Paramedics Exam Airway, Respiration, and Ventilation 3 — Questions and Answers
Question 1: A patient presents with paradoxical chest movement following blunt trauma. This is MOST consistent with:
- Open pneumothorax
- Tension pneumothorax
- Flail chest (Correct answer)
- Hemothorax
Correct answer: Flail chest
Flail chest occurs when multiple rib fractures create a free-floating segment that moves opposite to the rest of the chest wall (paradoxical movement).
Question 2: Which of the following is the CORRECT tidal volume to deliver when ventilating an adult with a BVM?
- 500-600 mL over 1 second (Correct answer)
- 800-1000 mL over 2 seconds
- 300-400 mL over 0.5 seconds
- 1000-1200 mL over 3 seconds
Correct answer: 500-600 mL over 1 second
Adult BVM ventilation should deliver 500-600 mL (enough to produce visible chest rise) over approximately 1 second to minimize gastric inflation.
Question 3: EtCO2 readings suddenly drop to near zero during transport of an intubated patient. The FIRST action should be:
- Increase ventilation rate
- Check for tube displacement (Correct answer)
- Administer sodium bicarbonate
- Begin CPR
Correct answer: Check for tube displacement
A sudden drop in EtCO2 to near zero most commonly indicates tube displacement, esophageal intubation, or circuit disconnection — tube position must be verified immediately.
Question 4: A CPAP device is being applied to a patient in acute pulmonary edema. Which pressure setting is MOST commonly used initially?
- 2-4 cm H2O
- 5-10 cm H2O (Correct answer)
- 15-20 cm H2O
- 20-25 cm H2O
Correct answer: 5-10 cm H2O
CPAP for pulmonary edema is typically initiated at 5-10 cm H2O, which recruits collapsed alveoli and reduces the work of breathing.
Question 5: Which of the following patients is the BEST candidate for CPAP therapy?
- Unconscious patient with no gag reflex
- Alert patient in respiratory distress with SpO2 of 88% (Correct answer)
- Patient in full cardiopulmonary arrest
- Patient with active vomiting and respiratory distress
Correct answer: Alert patient in respiratory distress with SpO2 of 88%
CPAP is appropriate for an alert, cooperative patient in respiratory distress; unconscious patients, arrest, and active vomiting are contraindications.
Question 6: The peak expiratory flow rate (PEFR) is used primarily to assess severity in which condition?
- Pneumonia
- Pulmonary embolism
- Asthma (Correct answer)
- Chronic bronchitis exacerbation
Correct answer: Asthma
PEFR measures how quickly a patient can exhale air and is a key objective tool to assess asthma severity and response to treatment.
Question 7: A patient with COPD presents with severe dyspnea and a SpO2 of 82%. Your primary concern with high-flow oxygen in this patient is:
- Oxygen toxicity causing lung damage
- Suppression of the hypoxic drive (Correct answer)
- Increased risk of pneumothorax
- Worsening bronchospasm
Correct answer: Suppression of the hypoxic drive
Some COPD patients rely on hypoxic drive for respiratory stimulation; high-flow O2 can suppress this drive, reducing respiratory effort.
Paramedics Exam Airway, Respiration, and Ventilation 3
A patient presents with paradoxical chest movement following blunt trauma.
This is MOST consistent with: