TMC test bank NBRC| Complete Questions and 100% Verified Solutions| With Rationales| A+ Rated| Updated

TMC test bank NBRC| Complete Questions and 100% Verified Solutions| With Rationales| A+ Rated| Updated Disadvantages of noninvasive ventilation include which one of the following? A. costs more than invasive ventilation B. requires heavy patient sedation C. limits direct access to lower airway D. increases the likelihood of VAP Disadvantages of noninvasive ventilation (NPPV) include the following: it can only be used in cooperative patients; it does not provide direct airway access (thus increasing the risk of secretion retention), and more therapist time is needed during the initial period of use. On the other hand NPPV may help decrease the incidence of VAP and typically costs less than invasive ventilation. The correct answer is: limits direct access to lower airway On a patient receiving volume control AC ventilation, you observe a flow-volume with a sawtooth pattern on exhalation. Which of the following actions would you consider most appropriate? A. recommend administering a bronchodilator B. assess the patient's need for suctioning C. measure the endotracheal tube cuff pressure D. switch to pressure control ventilation The flow-volume loop reveals irregular sawtooth- like oscillations, primarily in the expiratory portion of the loop. This indicates either 1) accumulation of airway secretions in the trachea/large airways (requiring suctioning), or 2) condensate partially blocking the expiratory limb of the ventilator circuit proximal to the expiratory flow sensor. Auscultation of rhonchi or tactile fremitus over the trachea would confirm excess secretions as the problem. The correct answer is: assess the patient's need for suctioning A 30 year-old male was found supine and unresponsive. In the ER it was confirmed he had aspirated while on his back. After the patient is transferred to ICU his physician orders postural drainage and percussion every 4 hours. What is the best position to place him in to drain the affected area? A. prone with a pillow under his hips B. prone with feet elevated 30 degrees C. supine with a pillow under his hips D. supine with feet elevated 30 degrees This patient aspirated while lying flat on his back. Most commonly, this affects the superior segments of both lower lobes. The position which facilitates drainage from this lung region is a prone position with a pillow under the patient's hips. The correct answer is: prone with a pillow under his hips You need to perform nasotracheal suctioning on a patient with retained secretions. As compared to suctioning via a tracheal airway, which of the following complications are unique to this procedure? A. hypotension B. gagging/aspiration C. hypoxemia D. increased ICP Complication/hazards common to both tracheobronchial and nasotracheal suctioning include hypoxemia, cardiac dysrhythmias, bradycardia, hyper-/hypotension, bronchospasm, atelectasis, increased intracranial pressure and the potential for contamination/infection. Unique complications of nasotracheal suctioning include nasal trauma/epistaxis, pharyngeal trauma, gagging (with potential 241 vomiting/aspiration), and laryngospasm. Also misdirection of the catheter is more common with nasotracheal suctioning. Which of the following indicates a deficit in fluid balance A. Pedal edema B. Poor skin turgor C. cap refill D. JVD Poor skin turgor ARDS patient, what should RT use to evaluate oxygen delivery for optimal PEEP A. ABG B. mixed venous C. serum lactate D. CO mixed venous RT performing a high calibration on a nitric oxide, expected value is A. 45 B. 10 C. 25 D. 80 45 To help prevent infection after an aerosol drug treatment provided via small volume nebulizer (SVN) you would: A. shake out any residual solution then bag the SVN B. rinse the SVN with tap water then dry and bag it C. run the SVN at high flows until completely dry D. rinse the SVN with sterile water then dry and bag it To minimize the likelihood of infection in patients receiving aerosol drug therapy via a small volume nebulizer (SVN), you should 1) use a different SVN for each patient, 2) change the SVN and tubing every 24 hours, and 3) perform thorough hand hygiene prior to each therapy session. It is also recommended that the nebulizer NOT be rinsed with tap water, but rather rinsed with sterile water and blown dry between uses. If rinsing with sterile water not feasible, rinse the device with filtered or tap water, then rinse with isopropyl alcohol and dry. The correct answer is: rinse the SVN with sterile water then dry and bag it A doctor orders aerosol drug therapy via small volume nebulizer for a patient receiving mechanical ventilation via a dual-limb breathing circuit. To prevent drug residue from affecting ventilator performance you must make sure that: A. both inspiratory and expiratory HEPA filters are in place B. a HEPA filter is in place on the inspiratory limb of the circuit C. a heat and moisture exchanger is in place at the patient connector D. a HEPA filter is in place on the expiratory limb of the circuit HEPA filters are needed to prevent drug residue from entering the ventilator and affecting its performance. For dual-limb circuits, be sure that inspiratory and expiratory HEPA filters are in place. For single-limb circuits, you normally only need an inspiratory HEPA filter; expiratory filtration may be required on patients with disorders requiring droplet or respiratory precautions. The correct answer is: both inspiratory and expiratory HEPA filters are in place Your patient is receiving aerosolized bronchodilators to treat her asthma. What is the best way to determine whether this treatment is achieving the desired goal? A. measure the patient's MIP before-and-after treatment