CORRECT SOLUTIONS
A patient with a confirmed pulmonary embolism is receiving oxygen by non-rebreathing
mask. When oxygen therapy was initiated, the reservoir completely with each breath.
Thirty minutes later the reservoir bag collapses only partially with each breath.
Respiratory rate has fallen from 28/min to 10/min. The therapist should respond by
A. continuing current therapy
B. assisting ventilation with a manual resuscitator
C. increasing flow to the NRB mask
D. beginning mechanical ventilation - ANSWER-A. continuing current therapy
When the reservoir on a non-rereading mask collapses completely, one must suspect
that the inspiratory flow the patient is producing is exceeding the total flow to the patient
from the flow meter. The solution to this is to increase the flow. However, in this case
after a few moments, the bag begins to collapse only partially which is normal. This
indicates that the patient has become less distressed and that the oxygen therapy has
been effective. Continuing current therapy is most appropriate.
An ECG is performed on a patient in the emergency room who is admitted for sharp
abdominal pain. The respiratory therapist notices pronounced Q waves on the ECG
tracing. This finding is most indicative of
A. hypokalemia
B. hyperkalemia
C. historical myocardial infarction
D. current myocardial ischemia - ANSWER-C. historical myocardial infarction
Pronounced Q waves on an ECG tracing indicate that the patient has had a myocardial
infarction in the past. Current myocardial infarction is demonstrated on the ECG
waveform as an elevated ST segment. Once a patient experiences infarction of cardiac
tissue, Q waves will forever be pronounced.
Which of the following data cannot be determined from a comatose patient?
A. SPO2
B. color
C. tidal volume
D. dysphagia - ANSWER-D. dysphagia
, A comatose patient cannot report symptoms. Of the options offered dysphagia is the
only symptom. Color, oxygen saturation, and tidal volume can all be measured by the
practitioner regardless of the alertness and cooperation of the patient.
Which of the following requires a quality control assessment?
A. closed oxygen flowmeter
B. point-of-care blood gas analyzer
C. air-oxygen blender
D. flexible endotracheal tube - ANSWER-B. point-of-care blood gas analyzer
Of the options listed, a point-of-care blood gas analyzer requires routine quality control
assessment. This is because a blood gas analyzer is used to make critical decisions
regarding the care of the patient and is considered a definitive source of information
upon which care decisions are made.
A patient in the intensive care unit (ICU) has a radial artery catheter in place on the left
arm. Blood pressure reported by a blood pressure cuff on the right arm is significantly
different than the pressure determined by the arterial catheter. Which of the following
could explain this difference?
A. the cuff is less accurate than the radial catheter
B. the transducer is not level with the heart
C. the patient has pulmonary embolus
D. the patient has hyperthermia - ANSWER-B. the transducer is not level with the heart
Which of the following can be used to determine cardiac output?
A. Fick equation
B. ejection fraction and heart rate
C. A-aDO2
D. C(a-v)O2 - ANSWER-A. Fick equation
Cardiac output can be measured and or calculated by multiplying the stroke volume by
the heart rate. It can also be determined by using the Fick equation for cardiac output.
Although the arterial venous oxygen content difference may be used in determining if
cardiac output is increasing or decreasing, it cannot actually measure cardiac output.
A patient who requires continuous mechanical ventilatory support is suspected for
having a perforation in the lung tissue of the left lower base. A chest radiograph
confirms this suspicion. Which form of ventilatory support would minimize the chance of
further perforation?
A. pressure-regulated volume control ventilation
B. inverse I:E ratio ventilation
C. high-frequency jet ventilation (HFJV)