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 - ANSWER heart fail-
ure
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 hyper-
resonant 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? - ANSWER Needle aspirate the 2nd left intercostal
space
All of the following strategies are likely to decrease the likelihood of damage to the tracheal
mucosa EXCEPT - ANSWER using a low residual volume, low compliance cuff
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 - ANSWER deep breathing & coughing to clear secretions
A 65 kg spinal cord injured patient develops atelectasis. His inspiratory capacity is 30% of his
predicted value. What bronchial hygiene therapy would be most appropriate initially? - AN-
SWER IPPB
A healthy adult female can exhale what portion of her forced vital capacity in the first sec-
ond? - ANSWER 70%
A patient on VC ventilation demonstrates auto-PEEP on ventilator graphics. Which of the fol-
lowing controls, when adjusted independently, would increase expiratory time?
1
,1. Tidal volume
2. respiratory rate
3. inspiratory flow
4. sensitivity - ANSWER 1, 2, and 3 only
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? - AN-
SWER insert a chest tube
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 5.0 vol %
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? - ANSWER 50 mL/cm
H2O
Immediately after extubation of a patient in the ICU, the respiratory therapist observes in-
creasing respiratory distress with intercostal retractions and marked stridor. The SpO2 on
40% oxygen is noted to be 76%. Which of the following would be most appropriate at this
time? - ANSWER Reintubation
Which of the following patients would most likely benefit from pressure support ventilation?
- ANSWER A patient on SIMV with a mandatory rate of 12/min and total rate of
24/min.
A patient receiving mechanical ventilation has developed a temperature of 99.9° F with pu-
rulent secretions over the last 12 hours. The respiratory therapist has also noted a steady in-
crease in peak inspiratory pressure. What initial recommendation should be made to ad-
dress these changes? - ANSWER obtain a sputum gram stain
2
, Which of the following information may be obtained from a FVC maneuver during bedside
pulmonary function testing?
1. FEV1
2. PEFR
3. FRC
4. RV - ANSWER 1 & 2 only
The respiratory therapist provides education for a patient who is being discharged home on
aerosol therapy. The most important reason for the patient to follow the recommended
cleaning procedures using a vinegar/water solution is that this solution will - AN-
SWER retard bacterial growth
A patient who complains of dyspnea is noted to have a dry, non-productive cough. On physi-
cal examination, breath sounds are diminished on the right, tactile fremitus is decreased and
there is dullness to percussion over the right lower lobe. The respiratory therapist should
suspect that the patient is suffering from - ANSWER pleural effusion
Which of the following suction catheters would be appropriate to use for a patient with a
size 8.0 mm ID endotracheal tube? - ANSWER 12 Fr
A patient who is receiving continuous mechanical ventilation is fighting the ventilator. His
breath sounds are markedly diminished on the left, there is dullness to percussion on the
left, and the trachea is shifted to the left. The most likely explanation for the problem is that
- ANSWER the endotracheal tube has slipped into the right main stem bronchus.
The respiratory therapist notes a developing hematoma after an arterial blood gas was
drawn from the right radial artery. The immediate response is to - ANSWER apply
pressure to the site
A patient's breathing pattern irregularly increases and decreases and is interspersed with pe-
riods of apnea up to 1 minute. Which of the following conditions is the most likely cause of
this problem? - ANSWER elevated intracranial pressure
3
3+ pitting edema in the ankles. These findings are consistent with - ANSWER heart fail-
ure
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 hyper-
resonant 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? - ANSWER Needle aspirate the 2nd left intercostal
space
All of the following strategies are likely to decrease the likelihood of damage to the tracheal
mucosa EXCEPT - ANSWER using a low residual volume, low compliance cuff
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 - ANSWER deep breathing & coughing to clear secretions
A 65 kg spinal cord injured patient develops atelectasis. His inspiratory capacity is 30% of his
predicted value. What bronchial hygiene therapy would be most appropriate initially? - AN-
SWER IPPB
A healthy adult female can exhale what portion of her forced vital capacity in the first sec-
ond? - ANSWER 70%
A patient on VC ventilation demonstrates auto-PEEP on ventilator graphics. Which of the fol-
lowing controls, when adjusted independently, would increase expiratory time?
1
,1. Tidal volume
2. respiratory rate
3. inspiratory flow
4. sensitivity - ANSWER 1, 2, and 3 only
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? - AN-
SWER insert a chest tube
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 5.0 vol %
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? - ANSWER 50 mL/cm
H2O
Immediately after extubation of a patient in the ICU, the respiratory therapist observes in-
creasing respiratory distress with intercostal retractions and marked stridor. The SpO2 on
40% oxygen is noted to be 76%. Which of the following would be most appropriate at this
time? - ANSWER Reintubation
Which of the following patients would most likely benefit from pressure support ventilation?
- ANSWER A patient on SIMV with a mandatory rate of 12/min and total rate of
24/min.
A patient receiving mechanical ventilation has developed a temperature of 99.9° F with pu-
rulent secretions over the last 12 hours. The respiratory therapist has also noted a steady in-
crease in peak inspiratory pressure. What initial recommendation should be made to ad-
dress these changes? - ANSWER obtain a sputum gram stain
2
, Which of the following information may be obtained from a FVC maneuver during bedside
pulmonary function testing?
1. FEV1
2. PEFR
3. FRC
4. RV - ANSWER 1 & 2 only
The respiratory therapist provides education for a patient who is being discharged home on
aerosol therapy. The most important reason for the patient to follow the recommended
cleaning procedures using a vinegar/water solution is that this solution will - AN-
SWER retard bacterial growth
A patient who complains of dyspnea is noted to have a dry, non-productive cough. On physi-
cal examination, breath sounds are diminished on the right, tactile fremitus is decreased and
there is dullness to percussion over the right lower lobe. The respiratory therapist should
suspect that the patient is suffering from - ANSWER pleural effusion
Which of the following suction catheters would be appropriate to use for a patient with a
size 8.0 mm ID endotracheal tube? - ANSWER 12 Fr
A patient who is receiving continuous mechanical ventilation is fighting the ventilator. His
breath sounds are markedly diminished on the left, there is dullness to percussion on the
left, and the trachea is shifted to the left. The most likely explanation for the problem is that
- ANSWER the endotracheal tube has slipped into the right main stem bronchus.
The respiratory therapist notes a developing hematoma after an arterial blood gas was
drawn from the right radial artery. The immediate response is to - ANSWER apply
pressure to the site
A patient's breathing pattern irregularly increases and decreases and is interspersed with pe-
riods of apnea up to 1 minute. Which of the following conditions is the most likely cause of
this problem? - ANSWER elevated intracranial pressure
3
