Kettering Practice Exam

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 Kettering Practice Exam
The CRT Practice exam that is in the Kettering package.

  
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  • 1. 
    What is the normal range for pulmonary capillary wedge pressure in an adult?    
    • A. 

      2 - 6 torr

    • B. 

      4 - 12 torr

    • C. 

      9 - 18 torr

    • D. 

      21 - 28 torr


  • 2. 
    Which of the following techniques measures total lung capacity? 1. Helium dilution 2. Body plethysmograph 3. Single Breath Nitrogen Elimination
    • A. 

      1 and 2 only

    • B. 

      2 and 3 only

    • C. 

      1 and 3 only

    • D. 

      1, 2 and 3


  • 3. 
    Which of the following will give the most accurate measurements of volume and flow? 
    • A. 

      Collins water-sealed spirometer

    • B. 

      Vortex-shedding pneumotachometer

    • C. 

      Wright respirometer

    • D. 

      Dry-rolling spirometer with electronic potentiometer


  • 4. 
    The most significant problem associated with the use of a bronchoscope is 
    • A. 

      Nosocomial infections

    • B. 

      Obtaining appropriate specimens

    • C. 

      Applying topical anesthesia

    • D. 

      Hemoptysis


  • 5. 
    All of the following are true statements about spacers and holding chambers, EXCEPT 
    • A. 

      They do not require patient cooperation with their breathing pattern.

    • B. 

      They improve the efficiency of MDI

    • C. 

      They can be used for drug delivery by MDl to intubated and mechanically ventilated patients.

    • D. 

      If a patient exhales immediately following activation of the inhaler, they will clear the medication from the device and waste the dose.


  • 6. 
    During oral endotracheal intubation, the tip of the Macintosh laryngoscope blade should be placed 
    • A. 

      Between the soft palate and tongue.

    • B. 

      In the vallecula.

    • C. 

      Under the epiglottis.

    • D. 

      Between the vocal cords.


  • 7. 
    A heat moisture exchanger (HME) could be appropriately used in which of the following situations?  1. Long term mechanical ventilation  2. Short term mechanical ventilation  3. Transport mechanical ventilation 
    • A. 

      1 and 2 only

    • B. 

      1 and 3 only

    • C. 

      2 and 3 only

    • D. 

      1,2, and 3


  • 8. 
    Which of the following statements is true concerning positive expiratory pressure (PEP) therapy? 
    • A. 

      It applies expiratory positive airway pressure (EPAP) using a one-way expiratory valve and a one-way inspiratory flow resistor.

    • B. 

      It is used for 5 -10 minute intervals every hour.

    • C. 

      The inspiratory flow resistor prevents end- inspiratory pressures from rising above zero.

    • D. 

      It may help improve secretion expectoration, decrease hyperinflation and improve airway maintenance.


  • 9. 
    Which of the following drug(s) can be administered via an endotracheal tube? 1. naloxone (Narcan) 2. epinephrine (Adrenaline) 3. diazepam (Valium) 
    • A. 

      1 only

    • B. 

      2 only

    • C. 

      2 and 3 only

    • D. 

      1,2, and 3


  • 10. 
    Which of the following drugs will increase cardiac output and decrease pulmonary vascular resistance? 
    • A. 

      Methyldopa (Aldomet)

    • B. 

      Procainamide (Pronestyl)

    • C. 

      Digitalis

    • D. 

      Quinidine


  • 11. 
    Which of the following drugs will lower blood pressure and decrease right ventricular preload by direct vasodilation? 
    • A. 

      Sodium nitroprusside (Nipride)

    • B. 

      Norepinephrine (Levophed)

    • C. 

      Propranolol (Inderal)

    • D. 

      Hydrochlorothiazide (Hydrodiuril)


  • 12. 
    Which of the following drugs should the therapist recommend for a patient with a serious gram negative infection? 
    • A. 

      Tobramycin (Nebcin)

    • B. 

      Cefaclor (Ceclor)

    • C. 

      Doxapram (Dopram)

    • D. 

      Pentamidine (NebuPent)


  • 13. 
    A patient has taken an overdose of morphine. What drug is indicated to counteract the effects of the morphine? 
    • A. 

      Naloxone

    • B. 

      Methaqualone

    • C. 

      Flurazepam

    • D. 

      Secobarbital


  • 14. 
    A patient with a head injury has increased intracranial swelling. What drug(s) should the therapist recommend to reduce the ICP?  1. acetazolamide (Diamox) 2. mannitol (Osmitrol) 3. succinylcholine (Anectine) 
    • A. 

      1 and 2 only

    • B. 

      2 and 3 only

    • C. 

      1 and 3 only

    • D. 

      1,2 and 3


  • 15. 
     What is the recommended I:E ratio for NPPV? 
    • A. 

      1:1

    • B. 

      1:2

    • C. 

      1:4

    • D. 

      1:5


  • 16. 
    All of the following statements are true concerning NPPV ventilation EXCEPT 
    • A. 

      Breaths are pressure controlled.

    • B. 

      Two levels of CPAP are applied.

    • C. 

      Breaths are flow triggered.

    • D. 

      It can be used for non-invasive ventilation.


  • 17. 
    Which of the following controls are available on a chest cuirass ventilator? 1. Tidal volume 2. FI02 3. Inspiratory Time 4. Negative Pressure 5. Flowrate 
    • A. 

      1, 2 and 5 only

    • B. 

      3 and 4 only

    • C. 

      2, 3 and 4 only

    • D. 

      1,2,3 and 5 only


  • 18. 
    What is the correct formula to measure the static lung compliance of a patient on a volume-limited ventilator? 
    • A. 

      Peak pressure + tidal volume

    • B. 

      tidal volume + (plateau pressure - PEEP)

    • C. 

      Tidal volume + (peak pressure + PEEP)

    • D. 

      (plateau pressure - PEEP) + tidal volume


  • 19. 
    Which artery should a therapist palpate when deciding whether to initiate chest compressions on an adult patient? 
    • A. 

      Radial

    • B. 

      Brachial

    • C. 

      Carotid

    • D. 

      Femoral


  • 20. 
    When initiating oxygen therapy on a patient with a nasal cannula, the therapist would need all of the following EXCEPT 
    • A. 

      Physician's order for the liter flow

    • B. 

      A flowmeter

    • C. 

      No smoking and oxygen in use signs

    • D. 

      An oxygen analyzer


  • 21. 
    Mycobacterium tuberculosis is spread primarily by 
    • A. 

      Contaminated equipment

    • B. 

      Infected sputum

    • C. 

      Fomites

    • D. 

      Inhalation of droplets


  • 22. 
    Which of the following presents the greatest potential for nosocomial infection? 
    • A. 

      Large-reservoir nebulizer

    • B. 

      Aerosol tent

    • C. 

      Heated humidifier

    • D. 

      Small-medication nebulizer


  • 23. 
    The distribution of ventilation in the lungs is measured by: 1. Phase III of the SBN2 Elimination Test 2. N2 wash out time 3. Ventilation lung scan 
    • A. 

      1 and 2 only

    • B. 

      2 and 3 only

    • C. 

      1 and 3 only

    • D. 

      1,2 and 3 only


  • 24. 
    Measurement of the PD20% is significant for which of the following? 
    • A. 

      Ventilatory drive

    • B. 

      Airway hyperreactivity

    • C. 

      Occlusion pressure

    • D. 

      Reversibility of bronchospasm


  • 25. 
    A patient develops ascites and shortness of breath. Where is tissue edema most likely to show up first? 
    • A. 

      Ankles

    • B. 

      Abdomen

    • C. 

      Thorax

    • D. 

      Hands


  • 26. 
    A patient has frequent premature ventricular contractions. Which of the following laboratory measurements would be helpful in determining the cause? 1. Ca02 2. BUN 3. serum electrolytes 
    • A. 

      1 only

    • B. 

      2 only

    • C. 

      3 only

    • D. 

      1 and 3 only


  • 27. 
    A 48-year-old man is brought to the emergency department after collapsing in a restaurant. Auscultation reveals fine rales in both bases and the electrocardiogram shows a right axis deviation with significant Q waves in leads I and AVL. What is the most likely diagnosis for this patient? 
    • A. 

      Cor Pulmonale

    • B. 

      Pulmonary Edema

    • C. 

      Myocardial Infarction

    • D. 

      Pulmonary Embolism


  • 28. 
    A patient's chest x-ray reveals increased vascular engorgement emanating from the hilar area in a bat-wing pattern. What is the most likely cause of this finding? 
    • A. 

      Pulmonary embolism

    • B. 

      Fluid overload

    • C. 

      Pneumonia

    • D. 

      Pleural effusion


  • 29. 
    A patient's electrocardiogram shows a _ depressed S-T segment and inverted T waves during an exercise tolerance test. This would indicate 
    • A. 

      Pulmonary infarction.

    • B. 

      Atrial hypertrophy.

    • C. 

      Myocardial ischemia.

    • D. 

      Mitral valve stenosis.


  • 30. 
    During bedside assessment, the therapist auscultates the patient's chest and determines that the patient has bilateral inspiratory and expiratory wheezing. This would imply the patient has 
    • A. 

      inflammation of the pleura.

    • B. 

      Bronchospasm.

    • C. 

      Excessive secretions.

    • D. 

      A tracheoesophageal fistula.


  • 31. 
    A flattened diaphragm, widened intercostal spaces and blunting of the costophrenic angles on a chest x-ray would be most consistent with 
    • A. 

      Pleural effusion.

    • B. 

      Pneumothorax.

    • C. 

      Pneumonia.

    • D. 

      Pulmonary edema.


  • 32. 
    Chest x-ray findings of a right-shift of the mediastinum, hyperlucency of the left chest with absent vascular markings would be most likely caused by 
    • A. 

      Right-side atelectasis.

    • B. 

      Left side pneumothorax.

    • C. 

      Pulmonary embolism.

    • D. 

      Pulmonary hypertension.


  • 33. 
    A fiberoptic light source is placed on an infant's right thorax. A lighted halo is seen around the point of contact. The light is then placed on the infant's left chest and no light can be seen. This would indicate that 
    • A. 

      The right hemidiaphragm is absent.

    • B. 

      There is a right pneumothorax.

    • C. 

      There is a pneumomediastinum present.

    • D. 

      The left hemidiaphragm is herniated.


  • 34. 
    Which of the following pieces of equipment would be LEAST appropriate for the victim of a house fire? 
    • A. 

      Pulse oximeter

    • B. 

      Non-rebreather mask

    • C. 

      Arterial blood gas kit

    • D. 

      CPAP system


  • 35. 
    A patient has a transcutaneous oxygen monitor ordered. In order to properly maintain the monitor the therapist should 
    • A. 

      Place the heat setting between 44 and 45°C.

    • B. 

      Change the electrode site each day.

    • C. 

      Calibrate the electrode each week.

    • D. 

      Correlate TcP02 readings with ABG Q2H.


  • 36. 
    A patient is suspected of having developed a pulmonary embolus. Which of the following tests should the therapist recommend to confirm the diagnosis? 
    • A. 

      (A-a)D02

    • B. 

      C(a-v)02

    • C. 

      VD/VT

    • D. 

      P50


  • 37. 

    The physician has ordered a shunt study for a patient. After administering 100% oxygen for 20 minutes arterial and mixed venous blood gases are obtained and analyzed:  The patient's PA02 is determined to be 650 mmHg. This would indicate the patient has 
    • A. 

      Normal lung function.

    • B. 

      A pulmonary embolus.

    • C. 

      Emphysema.

    • D. 

      Pneumonia.


  • 38. 
    The patient's P(A-a)02 is calculated to be 410 torr. This should be interpreted as 
    • A. 

      A normal oxygenation gradient.

    • B. 

      An increased gradient.

    • C. 

      A decreased gradient.

    • D. 

      A laboratory error.


  • 39. 
    Based on the P(A-a)02 the respiratory therapist should inform the physician this patient most likely has a problem with 
    • A. 

      Ventilation.

    • B. 

      V/Q mismatching.

    • C. 

      Shunting.

    • D. 

      Deadspace.


  • 40. 
    A patient's Ca02 is 20.1 vol% and the CV02 is 14.6 vol%. The oxygen consumption is 220 mLlmin. The patient's cardiac output would be 
    • A. 

      4 L/min

    • B. 

      7 L/min

    • C. 

      10 L/min

    • D. 

      14 L/min


  • 41. 
    A post-operative patient appears tachypneic and anxious. The patient's PaC02 is 40 torr and the PEC02 is 10 torr. What does this data indicate? 
    • A. 

      inaccurate exhaled CO2 reading

    • B. 

      Normal post-operative ventilation

    • C. 

      Increased deadspace

    • D. 

      Decreased shunting


  • 42. 

    A patient with chronic ventilatory failure enters the emergency room. The following blood gases and vital signs are obtained while he is breathing room air:  The patient is alert and oriented yet complaining of shortness of breath. Which of the following is the correct acid-base interpretation of these results? 
    • A. 

      Uncompensated respiratory acidosis

    • B. 

      Compensated metabolic alkalosis

    • C. 

      Acute metabolic acidosis

    • D. 

      Compensated respiratory acidosis


  • 43. 
    Serial measurements of the Ca02 and CV02 have been gathered on a patient receiving mechanical ventilation following coronary artery bypass surgery. Which of the a-v content differences below show the greatest decrease in cardiac output? 
    • A. 

      Ca02 (vol%) = 19.1 ; CV02 (vol%) = 12.0

    • B. 

      Ca02 (vol%) = 18.5 ; CV02 (vol%) = 11.1

    • C. 

      Ca02 (vol%) = 20.1 ; CV02 (vol%) = 15.5

    • D. 

      Ca02 (vol%) = 19.8 ; CV02 (vol%) = 16.0


  • 44. 
    A 10-year-old patient with asthma needs to monitor his airflow improvement following each Beta-2 agonist treatment taken at home. Which of the following should the therapist recommend? 
    • A. 

      Turbine pneumotachometer

    • B. 

      Peak flow meter

    • C. 

      Pulse oximeter

    • D. 

      Volume displacement spirometer


  • 45. 
    Which of the following can be used to calculate inspiratory capacity? 
    • A. 

      VC-RV

    • B. 

      TLC - FRC

    • C. 

      ERV+VT

    • D. 

      RV+ RV


  • 46. 
    The pulmonologist has ordered pulmonary function studies on a patient with severe kyphoscoliosis. Which method would be best to obtain the patient's height? 
    • A. 

      Measure from their hip to the ground and multiply by two

    • B. 

      Use their actual height from feet to head

    • C. 

      Calculate using their arm span

    • D. 

      Measure their girth and multiply by three


  • 47. 

    The following flow-volume loop was obtained from a 58-year-old man.  What is the most likely diagnosis? 
    • A. 

      Emphysema

    • B. 

      Pneumonia

    • C. 

      Fixed upper airway obstruction

    • D. 

      Pulmonary fibrosis


  • 48. 

    The following pulmonary function data was obtained from a patient:  These values would be consistent with which of the following conditions? 1. Restrictive pulmonary disease 2. Obstructive pulmonary disease 3. Pulmonary diffusion defect 
    • A. 

      2 only

    • B. 

      1 and 2 only

    • C. 

      1 and 3 only

    • D. 

      2 and 3 only


  • 49. 

    A therapist obtains the following information from a patient:  Given this information, this patient 
    • A. 

      Has an increased deadspace to tidal volume ratio.

    • B. 

      Has a 30% intrapulmonary shunt.

    • C. 

      Is breathing effectively.

    • D. 

      Should be started on oxygen therapy.


  • 50. 
    When the FI02 setting on a large volume nebulizer is changed from 40% to 60%, which of the following will occur? 1. Total flow to the patient will increase 2. More air will be entrained through the nebulizer 3. The density of the aerosol will increase 
    • A. 

      1 and 2 only

    • B. 

      2 only

    • C. 

      3 only

    • D. 

      1,2, and 3


  • 51. 
    An adult patient is intubated with a 7.0 mm 10 endotracheal tube. What size suction catheter should be used to suction this patient? 
    • A. 

      8 French

    • B. 

      10 French

    • C. 

      12 French

    • D. 

      14 French


  • 52. 
    A patient with chronic bronchitis is to receive therapy to help remove a large amount of thick purulent secretions. Which of the following devices would be most helpful? 1. mechanical percussor 2. incentive spirometer 3. heated humidifier 4. ultrasonic nebulizer 
    • A. 

      1 and 2 only

    • B. 

      2 and 3 only

    • C. 

      1 and 4 only

    • D. 

      1 and 3 only


  • 53. 
    A patient is receiving 60% oxygen via a heated nebulizer. The therapist notes that there is insufficient aerosol flow being delivered to the patient. Possible reasons for this include 1. water collecting in tubing 2. low nebulizer water level 3. excessive flow 4. shallow breathing 
    • A. 

      1 and 2 only

    • B. 

      1 and 3 only

    • C. 

      3 and 4 only

    • D. 

      2 and 4 only


  • 54. 
    A patient has a tracheostomy tube in place. The measured cuff pressure is 28 torr. Which of the following statements is/are true of this situation? 1. The pressure is appropriate for minimal tracheal occlusion. 2. This pressure will most likely cause arterial occlusion. 3. At this pressure, only lymphatic flow will be affected. 4. The pressure will cause tracheal necrosis if maintained. 
    • A. 

      2 and 4 only

    • B. 

      3 only

    • C. 

      1 and 3 only

    • D. 

      4 only


  • 55. 
    A patient has just been intubated with a naso- tracheal tube and is being manually ventilated. As the therapist ventilates the patient, he notices that there is no chest movement, minimal breath sounds and air escaping from the mouth as the bag is squeezed. A chest x-ray has determined that the endotracheal tube is in the correct position. What is the most likely cause of this situation? 
    • A. 

      The tube is in the esophagus.

    • B. 

      The patient has developed a tracheoesophageal fistula from the intubation process.

    • C. 

      The cuff ruptured during intubation.

    • D. 

      The cuff has herniated over the end of the tube.


  • 56. 
    A 2-year-old child with croup has been intubated for 4 days with a 4 mm ID uncuffed endotracheal tube. Heated aerosol at an FI02 of .21 has been delivered to the patient. The physician asks the therapist to evaluate the patient for possible extubation. Which of the following would most likely indicate that the patient is ready for extubation? 
    • A. 

      The patient is making normal quiet ventilatory efforts.

    • B. 

      A negative sputum culture and sensitivity has been reported.

    • C. 

      The patient's ABG are within normal range.

    • D. 

      Breath sounds are heard around the tube on auscultation.


  • 57. 
    The therapist receives an order for postural drainage and vibration. With the bed flat, the therapist places the patient in a prone position with pillows under his hips. Which lung segments are being treated with this position? 
    • A. 

      Anterior segment of the upper lobes

    • B. 

      Superior segment of the upper lobes

    • C. 

      Posterior basal segment of the lower lobes

    • D. 

      Superior segment of the lower lobes


  • 58. 
    During CPR the physician is having difficulty establishing an IV route to administer emergency medications. The therapist should recommend that the physician 
    • A. 

      Instill the medications through the patient's endotracheal tube.

    • B. 

      Wait until the IV is established.

    • C. 

      Administer a subcutaneous injection.

    • D. 

      Deliver medications through the ventilator.


  • 59. 
    While using a pressure-cycled ventilator, an increase in the patient's static lung compliance will 
    • A. 

      Increase the rate.

    • B. 

      Increase the volume.

    • C. 

      Increase the flow rate.

    • D. 

      Decrease minute volume.


  • 60. 
    A pressure-cycled ventilator being used for continuous ventilation fails to cycle into inspiration. This might be caused by: 1. Sensitivity set too high 2. Failure of apnea control 3. An obstruction in the system 4. Expiratory line disconnected 
    • A. 

      3 only

    • B. 

      2 and 4 only

    • C. 

      1 and 2 only

    • D. 

      1, 2, 3, and 4


  • 61. 
    A patient is receiving controlled ventilation via a Bird Mark 7 ventilator. Suddenly, the ventilator will not cycle into expiration. This problem may be caused by 1. development of pneumothorax. 2. disconnected expiratory valve. 3. leak in the patient tubing. 4. ruptured endotracheal tube cuff. 
    • A. 

      1, 2 and 3 only

    • B. 

      1, 3 and 4 only

    • C. 

      1, 2, and 4 only

    • D. 

      2, 3, and 4 only


  • 62. 
    Proper instruction for a post-op appendectomy patient receiving incentive spirometry therapy would include: 1. Deep inspirations 2. Inspiratory hold 3. Strong cough effort 4. Pursed lip breathing 
    • A. 

      1 and 2 only

    • B. 

      3 and 4 only

    • C. 

      1,2, and 3 only

    • D. 

      1,2,3 and 4


  • 63. 
    A patient with an artificial airway in place is being ventilated with a pressure cycled ventilator that will not cycle off at end- inspiration. The most likely problem is 
    • A. 

      The tube is placed in the right lung

    • B. 

      The cuff is over inflated

    • C. 

      A mucous plug is clogging the tube

    • D. 

      The cuff has ruptured


  • 64. 
    Which of the following will increase the volume delivered to a patient on a pressure limited ventilator?  1. Decreasing the sensitivity 2. Increasing the flow setting 3. Decreasing the flow setting 4. Increasing the pressure setting 
    • A. 

      1, 2 and 4 only

    • B. 

      3 and 4 only

    • C. 

      1 and 2 only

    • D. 

      2 and 4 only


  • 65. 
    The therapist wants to increase the minute volume for a patient receiving continuous ventilation with a volume-cycled ventilator. Which controls could help accomplish this? 1. Rate 2. Pressure limit 3. Tidal volume 4. Flowrate 
    • A. 

      1 and 2 only

    • B. 

      3 and 4 only

    • C. 

      2 and 4 only

    • D. 

      1 and 3 only


  • 66. 
    Over the last hour a patient being ventilated with a volume cycled ventilator in the control mode has had a decrease in urine output from 35 mLlhour to 10 mLlhour. The most likely cause of this change would be an increase in the 
    • A. 

      Respiratory rate.

    • B. 

      FI02 delivered.

    • C. 

      Peak pressure.

    • D. 

      Inspiratory flow.


  • 67. 

    The following data has been obtained from four patients who are receiving mechanical ventilation:  Which of the patients meets the criteria for weaning from mechanical ventilation? 
    • A. 

      Patient 1

    • B. 

      Patient 2

    • C. 

      Patient 3

    • D. 

      Patient 4


  • 68. 

    A patient with ARDS is receiving mechanical ventilation in the SIMV mode with an FI02 of 0.60. The physician asks the therapist to perform an optimal PEEP study and the following data is obtained:  What is the optimal PEEP level for this patient? 
    • A. 

      10 cmH20

    • B. 

      15 cmH20

    • C. 

      20 cmH20

    • D. 

      25 cmH20


  • 69. 

    A patient requires mechanical ventilation as a result of multiple trauma sustained in an automobile accident several days ago. The current settings are as follows:  The following hemodynamic values have been obtained over the past 4 hours:  The most probable cause for the change in the pressure values would be 
    • A. 

      High PEEP effects

    • B. 

      Septicemia

    • C. 

      Pulmonary embolus

    • D. 

      Bicuspid-valve stenosis


  • 70. 
    A patient has been weaned from mechanical ventilation. The physician would like the patient's respiratory muscle strength evaluated to determine further weanability. The therapist should evaluate which of the following? 1. VDNT 2. VE 3. MIP 4. CST 5. VC 
    • A. 

      1 and 2 only

    • B. 

      3 and 4 only

    • C. 

      3 and 5 only

    • D. 

      4 and 5 only


  • 71. 
    A patient's minute volume is 8.5 Llmin and the respiratory rate is 13. What is the tidal volume? 
    • A. 

      300 mL

    • B. 

      450 mL

    • C. 

      650 mL

    • D. 

      780 mL


  • 72. 
    A patient has reduced lung compliance. Which of the following approaches to ventilation would decrease the risk of barotrauma? 
    • A. 

      Time cycled, flow limited

    • B. 

      Pressure cycled, flow limited

    • C. 

      Volume cycled, time limited

    • D. 

      Flow cycled, pressure limited


  • 73. 
    In order to reduce a patient's PaC02 from 40 torr to 32 torr, all of the following could be increased EXCEPT 
    • A. 

      Tidal volume.

    • B. 

      Alveolar ventilation.

    • C. 

      Physiologic deadspace.

    • D. 

      Respiratory rate.


  • 74. 
    A change in airway resistance would be reflected by a change in 
    • A. 

      Dynamic compliance.

    • B. 

      Thoracic compliance.

    • C. 

      Lung compliance.

    • D. 

      Static compliance.


  • 75. 
    ll of the following could cause the high pressure alarm on a volume cycled ventilator to sound EXCEPT 
    • A. 

      Decrease in lung compliance.

    • B. 

      Increase in airway resistance.

    • C. 

      Peak flow setting of 80 Llmin.

    • D. 

      Bronchospasm.


  • 76. 
    The first parameter to measure when a mechanically ventilated patient is placed on PEEP is 
    • A. 

      Respiratory rate and cardiac rate.

    • B. 

      Compliance.

    • C. 

      Airway resistance.

    • D. 

      Pa02.


  • 77. 
    Which of the following would NOT occur when increasing the flowrate on a constant flow, volume-cycled ventilator that is in the control mode? 
    • A. 

      Inspiratory time would decrease

    • B. 

      The I:E ratio would change

    • C. 

      The expiratory time would increase

    • D. 

      He minute ventilation would increase


  • 78. 
    Which of the following would indicate that the lung compliance of a patient on a volume cycled ventilator is increasing? 
    • A. 

      The system peak pressure begins to decrease

    • B. 

      The system peak pressure begins to increase

    • C. 

      Blood pressure decreases

    • D. 

      PaC02 decreases


  • 79. 
    When initiating mechanical ventilation for a patient with chronic CO2 retention, the therapist must assure adequate inspiratory flow in order to prevent 
    • A. 

      A decrease in the patient's FRC.

    • B. 

      An increase in blood pressure.

    • C. 

      Air trapping.

    • D. 

      An increase in system pressure.


  • 80. 
    A therapist is administering one rescuer CPR to an adult victim. Another therapist enters the room to help. The therapist doing chest compressions should 
    • A. 

      Start chest compressions at a rate of 60 compressions per minute.

    • B. 

      Start chest compressions at a rate of 100 compressions per minute.

    • C. 

      Stop CPR and allow the other therapist to continue one rescuer CPR.

    • D. 

      Start chest compressions and ventilations at a ratio of 15:2.


  • 81. 
    During resuscitation efforts, the therapist notes that the resuscitation bag collapses easily when squeezed and there is no evidence of chest expansion. What would cause this to occur? 
    • A. 

      A decrease in compliance

    • B. 

      An increase in airway resistance

    • C. 

      The endotracheal tube is in the right mainstem bronchus

    • D. 

      Malfunctioning inlet valve


  • 82. 
    The therapist is resuscitating a patient with chronic CO2 retention. Which of the following flow rates and oxygen concentrations should the therapist use to resuscitate this patient? 
    • A. 

      15 Llmin., 100% oxygen with a reservoir bag

    • B. 

      15 Llmin., 50% oxygen with a reservoir bag

    • C. 

      10 Llmin., 40% oxygen with no reservoir bag

    • D. 

      10 Llmin., 30% oxygen with no reservoir bag


  • 83. 
    The respiratory therapist is performing manual ventilation via endotracheal tube during cardiopulmonary resuscitation. The patient is a 65-year-old male with a history of lung carcinoma with recurrent pleural effusion. The therapist notes increased resistance during manual ventilation with decreased chest movement and diminished breath sounds on the left. The therapist's first response should be to 
    • A. 

      Check the position of the endotracheal tube.

    • B. 

      Perform needle decompression.

    • C. 

      Request a STAT chest x-ray.

    • D. 

      Perform a thoracentesis.


  • 84. 

    Polysomnography is conducted on a 46-year- old obese woman who complains of insomnia and nocturnal dyspnea. The following results were obtained:  This pattern represents 
    • A. 

      Restrictive sleep apnea.

    • B. 

      A normal sleep pattern.

    • C. 

      Obstructive sleep apnea.

    • D. 

      Central sleep apnea.


  • 85. 
    A patient is receiving oxygen therapy via a heated nebulizer with an FI02 of 0.60 at a flow of 8 Llmin. What is the total flow delivered to the patient? 
    • A. 

      8 L/min.

    • B. 

      16 L/min.

    • C. 

      24 L/min.

    • D. 

      32 L/min.


  • 86. 
    A patient is receiving 40% oxygen via a Venturi-mask at 8 Llmin. While performing oxygen rounds, the therapist notes that the flowmeter setting has been changed to 12 Llmin. How would this change affect the accuracy of the delivery device? 
    • A. 

      FI02 will remain unchanged

    • B. 

      FI02 will decrease to .35

    • C. 

      Air entrainment factor will decrease

    • D. 

      FI02 will increase to .50


  • 87. 
    A patient is receiving heliox therapy with an 80%/20% mixture via non-rebreathing mask. The therapist is using an oxygen flowmeter to deliver the gas mixture. The flowmeter is set at a flow of 10 Llmin. What is the actual flow being delivered to the patient? 
    • A. 

      8 L/min.

    • B. 

      12 L/min.

    • C. 

      18 L/min.

    • D. 

      24 L/min.


  • 88. 
    Which of the following devices is best suited for administration of oxygen to a patient with acute pulmonary edema? 
    • A. 

      Non-rebreathing mask

    • B. 

      Simple mask

    • C. 

      Partial rebreathing mask

    • D. 

      Air entrainment mask


  • 89. 
    A patient with tachypnea and a history of COPO is in the Emergency Room complaining of dyspnea. The ER physician orders oxygen therapy at an FI02 of 0.28. Which of the following devices would be most appropriate for this patient? 
    • A. 

      Nasal cannula

    • B. 

      Partial rebreathing mask

    • C. 

      Simple mask

    • D. 

      Venturi mask


  • 90. 

    The therapist collects the following data from a patient:  Which of the following would be the most appropriate initial device for providing 40% oxygen to this patient? 
    • A. 

      Simple mask

    • B. 

      Nasal cannula

    • C. 

      Non-rebreathing mask

    • D. 

      Transtracheal catheter


  • 91. 
    A patient with asthma records his peak flow as 75% of his personal best. This indicates that the patient is in which of the following peak flow zones? 
    • A. 

      Green

    • B. 

      Yellow

    • C. 

      Red

    • D. 

      Black


  • 92. 
    A patient has been sent to Radiology for a PET scan. The patient is on oxygen at 5 Llmin. from an E cylinder reading 1500 psi. How long will the E cylinder last if run until empty? 
    • A. 

      60 minutes

    • B. 

      90 minutes

    • C. 

      125 minutes

    • D. 

      180 minutes


  • 93. 
    A nursing home patient is being transported to the hospital for treatment of pneumonia. The patient is placed on a venturi device at 0.4 oxygen and cardiac monitoring. During transport, the patient becomes agitated and has a heart rate of 120 bpm. What is the most likely cause of this problem? 
    • A. 

      Patient is nervous about going to hospital

    • B. 

      Oxygen tank is empty

    • C. 

      This is normal for someone with pneumonia

    • D. 

      Patient is having a heart attack


  • 94. 
    After completing oxygen rounds the respiratory therapist must clean flowmeters that were removed from rooms where no patients were receiving oxygen therapy. Which of the following methods is most appropriate for disinfection of the flowmeters? 
    • A. 

      Steam autoclave

    • B. 

      Soak in acid gluteraldehyde

    • C. 

      Wash in pasteurmatic

    • D. 

      Wipe with alcohol


  • 95. 
    A patient has been participating in Pulmonary Rehabilitation for the past 5 weeks. The patient has recorded the results of his 6 minute walk test each week. The results indicate a steady increase in distance over the 5 week period. These results are consistent with 
    • A. 

      Need to wear supplemental oxygen while walking.

    • B. 

      Need for an additional 6 weeks of rehabilitation.

    • C. 

      Improvement in exercise ability.

    • D. 

      Early discharge from rehabilitation


  • 96. 
    The therapist is to suction a patient who has tested positive for the human immunodeficiency virus (HIV). Which of the following is the most appropriate infection control procedure to use for this patient? 
    • A. 

      Contact

    • B. 

      Droplet

    • C. 

      Airborne

    • D. 

      Standard


  • 97. 
    A premature infant has difficulty with oxygenation. The physician asks the respiratory therapist to rule out a patent ductus arteriosus. Which of the following methods would be most appropriate? 
    • A. 

      Obtain a capillary blood gas sample

    • B. 

      Assess two umbilical arterial line blood gases obtained 20 minutes apart

    • C. 

      Compare the right upper chest TcP02 to the abdominal TcP02

    • D. 

      Abdominal ultrasound


  • 98. 
    While performing auscultation of a patient's chest the therapist detects inspiratory stridor. Which of the following is most closely associated with this finding? 
    • A. 

      Bronchospasm

    • B. 

      Edematous upper airway

    • C. 

      Foreign body obstruction

    • D. 

      Chronic bronchitis


  • 99. 
    To ensure that a patient on mechanical ventilation is receiving the actual volume the physician has ordered, which of the following should the respiratory therapist utilize? 
    • A. 

      Dosimeter

    • B. 

      MEP manometer

    • C. 

      Respirometer

    • D. 

      Aneroid barometer


  • 100. 
    The Respiratory Care Department manager is budgeting for point-of-care testing equipment. Which of the following types of equipment could the manager consider for purchase to determine oxygen level in stable patients? 
    • A. 

      Pulse oximeter

    • B. 

      Calorimetry

    • C. 

      Serum electrolyte

    • D. 

      Carbon monoxide


  • 101. 

    The following data was collected during a pre-op pulmonary function test:  These results would represent 
    • A. 

      Normal spirometry

    • B. 

      Extrathoracic obstruction

    • C. 

      Fixed airway obstruction

    • D. 

      intrathoracic obstruction


  • 102. 
    A patient being weaned from mechanical ventilation has had his minute ventilation reduced from 12 L/min to 8 L/min. Which of the following would be the best indicator that this patient should not be weaned at this time? 
    • A. 

      Hyperventilation reducing PaC02 level

    • B. 

      Patient becomes agitated and combative

    • C. 

      Low pressure alarm is activated

    • D. 

      Low exhaled volume alarm sounds every breath


  • 103. 
    To reduce the chance of transmitting an infection from patient to patient, the therapist should 
    • A. 

      Wear gloves when dealing with patients.

    • B. 

      Wear goggles when dealing with body fluids.

    • C. 

      Wipe stethoscope with alcohol between patients.

    • D. 

      Sterilize equipment with ethylene oxide.


  • 104. 
    Assessment of a patient's activities of daily living is used to determine all of the following EXCEPT 
    • A. 

      Level of assistance needed by the patient.

    • B. 

      Educational needs of patient.

    • C. 

      insurance coverage.

    • D. 

      Patient's level of independence.


  • 105. 
    The therapist receives an order to administer bronchodilator therapy with albuterol. To reduce the chance of cross contamination, which route of administration should the therapist recommend? 
    • A. 

      Metered dose inhaler

    • B. 

      Dry powder inhaler

    • C. 

      Use a new nebulizer every 24 hours

    • D. 

      Wipe the nebulizer with alcohol every evening


  • 106. 
    A patient receiving a loop diuretic such as furosemide (Lasix) would most likely need what type of electrolyte replacement? 1. K+ 2. Na+ 3. CI- 4. HC03- 
    • A. 

      1 and 2 only

    • B. 

      2 and 3 only

    • C. 

      1 and 3 only

    • D. 

      2 and 4 only


  • 107. 

    A patient in the intensive care area has the following laboratory data:  Which of the following would you recommend based on these results? 
    • A. 

      Administer KCI

    • B. 

      Administer NaHC03-

    • C. 

      Administer NaCI

    • D. 

      Administer oxygen


  • 108. 
    A newborn infant has an APGAR score of 8 one minute after delivery. The most appropriate action at this time would be to 
    • A. 

      Intubate and ventilate the infant.

    • B. 

      Dry and monitor the infant.

    • C. 

      Aspirate the infant's nose and mouth.

    • D. 

      Begin CPR immediately.


  • 109. 
    A therapist enters a patient's room during oxygen rounds. The patient has end-stage emphysema and appears to be sleeping. The patient doesn't respond to questions and his pulse is 20 bpm. The therapist should immediately 
    • A. 

      Confirm DNR status.

    • B. 

      Go get help.

    • C. 

      Begin rescue ventilation.

    • D. 

      Begin chest compressions.


  • 110. 
    While attempting to calibrate a polarographic oxygen analyzer, the therapist notices that the analyzer reads 21 % when exposed to room air but only reads 64% when exposed to 100% oxygen. The most appropriate action at this time would be to 
    • A. 

      Reset the zero point.

    • B. 

      Change the battery.

    • C. 

      Change the fuel cell.

    • D. 

      Add electrolyte solution.


  • 111. 

    A 25-year-old, 58 kg (130 Ib) female is admitted to ICU after an emergency C- section. The patient is receiving mechanical ventilation via volume control ventilator. The current ventilator settings are:  The following laboratory data are available:  The respiratory therapist should recommend increasing which of the following? 
    • A. 

      Tidal volume to 700 mL

    • B. 

      PEEP to 8 cm H20

    • C. 

      Set rate to 15 bpm

    • D. 

      FI02 to .60


  • 112. 

    A 46-year-old patient who sustained a head injury is in the third day of hospitalization. The patient is intubated and receiving 65% oxygen via heated aerosol and a Brigg's adapter. The therapist has just obtained arterial blood gas tension measurements as follows:  The respiratory therapist should recommend 
    • A. 

      Mechanical ventilation with an FI02 of .65

    • B. 

      CPAP at 5 cmH20

    • C. 

      SIMV, FI02 .60 and PEEP of 10 cmH20

    • D. 

      SIMV, FI02 .70 and PEEP of 5 cmH20


  • 113. 

    A patient is being mechanically ventilated at the following settings: The laboratory results are listed below: The respiratory therapist should recommend which of the following? 
    • A. 

      Maintain current settings

    • B. 

      Decreasing PEEP to 15 cmH20

    • C. 

      Increasing the FI02 to .70

    • D. 

      Decreasing FI02 to .50


  • 114. 
    The respiratory therapist has analyzed the FI02 of a patient receiving 40% O2 via an aerosol mask. The therapist notes that the analyzed FI02 is 38%. The therapist should 
    • A. 

      Re-analyze the F102.

    • B. 

      Record the reading.

    • C. 

      Re-calibrate the analyzer.

    • D. 

      Increase the FI02 by 2%.


  • 115. 

    A 75 Kg (150 Ib) patient is receiving volume- controlled mechanical ventilation in the SIMV mode with flow-triggering. The current ventilator settings are:  The laboratory results indicate:  The respiratory therapist should recommend increasing which of the following? 
    • A. 

      Tidal volume to 900 mL

    • B. 

      Set rate to 20 bpm

    • C. 

      FI02 to .55

    • D. 

      PEEP to 20 cmH20


  • 116. 

    A 29-year-old male patient sustains multiple trauma in a motorcycle accident. The patient has rib fractures and x-ray reveals possible lung contusions. He is on a non-rebreathing mask at an FI02 of 75%. ABG reveal:  This patient would benefit most from which of the following? 
    • A. 

      CPAP

    • B. 

      Mechanical ventilation in the assist control mode

    • C. 

      Incentive spirometry

    • D. 

      Pressure support ventilation


  • 117. 
    The physician requests assistance in establishing a patent airway for a conscious patient who requires frequent suctioning. The therapist should recommend insertion of a/an 
    • A. 

      Nasopharyngeal airway.

    • B. 

      Endobronchial airway.

    • C. 

      Oropharyngeal airway.

    • D. 

      Nasal oxygen catheter.


  • 118. 
    A heat moisture exchanger (HME) is being utilized in a ventilator circuit. The therapist notices that the device has become clogged with secretions. The therapist should 
    • A. 

      Increase the peak airway pressure alarm.

    • B. 

      Replace the HME with a new HME.

    • C. 

      Change to a wick humidifier.

    • D. 

      Increase the frequency of suctioninq.


  • 119. 
    While conducting oxygen rounds, the therapist notices that there is no mist coming from the reservoir tubing on a Briggs adapter. What action should the therapist take at this time? 
    • A. 

      Decrease the flow

    • B. 

      Increase the dilution control setting on the nebulizer from 40% to 60%

    • C. 

      Check the function of the capillary tube

    • D. 

      Add an additional 6 inches of reservoir pH tubing to the Briggs adaptor


  • 120. 
    A 48-year-old patient is intubated with a size 8 mm 10 cuffed tracheostomy tube and is receiving continuous mechanical ventilation via volume ventilation. At the beginning of the shift, the cuff pressure was 20 mmHg with peak inspiratory pressure reading 34 cmH20. Four hours later the therapist notices that the peak inspiratory pressure is only reaching 14 cmH20. The therapist should 
    • A. 

      Recheck the cuff pressure.

    • B. 

      Increase the tidal volume setting.

    • C. 

      Suction the patient.

    • D. 

      Change to an uncuffed tracheostomy tube.


  • 121. 
    A nasally intubated patient is receiving mechanical ventilation via volume-cycled ventilator. While performing a patient- ventilator system check, the therapist notices that the high pressure alarm is sounding. The patient appears cyanotic and his heart rate is 48 beats per minute. The therapist is unable to pass a suction catheter. Thetherapist should 
    • A. 

      Remove the tube and manually ventilate the patient.

    • B. 

      Call the patient's physician.

    • C. 

      Obtain a stat arterial blood gas.

    • D. 

      Increase the FI02 to 1.0.


  • 122. 
    A patient with Myasthenia Gravis is being evaluated for removal of his fenestrated tracheostomy tube. The inner cannula is removed and the tube has been plugged. While examining the patient, the therapist notes that the patient is having difficulty swallowing and handling secretions, increased muscle weakness and a weak cough. Which of the following should the therapist consider at this time? 
    • A. 

      Replace the inner cannula and support ventilation.

    • B. 

      Insert a tracheal button.

    • C. 

      Remove the tracheostomy tube.

    • D. 

      Suction the patient's upper airway.


  • 123. 
    Several hours after extubation, a patient shows signs of mild inspiratory stridor, respiratory rate of 18 and moderate accessory muscle usage. Which of the following should the therapist recommend for the patient's care? 1. Reintubation of the patient 2. Administration of racemic epinephrine via medication nebulizer 3. Cool aerosol therapy 4. Emergency tracheostomy  
    • A. 

      1 and 4 only

    • B. 

      1 and 2 only

    • C. 

      2 and 3 only

    • D. 

      3 and 4 only


  • 124. 

    The following volume / pressure loop was obtained while performing a routine ventilator check.  Which of the following should the respiratory therapist recommend? 
    • A. 

      Increase the PEEP

    • B. 

      Change to pressure control mode

    • C. 

      Decrease the VT

    • D. 

      Increase the peak flow


  • 125. 
    The therapist has initiated ultrasonic therapy with 0.45% saline for a patient with bronchial pneumonia. After approximately 5 minutes of the treatment the patient begins to complain of shortness of breath. Upon auscultation the therapist notes severely diminished breath sounds and rhonchi. The patient is cyanotic, tachypneic, tachycardic, and retracting. Which of the following should the therapist perform first? 
    • A. 

      Suction the patient immediately

    • B. 

      Start O2 per nasal cannula at 4 LPM

    • C. 

      Give a stat racemic epinephrine treatment

    • D. 

      Intubate and mechanically ventilate


  • 126. 
    The therapist is verifying the ventilator parameters on a patient being ventilated by volume cycled ventilator. He notices that the exhaled tidal volume is 200 mL and the ordered tidal volume is 750 mL. The cuff pressure is 5 mmHg. After insertion of 10 cc of air, the cuff pressure is still 5 mmHg. Which of the following should the therapist do at this time? 
    • A. 

      Obtain a stat chest x-ray

    • B. 

      Extubate and reintubate

    • C. 

      Increase the FI02 to 1.0

    • D. 

      Insert 10 cc of air into the cuff


  • 127. 
    A patient's x-ray shows diffuse infiltrates in the lower lobes, auscultation reveals coarse rhonchi and rales bilaterally, and has a slight temperature is noted. Which of the following should the therapist recommend to improve her ventilation? 
    • A. 

      Ultrasonic nebulizer

    • B. 

      Pulmonary drainage and percussion

    • C. 

      Continuous ventilation

    • D. 

      Oxygen therapy


  • 128. 
    A patient with asthma enters the emergency room. Auscultation reveals bilateral wheezes. Which of the following drugs would be the most appropriate to administer at this time? 
    • A. 

      Tiotropium bromide (Spiriva)

    • B. 

      Cromolyn Sodium (Intal)

    • C. 

      Levalbuterol (Xopenex)

    • D. 

      Beclomethasone (Vanceril)


  • 129. 
    Which of the following drugs would be indicated for a 10-year-old patient with asthma who presents to the emergency room with acute, extrinsically-induced bronchospasm? 1. Montelukast 2. Epinephrine 3. Aminophylline 4. Cromolyn sodium 5. Levalbuterol 
    • A. 

      1, 3 and 5 only

    • B. 

      2, 3 and 5 only

    • C. 

      2 and 4 only

    • D. 

      1 and 5 only


  • 130. 
    A patient arrives in the emergency room with burns around her face and marked inspiratory stridor. The most appropriate action at this time would be to 
    • A. 

      Administer oxygen via non-rebreather mask.

    • B. 

      Intubate and assist ventilation.

    • C. 

      Place on mask CPAP.

    • D. 

      Draw an arterial blood gas.


  • 131. 
    A therapist is administering IPPB to a patient using a Bird Mark VII ventilator. The patient slumps over in bed and does not cycle the machine. Which of the following would be appropriate for the therapist to do at this time? 1. Manually cycle the ventilator 2. Turn the expiratory control timer so that the machine delivers 12 b/min. 3. Assess the patient's responsiveness 4. Check for exhaled air over the mouth and nose 
    • A. 

      1 and 3 only

    • B. 

      2 and 3 only

    • C. 

      3 and 4 only

    • D. 

      2 and 4 only


  • 132. 
    A patient's chest X-ray reveals atelectasis. The patient is being ventilated with a volume- cycled ventilator and the physician would like the therapist to recommend modifications to reverse the atelectasis. Appropriate recommendations would include 1. increase the respiratory rate. 2. add PEEP. 3. increase the FI02. 4. add inspiratory hold. 
    • A. 

      1 only

    • B. 

      3 only

    • C. 

      2 and 4 only

    • D. 

      2 and 3 only


  • 133. 

    A patient has the following arterial blood gas results:  The patient is being ventilated with a volume cycled ventilator on 40% FI02. The most appropriate action would be to 
    • A. 

      Increase the tidal volume.

    • B. 

      Increase the respiratory rate.

    • C. 

      Increase the FI02.

    • D. 

      Decrease the flow rate.


  • 134. 

    A patient is being ventilated with a volume controlled ventilator following Current settings include:  On the basis of the above information the most appropriate action would be to 
    • A. 

      Increase FI02.

    • B. 

      Remove the mechanical deadspace.

    • C. 

      Increase minute ventilation.

    • D. 

      Increase PEEP.


  • 135. 

    A patient with a flail chest has been placed on a volume cycled ventilator in the emergency room at the following settings:  The patient is conscious and very agitated. The high pressure alarm is sounding with every other breath. After twenty minutes, blood gases show: .  In this situation which of the following would be most appropriate? 
    • A. 

      Increase the PEEP

    • B. 

      Increase the peak flow

    • C. 

      Increase the minute ventilation

    • D. 

      Sedate the patient


  • 136. 

    A patient is being weaned from continuous mechanical ventilation and the following data is recorded during the weaning period:  Which of the following should the therapist recommend? 
    • A. 

      Change the SIMV rate to 2

    • B. 

      Change the FI02 to .30

    • C. 

      Change the PEEP to 0

    • D. 

      Extubate the patient


  • 137. 

    The following data has been collected from a patient being ventilated with a High Frequency Jet Ventilator:  Appropriate recommendations at this time include 1. Increase amplitude 2. Increase FI02 3. Add PEEP 4. Increase set tidal volume 5. Administer whole blood 
    • A. 

      1 and 5 only

    • B. 

      3 and 4 only

    • C. 

      3, 4 and 5 only

    • D. 

      1, 2 and 5 only


  • 138. 

    A volume cycled ventilator is being used to ventilate a 55 kg patient who has the following blood gas measurements:  Ventilator parameters include the following:  The physician would like to normalize the blood gases. Which of the following would best accomplish this? 
    • A. 

      Decrease the tidal volume to 350 mL

    • B. 

      Decrease the PEEP to 15 cm H20

    • C. 

      Increase the FI02 to .70

    • D. 

      Decrease the rate to 8


  • 139. 

    A 60 kg (132Ib) post-op craniotomy patient is receiving volume ventilation at a tidal volume of 900 mL and a rate of 16 b/m. The patient's arterial blood gas results are as follows:  The therapist should recommend 
    • A. 

      Maintain the current settings.

    • B. 

      Add mechanical deadspace.

    • C. 

      Decrease the tidal volume.

    • D. 

      Decrease the rate.


  • 140. 
    During medical rounds the physician asks the therapist to determine if a patient can tolerate weaning from mechanical ventilation. The following information is obtained: SIMV mode, mandatory rate 1O/min,total rate 10/min, VT 650 mL, FI02 0.4, + 5 PEEP Shortly after the therapist reduces the mandatory rate, the low exhaled volume and high rate alarms sound. Which of the following should the therapist recommend? 
    • A. 

      Add pressure support

    • B. 

      Place patient on 40% T-piece

    • C. 

      Set mandatory rate at 16/min

    • D. 

      Reduce exhaled volume alarm setting


  • 141. 
    The I:E ratio alarm on a volume controlled ventilator is sounding. How should the therapist correct this situation? 
    • A. 

      Increase the respiratory rate

    • B. 

      Increase the peak flow

    • C. 

      Increase the tidal volume

    • D. 

      Decrease the peak flow


  • 142. 
    An 80 kg (176 Ib) patient suffered a cardio- respiratory arrest two weeks ago. Since that time the patient has had an endotracheal tube in place and has been in assist-control mode at a VT of 700 mL., rate 12 breaths/min. and a FI02.35. His ABG show pH 7.37, PC02 43, P0285. NIF is -5 cm H20 in 20 sec. and VDNT is 40%. Spontaneous VT 200 ml and spontaneous respirations are seven per minute. The therapist should recommend which of the following at this time? 
    • A. 

      Change the patient to an IMV rate of seven per minute

    • B. 

      Decrease the patient's VT to 600 mL

    • C. 

      No change in the patient's ventilator parameters at this time

    • D. 

      Discontinue mechanical ventilation and extubate


  • 143. 

    An adult patient is receiving external cardiac compressions and manual ventilation. When cardiac compressions are momentarily discontinued the patient is pulseless and the ECG shows the following pattern:  The most appropriate action at this time would be to 
    • A. 

      Stop CPR.

    • B. 

      Administer 2 ampules of sodium bicarbonate.

    • C. 

      Give atropine sulfate.

    • D. 

      Defibrillate at 360 joules.


  • 144. 
    The respiratory therapist is part of the team conducting an exercise tolerance test on a rehabilitation candidate. During testing, the heart monitor shows an atrial rate of 202 and ventricular rate of 67. The immediate treatment for this situation would be to 
    • A. 

      Perform cardioversion.

    • B. 

      Perform defibrillation.

    • C. 

      Perform precordial thump.

    • D. 

      Perform cardiac catheterization.


  • 145. 
    When the therapist enters a patient's room, he notices that the patient appears to be sleeping and his EKG monitor line is flat. The therapist should 
    • A. 

      Administer a pre-cordial thump.

    • B. 

      Open the airway.

    • C. 

      Check for patient responsiveness.

    • D. 

      perform external cardiac compressions.


  • 146. 
    When attempting to ventilate a patient with mouth-to-mask ventilation, the rescuer notes that the victim's lungs are not being ventilated. The rescuer should 
    • A. 

      Go get suction equipment.

    • B. 

      Reposition the patient's head.

    • C. 

      Give four back blows.

    • D. 

      Give four abdominal thrusts.


  • 147. 
    A post-operative thoracotomy patient has 2 mediastinal chest tubes inserted. The therapist notes that there is continuous bubbling in the water seal chamber of the chest drainage system. The respiratory therapist should 
    • A. 

      Check for a leak in the system.

    • B. 

      Add water to the water seal chamber.

    • C. 

      Increase the amount of suction.

    • D. 

      Advance the chest tube 2 cm.


  • 148. 
    A patient who had his chest tube clamped for 18 hours with no apparent respiratory distress is now tachypneic and diaphoretic and complaining of dyspnea and general uneasiness. The therapist should 
    • A. 

      Obtain a chest x-ray.

    • B. 

      Unclamp the chest tube.

    • C. 

      Increase the suction through the system.

    • D. 

      Add more fluid to the suction control bottle.


  • 149. 
    A patient involved in an automobile accident is brought to the ER with tachypnea, trachea deviated to the right, splinting, asymmetrical chest movement, and decreased breath sounds on the left side. The best treatment for this patient would be to 
    • A. 

      Insert a chest tube.

    • B. 

      Administer 100% oxygen via mask and perform ABG.

    • C. 

      initiate intubation and mechanical ventilation with IMV.

    • D. 

      Institute non-invasive positive pressure ventilation.


  • 150. 
    A patient receiving oxygen therapy at home calls the hospital concerned that his H cylinder of oxygen has only 500 PSI and he is using it at 1 Llmin. The oxygen supply company said they would have a new cylinder to him before 5:00 PM. It is now 1:00 PM and the patient wants to know what to do. The therapist should tell the patient to 
    • A. 

      Call another company for faster service.

    • B. 

      Call an ambulance.

    • C. 

      Decrease the oxygen flow to 0.5 L/min.

    • D. 

      Relax because there is enough oxygen to last over 24 hours.


  • 151. 

    A patient with COPO and pneumonia has the following arterial·blood gas results while breathing room air:  The therapist should recommend 
    • A. 

      Nasal cannula at 6 L/min.

    • B. 

      Partial rebreather mask at 10 L/min.

    • C. 

      Non-rebreather mask at 15 L/min.

    • D. 

      Air entrainment mask with an FI02 of .28


  • 152. 
    A patient breathing spontaneously through a tracheostomy tube has an oxyhemoglobin level of 88% on room air. Which of the following would best assist this patient? 
    • A. 

      Maintain current therapy

    • B. 

      Obtain arterial blood gas for ventilation assessment

    • C. 

      Oxygen therapy with T-piece or trach collar at 40%

    • D. 

      Obtain chest radiograph


  • 153. 
    The therapist is performing a routine ventilator check when he notices the capnograph level is reading 8%. The therapist should 
    • A. 

      Recalibrate the capnogram.

    • B. 

      Record indicated level as normal.

    • C. 

      Increase minute ventilation.

    • D. 

      Clear secretions from sampling window.


  • 154. 
    A 32-year-old patient with muscular dystrophy is in intensive care on volume ventilation. Arterial blood gas analysis reveals a PaC02 50 torr with a Pa02 of 72 torr. Other pertinent information includes AlC mode, rate 10/min, total rate 10/min, VT 600 mL and VDNT 0.4. The physician would like this patient's PaC02 level to be 40. This can be best accomplished by 
    • A. 

      Adding pressure support.

    • B. 

      Increasing tidal volume to 750 mL.

    • C. 

      Increasing set rate to 25/min.

    • D. 

      Changing to SIMV mode.


  • 155. 
    A physician has ordered aerosolized bronchodilator therapy for a patient ready to enter a pulmonary rehabilitation program. Which of the following devices should the therapist utilize if the patient has a reduced tidal volume? 
    • A. 

      Small volume nebulizer

    • B. 

      Dry powder inhaler

    • C. 

      Small particle aerosol generator

    • D. 

      Spacer


  • 156. 
    A patient in intensive care is nasally intubated and receiving mechanical ventilation. The patient is febrile and has developed sinusitis. Which of the following should the therapist recommend? 
    • A. 

      Extubate and reintubate with an oral endotracheal tube

    • B. 

      Send patient to surgery for tracheostomy

    • C. 

      Switch the nasotracheal tube to the other nare

    • D. 

      Administer appropriate antibiotic


  • 157. 
    The therapist is teaching a patient with asthma how to correctly perform incentive spirometry using a flow-oriented device. The patient is having a difficult time achieving the set goal. The therapist should recommend 
    • A. 

      Changing the therapy to IPPB.

    • B. 

      Complete pulmonary function testing.

    • C. 

      Switching to a volume-oriented device.

    • D. 

      Teaching the patient deep breathing exercises.


  • 158. 
    During a ventilator circuit change the patient shows signs of hypoxia. What is the most appropriate action for the therapist to take to prevent this from happening again? 
    • A. 

      Monitor patient with pulse oximeter

    • B. 

      Manually ventilate during circuit change

    • C. 

      Hyperoxygenate prior to changing equipment

    • D. 

      Suction the patient before attempting circuit change


  • 159. 
    The physician has asked the therapist to evaluate a patient in the Emergency Department for possible intubation. Spontaneous parameters obtained are as follows: VT 5mLlkg    VC    15 mL/kg   MEP 45 cmH20 The therapist should recommend 
    • A. 

      Intubation and mechanical ventilation

    • B. 

      Incentive spirometry

    • C. 

      Reassess parameters after twenty minutes of oxygen therapy

    • D. 

      CPAP therapy


  • 160. 
    A patient with a neuromuscular pathology is being ventilated with a negative pressure ventilator at a vacuum setting of 20 cmH20 . The transcutaneous monitor records a CO2 level of 68 torr and an O2 level of 70 torr. Which of the following should the therapist recommend first? 
    • A. 

      Increase the rate

    • B. 

      Increase the negative pressure

    • C. 

      Increase the sensitivity

    • D. 

      Increase the oxygen percentage


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