Emergency Care, 13e (Limmer et al.)
Chapter 17 Respiratory Emergencies
1) Which of the following does NOT occur during inspiration?
A) Intercostal muscles contract
B) Chest cavity increases in size
C) Diaphragm lowers
D) Diaphragm relaxes
Objective: 17.1
2) Which of the following is true concerning expiration?
A) The chest cavity increases in size.
B) The diaphragm moves upward.
C) The intercostal muscles contract to force air out of the lungs.
D) The ribs move upward and outward.
Objective: 17.2
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3) Which of the following respiratory rates is considered an abnormal respiratory rate for an
adult?
A) 20 breaths/min
B) 12 breaths/min
C) 16 breaths/min
D) 8 breaths/min
Objective: 17.3
4) A patient who has shallow, slow, irregular gasping breaths is said to have ________
respirations.
A) Kussmaul’s
B) agonal
C) central neurogenic
D) Cheyne-Stokes
Objective: 17.3
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5) Which of the following respiratory rates should be cause for alarm in a 2-month-old child?
A) 28 breaths/min
B) 40 breaths/min
C) 16 breaths/min
D) 32 breaths/min
Objective: 17.3
6) Which of the following BEST defines inadequate breathing?
A) Wheezing noises when breathing
B) Breathing that is insufficient to sustain life
C) Breathing slower than normal
D) Breathing faster than normal
Objective: 17.3
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7) Which of the following may be seen just prior to respiratory arrest?
A) Breathing through the nose, not the mouth
B) Very deep, rapid respirations
C) Agonal respirations
D) Accessory respirations
Objective: 17.3
8) Which of the following patients does NOT necessarily have inadequate breathing?
A) Patient with cyanosis
B) Patient’s whose breath sounds cannot be heard
C) Patient with agonal respirations
D) Patient with an irregular respiratory rhythm
Objective: 17.3
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9) While assessing the airway of a pediatric patient, you will notice that it is different than that of
an adult. Which of the following is one of those differences?
A) The cricoid cartilage is less developed, reducing the possibility that it can be completely
occluded.
B) The tongue is smaller, taking up less room in the mouth and allowing larger objects to occlude
the airway.
C) The trachea is smaller, softer, and more flexible, allowing it to be more easily obstructed.
D) The chest wall is softer, making it easier for the chest to expand.
Objective: 17.4
10) While caring for a 3-year-old child, you should be concerned if his respiratory rate exceeds
________ breaths per minute.
A) 16
B) 20
C) 24
D) 30
Objective: 17.5
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11) Which of the following signs of inadequate breathing is more prominent in children than in
adults?
A) See-sawing of the chest and abdomen
B) Grunting respirations
C) Nasal flaring
D) All of the above
Objective: 17.5
12) Your patient is a 15-year-old male with a history of multiple prior hospitalizations for
asthma. Upon your arrival the patient responds only to painful stimuli and is making very weak
respiratory effort. Which of the following should you do next?
A) Contact medical control.
B) Check the patient’s oxygen saturation level.
C) Assist the patient with his inhaler.
D) Assist the patient’s ventilations with a bag-valve-mask device and supplemental oxygen.
Objective: 17.6
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13) Which of the following is a sign of adequate artificial ventilations in a pediatric patient?
A) The breath is delivered easily.
B) Pulse rate slows down.
C) Pulse rate increases.
D) You notice cyanosis developing around the mouth.
Objective: 17.6
14) When ventilating a child with inadequate respirations, which of the following is the
maximum rate at which artificial respirations should be delivered?
A) 15 per minute
B) 12 per minute
C) 24 per minute
D) 20 per minute
Objective: 17.6
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15) Your patient is a 24-year-old woman with asthma who is struggling to breathe and is very
agitated. She has cyanosis of her lips and nail beds, and is cool and clammy to the touch. When
you attempt to assist her ventilations with a bag-valve-mask device, she becomes combative and
repeatedly pushes the mask away from her face. Which of the following is the BEST option?
A) Use a nasal cannula to administer supplemental oxygen.
B) Have your partner restrain the patient’s hands so you can ventilate her.
C) Begin transport immediately and contact medical control for advice.
D) Wait for the patient‘s level of consciousness to decrease so that she can no longer resist your
attempts to ventilate.
Objective: 17.6
16) What is the best way to determine that you are getting adequate ventilation with a bag-valve
mask?
A) Look for chest rise and fall.
B) Push the full amount of the bag into the patient.
C) Ensure the pulse oximeter reads 95 to 100%.
D) Hyperventilate the patient until the oxygen saturation reaches 100%.
Objective: 17.6
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17) Which of the following patients with difficulty breathing should NOT receive supplemental
oxygen?
A) A patient with a chronic lung disease who may have a hypoxic drive
B) An infant whose eyes may be damaged by excessive oxygen administration
C) A patient whose oxygen saturation level is 100% on room air
D) None of these patients should have oxygen withheld.
Objective: 17.6
18) Your patient is a 60-year-old female with a sudden onset of severe difficulty breathing. She
has no prior history of respiratory problems. Which of the following should be done before
applying oxygen by nonrebreather mask?
A) Listen to the patient’s breath sounds.
B) Obtain a history of the present illness.
C) Check the patient’s oxygen saturation level.
D) None of the above
Objective: 17.6
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19) You are first on the scene of a 61-year-old female in need of assistance with her respirations.
You have a pocket mask with supplemental oxygen. How can you determine that your artificial
ventilation is effective?
A) You are assisting respirations at 10 breaths per minute.
B) Patient’s pulse returns to normal.
C) You assure oxygen is being delivered at 15 liters per minute.
D) Patient’s skin color remains the same.
Objective: 17.7
20) You are ventilating a 6-year-old child and note that his heart rate has decreased from 70 to
54. Which of the following is NOT appropriate?
A) Notify medical control that the patient’s condition has improved.
B) Check the flow of oxygen reaching the bag-valve-mask device.
C) Increase the force of ventilations.
D) Insert an oropharyngeal airway and continue ventilating.
Objective: 17.7
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