TMC A/B

A patient has been diagnosed with sarcoidosis. Which of the following pulmonary function tests would best evaluate the degree of impariement?

A.) FEV1

B.) MVV

C.) VC

D.) FEF25-75

C

A patient has been receiving incentive spirometry therapy for the treatment of atelectasis. Which of the following would indicate improvement in the patient's condition?

A.) Increased crackles

B.) Vesicular breath sounds

C.) Decreased rhonchi

D.) Decreased wheezes

B

A patient is receiving VC, A/C in the intensive care unit. If the inspiratory phase of ventilation ends when a preset value for normal has been reached, which of the following variables is being controlled?

A.) Baseline variable

B.) Trigger variable

C.) Limit variable

D.) Cycle variable

D

Vascular markings on a chest radiograph are absent and the lung parenchyma is black. This would indicate:

A.) Congestive heart failure

B.) Overexposed film

C.) Pneumoconioisis

D.) Underexposed film.

B

A patient is receiving aerosolized oxygen therapy via a T-piece (Briggs' adaptor) in the emergency department. The patient has asymetrical chest movement with the left side rising while the right side falls. Which of the following should be considered the most likely reason for this breathing pattern?

A.) Pneumothorax

B.) Right main-stem intubation

C.) Flail Chest

D.) Bilateral pneumonia

C

Which of the following is equivalent to total lung capacity?

A.) VC + RV

B.) IC + RV

C.) IRV + Vt + ERV

D.) VC + FRC

A

For patients on mechanical ventilation, which of the following does NOT contribute to an elevated PaCO2?

A.) High glucose intake

B.) Sever intrapulmonary shunt

C.) Increased deadspace ventilation

D.) Fever

B

Vesicular breath sounds are auscultated with which of the following?

A.) Atelectasis

B.) Normal lungs

C.) Pneumonia

D.) Pulmonary edema

B

Severe internal hemorrhaging occurs during a fiberoptic bronchoscopy procedure. The respiratory therapist should recommend:

A.) Administration of 4% lidocaine via nebulizer

B.) Bronchial lavage with normal saline

C.) Application of epinephrine via bronchoscope

D.) Anesthesia using cetocaine solution

C

Mild swelling occurs following extubation of a patient. Which of the following treatment modalities would the respiratory therapist recommend?

A.) Suctioning

B.) Endotracheal intubation

C.) Cool aerosol therapy

D.) Nebulized racemic epinephrine

C

During the first day after birth a 34-week gestation neonate, transcutaneous monitoring indicates a PtCO2 of 65 torr for the right-upper quadrant and PtCO2 of 38 torr for the left-lower quadrant. The respiratory therapist should recommend

A.) A chest radiograph

B.) Administration of idomethecin

C.) Surgical repair of PDA

D.) Mechanical ventilation

B

A patient is being monitored in the cardiovascular intensive care unit following coronary arterial bypass surgery. Chest tubes are in place and the patient's vital signs have been stabilized. A routine check of the ventilator indicates that the average exhaled tidal volume is 150 mL below the set tidal volume. Which of the following is the most likely cause of this problem?

A.) Auto-PEEP

B.) Pleural leak

C.) Increased deadspace

D.) Air trapping

B

A 54-year-old man has been maintained on mechanical ventilation for several days in the ICU. The following data is available for morning arterial blood gases: Ph (7.54), PaCO2 (29 torr), PaO2 (43 torr), HCO3 (24 mEq/L). Which of the following should be recommended

A.) decrease the tidal volume

B.) Initiate weaning procedures

C.) Decrease the mandatory rate

D.) Increase the FiO2

D

A pleural fluid sample has been drawn by thoracentesis for examination and laboratory analysis. The sample is purulent with a Ph of 7.27. Which of the following disease processes should be rules out by these results?

A.) Liver cirrhosis

B.) Tuberculosis

C.) Lung abscess

D.) Sarcoidosis

A

A heat and moisture exchanger (HME) is being used to provide humidification for a patient receiving VC, SIMV. During a routine ventilator check there is a sudden increase in peak inspiratory pressures and the HME insert contains deposits of thick white mucus. Which of the following should be done next?

A.) Convert to a wick humidifier system

B.) Suction the patient

C.) Replace the HME

D.) Recommend a chest radiograph

C

An adult male patient is admitted to the hospital with Kartagener's syndrome. He complains of fatigue and shortness of breath. A foul smelling sputum sample is obtained that separates into three distinct layers. This type of sputum is most likely produced in patients with

A.) Bronchiectasis

B.) Tuberculosis

C.) Emphysema

D.) Pneumonia

A

A 35-year-old asthmatic patient with chronic rhinitis complains of severe headache. Which of the following medications should be recommended

A.) Aspirin

B.) Acetylcysteine (Mucomyst)

C.) Acetaminophen (Tylenol)

D.) Cromolyn Sodim (Intal)

C

Twenty minutes following intubation and placement of high-frequency oscillatory ventilation (HFOV) of a 26-week gestation newborn, the following data is obtained: Pulse (170), BP (55/53), Ph (7.23), PaCO2 (67), PaO2 (60), HCO3 (27). Which of the following should be recommended:

A.) Decrease mean airway pressure (MAP)

B.) Place on pressure-controlled ventilation

C.) Increase oscillatory pressure amplitude (AP)

D.) Wean FiO2 as tolerated

C

The following data is obtained during pulmonary function testing for a patient scheduled for surgery: FEV1 84% of predicted value FVC 58% of predicted value. These results are indicative of:

A.) Obstructive disease

B.) Restrictive disease

C.) Normal lung function

D.) Combined obstructive and restrictive disease

B

A patient brought to the emergency room is lethargic and breathing shallowly. The patient has a history of COPD and is receiving oxygen via nasal cannula at 4 L/min. Which of the following should the respiratory therapist recommend?

A.) Intubation and mechanical ventilation

B.) Chest radiograph

C.) Aerosolized bronchodilator treatments

D.) Arterial blood gas analysis

D

A 35-week gestation female has been delivered via cesarean section and placed on a radiant warmer. Which of the following should be done next?

A.) Dry the skin and remove wet linens

B.) Assess heart rate

C.) Open and clear the airway

D.) Apply PPV

C

A patient has been orally intubated with an endotracheal tube having an internal diameter of 9.0 mm. Which of the following catheter sizes would be most appropriate for the suctioning of this patient?

A.) 10 Fr

B.) 12 Fr

C.) 16 Fr

D.) 18 Fr

B

(9/2) * 3 = 13.5

Which of the following tests is most appropriate in evaluating a victim rescued from a burning building?

A.) Cardiac enzymes

B.) SpO2

C.) FEV1

D.) Carboxyhemoglobin

D

In the processing of hospital equipment, which of the following rapidly kills spores?

A.) Ethyl alcohol

B.) Peracetic acid

C.) Hydrogen peroxide

D.) Pasturization

B

A patient in the ICU is receiving VC, SIMV. Arterial blood gas analysis indicated an elevated PaCO2. Which of the following should be recommended?

A.) Decrease tidal volume

B.) Increase pressure support

C.) Decrease PEEP

D.) Increase inspiratory flow

B

While doing a ventilator check for a patient in the ICU, a short run of ventricular tachycardia is observed on the cardiac monitor. Which of the following should be recommended initially?

A.) Defibrillation

B.) Epinephrine

C.) Lidocaine

D.) Cardioversion

C

Trendelenburg positions for CPT should be avoided for patients hospitalized for which of the following?

A.) Cardiovascular surgery

B.) Stroke (CVA)

C.) Cystic Fibrosis

D.) Hip replacement surgery

B

An arterial sample of blood containing air bubbles has been drawn from a patient breathing room air. Expected errors in analysis should include which of the following?

A.) Decreased Ph, increased PaCO2, Increased PaO2

B.) Increased Ph, decreased PaCO2, Decreased PaO2

C.) Decreased Ph, increased PaCO2, Decreased PaO2

D.) Increased Ph, decreased PaCO2, Increased PaO2

D

Nursing asks for a bronchodilator treatment via SVN with 2.5 mg Albuterol (Ventolin) in 3 mL normal saline for a post-operative patient on the surgical floor. Which of the following should be done first?

A.) explain planned therapy and goals to the patient

B.) Review the patients chest radiograph

C.) Confirm the physicians order in the patients chart

D.) Determine patients oxygenation status using pulse oximetry

C

A mother is sewing buttons on a shirt when she accidentally spills her jar of buttons on the floor where her two-year-old daughter with a history of asthma is playing. An hour later, she observes her child wheezing audible and coughing. The mother quickly takes her child to the emergency department of a nearby hospital. The patient is short of breath and respirations are elevated. Auscultation indicated wheezing over the right lung only. Which of the following should be recommended?

A.) Bronchodilator treatments

B.) Cool aerosol mist

C.) Endotracheal intubation

D.) Fiberoptic bronchoscopy

D

The most severe complication of airway suctioning is which of the following?

A.) Hypoxemia

B.) Atelectasis

C.) Bradycardia

D.) Mucosal trauma

A

Laboratory analysis of a patient's electrolytes has the following results: Na+ (125), K+ (4.0), Glucose (90) BUN (12). These values indicate which of the following disorders?

A.) Hyperkalemia

B.) Renal failure

C.) Hyponatremia

D.) Diabetes

C

When applying supplemental oxygen during resuscitation of the newborn in the delivery room, a SpO2 of 85% to 90% should be the target after

A.) 2 minutes

B.) 3 minutes

C.) 5 minutes

D.) 10 minutes

D

Arterial blood gas analysis for a patient recieving mechanical ventilation in the ICU indicates the following: Ph (7.42), PaCO2 (38), PaO2 (125). Which of the following should be recommended at this time?

A.) Increase the tidal volume

B.) Decrease the FiO2

C.) Maintain current settings

D.) Increase deadspace

C

A patient is receiving mechanical ventilation with settings as follows: tidal volume 650 mL, PEEP 5 cmH2O, flow rate 60 L/min. During successive ventilator checks, the following parameters are recorded: 2:00 PM Peak inspiratory pressure 35 CmH2O, plateau pressure 25 cmH2O 4:00 PM Peak inspiratory pressure 45 cmH2O, plateau pressure 35 cmH2O. This data BEST indicates that

A.) Airway resistance has decreased

B.) Lung compliance has increased

C.) Airway resistance has increased

D.) Lung compliance has decreased

D

Which of the following diagnostic tests would be MOST useful in detecting the presence of a pleural effusion?

A.) Lateral decubitus chest radiograph

B.) Arterial blood gas analysis

C.) Forced vital capacity

D.) Ventilation scan

A

A patient with asthma in the outpatient department describes his disease symptom frequency as 3 to 4 days per week. This patient's level of impairment would be best classified as which of the following?

A.) Intermittent

B.) Moderate

C.) Persistent

D.) Severe

C

Bedside pulmonary function testing for a patient with Guillian-Barre syndrome indicated a tidal volume of 150 mL, Vital capacity of 400 mL, and a maximum inspiratory pressure of -16 cmH2O. Arterial blood gas results are as follows: Ph (7.29), PaCO2 (58), PaO2 (47), HCO3 (27). Based on this data, recommended action at this time should be

A.) Application of 100% NRB mask

B.) Intubation and mechanical ventilatory support

C.) CPAP via mask

D.) PEP therapy

B

Arterial blood gas analysis for a patient admitted to the emergency department indicate the following: Ph (7.56), PaCO2 (36), PaO2 (89), HCO3 (31). Which of the following should be recommended?

A.) IV administration of sodium bicarbonate

B.) Diuretic therapy

C.) IV administration of potassium chloride

D.) Supplemental oxygen

C

Hyperventilation and moderate hypoxemia develops after a patient has been placed on VC,SIMV. Which of the following should be recommended?

A.) Decrease mandatory rate

B.) Decrease tidal volume

C.) Increase the FiO2

D.) Add deadspace to the ventilator circuit

C

Following a bronchodilator treatment, the FEV1 for a COPD patient in the outpatient department is measured as 77% of predicted. This patients decreased airflow severity would be classified as

A.) Mild

B.) Moderate

C.) Severe

D.) Very severe

B

Oral inspection of the airway reveals that only the base of the uvula is visible. Which Mallampati classification is indicated?

A.) I

B.) II

C.) III

D.) IV

C

Fine crackles are heard on auscultation of a patient admitted to the hospital. These breath sounds are most closely associated with

A.) Emphysema

B.) Pulmonary Edema

C.) Asthma

D.) Pneumothorax

B

The following arterial blood gas results are obtained for a patient receiving VC, SIMV: Ph (7.33), PaCO2 (47), PaO2 (80), HCO3 (24). Which of the following ventilator changes would be appropriate?

A.) Decrease the mandatory rate

B.) Increase the flow rate

C.) Increase the FiO2

D.) Reduce deadspace

D

Blunting of the costaphrenic angle on the chest radiograph is characteristic of

A.) pulmonary edema

B.) Atelectasis

C.) Pulmonary emboli

D.) Pleural effusion

D

Following intubation of a male patient in the emergency department, his breath sounds are clearly audible to auscultation on the right but markedly decreased on the left. Which of the following should be done next?

A.) repositioning of ETT

B.) Extubation

C.) Arterial blood gas analysis

D.) Chest radiograph

A

An intubated patient weaned from mechanical ventilation becomes agitated and confused. Vital signs show marked increases in both heart rate and blood pressure. The patient has a low-grade fever and his respiratory rate is 32 breaths per minute. Which of the following should be recommended?

A.) Maintenance of current therapy

B.) Reassurance and calming of the patient

C.) Reinstitution of mechanical ventilation

D.) Extubation

C

The effectiveness of bronchodilator therapy is best assessed with which of the following?

A.) Auscultation of breath sounds

B.) Pulse oximetry

C.) Arterial blood gas analysis

D.) PEFR before and after treatment

D

A nonrebreathing mask is being used to deliver a 80/20 mixture of helium-oxygen to a COPD patient. The respiratory therapist notices that the reservoir bag on the mask completely collapses on inspiration. Which of the following actions should mostly likely resolve this problem?

A.) tightening the mask seal on the patient

B.) Removal of the on-way valves from the face mask

C.) Increasing the flowrate of the helium-oxygen mixture

D.) Conversion to a 70/30 mixture of helium-oxygen

C

When considering the differential diagnosis between OSA (Obstructive sleep apnea) and OHS (obesity-hypoventilation syndrome), which of the following occurs while the patient is awake?

A.) OSA patients will show high PaCO2 values

B.) OHS patients will show normal PaCO2 values

C.) OSA patients will show low PaCO2 values

D.) OHS patients will show high PaCO2 values

D

Tiamcinolone (Azmacort) is used in the treatment of asthma to

A.) Enhance mast cell release

B.) Mobilize secretions

C.) Decrease response to inflammation

D.) Reverse bronchospasm

C

In an emergency, the airway of choice for a patient with cervical spine injuries is which of the following?

A.) Oral endotracheal tube

B.) Nasal endotracheal tube

C.) Tracheostomy tube

D.) Lukens tube

B

Which of the following disorders is most closely associated with a breathing pattern that has an irregular rhythm with an increased rate and depth?

A.) Drug overdose

B.) Head trauma

C.) Diabetic keto-acidosis

D.) CHF

C

Quality control procedures are completed on a thermistor. Observed readings correspond to the actual flow rates for both low and high flow but are erroneously higher than actual for the mid-range flows. These results suggest a problem with

A.) Linearity

B.) Accuracy

C.) Inertia

D.) Precision

A

A COPD patient is receiving VC, A/C ventilation. His total respiratory rate is 28/min and there is evidence of air trapping. The respiratory therapist should recommend which of the following?

A.) PC ventilation

B.) Sedation

C.) SIMV

D.) Inspiratory hold

B

During a routine ventilator check on a patient in the cardiovascular intensive care unit, the cardiac monitor shows a pulmonary arterial pressure (PAP) of 24/9 mm Hg. This is an indication of which of the following?

A.) Pulmonary disorder

B.) Excessive PEEP

C.) Cardiac disorder

D.) Normal PAP

D

A 56-year-old patient has been admitted to the medical floor for exacerbation of COPD. During assessment, the patient says that his breathing is better when seated upright and worsens if he attempts to lay down. These symptoms indicate

A.) Orthopnea

B.) Dyspnea

C.) Apneusis

D.) Hyperpnea

A

After an appendectomy, a patient has been extubated and placed on a cool aerosol mask, FiO2 0.40. Blood gas results indicate: Ph (7.47), PaCO2 (34), PaO2 (46), HCO3 (24). The patients respirations are shallow and 30/min. Which of the following should be recommended?

A.) 100% non-rebreathing mask

B.) reintubation followed by VC, SIMV

C.) Incentive spirometry

D.) NPPV

D

Which of the following tests would BEST determine the presence and degree of progression of emphysema?

A.) Vital capacity

B.) Maximum inspiratory pressure (MIP)

C.) Arterial blood gas analysis

D.) FEV1

D

A 67-year-old male patient with congestive heart failure is found stuporous. A nasal cannula at 2 L/min is in place. The patients skin is cold and clammy, respirations are 6/min and shallow, and pulse is weak and difficult to obtain. Which of the following should be done first?

A.) Check oxygenation status with pulse oximetry

B.) Recommend a chest radiograph

C.) Obtain an arterial blood gas for analysis

D.) Alert the medical emergency team

D

A patient being mechanically ventilated has an elevated PaCO2. To remedy this problem, the respiratory therapist should increase

A.) mechanical deadspace

B.) PEEP

C.) Pressure support

D.) FiO2

C

COPD is characterized by which of the following?

A.) decreased volumes

B.) Increased airway resistance

C.) Decreased compliance

D.) Increased flows

B

Deep breathing and coughing exercises using an incentive spirometry device is indicated for a patient with

A.) tuberculosis

B.) A pleural effusion

C.) Atelectasis

D.) Head trauma

C

New orders have been written in a patients chart for the administration of an aerosolized breathing treatment with 2.5 mL Albuterol (Ventolin) in 2.5 mL normal saline, QID. Which of the following should the respiratory therapist do?

A.) Administer the treatment as ordered

B.) Confirm the orders with the patients nurse

C.) Increase the dilutent in the medication cup

D.) Clarify the treatment orders with the physician

D

Which of the following may be seen with dehydration?

A.) Hyponatremia

B.) Pedal edema

C.) Poor skin turgor

D.) Jugular venous distention

C

A patient being treated in the emergency department complains of shortness of breath and is diaphoretic. Her pulse is 136/min, blood pressure 140/95 mm Hg, and respiratory rate 30/min. Palpation reveals tracheal deviation to the patients left. Which of the following should be considered as a possible cause of this patients condition?

A.) Left basilar pleural effusion

B.) Right sided diaphragmatic paralysis

C.) Right lobar tumor

D.) Left pneumothorax

C

A "signet ring" pattern has been noted on a CT scan for a patient admitted to the hospital with severe shortness of breath. Which of the following diseases is indicated?

A.) Pulmonary fibrosis

B.) Bronchiectasis

C.) Emphysema

D.) Pulmonary edema

B

A patient admitted to the medical floor complains of shortness of breath. Vital signs are as follows: Pulse 120/min, RR 28/min, BP 142/92 mmHg, temp 99.5F (37.5C). During the patient interview, the respiratory therapist notices that the patient is anxious, shows confusion and is disoriented. Which of the following diagnostic procedures should be done NEXT to further assess this patinet?

A.) Serum electrolytes

B.) Chest radiograph, stat

C.) Electrocardiogram (ECG)

D.) Arterial blood gas analysis

D

Following endotracheal intubation of a patent in the emergency department, end-tidal CO2 levels rise sharply during end expiration and auscultation of the chest shows markedly diminished breath sounds on the left side. Which of the following should be considered?

A.) Esophageal intubation

B.) Lung collapse on the right side

C.) Intubation within the right mainstem bronchus

D.) Pleural effusion on the left side

C

The following data is available for a patient receiving mechanical ventilatory support in the ICU: Ventilating parameters: Assist/control, Rate 16/min, Vt 650 mL, FiO2 50%, PEEP 5 cmH2O. Arterial blood gas results: Ph (7.42), PaO2 (85), PaCO2 (39) Hemodynamic measurements: PCWP 18 mm Hg, Cardiac output 2.9 L/min. Based on these findings, what would be the most appropriate recommendation?

A.) Increase PEEP

B.) Increase flowrate

C.) Decrease RR

D.) Increase inspiratory time%

B

A patient is receiving VC, A/C ventilation in the ICU. While ventilating parameters for rate and volume are appropriate, the PaO2 obtained by arterial blood gas analysis is below 60 torr on an FiO2 greater than 0.60. Which of the following actions should the respiratory therapist recommend FIRST to improve the patients oxygenation status?

A.) Increase the FiO2

B.) Initiate HFV

C.) Change to PC ventilation

D.) Increase PEEP setting

D

Arterial blood gas results for a patient breathing room air yield the following data: Ph (7.38), PaCO2 (64), HCO3 (31). These results indicate:

A.) Acute respiratory alkalosis with moderate hypoxemia

B.) Uncompensated metabolic acidosis with severe hypoxemia

C.) Chronic respiratory acidosis with mild hypoxemia

D.) Acute hypercapnic respiratory failure with moderate hypoxemia

C

A patient with end stage emphysema is being mechanically ventilated in the ICU. At an FiO2 of 0.80, the following data is available: Ph (7.37), PaCO2 (55), PaO2 (43), HCO3 (31). The BEST therapeutic response would be to increase

A.) PEEP

B.) Mandatory rate

C.) FiO2

D.) Inspiratory flow rate

C

A patient has been placed on a cool aerosol mist via T-piece, FiO2 0.40. Nursing complains that they often find the T-piece dislodged from the patients tracheostomy tube. The respiratory therapist should

A.) Tape the T-piece to the tracheostomy tube

B.) Replace the T-piece with a tracheostomy collar

C.) Sedate the patient

D.) Apply wrist restraints

B

The following data is available for successive ventilator checks for a COPD patient receiving mechanical ventilatory support: 6:00 AM SpO2 96%, PIP 36, Plat 29. 8:00 AM SpO2 97%, PIP 34, Plat 28. 10:00 AM SpO2 84%, PIP 49, Plat 41. The ventilator settings have remained unchanged during this period. Which of the following should the respiratory therapist do fist?

A.) Suction the patient

B.) Administer a bronchodilator treatment

C.) Check cuff pressure

D.) Increase the FiO2 to 100%.

D

A 34-week gestational female has been delivered via cesarean section. As the respiratory therapist assisting, which of the following should be done next?

A.) Initiate PPV

B.) Open and clear the airway

C.) Place in infant with mother

D.) Place under radiant warmer

D

A patient in the ICU has been intubated following a cardiac arrest. The capnometry device used to verify tracheal intubation by producing a color changes gives a negative result. Which of the following should the respiratory therapist recommend FIRST?

A.) Remove the tube and reintubate

B.) auscultate, listening for equal, bilateral breath sounds

C.) Confirm tube placement with a chest radiograph

D.) Secure the tube with tape

B

A fireman, overcome by smoke, is being resuscitated in the emergecy room. Which of the following would provide the BEST evaluation of his oxygenation status?

A.) Pulse oximetry

B.) ABG assessment of PaO2

C.) Mass spectrometry

D.) Hemeoximetry

D

Ventilatory status is best evaluated with assessment of:

A.) PaO2

B.) VC

C.) PaCO2

D.) C(a-v)O2

C

A patient is receiving nasal oxygen therapy in his home at 2 L/min. He complains that his concentrator does not appear to be working properly as he doesn't feel any oxygen flow through the cannula. The respiratory therapist should FIRST:

A.) Change the bacteria filter

B.) Place the patient on the back-up oxygen cylinder system

C.) Place the nasal cannula in water to check for bubbles

D.) Increase the flowrate to 4 L/min

C

A patient has been receiving CPT and postural drainage for the treatment of right-lower lobe crackles. Following three days of therapy, vesicular breath sounds are auscultated throughout. Which of the following should be recommended?

A.) Use of a flutter valve

B.) Discontinuing therapy

C.) Administration of IV diuretics

D.) Continuing current therapy

B

Which of the following is adjusted to control oxygenation for a patient on HFOV?

A.) Bias flow

B.) Oscillatory pressure amplitude

C.) Mean airway pressure

D.) Frequency

C

Airflow around a patient's endotracheal tube and gurgling at the mouth is heard during a ventilator check. Which of the following is indicated?

A.) Cuff leak

B.) Biting on the tube by the patient

C.) Mucus plugs causing tube obstruction

D.) Cuff herniation

A

A patient receiving mechanical ventilatory support in the ICU. If the inspiratory phase of ventilation ends when a preset value for volume has been reached, which of the following variables is being controlled?

A.) Baseline variable

B.) Trigger variable

C.) Limit variable

D.) Cycle variable

D

Vital capacity is the

A.) Maximum volume of gas that may be inhaled following normal, quiet exhalation.

B.) Maximum volume of gas that may be breathed in 1 minute.

C.) Maximum volume of gas that may be exhaled following a maximum inhalation

D.) Volume of gas that remains in the lungs after a maximal exhalation

C

A patient in the cardiovascular ICU is being weaned from VC, SIMV. Ventilating parameters are: Mandatory rate 6, tidal volume 600 mL, FiO2 0.40, PEEP 5. The patients MIP is -30 cmH2O. Total respiratory rate is 26/min and minute volume is 5.2 L. Arterial blood gas analysis indicates the following: Ph (7.45), PaCO2 (34), PaO2 (94), HCO3 (23). The respiratory therapist should

A.) Place on CPAP, FiO2 0.40

B.) Add 5 cm PSV

C.) decrease the mandatory rate to 4.

D.) Decrease the FiO2 to 0.30

B

A patient is being transported from the emergency department to the medical floor. An E-cylinder fitted with a Bourdon guage is being used to deliver oxygen via nasal cannula at 4 L/min. During transport, an outlet restriction causes back pressure on the guage. This will result in

A.) unaffected flowrate readings

B.) an indicated flowrate higher than exists

C.) The pressure indicator falling to zero

D.) an indicated flowrate lower than exists.

B

A 74 kg (160 lb) male patient is intubated and being ventilated using 100% bag-valve resuscitator following cardiac arrest. With restoration of cardiac and respiratory functions, the patient has been transferred to the ICU. The physician has ordered placement on VC ventilation. Which of the following ventilator settings should be recommended?

A.) SIMV, mandatory rate 10, tidal volume 750 mL, FiO2 0.40, PEEP 10 cmH2O.

B.) A/C, mandatory rate 12, tidal volume 600 mL, FiO2 1.0, PEEP 5 cmH2O.

C.) SIMV, mandatory rate 10, tidal volume 450 mL, FiO2 1.0, PEEP 3 cmH2O.

D.) A/C, mandatory rate 12, tidal volume 850 mL, FiO2 0.40, PEEP 5 cmH2O

B

The I:E ratio alarm is sounding with each mandatory breath being delivered to a head trauma patient receiving mechanical ventilation in the assist-control mode. The patient has no inspiratory effort. Changes to which of the following ventilator changes would affect this alarm parameter?

1. mandatory rate

2. Tidal volume

3. Inspiratory flow rate

4. Sensitivity

A.) 1, 3, 4

B.) 1, 2, 3

C.) 2, 3, 4

D.) 1, 2, 4

B

Which of the following diseases will cause a decrease in the diffusing capacity of the lungs?

A.) Emphysema

B.) Chronic bronchitis

C.) Bronchiectasis

D.) Asthma

A

The most common problem encountered with PEP therapy is

A.) Patient fatigue

B.) Pulmonary barotrauma

C.) Increased ICP

D.) Air swallowing and regurgitation

A

A patient is receiving 4 LPM nasal oxygen. The patient's SpO2 is 94%. Which of the following should be done next?

A.) Discontinue oxygen therapy

B.) Recheck SpO2 on room air

C.) Decrease oxygen flowrate to 2 LPM

D.) Increase oxygen flowrate to 6 LPM

C

A patient with asthma presents in the emergency department with shortness of breath, and severely diminished breath sounds are auscultated. Following administration of an aerosolized bronchodilator, breath sounds reveal loud, scattered wheezes. This would indicate the patients condition is:

A.) Worse

B.) unchanged

C.) better

D.) normal

C

The variable that ends the inspiratory phase with VC, A/C is

A.) pressure

B.) time

C.) volume

D.) flow

C

A 37-week gestation female infant has been placed under an oxyhood, FiO2 0.35. Capillary blood gases show the following results: Ph (7.35), PaCO2 (47), PaO2 (40), HCO3 (25). Which of the following should be recommended?

A.) Increase the FiO2

B.) Place on mechanical ventilation

C.) Administer 3 cm nasal CPAP

D.) Decrease the FiO2

A

Which of the following indicates readiness for weaning from mechanical ventilation?

A.) PaCO2 = 33 torr

B.) Shallow breathing index = 155

C.) MIP = -25 cmH2O

D.) P(A-a)O2 = 400 torr

C

Arterial blood gas results for a patient receiving supplemental oxygen via a 40% air-entrainment mask are as follows: Ph (7.49), PaCO2 (31), PaO2 (52), HCO3 (23). Based on this data, which of the following should be recommended?

A.) 100% NRB

B.) intubation and mechanical ventilation

C.) Mast CPAP

D.) Diazepam (Valium)

A

Arterial blood gas analysis is ordered for a patient receiving mechanical ventilation in the ICU. The results are as follows: Ph (7.47), PaCO2 (29), PaO2 (57). Which of the following should be recommended?

A.) Increasing the tidal volume

B.) Decreasing the mandatory rate

C.) Decreasing the deadspace

D.) Increasing the FiO2

D

Air leaks at the sensor site of a transcutaneous monitor will cause which of the following erroneous values?

A.) Low PtcO2, high PtcCO2

B.) high PtcO2, high PtcCO2

C.) high PtcO2, low PtcCO2

D.) low PtcO2, low PtcCO2

C

Which of the following devices provides 100% humidity at body temperature?

A.) passover humidifer

B.) Bubble-diffusion humidifer

C.) Jet nebulizer

D.) Wick humidifier

D