RRT KETTERING WEBSITE PATIENT
ASSESSMENT EXAM QUESTIONS AND
ANSWERS
What is the normal range for mean pulmonary artery pressure in an adult?
A. 2-6 mm Hg
B. 4-12 mm Hg
C. 9-18 mm Hg
D. 21-28 mm Hg - ANSWER-c
Mean is average, normal should be in the teens so 13 - 14. A & B are below 13 and D is
too high so the best answer is C 9 - 18
While evaluating the A-P chest radiograph of a patient admitted to the Emergency
Department with dyspnea, the respiratory therapist notes the presence of considerable
cardiomegaly. This finding is most often associated with
A. cardiogenic shock.
B. myocardial infarction.
C. pericardial effusion.
D. pulmonary embolism. - ANSWER-c
Cardiomegaly means an enlarged heart. Pericardial effusion means there is fluid
accumulating inside the pericardial sack. It's a sack that surrounds the heart and
effusion is the movement of fluid into a location where it shouldn't be. This will expand
the heart shadow and make it look enlarged.
A patient in the intensive care unit has the following hemodynamic measurements:
CVP: 4 mm Hg
PAP: 48/16 mm Hg
PCWP: 8 mm Hg
MAP: 92 mm Hg
Cardiac Output: 5 L/min.
Cardiac Index: 2.5 L/min/m2
The respiratory therapist should recommend the administration of
A. bumex.
B. dopamine.
C. lidocaine.
D. oxygen. - ANSWER-d
,CVP 2 - 6 mmHg
PAP 25/8
PCWP 4 -12
MAP 93 - 94
CO 4 -8
CI 2.5 - 4
Looking at this shows that PAP is elevated, and the best answer is to give oxygen. This
pt has a lung disease and giving oxygen will help make pressures go down.
A patient in the emergency department has frothy secretions, moist crackles, and
tachypnea. The patient has marked dyspnea and a history of heart disease. Which of
the following should the respiratory therapist recommend?
1. Suction immediately
2. Administer 100% oxygen
3. Place in Fowlers position
4. Administer furosemide
A. 1, 2 & 3 only
B. 1, 3 & 4 only
C. 1, 2 & 4 only
D. 2, 3, & 4 only - ANSWER-d
This pt has very severe pulmonary edema, pt has marked dyspnea so place the patient
in Fowler's position, give O2 then administer meds furosemide to help with the
secretions. This is an emergency and even though suctioning will help but it isn't the
best answer because doing so will delay therapy.
Fine crepitant crackles are most commonly associated with which of the following
conditions?
A. Bronchiectasis
B. Congestive heart failure
C. Pneumonia
D. Croup - ANSWER-b
Fine crackles (moist crepitant rales) = alveoli, fluid.
Associated w/ CHF & pulmonary edema
A patient is found in full cardiopulmonary arrest. CPR is started and the patient is orally
intubated with an ETCO2 monitor attached. Which of the following ETCO2 patterns
would the respiratory therapist expect to observe on the monitor?
A. Initially high, then falling
, B. Initially low, then rising
C. Initially high, stays high
D. Initially low, stays low - ANSWER-b
Since you have a pt with cardiopulmonary arrest the C02 in the lungs will defuse outside
the lungs which will give you a low reading in the beginning. Once you start CPR it will
bring C02 into the lungs and it will rise. You can tell if CPR is working when the C02
rises.
The blood pressure obtained from the arterial line is higher than the blood pressure
obtained from a sphygmomanometer. Based upon this information, the respiratory
therapist should conclude that
A. non-compliant tubing is being used.
B. the transducer is placed too low.
C. the patient was lying flat during the measurement of the arterial line pressure.
D. the transducer dome contained air bubbles. - ANSWER-b
The transducer is placed below the heart, it gives a higher reading giving it more
pressure. Aline is reading higher, so gravity is pulling down which means the transducer
is too low.
A 2-year-old child enters the emergency room. The mother states that the child was
playing with friends and developed violent coughing and unilateral wheezing. Physical
examination reveals a hyper-resonant percussion note on the left and resonant
percussion note on the right. Inspiratory and expiratory chest films indicate air trapping
with no foreign bodies noted. The respiratory therapist should suspect that the child has
A. a pneumothorax.
B. orthopnea.
C. aspirated a foreign object.
D. tachyphylaxis. - ANSWER-c
This child was playing with friends and has unilateral wheezes, you should already
associate that with a foreign body object. Chest x-ray might not pick up the foreign
object because it depends on what it is made out of but just not unilateral wheezes
equal foreign object.
A patient is admitted to the ICU complaining of nausea and chest pain. A nasogastric
tube has been inserted to help relieve the nausea. The patient was started on lasix and
nitroglycerin. Which of the following should the respiratory therapist monitor closely to
identify side effects at this time?
A. Cardiac enzymes
B. Serum electrolytes
C. Arterial blood gases
ASSESSMENT EXAM QUESTIONS AND
ANSWERS
What is the normal range for mean pulmonary artery pressure in an adult?
A. 2-6 mm Hg
B. 4-12 mm Hg
C. 9-18 mm Hg
D. 21-28 mm Hg - ANSWER-c
Mean is average, normal should be in the teens so 13 - 14. A & B are below 13 and D is
too high so the best answer is C 9 - 18
While evaluating the A-P chest radiograph of a patient admitted to the Emergency
Department with dyspnea, the respiratory therapist notes the presence of considerable
cardiomegaly. This finding is most often associated with
A. cardiogenic shock.
B. myocardial infarction.
C. pericardial effusion.
D. pulmonary embolism. - ANSWER-c
Cardiomegaly means an enlarged heart. Pericardial effusion means there is fluid
accumulating inside the pericardial sack. It's a sack that surrounds the heart and
effusion is the movement of fluid into a location where it shouldn't be. This will expand
the heart shadow and make it look enlarged.
A patient in the intensive care unit has the following hemodynamic measurements:
CVP: 4 mm Hg
PAP: 48/16 mm Hg
PCWP: 8 mm Hg
MAP: 92 mm Hg
Cardiac Output: 5 L/min.
Cardiac Index: 2.5 L/min/m2
The respiratory therapist should recommend the administration of
A. bumex.
B. dopamine.
C. lidocaine.
D. oxygen. - ANSWER-d
,CVP 2 - 6 mmHg
PAP 25/8
PCWP 4 -12
MAP 93 - 94
CO 4 -8
CI 2.5 - 4
Looking at this shows that PAP is elevated, and the best answer is to give oxygen. This
pt has a lung disease and giving oxygen will help make pressures go down.
A patient in the emergency department has frothy secretions, moist crackles, and
tachypnea. The patient has marked dyspnea and a history of heart disease. Which of
the following should the respiratory therapist recommend?
1. Suction immediately
2. Administer 100% oxygen
3. Place in Fowlers position
4. Administer furosemide
A. 1, 2 & 3 only
B. 1, 3 & 4 only
C. 1, 2 & 4 only
D. 2, 3, & 4 only - ANSWER-d
This pt has very severe pulmonary edema, pt has marked dyspnea so place the patient
in Fowler's position, give O2 then administer meds furosemide to help with the
secretions. This is an emergency and even though suctioning will help but it isn't the
best answer because doing so will delay therapy.
Fine crepitant crackles are most commonly associated with which of the following
conditions?
A. Bronchiectasis
B. Congestive heart failure
C. Pneumonia
D. Croup - ANSWER-b
Fine crackles (moist crepitant rales) = alveoli, fluid.
Associated w/ CHF & pulmonary edema
A patient is found in full cardiopulmonary arrest. CPR is started and the patient is orally
intubated with an ETCO2 monitor attached. Which of the following ETCO2 patterns
would the respiratory therapist expect to observe on the monitor?
A. Initially high, then falling
, B. Initially low, then rising
C. Initially high, stays high
D. Initially low, stays low - ANSWER-b
Since you have a pt with cardiopulmonary arrest the C02 in the lungs will defuse outside
the lungs which will give you a low reading in the beginning. Once you start CPR it will
bring C02 into the lungs and it will rise. You can tell if CPR is working when the C02
rises.
The blood pressure obtained from the arterial line is higher than the blood pressure
obtained from a sphygmomanometer. Based upon this information, the respiratory
therapist should conclude that
A. non-compliant tubing is being used.
B. the transducer is placed too low.
C. the patient was lying flat during the measurement of the arterial line pressure.
D. the transducer dome contained air bubbles. - ANSWER-b
The transducer is placed below the heart, it gives a higher reading giving it more
pressure. Aline is reading higher, so gravity is pulling down which means the transducer
is too low.
A 2-year-old child enters the emergency room. The mother states that the child was
playing with friends and developed violent coughing and unilateral wheezing. Physical
examination reveals a hyper-resonant percussion note on the left and resonant
percussion note on the right. Inspiratory and expiratory chest films indicate air trapping
with no foreign bodies noted. The respiratory therapist should suspect that the child has
A. a pneumothorax.
B. orthopnea.
C. aspirated a foreign object.
D. tachyphylaxis. - ANSWER-c
This child was playing with friends and has unilateral wheezes, you should already
associate that with a foreign body object. Chest x-ray might not pick up the foreign
object because it depends on what it is made out of but just not unilateral wheezes
equal foreign object.
A patient is admitted to the ICU complaining of nausea and chest pain. A nasogastric
tube has been inserted to help relieve the nausea. The patient was started on lasix and
nitroglycerin. Which of the following should the respiratory therapist monitor closely to
identify side effects at this time?
A. Cardiac enzymes
B. Serum electrolytes
C. Arterial blood gases
