Lindsey Jones Test A Questions With Correct Answers

A patient receiving mechanical ventilation has received Halcion in the last twenty minutes. The physician orders the institution of spontaeneous breathing trials to commence immediately. Which of the following medications would be most helpful to the patient? A. Romazicon B. Valium C. Meperidine D. Morphine sulfate - Answer Romazicon In preparation for ventilator weaning the physician requests a VD/VT ratio assessment. Which of the following is needed to determine the deadspace-tidal volume ratio? A. helium dilution study and single breath nitrogen elimination B. arterial blood gases and capnographic data C. helium dilution study and an arterial blood gas D. single breath nitrogen elimination and capnographic data - Answer arterial blood gases and capnographic data A respiratory therapist is determining a VD/VT ratio. Which of the following is needed to complete this analysis? A. PECO2 and PaO2 B. FIO2 and PaO2 C. PetCO2 and PaCO2 D. VT and VA - Answer PetCO2 and PaCO2 Which of the following is LEAST likely to promote the spread of nosocomial infection in a hospital? A. frequent disconnection of a ventilator circuit B. changing small volume nebulizer equipment every 48 hours C. use of unit dose medication D. poor hand washing among staff - Answer use of unit dose medication Which of the following can be used to estimate the level of Hemoglobin? A. RBC B. C(a-v)O2 C. Theophylline level D. PAO2 - Answer RBC Which of the following alarms would be most important for a patient receiving positive pressure ventilation by a pressure-cycled ventilator? A. low FIO2 B. I:E ratio C. high pressure D. low volume - Answer low volume Patients with large necks who experience frequent dislodging of their tracheostomy tubes need (a) A. nasal intubation B. shorter tracheostomy tube C. larger tracheostomy tube D. longer tracheostomy tube - Answer longer tracheostomy tube Which of the following would be most effective at resolving a humidity deficit for a patient who is intubated with an 8.0-mm endotracheal tube? A. HME B. large volume nebulizer C. bubble humidifier D. concha heated humidifier - Answer concha heated humidifier A patient with suspected myasthenia gravis in the emergency room should receive which of the following to confirm a diagnosis? A. Norcuron B. Meperidine (Demerol) C. Edrophonium Bromide D. Neostigmine - Answer Edrophonium Bromide Which of the following is an important action when drawing an arterial blood gas sample? A. Use an 16 gauge needle B. run the sample within 15 minutes C. Choose a radial site with adequate ulnar circulation D. Compress the site prior to puncture - Answer Choose a radial site with adequate ulnar circulation Which of the following would be most helpful for a patient with fixed upper airway obstruction? A. corticosteroids B. aerosolized epinephrine C. beta II agonist medication D. heliox therapy - Answer heliox therapy Which of the following oxygen modalities would be appropriate for a 220-lb (100-kg) male with diabetic ketoacidosis who requires 40% supplemental oxygen? A. air-entrainment mask B. simple mask C. nasal cannula D. non-rebreathing mask - Answer air-entrainment mask While administering a treatment with Albuterol to a patient with COPD, the therapist notes a sudden change in the patient's color to marked cyanosis. The patient appears apneic and the heart rate on the pulse oximeter indicates 30/min. The therapist should FIRST A. go get help B. auscultate breath sounds C. administer oxygen by non-rebreathing mask D. begin mouth-to-mouth resuscitation - Answer begin mouth-to-mouth resuscitation A 70-kg (154-lb) female patient is receiving mechanical ventilation on the following settings: Mode assist/control Mandatory rate 14Total rate 14VT 500 mLFIO2 0.55PEEP 12 cmH2O Arterial blood gases reveal pH 7.49 PaCO2 32 mmHgPaO2 109 mmHgHCO3- 24 mEq/LBE 0 mEq/L The respiratory therapist should A. decrease mandatory rate B. increase mandatory rate C. decrease FIO2 D. decrease PEEP - Answer decrease PEEP Prior to the removal of chest tubes, which of the following should be done? A. the chest tube should be exposed to normal atmospheric pressure B. suction pressure should be increased temporarily C. clamp the chest tube for 24 hours D. flush the chest tube with normal saline - Answer clamp the chest tube for 24 hours Which of the following will help a patent to speak while intubated with a tracheostomy tube? A. obturator B. double lumen endotracheal tube C. inner cannula D. Passy-Muir valve - Answer Passy-Muir valve Prior to obtaining an MEP value with a pressure manometer, the respiratory therapist notes the needle is pointing at a positive pressure of -4 cmH2O prior to the maneuver. During the MEP maneuver, the needle reaches 32 cmH2O. The therapist should A. record and MEP of -28 cmH2O B. record an MEP of 36 cmH2O C. record an MEP of 28 cmH2O D. report the problem to the medical director - Answer record an MEP of 36 cmH2O A 70-kg (154-lb) male patient is receiving mechanical ventilation. After increasing PEEP, the following data is available: Arterial blood gases reveal pH 7.32 PaCO2 47 mmHgPaO2 80 mmHgHCO3- 26 mEq/LBE +2 mEq/LC.I. 2.5PAP 14 mmHgCVP 4 mmHgPCWP 8 mmHg The respiratory therapist should do which of the following? A. decrease FIO2 B. remove 100 mL of deadspace C. decrease mandatory rate D. administer sodium bicarbonate - Answer remove 100 mL of deadspace What would occur on a time-cycled ventilator with a fixed rate if the inspiratory flow rate were increased? A. increase in inspiratory time B. decrease in tidal volume C. increase in tidal volume D. decrease in inspiratory time - Answer increase in tidal volume Why should a respiratory therapist FIRST open the airway of a patient who is apneic? A. The physical contact may help to trigger a spontaneous breath B. The patient may be experiencing upper airway occlusion C. To facilitate the placement of an oral pharyngeal airway D. To protect the neck if the patient has experienced physical trauma - Answer The patient may be experiencing upper airway occlusion Which of the following is a strategy that may help reduce or prevent autoPEEP in a patient with ARDS? A. sedation of the patient B. increasing minute ventilation C. high flow rates D. matching PEEP - Answer high flow rates A pediatric patient has a non-productive cough. A chest radiograph reveals a foreign body in the right mainstem bronchi. Which of the following should be used to alleviate the problem? A. bronchoscope B. suction catheter C. laryngoscope D. tonsil suction device - Answer bronchoscope An adult male is being suctioned though an 8.0-mm ET tube with a 12 Fr. suction catheter at a pressure of 90 mmHg. Secretion removal has been ineffective. Which of the following modifications should be recommended? A. decrease suction pressure to 80 mmHg B. change to a 10-mm ET tube C. increase suction catheter size to 14 Fr. D. increase suction pressure to 110 mmHg - Answer increase suction pressure to 110 mmHg Which of the following is the most significant complication of bronchoscopy? A. hypotension B. vagal nerve stimulation C. laryngospasms D. coughing - Answer laryngospasms Which of the following can be instructed to a COPD patient to help reduce FRC? A. autogenic drainage B. incentive spirometry C. pursed-lip breathing D. serial coughing - Answer pursed-lip breathing A Bronchogram would be most helpful in evaluating and diagnosing which of the following? A. bronchiectasis B. ARDS C. mycoplasma pneumonia D. chronic bronchitis - Answer bronchiectasis An infant who is 35 weeks of gestation requires supplemental oxygen at 40%. Which of the following modalities is most appropriate? A. oxygen hood with an air/oxygen blender B. nasal cannula at 2 L/min C. nasal CPAP mask D. croup tent - Answer oxygen hood with an air/oxygen blender What is the respiratory therapist observing if monitoring the total amount of gas exhaled in 60 seconds after excluding dead space? A. minute ventilation B. alveolar minute ventilation C. maximum voluntary ventilation D. dead space ventilation - Answer alveolar minute ventilation Which of the following instructions should be given to a patient in preparation for incentive spirometry with a volume-type device? A. exhale to expiratory reserve volume B. breathe in complete inspiratory capacity C. breathe in to total lung capacity D. inhale as deeply as possible - Answer inhale as deeply as possible In providing a patient with education and direction for the performance of positive expiratory pressure (PEP) therapy, the respiratory therapist will include which of the following directives? A. inhale deeply and exhale actively B. inhale to normal tidal volume and exhale actively C. inhale quickly and exhale quickly D. exhale forcefully and inhale to normal tidal volume - Answer inhale deeply and exhale actively Which of the following equations would help determine cardiac output? A. Fick B. A-aDO2 C. oxygen consumption D. ejection fraction - Answer Fick A patient in the emergency room expectorates thick, yellow sputum. A CBC shows the following: RBC 6.0 mill/cu mm Hb 17 g/dLHCT 64 %WBC 22,000 cu mm The patient could benefit most from which of the following? A. sputum culture and sensitivity B. aerosolized Nystatin C. Acetylcysteine D. aerosolized Amphotericin B - Answer sputum culture and sensitivity A patient has a sleep study (PSG) which shows an AHI of 50 and an average oxygen desaturation of 10%. Which of the following should the respiratory therapist recommend? A. CPAP/BIPAP nocturnal titration study B. nocturnal supplemental oxygen C. surgical insertion of a tracheostomy D. weight loss - Answer CPAP/BIPAP nocturnal titration study A patient has the following input/output history and other clinical information: Yesterday Today IN 1900 cc 1600 ccOUT 2200 cc 1900 ccC.O. 5.1 L/min 3.8 L/minBP 110/80 mm Hg 110/80 mm HgCVP 5 mm Hg 5 mm Hg These data would result in which of the following? A. increase in PCWP B. increase in PAP C. decrease in PVR D. increase in SVR - Answer increase in SVR