Heart failure
A 48 year-old female is admitted to the ED
with diaphoresis, jugular venous
distension, and 3+ pitting edema in the
ankles. These findings are consistent with
A. liver failure.
B. pulmonary embolism.
C. heart failure.
D. electrolyte imbalances
Needle aspirate the 2nd left intercostal space.
A patient is admitted to the ED following a
motor vehicle accident. On physical exam,
the respiratory therapist discovers that
breath sounds are absent in the left chest
with a hyperresonant percussion note. The
trachea is shifted to the right. The patient's
heart rate is 45/min, respiratory rate is
30/min, and blood pressure is 60/40 mm
Hg. What action should the therapist
recommend first?
A. Call for a STAT chest x-ray.
B. Insert a chest tube into the left chest.
C. Needle aspirate the 2nd left intercostal
space.
D. Activate the medical emergency team to
intubate the patient.
monitoring intracuff pressures.
All of the following strategies are likely to
decrease the likelihood of damage to the
tracheal mucosa EXCEPT
A. maintaining cuff pressures between 20
and 25 mm Hg.
B. using the minimal leak technique for
inflation.
C. using a low-residual-volume, low-
compliance cuff.
D. monitoring intracuff pressures.
, deep breathing and coughing to clear secretions.
A 52 year-old post-operative
cholecystectomy patient's breath sounds
become more coarse upon completion of
postural drainage with percussion. The
respiratory therapist should recommend
A. continuing the therapy until breath
sounds improve.
B. administering dornase alpha.
C. administering albuterol therapy.
D. deep breathing and coughing to clear
secretions.
IPPB with normal saline
A 65 kg spinal cord injured patient has
developed atelectasis. His inspiratory
capacity is 30% of his predicted value.
What bronchial hygiene therapy would be
most appropriate initially?
A. IS / SMI
B. IPPB with normal saline
C. postural drainage and percussion
D. PEP therapy
1, 2, and 3 only
A patient on VC ventilation has
demonstrated auto-PEEP on ventilator
graphics. Which of the following controls,
when adjusted independently, would
increase expiratory time?
1. Tidal volume
2. Respiratory Rate
3. Inspiratory flow
4. Sensitivity
, Insert a chest tube
Which of the following would be the most
appropriate therapy for a dyspneic patient
who has crepitus with tracheal deviation to
the left and absent breath sounds on the
right?
A. Perform chest physiotherapy
B. Administer an IPPB treatment
C. Insert an endotracheal tube
D. Insert a chest tube
5.0 vol%
A 55 year-old post cardiac surgery patient
has the following ABG results: pH 7.50,
PaCO2 30 torr, PaO2 62 torr, HCO3 25
mEq/L, SaO2 92%, HB 14 g/dL, BE +2.
Venous blood gas results are pH 7.39,
PvCO2 43 torr, PvO2 37 torr, and SvO2
66%. Calculate the patient's C(a-v)O2.
A. 2.5 vol%
B. 4.0 vol%
C. 5.0 vol%
D. 5.5 vol%
50 mL/cm H2O
A patient on VC, SIMV with a VT of 500 mL
has a PIP of 25 cm H2O, Pplat of 15 cm
H2O and PEEP of 5 cm H2O. What is the
patient's static lung compliance
A. 25 mL/cm H2O
B. 35 mL/cm H2O
C. 45 mL/cm H2O
D. 50 mL/cm H2O
, reintubation
Immediately after extubation of a patient in
the ICU, the respiratory therapist observes
increasing respiratory distress with
intercostal retractions and marked stridor.
The SpO2 on 40% oxygen is noted to be
86%. Which of the following would be most
appropriate at this time?
A. cool mist aerosol treatment
B. aerosolized racemic epinephrine
C. manual ventilation with resuscitation
bag and mask
D. reintubation
A patient on SIMV with a set rate of 12/min and total rate of 24/min.
Which of the following patients would most
likely benefit from pressure support
ventilation?
A. An intubated patient with an absent
respiratory drive.
B. A patient on SIMV with a set rate of
12/min and total rate of 24/min.
C. A patient with acute lung injury.
D. A patient who requires short-term post-
operative ventilatory support.
A 48 year-old female is admitted to the ED
with diaphoresis, jugular venous
distension, and 3+ pitting edema in the
ankles. These findings are consistent with
A. liver failure.
B. pulmonary embolism.
C. heart failure.
D. electrolyte imbalances
Needle aspirate the 2nd left intercostal space.
A patient is admitted to the ED following a
motor vehicle accident. On physical exam,
the respiratory therapist discovers that
breath sounds are absent in the left chest
with a hyperresonant percussion note. The
trachea is shifted to the right. The patient's
heart rate is 45/min, respiratory rate is
30/min, and blood pressure is 60/40 mm
Hg. What action should the therapist
recommend first?
A. Call for a STAT chest x-ray.
B. Insert a chest tube into the left chest.
C. Needle aspirate the 2nd left intercostal
space.
D. Activate the medical emergency team to
intubate the patient.
monitoring intracuff pressures.
All of the following strategies are likely to
decrease the likelihood of damage to the
tracheal mucosa EXCEPT
A. maintaining cuff pressures between 20
and 25 mm Hg.
B. using the minimal leak technique for
inflation.
C. using a low-residual-volume, low-
compliance cuff.
D. monitoring intracuff pressures.
, deep breathing and coughing to clear secretions.
A 52 year-old post-operative
cholecystectomy patient's breath sounds
become more coarse upon completion of
postural drainage with percussion. The
respiratory therapist should recommend
A. continuing the therapy until breath
sounds improve.
B. administering dornase alpha.
C. administering albuterol therapy.
D. deep breathing and coughing to clear
secretions.
IPPB with normal saline
A 65 kg spinal cord injured patient has
developed atelectasis. His inspiratory
capacity is 30% of his predicted value.
What bronchial hygiene therapy would be
most appropriate initially?
A. IS / SMI
B. IPPB with normal saline
C. postural drainage and percussion
D. PEP therapy
1, 2, and 3 only
A patient on VC ventilation has
demonstrated auto-PEEP on ventilator
graphics. Which of the following controls,
when adjusted independently, would
increase expiratory time?
1. Tidal volume
2. Respiratory Rate
3. Inspiratory flow
4. Sensitivity
, Insert a chest tube
Which of the following would be the most
appropriate therapy for a dyspneic patient
who has crepitus with tracheal deviation to
the left and absent breath sounds on the
right?
A. Perform chest physiotherapy
B. Administer an IPPB treatment
C. Insert an endotracheal tube
D. Insert a chest tube
5.0 vol%
A 55 year-old post cardiac surgery patient
has the following ABG results: pH 7.50,
PaCO2 30 torr, PaO2 62 torr, HCO3 25
mEq/L, SaO2 92%, HB 14 g/dL, BE +2.
Venous blood gas results are pH 7.39,
PvCO2 43 torr, PvO2 37 torr, and SvO2
66%. Calculate the patient's C(a-v)O2.
A. 2.5 vol%
B. 4.0 vol%
C. 5.0 vol%
D. 5.5 vol%
50 mL/cm H2O
A patient on VC, SIMV with a VT of 500 mL
has a PIP of 25 cm H2O, Pplat of 15 cm
H2O and PEEP of 5 cm H2O. What is the
patient's static lung compliance
A. 25 mL/cm H2O
B. 35 mL/cm H2O
C. 45 mL/cm H2O
D. 50 mL/cm H2O
, reintubation
Immediately after extubation of a patient in
the ICU, the respiratory therapist observes
increasing respiratory distress with
intercostal retractions and marked stridor.
The SpO2 on 40% oxygen is noted to be
86%. Which of the following would be most
appropriate at this time?
A. cool mist aerosol treatment
B. aerosolized racemic epinephrine
C. manual ventilation with resuscitation
bag and mask
D. reintubation
A patient on SIMV with a set rate of 12/min and total rate of 24/min.
Which of the following patients would most
likely benefit from pressure support
ventilation?
A. An intubated patient with an absent
respiratory drive.
B. A patient on SIMV with a set rate of
12/min and total rate of 24/min.
C. A patient with acute lung injury.
D. A patient who requires short-term post-
operative ventilatory support.
