LINDSEY JONES - TEST E QUESTIONS
AND ANSWERS (GRADED A+)
A patient with a history of chronic bronchitis is post-operative for an exploratory
laparotomy. Review of the medical record suggests the physician has concern about
difficulty clearing secretions after the procedure. To assist the patient with mobilization
and removal of secretions, the respiratory therapist should recommend
A. administer tetracycline
B. instruction on deep breathing and coughing techniques
C. MDI therapy with an anti-inflammatory corticosteroid
D. administer cromolyn sodium - ANSWER-B. instruction on deep breathing and
coughing techniques
Which of the following conditions would be a contraindication for IPPB?
A. fractured ribs
B. pulmonary edema
C. untreated pneumothorax
D. a patient requiring bronchodilation AND lung expansion - ANSWER-C. untreated
pneumothorax
The respiratory therapist has an order to cap a patient with a fenestrated tracheostomy
tube in preparation for speech therapy. Prior to applying the cap on the end of the tube,
the therapist should also ensure
A. the inner cannula is in place and the cuff deflated
B. the inner cannula is in place and the cuff inflated.
C. the inner cannula is removed and the cuff deflated
D. the inner cannula is removed and the cuff inflated - ANSWER-C. the inner cannula is
removed and the cuff deflated
A 75-kg (165-lbs) male is in acute ventilatory failure. In preparation for mechanical
ventilatory support, the patient is to be orally intubated. Which of the following artificial
airways would be most appropriate for this patient?
A. Size 8.0 mm ET tube with a small volume, high pressure cuff
B. Jackson tracheostomy tube
C. Size 7.5 mm fenestrated tracheostomy tube
D. Size 7.0 mm ET tube with a large volume, low pressure cuff - ANSWER-D. Size 7.0
mm ET tube with a large volume, low pressure cuff
Which of the following devices is needed to determine a patient's airway resistance?
,A. turbine pneumotachometer
B. Wheatstone bridge helium analyzer
C. Geissler tube nitrogen analyzer
D. Body box - ANSWER-D. Body box
A patient is receiving manual ventilatory support with a bag-valve connected to a size
8.0 mm ET tube. While transporting the patient from CT scan back to the intensive care
unit, the respiratory therapist notices oxygen saturation has dropped to 88% and that
the bag-valve is easier to squeeze than normal. Suspecting mal-positioning of the ET
tube, the respiratory therapist should first
A. obtain an arterial blood gas
B. examine chest rise and auscultate breath sounds
C. call for a chest radiograph
D. perform diagnostic chest percussion - ANSWER-B. examine chest rise and
auscultate breath sounds
A 48-year-old patient has just been orally intubated prior to being placed on volume-
controlled ventilation. The respiratory therapist should do which of the following to best
confirm proper placement of the endotracheal tube?
A. assess chest rise symmetry
B. obtain a chest radiograph
C. auscultate breath sounds
D. examine tube markings near the lips - ANSWER-B. obtain a chest radiograph
After 20 minutes into a spontaneous breathing trial (SBT) a mechanically ventilated
female patient becomes anxious. Her baseline heart rate has increased by 20 /min.
What should the respiratory therapist do?
A. Return to full mechanical ventilation
B. Measure MIP
C. Calculate the RSBI
D. Increase the FIO2 and continue to monitor - ANSWER-A. Return to full mechanical
ventilation
What is needed to determine arterial oxygen content?
A. Oxygen index
B. PvO2
C. Hemoglobin level
D. P/F ratio - ANSWER-C. Hemoglobin level
A patient presents to the emergency room with fulminating pulmonary edema. Which of
the following would be experienced with this emergency?
, A. CVP 10 torr and PAP 10 torr
B. hypovolemia
C. elevated left ventricular filling pressure with low QT
D. a good response to supplemental O2 - ANSWER-C. elevated left ventricular filling
pressure with low QT
Which of the following conditions would benefit most from a thoracentesis?
A. complete opacification of the right lung
B. pericardial contusion
C. atelectasis
D. small pneumothorax - ANSWER-D. small pneumothorax
Which of the following conditions would benefit most from cardioversion?
A. ventricular fibrillation
B. frequent PVCs
C. asystole
D. ventricular tachycardia with a pulse - ANSWER-D. ventricular tachycardia with a
pulse
Which of the following is the best indicator of the adequacy of alveolar ventilation?
A. tidal volume
B. color
C. PaCO2 from an arterial blood gas analysis
D. respiratory rate - ANSWER-C. PaCO2 from an arterial blood gas analysis
A 32-gestational week newborn is receiving mechanical ventilation via a 3.0 mm
endotracheal tube. Which of the following are associated with ongoing assessment of
renal function?
A. PCWP
B. diaper weight and blood draw volumes are recorded
C. humidification is maintained at a non-invasive temperature
D. mPAP - ANSWER-B. diaper weight and blood draw volumes are recorded
A patient with ARDS and asthma could benefit from which of the following medications?
A. exogenous surfactant
B. cromolyn sodium
C. Tobramycin and albuterol
D. Spiriva and decadron - ANSWER-A. exogenous surfactant
, When analyzing the FIO2 for an infant in an oxygen hood receiving oxygen therapy with
a blender set at 50%, the respiratory therapist notes an oxygen concentration of 35%
near the patient's mouth. The jet nebulizer entrainment setting is set to 50%. To correct
the problem, the therapist should
A. change the nebulizer entrainment port to 100%
B. adjust blender setting to 60%
C. increase total flow to the oxyhood
D. obtain a smaller oxyhood - ANSWER-A. change the nebulizer entrainment port to
100%
Following the insertion of a tracheostomy tube, the patient is found to have diffuse
crackles upon auscultation secondary to subcutaneous emphysema. Which of the
following radiographic findings would be expected with this condition?
A. Tracheal shift from midline
B. Hyperlucency in the soft tissues
C. Scattered patchy infiltrates
D. Diffuse pulmonary hyperlucency - ANSWER-B. Hyperlucency in the soft tissues
Placement of a pulmonary artery catheter is associated with which of the following most
common complications?
A. cardiac arrhythmias
B. pulmonic valve damage
C. hypotension
D. internal bleeding - ANSWER-A. cardiac arrhythmias
During the placement of a pulmonary artery catheter, the respiratory therapist observes
the waveform on the monitor and notices it is repeatedly rising and falling from 0 mmHg
to 25 mmHg, which is an indication that the tip of the catheter is in the right ventricle of
the heart. Based on this information, the respiratory therapist will recommend
A. inflate the catheter balloon to sail the tip to the proper location
B. rotate the catheter to achieve a dicrotic notch in the waveform
C. suture the catheter in place
D. withdraw the catheter back to the upper vena cava - ANSWER-A. inflate the catheter
balloon to sail the tip to the proper location
The respiratory therapist should look to which of the following clinical data to determine
the effectiveness of incentive spirometry?
A. Inspiratory capacity predicted volume
B. Arterial blood gas analysis pre and post treatment
C. Breath sounds before and after every treatment
AND ANSWERS (GRADED A+)
A patient with a history of chronic bronchitis is post-operative for an exploratory
laparotomy. Review of the medical record suggests the physician has concern about
difficulty clearing secretions after the procedure. To assist the patient with mobilization
and removal of secretions, the respiratory therapist should recommend
A. administer tetracycline
B. instruction on deep breathing and coughing techniques
C. MDI therapy with an anti-inflammatory corticosteroid
D. administer cromolyn sodium - ANSWER-B. instruction on deep breathing and
coughing techniques
Which of the following conditions would be a contraindication for IPPB?
A. fractured ribs
B. pulmonary edema
C. untreated pneumothorax
D. a patient requiring bronchodilation AND lung expansion - ANSWER-C. untreated
pneumothorax
The respiratory therapist has an order to cap a patient with a fenestrated tracheostomy
tube in preparation for speech therapy. Prior to applying the cap on the end of the tube,
the therapist should also ensure
A. the inner cannula is in place and the cuff deflated
B. the inner cannula is in place and the cuff inflated.
C. the inner cannula is removed and the cuff deflated
D. the inner cannula is removed and the cuff inflated - ANSWER-C. the inner cannula is
removed and the cuff deflated
A 75-kg (165-lbs) male is in acute ventilatory failure. In preparation for mechanical
ventilatory support, the patient is to be orally intubated. Which of the following artificial
airways would be most appropriate for this patient?
A. Size 8.0 mm ET tube with a small volume, high pressure cuff
B. Jackson tracheostomy tube
C. Size 7.5 mm fenestrated tracheostomy tube
D. Size 7.0 mm ET tube with a large volume, low pressure cuff - ANSWER-D. Size 7.0
mm ET tube with a large volume, low pressure cuff
Which of the following devices is needed to determine a patient's airway resistance?
,A. turbine pneumotachometer
B. Wheatstone bridge helium analyzer
C. Geissler tube nitrogen analyzer
D. Body box - ANSWER-D. Body box
A patient is receiving manual ventilatory support with a bag-valve connected to a size
8.0 mm ET tube. While transporting the patient from CT scan back to the intensive care
unit, the respiratory therapist notices oxygen saturation has dropped to 88% and that
the bag-valve is easier to squeeze than normal. Suspecting mal-positioning of the ET
tube, the respiratory therapist should first
A. obtain an arterial blood gas
B. examine chest rise and auscultate breath sounds
C. call for a chest radiograph
D. perform diagnostic chest percussion - ANSWER-B. examine chest rise and
auscultate breath sounds
A 48-year-old patient has just been orally intubated prior to being placed on volume-
controlled ventilation. The respiratory therapist should do which of the following to best
confirm proper placement of the endotracheal tube?
A. assess chest rise symmetry
B. obtain a chest radiograph
C. auscultate breath sounds
D. examine tube markings near the lips - ANSWER-B. obtain a chest radiograph
After 20 minutes into a spontaneous breathing trial (SBT) a mechanically ventilated
female patient becomes anxious. Her baseline heart rate has increased by 20 /min.
What should the respiratory therapist do?
A. Return to full mechanical ventilation
B. Measure MIP
C. Calculate the RSBI
D. Increase the FIO2 and continue to monitor - ANSWER-A. Return to full mechanical
ventilation
What is needed to determine arterial oxygen content?
A. Oxygen index
B. PvO2
C. Hemoglobin level
D. P/F ratio - ANSWER-C. Hemoglobin level
A patient presents to the emergency room with fulminating pulmonary edema. Which of
the following would be experienced with this emergency?
, A. CVP 10 torr and PAP 10 torr
B. hypovolemia
C. elevated left ventricular filling pressure with low QT
D. a good response to supplemental O2 - ANSWER-C. elevated left ventricular filling
pressure with low QT
Which of the following conditions would benefit most from a thoracentesis?
A. complete opacification of the right lung
B. pericardial contusion
C. atelectasis
D. small pneumothorax - ANSWER-D. small pneumothorax
Which of the following conditions would benefit most from cardioversion?
A. ventricular fibrillation
B. frequent PVCs
C. asystole
D. ventricular tachycardia with a pulse - ANSWER-D. ventricular tachycardia with a
pulse
Which of the following is the best indicator of the adequacy of alveolar ventilation?
A. tidal volume
B. color
C. PaCO2 from an arterial blood gas analysis
D. respiratory rate - ANSWER-C. PaCO2 from an arterial blood gas analysis
A 32-gestational week newborn is receiving mechanical ventilation via a 3.0 mm
endotracheal tube. Which of the following are associated with ongoing assessment of
renal function?
A. PCWP
B. diaper weight and blood draw volumes are recorded
C. humidification is maintained at a non-invasive temperature
D. mPAP - ANSWER-B. diaper weight and blood draw volumes are recorded
A patient with ARDS and asthma could benefit from which of the following medications?
A. exogenous surfactant
B. cromolyn sodium
C. Tobramycin and albuterol
D. Spiriva and decadron - ANSWER-A. exogenous surfactant
, When analyzing the FIO2 for an infant in an oxygen hood receiving oxygen therapy with
a blender set at 50%, the respiratory therapist notes an oxygen concentration of 35%
near the patient's mouth. The jet nebulizer entrainment setting is set to 50%. To correct
the problem, the therapist should
A. change the nebulizer entrainment port to 100%
B. adjust blender setting to 60%
C. increase total flow to the oxyhood
D. obtain a smaller oxyhood - ANSWER-A. change the nebulizer entrainment port to
100%
Following the insertion of a tracheostomy tube, the patient is found to have diffuse
crackles upon auscultation secondary to subcutaneous emphysema. Which of the
following radiographic findings would be expected with this condition?
A. Tracheal shift from midline
B. Hyperlucency in the soft tissues
C. Scattered patchy infiltrates
D. Diffuse pulmonary hyperlucency - ANSWER-B. Hyperlucency in the soft tissues
Placement of a pulmonary artery catheter is associated with which of the following most
common complications?
A. cardiac arrhythmias
B. pulmonic valve damage
C. hypotension
D. internal bleeding - ANSWER-A. cardiac arrhythmias
During the placement of a pulmonary artery catheter, the respiratory therapist observes
the waveform on the monitor and notices it is repeatedly rising and falling from 0 mmHg
to 25 mmHg, which is an indication that the tip of the catheter is in the right ventricle of
the heart. Based on this information, the respiratory therapist will recommend
A. inflate the catheter balloon to sail the tip to the proper location
B. rotate the catheter to achieve a dicrotic notch in the waveform
C. suture the catheter in place
D. withdraw the catheter back to the upper vena cava - ANSWER-A. inflate the catheter
balloon to sail the tip to the proper location
The respiratory therapist should look to which of the following clinical data to determine
the effectiveness of incentive spirometry?
A. Inspiratory capacity predicted volume
B. Arterial blood gas analysis pre and post treatment
C. Breath sounds before and after every treatment
