CHAPTER 4 - Equipment

Question 1

A COPD patient enters the emergency department with the following room air blood gas data.
PaO2 45 torr
PaCO2 75 torr
pH 7.30
HCO3 ¯ 36 mEq/L
B.E. 12 mEq/L
The patient has an irregular pattern of breathing with a ventilatory rate of 22 breaths/min. Which of the following oxygen-delivery devices is most appropriate at this time?
A. air entrainment mask
B. partial rebreathing mask
C. nonrebreathing mask
D. simple mask

Answer 1

A. air entrainment mask

Question 2

The CRT is obtaining an E cylinder of oxygen for a patient who is to be transported from her room to the pulmonary function lab. Which of the following types of connections should the CRT use to secure the regulator to the E cylinder?
A. Diameter-Index Safety System
B. American Standard Safety System
C. Pin-Index Safety System
D. Quick Connect System

Answer 2

C. Pin-Index Safety System

Question 3

The CRT is responsible for selecting an antimicrobial agent to be used for hand washing. Which of the following agents is appropriate?
A. iodophor
B. soap and water
C. hexachlorophene
D. glutaraldehyde

Answer 3

A. iodophor

Question 4

Which of the following nebulizers would administer long-term, high-aerosol output while producing particles of 5µ or less via an aerosol tent?
A. ultrasonic nebulizer
B. Babington nebulizer
C. medication nebulizer
D. centrifugal nebulizer

Answer 4

B. Babington nebulizer

Question 5

A patient has been prescribed home oxygen therapy via a nasal cannula. The patient is concerned about the cost of the oxygen and other home-health interventions. Which of the following oxygen-delivery devices would conserve the use of oxygen and reduce the over
all cost of this therapeutic intervention?
I. a lanyard-style nasal cannula
II. a lariat-style nasal cannula
III. a pendant-style nasal cannula
IV. a nasal mask
A. IV only
B. III only
C. I, III only
D. I, II, III, IV

Answer 5

B. III only

Question 6

The CRT receives an order to administer a 2% solution of Virazole to an 18-month-old patient who has bronchiolitis. Which of the following devices should be used to administer this drug?
A. large-volume nebulizer
B. small-volume nebulizer
C. small-particle aerosol generator
D. jet nebulizer

Answer 6

C. small-particle aerosol generator

Question 7

A CRT is preparing to orally intubate a neonate. Which of the following equipment would be appropriate?
I. curved laryngoscope blade
II. stethoscope
III. oxygen tubing
IV. Magill forceps
A. I only
B. II, IV only
C. I, II, IV only
D. II, III, IV only

Answer 7

D. II, III, IV only

Question 8

Which of the following types of analyzers is appropriate to use when a carbon monoxide lung diffusion capacity study is performed?
A. infrared absorption analyzer
B. emission spectroscopy analyzer
C. thermal conductivity analyzer
D. gas chromatography analyzer

Answer 8

A. infrared absorption analyzer

Question 9

Which of the following oxygen devices can deliver an FIO2
higher than expected if the patient’s tidal volume decreases?
I. Venturi mask
II. simple oxygen mask
III. nasal cannula
IV. partial rebreather mask
V. aerosol mask
A. I, II, IV, V only
B. II, IV,V only
C. I, IV,V only
D. II, III, IV only

Answer 9

D. II, III, IV only

Question 10

The CRT is called to the CCU to set up a 28% aerosol mask on a patient. The only nebulizers available have variable FIO2
settings ranging from 0.35 to 1.00. The CRT decides to set up a titration system operating the nebulizer on air at the 35% entrainment setting at 10 liters/minute and titrating in 6 liters/minute of oxygen. Which of the following statements concerning this system is (are) correct?
I. This arrangement will create a low-flow system.
II. The total flow rate will be approximately 62 to 6 liters/minute.
III. The nebulizer should be changed to the 100% setting at 10 liters/minute and should titrate in 1liter/minute of oxygen.
IV. The nebulizer driving the aerosol should be attached to the oxygen flow meter while titrating air to the system.
A. I, III only
B. II only
C. II, IV only
D. I, IV only

Answer 10

B. II only

Question 11

A ventilator that operates directly from a rotary-driven piston will produce which of the following flow patterns?
A. sine wave
B. square wave
C. accelerating flow
D. decelerating flow

Answer 11

A. sine wave

Question 12

Oropharyngeal secretions are best removed by using which of the following catheters?
A. Yankauer suction tip
B. Trach Care closed suction system
C. Coudé suction catheter
D. modified whistle-tip catheter

Answer 12

A. Yankauer suction tip

Question 13

When assembling an IPPB circuit for patient use, a tube carrying gas during inspiration from the IPPB de
vice must be attached to the exhalation valve for the purpose of
A. providing a reservoir to maintain a consistent FIO2.
B. ensuring the delivery of inspiratory gas flow to the patient.
C. ensuring operation of the inspiratory nebulizer.
D. permitting exhalation before the ensuing inspiration.

Answer 13

B. ensuring the delivery of inspiratory gas flow to the patient.

Question 14

Which of the following sterilization techniques would require additional aeration time for equipment after sterilization and before its use with patients?
A. steam autoclave
B. ethylene oxide
C. Cidex
D. dry heat

Answer 14

B. ethylene oxide

Question 15

The CRT is in need of an oxygen analyzer that can perform rapid gas analysis during exercise testing. Which of the following oxygen analyzers would be suitable for this purpose?
I. galvanic
II. paramagnetic
III. polargraphic
IV. zirconium
A. I, III only
B. II, IV only
C. III, IV only
D. I, II only

Answer 15

C. III, IV only

Question 16

During the resuscitation of a neonate, the CRT attempts to ventilate the intubated neonate with a flow inflating manual resuscitator. During ventilation attempts, the CRT is unable to generate an effective delivery pressure and tidal volume with each bag compression. The oxygen line is patent and is connected to the bag and to the flow meter, which is set at 12 liters/min. What should the CRT do at this time?
A. Change the flow meter.
B. Compress the flow-inflating bag more frequently.
C. Pinch the tail of the bag during inflation and compression.
D. Increase the liter flow of oxygen to flush.

Answer 16

C. Pinch the tail of the bag during inflation and compression.

Question 17

A cascade humidifier is being used to humidify an air oxygen mixture from a blender. Water inside the unit is seen moving up the cascade tower and into the tubing connected to the cascade inlet. What should the CRT do to correct this problem?
A. Increase the inspiratory flow rate to oppose the back flow of the water.
B. Inspect the status of the one-way valve at the bottom of the tower.
C. Remove some water from the overfilled humidifier.
D. Replace the diffusion grid inside the cascade humidifier.

Answer 17

B. Inspect the status of the one-way valve at the bottom of the tower.

Question 18

A patient has had a permanent tracheostomy and has a conventional tracheostomy tube inserted. The physician asks the CRT to recommend a tracheostomy tube that will afford this patient the ability to breathe through the upper airway and to possibly speak. Which of the following tracheostomy tubes should the CRT select?
A. fenestrated tracheostomy tube
B. Kamen-Wilkinson Fome-Cuff tracheostomy tube
C. Lanz tracheostomy tube
D. Jackson tracheostomy tube

Answer 18

A. fenestrated tracheostomy tube

Question 19

A COPD patient has the following arterial blood gas data while breathing 2 liters/min. of oxygen from a nasal cannula.
PaO2 55 torr
PaCO2 70 torr
pH 7.30
HCO3 ¯ 34 mEq/L
B.E. 10 mEq/L
The patient complains of increased shortness of breath. The physician wants to initiate ventilatory support. Which of the following forms of mechanical ventilatory assistance would be appropriate for the CRT to recommend?
A. noninvasive positive pressure breathing
B. nasal CPAP breathing
C. controlled positive pressure breathing
D. inverse ratio ventilation

Answer 19

A. noninvasive positive pressure breathing

Question 20

A patient, brought to the emergency department, is suspected of having experienced smoke inhalation. Which of the following forms of oxygenation monitoring is most appropriate for this patient at this time?
A. arterial blood gas analysis
B. transcutaneous monitoring
C. co-oximetry
D. pulse oximetry

Answer 20

C. co-oximetry

Question 21

A CRT is summoned to a patient’s room to set up a nasal cannula to 2 liters/minute. Upon arrival, the physician asks the CRT to evaluate the patient to confirm his order. The evaluation presents the following findings:
60-year-old female
weight: 50 kg
ventilatory pattern: irregular and inconsistent
tidal volume: 200 to 350 ml
ventilatory rate: 24 to 34 breaths/minute
Which of the following recommendations should the CRT make to the physician?
A. Maintain the order at 2 liters/minute via the nasal cannula.
B. Recommend changing the order to read, “28% air entrainment mask.”
C. Change the order to prescribe a nasal cannula at 4 liters/minute.
D. Change the order to indicate a 35% aerosol mask.

Answer 21

B. Recommend changing the order to read, “28% air entrainment mask.”

Question 22

Which of the following humidifiers would be appropriate to use with adult mechanical ventilators?
I. bubble
II. bubble-jet
III. cascade
IV. wick
V. pass-over

A. III,V only
B. I, II, IV only
C. III, IV only
D. II, III, IV, V only

Answer 22

C. III, IV only

Question 23

A CRT in the adult CCU is mechanically ventilating a patient with a Bennett 7200a. Without changing any other settings, the CRT changes the flow pattern from
a constant flow to a decelerating flow. Which of the following statements is true regarding this change?
A. The inspiratory time increases while the peak flow and ventilatory rate remain unchanged.
B. The peak flow increases while the inspiratory time and ventilatory rate remain unchanged.
C. The ventilatory rate decreases while the inspiratory time and peak flow remain unchanged.
D. The inspiratory time and peak flow decrease while the ventilatory rate remains unchanged.

Answer 23

A. The inspiratory time increases while the peak

Question 24

A 45-year-old male patient of average stature require endotracheal intubation. Which of the following endotracheal tube sizes should the CRT select?
A. 6.5 mm I.D.
B. 7.5 mm O.D.
C. 8.5 mm I.D.
D. 9.0 mm I.D

Answer 24

C. 8.5 mm I.D.

Question 25

Which of the following accessory devices would be appropriate to use with an MDI for administration of metaproterenol to a patient who has hand-breath coordination difficulty?
A. incentive indicator
B. spacer
C. mask
D. one-way valve

Answer 25

B. spacer

Question 26

The CRT is about to assess the respiratory muscle strength of a ventilator patient by measuring the MIP. All of the following equipment would be appropriate to accomplish this task EXCEPT
A. a linear pressure gauge calibrated from 0 to –100
cm H2O.
B. a patient adaptor with one-way valves.
C. connection tubing.
D. nose clips.

Answer 26

D. nose clips

Question 27

Which of the following methods of oxygen analysis is most appropriate to use for monitoring a patient’s oxygenation status during bronchoscopy?
A. pulse oximetry
B. arterial blood gas analysis
C. co-oximetry
D. transcutaneous monitoring

Answer 27

A. pulse oximetry

Question 28

An 18-month-old cystic fibrosis patient is having increased, thick tracheobronchial secretions. Which of the following devices would be best suited for this patient?
A. incubator
B. mist tent
C. aerosol mask
D. oxyhood

Answer 28

B. mist tent

Question 29

A patient who received mechanical ventilatory assistance for acute ventilatory failure was weaned from mechanical ventilation and extubated 10 hours ago. The patient, receiving 60% oxygen by aerosol mask, is now experiencing dyspnea and increased WOB. Which of the following actions should the CRT take at this time?
A. Intubate the patient and administer oxygen via a T-piece.
B. Initiate NPPV.
C. Increase the patient’s FIO2 .
D. Intubate and reinitiate mechanical ventilation.

Answer 29

B. Initiate NPPV

Question 30

Which of the following oxygen-delivery devices is best suited for respiratory emergencies and for short-term oxygen therapy demanding moderate to high FIO2s?
A. air entrainment mask
B. simple mask
C. nonrebreathing mask
D. partial rebreathing mask

Answer 30

D. partial rebreathing mask

Question 31

During CPR, a patient vomits into the mask used for bag-mask ventilation. The vomitus contaminates the bag and valve assembly. How should the CRT process this equipment?
A. Place the mask, valve assembly, and bag into a glutaraldehyde solution for one hour.
B. Rinse the equipment clean of all debris and pasteurize the equipment.
C. Rinse the equipment clean of all debris and place it in glutaraldehyde for three hours.
D. Rinse the equipment clean of all debris and place it in an ethylene oxide sterilizer.

Answer 31

C. Rinse the equipment clean of all debris and place it in glutaraldehyde for three hours.

Question 32

For the past 48 hours, a patient who has acute atelectasis caused by retained secretions has been encouraged to cough following aerosol therapy and chest physiotherapy in an attempt to clear the secretions. The patient’s most recent chest radiograph reveals atelectasis in the right middle lobe and the absence of air bronchograms. Which of the following procedures is indicated at this time?
A. fiberoptic bronchoscopy
B. thoracentesis
C. thoracoscopy
D. mediastinoscopy

Answer 32

A. fiberoptic bronchoscopy

Question 33

Which of the following statements concerning an open-top tent are correct?
I. There is no cooling ability other than evaporation of the aerosol.
II. Oxygen concentrations of 30% to 40% are possible with flows of 10 to 15 liters/minute.
III. Flows of 20 to 40 liters/minute are recommended
to keep the tent temperature from rising above ambient temperature and to minimize CO2
accumulation.
IV. The primary function is to provide humidity.
A. I, II only
B. I, II, IV only
C. III, IV only
D. I, III, IV only

Answer 33

D. I, III, IV only

Question 34

A heat moisture exchange might not be a suitable humidification device for use in which of the following situations:
I. patients who have low tidal volumes
II. normothermic patients who are adequately hydrated
III. patients who have excessive amounts of secretions
IV. patients who have large airway leaks
A. I, II only
B. II, IV only
C. I, III, IV only
D. III only

Answer 34

C. I, III, IV only

Question 35

A CRT receives an order to insert a nasopharyngeal airway in order to facilitate suctioning. What is the proper method to determine the correct length of the airway to be inserted?
I. Measure the distance from the tip of the nose to the targus of the ear, and add one inch.
II. Measure the distance from the tip of the nose to the meatus of the ear.
III. Measure the distance from the tip of the nose to the targus of the ear, and subtract one inch.
IV. Measure the distance from the tip of the nose to the meatus of the ear, and subtract one inch.
A. I, II only
B. I, IV only
C. II, III only
D. III, IV only

Answer 35

A. I, II only

Question 36

The CRT wants to check the working pressure on a Thorpe tube regulator. The CRT has access to several pressure manometers—all of which can be attached to the regulator, but none that are calibrated in psig. Which one of the following manometers should be used?
I. a manometer calibrated in kPa from 0 to 700 kPa
II. a manometer calibrated in cm H2O from 0 to 3,000 cm H2O
III. a manometer calibrated in mm Hg from 0 to 2,000 mm Hg
IV. a manometer calibrated in inches Hg from 0 to 50 inches Hg
A. I only
B. II only
C. I, III only
D. II, IV only

Answer 36

A. I only

Question 37

All of the following statements are associated with the clinical use of mechanical percussors EXCEPT
A. they provide more effective therapy than manual percussion.
B. they are less tiring for the practitioner than manual percussion.
C. they facilitate quality control of therapeutic application of chest physiotherapy.
D. the frequency of vibrations/percussions can be
varied

Answer 37

A. they provide more effective therapy than manual
percussion.

Question 38

A 52-year-old adult male is diagnosed with obstructive sleep apnea. Which of the following modes of therapy might be beneficial in relieving the patient’s symptoms?
A. mask CPAP
B. IPPB Q4h
C. nasopharyngeal airway
D. bronchodilator therapy before sleep

Answer 38

A. mask CPAP

Question 39

All of the following statements are characteristics of heat moisture exchangers EXCEPT
A. they are designed to attach directly to artificial airways.
B. they contain hygroscopically treated material.
C. the efficiency of the device depends on the size of the inspired tidal volume.
D. they are primarily used for long-term support of spontaneously breathing patients.

Answer 39

D. they are primarily used for long-term support of spontaneously breathing patients.

Question 40

A patient with a tracheostomy needs oxygen therapy. Which of the following oxygen delivery devices would be most appropriate?
A. aerosol mask
B. face tent
C. tracheostomy collar
D. air-entrainment mas

Answer 40

C. tracheostomy collar

Question 41

While auscultating the chest of a 35-year-old non smoking patient who underwent a thoracotomy two days ago, the CRT hears fine, late inspiratory crackles over the region of the right middle lobe. The patient is oriented and coherent and has a respiratory rate of 22 breaths/min. The patient’s most recent chest X-ray reveals an increased opacity in the region of the right middle lobe. Which of the following devices should the CRT recommend for this patient?
A. IPPB device
B. incentive spirometer
C. peak flow rate
D. volume displacement pneumotachometer

Answer 41

B. incentive spirometer

Question 42

A home care oxygen-therapy patient needs a convenient and reliable source of oxygen. Which of the following modes of delivery would be most appropriate to select?
A. oxygen concentrator
B. compressed gas cylinders
c. liquid oxygen system
D. portable liquid oxygen container

Answer 42

A. oxygen concentrator

Question 43

A CRT is preparing to perform orotracheal intubation on a neonate. All of the following intubation equipment is required for this procedure EXCEPT
I. a MacIntosh laryngoscope blade.
II. tape.
III. a manual resuscitation bag.
IV. a stethoscope.
A. I only
B. II only
C. I, III only
D. II, IV only

Answer 43

A. I only

Question 44

While providing ventilation via a self-inflating manual resuscitator during resuscitation of a nonintubated adult patient, the CRT feels air moving around his hand (which he is using to secure and to seal the mask to the patient’s face). The flow meter is delivering 12 liters/min. to the bag. What should the CRT do at this time?
A. Squeeze the manual resuscitator more vigorously.
B. Obtain a larger-size mask.
C. Reduce the liter flow of oxygen from the flow meter.
D. Increase the frequency of bag compression.

Answer 44

B. Obtain a larger-size mask.

Question 45

Aside from a carbon monoxide gas analyzer, what other gas analyzer(s) is (are) necessary when performing the single-breath carbon monoxide lung diffusing capacity test?
I. oxygen analyzer
II. nitrogen analyzer
III. helium analyzer
IV. carbon dioxide analyzer
A. I only
B. III only
C. I, III only
D. II, IV only

Answer 45

B. III only

Question 46

A patient who has an endotracheal tube requires an FIO2 of 0.45. Which of the following oxygen administration devices would be most appropriate?
A. a high-flow air-entrainment device
B. a T-piece
C. a face tent
D. a tracheostomy collar

Answer 46

B. a T-piece

Question 47

Which of the following suction catheters would be most appropriate to facilitate the entrance to the left mainstem bronchus?
A. whistle-tip catheter
B. Coudé suction catheter
C. Yankauer suction tip
D. ring-tip catheter

Answer 47

B. Coudé suction catheter

Question 48

Which of the following equipment are necessary components of a ventilatory breathing circuit?
I. large-bore inspiratory limb
II. small-bore expiratory limb
III. exhalation manifold
IV. airway adaptor
V. patient Y-connector
A. I, II, III, IV, V
B. I, II, III, V only
C. II, III, V only
D. I, III, IV, V only

Answer 48

D. I, III, IV, V only

Question 49

An alert and cooperative patient who has a PaO2 of 40 torr while receiving an FIO2 of 0.60 is considered to be in acute oxygenation failure. The expectation is that the patient will require oxygenation for the next 24
to 72 hours. Which of the following devices would most appropriate for administering oxygen to this
patient?
A. nonrebreathing mask
B. mechanical ventilator
C. air-entrainment mask
D. mask CPAP

Answer 49

D. mask CPAP

Question 50

A stable, normothermic infant who is born at 32 weeks’ gestation is in need of oxygen therapy. Which of the following oxygen appliances would be most suitable for this infant?
A. oxygen tent
B. oxyhood
C. oxygen mask
D. isolette

Answer 50

B. oxyhood

Question 51

The CRT is asked to perform bedside spirometry. He
wants to use instrumentation that is lightweight and
easily portable. Which of the following devices should
he select?
I. heated-wire flow sensor
II. pressure-differential pneumotachometer
III. water-sealed spirometer
IV. wedge spirometer
A. I, II only
B. III, IV only
C. II, III only
D. I, IV only

Answer 51

A. I, II only

Question 52

The CRT is preparing to nasotracheally intubate an awake adult patient. Which of the following equipment would be necessary?
I. 0.25% phenylephrine spray
II. Magill forceps
III. 30-cc syringe
IV. 2% lidocaine spray
A. I, III only
B. I, II, IV only
C. II, III, IV only
D. I, II, III, IV

Answer 52

B. I, II, IV only

Question 53

The CRT is preparing respiratory therapy equipment for sterilization. Which of the following processing indicators best demonstrates that sterilization has actually occurred?
A. a chemical indicator
B. a light-sensitive indicator
C. a heat-sensitive indicator
D. a biologic indicator

Answer 53

D. a biologic indicator

Question 54

The CRT has been asked to measure a patient’s MIP. Which of the following instruments should he select to obtain this measurement?
A. pneumotachometer
B. pressure transducer
C. pressure strain-gauge
D. pressure manometer

Answer 54

D. pressure manometer

Question 55

A home care, COPD patient complains about the unaesthetic appearance and the nasal irritation caused by a nasal cannula. Which of the following oxygen therapy devices should the CRT select for this patient?
A. simple oxygen mask
B. transtracheal oxygen catheter
C. nasal mask
D. nasal catheter

Answer 55

B. transtracheal oxygen catheter

Question 56

The CRT is about to perform chest physiotherapy on an infant and notices that his hands are too large to administer the therapy effectively. Which of the following devices should he select to give the treatment?
I. manual percussor
II. flutter valve
III. electrically powered percussor
IV. pneumatically powered percussor
A. I only
B. III, IV only
C. I, III, IV only
D. I, II, III, IV

Answer 56

C. I, III, IV only

Question 57

A 48-year-old non-smoking patient has been hospitalized to undergo a cholecystectomy. Which of the following preoperative instructions should the patient receive?
A. CPR
B. incentive spirometry
C. MDI
D. IPPB

Answer 57

B. incentive spirometry

Question 58

Which of the following oxygen-administration devices would be most appropriate for an infant requiring heated humidity and a consistent FIO2?
A. incubator
B. mist tent
C. oxyhood
D. croupette

Answer 58

C. oxyhood

Question 59

What would be the most appropriate humidification system for a patient who has an artificial airway in place?
I. cool humidity
II. heated aerosol
III. cool water vapor
IV. heated humidity
A. I, II only
B. II, IV only
C. I only
D. II only

Answer 59

B. II, IV only

Question 60

Which of the following devices is appropriate to use for temporarily administering ventilation during CPR when a manual resuscitator is not available?
A. Berman airway
B. Guedel airway
C. partial rebreathing mask
D. mouth-to-valve mask

Answer 60

D. mouth-to-valve mask

Question 61

Which of the following statements concerning common PEEP mechanisms are correct?
I. For an underwater PEEP column to be functional as a threshold resistor, the container inlet and out
let must be unrestricted.
II. A spring-loaded diaphragm PEEP device might create expiratory resistance.
III. A pressurized balloon valve is the most common mechanism used to generate PEEP.
IV. A spring-loaded diaphragm PEEP device might create an expiratory retard.
A. I, III only
B. II, III only
C. I, IV only
D. I, II, III, IV

Answer 61

D. I, II, III, IV

Question 62

When preparing to perform an arterial puncture with a vented arterial sampler and crystalline anticoagulant, how should the CRT prepare the device to collect a 2.5-ml blood sample?
A. Pre-set the sampler plunger to 2.5 ml.
B. Place the sampler in ice water.
C. Aspirate 2.5 ml of normal saline into the sampler.
D. Eliminate any air from the sampler.

Answer 62

A. Pre-set the sampler plunger to 2.5 ml.

Question 63

All of the following are functional characteristics of an ultrasonic nebulizer EXCEPT
A. The device utilizes oxygen as carrier gas for aerosol to deliver a precise FIO2.
B. The device incorporates a piezoelectric transducer to produce aerosol.
C. The device uses an adjustable blower to deliver aerosol to the patient.
D. The device produces up to 6 ml/minute of aerosol output

Answer 63

A. The device utilizes oxygen as carrier gas for aerosol to deliver a precise FIO2

Question 64

A 47-year-old non-smoking patient in the recovery room following open-heart surgery is in need of oxygen therapy. Which of the following delivery devices would be most appropriate?
A. partial rebreathing mask
B. nasal catheter
C. air entrainment mask
D. simple mask

Answer 64

D. simple mask

Question 65

Which of the following equipment is designed to encourage deep breathing and to prevent post-operative atelectasis?
A. peak flow meters
B. chest percussors
C. flutter devices
D. incentive spirometers

Answer 65

D. incentive spirometers

Question 66

A home-care oxygen patient still maintains a relatively active lifestyle but feels confined with his present
oxygen-delivery system. Which of the following systems would provide the patient with the largest degree of mobility?
A. oxygen concentrator
B. compressed oxygen D cylinders
C. compressed oxygen E cylinders
D. liquid-oxygen system

Answer 66

D. liquid-oxygen system

Question 67

Which of the following types of humidifiers should the CRT select to reduce the accumulation of water in the circuit of a mechanical ventilator?
A. heat and moisture exchanger
B. heated cascade humidifier
C. heated wick humidifier
D. heated pass-over humidifier

Answer 67

A. heat and moisture exchanger

Question 68

The CRT needs to measure a patient’s expiratory volume and airflow rates. The CRT prefers an instrument that has few moving components, thereby minimizing the source of error related to rapid changes in the patient’s airflow patterns during inspiration and exhalation. Which of the following devices should the CRT choose?
I. pressure-differential flow-sensing device
II. water-sealed spirometer
III. volume-displacement device
IV. heated wire-flow sensor
A. I, II only
B. II, IV only
C. II, III only
D. I, IV only

Answer 68

D. I, IV only

Question 69

A CRT works at a hospital that uses recyclable ventilator tubing. A patient who tested positive for pulmonary tuberculosis died after coding while receiving mechanical ventilation. A coronary artery bypass patient is expected to be in the ICU in one hour. All of the ventilator circuits are in use. How should the CRT process the ventilator circuit to prevent transmission of the tuberculosis microorganism to the patient who will use the tubing next?
I. ethylene oxide sterilization
II. steam autoclaving
III. pasteurization
IV. glutaraldehyde
A. I, II only
B. II, III only
C. I, IV only
D. III, IV only

Answer 69

D. III, IV only

Question 70

Which of the following oxygen-delivery devices would be appropriate for a stable COPD patient who is mildly hypoxemic and normocapnic?
A. air-entrainment mask
B. simple mask
C. nasal cannula
D. partial rebreathing mask

Answer 70

C. nasal cannula

Question 71

All of the following mechanisms can be used to produce PEEP EXCEPT
A. a spring-loaded disk valve.
B. a magnetic valve.
C. a Rudolph valve.
D. a Venturi valve.

Answer 71

C. a Rudolph valve.

Question 72

An oxygen supply is needed to transport a patient from the hospital to an adjacent nursing home. Which of the following supply systems is appropriate to use for transport?
A. manifold system
B. liquid oxygen reservoir
C. air compressor
D. oxygen gas cylinder

Answer 72

D. oxygen gas cylinder

Question 73

Which of the following suction catheters would cause the LEAST amount of mucosal damage or bleeding?
A. whistle tip with two side ports
B. straight ring tip with four side ports
C. whistle tip without side ports
D. straight tip with two side ports

Answer 73

B. straight ring tip with four side ports

Question 74

Which of the following statements concerning laryngoscope blades are true?
I. A Miller blade is placed under the epiglottis, exposing the glottis when lifted and providing a greater visualization of the glottic opening.
II. A MacIntosh blade is placed in the vallecula, causing less epiglottic stimulation (and therefore, less chance of laryngospasm).
III. A straight blade is preferred in a pediatric patient, because the device enables greater exposure of the glottis and better exposure of the larynx.
IV. Laryngoscopes are made for right-handed persons.
A. I, III, IV only
B. II, III only
C. I, II, IV only
D. I, II, III, IV

Answer 74

D. I, II, III, IV

Question 75

Regarding the classification of mechanical ventilators, to which of the following mechanisms does the classification electric refer?
A. cycling mechanism
B. powering mechanism
C. monitoring mechanism
D. gas-flow mechanism

Answer 75

B. powering mechanism

Question 76

A patient who is brought to the emergency department is lethargic and has the scent of smoke on her clothes. She is in need of oxygen therapy. Which of the following oxygen-delivery devices is most appropriate for her at this time?
A. partial rebreathing mask
B. nonrebreathing mask
C. air-entrainment mask
D. simple mask

Answer 76

B. nonrebreathing mask

Question 77

Which of the following monitoring techniques is appropriate to use during endotracheal intubation?
A. electrocardiography
B. indirect calorimetry
C. conjunctival PO2 monitoring
D. capnography

Answer 77

D. capnography

Question 78

The CRT is preparing to assist with transporting a patient to another hospital about 45 minutes away by ambulance. The patient is receiving oxygen via a nasal cannula at 2 liters/min. from an E cylinder. Which of the following regulators would be most appropriate for this situation?
A. Bourdon gauge flow meter and a Bourdon pressure gauge reducing valve with a DISS connection
B. compensated Thorpe flow meter and a Bourdon pressure gauge reducing valve with a DISS connection
C. compensated Thorpe flow meter and a Bourdon pressure gauge reducing valve with a PISS connection
D. Bourdon gauge flow meter and a Bourdon pressure gauge reducing valve with a PISS connection

Answer 78

D. Bourdon gauge flow meter and a Bourdon pressure gauge reducing valve with a PISS connection

Question 79

A physician intends to wean a patient from a tracheostomy tube but still wants to prevent the stoma from closing and wants to maintain access to the trachea for suctioning or for emergency ventilation.
Which of the following devices should the CRT select to accomplish these purposes?
A. Lanz tracheostomy tube
B. tracheal button
C. speaking tracheostomy tube
D. Passy-Muir valve attached to a Kamen-Wilkinson
Fome-Cuff tracheostomy tube

Answer 79

B. tracheal button

Question 80

Which of the following suction devices is appropriate to use for removing vomitus or large particulate foreign matter from the oropharynx?
A. Lukens suction tube
B. Coudé suction catheter
C. Yankauer tonsil tip
D. Olympic suction catheter

Answer 80

C. Yankauer tonsil tip

Question 81

A CRT is asked to deliver 60% oxygen to a tracheotomized patient. The department uses standard nebulizers with a variable FIO2 setting of 0.35 to 1.0.
Which of the following oxygen-delivery devices is the most appropriate for the CRT to use?
A. tracheostomy collar
B. T-piece
C. canopy device
D. air-entrainment mask

Answer 81

B. T-piece

Question 82

An 80-kg, adult, male trauma patient has just been intubated with a 7.0 mm I.D. oral endotracheal tube that Chapter 4: Equipment has a low compliant cuff. Mechanical ventilation is also instituted. The CRT wants to measure the patient’s cuff pressure by using a cuff manometer calibrated in1 cm H2O increments from 0 to 60 cm H2O. What
should the CRT do at this time?
A. Deflate the cuff to the minimal occluding volume before measuring the cuff pressure.
B. Measure the cuff pressure first, then establish the minimal occluding volume.
C. Measure the cuff pressure first when a complete seal is formed.
D. Do not use the cuff manometer to measure this patient’s cuff pressure without the cuff manometer.

Answer 82

D. Do not use the cuff manometer to measure this patient’s cuff pressure without the cuff manometer.

Question 83

Which of the following design criteria should be considered essential for an effective CPAP system?
I. System flows capable of 60 to 90 liters/minute accompanied by a reservoir system must be provided.
II. The system must behave as a true threshold resistor, ideally generating no flow resistance.
III. An open system with flows of 20 to 30 liters/minute with a reservoir capacity of 2 to 3 liters/minute is required.
IV. Incorporation of a molecular high-humidity device, such as a Bennett cascade humidifier or a wick-type humidifier, is needed.
A. II, III only
B. II, III, IV only
C. I, II, IV only
D. I, IV only

Answer 83

C. I, II, IV only

Question 84

Which of the following features are characteristic of a piston-driven air compressor?
I. high flow output
II. capability of producing 50 psig
III. reservoir to meet peak flow demands
A. I, II only
B. I, III only
C. II, III only
D. I, II, III

Answer 84

D. I, II, III

Question 85

Which of the following devices is the most appropriate device for administering cool aerosol therapy to a three-year-old child who is diagnosed with laryngotracheobronchitis?
A. oxygen tent
B. mist tent
C. simple face mask
D. oxyhood

Answer 85

B. mist tent

Question 86

Within what pressure range will the safety-relief valve of a self-inflating resuscitation bag operate?
A. 30 to 35 cm H2O
B. 25 to 30 cm H2O
C. 20 to 25 cm H2O
D. 15 to 20 cm H2O

Answer 86

A. 30 to 35 cm H2O

Question 87

Which of the following procedures is (are) appropriate to use routinely for processing ventilatory tubing?
I. ethylene oxide sterilization
II. 70% ethyl alcohol solution
III. high-level disinfectants
IV. pasteurization
A. II, IV only
B. I, III, IV only
C. I, II, III only
D. I, II, III, IV

Answer 87

B. I, III, IV only

Question 88

Which of the following device(s) would be suitable for monitoring hyperoxia in a neonate?
I. pulse oximeter
II. transcutaneous oxygen electrode
III. co-oximeter
IV. arterial blood gas analyzer
A. IV only
B. I, III only
C. II, IV only
D. II, III, IV only

Answer 88

C. II, IV only

Question 89

Which of the following high-pressure reducing valves should be selected when a working pressure of less than 50 psig is needed?
A. adjustable reducing valve
B. preset reducing valve
C. present, single-stage reducing valve
D. multiple-stage reducing valve

Answer 89

A. adjustable reducing valve

Question 90

Which oxygen-delivery device would be most appropriate if the physician wishes to deliver oxygen to the patient at 24%?
A. nasal cannula at 1 liter/minute
B. partial rebreathing mask
C. simple mask at 5 liters/minute
D. air-entrainment device

Answer 90

D. air-entrainment device

Question 91

How should the CRT decontaminate a fiberoptic bronchoscope that has been used on a patient who has lung cancer?
A. glutaraldehyde
B. pasteurization
C. 90% isopropyl alcohol
D. acetic acid

Answer 91

A. glutaraldehyde

Question 92

The CRT wants to monitor the oxygen saturation of a patient who is prone to having episodes of poor perfusion. Which of the following monitoring techniques would be best suited for this type of patient?
A. arterial and mixed venous blood-gas analysis
B. pulse oximeter with a plethysmographic waveform display
C. co-oximetry of arterial and mixed venous blood
D. transcutaneous monitoring

Answer 92

B. pulse oximeter with a plethysmographic waveform display

Question 93

All of the following manual resuscitators enable spontaneous breathing to open the patient valve for oxygen EXCEPT
A. Hope II.
B. AMBU E-2.
C. Laerdal.
D. PMR II.

Answer 93

A. Hope II.

Question 94

For which of the following patients would an oropharyngeal airway be most appropriate?
A. an alert patient who requires frequent nasotracheal suctioning
B. a comatose patient who has a tracheotomy tube in place
C. an unconscious patient who requires ventilation before endotracheal intubation
D. a semi-comatose patient with a history of aspiration

Answer 94

C. an unconscious patient who requires ventilation

Question 95

Which of the following volume-pressure characteristics should an adult endotracheal tube cuff have?
A. high residual volume and low pressure
B. high residual volume and high pressure
C. low residual volume and low pressure
D. low residual volume and high pressure

Answer 95

A. high residual volume and low pressure

Question 96

Which of the following procedures is appropriate for processing bronchoscope biopsy forceps and brushes?
I. glutaraldehyde
II. ethylene oxide sterilization
III. steam autoclaving
IV. pasteurization
A. II, III only
B. I, IV only
C. I, II, III only
D. II, III, IV only

Answer 96

A. II, III only

Question 97

Which of the following methods of oxygen analysis is best suited when prescribing oxygen therapy for a home-care patient?
A. co-oximetry
B. transcutaneous oxygen monitoring
C. arterial blood-gas analysis
D. pulse oximetry

Answer 97

C. arterial blood-gas analysis

Question 98

When is the use of an oropharyngeal airway indicated?
A. in all bag-mask ventilation situations
B. when tracheobronchial suctioning is difficult
C. when performing bag-mask ventilation on a comatose patient
D. only in ventilatory arrest cases

Answer 98

C. when performing bag-mask ventilation on a comatose patient

Question 99

A CRT has been assigned to the pediatric unit and is responsible for supplying the emergency airway equipment. What endotracheal tube sizes should she recommend for insertion for an eight-year-old patient?
A. 5.5 mm, 6.0 mm, and 6.5 mm I.D.
B. 4.5 mm and 5.5 mm I.D.
C. 5.5 mm, 6.0 mm, and 6.5 mm O.D.
D. 4.5 mm and 5.5 mm O.D.

Answer 99

A. 5.5 mm, 6.0 mm, and 6.5 mm I.D.

Question 100

A motor vehicle accident victim who has oral trauma requires nasotracheal intubation. Which of the following devices should be used to assist with insertion of the endotracheal tube through the larynx?
A. MacIntosh blade
B. straight blade
C. curved blade
D. Magill forceps

Answer 100

D. Magill forceps

Question 101

Which statement represents one of the criteria of a suction catheter for suctioning through an ET tube?
A. The catheter’s external diameter should not exceed one-half of the internal diameter of the ET tube.
B. As long as the suction catheter will pass through the ET tube, the catheter can be used.
C. The suction catheter having the largest internal diameter should be used so that laminar flow through the catheter will be maintained.
D. During intubation, the largest ET tube should be chosen so that the largest suction catheter possible can be used when suctioning will be performed.

Answer 101

A. The catheter’s external diameter should not exceed one-half of the internal diameter of the ET tube.

Question 102

A patient who has a hemoglobin concentration of 8 g/dl has a pulse oximetry reading of 80%. What action would be appropriate at this time?
A. The reading should be accepted.
B. An arterial blood-gas analysis must be performed.
C. An arterial blood sample needs to be analyzed via a co-oximeter.
D. Arterial and mixed venous blood samples need to
be analyzed.

Answer 102

B. An arterial blood-gas analysis must be performed.

Question 103

Which of the following flow-regulating devices should be used to transport a patient who is receiving oxygen if the compressed gas tank is secured in a horizontal position?
A. a pressure-compensated Thorpe tube
B. a Bourdon gauge
C. a flow restrictor
D. a pressure regulator

Answer 103

B. a Bourdon gauge

Question 104

A CRT is called to the nuclear medicine department to determine the approximate time that an H cylinder of oxygen will last. The regulator reads 900 psig, and the patient is receiving oxygen via a nasal cannula at 6 liters/minute. How long will the cylinder last?
A. six hours and 10 minutes
B. seven hours and 50 minutes
C. eight hours and 30 minutes
D. nine hours and 15 minutes

Answer 104

B. seven hours and 50 minutes

Question 105

Which of the following characteristics are associated with the operation of air-oxygen blenders?
I. They can provide a consistent FIO2.
II. They use an internal pressure-balancing system.
III. They can be used for continuous flow CPAP systems.
IV. They require a single connection to a 50 psig oxygen source.
V. They incorporate a dual orifice proportional valve.
A. I, II, III, V only
B. I, III, IV only
C. II,V only
D. II, III, IV, V only

Answer 105

A. I, II, III, V only

Question 106

Which of the following substances is used in conjunction with collecting a sputum sample for cytology via a wide-mouthed, screw-top collection jar?
A. 20 ml of bacteriostatic saline
B. 20 ml of isotonic saline
C. 15 ml of 50% ethyl alcohol and 5 ml 3% NaCl
D. 20 ml of 50% ethyl alcohol and 2% carbowax

Answer 106

D. 20 ml of 50% ethyl alcohol and 2% carbowax

Question 107

All of the following devices are critical components of a CPAP system EXCEPT
A. a reservoir bag.
B. a one-way pop-off valve.
C. a nebulizer.
D. a threshold resistor

Answer 107

C. a nebulizer.

Question 108

When assembling a system to obtain a sputum specimen from an intubated patient, where should the CRT place the sterile sputum trap or specimen collector?
A. between the artificial airway and the suction catheter
B. between the suction catheter and the suction tubing
C. between the vacuum-regulating device and the suction tubing
D. between the vacuum reservoir and the suction tubing

Answer 108

B. between the suction catheter and the suction tubing

Question 109

A patient being transported on oxygen is using a nasal cannula at 4 liters/minute. The cannula is connected to a Bourdon type regulator attached to an E cylinder. When the side rail of the bed is raised into position, the tubing connecting the cannula to the regulator becomes kinked—occluding the oxygen flow. What will be the effect of this occlusion?
A. The flow indicated on the gauge will drop to zero.
B. The flow indicated on the gauge will continue to read 4 liters/minute.
C. The flow indicated on the gauge will increase higher than 4 liters/minute.
D. The flow indicated on the gauge will decrease slightly lower than 4 liters/minute.

Answer 109

C. The flow indicated on the gauge will increase

Question 110

What is the purpose of air compressors in the practice of respiratory care?
A. to produce uniform aerosol particles for aerosol therapy
B. to scrub oxygen from the air for oxygen therapy
C. to power equipment used for respiratory care procedures
D. to compress air for use in sterilization procedures

Answer 110

C. to power equipment used for respiratory care procedures

Question 111

111. Which of the following statements are true concerning endotracheal tube suctioning?
     I. In some instances, suctioning should be ordered on a predetermined basis.
     II. Endotracheal tube suctioning can be routinely performed as long as 25 seconds.
     III. Vagal nerve stimulation is a possible complication of tracheal suctioning.
     IV. The suction catheter should occupy as much as 50% of the internal diameter of the ET tube.
     A. I, II, III, IV
     B. III, IV only
     C. I, II, IV only
     D. II, III only

Answer 111

B. III, IV only

Question 112

A patient is receiving NPPV via a nasal mask for the treatment of respiratory failure associated with cardiogenic pulmonary edema. The CRT notices that the nasal mask does not fit the patient well. Which of the following measures should be taken?
A. Intubate the patient and administer oxygen via a T-piece.
B. Intubate the patient and apply CPAP.
C. Intubate and initiate conventional mechanical ventilation.
D. Use a full face mask.

Answer 112

D. Use a full face mask.

Question 113

While checking the operation of a mist tent being used by a two-year-old child who has cystic fibrosis, the CRT notices the absence of mist entering the enclosure. What corrective action(s) should be taken in this situation?
I. Tuck the canopy sides under the mattress.
II. Ensure that the canopy zipper is closed.
III. Check the water level in the nebulizer.
IV. Clean the nebulizer’s jet.
A. III only
B. I, II only
C. III, IV only
D. I, II, III, IV

Answer 113

C. III, IV only

Question 114

A patient is receiving oxygen via a 28% air entrainment mask. The physician asks the CRT to provide oxygen to this patient via a nasal cannula during meals. Which of the following liter flows would de
liver approximately 28% oxygen?
A. 1 liter/minute
B. 2 to 3 liters/minute
C. 4 liters/minute
D. 6 liters/minute

Answer 114

B. 2 to 3 liters/minute

Question 115

The CRT is having a tracheotomized patient perform an MIP maneuver to help determine the patient’s ability to be weaned from mechanical ventilation. The patient is a 70-kg male who has a known capability of producing a tidal volume of 400 ml. During the inspiratory maneuver, the meter does not register any reading. What might have contributed to this situation?
I. The patient port is open to the atmosphere and is
not occluded.
II. The internal diaphragm on the pressure device is
ruptured.
III. A tight seal is not being maintained.
A. I only
B. I, III only
C. II, III only
D. I, II, III

Answer 115

D. I, II, III

Question 116

While working in a CCU, the CRT hears the sound of the area alarm of the central oxygen supply system. Which of the following condition(s) can cause this alarm to sound?
I. A changeover from the primary to the secondary bank has occurred.
II. The dew point in the compressed air system exceeded its threshold.
III. The level of liquid in the bulk liquid oxygen supply reached a predetermined level.
IV. The normal operating line pressure changed by 20% or more.
A. I only
B. IV only
C. II, III only
D. I, II, III, IV

Answer 116

B. IV only

Question 117

While performing oxygen rounds, the CRT is told by a patient wearing a cannula, “It feels like nothing is coming out.” Which of the following aspects of this oxygen-delivery device should be examined?
I. that the cannula is connected to the flow meter
II. that the cannula or any of its tubing is not kinked
III. that the flow meter is working correctly
IV. that the humidifier is not leaking
A. I, II only
B. III, IV only
C. I, II, III only
D. I, II, III, IV

Answer 117

D. I, II, III, IV

Question 118

An ICU patient is receiving mechanical ventilation with a hygroscopic condenser humidifier in place. Over the course of a shift, the CRT notes a large increase in the quantity of secretions produced by the patient, and frequent suctioning is needed. What would be the appropriate action for the CRT to take?
A. replacing the hygroscopic condensing humidifier with a heated humidifier
B. adding a heated humidifier to the circuit
C. adding a second hygroscopic condensing humidifier in tandem
D. administering ultrasonic nebulization intermittently

Answer 118

A. replacing the hygroscopic condensing humidifier with a heated humidifier

Question 119

Which of the following conditions can expose a patient to excessive and dangerous airway pressure while being mechanically ventilated via a Babybird?
I. occlusion of the inspiratory limb of the circuit
II. occlusion of the expiratory limb of the circuit
III. obstruction of the exhalation valve charging line
IV. elevation of the FIO2 higher than 0.50
A. I only
B. II only
C. II, III only
D. I, II, III, IV

Answer 119

C. II, III only

Question 120

The CRT is informed of a fire in the west wing of the hospital. What is the most appropriate initial response to this situation?
I. Disconnect all flow meters from the wall outlets in the west wing.
II. Turn off the riser in the entire hospital.
III. Turn off the zone valve to the west wing.
IV. Provide emergency oxygen cylinders to patients who are relocated from the west wing.
A. I, II only
B. I, IV only
C. II, IV only
D. III, IV only

Answer 120

D. III, IV only

Question 121

A patient is breathing via an aerosol T-piece (Figure 4-1) during weaning from mechanical ventilation. The CRT notes that the aerosol coming from the T-piece disappears with each patient inspiration and that the patient’s SpO2
has fallen. To ensure that the patient receives the prescribed concentration of oxygen, the CRT should perform which of the following actions?
A. Recommend that the patient receive a respiratory depressant.
B. Increase the FIO2 setting.
C. Ask the patient to breathe less deeply.
D. Add reservoir tubing to the T-piece.

Answer 121

D. Add reservoir tubing to the T-piece.

Question 122

A mechanically ventilated patient who is being monitored via capnography has a continuous exhaled CO2 level of zero. An arterial blood-gas sample has just
been obtained, and the following data were obtained.
PaO2 90 torr; PaCO2 49 torr; pH 7.38; HCO3 ¯ 28 mEq/L
How should the CRT correct this problem?
A. Check to ensure that the endotracheal tube is not in the esophagus.
B. Check for an increase in mechanical dead space.
C. Check the tubing for a disconnection.
D. Examine the exhalation valve on the ventilator circuit

Answer 122

C. Check the tubing for a disconnection.

Question 123

What are the necessary components for calibrating a transcutaneous CO2
electrode?
I. sodium sulfite
II. barometric pressure
III. gas containing 0% CO2
IV. gas containing 10% CO2
A. I, III only
B. III, IV only
C. II, IV only
D. II, III, IV only

Answer 123

C. II, IV only

Question 124

Which of the following factors must be known to as certain the volume compressed in the ventilator circuit attached to a ventilator delivering a preset volume?
I. PIP
II. tidal volume delivered by the ventilator
III. compliance of the ventilator circuit
IV. PEEP
A. II, IV only
B. I, III, IV only
C. I, II, III only
D. I, II, III, IV

Answer 124

B. I, III, IV only

Question 125

The CRT is working with a patient who is receiving NPPV. The CRT notices the IPAP and EPAP preset pressures are not being achieved. Which of the following actions should be taken to correct this problem?
A. Determine the status of the air-intake filter.
B. Check the fuse or circuit breaker on the machine.
C. Increase the IPAP and EPAP pressure settings.
D. Set the ventilator to operate in the timed mode.

Answer 125

A. Determine the status of the air-intake filter.

Question 126

The CRT is checking an air compressor and notices that its output is low. Which of the following actions should the CRT immediately take to check this problem?
I. Examine the air inlet filter.
II. Check tubing and hoses for obstructions.
III. Check tubing and hoses for leaks.
IV. Ensure that the compressor is attached to a 50 psig air source.
A. I, IV only
B. I, II, III only
C. II, III, IV only
D. I, II, III, IV

Answer 126

B. I, II, III only

Question 127

A patient is receiving oxygen via an air entrainment mask set to deliver 28% oxygen. His bed sheet covers the entrainment ports. Which of the following statements are true concerning this situation?
I. The total liter flow will decrease.
II. The FIO2 will increase.
III. The patient will entrain more room air through the ports on the mask.
IV. The actual oxygen percentage will remain constant.
A. I, II, III only
B. I, III, IV only
C. II, III only
D. I only

Answer 127

A. I, II, III only

Question 128

A volume ventilator is being used in the recovery room to ventilate an apneic, post-operative trauma patient. The ventilator settings include
mode: assist/control
tidal volume: 800 ml
ventilatory rate: 12 breaths/minute
FIO2: 0.50
PEEP: 10 cm H2O
During rounds, the CRT notices that the ventilator is cycling at a rate of 28 breaths/minute. Additionally, the
CRT confirms that the sensitivity is set at 2 cm H2O below the PEEP level. What are possible causes for the increase in the ventilatory rate?
I. The assist is too sensitive.
II. The tidal volume is set too low.
III. The PEEP valve is malfunctioning.
IV. The circuit contains a leak.
A. I only
B. I, III only
C. II, IV only
D. III, IV only

Answer 128

D. III, IV only

Question 129

After an ultrasonic nebulizer has been in operation for several minutes, the temperature of the delivered gas is about 10ºC greater than room temperature. What ac
tion should the CRT take?
A. Replace the nebulizer.
B. Increase the gas flow through the nebulizer cup.
C. Do nothing.
D. Add more couplant.

Answer 129

C. Do nothing.

Question 130

Which statements can be considered advantages of nasal ET tubes as compared with oral ET tubes?
I. Nasal ET tubes are of a larger diameter, providing for more laminar flow.
II. Nasal tubes are considered to be better tolerated by the patient.
III. Once inserted, nasal tubes present fewer chances of kinking.
IV. Nasal tubes provide a better and more secure attachment for respiratory-care equipment.
A. II, III, IV only
B. I, III only
C. II, III only
D. III, IV only

Answer 130

A. II, III, IV only

Question 131

While monitoring the FIO2
of a patient with a Teledyne galvanic fuel cell analyzer, the CRT notes that the oxygen concentration is reading 102%. The most appropriate initial intervention would be to
A. Recalibrate the analyzer.
B. Change the electrolyte gel.
C. Change the fuel cell.
D. Secure another analyzer

Answer 131

A. Recalibrate the analyzer

Question 132

Incentive spirometry is being administered by using the Sherwood Medical Voldyne. The flow indicator rises above the clear chamber during inspiration. What
corrective action(s) should the CRT take?
I. Encourage the patient to take less forceful breaths.
II. Increase the length of the patient tubing.
III. Restrict flow through the mouthpiece.
IV. Decrease the diameter of the tubing connected to
the mouthpiece.
A. I only
B. II, III, IV only
C. II, IV only
D. III only

Answer 132

A. I only

Question 133

Which of the following liter flows is considered to be the minimum level necessary to prevent carbon dioxide buildup from occurring within an oxyhood?
A. 1 to 2 liters/minute
B. 5 to 7 liters/minute
C. 10 to 14 liters/minute
D. 16 to 20 liters/minute

Answer 133

B. 5 to 7 liters/minute

Question 134

When setting up an NPPV, how should the CRT establish the IPAP in relationship to the EPAP?
A. The IPAP and the EPAP need to be set at the same level.
B. The IPAP must be set higher than the EPAP.
C. The EPAP must be set higher than the IPAP.
D. The patient’s condition determines whether the IPAP or EPAP level will be higher.

Answer 134

B. The IPAP must be set higher than the EPAP.

Question 135

A patient who is being monitored with a transcutaneous PO2
electrode has the following arterial blood-gas data:
PaO2 92 torr
PaCO2 42 torr
pH 7.41
HCO3 ¯ 26 mEq/L
The PtcO2 readout indicates 159 torr. What action(s) should the CRT take?
I. Check the electrode for overheating.
II. Determine whether the patient’s skin perfusion has increased.
III. Inquire to find out whether the patient has recently received any vasoactive drugs.
IV. Examine the electrode for an adequate seal with the skin.
A. IV only
B. II, III only
C. I, III, IV only
D. I, II, III, IV

Answer 135

A. IV only

Question 136

The CRT is using capnography to monitor a patient’s PETCO2. The capnograph displays a low PETCO2.
Which of the following situation(s) can be responsible for this condition?
I. The patient is moving excessively.
II. The endotracheal tube is improperly placed.
III. The sensor is positioned too far from the patient’s mouth.
IV. The patient is experiencing an increased cardiac output.
A. II only
B. III only
C. I, IV only
D. II, III only

Answer 136

A. II only

Question 137

The CRT is checking the aerosol output from a jet nebulizer and notices that the aerosol output has decreased. Which of the following situations would cause a decreased aerosol output from a jet nebulizer?
I. the absence of a reservoir bag
II. an FIO2 of 0.70 or greater
III. a low water level in the reservoir
IV. a defective wick
A. I, II, III, IV
B. I, II, III only
C. II, III only
D. I, IV only

Answer 137

C. II, III only

Question 138

Which factor(s) would cause the delivered FIO2 to differ from the set FIO2 on an air-entrainment oxygen
delivery device?
I. the accumulation of condensate in the tubing
II. a low water level in the reservoir
III. an obstruction in the capillary tube in the reservoir
IV. a defective baffle
A. I only
B. I, III, IV only
C. II, III, IV only
D. I, II, III, IV

Answer 138

A. I only

Question 139

While analyzing the FIO2
in different areas of a mist tent providing aerosol therapy to an 18-month-old cystic fibrosis patient, the CRT notices that the analyzer reading is fluctuating from 25% to 35%. What action should be taken by the CRT at this time?
A. Increase the oxygen flow rate on the flow meter.
B. Use an oxyhood instead of a mist tent.
C. Use an air-oxygen blender to provide a set FIO2 .
D. Ensure that all of the possible sources of leaks are sealed.

Answer 139

D. Ensure that all of the possible sources of leaks are sealed.

Question 140

While cutting the tape to resecure an endotracheal tube of a patient who is being mechanically ventilated, the CRT inadvertently severs the cuff inflation line. What should the CRT do at this time?
A. Immediately remove the endotracheal tube.
B. Insert a needle, attached to a stopcock and small syringe, into the severed line and inject some air.
C. Clamp the severed cuff inflation line with hemostats and leave the tube in place.
D. Recommend a STAT portable chest X-ray to assess the status of the endotracheal tube.

Answer 140

B. Insert a needle, attached to a stopcock and small syringe, into the severed line and inject some air.

Question 141

While administering IPPB to an edentulous patient, the CRT notices that the patient is having difficulty cycling off the machine (and during some breaths is unable to cycle off the device). What adjustment would be appropriate for the CRT to make to correct this problem?
A. Make the IPPB machine less sensitive.
B. Decrease the peak flow.
C. Turn off the gas flow to the nebulizer.
D. Activate the terminal flow control.

Answer 141

D. Activate the terminal flow control.

Question 142

The CRT has obtained an arterial blood gas from a patient who is receiving 40% oxygen aerosol from a standard large-volume pneumatic nebulizer. The arterial PO2 is 50 mm Hg. The physician orders the FIO2 to be increased to 0.60. To accomplish this order, the CRT should perform which of the following tasks?
A. Turn the diluter control 60%
B. Turn the diluter control to 60% and increase the flow rate.
C. Turn the diluter control to 60% and connect a second nebulizer to the tubing with a Y-connector.
D. Leave the diluter control set at 40% and add a nasal cannula at 4 liters/minute.

Answer 142

C. Turn the diluter control to 60% and connect a second nebulizer to the tubing with a Y-connector.

Question 143

A CRT is using a closed-suction catheter system to suction a patient who is receiving mechanical ventilation. Before introducing the suction catheter, she has instilled 5 cc of normal saline through the suction system’s irrigation port. The patient begins coughing immediately, and the PIP indicated on the pressure manometer suddenly falls from 35 cm H2O to 15 cmH2O. What might have accounted for the drop in PIP?
A. The patient has developed bronchospasm.
B. The removal of secretions has caused the airway resistance to decrease.
C. The irrigation port on the suction catheter was inadvertently left open.
D. The patient Y-connector has come loose from the endotracheal tube adaptor on the closed-suction catheter system.

Answer 143

C. The irrigation port on the suction catheter was inadvertently left open.

Question 144

A CRT is asked to troubleshoot a Bourdon gauge flow meter. To understand the principle of operation, the CRT must have an appreciation of which of the following physical gas laws?
A. Boyle’s law
B. Charles’law
C. Dalton’s law
D. Poiseuille’s law

Answer 144

D. Poiseuille’s law

Question 145

In an attempt to remove vomitus from a patient’s mouth, the CRT selects a Yankauer suction device, sets the vacuum level at –80 mm Hg, and inserts the Yankauer suction device into the patient’s mouth. Little material enters the device. What should the CRT do in this situation?
A. Increase the negative suction pressure.
B. Switch to a size 12 French suction catheter.
C. Remove the Yankauer tube and use the connecting tube leading to the suction-collection bottle.
D. Replace the Yankauer suction device with a new one

Answer 145

A. Increase the negative suction pressure.

Question 146

A patient who requires mechanical ventilation at night breathes spontaneously through a fenestrated tracheostomy tube with a T-piece attached during the day. As the CRT re-establishes nocturnal mechanical ventilation, the low-pressure alarm on the ventilator sounds with each inspiration. What might be the problem in this situation?
A. The cuff might not have been reinflated.
B. The cuff might have been overinflated.
C. The patient might have developed a pneumothorax.
D. The patient might require endotracheal suctioning.

Answer 146

A. The cuff might not have been reinflated.

Question 147

A nurse in the neonatal ICU asks the CRT to check the FIO2
in the oxyhood on an infant. She says that the concentration ordered was to be 30% and she just analyzed it to be 25%. The blender supplying the oxyhood is set at 30% and analyzes at 30%. Which of the following statements is not a likely cause for the variation?
A. The hood is too large for the infant, enabling air to leak in around the neck.
B. The infant has too large a minute ventilation.
C. She is measuring the FIO2 near the top of the oxyhood.
D. The gas flow is insufficient.

Answer 147

B. The infant has too large a minute ventilation.

Question 148

How can the CRT prevent thermal injury to a patient’s skin when using a transcutaneous oxygen electrode?
A. Change the sensor site regularly.
B. Periodically lower the electrode temperature.
C. Remove the electrode from the skin occasionally.
D. Change sensors about every four hours.

Answer 148

A. Change the sensor site regularly.

Question 149

A CRT enters the home of a patient who is receiving oxygen from a nasal cannula attached to an H-cylinder. The oxygen concentrator is not operating despite being plugged into a 120-volt outlet. When the power switch on the machine is turned to the ON position, an audible alarm sounds. What corrective measure needs to be taken by the CRT at this time?
I. Test the outlet with a household appliance known to work.
II. Determine why the pressure of oxygen in the product tank is less than 10 psig.
III. Check the humidifier for an obstruction.
IV. Press the reset button to determine whether the circuit breaker has tripped.
A. II, III only
B. I, II only
C. I, IV only
D. I, II, IV only

Answer 149

C. I, IV only

Question 150

150. Which of the following factors can reduce the aerosol output from a jet nebulizer?
     I. a loose DISS connection at the flow meter
     II. a partial obstruction of the jet
     III. a full water trap
     IV. a full nebulizer reservoir
     A. I, II only
     B. II, IV only
     C. I, II, III only
     D. I, II, III, IV

Answer 150

A. I, II only

Question 151

What technique can be used to prevent the incidence of gastric insufflation during mouth-to-mask ventilation?
A. inserting an oropharyngeal airway
B. adding an oxygen flow of approximately 15 liters/minute
C. applying upward pressure to the mandible with the index, middle, and ring fingers of both hands
D. having a trained assistant apply pressure to the cricoid cartilage

Answer 151

D. having a trained assistant apply pressure to the cricoid cartilage

Question 152

A CRT is about to nasotracheally suction a patient and notes that the suction manometer reads –100 mm Hg. When the CRT covers the thumb port, no suction occurs at the catheter tip. At this point, the CRT should perform which of the following tasks?
A. Increase the wall suction to –120 mm Hg.
B. Replace the suction catheter
C. Add a water-soluble lubricant to the catheter tip.
D. Check the connections at the catheter and collection container.

Answer 152

D. Check the connections at the catheter and collection container.

Question 153

While checking a portable liquid oxygen reservoir in the home of a patient who is receiving oxygen via a nasal cannula at 2 liters/min., the CRT notices that the reservoir is not delivering oxygen. What action(s) should the CRT take to evaluate this problem?
I. Test the electrical outlet by plugging in an appliance known to work.
II. Verify the status of the weight scale.
III. Check all connections and feel and listen for escaping gas.
IV. Examine the filters in the system.
A. III only
B. I, II only
C. II, III only
D. I, II, III, IV

Answer 153

C. II, III only

Question 154

A continuous flow CPAP system using a threshold resistor is in operation on an adult ICU patient. During rounds, the CRT notices that the needle on the manometer swings from the prescribed 15 cm H2 O to 10 cm H2O during in
spiration. What can the CRT do to correct this problem?
A. Replace the manometer.
B. Change the threshold resistor to a flow resistor.
C. Discontinue the CPAP.
D. Increase the flow rate.

Answer 154

D. Increase the flow rate

Question 155

An adult patient has a Shiley cuffed tracheostomy tube inserted and is receiving aerosol therapy from a
T-piece. The patient complains of difficulty breathing. The CRT is unable to pass a 14-Fr suction catheter into the patient’s trachea. Which of the following courses of action would be appropriate to take at this time?
A. Instill 3 cc of normal saline and try to suction again.
B. Inspect the inner cannula.
C. Replace the tracheostomy tube.
D. Increase the FIO2
.

Answer 155

B. Inspect the inner cannula.

Question 156

A Bear-2 ventilator is being used to mechanically ventilate a patient. Suddenly, a continuous alarm sounds. When the CRT responds, he observes that the patient is showing no signs of distress and that the patient’s chest rises and falls in synchrony with the
cycling of the ventilator. Furthermore, the pressure manometer needle rotates to the appropriate level with each mechanical breath. The low exhaled volume alarm light is illuminated, and the digital display for the tidal volume equals zero. What should the CRT do to correct this situation?
A. He should disconnect the patient from the ventilator, institute manual ventilation, and call for help.
B. He should call the biomedical department for assistance.
C. He should note the situation in the chart after
pressing the alarm silence button.
D. He should blot dry the ultrasonic transducer and receiver surfaces of the pneumotach with a paper towel.

Answer 156

D. He should blot dry the ultrasonic transducer and receiver surfaces of the pneumotach with a paper towel.

Question 157

The CRT is summoned to the ICU because the low temperature alarm on a servo-controlled humidifier connected to the circuitry of a ventilated patient has been activated. The patient is receiving CPAP and is breathing only six times per minute with a tidal volume of 450 ml. The water-feed system and the humidifier are functioning properly. What is the most likely cause for the alarm activation?
A. An alarm malfunction has occurred.
B. The low flow rate through the system prevents the sensor from warming.
C. The room is too cool.
D. Condensate in the tubing is cooling the sensor.

Answer 157

B. The low flow rate through the system prevents the sensor from warming.

Question 158

As the CRT enters the room of a patient who is receiving supplemental oxygen through an air-oxygen blender, he hears the high-pitched alarm sounding from the blender. What is causing the alarm to sound?
A. A discrepancy between the delivered FIO2 and the set FIO2
has developed.
B. The oxygen pressure might be 10 psig greater than that of the compressed air.
C. A leak has occurred somewhere in the system.
D. The humidifier water level is low.

Answer 158

B. The oxygen pressure might be 10 psig greater than that of the compressed air.

Question 159

While an oropharyngeal airway is being inserted into an apparently unconscious patient, the patient suddenly beings coughing violently. What should the CRT do to ensure a patent airway in this patient?
A. Spray the back of the throat with lidocaine and reinsert the oropharyngeal airway.
B. Perform an emergency cricothyroidotomy.
C. Withdraw the oropharyngeal airway and insert a nasopharyngeal airway.
D. Continue the insertion of the oropharyngeal airway, because this response is normal.

Answer 159

C. Withdraw the oropharyngeal airway and insert a nasopharyngeal airway.

Question 160

While evaluating an oxygen concentrator at the home of a patient who is receiving supplemental oxygen via a nasal cannula, the CRT notices the oxygen concentration indicated on an oxygen analyzer, which is attached to the concentrator, decreases from 96% to 86% when the flow meter on the device is increased from 2liters/min. to 5 liters/min. What should the CRT do to correct this situation?
A. Recalibrate the oxygen analyzer.
B. Clean the filters on the concentrator.
C. Ensure that the air intake or exhaust is not blocked.
D. Nothing needs to be done, because this situation is normal.

Answer 160

D. Nothing needs to be done, because this situation is normal.

Question 161

What will happen in conjunction with an IPPB device if the nebulizer line becomes disconnected during a treatment?
A. The FIO2 will fluctuate.
B. The system flow rate will decrease.
C. The system pressure will increase.
D. The inspiratory phase will not terminate.

Answer 161

D. The inspiratory phase will not terminate.

Question 162

An air-oxygen blender is set up to deliver 35% oxygen to a patient. An oxygen analyzer indicates that a 75% oxygen concentration is being delivered. What should be the first action that the CRT takes?
A. Use a different nebulizer.
B. Look for leaks in the system.
C. Calibrate the oxygen analyzer.
D. Obtain another air-oxygen blender.

Answer 162

C. Calibrate the oxygen analyzer.

Question 163

The diagram in Figure 4-3 illustrates the graph generated when a nitrogen analyzer was exposed to high and low nitrogen calibration gases. Which of the following statements accurately de
scribe(s) the outcome of the calibration process?
I. A one-point calibration has been successfully performed.
II. The slope of the analyzer has been established.
III. The linearity of the analyzer has been established.
IV. The balance of the analyzer has been established.
A. I only
B. II, IV only
C. I, III only
D. II, III, IV only

Answer 163

B. II, IV only

Question 164

What should be done with the outer cannula of a tracheostomy tube when the inner cannula is being cleaned?
A. removed for cleaning first
B. replaced with a tracheal button
C. left in place
D. replaced with a sterile cannula

Answer 164

C. left in place

Question 165

A Bird high-flow oxygen blender set at 40% is delivering 80 liters/minute to a CPAP system. Oxygen-line pressure is considerably higher than the air-line pressure. What will be the result of this pressure difference?
A. The delivered FIO2 will decrease below 0.40.
B. The delivered FIO2 will increase above 0.40.
C. The delivered FIO2 will remain unchanged at the current flow rate.
D. The delivered FIO2 will decrease if the flow rate drops below 40 liters/minute

Answer 165

C. The delivered FIO2 will remain unchanged at the current flow rate.

Question 166

A patient is being mechanically ventilated with a Bennett 7200ae in the SIMV mode. Her mechanical rate is set at 6 breaths/minute, while her spontaneous rate is 10 breaths/minute. As the CRT administers an in-line aerosol treatment powered by a flow meter, he notices that the ventilator repeatedly converts to apnea ventilation. The best solution to this problem is
A. Discontinuing the treatment.
B. Powering the nebulizer with the ventilator nebulizer source.
C. Readjusting the apnea settings.
D. Reducing the flow rate to the nebulizer.

Answer 166

B. Powering the nebulizer with the ventilator nebulizer source.

Question 167

A CRT is performing a series of arterial blood-gas analyses on three patients and notes that the last three samples have consistently provided elevated PaO2
levels of 120 torr, 132 torr, and 138 torr, respectively. Previous sampling had demonstrated that all three of these patients had PaO2
values between 70 torr and 80 torr. Which of the following factors might account for this phenomenon?
A. Too long a delay between sampling and analysis might have taken place.
B. Air bubbles are being introduced into the samples.
C. Excessive amounts of blood are being analyzed.
D. The specimen is not being iced after procurement.

Answer 167

B. Air bubbles are being introduced into the samples.

Question 168

Which of the following techniques can be used to perform quality control of a body plethysmograph?
I. biologic controls
II. isothermal lung analog
III. comparison with gas dilution
IV. comparison with radiologic lung volumes
A. I only
B. I, III only
C. II, III, IV only
D. I, II, III, IV

Answer 168

D. I, II, III, IV

Question 169

The CRT enters the room of a patient who is receiving oxygen therapy from an appliance that is attached to a wick humidifier and notices little humidity out
put at the patient end. What should the CRT do at this time?
I. Check to see whether the unit is plugged into a 120 volt outlet.
II. Check the status of the float in the reservoir system.
III. Determine whether the temperature probe wire is loose or broken.
IV. Examine the reservoir feed system.
A. II, IV only
B. I, III only
C. II, III, IV only
D. I, II, III, IV

Answer 169

A. II, IV only

Question 170

How is the transcutaneous partial pressure of oxygen (PtcO2) influenced by hypotension?
A. The PtcO2 decreases.
B. The PtcO2 increases.
C. The PtcO2 fluctuates.
D. The PtcO2 correlates well with the PaO2

Answer 170

A. The PtcO2 decreases.

Question 171

While obtaining an SpO2
reading from a pulse oximeter with a finger probe attached to a patient, the CRT cannot obtain an SpO2
reading or a heart rate. Which of the following corrective measures would be appropriate at this time?
I. stopping the patient from moving excessively
II. shielding the probe from ambient light
III. massaging the site for about 30 seconds
IV. repositioning and correctly applying the sensor
A. I, II only
B. II, III, IV only
C. I, III, IV only
D. I, II, III, IV

Answer 171

D. I, II, III, IV

Question 172

The blood-gas laboratory at a hospital is concerned about the accuracy of arterial PO2
values in a pathologic range. Which of the following methods of PO2 electrode calibration would help reduce the laboratory’s concern?
A. one-point calibration using a gas containing 20% oxygen
B. one-point calibration using a gas containing 12% oxygen
C. two-point calibration using two gases containing 0% and 20% oxygen
D. two-point calibration using two gases containing 0% and 12% oxygen

Answer 172

D. two-point calibration using two gases containing 0% and 12% oxygen

Question 173

A patient is receiving oxygen-enriched aerosol therapy. The setting on the jet nebulizer is 40%; however, when the CRT analyzed the patient’s FIO2 , it was found to be 0.5. Which of the following reasons could have accounted for this discrepancy?
I. The oxygen flow rate must have been reduced.
II. Extra lengths of large bore tubing might have
been added to the system.
III. Condensate might be collecting in the delivery circuit.
IV. The air-entrainment port might have been opened more widely.
A. I, II only
B. II, IV only
C. III, IV only
D. II, III only

Answer 173

D. II, III only

Question 174

The CRT is unable to visualize the larynx of a neonate that she is attempting to intubate with a No. 1 Macintosh blade in the delivery room. What should she do next?
A. Use a No. 1 Miller blade instead.
B. Ask someone to provide laryngeal pressure.
C. Try a larger Macintosh blade.
D. Ventilate with a Mapleson and mask until someone else can try the intubation.

Answer 174

A. Use a No. 1 Miller blade instead.

Question 174

The CRT suspects that a bellows-type spirometer has developed a leak. How can the CRT determine the status of the bellows?
A. Use biologic controls when calibrating the instrument.
B. Use a calibration syringe.
C. Fill the bellows with air, seal the openings, and place a weight on the bellows.
D. Fill the bellows with air, maintain the opening, and observe the movement of the pen on the chart paper

Answer 174

C. Fill the bellows with air, seal the openings, and place a weight on the bellows.

Question 175

A Siemens Servo 900C has just been cleaned, and a new circuit has been attached. While evaluating ventilator performance, the CRT notices that the airway pressure reading is zero. What could be the reasons for this situation?
A. a loose tube between the inspiratory channel and the pressure transducer
B. too high a set working pressure
C. insufficient gas supply
D. an out-of-position safety valve

Answer 175

A. a loose tube between the inspiratory channel and the pressure transducer

Question 176

An adult male has just been intubated with an 8.0 mm I.D. oral ET tube. After inflating the cuff to 30 cmH2 O, a significant leak is noted with inflating pressures as low as 25 cm H2O. The X-ray reveals that the tube is in the proper position, but the inflated cuff is barely making contact with the tracheal wall. What should be done at this time?
A. Extubate the patient and reintubate with a larger sized tube.
B. Increase the cuff pressure in order to ensure a minimal seal.
C. Ventilate the patient with a larger volume in order to compensate for the leak.
D. Use high-frequency jet ventilation to avoid high inflating pressures.

Answer 176

A. Extubate the patient and reintubate with a larger sized tube.

Question 177

A diaphragm type, portable air compressor is being used to power a ventilator. The compressor is not powerful enough to meet the ventilator’s flow demand. What is the most serious problem that might result from this action?

A. The peak flow on the ventilator will be inaccurate because of a decrease in flow from the compressor.
B. “Wet air” might be delivered to the ventilator.
C. The compressor motor might be damaged.
D. The patient could contract a nosocomial infection secondary to contaminated air

Answer 177

B. “Wet air” might be delivered to the ventilator.

Question 178

The CRT is preparing to calibrate a helium gas analyzer before performing a closed circuit, helium dilution, FRC determination. Which of the following conditions must be present during the calibration of the helium analyzer?
I. The water vapor absorber must be removed during calibration.
II. The carbon dioxide scrubber must be connected during calibration.
III. A sample of room air can be used in the calibration process.
IV. A sample of gas containing 10% helium can be used in the collection process.
A. I, III only
B. II, IV only
C. II, III, IV only
D. I, II, III, IV

Answer 178

C. II, III, IV only

Question 179

The CRT enters the room of a patient who is wearing a simple mask attached to a pulse-dose oxygen-delivery device set in the pulse mode to deliver a flow rate of 4 liters/min. What should the CRT do at this time?
A. Remove the simple mask and place a cannula on the patient.
B. Increase the flow rate to 5 liters/min.
C. Increase the flow rate to 5 liters/min. and set the device in the continuous flow mode.
D. Nothing needs to be done, because the system is set up appropriately

Answer 179

A. Remove the simple mask and place a cannula on the patient.

Question 180

The CRT has applied the finger probe of a pulse oximeter to a patient, as pictured in Figure 4-4. What action needs to be taken?
A. Reverse the probe, because it is positioned upside down.
B. Switch the finger probe to a different finger.
C. Switch the finger probe to the left hand.
D. Align the tip of the finger with the LED and photodiode

Answer 180

D. Align the tip of the finger with the LED and photodiode

Question 181

A CRT is summoned to the bedside of a patient who is receiving an IPPB treatment with a Bird Mark VII powered with a diaphragm-type air compressor. The system pressure gauge is not achieving the desired 20 cm H2O; thus, the patient is not receiving an effective treatment. Upon further investigation, the CRT finds that the source pressure generated from the compressor is 32 psig. Based on the information provided, which of the following causes could be responsible for this condition?
A. The Bird Mark VII has been inadvertently set on 100% oxygen.
B. The compressor inlet filter is severely obstructed.
C. The compressor is not properly grounded.
D. The Bird Mark VII is out of calibration and needs
preventive maintenance.

Answer 181

B. The compressor inlet filter is severely obstructed

Question 182

When applying the finger probe of a pulse oximeter to a grossly obese patient, the CRT cannot align the tip of any of the patient’s fingers between the light-emitting diodes and the photodetector of the probe. What should the CRT do at this time?
A. Use the finger that provides the best fit.
B. Apply adhesive tape around the probe to secure it to one of the fingers.
C. Use a different style probe.
D. Obtain an arterial blood-gas sample.

Answer 182

C. Use a different style probe.

Question 183

While checking an H cylinder used as a backup by a home-care patient who is receiving oxygen therapy via an oxygen concentrator, the CRT turns on the cylinder valve and hears a constant hissing sound while the Bourdon gauge flow meter continuously registers 0 liter/min. What action should the CRT take at this time?

A. Replace the H cylinder.
B. Replace the regulator.
C. Apply a soap solution to the connections to identify the leak.
D. Turn on the flow meter

Answer 183

C. Apply a soap solution to the connections to identify the leak.

Question 184

The CRT is visiting the home of a mechanically ventilated patient when he notices that the patient has a 5-cm H2O, weighted-ball threshold resistor lying horizontally on the bed (while attached to the exhalation port). The pressure manometer falls to 5 cm H2O when the patient exhales. What should the CRT do at this time?
A. Nothing needs to be done, because everything is functioning properly.
B. The resistor is too close to the patient and needs to be moved.
C. A water column threshold resistor should be installed in place of the weighted ball.
D. The weighted-ball

Answer 184

D. The weighted-ball

Question 185

While checking a mechanically ventilated male patient, the CRT notices a leak around the cuff of the oral endotracheal tube. The CRT adds several cubic centimeters of air 1 cc at a time, observing no change in the size of the leak. She notes that the tube is taped at 20 cm at the corner of the mouth and that the pilot balloon has air in it. What should she do?
A. Deflate the cuff, advance the tube 2 to 3 cm, and reinflate the cuff.
B. Try adding a little more air to effect a seal.
C. Increase the volume delivered by the ventilator to compensate for the leak.
D. Replace the endotracheal tube, because the cuff probably leaks

Answer 185

A. Deflate the cuff, advance the tube 2 to 3 cm, and reinflate the cuff.

Question 186

A major problem encountered with the use of air oxygen blenders is
A. the loss of oxygen and air-line pressures.
B. the provision of inadequate humidification at high flow rates.
C. the lack of an alarm system.
D. the fluctuation in the oxygen percentage as back pressure increases.

Answer 186

B. the provision of inadequate humidification at high flow rates.

Question 187

The CRT is transporting a patient who is receiving oxygen via a simple mask at 6 liters/min., operating
off of an E cylinder with a regulator that uses a Bourdon gauge flow meter. If the humidifier imposes a greater-than-normal resistance to the oxygen flow, what will be the consequence?
A. The gas will have a higher relative humidity.
B. The oxygen flow meter will indicate a flow rate greater than 6 liters/min.
C. The FIO2 will decrease.
D. The E cylinder will empty faster.

Answer 187

B. The oxygen flow meter will indicate a flow rate

Question 188

A patient is receiving oxygen therapy via a partial re
breathing mask operating at 10 liters/min. The CRT notices that the reservoir bag does not completely refill during exhalation. Which of the following actions is appropriate to take at this time?
I. Increase the liter flow of oxygen.
II. Check the bag for a leak.
III. Examine the oxygen tubing for a kink or an obstruction.
IV. Ensure that the mask fits snugly on the patient’s face.
A. I, IV only
B. II, III only
C. III, IV only
D. II, III, IV only

Answer 188

D. II, III, IV only

Question 189

The CRT enters the emergency department and sees a patient who has a pneumothorax being drained with a 6.0 Fr. chest tube connected to a Heimlich valve. The CRT cannot determine whether the patient has an on going leak or not. How can the presence of an ongoing leak be ascertained?
B. Equal bilateral chest-wall movement can be observed.
C. Observe the chest wall on the same side rise after clamping the chest tube with a hemostat.
D. Watch for bubbling after immersing the valve under water.

Answer 189

D. Watch for bubbling after immersing the valve under water.

Question 190

While riding in an ambulance with a patient who is receiving oxygen from an E cylinder, the CRT notices the liter flow on a Thorpe tube flow meter indicates 0 liter/min. The Bourdon pressure gauge indicates 2,000 psig as the E-cylinder is positioned upright and is secured to the wall of the ambulance. What should the CRT do at this time?
A. Turn on the cylinder valve.
B. Position the cylinder horizontally.
C. Check the oxygen equipment for a leak.
D. Check the oxygen equipment for an obstruction.

Answer 190

D. Check the oxygen equipment for an obstruction.

Question 191

The CRT is working with a patient who is receiving 35% oxygen from a Venturi mask and notices that the patient has thickening secretions and increased, productive coughing. Which of the following actions would be appropriate at this time?
A. switching to a jet nebulizer operating an aerosol mask at 60%
B. performing endotracheal suctioning
C. increasing the oxygen concentration
D. adding aerosol through the aerosol collar, which is attached to the air-entrainment port

Answer 191

D. adding aerosol through the aerosol collar, which is attached to the air-entrainment port

Question 192

How should the CRT check the speed of a recorder time sweep of a volume-displacement spirometer?
A. with an X-Y plotter
B. with the chart (recording) paper
C. with a stopwatch
D. with a large-volume syringe

Answer 192

C. with a stopwatch

Question 193

The CRT notices the level of the water seal in a two bottle pleural drainage system fluctuate when the suction is momentarily turned off. What action needs to be taken at this time?

A. No action is necessary, because this response is normal.
B. The level of the water seal is low, and water needs
to be added to the bottle.
C. The chest tube leading to the system is obstructed and needs replacing.
D. The CRT needs to clamp the chest tube with a hemostat and suture the point of insertion of the chest tube at the chest wall.

Answer 193

A. No action is necessary, because this response is normal.

Question 194

The CRT is using an aneroid manometer to measure rapidly changing ventilatory pressures during patient breathing. Which of the following statements best describes the reliability of this device under these conditions?
A. The PIP will be overestimated, and the baseline pressure will be underestimated.
B. The PIP will be underestimated, and the baseline pressure will be overestimated.
C. Both pressures will be overestimated.
D. Both pressures will be underestimated.

Answer 194

B. The PIP will be underestimated, and the baseline pressure will be overestimated.

Question 195

The CRT is about to place a disposable nonrebreathing mask on a patient who has had carbon monoxide exposure. How should the oxygen flow rate be set in relation to the reservoir bag deflation during inspiration?
A. The reservoir bag should be allowed to completely deflate.
B. The reservoir bag should remain completely filled.
C. The reservoir bag should deflate by only one-third.
D. The reservoir bag should not completely deflate.

Answer 195

D. The reservoir bag should not completely deflate.

Question 196

The CRT is analyzing the FIO2
of a jet nebulizer set at 40% oxygen used to deliver aerosol therapy to a patient via an aerosol mask. The jet nebulizer is set to deliver 40% oxygen. The patient is capable of ambulating and prefers to move around; consequently, she has about 18 feet of aerosol tubing extending from the nebulizer out
let to the aerosol mask. The CRT analyzes the FIO2 to be 0.50. What should the CRT do in this situation?
A. Increase the oxygen liter flow.
B. Replace the jet nebulizer with two jet nebulizers in tandem.
C. Replace the aerosol setup with an air entrainment
mask.
D. Check the system for leaks.

Answer 196

B. Replace the jet nebulizer with two jet nebulizers in tandem.

Question 197

Upon entering the room of a patient who is receiving oxygen at 6 liters/min. by way of a partial rebreathing mask, the CRT notices that the reservoir bag does not completely fill when the patient exhales. Which of the following actions is appropriate to correct this situation?
A. switching to a nonrebreathing mask
B. checking to see whether the one-way valve be
tween the mask and the bag is stuck
C. ensuring that the humidifier jar is full
D. increasing the oxygen flow rate

Answer 197

D. increasing the oxygen flow rate

Question 198

The CRT is asked to check the frequency response of a spirometer, because the device is suspected to be inaccurate. What should the CRT use to determine the spirometer’s frequency of response?
A. stopwatch
B. sinusoidal pump
C. rotameter
D. calibrated syringe

Answer 198

B. sinusoidal pump

Question 199

Which of the following pleural drainage systems can operate directly from wall suction?
I. one-bottle system
II. two-bottle system
III. three-bottle system
IV. four-bottle system
A. II only
B. III only
C. I, II only
D. III, IV only

Answer 199

D. III, IV only

Question 200

The CRT enters the room of a patient who is receiving oxygen via a nasal cannula at 4 liters/min. with humidification. The pop-off valve on the bubble humidifier is sounding. What actions would be appropriate
for the CRT to take at this time?
A. adding water to the humidifier
B. reducing the liter flow
C. checking for kinked oxygen tubing
D. checking the system for loose connections

Answer 200

C. checking for kinked oxygen tubing

Question 201

The CRT notices the water level in the water-seal bottle of a three-bottle pleural drainage system remain constant as the patient continues breathing while the suction to the drainage system is momentarily turned off. What action needs to be taken at this time?
A. Water needs to be added to the water-seal bottle.
B. The water-seal bottle needs to vent to the atmosphere.
C. The chest tube needs to be replaced.
D. No action is necessary, because this response is
normal.

Answer 201

C. The chest tube needs to be replaced.

Question 202

The CRT sees an unconscious, spontaneously breathing patient wearing a simple oxygen mask, strapped in place and operating at 7 liters/min. What action should be taken at this time?
A. No action is necessary, because the patient and oxygen appliance are fine.
B. The mask should be unstrapped and allowed to rest on the patient’s face.
C. The oxygen flow rate should be increased to 10 liters/min.
D. A nasal cannula operating at 2 liters/min. should be used.

Answer 202

B. The mask should be unstrapped and allowed to rest on the patient’s face.

Question 203

The CRT is setting up a partial rebreathing mask on a patient. How should the flow rate of oxygen be set in relation to the reservoir bag deflation during inspiration?
A. The reservoir bag should remain half filled during inspiration.
B. The reservoir bag should remain one-third filled during inspiration.
C. The reservoir bag should be allowed to completely empty during inspiration.
D. The reservoir bag should remain completely filled during inspiration.

Answer 203

A. The reservoir bag should remain half filled during inspiration.

Question 204

The CRT suspects that a pressure transducer is providing erroneous measurements, because it might be out of calibration. How should he calibrate the pressure transducer?
A. zeroing the transducer
B. obtaining measurements from a normal subject
C. connecting the pressure transducer to a mercury manometer
D. sending a known electric current through the
Wheatstone bridge

Answer 204

C. connecting the pressure transducer to a mercury manometer

Question 205

The CRT is asked to perform quality control on a body plethysmograph. Which of the following forms of quality control can be performed on this device?
I. using a U-shaped water manometer
II. performing an isothermal lung analog
III. comparing with gas dilution volumes
IV. using a flow transducer
A. II only
B. I, IV only
C. II, III only
D. I, III, IV only

Answer 205

C. II, III only