Nbrc Tmc/Crt/Rrt Exam Latest Questions And Correct Answers

A patient is admitted to the ED following a vehicle accident. On physical exam, the RT 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, RR is 30/min and BP is 60/40 mmHg. What action should the therapist reccomend first? - ANSWER- Needle aspirate the 2nd left intercostal space A 65kg spinal cord injured patient has developed atelectasis. His inspiratory capacity is 30% of his predicted value. What bronchial hygiene therapy would be most appropriate initially? - ANSWER- IPPB with normal saline A healthy adult female can exhale what portion of her forced vital capacity in the first second? - ANSWER- 70% A patient on VC ventilation has demonstrated auto-PEEP on ventilator graphics. Which of the following controls, when adjusted independently, would increase expiratory time? - ANSWER- Tidal volume, Respiratory Rate and Inspiratory flow A 55 y/o post cardiac surgery 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- 4.0 vol% TO SOLVE: - Use formula: C(a-v)O2 = CaO2 - CvO2 - CaO2 = (Hb x 1.34 x SaO2) + (PaO2 x 0.003) **Normal amounts are 4-5% Immediately after extubation of a patient in the ICU, the RT observes increasing respiratory distress with intercostal retractions and marked stridor. The SpO2 on 40% O2 is noted to be 86%. What would be the most appropriate response at this time? - ANSWER- Reintubation (due to marked stridor) What may be obtained from a FVC maneuver during beside PFTs? - ANSWER- FEV1 and PEFR What suction catheter would be appropriate for a patient with a size 8.0mm ID ETT? - ANSWER- 12 Fr - Use formula ID size/2 X 3The RT notes a developing hematoma after and ABG was drawn from the right radial artery. The immediate response is to: - ANSWER- apply pressure to the site A patient on the general medical ward is on a 28% air entrainment mask with the flowmeter set at 5L/min. What is the total flow delivered to the patient? - ANSWER- 55L/min TO SOLVE - 28% -- 10:1 ratio -- 11 total flow factor - Total flow factor x set values for L/min (so 5L/min x 11 = 55L/min) What measurement is most indicative of pulmonary edema? - HR 120/min - BP of 92/72 mmHg - Pulmonary artery pressure of 25/10 mmHg - Pulmonary Capillary Wedge Pressure of 30mmHg - ANSWER- Pulmonary capillary wedge pressure of 30mmHg (normal range = 4-12mmHg) Sleep apnea can be defined as repeated episodes of complete cessation of airflow for: - ANSWER- 10 seconds or longer A patient in the ICU receiving mechanical ventilation has just undergone a fiberoptic bronchoscopy procedure in withh a tissue biopsy was collected. Immediately following the procedure, the RT notes that the peak inspiratory pressure on the ventilator has increased. Potential causes for this include: - ANSWER- Pneumothorax, pulmonary hemorrhage, bronchospasm/laryngospasm NOT hypoxemia A patient who suffered trauma in an ATV accident is being monitored in the ICU. A pulmonary artery catheter has been placed and the following data is available: - PvO2 46 torr - PCWP 19mm Hg - PAP (mean) 10mm Hg - CVP 12cm H20 - Qt 3L/min What should the RT recommend? - ANSWER- Positive inotropic agent (b/c decreased Qt) and diuretic therapy (b/c elevated PCWP) At 1 minute post-delivery, a newborn has blue extremities with a pink body, HR is 90/min, RR is 20/min with a weak cry, cough reflex is present, and there is some flexion of the extremities. At 5 mins post-delivery, the infant is completely pink, HR is 140/min, RR is 40/min, cough reflex is present and the baby is active with a strong cry. What APGAR scores should be assigned? - ANSWE