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RRT Exam > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

After a patient undergoes a thoracentesis, the respiratory therapist notes that the obtained pleural fluid is clear with a slight straw color. This fluid is most likely the result of

A.empyema.

B.congestive heart failure.

C.lung carcinoma.

D.hemothorax.

A

B.congestive heart failure.

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2
Q

Which of the following would be most important to evaluate for a patient who is entering a smoking cessation program?

A.Height

B.Smoking history

C.Weight

D.Diet

A

B.Smoking history

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3
Q

The respiratory therapist is calibrating a spirometer and checking the volume with a 3.0 liter super syringe. The volumes recorded are: 2.85 L, 2.8 L, and 2.8 L. Based upon the information obtained which of the following is a correct statement?

A.Another syringe needs to be used

B.Spirometer is accurate

C.The plunger was advanced too slowly

D.Spirometer may have a leak

A

D.Spirometer may have a leak

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4
Q

Which of the following is an indication for high frequency jet ventilation?

A.Bronchopleural fistula

B.Wilson Mikity syndrome

C.Necrotizing lesion of right lung

D.Centrilobular emphysema

A

A.Bronchopleural fistula

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5
Q

A 43-year-old female patient has just undergone a total abdominal hysterectomy. The patient arrives in the post anesthesia care unit obtunded with minimal response to painful stimulus. What treatment should the respiratory therapist recommend for this patient?

A.Initiate assisted ventilation

B.Insert oropharyngeal airway

C.Obtain positron emission tomography

D.Initiate noninvasive capnography

A

B.Insert oropharyngeal airway

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6
Q

A 44 week gestational age infant has just been delivered via C-section and is gasping, grunting, and has tachycardia and tachypnea. At one minute his Apgar score is 4 and at 5 minutes the score is 5. The infant is most likely suffering from

A.transient tachypnea of the newborn.

B.meconium aspiration.

C.bronchopulmonary dysplasia.

D.apnea of prematurity.

A

B.meconium aspiration.

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7
Q

What is the normal VD/VT ratio for a patient breathing room air?

A.5 - 15%

B.20 - 40%

C.45 - 55%

D.65 - 75%

A

B.20 - 40%

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8
Q

A heat moisture exchanger is indicated for humidification in which of the following situations?

A.Mechanical ventilation in a long-term care facility.

B.Transport to a tertiary care center.

C.Patient with tenacious secretions.

D.Delivery of aerosolized bronchodilators.

A

B.Transport to a tertiary care center.

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9
Q

All of the following could cause a patient’s right-hemidiaphragm to be elevated, EXCEPT

A.right lower lobe atelectasis.

B.right side hyperlucency, absent vascular markings.

C.hepatomegaly.

D.right lower lobe consolidation with air bronchograms.

A

B.right side hyperlucency, absent vascular markings.

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10
Q

A 64-year-old, 70 kg (154 lb) man with severe COPD is receiving independent (differential) lung ventilation following thoracotomy and right lower lobectomy. Which of the following setting combinations would be most appropriate for this patient?

A.Right lung 50 mL; left lung 650 mL

B.Right lung 150 mL; left lung 550 mL

C.Right lung 350 mL; left lung 350 mL

D.Right lung 550 mL; left lung 150 mL

A

B.Right lung 150 mL; left lung 550 mL

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11
Q

A patient in the intensive care unit has the following hemodynamic measurements:

CVP (mm Hg)5

PAP (mm Hg)29/8

PCWP (mm Hg)8

BP (mm Hg) 130/70

Cardiac output (L/min)5.1

Cardiac index (L/min/m2)2.7

What is the pulse pressure?

A.15 mm Hg

B.21 mm Hg

C.60 mm Hg

D.90 mm Hg

A

C.60 mm Hg

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12
Q

A 2-year-old child with croup has been intubated for 4 days with a 4 mm ID uncuffed endotracheal tube. Heated aerosol at an FIO2 of 0.30 has been delivered to the patient. The physician asks the respiratory therapist to evaluate the patient for possible extubation. Which of the following would most likely indicate that the patient is ready for extubation?

A.The patient is making normal quiet ventilatory efforts.

B.A negative sputum culture and sensitivity has been reported.

C.The patient’s ABG are within normal range.

D.Breath sounds are heard around the tube on auscultation.

A

D.Breath sounds are heard around the tube on auscultation.

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13
Q

A patient is seen in the Emergency Department for complaints of nausea and vomiting. A nasogastric tube has been inserted and the patient is started on lasix. Which of the following should the respiratory therapist monitor?

A.Cardiac enzymes

B.Serum electrolytes

C.Arterial blood gases

D.Cell hydration level

A

B.Serum electrolytes

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14
Q

While instructing a patient prior to a vital capacity maneuver, the respiratory therapist should direct the patient to

A.exhale to residual volume and inhale to inspiratory capacity.

B.inhale to total lung capacity then exhale to residual volume.

C.exhale normally then inhale to total lung capacity.

D.inhale normally then exhale to functional residual capacity.

A

B.inhale to total lung capacity then exhale to residual volume.

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15
Q

A patient involved in an automobile accident is brought to the ED with tachypnea, tracheal deviation to the right, splinting, asymmetrical chest movement, and decreased breath sounds on the left side. The respiratory therapist should initially

A.insert a chest tube.

B.administer 100% oxygen via mask.

C.perform endotracheal intubation.

D.initiate non-invasive positive pressure ventilation.

A

B.administer 100% oxygen via mask.

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16
Q

A 77-year-old male patient is admitted to the emergency room with shortness of breath, fine basilar crackles, +2 pitting edema and a chest radiogram with a butterfly pattern. These results are most consistent with which of the following?

A.Pulmonary edema

B.Pulmonary interstitial emphysema

C.Pneumothorax

D.Emphysema

A

A.Pulmonary edema

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17
Q

Which of the following formulas will determine the total flow being delivered to a patient with a 28% venturi mask running at 6 L/min?

A.total flow = 6 x 2

B.total flow = 6 x 4

C.total flow = 6 x 5

D.total flow = 6 x 11

A

D.total flow = 6 x 11

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18
Q

Fine crepitant crackles are most commonly associated with which of the following conditions?

A.Bronchitis

B.Pulmonary edema

C.Pneumonia

D.Foreign body aspiration

A

B.Pulmonary edema

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19
Q

A patient with end-stage pulmonary fibrosis is receiving oxygen at 2 L/min via a transtracheal oxygen catheter. The patient experiences an increased work of breathing and shortness of breath. The respiratory therapist should

A.manually ventilate the patient with a resuscitation bag.

B.increase the flow to the transtracheal catheter to 6 L/min.

C.evaluate the SpO2 with a pulse oximeter.

D.flush the transtracheal device with isotonic saline.

A

D.flush the transtracheal device with isotonic saline.

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20
Q

During bedside monitoring the respiratory therapist notices a dampened waveform on the arterial line graphic. To restore the graphic to normal, the therapist should first

A.verify the position of the transducer.

B.check the transducer dome for air bubbles.

C.flush the catheter with heparin solution.

D.attempt to draw blood from the arterial line.

A

B.check the transducer dome for air bubbles.

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21
Q

An optimal PEEP study is initiated on a patient receiving mechanical ventilation. The respiratory therapist first places the patient on a PEEP of 10 cm H2O for 20 minutes with no adverse effects. The PEEP is increased to 15 cm H2O and the patient’s heart rate rises significantly with a severe fall in the blood pressure. Based upon the above information, the therapist should conclude that the patient is suffering from

A.peripheral vasoconstriction.

B.hypovolemia.

C.increased venous return.

D.increased SVR.

A

B.hypovolemia.

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22
Q

A post-operative thoracotomy patient is receiving incentive spirometry therapy Q2H. Breath sounds are diminished in the bases of the lungs with scattered crackles. The patient’s inspiratory capacity has decreased over the past 2 days. A chest radiograph indicates thin-layered basilar densities. Which of the following has most likely occurred?

A.Atelectasis

B.Pneumonia

C.Pulmonary edema

D.Consolidation

A

A.Atelectasis

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23
Q

A patient is in full cardiopulmonary arrest and after several attempts, the patient is orally intubated with a size 7 mm ID endotracheal tube. The nurse is unable to establish IV access. The ECG monitor shows sinus bradycardia. Which of the following drugs should be administered through the endotracheal tube?

A.Lidocaine

B.Epinephrine

C.Atropine

D.Dobutamine

A

C.Atropine

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24
Q

The results of a patient’s spirometry are recorded as follows:

These results are indicative of

A.normal lung function.

B.sarcoidosis.

C.acute bronchitis.

D.cystic fibrosis.

A

B.sarcoidosis.

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25
Q

The respiratory therapist is in charge of transporting a patient with multiple trauma to a regional trauma center in a fixed wing aircraft. Which of the following should the therapist be most concerned about during the transport?

A.Tissue oxygenation

B.Pneumothorax

C.Pulmonary embolus

D.Humidification of the inspired gas

A

A.Tissue oxygenation

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26
Q

Transcutaneous monitoring of PO2 values will correlate well with arterial blood gas PO2 values in which of the following situations?

  1. Hypotension
  2. Hypothermia
  3. Pneumonia

A.1 only

B.3 only

C.1 and 2 only

D.2 and 3 only

A
  1. Hypotension
  2. Hypothermia
  3. Pneumonia

B.3 only

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27
Q

A patient is being ventilated in the intensive care unit. The following data is obtained:

What should the respiratory therapist report as the VD/VT ratio?

A.15%

B.25%

C.40%

D.50%

A

B.25%

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28
Q

What is the air-to-oxygen ratio for an air entrainment device delivering 60% oxygen?

A.1:1

B.3:1

C.4:1

D.10:1

A

A.1:1

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29
Q

Following surgery to correct an abdominal aortic aneurysm, a 54-year-old female patient suddenly develops intense substernal chest pain with severe dyspnea. The pain does not appear to be aggravated by her respirations. Auscultation reveals bilateral, basilar, moist, crepitant rales. The patient appears pale, cold and clammy. Which of the following should the respiratory therapist recommend for initial assessment of this patient?

A.Serum electrolytes

B.Chest x-ray

C.Complete blood cell count

D.Electrocardiograph

A

D.Electrocardiograph

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30
Q

An adult patient is intubated with a 7.0 mm ID endotracheal tube. What size suction catheter should be used to suction this patient?

A.8 French

B.10 French

C.12 French

D.14 French

A

B.10 French

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31
Q

Which of the following would be the most appropriate test to evaluate partial vocal cord paralysis in a patient complaining of difficulty swallowing?

A.SB nitrogen elimination

B.Maximum voluntary ventilation

C.Flow volume loop

D.Diffusing capacity

A

C.Flow volume loop

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32
Q

In order to reduce a patient’s PaCO2 from 40 torr to 32 torr, all of the following could be increased EXCEPT

A.tidal volume.

B.alveolar ventilation.

C.respiratory rate.

D.physiologic deadspace.

A

D.physiologic deadspace.

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33
Q

While examining the chest drainage system of a mechanically-ventilated patient following thoracotomy, the respiratory therapist observes bubbling in the water-seal chamber during inspiration. This would indicate

A.a leak in the chest drainage system.

B.air leaving the pleural space.

C.excessive pressure from the suction regulator.

D.inadequate water level in the water-seal chamber.

A

B.air leaving the pleural space.

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34
Q

A patient develops ascites and shortness of breath. Where is tissue edema most likely to show up first?

A.Ankles

B.Abdomen

C.Thorax

D.Hands

A

B.Abdomen

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35
Q

An acceptable level of PEEP therapy can be identified by all of the following EXCEPT

A.the lower inflection point of a volume-pressure loop graphic.

B.acceptable oxygenation without cardiovascular side effects.

C.increasing oxygenation with increasing plateau pressure.

D.increasing static compliance with acceptable oxygenation.

A

C.increasing oxygenation with increasing plateau pressure.

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36
Q

While suctioning a patient who is being mechanically ventilated, the respiratory therapist notes the following ECG pattern on the monitor:

Suctioning is stopped and the patient is returned to the ventilator. Which of the following drugs should the respiratory therapist recommend FIRST?

A.100% oxygen

B.atropine

C.lidocaine

D.epinephrine

A

A.100% oxygen

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37
Q

Adjusting the inspiratory flow during an IPPB treatment will result in a change in

A.respiratory rate.

B.peak pressure.

C.tidal volume.

D.inspiratory time.

A

D.inspiratory time.

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38
Q

A patient in the intensive care unit has the following hemodynamic measurements:

These results are most consistent with

A.normal cardiac function.

B.pulmonary hypertension.

C.left heart failure.

D.hypovolemia.

A

B.pulmonary hypertension.

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39
Q

A patient who is suspected of having a flail chest has been intubated and mechanically ventilated with PEEP therapy. The patient has just received pancuronium bromide. Which of the following ventilator alarms would be most important to set correctly for this patient?

A.Peak pressure alarm

B.Low PEEP pressure alarm

C.I:E ratio alarm

D.Low exhaled volume alarm

A

B.Low PEEP pressure alarm

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40
Q

A balloon-tipped, flow-directed catheter is positioned in the pulmonary artery with the balloon deflated. Which of the following pressures will be measured by the distal lumen?

A.CVP

B.PAP

C.PCWP

D.MAP

A

B.PAP

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41
Q

A pre-op patient who is at high risk for post-operative complications should be evaluated by obtaining the results of

A.VD/VT study.

B.diffusion studies.

C.basic spirometry.

D.indirect calorimetry.

A

C.basic spirometry.

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42
Q

A patient is receiving noninvasive positive pressure ventilation by mask. Current settings and arterial blood gas results are as follows:

IPAP 10 cm H2O

EPAP 5 cm H2O

Respiratory rate 12 /min

pH 7.31

PaCO2 56 torr

PaO2 63 torr

HCO3 25 mEq/L

BE +1 mEq/L

Which of the following should the respiratory therapist recommend?

A.Increase the EPAP to 10 cm H2O

B.Decrease the EPAP to 3 cm H2O

C.Increase the IPAP to 20 cm H2O

D.Decrease the IPAP to 5 cm H2O

A

C.Increase the IPAP to 20 cm H2O

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43
Q

During recovery from resection of an aortic aneurysm, a 65-year-old female patient suddenly develops severe substernal chest pain with grave dyspnea. The physician describes the bilateral breath sounds as basilar moist crepitant crackles. The patient appears pale, cool and diaphoretic. Which of the following should the respiratory therapist recommend as part of the initial assessment of this patient?

A.ECG

B.CBC

C.Serum electrolytes

D.Lateral decubitus radiograph

A

A.ECG

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44
Q

A patient is diagnosed with unilateral lung disease. The physician has requested that the effected lung be ventilated at a pressure 10 cm H2O lower than the normal lung. The respiratory therapist should recommend providing this type of ventilation via

A.cricothyroidotomy.

B.esophageal combi-tube.

C.transtracheal catheter.

D.double-lumen endobronchial tube.

A

D.double-lumen endobronchial tube.

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45
Q

Which of the following techniques measures total lung capacity?

A.

B.

C.

D.

A

A.

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46
Q

A 30-year-old male who weighs 68 kg (150 lb) has a minute ventilation of 9 L/min. and a respiratory rate of 20/min. What is his alveolar minute volume?

A.4 L/min.

B.6 L/min.

C.8 L/min.

D.12 L/min.

A

B.6 L/min.

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47
Q

During a cardiopulmonary stress test on a 55-year-old man, the respiratory therapist notes the following changes:

Heart rate increases
Blood pressure increases
VD/VT ratio decreases
Respiratory rate increases

The therapist should

A.continue the test.

B.terminate the test.

C.contact the physician.

D.administer amiodarone.

A

A.continue the test.

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48
Q

The respiratory therapist receives an order to administer bronchodilator therapy with albuterol. To reduce the chance of cross contamination, the therapist should

A.select a metered dose inhaler.

B.utilize a dry powder inhaler.

C.replace the small volume nebulizer every 24 hours.

D.wipe the surface of the nebulizer with alcohol every evening.

A

A.select a metered dose inhaler.

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49
Q

Which of the following is a FALSE statement about self-inflating resuscitation devices?

A.A reservoir is utilized to increase the delivered oxygen concentration.

B.The therapist can sense changes in the patient’s lung compliance and airway resistance.

C.A compressed gas source is necessary for the device to operate.

D.Excessive gas flow may cause the valve to malfunction.

A

C.A compressed gas source is necessary for the device to operate.

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50
Q

A 72-year-old male patient who is 5’ 10” tall and weighs 75 kg (165 lb) is receiving mechanical ventilation. The respiratory therapist notes diminished breath sounds in the bases of both lungs. The patient is on the following ventilator settings:

Based on this information, the respiratory therapist should

A.maintain the current settings.

B.increase the set rate to 12 br/min.

C.decrease the tidal volume to 500 mL.

D.increase the sigh volume to 1.0 L.

A

D.increase the sigh volume to 1.0 L.

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51
Q

A patient in the intensive care unit has the following hemodynamic measurements:

CVP: 12 mm Hg
PAP: 48/16 mm Hg
PCWP: 15 mm Hg
MAP: 99 mm Hg
Cardiac Output: 8.0 L/min.
Cardiac Index: 4.7 L/min/m2

Which of the following should the respiratory therapist recommend?

A.Oxygen

B.Dopamine

C.Lidocaine

D.Furosemide

A

D.Furosemide

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52
Q

The following pulmonary function data was reported for a 45 year old pre-op patient:

TLC - 5.4 L RV - 1.0 L

IRV - 2.6 L VC - 4.2 L

ERV - 1.0 L VT - 0.6 L

FRC - 2.0 L IC - 3.2 L

Which of the above capacities is incorrect?

A.TLC

B.VC

C.FRC

D.IC

A

A.TLC

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53
Q

A 16-year-old patient involved in a motorcycle accident has been admitted to the emergency department. The paramedic indicates that the patient was not wearing a helmet. To assess the patient’s neurologic status the respiratory therapist would assess the patient’s

A.vital capacity.

B.pupillary response.

C.herring bruer reflex .

D.moro reflexes.

A

B.pupillary response.

54
Q

The peak inspiratory pressure on a pressure-cycled ventilator is 30 cm H2O. The respiratory therapist decreases the inspiratory flow. This change would affect the

A.rate.

B.PEEP.

C.expiratory time.

D.I:E ratio.

A

D.I:E ratio.

55
Q

A patient recently underwent a coronary artery bypass and is now receiving Incentive Spirometry QID. The patient’s inspiratory capacity has diminished over the past several days and the patient is becoming increasingly short of breath. Chest radiograph shows left lower lobe consolidation with air bronchograms. The respiratory therapist would conclude that the patient has developed

A.pleural effusion.

B.atelectasis.

C.pneumothorax.

D.pneumonia.

A

D.pneumonia.

56
Q

A patient has a tracheostomy tube in place. The measured cuff pressure is 24 mm Hg. Which of the following statements is true of this situation?

A.The pressure is appropriate for minimal tracheal occlusion.

B.This pressure will most likely cause arterial occlusion.

C.At this pressure, there is a significant risk of VAP.

D.The pressure will cause tracheal necrosis if maintained.

A

A.The pressure is appropriate for minimal tracheal occlusion.

57
Q

The respiratory therapist receives an order for postural drainage and vibration. With the bed flat, the therapist places the patient in a prone position with pillows under his hips. Which lung segments are being treated with this position?

A.Anterior segments of the upper lobes

B.Superior segments of the upper lobes

C.Posterior basal segments of the lower lobes

D.Superior segments of the lower lobes

A

D.Superior segments of the lower lobes

58
Q

A patient has been admitted to the emergency department via ambulance. The cardiac monitor indicates sinus tachycardia. The patient is orally intubated with a size 7.5 mm ID endotracheal tube and is being manually ventilated. What other point of care monitoring should the respiratory therapist recommend for this patient?

A.Arterial blood gas analysis

B.Transcutaneous monitoring

C.Pulse oximetry

D.Serum electrolyte analysis

A

C.Pulse oximetry

59
Q

A patient has 2 mediastinal chest tubes following a thoracotomy. The respiratory therapist notes that there is continuous bubbling in the water seal chamber of the chest drainage system. The therapist should

A.check for a leak in the system.

B.add water to the water seal chamber.

C.increase the amount of suction.

D.advance the chest tube 2 cm.

A

A.check for a leak in the system.

60
Q

For a patient enrolled in a smoking cessation program, which of the following would indicate that the patient is non-compliant?

A.COHb level of 7%

B.Regular attendance at counseling sessions

C.Increased exercise tolerance

D.Decreased use of accessory muscles

A

A.COHb level of 7%

61
Q

A patient receiving a loop diuretic such as furosemide (Lasix) would most likely need what type of electrolyte replacement?

A.Potassium

B.Sodium

C.Chloride

D.Bicarbonate

A

A.Potassium

62
Q

The FRC measured by body plethysmography is 30% larger than that measured by helium dilution. This difference is best explained by

A.maldistribution of ventilation.

B.increased diffusing capacity.

C.trapped thoracic gas.

D.reduced lung compliance.

A

C.trapped thoracic gas.

63
Q

While performing a 12-lead electrocardiograph on a 68-year-old male patient, the respiratory therapist notices a sudden increase in artifact on the ECG paper. Upon further investigation, the therapist discovers that the V2 electrode has fallen off the chest. Where on the patient should the therapist place this electrode?

A.4th intercostal space on the left side of the sternum.

B.5th intercostal space, left mid-clavicular line.

C.6th intercostal space, left mid-axillary line.

D.7th intercostal space, right mid-clavicular line.

A

A.4th intercostal space on the left side of the sternum.

64
Q

Which of the following devices would produce the greatest humidity output for a patient?

A.Bubble humidifier

B.Wick-type humidifier

C.Large reservoir nebulizer

D.Ultrasonic nebulizer

A

D.Ultrasonic nebulizer

65
Q

A 7 year old child suspected of having epiglottitis would exhibit which of the following signs?

A.

B.

C.

D.

A

C.

66
Q

A spontaneous breathing trial has been initiated for a 64-year-old, intubated, post-op patient. Oxygen is being administered by T-piece at an FIO2 of 0.50 via heated air-entrainment nebulizer at a flow of 12 L/min and a temperature of 37.0oC. The respiratory therapist notices that the aerosol mist disappears from the reservoir outlet during the patient’s inspiration. The therapist should consider all the following EXCEPT

A.lenghtening the reservoir tubing.

B.adding an additional nebulizer.

C.increasing the flow to 15 L/min.

D.increasing the temperature to 39.0oC.

A

D.increasing the temperature to 39.0oC.

67
Q

A 62-year-old patient with a history of emphysema (body weight 50 kg, 110 lb) requires mechanical ventilation because of acute respiratory failure. The respiratory therapist notes the following:

Mode VC, SIMV

Set rate 10 br/min.

Total rate 16 br/min.

VT 400 mL

FIO2 0.28

Arterial blood gases are as follows:

pH 7.37

PCO2 56 torr

PO2 65 torr

HCO3- 32 mEq/L

The respiratory therapist should

A.increase the set rate to 8 br/min.

B.increase the FIO2 to 0.30.

C.maintain the current settings.

D.increase the VT to 650 mL.

A

C.maintain the current settings.

68
Q

A patient with a history of cardiovascular disease has been brought to the emergency department. He is intubated and is being manually ventilated. The ECG monitor shows a sinus rhythm with a rate of 50 beats/min. The patient’s pulse is weak and irregular. The nurse has been unable to place a central or peripheral venous catheter. The therapist should recommend endotracheal instillation of

A.atropine.

B.lidocaine.

C.epinephrine.

D.naloxone.

A

A.atropine.

69
Q

The following values are measured on a patient in the outpatient pulmonary function testing center:

Which trial should be recorded as the best test?

A.Trial 1

B.Trial 2

C.Trial 3

D.Trial 4

A

B.Trial 2

70
Q

A patient is receiving IPPB with a Bird Mark-7. The respiratory therapist notes that the patient is generating negative pressure at the beginning of inspiration although the machine does not switch into the inspiratory phase. The respiratory therapist should

A.decrease the flow.

B.increase the sensitivity.

C.adjust the apnea timer.

D.decrease the pressure.

A

B.increase the sensitivity.

71
Q

A patient is receiving continuous mechanical ventilation through an oral endotracheal tube. The respiratory therapist notes that the high pressure alarm sounds continuously during inspiration and the patient appears to be biting down on the ET tube. Which of the following should the therapist recommend?

A.Change to a nasal endotracheal tube

B.Add air to the cuff

C.Add water to the humidifier

D.Insert an oral pharyngeal airway

A

D.Insert an oral pharyngeal airway

72
Q

The most common complication associated with fiberoptic bronchoscopy via the nasal route is

A.nosocomial infection.

B.hypoxemia.

C.uncontrolled coughing.

D.mild epistaxis.

A

D.mild epistaxis.

73
Q

The respiratory therapist is reviewing a patient’s chart prior to performing a bedside assessment to determine readiness for weaning from ventilatory assistance. The patient weighs 60 kg (132 lb). The therapist would expect the patient to be able to achieve a spontaneous tidal volume of

A.200 – 355 mL

B.300 – 480 mL

C.400 – 620 mL

D.600 – 720 mL

A

B.300 – 480 mL

74
Q

The physician informs the patient that the results of his polysomnogram indicate obstructive sleep apnea. Treatment for this disorder might include

A.bronchial hygiene therapy.

B.respiratory stimulants.

C.tracheostomy.

D.negative pressure ventilation.

A

C.tracheostomy.

75
Q

After completing oxygen rounds, the respiratory therapist must clean flowmeters that were removed from rooms where no patients were receiving oxygen therapy. Which of the following methods is most appropriate for disinfection of the flowmeters?

A.Steam autoclave

B.Soak in acid gluteraldehyde

C.Wash in Pasteurmatic

D.Wipe with alcohol

A

D.Wipe with alcohol

76
Q

A 4-year-old girl is admitted to the emergency department with persistent dry coughing. Chest radiograph results reveal normal inspiration with the right lung remaining expanded on expiration. Which of the following should the respiratory therapist recommend at this time?

A.Endobronchial intubation

B.Arterial blood gas analysis

C.Bronchoscopic examination

D.Lateral neck radiograph

A

C.Bronchoscopic examination

77
Q

Which of the following would indicate that the lung compliance of a patient on a volume-cycled ventilator is increasing?

A.Plateau pressure begins to decrease

B.Peak pressure begins to increase

C.Blood pressure decreases

D.Arterial PCO2 decreases

A

A.Plateau pressure begins to decrease

78
Q

Heliox therapy is indicated for treatment of patients with post extubation stridor because of the

A.ability to effectively deliver humidity.

B.low density of the gas mixture.

C.high molecular weight of the gas mixture.

D.low risk of bronchospasm.

A

B.low density of the gas mixture.

79
Q

A 17 year-old patient is receiving 40% oxygen via a Venturi mask following a motor vehicle accident. He suddenly develops acute shortness of breath, is diaphoretic and SpO2 is 85%. Breath sounds are vesicular on the right and extremely diminished on the left. The respiratory therapist should evaluate the patient for the presence of

A.atelectasis.

B.a pneumothorax.

C.arterial hypertension.

D.a myocardial infarction.

A

B.a pneumothorax.

80
Q

Which of the following would NOT be required to perform a nasal intubation?

A.Magill forceps

B.Stylet

C.Laryngoscope

D.Endotracheal tube

A

B.Stylet

81
Q

Which of the following formulas will determine the amount of physiologic deadspace for a patient?

A.PAO2 - PaO2

B.CaO2 - CvO2

C.(PaCO2 - PECO2) / PaCO2

D.CcO2 - CaO2 / CcO2 - CvO2

A

C.(PaCO2 - PECO2) / PaCO2

82
Q

A balloon-tipped, flow-directed catheter is positioned in the pulmonary artery with the balloon inflated. Which of the following pressures will be measured by the distal lumen?

A.CVP

B.PAP

C.PCWP

D.MAP

A

C.PCWP

83
Q

Airways resistance (Raw) of 1.8 cm H2O/L/sec is measured for a patient receiving mechanical ventilation. The respiratory therapist should suspect that the patient may have

A.asthma.

B.ARDS.

C.neuromuscular disease.

D.normal airways.

A

D.normal airways.

84
Q

What is the normal range for central venous pressure in an adult?

A.2 - 6 mm Hg

B.4 - 12 mm Hg

C.9 - 18 mm Hg

D.21 - 28 mm Hg

A

A.2 - 6 mm Hg

85
Q

A patient has just been intubated with a naso-tracheal tube and is being manually ventilated. As the respiratory therapist ventilates the patient, he notices that there is no chest movement, minimal breath sounds and air escaping from the mouth as the bag is squeezed. A chest x-ray has determined that the endotracheal tube is in the correct position. What is the most likely cause of this situation?

A.The tube is in the esophagus.

B.The patient has developed a tracheoesophageal fistula from the intubation process.

C.The cuff ruptured during intubation.

D.The cuff has herniated over the end of the tube.

A

C.The cuff ruptured during intubation.

86
Q

A patient is receiving 40% oxygen via a Venturi mask at 8 L/min. While performing oxygen rounds, the respiratory therapist notes that the flowmeter setting has been changed to 12 L/min. How would this change affect the accuracy of this device?

A.FIO2 will remain unchanged

B.FIO2 will decrease to 0.35

C.air entrainment factor will decrease

D.FIO2 will increase to 0.50

A

A.FIO2 will remain unchanged

87
Q

Blood gas results from an apparently healthy patient reveal a pH of 7.37, PaCO2 of 15 torr, PaO2 of 140 torr. The patient is breathing room air and displays no tachycardia, tachypnea, or adventitious breath sounds. Which of the following is an appropriate conclusion to draw on the basis of this information?

A.A venous blood sample was drawn.

B.The blood gas sample was not cooled prior to analysis.

C.The blood gas sample had an air bubble in it.

D.The patient’s blood gas sample was mixed up with another sample.

A

C.The blood gas sample had an air bubble in it.

88
Q

Over the last hour a patient being ventilated with a volume cycled ventilator has had a decrease in urine output from 35 mL/hour to 10 mL/hour. The most likely cause of this change would be an increase in the

A.respiratory rate.

B.delivered FIO2 .

C.peak airway pressure.

D.inspiratory flow.

A

C.peak airway pressure.

89
Q

Following administration of oxygen, what additional therapy should the respiratory therapist recommend for a patient with decompression sickness?

A.Non-invasive ventilation

B.Inhaled nitric oxide

C.Hyperbaric oxygen therapy

D.Extracorporeal membrane oxygenation

A

C.Hyperbaric oxygen therapy

90
Q

A patient has been participating in Pulmonary Rehabilitation for the past 5 weeks. The patient has recorded the results of his 6 minute walk test each week. The results indicate a steady increase in distance over the 5 week period. These results are consistent with

A.need to wear supplemental oxygen while walking.

B.need for an additional 6 weeks of rehabilitation.

C.improvement in exercise ability.

D.early discharge from rehabilitation.

A

C.improvement in exercise ability.

91
Q

The following measurements were obtained from a patient being monitored with a balloon tipped, flow directed catheter:

CVP 2 cmH2O

PAP 12 torr (mean)

PCWP 3 torr

CI 1.2 L/min/m2

BP 110/90 mm Hg

Based on the above information, all of the following parameters would be decreased EXCEPT

A.right ventricular end diastolic pressure.

B.left atrial filling pressure.

C.systemic vascular resistance.

D.cardiac output.

A

C.systemic vascular resistance.

92
Q

Cardiopulmonary resuscitation has been performed on an adult patient for 15 minutes. The following pattern is seen on the ECG monitor:

The respiratory therapist has obtained the following arterial blood gas results:

pH 7.02

PaCO2 47 torr

PaO2 196 torr

HCO3 11 mEq/L

SaO2 94%

FIO2 1.0

Which of the following should the therapist recommend at this time?

A.Increase the minute volume

B.Administer sodium bicarbonate

C.Decrease the FIO2

D.Administer lidocaine

A

B.Administer sodium bicarbonate

93
Q

A patient recently underwent a thoracotomy and is now receiving IPPB QID. The patient’s inspiratory capacity has diminished over the past several days and the patient is becoming increasingly short of breath. Chest radiograph shows left lower lobe radiodensity with a concave upper border. The respiratory therapist would conclude that the patient has developed

A.a pleural effusion.

B.atelectasis.

C.a pneumothorax.

D.pneumonia.

A

A.a pleural effusion.

94
Q

Pressure-cycled ventilation would be LEAST appropriate for a patient with

A.kyphosis.

B.muscular dystrophy.

C.chronic CO2 retention.

D.a drug overdose.

A

C.chronic CO2 retention.

95
Q

A hyperresonant percussion note is associated with which of the following pathologies?

A.

B.

C.

D.

A

B.

96
Q

A patient involved in a motor vehicle accident has sustained a long bone fracture and remains in traction. The patient suddenly complains of chest pain and develops tachypnea and tachycardia. The respiratory therapist should

A.administer 100% oxygen.

B.recommend heparin.

C.recommend streptokinase.

D.request a chest X-ray.

A

A.administer 100% oxygen.

97
Q

How should the respiratory therapist assemble a Bird Mark 7 respirator to deliver 40% oxygen during an intermittent positive pressure breathing treatment?

A.Bleed in oxygen with the air-mix off

B.100% oxygen with the air-mix on

C.Air-mix on and attached to a blender set at 40%

D.Air-mix off and attached to a blender set at 40%

A

D.Air-mix off and attached to a blender set at 40%

98
Q

A patient is being ventilated with a high frequency ventilator. The results of an arterial blood gas analysis are as follows:

pH 7.29

PaCO2 68 torr

PaO2 73 torr

HCO3- 25 mEq/L

BE +1 mEq/L

The respiratory therapist should increase the

A.driving pressure.

B.frequency.

C.bias flow.

D.I:E ratio.

A

A.driving pressure.

99
Q

A 48-year-old woman is admitted to the coronary care unit for chest pain, dizziness and nausea. Her blood pressure is 60/40 mm Hg, respirations are 20/min. The cardiac monitor shows sinus rhythm at a rate of 50/minute with frequent multifocal PVC. The respiratory therapist should recommend administration of:

A.lidocaine.

B.nitroglycerin.

C.atropine.

D.amiodarone.

A

C.atropine.

100
Q

A patient with a size 8.5 mm ID oral endotracheal tube is transported from the Emergency Department to the Intensive Care Unit. The respiratory therapist suspects the tube has changed position during transport. Which of the following is the first step to assess the tube position?

A.Chest radiograph

B.Bilateral chest auscultation

C.Verify symmetrical chest movement

D.Diagnostic chest percussion

A

C.Verify symmetrical chest movement

101
Q

A newborn infant has an APGAR score of 8 one minute after delivery. The most appropriate action at this time would be to

A.intubate and ventilate the infant.

B.dry and monitor the infant.

C.initiate oxygen therapy.

D.begin chest compressions immediately.

A

B.dry and monitor the infant.

102
Q

Which of the following statements is TRUE concerning positive expiratory pressure (PEP) therapy?

A.It applies expiratory positive airway pressure (EPAP) using a one-way expiratory valve and a one-way inspiratory flow resistor.

B.It is used for 5 - 10 minute intervals every hour.

C.The inspiratory flow resistor prevents end-inspiratory pressures from rising above zero.

D.It may help improve secretion expectoration, decrease hyperinflation and improve airway maintenance

A

D.It may help improve secretion expectoration, decrease hyperinflation and improve airway maintenance

103
Q

A 10-year-old patient with asthma is asked to monitor his airflow improvement following each Beta-2 agonist treatment taken at home. Which of the following should the therapist provide for the patient?

A.Turbine pneumotachometer

B.Peak flow meter

C.Pulse oximeter

D.Volume displacement spirometer

A

B.Peak flow meter

104
Q

All of the following could cause the high pressure alarm on a volume cycled ventilator to sound EXCEPT

A.decrease in lung compliance.

B.increase in airway resistance.

C.peak flow setting of 75 L/min.

D.acute bronchospasm.

A

C.peak flow setting of 75 L/min.

105
Q

While reviewing the results of polysomnography on a 44-year-old patient, the respiratory therapist notes that the Apnea Hypopnea Index (AHI) is 25. This value should be reported as

A.normal.

B.mild.

C.moderate.

D.severe.

A

C.moderate.

106
Q

A patient is receiving mechanical ventilation with a PEEP of 10 cm H2O and requires a MRI scan. Before transporting the patient, the respiratory therapist should obtain a

A.manual resuscitation bag with a non-ferrous PEEP valve assembly.

B.pneumatically powered pressure cycled ventilator with a PEEP valve assembly.

C.pneumatically powered demand valve resuscitation device.

D.non-disposable resuscitation bag.

A

A.manual resuscitation bag with a non-ferrous PEEP valve assembly.

107
Q

A patient has performed both a forced vital capacity and a slow vital capacity maneuver with the following results:

FVC 2.4 L SVC 2.18 L

Which of the following statements is TRUE regarding these results?

A.The data meets ATS-ERS standards and should be reported.

B.The SVC shows poor effort and should be repeated.

C.The FVC shows poor effort and should be repeated.

D.The patient has obstructive lung disease.

A

B.The SVC shows poor effort and should be repeated.

108
Q

Which of the following could NOT cause a capnography reading to change from 36 torr to 30 torr?

A.Tachypnea

B.Hyperventilation

C.Pulmonary emboli

D.Endotracheal tube positioned in the right mainstem bronchus

A

D.Endotracheal tube positioned in the right mainstem bronchus

109
Q

A tracheostomy tube has just been changed on a patient receiving continuous volume-cycled ventilation. The patient suddenly becomes dyspneic and develops crepitus around the tracheostomy stoma. The respiratory therapist should

A.suction the patient.

B.insert a larger tracheostomy tube.

C.reposition the tracheostomy tube.

D.recommend an antihistamine.

A

C.reposition the tracheostomy tube.

110
Q

A patient’s cardiac output is increased and his QS/QT is calculated to be 20%. Based upon this information, the respiratory therapist would inform the physician this patient has

A.an elevated shunt.

B.a reduced cardiac index.

C.increased pulmonary vascular resistance.

D.normal lung mechanics.

A

A.an elevated shunt.

111
Q

How long will a full E cylinder of oxygen last if run until empty with a flowrate of 10 L/min?

A.1 hour

B.10 hours

C.33 hours

D.66 hours

A

A.1 hour

112
Q

The most common hazard associated with insertion of a central venous catheter is

A.pulmonary embolus.

B.hypoxemia.

C.rupture of the right atrium.

D.pneumothorax.

A

D.pneumothorax.

113
Q

During oral endotracheal intubation, the tip of the Macintosh laryngoscope blade should be placed

A.between the soft palate and tongue.

B.in the vallecula.

C.under the epiglottis.

D.between the vocal cords.

A

B.in the vallecula.

114
Q

While suctioning an adult patient, the respiratory therapist observes evidence of hypoxemia on the bedside heart monitor. Which of the following are acceptable forms of treatment for the therapist to recommend?

A.Perform cardioversion

B.Administer lidocaine

C.Administer 100% oxygen

D.Recommend nitroglycerin

A

C.Administer 100% oxygen

115
Q

A patient with chronic bronchitis is to receive therapy to help remove a large amount of thick purulent secretions. Which of the following would be most helpful?

A.Incentive Spirometry

B.IPPB

C.Postural drainage and percussion

D.Small volume nebulizer with normal saline

A

C.Postural drainage and percussion

116
Q

A patient is suspected of having developed a pulmonary embolus. Which of the following tests should the therapist recommend to confirm the diagnosis?

A.(A-a)DO2

B.C(a-v)O2

C.VD/VT

D.P50

A

C.VD/VT

117
Q

During mechanical ventilation, a patient initiates the breath and then the ventilator controls the remaining variables for that breath. This describes a/an

A.spontaneous breath.

B.assisted breath.

C.mandatory breath.

D.supported breath.

A

B.assisted breath.

118
Q

A 150 kg (330 lb) patient has been referred to a sleep center for evaluation of sleep apnea and daytime drowsiness. Which of the following is the most appropriate diagnostic procedure?

A.Spirometry

B.Pulse oximetry

C.Polysomnography

D.Body plethysmography

A

C.Polysomnography

119
Q

A 2100 g neonate is in the NICU and is being monitored with a TcPO2 monitor. The TcPO2 is reading 53 torr with the temperature set at 40oC. The arterial PO2 is 73 torr. Which of the following would best explain the difference in TcPO2 levels?

A.There was an error in the arterial blood gas analysis.

B.The TcPO2 monitor needs to be repositioned on the neonate.

C.The TcPO2 temperature setting is too low.

D.The TcPO2 monitor has come off the skin.

A

C.The TcPO2 temperature setting is too low.

120
Q

A 1600 g neonate is receiving oxygen by oxyhood at an FIO2 of 0.60. The flowmeter is set at 5 L/min. While analyzing the oxygen, the respiratory therapist notices varying FIO2 readings at different locations inside the oxyhood. Which of the following should the therapist do to correct the problem?

A.Re-calibrate the oxygen analyzing device

B.Increase the flow to the oxyhood

C.Place the neonate in an isolette at an FIO2 of 0.60

D.Check the water level of the humidifier

A

B.Increase the flow to the oxyhood

121
Q

The following measurements were obtained from a patient with a pulmonary artery catheter in place:

CVP 1 mm Hg

PAP 10 mm Hg (mean)

PCWP 8 mm Hg

CI 1.6 L/min/m2

BP 110/90 mm Hg

Based on the above information, all of the following values would be decreased EXCEPT

A.RVEDP.

B.PVR.

C.SVR.

D.QT.

A

C.SVR.

122
Q

A 75 kg (165 lb) male is being mechanically ventilated at the following settings:

Mode VC, SIMV

Set Rate 12 br/min

Total Rate 32 br/min

Tidal Volume 600 mL

PIP 35 cm H2O

Exhaled minute volume 9.2 L

FIO2 0.45

PEEP 8 cm H2O

The following patient information is available:

pH 7.36

PaCO2 45 torr

PaO2 89 torr

HCO3- 22 mEq/L

The respiratory therapist should

A.decrease PEEP.

B.increase set rate to 14 br/min.

C.add pressure support.

D.initiate pressure control mode.

A

C.add pressure support.

123
Q

A patient is receiving 60% oxygen at a flow of 8 LPM via a large volume nebulizer and aerosol mask. The patient’s inspiratory flowrate is 35 LPM. Which of the following should the respiratory therapist recommend?

A.Decrease the flow setting to 5 LPM

B.Maintain the current flow setting

C.Increase the flow setting to 15 LPM

D.Use two nebulizers at a flow of 10 LPM each

A

D.Use two nebulizers at a flow of 10 LPM each

124
Q

A patient with chronic hypercapnia is brought into the ED. The history of the present illness revealed that the patient passed out at home. A pulmonary artery catheter has been placed with the following measurements obtained:

PAP 25/10 mm Hg

BP 76/50 mm Hg

PCWP 4 mm Hg

SVR 1360 dynes

CVP 0 mm Hg

CI 1.8 L/min/m2

Which of the following is the most likely cause for his condition?

A.Hypovolemia

B.Drug overdose

C.Cor pulmonale

D.High FIO2 vasodilation

A

A.Hypovolemia

125
Q

The physician requests assistance in establishing a patent airway for a conscious patient who requires frequent suctioning. The respiratory therapist should recommend insertion of a/an

A.nasopharyngeal airway.

B.endobronchial airway.

C.oropharyngeal airway.

D.nasal oxygen catheter.

A

A.nasopharyngeal airway.

126
Q

Which of the following will give the most accurate measurement of volume and flow for spirometry?

A.Collins water-sealed spirometer

B.Vortex-shedding pneumotachometer

C.Wright respirometer

D.Dry-rolling spirometer

A

A.Collins water-sealed spirometer

127
Q

A patient who had his chest tube clamped for 18 hours with no apparent respiratory distress is now tachypneic, diaphoretic and complaining of dyspnea and general uneasiness. The respiratory therapist should

A.obtain a chest x-ray.

B.unclamp the chest tube.

C.increase the suction through the system.

D.add water to the suction control bottle.

A

B.unclamp the chest tube.

128
Q

If a patient’s PvO2 decreased from 30 torr to 20 torr, which of the following should the respiratory therapist assess?

A.Cardiac output

B.Venous blood gas

C.Capillary wedge pressure

D.Pulmonary vascular resistance

A

A.Cardiac output

129
Q

All of the following are TRUE statements about spacers and holding chambers, EXCEPT

A.Do not require patient cooperation with their breathing pattern.

B.Improve the efficiency of MDI.

C.Can be used for drug delivery by MDI to intubated and mechanically ventilated patients.

D.If a patient exhales immediately following activation of the inhaler, they will clear the medication from the device and waste the dose.

A

A.Do not require patient cooperation with their breathing pattern.

130
Q

A 19-year-old patient has a size 7 mm ID nasotracheal tube placed through the right nare. While attempting to suction the patient with a size 12 Fr catheter, resistance is met as the catheter is introduced into the endotracheal tube. The respiratory therapist should

A.lubricate the catheter with petroleum jelly prior to suctioning.

B.instill acetylcysteine into the endotracheal tube.

C.switch to a 10 Fr suction catheter.

D.extubate the patient and reintubate with a size 9 mm ID endotracheal tube.

A

C.switch to a 10 Fr suction catheter.

131
Q

During cardioversion, the defibrillator will deliver the synchronized electrical shock on the

A.P wave.

B.Q wave.

C.R wave.

D.T wave.

A

C.R wave.

132
Q
A

RRT Exam (2 decks)

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