You are the respiratory therapist working in a 600-bed urban medical center and your assignment
includes providing care to patients on the general medical floor. You are asked to assist in the care of a
recently admitted 32-year-old male patient who is 180 cm (5'11") tall and weighs 53 kg (117 lb). The
patient is pale and complains of persistent cough and fever for over a week. The hospitalist asks you to
evaluate the patient and report your findings. You arrive in the patient's room, introduce yourself, and
explain the purpose of your visit. Which of the following should you include in your assessment?
✔️✔️Vital Signs/ Pulse oximetry/ Breath sounds/ Respiratory pattern/ General appearance/ Past
medical history/ Diagnostic chest percussion/ History of present illness
You report your findings to the hospitalist, who asks for your recommendation. Based on your
assessment, which of the following would you recommend? ✔️✔️Administer oxygen by nasal cannula
at 5 L/min
The hospitalist asks what additional testing may be indicated. You should recommend ✔️✔️Arterial
blood gas/ Complete blood count/ chest radiograph/ 12-lead ECG/ Sputum culture/ Sputum acid-fast
stain/ drug toxicology/ serum electrolytes/ urinalysis/
An ELISA test confirms a diagnosis of HIV and a sputum acid fast stain is negative. Sputum culture
confirms the presence of Pneumocystis jiroveci. What additional therapy would you recommend at this
time? ✔️✔️Pentamidine
Four hours later, arterial blood gas analysis on 40% oxygen reveals: pH 7.20, PaCO2 60 torr, PaO2 64
torr, HCO3- 24 mEq/L, BE Zero, SaO2 (calc) 91%. Breath sounds are diminished with bilateral wheezing.
Which of the following would you recommend? ✔️✔️Initiate mechanical ventilation
The physician asks you to recommend initial ventilator settings. Which of the following would you
suggest? ✔️✔️VC/SIMV, VT 450 mL, f 12/min, FIO2 0.50, PEEP 3 cm H2O
You are the respiratory therapist working at a 330-bed suburban medical center. You are called to Labor
and Delivery to assist in the care of a 1500 g (3.3 lb) female neonate born at 30 weeks of gestation.The
neonate has been dried and placed on a radiant warmer. Her heart rate is 120/min, respiratory rate is
, 45/min, there is no activity or response to suctioning, and she is cyanotic. You should now
✔️✔️Administer oxygen
Two hours later you are called to the NICU to evaluate the neonate. She is currently receiving 50%
oxygen via oxyhood. Vital signs are: temperature 36.3° C (97.3° F), pulse 166/min, respirations 40/min,
BP 75/59 mm Hg, SpO2 81%. Auscultation reveals diminished breath sounds. Umbilical artery blood gas
results are: pH 7.32, PaCO2 45 torr, PaO2 49 torr, HCO3- 23 mEq/L, BE -1, SaO2 (calc) 79%. Which of the
following should you now recommend to the neonatologist? ✔️✔️Initiate nasal CPAP
An A-P chest radiograph reveals a ground glass appearance with diffuse bilateral radiopacities. Which of
the following would you recommend at this time? ✔️✔️Surfactant replacement therapy
Four hours later, you are asked to reassess the neonate. She is currently receiving 4 cm H2O CPAP
therapy via nasal prongs with 50% oxygen, Umbilical artery blood gas results are: pH 7.19, PaCO2 57
torr, PaO2 41 torr, HCO3- 22 mEq/L, BE -2, SaO2 (calc) 73%. You should now recommend ✔️✔️Initiate
mechanical ventilation
The neonatologist asks for your recommendation for initial ventilator settings. You should now
recommend ✔️✔️PC/SIMV, PIP 27 cm H2O, rate 29/min, FIO2 0.50, PEEP 4 cm H2O
You are the respiratory therapist working at a 350-bed suburban hospital. You receive a call from the
Emergency Department to assist in the care of a 53 year-old female patient who drove herself to the ED
after completing a high intensity exercise class. The patient presents with shortness of breath, nausea,
lightheadedness and an uncomfortable fullness in the center of her chest. She is 163 cm (5' 4") tall and
weighs 70 kg (154 lb). The ED physician asks you to evaluate the patient and report your findings.
✔️✔️Level of consciousness/ Vital signs/ Electrolytes/ Pulse oximetry/ General appearance/ ECG
monitor/ Breath sounds/ ABG results/ Diagnostic chest percussion/ CBC/ Troponin/ CXR
The ED physician asks for your recommendation. Which of the following would you recommend?
✔️✔️40% O2 via air-entrainment mask/ Continuous ECG monitor/ Aspirin therapy
The patient has been transferred to the Cardiac Cath Lab where a percutaneous cardiac catheterization
has been performed. The result of the catheterization indicated two blocked coronary vessels that have
been stented. During the procedure, the patient experienced a sudden decrease in heart rate, blood
pressure and oxygen saturation. The patient was successfully resuscitated and arrives in the Cardiac
Care Unit intubated and being manually ventilated. The intensivist asks you to recommend initial