Paramedics Exam Airway, Respiration, and Ventilation 4 — Questions and Answers
Question 1: A laryngeal mask airway (LMA) provides which level of airway protection?
- Complete protection against aspiration
- Supraglottic airway — no aspiration protection (Correct answer)
- Infraglottic protection similar to ETT
- Full protection only when cuff is inflated
Correct answer: Supraglottic airway — no aspiration protection
The LMA sits above the glottis (supraglottic) and does not provide protection against aspiration of gastric contents.
Question 2: When performing rapid sequence intubation (RSI), succinylcholine is selected as the paralytic agent. A contraindication to succinylcholine is:
- Hypertension
- Suspected crush injury 48 hours old (Correct answer)
- Asthma
- Acute head trauma
Correct answer: Suspected crush injury 48 hours old
Succinylcholine causes potassium release from muscle cells; in crush injuries older than 24-48 hours, this can cause life-threatening hyperkalemia.
Question 3: A patient has stridor and a barking cough following upper respiratory infection. This presentation is MOST consistent with:
- Epiglottitis
- Croup (laryngotracheobronchitis) (Correct answer)
- Anaphylaxis
- Foreign body aspiration
Correct answer: Croup (laryngotracheobronchitis)
Croup presents with a characteristic 'seal bark' cough, stridor, and low-grade fever after a viral URI, typically in young children.
Question 4: Hypercapnia (elevated CO2) causes which of the following physiologic effects?
- Respiratory alkalosis and vasoconstriction
- Respiratory acidosis and vasodilation (Correct answer)
- Metabolic alkalosis and tachycardia
- Metabolic acidosis and vasoconstriction
Correct answer: Respiratory acidosis and vasodilation
Elevated CO2 dissolves in blood to form carbonic acid, causing respiratory acidosis, and also acts as a potent vasodilator.
Question 5: Which of the following is the CORRECT method for sizing an oropharyngeal airway (OPA)?
- From the corner of the mouth to the earlobe (Correct answer)
- From the center of the mouth to the angle of the jaw
- From the corner of the mouth to the tip of the earlobe
- From the center of the lips to the mastoid process
Correct answer: From the corner of the mouth to the earlobe
An OPA is sized by measuring from the corner of the patient's mouth to the earlobe (or center of mouth to angle of jaw), ensuring proper fit.
Question 6: During endotracheal intubation, the vocal cords are best visualized using which laryngoscope blade design?
- Curved (Macintosh) blade placed in the vallecula (Correct answer)
- Straight (Miller) blade placed in the vallecula
- Curved (Macintosh) blade placed on the epiglottis
- Straight (Miller) blade placed in the pyriform fossa
Correct answer: Curved (Macintosh) blade placed in the vallecula
The curved Macintosh blade is placed in the vallecula and lifting indirectly elevates the epiglottis to expose the cords.
Question 7: Pulse oximetry may give a falsely HIGH reading in which of the following situations?
- Severe anemia
- Carbon monoxide poisoning (Correct answer)
- Peripheral vasoconstriction
- Hypothermia
Correct answer: Carbon monoxide poisoning
Pulse oximetry cannot distinguish between oxyhemoglobin and carboxyhemoglobin, so CO poisoning produces falsely normal or elevated SpO2 readings.
Paramedics Exam Airway, Respiration, and Ventilation 4
A laryngeal mask airway (LMA) provides which level of airway protection?