TMC practice questions
Which of the following should the RT consider when preparing for helicopter transport of a patient receiving mechanical ventilation? 1.Select a ventilator that uses demand valves rather than a reservoir IMV system 2.calculate oxygen cylinder duration of flow 3. selecting a ventilator that incorporates an internal air compressor
1 and 2 only
A patient receiving pressure controlled ventilation has acute hypoventilation with an ETCO2 of 70 torr. His vital signs include: HR 90, RR 18, SpO2 94. Which of the following changes will address the situation? 1. Increase the pressure limit 2. increase the sensitivity 3. increase the mandatory rate 4. Decrease the inspiratory time 1 and 4 only 1 and 3 only 2 and 3 only 1,2 and 4 only
1 and 3 only
The respiratory therapist is asked to administer 2.5 mg of albuterol to a patient via small volume nebulizer. The medication is available in a 0.5% solution. What volume of albuterol should be administered? 0.25 mL 0.50 mL 1.25 mL 2.5 mL
1.25 mL
The respiratory therapist prepares to administer inhaled nitric oxide to a neonate with RSD. The most appropriate initial dose of INO for this patient is 5 ppm 10 ppm 15 ppm 20 ppm
20 ppm Stardard inital dose is 20-40 ppm Do not exceed 80 ppm
Transcutaneous monitoring of PO2 values will correlate well with arterial blood gas PO2 values in which of the following situations? 1. Hypotension 2. hypothermia 3. pneumonia 1 only 3 only 1 and 2 only 2 and 3 only
3 only
Which of the following values for arterial carbon dioxide tension is consistent with significant alveolar hypoventilation? 20 torr 30 torr 40 torr 50 torr
50 torr-> duh, a high CO2 means acidotic and they are not ventilating well
At 1 minute post-delivery a newborn has blue extremities with a pink body, heart rate is 90/min, resp rate is 20/min with a weak cry, cough reflex is present, and there is some flexion of the extremities. At 5 minutes post delivery, the infant is completely pink, heart rate of 140/min, resp rate of 40/min, cough reflex is present, and the baby is active with a string cry. What APGAR scores should be assigned? 4 and 8 5 and 9 5 and 10 6 and 10
6 and 10
An healthy adult female can exhale what portion of her vital capacity in the first second? 50% 60% 70% 80%
70%
A capnograph used for continuous monitoring of a patient on mechanical ventilation should be recalibrated ever 2 hours 4 hours 8 hours 24 hours
8 hours
Which of the following would most likely benefit from pressure support ventilation? An intubated patient with an absent respiratory drive A patient on SIMV with a mandatory rate of 12/min and a total rate of 24/min A patient with acute lung injury A patient who requires short-term post-operative support
A patient on SIMV with a mandatory rate of 12/min and a total rate of 24/min
The RT should recommend home apnea monitoring infants with all of the following situations EXCEPT preterm infant with significant apnea periods sibling of a SIDS baby APGAR scores of 4 and 6 at delivery a history of snorning
APGAR scores of 4-6 at delivery
Pressured-cycled ventilation would be LEAST appropriate for a patient with... kyphosis muscular dystrophy ARDS a drug overdose
ARDS
A 2 year old child with croup has been intubated for 4 days with a 4 mm ID uncuffed endotracheal tube. Heated aerosol at an FiO2 of 0.30 has been delivered to the patient. The physician asks the respiratory therapist to evaluate the patient for possible extubation. Which of the following would most likely indicate that the patient is ready for extubation? The patient is making normal quiet ventilatory efforts A negative sputum culture and sensitivity has been reported The patients ABG are within normal range Breath sounds are heard around the tube on auscultation
Breath sounds are heard around the tube on auscultation
A young health adult with complaints of intermittent wheezing is seen in the pulmonary clinic. A pre/post bronchodilator spirometry reveals a normal study with no reversibility. Which of the following should the RT recommend? Helium dilution study DLCO Plethysmography Bronchial provocation
Bronchial Provocation
The physician asks the RT to select ventilator parameters that will deliver the lowest peak inspiratory pressure possible. Which of the following inspiratory flow patterns will enable the therapist to fulfill the physicians request? Decelerating square wave constant accelerating
Decelerating
All of the following are TRUE statements about spacers and holding chambers, EXCEPT... Do not require patient cooperation with their breathing pattern improve the efficiency of MDI can be used for drug delivery by MDI to intubated and mechanically ventilated patients if a patient exhales immediately following activation of the inhaler, they will clear the medication from the device and waste the dose
Do not require patient cooperation with their breathing pattern
A 7 year old child suspected of having epiglotittitis would exhit which of following signs Drooling Hyperextended neck stridor unilateral wheeze
Drooling hyper-extended neck Stridor
During recovery from a resection of an aortic aneurysm, a 65 year old female patient suddenly develops severe substernal chest pain with grave dyspnea. The pain does not appear to be aggravated by her respirations. Auscultation reveals bilateral, basilar, moist, crepitant rales. The patient appears pale, cold, and diaphoretic. Which of the following should the respiratory therapist recommend for initial assessment of this patient? ECG CBC Serum elctrolytes Lateral decubitus radograph
ECG
Following surgery to correct an abdominal aortic aneurysm, a 54 year old female patient suddenly develops intense substernal chest pain with severe dyspnea. The pain does not appear to be aggravated by her respirations. Auscultation reveals bilateral, basilar, moist, crepitant rales. The patient appears pale, cold, and clammy. Which of the following should the respiratory therapist recommend for initial assessment of this patient? Serum electrolytes chest x-ray CBC Electrocardiograph
Electrocardiograph
A patient's breathing pattern irregularly increases and decreases and is interspersed with periods of apnea up to 60 seconds. Which of the following conditions is the most likely cause of this problem? Diabetes insipidus Renal failure Metabolic acidosis Elevated intracranial pressure
Elevated intracranial pressure
Which of the following would NOT cause a capnography reading to change from 36 torr to 30 torr? Tachypnea Hyperventilation Pulmonary emboli Endotracheal tube positioned in the right mainstem bronchus
Endotracheal tube positioned in the right mainstem bronchus
Which of the following would be the most appropriate test to evaluate partial vocal cord paralysis in a patient complaining of difficulty swallowing? SB nitrogen elimination Max Voluntary Ventilation Flow volume loop Diffuse capacity
FVL- flow volume loop
Which of the following techniques measures TLC? Helium dilution Body Box Single breath nitrogen elimination
Helium and body box
A patient who suffered trauma in an ATV accident is being monitored in the ICU. A pulmonary artery catheter has been placed and the following data is available. PCWP 4 mm Hg PAP(mean) 8 mm Hg CVP 2 cm H2O Cardiac output 3/l min Therapist recommends: IV fluid challenge Positive inotropic agent Inhaled nitric oxide diuretic therapy
IV fluid challenge all numbers are low-> hypovolemia
A 75 year old patient with end stage COPD is admitted to the ED with an acute exacerbation. He has a DNI order in his chart. Physical exam reveals that the patient is ferbile and has a weak, non-productive cough. Breath sounds reveal bilateral coarse crackles with scattered wheezes. The patient is started on bronchodilator therapy and antibiotics. Serial ABG results are: FiO2 .21 to .4 pH 7.30 to 7.21 PaCO2 70 torr to 83 torr PaO2 48 to 58 torr HCO3 34 to 34 SpO2 78 to 89% Initiate comfort care procedures decrease FiO2 to .35 admin IPV Initiate NPPV
Intiate NPPV
The physician asks the RT to set an optimal PEEP level for a mechanically ventilated patient, The PEEP level is optimal when PEEP levels are less than 18 cm H2O PaO2 is 60 torr or greater Oxygen delivery to the tissues is maximal C(a-v)O2 is decreasing
Oxygen delivery to the tissues is maximal
A patient is admitted to the ED via ambulance. The cardiac monitor indicates sinus Tachycardia. The patient is orally intubated with a size 7.5 mm ID endotracheal tube and is being manually ventilated. What other point of care MONITORING should the RT recommend for this patient? ABG Transcutaneous monitoring Pulse Oximetry Serum electrolyte analysis
Pulse oximetry
While administering 3.5 mg of albuterol to a patient with asthma in the ICU, the RT notes that the patients heart rate increases from 120 to 150 bpm. What is the appropriate modification for the next treatment for this patient? Reduce the dose of albuterol DC the treament Change to 3 puffs of beclomethasone diproprionate(vanceril) Change to 0.63 mg of levalbuterol(Xopenex)
Reduce the dose of albuterol
A 64 year old, 70 kg (154 lb) man with severe COPD receives independent (differential) lung ventilation following thoracotomy and right lower lobectomy. Which of the following setting combinations would be most appropriate for this patient? Right Lung 50 mL, left lung 459 mL Right lung 159 ml, left lung 359 ml Right lung 250, left lung 250 ml Right lung 350 ml, left lung 150 ml
Right lung 150, left lung 350 ml
The following measurements were obtained from a patient with a pulmonary artery catheter in place: CVP 1 mm Hg PAP 10 mm Hg PCWP 8 mm Hg CI 1.6 L/min/m2 BP 110/90 mm Hg Based on the above information, all of the following values would be decreased EXCEPT RVEDP PVR SVR QT
SVR
Which of the following should the RT utilize in order to determine the severity of respiratory distress in a newborn? Transillumination APGAR score Ballard score Silverman score
Silverman score
The physician informs the patient that the results of his polysomnogram indicate obstructive sleep apnea. The treatment for this disorder might include... BHT Resp stimulants Tracheostomy Negative pressure ventilation
Tracheostomy treatments include: CPAP, NPPV Weight loss surgery respiratory stimulants(prematurity) Educational programs F-10
Which of the following devices would produce the greatest humidity output for a patient? Bubble humidifier wick-type humidifier large reservoir nebulizer ultrasonic nebulizer
Ultrasonic nebulizer
An intubated patient receiving 30% oxygen has a SpO2 of 80% and ETCO2 of 40 torr. After adminsitration of 50% oxygen for 30 minutes, the resp therapist notes that the SpO2 rises to 98% and the ETCO2 remains stable at 40 torr. The major cause of hypoxemia is this patient is hypoventilation shunt V/Q mismatch increase deadspace
V/Q mismatch
What is the primary advantage of volume controlled ventilation as compared to pressure controlled ventilation? VC limits and controls PIP VC provides a constant Minute ventilation VC ensures better patient-ventilator synchrony VC delivers a deceleration flow pattern
VC provides a constant minute ventilation-> provides a stable ABG
A patient on VC ventilation demonstrates auto-PEEP on the ventilator graphics. Which of the following controls when adjusted independently, would increase the expiratory time? Vt RR Inspiratory Flow Sensitivity
Vt, RR, and Inspiratory Flow
Which of the following is a FALSE statement about self-inflating resuscitation devices? A reservoir is utilized to increase the delivered oxygen concentration The RT can sense changes in the patients lung compliance and airway resistance A compressed gas source is necessary for the device to operate excessive gas flow may cause the valve to malfunction
a compressed gas source is necessary for the device to operate -> duh its self-inflating
The RT works with a patient with COPD in a smoking cessation program. The patient complains of recent weight gain. the therapist should explain that this is no unusual and is a result of an increasing feeling of loss of self control over-reliance on nicotine replacement therapy a need for a prescription for lorazepam a decrease in the patients metabolism
a decrease in the patients metabolism
A 75 kg male is being mechanically ventilated at the following setting: Mode VC SIMV set rate 12 total rate 32 Vt 600 PIP 35 exhaled minute volume 9.2 L FiO2 0.45 PEEP 8 cm H2O ABG: pH 7.36 PaCO2 45 torr PaO2 89 torr HCO3 25 mEq/L decrease PEEP increase set rate to 14 add pressure support initiate pressure control mode
add pressure support
A patient involved in a motor vehicle accident several days ago sustained a long bone fraction and remains in traction. The patient suddenly complains of chest pain and develops tachypnea and tachycardia. The RT should admin O2 recommend heparin recommend streptokinase request a chest X-ray
admin O2
While monitoring a newborn utilizing transcutaneous monitor, the respiratory therapist notices a change in PtcO2 from 60 to 142 torr and simultaneously the PtcCO2 changes from 37 to 2 torr. What is the most likely explanation for these changes? Upper airway obstruction poor peripheral perfusion air leak around the sensor device is out of range
air leak around the sensor
While examining the chest drainge system of a mechanically ventilated patient following thoracotomy, the RT observes bubbling in the water seal chamber inspiration. This would indicate.. A leak in the chest drainage system air leaving the pleural space excessive pressure from the suction regulator inadequate water level in the water-seal chamber
air leaving the pleural space
A patient's cardiac output is increased and his Qs/Qt is calculated to be 20%. Based upon this information, the RT would inform the physician this patient has an elevated shunt a reduced cardiac index increased pulmonary vascular resistance normal lung mechanics
an elevated shunt
A post operative thoracic surgery patient is having difficulty developing an effective cough. The respiratory therapist could recommend all of the following techniques to aid this patient in generating a more effective cough EXCEPT coordinating coughing with pain medication performing serial coughs applying pressure to patients abdomen during exhalation splinting the incision area
applying pressure to patients abdomen during exhalation
A 48 year old woman is admitted to the coronary care unit for chest pain, dizziness and mausea. Her blood pressure is 60/40 mm Hg, respirations are 20/min. The cardiac respiratory therapist should reccommend administration of... lidocaine nitroglycerin atropine amiodarone
atropine
During bedside monitoring the respiratory therapist notices a dampened waveform on the arterial line graphic. To restore the graphic to normal, the therapist should first A. verify the position of the transducer. B. check the transducer dome for air bubbles. C. flush the catheter with heparin solution. D. attempt to draw blood from the arterial line.
attempt to draw blood from the arterial line
The following results are obtained from the pulmonary artery catheter of a patient who collapsed during a visit with a friend in the hospital: CVP 10 PAP 33/27 PCWP 20 BP 108/72 mm Hg Tricuspid stenosis right ventricular failure cardiogenic pulmonary edema fluid overload
cardiogenic pulmonary edema
Dynamic hyperinflation is a major concern when using Volume Control, Assist/Control ventilation in patients with which of the following conditions? A. Post-traumatic chest trauma B. Community-acquired pneumonia C. Spinal cord injury D. Chronic bronchitis
chronic bronchitis
Which of the following give the most accurate measurement of volume and flow for spirometry? collins water sealed spirometer vortex-shedding pneumotachometer wright respirometer dry-rolling spirometer
collins water sealed spirometer
A respiratory therapist enters a patients room during oxygen rounds. The patient has end stage emphysema and appears to be sleeping. The patient doesnt respond to questions and his pulse is 20 bpm. The therapist should immediately... confirm DNR status go get help begin rescue ventilation begin chest compressions
confirm DNR status
During a cardiopulmonary stress test on a 55 year old man, the RT notes the following changes: increased HR increased BP VD/Vt ratio decreases RR increases Therapist should: continue the test terminate the test contact the physician administer amiodarone
continue the test These are all normal responses
A 2 year old child recently diagnosed with laryngotracheobronchitis requires the administration of 40% oxygen. What is the most appropriate method for delivering the oxygen? oxyhood connected to a blender cool aerosol mask venturi mask croup tent
cool aerosol mask
During inline suctioning of a patient's endotracheal tube, 100% oxygen is being supplied via the ventilator. The RT observes several premature ventricular contractions on the ECG monitor. The therapist should decrease the suctioning time per pass use a smaller suction catheter increase oxygenation time decrease the suction pressure
decrease the suctioning time per pass
A patient receives oxygen at home via nasal cannula at 1 lpm. He has 50 feet of extension tubing attached to his oxygen concentrator. The patient complains that there does not seem to be enough oxygen flow reaching the cannula. The respiratory therapist should recommend decreasing the length of the extension tubing increasing the concentrator flow changing to a liquid system analyzing the FiO2
decreasing the length of the extension tubing
A newborn infant APGAR score of 8 one minute after delivery. The most appropriate action at this time would be to... intubate and ventilate the infant dry and monitor the infant initiate oxygen therapy begin chest compressions immediately
dry and monitor the infant
While providing education to patients who will be discharged home on O2 therapy, the RT explains the hazards associated with O2 delivery equipment in the home. This instruction should include all of the following EXCEPT Liquid oxygen burns when refilling portable tanks how to properly secure oxygen cylinders for transport use of grounded 3 prong outlets for electrical equipment emergency procedures to deal with gs explosions
emergency procedures to deal with gas explosions
Which of the following would modify the expiratory time and change the I:E ratio for a patient receiving PEP therapy? Expiratory resistance valve Inspiratory flow rate control volume control
expiratory resistance valve
A patient with end-stage pulmonary fibrosis receieves oxygen at 2 L/min via transtracheal oxygen catheter. The patient complains of increased work of breathing and shortness of breath. The RT should... Manually ventilate the patient with a resusitation bag increase the flow to the transtracheal catheter to 6 lpm evaluate the SpO2 with a pulse oximeter flush the transtracheal device with saline
flush the transtracheal device with saline
A 52 year old post operative patients chest radiograph demonstrates infiltrates in the posterior basal segments of the lower lobes. Which of the following is the appropriate postural drainage position? Head down, patient supine with a pillow under knees patient prone with a pillow uder head, bed flat patient supine with a pillow under knees, bed flat Head down, patient prone with a pillow under the hips
head down, patient prone with a pillow under the hips
A 60 kg(132 lb) female patient with confestive heart failure receives NPPV with an IPAP of 16 cm H2O, EPAP of 10 cm H2O and FiO2 of 0.70. Available laboratory data includes: pH 7.40 PaCO2 42 torr, PaO2 145 torr, HCO3 26 mEq/L, SaO2 99%, CVP 10 cm H2O. Breath sounds reveal a few fine bibasilar crackles. This situation should be described as shunting hyperoxygenation hypoventilation fluid overload
hyperoxygenation
A 1600 g neonate receives oxygen by oxyhood at an FiO2 of 0.60. The flowmeter is set at 5 lpm. While analyzing the oxygen, the respiratory therapist notices varying FiO2 reading at different locations inside the oxyhood. The therapist should.... recalibrate the oxygen analyzing device increase the flow to the oxyhood place the neonate in an isolette at an FiO2 of 0.60 check the water level of the humidier
increae the flow to the oxyhood
A 72 year old male patient who is 5'10 tall and weighs 75 kg receives MV. The RT notes diminished breath sounds in the bases of both lungs. The patient is on the following settings: Mode VC, A/C Vt 600 ml Set rate 10 lpm PEEP 10 cm H2O FiO2 .50 sigh volume 0.6 L ABG pH 7.42 PaCO2 38 torr PaO2 82 torr SaO2 97% Maintain the current settings increase the set rate to 12 lpm decrease the Vt to 500 ml increase the sigh volume to 1.0 L
increase the sigh volume to 1.0 L
When instructing a patient prior to a vital capacity maneuver, the respiratory therapist should direct the patient to.... exhale to residual volume and inhale to inspiratory capacity inhale to total lung capacity then exhale to residual volume exhale normally then inhale to TLC inhale normally then exhale to FRC
inhale to TLC then exhale to RV
A patient with a flail chest is intubated and mechanically ventilated with PEEP therapy. Pancuronium bromide has been administered. Which of the following ventilator alarms would be most important to set correctly for this patient? Peak pressure alarm low pressure alarm I:E ratio alarm Low exhaled volume alarm
low pressure alarm -> remember the low pressure alarm in the most important of the alarms overall
A 44 week old gestational age infant is delivered via C-section and is gasping, grunting and has tachycardia and tachypnea. At one minute his APgar score is 4 and at 5 minutes the score is at 5. The infant is most likely suffering from transient tachypnea of the newborn meconium aspiration bronchopulmonary dysplasia apnea of prematurity
meconium aspiration
All of the following are TRUE with regard to cuff inflation techniques EXCEPT minimal leak/minimal occlusion volume techniques negate the need for cuff pressure monitoring minimal leak technique allows a small leak at the end of inspiration at minimal occlusion volume, air leakage around the tube cuff should cease cuff pressure should not exceed 35 cm H2O in order to allow circulation to tracheal mucosa
minimal leak volume techniques negate the need for cuff pressure monitoring
The ability to distinguish central apnea from obstructive apnea during a sleep study requires the RT to monitor electrocardiogram electroencephalogram nasal air flow chest wall compliance
nasal air flow chest wall compliance
A 19 year old patient is brought to the ED after taking a handful of pills. The patient is obtunded but is making regular, sonorous respirtory efforts Auscultation reveals coarse rhonchi bilaterally. Which of the following should be done FIRST to assess this patient? obtain a sputum specimen Obtain an ABG Measure peak expiratory flow Determine the Glasgow coma score
obtain an ABG
A patient receiving mechanical ventilation has developed a temperature of 99.9 degrees F with purulent secretions over the last 12 hours. The RT has also noted steady increase in peak inspiratory pressure. What initial recommendation should be made to address these changes? Initiate BHT Obtain a sputum gram stain Admin IPV Insert a CASS tube
obtain sputum gram stain
While measuring peak flow on a patient with well controlled asthma, the RT notes that the peak flow meter consistently reads 200 lpm despite excellent patient effort, The most likely explanation for the result is the peak flow meter is clogged patients asthma has worsened patient is fatigued peak flow meter is accurate
peak flow meter is clogged
The RT performs the quality control procedures for the blood gas analyzer in the NICU and notices a single data point that is a 3 standard deviations from the mean value from the pH electrode. The therapist should perform another control run contact the quality control supervisor recalibrate the electrode replace the electrode
perform another control run
The respiratory therapist obtains a blood gas sample from the patient's radial artery and applies pressure to the site for 10 minutes. After removing any excess air from the syringe, the next step for the proper handling of the blood sample is adding liquid heparin to the sample placing the syringe in an ice bath shaking the sample continuously applying a pressure bandage
placing the syringe in an ice bath
A 17 year-old patient receives 40% oxygen via a Venturi mask following a motor vehicle accident. He suddenly develops acute shortness of breath, is diaphoretic and SpO2 is 85%. Breath sounds are vesicular on the right and extremely diminished on the left. The respiratory therapist should evaluate the patient for the presence of... atelectasis pneumothorax arterial hypertension myocardial infarction
pneumothoax
A patient receiving a loop diuretic such as fuosemide would most likely require replacement of... potassium sodium choloride bicarbonate
potassium If you are receiving diurectics you are getting rid of fluid and therefore essential serum electrolytes. The most essential would be POTASSIUM.
A mixed venous blood sample is needed to determine the oxygen consumption of the tissues. the mixed blood sample should be obtained from the left atrium pulmonary vein pulmonary artery superior vena cava
pulmonary artery
All of the following conditions can be treated with hyperbaric oxygen (HBO) therapy EXCEPT carbon monoxide poisoning decompression sickness anaerobic infections pulmonary hypertension
pulmonary hypertension NO is used for it
While making O2 rounds the RT hears a high pitched sound coming from a bubble humidifier. the patient is receiving oxygen by air-entrainment mask at 28% and the oxygen flowmeter is set at 12 lpm. The therapist should replace the cracked humidifier incrase the FiO2 on the air entrainment mask increase the flow from the flowmeter remove the bubble humidifier
remove the bubble humidifier obstruction
While attempting to calibrate a polarographic oxygen analyzer, the respiratory therapist notices that the analyzer reads 21% when exposed to room air but only reads 64% when exposed to 100% oxygen. The most appropriate action at this time would be to... reset the zero point replace the battery replace the fuel cell add electrolyte solution
replace the battery
The RT assists with elective intubation of a patient with myasthenia gravis in the ICU. While providing manual ventilation, the self inflating resuscitation device becomes difficult to compress. Which of the following would the therapist do FIRST? Check the inlet valve check patient valve replace the manual resuscitation bag check for excessive oxygen flow
replace the manual resuscitation bag
A 44 year old patient who suffered a cerebral vascular accident has been moved from NeuroICU to the step down unit. He becomes diaphoretic and his SpO2 suddenly drops from 95 to 88 on a 32% tracheostomy collar. His HR is 115 bpm, RR is 42 bpm, and is brath sounds are very diminished. the RT is unsuccessful in attempting to pass a 12 Fr suction catheter. The therapist should increase the suction pressure to 120 mm Hg change to a 10 Fr suction catheter replace the tracheostomy tube orally intubate the patient
replace the trach tube
A tracheostomy tube has just been changed on a patient receiving coninuous volume cycled ventilation. The patient suddenly becomes dsypneic and develops crepitus around the tracheostomy stoma. The respiratory therapist should suction the patien insert a larger trach tube reposition the trach tube recommend an antihistamine
reposition the trach tube
The RT provides education for a patient who is being discharged home on aerosol therapy. The most important reason for the patient to follow the recommended cleaning procedures using a vinegar/water solution is that this solution will sterilize the equipment retard bacterial growth kill all micro-organisms and spores extend the equipment life
retard bacterial growth
All of the following could cause a patient's right-hemidiaphragm to be elevated, Except... right lower lobe atelectasis right side hyperlucency, absent vascular markings hepatomegaly right lower lobe consolidation with air bronchograms
right side hyperlucency, absent vascular markings
The physician asks the RT to monitor the effectiveness of bronchodilator therapy in a patient with asthma. What is the most appropriate parameter to monitor? improvement in level of dyspnea blood gas analysis results serial peak flow measurement improvement in chest x-ray
serial peak flow measurement
The primary reason for the use of respiratory care protocols is to decrease the patient workload for therapists standardize provision of care enhance departmental efficiency increase the autonomy of therapists
standardize provision of care
Which of the following would NOT be required to perform a nasal intubation? Magill forceps stylet larngoscope endotracheal tube
stylet
A patient receiving oxygen therapy at home calls in the middle of the night and reports that the oxygen supply tubing will not stay attached to her transtracheal catheter. The flow rate to the transtracheal catheter is set at 0.5 L/min. The patient has attempted to flush the catheter with saline and push a cleaning rod through it without success. The resp therapist should instruct the patient to tape the connection securely increase the flow to the catheter decrease the flow to the catheter switch to a nasal cannula
switch to a nasal cannula
The following measurements were obtained from a patient being monitored with a balloon tipped, flow directed catheter: CVP 2 cm H2O PAP 12 torr PCWP 3 torr CI 1.2 lpm/m BP 110/90 Based on the above information, all of the following parameters would be decreased EXCEPT Right ventricular end diastolic pressure left atrial filling pressure systemic vascular resistance cardiac output
systemic vascular Resistance would not decrease because you CVP is okay along with the BP
A patient performs both a forced vital capacity and a slow vital capacity maneuver with the following results: FVC 2.4 SVC 2.18 Which of the following statements is TRUE regarding these results? The data meets ATS-ERS standards and should be reported The SVC shows poor effort and should be repeated The FVC shows poor effort and should be repeated The patient has obstructive lung disease
the SVC shows poor effort and should be repeated
A patient has been intubated with a naso-tracheal tube and is being manually ventilated. As the RT ventilates the patient, he notices that there is no chest movement, minimal breath sounds and air escaping from the mouth as the bag is squeezed. A chest x-ray has determined that the endotracheal tube is in the correct position. What is the most likely cause of this situation? The tube is in the esophagus the patient has developed a tacheosophageal fistula from the intubation process the cuff ruptured during intubation the cuff has herniated over the end of the tube
the cuff ruptured during intubation
A sudden decrease in end-tidal CO2 occurs in a mechanically ventilated patient. A repeat analysis yields the same results. Which of the following situations might account for these readings? The ventilator circuit has become disconnected there is a leak around the endotracheal tube there is an increase in alveolar dead space the carbon dioxide absorber is exhausted
the ventilator circuit has become disconnected
The RT is in charge of transporting a patient with multiple trauma to a regional trauma center in a fixed wing aircraft. Which of the following should the therapist be most concerned about during the transport? Tissue oxygenation pneumothorax pulmonary embolus humidification of the inspired gas
tissue oxygenation
A 68 year old patient with advanced emphysema is receiving oxygen by nasal cannula at 1 lpm. the physician has ordered that the patients SpO2 be maintained at 90%. ABG on 1 lpm are pH7.34, PaCO2 65, PaO2 55, HCO3 35. What should the RT recommend FIRST? Initiate NIPPV Titrate oxygen flow to the nasal cannula change to a simple mask change to a non-rebreather mask
titrate oxygen flow to the nasal cannula
An oxygen-dependent patient uses a nasal cannula at 3 L/min continuously at home. He complains that his liquid oxygen portable device runs out too quickly when he attends church services and prevents him from dining out in restaurants afterwards. Which of the following devices should the respiratory therapist recommend to resolve the issue? A. Use a pulse-dose oxygen delivery system. B. Take a backup E-size oxygen cylinder. C. Reduce the oxygen flow to 2 L/min during church. D. Insertion of a transtracheal oxygen catheter.
use a pulse dose oxygen delivery system
