THERAPIST MULTIPLE-CHOICE EXAMINATION: PRACTICE TEST GRADE A+ SOLUTIONS

The physician orders a 35% aerosol mask to be set up for a patient who requires an inspiratory flow of 42 L/min. What is the minimum flow rate to which the flowmeter must be set to meet this patient's in- spiratory flow demands? A. 6 L/min B. 8 L/min C. 10 L/min D. 12 L/min B, The air/O2ratio for a 35% oxygen mixture is 5 : 1. To calculate total flow output from this device, add the ratio parts together and multiply by the liter flow: 6 ×6 = 36 L/min, 6 ×8 = 48 L/min, 6 × 10 = 60 L/min, 6 ×12 = 72 L/min. Total flow needed: 42 L/min. The minimum flow necessary is 8, giving a total flow of 48 L/min. (Analysis) A premature 3-week-old infant is receiving 1 L/min of O via a nasal cannula and has a PaO of 43 torr22 and a PaCO2 of 40 torr. The respiratory therapist should recommend which of the following? A. Increase the cannula flow to 2 L/min. B. Intubate and institute mechanical ventilation C. Initiate CPAP of 4 cm H2O and 50% O2 D. Increase the cannula flow to 5 L/min. A, A PaO2 of 43 torr represents hypoxemia. The normal PaO2 for an infant is 50-70 torr. Increasing the cannula flow by 1 L/min is the most appropriate choice to return the PaO2 to normal. With a normal PaCO2 of 40 torr, mechanical ventilation is not indicated. (Analysis) what is normal PaO2 for infant ? 50-70 torr. A patient arrives in the emergency department after being pulled from a burning house. The respiratory therapist should recommend obtaining which of the following measurements to best determine the sever- ity of the patient's smoke inhalation? A. SpO2 B. HbCO C. PaO2 D. Hb B, To best determine the severity of smoke inhalation, an HbCO level should be determined with a co-oximeter. The SpO2 value should never be evaluated on a patient suspected of CO poisoning because a pulse oximeter is not capable of determining what is bound to hemoglobin. Pulse oximeters work on the principle of spectrophotometry where lightweight probes direct filtered light of specific wavelengths through the skin or digit. The light absorbed differs for saturated and desaturated blood, whether it's saturated with oxygen or a combination of oxygen and carbon monoxide. Therefore the reading will be erroneously high when HbCO is present. (Analysis) To best determine the severity of smoke inhalation, an HbCO level should be determined with ? co-oximeter The physician has ordered O2 to be administered to an active 3-year-old with an SpO2 of 86%. Which of the following delivery devices would you recommend for this patient? A. 1- to 2-L nasal cannula B. Air-entrainment mask C. Simple O2 mask D.O2 hood A, An active 3-year-old generally tolerates a cannula much better than any kind of mask and is too large for an O2hood. (Application) The ability of the patient to follow instructions would be indicated by which of the following? A. Orientation to person B. Performance of tasks when asked C. Ability to feed himself D. Awareness of time B, If the patient is able to perform simple tasks when asked, this best determines his or her ability to follow instructions. This is important before administering an incentive spirometry or IPPB treatment, which requires the patient to be able to follow instructions well or the treatment will not be effective. (Recall) If the patient is able to perform simple tasks when asked, this best determines his or her ability to follow instructions. This is important before administering an? incentive spirometry or IPPB treatment, which requires the patient to be able to follow instructions well or the treatment will not be effective. (Recall) You suspect a patient may have a pulmonary embolism. Which of the following would be the most appropriate recommendation for diagnosis of this condition? A. Bronchoscopy B. V/Q lung scan C. Coagulation studies D. Shunt study B, The best diagnostic test to determine whether a pulmonary embolism is present is the V/Q lung scan. (Application) To most effectively increase a sedated, paralyzed patient's alveolar minute ventilation while the patient is on volume-controlled ventilation in the assist-control mode, you would recommend increasing which of the following? A. PEEP B. Inspiratory flow C. VT D. Ventilator rate C Alveolar minute ventilation = (VT - VD) × respiratory rate It represents the volume actually reaching the alveoli per minute. It takes into account anatomic dead space (VD), which is approximately 1 mL/lb of body weight. Anatomic VD is that portion of the airway where no gas exchange occurs. If a patient's alveolar minute ventilation is to be increased, the VT must be increased. If only the ventilator rate is increased, the same VT is delivered, even though the minute ventilation (VT × RR) increases. (Recall) what is the formula for alveolar minute ventilation ? (VT - VD) × respiratory rate Failure to hyperoxygenate a patient on a ventilator before ET suctioning may result in A. Hypoxemia B. Hypocapnia C. Bradycardia D. Hypertension A, It is important during ET suctioning that the PaO2 be maintained within a normal range. This requires increasing the oxygen percentage during the procedure. Failure to hyperoxygenate may cause hypoxemia, resulting in cardiac arrhythmias. Bradycardia may occur as a result of vagal stimulation. (Application) while ET suctioning , Failure to hyperoxygenate may cause hypoxemia, resulting in ? cardiac arrhythmias while ET suctioning a pt, Bradycardia may occur as a result of ? vagal stimulation CONTINUED.....