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1
Q 
A patient with CF who usually expectorates white sputum complains of increased cough & dark yellow sputum production over the past week.  She is febrile, a chest xray reveals right middle lobe infiltrate.  These clinical findings suggest
A. acute bronchitis
B. Pulmonary edema
C. hemoptysis
D. pneumonia
A

D. Pneumonia

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2
Q

An oxygen concentrator has been used in a patient’s home, a respiratory therapist must complete which maintenance procedure?
A. Change the filters
B. Check electrical system monthly
C. Check pressure in the oxygen reservoir
D. Lubricate oxygen tubing connections

A

A. Change the filters

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3
Q 
A respiratory therapist is checking a jet nebulizer with an entrainment setting of 35%; a properly calibrated O2 analyzer measures the concentration at 45%; which of the following best explains this finding?
A. water in tubing
B.  Inadequate flow through jet
C. Obstructed jet orifice
D. excessive flow from the flowmeter
A

a. Water in the tubing

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4
Q 
Which of the following should be used for high level disinfection of non disposable ventilator tubing
A. Pasteurization
B. Isopropyl alcohol
C. Ionizing radiation
D.  Hydrogen peroxide
A

A. Pasteurization

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5
Q 
A patient who is 70 kg is receiving VC, SIMV; xray shows moderate degree of bilateral, plate-like atelectasis in the lung bases;  Current vent settings are: FIO2 .40, RR 12, Vt 450 mL, Peep 5;  ABG: ph 7.34, PCO2 46, PO2 70, HCO3 24, BE -2; What should recommended to increase?
1.  FIO2
2, PEEP
3.  Mandatory Rate
4. Vt
A. 1, 3, 4
B. 1, 4
C. 2, 3
D. 2, 4
A

D. PEEP & Vt should be increased

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6
Q 
A 45 yr old man with bilateral pneumonia is receiving VC A/C ventilation.  Despite adequate minute ventilation his PaO2 falls below 60 torr with FIO2 of .60 & PEEP of 5.  Which should be done first to improve oxygenation?
A.  Increase PEEP
B.  Initiate SIMV
C.  Increase FIO2
D.  Initiate PC ventilation
A

A. Increase PEEP

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7
Q

An asthma patient in home care & performs a daily peak flow measurement which consistently reads 100 l?min. What actions should the therapist take?
A. Instruct the patient to increase daily exercise
B. Recommend complete pulmonary function studies
C. Recheck the patient’s peak flow with new peak flowmeter
D. Continue to monitor patientss peak flow for 2 wks

A

C. Recheck the patient’s peak flow with a new peak flow meter

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8
Q 
A RTH is performing a high calibration on a nitric oxide analyzer.  The expected value (PPM) is:
A. 45
B. 10
C. 25
D. 80
A

A. 45

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9
Q 
What is the correct equipment needed when assisting with a chest tube insertion, which is followed by pleurodesis, what additional equipment will be needed?
1. Hemostat
2. 3-way stop cock
3. hypertonic saline
4. pressure manometer
A.  1, 4
B. 2, 3
C. 1, 2
D. 3, 4
A

C. 1, 2; hemostat & 3 way stopcock

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10
Q

An adult patient’s DLCO is 20 ml/min/mm Hg. To further evaluate this patient a RTH should
A. Recommend CT of the chest with contrast
B. Recommend bronchoscopic exam
C. Perform lung volumes measured by plethysmography
D. Perform ABG analysis

A

C Perform lung volumes measured by plethysmography

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11
Q 
According to ATS standards a patient's FEV1 must increase by what % to indicate postbronchodilator improvement
A. 8
B. 12
C. 15
D. 20
A

B 12%

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12
Q 
An RTH notices a prolonged insp time and irregular cycling to exhalation for a patient receiving pressure cycled ventilation during intra-hospital transport.  In addition to checking the integrity of the circuit what else should be evaluated?
A. Auto Peep
B. Right mainstem intubation
C. ETT cuff
D. Mucus plugging
A

C. ETT cuff

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13
Q 
A 68 yr old with history of COPD is admitted to hospital for SOB and non productive cough.  Chest auscultation revealsexpiratory wheezes.  Which os best to improve the condition.
A. Beclomethasone (Vanceril)
B.  Ipratropium bromide (Atrovent)
C. Amoxicillin (Augmentin)
D.  Cromolyn Sodium (Intal)
A

B. Atrovent

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14
Q 
Which of the following is the best index of oxygen transport for a patient who has been resuscitated following carbon monoxide poisoning?
A.  Arterial oxygen tension
B. Alveolar-arterial oxygen difference
C.  Hematocrit
D. Arterial oxygen content
A

D. Arterial oxygen content

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15
Q 
Which of the following can increase metHB?
1. Inhaled CO
2. Topical Silver Nitrate
3.  Nitroglycerin Infusion
4. Inhaled NO
A. 1, 3, 4
B. 1, 2, 4
C. 1, 2, 3
D. 2, 3, 4
A

D. 2, 3, 4

Topical Silver nitrate, Nitroglycerin Infusion, Inhaled NO

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16
Q 
To produce capillary vasodilation, electrodes for transcutaneous monitoring must be heated to:
A. 30-33 C
B. 37-40 C
C. 42-45 C
D. 48-51 C
A

C 42-45 C

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17
Q 
Which of the following should be recommended to reduce systemic arterial BP & reduce ventricular preload
A. Sodium Nitroprusside (Nipride)
B. Dobutamine
C. Dopamine
D. Propranolol
A

A. Sodium Nitroprusside

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18
Q 
Which of the following pulmonary function tests measures FRC, RV, TLC?
A. Spirometry
B. Dlco
C. MVV
D. Body Plethysmography
A

D. Body Plethysmography

19
Q

The primary function of the respiratory department during a disaster is providing:
A. A roster of volunteers in the department
B. Triage assistance at the point of entry
C. Sufficient numbers of trained personnel
D. A list of those who are excused in the disaster

A

C. Sufficient number of trained personnel

20
Q 
While transporting a sedated patient using a portable ventilator, the RTH notices a drop in saturation from 97% to 84%, the HR increased from 87 to 126.  The therapist should first:
A. alert the medical emergency team
B. Manually ventilate the patient
C. Replace the ETT
D. Request additional sedation
A

B. Manually ventilate the patient

21
Q

Which of the following will lower mean airway
pressure in a patient receiving VC ventilation:
A. Increase the PEEP
B. Increase the Vt
C. Decrease the Itime
D. Decrease the trigger sensitivity

A

D. Decrease the trigger sensitivity

22
Q 
A chest xray for newly admitted patient shows honeycombing.  The patient exhibits dry, non productive cough and mild tachypnea.  Which of the following diagnostic procedures  should be suggested:
A. high resolution CT scan
B. V/Q Scan
C. Thoracentesis
D. BAL
A

A. high resolution CT scan

23
Q 
Quality control results using a 3.0 L calibration syringe spirometer are as follows:
Volume: 1 = 2.67 L
V2 = 2.70 L
V3=2.68 L
According to ATS/ERS Standards, the spirometer
A. is inaccurate
B. Is correctly calibrated
C. Shows inadequate repeatability
D. Shows a lack of linearity
A

A. Is inaccurate

24
Q

A patient has been intubated for 4 days. When suctioning a RTH notices that secretions are becoming tenacious. The therapist should:
A. instill 5 mL NS into ETT
B. Ensure proximal airway temp is at least 35 C
C. Switch to HME
D. Change from an aerosol to a passover humidifier

A

B. Ensure proximal airway temp is at least 35C

25
Q 
In a normal healthy adult, which pulmonary measurement is the largest
A. Inspiratory capacity
B. Vital capacity
C. FRC
D. Expiratory reserve volume
A

B. Vital capacity

26
Q

A manometer is being used to monitor continuous flow mask CPAP device set at 10 cm H2O, each time a patient inhales the pressure decreases to 2 cmH2o, then returns to 10 ob exhale. Which may be causing this?
A. the flow of gas to the patient system is insufficient
B. There is a leak in the patient system
C. The mask size is too large for the patient
D. THe CPAP pressure valve is too small for the patient

A

A. The flow of the gas is insufficient to the patient system

27
Q

While observing a patient performing incentive spirometry, a RTH notices the patient is not exhaling completely before beginning the next breath. The therapist should instruct the patient to:
A. perform a forced vital capacity maneuver after each breath
B. Allow a longer time before beginning the next breath
C. Take smaller breaths to allow complete exhalation
D. exhale more rapidly before inhaling

A

B. allow a longer time before beginning the next breath

28
Q

A CBG drawn from a 3 day old female reveals pH 7.37, PcCO2 62, PcO2 46, SpO2 97%, PtcCO2 42; Over the last 24 hrs, transcutaneous monitoring values consistently correlated with CBG. what would most likely cause the discrepancy in patient’s value
A. The sample site was the lateral aspect of the heel
B. The sample size was 100 microliters
C. The sample site was warmed to 36 C
D. the sample site was cleaned with alcohol

A

C. The sample site was warmed to 36 C

29
Q 
Lung fields will appear whiter on a chest xray when the imaging technique is:
A. underexposed
B. Overexposed
C. rotated
D. lateral view
A

A. underexposed

30
Q 
A patient who weighs 62 kg requires a minute ventilation of 15 lpm to maintain a PaCO2 of 36 during mechanical ventilation.  Which of the following could explain this ventilatory requirement. 
1. Increased dead space ventilation
2. febrile patient
3. Increased intrapulmonary shunt
4. excessive caloric intake
A. 1, 2, 3
B. 1, 2, 4
C. 1, 3, 4
D. 2, 3, 4
A

B. 1, 2, 4
increased dead space ventilation, febrile patient, and excessive caloric intake could cause this high ventilatory requirement

31
Q 
A patient with a bronchopleural fistula remains hypoxemic while receiving VC ventilation.  What should the therapist recommend next?
A. CPAP
B. PS ventilation
C. HFOV
D. PC inverse ratio ventilationr
A

C. HFOV

32
Q

A patient with a trach tube has transitioned from HME to heated aerosol. Acute dyspnea has developed. Which of the following is the most likely explanation.
A. crystals formed as aerosol evaporated
B. Secretions expanded as they became hydrated
C. Terminal airways became occluded by aerosol particles
D. Oxygen molecules were displaced by aerosol particles

A

B. Secretions expanded as they became hydrated

33
Q 
Which of the following devices can provide 100% humidity at body temperature?
A. heated wick humidifier
B. Bubble humidifier
C. Spinning disc humidifier
D. Pneumatic nebulizer
A

A. heated wick humidifier

34
Q 
A patient receiving a nebulizer treatment with a 3% saline complains of SOB a respiratory therapist should:
A. discontinue therapy
B. Add a bronchodilator to the neb
C. Decrease the neb output
D. Add oxygen to inspired gas
A

A. discontinue therapy

35
Q

The correct placement for the needle during decompression of a tension pneumothorax:
A. under the 2nd rib in the anterior axillary line
B. Over the 3rd rib in the mid-clavicular line
C. Under the 3rd rib in the mid clavicular line
D. Over the 2nd rib in the anterior axillary line

A

B. over the 3rd rib in the mid clavicular line

36
Q 
Which of the following serum sodium values is typical for a health adult:
A. 131
B. 121
C. 138
D. 148
A

C. 138

37
Q 
A patient who has ARDS is receiving PC, A/C ventilation.  Radial arterial and pulmonary artery catheter are placed for monitoring; which of the following should a respiratory therapist use to evaluate oxygen delivery to determine the optimal peep to the patient
A. ABG
B. Mixed venous blood gas
C. serum lactate level
D. CO
A

B. mixed venous blood gas

38
Q

When administering an MDI to a patient during mechanical ventilation how should the therapy be given:
A. insert the MDI adapter in the expiratory limb of the vent
B. place the mdi adapter in the inspiratory limb, close to the Y
C. increase the mandatory rate during MDI actuation
D. discharge the MDI directly into the ETT

A

B. place the MDI in the inspiratory limb, close to the Y

39
Q 
When assisting a physician with synchronized cardioversion, a respiratory therapist should ensure the defibrillator is sychronized to which waves on ECG?
A. R
B. P
C. T
D. U
A

A. R-wave

40
Q 
What volume remains in the lung at the end of normal exhale
A. IRV
B. FRC
C. ERV
D. FVC
A

B. FRC

41
Q 
A patient has an SpO2 of 85%, RR 28, rhonchi auscultated in all lung fields, and a weak ineffective cough.  The patient is intubated.  For 1 hr following intubation, an adult critical care specialist repeatedly suctions, thick copious mucus.  The high pressure alarm sounds regularly.  What should be done
A. instillation of sterile water
B. ETT suctioning prn
C. aerosolized acetylcysteine q4h
D. postural drainage with percussion
A

b. ETT suctioning PRN

42
Q 
A patient is diagnosed with severe right heart failure immediately following coronary artery bypass surgery.  BP is 88/30, SpO2 is 86%.  The adult critical care specialist should recommend
A. inhaled nitric oxide
B. Milrinone
C. Dobutamine
D. IV nitroglycerin
A

A. Inhaled NO

43
Q

Which of the following is most likely to happen with abrupt withdrawal of iNO
A. hemolytic anemia
B. metHB
C. increased pulmonary artery pressure
D. increased pulmonary artery occlusion pressure

A

C. increased pulmonary artery systolic pressure

44
Q

For APRV what is the most appropirate initial settings?
A. P-HIgh: 36, Plow 12; THigh 0.5; T-Low 2.0
B. P-High 32.0, P Low =12, T high 2.0, T Low 0.5,
C. P high =32, P Low = 14, T high =2.3, T Low 1.2
D. P high= 2.5, Pressure low 14, T high 2.5, T Low 1.0

A

B. P high 32, P Low 12, T high 2.0, T Low 0.5

practice exam (1 decks)

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