Lindsey Jones Practice Exam Qs w/ Explanations Updated

Lindsey Jones Practice Exam Qs w/ Explanations Updated 1. A patient has undergone overnight oximetry. Data shows several episodes of O2 desaturation throughout the night. The RTT would expect orders for which of the following kinds of testing: a. V/Q scan b. pulmonary function testing c. polysomnography d. 24-hour Holter monitoring Your answer: C Correct answer: C The use of overnight oximetery is often used to detect O2 desaturation during the night that may be associated with central or obstructive sleep apnea. Because data indicates some periodic desaturation, the practitioner should suspect possible sleep apnea and should order diagnostic testing that will confirm or rule out the suspicion. A routine screening blood gas performed on an asymptomatic patient prior to surgery shows the following: pH: 7.38 PaCO2: 42 PaO2: 80 HCO3: 26 SaO2: 96% COHb: 24% What should the RRT do? a. place the patient on a NRB mask b. report the findings and emphasize that the patient is likely a smoker c. evaluate saturation using a single wave-length spectrophotometer d. run quality control material and evaluate the accuracy of the co-oximeter your answer: D correct answer: D In this case the patient is presented as asyptomatic. A patient with a COHb level of 24% would feel dyspnea and present with tachypnea. Therefore, the RRT should evaluate the accuracy of the lab results, specifically the COHb. When checking accuracy of lab results, one would use quality control measures. The infection control department of a small hospital informs the RRT supervisor that the biological control accompanying some durable autoclaved equipment shows viable spores. The supervisor should do which of the following with the equipment: a. incinerate b. record date and place into service c. wipe with isopropyl alcohol before use d. resterilize your answer: D correct answer: D The presence of viable spores indicates the possibility of living organisms developing in the sterilized package or on the sterilized equipment. Sterilization suggest the absence of living organisms, therefore the presence of viable spores indicates the need to resterilize. A post-op patient is not progressing with sustained maximal inspiratory therapy and refuses to cough because of pain along the incision site. The RRT should instruct the patient to: a. pause at the top of each inspiration b. press a pillow against the incision site when coughing c. attempt coughing 1 hour after pain medication has been administered d. avoid coughing until the pain subsides your answer: B correct answer: B Explosive coughing by a post-op patient can inadvertently open incision sites. To prevent this, splinting the site with a pillow is an appropriate option. Several hours after oral endotracheal extubation of an 8.0-mm tube, and adult patient begins to demonstrate inspiratory stridor. Which of the following would be most helpful to the patient: a. racemic epinephrine b. albuterol c. atropine sulfate d. heated aerosol by mask your answer: A correct answer: A When a patient is extubated and has swelling of the upper airway tissues as demonstrated by stridor, racemic epinephrine is an appropriate medication to reduce swelling quickly. Another, less effective option, is to provide a cool mist. In extreme cases, such as marked stridor, reintubation, or an emergency tracheotomy may be indicated. An adult patient is receiving mechanical ventilatory support and is being suctioned through the endotracheal tube at a pressure of -90 mmHg. Secretions have been difficult to remove. What can be done FIRST to increase suctioning efficiency