Update 2024.
A 48 year-old female is admitted to the ED with diaphoresis, jugular venous distension,
and 3+ pitting edema in the ankles. These findings are consistent with
A. liver failure.
B. pulmonary embolism.
C. heart failure.
D. electrolyte imbalance. - Correct Answer C
A patient is admitted to the ED following a motor vehicle accident. On physical exam, the
respiratory therapist discovers that breath sounds are absent in the left chest with a
hyper-resonant percussion note. The trachea is shifted to the right. The patient's heart
rate is 45/min, respiratory rate is 30/min, and blood pressure is 60/40 mm Hg. What
action should the therapist recommend first?
A. Call for a STAT chest x-ray.
B. Insert a chest tube into the left chest.
C. Needle aspirate the 2nd left intercostal space.
D. Activate the medical emergency team to intubate the patient. - Correct Answer C
All of the following strategies are likely to decrease the likelihood of damage to the
tracheal mucosa EXCEPT
A. maintaining cuff pressures between 20 and 25 mm Hg.
B. using the minimal leak technique for inflation.
C. using a low-residual-volume, low-compliance cuff.
D. monitoring intracuff pressures. - Correct Answer C
A 52 year-old post-operative cholecystectomy patient's breath sounds become more
coarse upon completion of postural drainage with percussion. The respiratory therapist
should recommend
,A. continuing the therapy until breath sounds improve.
B. administering dornase alpha.
C. administering albuterol therapy.
D. deep breathing and coughing to clear secretions. - Correct Answer D
A 65 kg spinal cord injured patient develops atelectasis. His inspiratory capacity is 30% of
his predicted value. What bronchial hygiene therapy would be most appropriate initially?
A. Incentive spirometry
B. IPPB
C. Postural drainage and percussion
D. PEP therapy - Correct Answer B
A healthy adult female can exhale what portion of her forced vital capacity in the first
second?
A. 50%
B. 60%
C. 70%
D. 80% - Correct Answer C
A patient on VC ventilation demonstrates auto-PEEP on ventilator graphics. Which of the
following controls, when adjusted independently, would increase expiratory time?
1. Tidal volume
2. Respiratory Rate
3. Inspiratory flow
4. Sensitivity
A. 1, 2, and 3 only
B. 1, 2, and 4 only
C. 1, 3, and 4 only
,D. 2, 3, and 4 only - Correct Answer A
Which of the following would be the most appropriate therapy for a dyspneic patient who
has crepitus with tracheal deviation to the left and absent breath sounds on the right?
A. Perform chest physiotherapy
B. Administer an IPPB treatment
C. Insert an endotracheal tube
D. Insert a chest tube - Correct Answer D
Following cardiac surgery, a 55 year-old patient has the following ABG results:
pH 7.50
PaCO2 30 torr
PaO2 62 torr
HCO3 25 mEq/L
SaO2 92%
HB 14 g/dL
BE +2.
Venous blood gas results are
pH 7.39
PvCO2 43 torr
PvO2 37 torr
SvO2 66%.
Calculate the patient's C(a-v)O2.
A. 2.5 vol%
B. 4.0 vol%
C. 5.0 vol%
, D. 5.5 vol% - Correct Answer C
A patient on VC, SIMV with a VT of 500 mL has a PIP of 25 cm H2O, Pplat of 15 cm H2O
and PEEP of 5 cm H2O. What is the patient's static lung compliance?
A. 25 mL/cm H2O
B. 35 mL/cm H2O
C. 45 mL/cm H2O
D. 50 mL/cm H2O - Correct Answer D
Immediately after extubation of a patient in the ICU, the respiratory therapist observes
increasing respiratory distress with intercostal retractions and marked stridor. The SpO2
on 40% oxygen is noted to be 76%. Which of the following would be most appropriate at
this time?
A. Cool mist aerosol treatment
B. Aerosolized racemic epinephrine
C. Manual ventilation with resuscitation bag and mask
D. Reintubation - Correct Answer D
Which of the following patients would most likely benefit from pressure support
ventilation?
A. An intubated patient with an absent respiratory drive.
B. A patient on SIMV with a mandatory rate of 12/min and total rate of 24/min.
C. A patient with acute lung injury.
D. A patient who requires short-term post-operative ventilatory support. - Correct Answer
B
A patient receiving mechanical ventilation has developed a temperature of 99.9° F with
purulent secretions over the last 12 hours. The respiratory therapist has also noted a
steady increase in peak inspiratory pressure. What initial recommendation should be
made to address these changes?
A. Initiate bronchial hygiene therapy.