Therapist Multiple-Choice SAE Complete
Questions and 100% Correct Answers (A+)
‣ A premature 3-week-old infant is receiving 1 L/min
of O via a nasal cannula and has a PaO of 43 torr22
and a PaCO2 of 40 torr. The respiratory therapist should recommend which of the
following?
A. Increase the cannula flow to 2 L/min.
B. Intubate and institute mechanical ventilation
C. Initiate CPAP of 4 cm H2O and 50% O2
D. Increase the cannula flow to 5 L/min. -✓✓A, A PaO2 of 43 torr represents
hypoxemia. The normal PaO2 for an infant is 50-70 torr. Increasing the cannula flow by
1 L/min is the most appropriate choice to return the PaO2 to normal. With a normal
PaCO2 of 40 torr, mechanical ventilation is not indicated. (Analysis)
‣ what is normal PaO2 for infant ? -✓✓50-70 torr.
‣ A patient arrives in the emergency department after being pulled from a burning
house. The respiratory therapist should recommend obtaining which of the following
measurements to best determine the sever- ity of the patient's smoke inhalation?
A. SpO2
B. HbCO
C. PaO2
D. Hb -✓✓B, To best determine the severity of smoke inhalation, an HbCO level should
be determined with a co-oximeter. The SpO2 value should never be evaluated on a
patient suspected of CO poisoning because a pulse oximeter is not capable of
determining what is bound to hemoglobin.
Pulse oximeters work on the principle of spectrophotometry where lightweight probes
direct filtered light of specific wavelengths through the skin or digit. The light absorbed
differs for saturated and desaturated blood, whether it's saturated with oxygen or a
combination of oxygen and carbon monoxide. Therefore the reading will be erroneously
high when HbCO is present. (Analysis)
‣ To best determine the severity of smoke inhalation, an HbCO level should be
determined with ? -✓✓co-oximeter
‣ The physician has ordered O2 to be administered to an active 3-year-old with an
SpO2 of 86%. Which of the following delivery devices would you recommend for this
patient?
A. 1- to 2-L nasal cannula
B. Air-entrainment mask
C. Simple O2 mask
,D.O2 hood -✓✓A, An active 3-year-old generally tolerates a cannula much better than
any kind of mask and is too large for an O2hood. (Application)
‣ The ability of the patient to follow instructions would be indicated by which of the
following?
A. Orientation to person
B. Performance of tasks when asked
C. Ability to feed himself
D. Awareness of time -✓✓B, If the patient is able to perform simple tasks when asked,
this best determines his or her ability to follow instructions. This is important before
administering an incentive spirometry or IPPB treatment, which requires the patient to
be able to follow instructions well or the treatment will not be effective. (Recall)
‣ If the patient is able to perform simple tasks when asked, this best determines his or
her ability to follow instructions. This is important before administering an? -✓✓incentive
spirometry or IPPB treatment, which requires the patient to be able to follow instructions
well or the treatment will not be effective. (Recall)
‣ You suspect a patient may have a pulmonary embolism. Which of the following would
be the most appropriate recommendation for diagnosis of this condition?
A. Bronchoscopy
B. V/Q lung scan
C. Coagulation studies
D. Shunt study -✓✓B, The best diagnostic test to determine whether a pulmonary
embolism is present is the V/Q lung scan. (Application)
‣ To most effectively increase a sedated, paralyzed patient's alveolar minute ventilation
while the patient is on volume-controlled ventilation in the assist-control mode, you
would recommend increasing which of the following?
A. PEEP
B. Inspiratory flow
C. VT
D. Ventilator rate -✓✓C
Alveolar minute ventilation = (VT - VD) × respiratory rate
It represents the volume actually reaching the alveoli per minute. It takes into account
anatomic dead space (VD), which is approximately 1 mL/lb of body weight. Anatomic
VD is that portion of the airway where no gas exchange occurs. If a patient's alveolar
minute ventilation is to be increased, the VT must be increased. If only the ventilator
rate is increased, the same VT is delivered, even though the minute ventilation (VT ×
RR) increases. (Recall)
‣ what is the formula for alveolar minute ventilation ? -✓✓(VT - VD) × respiratory rate
‣ Failure to hyperoxygenate a patient on a ventilator before ET suctioning may result in
A. Hypoxemia
,B. Hypocapnia
C. Bradycardia
D. Hypertension -✓✓A, It is important during ET suctioning that the PaO2 be maintained
within a normal range. This requires increasing the oxygen percentage during the
procedure. Failure to hyperoxygenate may cause hypoxemia, resulting in cardiac
arrhythmias. Bradycardia may occur as a result of vagal stimulation. (Application)
‣ while ET suctioning , Failure to hyperoxygenate may cause hypoxemia, resulting in ? -
✓✓cardiac arrhythmias
‣ while ET suctioning a pt, Bradycardia may occur as a result of ? -✓✓vagal stimulation
‣ The most reliable method of determining whether the lungs of a patient receiving
mechanical ventila- tion are getting stiffer and harder to ventilate is by measuring the
A. Static lung compliance
B. Dynamic lung compliance
C. Spontaneous VT
D. PaO2 -✓✓A, When lungs get stiffer and harder to ventilate, greater pressure is
required to move the same volume of air. Because peak inspiratory pressure increases
when RAW increases (e.g., when airway secretions are present or water is in the
ventilator tubing), this pressure does not reflect how stiff the lungs actually are. We
determine the plateau or static pressure by holding the volume in the patient's lungs for
1 to 2 s. This pressure closely relates to alveolar pressure. PEEP (if used) is subtracted
from the plateau pressure and this number is divided into the VT. The results determine
how compliant the lungs are. (Application)
‣ We determine the plateau or static pressure by holding the volume in the patient's
lungs for?
what is the formula for static compliance ? -✓✓1 to 2 s.
This pressure closely relates to alveolar pressure. PEEP (if used) is subtracted from the
plateau pressure and this number is divided into the VT. The results determine how
compliant the lungs are.
‣ A 60-kg (132-lb) 52-year-old man is admitted to the ICU for the treatment of refractory
hypoxemia. He is currently on VC-SIMV and pressure support of 10 cm H2O with an
FiO2 of 0.60. Other pertinent data are below:
pH 7.49
PaCO2 30 torr
PaO2 59 torr
Heart rate 120min
, Respiratory rate 12
Spontaneous VT 400 ml
Ventilator VT 500 mL
PEEP 5 cm H2O
Total respiratory rate 22/min
Which of the following should the respiratory therapist recommend at this time?
A. Increase the pressure support level to 15 cm H2O
B. Increase PEEP to 8 cm H2O
C. Increase the FiO2 to 0.70 D. Decrease VT to 400 mL -✓✓B, Refractory hypoxemia
typically results from atelectasis, pneumonia, or pulmonary edema, whereby increasing
oxygen levels do not correct the hypoxemia. Although the patient is hyperventilating, VT
should not be decreased. The hyperventilation is a result of the low PaO2, therefore it
should be increasing the PaO2 first is necessary. We should not exceed 60% oxygen to
try to correct hypoxemia, so increasing the PEEP level is most appropriate. (Analysis)
‣ Refractory hypoxemia typically results from ? -✓✓atelectasis
pneumonia
pulmonary edema
‣ A peripheral lung mass is to be biopsied. Which of the following procedures should be
recommended to obtain the tissue sample?
A. Electromagnetic navigational bronchoscopy (ENB)
B. Fiberoptic bronchoscopy
C. Bronchoalveolar lavage (BAL)
D. Rigid bronchoscopy -✓✓. A, ENB is diagnostic tool that combines conventional
bronchoscopy with
virtual bronchoscopy that allows bronchoscopic instruments to reach peripheral lung
areas that traditional fiberoptic bronchscopes can't reach. (Analysis)
‣ A 70-kg (154-lb) male patient is receiving mechanical ventilation. The respiratory
therapist notes the patient's
SpO2 drops from 97% to 86%. The right lung is expanding more than the left, with clear
breath sounds on the right but absent breath sounds on the left. The patient's ET tube is
taped at the 29-cm mark at the lip. Which of the following should the respiratory
therapist do at this time?
A. Withdraw the tube to the 24-cm mark
B. Recommend an immediate chest x-ray
C. Advance the ET tube 2 cm
D. Obtain immediate ABG levels -✓✓A, The ET tube should be positioned 2 to 6 cm
above the level of the carina. That means the ET tube should be at the 21- to 25-cm
mark at the teeth. In this question, the tube is at the 29-cm mark and the patient has
decreased breath sounds in the left lung, which indicates the tube is in the right
mainstem bronchus and must be withdrawn.
Questions and 100% Correct Answers (A+)
‣ A premature 3-week-old infant is receiving 1 L/min
of O via a nasal cannula and has a PaO of 43 torr22
and a PaCO2 of 40 torr. The respiratory therapist should recommend which of the
following?
A. Increase the cannula flow to 2 L/min.
B. Intubate and institute mechanical ventilation
C. Initiate CPAP of 4 cm H2O and 50% O2
D. Increase the cannula flow to 5 L/min. -✓✓A, A PaO2 of 43 torr represents
hypoxemia. The normal PaO2 for an infant is 50-70 torr. Increasing the cannula flow by
1 L/min is the most appropriate choice to return the PaO2 to normal. With a normal
PaCO2 of 40 torr, mechanical ventilation is not indicated. (Analysis)
‣ what is normal PaO2 for infant ? -✓✓50-70 torr.
‣ A patient arrives in the emergency department after being pulled from a burning
house. The respiratory therapist should recommend obtaining which of the following
measurements to best determine the sever- ity of the patient's smoke inhalation?
A. SpO2
B. HbCO
C. PaO2
D. Hb -✓✓B, To best determine the severity of smoke inhalation, an HbCO level should
be determined with a co-oximeter. The SpO2 value should never be evaluated on a
patient suspected of CO poisoning because a pulse oximeter is not capable of
determining what is bound to hemoglobin.
Pulse oximeters work on the principle of spectrophotometry where lightweight probes
direct filtered light of specific wavelengths through the skin or digit. The light absorbed
differs for saturated and desaturated blood, whether it's saturated with oxygen or a
combination of oxygen and carbon monoxide. Therefore the reading will be erroneously
high when HbCO is present. (Analysis)
‣ To best determine the severity of smoke inhalation, an HbCO level should be
determined with ? -✓✓co-oximeter
‣ The physician has ordered O2 to be administered to an active 3-year-old with an
SpO2 of 86%. Which of the following delivery devices would you recommend for this
patient?
A. 1- to 2-L nasal cannula
B. Air-entrainment mask
C. Simple O2 mask
,D.O2 hood -✓✓A, An active 3-year-old generally tolerates a cannula much better than
any kind of mask and is too large for an O2hood. (Application)
‣ The ability of the patient to follow instructions would be indicated by which of the
following?
A. Orientation to person
B. Performance of tasks when asked
C. Ability to feed himself
D. Awareness of time -✓✓B, If the patient is able to perform simple tasks when asked,
this best determines his or her ability to follow instructions. This is important before
administering an incentive spirometry or IPPB treatment, which requires the patient to
be able to follow instructions well or the treatment will not be effective. (Recall)
‣ If the patient is able to perform simple tasks when asked, this best determines his or
her ability to follow instructions. This is important before administering an? -✓✓incentive
spirometry or IPPB treatment, which requires the patient to be able to follow instructions
well or the treatment will not be effective. (Recall)
‣ You suspect a patient may have a pulmonary embolism. Which of the following would
be the most appropriate recommendation for diagnosis of this condition?
A. Bronchoscopy
B. V/Q lung scan
C. Coagulation studies
D. Shunt study -✓✓B, The best diagnostic test to determine whether a pulmonary
embolism is present is the V/Q lung scan. (Application)
‣ To most effectively increase a sedated, paralyzed patient's alveolar minute ventilation
while the patient is on volume-controlled ventilation in the assist-control mode, you
would recommend increasing which of the following?
A. PEEP
B. Inspiratory flow
C. VT
D. Ventilator rate -✓✓C
Alveolar minute ventilation = (VT - VD) × respiratory rate
It represents the volume actually reaching the alveoli per minute. It takes into account
anatomic dead space (VD), which is approximately 1 mL/lb of body weight. Anatomic
VD is that portion of the airway where no gas exchange occurs. If a patient's alveolar
minute ventilation is to be increased, the VT must be increased. If only the ventilator
rate is increased, the same VT is delivered, even though the minute ventilation (VT ×
RR) increases. (Recall)
‣ what is the formula for alveolar minute ventilation ? -✓✓(VT - VD) × respiratory rate
‣ Failure to hyperoxygenate a patient on a ventilator before ET suctioning may result in
A. Hypoxemia
,B. Hypocapnia
C. Bradycardia
D. Hypertension -✓✓A, It is important during ET suctioning that the PaO2 be maintained
within a normal range. This requires increasing the oxygen percentage during the
procedure. Failure to hyperoxygenate may cause hypoxemia, resulting in cardiac
arrhythmias. Bradycardia may occur as a result of vagal stimulation. (Application)
‣ while ET suctioning , Failure to hyperoxygenate may cause hypoxemia, resulting in ? -
✓✓cardiac arrhythmias
‣ while ET suctioning a pt, Bradycardia may occur as a result of ? -✓✓vagal stimulation
‣ The most reliable method of determining whether the lungs of a patient receiving
mechanical ventila- tion are getting stiffer and harder to ventilate is by measuring the
A. Static lung compliance
B. Dynamic lung compliance
C. Spontaneous VT
D. PaO2 -✓✓A, When lungs get stiffer and harder to ventilate, greater pressure is
required to move the same volume of air. Because peak inspiratory pressure increases
when RAW increases (e.g., when airway secretions are present or water is in the
ventilator tubing), this pressure does not reflect how stiff the lungs actually are. We
determine the plateau or static pressure by holding the volume in the patient's lungs for
1 to 2 s. This pressure closely relates to alveolar pressure. PEEP (if used) is subtracted
from the plateau pressure and this number is divided into the VT. The results determine
how compliant the lungs are. (Application)
‣ We determine the plateau or static pressure by holding the volume in the patient's
lungs for?
what is the formula for static compliance ? -✓✓1 to 2 s.
This pressure closely relates to alveolar pressure. PEEP (if used) is subtracted from the
plateau pressure and this number is divided into the VT. The results determine how
compliant the lungs are.
‣ A 60-kg (132-lb) 52-year-old man is admitted to the ICU for the treatment of refractory
hypoxemia. He is currently on VC-SIMV and pressure support of 10 cm H2O with an
FiO2 of 0.60. Other pertinent data are below:
pH 7.49
PaCO2 30 torr
PaO2 59 torr
Heart rate 120min
, Respiratory rate 12
Spontaneous VT 400 ml
Ventilator VT 500 mL
PEEP 5 cm H2O
Total respiratory rate 22/min
Which of the following should the respiratory therapist recommend at this time?
A. Increase the pressure support level to 15 cm H2O
B. Increase PEEP to 8 cm H2O
C. Increase the FiO2 to 0.70 D. Decrease VT to 400 mL -✓✓B, Refractory hypoxemia
typically results from atelectasis, pneumonia, or pulmonary edema, whereby increasing
oxygen levels do not correct the hypoxemia. Although the patient is hyperventilating, VT
should not be decreased. The hyperventilation is a result of the low PaO2, therefore it
should be increasing the PaO2 first is necessary. We should not exceed 60% oxygen to
try to correct hypoxemia, so increasing the PEEP level is most appropriate. (Analysis)
‣ Refractory hypoxemia typically results from ? -✓✓atelectasis
pneumonia
pulmonary edema
‣ A peripheral lung mass is to be biopsied. Which of the following procedures should be
recommended to obtain the tissue sample?
A. Electromagnetic navigational bronchoscopy (ENB)
B. Fiberoptic bronchoscopy
C. Bronchoalveolar lavage (BAL)
D. Rigid bronchoscopy -✓✓. A, ENB is diagnostic tool that combines conventional
bronchoscopy with
virtual bronchoscopy that allows bronchoscopic instruments to reach peripheral lung
areas that traditional fiberoptic bronchscopes can't reach. (Analysis)
‣ A 70-kg (154-lb) male patient is receiving mechanical ventilation. The respiratory
therapist notes the patient's
SpO2 drops from 97% to 86%. The right lung is expanding more than the left, with clear
breath sounds on the right but absent breath sounds on the left. The patient's ET tube is
taped at the 29-cm mark at the lip. Which of the following should the respiratory
therapist do at this time?
A. Withdraw the tube to the 24-cm mark
B. Recommend an immediate chest x-ray
C. Advance the ET tube 2 cm
D. Obtain immediate ABG levels -✓✓A, The ET tube should be positioned 2 to 6 cm
above the level of the carina. That means the ET tube should be at the 21- to 25-cm
mark at the teeth. In this question, the tube is at the 29-cm mark and the patient has
decreased breath sounds in the left lung, which indicates the tube is in the right
mainstem bronchus and must be withdrawn.
