03/01/2024 NBRC some questions
A respiratory therapist observes the flow scalar on a patient's ventilator graphic. The RT notices the flow during exhalation does not return to baseline. The therapist should conclude: a. Auto PEEP is present b. There is a leak in the circuit c. The exhalation valve is faulty d. There is an expiratory hold
Answer: A.
A spontaneous breathing trial is ordered for a patient with a minute ventilation of 9.6 L/minute and the following vital signs: HR 84/min RR 18/min Sp02 93% Thirty minutes into the trial with PS of 5 cm H20 and PEEP of 5 cm H20, the patient's minute ventilation is 11.2 Liters/minute. The following vital signs are observed: HR 122/min RR 42 Sp02 85% Which of the following should a respiratory therapist anticipate? a. Return to mechanical ventilation to the previous settings b. Increase PS to 10 cmH20 and PEEP of 12 cm H20 c. Extubate the patient to supplemental Oxygen d. Continue the trial for an additional 30 minutes
Answer: A.
A respiratory therapist is caring for a 52-year-old male following surgical correction of a liver laceration 1 day ago. An SBT is initiated per protocol with a pressure support of 5 cm H20 and a PEEP of 5 cm H20. Fifteen minutes later, the patient is diaphoretic with a respiratory rate of 40/minute. Which of the following should the therapist do? a. Return to the previous vent settings b. Recommend sedating the patient c. Increase the pressure support to 10 cm H20 d. Continue the SBT for another 15 minutes
Answer: A. Failed the SBT
A 28-year-old male who is 173 cm (5ft 8 in) tall and weighs 70 kg (155 pounds) is receiving VC, SIMV with the following settings: Fi02: 0.50 Mandatory Rate: 12 Tidal Volume: 500 mL The low volume alarm begins to sound, and the ventilator displays an inspiratory pressure of 5 cmH20. A respiratory therapist should: a. Check the exhalation valve function b. Straighten the inspiratory link kink (increases Volume) c. Empty condensate from the breathing circuit d. Switch to the A/C mode
Answer: A. It acts like a little diaphragm in the ventilator.
A 5-ft-8-inch female is being evaluated for Guillian Barre Syndrome. Her most recent slow vital capacity is 630 mL. What should the respiratory recommend? a. Continue to monitor VC every two hours b. Prepare to intubate and mechanically ventilate the patient c. Provide high flow oxygen at 40 LPM d. Place the patient on venturi mask
Answer: B.
An ABG analysis for a 42-year-old male who is breathing room air reveals the following: pH: 7.49 PC02: 29 mmHg P02: 70 mmHg HC03: 22mEq/L BE: 0 mEq/L S02 94% Which of the following best describes these results? a. Acute respiratory acidosis with moderate hypoxemia b. Acute respiratory alkalosis with mild hypoxemia c. Acute metabolic acidosis with mild hypoxemia d. Compensated respiratory alkalosis with normal oxygenation
Answer: B.
For a patient who is breathing spontaneously, which of the following will result in an elevated baseline pressure during inspiration and expiration? a. IPPB b. PEP c. CPAP d. IPAP
Answer: C. A negative pressure during CPAP
A patient receiving NIV is on an IPAP of 12 cmH20 and and EPAP of 7 cm H20. Blood gas analysis reveals the following: pH: 7.30 PaC02: 58 mmHg Pa02: 50 mmHg HC03: 22 mEq/L BE: 0 mEq/L Sp02: 80% Which of the following changes would be best recommended? a. Increase EPAP to 9 cm H20; no change to IPAP b. Decrease EPAP to 5 cm H20; increase IPAP to 14 cm H20 c. Increase EPAP to 9 cm H20; Increase IPAP to 16 cm H20 d. Leave EPAP of 7 cm H20; Increase IPAP to 16 cm H20
Answer: C. Oxygenation and ventilation problem so we have to increase both but keep the delta the same.
5. A 191-cm (6-ft-3-in), 70-kg (154 lb) postoperative male is receiving VC/AC ventilation. Pertinent data are below: Fio2 0.30 Mandatory Rate 12 pH 7.29 Total Rate 14 PaC02 51 mmHg Tidal Volume 500 mL Pa02 86 mmHg Insp Time 1.0 sec HC03 25 mEq/L PEEP 5 cm H20 BE -2 mEq/L Sa02 96% Which of the following should a respiratory therapist recommend? a. 10 cm PEEP b. Inspiratory time of 1.5 seconds c. Mandatory Rate of 14 d. Tidal volume of 600 mL
Answer: D.
A 16-year-old male has been receiving VC, AC ventilation for 24 hours following admission for a drug overdose. The patient is alert and oriented, and has been weaned to PSV of 5 cm H20 and an Fi02 of 0.40. The following data are collected after 30 mintues: pH 7.47 PaC02 34 mmHg Pa02 121 mmHg HCO3 25 mEq/L BE +2 mEq/L Sa02 98% Also noted: Spont. Vt: 465 mL MIP: -36 cmH20 HR: 98/min RR: 18/min Which of the following should a respiratory therapist recommend? a. Continue PSV with current settings b. Return to VC, AC ventilation c. Decrease PS to 3 cm H20 d. Extubate the patient
Answer: D.
A patient with COPD is receiving PC ventilation with flow triggering and has significant air trapping displayed on the ventilator graphics. The patient's spontaneous breathing efforts are not always detected by the ventilator. Which of the following changes should a respiratory therapist recommend to improve patient-ventilator synchrony? a. Switch to pressure triggering (flow triggering is easier for the patient) b. Switch to a square-wave flow pattern c. Increase peak inspiratory flow d. Increase the set PEEP
Answer: D. Pressure and flow are two ways a patient can trigger a breath Flow trigger is easier for a patient can trigger the breath. Pressure control there is no inspiratory flow rate End expiratory Hold to get the hidden peep then set the peep closer to the total amount of PEEP.
