Advanced Respiratory Care and Project Management Quiz

To reduce the possibility of barotrauma on mechanical ventilation, it is important to not exceed certain pressure limits. While PIP (peak inspiratory pressure), MPaw (mean airway pressure), and Pplat (plateau pressure) should all be kept below certain thresholds, achieving higher PEEP (positive end-expiratory pressure) levels can actually help to improve oxygenation and stabilize alveoli. Therefore, PEEP > 30cmH2O is not a concern for barotrauma prevention.

Rapid Sequence Intubation is typically indicated for airway obstruction, severe hypoxemia, and abnormal spontaneous breathing rates. A Glasgow Coma Scale of 4 or less may not necessarily require rapid intubation.

In the treatment of mobilizing secretions in a COPD patient, Pulmozyme (Dornase alfa) is typically used in cystic fibrosis patients, not in COPD patients.

When heliox is used in aerosol therapy, the 70:30 and 60:40 ratios work best for a hypoxic patient because they help in better deposition of particles in the airways compared to other ratios.

Incentive spirometer is the correct choice as it helps the patient practice taking deep breaths, improving lung function and preventing complications such as pneumonia. Bronchodilator is used to expand the airways in conditions like asthma. Nasal canula and IPPB are not directly related to helping the patient with breathing exercises post-appendectomy.

When a trach patient is approved to start using a Passy Muir valve, it is important to ensure that the traditional trach tube cuff is deflated to prevent any possible distress for the patient (III. A. 3. g.).

When obtaining an ABG from a 15 year old patient in the ED, the first procedure should be to verify the doctor's order to ensure the test is indeed necessary before proceeding.

In patients suspected of having Guillian-Barre Syndrome, the two bedside PFT test results that will help determine if the diaphragm muscle is compromised are NIF (2) and VC (3). These two tests specifically assess the strength and function of the diaphragm muscle, unlike Vt and PF which do not directly measure diaphragm function.

When the peak flow meter result is at 60% of the patient's personal best, the correct action is to increase albuterol use up to 12 puffs MDI to manage the acute exacerbation.

In a patient with pneumonia exhibiting signs of bilateral coarse crackles and a weak cough, the appropriate care plan should focus on CPT (chest physiotherapy) including postural drainage and breathing therapy. This helps mobilize and clear secretions in the lungs, aiding in treatment and recovery.

The correct answer is C. 5 because according to the information given, there can be up to 5 more therapy sessions that day depending on the patient's response to the initial session.

The correct laryngoscope size for a premature infant like a 34-week-old baby is Miller size 0, which is smaller and more suitable for their airway anatomy.

For this scenario, the appropriate intervention for the baby would be CPAP to improve oxygenation. This provides continuous positive airway pressure to keep the air sacs open and improve oxygen exchange, helping the baby breathe better. Therefore, options A, C, and D are not the correct choices for this situation.

When a patient is diagnosed with a hemothorax, the specific thoracic area that is prepared to be drained is the 4 to 5th intercostal space midaxillary. This is the correct location for adequate drainage and management of a hemothorax.

When conducting a rapid response assessment, the essential basic information needed includes the patient's name, status of lines, fluids, medications, and treatments. While date & time can be important, it is not a crucial piece of information in the initial assessment.

The correct frequency range for setting on the IPV machine is 1.6 - 3.75 Hz, not 5.5 - 6.5Hz, 1.6 - 3.75 bpm, or 5.5 - 6.5 bpm.

SVC (slow vital capacity) measures the maximum volume of air a person can exhale slowly after a maximum inhalation. The test is influenced by air trapping and help, leading to a potentially higher volume than FVC (forced vital capacity). The values it measures typically include VC (vital capacity), IRV (inspiratory reserve volume), and ERV (expiratory reserve volume), but not RV (residual volume). RV is not included in SVC measurements because it represents the volume of air remaining in the lungs after a maximal exhalation, which is not part of the SVC measurement.

The correct range for the cuff pressure following endotracheal intubation is 25 - 35 cmH2O. This range helps prevent complications such as tracheal mucosal injury or pressure-related nerve damage.

The correct answer is C. 100 - 120 mmHg. When dealing with a trach tube in a patient with COPD and excessive secretions, the negative suction pressure should typically be set between 100 - 120 mmHg. This range is considered appropriate for effectively clearing secretions without causing harm to the patient.

The correct placement of the V4 ECG lead is in the 5th intercostal space mid-clavicular. This position allows for accurate recording of electrical signals from the heart.

Symbicort is a combination medication containing budesonide and formoterol that is commonly used for the maintenance treatment of asthma. Repimat, Douneb, and Spiriva are not typically used as maintenance treatments for asthma.

In cases of tracheal shift toward an affected side, it is often associated with conditions such as lung collapse, obstruction, or fibrosis. Therefore, the correct answer is A. Pulmonary fibrosis.

The correct protocol in this situation is to hand the baby over to the mother and monitor as per I., B. d. guidelines. Other options involving oxygen administration or keeping the baby at a warmer are not necessary based on the observed signs and are not the recommended course of action.

When using the Advair Discus for maintenance treatment of chronic asthma, holding your breath for 10 seconds or as long as possible after inhaling the medication is crucial for optimal delivery and absorption in the lungs.

In this scenario, the correct answer is D. Airway narrowing because it is not directly related to the observed breath sounds. Mainstem intubation, airway obstruction, and atelectasis can all lead to abnormal breath sounds, but airway narrowing is not specifically mentioned in the question as a cause.

The correct answer, Vital Capacity of 750ml, is a good indicator of the patient's ability to breathe on their own. This parameter reflects the maximum amount of air a person can expel after a maximum inhalation. In this case, a value of 750ml suggests that the patient has adequate respiratory muscle strength and function to potentially breathe without the assistance of a ventilator.

Emphysema is a chronic lung condition characterized by shortness of breath, barrel chest, tripodding, accessory muscle use, and muscle atrophy. These symptoms are not typically associated with Chronic Bronchitis, Bronchiectasis, or Asthma.