RCP 110 Final Exam Questions & Answers
A patients response to an interview quesiton is intially unclear. what response on your part would be most appropiate?
"Please explain that to me again?"
what is the appropiate distance for the intimate space?
0-18 inches
The normal QRS complex does not exceed what time on the horizontal axis?
0.12 seconds
What cylinder factor is used to compute the duration of flow for a 22 cu/ft O2 or air E cylinder?
0.28
How much time is represented on the horizontal axis of the ECG paper by five large boxes?
1 seconds
During Hyperbaric therapy, 2ATA (atmospheric pressure absolute) equals?
1,520 mmHg
What fraction of patients oler than 70 years has calcium deposits in their aortic or mitral valves?
1/3
For the test of collateral circulation pinking up of the hand is normal if it occurs within
10-15 seconds
The QRS of an ECG falls on a dark vertical line of the ECG paper. Subsequent QRS complexes fall on every other dark line (10mm apart). What is the ventricular rate?
150/min
The normal resting respiratory rate in elderly patients is in what range?
16-25 breaths/min
The gauge on an H cylinder of O2 reads 2000psig. About how long would the contents of this a cylinder last, until completely empty at a flow of 6L/min?
17hours and 30 minutes
what is the appropiate distance for personal space?
18 inches to 4 feet
What is the Pin Position for an oxygen E cylinder?
2-5
What is the ventricular heart rate when the AV node paces the heart?
20-40 beats min
what is the recommended maximum intial dose of inhaled NO in noenates with respiratory disease?
20ppm
What is the FiO2 range for an Oxygen Hood (Oxyhood):
21% to 100%
In the 65-74 year old age group, about what percentage experience hearing loss?
23%
Approximately what percent of patients receiving mechanical ventilation develope pneumonia as a complication?
25%
At what speed does the paper travel through the ECG machine?
25mm/sec
Bewtween which two tracheal ring will the incision for transtrcheal catherter be peformed?
2nd and 3rd
The normal capillary refill is less than
3 seconds
Under ideal conditions, pules oximetry readings usually fall in what range of those obtained with invasive ABG sampling?
3%-5%
An arterial puncture site normally should be compressed for a minimum of?
3-5 minutes after the puncture
What cylinder factor is used to compute the duration of flow for a 244cu/ft (H/K) O2 or air cylinder?
3.14
Convery 101.5 F inot Celcius
38.6 (101.5-32x9/5)
starting at what liter flow must you add humidication to a nasal cannula?
4 liters
what is the appropiate distance for the social space from the patient?
4-12 feet
A 27 yr old woman received from the emergency department is on a nasal cannual at 5L/min, Approxiamately what FIo2 is this patient receiving?
40%
What is the upper limit O2 concentrations available though tents?
40% to 50%
A 55yr old patient, who has been smoking a pack and a half cigarettes (30 cigarettes) per day for 30 years, what is the patients smoking history?
45 packs-yearsd
What is the water vapor pressure of saturated gas at normal body temperature (37C)
47.0 mmHg
In general, to deliver oxygen to upper airway a bubble humidifier is required only when the gas flow exceeds which of the following?
4L/min
A physician places a patient in respiratory failure on 100% O2. To avoid the hazards of O2 toxicity, you would recommend tht every effort be made to reduce this FIo2 to less than 50% within what time frame?
5 days
Department of Transportation (DOT) regulations require compressed gas cylinder to be hydrostatically tested for leaks and expansion every how often?
5-10 years
What is the maximum FIO2 expected to be delivered by the most air entrainment masks?
50%
A reading of 80% on the pulse oximetry is the appropiate equivalent of what PaO2?
50mmHg
The pressure of O2 or air in a bulk supply system is reduced to what standard working pressure?
50psig
what is the minimum flow setting for a simple mask applied to an adult?
5L/min
An elderly patient who gains more than how many pounds in a week may be suffering from CHF?
5lb
Normally when using a 50-psi flowmeter to drive a small volume jet nebulizer to what should you set the flow?
6-10L/min
What is the heart rate if the RR interval is five large boxes apart?
60 beats/min
The normal pulse rate range for the adult is
60 to 100 beats/min
What is the normal diastolic blood pressure in the adult patient?
60-90mmHg
What is the normal value arterial pH
7.35-7.45
What should be used to wipe down the surface of devices that cannot be immersed in water?
70% ethyl alcohol.
Pulse oximetry readings are generally unreliable at saturations below what level?
80%
what are the two available concentrations of Heliox?
80%He/20%Oxygen and 70% He/30% Oxygen
what is normal value for the PaO2 in the adult patient?
80-100mmHg
Convert 28C into Fahrenheit?
82.4 (28x9/5+32)
One cu/ft of liquid O2 is the equivalent of about how many cu/ft of gaseous O2?
860
You design an air entrainment system that mixes air with O2 at a fixed ratio of 1:7 (1 L air to 7L O2). About what O2 will this device provide? Formula: (air flow x21) + O2 x 100)/total flow?
90%
What is the normal range for systolic blood pressure in the adult patient?
90-140 mmHg
In healthy elderly patients , their SpO2 should be above?
93-94%
The normal range for oral body temperature in most people is
97.0:to 99.5 F
Which of the following reasons has been listed as the number one concern regarding use of the tympanic site for the body temperature measurement?
Accuracy
Divisions of public law (the relationship of private parties and the government) include?
Administrative and Criminal
Fire extinguisher training includes the acronym PASS, what does the letter A stands for?
Aim
A patient has a pH of 7.49 what would this define?
Alkalosis
What is the indexed safety systems for threaded high pressure connections between large compressed gas cylinder and their attachments?
American Standard Safety System (ASSS)
What term is used to describe abnormal collection of fluid in the peritoneal cavity?
Ascites
What should be done just before the patients ID bracelet is checked?
Ask the patient for permission
Which of the following techniques isn ot useful in measuring respiratory rate in the spontaneously breathing alert pateint?
Ask the patient to breathe normally
What cardiopulmonary conditions would not be found in the chief complaint?
Asthma
What dysrhythmia is characterized by a sawtooth pattern of waves between normal QRS complexes?
Atrial flutter
What ethical principle obliges a respiratory therapist to uphold a patients right to refuse a treatment?
Automony
Which of the following is the method of choice for measuring temperature of neonates?
Axillary
Which of the following organisms in NOT destroyed by a disinfection agent?
Bacterial-spores
The debate over prolongation of life versus life of suffering in elderly patients mainly involves differing opinions regarding what principle?
Beneficence
A health professional who withholds the truth from a patient, saying it is for his/her own good, is engaged in what practice?
Benevolent deception
Before an ABG is obtained, the patients clotting parameters should be evaluated because?
Bleeding time may be prolonged if they are abnormal
Digital Clubbing is associated with
COPD, cystic fibrosis, and bronchogenic carcinoma
What is the phenomenon whereby a liquid in a small tube tends to move upward against the force of gravity?
Capillary action
Which of the following is the most common complaint from a patient suffering from an acute myocardial infarction?
Chest Pain
While observing a patients breathing, you not that the depth and rate first increases, then decreases, followed by a period of apnea. what term is best describe this?
Chyene Stokes breathing
A nurse who practices below a reasonable standard of care is committing what type of malpractice?
Civil
What branch of law is concerned with the recognition and enforcement of the rights and duties of private individuals and organizations?
Civil
What is the first step in equipment processing for reuse on another patient?
Cleaning the equipment
What is believed to be responsible for production of the first heart sound?
Closure of the atrioventicular (AV) valves
The second heart sound (S2) is created primarily by which of the following?
Closure of the semilunar valves
Today, Respiratory care education program in the United States are accredited by what organization?
Committe on Accreditation for Respiratory Care (CoARC)
what is the physical process whereby the gaseous form a substance is changed back into it's liquid state?
Condesation
A clinican who justifies support for withdrawing life support from a patient because "in the end, it would be best fo all involved" is applying what ethical viewpoint?
Consequentialism
A patient with an acute exacerbation of asthma is not responding to the standard dose and frequency of an aerosolized bronchodilator and is now receiving small volume jet nebulizer (SVN) therapy every 20 minutes. Which of the following would you recommend to the patients physician at this time?
Consider continous nebulization of the drug
In the standard approach to hospitals fires, RACE plan has been suggested. What does the letter C stands for in this approach?
Contain
What is the primary means by which heat transfer occurs in fluid?f
Convection
A physician who participates in active euthanasia is commiting what type of malpractice?
Criminal
What safety system is designed to prevent accidental interchanging among low pressure (less than 200psig) connectors such as those found on flowmeters and ventilators?
DISS
What term describes sudden loss of negative charge inside the myocardial cells?
Depolarization
What is represented by the P wave ont he ECG tracing?
Depolarization of the atria
What does the QRS complex represent?
Depolarization of the ventricles
What is the retention of aerosol particles resulting from contact with the respiratory tract mucosa called?
Deposition
According to Pascal's principle the pressure exerted by a liquid in a container depends on which of the following?
Depth of the liquid and Density of the liquid
What is not one of the 5 key recommended components of an infection control program in the hospital setting?
Development
What is the physical process whereby atoms or molecules tend to move from an area of higher concentration or pressure to an area of lower concentration or pressure?
Diffusion
Nonverbal communication does not include what?
Discussion
The moral basis for rationing healthcare services falls under what ethical principle?
Distributive Justice
What types of advanced directives can patients use to help resolve ethical dilemmas involving their life-sustaining care?
Durable power of attorney and living will
Ototoxicity has a damaging effect on which cranial nerve?
Eighth Cranial Nerve
What disorder is associated with barrel chest?
Emphysema
What is the goal of the introductory phase?
Establish a rapport with the patient
What is the change in state of substance from liquid to gaseous from occuring below it's boiling point?
Evaporation
A Durable Power of Attorney for Health Care takes effect once the patient is admitted to the hospital
False
A living will allows patient to appoint someone else to make a medical decisions
False
Which of the following terms best describes foul smelling sputum?
Fetid
What is the most common manifestation in a patient with pulmonary disease?
Fever
Which of the following is not considered a typical site for temperature measurement?
Fingertip
what is the primary buffer system for fixed acids?
HCO-3
Where are the majority of RT's employed?
Hospitals and acute care settings
With the first therapuetic administration of oxygen it was discovered tha lack of oxygen would cause?
Hyperventilation
The gauge E cylinder of O2 reads 900 psig. About how long would the contents of this cylinder last until it reaches 200psig, at a flow of 3L/min
I hour 5 minutes
What technique is used by most hospitals to reduce host susceptibility to infection?f
Immunization
How is the education of respiratory therapist expected to change over the next decade?
Increase
A patient is receiving O2 thorugh a nonrebreathing mask set at a 8L/min . You notice that the mask's reservoir bag collapses completely before the end of each inspiration. what would you do?
Increase the liter flow.
What is not predicted to be a growing trend in respiratoty care for the future?
Increased use for intravascular lines for patient monitoring
what sequence of events best describes the cough mechanism?
Inspiration, closure of glottis, forceful opening of the glottis
After administering a 30-minute bland water aerosol treatment to a dehydrated elderly patient with chronic bronchitis, you note increased wheezing and a general decrease in the intensity of breath sounds. Which of the following has probably occured?
Inspissated secretions have swollen and worsened airway obstruction
Which stage of patient clinician interaction is the patient identification bracelet checked?
Introductory Stage
What is true about the American Association of Respiratory Care (AARC)?
It determines if graduationg students are competent to practice
To ensure a stable FIO2 under varying patient demands, what must an O2 delivery system do?
It must proveide all the gas needed by the patient during inspiration.
What are legitimate defenses against an intentional tort?
Lack of intent to harm the patient and Informed consent given by patient
What is the pattern of flow in which fluid moves in discrete cylindrical streamlines?
Laminar
The absence of informaton or thel ack of cumented recognition of specific problems could result in one of the following situations?
Malpractice
Who is professionally responsible for the clinical function of the respiratory care department?
Medical Director
Which of the following test is perfomed to check the collateral circulation of the radial artery before puncture?
Modified Allens Test
Which of the following grading systems is useful in qualifying the degree of dyspnea?
Modified Borg scale
What is the potential risk to patients receiving respiratory care?
Movement, ambulation, electrical shock, and fire hazards.
What organization has developed an examination to enable RT's to become licensed?
National Board of Respiratory Care
Structural requirements for the central piping systems that are used in hospitals to distributed gases are established by whom?
National Fire Protection Association (NFPA)
An RT is examining a patient suspected to have a left sided tension pneumothorax. During inspection and palpation, the RT notices the patient's trachea has shifted to the left. Is the patient's diagnosis correct?
No, the patient may have left upper lobe atelectasis
An O2 delivery device takes separate pressurized air and O2 sources as input, then mixes these gases though a precision valve? What does the describe?
O2 blending system
A Patient with chornic hypercapnia placedo n FIO2 of 0.6 starts hypoventilating. What is a possible cause of the phenomenon?
O2 induced hypoventilation
Which of the following is considered therapeutic gases?
O2, O2-NO mixture, and O2-He mixture
According to the National Institute of Standards and Technology of the US Department of Commerce, a gas cylinder that is color coded brown and green should contain which of the following?
O2-He mixture
How is competency to practice Respiratory Care determined?
Obtaining a passing grade on a credentialing exam administered by the NBRC after graduation from CoARC approved Program
What are the two primary factors that determine the harmful effects of O2?
PO2 and exposure time
Which of the following parameters is the respiratory component dof acid-base status?
PaCO2
What term is used to describe secretions strictly from the lungs and lower airways?
Phlegm
Which of the following words is not consistent with the definition of the SOAP charting method?
Physical Exam
A combination of neutral atoms, free electrons, and atomic nuclei describes?
Plasma
What disease woulld not recorded in the family history as a hereditary disorder?
Pneumonia
what clinical disorder will cause increased resonance to percussion?
Pneumothorax
To prevent an adverse rebound effect when withdraeing NO therapy, what should you do?
Reduce the NO to the lowest effective dose (ideally, less than 5ppm), Hyperoxygenate the patient just before discontinuing NO, and Ensure that the patient is hemodynamically stable.
What term describes the sinking inward of the skin overlying the rib cage with each inspiratory effort?
Retractions
what is the primary goal of The Joint Commission?
Review healthcare orgranizations to improve the quality of healthcare and patient safety.
Which chamber dof the heart initially receives deoxygenated blood from the venae cavae?
Right atrium
To minimize a patients infection risk between drug treatments with a small volume jet nebulizer (SVN) what would you do?
Rinse the SVN with sterile water; air dry
In 1662, a chemist published a book that described the relationship between gas, volume and pressure. What is the chemist name?
Robert Boyle
Where does the normal electrical impulse orginate for each heartbeatd?
SA node
What term describes aan abnormal lateral curvature of the spine?
Scoliosis
Which of the follwoing is the best definition of sputum?
Secretions from the nose, mouth and tracheobronchial tree
What is not a category under Expanded Precautions?
Standard Precautions
Lifting heavy objects is done with what technique?
Straight spine and bent legs
What term is used to describe a continous type of adventitous lung sound heard loudes over the neck of the patient with upper airway obstruction?
Stridor
What is NOT considered an increase risk of surgical patients for developing postoperative pneumonia?
Strong Cough
Which of the following best defines an aerosol?
Suspension of liquid or solid particles in a gas
An alert outpatient waiting bronchoscopy has a SpO2 reading of 81% breathing room air. The patient appears in no distress and exhibits no signs of hypoxemia. Which of the following would be the best initial act to take in this situation?
Switch site or replace the sensor probe
Data which is preceived by the patient describes?
Symptons
Which o fthe following waves represent repolarization of the ventricles?
T
The pulse rate about the normal range is a definition of which of the following terms?
Tachycardia
Why should the respiratory therapist perform a blood prssure assessment fairly quickly?
The Procedure cuts off blood flow to the forearm temporarily.
Which of the following is a hallmark of a prematue contraction (PVC)?
The QRS is wider than normal
What technique is NOT associated with the demonstration of active listening?
Use of touch
Solid maintains their shape because their atoms are kept in place by strong mutual atractive forces is called what?
Van der Waals force
What dysrythmia often follows sustained ventricular tachycardia?
Ventricular Fibrillation
Due to the aging of th majority of population, what will not be the focus of th RT's of the future?
Verifying insurance information
A clinical who justifies not billing a poor patient for services rendered because, "that's what a professional should do" is applying what ethical viewpoint?
Virtue ethics
What is the internal force that opposes the flow of fluids (equivalent to friction between solid substances)
Viscosity
To accurately determine the remaining contents of a liquid filled CO2 cylinder what would you do?
Weigh the contents of the cylinder
What term best describes continous types of adventitious lung sounds?
Wheeze
Under what conditions can the principle of confidentiality be breached?
When the welfare of the community or a vulnerable individual is at stake.
What breathing pattern is associated with fatigue of the diaphragm?
abdominal paradox
Based on the following ABG results what is the most likely acid base diagnosis? pH 7.43, PCO2 39mmHG HCO3 25.1 mEq/L
acid-bse status within normal limits
A patient receiving nasal oxygen at 3L/min complains of nasal dryness and irritation. Which of the following actions would be appropriate?
adding a humidifier to delivery system
Which of the following best describes the manner in which a clinican should address the older adult patient?
address patient by his or her last name with appropiate title.
What is the process by which aerosol suspension change over time?
aging
Low flow O2 delivery system used in respiratory care does not include what?
air-entrainment mask
All of the following drugs or drug categories have been associated with increased airway resistance and bronchospasm during aerosol administration except?
albuterol
What term is used to describe the chest pain associated with blockage of the coronary arteries?
angina
PRN
as needed
While int he patients room, what shoul dyou do before moving some books off their chair?
ask permission to move them and ask if I may sit down
What behavior is not consistent with resistive behavior of a patient?
asking the purpose of the treatment
Which of the following statement is FALSE about PISS standards?
The exact positions of pins and pinholes do not vary for each gas.
With which of the following devices are therapeutic aerosols generated?
atomizers and nebulizers
What structure serves as the backup pacemaker for the heart?
atrioventicular (AV) node
What term is used to define the ability of certain cardiac cells to depolarize without stimulation?
automaticity
What are potential causes of cardiac murmurs?
backflow of bloodthought an incompetent valve, forward flow through a stenotic valve and rapid flow though a normal valve.
dys
bad, difficult painful
An ABG result shows pH of 7.35 PaCO2 of 30 mmHg, and HCO3 of 18 mEq/L, what compensatory measure has the body taken to at least partially compensate for the acid-base disorder?
blown of CO2
cyanosis
blue discoloration of the skin
What artery is most often used to assess arterial blood pressue?
brachial
Dyspnea is defined as?
breahtlessness as perceived by the patient
An increase in intensity and clarity of vocal resonance because of enhanced transmission of sound is referred to as which of the following?
bronchophony
Which of the following is FALSE about a compensated Thorpe tube?
calibrated in L/min at atmospheric pressuref
Mixtures of carbon dioxide and oxygen in blends of 5%:95% or 7% to 93%, which are occasionally used to prevent complete washout of carbon dioxide during cardiopulmonary bypass or treat hiccoughs is known as which of the following?
carbogen
In what clinical situations would you recommend hyperbaric oxygen (HBO) therapy?
carbon monoxide poisoning, and cyanide poisoning
Age is the major risk factor for developing which of the following eye disorders?
cataract
What is the direct efffect of an increased PaCO2 on HCO3
cause it to increase
what is not true about Advance Directive?
changes cannot be made by the patient at any time after it is written
Which of the following would describe the ECG of a patient with atrial fibrillation?
chaotic baseline between QRS complexes
Normal heart sounds are created primarily by which of the following?
closure of the heart valves.
Given the following ABG results interret the acid-base status: pH7.44, PaCO2 25 mmHg, HCO3 17mEq/L?
compensated respiratory alkalosis
what is a normal response of the body to a failure in one component of the acid-base regulatory mechanism?
compensation
C/O
complains of
What term is used for the transfer of heat by the direct interaction of atoms or molecues in a hot area with atoms or molecules in a cooler area?
conduction
What is not true regarding the use of sterile gloves in the hospital setting?
The same pair can be used on numerous patients if noninvasive procedures are done
President Reagan proclaime that National Respiratory Care week would be?
The third week in October
For the CRT credential, what does the letter T stands for?
Therapist
what is not Some of the major disadvantages of the transtracheal catheter?
excessive oxygen use
What describes gas?
exhibit phenomenon of flow, molecular forces of attraction are minimal, gases are easliy compressible and expand to fill their container
what type is behavior is least appropiate in the patients intimate space?
eye contact
Which of the following devices would you recommend to administer bland water aerosol to an infant or small child?
face tent
What is the greatest hazard of pulse oximetry?
false results leading to incorrect decisions
Cylinders of liquid gases are filled according to what specification?
filling density
The patients medical record is a what?
financial document, legal document nd an educational tool
Which of the following is TRUE about an uncompensated Thorpe tube?
flow lower than actual if downstream pressure increases
If you have to deliver medical gas to a patient from a compressed gas cylinder, which of the following devices would you select to control gas flow?
flowmeter
A creaking or grating sound that increases in intensity with deep breathing and is similar to course crackles but is not affected by coughing best describes which of the following?
friction rub
Based on the following ABG results what is the most likely acid-base diagnosis? pH 7.35, PCO2 68 mmHg, HCO3 34.3 mEq/L PaO2 81?
fully compensated respiratory acidosis with normoxemia
Based on the following ABG results what is most likely acid base diagnosis? pH 7.43, PCO2 20mmHg, HCO3 is 12.6mEq/L
fully compensated respiratory alkalosis
What is the main purpose of the chief complaint?
give a brief explanation about why the patient sought health care
The sublimation phase transition includes what?
going directly from solid to vapor, never becoming liquid, and skiping the melting phase
what is best performed in the social space?
greeting/introduction
What is true about liquids?
hard to compress, exert pressure, exert bouyant force and conform to their containers
Which type of humidifier traps the patients body heat and expired water vapor to raise the humidity of inspired gas?
heat moisture exchanger
What are some problems common to mist tents?
heat retention and CO2 buildup
A patient presents in the emergency department with bood tinged sputum. The term associated with such sputum is?
hemoptysis
SBAR was developed to provide a tool to overcome?
hierarchical barriers, miscommunication, and standardize concise, factual information.
What is a potential limitation of flow triggered metered dose inhaler devices?
high flow necessary for actuation
stridor
high pitch harsh or crowing sound during inspiration from partial blockage of airway
A variant of a common low flow, nasal O2 delivery device which is capable of providing both high humidity and a high FiO2 is known as which of the following?
high-flow nasal cannula
Hx
history
Nosocomial
hospital inquired infection
What is considered the primary source of infection in the health care setting?
humans
What is the main compensatory mechanism for metabolic acidosis?
hyperventilation
What structure in the body is responsible fo regulating body temperature?
hypothalamus
What compensates for metabolic alkalosis?
hypoventilation
What is adecrease in tissue oxygentation called?
hypoxia
What is the greatest potential problems with quick connect DISS system (such as Ohio, NCG or Puritan)?
incompatibility among different manufacturers
What is the primary chemical event in respiratory acidosis?
increase in blood CO2 levels
Compensation for respiratory acidosis occurs through which of the following?
increase in blood HCO3 levels
What is the primary chemical event in metabolic alkalosis?
increase in blood HCO3 levels
What would help to decrease a patients loss of body heat?
increase the temperature of the room and move the patient from the cold windows
Inhalations of dry gases can do which of following?
increase viscosity of secretions, impair mucociliary motility, increase airway irritability
Decreased ventilation equals?
increased PaCO2
When assessing a patients response to bronchodilator therapy, you notice a decrease in wheezing accompanied by an overall decrease in the intensity of breath sounds. Which of the following is most likely?
increasing airway obstruction
Correction of uncompensated respiratory acidosis is accomplished by which of the following?
increasing alveolar ventilation
What is the most common route of pathogen transmission in the hospital setting?
indirect contact
What is the most common cause of fever above 102F
infection
itis
inflammation
Bronchitis
inflammation of the bronchial walls
Tracheitis
inflammation of the trachea
What is not an advantage of pulse oximetry?
invasive
Which of the following statements about He is false?
it is heavier than air
What is FALSE about heated humidifier condensate?
it poses minimal infection risk
Assuming a constant flow, what will happen to a fluid if the cross sectional area of the tube in which it flows decrease?
it's velocity will decrease
To minimize the risk of ROP, the American Academy of Pediatrics recommends?
keeping arterial PO2 infants lss than 80 mmHg
Which of the following factors should be used in properly selecting an O2 delivery device?
knowledge of general performance of the device and individual capabiities of the equipment
What breathing pattern is associated with diabetic ketoacidosis?
kussmaul breathing
What term is used to describe an abnormal antroposterior curvature of the spine?
kyphosis
What is th most surprising clinical finding in older patients with pneomonia that disguises its presence?
lack of fever
What is an indication for the use of helium-O2 mixtures?
large-airway obstruction
What is the most common device used to generate bland aerosols?
large-volume jet nebulizer
During the follow-up stage the patient asks you when will you be back to them, what should your response be?
later this afternoon
According to Bernoullis principle, as a fluid flows through a narrow passage or stricture, what will occur?
lateral pressure will fall
Obtaining background information during an interview is very important because it allows the interviewer to?
learn the impact of culture, relationships, and finances of his/her health, predict whether the patient is willing to cooperate in the treament of his/her disease and develope a basic understanding of the patient's experience with his/her disease
Which chamber normally has the largest muscle mass?
left ventricle
Factors affecting the accuracy of SpO2 reading does not include what?
lipstick
What are the economic damages that can be imposed on a defendant during a negligence law suit?
loss of employment or business opportunities, loss of use of property and lost of past and future earnings.
what are the advantages of the nasal cannula as a low flow O2 delivery system?
low cost, easy application and disposablity
What key property of He makes it useful as a therapeutic gas?
low density
Delivery system that provide only a portion of a pateints inspired gas ae referred to as what?
low flow O2 system
The bell portion of the stethoscope is best designed to listen to?
low pitched and heart sounds
What is the primary goal of humidity therapy?
maintain normal physiologic conditions
What is not a critical element of a patients past medica history?
marital status
What is the most common mode of administering nitric oxide?
mechanical ventilation
An ABG results shows pH of 7.35, PaCO2 of 30 mmHg and HCO3 of 18m Eq/L. Which of the following is the patients most likely primary disorder?
metabolic acidosis
Cough syncope is associated most often with which of the following types of patient?
middle aged men with underlying COPD
Some strategies for minimizing the risk of fire hazard with O2 therapy excludes what?
mixing the oxygen with carbon dioxide
The diagraph portion of the stethoscope is used to listen for?
most lung sounds
What problem is indicated by elevation of the ST segment?
myocardial ischemia
Which is not a common characterstic of a premature ventricular complex (PVC)
narrow QRS
A cooperative and alert post-op patient who is able to eat requires a continous but low FIO2. Precise FIO2 concentration are needed. Which of the following devies would best achieve this end?
nasal cannula
Simple unheated bubble humidifiers are commonly used to humidify gases with what type of systems?
nasal oxygen delivery
When determining a need for O2 therapy, the RT should assess for what?
neurologic status, pulmonary status and cardiac status
Your patient has a normal ECG reading. What does this finding tell you about the patient's likelihood of having myocardial infarction in the immediate future?
no predictive value
You must deliver the highest possible FIO2 to a 67 yr old man ith pulmonary edema breathing at a rate of 35/min. What O2 delivery system would you use?
nonrebreathing mask at 12-15L/min.
The primary goal of acid-base homeostasis is to maintain which of the following?
normal ph
NPO
nothing by mouth
When full a gas cylinder registers a pressure of 2200psig. After a few hours of use the pressure gauge reads 550psig. The cylinder is not how full?
one fourth
The key difference between a metered dose inhaler (MDI) holding chamber and a spacer is that the holding chamber incorporates which of the following?
one way inspiratory valve
An inablility to breath while lying down is known as?
orthopnea
Hypotension associated with changes in posture in patients dwith hypovolemia is known as?
orthostatic
what are factors affecting humidifiers performance include?
outlet size
The mass of aerosols particles produced by a nebulizer in a given unit time best describes which quality of the aerosols?
output
oxia
oxygen condition
Which of the following formulas should be used to calculate the pack year history of cigarette consumption?
packs per day x years smoked
Based on the following ABG results what is the most likely acid base diagnosis? pH 6.89, PCO2 24mmHg, HCO3 4.7mEq/L PaO2 39?
partially compensated metabolic acidosis with severe hypoxemia
A patient has the following ABG results pH 7.25, PaCO2 32 mmHg, HCO3 16mEq/L, based on these findings, the patient has which of the following?
partially compensated metabolic acidosis?
Air for medical use in a hospital should be which of the following?
particle free, oil free and dry.
In addition to bedside pulmonary function test measures, what other components of patients assessment are useful in evaluating bronchodilator therapy?
patient interview and observation, measurement of vital signs, chest auscultation, and arterial blood gas analysis and oximetry
What is the most common course of error and false alarms with pulse oximetry?
patient motion artifact
What is not used in the two patient identifers before intiating care?
patient room number
When would you recommend bland aerosol therapy administration?
patient with upper airway edema, patient with a bypassed upper airway, patient with active bronchoconstriction
Who is at greatest risk for absorption atelectasis?
patients breathing low at tidal volumes
Which of the following groups of patients are most likely to have difficulty using a simple metered-dose inhaler for aerosol drug therapy?
patients in acute distress, infants and young children, and elderly persons
What means can the internal energy of a substance be increased?
performing work on the substance and heating the substance
Which of the following findings is consistent with reduced perfusion?
peripheral cyanosis
What defines acidosis in a human?
ph<7.35
Oximetry is the measurement of blood hemoglobin staturations using what technique?
photoplethysymography and spectrophotometry
What term is used to describe shortness of breath in the upright position?
platypnea
What is the difference between pleuritic and nonpleuritic chest pain?
pleuritic pain is sharp and stabbing; nonpleuritic pain is dull and crushing
Clinical indications for delivery cool humidified gas include what?
post extubation edema, upper airway inflammation, croup (laryngotracheal bronchitis), epiglottis
Retinopathy of pre maturity (ROP) is a potentially serious management problem mainly in the care of whom?
premature or low birth weight infants
Which of the following mechanisms do all compressed gas cylinders use to avoid excessively high build up of cylinder pressure?
pressure-relief mechanism on the valve stem
What does the phrase Universal Precautions refer to?
protecting care givers from contagious diseases the patient may have
Which of the following characteristics is least typical for pleuritic chest pain?
radiate to the arm
An unconscious patient has no detectable pulse, and the ECG baseline waveform shows grossly irregular fluctuations with a zigzag pattern. What is the course of action to treat this patient?
rapid defibrillation, cardiopulmonary resuscitation, administration of oxygen an administration of an antiarrythmic medication
What is the usual method of monitoring the remaining contents is a gas filled cylinder?
read the pressure gauge
what is true regarding the use of disposable respiratory care equipment?
recent research supports their use as a cost effective measure, many quality issues exist, and reusing the equipment is often done.
What is not considered hazards and complications of bland aerosol therapy?
reconcentration
Indications for warming inspired gases include what?
reducing upper airway inflammation or swelling
What device is used to reduce the pressure and control the flow of a compressed medical gas?
regulator
An increase in the H+ ion concentration [H+] of the blood due only to an increase in the arterial PCO2 (hypercapnia) best describes which of the following?
respiratory acidosis
A decrease in the H+ ion concentration [H+] of the blood caused by a low PaCO2 best describes which of the following?
respiratory alkalosis
An ABG result shows the pH to be 7.56 and the HCO3 to be 23mEq/L. Which of the following is the most likely disorder?
respiratory alkalosis
What is indicated by the presence of central cyanosis?
respiratory failure
what is not a type o advance directives?
responsiblity for hospital payment
What clinical condition is associated with the onset pedal edema
right heart failure
Whis the most common cause of jugular venous distention (JVD)
right sided heart failure
Which of the following may cause the trachea to shift to the right?
right upper lobe atelectasis
Which chamber is responsible for pumpin blood into the pulmonary circulation?
right ventricle
Which of the following factors affect pulmonary deposition of an aerosol?
size of the particles, shape and motion of the particles, and physical characteristics of the airways
What is the key difference between small compressed gas cylinders (sizes AA to E) and their larger counterpart (sizes F to K)
small gas cyclinder use a yoke not threaded connector
A physician has ordered the antiviral agent ribavirin (Virazole) to be administered by aerosol to an infant with bronchiolitis. Which of the following devices would you recommend in this situation?
small-particle aerosol generator (SPAG)f
Drug aerosol delivery systems include all of the except?
spinning disk nebulizers
what is not Potential uses for inhaled NO?
status asthmaticus
To minimize the risk of infection associated with aerosol drug therapy, what should you do?
sterilize nebulizers between patients, frequently replace in use units, and rinse nebulizers with sterile water
What should the RT do if the patient is suffers serious side effects during treatment?
stop the treatment and notify the physician or supervisor
On palpating the neck region of a patient on a mechanical ventilator, you notice a crackling sound and sensation. What is the most likely cause of this observation?
subcatenous emphysema
hypoxia
subnormal oxygen levels in the cells
-ectomoy
surgical removal
ostomy
surgically creating an opening
What are the signs and symptoms associated with the presence of hypoxemia?
tachypnea, tachycardia, cyanosis, and somolence
what conditions must be met for a fire to occur?
temperatur high enough for combustio, presence of oxygen, and presence of flammable material
Which of the following is true regarding respiratory alkalosis?
the PaCO2 is less than 35 mmHg
Which of the following statemtns is false about low flow O2 delivery system?
the greater the patients inspiratory flow the greater the FIO2.
Which of the following activities is best performed in the personal space?
the interview
The greater the temperature of the gas?
the more water vapor it can hold
Your patient has an abnormal sensorium. what is mostly likely true about the patient?
the patient is confused about where he or she is
What is an example of Objective data?
the patients report of the amount of sputum that he or she produces daily
what is false about evaporation?
the processs of evaporation warms the surrounding air
What is true about fires in oxygen-enriched atmosphers?
they are more difficult to put out, burn more quickly, and more intensely
What is NOT true about liquids?
they expand to fill their container
what does not affect Communication between individuals?
time of day
necrosis
tissue death
Why is the electrical impuse temporarily delayed at the atrioventricular (AV) node?
to allow better filling of the ventricles
What is not a purpose for obtaining family history?
to determine whether the patient is adopted
What is not a purpose of an interview?
to identify plans for payment
What is the primary purpose of indexed connector system?
to prevent inadvertent misconnections between equipment
what is the main purpose of initial assessment stage?
to verify that the prescribed treatment is still needed and appropiate
what techniques for expressing genuine concern is most difficult to use appropiatly?
touch
A physician orders bland water aerosols administration to a patient with a tracheostomy. Which of the following airway devices could you to meet this goal?
tracheostomy mask, T tube
Causes of inadequate mist production with pneumatically powdered jet nebulizers include all of the following except?
tripped circuit breaker
What are the diseases that is transmitted primarily by airborne transmission?
tuberculosis, mealses and small pox
BID
twice a day
What are some key patient considerations in selecting, O2 therapy equipment?
type of airway (natural or artificial), severity ad cause of hypoxemia, age group (infant, child adult) and stability of the minute ventilation.
Which of the following nebulizer uses a peizoelectric transducer to generate liquid particle aerosols?
ultrasonic nebulizer
What is the major limitation with High Flow Nasal Cannula?
unable to determine and monitor levels of possitve pressure
Advantages of the dry powder inhaler (DPI) drug delivery systems include all the following except?
unaffected by humidity
Based on the following ABG results what is most likely acid base diagnosis? pH 7.28, PCO2 53 mmHg HCO3 25.8mEq/L PaO2 74?
uncompensated respiratory acidosis with mild hypoxemia
Wht is the method for communicating empathy to your patients?
use of touch, key words and eye contact
Which of the following methods can be used to minimize the harmful effects of enviroment exposure to ribavirin or pentamidine aerosols?
using an isolation booth or tent with HEPA filtered exhaust, have health care personnel wear a HEPA filtered mask, and Use a negative pressure room with adequate air exchange
what is not a common reservoir mask?
venturi mask
What can have an impact on the outcomes of thereapeutic communication between patient and practictioner
verbal and nonverbal components of expression, enviromental factors, values and beliefs of both patient and practioner and sensory and emotional factors
Soft, muffled sounds heard mainly during inspiration over the peripheral lung parnchyma best describe what breathing sounds?
vesicular
What is not considered a classifie as a classic vital sign?
vital signs trends are far more important than a single measurement
What parameter is measured on the vertical axis of the ECG paper?
voltage
When setting up a nasal cannula to a flowmeter, you set the floating ball inside the thorpe tube:
where it says on the flowmeter itself
WA
while awake
When one is conducting an interview with a patient, which of the following points is most important in facilitating an effective enteraction with the patient?
your ability to project a sense of individed interest in the patient.
What site is used to measure body temperature in comatose patients?
Rectal
Assessing the patients level of consciousness is important because it?
evaluates the adequacy of cerebral perfusion and oxygentation
What vaccination does OSHA require hospital employers to provide?
Hepatitis B
Who is considered the (Father of Medicine)?
Hippocrates
Which of the following is the most common site arterial puncture?
Radial artery
What method of heat transfer requires no direct contact between the warmer and cooler substance?
Radiation
What mechanism is responsible for production of an abnormal third heart sound?
Rapid filling of the ventricles immediatley after systole
Which of the following characteristics should be inclueded assessment of a patients pulse?
Rate, rhythm and strength
Medical records are strictly confidential and are protected under what law?
HIPPA
What disease is transmitted through direct contact?
HIV
HIPPA was established in 1996 to set standards related to sharing confidential health history information about patients, what does the letter P stands for?
Portability
Which state of patient-clinican interaction is the review of physician orders carried out?
Pre-interaction stage
What is a NOT a sanction that applies when one breaks the law?
Professional censure
To clean a cylinder valve outlet of foreign material , what should you do?
Quickly open, then close the valve
A physician specifies an incorrect dose in a prescription for a powerful bronchodilator drug to be given to an asthmatic patient. When the respiratory therapist gives the prescribed dose, the patient suffers a fatal response and dies. Based on the principle duty, against whom could a suit of negligence be brought?
RT, attending physician and dispensing pharmacist
which of the following organizations influences what need to be documented in a patient's medical records?
The Joint Commision
What is the term for a civil wrong committed against an individual or property for which a court provides a remedy in the form of damages?
Tort
A 35 year old, 54 kg woman with congestive heart failure enters the emergency department short of breath. An ABG shows the following results: pH 7.50, PaCO2 30 mmHg, HCO3 23mEq/L The patients ABG results indicate what?
Uncompensated respiratory acidosis
hemoptysis
coughing up blood stained sputum
Compensation for metabolic acidosis occurs through which of the following?
decrease in blood CO2 levels
You note that the air intake ports surrounding the jet of a 35% air entrainment mask are partially obstructed by the patients bedding. What would you expect?
decrease the device's total output flow
Specific clinical objectives of oxygen (2) therapy include what?
decrease the symptoms caused by chornic hypoxemia, decrease the workload hypoxemia imposes on the heart and lungs, and correct documented arterial hypoxemia.
With partially compensated respiratory alkalosis, which of the following blood gas abnormalities would you expect to encounter?
decreased HCO3, decreased PCO2 and increased pH.
In the face of uncompensated respiratory acidosis, which of the following blood gas abnormalities would you expect to encounter?
decreased pH and increased PCO2
Which of the following indicate that administration of bland water aerosol to a patient with post extubation upper airway edema was having the desired effect?
decreased work of breathing, improved vital signs, decreased stridor or dysnpnea, and improved oxygen saturation.
When assessing a patients response to bronchodilator therapy, you notice a decrease in wheezing accompanied by an overall increase in the intensity of breath sounds. Which of the following is most likely?
decreasing airway obstruction
hypo
deficient decreased
Dx
diagnosis
Which of the following abnormalities should the practioner be on the lookout for during inspection of the extremities?
digital clubbing, peripheral cyanosis, pedal edema, impaired capillary refill and low peripheral skin temperature
What is the major problem with using large volume nebulizers fro continous aerosol drug therapy?
drug concentration and toxicity
What is not a critical element of a patients social enviroment history?
drugs and medications`
Which of the following devices depends on the patients inspiratory effort to dispense the dose?
dry powder inhaler
What is the most common complication of hyperbaric oxygen therapy?
ear or sinus barotrauma
That term applies to any heartbeat that originates outside the SA node?
eccentric impulse
Which of the following clinical findings swould you expect in a fully compensated respiratory acidosis?
elevated HCO3 and pH between 7.35 and 7.39
Which of the following describes the mass of drug leaving the mouthpiece of a nebulizer as aerosols?
emitted dose
