CSE RRT EXAM STUDY QUESTIONS AND
ANSWERS RATED A.
Recommend intubation and mechanical ventilation for GBS pts if they have
(5 things)
-VC < 1.0 L or < 15 mL/kg
-MIP/NIF < -25 cm H2O, MEP < 40 cm H2O
-Inability to cough, swallow and protect the airway
-ABG evidence of respiratory failure
-Aspiration pneumonia with severe hypoxemia
Recommend trach for GBS pts if they (2 things)
-Severe weakness, especially if bulbar involvement (e.g., dysphagia)
-Likely need for mechanical ventilation > 10 days
Post-OP Atelectasis Signs and Symptoms (4 things)
-mild fever
-progressive hypoxemia and dyspnea
-decreased breath sounds and a dull percussion note over the affected area
-possible mediastinum to shift toward the areas of collapse.
Post Op Atelectasis CXR findings (4 things)
o Opacification of the collapsed lobe(s) or segment(s)
o Mediastinal shift toward the side of collapse
o Elevation of the hemidiaphragm on the side of collapse
o Hyperlucency of the remaining well-aerated lobes
Post Op Atelectasis Tx (3 things)
-O2 therapy as needed to maintain SpO2 ≥ 90%
-Early mobilization/ambulation as tolerated
,-Deep breathing with assisted coughing (e.g., huff cough/FET); be sure to help
splint wound
and coordinate therapy with appropriate analgesia
In planning implementation of the airway clearance protocol for CF pt, what
therapy sequence would you implement?
-albuterol, then pulmozyme, then airway clearance therapy
CF recommendations for diagnosis (4 things)
-genetic testing (definitive)
-sweat chloride test (positive if > 60)
-assess CXR for hyperinflation (due to air trapping),
-sputum culture and sensitivity (presence of P aeruginosa supports diagnosis)
CF CXR would show (3 things)
-peribronchial thickening
-broncheictasis
-RV hypertrophy
CF common clinical findings (6 things)
o chronic cough + sputum production, recurring respiratory infections
o presence of nasal polyps and sinusitis
o clubbing of fingers and toes
o signs of pancreatic insufficiency
o steatorrhea (fatty stool) and/or GI obstruction
o failure to thrive/retarded growth
To relieve airway obstruction in CF pts, recommend (5 things)
o airway clearance therapy + exercise (select/adjust to fit patient preference
and lifestyle)
o aerosol therapy
, o bronchodilator
o mucokinetic, i.e., Pulmozyme (dornase alfa) and/or hypertonic
o inhaled antibiotic
Recommend intubation and mechanical ventilation for any infant ≤ 27
gestational age whose mother did not receive antenatal steroids or if the
infant: (4 things)
o is apneic or
o is unable to maintain an adequate airway or
o exhibits increased work of breathing (grunting, retractions, flaring) on CPAP
or
o cannot maintain a pH > 7.25 on CPAP
On the exam, never choose heart sounds unless
the pt is a baby
On the exam, never choose an echocardiogram unless
the baby has a murmur
On the exam, never choose bowel sounds unless
there is suspected diaphragmatic hernia in the baby
On the exam never choose muscle tone unless ______________________.
Also never choose EMG unless_______________________
-unless the pt is a baby or a neuromuscular pt
-the pt is a neuromuscular pt
On the exam, never choose these things unless you're dealing with a
neuromuscular pt (3 things)
ANSWERS RATED A.
Recommend intubation and mechanical ventilation for GBS pts if they have
(5 things)
-VC < 1.0 L or < 15 mL/kg
-MIP/NIF < -25 cm H2O, MEP < 40 cm H2O
-Inability to cough, swallow and protect the airway
-ABG evidence of respiratory failure
-Aspiration pneumonia with severe hypoxemia
Recommend trach for GBS pts if they (2 things)
-Severe weakness, especially if bulbar involvement (e.g., dysphagia)
-Likely need for mechanical ventilation > 10 days
Post-OP Atelectasis Signs and Symptoms (4 things)
-mild fever
-progressive hypoxemia and dyspnea
-decreased breath sounds and a dull percussion note over the affected area
-possible mediastinum to shift toward the areas of collapse.
Post Op Atelectasis CXR findings (4 things)
o Opacification of the collapsed lobe(s) or segment(s)
o Mediastinal shift toward the side of collapse
o Elevation of the hemidiaphragm on the side of collapse
o Hyperlucency of the remaining well-aerated lobes
Post Op Atelectasis Tx (3 things)
-O2 therapy as needed to maintain SpO2 ≥ 90%
-Early mobilization/ambulation as tolerated
,-Deep breathing with assisted coughing (e.g., huff cough/FET); be sure to help
splint wound
and coordinate therapy with appropriate analgesia
In planning implementation of the airway clearance protocol for CF pt, what
therapy sequence would you implement?
-albuterol, then pulmozyme, then airway clearance therapy
CF recommendations for diagnosis (4 things)
-genetic testing (definitive)
-sweat chloride test (positive if > 60)
-assess CXR for hyperinflation (due to air trapping),
-sputum culture and sensitivity (presence of P aeruginosa supports diagnosis)
CF CXR would show (3 things)
-peribronchial thickening
-broncheictasis
-RV hypertrophy
CF common clinical findings (6 things)
o chronic cough + sputum production, recurring respiratory infections
o presence of nasal polyps and sinusitis
o clubbing of fingers and toes
o signs of pancreatic insufficiency
o steatorrhea (fatty stool) and/or GI obstruction
o failure to thrive/retarded growth
To relieve airway obstruction in CF pts, recommend (5 things)
o airway clearance therapy + exercise (select/adjust to fit patient preference
and lifestyle)
o aerosol therapy
, o bronchodilator
o mucokinetic, i.e., Pulmozyme (dornase alfa) and/or hypertonic
o inhaled antibiotic
Recommend intubation and mechanical ventilation for any infant ≤ 27
gestational age whose mother did not receive antenatal steroids or if the
infant: (4 things)
o is apneic or
o is unable to maintain an adequate airway or
o exhibits increased work of breathing (grunting, retractions, flaring) on CPAP
or
o cannot maintain a pH > 7.25 on CPAP
On the exam, never choose heart sounds unless
the pt is a baby
On the exam, never choose an echocardiogram unless
the baby has a murmur
On the exam, never choose bowel sounds unless
there is suspected diaphragmatic hernia in the baby
On the exam never choose muscle tone unless ______________________.
Also never choose EMG unless_______________________
-unless the pt is a baby or a neuromuscular pt
-the pt is a neuromuscular pt
On the exam, never choose these things unless you're dealing with a
neuromuscular pt (3 things)
