Emergency Care, 13e (Limmer et al.)
Chapter 10 Respiration and Artificial Ventilation
1) For life to be maintained, a balance of oxygen and carbon dioxide is needed. The condition
when oxygen levels are low is called:
A) hypotension.
B) hypercarbia.
C) hyperventilation.
D) hypoxia.
Objective: 10.1
2) What are the signs of hypoxia?
A) Warm dry skin, with difficulty in breathing, and hypertension
B) Commonly seen as blue or gray skin, deterioration of patient‘s mental status like confusion or
restlessness
C) Disease process that robs the patient of adequate breathing and perfusion
D) Shock caused from the lack of blood flowing to the vital organs like the brain and heart that is
irreversible
Objective: 10.1
1
3) What signs and symptoms would indicate inadequate breathing in a patient?
A) Increased effort to breathe, increased depth of respiration, pink dry skin, normal mental status
B) Rapid breathing, pale skin, and a normal mental status
C) Decreased depth of respiration, decreased rate of breathing, hot clammy skin, normal mental
status
D) Increased effort to breathe, cyanosis, cool clammy skin, altered mental status
Objective: 10.2
4) In assessing a patient’s breathing, what is your first question?
A) Is he breathing?
B) Is he alive or dead?
C) Is his breathing adequate or inadequate?
D) Is he big sick or little sick?
Objective: 10.2
2
5) Why is inhalation described as an active process?
A) It requires the diaphragm to relax and use energy to move, creating a positive pressure.
B) It requires chest muscles to relax and use energy to move, creating a positive pressure.
C) It requires chest muscles to contract and use energy to move, creating a negative pressure.
D) It uses oxygen to assist chest muscles to contract, creating a negative pressure.
Objective: 10.3
6) The process of air moving in and out of the chest is called:
A) tidal volume.
B) inhalation.
C) respiration.
D) ventilation.
Objective: 10.3
7) The normal stimulus to breathe is stimulated by the chemoreceptors that measure the change
of what two gases?
A) Low hydrogen and high carbon monoxide
B) High carbon monoxide and low oxygen
C) High hydrogen and low carbon dioxide
D) High carbon dioxide and low oxygen
Objective: 10.4
3
8) Which of the following describes why fast respiration may decrease minute volume?
A) The lungs may not have the time to fill and exchange gas.
B) The rate causes turbulence in the trachea that increases the friction and decreases the amount
of air movement.
C) It is due to the delay in the movement of the intercostal muscles and the pleural space.
D) The rate does not decrease minute volume; it actually increases.
Objective: 10.5
9) To calculate the minute volume, you need to multiply what two measurements?
A) Tidal volume and respiratory rate
B) Alveolar ventilation and respiratory rate
C) Respiratory rate and bronchial dilation
D) Tidal volume and dead space air
Objective: 10.5
4
10) Which of the following statements BEST describes the exchange of gas in the alveoli?
A) Blood moves by way of the pulmonary capillaries, air arrives at the alveoli, and osmosis
occurs.
B) Blood moves from the left heart to the lungs, air arrives in the alveoli sacks, and diffusion
occurs.
C) Air moves into the airway, blood arrives via the pulmonary veins, and osmosis occurs.
D) Air moves into the alveoli, blood is transported by the pulmonary capillaries, and diffusion
occurs.
Objective: 10.5
11) The movement of oxygen and carbon dioxide between the alveoli and circulating blood is
called:
A) internal respiration.
B) osmosis.
C) cellular respiration.
D) pulmonary (external) respiration.
Objective: 10.6
5
12) Why does a patient involved in an auto crash who has major internal abdominal bleeding
require oxygen to maintain internal respiration?
A) The red blood cells have a reduction of hemoglobin that reduces the amount of oxygen that
can be transported.
B) A lack of oxygen in the air decreases the oxygen diffused into the bloodstream, which creates
an increase of carbon dioxide.
C) The swelling of the abdominal space causes the diaphragm to be restricted, which will reduce
the thorax space.
D) A lack of circulating volume decreases the oxygen and carbon dioxide transport capability.
Objective: 10.6
13) The movement of oxygen and carbon dioxide across the cell membranes from the capillaries
is called:
A) external respiration.
B) dehydration.
C) internal respiration.
D) oxygenation.
Objective: 10.6
6
14) What is the relatively rare condition that can cause respiratory depression?
A) Lungs can react unfavorably to oxygen when the concentration is too high for a long period
of time and this can depress breathing.
B) Chronic obstructive pulmonary disease (COPD) has changed the stimulus to breathe to the
hypoxic drive and high concentration can depress breathing.
C) High concentration of oxygen can depress breathing when the patient has an allergic reaction
from the oxygen.
D) The eyes can develop scar tissue on the retina from a high concentration of oxygen.
Objective: 10.7
15) A 16-year-old patient presents with labored breathing and increased respiratory rate,
increased heart rate, and leaning forward with his hands on his knees. His skin is pink and his
accurate pulse oximetry is 96. This patient is suffering from respiratory:
A) failure.
B) hypoxia.
C) distress.
D) arrest.
Objective: 10.8
7
16) When does respiratory distress change to respiratory failure?
A) When the respiratory challenge continues, the systems fail with the demand for oxygen,
pupils dilate, and the skin becomes hot and dry.
B) When the respiratory challenge continues, the systems cannot keep up with the demand, and
skin color and mental status change.
C) When the patient who is short of breath, with noisy respiration, presents in the tripod position
but then suddenly has the condition clear up and return to normal.
D) When the compensatory mechanism is no longer needed and the patient goes into arrest.
Objective: 10.8
17) Which of the following BEST describes inadequate breathing?
A) The respiratory rate is slower than normal.
B) The minute volume is less than normal.
C) The minute volume is greater than normal.
D) The respiratory rate is faster than normal.
Objective: 10.8
8
18) You have arrived at the scene of a call for a “man down.” As you enter the residence you note
that your patient is a male in his mid-60s who is awake but does not seem to acknowledge your
presence. He is perspiring profusely, has cyanosis of his ears and lips, and has rapid, shallow
respirations. Which of the following should you do first?
A) Check for a radial pulse.
B) Obtain the patient’s medical history.
C) Listen to his lung sounds.
D) Assist ventilations with a bag-valve mask and supplemental oxygen.
Objective: 10.9
19) Your patient is a motorcyclist who was ejected after striking a guard rail. The patient is
unresponsive to painful stimuli and is breathing shallowly six to eight times per minute. Which
of the following should you do first?
A) Use a bag-valve mask with supplemental oxygen.
B) Perform a rapid trauma assessment.
C) Apply a cervical collar.
D) Apply a nonrebreather mask with an oxygen flow rate of 15 lpm.
Objective: 10.10
9
20) Which of the following patients does NOT require the administration of supplemental
oxygen?
A) A 60-year-old woman with a history of chronic obstructive pulmonary disease (COPD) who
can speak two or three words at a time without a breath
B) A 6-year-old male with a history of asthma whose breath sounds are silent and who is drowsy
C) A 31-year-old male who is unresponsive due to an overdose of narcotics
D) A 24-year-old woman who is breathing 28 times per minute after being in an argument with
her husband
Objective: 10.11
21) You are ventilating an adult patient with a bag-valve mask when you notice that his abdomen
is getting bigger. You should:
A) apply cricoid pressure.
B) decrease the flow of oxygen.
C) apply pressure to the abdomen.
D) suction the airway.
Objective: 10.12
10