CRT Practice 2
In a semi-comatose patient who has pulmonary edema, which of the following would indicate a loss of cough reflex? A)gurgling B)cynosis C)diaphoresis D)panting
A)gurgling
The respiratory care practitioner could suggest PEEP to achieve which of the following therapeutic goals? A)decreased FRC B)decreasing physiological shunting C)increased VC D)Increased IC
B)decreasing physiological shunting
While checking a ventilator that has a Cascade-type humidifier, the respiratory care practitioner notes that there is very little condensation in the tubing and that water does not have to be drained. The most likely explanation is that the A)ventilator is set very low B)heating element is not functioning C)flow is set too low D)ventilator is operating in the IMV mode
B)heating element is not functioning
An asthmatic patient in acute respiratory distress presents to the emergency room with markedly diminished breath sounds. Following bronchodilator therapy, auscultation of the chest reveals rhonchi and wheezing. This change suggests which of the following? A)Development of a pneumothorax B)improvement of the air flow C)worsening of the asthmatic condition D)onset of pneumonia
B)improvement of the air flow
Prior to suctioning the ETT of a patient who is being ventilated with an FiO2 of 0.40 the respiratory care practitioner should first do which of the following? A)Select a catheter with a diameter 3/4 the size of the ETT B)increase the FIO2 to 1.0 C)Cleanse the catheter with water D)Administer an FiO2 of 0.40 via a T-adapter (Briggs)
B)increase the FIO2 to 1.0
The accumulation of a large volume of liquid in the dependent portion of a large-bore delivery tube will have which of the following effects on a jet nebulizer system that is set to deliver an FiO2 of 0.40? A)decrease the condensation process B)increase the FiO2 C)Increase the gas temperature D)increase the aerosol particle size
B)increase the FiO2
A patient who is intubated with an endotracheal tube that has an internal diameter of 8 mm needs to be suctioned. A 14 French catheter and sterile tray are available. The vacuum setting is at -120 torr. Howeverthe secretions are too thick to be aspirated effectively. To suction the patient adequately as well as safely, it would be most appropriate to A)change the catheter to 12 F B)instill 4 ml of normal saline and then attempt to suction C)changed the catheter to an 18 F D)increase the vacuum setting to -180 torr
B)instill 4 ml of normal saline and then attempt to suction
When setting up mask CPAP equipment for an adult patient, which of the following alarms is the most important to ensure maintenance of therapy? A)pulse monitor B)low pressure C)high FIO2 D)I:E ratio
B)low pressure
During an epileptic seizure, a patient who is lying flat on his back aspirates and subsequently develops pneumonia. Drainage of the affected area would be best accomplished with the patient in which of the following positions? A)lying on his right side with a pillow under his hip B)lying his stomach with a pillow under his hips C)lying on his back with a pillow under his hips D)sitting and leaning forward with the left should and elbow raised 6 in. above the right shoulder and elbow
B)lying his stomach with a pillow under his hips
A conscious patient with an intact gag reflex requires an artificial airway solely to prevent obstruction of the upper airway by the tongue. Which of the following types of airways is most suitable in this situation? A)oropharyngeal B)nasopharyngeal C)orortracheal D)esophageal obturator
B)nasopharyngeal
Which of the following would probably characterize the emotional state of a patient with a tension pneumothorax? A)Embarrassment B)panic C)anger D)depression
B)panic
The best bedside measurement for determining the effectiveness of an aerosolized bronchodilator is A)peak inspiratory flow B)peak expiratory flow C)arterial blood gases D)negative inspiratory force
B)peak expiratory flow
Chest physiotherapy is ordered for a patient with atelectasis of the left upper lobe, including the lingula. The patient is most likely to become cyanotic during therapy when which of the following areas is being drained? A)right apical segment B)right anterior and right lateral basal segments C)apical segment, left upper lobe D)right and left posterior basal segments
B)right anterior and right lateral basal segments
The diagram above shows the forced vital capacity (FVC) for a patient before and after an Albuterol treatment. On the basis of the diagram, it can be concluded that the patient has which of the following? A)Severe restrictive lung disease B)some reversible airway obstruction C)idiosyncratic reaction to the medication D)no benefit from the medication
B)some reversible airway obstruction
Which of the following is the best test for assessing the degree of reversible bronchospasm in an asthmatic patient? A)nitrogen washout B)spirometry before and after bronchodilation C)closing volumes D)MVV
B)spirometry before and after bronchodilation
A RCP is checking the laryngoscope and blades on the code cart. The Miller blade is attached and the light shines bright white. The Macintosh (curved) handle is attached, but the light fails to turn on. The practitioner should initially A)replace the batteries B)tighten the bulb on the Macintosh blade C)take the Macintosh blade to the dept for repair D)strike the Macintosh blade against the edge of the table
B)tighten the bulb on the Macintosh blade
Which of the following would provide the best bedside assessment of the need for ventilatory assistance in a patient with myasthenia gravis? A)Functional residual capacity B)vital capacity C)closing volume D)total lung capacity
B)vital capacity
When administering the initial postural drainage and chest percussion treatment, the RCP should provide which of the following instructions to the patient? 1."Breathe at a normal depth" 2."Let me know if you become dizzy or weak" 3."You should breath approximately 30 times a minute" 4."Cough only when coaxed" A)1 and 2 B)1 and 4 C)2 and 4 D)3 and 4
A)1 and 2
A ventilator is set at a rate of 15/min. and an I:E ratio of 1:3. The length of inspiration will be which of the following? A)1.0 sec B)1.5 sec C)2.5 sec. D)3.0 sec
A)1.0 sec
Compared with other types of humidifiers, a major advantage of the Cascade humidifier is that A)100% relative humidity is easily attained B)heating is not required C)a baffle is not needed to produce the desired humidity D)the water particles produced are within the therapeutic range
A)100% relative humidity is easily attained
A 12 year old conscious, spontaneously breathing female, weighing 40kg (88lb) is brought into the ER with a sustained cervical spine injury without any evidence of other trauma from a motor vehicle accident. The head is secured with sandbags and arterial blood gas analysis shows respiratory failure. To maintain the patient's airway, the respiratory care practitioner should recommend a: A)6.0mm nasal endotracheal tube B)8.0 mm oral endotracheal tube C)7.0 mm tracheotomy tube D)8.0 mm esophageal obturator airway tube
A)6.0mm nasal endotracheal tube
Which of the following statements is true about the proper operation of a non-rebreathing mask? A)A reservoir bag should not collapse during inhalation B)The reservoir bag should empty during exhalation C)The one-way valve between the mask and bag is open during exhalation D)Room air is entrained during peak inspiration
A)A reservoir bag should not collapse during inhalation
A water barometer is being used to record the barometric pressure. The water within the barometer column has a meniscus formation. You would read the barometric pressure at the: A)Bottom of the meniscus B)Top of the meniscus C)Side of the meniscus D)Top and side of the meniscus
A)Bottom of the meniscus
Postoperatively, a patient suddenly develops a stabbing right-sided chest pain with decreased right-sided breath sounds. Which of the following is indicated? A)Chest x-ray B)VC measurement C)Vd/Vt ratio D)shunt study
A)Chest x-ray
When 15 cmH20 is initiated. the patients cardiac output decreases from 4 to 2 L/min. Which of the following should the respiratory care practitioner recommend? A)Decrease the PEEP to 10 cmH20 and recheck the cardiac output B)perform an arterial blood gas analysis to check the patient's oxygenation C)maintain the present settings and then check the abg in one hour D)increase PEEP slightly to reach the "optimal PEEP"
A)Decrease the PEEP to 10 cmH20 and recheck the cardiac output
The application of PEEP will physiologically cause an increase in which of the following? A)FRC B)TLC C)renal output D)venous return
A)FRC
During the intermittent positive-pressure breathing (IPPB) treatment, a 35 year old patient complains of difficulty in cycling the Bird Mark 7 ventilator on. The controls are set as follows: Sensitivity 5 Flow 5 Air-mix On Control Pressure 15 To correct this situation, the respiratory therapy practitioner should A)Increase the sensitivity B)Change the air-mix setting C)decrease the control pressure D)decrease the flow
A)Increase the sensitivity
A 6 year old child is intubated and being mechanically ventilated. Pertinent data are below. Mode A/C FiO2 0.90 Rate 20/min Vt 200 ml pH 7.46, PaCO2 32 torr, PaO2 58, HCO3 24 On the basis of these data, the respiratory care practitioner should recommend which of the following? A)Initiate 5 cmH2O PEEP B)decrease tidal volume to 150 ml C)increase rate to 25/min D)increase FiO2 1.0
A)Initiate 5 cmH2O PEEP
A patient with chronic obstructive pulmonary disease and chronic CO2 retention is admitted to the emergency room with an acute exacerbation of her condition. The most appropriate oxygen device to use initially is a A)NC 2LPM B)NC 6 LPM C)Simple mask 2 LPM D)Simple mask 6 LPM
A)NC 2LPM
Which of the following directly reflects sufficient oxygenation? A)PaO2 B)PaCO2 C)minute ventilation D)inspiratory force
A)PaO2
All mechanically ventilated patients in a surgical intensive care unit develop staphylococcus aureus lung infections. Which of the following factors is most likely the cause of the infection outbreak? A)Poor hand washing techniques by personnel in the unit B)Use of ineffective isolation procedures in the unit C)Use of contaminated intravenous solutions D)An outbreak of the infection in the community
A)Poor hand washing techniques by personnel in the unit
A patient tells the respiratory care practitioner that he has been coughing thick, green foul-smelling sputum. The practitioner would suspect the patient has: A)Psuedomonas infection B)pulmonary edema C)bronchial asthma D)a viral infection
A)Psuedomonas infection
A patient is on a volume cycle ventilator at a FIO2 of 1.0. You verify the FIO2 with a galvanic analyzer that reads 104% oxygen. You would do which of the following? A)Recalibrate the analyzer B)Change the fuel cell C)Decrease the FIO2 on the ventilator to read 100% on the analyzer D)Change the battery
A)Recalibrate the analyzer
Venous return is LEAST impaired by which of the following modes of mechanical ventilation? A)SIMV with a rate of 6 B)Continous PPV C)controlled mechanical ventilation D)assisted mechanical ventilation
A)SIMV with a rate of 6
The manometer being used to monitor a continuous flow CPAP device is set at 10cmH20. Each time the patient inhales, the pressure decreases to 2cmH20. It returns to 10 cmH20 on exhalation. Which of the following is the most likely cause of the problem? A)The flow of gas to the patient system is insufficient B)There is a leak in the patient system. C)The CPAP pressure is set too high for the patient. D)The CPAP pressure valve is set too high for the patient
A)The flow of gas to the patient system is insufficient
For a patient who has a tidal volume of 500 mLs and a respiratory rate that fluctuates between 15 and 25 breaths per minute, which of the following is the best device for the administration of a controlled oxygen concentration? A)a venturi mask B)a face tent C)a partial-rebreathing mask D)a simple oxygen mask
A)a venturi mask
Which of the following is the best index of oxygen transport for a patient who has been resuscitated after carbon monoxide poisoning? A)arterial oxygen content B)arterial oxygen tension C)alveolar-arterial oxygen content D)hemoglobin concentration
A)arterial oxygen content
In order for a tracheal tube cuff to allow circulation in tracheal mucosa, the cuff pressure must be directly related to the A)capillary pressure B)brachial artery pressure C)pulmonary artery pressure D)central venous pressure
A)capillary pressure
PEEP therapy is most likely to be indicated for a patient whose PaO2 A)decrease with an increasing FIO2 B)decreases with a decreasing FIO2 C)increases with an increasing FIO2 D)increases with a constant FIO@
A)decrease with an increasing FIO2
When pH in arterial blood decreases, the affinity of hemoglobin for oxygen is A)decreased in all cases B)decreased unless carbon monoxide is present C)unaffected unless carbon monoxide is present D)increased in all areas
A)decreased in all cases
A patient is being ventilated with a Bird Mark 7 ventilator. Which of the following actions should be initially taken to maintain a tidal volume if a small leak develops around the tracheostomy tube? A)increase the flow B)suction the patient C)change the tracheostomy tube D)decrease the pressure
A)increase the flow
When a patient refuses to take a treatment, the RCP should do which of the following? A)notify the nurse in charge and record the patient's refusal in the record B)give the treatment anyway and record that it was done C)leave the patient's room and discontinue the therapy D)ask the head nurse to convince the patient to take the treatment
A)notify the nurse in charge and record the patient's refusal in the record
A respiratory care practitioner is interviewing a patient for the first time. Which of the following would be indicated by the patient's comment that he has less difficulty breathing when upright than when lying down? A)orthopnea B)hyperpnea C)eupnea D)tachypnea
A)orthopnea
Which of the following clinical observations is most commonly associated with right heart failure? A)peripheral edema B)muscle wasting C)tracheal deviation D)assymetrical chest movement
A)peripheral edema
A patient with pulmonary edema who is receiving oxygen therapy should be placed in which of the following positions? A)sitting B)supine C)prone D)Trendelenburg's
A)sitting
While administering acetylcysteine with a HHN, a RCP notes that the patient is developing marked congestion with copious sputum production. The practitioner's most appropriate action would be to A)terminate the treatment and clear secretions B)administer the acetylcysteine with a IPPB breathing machine C)dilute the acetylcysteine with saline D)place the patient in Fowler's position for the remainder of the treatment
A)terminate the treatment and clear secretions
A patient properly utilizing diaphragmatic breathing can be recognized by observing which of the following? A)the abdomen rising on inspiration B)the abdomen rising on exhalation C)the use of the sternocleidomastoid muscles during inspiration D)the use of pursed-lip breathing
A)the abdomen rising on inspiration
What is the MAXIMUM number of seconds that a catheter should remain in the trachea during a suctioning procedure? A)5 B)15 C)25 D)35
B)15
The static compliance of a patient who is receiving controlled mechanical ventilation is being monitored. The tidal volume is 500 ml, the plateua pressure is 20 cmH20, and the peak pressure is 40 cmH20. The static compliance is: A)15 ml/H20 B)25 ml/H20 C)30 ml/H20 D)20 ml/H20
B)25 ml/H20
Which of the following is the approximate total flow that would be delivered from a 40% venturi mask operating at 12 L/min? A)12 L/min B)48 L/min C)52 L/min D)72 L/min
B)48 L/min
A patient is being mechanically ventilated in the control mode with an FiO2 of 0.6 a set rate of 18, and a tidal volume of 650 ml. Results of an arterial blood gas analysis are below. pH 7.52, PaCO2 27 torr, PaO2 75 torr, HCO3 21, SaO2 93% On the basis of these results, the most appropriate action would be to A)Increase the FIO2 B)Add mechanical dead space C)increase the tidal volume D)increase flow
B)Add mechanical dead space
A patient is to receive incentive spirometry at home. when explaining the therapeutic goals to the patient's family, the RCP should explain that the therapy A)helps resolve pneumonia B)Can decrease the change of lung collapse C)Will increase the stiffness of the lung D)Should decrease the frequency of the patient's cough
B)Can decrease the change of lung collapse
A patient's respirations are characterized by a gradual increase and then a gradual decrease in the depth of breathing, followed by a period of apnea. This pattern is known as which of the following? A)Biot's breathing B)Cheyne-Stokes breathing C)Kussmaul's breathing D)paradoxic breathing
B)Cheyne-Stokes breathing
Data necessary to calculate minute volume include which of the following? I. PaCO2 II. tidal volume III. respiratory rate IV. physiological dead space A)I and IV only B)II and III only C)I, II, and IV only D)II, III, and IV only
B)II and III only
The adequacy of ventilation is best reflected by which of the following? A)PaO2 B)PaCO2 C)VC D)FEF200-1200
B)PaCO2
Which of the following agents would be indicated for a patient with laryngeal edema? A)Atropine B)Racemic Epinephrine (Vaponefrin) C)Albuterol D)Acetylcysteine (Mucomyst)
B)Racemic Epinephrine (Vaponefrin)
Which of the following would indicate to the respiratory care practitioner that a COPD patient's physical conditioning regimen is effective? A)The resting pulse rate remains the same as one month prior B)The patient has increase his level-walking distance by 15% C)The patient's vital capacity has increased by 5% D)The patient tolerates aerosolized medication with less tachycardia
B)The patient has increase his level-walking distance by 15%
A 36 year old woman who has just undergone intestinal bypass surgery is brought to the recovery room intubated. She has normal pulmonary function, weighs 136 kg (300 lbs). and is 159 cm. (5 ft 2 in) tall. In this situation, the respiratory therapist should recommend which of the following ventilator settings? A)Vt 400 f 8 B)Vt 600 and f 10 C)Vt 800 and f 12 D)1100 and f 8
B)Vt 600 and f 10
In a patient with postoperative atelectasis, sustained maximal inspiratory maneuvers are likely to result in all of the following EXCEPT A)collateral ventilation B)a decrease in functional residual capacity C)more even distribution of inspired gas D)an increase in lung compliance
B)a decrease in functional residual capacity
A patient who is receiving an aerosol treatment with acetylcysteine (Mucomyst) suddenly becomes dyspneic. Which of the following is an appropriate treatment for the patient's problem? A)add ephedrine to the aerosol mixture B)add Albuterol to the aerosol mixture C)administer cromoly sodium (intal) D)give an antihistamine drug by mouth
B)add Albuterol to the aerosol mixture
A 25 year old patient is brought the emergency room suffering from respiratory depression caused by an acute drug overdose. An arterial blood gas analysis reveals a pH: 7.20 and a PaCO2 of 80 torr. The patient is not breathing adequately on his own and a RCP is asked to institute continuous mechanical ventilation. The practitioner's most appropriate action would be to A)adjust the ventilator so that the patient's PaCO2 will be decreased to 40 torr very gradually over 36 hours B)adjust the ventilator so that the patient's PaCO2 will be decreased to 40 torr within 1 hour since the rise in PaCO2 was acute C)recommend IPPB treatment Q2 to lower the patient's PaCO2 D)adjust the ventilator so that the patient's PaCO2 will be decrease to 60 torr to prevent respiratory alkalosis.
B)adjust the ventilator so that the patient's PaCO2 will be decreased to 40 torr within 1 hour since the rise in PaCO2 was acute
Which of the following conditions is most likely to cause an elevated white blood count? A)pulmonary fibrosis B)bacterial bronchitis C)pneumothorax D)hypertension
B)bacterial bronchitis
A patient complains that she has a chronic cough usually accompanied by sputum production. This information indicates that the patient probably has which of the following conditions? A)asthma B)bronchitis C)emphysema D)pulmonary edema
B)bronchitis
A patient who is receiving an aerosol treatment with acetylcystein (Mucomyst) and hypertonic saline via a hand held nebulizer suddenly becomes dyspneic. The most likely cause of this problem is A)hypercarbia B)bronchospasm C)pneumonthorax D)fluid overload
B)bronchospasm
On entering a patient's room to administer a treatment, a RCP finds the patient lying on the floor, The practitioner verifies that the patient is unresponsive: At this time, the practitioner should A)A run to the nursing station for help B)call for help C)go to the nearest telephone and call the operator D)wait until someone comes into the room and ask the person to get help
B)call for help
The major function of the baffle in a nebulizer is to A)entrain water from the capillary tube. B)cause the larger of the particles to return to the reservoir C)mix aerosol particles with the main gas flow D)promote the particle evaporation
B)cause the larger of the particles to return to the reservoir
On checking a patient's progress notes, the RCP reviews a physician's treatment plan that includes changes in respiratory care. The practitioner's most appropriate action is to do which of the following? A)initiate the changes immediately B)check to see if there are new respiratory care orders C)review the planned changes with the shift supervisor D)confer with the patient's nurse about when to implement the changes
B)check to see if there are new respiratory care orders
A patient is receiving oxygen at home from a liquid oxygen reservoir at 2 L/min. He complains that he does not feel gas coming out of the nasal cannula. Possible reasons for his complaint include which of the following? 1.The system is a low flow system 2.The equipment is not properly assembled 3.The electrical system has failed A)1 only B)3 only C)1 and 2 only D)All the above
C)1 and 2 only
If expiratory retard is used in conjunction with a patient's intermittent IPPB treatment, which of the following will be increased? 1.the patient's mean intrathoracic pressure 2.the patient's expiratory time 3.the patient's inspiratory time A)1 only B)2 only C)1 and 2 only D)1 and 3 only
C)1 and 2 only
A 60 year old, 68 kg (150 lb) woman arrives in the intensive car unit after CABG. She has a 54 pack per year history of smoking and currently smokes 2 packs a day. An order is written to initiate mechanical ventilation with a PB840 To ensure adequate ventilation during the next 20 minutes while the patient is stabilizing, which of the following should be adjusted? 1.RR 2.expiratory resistance 3.oxygen concentration 4.tidal volume 5.sighs per hour A)1 and 2 only B)3 an 4 only C)1, 3, and 4 only D)3, 4, and 5 only
C)1, 3, and 4 only
While changing the tubing circuit, the RCP notes that the inspiratory volume is registering 250 ml, less than before and that the peak pressure is 8 cmH20 lower. Which of the following could be the source of the problem? The expiratory limb of the circuit has been connected to the humidifier been connected to the humidifier outlet instead of the expiratory limb The cascade humidifier is not assembled tightly and leaks. The medication nebulizer is not connected tightly and leaks A)1 only B)3 only C)2 and 3 only D)1 and 2 only
C)2 and 3 only
An oropharyngeal airway is LEAST appropriate for which of the following? A)A who requires bag-and-mask ventilation B)A patient who is having seizures C)A conscious patient D)A heavily sedated patient
C)A conscious patient
A patient complains of dizziness and a tingling sensation in the fingers during an IPPB treatment. The most likely cause is which of the following? A)Increased airway resistance B)increased cardiac output C)Excessive CO2 elimination D)excessing N2 elimination
C)Excessive CO2 elimination
If the ratio light alarm on a ventilator is illuminating on each breath, which of the following controls may be adjusted to remedy the problem? I. volume II. respiratory rate III. sensitivity IV. expiratory retard V. inspiratory flow A)I and II only B)II and III only C)I, II, and V only D)III, IV, and V only
C)I, II, and V only
A patient's arterial blood gas results before and after administering oxygen via nasal cannula at 3 L/min remain unchanged. Which of the following should be assessed? I. breath sounds II. pulse III. patency of nasal pharynx IV. oxygen connections A)I and III only B)II and IV only C)III and IV only D)I, II, and IV only
C)III and IV only
which of the following data obtained on a 70 kg patient who is being mechanically ventilated indicates that weaning may be initiated? A)VD/Vt = 0.65 B)shunt (Qs/Qt) 45% C)Negative inspiratory pressure - 47 cmH20 D)Resting minute ventilation 3.5 liters
C)Negative inspiratory pressure - 47 cmH20
While administering an IPPB treatment, the RCP notices that the pressure has begun to increase more slowly toward the set pressure and rises to the set pressure only when the patient actively exhales. the most likely explanation is which of the following? A)The patient is tachypneic B)the patient is becoming apprehensive C)There is a leak in the system D)The demand valve is not cycling on immediately
C)There is a leak in the system
Which of the following would deliver the most particulate water to a patient's airway? A)a passover humidifier B)a bubble humidifier C)an ultrasonic nebulizer D)a jet nebulizer
C)an ultrasonic nebulizer
When an oropharyngeal suction device becomes obstructed while suctioning vomitus from a patient's mouth, the respiratory care practitioner should first A)increase the vacuum pressure B)change to a suction catheter C)clear the device of particular matter D)check the wall outlet vacuum pressure
C)clear the device of particular matter
All of the following could cause suctioning to stop suddenly during tracheobronchial aspiration EXCEPT A)kinked tubing B)disconnected tubing C)clearance of secretions D)a full suction reservoir
C)clearance of secretions
During an intermittent positive pressure breathing (IPPB) treatment with a Bird Mark 7 ventilator, the inspiratory time can be extended by A)decreasing the sensitivity B)increasing the sensitivity C)decreasing the flow D)increasing the flow
C)decreasing the flow
When adjusting the sensitivity control on an IPPB machine, the respiratory care practitioner would be altering the A)volume of gas available to the patient on inhalation B)effort required to cycle the machine "off" during exhalation C)effort required to cycle the machine "on" during inspiration D)amount of oxygen delivered as determined by the patient's requirements
C)effort required to cycle the machine "on" during inspiration
A patient is being sent home with an oxygen concentrator. To ensure the safety of the home environment, the respiratory care practitioner should assess which of the following? A)domestic water supply system B)landscaping C)electrical load capacity D)number of bedrooms
C)electrical load capacity
Pursed lip breathing would be most beneficial for a patient who has A)asthma B)croup C)emphysema D)pneumothorax
C)emphysema
While reviewing the chart of a patient with lobar pneumonia, the respiratory care practitioner notices that the respiratory rate for the last 24 hours has been between 42-48/min. While on a 50% Venturi mask. Which of the following most likely caused the increased respiratory rate? A)hypothermia B)weakened diaphragm C)hypoxemia D)metabolic alkalosis
C)hypoxemia
Which of the following is the most common problem associated with the removal of an esophageal obturator airway? A)tracheostenosis B)tracheomalacia C)gastric insufflation D)aspiration
D)aspiration
A patient is receiving oxygen via nonrebreathing mask at 8 L/min. The respiratory care practitioner notices that the reservoir bag on the mask empties during inspiration. The practitioner should immediately do which of the following? A)change to a partial rebreathing mask B)remove the mask C)increase the flow D)intubate the patient
C)increase the flow
If the reservoir bag of a nonrebreathing oxygen mask collapses during use, the respiratory care practitioner should A)notify the respiratory therapy supervisor B)replace the mask C)increase the oxygen flow D)change the exhalation valves
C)increase the oxygen flow
The arterial blood gas results for a 14-year-old comatose patient in the emergency room are below. pH 7.13, PaCO2 14 torr, PaO2 120, and HCO3 5 It can be concluded from these data that the patient A)must be breathing supplemental oxygen B)is hyperventilating supplemental oxygen hypoxemia C)is hyperventilating because of an acid-base disturbance D)has compensated for hyperventilation
C)is hyperventilating because of an acid-base disturbance
If a patient who is being mechanically ventilated has just received succinylcholine (anectine) or pancuronium (Pavulon), the most important ventilation monitoring alarm would be the one for A)the I/E ratio B)the FiO2 C)low pressure D)high pressure
C)low pressure
Which of the following will be observed when an incentive breathing device is being used properly? A)Vital capacity with an inspiratory hold B)sustained tidal volume C)maximum sustained inspiration D)maximum voluntary ventilation
C)maximum sustained inspiration
All of the following are used to wean a patient from a mechanical ventilator EXCEPT A)intermittent mandatory ventilation B)synchronous intermittent mandatory ventilation (SIMV) C)optimal positive end expiratory pressure (PEEP) D)trial on a T-piece
C)optimal positive end expiratory pressure (PEEP)
Which of the following conditions is an indication for the use of PEEP? A)COPD B)pulmonary embolism C)pulmonary edema D)asthma
C)pulmonary edema
While performing equipment rounds, the RCP observes continuous bubbling in the humidifier of a stand-by oxygen setup. The practitioner notes that the needle valve is completely closed. Which of the following should be done initially? A)Check the wall line pressure B)check the valve seat C)replace the flowmeter D)turn the flowmeter to flush
C)replace the flowmeter
The RCP notices that a nebulizer is delivering large water droplets down the large bore tube. To correct this problem, the practitioner should A)Add a heating collar to the nebulizer B)ask the patient to slow down respirations C)replace the nebulizer D)add water to the nebulizer
C)replace the nebulizer
The results of a patient's spirometry tests before and after bronchodilator therapy are below, Before After FEV1 32% predicted 65% predicted FVC 48% predicted 85% predicted FEV1/FVC 49% 60% Which of the following is the correct interpretation of these results? A)mild obstructive disease, no significant bronchodilator response B)mild restrictive disease, significant bronchodilator response C)severe obstructive disease, significant bronchodilator response D)severe restrictive disease, no significant bronchodilator response
C)severe obstructive disease, significant bronchodilator response
Which of the following is the simplest defense against nosocomial infections? A)instituting isolation procedures B)cleaning respiratory therapy equipment thoroughly C)using proper hand-washing techiques D)fogging contaminated patient rooms
C)using proper hand-washing techiques
A patient is being mechanically ventilated. Her endotracheal tube cuff is inflated so that a small air leak is heard at peak inspiratory pressure, with airway peak pressure of 40 cmH2O (minimal leak technique). One hour later, airway peak pressure is 20 cmH20. Correct statements about this situation include which of the following? 1.The leak at peak inspiration should now be either absent or much less than it was at peak pressure of 40 cmH20 2.The cuff inflation procedures should be repeated at peak pressure of 20 cmH20 3.An additional volume of air should be added to the cuff. A)1 only B)2 only C)3 only D)1 and 2 only
D)1 and 2 only
Factors involved in the prevention of a nosocomial infection when a mechanical ventilator is set up include which of the following? 1.sterilization of tubing 2.cleanliness of filters 3.temperature of humidifier A)1 only B)2 only C)3 only D)1 and 2 only
D)1 and 2 only
Which of the following minimize the danger of occlusion of a patient's endotracheal tube? 1.adequate hydration 2.adequate endotracheal suctioning 3.adequate humidification of gases A)1 only B)2 only C)2 and 3 only D)1, 2, and 3 only
D)1, 2, and 3 only
Compared with the inside diameter of a tracheostomy tube, the outside diameter of the suction catheter that is used to suction the airway should NOT BE MORE than A)1/10 as large B)1/8 as large C)1/4 as large D)1/2 as large
D)1/2 as large
At change of shift, a RCP reviews the ventilator flow sheet and finds that the peak pressure has been gradually rising for the past several hours. Possible causes include which of the following? 1.increasing pulmonary compliance 2.bronchospasm 3.accumulation of secretions A)2 only B)1 and 2 only C)1 and 3 only D)2 and 3 only
D)2 and 3 only
Common complications associated with arterial punctures include which of the following? 1.fistula formation 2.hematoma formation 3.spasm of the vessel A)1 only B)3 only C)1 and 2 only D)2 and 3 only
D)2 and 3 only
In a patient who has been weaned from mechanical ventilation but has not been extubated, ventilation should be reinstituted if which of the following occurs? 1.The blood pressure increases or decrease by 5 mmHg 2.The pulse increases 30 beats per minute 3.The respiratory rate increase 10 breaths per minute or exceeds 30 breaths per minute 4.The PaCO2 increase by 10 torr A)4 only B)2 and 3 only C)1, 2, and 3 only D)2, 3, and 4 only
D)2, 3, and 4 only
When one rescuer only is performing cardiopulmonary resuscitation on an adult the ratio of compressions to breaths would be A)5:2 B)5:1 C)15:2 D)30:2
D)30:2
Significant overinflation of an endotracheal tube cuff may cause which of the following? A)layngospasm B)tachycardia C)hyperpnea D)capillary flow alteration
D)capillary flow alteration
Which of the following is the most appropriate chart notation for the practitioner to make? A)Treatment given as ordered B)Aerosol therapy given, pulse stable, no changes during therapy, well tolerated C)Aerosol therapy given with 0.25 ml isoetharine and 2ml, normal saline, vitals signs stable: well tolerated D)Aerosol therapy given with 2.5 ml Albuterol and 2ml, normal saline; pulse stable at 72/min during therapy; BP stable at 120/80; RR 10/min; therapy well tolerated; chest clear on auscultation
D)Aerosol therapy given with 2.5 ml Albuterol and 2ml, normal saline; pulse stable at 72/min during therapy; BP stable at 120/80; RR 10/min; therapy well tolerated; chest clear on auscultation
A RCP is instructing an outpatient in the care of his respiratory equipment. Which of the following steps should be included in the cleaning procedure? 1.wash thoroughly in mild detergent 2.remove all soap by rinsing with water 3.soak in vinegar solution for 20 minutes 4.drain and dry without wiping A)1 and 2 only B)2 and 3 only C)2, 3, and 4 only D)All of the above
D)All of the above
A RCP is preparing to suction a patient. While gathering the appropriate equipment. the practitioner notices a half-full, 100 ml bottle of sterile water that has been opened and reclosed, dated the previous day. The practitioner should do which of the following? A)carefully reopen the bottle and insert the suction catheter, being careful not to touch the edges of the bottle B)refill the bottle with sterile water, being careful not to touch the edge of the bottle C)use the previously opened bottle, since water does not become contaminated in the first 48 hours after opening D)Discard the previously opened bottle and use an unopened bottle of the sterile water
D)Discard the previously opened bottle and use an unopened bottle of the sterile water
Which of the following measurements would best determine the effectiveness of an aerosolized isoetharine treatment administered to a patient with asthma? A)arterial blood gases (ABG) B)tidal volume (Vt) C)Maximal Inspiratory Pressure D)FEV1
D)FEV1
Adverse reactions associated with the administration of aerosolized isoproterenol therapy include which of the following? I. tachycardia II. bronchospasm III. tremor A)I only B)II only C)III only D)I and III only
D)I and III only
oxygen administration devices that are capable of providing the entire tidal volume include which of the following? I. venturi mask II. nasal cannula III. nonrebreathing mask A)II only B)III only C)I and II only D)I and III only
D)I and III only
Sputum of a patient who has acute pulmonary edema is which of the following? I. froth II. watery III. pinkish IV. offensive in odor A)I and II only B)II and III only C)III and IV only D)I, II, and III only
D)I, II, and III only
While preparing the testing an IPPB circuit for patient use, the respiratory care practitioner finds that the ventilator fails to cycle off. Which of the should the practitioner do to correct the problem? I. tighten the circuit connections II. add expiratory resistance III. test the exhalation valve IV. increase the inspiratory flow V. increase the inspiratory time A)I only B)IV only C)II and V only D)I, III, and IV only
D)I, III, and IV only
A 60 kg (132lb) patient is being ventilated with a Bennett MA-1 ventilator iwth the settings belowl Mode: IMV, FiO2: 0.60, Rate:12, and Vt: 500 The patient's abg results are as follow: pH: 7.44 PaCO2: 35 torr, PaO2: 40 torr and HCO3: 23 To improve the patient's oxygenation status, the most appropriate adjustment would be to increase: A)the tidal volume to 600 ml only B)the FiO2 to 0.70 only C)the tidal volume to 600 and FiO2 to 0.70 D)PEEP to 5 cmH2O
D)PEEP to 5 cmH2O
Optimal PEEP is indicated by which of the following data? A)PEEP: 3 Pplat: 23 PIP: 30 Vt: 500 B)PEEP: 6 Pplat: 23 PIP: 35 Vt: 500 C)PEEP: 9 Pplat: 24 PIP: 39 Vt: 500 D)PEEP: 12 Pplat: 26 PIP: 42 Vt: 500
D)PEEP: 12 Pplat: 26 PIP: 42 Vt: 500
The settings below are ordered for a PB 840 ventilator that is to be used for an 80 kg(176lb) man who has undergone a pneumonectomy. Mode: AC, FiO2: 0.5, Rate: 14, and Vt: 500 On the basis of this information, the respiratory therapy practitioner's most appropriate action would be to A)institute mechanical ventilation as ordered B)suggest PEEP C)Suggest SIMV mode D)Suggest the decrease in the ventilator rate
D)Suggest the decrease in the ventilator rate
Which of the following findings would most likely indicate that an adult patient should be extubated? A)VC: 5-10 NIP: -25 Vd/Vt: 0.50 B)VC : 5-8 NIP:-30 Vd/Vt: 0.70 C)VC: 12-14 NIP:-15 Vd/Vt: 0.65 D)VC:10-15 NIP:-20 Vd/Vt: 0.45
D)VC:10-15 NIP:-20 Vd/Vt: 0.45
A patient has an oral endotracheal tube in place and is being mechanically ventilated. A respiratory therapy practitioner hears a gurgling sound coming from the patient's mouth throughout the inspiratory phase of the ventilator. The practitioner should: A)monitor the patient B)extubate the patient and insert a larger C)withdraw 10 ml of air from the cuff D)add air to cuff just until no noise can be heard during the entire inspiratory cycle
D)add air to cuff just until no noise can be heard during the entire inspiratory cycle
Factors that affect the concentration of oxygen delivered by a venturi mask include which of the following? I. the velocity of the gas through the venturi II. the size of the entrainment port III. downstream obstruction A)I only B)II only C)I and II only D)all the above
D)all the above
Before oxygen therapy is initiated via nasal cannula at 6 L/min. It is necessary to have all of the following EXCEPT A)a physician's order B)no smoking signs C)an oxygen source with a flowmeter D)an oxygen analyzer
D)an oxygen analyzer
Incentive spirometry is to be initiated on a patient who had a cholecystectomy 8 hours ago. Which of the following represents the best method for determining the patient's ability to cooperate? A)Ask him to hod his breath for 3 sec B)ask him to count backwards from 10 C)determine his orientation to person, place, and time D)ask him to repeat the instructions
D)ask him to repeat the instructions
If a physician writes an admission order for respiratory therapy that does not meet conventional standards, it would be most appropriate for a respiratory therapy practitioner to do which of the following? A)ignore the order and not administer the therapy B)carry out the order without question C)carry out the order with modifications D)ask the prescribing physician to modify the order
D)ask the prescribing physician to modify the order
Use the previous scenario to answer the following On entering a patient's room to administer a treatment, a RCP finds the patient lying on the floor, The practitioner verifies that the patient is unresponsive: The practitioner next action should be to A)call the patient's physician B)call the supervisor and ask for assistance C)check the patient's mouth for foreign material D)check for a pulse and breathing
D)check for a pulse and breathing
A physician orders an FIO2 of 0.45 for a patient who is being mechanically ventilated with a Servo I ventilator. In this situation, the RCP should: A)run the machine off compressed air and bleed oxygen into the patient circuit B)dial in 0.45 because the machine has an accuracy of +/- 0.002 C)dial 0.45, wait 30 mins, and obtain an abg sample D)dial in 0.45, and verify the internal O2 analyzer is correlating with the set FIO2
D)dial in 0.45, and verify the internal O2 analyzer is correlating with the set FIO2
Use the previous scenario to answer the following On entering a patient's room to administer a treatment, a RCP finds the patient lying on the floor, The practitioner verifies that the patient is unresponsive: In this situation, the most appropriate method of maintaining a patent airway would be to: A)put a pillow under the patient's head B)sit the patient in a chair C)perform a cricothyrotomy D)extend the patient's neck and elevate his chin
D)extend the patient's neck and elevate his chin
Room air will NOT enter the exhalation ports of an aerosol face mask if the A)inspiratory valve is open B)expiratory valve is closed C)gas flow to the patient is low D)gas flow exceeds the peak inspiratory flow
D)gas flow exceeds the peak inspiratory flow
An obese patient who shows signs of air hunger and hypoxia should be placed in which of the following positions? A)prone, flat B)lateral, flat C)supine, flat D)lateral, Fowler's
D)lateral, Fowler's
During a CPR procedure, the physician asks a respiratory care practitioner to recommend the device that will deliver the highest FIO2. The practitioner should suggest a A)partial rebreathing mask B)simple oxygen mask C)manual resuscitator and mask only D)manual resuscitator with reservoir and mask
D)manual resuscitator with reservoir and mask
The oxygen concentration delivered (FDO2) by a manual resuscitator is dependent on all of the following EXCEPT the A)flow of oxygen B)bag refill time C)size of the resuscitator bag D)mean airway pressure
D)mean airway pressure
Prior to beginning the bronchodilator therapy the RCP notes that the patient has a heart rate of 150/min. The most appropriate action is to A)administer the treatment as prescribed B)substitute another bronchodilator C)record the patient's heart rate and return in 1 hour D)notify the charge nurse and inform the physician
D)notify the charge nurse and inform the physician
Which of the following medications administered in a therapeutic range would be most likely to interfere with a patient's ability to cooperate? A)cortisone B)ampicillin C)furosemide (Lasix) D)phenobarbital
D)phenobarbital
Postural drainaage is NOT indicated for patients with: A)asthma B)pneumonia C)bronchitis D)pleural effusion
D)pleural effusion
On auscultation, fine crackles are most likely associated with which of the following? A)pleural effusion B)hemothorax C)asthma D)pulmonary edema
D)pulmonary edema
Negative inspiratory pressure measurement provides information about which of the following? A)V/Q abnormality B)airway resistance C)functional residual capacity D)respiratory muscle force
D)respiratory muscle force
Which of the following types of aerosol generators is most appropriate for the administration of cromolyn sodium (intal) capsules? A)ultrasonic B)hand held C)atomizer D)spin haler
D)spin haler
Reitubation immediately after extubation is most commonly necessary because of which of the following conditions? A)vocal cord polyps B)mucosol ulceration C)tracheomalacia D)subglottic edema
D)subglottic edema
A patient is being ventilated with a Servo I ventilator and suddenly the high pressure alarm begins to sound. The corrective action would be to A)increase the pressure limit B)deflate the endotracheal tube cuff C)increase the flow D)suction the airway
D)suction the airway
A RCP receives an order to administer an IPPB treatment to a patient with COPD who is receiving oxygen via a 24% venturi mask. When the practitioner administers the treatment with 40% oxygen via a blender, the patient's spontaneous respiratory rate decreases from 16 to 6 per minute. The practitioner should: A)encourage the patient to breathe faster B)increase the pressure tobreath faster C)adjust the expiratory time control D)terminate the treatment and contact the physician
D)terminate the treatment and contact the physician
Nondisposable humidifiers for oxygen delivery devices should NOT be kept filled with water for extended periods of time because A)chemical contamination will be drawn from the plastic container B)the water will soon evaporate and be wasted C)minerals in the water will coat the inside of the humidifier D)there is a risk of bacterial contamination
D)there is a risk of bacterial contamination
