LINDSEY JONES TMC PRACTICE EXAM
QUESTIONS AND ANSWERS (GRADED
A+)
The medication prostacyclin is used for which of the following purposes?
A. decrease pulmonary hypertension
B. bronchodilate large airways
C. decrease systemic vascular resistance (SVR)
D. improve cardiac contractility - ANSWER-A. decrease pulmonary hypertension
The respiratory therapist obtains the following blood gas data on a patient breathing
spontaneously on room air:
pH 7.35 PaCO2 45 torr PaO2 50 torr HCO3- 27 mEq/L BE +2 mEq/L
The therapist could accurately estimate the patient's SaO2 to be which of the following?
A. 75%
B. 80%
C. 85%
D. 90% - ANSWER-B. 80%
A PaO2 of 50 mmHg most closely correlates with an oxygen saturation of about 80% on
the oxygen dissociation curve.
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. document that the education was effective.
B. re-instruct the patient to inhale immediately after actuation of the cannister.
C. instruct the patient to inhale while depressing the cannister.
D. remove the cannister and have the patient reattempt the dose delivery. - ANSWER-
B. 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 12-year-old male patient easily accomplishes the volume on an incentive spirometer
that he was able to reach prior to surgery. The respiratory therapist should
, A. increase the set volume.
B. switch a flow-type spirometer.
C. decrease the frequency of therapy.
D. evaluate the need for continued therapy. - ANSWER-D. evaluate the need for
continued therapy.
Of the options given, evaluating the patient for the need to continue the therapy is most
appropriate.
A respiratory therapist is having difficulty effectively removing secretions through
endotracheal suctioning of a 7-year-old child with cystic fibrosis. The ET tube size is
6.0-mm. The suction pressures is set at 75 mmHg and the suction catheter size is an 8
Fr. The therapist should do which of the following to increase the efficacy of suctioning?
A. increase suction during per pass
B. increase suction pressure to 80 mmHg
C. instill 20 cc of normal saline prior to each suction attempt
D. increase catheter size to 10 Fr - ANSWER-B. increase suction pressure to 80 mmHg
There are three ways to increase suction efficiency. In order: 1) increase suction
catheter size 2) increase suction pressure 3) increase suction time. However, prior to
any of these three one must first ensure adequate minimal pressure for the patient's age
is being used. This is a pediatric patient and suction pressure range should be between
80 and 100 mmHg. However, the suction pressure is only set at 75 mmHg. So, this
should be corrected first before considering any other action to improve suction
efficiency.
The physician has asked the respiratory therapist to help determine oxygen
consumption by the tissues. The therapist should suggest evaluation of which of the
following?
A. CaO2
B. CvO2
C. PaO2
D. C(a-v)O2 - ANSWER-D. C(a-v)O2
Oxygen available at the tissue level is best determined by examining the arterial oxygen
content or CaO2. However, to determine how much oxygen the tissue is consuming we
must look at both the CaO2 and the CVO2. This allows us to determine how much
oxygen existed before the tissues and how much oxygen exists after the tissues. When
we subtract one from the other we get the C(a-v)O2. This value is most closely related
with oxygen consumption at the tissue level.
In response to an Asthma action plan, the patient has attempted to contact their
physician after determining peak flow measurement is less than 50% of the patient's
, usual baseline value. The physician is not responding to the call. According to NAEP
guidelines, the patient should NEXT
A. take a short-term bronchodilator, check peak flow in 1 hour
B. take a corticosteroid inhaler and check again in 20 minutes
C. take a short-term bronchodilator and contact a different physician
D. report to the hospital or call an ambulance - ANSWER-D. report to the hospital or
call an ambulance
According the national asthma guidelines, a self monitored peak flow of 50% of baseline
is an indication to contact one's physician. However, if one's physician is not available,
the patient should report to the hospital or to the emergency room or call an ambulance.
A patient is orally intubated with a 7.0-mm ET tube. Immediately following the
procedure, the respiratory therapist will FIRST do which of the following to check for
proper positioning of the airway?
A. observe the color of the CO2 detector
B. obtain a chest radiograph
C. auscultate breath sounds
D. palpate the trachea - ANSWER-A. observe the color of the CO2 detector
When asked in a question what to do first in any given situation, the most likely answer
is that which is quickest. In this case a patient has just been inutbated and the therapist
is asked to determine if the tube is in the proper position. Palpating the trachea will not
be helpful but the other three options are all legitimate ways to ensure proper
positioning of the ET tube. But, the quickest way is to do something visual. In this case,
simply observing the color of the CO2 detector is quickest. The next best option is to
auscultate breath sounds. This is also very quick but takes a little longer than a simple
visual assessment. Finally, the next best answer is to obtain a chest radiograph. This
will provide conclusive evidence, but it is time-consuming and is not the best option
when trying to determine the position of the tube quickly.
Which of the following indicate a patient is ready to wean from mechanical ventilation?
A. A-aDO2 of 380 mmHg
B. RSBI 138
C. MIP of -12 cmH2O
D. VT of 6 mL/kg - ANSWER-D. VT of 6 mL/kg
In order to wean from the ventilator the MIP must be more than -28 cmH2O. Tidal
volume must be at least 5 mL per kilogram and RSBI must be less than 106. The
alveoli-arterial oxygen difference (A-a gradient) must be less than 300 mmHg. In this
case only the tidal volume of 6 mL per kilogram and the RSBI of 90 indicate the patient
is ready to wean from mechanical ventilatory support.
QUESTIONS AND ANSWERS (GRADED
A+)
The medication prostacyclin is used for which of the following purposes?
A. decrease pulmonary hypertension
B. bronchodilate large airways
C. decrease systemic vascular resistance (SVR)
D. improve cardiac contractility - ANSWER-A. decrease pulmonary hypertension
The respiratory therapist obtains the following blood gas data on a patient breathing
spontaneously on room air:
pH 7.35 PaCO2 45 torr PaO2 50 torr HCO3- 27 mEq/L BE +2 mEq/L
The therapist could accurately estimate the patient's SaO2 to be which of the following?
A. 75%
B. 80%
C. 85%
D. 90% - ANSWER-B. 80%
A PaO2 of 50 mmHg most closely correlates with an oxygen saturation of about 80% on
the oxygen dissociation curve.
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. document that the education was effective.
B. re-instruct the patient to inhale immediately after actuation of the cannister.
C. instruct the patient to inhale while depressing the cannister.
D. remove the cannister and have the patient reattempt the dose delivery. - ANSWER-
B. 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 12-year-old male patient easily accomplishes the volume on an incentive spirometer
that he was able to reach prior to surgery. The respiratory therapist should
, A. increase the set volume.
B. switch a flow-type spirometer.
C. decrease the frequency of therapy.
D. evaluate the need for continued therapy. - ANSWER-D. evaluate the need for
continued therapy.
Of the options given, evaluating the patient for the need to continue the therapy is most
appropriate.
A respiratory therapist is having difficulty effectively removing secretions through
endotracheal suctioning of a 7-year-old child with cystic fibrosis. The ET tube size is
6.0-mm. The suction pressures is set at 75 mmHg and the suction catheter size is an 8
Fr. The therapist should do which of the following to increase the efficacy of suctioning?
A. increase suction during per pass
B. increase suction pressure to 80 mmHg
C. instill 20 cc of normal saline prior to each suction attempt
D. increase catheter size to 10 Fr - ANSWER-B. increase suction pressure to 80 mmHg
There are three ways to increase suction efficiency. In order: 1) increase suction
catheter size 2) increase suction pressure 3) increase suction time. However, prior to
any of these three one must first ensure adequate minimal pressure for the patient's age
is being used. This is a pediatric patient and suction pressure range should be between
80 and 100 mmHg. However, the suction pressure is only set at 75 mmHg. So, this
should be corrected first before considering any other action to improve suction
efficiency.
The physician has asked the respiratory therapist to help determine oxygen
consumption by the tissues. The therapist should suggest evaluation of which of the
following?
A. CaO2
B. CvO2
C. PaO2
D. C(a-v)O2 - ANSWER-D. C(a-v)O2
Oxygen available at the tissue level is best determined by examining the arterial oxygen
content or CaO2. However, to determine how much oxygen the tissue is consuming we
must look at both the CaO2 and the CVO2. This allows us to determine how much
oxygen existed before the tissues and how much oxygen exists after the tissues. When
we subtract one from the other we get the C(a-v)O2. This value is most closely related
with oxygen consumption at the tissue level.
In response to an Asthma action plan, the patient has attempted to contact their
physician after determining peak flow measurement is less than 50% of the patient's
, usual baseline value. The physician is not responding to the call. According to NAEP
guidelines, the patient should NEXT
A. take a short-term bronchodilator, check peak flow in 1 hour
B. take a corticosteroid inhaler and check again in 20 minutes
C. take a short-term bronchodilator and contact a different physician
D. report to the hospital or call an ambulance - ANSWER-D. report to the hospital or
call an ambulance
According the national asthma guidelines, a self monitored peak flow of 50% of baseline
is an indication to contact one's physician. However, if one's physician is not available,
the patient should report to the hospital or to the emergency room or call an ambulance.
A patient is orally intubated with a 7.0-mm ET tube. Immediately following the
procedure, the respiratory therapist will FIRST do which of the following to check for
proper positioning of the airway?
A. observe the color of the CO2 detector
B. obtain a chest radiograph
C. auscultate breath sounds
D. palpate the trachea - ANSWER-A. observe the color of the CO2 detector
When asked in a question what to do first in any given situation, the most likely answer
is that which is quickest. In this case a patient has just been inutbated and the therapist
is asked to determine if the tube is in the proper position. Palpating the trachea will not
be helpful but the other three options are all legitimate ways to ensure proper
positioning of the ET tube. But, the quickest way is to do something visual. In this case,
simply observing the color of the CO2 detector is quickest. The next best option is to
auscultate breath sounds. This is also very quick but takes a little longer than a simple
visual assessment. Finally, the next best answer is to obtain a chest radiograph. This
will provide conclusive evidence, but it is time-consuming and is not the best option
when trying to determine the position of the tube quickly.
Which of the following indicate a patient is ready to wean from mechanical ventilation?
A. A-aDO2 of 380 mmHg
B. RSBI 138
C. MIP of -12 cmH2O
D. VT of 6 mL/kg - ANSWER-D. VT of 6 mL/kg
In order to wean from the ventilator the MIP must be more than -28 cmH2O. Tidal
volume must be at least 5 mL per kilogram and RSBI must be less than 106. The
alveoli-arterial oxygen difference (A-a gradient) must be less than 300 mmHg. In this
case only the tidal volume of 6 mL per kilogram and the RSBI of 90 indicate the patient
is ready to wean from mechanical ventilatory support.
