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001 Respiratory Therapy > ICU Test Semester 1 > Flashcards

ICU Test Semester 1 Flashcards

1
Q

Which of the following ventilator strategies would be most appropriate for a 62 kg patient with ARDS

CMV-VC, Vt 400 mL, RR 18 bpm, FiO2 0.70, PEEP 14 cmH2O

CMV-PC, Vt 450 mL, RR 12 bpm, FiO2 0.70, PEEP 7.5 cmH2O

SIMV-VC, Vt 480 mL, RR 18 bpm, PS 16 cmH2O, FiO2 0.70, PEEP 15 cmH2O

MMV-Pressure Adaptive, Vt 500 mL, RR 12 bpm, PS 16 cmH2O, FiO2 0.70, PEEP 10 cmH2O

A

CMV-VC, Vt 400 mL, RR 18 bpm, FiO2 0.70, PEEP 14 cmH2O

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2
Q

Which receptor will the use of moderate (5-10 mg/kg/min) Dopamine primarily stimulate?

a1 Adrenergic

B1 Adrenergic

B2 Adrenergic

Dopaminergic

A

B1 Adrenergic

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3
Q

You are assessing a patient with chronic CHF who appear to be fluid overloaded. Which of the following diuretic would you recommend due to the fact that it has the fastest peak effect?

Mannitol

Acetazolamide

Fureosemide

Thiomerin

A

Fureosemide

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4
Q

__________ is the agent of choice for treating life threatening VRE

Ceftriaxone

Doxcycline

Synercid

Zithromax

A

Synercid

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5
Q

What is the main use of HMEs

Warm and humidify gases delivered to the trachea from the ventilator

Humidity therapeutic gases delivered at high flows to the lower airway

Provide extra humidity for a patient with thick secretions

A

Warm and humidify gases delivered to the trachea from the ventilator

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6
Q

Which of the following drugs may increase blood pressure without causing peripheral vasoconstriction?

Epinephrine

Dopamine

Dobutamine

Norepinephrine

Vasopressin

A

Dobutamine

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7
Q

You are in CMV PC mode with the I:E ratio set to maintain a constant I:E ratio of 1:1. The rate is set at 15 and the inspiratory flow is returning to baseline. You then decrease the rate to 12 br/min. Which of the following occurs?

MV increases and mean airway pressure increases

Vt decreases and mean airway pressure remains unchanged

Vt decreases and mean airway pressure decreases

MV decreases and mean airway pressure remains unchanged

A

MV decreases and mean airway pressure remains unchanged

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8
Q

Your patient has an artline to monitor blood pressure. His pressure has been consistently 120-125 mmHg mmHg and 75-80 mmHg diastolic . The monitor suddenly starts to alarm low BP and is displaying the following

A

There is an air bubble in the transducing pressure line

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9
Q

Which of the following best defines acute lung injury

P(A-a)O2 <5 despite an Fio2 greater than or equal to 0.50

PaO2 <60 mmHg despite an FiO2 greater than or equal to 0.50

P/F ratio <300

pH >7.40

A

P/F ratio <300

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10
Q

Which of the following would result in a an overall decrease in V/Q

Pulmonary embolus

Emphysema

Hypovolemic shock

Pulmonary fibrosis

A

Pulmonary fibrosis

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11
Q

Which set of weaning parameters would best support discontinuing mechanical ventilation

80 kg pt, RR 35, Vt 330 mL, VC 1200 mL, NIF -25 cmH2O

70 kg pt, RR 12, Vt 500 mL, VC 600 mL, NIF -15 cmH2O

75 kg pt, RR 19, Vt 900 mL, VC 1300 mL, NIF -22 cmH2O

60 kg pt, RR 16, Vt 320 mL, VC 900 mL, NIF -31 cmH2O

A

60 kg pt, RR 16, Vt 320 mL, VC 900 mL, NIF -31 cmH2O

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12
Q

A physician has ordered you to extubate an orally intubated patient. Which of the following should be done before the tube itself is removed?

I. Suction the oropharynx

II. Pre-oxygenate

III. Ensure cuff is deflated

IV. Suction ETT

A

All of the above

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13
Q

You have received report on a patient who is on day 9 of ventilation? The original reason for ventilation has been resolved and the plan is to stop sedation, perform an SBT, and hopefully extubate. To help enacte the plan you should

I. Consult with the nurse on stopping feeds

II. Request another CXR

III. Test for cuff leak

IV. Perform an SBT for 30 min

A

I and III

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14
Q

Which of the following compliacations is the result of an ETT

I, Tracheal Ulcers

II. Tracheal Cartilage Loss

III. Tracheal Malacia

IV. Tracheoesophageal fistula

A

All of the above

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15
Q

What mode should be used for non-invasive vetnilation considering the following ABG; pH 7.31, 55, 65, 26, -1, 92%

CPAP

Pressure Support

SIMV

Continuous mandatory ventilation

A

Pressure Support

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16
Q

Verification of safety equipment by the bedside

Confirming contents in the intubation buckets and difficult airway carts

Reviewing vent monitoring record for the patient for their entire ICU stay

All of the above

A and B

A

A and B

17
Q

You are preparing to enter the room of a trach patient who is on contact isolation. In addition to being schedule for a full assessment the prior shift RT has told you that the patient is requiring more suction than normal. In light of what task you may have to perform once in the room, what isolation precautions apply to this patient?

I. Private room

II. Negative Pressure Room

III. Gloves

IV. Goggles

V. Mask/goggles

A

I, III, IV and V

18
Q

You are assessing a patient with a right subclavian central line that is monitored with a pressure transducing system. You notice that the CVP waveform fluctuates from 3-6 mmHg. Which of the following statements is true

The most accurate reading is 3 mmHg

The most accurate reading is 6 mmHg

Indication that there is an incorrectly placed central line

Need to replace the transducer

A

The most accurate reading is 3 mmHg

19
Q

Which of the following ventilation strategies would be consistent with TBI protocol

Permissive hypercapnia

Frequent LVRM

Hyperoxemia

Inverse ratio ventilation

A

Hyperoxemia

20
Q

In CMV-PC adaptive mode, which of the following events would occur if the ETT suddenly became partially occluded due to a slight kinking in the airway

The vent would immediately cycle to high pressure alarm setting

Deliver Vt would increase

The airway pressure would rise in steps with each subsequent breath

Nothing would change

A

The airway pressure would rise in steps with each subsequent breath

21
Q

In microbiology, a culture and sensitivity test is

A method to help understand the cultural difference of patient and to be sensitive to their beliefs

Growing organisms on media in the presence of antibiotics

Manufacturing various antibiotics and testing them on patients

A

Growing organisms on media in the presence of antibiotics

22
Q

Your patient has he following ECG, what can you determine

Other Parameters- BP 98/74 mmHg, PAP 35/26, PAWP 22 mmHg, CVP 10 mmHg

A

Stroke volume has likely decrease

23
Q

Your patient has a #8 trach tube in situ and is ventilated in CMV-VC, RR12, Vt 500 mL, FiO2 50% and PEEP 5 cmH2O. The minimal bedside safety equipment should include

OPE, BVM, #6 trach tube, obturator

OPE, BVM, #6 trach, #8 trach, obturator

OPA, BVM, PEEP valve, #6 trach tube, obturator

OPA, BVM, PEEP valve, #6 trach tube, #8 trach tube, obturator

A

OPE, BVM, #6 trach, #8 trach, obturator

24
Q

What finding on a chest x-ray is most helpful in differentiating ARDS from CHF

Normal HR

Bilateral alveolar infiltrates

Air bronchograms

Interstitial fluid

A

Normal HR

25
Q

A left shift in WBC count is caused by an increase in the number of

Immature basophils

Immature eosinophils

Immature neutrophils

Immature basophils, eosinophils, and neutrophils

A

Immature neutrophils

26
Q
A

Second degree heart Type 2 block

27
Q

Tx for Second degree heart Type 2 block

A

Transcutaneous pacing

28
Q

The patient SOB is increasing, her RR is 32 with accessory much use, and she has ++ JVD. On auscultation you hear coarse crackles throughout. Her CXR shows an enlarged heart with bilateral white fluffy infiltrates. Base on this which of the following would you expect

Decreased CVP, Decrease PAP, decreased PAWP

Decreased CVP, decreased PAP, Decreased PAWP

Increased CVP, Increased PAP, Decreased PAWP

Increased CVP, Increased PAP, Increased PAWP

A

Increased CVP, Increased PAP, Increased PAWP

29
Q
A

Ventricular Fibrillation

30
Q

Anti arrhythmic for VF

A

Cordarone

31
Q

Your are receiving a 19 yr old female who is post op neurosurgery for the removal of a benign pituitary tumor. The patient is sedated intubated and ventilated. The plan is to return the patient to the OR in 24 hours to complete the surgery and then wake and extubate. The patient has a history of moderate asthma and takes Symbicort BID. Her asthma has been well controlled with this. The physical wanted pharmacological management of her asthma to continue while she in intubated which of the following would meet this need.

Combivent Q4

Pulmicort and Oxese BID

Ventolin Q4 and Flovent BID

Ventolin and Atrovent Q4

A

Ventolin Q4 and Flovent BID

32
Q

Your patient has a TBI. Which of the following would be indicated to reduce the cerebral edema and increase ICP

Administration of collodial diuretic

Administration of vasopressor

Permissive hypercapnia

Administration of Lasix

A

Administration of collodial diuretic

33
Q

A chest x-ray is obtained and the tip of the ETT is resting at the fourth rib. Which of the following action should be taken

The tube should be advanced 2 cm

The tube should be advanced until equal breath sounds are heard

The tube should remain at this level

The tube should be withdrawn 3 cm

A

The tube should be withdrawn 3 cm

34
Q

Your are in CMV PC mode and the I:E ratio is set to maintain a constant I:E ratio of 1:1. The rate is set to 16 and the inspiratory flow is returning to baseline. You decrease rate to 12 breath which of the following will occur

MV increase and mean airway pressure increases

Vt decreases and mean airway pressure is unchanged

Vt decreases and mean airway pressure decreases

MV decreases and mean airway pressure is unchanged

A

MV decreases and mean airway pressure is unchanged

35
Q

Which of the follow would result in an overall decrease in V/Q

Pulmonary Embolus

Emphysema

Hypovolemic shock

Pulmonary fibrosis

A

Pulmonary fibrosis

36
Q

A patient is on volume controlled ventilation with the following settings

Vt 600 mL, RR 14 br/min. The low Vte alarm is set at 400 mL and is suddenly activated; the low pressure alarm is also activated. The Vte read 0 mL and PIP reads 2 cmH2O

Which of the following is likely the cause

Disconnection from the Y

Loss of volume from tubing compensation

Small leak around ETT

Active patient inspiration

A

Disconnection from the Y

001 Respiratory Therapy (53 decks)

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