EMT Airway and Breathing Practice Test — 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 designed to deliver low-flow oxygen, typically providing 24-44% oxygen concentration. Its maximum recommended flow rate is generally 6 liters per minute (LPM). Beyond this rate, the effectiveness of oxygen delivery does not significantly increase, and it can cause discomfort and dryness to the nasal passages.

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
Endothracheal Tube
Dual Lumen Airway (Correct answer)
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 blind insertion and feature two lumens and cuffs, one to seal the esophagus and the other to allow ventilation, often into the trachea or pharynx. This design facilitates effective ventilation and helps prevent gastric insufflation and aspiration in emergency situations.

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, often referred to as '100%' (though typically 90-100% with proper seal), a non-rebreather mask is used with a flow rate of 12-15 liters per minute (LPM). This high flow rate ensures the reservoir bag remains inflated, preventing the patient from rebreathing exhaled air and maximizing the delivery of supplemental oxygen.

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 off a ladder and is in respiratory distress, there is a high suspicion of spinal injury. The jaw thrust maneuver is the preferred airway opening technique in trauma patients because it minimizes movement of the cervical spine. Unlike the head-tilt, chin-lift, the jaw thrust helps open the airway without hyperextending the neck, thus reducing the risk of further spinal cord damage.

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 handheld device that delivers a precise, pre-measured dose of medication to the lungs in the form of an aerosolized mist. The patient activates the device while inhaling, allowing the medication to reach the lower airways. This method is commonly used for bronchodilators and corticosteroids to treat respiratory conditions like asthma and COPD.

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 anatomical division between the upper and lower respiratory tracts. Structures above the cricoid, including the pharynx, larynx (above the vocal cords), and epiglottis, are considered part of the upper airway.

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

The tongue is the most common cause of airway obstruction in an unconscious patient. When muscle tone is lost, the tongue relaxes and falls backward, occluding the pharynx. This blockage prevents air from reaching the trachea and lungs, leading to respiratory distress or arrest.

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 from the blood into the alveoli, occurs across the thin walls of the alveoli and the surrounding pulmonary capillary beds. These capillaries are tiny blood vessels that directly interface with the alveolar sacs, facilitating the efficient diffusion of gases between the lungs and the circulatory system.

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 contracts and moves downward, flattening its dome shape. This action increases the vertical dimension of the thoracic cavity, creating negative pressure within the chest. This negative pressure then draws air into the lungs, allowing for respiration.

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 reduces the volume of the thoracic cavity, increasing the pressure within the lungs. For air to be forced out of the lungs, this intrapulmonary pressure must rise above the atmospheric pressure outside the body, creating a pressure gradient that drives air outward.

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) technique is generally the least effective method for delivering adequate tidal volumes. It is challenging for one rescuer to maintain an effective mask seal while simultaneously squeezing the bag, often leading to air leaks and insufficient ventilation. Two-person BVM, mouth-to-mask, and FROPVDs typically allow for better seal and more consistent tidal volumes.

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 pressure compresses the esophagus against the cervical vertebrae, aiming to prevent gastric regurgitation and insufflation during intubation. It is a technique used to improve visualization of the vocal cords and protect the airway.

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

The patient's history of COPD, combined with shallow, rapid respirations and minimal chest wall motion, indicates ineffective ventilation. This impaired gas exchange means that carbon dioxide is not being adequately expelled from the lungs. Consequently, carbon dioxide will accumulate in the bloodstream, leading to elevated arterial carbon dioxide levels (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 history of trauma (hip fracture, head injury), progressively worsening labored breathing, diffuse rales, and signs of hypoperfusion (BP 98/70, HR 104) are highly suggestive of Adult Respiratory Distress Syndrome (ARDS). ARDS is a severe lung condition often triggered by major trauma or sepsis, characterized by widespread inflammation, fluid accumulation in the alveoli (rales), and impaired gas exchange, leading to severe respiratory failure.

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.

The two-person bag-valve-mask (BVM) technique is considered the most effective method for administering ventilations to an apneic patient. One rescuer can focus entirely on maintaining a tight mask seal with both hands, while the second rescuer squeezes the bag, ensuring consistent and adequate tidal volumes and minimizing air leaks. This approach optimizes airway patency and ventilation efficiency.

EMT Airway and Breathing Practice Test

What is the maximum flow rate for a Nasal Cannula?