TEMPORARY MEDICAL CARE

TMC Practice Exam A + B 2023/2024 1. A 52-year-old post-operative cholecystectomy patient's breath sounds become coarser upon completion of postural drainage with percussion. The respiratory therapist should recommend: A. Continuing the therapy until breath so unds improve. B. administering dornase alpha. C. administering albuterol therapy. D. deep breathing and coughing to clear secretions. - D. deep breathing and coughing to clear secretions. See Patient Assessment A healthy adult female can exhale what port ion of her forced vital capacity in the first second? - 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. - 5% volume What value for the apnea -hypopnea index (AHI) is consistent with mild obstructive sleep apnea? - 5 to 15 The respiratory therapist is asked to evaluate the pres ence of Auto -PEEP on a patient receiving mechanical ventilation. In order to do this, what should the RT do? - Initiate an expiratory hold just prior to the next ventilator -delivered breath What do bronchial breath sounds heard over the lung periphery ind icate? - lung consolidation (pneumonia) Rationale: should be vesicular in periphery 1. 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 pe ak airway pressure is 60 cm H2O and his SpO2 is 85%. A current chest x -ray shows diffuse bilateral infiltrates. 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. - B. Change to airway pressure release ventilation. 2. 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. Obtain an ABG. 3. A young healthy adult with complaints of intermittent wheezing is seen in the pulmonary clinic. A pre/post bronchodilator spirometry reveals a nor mal 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. Bronchial provocation 4. 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. - B. Increase the FIO2. 5. The respiratory thera pist obtains a blood gas sample from the patient's radial