A 13 year-old patient in the ED is complaining of dyspnea, chest tightness, and a loose
productive cough. The patient has a respiratory rate of 28 breaths/minute and bilateral
wheezing in the lungs. What treatment should the respiratory therapist initiate?
A. levalbuterol
B. oxygen
C. salmeterol
D. PEP -correct answer-oxygen
A 16 year-old patient with cystic fibrosis attends public high school. Which of the following
bronchial hygiene therapies would be most appropriate for this patient?
A. intrapulmonary percussive ventilation
B. dornase alpha therapy
C. vibratory / oscillatory PEP
D. postural drainage and manual percussion -correct answer-vibratory / oscillatory PEP
A 19-year-old patient is brought to the emergency department after taking a handful of pills.
The patient is obtunded but is making regular, sonorous respiratory efforts. Auscultation
reveals coarse rhonchi bilaterally. Which of the following should be done FIRST to assess this
patient?
A. Obtain a sputum specimen.
B. Obtain an ABG.
C. Measure peak expiratory flow.
D. Determine the Glasgow Coma Score. -correct answer-Obtain an ABG.
A 28 year-old female has just been admitted through the ED with suspected CO poisoning.
She is receiving oxygen by non-rebreather mask at 10 L/min. Upon entering the patient's
room, the respiratory therapist notes that the reservoir bag of the mask collapses during
inspiration. This is most likely the result of
A. faulty one-way valves.
B. tight seal between the mask and the patient's face.
,C. presence of a bubble humidifier.
D. insufficient flow to the reservoir bag. -correct answer-insufficient flow to the reservoir
bag.
A 30 year old male with bronchitis has coarse bilateral rales with a SpO2 of 90%. Despite a
good cough effort, he has great difficulty in removing his thick secretions. The respiratory
therapist should initiate
A. aerosol treatments with 3 cc normal saline every 4 hours.
B. sputum induction for gram stain.
C. a heated humidifier and oxygen therapy.
D. continuous ultrasonic via aerosol mask. -correct answer-a heated humidifier and oxygen
therapy.
A 36 year-old fireman was trapped and subsequently rescued from the collapse of a burning
building. Which of the following devices would be appropriate to accurately assess his
oxygenation status?
A. capnograph
B. pulse oximeter
C. blood gas analyzer
D. hemoximeter -correct answer-hemoximeter
A 36 year-old patient is admitted to the ED with a temperature of 38.5° C and suspected
pneumonia. The patient has no history of pulmonary disease. Auscultation reveal medium
crackles throughout both lungs. Which of the following should be recommended for
management of this patient?
A. Pre/post bronchodilator study
B. Ultrasonic nebulizer treatments
C. Manually assisted coughing
D. Regular coughing and deep breathing -correct answer-Regular coughing and deep
breathing
,A 42 year-old trauma patient in the ED has been intubated with a 6.5 mm oral endotracheal
tube equipped with a high-residual-volume, low-pressure cuff. The respiratory therapist
notes that a cuff pressure of 42 cm H2O is necessary to achieve a minimal occluding volume.
This would indicate that the
A. tube is not of the appropriate size.
B. pilot balloon and line are obstructed.
C. pressure manometer is defective.
D. cuff has herniated over the tip of the tube. -correct answer-tube is not of the appropriate
size.
A 44 year-old patient who suffered a cerebral vascular accident has been moved from
Neuro-ICU to the step-down unit. He becomes diaphoretic and his SpO2 suddenly drops
from 95% to 88% on a 32% tracheostomy collar. His heart rate is 115/min, respiratory rate is
42/min and his breath sounds are very diminished. The respiratory therapist is unsuccessful
in attempting to pass a 12 Fr suction catheter. The therapist should
A. increase the suction pressure to 120 mm Hg.
B. change to a 10 Fr suction catheter.
C. replace the tracheostomy tube.
D. orally intubate the patient. -correct answer-Replace the tracheostomy tube.
A 48 year-old female is admitted to the ED with diaphoresis, jugular venous distension, and
3+ pitting edema in the ankles. These findings are consistent with
A. liver failure.
B. pulmonary embolism.
C. heart failure.
D. electrolyte imbalances -correct answer-Heart failure
A 50 kg (110 lb) patient is being mechanically ventilated with the following settings: VC, A/C,
VT 400 mL, respiratory rate 14/min, FIO2 0.60 and 10 cm H2O PEEP. The chest radiograph
demonstrates diffuse bilateral radiopacity. ABG results are: pH 7.36, PaCO2 47 torr, PaO2 50
torr, and HCO3- 28 mEq/L. The respiratory therapist should increase the
, A. PEEP.
B. FIO2.
C. expiratory time.
D. respiratory rate. -correct answer-PEEP
A 52 year-old post-operative cholecystectomy patient's breath sounds become more coarse
upon completion of postural drainage with percussion. The respiratory therapist should
recommend
A. continuing the therapy until breath sounds improve.
B. administering dornase alpha.
C. administering albuterol therapy.
D. deep breathing and coughing to clear secretions. -correct answer-deep breathing and
coughing to clear secretions.
A 52 year-old post-operative patient's chest radiograph demonstrates infiltrates in the
posterior basal segments of the lower lobes. Which of the following is the appropriate
postural drainage position?
A. Head down, patient supine with a pillow under knees
B. Patient prone with a pillow under head, bed flat
C. Patient supine with a pillow under knees, bed flat
D. Head down, patient prone with a pillow under hips -correct answer-Head down, patient
prone with a pillow under hips
A 55 year-old male patient is being evaluated for pulmonary rehabilitation. During a cycle
ergometer cardiopulmonary stress procedure, the patient has a heart rate of 100/min and a
respiratory rate of 20/min. He suddenly begins to complain of chest pain and severe
shortness of breath. The respiratory therapist should
A. reduce the speed of the bike.
B. administer supplemental oxygen.
productive cough. The patient has a respiratory rate of 28 breaths/minute and bilateral
wheezing in the lungs. What treatment should the respiratory therapist initiate?
A. levalbuterol
B. oxygen
C. salmeterol
D. PEP -correct answer-oxygen
A 16 year-old patient with cystic fibrosis attends public high school. Which of the following
bronchial hygiene therapies would be most appropriate for this patient?
A. intrapulmonary percussive ventilation
B. dornase alpha therapy
C. vibratory / oscillatory PEP
D. postural drainage and manual percussion -correct answer-vibratory / oscillatory PEP
A 19-year-old patient is brought to the emergency department after taking a handful of pills.
The patient is obtunded but is making regular, sonorous respiratory efforts. Auscultation
reveals coarse rhonchi bilaterally. Which of the following should be done FIRST to assess this
patient?
A. Obtain a sputum specimen.
B. Obtain an ABG.
C. Measure peak expiratory flow.
D. Determine the Glasgow Coma Score. -correct answer-Obtain an ABG.
A 28 year-old female has just been admitted through the ED with suspected CO poisoning.
She is receiving oxygen by non-rebreather mask at 10 L/min. Upon entering the patient's
room, the respiratory therapist notes that the reservoir bag of the mask collapses during
inspiration. This is most likely the result of
A. faulty one-way valves.
B. tight seal between the mask and the patient's face.
,C. presence of a bubble humidifier.
D. insufficient flow to the reservoir bag. -correct answer-insufficient flow to the reservoir
bag.
A 30 year old male with bronchitis has coarse bilateral rales with a SpO2 of 90%. Despite a
good cough effort, he has great difficulty in removing his thick secretions. The respiratory
therapist should initiate
A. aerosol treatments with 3 cc normal saline every 4 hours.
B. sputum induction for gram stain.
C. a heated humidifier and oxygen therapy.
D. continuous ultrasonic via aerosol mask. -correct answer-a heated humidifier and oxygen
therapy.
A 36 year-old fireman was trapped and subsequently rescued from the collapse of a burning
building. Which of the following devices would be appropriate to accurately assess his
oxygenation status?
A. capnograph
B. pulse oximeter
C. blood gas analyzer
D. hemoximeter -correct answer-hemoximeter
A 36 year-old patient is admitted to the ED with a temperature of 38.5° C and suspected
pneumonia. The patient has no history of pulmonary disease. Auscultation reveal medium
crackles throughout both lungs. Which of the following should be recommended for
management of this patient?
A. Pre/post bronchodilator study
B. Ultrasonic nebulizer treatments
C. Manually assisted coughing
D. Regular coughing and deep breathing -correct answer-Regular coughing and deep
breathing
,A 42 year-old trauma patient in the ED has been intubated with a 6.5 mm oral endotracheal
tube equipped with a high-residual-volume, low-pressure cuff. The respiratory therapist
notes that a cuff pressure of 42 cm H2O is necessary to achieve a minimal occluding volume.
This would indicate that the
A. tube is not of the appropriate size.
B. pilot balloon and line are obstructed.
C. pressure manometer is defective.
D. cuff has herniated over the tip of the tube. -correct answer-tube is not of the appropriate
size.
A 44 year-old patient who suffered a cerebral vascular accident has been moved from
Neuro-ICU to the step-down unit. He becomes diaphoretic and his SpO2 suddenly drops
from 95% to 88% on a 32% tracheostomy collar. His heart rate is 115/min, respiratory rate is
42/min and his breath sounds are very diminished. The respiratory therapist is unsuccessful
in attempting to pass a 12 Fr suction catheter. The therapist should
A. increase the suction pressure to 120 mm Hg.
B. change to a 10 Fr suction catheter.
C. replace the tracheostomy tube.
D. orally intubate the patient. -correct answer-Replace the tracheostomy tube.
A 48 year-old female is admitted to the ED with diaphoresis, jugular venous distension, and
3+ pitting edema in the ankles. These findings are consistent with
A. liver failure.
B. pulmonary embolism.
C. heart failure.
D. electrolyte imbalances -correct answer-Heart failure
A 50 kg (110 lb) patient is being mechanically ventilated with the following settings: VC, A/C,
VT 400 mL, respiratory rate 14/min, FIO2 0.60 and 10 cm H2O PEEP. The chest radiograph
demonstrates diffuse bilateral radiopacity. ABG results are: pH 7.36, PaCO2 47 torr, PaO2 50
torr, and HCO3- 28 mEq/L. The respiratory therapist should increase the
, A. PEEP.
B. FIO2.
C. expiratory time.
D. respiratory rate. -correct answer-PEEP
A 52 year-old post-operative cholecystectomy patient's breath sounds become more coarse
upon completion of postural drainage with percussion. The respiratory therapist should
recommend
A. continuing the therapy until breath sounds improve.
B. administering dornase alpha.
C. administering albuterol therapy.
D. deep breathing and coughing to clear secretions. -correct answer-deep breathing and
coughing to clear secretions.
A 52 year-old post-operative patient's chest radiograph demonstrates infiltrates in the
posterior basal segments of the lower lobes. Which of the following is the appropriate
postural drainage position?
A. Head down, patient supine with a pillow under knees
B. Patient prone with a pillow under head, bed flat
C. Patient supine with a pillow under knees, bed flat
D. Head down, patient prone with a pillow under hips -correct answer-Head down, patient
prone with a pillow under hips
A 55 year-old male patient is being evaluated for pulmonary rehabilitation. During a cycle
ergometer cardiopulmonary stress procedure, the patient has a heart rate of 100/min and a
respiratory rate of 20/min. He suddenly begins to complain of chest pain and severe
shortness of breath. The respiratory therapist should
A. reduce the speed of the bike.
B. administer supplemental oxygen.
