Emergency Medical Technician (EMT) Intermediate Practice Exam

What does orthopnea indicate in a patient with congestive heart failure?

1. The severity of his respiratory difficulty varies with position

2. The patient is unable to lie flat due to distress

3. There is a complete airway obstruction

4. The patient has developed a pneumothorax

The correct answer is: The severity of his respiratory difficulty varies with position

Orthopnea is a term specifically used to describe the difficulty or discomfort in breathing that a person experiences when lying flat. In patients with congestive heart failure, this condition arises due to increased venous return to the heart when in a supine position, leading to pulmonary congestion and subsequent respiratory distress. The correct response indicates that the severity of respiratory difficulty experienced by the patient does indeed vary with their position. When sitting up, patients often find it easier to breathe, and their symptoms can ameliorate. This reflects the body's compensatory mechanisms to relieve symptoms associated with fluid overload in the lungs. While the second choice suggests that the patient is unable to lie flat due to distress, it does not encompass the broader variability in severity of respiratory difficulty that occurs with different positions. The other options refer to more acute conditions that aren’t typically described by orthopnea, such as complete airway obstruction or pneumothorax, which are distinctly different medical emergencies and involve entirely different clinical implications and presentations.