Comprehensive Respiratory and Critical Care Knowledge Quizlet

What is the most appropriate treatment for a diaphoretic patient with an axillary temperature of 102 F?

Morphine

Antibiotics

Positive inotropic agents

Diuretics

Antibiotics

What is the most appropriate treatment for a diaphoretic and hypoxemic patient with an axillary temperature of 102 F?

Antibiotics

Positive inotropic agents

Oxygen

Diuretics

Oxygen

What should the therapist recommend first for a patient with peripheral edema, diaphoresis, and a Spo2 of 87%?

Diuretics

Oxygen

Positive inotropic agents

Antibiotics

Oxygen

What condition is likely in a patient with acute onset of shortness of breath, diaphoresis, fine crackles in lung bases, and a temperature of 98.8?

Pleural effusion

Pneumothorax

Congestive heart failure

Pneumonia

Congestive heart failure

What is the most likely respiratory pattern of a patient with a history of diabetes who is breathing fast and deep?

Tachypnea

Kussmauls

Cheyne-Stokes

Biots

Kussmauls

What is increased accessory muscle use most often due to?

Poor cardiac output

Increase lung compliance

Hyperventilation

Increased airway resistance

Increased airway resistance

What would a patient with multiple right-sided rib fractures present with?

Flail chest

See-saw chest movement

Symmetrical chest expansion

Dull percussion on right side

Flail chest

What condition explains increased tactile fremitus in the right lower lobe?

COPD

Pneumothorax

Pleural effusion

Pneumonia

Pneumonia

What would cause a tracheal shift to the right side?

Right side pleural effusion

Right side atelectasis

Right side pneumonia

Left side pneumonia

Right side atelectasis

What is most likely indicated by coarse bilateral crackles during auscultation?

Pulmonary edema

Atelectasis

Pulmonary fibrosis

Secretions

secretions

What does it indicate if a patient can clearly whisper 'ninety-nine' while auscultating the right lower lobe?

Right side pneumothorax

Asthma

Normal lungs

Right lower lobe pneumonia

Right lower lobe pneumonia

Which vessels contain oxygenated blood?

Superior vena cava

Pulmonary artery

Inferior vena cava

Aorta

Aorta

Which hemodynamic value gives the best indication of tissue perfusion?

CVP

PAP

PCWP

MAP

MAP (Mean Arterial Pressure)

What should the respiratory therapist suspect with CVP = 10 mm Hg, PCWP = 15 mm Hg, QT = 11 L/min, and urine output of 100 mL/hr?

Hypervolemia

Left sided heart failure

Metabolic acidosis from shock

Hypovolemia

Hypervolemia

What should the respiratory therapist do if a lethargic patient coughs and gags after an oropharyngeal airway is placed?

Reassure the patient

Continue to monitor the patient

Remove the oropharyngeal airway

Intubate the patient

Remove the oropharyngeal airway

Which airway should be recommended for a conscious patient with a large amount of secretions?

Berman airway

Guedel airway

Tracheostomy tube

Nasopharyngeal airway

Nasopharyngeal airway

Which airway does not require a laryngoscope for insertion?

Esophageal tracheal combitube

Double lumen tube

Endotracheal tube

CASS tube

Esophageal tracheal combitube

Which airway has a single lumen for two cuffs?

King airway

Double lumen airway

Esophageal tracheal combitube

All of the above

King Airway

What is the most important item for transporting an intubated patient?

Additional size 8.0 ETT

Laryngeal mask airway

Cufflator

Bag valve mask device

Bag valve mask device

What should be done first to establish the airway of an unconscious patient?

Jaw thrust maneuver

Modified jaw thrust maneuver

Head-tilt/chin-lift maneuver

Reposition the patient on their side

Modified Jaw thrust maneuver

What should be done if peak pressures increase by 10 cm H2O while ventilating a patient?

Instill normal saline before each suctioning procedure

Add a second heat and moisture exchanger

Change to a wick-type heated humidifier

Use a larger suction catheter

Change to a wick-type heated humidifier

What should be recommended for a 35-year-old patient on mechanical ventilation who is restless and fighting the ventilator?

Give morphine for pain relief

Begin VC/SIMV

Add 10 cmH2O PEEP

Increase the respiratory rate by 5 times a minute

Begin VC/SIMV

How long can a patient receive O2 from an H tank at 3 L/min with a pressure of 1300 psig?

About 1300 hours

About 22 hours

About 2 hours

About 120 hours

About 22 hours

What does the arterial blood gas indicate for a patient breathing 40% FiO2 with pH 7.37, PaCO2 62 torr, and HCO3- 38 mEq/L?

1. Corrected hypoxemia

2. Uncorrected hypoxemia

3. Metabolic alkalosis

4. Uncompensated metabolic acidosis

5. Compensated respiratory acidosis

2 and 5

1 and 3

2 and 4

1 and 5

2 and 5

Which hemodynamic data indicates a problem in a patient?

PvO2 of 38 mm Hg

Shunt of 4%

CI of 3 L/min/m2 of body surface area

SVR of 600 dynes/s/cms

SVR of 600 dynes/s/cm5

A 45-year-old female patient with sepsis is developing ARDS. She weighs 64 kg (141 lbs) and has a ventilator tidal volume of 450 mL rate of 12/min and 10 cm H2O of PEEP. Her ABG values are acceptable on 40% FiO2 but her CST is decreasing and plateau pressure is now 36 cm H2O. What should be recommended to the physician?

Set the tidal volume to 500 mL and the rate to 10/min

Set a tidal volume of 300 mL and a rate of 20/min

Increase PEEP to 15 cmH2O

Continue to monitor ABGs and patient's condition

Set a tidal volume of 300 mL and a rate of 20/min

A patient has an HME in place for humidification purposes. The respiratory therapist notices that the peak pressure has increased by 10 cm H2O in the past hour. The nurse reported to you that the patient had thick secretions when last suctioned. What should be done in this situation?

Instill normal saline before the next suctioning

Change the HME to a new one

Switch to a heated wick-type humidifier

Switch to a cool passover-type humidifier

Switch to a heated wick-type humidifier

A patient with pneumonia is receiving mechanical ventilation and an HME is being used for humidification. After receiving an aerosolized bronchodilator treatment the patient coughs secretions into the HME. The high-pressure alarm begins to sound. What should be done next?

Suction the patient

Replace the HME

Stop the bronchodilator treatment

Reset the high pressure alarm

Replace the HME

What could be interpreted if the expiratory flow does not return to baseline before the next breath?

The tidal volume is too small

Decreasing airway resistance

Presence of auto-PEEP

Decreasing lung compliance

Presence of auto-PEEP

What is the patient's airway resistance if tidal volume is 500 mL, peak flow is 45 L/min, peak pressure is 40 cm H2O, plateau pressure is 20 cm H2O, and PEEP is 5 cm H2O?

38 cmH2O/L/sec

0.4 cmH2O/L/sec

27 cmH2O/L/sec

15 cmH2O/L/sec

27 cmH2O/L/sec

A 75-year-old male with congestive heart failure has been receiving mechanical ventilation over the past 24 hours. The diuretic drug furosemide has been given several times. What is the best way to evaluate how the patient's lung function is responding?

Compare the patient's admission weight versus the current weight

Evaluate breath sound changes over the past 24 hours

Compare airway resistance measurements at the start of therapy and currently

Compare Cst measurements at the start of therapy and currently

Compare Cst measurements at the start of therapy and currently

The following values are found on an adult patient receiving volume-cycled ventilation with the VC/AC mode.

Tidal volume 500 mL

Peak flow 45 L/min

Peak pressure 40 cm H2O

Plateau pressure 20 cm H2O

PEEP 5 cm H2O

Which of the following is the patient's airway resistance?

38 cmH2O/L/sec

0.4 cmH2O/L/sec

27 cmH2O/L/sec

15 cmH2O/L/sec

An abdominal surgery patient is awakening gradually from anesthesia. Her ventilator settings are as follows

Mode SIMV

Set VT 450 mL

Spont VT 300 mL when awake

Set rate 12/min

Total rate 16 when awake

FiO2 0.30

Inspiratory flow 40 l/min

When awake she is using accessory muscles and her breathing is not synchronized with the ventilator. What can be done to improve synchrony?

Decrease the set tidal volume

Give the patient pain medication

Increase the inspiratory flow to 50 L/min

Increase the FiO2

Increase the inspiratory flow to 50 L/min.

A conscious and cooperative 30-year-old female with end-stage cystic fibrosis has been receiving mechanical ventilation through an endotracheal tube for 2 weeks. She has refused her physician's request to have a tracheostomy performed for the anticipated long-term mechanical ventilation. Instead she wants to be removed from the ventilator and extubated. Her parents are assigned as her guardians and do not want this as it could lead to her death. A social worker is her case manager and has been mediating between all parties. Who has the right to make the final decisions about the patient's care?

Physicians

Case manager

Parents

Patient

patient

Diseases that may be transmitted via airborne particles include which of the following?

1. Tuberculosis

2. Legionellosis

3. Histoplasmosis

4. Pertussis

1 2 and 3

1 2 and 4

2 and 4

1 only

1 2 and 3

1,2 and 3

A high-efficiency particulate air (HEPA) filter should be used in the room of a patient with which type of condition?

Streptococcal pneumonia

Tuberucolosis

Adenovirus infection

Epiglottitis

Tuberculosis

Which of the following organisms is most frequently responsible for contamination of respiratory care equipment?

Klebsiella

Serratia

Escherichia coli

Pseudomonas

Pseudomonas.

A patient is diagnosed with pulmonary tuberculosis. Which of the following isolation precautions should the respiratory therapist recommend?

Enteric isolation

Droplet isolation

Reverse isolation

Airborne isolation

Airborne isolation.

Which of the following is most likely responsible for a staphylococcal outbreak in ICU patients requiring respiratory care?

Metered dose inhalers

Healthcare workers

Ventilators

Disposable humidifiers

Healthcare workers.

Which of the following should be worn as a precautionary measure when changing a patient’s ventilator circuit that incorporates a heated humidifier?

1. Gloves

2. Eye goggles

3. Gown

1 and 3

1 and 2

1 2 and 3

1 only

1,2 and 3

Which of the following procedures are capable of sterilizing equipment?

1. Pasteurization

2. Glutaraldehyde immersion

3. Acetic acid immersion

4. Ethylene oxide

2 and 3

1 and 2

1 2 and 4

2 and 4

2 and 4

A patient enters the emergency department after a motor vehicle accident in mild respiratory distress and complaining of soreness on the left side of the chest. Auscultation of breath sounds reveals diminished breath sounds in the left lung. After placing the patient on O2 the respiratory therapist should recommend which of the following first?

CPAP at 4 cmH2O

CBC count

IPPB with a bronchodilators

Stat chest radiograph

Stat chest radiograph.

A patient is on a 30% air-entrainment mask with an O2 flow of 4L/min. The total flow being delivered by this O2 setup is which of the following?

44 L/min

24 L/min

16 L/min

36 L/min

36 L/min

A 58-year-old emphysema patient enters the emergency department on a 2 L/min nasal cannula. ABGs are drawn and after the results are evaluated the O2 flow is increased to 5 L/min. Below are ABG results for both flow rates

(2 L/min) (5 L/min)

pH 7.34 7.28

PaCO2 62 torr 77 torr

PaO2 44 torr 52 torr

HCO3- 35 mEq/L 35 mEq/L

BE +10 +10

Based on these data which of the following should the respiratory therapist recommend?

Place on CPAP of 4 cmH2O and 60% O2

Decrease the liter flow to 3 L/min

Increase the liter flow to 6 L/min

Institute noninvasive ventilation

Decrease the liter flow to 3 L/min

Decrease the liter flow to 3 L/min.

The physician wants to wean a patient from a ventilator. Which of the following parameters obtained by the respiratory therapist indicate weaning will most likely be successful?

1. MIP of -28 cmH2O

2. P(A-a)O2 of less than 200 torr on 100% FiO2

3. Vital capacity of 19 mL/kg body weight

1 2 and 3

1 only

2 and 3

1 and 3

1 and 3

A 43-year-old patient in ICU is receiving 40% O2 by air-entrainment mask. His PaO2 is 58 torr and his shunt has been calculated to be 6%. Which of the following is most likely causing his hypoxemia?

Lobar pneumonia

Pneumothorax

Pulmonary edema

Hypoventilation

hypoventilation

While making ventilator checks the respiratory therapist measures the ETT cuff pressure to be 30 mmHg. At peak inspiratory pressure a small amount of air is passing around the cuff. Which of the following actions should the therapist take at this time?

Maintain the cuff pressure at 30 mmHg

Recommend changing to a larger tube

Decrease cuff pressure to 20 mmHg

Add more air to the cuff to stop the leak

Maintain the cuff pressure at 30 mmHg

An 80 kg male patient was admitted for an acute exacerbation of COPD. Volume-controlled ventilation was initiated with a tidal volume of 600 mL and a mandatory rate of 10/min. 30 minutes later ABG results showed a PaCO2 of 30 mmHg but the physician wants to increase the patient’s PaCO2 to 50 mmHg. Which of the following would you recommend?

Rate 10/min; Tidal volume 700 mL

Rate 15/min; Tidal volume 700 mL

Rate 10/min; Tidal volume 500 mL

Rate 15/min; Tidal volume 500 mL

Rate 10/min; Tidal volume 500 mL.

Which of the following problems is most likely associated with a patient whose ABG results show respiratory alkalosis?

Opiate overdose

CNS depression

Hypothermia

Hypoxemia

Hypoxemia.

A patient who was admitted to the emergency room has the following ABG results

pH 7.24

PaCO2 29 torr

PaO2 81 torr

HCO3- 13 mEq/L

Which of the following best describes the status of this patient?

Uncompensated respiratory acidosis

Partially compensated metabolic alkalosis

Uncompensated respiratory alkalosis

Partially compensated metabolic acidosis

Partially compensated metabolic acidosis.

The following ABG results were obtained on a 28-year-old female patient

pH 7.27

PaCO2 51 torr

HCO3 22 mEq/L

BE -2

PaO2 92 torr

This indicates which of the following?

Acute metabolic alkalosis

Acute respiratory acidosis

Partially compensated metabolic acidosis

Partially compensated respiratory alkalosis

acute respiratory acidosis

A 63-year-old postoperative female patient has been receiving oxygen via high-flow nasal cannula for four days. The device is set with an FiO2 of 70% and a flow at 20 L/min. Her ABG results are as follows

pH 7.39

PaCO2 43 torr

PaO2 159 torr

SaO2 99%

HCO3 24 mEq/L

Which of the following would you recommend?

Switch to a standard nasal cannula

Decrease the FiO2

Decrease the flow

Decrease both the flow and FiO2

Decrease the FiO2.

A 61-year-old male patient who weighs 160 lbs is receiving volume-controlled SIMV. The tidal volume is set at 500 mL rate of 12/min FiO2 of 60% and PEEP of 5 cmH2O. The patient’s ABG results are as follows

pH 7.45

PaCO2 37 torr

HCO3 24 mEq/L

PaO2 56 torr

SaO2 99%

Which of the following changes would you recommend?

Increase the rate

Decrease the tidal volume

Increase the PEEP

Decrease the FiO2

Increase the PEEP.

Can an oropharyngeal airway be used on a conscious patient?

True or False

False.

A. Dicrotic Notch

B.pulmonary capillary wedge pressure

C.QRS complex

D.Cntral Venous Pressure

E. Cardiac Output

1.CO = Heart Rate × Stroke Volume.

2.Small dip in aortic pressure waveform due to aortic valve closure

3.Estimates left atrial pressure indicating left heart function

4.Ventricles depolarize atrial repolarization occurs

5.Reflects the right atrial pressure affecting venous return

A.2 B.3 C.4 D.5 E.1

What is a normal range for Central Venous Pressure (CVP)?

2-6 mmHg.

What effect does inhalation have on intrathoracic pressure?

No effect on venous return

Decreases it enhancing venous returns

Increases it reducing venous return

Causes pulmonary edema

Decreases it, enhancing venous return.

What regulates stroke volume?

Autonomic nervous system only

Preload contractility and afterload

Pulmonary artery pressure

Blood pressure and heart rate

Preload, contractility, and afterload.

A patient has an HME in place for humidification purposes. The respiratory therapist notices that the peak pressure has increased by 10 cm H2O in the past hour. The nurse reported to you that the patient had thick secretions when last suctioned. What should be done in this situation?

Instill normal saline before the next suctioning

Change the HME to a new one

Switch to a heated wick-type humidifier

Switch to a cool passover-type humidifier

What is the anatomical location of the heart?

In the pericardium above the lungs

Below the diaphragm between the kidneys

In the pleural cavity to the right of the sternum

In the mediastinum between the lungs behind the sternum

In the mediastinum, between the lungs, behind the sternum

Which valve closes to produce the first heart sound (S1) during ventricular systole?

Pulmonary valve

Atrioventricular valves

Semilunar valves

Aortic valve

Atrioventricular valves

What is the primary role of the coronary sinus?

Supplies oxygenated blood to the heart muscle

Pumps blood into the pulmonary artery

Collects deoxygenated blood from the heart muscle

Regulates heart rate

Collects deoxygenated blood from the heart muscle

What might cause an elevated Central Venous Pressure (CVP)?

Vasodilation

Negative intrathoracic pressure

Hypovolemia

Right heart failure

Right Heart Failure

Which intervention might a respiratory therapist use for elevated PCWP?

Increase PEEP significantly

Administer diuretics (per orders)

Reduce fluid administration

Use vasoconstrictors

Administer diuretics (per orders)

What does the P-R interval represent on an ECG?

Ventricular systole

Atrial contraction and AV node delay

Ventricular depolarization

Atrial repolarization

Atrial contraction and AV node delay

The cardiac cycle includes only ventricular systole and diastole

True or False

False

Positive pressure ventilation can reduce venous return

True or False

True

Which of the following is not recommended for a critically ill patient who is showing signs of fluid overload?

The restriction and close monitoring of fluid intake

The initiation of diuretic therapy

The administration of corticosteroids

The administration of dialysis for renal failure

The administration of corticosteroids

Which of the following side effects often occurs after the administration of aerosolized epinephrine?

Laryngospasm

Bradycardia

Tachycardia

Bronchospasm

Tachycardia

You just finished administering a routine breathing treatment with albuterol via small volume nebulizer. Which of the following must be added to the patient's chart?

-Treatment given as ordered

-Aerosol therapy given; pulse stable, no changes during therapy; well tolerated

-Aerosol therapy given with 0.5 mL albuterol and 3 mL normal saline; vital signs stable; well tolerated

-Aerosol therapy given with 0.5 mL albuterol and 3 mL normal saline via SVN; heart rate of 74 beats/min during therapy; B.P. stable at 120/80; respiratory rate 16/min; therapy well tolerated; chest clear on auscultation

Aerosol therapy given with 0.5 mL albuterol and 3 mL normal saline via SVN; heart rate of 74 beats/min during therapy; B.P. stable at 120/80; respiratory rate 16/min; therapy well tolerated; chest clear on auscultation

A 60-year-old female patient with tachypnea, dyspnea, and expiratory wheezes was unresponsive to a bronchodilator treatment. This patient likely has which of the following condition?

Asthma

Pulmonary edema

Emphysema

Chronic bronchitis

Pulmonary Edema

A 21-year-old female patient was admitted to the emergency department with moderate to severe levels of dyspnea, and it was noted that she has a history of asthma. Which of the following drugs would you recommend for administration via nebulization?

Levalbuterol

Magnesium sulfate

Montelukast

Beclomethasone

Levalbuterol

A 54-year-old female patient in the ER is intubated and receiving CPR. The physician requested for atropine to be administered, but the paramedics were unable to establish IV access. Which of the following routes of administration would you recommend?

Endotracheal instillation

Intramuscular injection

Aerosolized via SVN

Nasogastric instillation

Endotracheal instillation

A 68-year-old female patient in the ICU is receiving mechanical ventilation but appears to be breathing asynchronously with the ventilator. Which of the following medications would you recommend?

Dextroamphetamine (Dexedrine)

Lorazepam (Ativan)

Cisatracurium (Nimbex)

Fluoxetine (Prozac)

Lorazepam(Ativan)

When a ventilated patient is given a paralytic, which ventilator parameter should you be mindful of?

FiO2

Minute ventilation

Respiratory rate

PEEP

Minute Ventilation

The physician has ordered acetylcysteine for a 66-year-old female patient with COPD who has a large amount of thick secretions. Upon assessment, you note that the patient has a weak, inadequate cough. Which of the following would you recommend?

Nasotracheal suctioning after the treatment

Postpone the therapy until the patient can cough effectively

Administer dornase alpha instead of acetylcysteine

Perform a bronchoalveolar lavage

Nasotracheal suctioning after the treatment

On discharge, a 52-year-old male patient was prescribed an inhaled corticosteroid via MDI for two puffs twice a day. In order to decrease the likelihood of an oral infection, which of the following would you recommend?

Decrease the frequency to once per day

A bronchodilator before the corticosteroid

Rinse the mouth after inhalation

An antibiotic prescription

Rinse the mouth after inhalation

Which mucolytic works by disrupting disulfide bonds in mucus?

Dornase alfa

Guaifenesin

Hypertonic saline

Acetylcysteine

Acetylcysteine

Which of the following is a short-acting anticholinergic?

Tiotropium

Aclidinium

Ipratropium

Umeclidinium

Ipratropium

What is the mechanism of action of corticosteroids in the airways?

Thin mucus

Stimulate ciliary action

Reduce inflammation

Relax smooth muscle

Reduce inflammation

Which mucolytic is also used as an antidote for acetaminophen overdose?

Acetylcysteine

Guaifenesin

Hypertonic saline

Dornase alfa

Acetylcysteine

Classify the following ABG. For each problem, please make sure you fully classify the problem, including the primary disorder, compensation, oxygenation, select if an anion gap is normal, increased, or not necessary.

pH 7.24

PaCO2 = 54 mm Hg

PaO2 = 50 mm Hg

Na = 135

Cl = 102

TCO2 = 24

Combined respiratory and metabolic acidosis with moderate hypoxemia and normal anion gap

Classify the following ABG. For each problem, please make sure you fully classify the problem, including the primary disorder, compensation, oxygenation, select if an anion gap is normal, increased, or not necessary.

pH 7.69

PaCO2 = 31 mm Hg

PaO2 = 104 mm Hg

Na = 137

Cl = 110

TCO2 = 22

Combined respiratory and metabolic alkalosis hyperoxemia and no anion gap

Classify the following ABG. For each problem, please make sure you fully classify the problem, including the primary disorder, compensation, oxygenation, select if an anion gap is normal, increased, or not necessary.

pH 7.56

PaCO2 = 33 mm Hg

PaO2 = 86 mm Hg

Na = 144

Cl = 109

TCO2 = 32

combined resp and metabolic alkalosis normoxemia no anion gap

Classify the following ABG. For each problem, please make sure you fully classify the problem, including the primary disorder, compensation, oxygenation, select if an anion gap is normal, increased, or not necessary.

pH 7.37

PaCO2 = 32 mm Hg

PaO2 = 145 mm Hg

Na = 139

Cl = 109

TCO2 = 19

Fully compensated metabolic acidosis hyperoxemia normal anion gap

Which of the following pulmonary condition(s) respond poorly to oxygen therapy?

1. Chronic obstructive pulmonary disease

2. Atelectasis

3. Asthma

4. Consolidation

1 and 3

3 only

2 and 4

1 only

2 and 4

A 68-year-old man presents in the emergency room with paralysis of the lower extremities that has progressively worsened over the past several hours.

ABG on RA: pH 7.12

PaCO2 86

PaO2 39

HCO3- 27

SaO2 70%

Which of the following is indicated?

Bronchodilator therapy

Ventilatory support with oxygen

Oxygen with nonrebreathing mask

Oxygen with continuous positive airway pressure

Ventilatory support with oxygen

A relative shunt is caused by:

1. Alveolar-capillary defect

2. Atelectasis

3. Airway obstruction

4. Consolidation

Incorrect answer:

2 only

2, 3, and 4

1, 2, 3, and 4

1 and 3

2,3 and 4

A 76-year-old woman in the ICU is in respiratory distress. She appears cyanotic and short of breath. Her vitals signs are as follows: BP 186/115, HR 125, RR 35 and shallow. Her PaO2 is 81 on 40%. Her PaO2/PAO2 ratio is 0.90, and her Qs/Qt is 4%. Her PaCO2 is 67, and her maximum inspiratory pressure is -12 cmH2O. Based on this information, which of the following is the primary problem?

Both hypercapnic and respiratory failure

Hypoxemia respiratory failure

Hypercapnic respiratory failure

Severe refractory hypoxemia

Hypercapnic respiratory failure

Which of the following indicate(s) the need for ventilatory support?

1. VC: 65 mL/kg

2. Qs/Qt : <5

3. MIP: > -20 (less negative)

4. P(A-a)O2: >350

2 and 4

1, 2, and 3

1 and 3

3 and 4

3 and 4

One cause of hypoxemic respiratory failure is alveolar hypoventilation. Which of the following best describes the pathophysiologic mechanism of alveolar hypoventilation?

Venous blood mixing with arterial blood

Decreased minute ventilation

Nonoxygenated blood mixing with arterial blood

Decreased oxygen concentration

Decreased minute ventilation

An 81-year-old man with a long history of COPD presents in the ED in respiratory distress. He is pursed-lip breathing and using accessory muscles of inspiration. His HR 125, BP 176/105. ABG on 2L NC: pH 7.54, PaCO2 56, HCO3- 46, and PaO2 41. Based on this information, which of the following best identifies the arterial blood gas status?

Acute alveolar hyperventilation

Acute ventilatory failure superimposed on chronic ventilatory failure

Acute ventilatory failure

Acute alveolar hyperventilation superimposed on chronic ventilatory failure

Acute alveolar hyperventilation superimposed on chronic ventilatory failure

The P(A-a)O2 finding is increased in which of the following conditions:

1. Alveolar atelectasis

2. Drug overdose

3. Consolidation

4. Obesity

2 and 4

1 and 3

2 and 3

1 and 2

1 and 3

a 67-year-old man with COPD presented in the ED with acute alveolar hyperventilation superimposed on chronic ventilatory failure. He was taken to the ICU and place on noninvasive ventilation (NIV) with supplemental oxygen at 40%. ABG values: pH 7.22, PaCO2 84, HCO3- 33, PaO2 43, SaO2 71%. At this time, which of the following would be the most appropriate treatment?

Change the patient to invasive ventilation

Change the NIV mask

Increase the FiO2

Recommend a sedative

change the patient to invasive ventilation

A 57-year-old woman presents in the coronary care unit in respiratory distress. She is alert and appropriately answering the doctor's questions. Her vitals: HR 145, BP 170/110, RR 23. She appears cyanotic, and her breath sounds reveal bilateral crackles. ABG on nonrebreathing mask: pH 7.51, PaCO2 27, HCO3- 21, PaO2 46. Based on this information, which of the following would you recommend to initially treat the patient?

Invasive ventilation

Nonrebreathing oxygen mask

High flow nasal cannula

Continuous positive airway pressure mask

Continuous positive airway pressure mask

While palpating the chest you determine that there are decreased vibrations over the right lower lobe. This may be the result of which of the following?

I. Pneumothorax

II. Atelectasis

III. Pneumonia

I and II

I only

I, II, and III

II and III

I only

Which of the following parameters will be most affected by too much heparin in a blood gas syringe?

PaO2

HCO3-

pH

PaCO2

pH

In which of the following conditions are fine, late inspiratory crackles (rales) most likely to be heard on auscultation?

Croup

Asthma

Pleural effusion

Pulmonary edema

pulmonary edema

Data below were obtained from a patient's medical record:

PaO2: 64 torr

PaCO2: 40 torr

PvO2: 33 torr

PeCO2: 30 torr

SaO2: 93%

SvO2: 64%

What is the patient's deadspace to tidal volume (VD/VT) ratio?

0.45

0.35

0.25

0.15

0.25

A patient with status asthmaticus is being mechanically ventilated. Which of the following values are consistent with this condition?

-Peak Pressure 60 cmH2O; Plateau Pressure 55 cmH2O; Tidal Volume 800 mL

-Peak Pressure 25 cmH2O; Plateau Pressure 20 cmH2O; Tidal Volume 800 mL

-Peak Pressure 40 cmH2O; Plateau Pressure 20 cmH2O; Tidal Volume 600 mL

-Peak Pressure 20 cmH2O; Plateau Pressure 15 cmH2O; Tidal Volume 600 mL

Peak Pressure 40 cmH2O; Plateau Pressure 20 cmH2O; Tidal Volume 600 mL