crackles.
Correct Answer: A
RATIONALE
Wheezes are caused by forcing air through narrowed bronchioles. Crackles are often
heard in pulmonary edema. Rhonchi are rattling sounds caused by air moving through
secretions. Bronchovesicular sounds are heard over the upper part of the chest, not the
lower.
10. A 3 month old male has blue-tinged skin. His mother tells you he has tetralogy
of Fallot. You palpate a weak, thready pulse and see occasional breaths. You
should
A) apply an AED.
B) begin compressions.
C) ventilate him.
D)administer blow-by oxygen.
,Correct Answer: C
RATIONALE
Thready pulse with occasional breaths in the face of this genetic heart disease warrants
ventilation. The term occasional breaths tend to indicate respiratory failure. It might
indicate a need for chest compressions if the pulse rate is low. We don't know that yet,
and you will start with ventilation, which may increase the heart rate. Blow-by-oxygen is
insufficient. Applying an AED is not done in a patient with a pulse.
11. A 2 year old female was eating grapes and began to choke. When you arrive,
she is unresponsive and not breathing. You should first
A)inspect the airway, if the object is seen perform finger sweeps.
B) lift the child by the feet and perform back slaps.
C) begin chest compressions.
D) perform a series of abdominal thrusts.
Correct Answer: C
RATIONALE
This patient is unresponsive and not breathing, so chest compressions are the first
recommendation to use to dislodge a possible foreign object. The other distractors are
not recommended.
12. Rapid ascent to high altitude without proper acclimatization may produce
A) anaerobic metabolism.
B) thrombophlebitis.
C) pulmonary edema.
D) pericarditis.
Correct Answer: C
RATIONALE
The only realistic choice is pulmonary edema. Anaerobic metabolism happens most
often when healthy people exercise beyond their aerobic range, and it is present in low
perfusion states. Pericarditis is wrong as it's an inflammation of the heart.
Thrombophlebitis happens when venous blood is not moving, or there is damage to the
lining of a vein. Acclimatization means getting used to an increased elevation over time.
13. When assessing the work of breathing in a pediatric patient, you should
assess
,A) chest expansion, skin color, and presence of wheezes or stridor.
B) using inspection, palpation, percussion, and auscultation of the chest.
C) breath sounds bilaterally, and ventilation rate, quality, and volume.
D) airway sounds, positioning, and presence of any retractions or nasal flaring.
Correct Answer: D
RATIONALE
Work of breathing requires assessment of airway sounds, positioning, and presence of
any retractions or nasal flaring. The other distractors are assessment findings but not
specifically related to work of breathing.
14. A 7 year old female is being cared for at home with a ventilator. When you
arrive, the ventilator alarm is sounding. Your partner reports her pulse rate is 40.
You should
A) troubleshoot the ventilator settings
B) increase the number of ventilation per minute delivered.
C) assist her ventilations with a BVM.
D) increase the volume of ventilation delivered by the ventilator.
Correct Answer: C
RATIONALE
She's exhibiting signs of hypoxia, so you need to take her off the malfunctioning
ventilator and ventilate her with a BVM. Troubleshooting the ventilator setting or
increasing the rate or volume delivered is likely time-consuming. She has signs of
hypoxia (low pulse rate) and needs assisted ventilation with a BVM.
15. The mother of a 3 month old male tells you that his apnea monitor alarmed
and when she checked on him he was not breathing. She stimulated him and
called 9-1-1. He is now breathing on his own. His vital signs are P 160, R 28, and
SpO2 is 98% on room air. You should first
A) determine what care she provided.
B) instruct her how to ventilate him.
C) administer blow-by oxygen at 6 L/minute
D) check the functions of the apnea monitor.
Correct Answer: A
RATIONALE
Some questions seek to find out if you'll over-treat patients. This child, at the time of
your arrival, is fine. So administering oxygen, checking the apnea monitor and teaching
,the parents is not necessary. You likely don't have the expertise regarding the monitor.
These items need to be part of this child's care plan at home.
16. A 68 year old male who has a prior history of heart attack awakens with
sudden onset of shortness of breath. You auscultate rales bilaterally in his lower
lung lobes. His vital signs are P 96, R 20, BP 104/84, and SpO2 is 88% on room air.
You should
A) assist his ventilation with a BVM.
B) transport him flat on the stretcher with his legs elevated.
C) administer oxygen until his SpO2 is 94% or greater.
D) apply an AED and push the analyze rhythm button.
Correct Answer: C
RATIONALE
This patient is hypoxic with an oxygen saturation of 88%. You should administer oxygen.
He does not appear to be in failure so the BVM isn't appropriate. Lying the patient flat
would worsen his respiratory distress and you don't apply the AED to a responsive
patient.
17. When a patient suffers a pulmonary embolism the clot will have its greatest
influence on
A) hydrostatic pressure.
B) oncotic pressure.
C) perfusion pressure.
D) ventilation pressure.
Correct Answer: C
RATIONALE
A large blood clot stops blood flow, thus decreasing perfusion pressure. Ventilation
pressure comes from breathing, hydrostatic pressure is water pressure in the blood
stream and oncotic pressure is the pulling pressure caused by actions of proteins in the
blood stream. Both hydrostatic and oncotic pressure are not taught in an EMT course as
frequently as they should be and should not be chosen as an option (they're wrong too).
18. A 32 year old male has been self-treating what he believes is pneumonia for
the past week. His family has urged him to go to the hospital but he has refused.
His skin is hot to touch. His vital signs are P 104, R 24, BP 96/78, and SpO2 is 88%
on room air. You should
,A) assist his ventilations until his SpO2 improves.
B) administer oxygen and transport rapidly.
C) lay him flat, warm him, and treat for shock.
D) administer aspirin for fever and oxygen for hypoxia.
Correct Answer: B
RATIONALE
Note only one choice includes rapid transport - the correct answer. He's hypotensive
(likely septic shock), and there is no indication that he needs assisted ventilations.
Keeping him warm when he is hot to touch is not good therapy. Using aspirin for fever,
in this case, is improper, not recommended and fails to recognize the severity of his
condition.
19. In order for a patient to progress to status asthmaticus, he must
A) not improve with medications when suffering an acute attack.
B) continue to wheeze after being medicated and then become hypoxic.
C) not improve through regular use of prescribed medications for two months.
D) continue to wheeze over lower lobes for over two hours.
Correct Answer: A
RATIONALE
Status asthmaticus is a prolonged condition that occurs when the patient doesn't
respond to medications in an acute attack. The other choice that you may have liked
here is continuing to wheeze and becoming hypoxic. Remember that attacks may be so
severe that the patient doesn't move enough air to create wheezes, making that choice
less correct.
20. What is the average minute volume of an adult at rest?
A) 3000 mL
B) 9000 mL
C) 500 mL
D) 6000 mL
Correct Answer: D
RATIONALE
The average minute volume is 6000 mL. It is calculated by multiplying the tidal volume
by the number of breaths per minute. Once again, if you don't know the answer, the best
guess is to remove the highest and lowest numbers and pick one in the middle.
, 21. A 67 year old male is unresponsive and snoring. As you insert a tongue
depressor to insert an oropharyngeal airway, he has a gag reflex. You should
A) insert a nasopharyngeal airway.
B) suction his airway.
C) maintain a head-tilt chin-lift maneuver.
D) turn him to the recovery position.
Correct Answer: A
RATIONALE
The patient is unresponsive and has snoring respirations. If a gag reflex keeps you from
inserting an oral airway, you should try a nasal airway. He needs more definitive care.
Suction would be appropriate if the patient exhibited gurgling sounds.
22. A 30 month old male has a fever of 102 degrees F, cough, and shortness of
breath. You observe increased work of breathing and auscultate diffuse wheezes
and crackles. His mother tells you he has never been this ill. You should suspect
A) croup.
B) bronchiolitis.
C) epiglottitis.
D) asthma.
Correct Answer: B
RATIONALE
Bronchiolitis is a viral respiratory infection seen in infants and young children. It matches
the signs and symptoms presented as well as the age range for this condition. Even if
you didn't know what bronchiolitis is, you should be able to figure it out as the best
answer. There is no mention of a "croupy" or seal-bark cough. Asthma alone doesn't
present with a fever and epiglottitis is an upper airway condition. The sounds from the
lungs wouldn't be there in epiglottitis and there is no mention of drooling or difficulty
swallowing. You should have ruled out these three, leaving bronchiolitis as the best
answer.
23. Which of the following patient presentations represent the most severe stage
of hypoxia?
A) A 68 year old male whose skin is cool and clammy whose vital signs are P 110, R 18,
and BP 108/72
B) A sleepy and confused 69 year old male who has discolored fingernail beds
Exam Prep
(600+ Practice Questions)
Answers with Rationales
This Document Description:
This document contains a collection of
617 verified multiple-choices questions
and Correct answers with Rationales.
Ideal for exam preparation and concept
reinforcement.
,1. Your team is performing CPR on a 68 year old male. You are assigned the
airway. When ventilating him, you should
A) ventilate him once with a BVM every 15 seconds.
B) use a two person ventilation technique.
C) ventilate him once when CPR stops after 30 compressions.
D) use a BVM that can refill in 3 seconds.
Correct Answer: B
RATIONALE
The two-person ventilation technique tends to provide better ventilations because one
rescuer can focus on the mask seal while the other squeezes the bag. Ventilations are
delivered at a 30:2 ratio for adult CPR, you wouldn't ventilate 4 times/minute (every 15
seconds) and there isn't a need for a BVM to refill in 3 seconds.
2. A 6 year old male has a fever and difficulty breathing. He is anxious, sitting in a
tripod position, and complains of a sore throat. You should suspect
A) rubeola.
B) pertussis.
C )esophagitis.
D) epiglottitis.
Correct Answer: D
RATIONALE
Epiglottitis is the best answer. Pertussis is whooping cough and there is no indication of
that characteristic cough. Rubeola is measles which causes skin rashes. Esophagitis is
much less likely to be seen in this patient.
3. A 52 year old male complains of sudden onset of shortness of breath. He has
some right-sided chest pain. He tells you he thinks he has some odd type of flu
because two days ago he flew home from Asia. His vitals are P 108, R 18, BP
102/84, and SpO2 is 86% on room air. You should suspect
A) pulmonary embolism.
B) cor pulmonale.
C) pneumonia.
D) Asian encephalitis.
,Correct Answer: A
RATIONALE
Lack of movement is a leading cause of pulmonary embolism, and this patient just
completed a long airline flight from Asia. Encephalitis (brain swelling) causes a
headache, not chest pain. Pneumonia could be possible, but it's less likely because he
is not coughing, doesn't complain of fever, and he has a stated report of long-distance
travel which likely led to venous obstruction. Cor pulmonale is right-sided heart failure,
and these vital signs and his history don't fit with that disease.
4. The sign you should assess which indicates a child in respiratory distress has
transitioned to respiratory failure is a change in the
A) depth of sternal retractions.
B) level of consciousness.
C) intensity of wheezes.
D) ability to speak in full sentences.
Correct Answer: B
RATIONALE
Respiratory distress progresses into respiratory failure when a child has an altered level
of consciousness. A child can be in distress and speak in one- or two-word sentences.
Sternal retractions occur in respiratory distress. Cessation of wheezes is a concern and
may be seen when the level of consciousness changes, but cessation alone does not
represent respiratory failure. The key differential between distress and failure is a
change in the level of consciousness.
5. Relaxation of smooth muscles that cause relief of symptoms associated with
asthma is influenced by
A) alpha adrenergic medications.
B) beta-adrenergic medications.
C) glucocorticoids.
D) anaphylactoids.
Correct Answer: B
RATIONALE
You should not administer or assist a patient in taking any drug without knowing its
mechanism of action. Beta 2 drugs relax the smooth muscles of the bronchi. Alpha
,drugs mostly cause vasoconstriction, glucocorticoids are steroids which protect cell
walls, and there is no type of drug called anaphylactoid.
6. Which of the following findings indicates a condition where air is trapped in the
lower airways?
A) Rhonchi
B) Rales
C) Wheezes
D) Pleural rub
Correct Answer: C
RATIONALE
Wheezes are caused by airflow through the narrowed lower airways (terminal
bronchioles) in asthma which traps air in the alveoli. Rhonchi are caused by airflow over
congestion (secretions) in the larger airways (bronchus) in conditions like pneumonia or
chronic smokers. Rales are caused by the alveoli reinflating in congestive heart failure.
A pleural rub is caused by the pleural lining rubbing together when there is
inflammation.
7. A 25 year old male complains of shortness of breath over the past four hours
after playing soccer. His chest expansion is normal and he has no chest wall
pain. You hear diminished breath sounds over his right upper thorax. His vital
signs are P 106, R 18, BP 126/84, and SpO2 is 92% on room air. You should
suspect
A) spontaneous pneumothorax.
B) pulmonary embolism.
C) costochondritis.
D) pleuritis.
Correct Answer: A
RATIONALE
He most likely suffered a spontaneous pneumothorax. Exertion during exercise of a
young male, (likely thin in body structure), that causes diminished breath sounds on one
side are the clues. A pulmonary embolism is unlikely in a young person who was
exercising. Costochondritis presents with chest wall pain. Pleuritis presents with chest
pain that dissipates when the patient holds their breath
,8. A 2 year old female who has had a cold for the past two days now has frequent
barking coughing. Her skin is warm to touch. She has inspiratory stridor, and her
SpO2 is 98% on room air. When transporting her, you should prepare for
A) emesis.
B) respiratory arrest.
C) sepsis.
D) airway obstruction.
Correct Answer: D
RATIONALE
You should know that whenever you hear stridor, partial airway obstruction is present
and soon could lead to complete airway obstruction. Airway obstruction would then lead
to respiratory arrest. Emesis and sepsis are poor choices in this situation.
9. An 8 year old female who has a history of asthma self-administered her
metered dose inhaler prior to your arrival. Her vital signs are P 96, R 16, BP
108/78, and SpO2 is 94% on room air. You auscultate her lung sounds over the
lower lobes and should expect to hear
A) wheezes.
B) rhonchi.
C) bronchovesicular sounds.
D) crackles.
Correct Answer: A
RATIONALE
Wheezes are caused by forcing air through narrowed bronchioles. Crackles are often
heard in pulmonary edema. Rhonchi are rattling sounds caused by air moving through
secretions. Bronchovesicular sounds are heard over the upper part of the chest, not the
lower.
10. A 3 month old male has blue-tinged skin. His mother tells you he has tetralogy
of Fallot. You palpate a weak, thready pulse and see occasional breaths. You
should
A) apply an AED.
B) begin compressions.
C) ventilate him.
D)administer blow-by oxygen.
,Correct Answer: C
RATIONALE
Thready pulse with occasional breaths in the face of this genetic heart disease warrants
ventilation. The term occasional breaths tend to indicate respiratory failure. It might
indicate a need for chest compressions if the pulse rate is low. We don't know that yet,
and you will start with ventilation, which may increase the heart rate. Blow-by-oxygen is
insufficient. Applying an AED is not done in a patient with a pulse.
11. A 2 year old female was eating grapes and began to choke. When you arrive,
she is unresponsive and not breathing. You should first
A)inspect the airway, if the object is seen perform finger sweeps.
B) lift the child by the feet and perform back slaps.
C) begin chest compressions.
D) perform a series of abdominal thrusts.
Correct Answer: C
RATIONALE
This patient is unresponsive and not breathing, so chest compressions are the first
recommendation to use to dislodge a possible foreign object. The other distractors are
not recommended.
12. Rapid ascent to high altitude without proper acclimatization may produce
A) anaerobic metabolism.
B) thrombophlebitis.
C) pulmonary edema.
D) pericarditis.
Correct Answer: C
RATIONALE
The only realistic choice is pulmonary edema. Anaerobic metabolism happens most
often when healthy people exercise beyond their aerobic range, and it is present in low
perfusion states. Pericarditis is wrong as it's an inflammation of the heart.
Thrombophlebitis happens when venous blood is not moving, or there is damage to the
lining of a vein. Acclimatization means getting used to an increased elevation over time.
13. When assessing the work of breathing in a pediatric patient, you should
assess
,A) chest expansion, skin color, and presence of wheezes or stridor.
B) using inspection, palpation, percussion, and auscultation of the chest.
C) breath sounds bilaterally, and ventilation rate, quality, and volume.
D) airway sounds, positioning, and presence of any retractions or nasal flaring.
Correct Answer: D
RATIONALE
Work of breathing requires assessment of airway sounds, positioning, and presence of
any retractions or nasal flaring. The other distractors are assessment findings but not
specifically related to work of breathing.
14. A 7 year old female is being cared for at home with a ventilator. When you
arrive, the ventilator alarm is sounding. Your partner reports her pulse rate is 40.
You should
A) troubleshoot the ventilator settings
B) increase the number of ventilation per minute delivered.
C) assist her ventilations with a BVM.
D) increase the volume of ventilation delivered by the ventilator.
Correct Answer: C
RATIONALE
She's exhibiting signs of hypoxia, so you need to take her off the malfunctioning
ventilator and ventilate her with a BVM. Troubleshooting the ventilator setting or
increasing the rate or volume delivered is likely time-consuming. She has signs of
hypoxia (low pulse rate) and needs assisted ventilation with a BVM.
15. The mother of a 3 month old male tells you that his apnea monitor alarmed
and when she checked on him he was not breathing. She stimulated him and
called 9-1-1. He is now breathing on his own. His vital signs are P 160, R 28, and
SpO2 is 98% on room air. You should first
A) determine what care she provided.
B) instruct her how to ventilate him.
C) administer blow-by oxygen at 6 L/minute
D) check the functions of the apnea monitor.
Correct Answer: A
RATIONALE
Some questions seek to find out if you'll over-treat patients. This child, at the time of
your arrival, is fine. So administering oxygen, checking the apnea monitor and teaching
,the parents is not necessary. You likely don't have the expertise regarding the monitor.
These items need to be part of this child's care plan at home.
16. A 68 year old male who has a prior history of heart attack awakens with
sudden onset of shortness of breath. You auscultate rales bilaterally in his lower
lung lobes. His vital signs are P 96, R 20, BP 104/84, and SpO2 is 88% on room air.
You should
A) assist his ventilation with a BVM.
B) transport him flat on the stretcher with his legs elevated.
C) administer oxygen until his SpO2 is 94% or greater.
D) apply an AED and push the analyze rhythm button.
Correct Answer: C
RATIONALE
This patient is hypoxic with an oxygen saturation of 88%. You should administer oxygen.
He does not appear to be in failure so the BVM isn't appropriate. Lying the patient flat
would worsen his respiratory distress and you don't apply the AED to a responsive
patient.
17. When a patient suffers a pulmonary embolism the clot will have its greatest
influence on
A) hydrostatic pressure.
B) oncotic pressure.
C) perfusion pressure.
D) ventilation pressure.
Correct Answer: C
RATIONALE
A large blood clot stops blood flow, thus decreasing perfusion pressure. Ventilation
pressure comes from breathing, hydrostatic pressure is water pressure in the blood
stream and oncotic pressure is the pulling pressure caused by actions of proteins in the
blood stream. Both hydrostatic and oncotic pressure are not taught in an EMT course as
frequently as they should be and should not be chosen as an option (they're wrong too).
18. A 32 year old male has been self-treating what he believes is pneumonia for
the past week. His family has urged him to go to the hospital but he has refused.
His skin is hot to touch. His vital signs are P 104, R 24, BP 96/78, and SpO2 is 88%
on room air. You should
,A) assist his ventilations until his SpO2 improves.
B) administer oxygen and transport rapidly.
C) lay him flat, warm him, and treat for shock.
D) administer aspirin for fever and oxygen for hypoxia.
Correct Answer: B
RATIONALE
Note only one choice includes rapid transport - the correct answer. He's hypotensive
(likely septic shock), and there is no indication that he needs assisted ventilations.
Keeping him warm when he is hot to touch is not good therapy. Using aspirin for fever,
in this case, is improper, not recommended and fails to recognize the severity of his
condition.
19. In order for a patient to progress to status asthmaticus, he must
A) not improve with medications when suffering an acute attack.
B) continue to wheeze after being medicated and then become hypoxic.
C) not improve through regular use of prescribed medications for two months.
D) continue to wheeze over lower lobes for over two hours.
Correct Answer: A
RATIONALE
Status asthmaticus is a prolonged condition that occurs when the patient doesn't
respond to medications in an acute attack. The other choice that you may have liked
here is continuing to wheeze and becoming hypoxic. Remember that attacks may be so
severe that the patient doesn't move enough air to create wheezes, making that choice
less correct.
20. What is the average minute volume of an adult at rest?
A) 3000 mL
B) 9000 mL
C) 500 mL
D) 6000 mL
Correct Answer: D
RATIONALE
The average minute volume is 6000 mL. It is calculated by multiplying the tidal volume
by the number of breaths per minute. Once again, if you don't know the answer, the best
guess is to remove the highest and lowest numbers and pick one in the middle.
, 21. A 67 year old male is unresponsive and snoring. As you insert a tongue
depressor to insert an oropharyngeal airway, he has a gag reflex. You should
A) insert a nasopharyngeal airway.
B) suction his airway.
C) maintain a head-tilt chin-lift maneuver.
D) turn him to the recovery position.
Correct Answer: A
RATIONALE
The patient is unresponsive and has snoring respirations. If a gag reflex keeps you from
inserting an oral airway, you should try a nasal airway. He needs more definitive care.
Suction would be appropriate if the patient exhibited gurgling sounds.
22. A 30 month old male has a fever of 102 degrees F, cough, and shortness of
breath. You observe increased work of breathing and auscultate diffuse wheezes
and crackles. His mother tells you he has never been this ill. You should suspect
A) croup.
B) bronchiolitis.
C) epiglottitis.
D) asthma.
Correct Answer: B
RATIONALE
Bronchiolitis is a viral respiratory infection seen in infants and young children. It matches
the signs and symptoms presented as well as the age range for this condition. Even if
you didn't know what bronchiolitis is, you should be able to figure it out as the best
answer. There is no mention of a "croupy" or seal-bark cough. Asthma alone doesn't
present with a fever and epiglottitis is an upper airway condition. The sounds from the
lungs wouldn't be there in epiglottitis and there is no mention of drooling or difficulty
swallowing. You should have ruled out these three, leaving bronchiolitis as the best
answer.
23. Which of the following patient presentations represent the most severe stage
of hypoxia?
A) A 68 year old male whose skin is cool and clammy whose vital signs are P 110, R 18,
and BP 108/72
B) A sleepy and confused 69 year old male who has discolored fingernail beds
