TMC Exam C, FORM M, Lindsey Jones G, TMC I Questions With Verified Answers

a. manual dexterity - Answer The respiratory therapist should evaluate which of the following to develop a teaching plan for a patient who will be using a small volume nebulizer at home? a. manual dexterity b. highest grade level achieved in school c. spousal support d. English speaking proficiency d. bronchoscopy - Answer Which of the following would be most beneficial in resolving microatelectasis? a. chest tubes b. percutaneous ventilation c. thoracentesis d. bronchoscopy b. oropharyngeal airway - Answer A 45 year-old patient is recovering in the intensive care unit after undergoing a surgical procedure to repair a hernia. The patient remains unconscious. To prevent soft tissue obstruction, the respiratory therapist should recommend a(n) a. double-lumen endobronchial tube b. oropharyngeal airway c. bite block d. nasopharyngeal airway d. Run 2 only - Answer Quality control material has published values for pH of 7.20, PO2 of 65 mmHg. Documentation indicates the range of pH is 0.5% and is 3% for PO2. Machine results are as follows: Run 1: pH 7.19, PO2 64 Run 2: pH 7.10, PO2 69 Run 3: pH 7.21, PO2 65 Which quality control run(s) indicate the machine is out of control? a. Run 1 and 2 b. Run 2 and 3 c. Run 3 only d. Run 2 only a. ABG and alveolar oxygen tension - Answer A respiratory therapist is considering a patient's readiness to wean from mechanical ventilation. To determine the A-aDO2, the therapist will need which of the following? a. ABG and alveolar oxygen tension b. VD/VT and PAO2 c. CaO2 and PAO2 d. VD/VT and ABG c. heliox therapy - Answer A patient with increased airway resistance from a fixed upper airway obstruction would benefit most from which of the following? a. bronchodilator therapy b. epinephrine c. heliox therapy d. aerosolized atropine d. inspiratory muscle strength - Answer Evaluating MIP (maximum inspiratory pressure) is most useful in evaluating which of the following? a. presence of a restrictive pulmonary defect b. effectiveness of cough c. presence of obstructive pulmonary defect d. inspiratory muscle strength b. excess water in the tubing - Answer An air-entrainment jet nebulizer is set at 50%. The respiratory therapist analyzes the oxygen coming from the end of the tubing and finds it is 60%. Which of the following most likely explains this finding? a. poorly calibrate analyzer b. excess water in the tubing c. low flow through the jet orifice d. leak in the tubing a. examine the ventilator circuit for proper connections - Answer During a preoperational test of the ventilator with a test lung, the respiratory therapist notes a return tidal volume of 600 cc. Ventilator settings are: Mode: Assist/control FiO2: 0.50 Mandatory rate: 10 VT: 750 mL What action should the therapist take? a. examine the ventilator circuit for proper connections b. obtain a larger test lung c. increase the set tidal volume to 900 mL d. obtain a smaller test lung d. change the fuel cell - Answer During the preoperational test of the ventilator, the respiratory therapist notices the galvanic analyzer on the ventilator is reading erroneously low. Which of the following can the respiratory therapist do to correct the problem? a. replace the analyzer batteries b. replace the electrolyte solution in the analyzer c. tag the ventilator as non-functional and avoid placing it in service d. change the fuel cell b. poor hand washing among staff - Answer Which of the following is most likely to increase nosocomial infection in a hospital? a. use of an HME for 48 hours b. poor hand washing among staff c. frequent disconnection in the ventilator circuit d. use of alcohol-based hand cleaners b. disconnected thermistor line - Answer While monitoring a patient receiving mechanical ventilation, the respiratory therapist notices the low-pressure and low exhaled volume alarms are sounding. Which of the following could be the cause? a. kinked endotracheal tube b. disconnected thermistor line c. excess water in the inspiratory limb of the circuit d. herniated endotracheal tube cuff a. a fracture in the plastic wye - Answer A patient receiving positive pressure ventilation has a low-pressure alarm sounding. Which of the following could be the cause? a. a fracture in the plastic wye b. herniated cuff c. excess secretions in the airway d. kinked ET tube a. provide manual ventilation - Answer The high pressure alarm is sounding on a patient receiving volume controlled ventilation. The respiratory therapist should FIRST a. provide manual ventilation b. suction the patient c. observe the alarm panel to determine source d. cancel the alarm d. Anectine (succinylcholine chloride) - Answer Which of the following medications is shown to have sufficient affect when facial muscle twitching is observed? a. Halcion b. Curare (d-turbo curare) c. Romazicon d. Anectine (succinylcholine chloride) d. respirometer - Answer A respiratory therapist is preparing to measure SVC on a patient in the emergency department. Which of the following equipment is required? a. Collins water-seal spirometer b. Geissler tube c. Wheatstone bridge d. respirometer b. pressure manometer - Answer A respiratory therapist is asked to determine a patient's inspiratory muscle strength. Which of the following equipment is required for this evaluation? a. Fleisch pneumotrachometer b. pressure manometer c. respirometer d. peak flow meter b. peak flow meter - Answer A respiratory therapist is ordered to do a bedside assessment of the effectiveness of a bronchodilator on a patient with an acute asthmatic episode. Which of the following equipment will be needed to perform this evaluation? a. maximum inspiratory pressure manometer b. peak flow meter c. Collins water-seal spirometer d. respirometer a. 25/8 mmHg - Answer Which of the following pressures is most consistent with a normal pulmonary artery pressure (PAP)? a. 25/8 mmHg b. 12/8 mmHg c. 120/80 mmHg d. 25/4 mmHg d. change to an 80%/20% heliox mixture - Answer A patient receiving heliox therapy at 70%/30% mixture by non-rebreathing mask has the following arterial blood gas results: pH 7.35 / PaCO2 45 / PaO2 110 / HCO3 24 / BE 0 Which of the following actions is appropriate? a. change to a heliox mixture of 60%/40% b. discontinue heliox therapy c. switch to a partial rebreathing mask d. change to an 80%/20% heliox mixture c. use an air-entrainment mask set at 28% - Answer A COPD patient complains of shortness of breath while exercising with a 2 L/min nasal cannula. During exercise, SPO2 is noted to fall to 84%. Which of the following would be most helpful to the patient during exercise? a. decrease flow to 1 L/min nasal cannula b. avoid exercising c. use an air-entrainment mask set at 28% d. use a non-rebreathing mask a. place the patient on a non-rebreathing mask - Answer A patient in the emergency room is receiving oxygen by nasal cannula at 3 L/min. Blood gases reveal the following: pH 7.53 / PaCO2 30 / PaO2 51 / HCO3 23 / BE -1 The respiratory therapist should immediately a. place the patient on a non-rebreathing mask b. decrease flow to 1 L/min c. increase flow to 5 L/min d. place the patient on a Venturi mask at 40% d. increase PEEP to 22 cmH2O - Answer An 80-kg (176-lb) female patient is receiving mechanical ventilation on the following settings: Mode: assist/control Mandatory rate: 14/min Total rate: 14/min VT: 550 mL FiO2: 0.60 PEEP: 20 cmH2O ABG: pH 7.38 / PaCO2 42 / PaO2 62 / HCO3 26 / BE +2 The respiratory therapist should a. increase the FIO2 to 0.7 b. order a chest radiograph c. increase FiO2 to 1.0 d. increase PEEP to 22 cmH2O b. increase flow to 15 L/min - Answer A patient is showing signs of respiratory distress with a respiratory rate to 30/min and a spontaneous tidal volume of 800 mL. The patient is receiving oxygen at 60% by large volume nebulizer with the flow set at 10 L/min. The respiratory therapist should suggest to a. increase FiO2 to 1.0 and the flow to 15 L/min b. increase flow to 15 L/min c. sedate the patient d. decrease the FiO2 to 0.50 d. decrease inspiratory time - Answer The physician orders a change in I:E ratio from 1:2 to 1:4 for a COPD patient receiving volume-cycled mechanical ventilation. Which of the following accommodates the physician's request if the mandatory rate is not changed? a. increase the inspiratory time b. decrease the inspiratory flow rate c. decrease expiratory time d. decrease inspiratory time a. autoPEEP - Answer For a patient receiving volume-controlled ventilation in the assist/control mode, the starting of the inhalation cycle before the expiratory flow rate returns to zero would result in which of the following? a. autoPEEP b. atelectasis c. alveolar collapse d. decreased FRC c. epinephrine - Answer While assisting a physician during a bronchoscopy procedure, the therapist notices bright red blood in the specimen tube. The therapist should prepare which of the following NEXT? a. Heparin b. atropine c. epinephrine d. cold normal saline d. Bodai adapter - Answer A respiratory therapist is asked to assist a physician with a bronchoscopy procedure on a patient who is ventilator dependent and requires high levels of PEEP. Which of the following equipment should be used? a. closed in-line suction catheter b. manual PEEP valve c. Magill forceps d. Bodai adapter b. reduce future treatment dosage to 0.25 mL - Answer A patient receiving 0.5 mL Albuterol by small volume nebulizer complains of tingling fingers, nervousness, and heart palpitations. The therapist should a. decrease dosage to 0.15 mL b. reduce future treatment dosage to 0.25 mL c. have the patient pause at the top of each breath d. instruct the patient in performing shallow inspirations a. cancerous mass in the lung - Answer For which of the following is the respiratory therapist observing if obtaining a series of oblique chest radiographs? a. cancerous mass in the lung b. pneumonia c. pneumothorax d. pleural effusion d. mass in the left lobe - Answer A spiral CT scan would be most helpful in evaluating which of the following? a. atelectasis b. asbestosis c. pneumonia d. mass in the left lobe b. decrease tidal volume - Answer A 65-kg (143-lb) patient with pneumonia is receiving mechanical ventilator support by a Servo adult ventilator on the following settings with corresponding arterial blood gas values: Mode: assist/control Mandatory rate: 10/min VT: 700 mL FiO2: 0.50 pH 7.48 / PaCO2 33 / PaO2 98 / HCO3 24 / BE 0 Which of the following actions is most appropriate? a. increase tidal volume b. decrease tidal volume c. decrease FiO2 d. decrease mandatory rate b. increase alveolar ventilation - Answer A patient is undergoing a full cardiopulmonary arrest. The patient is intubated and is being monitored with an infrared capnographic device. PetCO2 data is showing 3%. Which of the following is most appropriate? a. obtain PaCO2 by a Douglas bag b. increase alveolar ventilation c. recalibrate the capnometer d. clean the infrared device c. ET tube markings at the lips - Answer Which of the following can be examined to initially determine the approximate position of the oral endotracheal tube? a. chest radiograph b. lateral neck radiograph c. ET tube markings at the lips d. diaphragmatic excursion a. radiologist reports the ET tube is 1 inch above the carina - Answer Which of the follow data, if observed, would indicate proper positioning of an oral endotracheal tube? a. radiologist reports the ET tube is 1 inch above the carina b. end of ET tube 2 cm below the aortic knob c. end of ET tube is 6 cm above the carina d. poor left chest symmetry d. racemic epinephrine - Answer A child has been extubated and is demonstrating mild stridor. Which of the following agents would be most helpful to administer by aerosol? a. albuterol b. Atropine c. Aminophylline d. racemic epinephrine b. ventilator circuit bronchoscopy adapter - Answer A respiratory therapist is asked to assist a physician for a diagnostic bronchoscopy on a mechanically ventilated patient. What special equipment should be brought to the room? a. laryngoscope and blade b. ventilator circuit bronchoscopy adapter c. ventilator circuit endotracheal tube wedge d. Wrights respirometer d. stroke volume - Answer Which of the following data is needed to calculate cardiac output? a. VO2 b. QS/QT c. A-aDO2 d. stroke volume c. IC - Answer Which of the following volumes is being observed when a patient is using a volume-type incentive spirometer? a. ERV b. TLC c. IC d. IRV b. cystic fibrosis - Answer For which of the following conditions is chest wall oscillation therapy most beneficial? a. ARDS b. cystic fibrosis c. drug overdose d. Guillain-Barre syndrome a. hemoglobin - Answer Which of the following is needed to determine C(a-v)O2? a. hemoglobin b. VD/VT c. PvO2 d. PaO2 c. combined metabolic and respiratory acidosis - Answer Arterial blood gases on a patient in the cardiac intensive care unit are as follows: pH 7.10 / PaCO2 52 / PaO2 65 / HCO3 15 / BE -9 Which of the following represents an accurate interpretation of these results? a. metabolic compensated respiratory acidosis b. metabolic acidosis c. combined metabolic and respiratory acidosis d. respiratory acidosis a. report the problem to the supervisor - Answer In spite of repeated attempts, a respiratory therapist is unable to obtain successful quality control values on a blood gas analyzer. The therapist should a. report the problem to the supervisor b. continue running quality control samples c. inform the medical director d. place the machine in service but monitor closely b. change the electrode - Answer A therapist is unable to obtain a reading with a galvanic-type oxygen analyzer when attempting to measure oxygen percentage inside an isolette while the red warning flag is active. The therapist should? a. replace the batteries b. change the electrode c. discontinue the red-flag warning system d. replace the electrolyte solution b. administer 2 units of blood - Answer Four hours after a quadruple coronary artery bypass graft, a patient's blood pressure is 90/50 mmHg and the patient is ashen in color. The following data is also available: PAP: 10 mmHg PCWP: 5 mmHg CVP: 1 mmHg The patient could benefit most from which of the following? a. adminster normal saline, IV b. administer 2 units of blood c. an echocardiogram d. Lasix (furosemide) a. decrease EPAP only - Answer A patient is receiving non-invasive positive pressure ventilation by mask with an IPAP of 16 cmH2O and an EPAP of 8 cmH2O. Corresponding blood gas data is as follows: pH 7.29 / PaCO2 51 / PaO2 108 / HCO3 24 / BE 0 Which adjustment is most appropriate? a. decrease EPAP only b. increase IPAP and EPAP c. increase IPAP only d. decrease EPAP and IPAP b. decreasing pulmonary vascular resistance - Answer A patient has the following input/output history and other clinical information: Yesterday --> Today IN: 1900 cc --> 1600 cc OUT: 2200 cc --> 1900 cc C.O.: 6.1 L/min --> 3.7 L/min BP: 120/78 --> 120/82 CVP: 3 --> 3 PAP: 12 --> 12 PCWP: 7 --> 7 These data would result in which of the following? a. decrease in V/Q mismatching b. decreasing pulmonary vascular resistance c. increase in left end-diastolic pressure d. increase in CVP b. loop diuretics - Answer A patient with fulminating pulmonary edema has the following data obtained from a Swan-Ganz pulmonary artery catheter: CVP: 10 mmHg PAP: 25 mmHg PCWP: 15 mmHg C.O.: 3.9 L/min The patient would benefit most from which of the following? a. blood expanding agents b. loop diuretics c. Penicillin-class antibiotics d. administration of whole blood c. aerosolized Albuterol and Atrovent - Answer An adult patient in the emergency room is wheezing bilaterally after multiple metered dose inhaler treatments with Albuterol at home. The patient may best benefit from which of the following? a. continous bronchodilator therapy with Albuterol at 3 mg/hr b. aerosolized Pulmicort( (Budesonide) c. aerosolized Albuterol and Atrovent d. aerosolized Atropine c. cardiac index - Answer L/min/m2 is the unit of measure for a. stroke volume b. cardiac output c. cardiac index d. systemic vascular resistance a. 5 L/min nasal cannula - Answer A spontaneously breathing patient has the following arterial blood gas results: pH 7.38 / PaCO2 42 / PaO2 76 / HCO3 24 / BE 0 Which of the following supplemental oxygen levels is most appropriate? a. 5 L/min nasal cannula b. Venturi mask at 30% c. non-rebreathing mask d. 2 L/min nasal cannula d. spontaneous tidal volume - Answer Which of the following is considered objective information? a. dysphagia b. chest pain c. dyspnea d. spontaneous tidal volume b. determine FRC - Answer What is the primary purpose for a helium dilution test? a. quantify alveolar deadspace b. determine FRC c. directly measure TLC d. determine alveolar diffusion capacity a. discontinue ventilatory support - Answer A patient with myasthenia gravis receiving volume-controlled ventilation is able to exhale a vital capacity of 2.4 L, has a spontaneous VT of 450 mL and is able to achieve -38 cmH2O on the MIP manometer. As the patient becomes alert, the respiratory therapist should recommend a. discontinue ventilatory support b. adminster a maintenance dose of Tensilon c. sedating the patient. continuing to monitor d. checking VC q4 hours c. ARDS - Answer Which of the following patients or conditions would benefit most from pressure control ventilation? a. COPD b. myasthenia gravis c. ARDS d. pneumonia b. performing a defribrillation at 150 joules biphasic - Answer A 74-year old male has ventricular tachycardia. The patient is not alert and will not respond to verbal commands. A pulse is not palpable. The respiratory therapist will respond by a. adminstering aminophylline, IV b. performing a defribrillation at 150 joules biphasic c. cardioverting the patient at 100 joules d. administering sodium bicarbonate c. pulmonary hypertension - Answer A patient in the cardiac intensive care unit has a Swan-Ganz pulmonary artery catheter in place. The following data is available: CVP: 6 torr mPAP: 18 torr PCWP: 8 torr C.I.: 2.0 L/min/m2 Which of the following most likely represents the patient's condition? a. dehydration b. cor pulmonale c. pulmonary hypertension d. left heart failure c. CVP - Answer Hypovolemia would first be manifested in which of the following values? a. PCWP b. PAP c. CVP d. PVR d. cardiac output and wedge pressure - Answer Left heart failure would be manifested in which of the following values? a. MAP and SVR b. CVP and mPAP c. mPAP and wedge pressure d. cardiac output and wedge pressure a. pulmonary capillary wedge pressure - Answer Which of the following hemodynamic values is associated with the function of the left heart? a. pulmonary capillary wedge pressure b. systemic vascular resistance c. mean pulmonary artery pressure d. central venous pressure c. 14 L/min - Answer A patient is on 60%/40% heliox therapy by nonrebreathing mask. If flowing through an oxygen flow meter, what is the actual flow of the mixture if the flow meter indicates 10 L/min? a. 18 L/min b. 10 L/min c. 14 L/min d. 16 L/min