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Change to airway pressure release ventilation - ANSWER-
A 60 kg (132 lb) patient is being mechanically ventilated with the following se
ttings: VC, A/C; VT 500 mL, respiratory rate 12/min, FIO2 1.0 and 10 cm H2
O PEEP. The patient's peak airway pressure is 60 cm H2O and his SpO2 is
85%. A current chest x-
ray shows diffuse bilateral infiltrates. Which of the following is the most appr
opriate action in order to reduce peak airway pressure?
2, 3 & 4 - ANSWER-
While performing diagnostic chest percussion, the respiratory therapist no
tes decreased resonance to percussion. Which of the following are potenti
al causes of this finding?.
1. pneumothorax
2. pleural effusion
3. pneumonia
4. atelectasis
Persistent bronchopleural fistula - ANSWER-A post-
operative patient on volume-
control ventilation has a chest tube in the left pleural space. While inspecti
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ng the chest drainage system, the respiratory therapist notes
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bubbling in the water seal chamber during the inspiratory phase. The thera
pist should report this to the physician:
Increase the FiO2 - ANSWER-A post-K
operative patient is receiving mechanical ventilation in the ICU at the followi
ng settings: VC, A/C; VT550 mL, respiratory rate 14/min, FIO2 0.50 and 10 c
m H2O PEEP. Bedside monitoring results demonstrate that the PvO2 is 33
mm Hg and the SpO2 is 90%. The patient is alert and oriented with stable vit
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al signs. Which of the following should the respiratory therapist recommend?
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1, 2 & 3 - ANSWER-
After assisting with bronchoalveolar lavage and lung biopsy on a mechanical
ly ventilated patient, the respiratory therapist notes the activation of a high pr
essure alarm. Peak inspiratory pressure has increased from 32 cm H2O bef
ore the procedure to 45 cm H2O after the procedure. Possible causes for th
e increased pressure include
1. bronchospasm
2. pneumothorax.
3. pulmonary hemorrhage.
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Endobronchial intubation - ANSWER-Following blunt chest trauma, a 35-
year-
old male is orally intubated and continuous mechanical ventilation is initiat
ed. Physical assessment of the neck and chest reveal a midline trachea a
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nd significant reduction in thoracic expansion of the left chest.
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There are diminished breath sounds in the left lung compared to the right l
ung. These findings most likely indicate which of the following?
Tube is not of the appropriate size - ANSWER-A 42 year-
old trauma patient in the ED has been intubated with a 6.5 mm oral endotrac
heal tube equipped with a high-residual-volume, low-
pressure cuff. The respiratory therapist notes that a cuff pressure of 42 cm H
2O is necessary to achieve a minimal occluding volume. This would indicate
that the:
Recalibrate the blood analyzer - ANSWER-
A new blood gas analyzer is calibrated by the manufacturer at sea level. U
pon receiving the new analyzer at a higher altitude, a respiratory therapist K
should:
Mean Airway Pressure - ANSWER-
While receiving an FIO2 of 1.0 and a tidal volume of 400 mL during volume-
controlled ventilation, a 60-kg (132-
lb) patient is having difficulty achieving adequate oxygenation. To improve
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oxygenation, a respiratory therapist should manipulate ventilator settings to i
ncrease which of the following?
Increase the IPAP - ANSWER-
A patient is receiving noninvasive positive pressure ventilation. Pulmonary c
ompliance has decreased over the past 4 hours. To increase the patient's tid
al volume, it would be most appropriate to:
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Fifth intercostal space in mid-axillary line - ANSWER-
A respiratory therapist is reviewing a chest radiograph and notes the presen
ce of a chest tube.
The patient has a hemothorax. Which of the following locations is most app
ropriate for this chest tube to be placed?
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Administering ipratropium bromide (atrovent) - ANSWER-
A patient with COPD is receiving mechanical ventilation. The patient continu
es to wheeze despite treatment with albuterol. Peak airway pressure is incre
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ased with no change in plateau pressure. A respiratory therapist should reco
mmend:
MIP - ANSWER-
Which of the following should be used to determine the return of a postope
rative patient's ability to breathe adequately after anesthesia?