NREMT EMT Level Quiz: Breathing Assessment And Oxygen Therapy

What this quiz covers

This quiz focuses on Breathing Assessment And Oxygen Therapy, giving you a quick way to practice the rules, question types, and explanations that matter most for NREMT EMT Level.

How to use this quiz

Try each quiz question before looking at the correct answer. Use the explanations to review missed ideas, then come back to similar questions until the pattern feels familiar.

Question 1

1. 1-6 liters per minute to deliver 24-44% oxygen concentration (correct answer)
2. 6-10 liters per minute to deliver 35-60% oxygen concentration
3. 10-15 liters per minute to deliver 85-100% oxygen concentration
4. 15-25 liters per minute to deliver maximum oxygen saturation

Explanation: Nasal cannula operates at 1-6 LPM delivering 24-44% oxygen. Higher flow rates cause patient discomfort and don't significantly increase oxygen delivery. Option B describes simple face mask flows. Option C describes non-rebreather mask flows. Option D exceeds safe nasal cannula parameters.

Question 2

1. Nasal cannula at 2-4 liters per minute for mild respiratory distress
2. Non-rebreather mask at 10-15 liters per minute for potential anaphylaxis (correct answer)
3. Bag-valve-mask ventilation to assist with increased respiratory effort
4. Simple face mask at 6-8 liters per minute for moderate dyspnea

Explanation: Bee sting with dyspnea suggests possible allergic reaction/anaphylaxis requiring high-concentration oxygen via non-rebreather mask. Nasal cannula (option A) provides insufficient oxygen for potential anaphylaxis. BVM (option C) is inappropriate for adequate breathing. Simple face mask (option D) provides lower oxygen concentration than needed for this emergency.

Question 3

1. No oxygen therapy needed since patient is speaking normally
2. Nasal cannula at 2-4 liters per minute for comfort measures
3. Non-rebreather mask at 10-15 liters per minute for chest pain protocol (correct answer)
4. Bag-valve-mask assistance to reduce respiratory workload

Explanation: Chest pain patients receive high-concentration oxygen via non-rebreather mask regardless of apparent breathing adequacy, as this may indicate cardiac ischemia. Option A ignores chest pain protocol. Nasal cannula (option B) provides insufficient oxygen for potential cardiac event. BVM (option D) is inappropriate for adequate breathing.

Question 4

1. Rapid chest compressions with maximum pressure delivery technique
2. Visible chest rise and fall with each ventilation at appropriate rate (correct answer)
3. Fast ventilation rate to quickly improve patient's oxygen saturation levels
4. Maximum bag compression to deliver largest possible tidal volume safely

Explanation: Effective BVM ventilation is indicated by visible chest rise and fall at the appropriate rate (10-12/min for adults). Option A describes chest compressions, not ventilation. Option C risks hyperventilation. Option D can cause gastric distension and lung injury.

Question 5

1. Apply nasal cannula oxygen and monitor respiratory pattern development closely
2. Position patient in recovery position and provide supplemental oxygen therapy
3. Begin immediate bag-valve-mask ventilation with high-flow oxygen delivery (correct answer)
4. Coach patient to breathe more regularly and deeply with verbal encouragement

Explanation: Agonal respirations are inadequate and indicate impending respiratory arrest requiring immediate BVM ventilation. Nasal cannula (option A) won't help inadequate breathing. Recovery position (option B) is inappropriate for someone needing ventilation assistance. The patient is unconscious and cannot respond to coaching (option D).

Question 6

1. Apply high-flow oxygen via nasal cannula at 6 liters per minute
2. Position patient upright and coach deep breathing techniques
3. Open airway with head-tilt chin-lift and begin bag-valve-mask ventilation (correct answer)
4. Insert nasopharyngeal airway and monitor respiratory status closely

Explanation: This patient has inadequate breathing (bradypnea with poor tidal volume) and airway obstruction (snoring). Head-tilt chin-lift opens the airway, and BVM provides needed ventilation. Nasal cannula (option A) won't help inadequate breathing. Patient is unconscious (option B). NPA alone (option D) doesn't address inadequate ventilation.

Question 7

1. Tachypnea indicates developing pneumonia from smoke exposure
2. Potential airway burns and swelling requiring close airway monitoring (correct answer)
3. Carbon monoxide poisoning causing altered respiratory drive patterns
4. Anxiety-related hyperventilation from traumatic fire experience

Explanation: Hoarse voice and cough after fire exposure suggest airway burns and potential swelling that could rapidly compromise the airway. While CO poisoning (option C) is a concern, airway burns are more immediately life-threatening. Pneumonia (option A) develops later. Anxiety (option D) doesn't explain the hoarse voice.

Question 8

1. Begin positive pressure ventilation with bag-valve-mask immediately
2. Apply a non-rebreather mask and coach slow, deep breathing (correct answer)
3. Insert an oral airway and provide high-flow oxygen therapy
4. Place patient supine and elevate legs for shock positioning

Explanation: This patient shows signs of hyperventilation with adequate chest rise and normal skin color. Coaching breathing and providing oxygen is appropriate. BVM (option A) is for inadequate breathing. OPA (option C) is for unconscious patients with airway issues. Shock positioning (option D) is unrelated to this breathing problem.

Question 9

1. Increase oxygen flow rate on the current nasal cannula delivery device
2. Switch from nasal cannula to non-rebreather mask for improved oxygen delivery
3. Begin assisted ventilation with bag-valve-mask due to inadequate breathing pattern (correct answer)
4. Encourage patient to take deeper breaths and monitor respiratory status closely

Explanation: Shallow breathing at 8 breaths per minute indicates inadequate ventilation requiring assisted ventilation with BVM. Simply increasing oxygen flow (option A) or switching devices (option B) won't help inadequate breathing. An unconscious or obtunded patient cannot respond to breathing encouragement (option D).

Question 10

1. Nasal cannula at 2-6 liters per minute
2. Non-rebreather mask at 10-15 liters per minute (correct answer)
3. Bag-valve-mask with high-flow oxygen
4. Simple face mask at 6-10 liters per minute

Explanation: A patient in moderate to severe respiratory distress with accessory muscle use requires high-concentration oxygen via non-rebreather mask at 10-15 LPM. Nasal cannula provides insufficient oxygen concentration. BVM is for inadequate breathing/respiratory failure. Simple face mask is rarely used and provides lower oxygen concentration than needed.

Question 11

1. Respiratory rate of 16 breaths per minute with good chest rise
2. Shallow breathing with minimal chest movement and cyanosis around lips (correct answer)
3. Deep, regular respirations at 18 breaths per minute with clear sounds
4. Slight increase in respiratory rate to 22 during mild exertion

Explanation: Shallow breathing with minimal chest movement and cyanosis indicates inadequate ventilation requiring assisted ventilation. Option A shows normal breathing. Option C shows adequate, possibly slightly deep breathing. Option D shows normal physiologic response to exertion.

Question 12

1. Breathing is adequate but patient requires emotional reassurance and positioning
2. Patient shows severe respiratory distress requiring high-concentration oxygen therapy (correct answer)
3. Normal age-related changes in respiratory function with mild exertion
4. Anxiety-induced hyperventilation that will resolve with calming techniques

Explanation: Tripod positioning, severe tachypnea, inability to speak full sentences, and fatigue indicate severe respiratory distress requiring immediate high-flow oxygen. This is not adequate breathing (option A), not normal aging (option C), and more serious than anxiety hyperventilation (option D).

Question 13

1. Respiratory rate below 8 breaths per minute regardless of other assessment parameters
2. Inadequate tidal volume evidenced by minimal chest rise and poor air movement (correct answer)
3. Altered mental status with response only to painful stimuli during assessment
4. Suspected opioid overdose with classic presentation of central nervous system depression

Explanation: Inadequate tidal volume (shallow breathing with poor chest rise and minimal air movement) is the primary indicator for assisted ventilation, regardless of respiratory rate. While bradypnea is concerning, adequate tidal volume can still provide sufficient ventilation. Altered mental status and drug overdose are contextual factors, but the decision for ventilation assistance should be based on the adequacy of breathing mechanics and air exchange.

Question 14

1. Respiratory distress requiring immediate high-flow oxygen and ventilation assistance
2. Compensatory hyperventilation attempting to correct metabolic acidosis (correct answer)
3. Anxiety-related hyperventilation secondary to feeling unwell and weak
4. Early sign of respiratory failure requiring preparation for airway management

Explanation: Deep, rapid breathing (Kussmaul respirations) with fruity breath odor and dehydration suggests diabetic ketoacidosis. The respiratory pattern is compensatory - the body is trying to blow off CO2 to counteract metabolic acidosis. This is appropriate physiologic compensation, not respiratory distress requiring intervention. Interrupting this compensation with assisted ventilation could worsen the acidosis.

Question 15

1. Persistent coughing with production of water from the respiratory tract
2. Altered mental status with confusion and disorientation following submersion
3. Inadequate chest rise with poor air movement despite conscious respiratory effort (correct answer)
4. History of prolonged submersion time regardless of current respiratory status

Explanation: Poor chest rise and inadequate air movement indicate that despite being conscious, the patient cannot generate effective ventilation - possibly due to laryngospasm, pulmonary edema, or aspiration. This requires assisted ventilation. Coughing up water is expected and helps clear the airway. Altered mental status and submersion history are concerning but don't alone indicate the need for ventilation assistance if breathing mechanics are adequate.

Question 16

1. Presence of sharp, stabbing chest pain that worsens with deep inspiration
2. Absence of audible wheezing despite significant respiratory distress
3. Unilateral diminished breath sounds compared to the contralateral side (correct answer)
4. Patient's preference for sitting upright rather than lying down during assessment

Explanation: Unilateral diminished breath sounds strongly suggest pneumothorax, where air in the pleural space prevents lung expansion on the affected side. Asthma typically causes bilateral findings. While chest pain can occur with pneumothorax, it can also occur with severe asthma. Absence of wheezing and positional preference can occur with both conditions, making them less diagnostic differentiators.

Question 17

1. Limit oxygen to 2 L/min via nasal cannula to prevent suppressing his hypoxic respiratory drive
2. Provide high-flow oxygen via nonrebreather mask despite COPD history due to current distress level (correct answer)
3. Alternate between room air and low-flow oxygen every few minutes to maintain drive
4. Avoid supplemental oxygen completely and focus on positioning and bronchodilator assistance only

Explanation: Current EMS protocols prioritize treating hypoxemia in COPD patients experiencing acute respiratory distress. The cyanosis, severe tachypnea, and inability to speak in full sentences indicate significant respiratory compromise requiring high-flow oxygen. The concern about suppressing respiratory drive is secondary to preventing hypoxemic organ damage. Withholding adequate oxygen or using inadequate flow rates could be life-threatening in this acute situation.

Question 18

1. High-flow oxygen via nonrebreather mask to ensure adequate tissue oxygenation
2. Coaching breathing exercises and monitoring; oxygen may not be immediately necessary (correct answer)
3. Assisted ventilation with bag-valve-mask to control the respiratory rate effectively
4. Paper bag rebreathing technique to increase carbon dioxide levels and stop hyperventilation

Explanation: Hyperventilation due to anxiety typically doesn't require immediate oxygen therapy if the patient is alert and has adequate oxygen saturation. Coaching slow, controlled breathing is the primary intervention. Adding oxygen to hyperventilation can worsen alkalosis. Assisted ventilation is unnecessary for a conscious, adequately breathing patient. Paper bag rebreathing is contraindicated in EMS due to risk of hypoxemia and inability to monitor oxygen levels.

Question 19

1. Carbon monoxide poisoning requiring immediate high-flow oxygen administration
2. Thermal injury to upper airway with potential for rapid swelling and obstruction (correct answer)
3. Smoke inhalation pneumonitis causing inflammation of the lower respiratory tract
4. Anxiety-related tachypnea from psychological trauma of the fire experience

Explanation: Soot around nose/mouth, singed facial hair, and hoarse voice are classic signs of upper airway thermal injury. In pediatric patients, airway swelling can cause rapid obstruction due to smaller airway diameter. While carbon monoxide and smoke inhalation are concerns, the immediate threat is airway compromise. These physical signs indicate direct heat exposure to the airway, not just smoke exposure or anxiety.

Question 20

1. Perform immediate oral airway examination to visualize the throat and assess swelling
2. Keep the child calm, avoid agitation, and transport immediately with high-flow oxygen (correct answer)
3. Encourage the child to lie down to improve breathing mechanics and reduce work
4. Attempt bag-valve-mask ventilation to overcome the upper airway obstruction

Explanation: This presentation suggests epiglottitis - a true airway emergency in children. The key is to avoid any intervention that might agitate the child and cause complete airway obstruction. Examining the throat, forcing position changes, or attempting ventilation could precipitate total obstruction. Keeping the child calm in their position of comfort while providing oxygen and rapid transport is the safest approach.