Lindsey Jones Practice 2 Questions With Complete Solutions

After several moments of cardiac compressions with a patient suffering from a complete cardiopulmonary collapse, the patient's cardiac rhythm is consistent with asystole when compressions are momentarily halted. Which of the following medications would be most helpful to the patient: A. Quinidine B. epinephrine C. Romazicon D. Lidocaine correct answer: The correct answer is : B Explanation : Epinephrine is the drug of choice to treat asystole. The other medications are not used in the situation. A patient has been on mechanical ventilator support for 5 days. The physician would like to consider weaning the patient. The following clinical data is available: MIP -34 cmH2O VT (spont) 450 mL A-aDO2 220 mmHg VD/VT 0.70 VC 1.6 L RR 18/min Based on this data, the therapist should recommend A. obtain arterial blood gas analysis B. avoid weaning at this time C. perform pulmonary function testing D. begin weaning with pressure support correct answer: The correct answer is : B Explanation : All data suggests that the patient is ready to wean except for one piece of data. That is the VD/VT ratio which is above 60%. It must be below 60% for weaning to be considered What is the minute ventilation (L/min) of a 150-lb (68-kg) male who has a tidal volume 425 mL and a respiratory rate of 12? A. 6.2 B. 3.3 C. 5.1 D. 7.4 correct answer: The correct answer is : C Explanation : To determine the minute ventilation of the patient, one should multiply the tidal volume by the rate. In this case, tidal volume is expressed in milliliters. Because minute ventilation should be expressed as L/min, tidal volume must be translated to liters. Thus, .425 x 12 = 5.1 L During bedside spirometry, the respiratory therapist asks the patient to take a deep breath followed by a maximal, forceful exhalation. The therapist observes the point on the graph that shows the fastest air movement. Which of the following is being measured? A. FEV1 B. peak flow C. FEF 200-1200 D. forced vital capacity correct answer: The correct answer is : B Explanation : The maneuver expressed here, which is a deep breath followed by a maximal forceful exhalation, is called peak flow. A 52-year-old patient with COPD has been undergoing daily T-piece trails in an attempt to gradually wean from mechanical ventilation. For three consecutive days, the patient is unable to tolerate the trials for more than one hour and must be returned to full ventilatory support. The respiratory therapist should recommend which of the following? A. discontinue all weaning trails for one week B. pressure support mode C. extubate the patient D. provide Xanax during trails correct answer: The correct answer is : B Explanation : COPD patients often have difficulty weaning or liberating from mechanical ventilation. In this case, the use of pressure support would be most helpful as it augments the patient's spontaneous tidal volume, thus decreasing the work of breathing overall and facilitating longer spontaneous breathing trials The following data were obtained while an adult patient was receiving VC AC ventilation with an FIO2 0.60. HR BP (mm Hg) 135/88 128/86 119/80 101/75 SpO2 (%) Static Comp. PEEP (cm H2O 5 10 15 20 Which of the following PEEP levels should the respiratory therapist recommend? A. 10 cm H2O B. 5 cm H2O C. 20 cm H2O D. 15 cm H2O correct answer: The correct answer is : D Explanation : This group of data shows that with increasing PEEP the patient exhibits improved oxygen saturation. However, as PEEP is further increased, there is an ultimate degradation in hemodynamics that may result. According to this data, the patient's hemodynamic status deteriorates significantly at a PEEP level of 20 cm H2O. This is manifested by a sudden decrease in pulmonary compliance from 61 to 50 mL/cm H2O and a corresponding sharp decrease in blood pressure. After completing arterial puncture and blood extraction into a disposable 3.0 mL syringe, the respiratory therapist should handle the sample by A. placing the sample in an ice bath B. agitating the sample vigorously C. purging all air from the syringe D. adding heparin to the syringe correct answer: The correct answer is : C Explanation : A significant step in the performance of arterial bloo