Advanced Emergency Medical Technician (AEMT) Practice Test

Which of the following patients with respiratory distress is the most critically ill?

1. A patient with a pulse oximetry reading of 93 percent.

2. A patient who speaks in five or six word sentences.

3. A patient with no breath sounds on auscultation.

4. A patient with wheezing in the lower lobes.

The correct answer is: A patient with no breath sounds on auscultation.

The patient with no breath sounds on auscultation is considered the most critically ill in this scenario because the absence of breath sounds can indicate a severe obstruction or collapse of the airway, which can lead to inadequate ventilation and oxygenation. If the airway is significantly compromised, it may result in respiratory failure if not promptly addressed. In the context of respiratory distress, it is essential to evaluate not only the oxygen saturation levels or the ability to speak in full sentences but also the overall airway patency and lung function. For example, a pulse oximetry reading of 93 percent indicates a level of hypoxia, yet it does not signify the immediate danger that the absence of breath sounds does. Similarly, while being able to speak in five or six-word sentences suggests some level of respiratory function, it does not confirm adequate ventilation or the absence of distress. Wheezing can indicate bronchospasm or reactive airway disease but does not necessarily equate to critical status as the presence of breath sounds still indicates airflow through the lungs, albeit with difficulty. Therefore, the patient with no breath sounds requires immediate assessment and intervention due to the potentially life-threatening nature of their condition.