LINDSEY JONES EXAM QUESTIONS
AND ANSWERS (GRADED A)
Which is the preferred order to manipulate a mechanical ventilator in order to gradually
increase alveolar minute ventilation while limiting MAP? - ANSWER-Decrease
mechanical deadspace, increase VT, increase RR
Which of the following is an important considerations when preparing a patient to
receive continuous mechanical ventilatory support at home, 24 hours a day, seven days
a week? - ANSWER-Back-up ventilator in the home
The emergency room physician orders the administration of 80% / 20% heliox gas
mixture for a patient who has persistent upper airway inflammation and stridor. Which of
the following equipment is important for this therapy? - ANSWER-Nonrebreathing mask
What would most likely be indicated by an elevated CVP? - ANSWER-Fluid overload
During the education of a patient on the proper use of a metered-dose inhaler (MDI) and
a spacer, the therapist hears a whistling sound as the patient inhales deeply from the
spacer. The therapist should - ANSWER-Instruct the patient to inhale more slowly
An air-entrainment jet nebulizer is set at 50%. The respiratory therapist analyzes the
oxygen coming from the end of the tubing and finds it is 60%. Which of the following
most likely explains this finding? - ANSWER-Excess water in the tubing
Which APGAR score necessitates the delivery of basic and/or advanced cardiac life
support for a newborn? - ANSWER-2
Blood gas results for a patient receiving mechanical ventilation with an FIO2 0.60 and
PEEP of 5 cm H2O are as follows:
pH 7.41
PaCO2 40 torr
PaO2 62 torr
HCO3- 22 mEq/L
BE -2 mEq/L
The respiratory therapist should recommend - ANSWER-An increase in PEEP
A respiratory therapist is participating on a Medical Emergency Response Team with a
patient who is exhibiting severe hypoxemia. The patient has a DNI advanced directive.
To maximize arterial oxygenation, the therapist should - ANSWER-Utilize a
nonrebreather mask with the flow on flush
,Which of the following should the respiratory therapist do or observe to rapidly estimate
the adequacy of oxygenation? - ANSWER-Color
The respiratory therapist notices short, puffs of aerosol coming from an aerosol mask on
a patient receiving humidity therapy with an ultrasonic nebulizer. The therapist should
correct the problem by - ANSWER-Emptying water from the corrugated aerosol tubing
A 48-year-old patient has just been orally intubated prior to being placed on volume-
controlled ventilation. The respiratory therapist should do which of the following to best
confirm proper placement of the endotracheal tube? - ANSWER-Obtain a chest
radiograph
Which of following calculations will determine FRC? - ANSWER-TLC - VC + ERV
In preparation for pulmonary function testing, the respiratory therapist interviews the
patient to investigate use of tobacco products. The patient reports smoking 5 packs a
day for 10 years and 1.5 packs a day for 20 years. What is the pack-year history of
smoking for this patient? - ANSWER-80
A patient with COPD is receiving mechanical ventilation on the following settings:
Mode Assist/control
Mandatory rate 12
VT 450 mL
FIO2 0.40
PEEP 5 cm H2O
Total rate 14
I:E 1:1.8
The physician is concerned about air trapping and development of auto PEEP. The
therapist should recommend which of the following? - ANSWER-Increase inspiratory
flow
A normally health track runner is hospitalized with right side pneumonia. The patient has
chills and a temperature of 38.9 deg C (102 deg F). Which of the following will mostly
likely provide sufficient aid to the patient? - ANSWER-Coached coughing and deep
breathing exercises
Which of the following can safely be combined with inhaled albuterol? - ANSWER-
Ipratropium Bromide
A tracheostomy tube is changed on a patient who has been receiving continuous
mechanical ventilation for the last several weeks. Within moments after intubation, the
respiratory therapist observes the patient is suddenly agitated and SPO2 is 88% and
dropping. This clinical change is most likely caused by - ANSWER-Malpositioning of the
tracheostomy tube
,A patient with asbestosis has a PaO2 of 48 torr after being on a nasal cannula at 6
L/min for 1 hour. The respiratory therapist should recommend - ANSWER-A
nonrebreathing mask
A 75-kg (166-lb), 173-cm (5-ft, 8-in) patient is receiving PC, SIMV ventilation on the
following settings:
FIO2 0.50
Mandatory rate 16/min
Exhaled VT 780 mL
IP 32 cm H2O
PEEP 5 cm H2O
I:E ratio 1:1.9
ABGs are as follows:
pH 7.51
PaCO2 30 torr
PaO2 109 torr
HCO3- 25 mEq/L
BE 5 mEq/L
The respiratory therapist should - ANSWER-Decrease set inspiratory pressure.
In spite of repeated attempts, the respiratory therapist has been unable to retrieve a
non-contaminated sputum sample through deep suctioning and normal expectoration.
Which of the following could be recommended to obtain a better sputum specimen for
laboratory analysis? - ANSWER-BAL
A morbidly obese female patient with a large neck circumference is trached with a 7.5
mm tracheostomy tube. The tube frequently becomes dislodged with her cough. What
should be done to resolve the problem? - ANSWER-Replace the tube with a longer
tube.
A patient with cystic fibrosis is receiving VC, SIMV ventilation. The respiratory therapist
notices secretions have become thick and tenacious over the last 24 hours. Which of
the following would be most helpful in addressing the thickness of secretions? -
ANSWER-Heated humidity
, Immediately after insertion of a nasopharyngeal airway the patient begins to cough
violently and does not stop. The respiratory therapist should - ANSWER-Obtain and
insert a shorter airway
After running a blood gas, the respiratory therapist has concerns about the accuracy of
the reportable physiological range of the PO2 electrode in the blood gas machine. The
therapist should - ANSWER-Replace the PO2 electrode
A patient is expectorating pink frothy secretions as a result of exacerbation of
congestive heart failure. An ECG cannot be obtained due to marked diaphoresis. Non-
invasive ventilation is applied by full-face mask. What additional therapy would likely
provide relief from the patient's current condition? - ANSWER-Furosemide (Lasix)
A patient in the emergency room expectorates thick, yellow sputum. A CBC shows the
following:
RBC 6.0 mill/cu mm
Hb 17 g/dL
HCT 64 %
WBC 22,000 cu mm
The patient could benefit most from which of the following? - ANSWER-Sputum culture
and sensitivity
A patient with lower lobe pneumonia and consolidation of infiltrates in the right lower
lobes is receiving postural drainage and percussion when the patient vomits and
obviously aspirates. The respiratory therapist's first action should be to - ANSWER-
Suction the patient's airway
Administration of a 60/40% helium-oxygen mixture requires which of the following
masks? - ANSWER-Nonrebreather
A 52-year old male presents in the emergency department with the following arterial
blood gas results while receiving supplemental oxygen at FIO2 0.5 via an air-
entrainment oxygen device.
pH 7.49
PaCO2 30 torr
PaO2 100 torr
HCO3 - 22 mEq/L
BE -2 mEq/L
The respiratory therapist should conclude which of the following regarding the patient's
condition? - ANSWER-Ventilation/perfusion mismatch
AND ANSWERS (GRADED A)
Which is the preferred order to manipulate a mechanical ventilator in order to gradually
increase alveolar minute ventilation while limiting MAP? - ANSWER-Decrease
mechanical deadspace, increase VT, increase RR
Which of the following is an important considerations when preparing a patient to
receive continuous mechanical ventilatory support at home, 24 hours a day, seven days
a week? - ANSWER-Back-up ventilator in the home
The emergency room physician orders the administration of 80% / 20% heliox gas
mixture for a patient who has persistent upper airway inflammation and stridor. Which of
the following equipment is important for this therapy? - ANSWER-Nonrebreathing mask
What would most likely be indicated by an elevated CVP? - ANSWER-Fluid overload
During the education of a patient on the proper use of a metered-dose inhaler (MDI) and
a spacer, the therapist hears a whistling sound as the patient inhales deeply from the
spacer. The therapist should - ANSWER-Instruct the patient to inhale more slowly
An air-entrainment jet nebulizer is set at 50%. The respiratory therapist analyzes the
oxygen coming from the end of the tubing and finds it is 60%. Which of the following
most likely explains this finding? - ANSWER-Excess water in the tubing
Which APGAR score necessitates the delivery of basic and/or advanced cardiac life
support for a newborn? - ANSWER-2
Blood gas results for a patient receiving mechanical ventilation with an FIO2 0.60 and
PEEP of 5 cm H2O are as follows:
pH 7.41
PaCO2 40 torr
PaO2 62 torr
HCO3- 22 mEq/L
BE -2 mEq/L
The respiratory therapist should recommend - ANSWER-An increase in PEEP
A respiratory therapist is participating on a Medical Emergency Response Team with a
patient who is exhibiting severe hypoxemia. The patient has a DNI advanced directive.
To maximize arterial oxygenation, the therapist should - ANSWER-Utilize a
nonrebreather mask with the flow on flush
,Which of the following should the respiratory therapist do or observe to rapidly estimate
the adequacy of oxygenation? - ANSWER-Color
The respiratory therapist notices short, puffs of aerosol coming from an aerosol mask on
a patient receiving humidity therapy with an ultrasonic nebulizer. The therapist should
correct the problem by - ANSWER-Emptying water from the corrugated aerosol tubing
A 48-year-old patient has just been orally intubated prior to being placed on volume-
controlled ventilation. The respiratory therapist should do which of the following to best
confirm proper placement of the endotracheal tube? - ANSWER-Obtain a chest
radiograph
Which of following calculations will determine FRC? - ANSWER-TLC - VC + ERV
In preparation for pulmonary function testing, the respiratory therapist interviews the
patient to investigate use of tobacco products. The patient reports smoking 5 packs a
day for 10 years and 1.5 packs a day for 20 years. What is the pack-year history of
smoking for this patient? - ANSWER-80
A patient with COPD is receiving mechanical ventilation on the following settings:
Mode Assist/control
Mandatory rate 12
VT 450 mL
FIO2 0.40
PEEP 5 cm H2O
Total rate 14
I:E 1:1.8
The physician is concerned about air trapping and development of auto PEEP. The
therapist should recommend which of the following? - ANSWER-Increase inspiratory
flow
A normally health track runner is hospitalized with right side pneumonia. The patient has
chills and a temperature of 38.9 deg C (102 deg F). Which of the following will mostly
likely provide sufficient aid to the patient? - ANSWER-Coached coughing and deep
breathing exercises
Which of the following can safely be combined with inhaled albuterol? - ANSWER-
Ipratropium Bromide
A tracheostomy tube is changed on a patient who has been receiving continuous
mechanical ventilation for the last several weeks. Within moments after intubation, the
respiratory therapist observes the patient is suddenly agitated and SPO2 is 88% and
dropping. This clinical change is most likely caused by - ANSWER-Malpositioning of the
tracheostomy tube
,A patient with asbestosis has a PaO2 of 48 torr after being on a nasal cannula at 6
L/min for 1 hour. The respiratory therapist should recommend - ANSWER-A
nonrebreathing mask
A 75-kg (166-lb), 173-cm (5-ft, 8-in) patient is receiving PC, SIMV ventilation on the
following settings:
FIO2 0.50
Mandatory rate 16/min
Exhaled VT 780 mL
IP 32 cm H2O
PEEP 5 cm H2O
I:E ratio 1:1.9
ABGs are as follows:
pH 7.51
PaCO2 30 torr
PaO2 109 torr
HCO3- 25 mEq/L
BE 5 mEq/L
The respiratory therapist should - ANSWER-Decrease set inspiratory pressure.
In spite of repeated attempts, the respiratory therapist has been unable to retrieve a
non-contaminated sputum sample through deep suctioning and normal expectoration.
Which of the following could be recommended to obtain a better sputum specimen for
laboratory analysis? - ANSWER-BAL
A morbidly obese female patient with a large neck circumference is trached with a 7.5
mm tracheostomy tube. The tube frequently becomes dislodged with her cough. What
should be done to resolve the problem? - ANSWER-Replace the tube with a longer
tube.
A patient with cystic fibrosis is receiving VC, SIMV ventilation. The respiratory therapist
notices secretions have become thick and tenacious over the last 24 hours. Which of
the following would be most helpful in addressing the thickness of secretions? -
ANSWER-Heated humidity
, Immediately after insertion of a nasopharyngeal airway the patient begins to cough
violently and does not stop. The respiratory therapist should - ANSWER-Obtain and
insert a shorter airway
After running a blood gas, the respiratory therapist has concerns about the accuracy of
the reportable physiological range of the PO2 electrode in the blood gas machine. The
therapist should - ANSWER-Replace the PO2 electrode
A patient is expectorating pink frothy secretions as a result of exacerbation of
congestive heart failure. An ECG cannot be obtained due to marked diaphoresis. Non-
invasive ventilation is applied by full-face mask. What additional therapy would likely
provide relief from the patient's current condition? - ANSWER-Furosemide (Lasix)
A patient in the emergency room expectorates thick, yellow sputum. A CBC shows the
following:
RBC 6.0 mill/cu mm
Hb 17 g/dL
HCT 64 %
WBC 22,000 cu mm
The patient could benefit most from which of the following? - ANSWER-Sputum culture
and sensitivity
A patient with lower lobe pneumonia and consolidation of infiltrates in the right lower
lobes is receiving postural drainage and percussion when the patient vomits and
obviously aspirates. The respiratory therapist's first action should be to - ANSWER-
Suction the patient's airway
Administration of a 60/40% helium-oxygen mixture requires which of the following
masks? - ANSWER-Nonrebreather
A 52-year old male presents in the emergency department with the following arterial
blood gas results while receiving supplemental oxygen at FIO2 0.5 via an air-
entrainment oxygen device.
pH 7.49
PaCO2 30 torr
PaO2 100 torr
HCO3 - 22 mEq/L
BE -2 mEq/L
The respiratory therapist should conclude which of the following regarding the patient's
condition? - ANSWER-Ventilation/perfusion mismatch
