RRT CLINICAL SIMULATIONS (CSE) – NBRC PRACTICE SCENARIOS

RRT CLINICAL SIMULATIONS (CSE) – NBRC PRACTICE
SCENARIOS | FREQUENTLY TESTED QUESTIONS WITH
CORRECT ANSWERS | BRAND NEW!




Emphysema - -------CORRECT ANSWER----Weakening and permanent enlargement of the air spaces distal
to the terminal bronchioles



Etiology of Emphysema - -------CORRECT ANSWER----Cigarette smoking >80% of all cases

Genetic predisposition

Occupational exposure

Atmospheric pollutants



Primary Assessment of Emphysema - -------CORRECT ANSWER----Past medical history

Shortness of breath

Cough

Appearance of the chest

Respiratory Pattern

Color

Appearance of the nail beds

Diagnostic chest percussion

Breath sounds



Secondary Assessment of Emphysema - -------CORRECT ANSWER----CXR

Arterial Blood Gas

,Pulmonary Function

CBC

Sputum



Appearance of CXR in patient with Emphysema - -------CORRECT ANSWER----Hyperlucent lung fields

Depressed or flattened diaphragm

Narrow heart

Increased retro sternal air space (lateral film)



Arterial Blood Gas findings in patient with Emphysema - -------CORRECT ANSWER----Mild to moderate
Emphysema

Acute alveolar hyperventilation with hypoxemia



Severe Emphysema

Chronic ventilatory failure with hypoxemia



Pulmonary Function Findings in patient with Emphysema - -------CORRECT ANSWER----Decreased flow
rates and Decreased DLco



CBC findings in a patient with Emphysema - -------CORRECT ANSWER----Increased RBC, Hb, HCT



Sputum findings in a patient with Emphysema - -------CORRECT ANSWER----May indicate bacterial
infection



Treatment/Management of Emphysema - -------CORRECT ANSWER----Low Flow (FiO2) oxygen therapy 1-
2 L/min (.24-.28)

Antibiotics as indicated by sputum culture

Pulmonary Rehab and Home Care

Aerosolized medications

Consider NPPV for acute exacerbation of ventilatory failure

,Annual Flu injection

Smoking cessation

Pulmonary Hygiene



Chronic Bronchitis - -------CORRECT ANSWER----Daily productive cough for at least 3 consecutive month
each year for 2 years in a row



Etiology of Chronic Bronchitis - -------CORRECT ANSWER----Cigarette smoking

Pollution

Infection

GERD



Primary Assessment of Chronic Bronchitis - -------CORRECT ANSWER----Past medical history

Shortness of Breath

Cough

Appearance of the Chest

Respiratory Pattern

Color

Appearance of Nail beds

Diagnostic Chest Percussion

Breath Sounds



Secondary Assessment of Chronic Bronchitis - -------CORRECT ANSWER----CXR

Arterial Blood Gas

Pulmonary Function

CBC

Sputum Electrolytes



CXR findings in a patient with Chronic Bronchitis - -------CORRECT ANSWER----Hyper lucent lung fields

, Depressed or flattened diaphragm

Enlarged or elongated heart



Arterial Blood gas in a patient with mild to moderate Chronic Bronchitis - -------CORRECT ANSWER----
Acute alveolar hyperventilation with hypoxemia



ABG in a patient with severe Chronic Bronchitis - -------CORRECT ANSWER----Chronic ventilatory failure
with hypoxemia



Pulmonary Function test in a patient with Chronic Bronchitis - -------CORRECT ANSWER----Decreased flow
rates



CBC in a patient with Chronic Bronchitis - -------CORRECT ANSWER----Increased Hb and HCT



Sputum findings in a patient with Chronic Bronchitis - -------CORRECT ANSWER----May indicate infection



Electrolyte findings in a patient with Chronic Bronchitis - -------CORRECT ANSWER----Increased HCO3
(chronic ventilatory failure)



Treatment and Management of a patient with Chronic Bronchitis - -------CORRECT ANSWER----Pulmonary
Hygiene therapy

Antibiotics for infection

Oxygen for hypoxemia

Aerosolized mediations

Consider NPPV for acute exacerbations

Smoking cessation

Reduce risk factors



What aerosolized medications should be considered for Chronic Bronchitis - -------CORRECT ANSWER----
Short acting Beta 2 agonists

Anticholinergics