TMC questions from Lindsey Jones (Part 2)
Questions And Answers
Which device is most appropriate to send to the central processing department for sterilization
after use on an infectious patient? Battery-powered laryngoscope handle
· In this example the laryngoscope handle is an electronic device and may be damaged with
customary soaking in glutaraldehyde. A fiber-optic laryngoscope blade and a reusable stylet can
both be soaked in a glutaraldehyde solution. An infant ventilator cannot be soaked or sent for
sterilization. A ventilator is wiped down. The use of filters prevents contamination of the inner
parts.
Following extubation after shoulder surgery a 15-year-old male patient is experiencing 30-
second periods of apnea. The respiratory therapist should Ventilate with a manual
resuscitator
· 30-second periods of apnea indicate the need for immediate assistance with ventilation. Of the
choices offered, only ventilation with a manual resuscitator meets this requirement. One may be
tempted to choose to intubate the patient, but intubation does not automatically imply that
mechanical ventilation will be provided. Intubation is for airway protection.
, TMC questions from Lindsey Jones (Part 2)
Questions And Answers
When transitioning from a speaking configuration to a positive pressure ventilation configuration
in a trach patient, what is the order? the first step is to remove the cap, then inflate the
cuff, and finally, insert the inner cannula.
A patient is experiencing reduced tidal volumes on a volume-cycled ventilator. There is a
gurgling sound coming from his mouth with each breath and the endotracheal tube marking is 19
cm at the lips. The respiratory therapist should Add air to the pilot balloon while
auscultating over the neck
· The scenario presents an airway management problem including an air leak with an
endotracheal tube. The cause is likely due to a lack of air in the cuff, but could be several other
things, such as a hole in the cuff, or a misplaced tube. By first adding air to the cuff the
respiratory therapist will either solve the problem, or further isolate the problem. For example, if
a hole exists in the cuff, the leak will shortly return, and the therapist will know to replace the
tube.
A 72-kg (158-lb) patient is receiving volume-cycled mechanical ventilation on the following
settings:
Mode SIMV
Rate 12
, TMC questions from Lindsey Jones (Part 2)
Questions And Answers
VT 550 ml
FIO2 0.40
PEEP 10 cm H2O
Which of the following alarm settings is most appropriate? Low VT alarm of 450mL
· The low tidal volume alarm should be set at about 100 mL below the preset/returned tidal
volume. Be prepared to lower the low VT alarm when the patient's lung compliance increases.
An 8-year-old pediatric patient with a 6.0 mm endotracheal tube requiring endotracheal
suctioning is experiencing bradycardia during the procedure. Suction pressure is set to -100 mm
Hg. A respiratory therapist is suctioning for approximately 15 seconds using a 9 Fr catheter and
is able to clear the airway effectively. To remedy the problem, the therapist should
Decrease suction duration time
· If suctioning is not adequate, correct the problem in this order: 1. check connections, change
collection bottle if full 2. ensure suction pressure is in the right range 3. increase to the maximum
size catheter within range 4. increase pressure within range 5. increase suction time
, TMC questions from Lindsey Jones (Part 2)
Questions And Answers
An adult is receiving NT suctioning and experiences a decrease in SpO2 from 98% to 80%
during the procedure. The respiratory should Stop the suction procedure
· The respiratory therapist should immediately stop suctioning if any signs of distress are present
cardiac, desaturation, or otherwise).
What is a molecular sieve device also known as? Oxygen concentrator
A respiratory therapist is called STAT to the general floor where a patient with a tracheal button
in place is unable to breathe. The respiratory therapist should Attempt to manually
ventilate
· The respiratory therapist should not confuse a tracheal button with a cap, which would be
utilized with a fenestrated tracheostomy tube. A button is inserted into the stoma as a
placeholder. Therefore, this patient should be treated as any other patient who cannot breathe by
attempting to manually ventilate after opening the airway.
Questions And Answers
Which device is most appropriate to send to the central processing department for sterilization
after use on an infectious patient? Battery-powered laryngoscope handle
· In this example the laryngoscope handle is an electronic device and may be damaged with
customary soaking in glutaraldehyde. A fiber-optic laryngoscope blade and a reusable stylet can
both be soaked in a glutaraldehyde solution. An infant ventilator cannot be soaked or sent for
sterilization. A ventilator is wiped down. The use of filters prevents contamination of the inner
parts.
Following extubation after shoulder surgery a 15-year-old male patient is experiencing 30-
second periods of apnea. The respiratory therapist should Ventilate with a manual
resuscitator
· 30-second periods of apnea indicate the need for immediate assistance with ventilation. Of the
choices offered, only ventilation with a manual resuscitator meets this requirement. One may be
tempted to choose to intubate the patient, but intubation does not automatically imply that
mechanical ventilation will be provided. Intubation is for airway protection.
, TMC questions from Lindsey Jones (Part 2)
Questions And Answers
When transitioning from a speaking configuration to a positive pressure ventilation configuration
in a trach patient, what is the order? the first step is to remove the cap, then inflate the
cuff, and finally, insert the inner cannula.
A patient is experiencing reduced tidal volumes on a volume-cycled ventilator. There is a
gurgling sound coming from his mouth with each breath and the endotracheal tube marking is 19
cm at the lips. The respiratory therapist should Add air to the pilot balloon while
auscultating over the neck
· The scenario presents an airway management problem including an air leak with an
endotracheal tube. The cause is likely due to a lack of air in the cuff, but could be several other
things, such as a hole in the cuff, or a misplaced tube. By first adding air to the cuff the
respiratory therapist will either solve the problem, or further isolate the problem. For example, if
a hole exists in the cuff, the leak will shortly return, and the therapist will know to replace the
tube.
A 72-kg (158-lb) patient is receiving volume-cycled mechanical ventilation on the following
settings:
Mode SIMV
Rate 12
, TMC questions from Lindsey Jones (Part 2)
Questions And Answers
VT 550 ml
FIO2 0.40
PEEP 10 cm H2O
Which of the following alarm settings is most appropriate? Low VT alarm of 450mL
· The low tidal volume alarm should be set at about 100 mL below the preset/returned tidal
volume. Be prepared to lower the low VT alarm when the patient's lung compliance increases.
An 8-year-old pediatric patient with a 6.0 mm endotracheal tube requiring endotracheal
suctioning is experiencing bradycardia during the procedure. Suction pressure is set to -100 mm
Hg. A respiratory therapist is suctioning for approximately 15 seconds using a 9 Fr catheter and
is able to clear the airway effectively. To remedy the problem, the therapist should
Decrease suction duration time
· If suctioning is not adequate, correct the problem in this order: 1. check connections, change
collection bottle if full 2. ensure suction pressure is in the right range 3. increase to the maximum
size catheter within range 4. increase pressure within range 5. increase suction time
, TMC questions from Lindsey Jones (Part 2)
Questions And Answers
An adult is receiving NT suctioning and experiences a decrease in SpO2 from 98% to 80%
during the procedure. The respiratory should Stop the suction procedure
· The respiratory therapist should immediately stop suctioning if any signs of distress are present
cardiac, desaturation, or otherwise).
What is a molecular sieve device also known as? Oxygen concentrator
A respiratory therapist is called STAT to the general floor where a patient with a tracheal button
in place is unable to breathe. The respiratory therapist should Attempt to manually
ventilate
· The respiratory therapist should not confuse a tracheal button with a cap, which would be
utilized with a fenestrated tracheostomy tube. A button is inserted into the stoma as a
placeholder. Therefore, this patient should be treated as any other patient who cannot breathe by
attempting to manually ventilate after opening the airway.
