LINDSEY JONES PRACTICE EXAM QS
W/ EXPLANATIONS
1. A patient has undergone overnight oximetry. Data shows several episodes of O2
desaturation throughout the night. The RTT would expect orders for which of the
following kinds of testing:
a. V/Q scan
b. pulmonary function testing
c. polysomnography
d. 24-hour Holter monitoring - ANSWER-Your answer: C
Correct answer: C
The use of overnight oximetery is often used to detect O2 desaturation during the night
that may be associated with central or obstructive sleep apnea. Because data indicates
some periodic desaturation, the practitioner should suspect possible sleep apnea and
should order diagnostic testing that will confirm or rule out the suspicion.
A routine screening blood gas performed on an asymptomatic patient prior to surgery
shows the following:
pH: 7.38
PaCO2: 42
PaO2: 80
HCO3: 26
SaO2: 96%
COHb: 24%
What should the RRT do?
a. place the patient on a NRB mask
b. report the findings and emphasize that the patient is likely a smoker
c. evaluate saturation using a single wave-length spectrophotometer
d. run quality control material and evaluate the accuracy of the co-oximeter - ANSWER-
your answer: D
correct answer: D
In this case the patient is presented as asyptomatic. A patient with a COHb level of 24%
would feel dyspnea and present with tachypnea. Therefore, the RRT should evaluate
the accuracy of the lab results, specifically the COHb. When checking accuracy of lab
results, one would use quality control measures.
,The infection control department of a small hospital informs the RRT supervisor that the
biological control accompanying some durable autoclaved equipment shows viable
spores. The supervisor should do which of the following with the equipment:
a. incinerate
b. record date and place into service
c. wipe with isopropyl alcohol before use
d. resterilize - ANSWER-your answer: D
correct answer: D
The presence of viable spores indicates the possibility of living organisms developing in
the sterilized package or on the sterilized equipment. Sterilization suggest the absence
of living organisms, therefore the presence of viable spores indicates the need to
resterilize.
A post-op patient is not progressing with sustained maximal inspiratory therapy and
refuses to cough because of pain along the incision site. The RRT should instruct the
patient to:
a. pause at the top of each inspiration
b. press a pillow against the incision site when coughing
c. attempt coughing 1 hour after pain medication has been administered
d. avoid coughing until the pain subsides - ANSWER-your answer: B
correct answer: B
Explosive coughing by a post-op patient can inadvertently open incision sites. To
prevent this, splinting the site with a pillow is an appropriate option.
Several hours after oral endotracheal extubation of an 8.0-mm tube, and adult patient
begins to demonstrate inspiratory stridor. Which of the following would be most helpful
to the patient:
a. racemic epinephrine
b. albuterol
c. atropine sulfate
d. heated aerosol by mask - ANSWER-your answer: A
correct answer: A
When a patient is extubated and has swelling of the upper airway tissues as
demonstrated by stridor, racemic epinephrine is an appropriate medication to reduce
swelling quickly. Another, less effective option, is to provide a cool mist. In extreme
cases, such as marked stridor, reintubation, or an emergency tracheotomy may be
indicated.
,An adult patient is receiving mechanical ventilatory support and is being suctioned
through the endotracheal tube at a pressure of -90 mmHg. Secretions have been
difficult to remove. What can be done FIRST to increase suctioning efficiency:
a. increase suction time
b. decrease suction to 80 mmHg
c. increase suction pressure to 100 mmHg
d. increase suction catheter size - ANSWER-your answer: C
Correct answer: C
An increase in suctioning effectiveness is done through three different ways - increasing
suction catheter diameter, increasing suction pressure, and increasing suction time.
Before increasing catheter size, the first thing that should be done is to ensure the
appropriate range of suction pressure is being used. In this case, the appropriate
suction pressure for an adult is 100-120 mmHg. A pressure of 90 mmHg is being used,
which is insufficient suction pressure. This should be corrected before doing anything
else to increase suction effectiveness.
A chemical indicator tape found inside the sealed, packeaged disposable mask helps
determine which of the following:
a. if the equipment is sterile
b. if the equipment has been properly sterilized
c. if microorganisms remain viable on the equipment
d. if the package has remained closed - ANSWER-your answer: A
correct answer: B
A chemical indicator tape inside a sterilized package does not actually indicated the
presence or absence of viable spores. It does, however, indicate if the equipment has
been through the sterilization process.
Following a full cardiopulmonary arrest and successful resuscitation, the patient has
received dopamine to raise blood pressure, The RRT is having difficulty obtaining
arterial blood from the radial artery due to hypotension. From which of the following
sites should the therapist attempt to perform an arterial puncture:
a. pedal artery
b. femoral artery
c. umbilical artery
d. carotid artery - ANSWER-your answer: B
correct answer: B
During CPR, blood pressure exists because of cardiac compressions and is usually low.
Palpation of pulse, therefore, is difficult in the usual locations such as the radial or
brachial arteries. When blood gases are needed during a code with a patient who has
very low blood pressure, the femoral artery is the location of choice.
, While coaching a patient with CF on the use of a PEP therapy device, the patient
suddenly becomes short of breath and cyanotic above the waist. The most appropriate
action is to:
a. schedule a V/Q scan after completion of the Tx
b. discontinue the Tx
c. perform NT suctioning
d. switch to IPV - ANSWER-your answer: D
correct answer: B
This patient is exhibiting an adverse reaction to the therapy. The first reaction of the
therapist should be to stop the therapy and ensure the patient's vital stability.
Subsequently, alternative therapies may be considered to accomplish the same
objective without causing a similar adverse reaction.
The low ventilator alarm is sounding on a 28-year old patient with myasthenia gravis.
The respiratory therapist notes the oral endotracheal tube cuff is failing to hold pressure.
The ET tube is positioned at 22 cm at the teeth. The RRT should:
a. increase the tidal volume
b. decrease the low tidal volume alarm
c. replace the ET tube
d. send to surgery for placement of a tracheostomy - ANSWER-your answer: C
correct answer: C
An ET tube whose cuff is failing to retain air is considered defective and should be
replaced.
The following ECG tracing suddenly presents on a patient in the emergency department
(ED) who was admitted for chest pain. The tracing is confirmed in two leads. The
therapist should immediately:
[asystole tracing]
A. administer Lidocaine
B. defibrillate at 360 joules with synchronization set to OFF
C. administer sublingual nitroglycerin (Isordil)
D. begin chest compressions - ANSWER-Your answer was : D
The correct answer is : D
Explanation :
After confirming this rhythm (asystole) in 2 leads, the primary treatment is chest
compressions.
W/ EXPLANATIONS
1. A patient has undergone overnight oximetry. Data shows several episodes of O2
desaturation throughout the night. The RTT would expect orders for which of the
following kinds of testing:
a. V/Q scan
b. pulmonary function testing
c. polysomnography
d. 24-hour Holter monitoring - ANSWER-Your answer: C
Correct answer: C
The use of overnight oximetery is often used to detect O2 desaturation during the night
that may be associated with central or obstructive sleep apnea. Because data indicates
some periodic desaturation, the practitioner should suspect possible sleep apnea and
should order diagnostic testing that will confirm or rule out the suspicion.
A routine screening blood gas performed on an asymptomatic patient prior to surgery
shows the following:
pH: 7.38
PaCO2: 42
PaO2: 80
HCO3: 26
SaO2: 96%
COHb: 24%
What should the RRT do?
a. place the patient on a NRB mask
b. report the findings and emphasize that the patient is likely a smoker
c. evaluate saturation using a single wave-length spectrophotometer
d. run quality control material and evaluate the accuracy of the co-oximeter - ANSWER-
your answer: D
correct answer: D
In this case the patient is presented as asyptomatic. A patient with a COHb level of 24%
would feel dyspnea and present with tachypnea. Therefore, the RRT should evaluate
the accuracy of the lab results, specifically the COHb. When checking accuracy of lab
results, one would use quality control measures.
,The infection control department of a small hospital informs the RRT supervisor that the
biological control accompanying some durable autoclaved equipment shows viable
spores. The supervisor should do which of the following with the equipment:
a. incinerate
b. record date and place into service
c. wipe with isopropyl alcohol before use
d. resterilize - ANSWER-your answer: D
correct answer: D
The presence of viable spores indicates the possibility of living organisms developing in
the sterilized package or on the sterilized equipment. Sterilization suggest the absence
of living organisms, therefore the presence of viable spores indicates the need to
resterilize.
A post-op patient is not progressing with sustained maximal inspiratory therapy and
refuses to cough because of pain along the incision site. The RRT should instruct the
patient to:
a. pause at the top of each inspiration
b. press a pillow against the incision site when coughing
c. attempt coughing 1 hour after pain medication has been administered
d. avoid coughing until the pain subsides - ANSWER-your answer: B
correct answer: B
Explosive coughing by a post-op patient can inadvertently open incision sites. To
prevent this, splinting the site with a pillow is an appropriate option.
Several hours after oral endotracheal extubation of an 8.0-mm tube, and adult patient
begins to demonstrate inspiratory stridor. Which of the following would be most helpful
to the patient:
a. racemic epinephrine
b. albuterol
c. atropine sulfate
d. heated aerosol by mask - ANSWER-your answer: A
correct answer: A
When a patient is extubated and has swelling of the upper airway tissues as
demonstrated by stridor, racemic epinephrine is an appropriate medication to reduce
swelling quickly. Another, less effective option, is to provide a cool mist. In extreme
cases, such as marked stridor, reintubation, or an emergency tracheotomy may be
indicated.
,An adult patient is receiving mechanical ventilatory support and is being suctioned
through the endotracheal tube at a pressure of -90 mmHg. Secretions have been
difficult to remove. What can be done FIRST to increase suctioning efficiency:
a. increase suction time
b. decrease suction to 80 mmHg
c. increase suction pressure to 100 mmHg
d. increase suction catheter size - ANSWER-your answer: C
Correct answer: C
An increase in suctioning effectiveness is done through three different ways - increasing
suction catheter diameter, increasing suction pressure, and increasing suction time.
Before increasing catheter size, the first thing that should be done is to ensure the
appropriate range of suction pressure is being used. In this case, the appropriate
suction pressure for an adult is 100-120 mmHg. A pressure of 90 mmHg is being used,
which is insufficient suction pressure. This should be corrected before doing anything
else to increase suction effectiveness.
A chemical indicator tape found inside the sealed, packeaged disposable mask helps
determine which of the following:
a. if the equipment is sterile
b. if the equipment has been properly sterilized
c. if microorganisms remain viable on the equipment
d. if the package has remained closed - ANSWER-your answer: A
correct answer: B
A chemical indicator tape inside a sterilized package does not actually indicated the
presence or absence of viable spores. It does, however, indicate if the equipment has
been through the sterilization process.
Following a full cardiopulmonary arrest and successful resuscitation, the patient has
received dopamine to raise blood pressure, The RRT is having difficulty obtaining
arterial blood from the radial artery due to hypotension. From which of the following
sites should the therapist attempt to perform an arterial puncture:
a. pedal artery
b. femoral artery
c. umbilical artery
d. carotid artery - ANSWER-your answer: B
correct answer: B
During CPR, blood pressure exists because of cardiac compressions and is usually low.
Palpation of pulse, therefore, is difficult in the usual locations such as the radial or
brachial arteries. When blood gases are needed during a code with a patient who has
very low blood pressure, the femoral artery is the location of choice.
, While coaching a patient with CF on the use of a PEP therapy device, the patient
suddenly becomes short of breath and cyanotic above the waist. The most appropriate
action is to:
a. schedule a V/Q scan after completion of the Tx
b. discontinue the Tx
c. perform NT suctioning
d. switch to IPV - ANSWER-your answer: D
correct answer: B
This patient is exhibiting an adverse reaction to the therapy. The first reaction of the
therapist should be to stop the therapy and ensure the patient's vital stability.
Subsequently, alternative therapies may be considered to accomplish the same
objective without causing a similar adverse reaction.
The low ventilator alarm is sounding on a 28-year old patient with myasthenia gravis.
The respiratory therapist notes the oral endotracheal tube cuff is failing to hold pressure.
The ET tube is positioned at 22 cm at the teeth. The RRT should:
a. increase the tidal volume
b. decrease the low tidal volume alarm
c. replace the ET tube
d. send to surgery for placement of a tracheostomy - ANSWER-your answer: C
correct answer: C
An ET tube whose cuff is failing to retain air is considered defective and should be
replaced.
The following ECG tracing suddenly presents on a patient in the emergency department
(ED) who was admitted for chest pain. The tracing is confirmed in two leads. The
therapist should immediately:
[asystole tracing]
A. administer Lidocaine
B. defibrillate at 360 joules with synchronization set to OFF
C. administer sublingual nitroglycerin (Isordil)
D. begin chest compressions - ANSWER-Your answer was : D
The correct answer is : D
Explanation :
After confirming this rhythm (asystole) in 2 leads, the primary treatment is chest
compressions.
