Lindsey Jones Practice Questions With Correct Answers |
2025
How often should ventilator circuits be changed? - every 7 days or when visibly soiled
When should an HME be replaced with heated humidity? - presence of thick secretions
What measurement is essential to monitor with a ventilator-dependent newborn with IRDS? -
fluid intake & output is essential
A female patient who is morbidly obese has an 8.0 mm tracheostomy tube. She has been placed
on an ulcer prevention mattress in the Intensive Care Unit. Following transport to the new bed,
the nurse calls a respiratory therapist to assess her because she is complaining of air hunger.
Diffuse dry crackles are auscultated with crepitus noted upon palpation. These findings are most
closely associated with - subcutaneous emphysema; In this case, the respiratory therapist
should assume that the tracheostomy tube has become dislodged due to the patient transfer.
Positive pressure ventilation through the tube while it was dislodged has resulted in
subcutaneous emphysema, or air under the skin outside of the lung. Auscultation usually
reveals dry crackles and palpation reveals a crepitus sensation.
While performing routine oxygen rounds, the respiratory therapist notes a COPD patient who is
receiving supplemental oxygen at 2 L/min is markedly cyanotic and has a heart rate of 30/min.
The therapist should FIRST - switch to FIO2 1.0;
Even though a COPD patient should rarely receive more than 2 L/min oxygen, there are
emergency circumstances that would dictate more supplemental oxygen. The use of the word
"markedly" is an indication of an emergency. In this case the patient is markedly cyanotic and
therefore has an oxygenation emergency. Switching to 100% oxygen is appropriate.
A respiratory therapist is having difficulty advancing a suction catheter down a fenestrated
tracheostomy tube while the inner cannula is removed. The cannula appears to meet resistance
within a few inches from insertion. The therapist should - twist the catheter while attempting to
advance;
, When suctioning somebody with a fenestrated tracheostomy tube, it must be remembered that
the suction catheters can sometimes get stuck on the fenestration hole inside the tube. The
best remedy for this is to twist the suction catheter until the end is clear of the hole.
A patient who requires 10 cmH2O of PEEP when mechanically ventilated is being transported. A
spring PEEP valve will be used in conjunction with the resuscitation bag. Where should the PEEP
valve be placed? - distal to the outlet valve; When using a resuscitation bag for a patient who
requires constant PEEP, a PEEP valve may be placed at the distal end of the outlet valve. Placing
the valve anywhere else will not provide positive end-expiratory pressure.
A patient shows signs of hypoxemia while on a heated aerosol set at 40% with the flow rate set
to 8 L/min. The patient's minute ventilation is 38.0 L. Which of the following changes should be
made? - increase flow rate to 10 L/min;
This question requires one to recognize that the flow rate is not meeting the patient's
ventilatory demand. It requires a little math to determine how much total flow the patient is
receiving. In this case the ratio for 40% is 3:1. If you add 3+1, you get 4. Then, if you multiply 4
times 8 L/min. you get a total flow of 32 L per minute. The patient's reported minute ventilation
is 38 L per minute. This would cause the patient to entrain extra air and would ultimately lower
FIO2, resulting in an increase in hypoxemia.
A spiral CT scan would best evaluate which of the following? - pulmonary embolism;
A spiral CT scan is a way of examining the lungs in a three-dimensional fashion. So, it would be
most useful for evaluating for a pulmonary embolism. Pneumonia, atelectasis, and sarcoidosis
do not have three-dimensional qualities and therefore do not need to be observed through a
spiral CT scan.
A patient is undergoing a full cardiopulmonary arrest. The patient is intubated and is being
monitored with an infrared capnographic device. PetCO2 data is showing 3%. Which of the
following best explains this value? - poor alveolar perfusion;
An end-tidal CO2 of only 3% is low. This indicates poor ventilation. In looking at the answers the
best one is poor alveolar perfusion. Poor systemic perfusion does not relate and increased
alveolar oxygen tension does not relate to low alveolar CO2.
2025
How often should ventilator circuits be changed? - every 7 days or when visibly soiled
When should an HME be replaced with heated humidity? - presence of thick secretions
What measurement is essential to monitor with a ventilator-dependent newborn with IRDS? -
fluid intake & output is essential
A female patient who is morbidly obese has an 8.0 mm tracheostomy tube. She has been placed
on an ulcer prevention mattress in the Intensive Care Unit. Following transport to the new bed,
the nurse calls a respiratory therapist to assess her because she is complaining of air hunger.
Diffuse dry crackles are auscultated with crepitus noted upon palpation. These findings are most
closely associated with - subcutaneous emphysema; In this case, the respiratory therapist
should assume that the tracheostomy tube has become dislodged due to the patient transfer.
Positive pressure ventilation through the tube while it was dislodged has resulted in
subcutaneous emphysema, or air under the skin outside of the lung. Auscultation usually
reveals dry crackles and palpation reveals a crepitus sensation.
While performing routine oxygen rounds, the respiratory therapist notes a COPD patient who is
receiving supplemental oxygen at 2 L/min is markedly cyanotic and has a heart rate of 30/min.
The therapist should FIRST - switch to FIO2 1.0;
Even though a COPD patient should rarely receive more than 2 L/min oxygen, there are
emergency circumstances that would dictate more supplemental oxygen. The use of the word
"markedly" is an indication of an emergency. In this case the patient is markedly cyanotic and
therefore has an oxygenation emergency. Switching to 100% oxygen is appropriate.
A respiratory therapist is having difficulty advancing a suction catheter down a fenestrated
tracheostomy tube while the inner cannula is removed. The cannula appears to meet resistance
within a few inches from insertion. The therapist should - twist the catheter while attempting to
advance;
, When suctioning somebody with a fenestrated tracheostomy tube, it must be remembered that
the suction catheters can sometimes get stuck on the fenestration hole inside the tube. The
best remedy for this is to twist the suction catheter until the end is clear of the hole.
A patient who requires 10 cmH2O of PEEP when mechanically ventilated is being transported. A
spring PEEP valve will be used in conjunction with the resuscitation bag. Where should the PEEP
valve be placed? - distal to the outlet valve; When using a resuscitation bag for a patient who
requires constant PEEP, a PEEP valve may be placed at the distal end of the outlet valve. Placing
the valve anywhere else will not provide positive end-expiratory pressure.
A patient shows signs of hypoxemia while on a heated aerosol set at 40% with the flow rate set
to 8 L/min. The patient's minute ventilation is 38.0 L. Which of the following changes should be
made? - increase flow rate to 10 L/min;
This question requires one to recognize that the flow rate is not meeting the patient's
ventilatory demand. It requires a little math to determine how much total flow the patient is
receiving. In this case the ratio for 40% is 3:1. If you add 3+1, you get 4. Then, if you multiply 4
times 8 L/min. you get a total flow of 32 L per minute. The patient's reported minute ventilation
is 38 L per minute. This would cause the patient to entrain extra air and would ultimately lower
FIO2, resulting in an increase in hypoxemia.
A spiral CT scan would best evaluate which of the following? - pulmonary embolism;
A spiral CT scan is a way of examining the lungs in a three-dimensional fashion. So, it would be
most useful for evaluating for a pulmonary embolism. Pneumonia, atelectasis, and sarcoidosis
do not have three-dimensional qualities and therefore do not need to be observed through a
spiral CT scan.
A patient is undergoing a full cardiopulmonary arrest. The patient is intubated and is being
monitored with an infrared capnographic device. PetCO2 data is showing 3%. Which of the
following best explains this value? - poor alveolar perfusion;
An end-tidal CO2 of only 3% is low. This indicates poor ventilation. In looking at the answers the
best one is poor alveolar perfusion. Poor systemic perfusion does not relate and increased
alveolar oxygen tension does not relate to low alveolar CO2.
