KETTERING TMC COMPREHENSIVE
FINAL EXAM FOR RESPIRATORY
THERAPISTS QUESTIONS AND
ANSWERS
1. A 65-year-old patient with COPD is receiving oxygen via a 28% air-entrainment mask. The
patient’s PaO2 is 55 mmHg and PaCO2 is 68 mmHg. Which of the following actions is most
appropriate?
A. Increase the FiO2 to 40%
B. Intubate and initiate mechanical ventilation
C. Initiate Non-invasive Positive Pressure Ventilation (NiPPV)
D. Maintain current therapy and monitor
Answer: C
Conceptual Explanation: In a COPD patient with acute-on-chronic respiratory failure
(hypercapnia and hypoxemia), NiPPV is the first-line treatment to avoid intubation and
reduce work of breathing.
,2. While monitoring a patient in the ICU, the therapist notes the CVP is 12 mmHg and the
PCWP is 6 mmHg. This data is most consistent with:
A. Left heart failure
B. Hypovolemia
C. Pulmonary edema
D. Right heart failure
Answer: D
Conceptual Explanation: A high CVP (normal 2-6 mmHg) with a normal PCWP (normal 4-
12 mmHg) indicates a problem originating in the right heart or pulmonary vasculature,
such as right heart failure or pulmonary hypertension.
3. An adult patient receiving volume-controlled ventilation has an exhaled tidal volume of
500 mL and a plateau pressure of 25 cmH2O. If the PEEP is increased from 5 to 10 cmH2O and
the plateau pressure rises to 30 cmH2O, what has happened to the static compliance?
A. It increased
B. It decreased
C. It remained the same
D. It cannot be determined
Answer: C
, Conceptual Explanation: Static Compliance = VT / (Plateau - PEEP). Initially: 500 / (25-5)
= 25 mL/cmH2O. After change: 500 / (30-10) = 25 mL/cmH2O. The compliance is
unchanged.
4. A patient’s X-ray shows a ‘ground glass’ appearance with air bronchograms. The patient is
most likely suffering from:
A. Pneumothorax
B. Pleural effusion
C. Emphysema
D. ARDS
Answer: D
Conceptual Explanation: Ground glass opacities and air bronchograms are classic
radiographic signs of ARDS or significant diffuse alveolar infiltrates.
5. During a bedside assessment, a patient is found to be unresponsive, pulseless, and apneic.
The ECG monitor shows a fine, irregular, wavy line. The therapist should immediately:
A. Defibrillate at 200 Joules (Biphasic)
B. Administer Epinephrine 1mg IV
C. Perform synchronized cardioversion
D. Perform a carotid massage
Answer: A
FINAL EXAM FOR RESPIRATORY
THERAPISTS QUESTIONS AND
ANSWERS
1. A 65-year-old patient with COPD is receiving oxygen via a 28% air-entrainment mask. The
patient’s PaO2 is 55 mmHg and PaCO2 is 68 mmHg. Which of the following actions is most
appropriate?
A. Increase the FiO2 to 40%
B. Intubate and initiate mechanical ventilation
C. Initiate Non-invasive Positive Pressure Ventilation (NiPPV)
D. Maintain current therapy and monitor
Answer: C
Conceptual Explanation: In a COPD patient with acute-on-chronic respiratory failure
(hypercapnia and hypoxemia), NiPPV is the first-line treatment to avoid intubation and
reduce work of breathing.
,2. While monitoring a patient in the ICU, the therapist notes the CVP is 12 mmHg and the
PCWP is 6 mmHg. This data is most consistent with:
A. Left heart failure
B. Hypovolemia
C. Pulmonary edema
D. Right heart failure
Answer: D
Conceptual Explanation: A high CVP (normal 2-6 mmHg) with a normal PCWP (normal 4-
12 mmHg) indicates a problem originating in the right heart or pulmonary vasculature,
such as right heart failure or pulmonary hypertension.
3. An adult patient receiving volume-controlled ventilation has an exhaled tidal volume of
500 mL and a plateau pressure of 25 cmH2O. If the PEEP is increased from 5 to 10 cmH2O and
the plateau pressure rises to 30 cmH2O, what has happened to the static compliance?
A. It increased
B. It decreased
C. It remained the same
D. It cannot be determined
Answer: C
, Conceptual Explanation: Static Compliance = VT / (Plateau - PEEP). Initially: 500 / (25-5)
= 25 mL/cmH2O. After change: 500 / (30-10) = 25 mL/cmH2O. The compliance is
unchanged.
4. A patient’s X-ray shows a ‘ground glass’ appearance with air bronchograms. The patient is
most likely suffering from:
A. Pneumothorax
B. Pleural effusion
C. Emphysema
D. ARDS
Answer: D
Conceptual Explanation: Ground glass opacities and air bronchograms are classic
radiographic signs of ARDS or significant diffuse alveolar infiltrates.
5. During a bedside assessment, a patient is found to be unresponsive, pulseless, and apneic.
The ECG monitor shows a fine, irregular, wavy line. The therapist should immediately:
A. Defibrillate at 200 Joules (Biphasic)
B. Administer Epinephrine 1mg IV
C. Perform synchronized cardioversion
D. Perform a carotid massage
Answer: A
