CRT exam 1A UPDATED ACTUAL
Questions and CORRECT Answers
You come upon a patient who is unresponsive and is not breathing. You had heard from her
nurse that she had discussed a do not resuscitate (DNR) order with her physician. You should -
CORRECT ANSWER - Immediate call a code and begin resuscitation efforts
If there is any doubt regarding a do not resuscitate (DNR) order or when written orders are not
present, resuscitation efforts should be begun. Formal or informal directives such as "slow code"
or "code gray" bypass the patient's rights and are generally
If the pH of a patient's blood falls below normal: - CORRECT ANSWER - the hemoglobin
saturation for a given PO2 falls. the affinity of hemoglobin for O2 decreases
The impact of variations in blood pH on the affinity of Hb for oxygen is called the Bohr effect.
According to the Bohr effect, a decrease in pH shifts the oxyhemoglobin dissociation curve to
the right. This right shift results in a decreased Hb affinity for O2, as manifested by a drop in the
Hb saturation for a given PO2.
While examining a patient in the ICU, you note that they appear somewhat edematous and the
nurse has indicated that the patient's urine output is "minimal." In what section of the medical
record would you check to determine the patient's fluid balance (intake vs. output)? - CORRECT
ANSWER - nurses' notes and flowsheet
A patient's fluid balance is the relationship between fluid intake and outputs primarily from
urination. It is normally noted in the nurses notes and flowsheet section of the medical record.
The normal fluid intake and output for adults is 1 to 2 liters per day, or 25 to 50 ml per hour. A
positive fluid balance results from excessive intake and/or decreased output and may contribute
to pulmonary or peripheral edema and hypertension. A negative fluid balance is generally due to
insufficient hydration and/or excessive urination from medications such as diuretics or
theophylline and may lead to hypotension and low cardiac output.
The normal range for vital capacity in a young healthy male of average size is:
Choose one answer. - CORRECT ANSWER - 4000 to 5000 ml
The normal range for vital capacity is 4000-5000 ml, representing about 80% of the total lung
capacity. Normal values vary significantly depending on age, sex, and test position. Weight is
not a factor in predicting normal values. Various nomograms are available for predicting normal
values.
, Incorrect
Compensation for metabolic acidosis occurs via:
Choose one answer. - CORRECT ANSWER - a decrease in blood CO2 levels
In compensatory processes, the system not primarily affected assumes responsibility for
returning the pH to normal. Thus compensation for metabolic acidosis would occur via changes
in blood CO2 levels, as regulated by the lungs. Specifically, the lungs would increase excretion
of CO2 (by hyperventilation) to offset the drop in HCO3 (base), thus restoring the pH toward
normal.
The diagnostic procedure most likely to confirm the presence of bronchogenic carcinoma is: -
CORRECT ANSWER - tissue biopsy via fiberoptic bronchoscopy
About three-quarters (75-80%) of all bronchogenic carcinomas are diagnosed by tissue biopsy
obtained via fiberoptic bronchoscopy. Cytologic examination of the sputum is an alternative
diagnostic method, but is only 40-60% diagnostic.
Diagnosis of myasthenia gravis may be confirmed via:
Choose one answer. - CORRECT ANSWER - injection of edrophonium (Tensilon)
In most cases, diagnosis of myasthenia gravis is based on the history and physical. Diagnosis is
confirmed using the Tensilon (edrophonium) test. Tensilon is a quaternary ammonium salt that
exerts a direct stimulant effect on the neuromuscular junction. Intravenous injection of 10 mg of
Tensilon relieves weakness caused by myasthenia gravis within 20-30 seconds of administration.
A patient has a TLC of 5500 mL, a VC of 4000 mL, and an IC of 3000 mL. What is his
functional residual capacity (FRC)? - CORRECT ANSWER - 2500 mL
FRC = TLC - IC = 5500 - 3000 = 2500 mL.
The amount of gas that can be inhaled over and above that normally inhaled during quiet
breathing is the: - CORRECT ANSWER - IRV
The inspiratory reserve volume or IRV is the maximum volume of air that can be inhaled
following a normal quiet inspiration.
Questions and CORRECT Answers
You come upon a patient who is unresponsive and is not breathing. You had heard from her
nurse that she had discussed a do not resuscitate (DNR) order with her physician. You should -
CORRECT ANSWER - Immediate call a code and begin resuscitation efforts
If there is any doubt regarding a do not resuscitate (DNR) order or when written orders are not
present, resuscitation efforts should be begun. Formal or informal directives such as "slow code"
or "code gray" bypass the patient's rights and are generally
If the pH of a patient's blood falls below normal: - CORRECT ANSWER - the hemoglobin
saturation for a given PO2 falls. the affinity of hemoglobin for O2 decreases
The impact of variations in blood pH on the affinity of Hb for oxygen is called the Bohr effect.
According to the Bohr effect, a decrease in pH shifts the oxyhemoglobin dissociation curve to
the right. This right shift results in a decreased Hb affinity for O2, as manifested by a drop in the
Hb saturation for a given PO2.
While examining a patient in the ICU, you note that they appear somewhat edematous and the
nurse has indicated that the patient's urine output is "minimal." In what section of the medical
record would you check to determine the patient's fluid balance (intake vs. output)? - CORRECT
ANSWER - nurses' notes and flowsheet
A patient's fluid balance is the relationship between fluid intake and outputs primarily from
urination. It is normally noted in the nurses notes and flowsheet section of the medical record.
The normal fluid intake and output for adults is 1 to 2 liters per day, or 25 to 50 ml per hour. A
positive fluid balance results from excessive intake and/or decreased output and may contribute
to pulmonary or peripheral edema and hypertension. A negative fluid balance is generally due to
insufficient hydration and/or excessive urination from medications such as diuretics or
theophylline and may lead to hypotension and low cardiac output.
The normal range for vital capacity in a young healthy male of average size is:
Choose one answer. - CORRECT ANSWER - 4000 to 5000 ml
The normal range for vital capacity is 4000-5000 ml, representing about 80% of the total lung
capacity. Normal values vary significantly depending on age, sex, and test position. Weight is
not a factor in predicting normal values. Various nomograms are available for predicting normal
values.
, Incorrect
Compensation for metabolic acidosis occurs via:
Choose one answer. - CORRECT ANSWER - a decrease in blood CO2 levels
In compensatory processes, the system not primarily affected assumes responsibility for
returning the pH to normal. Thus compensation for metabolic acidosis would occur via changes
in blood CO2 levels, as regulated by the lungs. Specifically, the lungs would increase excretion
of CO2 (by hyperventilation) to offset the drop in HCO3 (base), thus restoring the pH toward
normal.
The diagnostic procedure most likely to confirm the presence of bronchogenic carcinoma is: -
CORRECT ANSWER - tissue biopsy via fiberoptic bronchoscopy
About three-quarters (75-80%) of all bronchogenic carcinomas are diagnosed by tissue biopsy
obtained via fiberoptic bronchoscopy. Cytologic examination of the sputum is an alternative
diagnostic method, but is only 40-60% diagnostic.
Diagnosis of myasthenia gravis may be confirmed via:
Choose one answer. - CORRECT ANSWER - injection of edrophonium (Tensilon)
In most cases, diagnosis of myasthenia gravis is based on the history and physical. Diagnosis is
confirmed using the Tensilon (edrophonium) test. Tensilon is a quaternary ammonium salt that
exerts a direct stimulant effect on the neuromuscular junction. Intravenous injection of 10 mg of
Tensilon relieves weakness caused by myasthenia gravis within 20-30 seconds of administration.
A patient has a TLC of 5500 mL, a VC of 4000 mL, and an IC of 3000 mL. What is his
functional residual capacity (FRC)? - CORRECT ANSWER - 2500 mL
FRC = TLC - IC = 5500 - 3000 = 2500 mL.
The amount of gas that can be inhaled over and above that normally inhaled during quiet
breathing is the: - CORRECT ANSWER - IRV
The inspiratory reserve volume or IRV is the maximum volume of air that can be inhaled
following a normal quiet inspiration.
