CPR CPR - Certified Paramedic Response Respiratory Emergencies and Management Questions and Answers 2 — Questions and Answers
Question 1: When using CPAP for a patient in acute pulmonary edema, which of the following patient presentations is a CONTRAINDICATION to CPAP use?
- Respiratory rate of 28 breaths/min
- SpO2 of 85% on 15 LPM non-rebreather
- Systolic BP of 70 mmHg with altered mental status (Correct answer)
- Bilateral crackles on auscultation
Correct answer: Systolic BP of 70 mmHg with altered mental status
Severely hypotensive patients with altered mental status cannot protect their airway and cannot tolerate the positive pressure that CPAP delivers.
Question 2: A 55-year-old male presents with sudden onset pleuritic chest pain, dyspnea, and tachycardia after a long flight. Which condition should be suspected FIRST?
- Spontaneous pneumothorax
- Pulmonary embolism (Correct answer)
- Aortic dissection
- Acute MI
Correct answer: Pulmonary embolism
Sudden pleuritic chest pain, dyspnea, tachycardia after prolonged immobility (long flight) is the classic presentation of pulmonary embolism.
Question 3: During nebulized albuterol therapy, which of the following patient assessments BEST indicates a therapeutic response?
- Heart rate decrease from 110 to 90 bpm
- Improved breath sounds with decreased wheezing and increased air movement (Correct answer)
- Blood pressure increase from 90/60 to 110/70
- Respiratory rate increase from 18 to 24 breaths/min
Correct answer: Improved breath sounds with decreased wheezing and increased air movement
Therapeutic response to albuterol is confirmed by improved air entry, reduced wheezing on auscultation, and decreased work of breathing.
Question 4: In a patient requiring RSI (Rapid Sequence Intubation), what is the CORRECT sequence of medication administration?
- Succinylcholine first, then etomidate
- Sedative/induction agent first, then neuromuscular blocking agent (Correct answer)
- Neuromuscular blocking agent first, then sedative
- Concurrent administration of both agents simultaneously
Correct answer: Sedative/induction agent first, then neuromuscular blocking agent
In RSI, the induction/sedative agent is always given first to achieve unconsciousness before the neuromuscular blocking agent is administered.
Question 5: A patient with COPD presents with worsening dyspnea and is using accessory muscles. Their ETCO2 is 58 mmHg. This value MOST likely indicates:
- Hyperventilation
- Hypoventilation with CO2 retention (Correct answer)
- Normal ventilation for a COPD patient
- Adequate respiratory compensation
Correct answer: Hypoventilation with CO2 retention
ETCO2 of 58 mmHg indicates hypoventilation and CO2 retention (hypercapnia), consistent with a COPD exacerbation with impending respiratory failure.
Question 6: Which of the following is the CORRECT position to place a patient in respiratory distress who is conscious and hemodynamically stable?
- Supine with head of stretcher flat
- Left lateral recumbent position
- High Fowler's position (sitting upright at 90 degrees) (Correct answer)
- Trendelenburg position
Correct answer: High Fowler's position (sitting upright at 90 degrees)
High Fowler's position maximizes diaphragmatic excursion and lung expansion, reducing the work of breathing in a conscious patient.
CPR CPR - Certified Paramedic Response Respiratory Emergencies and Management Questions and Answers 2
When using CPAP for a patient in acute pulmonary edema, which of the following patient presentations is a CONTRAINDICATION to CPAP use?