RCP 160 UPDATED EXAM SCRIPT QUESTIONS AND
SOLUTIONS GRADED A+
✔✔Know how to calculate respiratory rate using Thigh and Tlow with the APRV mode -
✔✔60/ Thigh + Tlow
✔✔What could the RT change on the APRV mode to remove CO2? - ✔✔Phigh
✔✔Contraindication to Permissive Hypercapnia - ✔✔ICP, seizure disorders, severe
pulmonary
hypertension, uncontrolled metabolic acidosis
✔✔How do we determine Tlow in APRV mode? - ✔✔Set it to terminate expiratory flow
at 75% of
PEFR
✔✔Signs of inability to protect airway - ✔✔gag reflex absent, inability to clear
secretions,
aspiration, loc
✔✔What does the colorimetric capnogram show us after intubation? - ✔✔Confirms
tracheal
placement of ET tube by changing color in the presence of exhaled CO2
✔✔Review Passy Muir Valve and what is important to do before you place it? -
✔✔Deflate the cuff
✔✔Primary indications for a tracheostomy - ✔✔prolonged mechanical ventilation,
secretion
management, airway protection, bypassing upper airway obstruction
✔✔Differences between a percutaneous and traditional tracheostomy -
✔✔percutaneous is done at
the bedside, quicker, traditional is done in OR, proffered for emergency or difficult
anatomy cases
✔✔Benefits of the tracheostomy over an ETT - ✔✔less need for sedation, easier
weaning, reduced
airway trauma, improved oral care, decreased vap
✔✔What issue is common with a fenestrated tracheostomy tube? - ✔✔Granulation
tissue formation
, ✔✔What tracheostomy oxygen device would minimize pulling on the tube? - ✔✔T piece
or trach
collar with flexible tubing
✔✔What situation would be most appropriate to use a Bougie? - ✔✔Difficult intubation
✔✔What situation would be most appropriate to use a Cook catheter? - ✔✔Airway
exchange
✔✔lidocaine dosage levels? - ✔✔4-5 mg/kg
✔✔side effects of over medicating with lidocaine? - ✔✔Tinnitus, numbness, dizziness,
seizures,
hypotension, cardiac arrhythmias
✔✔indications for bronchoscopy? - ✔✔Hemoptysis, suspected tumor, persistent
infiltrates, foreign body removal, airway trauma, unresolved pneumonia, secretion
removal
✔✔contraindications for bronchoscopy? - ✔✔Severe hypoxemia, unstable
cardiovascular status,
uncontrolled bleeding disorders, refractory arrhythmias
✔✔cardiogenic - ✔✔transudate (low protein, few inflammatory cells)
✔✔non cardiogenic= - ✔✔exudate (protein rich, inflammatory cells)
✔✔Review possible complications and how we can avoid them - ✔✔bleeding monitor
coagulation,
hypoxemia pre oxygenate, aspiration keep NPO
✔✔Cause of Chylothorax - ✔✔leakage of lymphatic fluid into the pleural space due to
thoracic duct
injury
✔✔Cause of Hemothorax - ✔✔blood in the pleural space caused by chest trauma,
surgery, or ruptured vessels
✔✔Most likely cause for spontaneous pneumothorax - ✔✔rupture of a bleb in a young
tall thin
male without underlying disease
✔✔Most likely cause for secondary pneumothorax - ✔✔COPD
SOLUTIONS GRADED A+
✔✔Know how to calculate respiratory rate using Thigh and Tlow with the APRV mode -
✔✔60/ Thigh + Tlow
✔✔What could the RT change on the APRV mode to remove CO2? - ✔✔Phigh
✔✔Contraindication to Permissive Hypercapnia - ✔✔ICP, seizure disorders, severe
pulmonary
hypertension, uncontrolled metabolic acidosis
✔✔How do we determine Tlow in APRV mode? - ✔✔Set it to terminate expiratory flow
at 75% of
PEFR
✔✔Signs of inability to protect airway - ✔✔gag reflex absent, inability to clear
secretions,
aspiration, loc
✔✔What does the colorimetric capnogram show us after intubation? - ✔✔Confirms
tracheal
placement of ET tube by changing color in the presence of exhaled CO2
✔✔Review Passy Muir Valve and what is important to do before you place it? -
✔✔Deflate the cuff
✔✔Primary indications for a tracheostomy - ✔✔prolonged mechanical ventilation,
secretion
management, airway protection, bypassing upper airway obstruction
✔✔Differences between a percutaneous and traditional tracheostomy -
✔✔percutaneous is done at
the bedside, quicker, traditional is done in OR, proffered for emergency or difficult
anatomy cases
✔✔Benefits of the tracheostomy over an ETT - ✔✔less need for sedation, easier
weaning, reduced
airway trauma, improved oral care, decreased vap
✔✔What issue is common with a fenestrated tracheostomy tube? - ✔✔Granulation
tissue formation
, ✔✔What tracheostomy oxygen device would minimize pulling on the tube? - ✔✔T piece
or trach
collar with flexible tubing
✔✔What situation would be most appropriate to use a Bougie? - ✔✔Difficult intubation
✔✔What situation would be most appropriate to use a Cook catheter? - ✔✔Airway
exchange
✔✔lidocaine dosage levels? - ✔✔4-5 mg/kg
✔✔side effects of over medicating with lidocaine? - ✔✔Tinnitus, numbness, dizziness,
seizures,
hypotension, cardiac arrhythmias
✔✔indications for bronchoscopy? - ✔✔Hemoptysis, suspected tumor, persistent
infiltrates, foreign body removal, airway trauma, unresolved pneumonia, secretion
removal
✔✔contraindications for bronchoscopy? - ✔✔Severe hypoxemia, unstable
cardiovascular status,
uncontrolled bleeding disorders, refractory arrhythmias
✔✔cardiogenic - ✔✔transudate (low protein, few inflammatory cells)
✔✔non cardiogenic= - ✔✔exudate (protein rich, inflammatory cells)
✔✔Review possible complications and how we can avoid them - ✔✔bleeding monitor
coagulation,
hypoxemia pre oxygenate, aspiration keep NPO
✔✔Cause of Chylothorax - ✔✔leakage of lymphatic fluid into the pleural space due to
thoracic duct
injury
✔✔Cause of Hemothorax - ✔✔blood in the pleural space caused by chest trauma,
surgery, or ruptured vessels
✔✔Most likely cause for spontaneous pneumothorax - ✔✔rupture of a bleb in a young
tall thin
male without underlying disease
✔✔Most likely cause for secondary pneumothorax - ✔✔COPD
