module questions for clinical 2 final

An RT is orienting a new graduate RT to the concepts of home oxygen therapy. When asked to identify an OCD, which response by the new graduate RT is correct? A. "A transtracheal oxygen catheter is a type of OCD." B. "A nonreservoir nasal cannula is the preferred OCD." C. "A compressed oxygen cylinder is a kind of OCD." D. "One type of OCD is a reservoir mask."

A. "A transtracheal oxygen catheter is a type of OCD."

Which should not be delivered by high-flow nasal oxygen therapy? A. 21% to 100% FIO2 without regard to the patient's respiratory drive B. 21% to 100% FIO2 with regard to the patient's respiratory drive C. 40% to 100% FIO2 with regard to the patient's respiratory drive D. 21% to 90% FIO2 with regard to the patient's respiratory drive

A. 21% to 100% FIO2 without regard to the patient's respiratory drive

A respiratory therapist is educating a patient with a newly prescribed peak flowmeter. The patient has completed three PEF attempts with results of 550 L/min, 580 L/min, and 575 L/min. Which value should be recorded as the patient's personal best? A. 580 L/min B. 550 L/min C. 575 L/min D. 568 L/min

A. 580 L/min

A patient with a traumatic brain injury has been receiving mechanical ventilation for 2 days. The RT is assessing the best mode of ventilation to be used during weaning and needs to decide between CPAP and a T-piece trial. When determining which mode to use, what is one factor to consider? A. A T-piece allows for close monitoring of the respiratory rate and VT through the ventilator. B. A patient with a traumatic brain injury will generally tolerate a T-piece trial better than CPAP. C. CPAP allows for close monitoring of the respiratory rate and VTthrough the ventilator. D. A CPAP trial on a patient with a traumatic brain injury is contraindicated because this trial enlists hypercarbia as a means of weaning.

A. A T-piece allows for close monitoring of the respiratory rate and VT through the ventilator.

A patient is on dopamine, and the respiratory therapist notices that his extremities feel cool to the touch. Which is the most accurate device to continuously monitor SpO2? A. A forehead reflectance sensor B. A disposable finger probe on any extremity C. A reusable finger probe on a hand placed under a blanket D. A finger probe placed on the side without a noninvasive automated blood pressure monitor cuff

A. A forehead reflectance sensor

When a bronchodilator is prescribed for a 5-year-old patient, the respiratory therapist should understand which concept? A. A spacer is recommended. B. The patient is too young for asthma. C. The patient can self-administer the medication at school. D. The patient is less susceptible to systemic effects.

A. A spacer is recommended.

Which sputum specimen test supports a diagnosis of tuberculosis? A. AFB B. General cytology C. Chemical analysis D. Culture and sensitivity

A. AFB

A patient receiving mechanical ventilation for status asthmaticus has developed elevated plateau pressures and hypotension. The respiratory therapist notifies the authorized practitioner. What orders should the respiratory therapist anticipate? A. Administer sedatives or paralytics (or both). B. Withhold any further bronchodilators. C. Adjust the ventilator to increase the inspiratory time and decrease the expiratory time. D. Place a smaller-diameter ET tube.

A. Administer sedatives or paralytics (or both).

A patient in an SBT with a T-piece after prolonged ventilator use begins to cough, and the pulse oximetry reading drops to 73%. What should the respiratory therapist do first? A. Assess and manage any airway patency issues. B. Reconnect the patient to the ventilator. C. Increase the oxygen flow to the T-piece. D. Drain excess water from the water trap.

A. Assess and manage any airway patency issues.

The RT has successfully exchanged the malfunctioning ET tube. To ensure patient stability, the RT should now perform which task? A. Assessing for bilateral breath sounds B. Assessing the malfunctioning ET tube to determine the type of damage C. Assessing for correct ET tube size D. Assessing for leaks in the new ET tube

A. Assessing for bilateral breath sounds

. A patient who has been receiving long-term mechanical ventilation in the intensive care unit is beginning to show signs of respiratory improvement. The RT decides to place the patient on a pressure-supported CPAP weaning trial with a PSV level of 20 cm H2O and CPAP level of 8 cm H2O. Thirty minutes after PSV is started, the patient's spontaneous respiratory rate is 18 breaths/min with a spontaneous VT of 8 ml/kg. What is the most appropriate intervention? A. Continue to assess the patient closely for fatigue and provide full ventilatory support during the night to facilitate rest. B. Increase the level of PSV to facilitate weaning and extubation within 24 hours. C. Continue at the same settings around the clock to encourage endurance conditioning because the patient has been receiving long-term mechanical ventilation. D. Discontinue the PSV mode and provide full ventilatory support immediately.

A. Continue to assess the patient closely for fatigue and provide full ventilatory support during the night to facilitate rest.

When performing chest physiotherapy for a patient with continuous tube feeding, what action should the RT take? A. Ensure that an order is in place to stop the feeding before therapy begins and for at least 1½ to 2 hours after the treatment ends. B. Withhold therapy if any tube-feeding residue is present. C. Refrain from performing chest physiotherapy because it is contraindicated in patients receiving tube feedings. D. Ensure that the feedings are uninterrupted during chest physiotherapy.

A. Ensure that an order is in place to stop the feeding before therapy begins and for at least 1½ to 2 hours after the treatment ends.

Which is the correct sequence for using a laryngoscope when orally intubating a patient in respiratory arrest? A. Grasp the laryngoscope in the left hand, enter the right side of the patient's mouth, and push the tongue to the left. B. Grasp the laryngoscope in the right hand, enter the right side of the patient's mouth, and push the tongue to the left. C. Grasp the laryngoscope in the left hand, enter the left side of the patient's mouth, and push the tongue to the right. D. Grasp the laryngoscope in the right hand, enter the left side of the patient's mouth, and push the tongue to the right.

A. Grasp the laryngoscope in the left hand, enter the right side of the patient's mouth, and push the tongue to the left.

While placing the electrodes on the patient's head using the international 10-20 system, the RT cleans and prepares the electrode sites to reduce which item? A. Impedance B. Conduction C. Convection D. Voltage

A. Impedance

Which finding is an expected outcome of nasotracheal suctioning? A. Improvement in breath sounds B. Worsening respiratory distress C. Difficulty passing the suction catheter D. Suctioning bloody secretions

A. Improvement in breath sounds

When explaining the use of the incentive spirometer to a family, the respiratory therapist should emphasize which information? A. Incentive spirometry is one way to help prevent postoperative lung collapse. B. Deep breathing and coughing are not as effective in preventing postoperative lung collapse. C. Young children are unable to breathe deeply enough to use incentive spirometry. D. The child's achievement of the target volume and number of repetitions is not important.

A. Incentive spirometry is one way to help prevent postoperative lung collapse.

The patient has performed four spirometry maneuvers with the following results:FVC 4 L, 3.9 L, 3.95 L, 3.98 L; and FEV1 2.5 L, 2.3 L, 2.1 L, 2.69 L.How should the RT respond to the results? A. Instruct the patient to blow out harder. B. Instruct the patient to take in a deeper breath. C. Instruct the patient to blow out longer. D. Instruct the patient not to hesitate before taking in a breath.

A. Instruct the patient to blow out harder.

Exhaling into the DPI may cause which problem? A. Loss of medication dose because of exposure to humidity or moisture B. Increase the volume of medication delivered C. Contaminate the device D. Influence the dose counter

A. Loss of medication dose because of exposure to humidity or moisture

To avoid damage to the tracheobronchial mucosa when advancing the tube exchanger through the current ET tube, which requires the closest attention? A. Marking placed on the tube exchanger for the insertion depth line B. Marking placed on the tube exchanger for the leveling line C. Centimeter position of the current ET tube at the lip D. Position of the new ET tube

A. Marking placed on the tube exchanger for the insertion depth line

Following a successful weaning trial using an SBT T-piece at 50% FIO2, CPAP, and an IMV rate of six breaths/min, the RT should document which elements of a successful weaning trial in the medical record? A. Mode of weaning, level of support, and weaning tolerance B. Level of consciousness, respiratory rate, and amount of oxygen C. Weaning goals, patient education, and respiratory interventions D. Duration of the trial, individual weaning goals, and family reaction

A. Mode of weaning, level of support, and weaning tolerance

Detecting auto-PEEP in patients with asthma may be difficult. Which is the best intervention to assist in decreasing auto-PEEP in a patient with a history of status asthmaticus? A. Monitoring plateau pressure and placing a larger-diameter ET tube B. Sedating the patient and increasing the respiratory rate C. Monitoring plateau pressure and placing a smaller-diameter ET tube D. Occluding the expiratory port of the ventilator with a gloved hand at the end of expiration while watching the airway pressure manometer

A. Monitoring plateau pressure and placing a larger-diameter ET tube

A patient is receiving mechanical ventilatory support as a result of trauma. The patient has no previous medical problems. The latest ABG results reveal pH 7.4, PaCO2 40 mm Hg, PaO2 90 mm Hg, and HCO3- 25 mEq/L. Which interpretation of these ABG results is best? A. Normal B. Metabolic acidosis C. Respiratory acidosis with metabolic compensation D. Metabolic alkalosis with respiratory compensation

A. Normal

How should the respiratory therapist assess the child's ability to perform incentive spirometry correctly? A. Observe the child forming a tight seal and inhaling slowly and steadily. B. Observe the child inhaling rapidly to raise the floating ball. C. Observe the child exhaling quickly to lower the floating ball. D. Observe the child holding his or her breath for 15 seconds.

A. Observe the child forming a tight seal and inhaling slowly and steadily.

An infant requires oxygen therapy at 28% FIO2. What is the appropriate setup and flow rate? A. Oxygen hood at greater than 7 L/min B. Nasal cannula at 5 L/min C. Simple face mask at 4 L/min D. Partial rebreather mask at 4 L/min

A. Oxygen hood at greater than 7 L/min

During a sleep study, the RT documents EEG arousals. Which phrase describes EEG arousal? A. Paroxysms of activity lasting 3 seconds or longer but less than 15 seconds, with sleep maintained before and after the arousal B. Delta activity of 4 Hz or slower C. Predominant theta activity D. Vertex sharp waves that may occur toward the end of stage 1 sleep

A. Paroxysms of activity lasting 3 seconds or longer but less than 15 seconds, with sleep maintained before and after the arousal

When treating pneumonia, which is the best way to determine the correct antibiotic to use? A. Perform a sputum examination. B. Obtain a radiograph. C. Assess the patient's history. D. Assess the patient's breath sounds.

A. Perform a sputum examination.

The RT is precepting a new RT who is preparing for the emergency intrafacility transport of a critically ill patient who is receiving mechanical ventilation. Which action would indicate the new RT needs further education? A. Placing the transport ventilator in the bed with the patient. B. Checking the operation and battery capacity of the transport ventilator. C. Reviewing the patient's medical record for infection status. D. Giving a thorough handoff report of the RT's other patients.

A. Placing the transport ventilator in the bed with the patient.

An unconscious older adult patient with significant respiratory distress needs to be intubated. Which is the most appropriate sequence of actions? A. Preoxygenate the patient with a self-inflating bag-mask device and premedicate him or her with sedatives. B. Premedicate the patient with paralytics, insert an oral airway, and preoxygenate him or her with a self-inflating bag-mask device. C. Preoxygenate the patient with a self-inflating bag-mask device, premedicate him or her with sedatives and paralytics, and insert an oral airway. D. Premedicate the patient with sedatives and paralytics and preoxygenate him or her with a self-inflating bag-mask device.

A. Preoxygenate the patient with a self-inflating bag-mask device and premedicate him or her with sedatives.

If the patient is to use a single-dose DPI, the respiratory therapist should assess his or her ability to perform which action? A. Remove the cap, puncture the foil packet, and place the capsule in the DPI. B. Observe the dose counter on the device. C. Attach the valve spacing device. D. Clean the device with soap and water after each use.

A. Remove the cap, puncture the foil packet, and place the capsule in the DPI.

Which condition is an unexpected outcome of suctioning an artificial airway? A. Return of bloody secretions B. Normalization of heart rate, blood pressure, and respiratory rate and effort C. Normalization of pulse oximetry D. Absent or diminished adventitious breath sounds

A. Return of bloody secretions

A patient with COPD is recovering from postoperative abdominal surgery. The prescribing practitioner has ordered an incentive spirometer to decrease the chance of pneumonia. Which outcome is an unexpected outcome? A. Shortness of breath after the use of the incentive spirometer B. Correct patient demonstration of use of the incentive spirometer C. Improved breath sounds after the use of the incentive spirometer D. Patient achievement of target volume and number of repetitions per hour after the use of the incentive spirometer

A. Shortness of breath after the use of the incentive spirometer

PEP would be indicated in a patient with which parameter? A. SpO2 less than 90% B. Hemoptysis C. ICP greater than 20 mm Hg D. Recent otolaryngologic surgery

A. SpO2 less than 90%

A patient had a preoperative inspiratory capacity volume measurement of 6000 ml, which was equal to his predicted value before an appendectomy. What is the minimum acceptable postoperative volume to be achieved with an incentive spirometer? A. 1000 ml B. 2000 ml C. 4000 ml D. 5000 ml

B. 2000 ml

When suctioning a patient for a sputum sample, which action should be taken? A. Suction for no longer than 15 seconds. B. Suction for 5 to 10 seconds while the patient inhales. C. Suction until sputum is obtained no matter how long it takes. D. Apply suction while inserting the catheter.

A. Suction for no longer than 15 seconds.

While caring for a patient who has ARDS, the RT notices that the Cstatremains the same whereas the Cdyn is decreasing. What should the RT understand about these changes? A. The patient has increased RAW and should be evaluated for bronchospasms or retained secretions. B. The patient's compliance is most likely getting worse, and he is at increased risk for barotrauma or volutrauma. C. The patient's lungs are getting stiffer and may benefit from a higher VT to improve ventilation. D. The patient may benefit from a smaller ET tube to increase airflow to the lungs.

A. The patient has increased RAW and should be evaluated for bronchospasms or retained secretions.

Which statement demonstrates the patient's ability to perform incentive spirometry correctly? A. The patient inhales slowly and deeply from a normal expiratory breath. B. The patient inhales rapidly from a small expiratory breath. C. The patient exhales quickly from a deep expiratory breath. D. The patient holds the breath for 15 seconds.

A. The patient inhales slowly and deeply from a normal expiratory breath.

Which practice indicates that the patient understood the home health instructions regarding the use of an oxygen delivery system? A. The patient requests guests to smoke outside the home. B. The patient stores the oxygen system inside a closet. C. The patient stores the oxygen tanks on their sides. D. The patient cooks dinner on a gas stove.

A. The patient requests guests to smoke outside the home.

The VTS of a 70-kg (154-lb) patient receiving mechanical ventilation is 350 ml. Which physiologic process does VTS measure? A. The patient's respiratory muscle endurance, and 350 ml indicates adequate respiratory strength for this patient B. The patient's expiratory force, and 350 ml indicates a strong expiratory force and suggests that extubation will probably be successful for the patient C. The patient's ability to tolerate extubation; the threshold is 4 ml/kg D. The patient's respiratory muscle endurance, and the f/VT ratio indicates that the patient will tolerate extubation

A. The patient's respiratory muscle endurance, and 350 ml indicates adequate respiratory strength for this patient

When receiving medication through a pMDI with a spacer and mask, a young child should breathe through the mask how many times? A. Three to seven times B. One time and then hold the breath for 10 seconds C. Three times and then hold the breath for 5 seconds D. Two times

A. Three to seven times

Which situation describes when the femoral artery should be considered as the site for arterial puncture? A. Upper extremities have altered perfusion. B. Lower-extremity limb ischemia is present. C. Hemostasis is difficult to obtain after puncture. D. The brachial artery is accessible.

A. Upper extremities have altered perfusion.

If a patient is unwilling to quit smoking, what should the RT do? A. Use a brief intervention based on principles of motivational interviewing. B. Recommend the use of approved medications that have been found to be effective. C. Arrange for follow-up contacts soon after the quit date. D. Encourage the patient to tell family, friends, and coworkers about quitting and to request their understanding and support.

A. Use a brief intervention based on principles of motivational interviewing.

Soon after being extubated due to good weaning indices, a patient in the intensive care unit experiences dyspnea, becomes restless, and uses accessory muscles to breathe. The RT realizes that the patient cannot tolerate extubation and immediately facilitates reintubation. What is the most reasonable explanation as to why this patient may be unable to tolerate extubation? A. Weaning indices are poor positive predictors but are strong negative predictors. B. Weaning indices are strong positive predictors but are poor negative predictors. C. Obtaining the weaning indices fatigued the patient. D. Weaning indices were obtained incorrectly, and inaccurate results were documented.

A. Weaning indices are poor positive predictors but are strong negative predictors.

A patient has been admitted with a diagnosis of advanced Parkinson disease. The respiratory therapist is asked to assess the patient using pulse oximetry. What is the most efficient sensor to use for this patient? A. Toe probe B. Finger probe C. Earlobe probe D. Disposable sensor pad

C. Earlobe probe

When instructing a patient about how to breathe during a nebulizer treatment, the respiratory therapist should give which directive? A. "Perform huff coughs after every fourth or fifth breath." B. "Take a slow, deep breath, allow a brief end-inspiratory pause, and then exhale passively." C. "Breathe in and out rapidly, as during a respiratory assessment." D. "Breathe normally during the treatment."

B. "Take a slow, deep breath, allow a brief end-inspiratory pause, and then exhale passively."

When teaching a patient how to perform a huff cough, the respiratory therapist should include which instruction? A. "Complete the huff breaths before the PEP device treatment, and then repeat them after the treatment." B. "Take in a slow, deep breath that is larger than normal and hold it for 2 to 3 seconds." C. "Keep your mouth closed around the PEP device and huff out through your nose." D. "Take in three rapid breaths and breathe out with a huff."

B. "Take in a slow, deep breath that is larger than normal and hold it for 2 to 3 seconds."

A 70-kg (154-lb) patient who has ARDS has these ventilator settings: fraction of inspired oxygen, 0.5; PEEP, +20 cm H2O; synchronized intermittent mandatory ventilation, 14 breaths/min; pressure support, 10 cm H2O; flow rate, 40 L/min; PIP, 60; plateau pressure, 40; and VT, 700 ml. What is the calculated value and conclusion for RAW? A. 30.3 cm H2O/(L/sec), normal B. 30.3 cm H2O/(L/sec), increased C. 0.5 cm H2O/(L/sec), increased D. 0.5 cm H2O/(L/sec), normal

B. 30.3 cm H2O/(L/sec), increased

A PEF measurement should not be attempted on which patient? A. A 64-year-old patient with mild retractions, respiratory rate of 28 breaths/min, and pale skin B. A 24-year-old patient who is diaphoretic and is speaking only one word at a time C. A 6-year-old child with expiratory wheezing after T-ball practice who is speaking in complete sentences D. A 19-year-old patient with a respiratory rate of 24 breaths/min whose skin is warm, pink, and dry

B. A 24-year-old patient who is diaphoretic and is speaking only one word at a time

While assessing weaning criteria for a patient with pneumonia, the respiratory therapist obtains an NIF of −30 cm H2O. Which condition does this result indicate? A. A weak NIF, which suggests that the patient will do poorly with extubation B. A strong NIF, which is just one indicator that the patient will tolerate extubation C. A strong NIF, which indicates patient cooperation because NIF is an effort-dependent test D. A weak NIF, which indicates that the patient will most likely do well with extubation

B. A strong NIF, which is just one indicator that the patient will tolerate extubation

To ensure proper medication delivery with a DPI, the respiratory therapist should assess the patient's ability to perform which action? A. Take a slow, deep breath. B. Achieve an adequate inspiratory flow. C. Exhale while loading the capsule into the DPI. D. Attach a spacer device to the DPI.

B. Achieve an adequate inspiratory flow.

In preparation for extubation, a 48-year-old trauma patient has been decreased from an IMV rate of 12 breaths/min to an IMV rate of six breaths/min to facilitate spontaneous breathing. The patient has tachypnea and appears to be displaying early signs of respiratory fatigue. What is the most appropriate intervention? A. Continue with the IMV rate of six breaths/min to facilitate muscle strengthening and keep the patient on track for extubation. B. Add PSV to the ventilator settings to encourage weaning and offset the work associated with circuit resistance. C. Return the patient to full ventilator support to prevent respiratory fatigue. D. Manually ventilate the patient and return to full ventilator support because the tachypnea indicates that the patient is not ready for extubation.

B. Add PSV to the ventilator settings to encourage weaning and offset the work associated with circuit resistance.

To allow adequate ventilation and oxygenation during suctioning, which action should the RT take? A. Perform at least four suctioning passes but no more than five passes with the suction catheter. B. Allow adequate time between suctioning passes. C. Suction again immediately after a pass to minimize the overall procedure time. D. Perform at least three suctioning passes but no more than four passes with the suction catheter.

B. Allow adequate time between suctioning passes.

What is not needed during preparation for the administration of high-flow nasal oxygen therapy? A. An appropriate circuit for the high-flow device B. An oxygen E-cylinder C. Sterile water to fill the humidifier chamber D. A nasal cannula of appropriate size

B. An oxygen E-cylinder

What is the first step made by an RT using the "5 As" counseling model for treating tobacco use and dependency? A. Advise the patient to quit. B. Assess the patient's tobacco-use status. C. Assess the patient's willingness to quit. D. Arrange for follow-up care.

B. Assess the patient's tobacco-use status.

During an SBT, an aerosol nebulizer was used to deliver cool aerosol to the patient using a T-piece. Tenacious secretions made suctioning difficult. What should the respiratory therapist do? A. Replace the aerosol nebulizer. B. Attach a heater to the aerosol nebulizer. C. Lengthen the reservoir tubing. D. Increase suction pressure.

B. Attach a heater to the aerosol nebulizer.

How can an adult patient make PEF assessment more accurate? A. By being supine and relaxed during the attempt B. By standing or sitting up straight (if unable to stand) C. By exhaling through both the mouth and the nose to empty the lungs quickly D. By holding the mouthpiece loosely between the lips to avoid obstructing the scale

B. By standing or sitting up straight (if unable to stand)

The patient has performed three acceptable spirometry maneuvers. What should the RT do now? A. Check for reproducibility. B. Check for repeatability. C. Check for usability. D. Check for "Gold Standard" acceptability.

B. Check for repeatability.

A critically ill patient receiving mechanical ventilation has just returned to the unit after a intrafacility transport to the radiology department. Which intervention is the lowest priority for the RT upon returning to the unit? A. Monitor the transported patient's vital signs and ventilator-delivered tidal volumes. B. Check on other patients in the unit who were left during the absence. C. Check the transported patient's ET tube for correct placement and cuff pressure. D. Monitor the transported patient's end-tidal carbon dioxide level.

B. Check on other patients in the unit who were left during the absence.

What is the most important patient information the RT should have before obtaining a blood sample for ABG analysis? A. Isolation precautions B. Coagulation values C. Weaning parameters D. Mixed venous oxygen results

B. Coagulation values

When educating patients during pulmonary rehabilitation, which of these should the RT use? A. Didactic format B. Collaborative self-management education C. Educational videos D. The patient's own educational research

B. Collaborative self-management education

A patient has a prescription for a medication to be administered by pMDI. To determine whether the patient requires a spacer for the inhaler, what should the respiratory therapist assess? A. Ability to mix medications B. Coordination C. Medication dosage D. Medication schedule

B. Coordination

A patient is observed to have delayed hemostasis after an arterial puncture for ABG analysis. The hemostasis is most likely due to which cause? A. Hyperlipidemia B. Coronary artery disease C. Elevated PT, PTT, or INR D. Acute renal failure

C. Elevated PT, PTT, or INR

A patient who has a history of heart failure and pulmonary edema is at risk for which condition? A. Increased values in Cdyn and Cstat indicating increased lung compliance B. Decreased values in Cdyn and Cstat indicating decreased lung compliance C. Decreased values in Cdyn and Cstat indicating increased lung compliance D. Increased values in Cdyn and Cstat indicating decreased lung compliance

B. Decreased values in Cdyn and Cstat indicating decreased lung compliance

During the primary assessment of a patient with an ET tube, auscultation detects air movement and gurgling over the epigastrium. Which actions are the most appropriate? A. Secure the ET tube, connect to mechanical ventilation, and order a chest radiograph immediately. B. Deflate the cuff, remove the ET tube immediately, and ventilate the patient with a self-inflating bag-mask device. C. Manually ventilate the patient through the ET tube using a bag-mask device and order a chest radiograph immediately. D. Connect the patient to a pulse oximeter and cardiac monitor and assess him or her closely for signs and symptoms of hypoxemia.

B. Deflate the cuff, remove the ET tube immediately, and ventilate the patient with a self-inflating bag-mask device.

During the primary assessment of a patient with an endotracheal tube, auscultation detects air movement and gurgling over the epigastrium. Which action is the most appropriate? A. Secure the endotracheal tube, connect it to mechanical ventilation, and order a chest radiograph immediately. B. Deflate the cuff, remove the endotracheal tube immediately, and ventilate the patient with a self-inflating bag-mask device. C. Manually ventilate the patient through the endotracheal tube using a bag-mask device and order a chest radiograph immediately. D. Connect the patient to a pulse oximeter and cardiac monitor and assess him or her closely for signs and symptoms of hypoxemia.

B. Deflate the cuff, remove the endotracheal tube immediately, and ventilate the patient with a self-inflating bag-mask device.

What type of home educational program should the RT provide the patient? A. Group-oriented to cover everyone's goals B. Detailed, tailored, and individualized C. Geared to help the RT cover his or her goals D. Geared to help the program directives

B. Detailed, tailored, and individualized

A patient appears anxious about having an ABG sample drawn. How can the RT ease the patient's concerns? A. Starting the patient on oxygen B. Educating and preparing the patient for the test C. Performing a modified Allen test before initiating the puncture D. Using a nonheparinized syringe

B. Educating and preparing the patient for the test

A 70-kg patient with a history of acute respiratory distress syndrome has the following weaning measurements: negative inspiratory pressure of -20 cm H2O, spontaneous VT of 400 ml, MV of 8 L/min, and a spontaneous respiratory rate of 20 breaths/min after a CPAP weaning trial. The patient has a PaO2 of 97 mm Hg on 35% FIO2. Based on these values, how does the RT rate the patient as a candidate for extubation? A. Poor candidate for extubation because of an inadequate inspiratory force and high MV B. Good candidate for extubation but will most likely require supplemental oxygen once extubated C. Poor candidate for extubation because of FIO2 requirements and an inadequate spontaneous VT D. Good candidate for extubation and will not require supplemental oxygen once extubated

B. Good candidate for extubation but will most likely require supplemental oxygen once extubated

The RT is caring for a patient who is to undergo an initial weaning trial for 4 hours beginning at 2:00 PM. The patient is placed on CPAP with PSV. An ABG evaluation following completion of the trial notes a pH of 7.36, PaCO2 of 45 mm Hg, hydrogen carbonate of 26, and PaO2 of 80 mm Hg on 40% FIO2. The RT's assessment is that the patient is alert, with a respiratory rate of 20 with minimal use of accessory muscles. What is the most appropriate interpretation of these findings regarding the patient? A. Has not tolerated the trial and should be placed back on full support B. Has tolerated the trial and should have full support during the night C. Has tolerated the trial and is ready for immediate extubation D. Has not tolerated the trial and will need continued full support

B. Has tolerated the trial and should have full support during the night

When a patient is willing to attempt quitting, how should the RT respond? A. Use a brief intervention designed to promote the motivation to quit. B. Help the patient create a quit plan by setting a quit date. C. Ask the patient to identify barriers or impediments to quitting. D. Reinforce the patient's success at quitting.

B. Help the patient create a quit plan by setting a quit date.

The RT is preparing to perform nasotracheal suctioning. Unless contraindicated, before suctioning, the RT should first perform which action? A. Reassess the patient's respiratory status. B. Increase the supplemental oxygen. C. Remove the patient's oxygen source. D. Disconnect the tubing and the suction catheter.

B. Increase the supplemental oxygen.

What is one benefit of the Acapella device as an alternative for chest physiotherapy? A. It can be used at home with the assistance of one other caregiver. B. It does not depend on position, so the patient can sit, stand, or recline when using it. C. It needs to be used twice a day. D. It can be used with unconscious or heavily sedated patients.

B. It does not depend on position, so the patient can sit, stand, or recline when using it.

The RT walks into a postoperative patient's room with an incentive spirometer and the patient asks, "What is the purpose of that?" What is the most appropriate response describing the purpose of incentive spirometry? A. It administers aerosolized medications. B. It prevents postoperative complications. C. It measures the patient's peak flow. D. It improves expiratory flow.

B. It prevents postoperative complications.

What should the RT instruct the patient to do to facilitate the elimination of alpha activity? A. Close the eyes B. Keep eyes open C. Look left and right repeatedly while keeping head still D. Move the chest and abdomen in and out while holding breath

B. Keep eyes open

The respiratory therapist has connected a T-piece to a patient's ET tube. What indicates that the unit is not functioning properly? A. Visible mist at the reservoir during inspiration B. Lack of mist visible at the T-piece C. Primary oxygen flow rate of 14 L/min D. Pulse oximeter reading of greater than 95%

B. Lack of mist visible at the T-piece

What should the RT do when performing ET intubation on a patient with suspected cervical spine injuries? A. Do nothing different than when performing this procedure on any other patient. B. Maintain inline cervical immobilization. C. Place a small towel under the occiput to facilitate placement of the ET tube. D. Place a small towel under the shoulders to facilitate placement of the ET tube.

B. Maintain inline cervical immobilization.

Which action should the RT take during nasotracheal intubation of a patient who has suspected cervical spine injuries? A. Do nothing different than when performing this procedure on any other patient. B. Maintain inline cervical immobilization. C. Place a small towel under the occiput to facilitate placement of the endotracheal tube. D. Place a small towel under the shoulders to facilitate placement of the endotracheal tube.

B. Maintain inline cervical immobilization.

An adult male is ready to perform spirometry testing. What are the predicted values an RT in the United States should choose for the test? A. European Coal Center B. NHANES III (Hankinson) C. Crapo D. Knudson

B. NHANES III (Hankinson)

The multidisciplinary team is transporting a patient for a computed tomography scan. The RT observes that the patient is becoming agitated as they approach the elevator. What is the RT's next step? A. Proceed to the elevator. B. Notify the other team members of the patient's agitation. C. Return to the intensive care unit. D. Consider the agitation a normal response to transport.

B. Notify the other team members of the patient's agitation.

What does primary assessment for correct ET tube placement include? A. Observation of the tube passing through the vocal cords, colorimetric ETCO2 color change, and mist in the tube B. Observation of the tube passing through the vocal cords and auscultation of bilateral breath sounds C. Absence of gurgling over the epigastrium, auscultation of bilateral breath sounds, and a positive reading on the continuous ETCO2 monitor D. Absence of gurgling over the epigastrium, bilateral chest rise and fall during ventilation, and an esophageal detection device that does not reexpand

B. Observation of the tube passing through the vocal cords and auscultation of bilateral breath sounds

A patient has these ABG results: pH 7.31, PaCO2 58 mm Hg, PaO2 80 mm Hg, HCO3- 30 mEq/L, and base excess +4. Which interpretation of these ABG results is best? A. Metabolic acidosis with respiratory compensation B. Respiratory acidosis with metabolic compensation C. Respiratory acidosis without compensation D. Respiratory alkalosis with metabolic compensation

B. Respiratory acidosis with metabolic compensation

The ABG results of an otherwise healthy patient who was recently placed on mechanical ventilatory support receiving 100% FIO2 are: pH 7.51, PaCO2 26 mm Hg, PaO2 186 mm Hg, and HCO3- 24 mEq/L. Which interpretation of these ABG results is best? A. Respiratory acidosis B. Respiratory alkalosis C. Metabolic alkalosis D. Metabolic acidosis

B. Respiratory alkalosis

What should the respiratory therapist do before a patient uses an oscillatory PEP device with adjustable resistance for the first time? A. Contact the practitioner to determine the ordered resistance adjustment setting. B. Set the resistance adjustment at the lowest setting. C. Set the resistance adjustment at the highest setting. D. Set the resistance adjustment at the midpoint and adjust as necessary.

B. Set the resistance adjustment at the lowest setting.

The respiratory therapist is attempting to gather a sputum specimen from a patient following an abdominal hernia repair. What should the respiratory therapist advise the patient to do? A. Take a deep breath, cough hard, and expectorate. B. Splint the surgical incision before coughing. C. Use mouthwash before the collection. D. Try to provide a sample immediately after eating.

B. Splint the surgical incision before coughing.

The RT is instructing the caregiver on what to do immediately after the oxygen cylinder has been turned on and the pressure gauge has been checked. Which action by the caregiver indicates that he or she understood the instructions? A. The caregiver disengages the ambulatory unit from the stationary reservoir when the hissing noise changes. B. The caregiver connects the patient's nasal cannula to the oxygen cylinder. C. The caregiver places the nasal cannula on the patient. D. The caregiver adjusts the flow of the oxygen using the regulator on the cylinder.

B. The caregiver connects the patient's nasal cannula to the oxygen cylinder.

A respiratory therapist is assessing a child's ability to perform incentive spirometry correctly by viewing a return demonstration. Which situation indicates that the child needs additional education? A. The child examines the sputum expectorated. B. The child performs a series of short inspirations. C. The child creates a complete seal over the mouthpiece. D. The child holds breath for 5 seconds after maximum inhalation.

B. The child performs a series of short inspirations.

A respiratory therapist observes as a family member administers a nebulized treatment to an older adult patient. Which observation indicates that more education is needed? A. The patient is holding the mouthpiece between his lips with gentle pressure. B. The family member is holding the nebulizer away from the patient's nose and mouth. C. The family member employs the use of a face mask when the patient is too tired to hold the nebulizer. D. The family member allows the patient to hold the mouthpiece between his lips.

B. The family member is holding the nebulizer away from the patient's nose and mouth.

The RT records the centimeter position of the current ET tube at the patient's lip and marks the position on the tube exchanger. What will this determine? A. The tube exchanger's insertion depth line B. The tube exchanger's leveling line C. The level at which to withdraw the current ET tube D. How far to advance the tube exchanger into the new ET tube

B. The tube exchanger's leveling line

The RT who is preparing to intubate a patient, being mindful of the importance of VAP prevention, might choose to implement which intervention? A. Keep the patient's bed flat B. Use a silver-coated ET tube C. Perform ventilator circuit changes every 8 hours D. Conduct saline lavage in the artificial airway to decrease secretions before suctioning

B. Use a silver-coated ET tube

An admitted patient requires supplemental oxygen to treat respiratory distress. The authorized practitioner orders an FIO2 of 35%. What is the most appropriate delivery device for this patient? A. Partial rebreather mask B. Venturi mask C. Nonrebreather mask D. Simple face mask

B. Venturi mask

When should the RT use the straight (Miller) blade of the laryngoscope? A. When intubating a patient with spinal cord injuries B. When intubating an infant or a young child because of his or her anterior airway anatomy C. When seeking to prevent injury to the teeth during ET tube placement D. When attempting to place the tip of the blade into the vallecula

B. When intubating an infant or a young child because of his or her anterior airway anatomy

When is postural drainage contraindicated? A. With cystic fibrosis B. With hemoptysis C. With recent pneumonia D. With tube feedings

B. With hemoptysis

An intubated patient with COPD continues to have auto-PEEP. Which of the action is the most appropriate intervention for treating the auto-PEEP? A. Increase the patient's respiratory rate. B. Administer bronchodilators. C. Add set-PEEP to the ventilator settings. D. Increase the minute ventilation.

C. Add set-PEEP to the ventilator settings.

What is an early sign of hypoxemia? A. Cyanosis B. Nail bed clubbing C. Apprehension D. Decreased blood pressure

C. Apprehension

What is included in the primary assessment for correct nasotracheal tube placement after a blind intubation? A. Observation of the tube passing through the vocal cords and a positive reading on the continuous ETCO2 monitor B. Observation of the tube passing through the vocal cords, colorimetric ETCO2 color change, and mist in the tube C. Auscultation of bilateral breath sounds D. Presence of gurgling over the epigastrium, bilateral chest rise and fall during spontaneous ventilation, and an esophageal detection device that does not reexpand

C. Auscultation of bilateral breath sounds

To help reduce the spread of microorganisms while obtaining a sputum sample, what should the respiratory therapist do? A. Allow the patient to collect his or her own sputum sample. B. Obtain the sputum specimen first thing in the morning. C. Avoid contaminating the outside of the specimen container. D. Send the sputum specimen to the laboratory immediately.

C. Avoid contaminating the outside of the specimen container.

When interpreting ABG results, which parameter would an RT not be able to evaluate? A. HCO3- level B. PaCO2 level C. Chloride level D. pH level

C. Chloride level

Which situation does DPI use eliminate for the patient? A. Taking medication daily B. Recording the number of doses left in the device C. Coordinating inhalation with actuation of the device D. Obtaining proper instructions for DPI use

C. Coordinating inhalation with actuation of the device

What should the RT do when establishing the plan for intrafacility transfer of critically ill patients? A. Proceed with the transport immediately after changing the patient's ventilation mode to one that is compatible with the transport ventilator. B. Quickly prepare equipment and supplies to facilitate rapid transfers. C. Ensure that transport personnel are knowledgeable of the principles of basic life support. D. Ensure that the team consists of at least one licensed vocational nurse and an RT.

C. Ensure that transport personnel are knowledgeable of the principles of basic life support.

While assessing a patient who is being mechanically ventilated, the RT notices a gross leak in the ET tube cuff and suspects a balloon rupture of the ET tube. What should the RT do? A. Wait and test the ET tube cuff at the next ventilator assessment. B. Increase the set tidal volume on the ventilator. C. Exchange the ET tube. D. Ask the patient to take deeper breaths.

C. Exchange the ET tube.

When using a PEP device, the patient takes a deep breath, places the device in the mouth and holds it for 2 to 3 seconds. What is the next step? A. Cough and then inhale through the mouthpiece for 3 or 4 seconds. B. Perform three or four huff coughs and one or two forced exhalations. C. Exhale slowly through the device while it is vibrating. D. Try not to cough, but inhale again slowly through the device.

C. Exhale slowly through the device while it is vibrating.

What is the RT's ultimate goal during smoking-cessation counseling? A. Assist the patient in resolving any residual problems arising from quitting. B. Encourage the patient to review the benefits of quitting. C. Help the patient to make a decision to stop smoking. D. Reinforce the patient's success at quitting.

C. Help the patient to make a decision to stop smoking.

When evaluating the outcomes of the child's use of incentive spirometry, the respiratory therapist knows that which parameter is an unexpected outcome of the therapy? A. Increased SaO2 B. Increased PaO2 C. Increased respiratory rate D. Increased normal breath sounds

C. Increased respiratory rate

After the patient performs spirometry testing, the RT has obtained three trials. On the first trial, the patient had a slow start with hesitation, but the next two trials were usable. What should the RT do next? A. Instruct the patient to blow out harder. B. Instruct the patient to blow out longer. C. Instruct the patient to perform another maneuver. D. Check for repeatability.

C. Instruct the patient to perform another maneuver.

What is the primary disadvantage of the disposable sensor pad for pulse oximetry? A. It is available in different sizes. B. It is less restrictive. C. It contains latex. D. It is less expensive to use.

C. It contains latex.

What is not a potential complication of using a T-piece? A. Aspiration of water from the tubing B. Aerosolization of bacteria into the patient's lungs C. Oxygenation of a spontaneously breathing patient D. Inability to tolerate a T-piece because of anxiety

C. Oxygenation of a spontaneously breathing patient

Which organism is likely to be associated with VAP? A. Gardnerella vaginalis B. Escherichia coli C. P. aeruginosa D. Trichomonas hominis

C. P. aeruginosa

A patient becomes restless and agitated 10 seconds into NIF testing. Which situation is the most likely cause of this response? A. Inadequate VTS, which leads to decreased oxygenation and ventilation B. Inappropriate test performance beyond the time limit, which leads to decreased oxygenation C. Patient's inability to take a breath during the test D. Excessive VC, which leads to quick respiratory fatigue and restlessness

C. Patient's inability to take a breath during the test

When preparing to begin a weaning trial on a 65-year-old patient who has been receiving mechanical ventilation for 22 days, what should the RT understand? A. Once weaning has begun, the patient should remain on the weaning modes until extubation. B. These patients do well with weaning plans similar to those used for patients who have received short-term mechanical ventilation. C. Patients who have received long-term mechanical ventilation may require a longer period of weaning trials. D. The weaning trial can be customized to the individual patient.

C. Patients who have received long-term mechanical ventilation may require a longer period of weaning trials.

5. During the afternoon assessment, the respiratory therapist determines that the patient has become increasingly confused and is complaining of a severe headache. The respiratory therapist realizes that the patient is breathing at a rate of 40 breaths per minute and is extremely anxious. Further assessment reveals that the patient's oxygen saturation is 95%. What is the most appropriate intervention? A. Administer a breathing treatment. B. Notify the authorized practitioner of the patient's potential carbon dioxide retention. C. Place the head of the patient's bed into a high-Fowler position. D. Notify the authorized practitioner that the patient is hypoxic.

C. Place the head of the patient's bed into a high-Fowler position.

A neonate at 27 weeks' gestation is on high-flow nasal oxygen therapy at a flow of 2 L/min and an FIO2 of 28%. The pulse oximeter alarm begins to sound, the SpO2 is 86 and dropping, the respiratory rate is 110, retractions are noticed, and blood pressure is dropping. What should the RT look for? A. A malfunctioning pulse oximeter probe B. Sepsis C. Pneumothorax D. Alarm settings that are too tight

C. Pneumothorax

An unconscious older adult patient with significant respiratory distress needs to be intubated. What is the most appropriate sequence of action? A. Preoxygenate the patient with a self-inflating bag-mask device, premedicate the patient with sedatives and paralytics, and insert an oral airway. B. Premedicate the patient with sedatives and paralytics, insert an oral airway, and preoxygenate the patient with a self-inflating bag-mask device. C. Preoxygenate the patient with a self-inflating bag-mask device and premedicate the patient with sedatives and paralytics. D. Premedicate the patient with sedatives and paralytics and preoxygenate the patient with a self-inflating bag-mask device.

C. Preoxygenate the patient with a self-inflating bag-mask device and premedicate the patient with sedatives and paralytics.

The content areas that the RT plans to address in a motivational counseling intervention can be captured by the "5 Rs" strategy. This strategy includes which component? A. Redirect B. Relinquish C. Repetition D. Respect

C. Repetition

An RT is having difficulty measuring Cstat in an intubated agitated patient who has rapid spontaneous breathing while on mechanical ventilation. Which intervention is the most appropriate for this patient? A. Abort the measurement to decrease the risk of lung injury. B. Activate the inspiratory pause at end-expiration to allow the patient to get a full breath. C. Request the administration of sedatives to slow the respiratory rate and decrease the patient's level of agitation. D. Keep the inspiratory pause depressed for an extended period during the measurement to decrease the patient's anxiety.

C. Request the administration of sedatives to slow the respiratory rate and decrease the patient's level of agitation.

During the initial interview and assessment, the RT should obtain which parameters as baselines for comparison during all future patient sessions? A. Arterial blood gas levels and resting blood pressure B. Blood pressure after exercising and oxygen saturation C. Resting blood pressure and oxygen saturation D. Blood pressure after exercising and heart rate

C. Resting blood pressure and oxygen saturation

When the prescribed medication is an inhaled corticosteroid, which instruction should be given to the patient? A. Use as needed for wheezing or shortness of breath. B. Administer the inhaled corticosteroid before the bronchodilator. C. Rinse the mouth after administration. D. Avoid the use of a spacer.

C. Rinse the mouth after administration.

A patient wants to enter the pulmonary rehabilitation exercise program. What must the patient be willing to do to enter the program? A. Obtain Medicare insurance B. Continue smoking C. Take a 6-minute walk test D. Take a 10-minute walk test

C. Take a 6-minute walk test

A 21-year-old male patient measures his peak flow in the morning and it is 190 L/min. His normal peak flow is 400 L/min. Which action should the patient take? A. No action is needed as this result is normal B. Take his normal medications as directed C. Take his rescue medication immediately D. Make an appointment to see his practitioner next week

C. Take his rescue medication immediately

What is one advantage of the closed (inline) system for suctioning an ET tube or tracheostomy tube? A. There are no complications with its use. B. Longer periods of suctioning are possible. C. The artificial airway does not have to be disconnected from the ventilator. D. The need to oxygenate the patient before suctioning is eliminated.

C. The artificial airway does not have to be disconnected from the ventilator.

A. "Each suction pass should be limited to less than 15 seconds." B. "In a patient at high risk for suction-related complications, the catheter should be inserted into the artificial airway until it emerges out of the end of the airway." C. The outer diameter of the suction catheter should be more than one half the size of the inner diameter of the artificial airway. D. "In a patient, not at risk for suction-related complications, the catheter can be inserted into the artificial airway until resistance is met and then pull back 1 to 2 cm."

C. The outer diameter of the suction catheter should be more than one half the size of the inner diameter of the artificial airway.

The respiratory therapist who is evaluating a patient receiving mechanical ventilation observes that the patient is having extensive episodes of bronchospasm and ventilator dyssynchrony. Which situation is the most likely patient scenario? A. The patient is at risk for increased auto-PEEP; clinical goals should be aimed at increasing hyperinflation to decrease potential lung injury. B. The patient is at risk for auto-PEEP and may require an increased respiratory rate to facilitate permissive hypercarbia. C. The patient is at risk for auto-PEEP and barotrauma and may need to be sedated or to be given paralytics. D. The patient is at risk for auto-PEEP and barotrauma and may require a decrease in sedation and paralytics.

C. The patient is at risk for auto-PEEP and barotrauma and may need to be sedated or to be given paralytics.

During polysomnography, which device does the RT use to measure airflow? A. Electrode B. Microphone C. Thermistor D. Positive pressure device

C. Thermistor

A patient with a tracheostomy tube has an order for a nebulized corticosteroid to be given every 4 hours. What should the respiratory therapist do next? A. Request an order for an oral corticosteroid. B. Perform deep suctioning before each nebulizer treatment. C. Use a T-piece adapter to connect the nebulizer to the tracheostomy tube. D. Hold the nebulizer within 15 cm (6 in) of the tracheostomy.

C. Use a T-piece adapter to connect the nebulizer to the tracheostomy tube.

A patient has been performing nebulizer treatments at home and says that the treatments usually last about 10 minutes but lately they have been taking 25 minutes. Which action should the respiratory therapist take? A. Instruct the patient to add diluent to the medication so the procedure lasts 30 minutes. B. Instruct the patient to continue with the current method. C. Verify that the patient's procedure is effective and the equipment is functioning properly. D. Reinforce that medication should be administered in 5 minutes or less.

C. Verify that the patient's procedure is effective and the equipment is functioning properly.

A patient presents with a weak, congested, and nonproductive cough. When is nasotracheal suction appropriate for this patient? A. Every day B. Every 4 hours C. When indicated D. Only at night

C. When indicated

In which situation should the RT use the Magill forceps and the laryngoscope? A. When the ET tube can be blindly passed through the vocal cords B. When a tube can be fiberoptically passed through the vocal cords C. When the ET tube cannot be passed through the vocal cords because of an obstruction D. When the patient's mouth cannot be opened

C. When the ET tube cannot be passed through the vocal cords because of an obstruction

In which situation should the RT use Magill forceps and the laryngoscope? A. When the endotracheal tube can be blindly passed through the vocal cords B. When a tube can be fiberoptically passed through the vocal cords C. When the endotracheal tube cannot be blindly passed through the vocal cords D. When the patient's mouth cannot be opened

C. When the endotracheal tube cannot be blindly passed through the vocal cords

The RT is teaching a patient who has been diagnosed with COPD and prescribed home oxygen therapy regarding how to fill an ambulatory liquid tank from the stationary reservoir. What is the first step the RT should instruct the patient to do? A. Firmly attach the ambulatory tank to the reservoir. B. Open the fill valve on the ambulatory tank. C. Wipe the connectors of both tanks with a clean, dry, lint-free cloth. D. Press down firmly on the top of the ambulatory tank.

C. Wipe the connectors of both tanks with a clean, dry, lint-free cloth.

VAP is defined as pneumonia that develops in which time frame? A. Less than 24 hours after mechanical ventilation is started B. Less than 48 hours after mechanical ventilation is started C. Within 48 to 72 hours after intubation D. Between 24 and 48 hours after intubation

C. Within 48 to 72 hours after intubation

The RT is helping to develop a protocol to use for intrafacility transport of patients. To help minimize the length of time to plan for emergency transfers, what should the RT suggest? A. A method to reduce the number of team members needed B. An extensive manual prepared for each team member on the day of transport C. An algorithm for weaning the ventilator during transport D. A comprehensive checklist for pretransport use

D. A comprehensive checklist for pretransport use

Which patient has an unmodifiable risk factor for acquiring VAP? A. A patient receiving corticosteroid therapy B. A patient receiving enteral nutrition C. A patient with a nasogastric tube D. An older age patient

D. An older age patient

When performing nasotracheal suctioning on an adult patient, the RT should perform which action? A. Slant the catheter upward through the mouth. B. Apply suction for at least 45 seconds. C. Apply suction pressure when inserting the catheter through the naris. D. Apply suction for less than 15 seconds.

D. Apply suction for less than 15 seconds.

A patient with reactive airway disease arrives in the emergency department with complaints of increasing dyspnea. His personal best PEF is 480 L/min, and his PEF this morning was 260 L/min. What should the respiratory therapist do? A. Characterize the episode as a mild exacerbation and ask if the patient has been exposed to allergens. B. Document that the PEF is within normal limits and consider the patient's condition to be nonurgent. C. Characterize the episode as a severe exacerbation and immediately place the patient on oxygen. D. Characterize the episode as a moderate exacerbation and ask the patient if he has used a rescue inhaler.

D. Characterize the episode as a moderate exacerbation and ask the patient if he has used a rescue inhaler.

Which statement is true regarding the application of cricoid pressure (Sellick maneuver) while performing ET intubation? A. Cricoid pressure may be released as soon as the practitioner identifies the vocal cords. B. Cricoid pressure allows better observation of the vallecula and glottic opening. C. Cricoid pressure is most effective in patients with cranial fractures. D. Cricoid pressure should not be applied universally.

D. Cricoid pressure should not be applied universally.

Measuring static pressure in a patient with ARDS increases the risk of which unexpected outcomes? A. Increased bronchospasm and decreased RAW B. Increased cardiac output and hemothorax C. Decreased lung compliance and increased RAW D. Decreased cardiac output and tension pneumothorax

D. Decreased cardiac output and tension pneumothorax

A patient is using accessory muscles to breathe and seems to be struggling to get enough air while on the T-piece. What is the first step the respiratory therapist should take? A. Evaluate the underlying pathology to see if it can be reversed. B. Consult with the practitioner to consider a chest radiograph. C. Suggest the use of sedatives to help relieve anxiety. D. Evaluate the tubing for water pooling and drain the fluid.

D. Evaluate the tubing for water pooling and drain the fluid.

When should the RT teach patients varied education topics? A. Every third session B. Once per month C. During the initial assessment D. Every session

D. Every session

During a weaning trial on a 74-year-old patient with congestive heart failure who has been intubated for 3 days, the RT notices that the patient has tachypnea and chest-abdominal asynchrony. The weaning trial ABG value indicates that the patient has a PaCO2 of 55 mm Hg. What is the RT's assessment of the patient's condition? A. Not ready to be extubated, as indicated by the alkalotic PaCO2 B. Ready for extubation but may require PEEP to maintain adequate ventilation and oxygenation C. Experiencing muscle fatigue but will benefit from an extended weaning trial to build up muscle strength D. Experiencing muscle fatigue, and the weaning trial may be premature

D. Experiencing muscle fatigue, and the weaning trial may be premature

The respiratory therapist is coaching a patient with signs and symptoms of pneumonia to provide a sputum sample for culture and analysis. While the patient is attempting to provide a productive expectorant, the oxygen saturation by pulse oximetry begins to fall, and the patient becomes distressed. What should the respiratory therapist do? A. Have the patient lie down and take deep breaths before continuing with the specimen collection. B. Continue with the procedure and complete it quickly. C. Suction the patient thoroughly. D. Stop the procedure and provide supplemental oxygen.

D. Stop the procedure and provide supplemental oxygen.

A 75-kg (165-lb) patient has the following results during a weaning continuous positive airway pressure trial: NIF of −20 cm H2O, VTS of 400 ml/kg, PEP of 30 cm H2O, and VC of 1200 ml. Which action is the most appropriate intervention? A. Continue with mechanical ventilation because the PEP indicates that the patient's expiratory force is inadequate. B. Continue with mechanical ventilation because the VTS indicates inadequate respiratory muscle endurance. C. Extubate the patient and administer continuous positive airway pressure to increase VC to ensure the extubation is successful. D. Extubate the patient because these results indicate a strong probability that extubation will be tolerated.

D. Extubate the patient because these results indicate a strong probability that extubation will be tolerated.

When performing a modified Allen test, direct pressure is applied to the radial and ulnar arteries. When pressure is released over the ulnar artery, how many seconds should it take for color to return to the hand? A. 10 to 15 seconds B. 15 to 20 seconds C. 12 to 16 seconds D. Fewer than 10 seconds

D. Fewer than 10 seconds

A patient with COPD needs increased levels of oxygen. What should the RT know before placing this patient on high-flow nasal oxygen therapy? A. If the patient is still smoking B. The results of the patient's most recent CBC C. The results of the patient's most recent chest x-ray D. If the patient chronically retains carbon dioxide

D. If the patient chronically retains carbon dioxide

The respiratory therapy preceptor is discussing ventilator management with a new graduate. The preceptor knows that the graduate respiratory therapist is knowledgeable about auto-PEEP when the graduate says that auto-PEEP potentially leads to which outcome? A. Respiratory acidosis and increased filling pressures B. Decreased pulmonary pressures and increased blood pressure C. Increased cardiac output and improved oxygenation D. Increased risk for bronchospasm and barotrauma

D. Increased risk for bronchospasm and barotrauma

A patient in the intensive care unit is to have a CPAP trial to facilitate weaning from the ventilator. What does this kind of weaning process generally involve? A. Low-pressure, high-volume work that is of long duration with full rest between episodes B. Low-pressure, high-volume work that is generally sustained over long periods C. High-pressure, low-volume work that is used with PSV D. Increased workload that is of short duration with full rest between episodes

D. Increased workload that is of short duration with full rest between episodes

The patient has performed four spirometry maneuvers with the following results:FVC 4 L, 3.81 L, 3.65 L, 3.49 L; and FEV1 2.5 L, 2.52 L, 2.54 L, 2.6 L.How should the RT respond to the results? A. Stop the test because these results are acceptable and repeatable. B. Instruct the patient to blow out harder. C. Instruct the patient to blow out longer. D. Instruct the patient to take in a deeper breath.

D. Instruct the patient to take in a deeper breath.

When placing the electrodes on the patient's head using the international 10-20 system, what should the RT do first? A. Measure the circumference of the patient's head B. Measure the distance between the nasion and inion C. Measure the distance between the preauricular points D. Locate the four landmarks used for electrode placement

D. Locate the four landmarks used for electrode placement

A patient's latest ABG results are: pH 7.31, PaCO2 30 mm Hg, PaO2 80 mm Hg, HCO3- 20 mEq/L, and a base excess of -4. Which interpretation of these ABG results is best? A. Normal B. Respiratory acidosis C. Metabolic alkalosis D. Metabolic acidosis with respiratory compensation

D. Metabolic acidosis with respiratory compensation

A patient with a history of chronic obstructive pulmonary disease is admitted for cardiac monitoring. Which oxygen delivery device should the respiratory therapist anticipate using? A. Simple face mask B. Nonrebreather mask C. Face tent D. Nasal cannula

D. Nasal cannula

In preparation for exchanging an ET tube, into which of these should the RT first advance the tube exchanger? A. Patient's trachea B. Current ET tube C. Patient's oropharynx D. New ET tube

D. New ET tube

Which of these actions is an appropriate step for artificial airway suctioning? A. Instill normal saline solution before suctioning. B. Don clean nonsterile gloves for open technique. C. Apply suction when introducing the catheter into the trachea. D. Oxygenate the patient with 100% oxygen before suctioning.

D. Oxygenate the patient with 100% oxygen before suctioning.

A respiratory therapist is caring for a partially sedated patient who is receiving mechanical ventilation. Weaning assessment indicates an NIF of −30 cm H2O and a PEP of 20 cm H2O. Which information should the respiratory therapist know about the assessment? A. NIF is effort dependent, and the result indicates the patient has a strong inspiratory force and meets the threshold for this parameter. B. NIF is effort independent, and the result indicates that the patient's inspiratory force is inadequate to support extubation. C. PEP is effort independent, and the result indicates that the patient has a strong expiratory force and should tolerate extubation. D. PEP is effort dependent, and the result may be artificially low because of the patient's effort during the procedure.

D. PEP is effort dependent, and the result may be artificially low because of the patient's effort during the procedure.

For which condition might the RT consider the use of high-flow nasal oxygen therapy for a neonate? A. Upper-airway anomalies B. Acute respiratory failure C. Frequent apnea despite routine caffeine administration D. Prematurity with low sustained oxygen saturations

D. Prematurity with low sustained oxygen saturations

After administering a nebulized corticosteroid treatment, the respiratory therapist should instruct the patient to perform which action? A. Check for the common the adverse effect of bruising. B. Continue to breathe deeply for 20 minutes. C. Rinse the nebulizer with tap water. D. Rinse his or her mouth and gargle with warm water.

D. Rinse his or her mouth and gargle with warm water.

The RT is caring for a patient in the home who requires short-term oxygen therapy with moderate FIO2 needs. Which oxygen device is best for the patient? A. Nasal cannula B. Reservoir mask C. Nonrebreather mask D. Simple oxygen mask

D. Simple oxygen mask

Chest physiotherapy (postural drainage, percussion, and vibration) has been prescribed for a 45-year-old patient with resolving atelectasis. The RT has positioned the patient to perform chest physiotherapy on the posterior apical segment of the left and right lobes. Five minutes into the therapy, the RT notices that the patient's oxygen saturation is 80% and blood pressure is 80/50 mm Hg. What should the RT do first? A. Place the patient in the Trendelenburg position and continue therapy. B. Assure the patient that this is a normal response to the therapy. C. Encourage the patient to cough. D. Stop therapy and return the patient to the original resting position.

D. Stop therapy and return the patient to the original resting position.

After a session of postural drainage, what should a patient be instructed to do? A. Breathe quickly and shallowly while sitting. B. Breathe quickly and shallowly while lying flat. C. Cough while lying flat. D. Take a deep breath and cough while sitting.

D. Take a deep breath and cough while sitting.

The respiratory therapist is deciding whether to use a finger probe to assess the oxygen saturation of a patient who has shortness of breath. Which factor correlates with the most reliable SpO2 reading? A. The location of the IV site B. The patient's size C. The amount of hemoglobin available D. The capillary refill time

D. The capillary refill time

While performing nasotracheal suctioning, the patient starts to cough. What is the most likely cause of this? A. The catheter is advancing into the esophagus. B. The patient does not like the feel of the catheter in the nose. C. The patient is tilting the chin down toward the chest. D. The catheter is advancing into the lungs.

D. The catheter is advancing into the lungs.

A patient has a diagnosis of postoperative atelectasis. The RT should select areas of the lung for drainage based on all of the following EXCEPT which one? A. Knowledge of the patient's area of lung congestion B. Physical assessment of the chest C. The patient's diagnosis of atelectasis D. The extent of the pathologic condition and lobe involvement

D. The extent of the pathologic condition and lobe involvement

Which finding indicates that the patient is correctly administering the medication via pMDI? A. The patient does not shake the canister. B. The patient presses the canister before taking a breath. C. The patient administers a second actuation immediately after the first. D. The patient holds his or her breath for up to 10 seconds after inhalation.

D. The patient holds his or her breath for up to 10 seconds after inhalation.

The respiratory therapist is demonstrating incentive spirometry to a 5-year-old child and the family postoperatively. Which outcome should the respiratory therapist tell them is the greatest advantage of incentive spirometry? A. The improved lung function after surgery B. The ease with which the device is used C. The measure of the child's peak flow D. The visual feedback immediately provided by the device

D. The visual feedback immediately provided by the device

When performing continuous monitoring of an older adult patient's oxygen saturation, what should the respiratory therapist remember? A. To never use extremity readings in older patients because of the increased likelihood of peripheral vascular disease B. To ensure the probe remains on the same finger for consistency of measurements C. To remove the blankets from the patient's extremities to prevent pulse oximetry interference D. To monitor the skin beneath a finger probe to prevent tissue breakdown

D. To monitor the skin beneath a finger probe to prevent tissue breakdown

In the acute care setting, how often does the patient typically use an oscillatory PEP device? A. After meals B. Once every 24 hours C. Twice per day D. Two to four times daily based on the patient's response

D. Two to four times daily based on the patient's response

Which action should be taken when performing a difficult nasotracheal intubation on a patient with a suspected mandibular fixation? A. Consider the use of endotracheal intubation. B. Perform a tracheostomy. C. Perform an emergency cricoidotomy. D. Use a smaller endotracheal tube.

D. Use a smaller endotracheal tube.

An RT is assessing the patient's ability to perform incentive spirometry correctly by viewing a return demonstration. When is additional patient education needed? A. When the patient examines the sputum expectorated B. When the patient creates a complete seal over the mouthpiece C. When the patient holds a breath for 5 seconds after maximum inhalation D. When the patient performs a series of short inspirations

D. When the patient performs a series of short inspirations

DPIs are not recommended for young children for which reason? A. Studies show that children can have adverse reactions to the device. B. The medications available with DPIs require low flow rates. C. Young children cannot benefit from inhaled medications. D. Young children are unable to generate an adequate inspiratory flow.

D. Young children are unable to generate an adequate inspiratory flow.