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001 Respiratory Therapy > Review Tests > Flashcards

Review Tests Flashcards

1
Q

Which of the following is the recommended care of the ventilator circuit for prevention of VAP?

  1. The vent circuit must be changed every 4 days
  2. Closed sx systems are recommended
  3. Circuit condensate should be used to instill the patient
  4. Passive humidifiers can be safely used for 48 hours
A

2 and 4

The ventilator circuit should be changed every 7 days. Closed suction is recommended as you do not have to break the circuit in order to suction. Only distilled water should be used to instill the patient/ Passive humidifier can be used for 48 hours.

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2
Q
  1. Which of the following is the most common cause of community acquired pneumonia?
  2. Staphylococcus aureus
  3. Pseudomonas aeruginosa
  4. Escherichia coli
  5. Diplococcus pneumonia
A

Diplococcus pneumonia

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3
Q
  1. What question does ethics try to answer

Who is right

What treatment is best

Who benefits the most

How should we act

A

How should we act

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4
Q
  1. A patient on mechanical ventilation has a compliance of 90 mL/cmH2O and an airway resistance of 5.0 cmH2O/L/sec. what is the calculated time constant?
  2. 45 sec

B.1.35 sec

C. 4.5 sec

D. 450 sec

A

a. 0.45 sec
5. 0 cmH2O/L/sec x 0.09 L/cmH2O= 0.45 seconds

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5
Q

Time Constant Equation

A

Compliance x Resistance

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6
Q

Which of the following best defines the term sterilization?

a. Use of chemicals to destroy pathogens
b. Process that destroys all forms of microbial life
c. Process of sanitization
d. Use of soap and water to aid in removal of soil/body secretions

A

b. Process that destroys all forms of microbial life

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7
Q

During an allergic reaction there is an increase in circulating antibody

a. IgA
b. IgD
c. IgE
d. IgG
e. IgM

A

c. IgE

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8
Q
  1. Which of the following is incorrect in regards to the body’s normal flora
    a. They will not cause harm as long as they stay in the expected site
    b. They are different from person to person for a given site
    c. If they are removed from a site, opportunistic microorganism may take over
    d. They are found on the skin and some mucous membranes

Thrush is an example of abnormal flora

A

a. They will not cause harm as long as they stay in the expected site
b. They are different from person to person for a given site

Thrush is an example of abnormal flora

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9
Q

Which of the following statement is/are true regarding pressure differences

a. The apical alveoli resting volume is less than basal
b. Pleural pressure at the base is more negative than at the apex
c. Transpulmonary pressure gradient is greatest at apex
d. All state are true

A

c. Transpulmonary pressure gradient is greatest at apex

Apical should be more negative than the basal.

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10
Q

Which of the following could result in a higher than normal SvO2

a. Decreased CO -would increase SvO2, more time to pull O2 out
b. Pyrexia - increase in metabolic rate, increase O2
c. Decreased oxygen extraction ratio
d. All of the above

A

c. Decreased oxygen extraction ratio

A higher than normal SvO2 means you are not extracting so a decrease CO means you have more time to pull it out.

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11
Q

Which of the following best defines the term sterilization?

a. Use of chemicals to destroy pathogens
b. Process that destroys all forms of microbial life
c. Process of sanitization
d. Use of soap and water to aid in removal of soil/body secretions

A

b. Process that destroys all forms of microbial life

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12
Q

During an allergic reaction there is an increase in circulating antibody

a. IgA
b. IgD
c. IgE
d. IgG
e. IgM

A

c. IgE

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13
Q

Tank Calculation

A

Duration of Flow =

Oxygen Tank Conversion Factor * Remaining Tank Pressure (psi) / Continuous Flow Rate (L/min)

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14
Q

Oxygen Cylinder Conversion Factors

D Tank

A

D Tank = 0.16

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15
Q

Oxygen Cylinder Conversion Factors

E Tank

A

E Tank = 0.28

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16
Q

Oxygen Cylinder Conversion Factors

G Tank

A

G Tank = 2.41

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17
Q

Oxygen Cylinder Conversion Factors

H/K Tank

A

H/K Tank = 3.14

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18
Q

Oxygen Cylinder Conversion Factors

M Tank

A

M tank = 1.56

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19
Q

Total Arterial O2 Content

A

CaO2= (1.34 x Hb x SpO2) + (PaO2 x 0.003)

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20
Q

How to Determine Pt Inspiratory Flow

A

Flow= Volume (L)/time (min)

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21
Q

Determining the total flow in a high flow delivery device

A

If air/O2 is for example 30 then it is 8:1 so for every 1 litre of oxygen 8 L is being entrained into the device

for total flow add the two toegther (=9) and then multiple by the set flow

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22
Q

Calculating Flow in Liquid Oxygen System

A

Gas Remaining= (Liquid Weight [lb]) x 860/ 2.5 L/Ib

Duration of Contents (min)= Gas Remaining (L)/ Flow (L/min)

Remeber 1 L of Liquid O2 = 2.5 lb

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23
Q

PAO2 Calculation

A

[(Pbaro-47) x FiO2] - (PCO2*1.25)

Pbaro in Calgary is 670mmHg

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24
Q

PA-aO2 Calculation

A

PAO2- PaO2

Normal in a young adult >4 (5-10)

The A–a gradient will increase with age. For every decade a person has lived, their A–a gradient is expected to increase by 1 mmHg.

A conservative estimate of normal A–a gradient is less than [age in years/4] + 4.

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25
Q

PAO2/ PaO2

A

PAO2/ PaO2

Normal >0.60

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26
Q

P/F Ratio

A

PaO2/FiO2

Normal 400-500

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27
Q

CaO2 Vol%

A

(Hb x 1.34 x (SO2/100)) + (PO2*0.003)

Normal 16-20

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28
Q

CvO2 Vol%

A

(Hb x 1.34 x (Sv2/100)) + (Pv2*0.003)

Normal 12-15

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29
Q

C(a-v)O2

A

CaO2-CvO2

Normal = 5

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30
Q

CcO2

A

(Hb*1.34) + (PAO2* 0.003)

Normal = 20

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31
Q

VO2 ml/min

A

CO x Ca-vO2 x 10

Normal 200-300

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32
Q

VO2/ml/kg/min

A

(VO2/ml/min) / Pt body wieght in kg

Normal 3.5-4

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33
Q

O2 Del ml/min

A

CaO2 Vol% * CO * 10

Normal 1000

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34
Q

O2 Del/kg/min

A

(O2 Del ml/min) / Pt weight in Kg

Critical is 8-10

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35
Q

Qs/Qt% Classic

A

(CcO2-CaO2)/ (CcO2-CvO2 vol%)

Normal <10

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36
Q

Qt (Fick) L/min

A

250/ (Ca-vO2*10)

Normal 5-8

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37
Q

Normal Hemoglobin Levels

A

Men 13.8-17.2

Women 12.1- 15.1

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38
Q

Compliance Calculation

A

Complicance (ml/cmH2O)

= Vt / (Pplat-PEEP)

Normal 60 to 100 ml/cm H2O

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39
Q

Resistance Calculation

A

R= (PIP- Pplat)/ Flow

Use L/sec for flow

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40
Q

Minute Ventilation Calculation

A

MV = Rate * Vt

On a ventilator try to aim for 10 x IBW

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41
Q

FiO2 Required

A

FiO2 required = (PaO2 Desired * FiO2 Present) / PaO2 initial ABG

PaO2 Desired is usually established to give a safe SpO2 of between 90% - 95%

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42
Q

New PaCO2 Desired

A

New PaCO2 Desired = Present PaCO2 – [ (pH Goal – pH Present) / 0.01}

pH Goal: is usually established with the physicians orders but should be above 7.25

Note: this equation is used usually to correct for accidosis and is only an approximation

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43
Q

MV Required

A

MV required = (PaCO2 Initial * MV) / PaCO2 desired

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44
Q

I:E

A

I:E = Ti/Ti : Te/Ti - given has whole numbers ex: 1:4.5

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45
Q

TCT

A

TCT = 60/Rate

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46
Q

Ti

A

Ti = Vt/Flow

Use L for Vt, and L/sec for flow

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47
Q

Te

A

Te = TCT – Ti

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48
Q

Ideal Body Weight​

A

Men: Kg = 50 +2.3(height in inches – 60)

Women: Kg = 45.5 + 2.3(height in inches – 60)

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49
Q

PA-aO2

A

A measure of the difference between alveolar concentration of oxygen and the arterial concentration of oxygen.

It is used to diagnose the source of hypoxemia. The measurement helps isolate the location of the problem as either intrapulmonary (within the lungs) or extrapulmonary (elsewhere in the body).

Ex. In high altitude arterial oxygen (PaO2) is low due to the fact that alveolar oxygen PAO2 is also low, where with V/Q mismatch (pulmonary embolism or right to left shunt oxygen is not effectively transferred for alveoli

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50
Q

Increased PA-aO2

A

An increased PA-aO2 suggests a defect in diffusion, V/Q mismatch, or right to left shunt

A high A–a gradient could indicate a patient breathing hard to achieve normal oxygenation, a patient breathing normally and attaining low oxygenation, or a patient breathing hard and still failing to achieve normal oxygenation.

If lack of oxygenation is proportional to low respiratory effort, then the A–a gradient is not increased; a healthy person who hypoventilates would have hypoxia, but a normal A–a gradient.

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51
Q

A–a gradient and Respiratory Effort

A

CO2 is easily exchanged in the lungs and a low PCO2 directly correlates with high minute ventilation; therefore a low PaCO2 indicates that extra respiratory effort is being used to oxygenate the blood.

A low PaO2 indicates that the patient’s current minute ventilation (whether high or normal) is not enough to allow adequate oxygen diffusion into the blood.

Therefore, the A–a gradient essentially demonstrates a high respiratory effort (low arterial PCO2) relative to the achieved level of oxygenation (arterial PO2).

At an extreme, high CO2 levels from hypoventilation can mask an existing high A-a gradient. This mathematical artifact makes A-a gradient more clinically useful in the setting of hyperventilation.

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52
Q

What RR to Set

A

Inital MV Goal/ Vt Goal

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53
Q

What Should Be You Inital Goal in MV

A

IBW x 100

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54
Q

. What type of lung unit(s) would result in a long time constant

a. Decreased airway resistance
b. Decrease Elastance
c. Decrease Compliance - causes a decrease in TC
d. Decreased Surfactant - causes a decrease in C

TC = R*C

A

b. Decrease Elastance-Will increase compliance

TC = R*C

Decrease Compliance - causes a decrease in TC

Decreased Surfactant - causes a decrease in C

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55
Q

Mechanical ventilation is indicated for which of the following blood gases done on room air?

a. pH 7.23, PaCO2 56 mmHg, PaO2 76 mmHg, HCO3 23 mmol/L
b. pH 7.34, PaCO2 46 mmHg, PaO2 51 mmHg, HCO3 24 mmol/L
c. pH 7.31, PaCO2 50 mmHg, PaO2 46 mmHg, HCO3 24 mmol/L
d. All of the above
e. A and B only

A

a. pH 7.23, PaCO2 56 mmHg, PaO2 76 mmHg, HCO3 23 mmol/L

We are just looking at the cut off of pH of < 7.25

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56
Q

Regarding the thoracic pump, which of the following isnot true

a. During PPV there is an increase cardiac stroke volume
b. During spontaneous breathing there is increase venous return
c. During PPV there is an increased central venous pressure
d. During spontaneous breathing the thoracic pump is most effective during inspiration

A

a. During PPV there is an increase cardiac stroke volume

During PPV we have an increase thoracic pressure and decreased venous return so we fill up less and then via Starling Law we contract less

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57
Q
  1. Positive pressure ventilation results in
    a. Increase dead-space ventilation
    b. Decreased dead-space ventilation
    c. Decreased intrathoracic pressure
    d. A and C
    e. B and C
A

a. Increase dead-space ventilation

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58
Q

The phase variable that begins the inspiratory phase is called ___________ that ends in the inspiratory phase called the _________

a. Trigger, limit
b. Trigger, cycle
c. Cycle, trigger
d. Limit, cycle

A

b. Trigger, cycle

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59
Q

In a volume controlled breath, as the patient’s compliance increases the pressure _______ and the tidal volume _________

a. Decrease, Decrease
b. Increase, Remain the Same
c. Decrease, Increase
d. Decrease, Remains the Same

A

d. Decrease, Remains the Same

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60
Q

Starling Law of Capillaries state that

a. The volume of fluid and solutes reabsorbed is normally nearly as large as the volume filtered
b. The volume of fluid and solutes reabsorbed is normally larger than the volume filtered
c. The volume of fluid and solutes filtered at the arterial end is less than the volume of fluid and solutes filtered at the venous end
d. The pressure of the fluids and solutes filtered is normally less than the pressure reabsorbed.

A

a. The volume of fluid and solutes reabsorbed is normally nearly as large as the volume filtered

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61
Q

Which of the following represents the correct pathway of impulse conduction through the heart

a. AV Node, SA Node, Conduction Myofibers, purkinje fibres
b. AV Node, Bundle Branches, SA Node, Purkinje Fibers
c. SA Node, AV Node, Bundle Branches, Conduction fibres
d. SA Node, Bundle Branches, AV Node, Conduction myofibers

A

c. SA Node, AV Node, Bundle Branches, Conduction fibres

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62
Q

The T-Wave in lead II ECG represents

a. Onset of atrial depolarization- P wave
b. Onset of ventricular depolarization-QRS
c. Atrial repolarization-Will get lost in QRS complex
d. Ventricular repolarization

A

d. Ventricular repolarization

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63
Q

main pressure promoting reabsorption of fluid into the capillaries is the:

a. Osmotic pressure of interstitial fluid
b. Hydrostatic pressure of the interstitial fluid
c. Osmotic pressure of the capillary
d. Hydrostatic pressure of capillary
e. Oncotic pressure of interstitial fluid

A

c. Osmotic pressure of the capillary

Hydrostatic pressure of capillary - pressure due to fluid - will push fluid out

Osmotic pulls fluid in (caused by solute concentration); oncotic pushes fluid out (due to difference in protein concentration)

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64
Q

Pursed lip breathing when done properly, may result in which of the following

a. Equal pressure point moves down to smaller airways-Will move to the larger airways
b. Decreased early airway collapse
c. Increase expiratory flow rates-We are adding an obstruction to the flow
d. B and C

A

b. Decreased early airway collapse

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65
Q

A blending device is mixing 11.3 L of air with 4.7 L of oxygen. What FiO2 is the device producing?

a. 0.4
b. 0.45
c. 0.5
d. 0.55

A

b. 0.45

(11.3 L (air) * 0.21 + 4.7 L (O2)) / 16 = 0.44

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66
Q

When we are using a full “D” tank oxygen cylinder for transport. The clinician set the flow rate on prongs to deliver 4 LPM; the approximate duration of flow would be

a. ~15 min
b. ~30 min
c. >1 hour
d. >2 hour

A

c. >1 hour

D = 0.16 L/psi

2200 psi or (subtract 500 for safety buffer) = 1700 psi → answer works for both

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67
Q

Which of the following statement is/are true regarding cyanosis

a. Polycythemia patient may show signs of cyanosis but may not be hypoxemic
b. All polycythemic patient that show signs of cyanosis are hypoxemic
c. In anemic patients, cyanosis is an early indicator of hypoxemia
d. All of the above are true

A

a. Polycythemia patient may show signs of cyanosis but may not be hypoxemic

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68
Q

A patient has been admitted to the coronary care unit after a myocardial infarction involving left side of the heart. The following information is collected from ABG while the patient is on room air. Hb 154 g/L

pH 7.48, PaCO2 31 mmHg, PaO2 54 mmHg, HC3 22 mmol/L, BE -1, SaO2 87%

What are the indications for O2 therapy for this patient?

i) Hypoxemia
ii) Hypercarbia
iii) To decrease myocardial workload
iv) Anxiety

A

1 and 3

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69
Q

A young man presents to ER in Red Deer (667 mmHg) with neck trauma after bike crash. Given O2 via mask (FiO2 0.8). Initial ABG: 7.32/54/

A-a DO2?

388

348

362

484

A

362

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70
Q

Keeping the absolute humidity constant. As the temperature of the air ___ the relative humidity will ______.

Increase, increase

Increase, decrease

Decrease, decrease

A & C

None of the above

A

Increase, decrease

Temp increase can hold more water, but abs. Is constant

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71
Q

Choose the true statements regarding Bourdon pressure gauges.

i) a coiled metal tube has a sub-atmospheric pressure introduced to it
ii) the display needle should periodically be “zeroed”
iii) are used to measure changes in pressure
iv) will straighten in response to an increase in pressure

A

ii, iii, iv

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72
Q

The CARTA code of Ethics instructs us to “guard against conflicts of professional interest” and to specifically consult the _______________________ to prevent a real or perceived conflict of interest? Who is the individual/or department that Alberta RRTs are to consult?

The Alberta Health

The CARTA Registrar

The alberta department of justice

Your employer

A

The CARTA Registrar

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73
Q

To maintain your clinical competency in Alberta you must complete _______ hours of practice over a five year period. How many hour of practice are needed?

a. 48
b. 500
c. 720
d. 1600

A

c. 720

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74
Q

Bess is a 73 year old woman who has come into the emergency department complaining of severe chest pain and SOB. SpO2 is 77% on room air. You put her on 5 LPM oxygen via nasal cannula and begin your assessment. You observe that she is a heavy set woman who is currently sitting up with her arms pressed straight down on the mattress. She has obvious accessory muscle use and is markedly cyanotic around the lips. She has a productive cough, and is bringing up thick yellow sputum. When you ask her is she normally has a productive cough, she says usually she cough up about a half a cup of grey sputum in the morning. Her cough is generally more prevalent through the winter months. She has a RR of 37 bpm and a pulse rate of 130 bpm. Her temp is 38.8 C and SpO2 is now 87%. Bess describes her chest pain as “sharp and stabbing” and gets worse with inhalation. She is speaking in 2 word sentences.

  1. Based on your finding so far, what is most likely to be Bess’ underlying diagnosis
    a. COPD, Chronic Bronchitis
    b. COPD, emphysema
    c. COPD, asthma
    d. COPD, bronchiectasis
    e. Cystic Fibrosis
A

a. COPD, Chronic Bronchitis

Sputum is grey, which is often seen in chronic bronchitis. Grey in the sputum indicates dead cells.

Bronchiectasis can have a dry cough or a lot of sputum

The fever hints more towards chronic bronchitis

Ways to make this question better- Add in a ABG to show and acute on chronic condition. Add into case stem that the sputum is smelling. And/or include and x-ray report which will not show any dilation.

Your will mostly find the difference between chronic bronchitis and bronchiectasis in the x-ray

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75
Q

skeptical of her asthma diagnosis. Why?

i. Asthma is usually diagnosed before the age of 40
ii. The cough she describes is a cardinal sign of bronchiectasis
iii. If she had asthma, swallowing the little pills would help
iv. The grey puffer is not usually prescribed to asthmatics
v. Cigarette smoking is not causal for asthma

A

I, IV, V

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76
Q

What is the root cause of the distended neck veins, severely clubbedfingers and pitting peripheral edema?

a. Severe chronic hypercapnia

B. Severe chronic acidemia

C. Severe chronic hypoxemia

D. Severe chronic hypocapnia

A

C. Severe chronic hypoxemia

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77
Q

Bess likely has:

Left ventricular insufficiency

Cor pulmonale

Right sided heart failure

None of the above

b and c

A

b and c

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78
Q

Once the CVP is in place, the transducer is leveled appropriately and zeroed. The monitor is showing a good waveform, with an a wave, …

Volume overload

Pulmonary hypertension

VSD

Pulmonary embolism

A

Pulmonary hypertension

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79
Q

As you are monitoring Bess you notice that her “a” wave has disappeared from her CVP waveform. This is an indication that:

a. The transducer is sitting below the level of the right atrium
b. Bess has stopped breathing
c. The tricuspid valve is incompetent causing regurgitation of blood into right atrium
d. The atria are not contracting, Bess is in atrial fibrillation

A

d . The atria are not contracting, Bess is in atrial fibrillation

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80
Q

Intrepret this ABG

ABG: pH 7.56, PaCO2 26 mmHg, PaO2 61 mmHg, HCO3 22 mmol/L, BE 1, SaO2 90

A

c. Uncompensated respiratory alkalosis

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81
Q

Minimum flow rate for simple mask

A

5 LPM is the minimum flow rate for a simple mask so that it can flush out the CO2.

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82
Q

) Which of the follow is recommended for initial mechanical ventilator settings? Pt is unconscious, sedated and medically paralyzed

a. CMV VC, f 16 br/min, Vt 550 mls, PEEP 5
b. IMV VC, f 14 br/min, Vt 750 mls, PEEP 5
c. CMV APV, f 18 br/min, Vt 600 mls, PEEP 3
d. CSV PC, pressure support 10 cmH2O, CPAP 5

A

a. CMV VC, f 16 br/min, Vt 550 mls, PEEP 5

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83
Q

It is determined the patient has a refractory hypoxemia, which of the following would be the course of action at this time

a. Increase FiO2
b. Increase RR
c. Increase the tidal volume
d. Increase the PEEP

A

d. Increase the PEEP

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84
Q

You are paged to the ED to assess a patient brought in

VS: Bp 158/108 mmHg, pulse 137 bpm and irregular. Her oxygen

  1. Which of the following is the correct action given the patients oxygen status.
  2. Apply a 50% air entrainment ventimask system to maximize forward flow
  3. Apply a 70% large vol neb bc she is breathing so rapidly, she will soon become dehydrated
  4. Apply a nrb bc it’s quick and easy to set up
  5. Do not start O2, she may be a CO2 retainer
A
  1. Apply a nrb bc it’s quick and easy to set up
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85
Q

Her elevated HR may be due to

Stimulation of the parasympathetic branch of the autonomic nervous system

Secondary to the pain she is in

Due to an attempt by her heart to maintain cardiac output

All of the above

b & c

A

b & c

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86
Q

The CXR in addition to confirming the flail, shows a large white area obscuring the lower half of the left lung and blunting of the costophrenic angle. The ED physician also makes note of these findings and asks you to assist with the insertion of a chest tube.

  1. What could cause blunting of the costophrenic angle in this case?

Pneumothorax

Pneumomediastinum

Hemothorax

All of the above

A & B

A

Hemothorax

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87
Q

Give the substance to be drained, it is more probable that the physician will insert a large bore chest tube

Into the 2nd intercostal space, mid-clavicular line

Superiorly, as air rises

Inferiorly, as fluid is gravity dependent

Along the inferior surface of any rib

A

Inferiorly, as fluid is gravity dependent

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88
Q

You set up a drythoracic drainage unit. How much water will you put into the suction control chamber?

a. None
b. Fill it to 2 cm
c. Fill it to the 20 cm mark
d. Start at 10 cm and slowly

A

a. None

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89
Q

The patient is intubated and placed on a mechanical ventilator, during a mandatory inspiration you observe tidaling in the underwater seal of the thoracic drainage unit. Which direction is it observed?

Move towards the suction control chamber

Moves toward the patient

Moves away from the patient

Tidaling should never be observed in the underwater seal

A

Moves away from the patient

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90
Q

What is the mode of action of singulair

a. B2 Selective Bronchodilator
b. Anti-inflammatory Leukotriene Receptor
c. Oral Corticosteroid
d. IgI Blocker

A

b. Anti-inflammatory Leukotriene Receptor

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91
Q

A 25 year old female was admitted to the emergency department in hemorrhagic shock following a gunshot wound. She received fluid administration to treat her bleeding and was stabilized. Following placement of a pulmonary artery catheter the following data was collected. Interpret the hemodynamic data.

PAP 48/32 mmHg

PCWP 22 mmHg

CVP 15 mmHg

C(a-v)O2 2.6%

  1. Cor pulmonale
  2. Pulmonary hypertension
  3. Hypervolemia
  4. Hypovolemia
A

Hypervolemia

PAP is high PCWP is high CVP is high (backing up to right side of the heart). C(a-v)O2 is low. Her blood is diluted because she was given too much fluid.

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92
Q

Which of the following is/are the major characteristic of increased alveolar dead=space

Minute ventilation out of proportion to PaCO2

Decreased WOB

Hyperoxemia

FiO2 >0.50 and PaO2 <50 mmHg

A and C only

A

Minute ventilation out of proportion to PaCO2

Increase amount of air that is not participating in gas exchange so you are moving more air in and less air out, you would have increased WOB, you would have hypoxemia not hyperoxemia.

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93
Q

Which of the following is the body’s main means of heat loss at high environmental temperatures?

Evaporation

Conduction

Convection

Radiation

A

Evaporation

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94
Q

Which of the following statements refer to EF?

The portion of EDV ejected on each beat

Amount of blood in the ventricle at end of diastole

Amount of blood ejected into the ventricle after each atrial contraction

All of the above

A and C only

A

The portion of EDV ejected on each beat

Most of atrial contraction is passive which is why the amount of blood ejected into the ventricle after the atrial contraction will not be equal to portion EDV ejected.

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95
Q

Amphotericin B is used to treat:

Systemic bacterial infections

Systemic Fungal infections

Pulmonary fungal infections

B and C only

A

B and C only

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96
Q

Which of the following describes a mode of ventilation that would best preserve tidal volume when a patient’s lung/thorax compliance increases?

Pressure cycled

Pressure limited, time cycled mode

Volume limited, time cycled mode

Pressure limited, flow cycled mode

A

Volume limited, time cycled mode

If compliance decreased the answer would be the same.

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97
Q

Which of the following does not cause an increase in measured pcwp?

Hypervolemia

Left ventricular failure

Mitral stenosis

3rd spacing

A

3rd spacing

3rd spacing would result in a lower wedge pressure

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98
Q

You have a liquid system and a patient that requires a flow of 4 LPM. The liquid oxygen unit weighs 4100g. How long does the patient have for their oxygen usage?

Approximately 8.3 hours

Approximately 9.5 hours

Approximately 11 hours

Approximately 13.3 hours

None of the above

A

Approximately 13.3 hours

1 L(liq) = 1.1 kg(liq); 1L liq = 860 L gas

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99
Q

In the face of significant back-pressure, which of the following devices would read accurately?

A device with a needle valve and a multiple orifice flowmeter.

A device with a needle valve and a variable orifice flowmeter.

A regulator with a bourdon gauge pressure and flowmeter.

A regulator with a set pressure and multiple orifice flowmeter.

A

A device with a needle valve and a variable orifice flowmeter.

Thorpe tube

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100
Q

Which of the following cannot easily be configured to be a fixed performance device at low FiO2’s?

  1. Nasal cannula
  2. Large volume cold neb
  3. Air entrainment mask/ventimask
  4. Simple mask
A

1, 4

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101
Q

Of the following, the proper device to supply humidified oxygen for a spontaneously breathing patient with an endotracheal tube in place is?

Venti mask with entrained aerosol/humidity

Venti mask with trach adaptor

LVN with a trach cradle

LVN with a t-piece

A

LVN with a t -piece

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102
Q

. A patient is breathing a rate of 12 br/min. Their tidal volume is 450 mL/breath, and they are on a large volume nebulizer at an FiO2 of 0.35 with a set O2 flow of 12 LPM. Is this likely to be a fixed performance device AND what approximate FiO2 is the patient receiving?

Yes/=0.35

No/<0.35

No/>0.35

Cannot calculate

Yes/<0.35

A

Yes/=0.35

Magic box: 64 lpm total flow rate, TCT = 5, if I:E = 1:2 (assumed), ti = 1.67s

.450L / 1.67s = 0.28L/s = 16.9 lpm

If the flow being delivered (64 lpm) is higher than the flow the patient is generating (16.9 lpm), it is a fixed device.

* When information is given to us about a patient’s breathing pattern, it is more than just determining a fixed performance device using the “rule of 60”. We must consider how they are breathing. This patient is breathing at a slower rate, indicating that he’s not that air hungry, and so giving us a better idea that the flows that they are generating are not that high (and therefore, the flows being delivered are likely higher than what the patient is generating). If the patient was breathing at a faster rate, this would change their I:E, therefore changing the flow the patient is generating, potentially changing whether or not the device is fixed for them.

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103
Q

Patients on high FiO2s that suddenly experience mucous plugging of a large airway are in danger of:

Increased dead-space ventilation

Decreased CO

Absorption atelectasis

A

Absorption atelectasis

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104
Q

Entering a patient care room you see the cold neb (CN) is set to deliver 28% oxygen and the oxygen flow meter is set at 6 LPM. The total flow from the CN is:

24 LPM

32 LPM

48 LPM

60 LPM

72 LPM

A

60 LPM

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105
Q

What is the RH when the AH is 15 mg H2O/L and the capacity of a gas is 20.6 mg H2O/L?

15%

20%

30%

72%

A

72%

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106
Q

Regarding the cardiac waveform below, please identify where the distal port of the PAC catheter is sitting at the section of the waveform labeled “A”?

A

Pulmonary artery

Proximal port would be R. atrium

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107
Q

Application of nasal CPAP to neonates can:

Be used to treat apnea associated with intraventricular hemorrhage

Treat babies with necrotizing enterocolitis

Be used immediately post-extubation

Used immediately post-delivery in babies with congenital diaphragmatic hernia

None of the above

A

Be used immediately post-extubation

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108
Q

Defibrillation:

Results in depolarization of just the ventricles

Is an effective electrical treatment for ventricular fibrillation

Can be used to treat asystole

B and C only

A

Is an effective electrical treatment for ventricular fibrillation

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109
Q

What effect do glucocorticoids have on beta adrenergic receptors?

No effect

Stimulates B2 receptors to relax bronchial smooth muscles

restores/enhances responsiveness of B2 receptors to B2 specific agents

Inhibits mast cell release

A

restores/enhances responsiveness of B2 receptors to B2 specific agents

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110
Q

COPD pts who have OSA:

Have worse nocturnal desats compared to someone with only OSA

Often have nocturnal hypoventilation due to impaired ventilatory mechanics during sleep

Have a higher rate of mortality then someone who has only OSA

All of the above

A and C only

A

All of the above

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111
Q

Which of the following is a contraindication to hyperbaric therapy?

Cleft palate

Pleural effusion

Pneumothorax

Restrictive lung disease

A

Pneumothorax

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112
Q

Which of the following is considered the main mechanism by which hypertonic aerosols aid mucociliary clearance?

Increased stimulation of the irritant cough reflex

Alterations of peak insp airway resistance

Enhanced sensory somatic nervous impulses

Altering the pH level

A

Increased stimulation of the irritant cough reflex

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113
Q

Any device used for chest drainage must have which basic component:

A separate underwater seal chamber

Continuous low suction

Collection chamber placed below the insertion site to facilitate gravity drainage

A suction control chamber filled with water

A

A separate underwater seal chamber

Water seal is a one way valve

114
Q

Which of the following statement is true regarding DPI?

They are good for all age groups

They do not require a spacing device

Laminar flow from the use during inspiration is needed to create an aerosol

They are cumbersome to carry

A

They do not require a spacing device

115
Q

A 79 year old male presents to the ER, he is currently sitting on the edge of the bed leaning forward. On exam: he has an increased AP thoracic diameter, a prolonged expiratory phase, is using his accessory muscles and is pursed lip breathing. He complains of shaking chills last evening and SOB at rest. He states that he smoked 1.5 packs/day of cigarettes for 35 years but that he quit smoking 10 years ago.

  1. Which of the following should be assessed first?

Sputum collection for C&S

RR

ABG

Auscultation

A

RR

116
Q

Based on his initial presentation, what type of lung disease is predominate in this patient?

Restrictive lung disease due to suspected pneumonia

Obstructive lung disease due to apparent pneumonia

Infectious lung disease due to apparent pneumonia

Obstructive lung disease secondary to cigarette smoking

Restrictive lung disease secondary to cigarette smoking

A

Obstructive lung disease secondary to cigarette smoking

117
Q

Coronary artery disease may be diagnosed with which of the following?

Cardiac enzymes

V/Q scan

Cardiac angiogram

All of the above

a and c only

A

Cardiac angiogram

118
Q

In compensating for heart failure, the body will:

Increase blood volume

Dilate the peripheral vasculature

Decrease the HR

Increase the urine output

A

Increase blood volume

119
Q

Which of the following is a risk factor for the development of an aortic aneurysm?

Systemic HTN

COPD

Family history of AAA

All of the above

a and c only

A

a and c only

120
Q

Your patient has a severe tricuspid valve stenosis. A hemodynamic profile consistent with this would be:

CVP 14 mmHg, PAP 35/29 mmHg, PCWP 4 mmHg

CVP 2 mmHg, PAP 10/6 mmHg, PCWP 4 mmHg

CVP 14 mmHg, PAP 11/6 mmHg, PCWP 3 mmHg

CVP 16 mmHg, PAP 33/26 mmHg, PCWP 21 mmHg

CVP 19 mmHg, PAP 19/12 mmHg, PCWP 7 mmHg

A

CVP 14 mmHg, PAP 11/6 mmHg, PCWP 3 mmHg

121
Q

The major pathophysiology seen in a near, wet-drowning is:

Non-cardiogenic pulmonary edema

Cardiogenic pulmonary edema

Hypovolemic shock

Laryngospasm

A

Non-cardiogenic pulmonary edema

122
Q

Hyperventilation as a therapy for an acute head injury is used for its _____ effects and _____ cerebral blood flow.

Vasodilatory, increases

Vasoconstrictory, increases

Vasodilatory, decreases

Vasoconstrictory, decreases

A

Vasoconstrictory , decreases

123
Q

Given the following data:

Mode: PRVC

FiO2: 0.80

Set Vt: 600 mL

RRset: 12

PEEP: 5

Ti: 1.20 sec

Vtexhaled: 540 mL

RRmeasured: 16

PIP: 36 cmH2O

Pplat: 26 cmH2O

The patient’s static compliance is:

  1. 4 mL/cmH2O
  2. 1 mL/cmH2O
  3. 7 mL/cmH2O
  4. 6 mL/cmH2O
A

25.7 mL/cmH2O

Vtexhaled is measured back at the ventilator, and because of the change in temperature that the exhaled gas undergoes leads to a change in volume, which is why the Vtexhaled is always lower than the Vtset. We SHOULD use the Vtset.

124
Q

Define volatile anesthetic agent

Molecules of a liquid that break away and enter the space at the top of the vaporizer

Pressure created when the molecules bombard the walls of the container

Molecules entering the liquid phase

Liquid that has a tendency to change to a vapor at standard temperature and pressure

A

Liquid that has a tendency to change to a vapor at standard temperature and pressure

125
Q

Which of the following additives to spinal anesthesia will help provide postoperative analgesic properties?

Lidocaine

Bupivicaine

Cocaine

Fentanyl

A

Fentanyl

126
Q

What stage of sleep is characterized by deep, restorative sleep?

Stage 1 NREM

Stage 2 NREM

Stage 3 NREM

REM

A

Stage 3 NREM

127
Q

A rigid bronchoscope is the preferred type of scope for/if:

The removal of a large foreign body

A difficult intubation is expected

Examination of the lung apices are needed

Visualization of the lower portions of the respiratory tract is required

A

The removal of a large foreign body

128
Q

Which of the following is considered therapeutic bronchoscopy?

BAL

Bronchial samples for C & S

Bronchial toileting

Needle aspiration

A

Bronchial toileting -same as lavage

C&S, Needle aspiration are to collect samples. Bronchial toileting is therapeutic

129
Q

Albumin plays many essential roles in the body. 2 of these roles include:

Maintaining osmotic pressure gradients, and molecular transport

Molecular transport, and metabolizing denatured proteins

Opposing osmotic pressure gradients, and combating liver disease

Maintaining renal output, and supporting molecular transport

A

Maintaining osmotic pressure gradients, and molecular transport

130
Q

The electrolyte most closely tied to cardiac arrhythmias when its level is out of normal range (either too high or low) is:

Sodium

Chloride

Potassium

Hydrogen ion

A

Potassium

131
Q

Assessment of an area of consolidation in the lung would most likely reveal:

Dull percussion

Tracheal deviation

Decreased fremitus

Late inspiratory crackles

A

Dull percussion

Could be late inspiratory crackles too

132
Q

In which of the following modes of ventilation will effective tidal volume vary the most with changes in patient resistance of compliance?

Pressure-regulated volume control

CMV with autoflow

Volume support

Pressure support

A

Pressure support

133
Q

Aerosol deposition in the distal airways can be improved with:

Deep, slow insp flow breaths

Deep, fast insp flow breaths

Shallow, slow insp flow breaths

Shallow, fast insp flow breaths

A

Deep, slow insp flow breaths

MDI

The slower the movement, the less inertial impaction

134
Q

The following pressure-time waveform indicates:

A

High airway resistance

135
Q

Exercise training in patients wiht COPD improves:

Exercise capacity

Psychologic state

Pulmonary function

A and B

All of the above

A

A and B

Lung mechanics wouldn’t actually change

136
Q

Tank Calculation

A

Duration of Flow =

Oxygen Tank Conversion Factor * Remaining Tank Pressure (psi) / Continuous Flow Rate (L/min)

137
Q

Oxygen Cylinder Conversion Factors

D Tank

A

D Tank = 0.16

138
Q

Oxygen Cylinder Conversion Factors

E Tank

A

E Tank = 0.28

139
Q

Oxygen Cylinder Conversion Factors

G Tank

A

G Tank = 2.41

140
Q

Oxygen Cylinder Conversion Factors

H/K Tank

A

H/K Tank = 3.14

141
Q

Oxygen Cylinder Conversion Factors

M Tank

A

M tank = 1.56

142
Q

Total Arterial O2 Content

A

CaO2= (1.34 x Hb x SpO2) + (PaO2 x 0.003)

143
Q

How to Determine Pt Inspiratory Flow

A

Flow= Volume (L)/time (min)

144
Q

Determining the total flow in a high flow delivery device

A

If air/O2 is for example 30 then it is 8:1 so for every 1 litre of oxygen 8 L is being entrained into the device

for total flow add the two toegther (=9) and then multiple by the set flow

145
Q

Calculating Flow in Liquid Oxygen System

A

Gas Remaining= (Liquid Weight [lb]) x 860/ 2.5 L/Ib

Duration of Contents (min)= Gas Remaining (L)/ Flow (L/min)

Remeber 1 L of Liquid O2 = 2.5 lb

146
Q

How long should it take to complete on circuit of the NRP algorithm? (from birth to administration of first dose of epinephrine?

30 sec

60 sec

90 sec

120 sec

150 sec

A

90 sec

147
Q

How often should you be evaluating the patient according to the NRP algorithm?

Ever minutes

Every 2 minutes

Every 15 sec

Every 30 sec

Whenever there is a change in the patient’s status

A

Every 30 sec

148
Q

Restoration of adequate ventilation usually will result in _______ improvement in heart rate?

Rapid

Gradual

Slow

A

Rapid

149
Q

a term newborn is apneic with a HR of 55 bpm you should?

Give supplemental oxygen

Provide positive pressure ventilation

Administer chest compressions

Both b and c

All of the above

A

All of the above

150
Q

If a newborn has meconium stained amniotic fluid and has been vigorous since delivery you should?

Suction mouth and trachea

Clear mouth and nose of secretions

Dry, stimulate and reposition

Both b and c

All of the above

A

Both b and c

151
Q

A newborn that is born at term, has no meconium in the amniotic fluid or on the skin, is breathing well, and has good muscle tone________________ need resuscitation.

Does

Does Not

A

Does Not

152
Q

If a newborn is still not breathing after a few seconds of stimulation. The next action should be to administer__________

Additional stimulation

Positive Pressure ventilation

Compressions

Only b and c

All of the above

A

Positive Pressure ventilation

153
Q

Which of these would be your first actions if the HR remains below 60 bpm, despite administration of ventilation and chest compressions?

Ensure ventilation is being given properly

Ensure chest compressions are being given optimally

Ensure that you are using 100% oxygen

Give the patient epinephrine.

Only a,b, and c.

A

Only a,b, and c.

154
Q

What concentration of epinephrine should you use during resuscitation?

1: 10
1: 100
1: 1,000
1: 10,000

None of the above.

A

1:10,000

155
Q

What dose of epinephrine should you instill through the ETT during resuscitation?

  1. 1 ml/kg
  2. 01 mg/kg

10 ml/kg

1.0 ml/kg

Both a and b

A

Both a and b

156
Q

If you have a 4.1 kg newborn patient requiring epinephrine how much should you instill through the ETT? (type in the amount to one decimal place no need to state ml)

A

0.3

157
Q

How often can you repeat the dose of epinephrine if the patient does not respond with an increased HR?

Every 30 seconds

Every minute

Every 3 minutes

Every 5 minutes

Both c and d

A

Both c and d

158
Q

How soon should you check the HR after administration of epinephrine?

Every 30 seconds

Every minute

Every 3 minutes

Every 5 minutes

Both c and d

A

Every 30 seconds

159
Q

What should you do if you suspect a patient’s airway is blocked due to Robin Syndrome?

Intubate the trachea

Prone position the baby

Provide PPV with increased pressures

Both b and c

A

Prone position the baby

160
Q

Which of these is a contraindication for giving Naloxone?

Mother is addicted to narcotics

Mother has been given narcotics within the last 4 hours

Baby has normal HR and color with PPV

Baby presents with recurrent respiratory depression

A

Mother is addicted to narcotics

161
Q

A 38 week gestation neonate (2750 g) is ventilated on the Hamilton G5. Settings:

Mode: P-CMV

PCset: 18 cmH2O

PEEP: 7 cmH2O

VtE: 14 mL

Ti: 0.40 sec

RRset: 40 bpm

RRtotal: 47 bpm

FiO2: 0.55

ABG: 7.34 / 40 / 68 / 21 / -4.2 / 94%

Based on this information, the best change to the vent settings would be:

Increase RR

Increase PC level

Decrease PC level and decrease FiO2

Decrease PC level and decrease PEEP

Decrease RR and decrease FiO2

A

Decrease PC level and decrease FiO2

ABG goals for term babies → pH 7.25, CO2 45-55

Decrease PCset → 18+7 = 25, would want to decrease to a total of 18 to reach into the weaning parameters

162
Q

You are ventilating an adult patient (IBW 75 kg) who had H1N1 pneumonia. Normal ABGs and SpO2 >/= 90% are currently targeted

Mode: APRV

PHigh: 28 cmH2O

Plow: 0 cmH2O

Thigh: 5.5 s

Tlow: 0.5s

FiO2: 0.60

VTE: 610 ml

ABG: 7.28/52/61/24/0/91%

Based on the information the best change to the ventilator settings would be:

Increase Thigh

Decrease Thigh

Increase Phigh

Decrease Phigh

A

Decrease Thigh

163
Q

You are ventilating an adult patient (IBW 70 kg) in APRV. The patient had developed ARDS secondary to sepesis and is now resolving. Normal ABGs and SpO2 >/= 90% are being targeted.

Mode: APRV

Phigh: 26 cmH2O

Plow: 0 cmH2O

Thigh: 5.0 s

Tlow: 0.5 s

FiO2: 0.40

VTE: 575 ml

ABG: 7.46/33/97/24/0/98%

Based on the information, when weaning this patient within APRV the strategy would include:

Decreasing Thigh, decreasing Phigh

Increasing Thigh, decreasing Phigh

Increasing TLow, decreasing Phigh

Increasing Thigh, increasing Tlow

A

Increasing Thigh, increasing Tlow

164
Q

A neonatal patient is ventilated on the sensorimedics 3100A. If the patient’s ETT were to become kincked you would expect:

The SpO2 to decrease

The adjustable high MAP alarm to be activated\

The adjustable low MAP alarm to be activated

The dump valve to open

B and d

A

The SpO2 to decrease

No alarms for obstructed tubes on oscillators.

165
Q

A 27 week neonate is ventilated on the Sensormedics 3100A

Frequency: 13 Hz

MAP: 11 cmH2O

Amplitude (change in P): 18 cmH2O

I time %: 33%

FiO2: 0.60

ABG: 7.22/58/46/23/82%

Which of the following changes to the oscillating settings would help to return the blood gas values to goal ranges?

Increased amplitude, decreased MAP

Decreased amplitude, decreased MAP

Increased amplitude, increased MAP

Decreased amplitude, increased MAP

A

Increased amplitude, increased MAP

166
Q

You are ventilating a patient on the 3100 oscillator and increase frequency control how will that change tidal volume

A

Decrease

167
Q

You are ventilating a patient on the 3100 oscillator and increase frequency control how will that change Minute volume

A

Decrease

168
Q

You are ventilating a patient on the 3100 oscillator and increase frequency control how will that change PaCO2

A

Increase

169
Q

You are ventilating a patient on the 3100 oscillator and increase frequency control how will that change PaO2

A

No Change

170
Q

Prone positioning may be part of a ventilation strategy for which of the following patient conditions:

ARDS

Pneumonia

Severe asthma exacerbation

All of the above

a and b only

A

a and b only

171
Q

You are ventilating a 70 kg patient with the following settings:

Mode: MMV

RRset: 12

RRtotal: 26

Vtset: 560 mL

Vtspont: 280 mL

PEEP: 10 cmH2O

FiO2: 0.45

PS: 10 cmH2O

Current orders: ventilate to pH 7.35 - 7.45, PaCO2 35 - 45, keep SpO2 > 90%

Current ABG: 7.29 / 56 / 64 / 26 / -1 / 91%

What changes could be made to correct this ABG?

Increase RRset to 15

Increase Vtset to 690 mL

Increase PEEP to 12 cmH2O

Increase PS to 17 cmH2O

A

Increase PS to 17 cmH2O

172
Q

For a healthy individual, the expected difference between points C & D (on the above diagram is 3-5mmHg of CO2, what does point D represent?

A

The partial pressure of CO2 dissolved in arterial blood

173
Q

What Does the Shaded Area Represent

A

CO2 from alveoli experiencing decreased capillary blood flow

Not all cells of the lung participate in gas exchange, but still need O2 for metabolism, so CO2 from these cells add to the CO2 level. Shunt and alveolar deadspace contribute to the PaCO2. Everything below dotted line is due to alveolar deadspace, above the line is shunt

Vd/Vt = (PaCO2 - PECO2)/ PaCO2 → enghoff (all the shaded area)

Vd/Vt = (PACO2 - PECO2) / PACO2 –>bohr (true alv. Deadspace -assumes gas exchange did occur)

174
Q
A

Increase the % support

175
Q

You have a pt that is complaining of chest pain and on 4 LPM O2 and nitroglycerin. He has been stable and comfortable for the last hour when you assess him he is responsive alert RR 16 and BP 138/87 with the following rhythm what should you do

A

Should request cardiology consult

176
Q

A patient is symptomatic with the following rhythm what should you do

A

Cardiovert

177
Q

Your patient is currently on an SBT. Approx 15 minutes into the trial you observe that his RR has increased from 18 to 25 and he seems to be working using more accessory muscles to breathe. In that same amount of time your volumetric capnograph has shown an increase in VtCO2. What should you do for patient?

This is a normal response to the imposed WOB of the SBT. Continue SBT

This is an abnormal response to the imposed WOB of the SBT. Discontinue the SBT

The increase in VtCO2 correlates with an increase in PaCO2 and the patient is failing. Discontinue the SBT

The VtCO2 is an indication of how much CO2 is present in exhaled gas at any given time and normally increases from the start of exhalation to the end of exhalation. Continue the SBT

A

This is a normal response to the imposed WOB of the SBT. Continue SBT

Workload goes up, CO2 goes up → appropriate change (if CO2 decreased, patient is tiring out → stop)

D. doesn’t explain the changes we saw. It’s true for every breath.

178
Q

Calculating deadspace volume

A

Use Vd/Vt = (PaCO2 - PECO2)/ PaCO2

PECO2 = (Pbaro - 47) * FECO2

→ FECO2 from etCO2

Vd/Vt * Vt = Vd

179
Q

You have stabilized a bradycardic patient in third degree heart block using TCP at a rate of 60 bpm. Mechanical capture has been confirmed. The patient remains hypotensive. Your next action would be to:

Increase the mA setting

Increasing the rate of pacing

Start an infusion of epinephrine

Cardiovert the patient at 50 J

A

Increasing the rate of pacing

180
Q

A neonate is being managed immediately post-delivery. They are receiving ventilaion by mask with a good technique and are not improving after 2 min. The mask seal is verified yet the heart rate remains 85 bpm and there is poor chest movement. The next action should be:

Perform endotracheal intubation

Perform chest compressions

Give epinephrine

All the above

A

Perform endotracheal intubation

181
Q

A baby is born and placed on the radiant warmer. You immediately note no crying, limp tone, and gasping respirations. Your first action should be to:

Dry and stimulate the baby

Provide PPV

Perform intubation

Provide O2 therapy

A

Dry and stimulate the baby

182
Q

A 28 year old female is delivering a 39 week infant, pre-natal care was followed. The membranes ruptured 5 hours ago and the fluid is clear, she has received fentanyl 30 minutes prior to delivery. Baby is placed under the warmer, positioned, airway cleared, dried and stimulated. HR is 110, no tone, no respiratory effort. Which of the following is the next action?

Give narcan

Intubate

Provide tactile stimulation

PPV

Initiate chest compressions

A

PPV

183
Q

A 2 year old child is seen in the ER of a local hospital and diagnosed with croup. The physician orders a dose of aerosolized epinephrine via small volume nebulizer. What size aerosol particle is most likely to provide the greatest therapeutic benefit to the patient?

Particles > 10 um

Particles 5 - 10 um

Particles 2 - 5 um

Particles 0.8 - 3 um

A

Particles 5 - 10 um

184
Q

You are delivering a mixture of 30:70 heliox continuously to a patient with a non-rebreather. The O2 flowmeter reads 12 lpm. What flow is being delivered to the patient?

12 lpm

22 lpm

19 lpm

8 lpm

A

19 lpm

185
Q

A 10 kg child requires salbutamol; the order is for 0.03 mL/kg. How many mL of solution will you need?

  1. 3 mL
  2. 03 mL

3 mL

30 mL

A

0.3 mL

186
Q

Common uses for inhaled nitric oxide include all of the following except:

ARDS

PPHN

Primary pulmonary hypertension

Status asthmaticus

A

Status asthmaticus

187
Q

An asthmatic girl has been using a SVN for Ventolin treatment for the past few years. Her prescription was to use 2.5 mg. How many puffs with an MDI and spacer should she use?

2

5

8

10

A

5

188
Q

Nebulized epinephrine has been ordered for a child with croup in the ED. You draw up 5 mL from a multidose vial that reads 1:1000 epinephrine. How many mg of epi is in the solution that is drawn up?

10 mg

5 mg

  1. 5 mg
  2. 5 mg
A

5 mg

189
Q

One of these statements about methemoglobinemia is NOT correct

Causes blood to appear rusty brown

Causes SpO2 to be erroneously high

Is defined as metHg of over 10%

Can be treated with methylene blue

A

Is defined as metHg of over 10%

190
Q

Deadspace Equation

A
191
Q

Shunt Equation

A
192
Q

Mean Airway Pressure Formula

A
193
Q

Which of the following best defines the term sterilization?

a. Use of chemicals to destroy pathogens
b. Process that destroys all forms of microbial life
c. Process of sanitization
d. Use of soap and water to aid in removal of soil/body secretions

A

b. Process that destroys all forms of microbial life

194
Q

During an allergic reaction there is an increase in circulating antibody

a. IgA
b. IgD
c. IgE
d. IgG
e. IgM

A

c. IgE

195
Q

Which of the following statement is/are true regarding pressure differences

a. The apical alveoli resting volume is less than basal
b. Pleural pressure at the base is more negative than at the apex
c. Transpulmonary pressure gradient is greatest at apex
d. All state are true

A

c. Transpulmonary pressure gradient is greatest at apex

Apical should be more negative than the basal.

196
Q

Which of the following could result in a higher than normal SvO2

a. Decreased CO
b. Pyrexia
c. Decreased oxygen extraction ratio
d. All of the above

A

c. Decreased oxygen extraction ratio

SvO2 (O2 stays in blood ) A higher than normal SvO2 means you are not extracting so a decrease CO means you have more time to pull it out.

Decreased CO -would increase SvO2, more time to pull O2 out

Pyrexia - increase in metabolic rate, increase O2

197
Q

arterial oxygen content Calculation

A

CaO2 = (Hb x 1.34)SpO2 + PaO2 x 0.003

198
Q

What type of lung unit(s) would result in a long time constant

a. Decreased airway resistance
b. Decrease Elastance-increased compliance
c. Decrease Compliance - causes a decrease in TC
d. Decreased Surfactant

A

b. Decrease Elastance

TC = R*C

Decrease Elastance will increased compliance

Decrease Compliance will causes a decrease in TC

Decreased Surfactant - causes a decrease in C

199
Q

. (Invasive) Mechanical ventilation is indicated for which of the following blood gases done on room air?

a. pH 7.23, PaCO2 56 mmHg, PaO2 76 mmHg, HCO3 23 mmol/L
b. pH 7.34, PaCO2 46 mmHg, PaO2 51 mmHg, HCO3 24 mmol/L
c. pH 7.31, PaCO2 50 mmHg, PaO2 46 mmHg, HCO3 24 mmol/L
d. All of the above
e. A and B only

A

a. pH 7.23, PaCO2 56 mmHg, PaO2 76 mmHg, HCO3 23 mmol/ L

We are just looking at the cut off of pH of < 7.25

200
Q

Regarding the thoracic pump, which of the following isnot true

a. During PPV there is an increase cardiac stroke volume
b. During spontaneous breathing there is increase venous return
c. During PPV there is an increased central venous pressure
d. During spontaneous breathing the thoracic pump is most effective during inspiration

A

a. During PPV there is an increase cardiac stroke volume

During PPV we have an increase thoracic pressure and decreased venous return so we fill up less and then via Starling Law we contract less

201
Q

Positive pressure ventilation results in

a. Increase dead-space ventilation
b. Decreased dead-space ventilation
c. Decreased intrathoracic pressure
d. A and C
e. B and C

A

a . Increase dead-space ventilation

202
Q

The phase variable that begins the inspiratory phase is called ___________ that ends in the inspiratory phase called the _________

a. Trigger, limit
b. Trigger, cycle
c. Cycle, trigger

A

b. Trigger, cycle

203
Q

. In a volume controlled breath, as the patient’s compliance increases the pressure _______ and the tidal volume _________

a. Decrease, Decrease
b. Increase, Remain the Same
c. Decrease, Increase
d. Decrease, Remains the Same

A

d. Decrease, Remains the Same

204
Q

Starling Law of Capillaries state that

a. The volume of fluid and solutes reabsorbed is normally nearly as large as the volume filtered
b. The volume of fluid and solutes reabsorbed is normally larger than the volume filtered
c. The volume of fluid and solutes filtered at the arterial end is less than the volume of fluid and solutes filtered at the venous end
d. The pressure of the fluids and solutes filtered is normally less than the pressure reabsorbed.

A

a. The volume of fluid and solutes reabsorbed is normally nearly as large as the volume filtered

205
Q

Which of the following represents the correct pathway of impulse conduction through the heart

a. AV Node, SA Node, Conduction Myofibers, purkinje fibres
b. AV Node, Bundle Branches, SA Node, Purkinje Fibers
c. SA Node, AV Node, Bundle Branches, Conduction fibres
d. SA Node, Bundle Branches, AV Node, Conduction myofibers

A

c. SA Node, AV Node, Bundle Branches, Conduction fibres

206
Q

The T-Wave in lead II ECG represents

a. Onset of atrial depolarization
b. Onset of ventricular depolarization
c. Atrial repolarization
d. Ventricular repolarization

A

d. Ventricular repolarization

Onset of atrial depolarization- P wave

Onset of ventricular depolarization-QRS

Atrial repolarization-Will get lost in QRS complex

207
Q

The main pressure promoting reabsorption of fluid into the capillaries is the:

a. Osmotic pressure of interstitial fluid
b. Hydrostatic pressure of the interstitial fluid
c. Osmotic pressure of the capillary
d. Hydrostatic pressure of capillary
e. Oncotic pressure of interstitial fluid

A

c. Osmotic pressure of the capillary

Hydrostatic pressure of capillary - pressure due to fluid - will push fluid out

Osmotic pulls fluid in (caused by solute concentration); oncotic pushes fluid out (due to difference in protein concentration)

208
Q

Pursed lip breathing when done properly, may result in which of the following

a. Equal pressure point moves down to smaller airways-Will move to the larger airways
b. Decreased early airway collapse
c. Increase expiratory flow rates
d. B and C

A

b. Decreased early airway collapse

Increase expiratory flow rates-We are adding an obstruction to the flow

209
Q

A blending device is mixing 11.3 L of air with 4.7 L of oxygen. What FiO2 is the device producing?

a. 0.4
b. 0.45
c. 0.5
d. 0.55

A

0.45

(11.3 L (air) * 0.21 + 4.7 L (O2)) / 16 = 0.44

210
Q

When we are using a full “D” tank oxygen cylinder for transport. The clinician set the flow rate on prongs to deliver 4 LPM; the approximate duration of flow would be

a. ~15 min
b. ~30 min
c. >1 hour
d. >2 hour

A

c. >1 hour

D = 0.16 L/psi

2200 psi or (subtract 500 for safety buffer) = 1700 psi → answer works for both

211
Q

Which of the following statement is/are true regarding cyanosis

a. Polycythemia patient may show signs of cyanosis but may not be hypoxemic
b. All polycythemic patient that show signs of cyanosis are hypoxemic
c. In anemic patients, cyanosis is an early indicator of hypoxemia
d. All of the above are true

A

a. Polycythemia patient may show signs of cyanosis but may not be hypoxemic

212
Q

A patient has been admitted to the coronary care unit after a myocardial infarction involving left side of the heart. The following information is collected from ABG while the patient is on room air. Hb 154 g/L

pH 7.48, PaCO2 31 mmHg, PaO2 54 mmHg, HC3 22 mmol/L, BE -1, SaO2 87%

What are the indications for O2 therapy for this patient?

i) Hypoxemia
ii) Hypercarbia
iii) To decrease myocardial workload
iv) Anxiety

A

i and iii

213
Q

The amount of air entrained in a Venturi device is ________ proportional to the size of the entrainment port and _______ to the jet orifice?

A

a. Directly, inversly

214
Q

Keeping the absolute humidity constant. As the temperature of the air ___ the relative humidity will ______.

A

a. Increase, decrease

215
Q

Choose the true statements regarding Bourdon pressure gauges.

i) a coiled metal tube has a sub-atmospheric pressure introduced to it
ii) the display needle should periodically be “zeroed”
iii) are used to measure changes in pressure
iv) will straighten in response to an increase in pressure

A

a. ii, iii, iv

216
Q

The CARTA code of Ethics instructs us to “guard against conflicts of professional interest” and to specifically consult the _______________________ to prevent a real or perceived conflict of interest? Who is the individual/or department that Alberta RRTs are to consult?

a. The Alberta Health
b. The CARTA Registrar
c. The alberta department of justice
d. Your employer

A

b . The CARTA Registrar

217
Q

To maintain your clinical competency in Alberta you must complete _______ hours of practice over a five year period. How many hour of practice are needed?

a. 48
b. 500
c. 720
d. 1600

A

c. 720

218
Q

Once the CVP is in place, the transducer is leveled appropriately and zeroed. The monitor is showing a good waveform, with an a wave, …

a. Volume overload
b. Pulmonary hypertension
c. VSD
d. Pulmonary embolism

A

b. Pulmonary hypertension

219
Q

As you are monitoring Bess you notice that her “a” wave has disappeared from her CVP waveform. This is an indication that:

a. The transducer is sitting below the level of the right atrium
b. Bess has stopped breathing
c. The tricuspid valve is incompetent causing regurgitation of blood into right atrium
d. The atria are not contracting, Bess is in atrial fibrillation

A

d . The atria are not contracting, Bess is in atrial fibrillation

220
Q

Which of the follow is recommended for initial mechanical ventilator settings? Pt is unconscious, sedated and medically paralyzed

a. CMV VC, f 16 br/min, Vt 550 mls, PEEP 5
b. IMV VC, f 14 br/min, Vt 750 mls, PEEP 5
c. CMV APV, f 18 br/min, Vt 600 mls, PEEP 3 - PEEP too low
d. CSV PC, pressure support 10 cmH2O, CPAP 5

A

a. CMV VC, f 16 br /min, Vt 550 mls , PEEP 5

221
Q

It is determined the patient has a refractory hypoxemia, which of the following would be the course of action at this time

a. Increase FiO2
b. Increase RR
c. Increase the tidal volume
d. Increase the PEEP

A

Increase PEEP

222
Q

VS: Bp 158/108 mmHg, pulse 137 bpm and irregular. Her oxygen

  1. Which of the following is the correct action given the patients oxygen status.
    a. Apply a 50% air entrainment ventimask system to maximize forward flow
    b. Apply a 70% large vol neb bc she is breathing so rapidly, she will soon become dehydrated
    c. Apply a nrb bc it’s quick and easy to set up
    d. Do not start O2, she may be a CO2 retainer
A

c. Apply a nrb bc it’s quick and easy to set up

223
Q

Her elevated HR may be due to

a. Stimulation of the parasympathetic branch of the autonomic nervous system
b. Secondary to the pain she is in
c. Due to an attempt by her heart to maintain cardiac output
d. All of the above
e. b & c

A

e. b & c

224
Q

The CXR in addition to confirming the flail, shows a large white area obscuring the lower half of the left lung and blunting of the costophrenic angle. The ED physician also makes note of these findings and asks you to assist with the insertion of a chest tube.

  1. What could cause blunting of the costophrenic angle in this case?
    a. Pneumothorax
    b. Pneumomediastinum
    c. Hemothorax
    d. All of the above
    e. A & B
A

c. Hemothorax

225
Q

Give the substance to be drained, it is more probable that the physician will insert a large bore chest tube

a. Into the 2nd intercostal space, mid-clavicular line
b. Superiorly, as air rises
c. Inferiorly, as fluid is gravity dependent
d. Along the inferior surface of any rib

A

c. Inferiorly, as fluid is gravity dependent

226
Q

You set up a dry thoracic drainage unit. How much water will you put into the suction control chamber?

a. None
b. Fill it to 2 cm
c. Fill it to the 20 cm mark
d. Start at 10 cm and slowly

A

a. None

227
Q

The patient is intubated and placed on a mechanical ventilator, during a mandatory inspiration you observe tidaling in the underwater seal of the thoracic drainage unit. Which direction is it observed?

a. Move towards the suction control chamber
b. Moves toward the patient
c. Moves away from the patient
d. Tidaling should never be observed in the underwater seal

A

c. Moves away from the patient

228
Q

What is the mode of action of singulair

a. B2 Selective Bronchodilator
b. Anti-inflammatory Leukotriene Receptor
c. Oral Corticosteroid
d. IgI Blocker

A

b. Anti-inflammatory Leukotriene Receptor

229
Q

Which of the following is the recommended care of the ventilator circuit for prevention of VAP?

The vent circuit must be changed every 4 days

Closed sx systems are recommended

Circuit condensate should be used to instill the patient

Passive humidifiers can be safely used for 48 hours

A

2, 4

230
Q

Which of the following is the most common cause of community acquired pneumonia?

Staphylococcus aureus

Pseudomonas aeruginosa

Escherichia coli

Diplococcus pneumonia

A

Diplococcus pneumonia

231
Q

What question does ethics try to answer

Who is right

What treatment is best

Who benefits the most

How should we act

A

How should we act

232
Q

A patient on mechanical ventilation has a compliance of 90 mL/cmH2O and an airway resistance of 5.0 cmH2O/L/sec. what is the calculated time constant?

a. 0.45 sec

B.1.35 sec

C. 4.5 sec

D. 450 sec

A

a. 0.45 sec

Time Constant (seconds)=Compliance (mL/cmH2O) x Resistance (cmH2O/L/sec)

5.0 cmH2O/L/sec x 0.09 L/cmH2O= 0.45 seconds

233
Q

A 25 year old female was admitted to the emergency department in hemorrhagic shock following a gunshot wound. She received fluid administration to treat her bleeding and was stabilized. Following placement of a pulmonary artery catheter the following data was collected. Interpret the hemodynamic data.

PAP 48/32 mmHg

PCWP 22 mmHg

CVP 15 mmHg

C(a-v)O2 2.6%

Cor pulmonale

Pulmonary hypertension

Hypervolemia

A

Hypervolemia

PAP is high PCWP is high CVP is high (backing up to right side of the heart). C(a-v)O2 is low. Her blood is diluted because she was given too much fluid.

234
Q

Which of the following is/are the major characteristic of increased alveolar dead=space

Minute ventilation out of proportion to PaCO2

Decreased WOB

Hyperoxemia

FiO2 >0.50 and PaO2 <50 mmHg

A and C only

A

Minute ventilation out of proportion to PaCO2

Increase amount of air that is not participating in gas exchange so you are moving more air in and less air out, you would have increased WOB, you would have hypoxemia not hyperoxemia.

235
Q

Which of the following is the body’s main means of heat loss at high environmental temperatures?

Evaporation

Conduction

Convection

Radiation

A

Evaporation

236
Q

Which of the following statements refer to EF?

The portion of EDV ejected on each beat

Amount of blood in the ventricle at end of diastole

Amount of blood ejected into the ventricle after each atrial contraction

All of the above

A and C only

A

The portion of EDV ejected on each beat

Most of atrial contraction is passive which is why the amount of blood ejected into the ventricle after the atrial contraction will not be equal to portion EDV ejected.

237
Q

Amphotericin B is used to treat:

Systemic bacterial infections

Systemic Fungal infections

Pulmonary fungal infections

B and C only

A

B and C only

238
Q

Which of the following describes a mode of ventilation that would best preserve tidal volume when a patient’s lung/thorax compliance increases?

Pressure cycled

Pressure limited, time cycled mode

Volume limited, time cycled mode

Pressure limited, flow cycled mode

A

Volume limited, time cycled mode

239
Q

Which of the following does not cause an increase in measured pcwp?

Hypervolemia

Left ventricular failure

Mitral stenosis

3rd spacing

A

3rd spacing

240
Q

You have a liquid system and a patient that requires a flow of 4 LPM. The liquid oxygen unit weighs 4100g. How long does the patient have for their oxygen usage?

Approximately 8.3 hours

Approximately 9.5 hours

Approximately 11 hours

Approximately 13.3 hours

None of the above

A

Approximately 13.3 hours

1 L(liq) = 1.1 kg(liq); 1L liq = 860 L gas

241
Q

In the face of significant back-pressure, which of the following devices would read accurately?

A device with a needle valve and a multiple orifice flowmeter.

A device with a needle valve and a variable orifice flowmeter.

A regulator with a bourdon gauge pressure and flowmeter.

A regulator with a set pressure and multiple orifice flowmeter.

A

A device with a needle valve and a variable orifice flowmeter.

242
Q

Which of the following cannot easily be configured to be a fixed performance device at low FiO2’s?

  1. Nasal cannula
  2. Large volume cold neb
  3. Air entrainment mask/ventimask
  4. Simple mask
A

1 and 4

243
Q

Of the following, the proper device to supply humidified oxygen for a spontaneously breathing patient with an endotracheal tube in place is?

Venti mask with entrained aerosol/humidity

Venti mask with trach adaptor

LVN with a trach cradle

LVN with a t-piece

A

LVN with a t-piece

244
Q

A patient is breathing a rate of 12 br/min. Their tidal volume is 450 mL/breath, and they are on a large volume nebulizer at an FiO2 of 0.35 with a set O2 flow of 12 LPM. Is this likely to be a fixed performance device AND what approximate FiO2 is the patient receiving?

Yes/=0.35

No/<0.35

No/>0.35

Cannot calculate

Yes/<0.35

A

Yes/=0.35

Magic box: 64 lpm total flow rate, TCT = 5, if I:E = 1:2 (assumed), ti = 1.67s

.450L / 1.67s = 0.28L/s = 16.9 lpm

If the flow being delivered (64 lpm) is higher than the flow the patient is generating (16.9 lpm), it is a fixed device.

* When information is given to us about a patient’s breathing pattern, it is more than just determining a fixed performance device using the “rule of 60”. We must consider how they are breathing. This patient is breathing at a slower rate, indicating that he’s not that air hungry, and so giving us a better idea that the flows that they are generating are not that high (and therefore, the flows being delivered are likely higher than what the patient is generating). If the patient was breathing at a faster rate, this would change their I:E, therefore changing the flow the patient is generating, potentially changing whether or not the device is fixed for them.

245
Q

Patients on high FiO2s that suddenly experience mucous plugging of a large airway are in danger of:

Increased dead-space ventilation

Decreased CO

Absorption atelectasis

A

Absorption atelectasis

246
Q

Entering a patient care room you see the cold neb (CN) is set to deliver 28% oxygen and the oxygen flow meter is set at 6 LPM. The total flow from the CN is:

24 LPM

32 LPM

48 LPM

60 LPM

72 LPM

A

60 LPM

247
Q

What is the RH when the AH is 15 mg H2O/L and the capacity of a gas is 20.6 mg H2O/L?

15%

20%

30%

72%

A

72%

248
Q

Regarding the cardiac waveform below, please identify where the distal port of the PAC catheter is sitting at the section of the waveform labeled “A”?

A

Pulmonary artery

249
Q

What is the RH when the AH is 15 mg H2O/L and the capacity of a gas is 20.6 mg H2O/L?

15%

20%

30%

72%

A

72%

250
Q

Common causes of weaning/liberation failure include all of the following except:

Myocardial ischemia

Ventilatory demand in excess of capacity

Psychological dependence

Secondary polycythemia

A

Secondary polycythemia

251
Q

Application of nasal CPAP to neonates can:

Be used to treat apnea associated with intraventricular hemorrhage

Treat babies with necrotizing enterocolitis

Be used immediately post-extubation

Used immediately post-delivery in babies with congenital diaphragmatic hernia

None of the above

A

Be used immediately post-extubation

252
Q

Defibrillation:

Results in depolarization of just the ventricles

Is an effective electrical treatment for ventricular fibrillation

Can be used to treat asystole

B and C only

A

Is an effective electrical treatment for ventricular fibrillation

253
Q

What effect do glucocorticoids have on beta adrenergic receptors?

No effect

Stimulates B2 receptors to relax bronchial smooth muscles

restores/enhances responsiveness of B2 receptors to B2 specific agents

Inhibits mast cell release

A

restores/enhances responsiveness of B2 receptors to B2 specific agents

254
Q

COPD pts who have OSA:

Have worse nocturnal desats compared to someone with only OSA

Often have nocturnal hypoventilation due to impaired ventilatory mechanics during sleep

Have a higher rate of mortality then someone who has only OSA

All of the above

A and C only

A

All of the above

255
Q

Which of the following is a contraindication to hyperbaric therapy?

Cleft palate

Pleural effusion

Pneumothorax

Restrictive lung disease

A

Pneumothorax

256
Q

Which of the following is considered the main mechanism by which hypertonic aerosols aid mucociliary clearance?

Increased stimulation of the irritant cough reflex

Alterations of peak insp airway resistance

Enhanced sensory somatic nervous impulses

Altering the pH level

A

Increased stimulation of the irritant cough reflex

257
Q

Any device used for chest drainage must have which basic component:

A separate underwater seal chamber

Continuous low suction

Collection chamber placed below the insertion site to facilitate gravity drainage

A suction control chamber filled with water

A

A separate underwater seal chamber

258
Q

Which of the following statement is true regarding DPI?

They are good for all age groups

They do not require a spacing device

Laminar flow from the use during inspiration is needed to create an aerosol

They are cumbersome to carry

A

They do not require a spacing device

259
Q

Which of the following should be assessed first?

Sputum collection for C&S

RR

ABG

Auscultation

A

RR

260
Q

Based on his initial presentation, what type of lung disease is predominate in this patient?

Restrictive lung disease due to suspected pneumonia

Obstructive lung disease due to apparent pneumonia

Infectious lung disease due to apparent pneumonia

Obstructive lung disease secondary to cigarette smoking

Restrictive lung disease secondary to cigarette smoking

A

Obstructive lung disease secondary to cigarette smoking

261
Q

Coronary artery disease may be diagnosed with which of the following?

Cardiac enzymes

V/Q scan

Cardiac angiogram

All of the above

a and c only

A

Cardiac angiogram

262
Q

In compensating for heart failure, the body will:

Increase blood volume

Dilate the peripheral vasculature

Decrease the HR

Increase the urine output

A

Increase blood volume

263
Q

Which of the following is a risk factor for the development of an aortic aneurysm?

Systemic HTN- due to extra stress on arteries

COPD

Family history of AAA

All of the above

a and c only

A

a and c only

264
Q

Your patient has a severe tricuspid valve stenosis. A hemodynamic profile consistent with this would be:

CVP 14 mmHg, PAP 35/29 mmHg, PCWP 4 mmHg

CVP 2 mmHg, PAP 10/6 mmHg, PCWP 4 mmHg

CVP 14 mmHg, PAP 11/6 mmHg, PCWP 3 mmHg

CVP 16 mmHg, PAP 33/26 mmHg, PCWP 21 mmHg

CVP 19 mmHg, PAP 19/12 mmHg, PCWP 7 mmHg

A

CVP 14 mmHg, PAP 11/6 mmHg, PCWP 3 mmHg

265
Q

The major pathophysiology seen in a near, wet-drowning is:

Non-cardiogenic pulmonary edema

Cardiogenic pulmonary edema

Hypovolemic shock

Laryngospasm

A

Non-cardiogenic pulmonary edema

266
Q

Hyperventilation as a therapy for an acute head injury is used for its _____ effects and _____ cerebral blood flow.

Vasodilatory, increases

Vasoconstrictory, increases

Vasodilatory, decreases

Vasoconstrictory, decreases

A

Vasoconstrictory , decreases

267
Q

Given the following data:

Mode: PRVC

FiO2: 0.80

Set Vt: 600 mL

RRset: 12

PEEP: 5

Ti: 1.20 sec

Vtexhaled: 540 mL

RRmeasured: 16

PIP: 36 cmH2O

Pplat: 26 cmH2O

The patient’s static compliance is:

  1. 4 mL/cmH2O
  2. 1 mL/cmH2O
  3. 7 mL/cmH2O
  4. 6 mL/cmH2O
A

25.7 mL/cmH2O

Vtexhaled is measured back at the ventilator, and because of the change in temperature that the exhaled gas undergoes leads to a change in volume, which is why the Vtexhaled is always lower than the Vtset. We SHOULD use the Vtset.

268
Q

Define volatile anesthetic agent

Molecules of a liquid that break away and enter the space at the top of the vaporizer

Pressure created when the molecules bombard the walls of the container

Molecules entering the liquid phase

Liquid that has a tendency to change to a vapor at standard temperature and pressure

A

Liquid that has a tendency to change to a vapor at standard temperature and pressure

269
Q

Which of the following additives to spinal anesthesia will help provide postoperative analgesic properties?

Lidocaine

Bupivicaine

Cocaine

Fentanyl

A

Fentanyl

270
Q

What stage of sleep is characterized by deep, restorative sleep?

Stage 1 NREM

Stage 2 NREM

Stage 3 NREM

REM

A

Stage 3 NREM

271
Q

. A rigid bronchoscope is the preferred type of scope for/if:

The removal of a large foreign body

A difficult intubation is expected

Examination of the lung apices are needed

Visualization of the lower portions of the respiratory tract is required

A

The removal of a large foreign body

272
Q

Which of the following is considered therapeutic bronchoscopy?

BAL

Bronchial samples for C & S

Bronchial toileting -same as lavage

Needle aspiration

A

Bronchial toileting -same as lavage

273
Q

Albumin plays many essential roles in the body. 2 of these roles include:

Maintaining osmotic pressure gradients, and molecular transport

Molecular transport, and metabolizing denatured proteins

Opposing osmotic pressure gradients, and combating liver disease

Maintaining renal output, and supporting molecular transport

A

Maintaining osmotic pressure gradients, and molecular transport

274
Q

The electrolyte most closely tied to cardiac arrhythmias when its level is out of normal range (either too high or low) is:

Sodium

Chloride

Potassium

Hydrogen ion

A

Potassium

275
Q

Assessment of an area of consolidation in the lung would most likely reveal:

Dull percussion

Tracheal deviation

Decreased fremitus

Late inspiratory crackles

A

Dull percussion

276
Q

In which of the following modes of ventilation will effective tidal volume vary the most with changes in patient resistance of compliance?

Pressure-regulated volume control

CMV with autoflow

Volume support

Pressure support

A

Pressure support

277
Q

Aerosol deposition in the distal airways can be improved with:

Deep, slow insp flow breaths

Deep, fast insp flow breaths

Shallow, slow insp flow breaths

Shallow, fast insp flow breaths

A

Deep, slow insp flow breaths

278
Q
A

High airway resistance

279
Q

Exercise training in patients wiht COPD improves:

Exercise capacity

Psychologic state

Pulmonary function

A and B

All of the above

A

A and B

280
Q

Relative Humidity Equation

A

001 Respiratory Therapy (53 decks)

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