RESPIRATORY CARE EXAM REVIEW
QUESTIONS AND ANSWERS
List 5 hazards of aerosol therapy; - ANSWER-Bronchospasm, overhydration,
overheating, tubing condensation, contaminated water
How much of a humidity deficit exists when a patient inspires air holding 30 mg H20/L? -
ANSWER-14 mg/L
A clogged filter or capillary tube on a jet nebulizer has what effect on the operation of
the device? - ANSWER-Decreased water output
List 5 clinical indications for aerosol therapy - ANSWER-Improved secretion
mobilization, increased delivery of aerosolized medication, prevent dehydration, induce
cough, relieve upper airway inflammation, and hydrate airways
How should a patient be instructed to breathe - ANSWER-slow, deep breaths with 2-3
second hold on inspiration
What is the objective of humidity therapy? - ANSWER-make up for water loss that
occurs due to dry gas administration or when upper airway is bypassed
Water capacity at body temperature - ANSWER-44 mg/L
Name 3 factors that affect humidity operation - ANSWER-duration of contact between
gas and water, surface area, and temperature
What dose reaches the lower respiratory tract when given by MDI? - ANSWER-10%
Humidity deficit - ANSWER-inspired air that is not fully saturated at body temperature
Perfusion in the extremities may best be determined by which method? - ANSWER-
Assessing capillary refill
While palpating the chest, the RT determines there are decreased vibrations over RLL.
This may be the result of; - ANSWER-Pneumothorax and effusion
A CXR obtained after intubation shows the tip of the ETT resting at the fourth rib. What
action should be taken? - ANSWER-Tube should be withdrawn 3 cm
A patient is suspected of having intrathoracic metastatic disease. Which imaging study
should the RT recommend to determine whether the disease is present? - ANSWER-
PET
,Which imaging study/studies may be useful in determining whether a pulmonary
embolism is present? - ANSWER-MRI and CT
Which muscles are used for normal ventilation? - ANSWER-External intercostals and
diaphragm
Name two conditions in which hyperresonance percussion is noted - ANSWER-
pneumothorax, emphysema
Name two conditions in which dull percussion is noted - ANSWER-effusion,
consolidation
What does a decrease in Hb, HCT, and RBC indicate? - ANSWER-Inadequate oxygen
carrying capacity
Patients with decreased platelet count and increased PT are at greater risk for what
occurrences? - ANSWER-Hemorrhaging
A patient has just been intubated and the CO2 detector placed on the proximal end of
the ETT reads 1.5%. What should the RT suspect? - ANSWER-The tube is in the
esophagus
McGill forceps are used during what procedure? - ANSWER-Nasotracheal intubation
The physician wants to begin weaning a patient from a tracheostomy tube. How may
this be best accomplished? - ANSWER-Change to a fenestrated trach
You are called to a patient's room because a ventilator alarm is sounding. You hear an
audible leak around the patient's ETT during a ventilator breath and notice the exhaled
volume is reading 150 mL less than the set VT. You check the cuff pressure and find it's
12 mmHg. What is the most appropriate action to take? - ANSWER-While listening with
a stethoscope at the larynx, instill air into the cuff until a slight leak is heard on
inspiration
You want to pass a suction catheter into the patient's left lung to obtain a sputum
specimen. What is the most appropriate method to accomplishing this? - ANSWER-Use
a coude suction catheter
To prevent venous congestion on the tracheal wall, the ETT cuff should be maintained
below what level of pressure? - ANSWER-20 cmH20
Inspiratory stridor is a major clinical sign of what airway condition? - ANSWER-Glottic
edema
List some problems associated with use of oral ETT - ANSWER-
, What is the maximum amount of suction pressure that may be used to suction an adult
patient's airway? - ANSWER--120 cmH20
When extubating a patient, the ETT should be withdrawn at what point in the breathing
cycle? - ANSWER-Peak inspiration
What level must oxygenated Hb decrease by prior to cyanosis occurring? - ANSWER-5
g/dL
abnormal sound heard over the heart, arteries, or veins caused by turbulent blood flow
or obstruction - ANSWER-bruit
Most common position for chest x-ray - ANSWER-Posterior Anterior
Which spinal abnormality can affect the respiratory system? - ANSWER-Kyphoscoliosis
Name some causes of unequal lung expansion - ANSWER-atx, ptx, chest deformities,
and flail chest
What is the main cause of upper airway obstruction? - ANSWER-Tongue
Average distance from teeth to carina - ANSWER-27 cm
Where is the carina seen on CXR - ANSWER-4th rib or 4th thoracic vertebrae
What is the proper catheter size to use when suctioning an 8 mm ETT? - ANSWER-14
Fr
Cuffs should employ what style? - ANSWER-high-volume, low pressure (HVLP)
What increases delivered Vt to a patient taking an IPPB treatment with a Bird Mark 7? -
ANSWER-increase inspiratory pressure and decrease flow rate
During an IPPB treatment, the pt suddenly complains of chest pain and SOB. Upon
assessment, you hear decreased BS on the left. What does this indicate? - ANSWER-
Left sided ptx
What are some of the hazards associated with IPPB therapy? - ANSWER-excessive
ventilation
The RCP has received an order to deliver IPPB to a patient with head trauma. What
modifications would benefit the patient? - ANSWER-use a higher flow rate and lower
peak pressures
QUESTIONS AND ANSWERS
List 5 hazards of aerosol therapy; - ANSWER-Bronchospasm, overhydration,
overheating, tubing condensation, contaminated water
How much of a humidity deficit exists when a patient inspires air holding 30 mg H20/L? -
ANSWER-14 mg/L
A clogged filter or capillary tube on a jet nebulizer has what effect on the operation of
the device? - ANSWER-Decreased water output
List 5 clinical indications for aerosol therapy - ANSWER-Improved secretion
mobilization, increased delivery of aerosolized medication, prevent dehydration, induce
cough, relieve upper airway inflammation, and hydrate airways
How should a patient be instructed to breathe - ANSWER-slow, deep breaths with 2-3
second hold on inspiration
What is the objective of humidity therapy? - ANSWER-make up for water loss that
occurs due to dry gas administration or when upper airway is bypassed
Water capacity at body temperature - ANSWER-44 mg/L
Name 3 factors that affect humidity operation - ANSWER-duration of contact between
gas and water, surface area, and temperature
What dose reaches the lower respiratory tract when given by MDI? - ANSWER-10%
Humidity deficit - ANSWER-inspired air that is not fully saturated at body temperature
Perfusion in the extremities may best be determined by which method? - ANSWER-
Assessing capillary refill
While palpating the chest, the RT determines there are decreased vibrations over RLL.
This may be the result of; - ANSWER-Pneumothorax and effusion
A CXR obtained after intubation shows the tip of the ETT resting at the fourth rib. What
action should be taken? - ANSWER-Tube should be withdrawn 3 cm
A patient is suspected of having intrathoracic metastatic disease. Which imaging study
should the RT recommend to determine whether the disease is present? - ANSWER-
PET
,Which imaging study/studies may be useful in determining whether a pulmonary
embolism is present? - ANSWER-MRI and CT
Which muscles are used for normal ventilation? - ANSWER-External intercostals and
diaphragm
Name two conditions in which hyperresonance percussion is noted - ANSWER-
pneumothorax, emphysema
Name two conditions in which dull percussion is noted - ANSWER-effusion,
consolidation
What does a decrease in Hb, HCT, and RBC indicate? - ANSWER-Inadequate oxygen
carrying capacity
Patients with decreased platelet count and increased PT are at greater risk for what
occurrences? - ANSWER-Hemorrhaging
A patient has just been intubated and the CO2 detector placed on the proximal end of
the ETT reads 1.5%. What should the RT suspect? - ANSWER-The tube is in the
esophagus
McGill forceps are used during what procedure? - ANSWER-Nasotracheal intubation
The physician wants to begin weaning a patient from a tracheostomy tube. How may
this be best accomplished? - ANSWER-Change to a fenestrated trach
You are called to a patient's room because a ventilator alarm is sounding. You hear an
audible leak around the patient's ETT during a ventilator breath and notice the exhaled
volume is reading 150 mL less than the set VT. You check the cuff pressure and find it's
12 mmHg. What is the most appropriate action to take? - ANSWER-While listening with
a stethoscope at the larynx, instill air into the cuff until a slight leak is heard on
inspiration
You want to pass a suction catheter into the patient's left lung to obtain a sputum
specimen. What is the most appropriate method to accomplishing this? - ANSWER-Use
a coude suction catheter
To prevent venous congestion on the tracheal wall, the ETT cuff should be maintained
below what level of pressure? - ANSWER-20 cmH20
Inspiratory stridor is a major clinical sign of what airway condition? - ANSWER-Glottic
edema
List some problems associated with use of oral ETT - ANSWER-
, What is the maximum amount of suction pressure that may be used to suction an adult
patient's airway? - ANSWER--120 cmH20
When extubating a patient, the ETT should be withdrawn at what point in the breathing
cycle? - ANSWER-Peak inspiration
What level must oxygenated Hb decrease by prior to cyanosis occurring? - ANSWER-5
g/dL
abnormal sound heard over the heart, arteries, or veins caused by turbulent blood flow
or obstruction - ANSWER-bruit
Most common position for chest x-ray - ANSWER-Posterior Anterior
Which spinal abnormality can affect the respiratory system? - ANSWER-Kyphoscoliosis
Name some causes of unequal lung expansion - ANSWER-atx, ptx, chest deformities,
and flail chest
What is the main cause of upper airway obstruction? - ANSWER-Tongue
Average distance from teeth to carina - ANSWER-27 cm
Where is the carina seen on CXR - ANSWER-4th rib or 4th thoracic vertebrae
What is the proper catheter size to use when suctioning an 8 mm ETT? - ANSWER-14
Fr
Cuffs should employ what style? - ANSWER-high-volume, low pressure (HVLP)
What increases delivered Vt to a patient taking an IPPB treatment with a Bird Mark 7? -
ANSWER-increase inspiratory pressure and decrease flow rate
During an IPPB treatment, the pt suddenly complains of chest pain and SOB. Upon
assessment, you hear decreased BS on the left. What does this indicate? - ANSWER-
Left sided ptx
What are some of the hazards associated with IPPB therapy? - ANSWER-excessive
ventilation
The RCP has received an order to deliver IPPB to a patient with head trauma. What
modifications would benefit the patient? - ANSWER-use a higher flow rate and lower
peak pressures
