Lindsey Jones Practice Exam Qs w/
Explanations
1. A patient has undergone overnight oximetry. Data shows several episodes of O2 desaturation
throughout the night. The RTT would expect orders for which of the following kinds of testing:
a. V/Q scan
b. pulmonary function testing
c. polysomnography
d. 24-hour Holter monitoring - ANSYour answer: C
Correct answer: C
The use of overnight oximetery is often used to detect O2 desaturation during the night that may
be associated with central or obstructive sleep apnea. Because data indicates some periodic
desaturation, the practitioner should suspect possible sleep apnea and should order diagnostic
testing that will confirm or rule out the suspicion.
A routine screening blood gas performed on an asymptomatic patient prior to surgery shows the
following:
pH: 7.38
PaCO2: 42
PaO2: 80
HCO3: 26
SaO2: 96%
COHb: 24%
What should the RRT do?
a. place the patient on a NRB mask
b. report the findings and emphasize that the patient is likely a smoker
c. evaluate saturation using a single wave-length spectrophotometer
d. run quality control material and evaluate the accuracy of the co-oximeter - ANSyour answer:
D
correct answer: D
In this case the patient is presented as asyptomatic. A patient with a COHb level of 24% would
feel dyspnea and present with tachypnea. Therefore, the RRT should evaluate the accuracy of
the lab results, specifically the COHb. When checking accuracy of lab results, one would use
quality control measures.
,The infection control department of a small hospital informs the RRT supervisor that the
biological control accompanying some durable autoclaved equipment shows viable spores. The
supervisor should do which of the following with the equipment:
a. incinerate
b. record date and place into service
c. wipe with isopropyl alcohol before use
d. resterilize - ANSyour answer: D
correct answer: D
The presence of viable spores indicates the possibility of living organisms developing in the
sterilized package or on the sterilized equipment. Sterilization suggest the absence of living
organisms, therefore the presence of viable spores indicates the need to resterilize.
A post-op patient is not progressing with sustained maximal inspiratory therapy and refuses to
cough because of pain along the incision site. The RRT should instruct the patient to:
a. pause at the top of each inspiration
b. press a pillow against the incision site when coughing
c. attempt coughing 1 hour after pain medication has been administered
d. avoid coughing until the pain subsides - ANSyour answer: B
correct answer: B
Explosive coughing by a post-op patient can inadvertently open incision sites. To prevent this,
splinting the site with a pillow is an appropriate option.
Several hours after oral endotracheal extubation of an 8.0-mm tube, and adult patient begins to
demonstrate inspiratory stridor. Which of the following would be most helpful to the patient:
a. racemic epinephrine
b. albuterol
c. atropine sulfate
d. heated aerosol by mask - ANSyour answer: A
correct answer: A
When a patient is extubated and has swelling of the upper airway tissues as demonstrated by
stridor, racemic epinephrine is an appropriate medication to reduce swelling quickly. Another,
less effective option, is to provide a cool mist. In extreme cases, such as marked stridor,
reintubation, or an emergency tracheotomy may be indicated.
An adult patient is receiving mechanical ventilatory support and is being suctioned through the
endotracheal tube at a pressure of -90 mmHg. Secretions have been difficult to remove. What
can be done FIRST to increase suctioning efficiency:
,a. increase suction time
b. decrease suction to 80 mmHg
c. increase suction pressure to 100 mmHg
d. increase suction catheter size - ANSyour answer: C
Correct answer: C
An increase in suctioning effectiveness is done through three different ways - increasing suction
catheter diameter, increasing suction pressure, and increasing suction time. Before increasing
catheter size, the first thing that should be done is to ensure the appropriate range of suction
pressure is being used. In this case, the appropriate suction pressure for an adult is 100-120
mmHg. A pressure of 90 mmHg is being used, which is insufficient suction pressure. This
should be corrected before doing anything else to increase suction effectiveness.
A chemical indicator tape found inside the sealed, packeaged disposable mask helps determine
which of the following:
a. if the equipment is sterile
b. if the equipment has been properly sterilized
c. if microorganisms remain viable on the equipment
d. if the package has remained closed - ANSyour answer: A
correct answer: B
A chemical indicator tape inside a sterilized package does not actually indicated the presence or
absence of viable spores. It does, however, indicate if the equipment has been through the
sterilization process.
A 23-year old female patient in active child labor is receiving O2 by partial-rebreathing mask at
9/L/min. The reservoir bag collapses completely during contractions due to the patient's deep
rapid breaths. The RRT should recommend:
a. increasing the flow to the mask
b. changing to a nasal cannula
c. changing to 100% NRB
d. coaching the patient to take smaller breaths - ANSyour answer: C
correct answer: A
When the reservoir bag on a non-rebreather mask collapses completely with each breath, the
problem is most likely due to insufficient flow to the mask.
A radiology report of a chest x-ray indicates the end of the radio-opaque line on an oral
endotracheal tube is resting 1 cm above the carina. The RRT should suggest:
a. advance the ET tube 1 cm
b. withdraw the ET tube 2 cm
, c. withdraw the ET tube 5 cm
d. advance the ET tube 2 cm - ANSyour answer: B
correct answer: B
The ET tube is properly positioned when the end is 2-5 cm above the carina. In this case, the
tube is only 1 cm above the carina. Withdrawing the ET tube by 2-4 cm is appropriate.
Peak flow measurements are indicated in which of the following conditions, if present?
a. ARDS
b. airway obstruction
c. myasthenia gravis
d. Guillain-Barre - ANSyour answer: A
correct answer: B
Peak flow measurements are especially helpful in patients with asthma or patients who are
suspected to have airway obstruction, mostly due to bronchoconstriction.
A female patient is intubated with a 7.0 mm ET tube. The tube is noted to be positioned at 26
cm at the teeth. Breath sounds are not bilateral. Which of the following will best confirm
placement of the artificial airway:
a. capnography
b. chest radiograph
c. chest rise
d. breath sounds - ANSyour answer: B
correct answer: B
There are several ways to assess proper ET tube placement, such as auscultation of
breathsounds, observance of symmetric chest rise, or end-tidal CO2 evaluation. However, this
scenario asks for confirmation of proper placement, which is accomplished with a chest x-ray.
A blood gas analyzer fails again to produce acceptable results on the pH value when running
quality control material for the second time. The RRT should:
a. remove the machine from service
b. perform a one-point calibration
c. perform proficiency testing
d. monitor future results - ANSyour answer: A
correct answer: A
When a blood gas machine fails to produce accurate results on one of its analytes the RRT may
respond by removing the machine from service, notifying the supervisor, or rerunning the
control. In this case, removing the machine from service is the only suitable answer offered.
Explanations
1. A patient has undergone overnight oximetry. Data shows several episodes of O2 desaturation
throughout the night. The RTT would expect orders for which of the following kinds of testing:
a. V/Q scan
b. pulmonary function testing
c. polysomnography
d. 24-hour Holter monitoring - ANSYour answer: C
Correct answer: C
The use of overnight oximetery is often used to detect O2 desaturation during the night that may
be associated with central or obstructive sleep apnea. Because data indicates some periodic
desaturation, the practitioner should suspect possible sleep apnea and should order diagnostic
testing that will confirm or rule out the suspicion.
A routine screening blood gas performed on an asymptomatic patient prior to surgery shows the
following:
pH: 7.38
PaCO2: 42
PaO2: 80
HCO3: 26
SaO2: 96%
COHb: 24%
What should the RRT do?
a. place the patient on a NRB mask
b. report the findings and emphasize that the patient is likely a smoker
c. evaluate saturation using a single wave-length spectrophotometer
d. run quality control material and evaluate the accuracy of the co-oximeter - ANSyour answer:
D
correct answer: D
In this case the patient is presented as asyptomatic. A patient with a COHb level of 24% would
feel dyspnea and present with tachypnea. Therefore, the RRT should evaluate the accuracy of
the lab results, specifically the COHb. When checking accuracy of lab results, one would use
quality control measures.
,The infection control department of a small hospital informs the RRT supervisor that the
biological control accompanying some durable autoclaved equipment shows viable spores. The
supervisor should do which of the following with the equipment:
a. incinerate
b. record date and place into service
c. wipe with isopropyl alcohol before use
d. resterilize - ANSyour answer: D
correct answer: D
The presence of viable spores indicates the possibility of living organisms developing in the
sterilized package or on the sterilized equipment. Sterilization suggest the absence of living
organisms, therefore the presence of viable spores indicates the need to resterilize.
A post-op patient is not progressing with sustained maximal inspiratory therapy and refuses to
cough because of pain along the incision site. The RRT should instruct the patient to:
a. pause at the top of each inspiration
b. press a pillow against the incision site when coughing
c. attempt coughing 1 hour after pain medication has been administered
d. avoid coughing until the pain subsides - ANSyour answer: B
correct answer: B
Explosive coughing by a post-op patient can inadvertently open incision sites. To prevent this,
splinting the site with a pillow is an appropriate option.
Several hours after oral endotracheal extubation of an 8.0-mm tube, and adult patient begins to
demonstrate inspiratory stridor. Which of the following would be most helpful to the patient:
a. racemic epinephrine
b. albuterol
c. atropine sulfate
d. heated aerosol by mask - ANSyour answer: A
correct answer: A
When a patient is extubated and has swelling of the upper airway tissues as demonstrated by
stridor, racemic epinephrine is an appropriate medication to reduce swelling quickly. Another,
less effective option, is to provide a cool mist. In extreme cases, such as marked stridor,
reintubation, or an emergency tracheotomy may be indicated.
An adult patient is receiving mechanical ventilatory support and is being suctioned through the
endotracheal tube at a pressure of -90 mmHg. Secretions have been difficult to remove. What
can be done FIRST to increase suctioning efficiency:
,a. increase suction time
b. decrease suction to 80 mmHg
c. increase suction pressure to 100 mmHg
d. increase suction catheter size - ANSyour answer: C
Correct answer: C
An increase in suctioning effectiveness is done through three different ways - increasing suction
catheter diameter, increasing suction pressure, and increasing suction time. Before increasing
catheter size, the first thing that should be done is to ensure the appropriate range of suction
pressure is being used. In this case, the appropriate suction pressure for an adult is 100-120
mmHg. A pressure of 90 mmHg is being used, which is insufficient suction pressure. This
should be corrected before doing anything else to increase suction effectiveness.
A chemical indicator tape found inside the sealed, packeaged disposable mask helps determine
which of the following:
a. if the equipment is sterile
b. if the equipment has been properly sterilized
c. if microorganisms remain viable on the equipment
d. if the package has remained closed - ANSyour answer: A
correct answer: B
A chemical indicator tape inside a sterilized package does not actually indicated the presence or
absence of viable spores. It does, however, indicate if the equipment has been through the
sterilization process.
A 23-year old female patient in active child labor is receiving O2 by partial-rebreathing mask at
9/L/min. The reservoir bag collapses completely during contractions due to the patient's deep
rapid breaths. The RRT should recommend:
a. increasing the flow to the mask
b. changing to a nasal cannula
c. changing to 100% NRB
d. coaching the patient to take smaller breaths - ANSyour answer: C
correct answer: A
When the reservoir bag on a non-rebreather mask collapses completely with each breath, the
problem is most likely due to insufficient flow to the mask.
A radiology report of a chest x-ray indicates the end of the radio-opaque line on an oral
endotracheal tube is resting 1 cm above the carina. The RRT should suggest:
a. advance the ET tube 1 cm
b. withdraw the ET tube 2 cm
, c. withdraw the ET tube 5 cm
d. advance the ET tube 2 cm - ANSyour answer: B
correct answer: B
The ET tube is properly positioned when the end is 2-5 cm above the carina. In this case, the
tube is only 1 cm above the carina. Withdrawing the ET tube by 2-4 cm is appropriate.
Peak flow measurements are indicated in which of the following conditions, if present?
a. ARDS
b. airway obstruction
c. myasthenia gravis
d. Guillain-Barre - ANSyour answer: A
correct answer: B
Peak flow measurements are especially helpful in patients with asthma or patients who are
suspected to have airway obstruction, mostly due to bronchoconstriction.
A female patient is intubated with a 7.0 mm ET tube. The tube is noted to be positioned at 26
cm at the teeth. Breath sounds are not bilateral. Which of the following will best confirm
placement of the artificial airway:
a. capnography
b. chest radiograph
c. chest rise
d. breath sounds - ANSyour answer: B
correct answer: B
There are several ways to assess proper ET tube placement, such as auscultation of
breathsounds, observance of symmetric chest rise, or end-tidal CO2 evaluation. However, this
scenario asks for confirmation of proper placement, which is accomplished with a chest x-ray.
A blood gas analyzer fails again to produce acceptable results on the pH value when running
quality control material for the second time. The RRT should:
a. remove the machine from service
b. perform a one-point calibration
c. perform proficiency testing
d. monitor future results - ANSyour answer: A
correct answer: A
When a blood gas machine fails to produce accurate results on one of its analytes the RRT may
respond by removing the machine from service, notifying the supervisor, or rerunning the
control. In this case, removing the machine from service is the only suitable answer offered.
