CRT/RRT RESPIRATORY EXAM – QUESTIONS AND ANSWERS |
VERIFIED AND WELL DETAILED ANSWERS | PLUS RATIONALES |
GUARANTEED PASS | LATEST EXAM UPDATE
*Core Domains:*
*- Patient Asses
*- Airway Manage
*- Mechanical Ve
*- Cardiopulmona
*- Pharmacology
*- Neonatal and
*- Pulmonary Reh
*- Professional
*Introduction:*
*The purpose of
SECTION ONE: QUESTIONS 1–100
Question 1
A 56-year-old male with a history of COPD presents to the emergency
department in acute respiratory distress. Arterial blood gas analysis on
room air reveals: pH 7.31, PaCO2 62 mmHg, PaO2 52 mmHg, HCO3
31 mEq/L. Which of the following is the most appropriate initial oxygen
therapy device?
A. Non-rebreather mask at 15 L/min
B. Nasal cannula at 2 L/min
C. Simple mask at 8 L/min
D. Venturi mask delivering 40 percent oxygen
🟢 B. Nasal cannula at 2 L/min
🔴 Explanation: Patients with chronic hypercapnia and COPD rely on
hypoxic drive and are at risk for oxygen-induced hyperventilation and
worsening respiratory acidosis if given high-flow oxygen. A low-flow
,device like a nasal cannula allows precise, controlled titration to achieve
an acceptable SpO2 without abolishing the hypoxic drive.
Question 2
A patient is receiving volume-controlled ventilation. The respiratory
therapist notes that the peak inspiratory pressure (PIP) has increased
significantly while the plateau pressure remains unchanged. Which of
the following conditions is most likely responsible for this finding?
A. Pulmonary fibrosis
B. Right mainstem intubation
C. Mucus plugging in the endotracheal tube
D. Primary acute respiratory distress syndrome
🟢 C. Mucus plugging in the endotracheal tube
🔴 Explanation: An increase in peak inspiratory pressure with a normal
plateau pressure indicates an increase in airway resistance rather than
a change in lung compliance. Mucus plugging or biting the endotracheal
tube increases resistance, raising PIP while leaving transalveolar
pressures unaffected.
Question 3
During a pre-operative evaluation, a patient performs spirometry. The
results show a forced expiratory volume in one second (FEV1) of 75
percent of predicted, a forced vital capacity (FVC) of 80 percent of
predicted, and an FEV1/FVC ratio of 68 percent. How should these
findings be interpreted?
A. Normal pulmonary function test
B. Severe restrictive ventilatory defect
C. Mild obstructive ventilatory defect
D. Combined restrictive and obstructive defect
🟢 C. Mild obstructive ventilatory defect
🔴 Explanation: An FEV1/FVC ratio below the lower limit of normal
(typically less than 70 percent) indicates an obstruction. With an FEV1
of 75 percent of predicted, the obstruction is classified as mild.
Question 4
A neonate born at 28 weeks of gestation develops increasing
,respiratory distress, nasal flaring, and expiratory grunting shortly after
delivery. A chest radiograph reveals diffuse bilateral reticulogranular
densities and air bronchograms. Which of the following is the primary
pathophysiological mechanism of this condition?
A. Pulmonary hypoplasia secondary to oligohydramnios
B. Deficiency of pulmonary surfactant leading to alveolar collapse
C. Aspiration of amniotic fluid causing mechanical airway obstruction
D. Persistent fetal circulation with pulmonary vascular hypertension
🟢 B. Deficiency of pulmonary surfactant leading to alveolar collapse
🔴 Explanation: The clinical presentation and radiographic findings are
classic for respiratory distress syndrome (RDS) of the newborn, caused
by immature type II alveolar cells failing to produce adequate
surfactant, which drastically increases surface tension and causes
diffuse microatelectasis.
Question 5
An adult patient with severe ARDS is placed on a mechanical ventilator
in the volume-control mode. To minimize the risk of ventilator-induced
lung injury, which of the following ventilator parameters should be
strictly monitored and limited?
A. Peak inspiratory pressure
B. Plateau pressure
C. Mean airway pressure
D. Total cycle time
🟢 B. Plateau pressure
🔴 Explanation: Plateau pressure reflects alveolar pressure at the end
of inspiration. Limiting plateau pressure to less than 30 cmH2O is a
fundamental cornerstone of lung-protective ventilation to prevent
alveolar overdistension and barotrauma/volutrauma in ARDS.
Question 6
A respiratory therapist is calibrating a Clark polarographic oxygen
electrode. The therapist exposes the sensor to 100 percent oxygen and
adjusts the reading to match the calibration standard. What is the next
essential step in the calibration process before clinical use?
, A. Expose the sensor to room air and verify a 21 percent reading
B. Expose the sensor to zero gas to establish a baseline
C. Disassemble the galvanic cell and replace the potassium hydroxide
electrolyte
D. Submerge the probe in sterile water to check for water vapor
pressure
🟢 A. Expose the sensor to room air and verify a 21 percent reading
🔴 Explanation: Polarographic oxygen analyzers require a two-point or
secondary verification check to ensure linearity. After calibrating at 100
percent, checking the sensor against room air (21 percent) confirms
proper function and scaling across the clinical measurement range.
Question 7
A patient with a suspected narcotic overdose is unresponsive, with a
respiratory rate of 6 breaths per minute and shallow breathing. Arterial
blood gas values show: pH 7.15, PaCO2 78 mmHg, PaO2 60 mmHg,
HCO3 24 mEq/L. Which classification best describes this acid-base
disturbance?
A. Acute respiratory acidosis
B. Chronic respiratory acidosis
C. Metabolic acidosis with respiratory compensation
D. Acute respiratory alkalosis
🟢 A. Acute respiratory acidosis
🔴 Explanation: The low pH, elevated PaCO2, and normal HCO3
indicate an acute uncompensated respiratory acidosis caused by
alveolar hypoventilation secondary to central nervous system
depression from the narcotic overdose.
Question 8
Which of the following pharmacological agents is classified as a short-
acting beta-2 adrenergic agonist commonly used for rapid relief of
bronchospasm?
A. Salmeterol
B. Ipratropium bromide
VERIFIED AND WELL DETAILED ANSWERS | PLUS RATIONALES |
GUARANTEED PASS | LATEST EXAM UPDATE
*Core Domains:*
*- Patient Asses
*- Airway Manage
*- Mechanical Ve
*- Cardiopulmona
*- Pharmacology
*- Neonatal and
*- Pulmonary Reh
*- Professional
*Introduction:*
*The purpose of
SECTION ONE: QUESTIONS 1–100
Question 1
A 56-year-old male with a history of COPD presents to the emergency
department in acute respiratory distress. Arterial blood gas analysis on
room air reveals: pH 7.31, PaCO2 62 mmHg, PaO2 52 mmHg, HCO3
31 mEq/L. Which of the following is the most appropriate initial oxygen
therapy device?
A. Non-rebreather mask at 15 L/min
B. Nasal cannula at 2 L/min
C. Simple mask at 8 L/min
D. Venturi mask delivering 40 percent oxygen
🟢 B. Nasal cannula at 2 L/min
🔴 Explanation: Patients with chronic hypercapnia and COPD rely on
hypoxic drive and are at risk for oxygen-induced hyperventilation and
worsening respiratory acidosis if given high-flow oxygen. A low-flow
,device like a nasal cannula allows precise, controlled titration to achieve
an acceptable SpO2 without abolishing the hypoxic drive.
Question 2
A patient is receiving volume-controlled ventilation. The respiratory
therapist notes that the peak inspiratory pressure (PIP) has increased
significantly while the plateau pressure remains unchanged. Which of
the following conditions is most likely responsible for this finding?
A. Pulmonary fibrosis
B. Right mainstem intubation
C. Mucus plugging in the endotracheal tube
D. Primary acute respiratory distress syndrome
🟢 C. Mucus plugging in the endotracheal tube
🔴 Explanation: An increase in peak inspiratory pressure with a normal
plateau pressure indicates an increase in airway resistance rather than
a change in lung compliance. Mucus plugging or biting the endotracheal
tube increases resistance, raising PIP while leaving transalveolar
pressures unaffected.
Question 3
During a pre-operative evaluation, a patient performs spirometry. The
results show a forced expiratory volume in one second (FEV1) of 75
percent of predicted, a forced vital capacity (FVC) of 80 percent of
predicted, and an FEV1/FVC ratio of 68 percent. How should these
findings be interpreted?
A. Normal pulmonary function test
B. Severe restrictive ventilatory defect
C. Mild obstructive ventilatory defect
D. Combined restrictive and obstructive defect
🟢 C. Mild obstructive ventilatory defect
🔴 Explanation: An FEV1/FVC ratio below the lower limit of normal
(typically less than 70 percent) indicates an obstruction. With an FEV1
of 75 percent of predicted, the obstruction is classified as mild.
Question 4
A neonate born at 28 weeks of gestation develops increasing
,respiratory distress, nasal flaring, and expiratory grunting shortly after
delivery. A chest radiograph reveals diffuse bilateral reticulogranular
densities and air bronchograms. Which of the following is the primary
pathophysiological mechanism of this condition?
A. Pulmonary hypoplasia secondary to oligohydramnios
B. Deficiency of pulmonary surfactant leading to alveolar collapse
C. Aspiration of amniotic fluid causing mechanical airway obstruction
D. Persistent fetal circulation with pulmonary vascular hypertension
🟢 B. Deficiency of pulmonary surfactant leading to alveolar collapse
🔴 Explanation: The clinical presentation and radiographic findings are
classic for respiratory distress syndrome (RDS) of the newborn, caused
by immature type II alveolar cells failing to produce adequate
surfactant, which drastically increases surface tension and causes
diffuse microatelectasis.
Question 5
An adult patient with severe ARDS is placed on a mechanical ventilator
in the volume-control mode. To minimize the risk of ventilator-induced
lung injury, which of the following ventilator parameters should be
strictly monitored and limited?
A. Peak inspiratory pressure
B. Plateau pressure
C. Mean airway pressure
D. Total cycle time
🟢 B. Plateau pressure
🔴 Explanation: Plateau pressure reflects alveolar pressure at the end
of inspiration. Limiting plateau pressure to less than 30 cmH2O is a
fundamental cornerstone of lung-protective ventilation to prevent
alveolar overdistension and barotrauma/volutrauma in ARDS.
Question 6
A respiratory therapist is calibrating a Clark polarographic oxygen
electrode. The therapist exposes the sensor to 100 percent oxygen and
adjusts the reading to match the calibration standard. What is the next
essential step in the calibration process before clinical use?
, A. Expose the sensor to room air and verify a 21 percent reading
B. Expose the sensor to zero gas to establish a baseline
C. Disassemble the galvanic cell and replace the potassium hydroxide
electrolyte
D. Submerge the probe in sterile water to check for water vapor
pressure
🟢 A. Expose the sensor to room air and verify a 21 percent reading
🔴 Explanation: Polarographic oxygen analyzers require a two-point or
secondary verification check to ensure linearity. After calibrating at 100
percent, checking the sensor against room air (21 percent) confirms
proper function and scaling across the clinical measurement range.
Question 7
A patient with a suspected narcotic overdose is unresponsive, with a
respiratory rate of 6 breaths per minute and shallow breathing. Arterial
blood gas values show: pH 7.15, PaCO2 78 mmHg, PaO2 60 mmHg,
HCO3 24 mEq/L. Which classification best describes this acid-base
disturbance?
A. Acute respiratory acidosis
B. Chronic respiratory acidosis
C. Metabolic acidosis with respiratory compensation
D. Acute respiratory alkalosis
🟢 A. Acute respiratory acidosis
🔴 Explanation: The low pH, elevated PaCO2, and normal HCO3
indicate an acute uncompensated respiratory acidosis caused by
alveolar hypoventilation secondary to central nervous system
depression from the narcotic overdose.
Question 8
Which of the following pharmacological agents is classified as a short-
acting beta-2 adrenergic agonist commonly used for rapid relief of
bronchospasm?
A. Salmeterol
B. Ipratropium bromide
