Clinical past exam questions

Which of the following oxygen administration devices would qualify as a "low-flow" oxygen system? I. Simple mask II. Nasal cannula III. Venturi mask IV. Partial rebreathing mask

I, II, and IV only

A patient's chart has a note on the front stating a "DNR status". What does this indicate to care givers?

That the patient does not want to be resuscitated

What is the proper rate of external chest compressions for children up to 8 and to the age of puberty?

100/minute

Which piece of equipment would be needed to set up a tracheostomy collar on a patient?

Heated aerosol generator

You measure the blood pressure of a patient as 88/53. Which of the following entries would you use to describe this finding?

Patient is hypotensive

A pneumatic nebulizer that delivers 70% oxygen would have a air to oxygen ratio of :

.6:1

Heavy smokers commonly have HbCO levels as high as:

10%

A nebulizer driven by oxygen at 8 liters per minute with an FiO2 of .40 will have a total flow between:

30-34 L/min

The compression-breath ratio for one-rescuer CPR on an adult victim is which of the following?

30:2

A patient is on a 30% Venturi mask at an O2 flow of 5 L/min. The total flow delivered by this device is which of the following?

45 L/min

How long will an E cylinder with 1000 psig last running at 5 L/min until it reaches 200 psig?

45 minutes

An H cylinder of oxygen was placed in service with 2000 psig and has been used for 5 hours at a flow rate of 10 L/min. It can be used for how many additional hours?

5

Two flowmeters are needed to supply a FiO2 of 60%. What flow rate needs to be set on the oxygen flowmeter, and what flow rate needs to be set on the air flowmeter to deliver 60% FiO2 and keep the total flow at 10 L/min?

5 L O2 and 5 L Air

How long will an H cylinder take to empty running at 12 LPM with 1200 psig?

5 hour

In order to help prevent Retinopathy of Prematurity, it is recommended that the PaO2 should be kept to what values during the first week of life?

50 to 60 mmHg

A COPD patient is experiencing dyspnea and a dry cough on a day when the temperature is 33 degrees C. The air can hold 36 mg/L of humidity, but the content is actually 28 mg/L. What is the relative humidity under these conditions?

77%

A heart rate of 160 beats/minute could be considered normal for which of the following patient's?

A neonate at birth

Pulse oximetry should NOT be recommended to determine oxygenation status in which of the following situations?

A patient arrives in the ER department after being pulled from a burning house

A patient on 2L/min nasal cannula has the following ABG results: pH 7.51 PaCO2 27 mmHg PaO2 62 mmHg HCO3- 23 mEq/L These results indicate which of the following conditions?

Acute respiratory alkalosis

Bilateral, high-pitched polyphonic expiratory wheezes most likely indicate:

Asthma

You enter a patient's room to give a treatment and observe the patient is unconscious and not breathing. Your first action should be which of the following?

Call for help

On receiving a new medication nebulizer treatment order, the RCP checks the order and finds the order is written incorrectly. What should the RCP do?

Call the physician and clarify the order

The respiratory therapist has received an order to obtain ABG levels from a patient, but an Allen's test indicates collateral circulation is not present in the right wrist. At this time the therapist would:

Check collateral circulation in the left wrist

A patient displays the following physical findings: prolonged expiratory times, an increased AP chest diameter, use of accessory muscles, depressed hemidiaphragms and diminished breath sounds. These findings suggest

Chronic Obstruction Pulmonary Disease

An RCP has just performed incentive spirometry on a post-operative patient and when you ask the patient to cough, she states that it is too painful to cough. The RCP should encourage which of the following modifications to coughing?

Cough assisance with splinting

You are called to ER to see Mr. Jones who is lethargic and cyanotic. He has a history of emphysema. He was complaining of SOB and was placed on 6 L/min via a nasal cannula. His ABGs after 20 minutes are as follows: pH 7.32 PaCO2 74 torr PaO2 80 torr HCO3- 31 mEq/L What is the cause of his symptoms?

Decreased hypoxic drive

A patient has come to the ER with nasal trauma due to a burn. His eyes and nasal area are also very swollen. Which of the following devices would be appropriate to deliver O2 to this patient?

Face tent

A patient enters the emergency department and on initial examination, the respiratory care practitioner observes paradoxical respirations. Which of the following should the practitioner suspect?

Flail chest

All of the following are conditions where bronchial and bronchovesicular breath sounds may be heard over consolidated areas EXCEPT:

Foreign body aspiration

Indications for warm humidity therapy include which of the following? I. Treat hypothermic patient II. Provide humidity to a patient with a tracheostomy tube in place III. Treat a pediatric patient with croup IV. Treat an adult patient with acute laryngospasm

I and II only

While palpating the chest, the respiratory care practitioner determines that is decreased vibrations (decreased tactile fremitus) over the right lower lobe. This may be the result of which of the following? I. Pneumothroax II. Pleural effusion III. Pneumonia

I and II only

You set up a bubble humidifier and no bubbling occurs. What could be the cause of this? I. The humidifier jar is loose II. The delivery (capillary) tube is obstructed III. The flowmeter is set too high

I and II only

Which of the following humidity devices is capable of providing 100% of a patient's body humidity? I. Heated passover membrane humidifier II. HME III. Heated wick humidifier IV. Bubble humidifier

I and III

Which of the following conditions would be standard requirements for a patient with localized herpes zoster (shingles) I. Gloves and handwashing II. A special respirator mask III. Gown IV. Patient placed in a room with negative pressure ventilation

I and III only

A RCP is asked to obtain a cylinder of carbon dioxide and oxygen for a diagnostic test. To ensure the correct cylinder is chosen, the RCP should: I. Choose a cylinder that is gray and green II. Inform the supervisor that is mixture of gases does not exist III. Choose a cylinder that is blue and green IV. Read the label on the cylinder

I and IV only

Dark yellow secretions with a foul odor may be due to: I. Bronchiectasis II. Asthma III. Pulmonary edema IV. Lung abscess

I and IV only

Which of the following methods of disinfection are effective against TB, bacteria, viruses, and fungi? I. Cidex 7 II. Iodine with 70% ethyl alcohol III. Pasteurization IV. Vinegar solutions

I, II and III

A patient has a productive cough of clear to white sputum. What does this indicate about the patient's secretions? I. The secretions contain cellular debris II. The patient is likely suffering from asthma III. White blood cells are present in the sputum IV. The sputum is mucoid

I, II and IV only

Which of the following are possible techniques to accurately check a patient's pulse rate? I. Listen to heart tones with a stethoscope II. Locate and palpate the radial artery III. Locate and palpate the brachial artery IV. Locate and palpate the carotid artery

I, II, III, and IV

To protect yourself from contamination by a patient who coughs violently during endotracheal suctioning, which of the following should be done? I. Wear a mask II. Wear goggles III. Restrain the patient IV. Wear gloves

I, II, and IV

Which of the following oxygen delivery devices may have their FiO2's vary due to changes in a patient's ventilatory pattern? I. Partial rebreathing mask II. Nasal cannula III. Entrainment (venturi) mask IV. Simple oxygen mask

I, II, and IV

A RCP is ensuring that a patient is receiving 40% from a nebulizer with an aerosol face mask. When analyzed, the reading is 65%. The RCP should do which of the following I. Open the air-entrainment port to a larger size II. Drain any condensation from the large bore tubing III. Analyze the O2 percentage near the patient IV. Decrease flow from the flowmeter

II and III

You are called to the nursery to help provide emergency care to a 9-month-old infant. The infant has had a cardiac arrest. Which of the following apply to correct technique for providing external chest compressions to this infant? I. Sternum should be depressed 3 inches with each compression II. A compression: ventilation ratio of 30:2 should be used III. Two fingers should be placed just below the nipple line IV. A compression: ventilation ratio of 5: 1 should be used

II and III

A patient is being manually ventilated at a rate of 12/min with a bag-valve resuscitation bag. With the oxygen flow running at 8 L/min into the bag, the patient's PaO2 is 55 torr. Which of the following actions would increase the FiO2 delivered to the patient? I. Increasing the ventilation rate to 30/min II. Increasing the oxygen flow to 15 L/min III. Ensue that an oxygen reservoir is connected to the bag

II and III only

Crackles (rales) are generally heard when the patient has: I. Pneumothorax II. Atelectasis III. Pulmonary edema IV. Pleural effusion

II and III only

In which of the following conditions would you NOT recommend keeping the dependent (good) lung in the upright position for better oxygenation? I. Left lower lobe pneumonia II. Lung abscess III. Neonatal diaphragmatic hernia

II and III only

A patient who has just been extubated is exhibiting mild respiratory distress. The RCP is asked to administer aerosol therapy to the patient. Which of the following statements are true in this situation? I. The RCP needs to administer a hypertonic saline solution II. The RCP needs to administer aerosol at room temperature III. The RCP needs to add heat to the aerosol therapy to assist with coughing IV. The RCP needs to administer a sterile water solution

II and IV

Signs of pneumonia on the chest x-ray may include: I. Hyperlucency II. Consolidation of the affected area III. Flattened diaphragm

II only

While administering O2 through a non-rebreather mask, a patient suddenly becomes more dyspneic and experiences respiratory distress. Which of the following actions are correct for the RCP to take? I. Change the non-rebreathing mask to a simple mask at 15 lpm II. Check the patient's SpO2 III. Increase the flow to the reservoir bag on the NRB mask IV. Ensure that the mask fits snuggly and tight on the patent's face

II, III, and IV only

A RCP is teaching a patient who is to be discharged how to clean their small volume nebulizer at home. Important steps would include: I. Purchase Cidex 7 for home use and store in a well-ventilated area II. Wash equipment in detergent solution and rinse well III. Soak equipment in a vinegar solution of 1 part vinegar and 3 parts water IV. Soak equipment in a 10% ethyl alcohol solution V. Rinse equipment well after soaking and air dry

II, III, and V

Which of the following conditions will appear hyperlucent with retrosternal air space on a chest x-ray? I. Atelectasis II. Pneumothorax III. Pneumonia IV. Emphysema V. Acute asthma

II, IV, and V

After obtaining a blood gas sample, the respiratory care practitioner fails to rid the sample of an air bubble before analyzing the blood. This could result in: I. An abnormal high CO2 II. An abnormal low pH III. An abnormal high O2 IV. An abnormal low CO2

III and IV

A physical exam reveals the following: decreased expansion, a dull percussion note on the left lower lobe area, absence of breath sounds in the left lower lobe and a shift of the trachea to the left. These findings suggest:

Left sided atelectasis

After setting up a partial rebreathing mask on a patient at a flow of 8 L/min, the reservoir bag collapses before the patient finishes inspiring. The respiratory care practitioner should do which of the following?

Increase the flow

A patient with a pH of 7.15 is breathing abnormally. He has an increased respiratory rate and increased tidal volume for his size. This type of breathing pattern is called:

Kussmaul's respirations

In inspecting an elderly female patient, you note that her spine has an abnormal anteroposterior (AP) curvature of the upper spine which results in a hunchback appearance. Which of the following terms would you use in charting this observation?

Kyphosis

During a bedside assessment of an adult patient, the respiratory care practitioner hears a harsh, monophonic, inspiratory sound over the larynx. A note should be put in the chart that this represents:

Laryngeal edema

As you enter the patient's room to administer a nebulizer treatment, you notice the patient is breathing rapidly and looks to be in distress. You notice the following during the physical exam: reduced chest expansion, a hyperresonant percussion note on the left side, absence of breath sounds on the left and a tracheal shift to the right. This suggests:

Left sided pneumothorax

A RCP enters a patient's room to administer an IPPB treatment. The RCP finds the patient sleepy with slow responses and answers inappropriately to questions. This finding would be termed:

Lethargic

A patient who has overdosed on narcotics has been admitted to the ER. The RCP hears course breath sounds in the right lower lobe and it is determined that the patient has aspirated vomitus. Which of the following chest x-ray findings is consistent with this diagnosis?

Lobar consolidation and air bronchograms on the right

A patient is admitted to the hospital with the diagnosis of a severe intestinal virus. An arterial blood gas sample drawn while the patient is breathing room air reveals the following results: pH 7.54 PaCO2 38 torr PaO2 83 torr HCO3- 33 mEq/L The patient's arterial blood gas results indicate:

Metabolic alkalosis

A 50-year-old patient has a PaO2 of 72 torr when breathing room air. You would interpret this as

Mild hypoxemia

A physician orders an ABG on a patient who is receiving O2 via a non-rebreather at 15 LPM. The RCP should record the O2 percentage on the ABG order form as:

NRB at 15 L/min

It is recommended to use a filter small volume nebulizer when administering which of the following drugs?

NebuPent

Which of the following oxygen administration devices would you recommend for a patient suffering from acute carbon monoxide poisoning?

Non-Rebreathing mask

When asking a patient if she knows what hospital she is in and what day of the week it is, you are trying to assess the patient's:

Orientation to place and time

A term used to describe a condition in which a patient has difficulty breathing while in a supine position is which of the following?

Orthopnea

The physician has ordered and active 3-year-old to be placed on 40% oxygen. Which device would you recommend as being the most tolerable for this patient?

Oxygen tent

You are preparing to perform a right radial puncture on a patient and are doing the Allen's test prior to the puncture. The response to the test is for the patient's hand to "pink up" after pressure is released. The results are consistent with

Patent ulnar artery

A patient who is in bed is in respiratory distress, displaying use of accessory muscles and nasal flaring. What is the best explanation for the nasal flaring?

Patient is attempting to decrease airway resistance by dilating nares

The E cylinder has a special oxygen connection. This connection is to ensure safety in the use of oxygen. This system is called:

Pin Index Safety System

In order to palpate for symmetrical chest movement of a patient, the respiratory care practitioner should do which of the following?

Place a hand on the chest and observe chest movement

What is the most cost-effective method of minimizing the contamination of a tracheostomy patient's airway?

Practice proper handwashing technique

A RCP is called to give a STAT aerosol treatment with Xopenex to a patient in respiratory distress. The patient appears very fearful and anxious and tells the RCP that he does not want the treatment. What action should the RCP take at this time?

Reassure the patient, explain the benefits of the treatment and attempt to give the treatment again

The most effective way to communicate with other members of the health care team about a patient's condition is by

Recording the information in the patient's chart

After removing an oxygen flowmeter from the wall connector, you note that oxygen starts leaking from the wall connector. The best IMMEDIATE action would be to:

Reinsert the flowmeter into the wall connector and turn flowmeter off

While making 02 rounds you notice that a disposable bubble humidifier contains only 20 ml of sterile water. What is the appropriate action to take?

Replace it with a new disposable humidifier

A patient has been supported by a mechanical ventilator using a hygroscopic condenser humidifier (HME) for the last 3 days. Suctioning reveals an increase in the amount and tenacity of secretions. Which of the following actions are indicated?

Switch the patient to a heated wick humidifier

Arterial blood gas results obtained from a patient are as follows: pH 7.24 PaCO2 54 torr PaO2 81 torr HCO3- 25 mEq/L B.E. -1 You would interpret these ABG results as:

Uncompensated respiratory acidosis

All of the following statements concerning a Bourdon gauge are true EXCEPT: It is not compensated for pressure Its flow reading is not affected when placed in a horizontal position It measures pressure directly and flow indirectly The gauge reads lower than the amount the patient actually receives

The gauge reads lower than the amount the patient actually receives

Aerosol output of an ultrasonic nebulizer is dependent upon:

The setting on the amplitude control

A patient arrives in the ER after being pulled from a burning house. The RCP places a pulse oximeter on the patient's ear lobe and obtains a SpO2 reading of 93%. An ABG is drawn and the SaO2 analyzed by co-oximetry is 76%. Which of the following is the most likely reason for the discrepancy in the two saturation readings?

There is an elevated HbCO level

A patient is on a nasal cannula at 8 LPM; the patient is complaining of discomfort, this is primarily due to

Too high of a flow

A patient has normal breath sounds following therapy. Which of the following best describes this finding?

Vesicular

It is determined that a patient's respiratory rate is 35 beats/minute. This would be considered normal with which patient age population?

newborn or infant

Which of the following sets of ABG measurements would be indicative of a renal compensated respiratory acidosis?

pH 7.37, PCO2 58 torr, PO2 60 torr, HCO3- 31 mEq/L, BE +8