LINDSEY JONES PRACTICE
QUESTIONS WITH CORRECT
SOLUTIONS
A patient is undergoing a cardiac workup and tolerance assessment while riding a
stationary bicycle. After a few minutes of observing the patient, the respiratory therapist
increases the tension to the cycle and observes the following change in blood pressure,
SpO2, and heart rate:
Before After
HR 98 119
BP 122/85 mm Hg 149/98 mm Hg
SpO2 0.97 0.95
A. administer Dobutrex (dobutamine).
B. reduce the cycle tension to the previous level.
C. continue the evaluation.
D. discontinue the assessment and document. - ANSWER-C. continue the evaluation.
A respiratory therapist is given the charge to sterilize a bronchoscope. Which of the
following should the respiratory therapist use to accomplish sterilization?
A. Steam autoclave
B. Irradiation followed by ethylene oxide
C. Alkaline gluteraldehyde (Cidex)
D. Pasteurization - ANSWER-C. Alkaline gluteraldehyde (Cidex)
A patient has been gradually weaning from mechanical ventilation for the past two
weeks. The physician requests data to determine the patient's current ability to breathe
on his own. Which of the following tests would not be indicated?
A. VC
B. VT
C. MVV
D. MIP - ANSWER-C. MVV
A patient in the intensive care unit has the following clinical and laboratory data:
PB 747 mm Hg
,PH2O 47 mm Hg
pH 7.28
PaCO2 52 mm Hg
PaO2 70 mm Hg
HCO3- 27 mEq/L
BE +2 mEq/L
FIO2 0.6
SaO2 1.0
CvO2 12 vol%
CaO2 17 vol%
Hb 15 gm/dL
Which of the following represents the C(a-v)O2?
A. 2 vol%
B. 200 vol%
C. 5 vol%
D. 25 vol% - ANSWER-C. 5 vol%
A patient is receiving volume-controlled ventilation following bariatric surgery for obesity.
Which of the following medications should the respiratory therapist recommend to
ensure the patient's comfort and assist in ventilator management?
A. Pronestyl
B. morphine sulfate
C. vecuronium bromide (Norcuron)
D. Mestinon - ANSWER-B. morphine sulfate
Morphine sulfate is one of the best medications to administer to patients receiving
mechanical ventilatory support to help the patient rest pain-free and to generally sedate
and relax the patient.
A 12-year-old patient in the emergency room with asthma has received a dose of Solu-
Medrol, four albuterol nebulizer treatments, and 1 hour of continuous albuterol at 10
mg/hr. The patient has not improved and maintains a PEFR of 50% of predicted and an
SaO2 of 91% on air. The respiratory therapist should recommend which of the
following?
A. add Atrovent (Ipratropium bromide) to albuterol by nebulizer
B. obtain an arterial blood gas
C. administer 60%/40% helium-oxygen
D. place the patient on high-flow oxygen - ANSWER-C. administer 60%/40% helium-
oxygen
On a patient receiving mechanical ventilation, it is observed that peak airway pressures
have been rising. During that same time interval, plateau pressures have been rising by
approximately the same amount. This is most suggestive of
, A. increasing dynamic compliance.
B. a decrease in pulmonary atelectasis.
C. decreasing pulmonary compliance.
D. increased elasticity of interstitial pulmonary tissue. - ANSWER-C. decreasing
pulmonary compliance.
A patient is on his second week in the intensive care unit (ICU). A tracheostomy is in
place and he is receiving ventilatory support by VC, A/C ventilation on the following
settings:
FIO2 0.6
PEEP 18 cm H2O
Rate 18/min
VT 450 mL
Other data shows:
PAW 42 cm H2O
HR 110/min
PAP 34/10 mm Hg
CVP 6 mm Hg
PCWP 8 cm H2O
C.I. 2.3 L/min/m2
ABGs
pH 7.30
PaCO2 51 mm Hg
PaO2 50 mm Hg
HCO3- 26 mEq/L
BE -4 mEq/L
Based on this information, the respiratory therapist should recommend
A. an intra-aortic balloon pump.
B. ECMO.
C. transtracheal oxygen.
D. NAVA ventilation - ANSWER-B. ECMO.
, The current oxygen index is calculated to be above 50. Once an oxygen index is greater
than 40, the patient 1) most likely has ARDS and could benefit from extracorporeal
membrane oxygenation (ECMO). Oxygen index is calculated by: OI = (O2% x PAW) /
PaO2 OI = (60 x 42) / 50 OI = OI = 50.4
A patient who has suffered a cerebral vascular accident cannot move her arms. She is
recovering in a long-term care department of a 250-bed hospital. The patient requires
frequent assistance with pulmonary hygiene as she is unable to expectorate. She has a
strong and effective cough. Which of the following devices is the most appropriate to
assist with secretion removal?
A. oral tip catheter, self-administered
B. nasal pharyngeal airway
C. tracheostomy tube
D. oral pharyngeal airway - ANSWER-B. nasal pharyngeal airway
Explanation :
A nasopharyngeal airway, also known as a nasal trumpet, is inserted into one of the
nostrils using a water-based lubricant. The size is determined by matching the inside
diameter of the inner naris. The Iength is approximately equal to the distance between
the earlobe and the nasal septum. When too long, the patient make cough
uncontrollably. These devices help to facilitate secretion removal for a patient requiring
frequent nasotracheal suctioning.
A pulse oximeter reading is significantly less than oxygen saturation by blood gas.
Which of the following could be the cause?
A. decreased QsQt
B. decreased CVP
C. marked hypotension
D. increased SVR - ANSWER-C. marked hypotension
Explanation :
Pulse oximeters are also known as single wavelength spectrophotometers. There are
multiple reasons why they may read inaccurately. Those reasons include: high ambient
light, the use of fingernail polish, poor peripheral perfusion, and marked hypotension. All
are correct.
Which of the following equations would help determine cardiac output?
A. ejection fraction
B. A-aDO2
C. Fick
D. oxygen consumption - ANSWER-C. Fick
What would most likely be indicated by an elevated CVP?
QUESTIONS WITH CORRECT
SOLUTIONS
A patient is undergoing a cardiac workup and tolerance assessment while riding a
stationary bicycle. After a few minutes of observing the patient, the respiratory therapist
increases the tension to the cycle and observes the following change in blood pressure,
SpO2, and heart rate:
Before After
HR 98 119
BP 122/85 mm Hg 149/98 mm Hg
SpO2 0.97 0.95
A. administer Dobutrex (dobutamine).
B. reduce the cycle tension to the previous level.
C. continue the evaluation.
D. discontinue the assessment and document. - ANSWER-C. continue the evaluation.
A respiratory therapist is given the charge to sterilize a bronchoscope. Which of the
following should the respiratory therapist use to accomplish sterilization?
A. Steam autoclave
B. Irradiation followed by ethylene oxide
C. Alkaline gluteraldehyde (Cidex)
D. Pasteurization - ANSWER-C. Alkaline gluteraldehyde (Cidex)
A patient has been gradually weaning from mechanical ventilation for the past two
weeks. The physician requests data to determine the patient's current ability to breathe
on his own. Which of the following tests would not be indicated?
A. VC
B. VT
C. MVV
D. MIP - ANSWER-C. MVV
A patient in the intensive care unit has the following clinical and laboratory data:
PB 747 mm Hg
,PH2O 47 mm Hg
pH 7.28
PaCO2 52 mm Hg
PaO2 70 mm Hg
HCO3- 27 mEq/L
BE +2 mEq/L
FIO2 0.6
SaO2 1.0
CvO2 12 vol%
CaO2 17 vol%
Hb 15 gm/dL
Which of the following represents the C(a-v)O2?
A. 2 vol%
B. 200 vol%
C. 5 vol%
D. 25 vol% - ANSWER-C. 5 vol%
A patient is receiving volume-controlled ventilation following bariatric surgery for obesity.
Which of the following medications should the respiratory therapist recommend to
ensure the patient's comfort and assist in ventilator management?
A. Pronestyl
B. morphine sulfate
C. vecuronium bromide (Norcuron)
D. Mestinon - ANSWER-B. morphine sulfate
Morphine sulfate is one of the best medications to administer to patients receiving
mechanical ventilatory support to help the patient rest pain-free and to generally sedate
and relax the patient.
A 12-year-old patient in the emergency room with asthma has received a dose of Solu-
Medrol, four albuterol nebulizer treatments, and 1 hour of continuous albuterol at 10
mg/hr. The patient has not improved and maintains a PEFR of 50% of predicted and an
SaO2 of 91% on air. The respiratory therapist should recommend which of the
following?
A. add Atrovent (Ipratropium bromide) to albuterol by nebulizer
B. obtain an arterial blood gas
C. administer 60%/40% helium-oxygen
D. place the patient on high-flow oxygen - ANSWER-C. administer 60%/40% helium-
oxygen
On a patient receiving mechanical ventilation, it is observed that peak airway pressures
have been rising. During that same time interval, plateau pressures have been rising by
approximately the same amount. This is most suggestive of
, A. increasing dynamic compliance.
B. a decrease in pulmonary atelectasis.
C. decreasing pulmonary compliance.
D. increased elasticity of interstitial pulmonary tissue. - ANSWER-C. decreasing
pulmonary compliance.
A patient is on his second week in the intensive care unit (ICU). A tracheostomy is in
place and he is receiving ventilatory support by VC, A/C ventilation on the following
settings:
FIO2 0.6
PEEP 18 cm H2O
Rate 18/min
VT 450 mL
Other data shows:
PAW 42 cm H2O
HR 110/min
PAP 34/10 mm Hg
CVP 6 mm Hg
PCWP 8 cm H2O
C.I. 2.3 L/min/m2
ABGs
pH 7.30
PaCO2 51 mm Hg
PaO2 50 mm Hg
HCO3- 26 mEq/L
BE -4 mEq/L
Based on this information, the respiratory therapist should recommend
A. an intra-aortic balloon pump.
B. ECMO.
C. transtracheal oxygen.
D. NAVA ventilation - ANSWER-B. ECMO.
, The current oxygen index is calculated to be above 50. Once an oxygen index is greater
than 40, the patient 1) most likely has ARDS and could benefit from extracorporeal
membrane oxygenation (ECMO). Oxygen index is calculated by: OI = (O2% x PAW) /
PaO2 OI = (60 x 42) / 50 OI = OI = 50.4
A patient who has suffered a cerebral vascular accident cannot move her arms. She is
recovering in a long-term care department of a 250-bed hospital. The patient requires
frequent assistance with pulmonary hygiene as she is unable to expectorate. She has a
strong and effective cough. Which of the following devices is the most appropriate to
assist with secretion removal?
A. oral tip catheter, self-administered
B. nasal pharyngeal airway
C. tracheostomy tube
D. oral pharyngeal airway - ANSWER-B. nasal pharyngeal airway
Explanation :
A nasopharyngeal airway, also known as a nasal trumpet, is inserted into one of the
nostrils using a water-based lubricant. The size is determined by matching the inside
diameter of the inner naris. The Iength is approximately equal to the distance between
the earlobe and the nasal septum. When too long, the patient make cough
uncontrollably. These devices help to facilitate secretion removal for a patient requiring
frequent nasotracheal suctioning.
A pulse oximeter reading is significantly less than oxygen saturation by blood gas.
Which of the following could be the cause?
A. decreased QsQt
B. decreased CVP
C. marked hypotension
D. increased SVR - ANSWER-C. marked hypotension
Explanation :
Pulse oximeters are also known as single wavelength spectrophotometers. There are
multiple reasons why they may read inaccurately. Those reasons include: high ambient
light, the use of fingernail polish, poor peripheral perfusion, and marked hypotension. All
are correct.
Which of the following equations would help determine cardiac output?
A. ejection fraction
B. A-aDO2
C. Fick
D. oxygen consumption - ANSWER-C. Fick
What would most likely be indicated by an elevated CVP?
