CSE 1 exam with complete verified solutions 2024 already graded A+

1. various oxygen administration devices 2. intubation equipment 3. suction equipment 4. chest tube placement equipment 5. Bag-valve device with various sizes of mask 6. medications for pain and agitation 7. fluids for vascular support 8. Venous and arterial line equipment 9. cardiac monitor and defibrillator clinical simulation 1 A respiratory therapist assigned to the ED is asked to assist in the evaluation of a 24 year old male victim of a motorcycle accident who will be arriving in 5 minutes. Which of the following should be available for the arrival of this patient? 1. Vital signs (TPR) and blood pressure 2. general appearance 3. breath sounds 4. chest inspection 5. SpO2 6. skin color 7. ECG via cardiac monitor 8. pupillary response When the patient arrives at the ED, he is awake, but agitated. He has a cervical collar on and is moving all extremities while breathing room air. During the initial evaluation of this patient, which of the following should be assessed? oxygen via nonrebreathing mask at 12L/min Which of the following should be recommended? Arterial blood gas analysis 12-lead ECG Chest x-ray CBC Chemistry and toxicology Electrolytes The ED physician requests recommendations of diagnostic studies and laboratory data that would help to further assess the patients condition. Which of the following should be evaluated? Endotracheal intubation and manual ventilation Which of the following should be recommended to the ED physician? Continue manual ventilation and begin chest compressions clinical simulation 2 An evening shift respiratory therapist on call for labor and delivery (L&D) receives a page to report immediately to the L&D to assist in the management of an infant female who was delivered limp and cyanotic. The infant is manually ventilated via mask and resuscitator bag. There are no efforts at spontaneous respirations and the heart rate is approximately 50 breaths/min. The infant is 36 weeks gestation and weighs 2622 grams. Which of the following should be recommended? 3.0-mm internal diameter; uncuffed endotracheal tube One minute later, the infant remains unresponsive and with minimal improvement in color. The physician now requests assistance in performing endotracheal intubation. Which of the following endotracheal tubes should be selected for this infant? Heart rate Spontaneous respirations Chest excursion Breath sounds The infant is intubated and manual ventilation is resumed. Which of the following should now be assessed? Reposition the endotracheal tube Which of the following should be recommended? Stop chest compression; continue to manually ventilate; transfer the infant to the NICU Five minutes later, the infants color has significantly improved. The heart rate is now 136/minute. No detectable spontaneous respirations are observed. Which of the following should be recommended? VC- SIMV; FIO2 0.40, PS 10 cmH2O; mandatory rate 14; Tidal volume 575mL; PEEP 5 cmH20 OR VC-AC; FIO2 0.40; mandatory rate 14; tidal volume 575 mL; PEEP 5 cmH2O clinical simulation 3 A respiratory therapist assigned to the cardiac intensive care unit (CICU) will be managing the ventilator care of a coronary artery bypass (CABG) patient who will be admitted to the unit after surgery. When the patient arrives in the unit, the anesthesiologist states that the patients PaO2 normalizes with an FIO2 of 0.40. The patient is 178 cm (5ft, 10 in) tall and weighs 83 kg (183lbs). Which of the following initial ventilator settings should be recommended? ECG via cardiac monitor General appearance Ventilator settings Ventilator alarms Breath Sounds SpO2 Vital signs (TPR) and blood pressure Which of the following should be assessed immediately after connecting the patient to the ventilator? Maintain the present ventilator settings Thirty minutes later, arterial blood gases are obtained and the results are pH 7.39, PaCO2 43 mmHg, HCO3 26 mEq/L, PaO2 96 mmHg, and SaO2 97%. Which of the following should be recommended? stop suctioning and continue to closely observe One hour later, the patient requires suctioning. While suctioning the patient with an FIO2 of 1.0 and via a closed suction system, the following ECG rhythm is noted on the patients cardiac monitor. Which of the following should be recommended? ** CLICK IMAGE TO ENLARGE** Check the manual resuscitator bag for proper function The ECG rhythm deteriorates to ventricular bigeminy and manual ventilation is initiated. While manually ventilating the patient, there is minimal resistance to bag compression and the patients chest is barely rising during bag compression. Which of the following should be done? Disconnect the patient from the ventilator and manually ventilate The patient is now stable and has been reconnected to the ventilator. At this time, the high pressure alarm sounds. Which of the following should be done? Emphysema clinical simulation 4 A respiratory therapist assigned to the surgical floor is asked to evaluate a 72 year old, 64 kg (141 lbs), 173 cm (5 ft, 8 in) tall male who recently had colectomy surgery. The patients nurse states that the patient has been reluctant to get out of bed since surgery. The patient is currently receiving oxygen therapy via nasal cannula at 1 L/min. Theo-Dur 200 mg bid, aerosol albuterol (Ventolin) and ipratropium (Atrovent) every 4 hours while awake. The chest x-ray shown below is an x-ray taken of the patient on the day of admission. On the basis of this x-ray, which of the following is the most likely diagnosis of this patient? **CLICK IMAGE TO ENLARGE** Current physician orders Past medical history Past and current respiratory modalities Laboratory data Code status Electrocardiographic studies pulmonary function studies Nurses notes Progress notes Radiologic reports Past and present surgical procedures Which of the following would be pertinent to review in the patients medical chart? Temperature Heart rate Respiratory rate and pattern Blood pressure Sensorium Appearance of extremities Breath sounds Character of sputum General appearance Chest inspection SpO2 Which of the following should be assessed? Aerosol albuterol (Ventolin) treatment Which of the following should be recommended? Allow him to rest for a few minutes and instruct him to slow his respirations; then continue the treatment Five minutes after therapy is started, the patient complains of shakiness and lightheadedness. The pulse has essentially remained the same, but the patients respirations have increased to 32/minute. Which of the following should be done? Heart rate Blood pressure Respirations Breath sounds Hemodynamic status ECG via cardiac monitor Position of ET tube Ventilator settings Ventilator alarm settings End-tidal CO2 SpO2 clinical simulation 5 A 27 year old, 52 kg (115 lbs) 160 cm (5ft, 3 in) tall female is undergoing surgery for removal of a large mediastinal tumor. Following surgery, the patient is stabilized and transferred to the recovery room. The respiratory therapist is asked to assist in the ventilator management of this patient while in the recovery room. Which of the following should be assessed? Set the FIO2 at 0.50 Arterial blood gases are obtained and the results are pH 7.35, PaCO2 43 mmHg, HCO3 23 mEq/L, PaO2 139 mmHg, and SaO2 99%. Which of the following should be recommended? continue with the current course of therapy One hour later, the patient is transferred to the ICU. After transferring the patient to the bed and connecting to the ventilator, the following ECG rhythm is noted on the cardiac monitor. Which of the following should be recommended? **CLICK IMAGE TO ENLARGE** Ask the nurse to manually ventilate the patient and tell the nurse she will be right there While the therapist is on lunch break, the patients nurse calls and informs the therapist that the ventilator is alarming. Which of the following should the therapist do? Check the oxygen dial on the ventilator Check the oxygen and air hoses for occlusions Check the oxygen and air connections After arriving in the patients room, the therapist finds that the ventilators oxygen alarm had been activated. Which of the following should be done? Reconnect the patient to the ventilator and perform a system check During the system check, the therapist finds that the oxygen connection at the wall outlet had become loose. After tightening the connection, the therapist resets the alarm. Which of the following should the therapist do next? Pulse and blood pressure Respiratory rate and pattern ECG via cardiac monitor CBC General appearance Breath sounds Chest x-ray Arterial blood gas analysis Position of trachea clinical simulation 6 A respiratory therapist assigned to the pediatric intensive care unit (PICU) is asked to evaluate a restless and agitated 9 year old female who was admitted two days prior for community acquired pneumonia (CAP). The patient is currently receiving IV antibiotics and oxygen via 28% air entrainment mask. The patient weighs 29 kg (64 lbs) and is 119 cm (3ft 11in) tall. Which of the following should be assessed and evaluated? Endotracheal intubation and mechanical ventilation Which of the following should be recommended? 5.0-mm internal diameter; cuffed endotracheal tube OR 6.0-mm internal diameter; uncuffed endotracheal tube Which of the following endotracheal tubes should be selected for this patient? VC-SIMV; FIO2 1.0; PS 5 cm H2O; mandatory rate 25; tidal volume 225 mL; PEEP 3 cmH2O The patient has been successfully intubated. Which of the following initial ventilator settings should recommended? Chest x-ray Medication for sedation Elevation of the head of the bed Arterial blood gas analysis Which of the following should be recommended for post intubation care and support? Vital signs (TPR) and blood pressure Chest inspection Respiratory pattern Breath sounds General appearance SpO2 clinical simulation 7 A respiratory therapist is asked to come to the medical floor to evaluate a 77 year old male patient with a long standing history of COPD who is exhibiting signs of increasing respiratory distress. Which of the following should be assessed? Arterial blood gas analysis Which of the following should be recommended? Manual ventilation Which of the following should be recommended now? Endotracheal intubation and mechanical ventilation While manually ventilating, it is noted that the patient now has sporadic and gasping spontaneous efforts. Which of the following should be recommended next? VC-SIMV; FIO2 0.40; PS 10 cm H2O; mandatory rate 12; tidal volume 550 mL; PEEP 5 cm H20 OR VC-A/C; FIO2 0.40; mandatory rate 10; tidal volume 550 mL; PEEP 5 cmH2O The patient is 175 cm (5ft 9in) tall and weighs 62 kg (136 lbs). Which of the following initial ventilator settings should be recommended? Assess the patients condition clinical simulation 8 A respiratory therapist assigned to the ED is asked to evaluate an adult female who has just been brought to the ED by the local paramedics. The paramedics