review

a patient arrives in the ED after being pulled from a burning house. The RT should recommend obtaining which of the following measurements to best determine the severity of the patient's smoke inhalation? A. SpO2 B. HbCO c. PaO2 D. Hb

B. HbCO

The respiratory therapist is transporting a patient with a nasal cannula running at 6 l/min. for the E cylinder to last at least 1 h what is the minimum amount of pressure it must contain? a. 1000 psig b. 1200 psig c. 1400 psig d 1600 psig

( cylinder pressure X cylinder factor )/ liter flow e cylinder- .28 answer is C

the therapeutic use of O2 may aid in which of the following 1. decrease WOB 2. decrease myocardia work 3. prevent ARDS 4. increase the patients RR

1 and 2 only

while making o2 rounds, you discover that the 6 inch reservoir tubing on a t-piece (briggs adapter) setup has fallen off. What may result from this? 1. delivered FiO2 would decrease 2. delivered FiO2 would increase 3. the patient would entrain room air during inspiration 4. the total flow from the nebulizer would decrease

1 and 3

Administration of high O2 concentrations to a neonate for a prolonged period of time may result in which of the following? 1. atelectasis 2. retinopathy of prematurity 3. pneumothorax 4. persistent pulmonary hypertension of the newborn

1. atelectasis 2. retinopathy of prematurity

Advantages of low-pressure, high-volume ET tube cuffs include: 1. easier insertion into the airway 2. less occlusion to tracheal blood flow 3. improved distribution of alveolar air

2. only. (less occlusion to tracheal blood flow)

to prevent the obstruction of venous blood flow form the trachea, ET tube cuff pressure should not exceed a. 5 mmHg b. 10 mmHg c. 20 mmHg d. 25mmHg

20mmHg

You suspect a patient may have a pulmonary embolism. Which of the following would be the most appropriate recommendation for diagnosis of this condition? a. bronchoscopy b. v/q lung scan c. coagulation studies d. shunt study

B. the best diagnostic test to determine whether a pulmonary embolism is present is the V/Q lung scan

PIP 50 cmh2o Pplat 40 cmh2o vt 800mL PEEP 10 cmh2O on the basis of this information, the patient's static lung compliance is approximately?

Vt / (Pplat-PEEP) =27cmH2o

The physician orders a 35% aerosol mask to be set up for a patient who requires an inspiratory flow of 42 l/min. What is the minimum flow rate to which the flowmeter must be set to meet this patient's inspiratory flow demand?

The air/o2 ratio for a 35% oxygen mixture is 5:1. (5+1)=6 6*8= 48 L/min 8 L/min

a 70-kg patient is receiving mechanical ventilation. The respiratory therapist notes the patient's SpO2 drops from 97% to 86%. the right lung is expanding more than the left, with clear breath sounds on the right but diminished ones on the left. The patient's ET tube is tabed at the 29-cm mark at the lip. Which of the following should the RT do at this time?

Tube should be withdrawn.

which of the following medications would be most indicated in the TX of a patient with Lg amounts of thick secretions? a. salmeterol b. hypotonic saline c. acetylcysteine d. albuterol

c. acetylcysteine

the physician has ordered 40% o2 to be administered to an active 3 year old. which of the following delivery devices would you recommend for this patient a. o2 tent b. air entrainment mask c.simple o2 mask d.o2 hood

a. O2 tent an active 3-year-old generally tolerates an oxygen tent much better than any kind of mask and is too large for an O2 hood

the respiratory therapist is asked to deliver a mediation to a patient with CF via nonpressurized aerosol that will improve mobilization of sputum. Which of the following should be recommended? a. acetylcysteine (mucomyst) b. propylene glycol c. R. epi d. dexamethasone

a. acetylcysteine

a patient receiving mechanical ventilation with a volume ventilator is ordered to have PEEP initiated. Observation of which of the following values will best determine the optimal level of PEEP a. cardiac output b. PaO2 c. PaCo2 d. vd/vt

a. cardiac output

during CPR, the physician is preparing to administer lidocaine IV and discovers that the IV is infiltrated. The most appropriate action to take at this time is to a. instill the Lidocaine down the ETT b. administer the lidocaine using a HHN c. place a new IV line and administer the lidocaine d. administer the lidocaine sublingually

a. instill the lidocaine down the ETT

it is important to monitor airway pressure in a patient receiving mechanical ventilation because it best reflects a. lung compliance b. PaO2 c. PaCO2 d. ICP

a. lung compliance

tracheal secretions tend to dry out in an intubated patient when inspired air has which of the following characteristics? 1. an absolute humidicty of 24mg/L 2. a water vapor pressure of 47 mmHg 3. 50 mg of particulate water per liter of gas 4. a relative humidity of 100% at 25C

an absolute humidity of 24 mg/L of gas a relative humidity of 100% at 25C

to begin the weaning process form the ventilator, a patient should be able to obtain a MIP of at least a. -10 b. -20 c. -30 d. -40

b. -20

while assessing a patient with chest trauma in the ICU, the respiratory therapist observes that the patient's chest tube, which is connected to an underwater seal drainage system, is outside the chest wall. Which of the following statemtns are correct about this situation? a. the tube should be clamped immediately b. a complete pneumothorax is possible c. the tube should be disconnected from suction d. suction pressure should be increased

b. a complete pneumothorax is possible

you are instructing a patient about the proper procedure for using an MDI. you would instruct the patient to activate the medication in the inhaler a. just before inspiration b. just after inspiration has begun c. at the end of exhalation d. after inhaling as deeply as possible

b. just after inspiration has begun

which one of these drugs would be best to use to temporarily paralyze a patient to facilitate tracheal intubation a. atropine sulfate b. succinylcholine c. midazolam d. pancuronium bromide

b. succinylcholine

which of these devices is not a low-flow device? a. nasal cannula b. venturi mask c. partial rebreathing mask d. simple o2 mask

b. venturi mask

failure to hyperoxygenate a patient on a ventilator before ET suctioning may result in 1. Hypocarbia 2. Hypoxemia 3. Hypertension 4. Bradycardia

bradycardia and hypoxemia

a post-op 80 kg patient is breathing spontaneously at a rate of 30/min, with an FiO2 of .50. ABG: 7.29. 62, PaO2 64 HcO3 29 mEq/L, BE +4 mechanical ventilation is institute with a Vt of 800 and fio2 of .5 simv rate should be a. 4/min b. 6/min c. 12/min d. 16/min

c. 12/min

COPD in ED and is complaining of SOB, ABG: 7.31, 62, 44, 34, +10 the most appropriate recommendation for o2 therapy would be a. simple mask 10 l/min b. nasal cannula 6 l/min c. AEM 28% d. aerosol mask 40%

c. AEM at 28%

to most effectively increase a patient's alveolar minute ventilation while the patient is using a ventilator in the control mode, you would recommend increasing which of the following? a. sigh rate b. inspiratory flow c. Vt d. ventilator rate

c. Vt Alveolar minute ventilation = (Vt-Vd) * RR

an 80 kg patient with ARDS is intubated and is receiving mechanical ventilation with the following settings: simv, 10/min, 700mL, 10 cm H2O the therapist notes that the patient's spo2 has dropped from 98% to 85% over the past 2 h. the therapist notes that the PIP has increased from 36 cmh2o to 46, and the pplat has increased from 28 to 38. Which of the following should be recommended? a. increase the Fio2 to 100 b. suction the patient c. increase the PEEP to 12 cmh2o d. administer aerosolized albuterol

c. increase the PEEP to 12 cmH2O

vt 750, mode simv, rate 4/min, spontaneous rate 12/min, fio2 35%, ABG: 7.29, 50, 72, 26, +1 on the basis of this data, which of the following should be recommended? a. increase Vt to 850 mL b. increase fio2 to .40 c. increase the ventilator rate to 8/min d. change to assist/control of 15/min

c. increase the ventilator rate to 8/min

the use of inspiratory plateau setting on a ventilator results in 1. decreasing mean intrathoracic pressure 2. increasing diffusion of gases 3. decreasing atelectasis

d. 2 and 3 only

if not cleaned properly, which one of the following devices is most likely to contaminate a patient's airway with bacteria? a. bubble humidifier b. heated wick humidifier c. hydrosphere d. heated jet nebulizer

d. heated jet nebulizer

when a patient is receiving ventilation in the control mode, how may the PaCo2 best be raised? a. increase Vt b. incrase fiO2 c. decrease the mechanical dead space d. decrease the RR

decrease the RR

a patient is receiving ventilation with a volume-cycled ventilator, and the low-pressure alarm suddenly sounds, The corrective action would be to: a. suction the patient b. begin manual resuscitation c. increase the flow d. determine whether the patient is disconnected from the ventilator

determine whether the patient is disconnected from the ventilator

inspiratory stridor is the major clinical sign of a. tracheal malacia b. tracheal stenosis c. glottis edema d. laryngeal web

glottic edema

A premature infant is receiving O2 via a 50% O2 hood and had a PaO2 of 43 torr and a PaCO2 of 40 torr. The respiratory therapist should

initiate CPAP of 4 cmh2O and 50% O2 (increase the PaO2 by increasing the o2 no more than 60%. Mechanical ventilation is not indicated because the patient's CO2 is normal

an 8-day-old neonate is receiving pressure-limited, time cycled mechanical ventilation. over the past 36 hours, the neonate's PaO2 has decreased from 58 torr to 47 torr. the physician wants to increase the MAP. which of the following increase the map 1. increasing pressure limit 2. expiratory time 3. inspiratory time

inspiratory pressure limit inspiratory time

a 60-kg, 52 year old man is admitted to the ICU for the treatment of refractory hypoxemia. He is currently using a ventilator in the pressure support mode at 10 cm H2O and an FiO2 of 60. 7.49 30 59 Hr 120 RR 26

institute 5cmh2o of peep

a patient has been paralyzed with vecuronium and is receiving mechanical ventilation, which of the following ventilator monitoring alarms would be the most important? a. low pressure b. high pressure c. inspired gas temperature d. I:E time

low pressure

a patient recovering postoperatively is receiving ventilation in the SIMV mode. The patient has a normal ABG with the use of 35% O2 but is still drowsy. The respiratory therapist should recommend decreasing the a. simv rate b. inspiratory time c. Vt d. sign volume

simv rate

the most reliable method of determining whether the lungs of a patient receiving mechanical ventilation are getting stiffer and harder to ventilate is by measuring the

static lung compliance

a 6-day-old premature infant of 30 weeks gestation is experiencing frequent periods of apnea with desaturation. Which of the following medications should the therapist recommend? a. surfactant b. albuterol c. theophylline d. naloxone (narcan)

theophylline