LINDSEY JONES FINAL TMC
QUESTIONS AND ANWERS (GRADED
A+)
Condensation has developed on the fuel cell of a galvanic oxygenation analyzer. Which
of the following is true?
A. The fuel cell should be replaced
B. The analyzer will still function properly
C. The gold grid in the analyzer should be replaced
D. The reading will be erroneous - ANSWER-D. The reading will be erroneous
Condensation on the fuel cell of a galvanic-type oxygen analyzer may result in an
erroneous reading of oxygen percentage.
A sputum gram stain report indicates the presence of a gram-positive organism
(diplococcus) in the sputum. The following data is available:
WBC 28,000 cu mm
Hb 14.5 g/dL
RBC 4.6 g/dL
HCT 42%
Which of the following medication would be most appropriate?
A. vancomycin
B. gentamycin
C. budesonide
D. amoxicillin - ANSWER-D. amoxicillin
Gram positive organisms, such as diplococcus, staphylococcus, etc) are treated using
penicillin class antimicrobials. These include penicillin, amoxicillin, carbenicillin, and
others.
Which of the following data should be recorded in the patient's medical record after the
therapist coaches a post-op patient through sustained maximal inhalation therapy with a
volume-oriented incentive spirometer?
A. expiratory reserve volume
B. inspiratory reserve volume
C. inspiratory capacity
D. vital capacity - ANSWER-C. inspiratory capacity
,If the patient is using a volume oriented incentive spirometer, inspiratory capacity must
be included in the documentation in the medical record.
A 39-week gestational age neonate delivered 1 hour prior requires oxygen by hood.
Which of the following devices should be assembled?
1. aerosol heater
2. O2/air blender
3. large-bore tubing
4. oxygen analyzer
A. 2, 3, and 4
B. 1, 2, 3, and 4
C. 1, 3, and 4
D. 1, 2, and 3 - ANSWER-B. 1, 2, 3, and 4
Because maintaining constant body temperature is paramount for an infant, use of an
aerosol heater is important. An oxygen-air blender, along with large-bore corrugated
tubing will also be needed to deliver supplemental oxygen. Additionally, an oxygen
analyzer will be needed to determine, maintain, and adjust FIO2 as needed.
The respiratory therapist notices a disparity in the heart rate as reported by an SpO2
monitor and a finger probe compared to a palpated heart rate. Which can best explain
this?
1. poor peripheral perfusion
2. excessive ambient light
3. presence of finger-nail polish
4. low hemoglobin
A. 1, 2, and 3 only
B. 1 and 4 only
C. 2 and 3 only
D. 2, 3, and 4 only - ANSWER-A. 1, 2, and 3 only
A 150-lb (68-kg) male is receiving volume-cycled mechanical ventilation on the following
settings:
Mode SIMV
Rate 16
VT 450 mL
FIO2 0.45
PEEP 12 cm H2O
Peak Pressure 32 cm H2O
Which of the following alarm settings is most appropriate?
, A. Low VT 350 mL, low pressure 22 cmH2O, high pressure 45 cmH2O
B. Low VT 350 mL, low pressure 30 cmH2O, high pressure 35 cmH2O
C. Low VT 400 mL, low pressure 20 cmH2O, high pressure 50 cmH2O
D. Low VT 300 mL, low pressure 30 cmH2O, high pressure 48 cmH2O - ANSWER-A.
Low VT 350 mL, low pressure 22 cmH2O, high pressure 45 cmH2O
The low VT alarm should be set at 100 mL below VT, low-pressure should be set at 10
cm H2O below baseline peak pressures, and the high-pressure limit alarms should be
set 10-15 cm H2O above the baseline peak pressure.
A patient is orally intubated and receiving mechanical ventilation. The respiratory
therapist notes the PetCO2 monitor is persistently reading 60 mmHg. Which of the
following can the therapist conclude?
A. the patient is being hyperventilated
B. the CO2 detector is covered with condensate
C. minute ventilation should be increased
D. the infrared device is not working properly - ANSWER-C. minute ventilation should
be increased
End-tidal CO2 is correlated to arterial CO2. An end-tidal CO2 reading of 60 mmHg
correlates with an arterial CO2 of 70 mmHg. This is clearly hypoventilation and should
be addressed by increasing minute ventilation.
What pulmonary function maneuver will reveal information required to diagnose COPD?
A. SBN2
B. FVC
C. DLCO
D. SVC - ANSWER-B. FVC
Although FVC is a volume, which is not directly helpful in diagnosing COPD, the actual
name of the maneuver that is used to establish flow rates such as FEV1, is forced vital
capacity (FVC). This can be confusing because the FVC is an actual volume, but when
compared to time it also produces flow data, which is used to diagnose obstructive lung
disease.
According to the ARDSnet protocol, PaO2 should be kept between 55 and 80 mm Hg
during ventilatory support. This is known as permissive hypoxemia.
After instructing a patient and demonstrating the proper use of a metered dose inhaler
with a valved holding chamber, the patient performs the maneuver by placing the
chamber in his mouth, actuating the cannister, and then exhaling prior to performing
inhalation. The respiratory therapist should
, A. remove the cannister and have the patient reattempt the dose delivery.
B. instruct the patient to inhale while depressing the cannister.
C. document that the education was effective.
D. re-instruct the patient to inhale immediately after actuation of the cannister. -
ANSWER-D. re-instruct the patient to inhale immediately after actuation of the
cannister.
If the patient exhales through the chamber immediately after actuating the inhaler, the
medication may be ejected through the valve and out of the chamber. This would
discard the medication. After depressing the cannister, the first action should be to
inhale through the chamber.
A patient receiving PSV with pressure of 12 cm H2O is demonstrating signs of
increased work of breathing. RR 24/min. VT(spont) 180 mL. SpO2 88%. The physician
orders an increase in the PS pressure. This will result in an increase in which of the
following?
A. PAO2
B. cardiac index
C. functional hemoglobin
D. alveolar ventilation - ANSWER-D. alveolar ventilation
Local FEMA representatives have asked a hospital to prepare for intermittent, sweeping
power outages in the area due to a nearby passing F4 hurricane. Which of the following
would be the most important preparation that a respiratory care supervisor should
consider?
A. Call for extra staff to report the hospital.
B. Instruct nurses on proper techniques for providing manual resuscitation.
C. Contract an equipment rental company for extra ventilators.
D. Check the function of back-up power outlets (red plugs) in critical areas. - ANSWER-
D. Check the function of back-up power outlets (red plugs) in critical areas.
Of the options listed, checking for the proper operation of red plugs during a power
outage is most helpful. It would also be appropriate to ensure vital equipment (life
support machines) are plugged into those red outlets.
Which is the preferred order to manipulate a mechanical ventilator in order to gradually
increase alveolar minute ventilation while limiting MAP?
A. increase VT, increase RR, decrease mechanical deadspace
B. increase RR, decrease mechanical deadspace, increase VT
C. increase VT, decrease mechanical deadspace, increase RR
D. decrease mechanical deadspace, increase VT, increase RR - ANSWER-D.
decrease mechanical deadspace, increase VT, increase RR
QUESTIONS AND ANWERS (GRADED
A+)
Condensation has developed on the fuel cell of a galvanic oxygenation analyzer. Which
of the following is true?
A. The fuel cell should be replaced
B. The analyzer will still function properly
C. The gold grid in the analyzer should be replaced
D. The reading will be erroneous - ANSWER-D. The reading will be erroneous
Condensation on the fuel cell of a galvanic-type oxygen analyzer may result in an
erroneous reading of oxygen percentage.
A sputum gram stain report indicates the presence of a gram-positive organism
(diplococcus) in the sputum. The following data is available:
WBC 28,000 cu mm
Hb 14.5 g/dL
RBC 4.6 g/dL
HCT 42%
Which of the following medication would be most appropriate?
A. vancomycin
B. gentamycin
C. budesonide
D. amoxicillin - ANSWER-D. amoxicillin
Gram positive organisms, such as diplococcus, staphylococcus, etc) are treated using
penicillin class antimicrobials. These include penicillin, amoxicillin, carbenicillin, and
others.
Which of the following data should be recorded in the patient's medical record after the
therapist coaches a post-op patient through sustained maximal inhalation therapy with a
volume-oriented incentive spirometer?
A. expiratory reserve volume
B. inspiratory reserve volume
C. inspiratory capacity
D. vital capacity - ANSWER-C. inspiratory capacity
,If the patient is using a volume oriented incentive spirometer, inspiratory capacity must
be included in the documentation in the medical record.
A 39-week gestational age neonate delivered 1 hour prior requires oxygen by hood.
Which of the following devices should be assembled?
1. aerosol heater
2. O2/air blender
3. large-bore tubing
4. oxygen analyzer
A. 2, 3, and 4
B. 1, 2, 3, and 4
C. 1, 3, and 4
D. 1, 2, and 3 - ANSWER-B. 1, 2, 3, and 4
Because maintaining constant body temperature is paramount for an infant, use of an
aerosol heater is important. An oxygen-air blender, along with large-bore corrugated
tubing will also be needed to deliver supplemental oxygen. Additionally, an oxygen
analyzer will be needed to determine, maintain, and adjust FIO2 as needed.
The respiratory therapist notices a disparity in the heart rate as reported by an SpO2
monitor and a finger probe compared to a palpated heart rate. Which can best explain
this?
1. poor peripheral perfusion
2. excessive ambient light
3. presence of finger-nail polish
4. low hemoglobin
A. 1, 2, and 3 only
B. 1 and 4 only
C. 2 and 3 only
D. 2, 3, and 4 only - ANSWER-A. 1, 2, and 3 only
A 150-lb (68-kg) male is receiving volume-cycled mechanical ventilation on the following
settings:
Mode SIMV
Rate 16
VT 450 mL
FIO2 0.45
PEEP 12 cm H2O
Peak Pressure 32 cm H2O
Which of the following alarm settings is most appropriate?
, A. Low VT 350 mL, low pressure 22 cmH2O, high pressure 45 cmH2O
B. Low VT 350 mL, low pressure 30 cmH2O, high pressure 35 cmH2O
C. Low VT 400 mL, low pressure 20 cmH2O, high pressure 50 cmH2O
D. Low VT 300 mL, low pressure 30 cmH2O, high pressure 48 cmH2O - ANSWER-A.
Low VT 350 mL, low pressure 22 cmH2O, high pressure 45 cmH2O
The low VT alarm should be set at 100 mL below VT, low-pressure should be set at 10
cm H2O below baseline peak pressures, and the high-pressure limit alarms should be
set 10-15 cm H2O above the baseline peak pressure.
A patient is orally intubated and receiving mechanical ventilation. The respiratory
therapist notes the PetCO2 monitor is persistently reading 60 mmHg. Which of the
following can the therapist conclude?
A. the patient is being hyperventilated
B. the CO2 detector is covered with condensate
C. minute ventilation should be increased
D. the infrared device is not working properly - ANSWER-C. minute ventilation should
be increased
End-tidal CO2 is correlated to arterial CO2. An end-tidal CO2 reading of 60 mmHg
correlates with an arterial CO2 of 70 mmHg. This is clearly hypoventilation and should
be addressed by increasing minute ventilation.
What pulmonary function maneuver will reveal information required to diagnose COPD?
A. SBN2
B. FVC
C. DLCO
D. SVC - ANSWER-B. FVC
Although FVC is a volume, which is not directly helpful in diagnosing COPD, the actual
name of the maneuver that is used to establish flow rates such as FEV1, is forced vital
capacity (FVC). This can be confusing because the FVC is an actual volume, but when
compared to time it also produces flow data, which is used to diagnose obstructive lung
disease.
According to the ARDSnet protocol, PaO2 should be kept between 55 and 80 mm Hg
during ventilatory support. This is known as permissive hypoxemia.
After instructing a patient and demonstrating the proper use of a metered dose inhaler
with a valved holding chamber, the patient performs the maneuver by placing the
chamber in his mouth, actuating the cannister, and then exhaling prior to performing
inhalation. The respiratory therapist should
, A. remove the cannister and have the patient reattempt the dose delivery.
B. instruct the patient to inhale while depressing the cannister.
C. document that the education was effective.
D. re-instruct the patient to inhale immediately after actuation of the cannister. -
ANSWER-D. re-instruct the patient to inhale immediately after actuation of the
cannister.
If the patient exhales through the chamber immediately after actuating the inhaler, the
medication may be ejected through the valve and out of the chamber. This would
discard the medication. After depressing the cannister, the first action should be to
inhale through the chamber.
A patient receiving PSV with pressure of 12 cm H2O is demonstrating signs of
increased work of breathing. RR 24/min. VT(spont) 180 mL. SpO2 88%. The physician
orders an increase in the PS pressure. This will result in an increase in which of the
following?
A. PAO2
B. cardiac index
C. functional hemoglobin
D. alveolar ventilation - ANSWER-D. alveolar ventilation
Local FEMA representatives have asked a hospital to prepare for intermittent, sweeping
power outages in the area due to a nearby passing F4 hurricane. Which of the following
would be the most important preparation that a respiratory care supervisor should
consider?
A. Call for extra staff to report the hospital.
B. Instruct nurses on proper techniques for providing manual resuscitation.
C. Contract an equipment rental company for extra ventilators.
D. Check the function of back-up power outlets (red plugs) in critical areas. - ANSWER-
D. Check the function of back-up power outlets (red plugs) in critical areas.
Of the options listed, checking for the proper operation of red plugs during a power
outage is most helpful. It would also be appropriate to ensure vital equipment (life
support machines) are plugged into those red outlets.
Which is the preferred order to manipulate a mechanical ventilator in order to gradually
increase alveolar minute ventilation while limiting MAP?
A. increase VT, increase RR, decrease mechanical deadspace
B. increase RR, decrease mechanical deadspace, increase VT
C. increase VT, decrease mechanical deadspace, increase RR
D. decrease mechanical deadspace, increase VT, increase RR - ANSWER-D.
decrease mechanical deadspace, increase VT, increase RR
