BLS Respiratory Arrest 4 — Questions and Answers
Question 1: A patient with a laryngectomy (neck breather) is in respiratory arrest. How should you provide rescue breaths?
- Seal the stoma and ventilate directly into the stoma (Correct answer)
- Use mouth-to-mouth only — avoid the stoma
- Seal both the mouth and nose, then ventilate the stoma
- Cover the stoma and ventilate mouth-to-mouth as normal
Correct answer: Seal the stoma and ventilate directly into the stoma
For a total laryngectomy patient, ventilate directly into the stoma since the upper airway is disconnected.
Question 2: Which of the following BEST describes the purpose of the nasopharyngeal airway (NPA) during BLS?
- It maintains airway patency in semi-conscious patients who may gag on an OPA (Correct answer)
- It replaces the need for rescue breaths in respiratory arrest
- It is used only after intubation fails
- It seals the airway to prevent gastric inflation
Correct answer: It maintains airway patency in semi-conscious patients who may gag on an OPA
An NPA is tolerated by patients with a gag reflex and keeps the nasopharyngeal passage open for ventilation.
Question 3: During two-rescuer BLS for an adult in cardiac arrest, how often should rescue breaths be given?
- 2 breaths after every 30 compressions (Correct answer)
- 1 breath after every 15 compressions
- 2 breaths after every 15 compressions
- 1 breath after every 30 compressions
Correct answer: 2 breaths after every 30 compressions
The 30:2 compression-to-ventilation ratio applies to adult BLS regardless of rescuer count.
Question 4: Supplemental oxygen provided during rescue breathing should ideally deliver what fraction of inspired oxygen (FiO₂)?
- Close to 100% (high-flow oxygen) (Correct answer)
- 21% (room air is adequate)
- 40–50% via simple face mask
- 28% via nasal cannula
Correct answer: Close to 100% (high-flow oxygen)
High-flow oxygen maximizes oxygen delivery to hypoxic tissues during resuscitation.
Question 5: A patient in respiratory arrest from suspected opioid overdose regains breathing after naloxone. What should you do next?
- Keep the patient on their side and monitor closely because the naloxone may wear off (Correct answer)
- Discharge the patient home once breathing normalizes
- Administer a second dose of naloxone immediately regardless of response
- Stop monitoring — the emergency is resolved
Correct answer: Keep the patient on their side and monitor closely because the naloxone may wear off
Naloxone has a shorter duration than most opioids, so respiratory depression can recur; continued monitoring is essential.
Question 6: When assessing breathing, how long should you take to determine if breathing is absent or abnormal?
- No more than 10 seconds (Correct answer)
- 30 seconds
- At least 1 full minute
- Until a pulse check is completed separately
Correct answer: No more than 10 seconds
AHA guidelines state breathing should be assessed simultaneously with pulse check in under 10 seconds to minimize delay.
Question 7: Which of the following is the MOST reliable indicator that rescue breaths are effective during BLS?
- Visible chest rise with each breath (Correct answer)
- Increase in the patient's skin color
- A beeping sound from the bag-mask valve
- Decrease in the patient's heart rate
Correct answer: Visible chest rise with each breath
Visible chest rise confirms air is entering the lungs rather than the stomach or leaking around the mask.
BLS Respiratory Arrest 4
A patient with a laryngectomy (neck breather) is in respiratory arrest.
How should you provide rescue breaths?