TMC KETTERING PATHOLOGY EVALUATION TEST
QUESTIONS AND ANSWERS SET A+
✔✔Following thoracotomy, a patient on volume-control ventilation has a chest tube in
the left pleural space. While inspecting the chest drainage system, the respiratory
therapist notes bubbling in the water seal chamber during the inspiratory phase. The
therapist should report this to the physician as
A. a persistent bronchopleural fistula.
B. a resolved pneumothorax.
C. back-pressure from the suction chamber.
D. normal function of the water seal chamber. - ✔✔A
✔✔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 reveals 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. - ✔✔B
✔✔A 60 year-old male is admitted to the ED with chest pain. The CBC and electrolytes
are normal. Troponin level is 0.4 ng/mL. The physician should report to the patient that
he is suffering from
A. congestive heart failure.
B. pulmonary embolism.
C. myocardial infarction.
D. valvular stenosis. - ✔✔C
,✔✔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 - ✔✔D
✔✔Twenty-four hours after a patient was intubated, she develops a fever of 99.9°F, a
right lower lobe infiltrate, and her white blood cell count is 12,000 per mm3. The
respiratory therapist should recommend
A. antiviral therapy.
B. blood transfusion.
C. SABA by small volume nebulizer.
D .antibiotic therapy. - ✔✔D
✔✔A tracheostomy tube has just been inserted percutaneously into a patient with a C3
fracture. How much air should the respiratory therapist initially inject into the cuff?
A. Enough to achieve a pressure of 25-35 cm H2O.
B. Enough to achieve a minimal occluding volume.
C. A minimum of 20 mL.
D. Until firm tension is felt in the pilot balloon. - ✔✔A
✔✔All of the following conditions can be treated with hyperbaric oxygen (HBO) therapy
EXCEPT
A. carbon monoxide poisoning.
B. decompression sickness.
C. anaerobic infections.
D. pulmonary hypertension. - ✔✔D
✔✔Which of the following factors are determinants of cardiac output?
A. Ventricular filling and heart rate
B. Stroke volume and heart rate
C. Stroke volume and respiratory rate
D. Heart rate and tidal volume - ✔✔B
✔✔The following ABG results are reported for a patient in the ED on room air: pH 7.20;
PaCO2 24 torr; PaO2 95 torr; HCO3 10 mEq/L; SaO2 95%; BE -15 mEq/L. The
respiratory therapist should recommend
, A. initiating oxygen therapy via nasal cannula at 4 L/min.
B. intubating and initiating mechanical ventilation.
C. administering sodium bicarbonate.
D. initiating non-invasive ventilation. - ✔✔C
✔✔The physician asks the respiratory therapist to select ventilator parameters that will
deliver the lowest peak inspiratory pressure possible. Which of the following inspiratory
flow patterns will enable the therapist to fulfill the physician's request?
A. Decelerating
B. Square wave
C. Constant
D. Accelerating - ✔✔A
✔✔An intubated patient receiving 30% oxygen has a SpO2 of 80% and ETCO2 of 40
torr. After administration of 50% oxygen for 30 minutes, the respiratory therapist notes
that the SpO2 rises to 98% and the ETCO2 remains stable at 40 torr. The major cause
of hypoxemia in this patient is
A. hypoventilation.
B. shunt.
C. ventilation/perfusion mismatch.
D. increased deadspace. - ✔✔C
✔✔A 16 year-old patient with cystic fibrosis attends high school. Which of the following
bronchial hygiene therapies would be most appropriate for this patient?
A. Intrapulmonary percussive ventilation
B. Dornase alpha therapy
C. Vibratory / oscillatory PEP
D. Postural drainage and manual percussion - ✔✔C
✔✔A patient reports that he has difficulty breathing while lying in a supine position and
prefers to sleep sitting in a chair. The respiratory therapist should record this complaint
in the medical record as
A. orthopnea.
B. platypnea.
C. eupnea.
D. Kussmaul breathing. - ✔✔A
✔✔A patient receiving oxygen therapy at home calls in the middle of the night and
reports that the oxygen supply tubing will not stay attached to her transtracheal
catheter. The flow rate to the transtracheal catheter is set at 0.5 L/min. The patient has
QUESTIONS AND ANSWERS SET A+
✔✔Following thoracotomy, a patient on volume-control ventilation has a chest tube in
the left pleural space. While inspecting the chest drainage system, the respiratory
therapist notes bubbling in the water seal chamber during the inspiratory phase. The
therapist should report this to the physician as
A. a persistent bronchopleural fistula.
B. a resolved pneumothorax.
C. back-pressure from the suction chamber.
D. normal function of the water seal chamber. - ✔✔A
✔✔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 reveals 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. - ✔✔B
✔✔A 60 year-old male is admitted to the ED with chest pain. The CBC and electrolytes
are normal. Troponin level is 0.4 ng/mL. The physician should report to the patient that
he is suffering from
A. congestive heart failure.
B. pulmonary embolism.
C. myocardial infarction.
D. valvular stenosis. - ✔✔C
,✔✔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 - ✔✔D
✔✔Twenty-four hours after a patient was intubated, she develops a fever of 99.9°F, a
right lower lobe infiltrate, and her white blood cell count is 12,000 per mm3. The
respiratory therapist should recommend
A. antiviral therapy.
B. blood transfusion.
C. SABA by small volume nebulizer.
D .antibiotic therapy. - ✔✔D
✔✔A tracheostomy tube has just been inserted percutaneously into a patient with a C3
fracture. How much air should the respiratory therapist initially inject into the cuff?
A. Enough to achieve a pressure of 25-35 cm H2O.
B. Enough to achieve a minimal occluding volume.
C. A minimum of 20 mL.
D. Until firm tension is felt in the pilot balloon. - ✔✔A
✔✔All of the following conditions can be treated with hyperbaric oxygen (HBO) therapy
EXCEPT
A. carbon monoxide poisoning.
B. decompression sickness.
C. anaerobic infections.
D. pulmonary hypertension. - ✔✔D
✔✔Which of the following factors are determinants of cardiac output?
A. Ventricular filling and heart rate
B. Stroke volume and heart rate
C. Stroke volume and respiratory rate
D. Heart rate and tidal volume - ✔✔B
✔✔The following ABG results are reported for a patient in the ED on room air: pH 7.20;
PaCO2 24 torr; PaO2 95 torr; HCO3 10 mEq/L; SaO2 95%; BE -15 mEq/L. The
respiratory therapist should recommend
, A. initiating oxygen therapy via nasal cannula at 4 L/min.
B. intubating and initiating mechanical ventilation.
C. administering sodium bicarbonate.
D. initiating non-invasive ventilation. - ✔✔C
✔✔The physician asks the respiratory therapist to select ventilator parameters that will
deliver the lowest peak inspiratory pressure possible. Which of the following inspiratory
flow patterns will enable the therapist to fulfill the physician's request?
A. Decelerating
B. Square wave
C. Constant
D. Accelerating - ✔✔A
✔✔An intubated patient receiving 30% oxygen has a SpO2 of 80% and ETCO2 of 40
torr. After administration of 50% oxygen for 30 minutes, the respiratory therapist notes
that the SpO2 rises to 98% and the ETCO2 remains stable at 40 torr. The major cause
of hypoxemia in this patient is
A. hypoventilation.
B. shunt.
C. ventilation/perfusion mismatch.
D. increased deadspace. - ✔✔C
✔✔A 16 year-old patient with cystic fibrosis attends high school. Which of the following
bronchial hygiene therapies would be most appropriate for this patient?
A. Intrapulmonary percussive ventilation
B. Dornase alpha therapy
C. Vibratory / oscillatory PEP
D. Postural drainage and manual percussion - ✔✔C
✔✔A patient reports that he has difficulty breathing while lying in a supine position and
prefers to sleep sitting in a chair. The respiratory therapist should record this complaint
in the medical record as
A. orthopnea.
B. platypnea.
C. eupnea.
D. Kussmaul breathing. - ✔✔A
✔✔A patient receiving oxygen therapy at home calls in the middle of the night and
reports that the oxygen supply tubing will not stay attached to her transtracheal
catheter. The flow rate to the transtracheal catheter is set at 0.5 L/min. The patient has
