EMT Airway and Breathing Practice Test 1 — Questions and Answers

Question 1: What is the maximum flow rate for a Nasal Cannula?

2 lpm
8 lpm
12 lpm
6 lpm (Correct answer)

Correct answer: 6 lpm

A nasal cannula is a low-flow oxygen delivery device used for patients requiring supplemental oxygen at lower concentrations. While it can deliver oxygen at rates from 1 to 6 liters per minute (lpm), exceeding 6 lpm with a nasal cannula is generally not recommended. Higher flow rates can become uncomfortable for the patient, cause nasal dryness, and do not significantly increase the delivered oxygen concentration due to the limitations of the device.

Question 2: What is the following device ? A device designed to facilitate the blind intubation of a patient. It consists of a cuffed double-lumen tube with one blind end. Inflation of the cuff allows the device to function as an endotracheal tube and closes off the esophagus, allowing ventilation and preventing reflux of gastric contents.

Nasal Gastric Tube
Dual Lumen Airway (Correct answer)
Endothracheal Tube
Non Rebreather

Correct answer: Dual Lumen Airway

The description accurately defines a Dual Lumen Airway, such as a Combitube or King LT airway. These devices are designed for emergency airway management, particularly for blind intubation, by creating a seal in the esophagus or pharynx. This allows for effective ventilation and helps prevent aspiration of gastric contents, making them valuable tools when direct visualization of the larynx is difficult.

Question 3: In order to provide Oxygen Therapy at "100%" what should the flow rate be?

12-15 LPM (Correct answer)
100 LPM
20-24 LPM
2-6 LPM

Correct answer: 12-15 LPM

To provide the highest possible concentration of oxygen to a spontaneously breathing patient, typically close to 100%, a non-rebreather mask is used. This device requires a flow rate of 12-15 liters per minute (LPM) to ensure the reservoir bag remains inflated. This high flow rate prevents rebreathing of exhaled air and delivers nearly pure oxygen from the source.

Question 4: What airway opening maneuver should be used on a man that has fallen off a ladder and is suffering from respiratory distress?

Head Tilt - Chin Lift
Intubation
Bite Block
Jaw Thrust (Correct answer)

Correct answer: Jaw Thrust

For a patient who has fallen and may have a spinal injury, the Jaw Thrust maneuver is the preferred method for opening the airway. This technique minimizes movement of the cervical spine, reducing the risk of exacerbating a potential spinal cord injury. Unlike the Head Tilt-Chin Lift, it lifts the jaw forward without extending the neck.

Question 5: A device that delivers a specific amount of medication to the lungs, in the form of a short burst of aerosolized medicine that is inhaled by the patient is known as a(n)?

Nebulizer
Aero Chamber
Metered Dose Inhaler (Correct answer)
Albuterol infuser

Correct answer: Metered Dose Inhaler

A Metered Dose Inhaler (MDI) is a common medical device used to deliver a precise, pre-measured dose of aerosolized medication directly into the lungs. Patients activate the device while inhaling, allowing the medication to reach the airways for conditions like asthma or COPD. It provides targeted drug delivery with minimal systemic side effects.

Question 6: The anatomy of the airway consists of the upper and the lower airways. The upper airway starts at the mouth and Nares and ends at the _________?

Thyroid cartilage
Epiglottis
Cricoid cartilage (Correct answer)
Vocal cords

Correct answer: Cricoid cartilage

The upper airway extends from the mouth and nares down to the cricoid cartilage. The cricoid cartilage is the only complete ring of cartilage in the airway and marks the inferior border of the larynx, serving as the anatomical transition point to the lower airway (trachea). This landmark is crucial in airway management and intubation procedures.

Question 7: The tongue often is a source of airway obstruction; it falls back and occludes the _________?

Larynx
Trachea
Nasopharynx
Pharynx (Correct answer)

Correct answer: Pharynx

In an unconscious or unresponsive patient, the most common cause of airway obstruction is the tongue falling back. When muscle tone is lost, the tongue can relax and occlude the pharynx, blocking the passage of air. Airway maneuvers like the head-tilt chin-lift or jaw-thrust are designed to lift the tongue off the posterior pharyngeal wall.

Question 8: The lower airway ends at the Alveoli, where gas exchange occurs. Oxygen moves to the hemoglobin by passing through a semipermeable membrane. Where does this occur?

Capillary bed (Correct answer)
Bronchioles
Capillary blood
Veinules

Correct answer: Capillary bed

Gas exchange, where oxygen moves from the alveoli into the bloodstream and carbon dioxide moves out, occurs primarily in the capillary bed surrounding the alveoli. The thin walls of the alveoli and capillaries form the respiratory membrane, facilitating efficient diffusion of gases. Hemoglobin within the red blood cells in these capillaries then binds to the oxygen for transport throughout the body.

Question 9: To create negative pressure in the thorax (chest cavity) the diaphragm contracts and moves _____________. This action expands the volume of the thorax, allowing air to rush into the lungs.

Upward
Outward
Downward (Correct answer)
The diaphragm does not move, the chest wall expands.

Correct answer: Downward

During inhalation, the diaphragm, a dome-shaped muscle, contracts and moves downward. This action increases the vertical dimension of the thoracic cavity, expanding its overall volume. The increase in volume creates a negative pressure within the chest, drawing air from the higher atmospheric pressure into the lungs.

Question 10: When the diaphragm relaxes, it regains its domed shape. This action causes an increase in thoracic pressure which forces air out of the lungs. To have air forced out of the lungs, the pressure in the thorax must rise above _______________ pressure?

Trans thoracic
Atmospheric (Correct answer)
Trans abdominal
Respiratory

Correct answer: Atmospheric

During exhalation, the diaphragm relaxes and moves upward, returning to its domed shape. This, along with the elastic recoil of the lungs and chest wall, decreases the volume of the thoracic cavity. The reduction in volume increases the pressure within the thorax above atmospheric pressure, forcing air out of the lungs.

Question 11: Which of the following ventilatory techniques is likely to yield the LOWEST tidal volumes?

One person bag-valve-mask (Correct answer)
Two person bag-valve-mask
Flow restricted oxygen powered ventilatory device
Mouth-to-mask

Correct answer: One person bag-valve-mask

A one-person bag-valve-mask (BVM) ventilation technique is often less effective than other methods due to the difficulty in simultaneously maintaining an adequate mask seal and squeezing the bag. This can lead to air leakage and insufficient tidal volumes delivered to the patient. Two-person BVM ventilation, mouth-to-mask, or mechanical devices generally provide more consistent and effective ventilations.

Question 12: In order to assist intubation, a paramedic may utilize Sellick's maneuver. In this procedure, which cartilage are you compressing?

Cricoid cartilage (Correct answer)
Aryepiglottic cartilage
Thyroid cartilage
Hyoid cartilage

Correct answer: Cricoid cartilage

Sellick's maneuver, also known as cricoid pressure, involves applying firm pressure to the cricoid cartilage. This maneuver is performed during intubation to compress the esophagus against the cervical vertebrae, aiming to prevent gastric regurgitation and aspiration into the lungs. It helps improve visualization of the vocal cords by displacing the larynx posteriorly.

Question 13: You are transporting an elderly male patient in respiratory distress with a history of COPD... The patient has very shallow, rapid respirations with minimal chest wall motion and slight wheezing in the upper lung fields. Given this situation, what would you expect the arterial carbon dioxide levels to be?

Not enough information to determine
Normal
Lowered
Elevated (Correct answer)

Correct answer: Elevated

Shallow, rapid respirations with minimal chest wall motion in a COPD patient indicate ineffective ventilation. This type of breathing pattern does not allow for adequate gas exchange, leading to the retention of carbon dioxide in the blood. Consequently, the arterial carbon dioxide levels would be elevated, a condition known as hypercapnia.

Question 14: You are transporting a 48-year-old male patient between medical facilities... During the history, you learn that the patient was involved in a fall at work and suffered a hip fracture and a head injury. The patient is now presenting with labored breathing at 30/min that has progressively worsened over the last 24 hours, a heart rate of 104, and a blood pressure of 98/70. On auscultation, you hear diffuse rales. The patient denies any complaints of pain other than those related to his recent fall. What is the most likely cause of the patient's respiratory distress?

Cardiogenic shock
Congestive heart failure
Acute bronchitis
Adult respiratory distress syndrome (Correct answer)

Correct answer: Adult respiratory distress syndrome

The patient's presentation, including a history of trauma (fall, head injury, hip fracture), progressively worsening labored breathing, diffuse rales, and signs of hypoperfusion (low blood pressure), is highly suggestive of Adult Respiratory Distress Syndrome (ARDS). ARDS is a severe lung condition often triggered by systemic inflammation or injury, leading to widespread inflammation and fluid accumulation in the lungs, impairing gas exchange.

Question 15: Which of the following is the most effective method for administering ventilations to an apneic patient?

Two person bag-valve-mask. (Correct answer)
FROPVD
One person bag-valve-mask.
Mouth-to-mouth.

Correct answer: Two person bag-valve-mask.

For an apneic patient, a two-person bag-valve-mask (BVM) technique is considered the most effective method for administering ventilations. One rescuer can focus entirely on maintaining a tight mask seal with both hands, while the second rescuer squeezes the bag to deliver consistent and adequate tidal volumes. This approach minimizes air leakage and optimizes ventilation compared to a single rescuer.

EMT Airway and Breathing Practice Test 1

What is the maximum flow rate for a Nasal Cannula?