CPR CPR - Certified Paramedic Response Respiratory Emergencies and Management Questions and Answers 1 — Questions and Answers
Question 1: A patient presents with severe acute asthma not responding to two albuterol nebulizations. What is the MOST appropriate next pharmacological intervention?
- Repeat albuterol nebulization only
- Administer ipratropium bromide in combination with albuterol (Correct answer)
- Administer IV diphenhydramine
- Administer oral methylprednisolone only
Correct answer: Administer ipratropium bromide in combination with albuterol
Ipratropium bromide combined with albuterol provides additive bronchodilation through different receptor pathways and is recommended for severe acute asthma.
Question 2: Which of the following SpO2 values would indicate the NEED for supplemental oxygen in a patient with COPD per current evidence-based guidelines?
- SpO2 > 95%
- SpO2 91–94%
- SpO2 < 88% (Correct answer)
- SpO2 89–90%
Correct answer: SpO2 < 88%
Supplemental oxygen is indicated in COPD patients when SpO2 drops below 88% to target a safe range of 88–92% and avoid hypoxic drive suppression.
Question 3: A patient in respiratory failure with a GCS of 8 is being managed. Bag-valve-mask ventilation is in progress. What tidal volume and rate are appropriate for adult BVM ventilation?
- 800–1000 mL at 20 breaths/min
- 500–600 mL at 10–12 breaths/min (Correct answer)
- 300–400 mL at 16–18 breaths/min
- 700–800 mL at 14–16 breaths/min
Correct answer: 500–600 mL at 10–12 breaths/min
Adult BVM ventilation should deliver 500–600 mL (6–7 mL/kg) at 10–12 breaths/min to avoid hyperventilation and barotrauma.
Question 4: Which of the following is the MOST reliable indicator of correct endotracheal tube placement in the prehospital setting?
- Bilateral chest rise on ventilation
- Auscultation of breath sounds over bilateral lung fields
- Continuous waveform capnography with ETCO2 35–45 mmHg (Correct answer)
- Fogging of the ETT during ventilation
Correct answer: Continuous waveform capnography with ETCO2 35–45 mmHg
Continuous waveform capnography is the gold standard for confirming and monitoring endotracheal tube placement throughout transport.
Question 5: A patient presents in anaphylaxis with respiratory distress and stridor. Epinephrine 1:1,000 has been administered IM. If stridor persists, what is the NEXT priority airway intervention?
- Administer a second dose of diphenhydramine
- Prepare for surgical cricothyrotomy if airway obstruction worsens (Correct answer)
- Administer nebulized albuterol as first priority
- Perform nasotracheal intubation immediately
Correct answer: Prepare for surgical cricothyrotomy if airway obstruction worsens
Persistent stridor after epinephrine in anaphylaxis indicates severe upper airway edema, and the paramedic must be prepared for a surgical airway if obstruction progresses.
Question 6: What is the ETCO2 value that BEST indicates effective CPR compressions during cardiac arrest resuscitation?
- < 10 mmHg
- 10–15 mmHg
- > 20 mmHg (Correct answer)
- 35–45 mmHg
Correct answer: > 20 mmHg
An ETCO2 greater than 20 mmHg during CPR indicates adequate chest compressions generating sufficient cardiac output.
CPR CPR - Certified Paramedic Response Respiratory Emergencies and Management Questions and Answers 1
A patient presents with severe acute asthma not responding to two albuterol nebulizations.
What is the MOST appropriate next pharmacological intervention?