Respiratory Therapist Competency Exams Prep Test
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Following extubation a patient has moderate stridor. The patient’s Spo2 on 0.30 FiO2 cool aerosol face mask is 95%. The patient’s heart rate is 90/min and respiratory rate is 20/min. What should the respiratory therapist recommend NEXT?
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Intubation and mechanical ventilation
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Chest physiotherapy
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Racemic epinephrine
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Cromolyn Sodium
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About This Quiz
Welcome to the Respiratory Therapist Competency Exams Prep Test. Respiratory therapists are responsible for examining and treating patients with cardiopulmonary or breathing disorders. Are you preparing for the final exam? If you are, then these questions will cover various sub-topics important for the exam.
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- 2.
A patient with multiple right sided rib fractures would present with which the following findings?
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Dull percussion on right side
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See-saw chest movement
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Symmetrical chest expansion
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Flail chest
Correct Answer
A. Flail chestExplanation
A patient with multiple right-sided rib fractures would present with flail chest. Flail chest refers to a condition where a segment of the chest wall becomes detached from the rest of the chest due to multiple rib fractures. This results in paradoxical chest movement, where the affected segment moves in an opposite direction to the rest of the chest during respiration. It is characterized by inward movement during inspiration and outward movement during expiration. Dull percussion on the right side may be present due to the underlying rib fractures, but it is not specific to flail chest. Symmetrical chest expansion would not be expected in flail chest.Rate this question:
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- 3.
Spiked or peaked T waves on an ECG may be due to?
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Hypokalemia
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Hyperkalemia
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Metabolic alkalosis
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Normal finding
Correct Answer
A. HyperkalemiaExplanation
Spiked or peaked T waves on an ECG may be due to hyperkalemia. Hyperkalemia is a condition characterized by high levels of potassium in the blood. This can affect the electrical conduction system of the heart, leading to changes in the T wave on an ECG. The elevated potassium levels can cause delayed repolarization of the ventricles, resulting in tall and peaked T waves. It is important to identify and treat hyperkalemia promptly, as it can lead to serious cardiac complications.Rate this question:
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- 4.
A patient receiving mechanical ventilation has increased peak inspiratory pressures, coarse rhonchi, and a fever. What should the respiratory therapist recommend?
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Sputum culture and gram stain
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Increase the tidal volume
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Chest physiotherapy
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Spontaneous breath trial
Correct Answer
A. Sputum culture and gram stainExplanation
The patient's symptoms, including increased peak inspiratory pressures, coarse rhonchi, and a fever, suggest the presence of a respiratory infection. Therefore, the respiratory therapist should recommend a sputum culture and gram stain to identify the causative organism and guide appropriate antibiotic treatment. This will help in determining the most effective treatment for the patient's condition.Rate this question:
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- 5.
An elevated ST segment may indicate?
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Myocardial infarction
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Myocardial ischemia
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Normal
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Hyperkalemia
Correct Answer
A. Myocardial infarctionExplanation
An elevated ST segment is often a sign of myocardial infarction, also known as a heart attack. During a heart attack, the blood supply to a part of the heart is blocked, leading to damage in the affected area. This can cause changes in the electrical activity of the heart, including an elevation of the ST segment on an electrocardiogram (ECG). It is an important diagnostic finding that helps healthcare professionals identify and treat a heart attack promptly.Rate this question:
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- 6.
A patient receiving mechanical ventilation has distant breath sounds on the left side with a tracheal shift to the right. The therapist should suspect?
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Right mainstem intubation
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Left side pneumothorax
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Left upper lobe pneumonia
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Pulmonary embolus
Correct Answer
A. Left side pneumothoraxExplanation
The presence of distant breath sounds on the left side with a tracheal shift to the right indicates a potential left side pneumothorax. A pneumothorax occurs when air accumulates in the pleural space, causing the lung to collapse. In this case, the shift in the trachea suggests that the lung on the left side is affected, causing it to collapse and shift the trachea towards the unaffected side. This is a serious condition that requires immediate attention and intervention.Rate this question:
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- 7.
Increased accessory muscle use is most often due to?
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Hyperventilation
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Increased airway resistance
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Increased lung compliance
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Poor cardiac output
Correct Answer
A. Increased airway resistanceExplanation
Increased airway resistance causes difficulty in moving air in and out of the lungs, leading to increased effort from the accessory muscles to aid in breathing. When the airways become narrowed or obstructed, such as in conditions like asthma or chronic obstructive pulmonary disease (COPD), the body compensates by recruiting additional muscles to assist with breathing. This increased accessory muscle use is a protective mechanism to ensure adequate ventilation and oxygenation of the body.Rate this question:
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- 8.
While auscultating voice sounds the therapist hears the soft A sound, or ahhhh, when the patient says the letter “E”. This change in sound is associated with which of the following conditions?
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Pneumothorax
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Pneumonia
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Pulmonary Edema
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COPD
Correct Answer
A. PneumoniaExplanation
When the therapist hears the soft A sound, or "ahhhh," when the patient says the letter "E," it indicates a change in voice sounds. This change is commonly associated with the condition of pneumonia.Rate this question:
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- 9.
Following endotracheal intubation, chest assessment reveals breath sounds on the left side are distant and resonant to percussion. This is most likely due to?
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Right mainstem intubation
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Left side pneumothorax
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Large pleural effusion
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Esophageal intubation
Correct Answer
A. Right mainstem intubationExplanation
The distant breath sounds and resonant percussion on the left side suggest that the endotracheal tube has been placed too far into the right mainstem bronchus. This causes ventilation to be directed primarily to the right lung, resulting in decreased airflow and breath sounds on the left side.Rate this question:
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- 10.
Auscultation of a patient’s lungs reveals coarse bilateral crackles. This is most likely due to?
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Secretions
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Pulmonary edema
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Pulmonary fibrosis
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Atelectasis
Correct Answer
A. SecretionsExplanation
Coarse bilateral crackles heard during lung auscultation are most likely due to secretions. Secretions in the airways can cause obstruction and result in abnormal lung sounds. This can occur in conditions such as bronchitis, pneumonia, or respiratory tract infections where there is an excessive production of mucus or phlegm. These secretions can create a gurgling or rattling sound when air passes through them, leading to coarse crackles on auscultation. Pulmonary edema, pulmonary fibrosis, and atelectasis may also cause abnormal lung sounds, but secretions are the most likely cause in this scenario.Rate this question:
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- 11.
Palpation of the patient’s trachea reveals a tracheal shift to the right side. Which of the following would most likely cause this finding?
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Right side atelectasis
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Right side pneumothorax
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Right side pleural effusion
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Left side pneumonia
Correct Answer
A. Right side atelectasisExplanation
A tracheal shift to the right side is most likely caused by right side atelectasis. Atelectasis refers to the collapse or closure of a lung or a part of it, which can result in a shift of the trachea towards the affected side. This occurs because the collapsed lung is unable to maintain its normal position, causing the trachea to deviate towards the unaffected side. In this case, the right side atelectasis is causing the tracheal shift to the right side.Rate this question:
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- 12.
A patient in the cardiac ICU has a pulmonary artery catheter in place. The patient is edematous and has a CVP reading of 12. The patient most likely has?
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Shock
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Hypovolemia
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Hypervolemia
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This CVP is normal
Correct Answer
A. HypervolemiaExplanation
The patient's edema and elevated CVP reading of 12 suggest hypervolemia, which refers to an excess of fluid volume in the body. In hypervolemia, there is an increase in blood volume, leading to fluid accumulation in the tissues and organs. This condition can be caused by various factors such as heart failure, kidney disease, or excessive fluid intake. The presence of a pulmonary artery catheter indicates that the patient is in a critical condition and requires close monitoring of their fluid status.Rate this question:
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- 13.
Increased tactile fremitus is noted in the patient’s right lower lobe. Which of the following conditions would explain this?
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Pneumothorax
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Pneumonia
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COPD
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Pleural effusion
Correct Answer
A. PneumoniaExplanation
Pneumonia is an infection in the lungs that causes inflammation and fluid buildup. This can lead to increased tactile fremitus, which is the vibration felt when a patient speaks. The inflammation and fluid in the right lower lobe of the patient's lungs would cause increased transmission of vibrations, resulting in increased tactile fremitus. Pneumothorax, COPD, and pleural effusion are not typically associated with increased tactile fremitus.Rate this question:
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- 14.
Auscultation of a 3-year-old child’s lungs reveals unilateral wheezing. This patient most likely has?
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Asthma
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Secretions in the airway
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Foreign body airway obstruction
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Pneumonia
Correct Answer
A. Foreign body airway obstructionExplanation
The correct answer is Foreign body airway obstruction. Auscultation of unilateral wheezing in a 3-year-old child suggests a partial obstruction in the airway caused by a foreign body. Asthma typically presents with bilateral wheezing, secretions in the airway may cause crackles rather than wheezing, and pneumonia usually presents with bilateral findings such as crackles or decreased breath sounds.Rate this question:
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- 15.
Immediate potential complications with percutaneous tracheostomy tube insertion include everything except?
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Bleeding
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Pneumothorax
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Decreased LOC
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Subcutaneous Emphysema
Correct Answer
A. Decreased LOCExplanation
Decreased LOC (Level of Consciousness) is not an immediate potential complication of percutaneous tracheostomy tube insertion. This procedure involves creating a surgical opening in the trachea to assist with breathing, and complications can occur. Bleeding, pneumothorax (collapsed lung), and subcutaneous emphysema (air trapped under the skin) are all possible immediate complications. However, decreased LOC is not directly related to the procedure itself and is more likely to be caused by other factors such as anesthesia or underlying medical conditions.Rate this question:
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- 16.
An unconscious patient arrives in the emergency department following a motor vehicle accident. What should the respiratory therapist do FIRST to establish this patient’s airway?
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Head-tilt/chin-lift maneuver
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Modified jaw thrust maneuver
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Reposition the patient on their side
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Jaw thrust maneuver
Correct Answer
A. Modified jaw thrust maneuverExplanation
The correct answer is the Modified jaw thrust maneuver. This technique is used to open the airway of an unconscious patient without moving the neck or spine. It involves placing the fingers behind the angle of the mandible and lifting the jaw forward, which helps to bring the tongue away from the back of the throat and allows for better airflow. This maneuver is considered the safest and most effective way to establish an airway in patients with potential cervical spine injuries.Rate this question:
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- 17.
Auscultation and percussion of a hemodynamically unstable patient’s left lung reveals distant breath sounds and hyperresonance. The respiratory therapist suspects a pneumothorax. What should the therapist recommend NEXT?
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Obtain an ABG
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Order a chest X-ray
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Needle decompression
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Chest tube insertion
Correct Answer
A. Needle decompressionExplanation
Given the auscultation and percussion findings of distant breath sounds and hyperresonance, along with the suspicion of a pneumothorax, the next recommended step would be needle decompression. This procedure involves inserting a large-bore needle into the chest to release trapped air and relieve the pressure on the lung. It is an immediate intervention that can be life-saving for a hemodynamically unstable patient with a suspected pneumothorax. Obtaining an ABG or ordering a chest X-ray may provide further information, but needle decompression takes priority in this critical situation. Chest tube insertion may be considered if the pneumothorax is confirmed or if the needle decompression is not effective.Rate this question:
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- 18.
What is the estimated heart rate of this ECG?
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60
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50
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100
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75
Correct Answer
A. 75Explanation
The estimated heart rate of this ECG is 75. This can be determined by counting the number of QRS complexes (the spikes on the ECG) within a specific time frame, usually one minute. In this case, the ECG shows a heart rate of 75 beats per minute.Rate this question:
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- 19.
A patient’s bed in the ICU is raised to provide routine care. The patient has a pulmonary artery catheter (PAC) in place and the transducer is attached to an IV pole next to the bed. What effect will this have on the patients CVP?
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No effect
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It will cause a false high reading
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It will cause a false low reading
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It will cause PVC’s
Correct Answer
A. It will cause a false low readingExplanation
When the patient's bed in the ICU is raised, it will cause a false low reading of the patient's central venous pressure (CVP). This is because the transducer, which is attached to an IV pole, measures the pressure at the level of the heart. When the bed is raised, the transducer is positioned below the level of the heart, leading to a decrease in hydrostatic pressure and a false low reading of the CVP.Rate this question:
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- 20.
A large difference between PIP and Pplat is most likely to be seen in which of the following disease states?
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Pulmonary Fibrosis
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Bronchiectasis
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Quadriplegia
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Status Asthmaticus
Correct Answer
A. Status AsthmaticusExplanation
In status asthmaticus, there is severe and prolonged bronchoconstriction, leading to increased resistance in the airways. This results in a significant increase in airway pressure during inspiration, leading to a large difference between PIP (peak inspiratory pressure) and Pplat (plateau pressure). Pulmonary fibrosis and bronchiectasis may cause increased airway resistance, but they do not typically result in the same degree of bronchoconstriction as seen in status asthmaticus. Quadriplegia does not directly affect the airways and would not cause a large difference between PIP and Pplat.Rate this question:
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Current Version
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Mar 21, 2023Quiz Edited by
ProProfs Editorial Team -
Jan 22, 2021Quiz Created by
Catherine Halcomb
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