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Northwest Community EMS System
Continuing Education Class Credit Questions
Respiratory Assessment – January 2012

Reminder: You must schedule to take the class post-test with your assigned hospital EMS Coordinator/educator or
their designee after this packet has been approved as complete.
The answers are found in the January 2012 class handout, independent study materials and/or the SOPs.
All respiratory problems can be categorized as impacting one of three things. List them. It's our job to figure out what’s wrong to determine appropriate care. What are the purposes of conducting a physical assessment? List at least two. Why does a patient with ventilatory impairment or respiratory distress often assume an upright or sitting position? What should EMS inspect specifically about the AIRWAY during the Primary Assessment? What audible sounds indicating airway or ventilatory impairment can be heard w/o a stethoscope when inspecting the airway? List 2 of 8 What should be the first thing to assess about breathing during the Primary Assessment? What 3 thoracic injuries present an immediate life-threat and must be found & resuscitated during the “B” (Breathing) phase of the Primary Assessment? Northwest Community EMS System
Continuing Education Class Credit Questions
Respiratory Assessment – January 2012
If a patient presents with asymmetric chest expansion (hyperinflation of one side) and jugular vein distension, what two things should EMS assess next to differentiate the life threat? If a pt presents with paradoxical chest wall motion, severe pleuritic chest pain, dyspnea, crepitus, shallow, rapid respirations, clear bilateral breath sounds yet SpO2 < 90 despite O2, administration, what should be suspected? What O2 device should be applied to this patient to provide non-invasive pressure support? Why does an open pneumothorax pose an immediate life threat? What is the assessment finding that suggests airway resistance or increased work of breathing? What injury should be suspected if a pt breathes using only their diaphragm and not the chest wall? Why does a patient with COPD breathe out passed pursed lips? What should be suspected if a patient presents with a new onset voice change or stuttering? Why does gastric distension with air pose a ventilation problem? What should be anticipated in ps who are obese with respect to the primary assessment/care? SpO2 monitoring (results and type of sensor to use): What general information is obtained by assessing skin color, temp & moisture? Northwest Community EMS System
Continuing Education Class Credit Questions
Respiratory Assessment – January 2012
What changes the skin from a normal to a dusky color when a patient is severely hypoxic? Under what circumstances is skin color an unreliable clinical finding? List 2 subjective (non-numeric) S&S of hypoxia What does the pulse oximetry monitor measure? Does the pulse ox monitor measure the oxygenation status of tissues and organ cells? … Yes
… No
If a patient is cold, tremoring, vasoconstricted or has poor peripheral perfusion, what adjustment should be made to monitoring their oxygenation status? Assume they are hypoxic and give 100% oxygen Put a blanket over the hand with the pulse ox sensor to warm it up Which of these will influence the amount of O2 delivered to cells? A. Acid-base Which of these will cause the SpO2 reading to be an unreliable reflection of the pt’s oxygenation status? A. Severe Match the shape of the capnography waveform that is likely to be seen with each disease process. Respiratory condition with delayed exhalation like asthma or COPD What EtCO numeric reading indicates hypoventilation with impending ventilatory failure? Northwest Community EMS System
Continuing Education Class Credit Questions
Respiratory Assessment – January 2012
Why can a patient with an uncomplicated AMI be harmed by hyperoxia? What should be the pulse ox target reading for a patient with return of spontaneous circulation (ROSC) What should be the pulse ox target reading for a patient with COPD? Which of these is NOT a possible complication of using CPAP? Why is a 12 L ECG indicated if a patient presents with shortness of breath? What types of conditions can present with pleuritic chest pain? (List 2) Why should EMS listen for an S3 heart sound if a patient has frothy sputum? Match the class or type to each of these drugs
Match the class or type to each of these drugs
Why does a patient with chronic bronchitis develop JVD and peripheral edema? What should be assessed, as indicated, when palpating the chest? (List at least three things) Northwest Community EMS System
Continuing Education Class Credit Questions
Respiratory Assessment – January 2012
What percussion note is elicited over normal aerated lung tissue? What percussion note is elicited over a pneumothorax? What percussion note is elicited over a hemothorax? Technique of breath sound assessment
Directly on skin / over one layer of clothing (circle one)
Ask the patient to breathe through their mouth / nose (circle one)
Where should one start on the anterior chest? When listening to normal vesicular lung sounds, inspiration / expiration (circle one) should sound louder
and 2 times longer with a high / low (circle one) pitch.
Apply the concept of “sound matching”:
■ What will cause transmission of lungs sounds to be enhanced producing louder than normal sounds with higher frequencies? Consolidation / air or fluid in the pleural space (circle one)
■ What will cause reflection of sound away from the chest wall causing breath sounds to be diminished or absent? Consolidation / air or fluid in the pleural space (circle one)
If bronchial breath sounds are heard over the periphery, what should one suspect? Fill in the tables below:
Northwest Community EMS System
Continuing Education Class Credit Questions
Respiratory Assessment – January 2012
How can EMS tell the difference between wheezes caused by asthma or COPD and those caused by heart failure? List at least three differentiating assessments.

Source: http://www.nwcemss.org/assets/1/continuing_education/Credit_questions_Resp_assess_1-12_UNKEYED.pdf