RESPIRATORY THERAPY RCP190 FW: CLINICAL SIMULATION SELF-ASSESSMENT EXAMINATION (FORM 2020B) ACTUAL CASE STUDIES & EXPLANATIONS (FOR YR. 2026/2027) RESULTS FOR TAYLOR HARRIS

RESPIRATORY THERAPY RCP190 FW: CLINICAL SIMULATION SELF-ASSESSMENT EXAMINATION (FORM 2020B) ACTUAL CASE STUDIES & EXPLANATIONS (FOR YR. 2026/2027) RESULTS FOR TAYLOR HARRIS () From: Michael Valverde To: Taylor Harris (HATA06771) Cc: Erin O'Rourke Date: Thu, Oct 10, 2025, 10:44 AM SimSummary.PDF 91 KB San Joaquin Valley College| Bakersfield, CA The National Board for Respiratory Care, Inc. Clinical Simulation Self-Assessment Examination (Form 2020 B) SIMULATION RESPONSE REPORT ID: Name: Taylor Harris Finish date: 10/10/2025 12:01 PM Central Daylight Time Simulation 1: B. Adult Trauma The night-shift respiratory therapy supervisor is evaluating a 25-year-old male unrestrained driver who was involved in a head-on collision. The patient is agitated and has a cervical spine collar in place. He is 183 cm (6 ft) tall and weighs 80 kg (176 lb). While receiving O2 by nasal cannula at 3 L/min, vital signs are: Temperature 36.2º C (97.2º F) HR 120/min RR 30/min BP 90/60 mm Hg SpO2 87% O2 flow is increased to 6 L/min. Which of the following information should be evaluated? (SELECT AS MANY as you consider indicated, then click on the Go To Next Section button to proceed.) 1 Presence of craniofacial trauma Scattered facial ecchymosis and lacerations requiring suture Explanation: Craniofacial trauma may complicate intubation or the use of certain NPPV interfaces. 2 Level of consciousness Confused and grimacing; Glasgow Coma Scale score 12 Explanation: This is necessary to judge severity of central nervous system injury, respiratory drive, need for airway protection, and ability to cooperate. 2 Physical examination of the chest Slight paradoxical movement of the left side of the chest, decreased breath sounds on the left side Explanation: Trauma patients must be evaluated for disruption of chest wall integrity. Breath sounds are important when assessing ventilatory function. 1 Physical examination of the abdomen Soft and non-tender Explanation: Assessment of the abdomen in trauma patients is done to anticipate further problems such as internal bleeding and ventilatory insufficiency. The patient is agitated, with a GCS score of 12, and has scattered facial ecchymosis and lacerations. A left apical pneumothorax is observed along with paradoxical movement of the left chest. Breath sounds are reduced on the left side. SpO2 is 86% while receiving O2 by nasal cannula at 6 L/min. Which of the following should the therapist recommend? (CHOOSE ONLY ONE unless you are directed to "Make another selection.") -1 Intubate and initiate mechanical ventilation. Make another selection. Explanation: A trial of less invasive therapy is indicated prior to intubation and mechanical ventilation. 1 Administer O2 by nonrebreathing mask. The physician prefers HHFNC at 50 L/min with an FIO2 of 1.0. Explanation: Use of HHFNC in severe hypoxic respiratory failure is recommended. Five minutes later, SpO2 is 93% while the patient is receiving HHFNC at 50 L/min with an FIO2 of 1.0. A strong odor of alcohol is noted on the patient. A chest radiograph reveals ribs 2 through 7 are fractured in several places on the left and there is an infiltrate consistent with pulmonary contusion on the left side of the chest. Which of the following should be evaluated? (SELECT AS MANY as you consider indicated, then click on the Go To Next Section button to proceed.) 2 Chest CT Fractured ribs 2-7 on the left side, basilar atelectasis, apical pneumothorax on the left, small lung volumes Explanation: A chest CT is indicated after a high-speed trauma with associated pulmonary dysfunction. 2 CBC Hb 15 g/dL, Hct 44%, WBC 6000/µL, platelets 221,000/µL Explanation: In trauma, bleeding is always a consideration, and an early CBC will give baseline data. -2 Sputum culture Not indicated at this time Explanation: There is no indication of respiratory infection immediately after acute injury, and obtaining a sample using nasotracheal suctioning may be harmful. 1 Toxicology screen Results pending /This is an important evaluation to assess the possible source of agitation in a trauma patient. 1 Cervical spine radiograph No abnormalities; cervical collar maintained pending further assessment Explanation: Cervical spine radiographs may indicate the presence of fracture or dislocation of the cervical spine.