LINDSEY JONES J TEST QUESTIONS
AND ANSWERS 100% CORRECT
Which of the following can cause inverted T waves on a 12-lead ECG?
A. second degree heart block
B. hypokalemia
C. digitalis toxicity
D. hyperkalemia - ANSWER-C. digitalis toxicity
There are two causes of inverted T waves: cardiac ischemia and digitalis toxicity.
How many portable oxygen E cylinders will be required for a 12-hour car trip with a flow
rate of 2 L/min?
A. 5
B. 2
C. 3
D. 4 - ANSWER-C. 3
To answer this question you must know that the tank factor for an E cylinder is 0.28. A
full E cylinder is 2200 PSI. Therefore 2200x0.28 is equal to 616 L. 616 divided by two is
equal to 308 min. A 12 hour car trip is 720 min. Therefore the patient will need three E
cylinders of oxygen to go on a 12 hour trip.
An oral pharyngeal airway is measured from the patient's jaw angle to the tip of the chin.
After placement, the semi-conscious patient repeatedly pushes the airway out with his
tongue. The therapist should
A. insert a larger airway.
B. replace with a nasal endotracheal tube
C. reinsert the oral airway.
D. secure the airway with tape. - ANSWER-C. reinsert the oral airway.
It is normal for a patient to reject an oral airway with their tongue. Reinserting the airway
is most appropriate.
A respiratory therapist changes from a normal adult ventilator circuit to a heated-wire
circuit. Arterial blood gases are as follows:
pH 7.31 PaCO2 48 torr
PaO2 81 torr
HCO3- 24 mEq/L
,BE 0 mEq/L
Which of the following changes is most indicated?
A. increase inspiratory flow rate
B. revert to the normal non-heated wire circuit
C. remove 50-100 mL of deadspace between the wye and patient
D. add 100 mL of deadspace at the patient-ventilator interface - ANSWER-C. remove
50-100 mL of deadspace between the wye and patient
Removing deadspace is the best option and is the only option that will reduce carbon
dioxide. What also makes this appropriate is the fact that CO2 is off target by a very
small amount, making a change in deadspace appropriate.
A patient in the emergency room, who is breathing rapidly and deeply, is receiving
heated aerosol by mask and large-volume nebulizer with FIO2 set at 1.0 and the flow
set at 15 L/min. The therapist notices the aerosol disappears completely with each
breath. Pulse oximetry shows an oxygen saturation of 88%. The therapist should
recommend
A. switch to a non-rebreathing mask at the same flow
B. increase flow to 20 L/min
C. decrease FIO2 to 0.6
D. a tandem aerosol device - ANSWER-D. a tandem aerosol device
A large volume nebulizer set at 60% with a flow of 15 L/min is producing a total gas flow
of 15 L/min. Because this patient is breathing rapidly and deeply and is hypoxic, it is
likely that the total flow is not meeting the inspiratory demands of the patient. Because
the flow of the large-volume nebulizer may not be increased significantly due to back
pressure the solution for this case is to add another tandem large-volume nebulizer
device, producing a total gas flow of 30 L/min.
A respiratory therapist is assisting in a cardiopulmonary stress testing of a patient. After
several increases in workload by increasing the incline on the treadmill, heart rate is
120/min, blood pressure is 130/95 mmHg and O2 Sat is 97%. Increasing the treadmill
further shows no further increase in these values, but the patient appears pale in color.
The therapist should recommend
A. after two minutes, increase workload
B. discontinue the test, document findings
C. monitor the patient closely
D. decrease workload - ANSWER-B. discontinue the test, document findings
The laboratory results of a sputum culture and sensitivity have returned for a patient
who has bilateral bacterial pneumonia. The culture reveals streptococcus, a gram-
,positive bacteria. The medical records indicates the patient is allergic to penicillin.
Which of the following should the respiratory therapist recommend?
A. Amoxicillin
B. Cephalexine (Keflex)
C. Methacillin
D. Nafcillin - ANSWER-B. Cephalexine (Keflex)
Normally gram-positive bacteria may be killed by penicillin-type antibiotics. But, because
the patient is allergic to penicillin, a suitable drug is cephalexine. Nafcillin and
methacillin are suitable antibiotics when a patient is penicillin-resistant but not when
they are allergic.
A patient with cystic fibrosis develops rhonchi after 5 minutes of PEP therapy at 20 cm
H2O. The respiratory therapist should
A. switching to flutter therapy
B. discontinue treatment, report to findings to the physician
C. begin cool bland aerosol therapy
D. continue the therapy - ANSWER-D. continue the therapy
The development of rhonchi in response to PEP therapy is considered to be a good
outcome for the therapy. The purpose of the therapy is to mobilize and promote
expectoration of secretions. The development of rhonchi is an indication that secretions
are moving from small and middle-sized airways to the larger size airways where they
may be naturally expectorated or suctioned. The therapy should be continued because
it is effective.
Excessive bubbling is noted in the water seal chamber of a chest tube drainage system.
Which of the following could be the cause?
A. water seal fluid level is too high
B. water seal fluid level is too low
C. wall pressure is too low
D. leak in the drainage tubing coming from the patient - ANSWER-D. leak in the
drainage tubing coming from the patient
A leak in the drainage tubing coming from a patient's chest will cause the entrainment of
additional air into the system which will show up as excessive bubbling in the water-seal
compartment. Normally gentle bubbling should be observed. When excessive bubbling
is present, a leak most likely exists somewhere between the waterseal compartment
and the patient's lung tissue and may be caused from a perforation or hole in the lung
tissue.
Which of the following would result in an increase in anatomical airway resistance?
A. an undersized endotracheal tube
, B. autoPEEP
C. pulmonary secretions
D. water build up in the ventilator circuit - ANSWER-C. pulmonary secretions
Airway resistance is increased in the presence of pulmonary secretions and
bronchoconstriction. The other examples listed are not anatomically related.
A patient presents in the emergency department (ED) with shallow, irregular
respirations. Which of the following diagnostic procedures would best help rule out a
pleural effusion?
A. PA chest radiograph
B. series of oblique chest radiographs
C. pulmonary angiogram
D. ventilation/perfusion (V/Q scan) - ANSWER-B. series of oblique chest radiographs
Pleural effusions may be diagnosed through obtaining a lateral decubitus x-ray or by
obtaining a series of x-rays from oblique angles and different positions.
The pulmonary function data shows decreased flows but normal volumes with
decreased DLCO
A. asthma
B. emphysema
C. chronic bronchitis
D. pulmonary fibrosis - ANSWER-B. emphysema
only obstructive disease with a low DLCO
A patient with ARDS receiving volume-controlled ventilation has the following arterial
blood results on the settings below:
Mode Assist/control Mandatory rate 22
VT 350 mL
FIO2 0.70
PEEP 22 cm H2O
C.I. 2.2 L/min/m2
Heart rate 102
pH 7.35
PaCO2 45 torr
PaO2 58 torr
HCO3- 25 mEq/L
BE +1 mEq/L
Which of the following changes is most appropriate?
A. increase FIO2 to 0.8
B. decrease PEEP to 20 cm H2O
AND ANSWERS 100% CORRECT
Which of the following can cause inverted T waves on a 12-lead ECG?
A. second degree heart block
B. hypokalemia
C. digitalis toxicity
D. hyperkalemia - ANSWER-C. digitalis toxicity
There are two causes of inverted T waves: cardiac ischemia and digitalis toxicity.
How many portable oxygen E cylinders will be required for a 12-hour car trip with a flow
rate of 2 L/min?
A. 5
B. 2
C. 3
D. 4 - ANSWER-C. 3
To answer this question you must know that the tank factor for an E cylinder is 0.28. A
full E cylinder is 2200 PSI. Therefore 2200x0.28 is equal to 616 L. 616 divided by two is
equal to 308 min. A 12 hour car trip is 720 min. Therefore the patient will need three E
cylinders of oxygen to go on a 12 hour trip.
An oral pharyngeal airway is measured from the patient's jaw angle to the tip of the chin.
After placement, the semi-conscious patient repeatedly pushes the airway out with his
tongue. The therapist should
A. insert a larger airway.
B. replace with a nasal endotracheal tube
C. reinsert the oral airway.
D. secure the airway with tape. - ANSWER-C. reinsert the oral airway.
It is normal for a patient to reject an oral airway with their tongue. Reinserting the airway
is most appropriate.
A respiratory therapist changes from a normal adult ventilator circuit to a heated-wire
circuit. Arterial blood gases are as follows:
pH 7.31 PaCO2 48 torr
PaO2 81 torr
HCO3- 24 mEq/L
,BE 0 mEq/L
Which of the following changes is most indicated?
A. increase inspiratory flow rate
B. revert to the normal non-heated wire circuit
C. remove 50-100 mL of deadspace between the wye and patient
D. add 100 mL of deadspace at the patient-ventilator interface - ANSWER-C. remove
50-100 mL of deadspace between the wye and patient
Removing deadspace is the best option and is the only option that will reduce carbon
dioxide. What also makes this appropriate is the fact that CO2 is off target by a very
small amount, making a change in deadspace appropriate.
A patient in the emergency room, who is breathing rapidly and deeply, is receiving
heated aerosol by mask and large-volume nebulizer with FIO2 set at 1.0 and the flow
set at 15 L/min. The therapist notices the aerosol disappears completely with each
breath. Pulse oximetry shows an oxygen saturation of 88%. The therapist should
recommend
A. switch to a non-rebreathing mask at the same flow
B. increase flow to 20 L/min
C. decrease FIO2 to 0.6
D. a tandem aerosol device - ANSWER-D. a tandem aerosol device
A large volume nebulizer set at 60% with a flow of 15 L/min is producing a total gas flow
of 15 L/min. Because this patient is breathing rapidly and deeply and is hypoxic, it is
likely that the total flow is not meeting the inspiratory demands of the patient. Because
the flow of the large-volume nebulizer may not be increased significantly due to back
pressure the solution for this case is to add another tandem large-volume nebulizer
device, producing a total gas flow of 30 L/min.
A respiratory therapist is assisting in a cardiopulmonary stress testing of a patient. After
several increases in workload by increasing the incline on the treadmill, heart rate is
120/min, blood pressure is 130/95 mmHg and O2 Sat is 97%. Increasing the treadmill
further shows no further increase in these values, but the patient appears pale in color.
The therapist should recommend
A. after two minutes, increase workload
B. discontinue the test, document findings
C. monitor the patient closely
D. decrease workload - ANSWER-B. discontinue the test, document findings
The laboratory results of a sputum culture and sensitivity have returned for a patient
who has bilateral bacterial pneumonia. The culture reveals streptococcus, a gram-
,positive bacteria. The medical records indicates the patient is allergic to penicillin.
Which of the following should the respiratory therapist recommend?
A. Amoxicillin
B. Cephalexine (Keflex)
C. Methacillin
D. Nafcillin - ANSWER-B. Cephalexine (Keflex)
Normally gram-positive bacteria may be killed by penicillin-type antibiotics. But, because
the patient is allergic to penicillin, a suitable drug is cephalexine. Nafcillin and
methacillin are suitable antibiotics when a patient is penicillin-resistant but not when
they are allergic.
A patient with cystic fibrosis develops rhonchi after 5 minutes of PEP therapy at 20 cm
H2O. The respiratory therapist should
A. switching to flutter therapy
B. discontinue treatment, report to findings to the physician
C. begin cool bland aerosol therapy
D. continue the therapy - ANSWER-D. continue the therapy
The development of rhonchi in response to PEP therapy is considered to be a good
outcome for the therapy. The purpose of the therapy is to mobilize and promote
expectoration of secretions. The development of rhonchi is an indication that secretions
are moving from small and middle-sized airways to the larger size airways where they
may be naturally expectorated or suctioned. The therapy should be continued because
it is effective.
Excessive bubbling is noted in the water seal chamber of a chest tube drainage system.
Which of the following could be the cause?
A. water seal fluid level is too high
B. water seal fluid level is too low
C. wall pressure is too low
D. leak in the drainage tubing coming from the patient - ANSWER-D. leak in the
drainage tubing coming from the patient
A leak in the drainage tubing coming from a patient's chest will cause the entrainment of
additional air into the system which will show up as excessive bubbling in the water-seal
compartment. Normally gentle bubbling should be observed. When excessive bubbling
is present, a leak most likely exists somewhere between the waterseal compartment
and the patient's lung tissue and may be caused from a perforation or hole in the lung
tissue.
Which of the following would result in an increase in anatomical airway resistance?
A. an undersized endotracheal tube
, B. autoPEEP
C. pulmonary secretions
D. water build up in the ventilator circuit - ANSWER-C. pulmonary secretions
Airway resistance is increased in the presence of pulmonary secretions and
bronchoconstriction. The other examples listed are not anatomically related.
A patient presents in the emergency department (ED) with shallow, irregular
respirations. Which of the following diagnostic procedures would best help rule out a
pleural effusion?
A. PA chest radiograph
B. series of oblique chest radiographs
C. pulmonary angiogram
D. ventilation/perfusion (V/Q scan) - ANSWER-B. series of oblique chest radiographs
Pleural effusions may be diagnosed through obtaining a lateral decubitus x-ray or by
obtaining a series of x-rays from oblique angles and different positions.
The pulmonary function data shows decreased flows but normal volumes with
decreased DLCO
A. asthma
B. emphysema
C. chronic bronchitis
D. pulmonary fibrosis - ANSWER-B. emphysema
only obstructive disease with a low DLCO
A patient with ARDS receiving volume-controlled ventilation has the following arterial
blood results on the settings below:
Mode Assist/control Mandatory rate 22
VT 350 mL
FIO2 0.70
PEEP 22 cm H2O
C.I. 2.2 L/min/m2
Heart rate 102
pH 7.35
PaCO2 45 torr
PaO2 58 torr
HCO3- 25 mEq/L
BE +1 mEq/L
Which of the following changes is most appropriate?
A. increase FIO2 to 0.8
B. decrease PEEP to 20 cm H2O
