Cluster 3

Question 1

A home care patient has a problem with his O2 concentrator and needs to change to the H tank of O2. If the patient’s nasal cannula is receiving a flow of 3L/min and the tank pressure is 1300 psig, how long can the patient receive O2

A. about 2 hours
B. About 22 hours
C. About 120 hours
D. About 1300 hours

Answer 1

B. About 22 hours

Question 2

What is the most likely problem to watch for in a patient with severe COPD who is receiving supplemental O2?
A. Pulmonary Edema from O2 toxicity
B. Hypoventilation
C. Retinopathy of Prematurity
D. Hyperventilation

Answer 2

B. Hypoventilation

Question 3

An order is received to set up a HFNC on a patient. What will be needed?

1. Humidifier
2. High-pressure oxygen source
3. Sterile saline
4. Blender
5. High pressure source

A. 2,4, and 5
B.2, 3, and 4
C. 1, 2, 4, and 5
D. 1, 2, 3, 4, 5

Answer 3

C. 1, 2, 4, and 5

Question 4

A respiratory therapist is making general rounds in the hospital and finds a patient whose reservoir tubing has fallen off his 40% T-piece. This would result in which of the following?

A. Increased inspired O2
B. Increased inspired CO2
C. Decreased inspired CO2
D. Decreased inspired O2

Answer 4

D. Decreased inspired O2

Question 5

The risk of O2 therapy include all of the following EXCEPT:

A. Pulmonary O2 toxicity
B. Denitrogen absorption atelectasis
C. O2- induced hyperventilation
D. Retinopathy of Prematurity

Answer 5

C. O2- induced hyperventilation

Question 6

A patient is wearing a face tent because of recent facial surgery. It is set at 35% O2. The nurse moves the patient from an upright to a supine position in bed. What effect will this have on the patient’s respiratory status?

A. Increased VT
B. Increased Inspired O2
C. Increased inspired CO2
D. Decreased inspired O2

Answer 6

D. Decreased inspired O2

Question 7

To minimize the risk of hypoxemia during a treatment or procedure, which of the following should be.
1. Increase the O2 percentage by 20% above the normal setting before suctioning or changing equipment
2. Keep the O2 percentage the same as if the patient were not hypoxemic at this time
3. Minimize the time that the patient would be breathing room air
4. Increase the O2 percentage to 100% before suctioning
5. Make sure the replacement equipment is working properly before you place it on the patient.
A. 1, 3
B. 2, 5
C. 3, 4
D. 3, 4, 5

Answer 7

D. 3, 4, 5

Question 8

An anxious 68 year old with congestive heart failure will not keep the nonrebreathing mask on. What should be recommended to treat the patient’s hypoxemia?
A. HFNC
B. Partial rebreathing mask
C. 50% air entrainment mask
D. 40/60 heliox mix by nonrebreathing mask

Answer 8

A. HFNC

Question 9

A patient is wearing a partial-rebreathing mask. The reservoir bag almost totally collapses during inspiration. Which of the following should be done?

A. Tell the patient to breather more slowly
B. Put a standard nasal cannula on the patient
C. Tell the patient to breathe more rapidly
D. Increase the O2 flow

Answer 9

D. Increase the O2 flow

Question 10

What O2 delivery device should be recommended for a patient who has a variable respiratory rate, I:E ratio, and VT?
A. Nasal cannula
B. Air entrainment mask
C. SImple O2 mask
D. Transtracheal Catheter

Answer 10

B. Air entrainment mask

Question 11

The physician asks the respiratory therapist which O2 delivery device would be best for a patient who needs about 75% O2. What should be recommended?
A. Non rebreathing mask
B. 6 L/min nasal cannula
C. Transtracheal catheter
D. Simple O2 mask

Answer 11

A. Non rebreathing mask

Question 12

What is the duration of flow of an E cylinder with 1700 psig that is running at 5L/min?
A. 0.9 hour
B. 1.6 hours
C. 7.7 hours
D. 13.7 hours

Answer 12

B. 1.6 hours

Question 13

The respiratory therapist is called to draw an arterial blood sample from a patient who is wearing 35% air entrainment ports of the mask. Upon entering the room, the therapist notices that the patient covers are drawn up over the air entrainment ports of the mask. How would this affect the function of the mask?

A. The total flow will be increased
B. There will be no effects
C. The O2 percentage will be increased
D. The O2 percentage will be decreased

Answer 13

C. The O2 percentage will be increased

Question 14

A 58 year old patient with advanced emphysema is admitted with an acute exacerbation of the condition. While breathing 2 L/min of oxygen through a transtracheal oxygen catheter, the patient has the following ABG results:
pH 7.38, PaCO2 57 torr HCO3 31 mEq/L SaO2, 80% BAsed on these findings, what should be done?

A. Change the patient to 24% oxygen by an air entrainment mask.
B. Initiate bilevel mask ventilation
C. Change the patient to a nonrebreathing mask with 10L/min
D. Increase the oxygen flow to 3L/min

Answer 14

D. Increase the oxygen flow to 3L/min

Question 15

A comatose patient is intubated and is receiving 35% O2 with aerosol through a T-piece. While watching the patient breathe, the therapist notices that during each inspiration, the mist disappears from the downstream end of the T-piece. What should be recommended?
A. Add aerosol tubing to the end of the T-piece
B. Change the O2 to 30% and increase the flow
C. Change the O2 to 40% and decreased the flow
D. Tell the patient not to breathe so deeply

Answer 15

A. Add aerosol tubing to the end of the T-piece

Question 16

A 65 year old female patient with pulmonary edema is very short of breath and hypoxemic. She is ordered to have a non rebreathing mask with 10 L/min of oxygen going to it. However she keeps taking off her mask because of anxiety and claustrophobia. When she removes the mask, her pulse oximeter reading drops from 90% to 82% What should be recomended to help manage the patient?

A. Give her nasal cannula at 10L/min oxygen
B. Sedate the patient so that she will keep her non rebreathing mask on
C. Initiate CPAP by mask at 8 cm water and 40% oxygen
D. Begin an HFNC at >10L/min

Answer 16

D. Begin an HFNC at >10L/min

Question 17

An uncooperative 13 year olf patient with status asthmaticus is being treated to receive a 70% helium 30% oxygen mic and continuous nebulized albuterol. What should be recommended as the best way to deliver this?

A. Partial Rebreathing mask with reservoir bag
B. HFNC
C. Nonrebrething mask with reservoir bag
D. Through a mechanical ventilator

Answer 17

C. Nonrebrething mask with reservoir bag

Question 18

The respiratory therapist is attempting to calibrate a polarographic oxygen analyzer but finds that it cannot be done. Possible reasons for this include;

1. The membrane is torn on the probe
2. The gas-sampling capillary tibe is plugged with debris
3. The electrode solution has evaporated
4. the battery needs to be replaced
5. Water has condensed on the membrane

A. 1 and 3
B. 2 and 3
C. 3, 4 , and 5
D. 1, 3, 4, and 5

Answer 18

D. 1, 3, 4, and 5

Question 19

A patient has just been admitted through the emergency department with suspected Co poisoning. The physician wants the patient to receive the highest possible O2 percentage. What should be recommended

A. CPAP mask at 5cm H2O and 40% O2
B. Simple mask at 6 L/min flow
C. 50% air entrainment nebulizer to aerosol mask
D. Nonrebreathing mask

Answer 19

D. Nonrebreathing mask

Question 20

The respiratory therapist is called to evaluate a female patient known to have advanced emphysema. She is wearing a nasal cannula at 6L/min. The nurse says that she has become drowsy and less responsive since the oxygen was given to her an hour ago. Her ABG results on the oxygen show the following:
PaO2 84 torr, PaCO2 65 torr, pH 7.32 Which of the following should be recommended?
1. Leave her on the cannula
2. Change her to 24% O2 on an air entrainment mask and repeat the ABG in 20 minutes
3. Change her to a simple oxygen mask and repeat the ABG in 20 minutes
4. Let her rest undisturbed
5. Monitor her closely for becoming more alert

A. 1 and 4
B. 3 and 4
C. 2 and 5
D. 3 and 5

Answer 20

C. 2 and 5

Question 21

The respiratory therapist is assisting with a bronchoscopy to obtain a biopsy of a suspicious laryngeal node on a patient. Afterward, the patient complains shortness of breath and a “tight” throat. Which of the following recommendations should be given to the physician?

A. Give the patient an 80/120 heliox mix to breathe
B. Put the head of the bed down 30 degrees
C. Give the patient a carbogen mic to breathe
D. Do a 7 minute helium dilution test

Answer 21

A. Give the patient an 80/120 heliox mix to breathe

Question 22

An adult patient who was rescued a house fire is being received in the emergency department. The patient is wearing a simple oxygen mask at 5 L/min. The SaO2 value by pulse oxymeter is 100% and his SaO2 value from an ABG sample analyzed on a CO oxymeter is 73%. What should be recommended at this time?

A. Maintain the simple oxygen mask at the present flow
B. Change the patient to a nonrebreathing mask
C. Decrease the oxygen flow to the simple mask to 4 L/min
D. Maintain present therapy and recalibrate the CO oximeter

Answer 22

B. Change the patient to a nonrebreathing mask

Question 23

An 8 year old patient with asthma is going to be given a 30% oxygen and 70% helium mix of heliox through a nonrebreathing mask and reservoir bag The physician has ordered the child to receive 7L/min of the gas mix. Because it will be delivered through an oxygen flowmeter, what flow should be set?

A. 3.9L/min
B. 4.4 L/min
C. 9.8 L/min
D. 11.2 L/min

Answer 23

C. 9.8 L/min

Question 24

The RT is working with a patient who has a tracheal tumor. The patient is wearing nonrebrwathing mask with 70% helium and 30% oxygen mix. Pulse oximeter saturation is 96%. The patient says that it is getting harder to saturation is 96% The patient says that it is getting harder to breathe and it is noticed that the reservoir bag has collapsed. The most appropriate action is to:

A. Decrease the flow of gas
B. Switch to a 28% air entrainment mask
C. Increase the flow of gas
D. Switch to a 60% helium and 40% oxygen mix

Answer 24

C. Increase the flow of gas

Question 25

A 36 week hestational age meonate is hypoxemic despite mechanical ventilation and has clinical evidence of persistent hypertension of the newborn. What can be done to correct the hypoxemia?

A. Instill intratracheal surfactant
B. Begin nitric oxide therapy
C. Begin 10 cm water PEEP
D. Begin carbogen therapy

Answer 25

B. Begin nitric oxide therapy

Question 26

A RT is assigned to the ER of a major medical center when a 24 yr old patient with status asthmaticus is transferred by ambulance from a small rural hospital. The px has been given continuous bronchodilator therapy and intravenous corticosteroids and aminophylline. The patient is becoming exhausted but refuses to allow intubation and mechanical ventilation. What should be recommended?

A. Begin heliox therapy
B. Begin nitric oxide therapy
C. Intubate and ventilate the patient despite the protests
D. Follow the parient wishes

Answer 26

A. Begin heliox therapy

Question 27

A neonatal patient has a primary pulmonary hypertension and is receiving mechanical ventilation. After the neonate receives 20ppm of nitric oxide therapy, PVR returns to the normal range. What should be reccomended this time

A. Discontinue the nitric oxide therapy
B. Decrease the nitric oxide to 10ppm
C. Add 1% carbogen to nitric oxide mix
D. Increase the nitric oxide therapy to 30 ppm

Answer 27

B. Decrease the nitric oxide to 10ppm

Question 28

A 16 yr old patient with status asthmaticus is started on a 70% helium 30% oxygen mix through a non rebreather mask. It is noticed that the oxygen flowmeter shows the delivery of 8L/min of gas. What is tha actual heliox gas flow

A. 5L/min
B. 8L/min
C. 12.8 (13) L/min
D. 14.4 (14) L/min

Answer 28

C. 12.8 (13) L/min

Question 29

A patient is quite weak and is unable to raise the ball marker on a flow-oriented incentive spirometer to meet the set goal The patient is becoming discouraged. What should be recommended?

A. Have the patient continue trying.

B Recommend that the patient be switched to IPPB.

C. Change the patient to a volume-oriented unit.

D. Discontinue the treatment because it is not effective.

Answer 29

C. Change the patient to a volume-oriented unit.

Question 30

A 16-year-old postoperative appendectomy patient has clear breath sounds and normal vital signs. What should be recommended to prevent atelectasis?

A CPAP at 5 cm H20

B. PEP therapy

C. IPPB

D. IS

Answer 30

D. IS

Question 31

. A 12-year-old patient with cystic fibrosis will be discharged

to go home. What type of directed cough should be recommended to improve secretion removal without causing airway collapse?
A.Chicken breath

B. Quad

C. Splinted

D. Lateral chest compression

Answer 31

B. Quad

Question 32

If pulmonary function results are not available, what initial IS goal should be set?

A. The IC measured at the bedside

B. The VC measured at the bedside

C. Three times the VT measured at the bedside

D. Twice the VT measured at the bedside challanged to take a

Answer 32

A. The IC measured at the bedside

Question 33

A patient has just performed several excellent IS efforts. The patient complains of tingling fingers and dizziness. What should be done?

A. Have the patient continue with additional maneuvers

B. Check the patient’s fingers and forehead for cyanosis

C. Call the patient’s physician to cancel the treatment order

D. Tell the patient to relax and breathe quietly

Answer 33

D. Tell the patient to relax and breathe quietly

Question 34

A patient has a flow oriented type of IS efforts. The patient is attempting but is unable to inhale forcibly through it. What is the most likely problem?

A. The inspiratory tube is obstructed

B. The patient is not really trying

C. The flow resistance is set too high

D. The bellows is in the locked-down position

Answer 34

C. The flow resistance is set too high