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 rec-
ommend:
A. Continuing the therapy until breath sounds improve.
B. administering dornase alpha.
C. administering albuterol therapy.
D. deep breathing and coughing to clear secretions. - ANSWER D. deep breathing and
coughing to clear secretions.
See Patient Assessment
A healthy adult female can exhale what portion of her forced vital capacity in the first sec-
ond? - ANSWER 70%
Following cardiac surgery, a 55 year-old 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. - ANSWER 5% volume
What value for the apnea-hypopnea index (AHI) is consistent with mild obstructive sleep ap-
nea? - ANSWER 5 to 15
1
,The respiratory therapist is asked to evaluate the presence of Auto-PEEP on a patient receiv-
ing mechanical ventilation. In order to do this, what should the RT do? - ANSWER Initi-
ate an expiratory hold just prior to the next ventilator-delivered breath
What do bronchial breath sounds heard over the lung periphery indicate? - AN-
SWER lung consolidation (pneumonia)
Rationale: should be vesicular in periphery
A 60 kg (132 lb) patient is mechanically ventilated at the following settings: VC, A/C; VT 500
mL, respiratory rate 12/min, FIO2 1.00 and 10 cm H2O PEEP. The patient's peak airway pres-
sure is 60 cm H2O and his SpO2 is 85%. A current chest x-ray shows diffuse bilateral infil-
trates. Which of the following is the most appropriate action in order to reduce peak airway
pressure?
A. Increase the frequency.
B. Change to airway pressure release ventilation.
C. Decrease the inspiratory time.
D. Increase PEEP to 15 cm H2O. - ANSWER B. Change to airway pressure release venti-
lation.
A 19-year-old patient is brought to the Emergency Department after taking a handful of pills.
The patient is obtunded but is making regular, sonorous respiratory efforts. Auscultation re-
veals coarse rhonchi bilaterally. Which of the following should be done FIRST to assess this
patient?
A. Obtain a sputum specimen.
B. Obtain an ABG.
C. Measure peak expiratory flow.
D. Determine the Glasgow Coma Score. - ANSWER B. Obtain an ABG.
2
, A young healthy adult with complaints of intermittent wheezing is seen in the pulmonary
clinic. A pre/post bronchodilator spirometry reveals a normal study with no reversibility.
Which of the following should the respiratory therapist recommend?
A. Helium dilution study
B. DLCO
C. Plethysmography
D. Bronchial provocation - ANSWER D. Bronchial provocation
Following abdominal surgery, a 70 year-old patient receives mechanical ventilation in the
ICU at the following settings: VC, A/C; VT 550 mL, respiratory rate 14/min, FIO2 0.50 and 10
cm H2O PEEP. Bedside monitoring results demonstrate that the PvO2 is 35 torr and the SpO2
is 90%. The patient is alert and oriented with stable vital signs. Which of the following should
the respiratory therapist recommend?
A. Decrease the PEEP.
B. Increase the FIO2.
C. Initiation diuretic therapy.
D. Continue to monitor closely. - ANSWER B. Increase the FIO2.
The respiratory therapist obtains a blood gas sample from the patient's radial artery and ap-
plies pressure to the site for 10 minutes. After removing any excess air from the syringe, the
next step for proper handling of the blood sample is:
A. adding liquid heparin to the sample.
B. placing the syringe in an ice bath.
C. shaking the sample continuously.
D. applying a pressure bandage. - ANSWER B. placing the syringe in an ice bath.
3
upon completion of postural drainage with percussion. The respiratory therapist should rec-
ommend:
A. Continuing the therapy until breath sounds improve.
B. administering dornase alpha.
C. administering albuterol therapy.
D. deep breathing and coughing to clear secretions. - ANSWER D. deep breathing and
coughing to clear secretions.
See Patient Assessment
A healthy adult female can exhale what portion of her forced vital capacity in the first sec-
ond? - ANSWER 70%
Following cardiac surgery, a 55 year-old 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. - ANSWER 5% volume
What value for the apnea-hypopnea index (AHI) is consistent with mild obstructive sleep ap-
nea? - ANSWER 5 to 15
1
,The respiratory therapist is asked to evaluate the presence of Auto-PEEP on a patient receiv-
ing mechanical ventilation. In order to do this, what should the RT do? - ANSWER Initi-
ate an expiratory hold just prior to the next ventilator-delivered breath
What do bronchial breath sounds heard over the lung periphery indicate? - AN-
SWER lung consolidation (pneumonia)
Rationale: should be vesicular in periphery
A 60 kg (132 lb) patient is mechanically ventilated at the following settings: VC, A/C; VT 500
mL, respiratory rate 12/min, FIO2 1.00 and 10 cm H2O PEEP. The patient's peak airway pres-
sure is 60 cm H2O and his SpO2 is 85%. A current chest x-ray shows diffuse bilateral infil-
trates. Which of the following is the most appropriate action in order to reduce peak airway
pressure?
A. Increase the frequency.
B. Change to airway pressure release ventilation.
C. Decrease the inspiratory time.
D. Increase PEEP to 15 cm H2O. - ANSWER B. Change to airway pressure release venti-
lation.
A 19-year-old patient is brought to the Emergency Department after taking a handful of pills.
The patient is obtunded but is making regular, sonorous respiratory efforts. Auscultation re-
veals coarse rhonchi bilaterally. Which of the following should be done FIRST to assess this
patient?
A. Obtain a sputum specimen.
B. Obtain an ABG.
C. Measure peak expiratory flow.
D. Determine the Glasgow Coma Score. - ANSWER B. Obtain an ABG.
2
, A young healthy adult with complaints of intermittent wheezing is seen in the pulmonary
clinic. A pre/post bronchodilator spirometry reveals a normal study with no reversibility.
Which of the following should the respiratory therapist recommend?
A. Helium dilution study
B. DLCO
C. Plethysmography
D. Bronchial provocation - ANSWER D. Bronchial provocation
Following abdominal surgery, a 70 year-old patient receives mechanical ventilation in the
ICU at the following settings: VC, A/C; VT 550 mL, respiratory rate 14/min, FIO2 0.50 and 10
cm H2O PEEP. Bedside monitoring results demonstrate that the PvO2 is 35 torr and the SpO2
is 90%. The patient is alert and oriented with stable vital signs. Which of the following should
the respiratory therapist recommend?
A. Decrease the PEEP.
B. Increase the FIO2.
C. Initiation diuretic therapy.
D. Continue to monitor closely. - ANSWER B. Increase the FIO2.
The respiratory therapist obtains a blood gas sample from the patient's radial artery and ap-
plies pressure to the site for 10 minutes. After removing any excess air from the syringe, the
next step for proper handling of the blood sample is:
A. adding liquid heparin to the sample.
B. placing the syringe in an ice bath.
C. shaking the sample continuously.
D. applying a pressure bandage. - ANSWER B. placing the syringe in an ice bath.
3
