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Final
190 first final
| Question | Answer |
|---|---|
| Which of the following is the most effective device to increase the absolute humidity delivered to a patient? | Heated passover humidifier |
| When reviewing a patient arterial BP waveform, a RT notes that the systolic BP is 120mmHg during inspiration and 135 mmHg during expiration. This should be documented as: | D. Pulsus paradoxus |
| A patient admitted with pneumonia and bilateral atelectasis has been receiving 20 L/min oxygen by high-flow cannula at an FiO2 of 0.70 for 3 days. ABG analysis results are: pH 7.43 PCO2 38mmHg PO2 120mmHg HCO3 25 mEq/L BE +1 mEq/L SaO2 (calc) 98% | B. Decrease the FiO2 |
| The lung volume data below are reported for an adult patient: Predicted Observed Percent (L) (L) predicted FVC 4.47 4.26 95% IC 3.42 3.33 97% IRV 2.82 2.80 99% VT 0.60 0.53 88% ERV 1.05 0.93 89% These values are: | A. within normal limits |
| A RT is managing the ventilatory support of an intubated patient being transported in an unpressurized aircraft at 8000ft. Which of the following is most critical to monitor during transport? | D. Pulse oximetry |
| A RT is reviewing a chart of a 60 year old male who is 178 cm( 5 ft 10in) tall. Weighs 73 kg and has moderate dyspnea. The CXR report indicates the patient has flattened diaphragm, severe hyperinflation and small cardiothoracic ratio. The PFT results are | A. Flow-volume loop |
| A RT runs a control solution through a blood gas analyzer as part of daily maintenance. The measured PO2 is 0.5 mmHg outside of the acceptable range. The RT should: | D. Perform a two-point calibration and return the control |
| A patient receiving mechanical ventilation requires frequent suctioning. A RT should FIRST: | Install a closed-circuit suction catheter |
| A patient is admitted to the hospital with diagnosis of pneumonia. A CXR indicates infiltrates in the right lower lobe with elevation of the right hemidiaphragm. The patient has a cough producing a minimal amount of tenacious, purulent sputum. | D. Recommend vibratory PEP therapy |
| A mini-bronchalveolar lavage procedure is recommended for diagnosing? | A. Ventilator associated pneumonia |
| Which of the following is most likely to cause a collection of subcutaneous air around the patient neck and face following a routine tracheostomy tube: | D. the tracheotomy tube was inserted into a false lumen |
| The results of a 6MWT are based primarily on? | A. Distance traveled |
| Oropharyngeal suctioning is being performed on an adult patient. The vacuum pressure is 80mmHg. Secretions aspirate when RT occludes the catheter's control port, to improve suctioning the RT should: | D. Increase the vacuum pressure to 129mmHg |
| A 56 year old male with an uncontrolled BP is receiving norepinephrine in the ICU. Which of the ff catheters should the RT use to most effectively monitor the patient response to therapy? | B. Central Venous |
| Which of the following conditions may be caused by persistent vomiting? | D. Alkalosis |
| A patient receiving home care for COPD is having difficulty clearing secretions, which of the following should the RT recommend first? | C. Vibratory PEP device |
| Due to progressive detorioration in ABG values and continued respiratory muscle weakness, a physician decides to intubate a 50 year old, 77 kg male patient. After attaching a CO2 colorimetric device, the RT should observe: | D. Approximately 5% end tidal CO2 |
| An intubated patient is receiving mechanical ventilation. The patient condition has not changed, but PIP are increasing. Which of the following is most likely the cause? | B. The endotracheal tube is partially obstructed |
| An 8 year old boy presents to the ED with an acute exacerbation of asthma and now being prepared for discharge. Which of the ff is the most appropriate instructions for the RT to give to the parents? | B. monitor the child peak flow daily |
| After assisting a physician with the insertion of an LMA, the RT notices a decrease in chest rise and air movement. Which of the following should the RT recommend FIRST? | B. Reposition the LMA |
| Which of the following devices best measures the accuracy of an air/O2 blender? | D. Polagraphic analyzer |
| A CXR for a 58 year old female shows right lower lobe atelectasis. Which of the ff positions should the RT recommend to improve oxygenation? | C. Left lateral decubitus |
| The RT is called to assist in the management of a 36 year old patient with a crush injury to the chest. The patient is hypotensive, asymmetrical chest wall movements are observed and breath sounds are absent on the right. Which of the following should the | D. Needle decompression of the chest |
| A patient is receiving mechanical ventilation following abdominal surgery. Weaning attempts have been unsuccessful due to muscle weakness. Which of the ff tests will be most helpful in determining the cause of the weakness? | A. Electrolytes |
| A 165 cm (5ft 5in) 74kg, 53 year old female with a recent diagnosis of OSA presents for a CAP titration study. CPAP of 6 cmH20 is initiated with a nasal mask. 2 hours into the study. CPAP has been titrated to 12 cmH20. The RT notes the patient is lightly | D. Increase the CAP level to 13 cmH20 |
| The radial artery is the site of choice when performing an arterial puncture for which of the following reasons? | A. Collateral blood flow is usually present |
| Which of the following scores should the RT use to determine a neonate's gestational age by | B. Ballard |
| A respiratory therapist is reviewing a CXR of a 26 year old patient. The tip of a properly positioned endotracheal tube will be located: | B. 5 cm above the carina |
| Mechanical ventilation dead space is added while a patient is receiving mechanical ventilation. The minute ventilation does not change. Which of the following will increase? | B. PaCO2 |
| A respiratory therapist views a CXR in which of the clavicles are asymmetrically spaced around the sternum. The RT should conclude that: | A. Patient was rotated |
| A respiratory therapist notes a low pressure alarm sounding continuously. Which of the following should the RT do FIRTST? | B. Assess for a leak |
| When attempting to obtain an ABG sample, a respiratory therapist performs a modified Allen's test. The RT observes that only the left palm remains pale following testing. From which of the following arteries should the RT obtain a sample? | B. Right radial |
| A 44 year old patient who underwent abdominal surgery is receiving vibratory PEP therapy. After 24 hours of Q4H therapy, the patient can ambulate independently while breathing air. A respiratory therapist should recommend? | A. DC therapy |
| The preferred method of determining the proper depth of insertion for a nasopharyngeal airway is to measure from the: | D. Tip of the nare to the tip of the Earlobe |
| The semi- Fowler position is most appropriate to drain the? | a. Apical segments, upper lobes of both lungs |
| The following CXR is obtained for a 31 yr old male in the ED, A RT should conclude the CR is most consistent with diagnosis of? | b. Pneumothorax |
| The following data are obtained for a pt who is receiving VC, AC ventilation: Set Vt: 500 mL PEEP : 10 cmH20 Exhaled VT : 450 mL PIP : 30 cm20 Pplat: 20 cmH20 What is the static cL (mL/cmH2O)? | D. 45 |
| During in-line suctioning of a patient who is receiving mechanical ventilation, the pt develops tachycardia. Prior to suctioning, a RT can minimize this problem by? | b. Increasing the FiO2 |
| Which of the following procedures should be followed when collecting an ABG sample that will be analyzed outside of the patient's room? | c. Wash hands immediately after handling the sample |
| A 66 year old pt in the PACU had abdominal surgery with severe blood loss. The pt has tachypnea and tachycardia. SpO2 is 85% while the pt is receiving 4L/min 02 by nasal cannula. A RT should initially change to? | a. NRB mask |
| An adult pt who was recently extubated has developed inspiratory stridor. The patient's HR is 98/min and RR is 14/min. A RT should? | d. Administer racemic epinephrine by medication nebulizer |
| A pt is receiving PS ventilation. The PETCO2 has decreased by 10 mmHg over the last 2 hours. Which of the following is the most likely cause? | b. Increased RR |
| While performing spirometry on a 38 year old pt with a history of asthma, a RT obtains the following flowvolume loop during the first maneuver: Prior to the second maneuver, the therapist should instruct the pt to? | c. Take in a deeper breath |
| A RT observes the following volume-time waveform: To correct the problem illustrated by this pattern, the RT should | c. Seek a source for a possible system leak |
| Which of the following statements indicates the presence of dyspnea in a patient? | d. " I feel short of breath while walking and have to stop to rest" |
| One limitation of a portable liquid oxygen system is that the: | a. Supply port can freeze open |
| A pt with chronic bronchitis is receiving an aerosolized bronchodilator tx. The pt has a congested, non productive cough. A Rt should: | c. Adding PEP therapy |
| A RT is attempting to wean an 86 g (190 (b) pt from VC, SIMV with a mandatory rate of 8 and a VT of 500 mL. During an SBT, the patient's HR increases from 96 to 110/min within 2 mins, the RT should: | d. Continue SBT |
| Which of the following agents is most beneficial for a pt with acute severe bronchospasm? | b. Albuterol |
| A pt who was in motor vehicle crash is receiving VC ventilation. The water-seal chamber of the patient's chest drainage system bubbles toward the end of each inspiration. Assessment shows the connecting tubings are intact and the chest tube is properly pl | C.. The pt has a pleural leak |
| A pt with exacerbation of COPD is receiving NPPV in spontaneous mode with a nasal mask. The following data are available: FiO2: 0.24 RR: 28/min IPAP : 12 cmH20 EPAP: 6 cmH20 One hour later, the following data are available: pH: 7.27 PaCO2: 76 mmHg | c. Change to a full-face mask |
| Which of the following should be evaluated to determine the presence of auto-PEEP? | b. Flow waveform |
| A 69 year old female is in the general care unit with a 72-hour history of nausea and vomiting. Vital signs are : Temp: 37 C ( 98.6 F) HR: 100/min RR: 16/min BP: 95/60 Urine output: 10mL/h Which of the following should be given immediately? | c. Intravenous fluids |
| Which of the following tx options is most effective for a pt with the diagnosis if central sleep apnea? | c. bilevel positive airway pressure |
| Which of the following is the most frequent finding with a pneumothorax? | c. Unequal Breath sounds |
| A RT plans to teach the therapeutic goals of CPT to the family of a child with CF. English is not the primary language of the family. The RT should: | b. Use a medical interpreter during instruction |
| Observing decreased PaO2 and increase P(A-a) 02 during exercise testing indicates: | b. Pulmonary limitation to exercise |
| One hour following a successful placement of a subclavian catheter, a pt is becomes SOB. SpO2 is 92%. A RT should FIRST recommend obtaining: | C. CXR |
| A pt CXR shows a large, right - sided pleural effusion. Which of the following should a RT recommend? | d. Thoracentesis |
| A tracheostomy collar set-up for a postoperative pt should include which of the following as the external source of humidity? | d. A heat moisture exchanger |
| A 58 year old pt with an exacerbation of chronic bronchitis has been receiving postural drainage and percussion QUD for 4 days. A RT notes the pt has clear BS and strong cough. The RT should recommend: | a. Discontinuing therapy |
| An adult pt with asthma is receiving an 80/20 heliox mixture through a NRB mask. The reservoir bag collapses all the way down with each inspiration. A RT should | a. Increase the gas flow |
| An adult pt with asthma is receiving an 80/20 heliox mixture through a NRB mask. The reservoir bag collapses all the way down with each inspiration. A RT should | a. Increase the gas flow |
| A post surgical pt with no history of pulmonary or cardiac diseases is 175 cm (5ft 9in) tall and weighs 75 kg (165 lb). The pt is receiving PSV and the following data are obtained: | a. Increase PS |
| A man presents to an ED following a 20 ft fall. During physical assessment, a RT observes asymmetric movement of the left chest. This is most consistent with: | d. Flail chest |
| A 4l yr old male is admitted to the hospital for hypoxemic resp failure following a 6-hour commercial flight. He is complaining of chest pain and SOB. His physical examination revealss a temperature of 37C (98.6F) with diminished BS. After minimal impr | c. Pulmonary embolus |
| A previously healthy 33 year old female presents to the ED with complaints of acute onset of left-sided chest pain and SOB. The following CXR is obtained: Physical examinations reveals bilateral and equal BS. Vitals are as follows: | c. Congestive heart failure |
| After decreasing MAP in a pt receiving PPV, urinary output increased. This is most likely a result in increase in: | d. PCWP |
| Apt suddenly loses consciousness. To ensure airway patency, a RT should FIRST: | a. Perform the head-tilt, chin-lift maneuver |
| Before administering CPT to a pt, a RT must review the medical record for: | a. Hx and physical examination notes |
| To assess respiratory muscle strength in a pt with a suspected neuromuscular disorder, a RT should select a: | b. Pressure manometer |
| A RT is assisting a physician with insertion of a chest tube in a pt with a pleural effusion. After the tube is place and the chest drainage system is functioning properly, which of the following should be observed in the water-seal chamber? | b. Water level functioning with breathing |
| A 27 year old female is admitted with septic shock. BP obtained by an indwelling arterial catheter is 78/50 mmHg. A physician orders initiation of a norepinephrine (levophed) infusion. | a. Insertion of a CVP catheter |
| A 178 cm (5ft 10 in), 73kg (161 lbs) man with septicemia has been receiving VC-AC ventilation for 72 hours. The following data are observed: | b. Increase to 20 cm H2O PEEP |
| Humidification for a hypothermic pt who has a tracheostomy should: | a. Provide 100% relative humidity at 37C (98.6 F) |
| A RT interviews a 14 year old pt who has CF and notes the following daily medications regimen: Albuterol HFA Q6H 7% NaCl aerosol Q8H HFCWO vest Q8H | d. Dornase alfa (pulmozyme) |
| For an 80 kg (176 lbs) pt receiving invasive mechanical ventilation, which of the following contraindicates weaning? | c. Resting Ve of 1.76 L |
| A RT is reviewing pt ventilator flow sheet. While the pt ventilator parameters have not changed, the RT observes the following PETCO2 values recorded over a period of 6 hours: | a. The pt is developing hypocapnia |
| An intubated pt begins coughing during a bronchoscopy procedure. A RT should instill which of the following medications? | b. Lidocaine HCI |
| The following data are obtained for an 80 kg (176 lbs), 26 year old male trauma pt while receiving VCSIMV: FiO2 0.50 Double check Mandatory RR 12 Total | d. administer cisatracurium (nimbex) |
| A pt with ARDS is receiving PC ventilation. One of the pt ventilator graphics is shown below: Which of the following should a RT do to increase the pt VT? | d. Increase the inspiratory pressure |
| When preparing to assist during synchronized electrical cardioversion, which of the following should a RT obtain? i. Pulse oximeter ii. Intubation equipment ili. Suction equipment iv. Trancutaneous pacemaker | b. 1,2 and 4 |
| Which of the following should a RT do to improve manual ventilation of an unconscious pt with a suspected neck injury? | d. Insert an oropharyneal airway |
| If the inspiratory flow is increased during VC ventilation, a RT should expect which of the following to decrease? | b. Inspiratory time |
| A pt is receiving O2 therapy with a simple mask while awaiting surgery for a laryngeal mass. A RT notes tachypnea, tachycardia, and agitation. Which of the following should the RT recommend? | c. 70/30 heliox |
| While changing tracheostomy tube dressing, a RT feels vibrations during the pt chest wall on inspiration and expiration. The RT should: | a. Suction the pt |
| Which of the following is the MOST appropriate initial frequency range for HFOV of a neonate? | c. 10 to 15 HZ |
| To optimize particle deposition during bronchodilator therapy with a DPI, a RT should instruct the pt in which of the following breathing patterns? Inspiratory flow Inspiratory Vol. End-inspi hold | A. 1 |
| A 5 month old infant is being fed every 3 hours, A physician writes an order for chest percussion and postural drainage to the right upper lobe every 4 hours. Which of the following is most appropriate? | d. Adjust the timing of chest percussion to occur 1 hour after feedings |
| What ejection fraction is expected in a healthy adult? | d. 60% |
| Which of the following drugs reverses narcotic-induced hypoventilation? | c. Naloxene HCI (narcan) |
| When interviewing a pt, a RT notes use of sternocleidomastoid and anterior scalene muscles during inspiration at rest. This findings is most consistent with: | a. Increased WOB |
| A RT is preparing to move a pt from the ICU to the MRI suite. After initiating mechanical ventilation with a transport ventilator, the RT observes Sp02 drop to 82%. After restoring ventilation through the ICU ventilator, SpO2 returns to 97%. The RT shoul | c. Confirm the settings on the transport ventilator |
| When discussing a pulmonary rehabilitation program with a pt who has COPD and her family, which of the following should RT explain? | d. The pt may have improved exercise tolerance |
| • An 82 year old woman with end-stage interstitial lung disease who is receiving 6L/min home 02 is admitted with community-acquired pneumonia. She has a signed DNR/DNI order in the chart that was confirmed on admission. Two days after admission, | b. Initiating NPPV |
| A 63 year old female presents to the ED with recent onset of fever, chills, cough, and SOB. Bronchial BS are noted in the left lung base. An AP CXR will most likely reveal: | b. Increased density with air bronchograms |
| Which of the following should a pt be instructed to do while performing an MVV maneuver? | b. Breathe rapidly and deeply for 12 secs |
| For which of the following clinical conditions is bronchoscopy most usefully. | D. Lobar atelectasis |
| According to clinical laboratory improvement amendments (CLIA) standars, the required frequency of quality control for blood gas analyzes is every? | C. 8 hours |
| A 75kg (165 lbs) patient is receiving VC-SIMV with the mandatory rate of 8. The following data are collected during a bedside assessment: Spontaneous VT 300 mL Minute Ventilation 12L/min Vital Capacity 600 mL | B. Post pone weaning trial |
| Following a cerebrovascular accident, a 54 year old male was intubated for airway protection. The next day, the patient's vital signs are stable and he passes a 30-minute SBT. A RIT notes no excessive secretions, but the pt has a strong cough with suctio | b. Continuing current management with full support and repeating SBT daily |
| Which of the following devices can be used to deliver INO to an infant? i. HFNC i. HFOV ill. Mechanical ventilator | a. 1, 2, 3 |
| A pt with a history of sleep apnea is receiving NPPV with IPAP 12 cmH20 and EPAP 4 cmH20. The pt no longer demonstrates periods of apnea. ABG analysis results are as follows: | a. Increase the IPAP settings |
| Which of the following ECG leads should be placed in the left midclavicular line? | C. V4 |
| A31 year old female is receiving mechanical ventilation after an expiratory laparotomy. She has an MIP of -25 cmH2O. A RT should conclude the pt has: | d. Sufficient muscle strength to consider extubation |
| A pt with a 60 pack year history of smoking presents with hemoptysis. A CT scan of the chest reveals a nodule in the right upper lung field. Which of the following procedures should the RT recommend to assist wit diagnosis? | a. Bronchoscopy |
| A RT views a CXR in which the clavicles are asymmetrically spaced around the sternum. The RT should conclude that: | a. Pt was rotated |
| A 38 year old male is being considered for possible extubation after receiving tx for an asthma exacerbation over the last 36 hrs. BS are clear, and no current distress us noted. | a. Pt is ready for extubation |
| 52 year old male, 188 cm 6ft 1 in) tall and weighs 85 kg has ARDS and is receiving VC-AC. 1 hour ago, the A 30 year old female who is 160 cm (5 ft 4 in) is admitted to the ICU due to ARDS. SpO2 is 84% while the pt is decision was made to increase from | b. Wean the fio2 to 0.90 |
| To estimate intrapulmonary shunt using the modified shunt equation, blood gas samples are needed from which of the following catheters? | b.3 |
| A 60 year old pt in cardiogenic shock is receiving VC-AC ventilation. BP os 75/40 mmHg and SpO2 is 86%. Ventilator settings are: | c. Increase to 15 cmH20 PEEP |
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