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1) 24-year-old male is admitted with a suspected…
1) 24-year-old male is admitted with a suspected drug overdose. The patient is unresponsive and is not breathing A code blue is initiated. resuscitation bag, but the patient’s chest does not rise. Which of the following should a respiratory therapist do FIRST?
A. Switch resuscitation device.
B. Ensure that oxygen is attached to the resuscitation device.
C. Intubate the patient.
D. Reposition the patient’s airway.
2) A patient with a diagnosis of sleep apnea is referred for a CPAP titration study. CPAP is initiated at 4 cm H2O and increased to 10 cm H2O over the first 30-minute period. During the next 30 minutes, the patient experiences three obstructive apnea events and three hypopnea events. Which of the following should a respiratory do?
A. Maintain current CPAP setting.
B. Discontinue testing.
C. Continue CPAP titration.
D. Change to bilevel PAP.
3) On initial assessment of a patient, a respiratory therapist notes bibasilar crackles and peripheral edema. Which of the following clinical condition is most consistent with the findings?
A. pneumonia
B. congestive heart failure
C. COPD
D. deep vein thrombosis
4) An adult patient is admitted to the ICU after undergoing tracheal reconstruction. The patient remains intubated and pharmacologically paralyzed. She is receiving continues mechanical ventilation with an FiO2 of 0.30, and the following ABG analysis results are obtained:
pH 7.50
PCO2 28 mm Hg
PO2 150 mm Hg
HCO3-2 22 mEq/L
BE 0 mEq/L
SO2 (meas) 99%
Hb 14.8 g/dL
A respiratory therapist should recommend
A. administering acetazolamide (Diamox).
B. decreasing the FiO2
C. reducing alveolar minute ventilation.
D. maintaining the current therapy.
5) A physician requests respiratory muscle strength to be evaluated for a 43-year-old with myasthenia gravis. Which of the following equipment should a respiratory therapist obtain?
A. Bourdon gauge
B. Incentive spirometer
C. peak flow meter
D. pressure manometer
6) A respiratory therapist reviews the following blood gas analysis results for a patient receiving 40% oxygen
pH 7.41
PaCO2 38 mm Hg
PaO2 107 mm Hg
HCO3- 24 mEq/L
BE 0 mEq/L
SaO2 (cale) 98%
Pb 760 mm Hg
The alveolar oxygen tension is
A. 237 mm Hg.
B. 285 mm Hg.
C. 130 mm Hg.
D. 107 mm Hg.
7) A respiratory therapist is evaluating a patient 10 hours after a motor vehicle crash. The patient is conscious and agitated. His skin appears pain and is cool time touch. Respiratory rate is 25/min and shallow. Heart rate is 110/min and blood pressure is 95/65 mm Hg. A pulse oximeter is unable to detect an SpO2 or pulse . Which of the following is most important to assess?
A. electrolytes
B. white blood cell count
C. blood alcohol level
D. hemoglobin and hematocrit
8) A 38-year-old patient who underwent an open colon resection 24 hours ago is unable to clear secretions adequately. The following data are available:
Temperature 37° C (98.6° F)
HR 104/min
RR 26/min
O2 2 L/min
SpO2 95%
Pain score 8 (1-10 scale)
Which of the following should a respiratory therapist do NEXT?
A. Add IPPB with a mucolytic to the therapeutic regimen.
B. Provide nasotracheal suctioning every 4 hours and as needed.
C. Recommend fiberoptic bronchoscopy to clear the patient’s airway.
D. Coordinate analgesic administration with cough and deep breathing.
9. A respiratory therapist is reviewing the care plan of a patient diagnosed with COPD. Albuterol pm is ordered. The patient reports using albuterol night time daily and persistent symptoms of shortness of breath and cough. Which of the following should the therapist recommend?
A. Switch to an inhaled corticosteroid.
B. Continue the current therapy.
C. Start a long-acting anticholinergic agent
D. Add a leukotriene modifier.
11. Heliox therapy increases
A. turbulent flow
B. gas viscosity.
C. laminar flow.
D. gas density
12. A respiratory therapist is preparing to provide bag-mask ventilation to a premature neonate following a high-risk delivery. Which of the following should the therapist _______ is available?
A. large-volume aerosol generator
B. oxygen blender
C. air-entrainment adapter
D air and oxygen flowmeters
13. Decreasing which of the following settings will reduce the mean airway pressure during pressure-limited, time-cycled mechanical ventilation?
A. FiO2
B. sensitivity
C. PEEP
D. expiratory time
14. During mechanical ventilation of a patient with COPD, a respiratory therapist observes the following flow-volume loop
Which of the following ventilator settings should the therapist increase?
A. mandatory rate
B. mandatory tidal volume
C. Inspiratory time %
D. inspiratory flow
15. A 71-year-old woman is admitted to the hospital with shortness of breath, orthopnea, and bibasilar crackles. Which of the following is the most helpful for patient’s condition?
A. peak flow
B. electrolytes
C. Holter monitor
D. intake and output
16. A patient who is post-CABG is receiving incentive spirometry and complains of moderate pain during inspiration. Which of the following should a respiratory therapist recommend?
A. Change to IPPB therapy.
B. Splint the incision during therapy.
C. Administer oxygen during therapy
D. Obtain an ECG.
17. Which of the following radiographic findings is most characteristic of tuberculosis?
A. upper lobe cavitation’s
B. silhouetting of the left diaphragm
C. increased retrosternal air
D. bilateral lower lobe pulmonary edema
18. A patient receiving NPPV with IPAP 10 cm H2O and EPAP 5 cm H2O has the following ABG analysis results
PH 7.30
PCO2 58 mm Hg
PO2 85 mm Hg
HCO3- 29 mEq/L
BE +1 mEq/L
SO2(calc) 96%
Which of the following pressure settings will most likely correct the problem?
IPAP EPAP
(cm H2O) (cm H2O)
1. 7 2
2. 10 8
2. 12 7
3. 15 5
A. 3
B. 4
C. 2
D. 1
19. A 173-cm (5-ft 8-in), 65-kg (143-lb) female with resolving ARDS is receiving VC, A/C ventilation. The following data are observed
FIO2 0.40
Mandatory rate 10
Total rate 15
VT 450 mL
PEEP 15 cm H2O
PIP 28 cm H2O
Pplateau 24 cm H2O
SpO2 97%
Which of the following should a respiratory therapist do NEXT?
A. Initiate PC ventilation.
B. Increase the VT.
C. Decrease the PEEP.
D. Perform an SBT.
20. The proper administration of oxygen to a patient with chronic emphysema with hypoxemia may increase
A. red blood cell count.
B. pulmonary vascular resistance.
C. exercise tolerance.
D. PaCO2
21. A respiratory therapist is called to the bedside of a patient whose low-pressure alarm is sounding. The therapist observes the following data while the patient is receiving VC SIMV
Mandatory rate 12
VY 600 mL
Exhaled VT 590 mL
High pressure alarm limit 30 cm H2O
Low pressure alarm limit 22 cm H2O
PIP 20 cm H2O
PS 10 cm H2O
PEEP 5 cm H2O
Which of the following should the therapist do?
A. Change PS to 20 cm H2O.
B. Decrease the low-pressure limit to 10 cm H2O.
C. Replace the ventilator circuit.
D. Adjust the tidal volume to 700 mL
22. Which of the following devices can be used to measure tidal volume and vital capacity for a patient receiving
A. pressure manometer
B. peak flow meter
C. dosimeter
D. respirometer
23. A respiratory therapist is preparing to obtain an ABG sample from a patient who is positive for HIV. Which of the following types of precaution should a respiratory therapist use?
A. standard
B. droplet
C. contact
D. airborne
24. A patient is being weaned from mechanical ventilation. Which of the following is the best rationis for postponing extubating?
A. vital capacity of 1.1 L
B. MIP of -28 cm H2O
C. RSBI of 80
D. P(A-a)O; of 300 mm Hg
25. A respiratory therapist is asked to assist a physician in performing a tracheostomy at the bedside Immediately after the tube is inserted and cuff is inflated the therapist identifies subcutaneous emphysema and increased airways resistance with manual ventilation. Which of the following should be suspected?
A. mainstem tube placement
B. obstruction from mucus plugs
C. misplaced tracheostomy tube
D. tracheoesophageal fistula
26. A patient who underwent an emergency tracheotomy was decannulated and discharged home. Six weeks later, the patient presents to an outpatient clinic for increased hoarseness, cough, and shortness of breath on exertion. Which of the following should a respiratory therapist recommend?
A. Obtain the flow-volume loop
B. Initiate cool aerosol therapy.
C. Measure the diffusing capacity.
D. Start bronchodilator therapy
27. The following pulmonary function test result is observed
Which of the numbered lines above represents tidal volume?
A. .4
B. 7
C. 1
D. 5
28. The bottom of an infant’s left heel is represented by the figure below
Image transcription text
OoOOO
From which locations can a puncture for a capillary blood sample be taken?
A. 1 or 3 only
B. 1 or 2 only
C. 2 or 3 only
D. 1, 2, or 3
30. Which of the following types of isolation should be used for a patient suspected of having pertussis?
A. reverse
B. droplet
C. airborne
D. contact
31. A 178-cm (5-t 10-in), 80-kg (176-lb), 32-year-old male patient experiencing an asthma exacerbation is sedated and VC ventilation is initiated. The following are noted
8:00 AM 8.05 AM
Mandatory rate 15 15
VT 600 mL 600 mL
PEEP 5 cm H2O 5 cm H2O
Peak flow 45 L/min 45 L/min
PIP 50 cm H2O 60 cm H2O
Which of the following should a respiratory therapist conclude caused this change?
A. decreasing bronchospasm
B. pulmonary hypertension
C. pulmonary embolism
D. Increasing auto-PEEP
32. Insertion of an endotracheal tube into the trachea is best verified by direct visualization of which of the following structures?
A. epiglottis
B. vocal cords
C. carina
D. base of the tongue
33. A 27-week gestational age neonate is receiving 28% oxygen by nasal cannula at 1 L/min using an air-oxygen blender. The pr SpO2 of 82%. Which of the following is the most appropriate action to improve oxygenation?
A. Initiate HFOV
B. Intubate and mechanically ventilates
C. Increase the FiO2 to 0.32
D. Change to an oxygen hood at 4 L/min.
34. A male patient who is 183 cm (6 ft) tall and weighs 80 kg (176 fb) is receiving PRVC, A/C ventilation after emergent intubation for pulmonary edema. The following date are collected after initiation of mechanical ventilation with a mandatory rate of 10
0800 1200 1600 2000
FIO2 1.00 0.70 0.50 0.40
Total rats 18 16 13 12
PIP (cm H2O) 20 18 15 12
Exhaled Vt (mL) 500 510 495 500
PEEP 10 10 8 5
Which of the following actions should the respiratory therapist recommend?
A. Evaluate waveforms for the presence of auto-PEEP
B. Perform a spontaneous breathing trial.
C. Change to SIMV mode.
D. Decrease the mandatory rate to 8.
35. Given a normal pH, a pulse oximeter reading of 90% correlates with a PaO2 of approximately
A. 80 mm Hg
B. 100 mm Hg.
C. 40 mm Hg
D. 60 mm Hg
36. A 27-week gestational age neonate is receiving 28% oxygen by nasal cannula at 1 L/min using an air-oxygen blender. The patient has an HR of 155 min. and SpO2 of 82%. Which of the following is the most appropriate action to improve oxygenation?
A. Initiate HFOV
B. Intubate and mechanically ventilate
C. Increase the FiO2 to 0.32
D. Change to an oxygen hood at 4 L/min.
37. A patient with COPD is receiving VC ventilation. The flow-time graph does not return to 0 L/min before the next mandatory breath begins A respiratory therapist should recommend increasing the
A. expiratory time.
B. Inspiratory time.
C. tidal volume
D. minute ventilation
Please explain your answers
