Kettering Evaluation Exam Updated Questions And Solutions Rated A+

KETTERING EVALUATION EXAM UPDATED QUESTIONS
AND SOLUTIONS RATED A+
✔✔Biot's respiration definition and cause - ✔✔- Increased RR and depth with irregular
periods of apnea. Each breath has the same depth. *No pattern*
- Caused by: CNS problem

✔✔Kussmaul's respiration definition and cause - ✔✔- Increased RR (usually over 20
BPM). increased depth, irregular rhythm, breathing sounds labored.
- Caused by: Hypoxemia, metabolic acidosis, renal failure, *diabetic ketoacidosis*

✔✔Agonal respirations (apneustic) definition and cause - ✔✔- Prolonged *gasping*
inspiration followed by extremely short, insufficient expiration.
- Caused by: problem with respiratory center, trauma or tumor

✔✔Mallampati score "rule of 5" - ✔✔- your score should equal 5 (Example: if you have
a class 2, then you have only 3 visuals... 2+3 = 5)
- Class 1 = 4 visuals (soft palate, uvula, fauces, and pillars visible
- Class 2 = 3 visuals (soft palate, uvula, and fauces visible)
- Class 3 = 2 visuals (soft palate and base of uvula visible)
- Class 4 = 1 visual (Hard palate only visible)
- *Assess the difficulty of intubation*

✔✔A change in HR of more than what considered an adverse reaction? - ✔✔- A
change of HR *more than 20 beats/min* is considered an adverse reaction
- Stop the therapy, notify nurse and doctor, and record the event

✔✔Pulsus paradoxus definition and cause - ✔✔- A decrease in pulse pressures during
inspiration
- Caused by: *cardiac tamponade*, *air trapping*, status asthmaticus, and tension
pneumothorax

✔✔Where do you hear Fine Crackles - ✔✔- In the alveoli
- Associated with CHF and pulmonary edema
- Recommended treatment is PPV and Diuretics

✔✔First heart sound (S1) is created by? (Lub) - ✔✔- Created by the normal closure of
the mitral and tricuspid (AV) valves at the beginning of ventricular contraction

✔✔Second heart sound (S2) is created by? (Dub) - ✔✔- Created when systole ends.
The ventricles relax and the pulmonic and aortic valves close.

✔✔How does normal CXR look? - ✔✔- Both hemidiaphragms are rounded (dome-
shaped)
- The right hemidiaphragm is slightly higher than the left (because of the liver)

, - Trachea is midline, bilateral radiolucent appearance of lungs, with sharp costophrenic
angles
- *Vertebrae are just visible behind the heart*

✔✔Crowded ribs on an x-ray are associated with what? - ✔✔- Atelectasis

✔✔straight or horizontal ribs on x-ray are associated with what? - ✔✔- Air trapping or
overdistention

✔✔What position is used to diagnose small pleural effusions? - ✔✔- *Lateral decubitus
position*
- Creates more surface area to be seen

✔✔Where should the tip of the ETT be positioned on a CXR? - ✔✔- *2-6 cm above the
carina*
- At the level of the aortic arch (notch)

✔✔Where should the pulmonary artery catheter be located when positioned properly? -
✔✔- Right lower lung field

✔✔Croup on x-ray? - ✔✔- Tracheal narrowing with *subglottic swelling*
- *STEEPLE SIGN*

✔✔Epiglottis on X-Ray? - ✔✔- *Supraglottic narrowing* with an enlarged and flattened
epiglottis
- *THUMB SIGN*

✔✔Description, Interpretation, and Treatment for *Pulmonary Edema* on CXR - ✔✔-
*Fluffy infiltrates*
- Butterfly pattern
- Treated by Diuretics and PPV

✔✔Description, Interpretation, and Treatment for *Atelectasis* on CXR - ✔✔- *Patchy
infiltrates*
- Scattered densities
- Treated by Lung expansion therapy (PEEP, IPPV, CPAP)

✔✔Description, Interpretation, and Treatment for *ARDS* on CXR - ✔✔- *GROUND
GLASS APPEARANCE*
- "Reticulogranular"
- Treated by Oxygen, *Low Vt or PIP*, CPAP, *Higher PEEPs*

✔✔Description, Interpretation, and Treatment for *Pleural Effusion* on CXR - ✔✔-
*Blunting of costophrenic angles*
- *Basilar (think "base", you F***ING idiot) infiltrates*