Lindsey Jones - Test E Questions With Correct Answers

A patient with a history of chronic bronchitis is post-operative for an exploratory laparotomy. Review of the medical record suggests the physician has concern about difficulty clearing secretions after the procedure. To assist the patient with mobilization and removal of secretions, the respiratory therapist should recommend A. administer tetracycline B. instruction on deep breathing and coughing techniques C. MDI therapy with an anti-inflammatory corticosteroid D. administer cromolyn sodium - Answer B. instruction on deep breathing and coughing techniques Which of the following conditions would be a contraindication for IPPB? A. fractured ribs B. pulmonary edema C. untreated pneumothorax D. a patient requiring bronchodilation AND lung expansion - Answer C. untreated pneumothorax The respiratory therapist has an order to cap a patient with a fenestrated tracheostomy tube in preparation for speech therapy. Prior to applying the cap on the end of the tube, the therapist should also ensure A. the inner cannula is in place and the cuff deflated B. the inner cannula is in place and the cuff inflated. C. the inner cannula is removed and the cuff deflated D. the inner cannula is removed and the cuff inflated - Answer C. the inner cannula is removed and the cuff deflated A 75-kg (165-lbs) male is in acute ventilatory failure. In preparation for mechanical ventilatory support, the patient is to be orally intubated. Which of the following artificial airways would be most appropriate for this patient? A. Size 8.0 mm ET tube with a small volume, high pressure cuff B. Jackson tracheostomy tube C. Size 7.5 mm fenestrated tracheostomy tube D. Size 7.0 mm ET tube with a large volume, low pressure cuff - Answer D. Size 7.0 mm ET tube with a large volume, low pressure cuff Which of the following devices is needed to determine a patient's airway resistance? A. turbine pneumotachometer B. Wheatstone bridge helium analyzer C. Geissler tube nitrogen analyzer D. Body box - Answer D. Body box A patient is receiving manual ventilatory support with a bag-valve connected to a size 8.0 mm ET tube. While transporting the patient from CT scan back to the intensive care unit, the respiratory therapist notices oxygen saturation has dropped to 88% and that the bag-valve is easier to squeeze than normal. Suspecting mal-positioning of the ET tube, the respiratory therapist should first A. obtain an arterial blood gas B. examine chest rise and auscultate breath sounds C. call for a chest radiograph D. perform diagnostic chest percussion - Answer B. examine chest rise and auscultate breath sounds A 48-year-old patient has just been orally intubated prior to being placed on volume-controlled ventilation. The respiratory therapist should do which of the following to best confirm proper placement of the endotracheal tube? A. assess chest rise symmetry B. obtain a chest radiograph C. auscultate breath sounds D. examine tube markings near the lips - Answer B. obtain a chest radiograph After 20 minutes into a spontaneous breathing trial (SBT) a mechanically ventilated female patient becomes anxious. Her baseline heart rate has increased by 20 /min. What should the respiratory therapist do? A. Return to full mechanical ventilation B. Measure MIP C. Calculate the RSBI D. Increase the FIO2 and continue to monitor - Answer A. Return to full mechanical ventilation What is needed to determine arterial oxygen content? A. Oxygen index B. PvO2 C. Hemoglobin level D. P/F ratio - Answer C. Hemoglobin level A patient presents to the emergency room with fulminating pulmonary edema. Which of the following would be experienced with this emergency? A. CVP 10 torr and PAP 10 torr B. hypovolemia C. elevated left ventricular filling pressure with low QT D. a good response to supplemental O2 - Answer C. elevated left ventricular filling pressure with low QT Which of the following conditions would benefit most from a thoracentesis? A. complete opacification of the right lung B. pericardial contusion C. atelectasis D. small pneumothorax - Answer D. small pneumothorax Which of the following conditions would benefit most from cardioversion? A. ventricular fibrillation B. frequent PVCs C. asystole D. ventricular tachycardia with a pulse - Answer D. ventricular tachycardia with a pulse Which of the following is the best indicator of the adequacy of alveolar ventilation? A. tidal volume B. color C. PaCO2 from an arterial blood gas analysis D. respiratory rate - Answer C. PaCO2 from an arterial blood gas analysis A 32-gestational week newborn is receiving mechanical ventilation via a 3.0 mm endotracheal tube. Which of the following are associated with ongoing assessment of renal function? A. PCWP B. diaper weight and blood draw volumes are recorded C. humidification is maintained at a non-invasive temperature D. mPAP - Answer B. diaper weight and blood draw volumes are recorded A patient with ARDS and asthma could benefit from which of the following medications? A. exogenous surfactant B. cromolyn sodium C. Tobramycin and albuterol D. Spiriva and decadron - Answer A. exogenous surfactant The respiratory therapist should look to which of the following clinical data to determine the effectiveness of incentive spirometry? A. Inspiratory capacity predicted volume B. Arterial blood gas analysis pre and post treatment C. Breath sounds before and after every treatment D. Maximum voluntary ventilation done periodically - Answer C. Breath sounds before and after every treatment Which of the following cannot be measured or evaluated in a comatose patient? A. pupillary response B. tidal volume C. objective information D. symptoms - Answer D. symptoms A patient with a tracheostomy is receiving supplemental oxygen via tracheostomy collar connected to a large volume nebulizer set at 40%. The respiratory therapist analyzes the FIO2 at the tracheostomy collar with a galvanic fuel cell analyzer. The analysis shows the FIO2 to be 55%. Which of the following could be the cause of the increase in FIO2? A. calibration error in the galvanic fuel cell B. clogged jet orifice in the nebulizer C. too much water in the circuit D. the aerosol tubing is too short - Answer C. too much water in the circuit A patient receiving volume-controlled ventilation in SIMV mode has a total respiratory rate of 26/min and is showing signs of increased labor of breathing. The mandatory rate is 14/min. Which of the following would most likely help the patient? A. Use of pressure support B. Increase the machine flow rate C. Increase PEEP D. Switch to pressure control ventilation - Answer A. Use of pressure support A patient is experiencing atrial arrhythmias and is complaining of light-headedness and nausea. Which of the following should the respiratory therapist recommend to help remedy the problem? A. administration of Lidocaine B. atropine sulfate C. cardioversion D. unsynchronized defibrillation - Answer C. cardioversion When selecting a suction catheter to be used in an oral endotracheal tube, the respiratory therapist should select a catheter whose diameter should not exceed what fraction of the internal diameter of the endotracheal tube? A. 1/4 B. 2/3 C. 3/4 D. 1/2 - Answer D. 1/2 Which of the following would be most helpful in diagnosing vocal cord paralysis in an adult? A. Thoracic gas volume measurement B. Neck radiograph C. FVC maneuver D. Flow volume loop - Answer D. Flow volume loop When analyzing the FIO2 for an infant in an oxygen hood receiving oxygen therapy with a blender set at 50%, the respiratory therapist notes an oxygen concentration of 35% near the patient's mouth. The jet nebulizer entrainment setting is set to 50%. To correct the problem, the therapist should A. change the nebulizer entrainment port to 100% B. adjust blender setting to 60% C. increase total flow to the oxyhood D. obtain a smaller oxyhood - Answer A. change the nebulizer entrainment port to 100% Following the insertion of a tracheostomy tube, the patient is found to have diffuse crackles upon auscultation secondary to subcutaneous emphysema. Which of the following radiographic findings would be expected with this condition? A. Tracheal shift from midline B. Hyperlucency in the soft tissues C. Scattered patchy infiltrates D. Diffuse pulmonary hyperlucency - Answer B. Hyperlucency in the soft tissues Placement of a pulmonary artery catheter is associated with which of the following most common complications? A. cardiac arrhythmias B. pulmonic valve damage C. hypotension D. internal bleeding - Answer A. cardiac arrhythmias During the placement of a pulmonary artery catheter, the respiratory therapist observes the waveform on the monitor and notices it is repeatedly rising and falling from 0 mmHg to 25 mmHg, which is an indication that the tip of the catheter is in the right ventricle of the heart. Based on this information, the respiratory therapist will recommend A. inflate the catheter balloon to sail the tip to the proper location B. rotate the catheter to achieve a dicrotic notch in the waveform C. suture the catheter in place D. withdraw the catheter back to the upper vena cava - Answer A. inflate the catheter balloon to sail the tip to the proper location A patient has been gradually weaning from mechanical ventilation for the past two weeks. The physician requests data to determine the patient's current ability to breathe on his own. Which of the following tests would not be indicated? A. MVV B. VT C. MIP D. VC - Answer A. MVV The most reliable test to determine if a pulmonary rehab patient has stopped smoking is a A. methemoglobin level B. treadmill trial C. complete PFT D. carboxyhemoglobin level - Answer D. carboxyhemoglobin level While performing nasal tracheal suctioning on a patient with mycoplasma pneumonia, the respiratory therapist notices PVCs on the monitor. The first action of the therapist should be to A. monitor the patient carefully B. recommend administration of Lidocaine for future suctioning of the patient C. decrease the suction pressure D. discontinue suctioning - Answer D. discontinue suctioning A galvanic fuel cell oxygen analyzer may read erroneously high under which of the following conditions? A. during a sudden increase in the partial pressure of oxygen B. when liquid gets on the membrane C. when the analyzer batteries are depleted D. when a volume-controlled ventilator at high inspiratory pressures - Answer D. when a volume-controlled ventilator at high inspiratory pressures Results of a quality control maneuver for a spirometer using a 3.0 L calibration syringe as follows: Volume 1 2.65 L Volume 2 2.68 L Volume 3 2.66 L According to ATS Standards, the spirometer is A. inaccurate B. lacking in precision C. operating correctly D. proof that the syringe requires calibration - Answer A. inaccurate Which of the following will be most helpful at preventing complications for a 48-year-old male patient who has just undergone bariatric surgery for obesity? A. IPPB with 3.0 mL normal saline every 4 hours B. Incentive spirometry every hour C. Ambulation twice a day D. Small volume nebulizer therapy with Albuterol every 4 hours - Answer B. Incentive spirometry every hour A patient experiencing exacerbation of asthma is receiving small volume nebulizer treatments with albuterol via aerosol mask. The patient suddenly complains of nausea, tingling of the digits and seems very anxious. The best course of action would be to A. instruct the patient to breathe less deeply during the treatment B. change to a mouthpiece C. discontinue therapy and report your findings to the doctor D. continue current therapy - Answer C. discontinue therapy and report your findings to the doctor Polysomnography reveals a patient has chest movement with no nasal airflow and severe oxygen desaturation. Which of the following therapies should the respiratory therapist recommend for the patient? A. oxygen via nasal cannula when sleeping B. nocturnal mechanical ventilatory support C. Doxapram (dopram) D. nasal CPAP - Answer D. nasal CPAP In which of the following would the respiratory therapist expect to see a decrease if inspiratory flow is reduced but the rate does not change? A. expiratory time B. gas distribution C. I:E ratio D. inspiratory time - Answer A. expiratory time A 70-year-old male presents in the emergency department with shortness of breath and a non-productive cough. Auscultation of the chest reveals bilateral expiratory wheezes. Which of the following intervention would be most helpful to the patient? A. osmitrol (Mannitol) B. dexamethasone (Decadron) C. comolyn sodium (Intal) D. ipratropium bromide (Atrovent) - Answer D. ipratropium bromide (Atrovent) A 1000 g, 28-week gestational age infant has the following umbilical artery blood gas results: pH 7.35 PaCO2 44 torr PaO2 39 torr HCO3- 27 mEq/L BE +1 mEq/L Which of the following should the respiratory therapist recommend to monitor the infant's oxygenation? A. capillary blood gas analysis B. arterial blood gas analysis C. transcutaneous PCO2 monitor D. pulse oximetery - Answer D. pulse oximetery Which of the following results should the respiratory therapist evaluate to determine the adequacy of oxygen transport on a patient who is diagnosed with carbon monoxide poisoning and is being treated with FIO2 of 1.0? A. cardiac output B. oxygen consumption at the tissues C. arterial-venous oxygen content difference D. arterial oxygen content - Answer D. arterial oxygen content A patient with a history of chronic bronchitis is post-operative for an exploratory laparotomy. Review of the medical record suggests the physician has concern about difficulty clearing secretions after the procedure. To assist the patient with mobilization and removal of secretions, the respiratory therapist should recommend A. Switch to hypotonic saline B. Switch to normal saline C. Add Albuterol to the nebulizer treatment D. Discontinue therapy and notify the physician - Answer D. Discontinue therapy and notify the physician Which of the following laboratory examinations is most appropriate to further evaluate a patient with kidney failure and CHF? A. creatinine B. Theophylline level C. urinalysis D. BUN - Answer A. creatinine In preparation for a helium dilution study, a respiratory therapist is calibrating the helium analyzer. While exposing the analyzer to ambient room air, what will the analyzer read for helium concentration? A. 0% B. 79% C. 21% D. 2% - Answer A. 0% Which of the following will result in a decrease in mean airway pressure for a patient on a mechanical ventilator in the assist/control mode? A. decreasing inspiratory flow B. use of expiratory retard C. decrease in inspiratory time D. institution of a 1.0 sec inspiratory plateau - Answer C. decrease in inspiratory time A chest radiograph of an abdominal post-operative patient shows abnormal elevation of the left hemidiaphragm. Which of the following conditions explains the observation? A. herniation of the left hemidiaphragm B. hemothorax C. pneumothorax on the left D. atelectasis in the left lower lobe - Answer D. atelectasis in the left lower lobe For which of the following is the respiratory therapist observing if obtaining an MEP measurement? A. strength and ability to cough B. inspiratory muscle strength C. RSBI D. presence of fixed upper airway obstruction - Answer A. strength and ability to cough