KETTERING TMC PRACTICE EXAM
Questions and Answers
1.A patient is admitted to the ED following a motor vehicle accident.
On physical exam, the respiratory therapist discovers that breath sounds
are absent in the left chest with a hyper-resonant percussion note. The
trachea is shifted to the right. The patient's heart rate is 45/min,
respiratory rate is
30/min, and blood pressure is 60/40 mm Hg. What action should the therapis
recommend first?
ANS Needle aspirate the 2nd left intercostal space.
2.A healthy adult female can exhale what portion of her forced vital
capacity in the first second?
ANS 70%
3.A patient on VC ventilation demonstrates auto-PEEP on ventilator
graphics. Which of the following controls, when adjusted independently,
would increase expiratory time?
1. Tidal volume
2. Respiratory Rate
3. Inspiratory flow
4. Sensitivity
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39
, ANS *A. 1, 2, and 3 only
4.Which of the following patients would most likely benefit from
pressure support ventilation?
A.
An intubated patient with an absent respiratory drive.
B.
A patient on SIMV with a mandatory rate of 12/min and total rate of 24/min.
C.
A patient with acute lung injury.
D.
A patient who requires short-term post-operative ventilatory support.
ANS A patient on SIMV with a mandatory rate of 12/min and total rate of
24/min.
5.A patient receiving mechanical ventilation has developed a
temperature of 99.9° F with purulent secretions over the last 12 hours.
The respiratory
therapist has also noted a steady increase in peak inspiratory pressure. Wha
initial recommendation should be made to address these changes?
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39
,A.
Initiate bronchial hygiene therapy.
B.
Obtain a sputum gram stain.
C.
Administer
IPV. D.
Insert a CASS tube.
ANS B.
Obtain a sputum gram stain
6.What value for the apnea-hypopnea index (AHI) is consistent with
mild obstructive sleep apnea?
ANS B.
5 to 15
7.While monitoring a newborn utilizing a transcutaneous monitor,
the respiratory therapist notices a change in PtcO2 from 60 to 142 torr and
simultaneously the PtcCO2 changes from 37 to 2 torr. What is the most
likely explanation for these changes?
3/
39
, ANS Air leak around the sensor
8.Which of the following measurements is most indicative of congestive
heart failure?
ANS pulmonary capillary wedge pressure of 30 mmHg
9.Sleep apnea can be defined as repeated episodes of complete cessation
of airflow for
A. 5 seconds or longer.
B. 10 seconds or longer.
C. 15 seconds or longer.
D. 20 seconds or longer.
ANS B 10 seconds or longer
10.A patient in the ICU receiving mechanical ventilation underwent
fiberoptic bronchoscopy during which a tissue biopsy was collected.
Immediately fol- lowing the procedure, the respiratory therapist notes that
the peak inspiratory pressure on the ventilator has increased. Potential
causes for this include all of the following EXCEPT
ANS hypoxemia
11.What is the primary advantage of volume-controlled ventilation as com-
pared to pressure-controlled ventilation?
ANS VC provides a constant minute ventilation.
4/
39
Questions and Answers
1.A patient is admitted to the ED following a motor vehicle accident.
On physical exam, the respiratory therapist discovers that breath sounds
are absent in the left chest with a hyper-resonant percussion note. The
trachea is shifted to the right. The patient's heart rate is 45/min,
respiratory rate is
30/min, and blood pressure is 60/40 mm Hg. What action should the therapis
recommend first?
ANS Needle aspirate the 2nd left intercostal space.
2.A healthy adult female can exhale what portion of her forced vital
capacity in the first second?
ANS 70%
3.A patient on VC ventilation demonstrates auto-PEEP on ventilator
graphics. Which of the following controls, when adjusted independently,
would increase expiratory time?
1. Tidal volume
2. Respiratory Rate
3. Inspiratory flow
4. Sensitivity
1/
39
, ANS *A. 1, 2, and 3 only
4.Which of the following patients would most likely benefit from
pressure support ventilation?
A.
An intubated patient with an absent respiratory drive.
B.
A patient on SIMV with a mandatory rate of 12/min and total rate of 24/min.
C.
A patient with acute lung injury.
D.
A patient who requires short-term post-operative ventilatory support.
ANS A patient on SIMV with a mandatory rate of 12/min and total rate of
24/min.
5.A patient receiving mechanical ventilation has developed a
temperature of 99.9° F with purulent secretions over the last 12 hours.
The respiratory
therapist has also noted a steady increase in peak inspiratory pressure. Wha
initial recommendation should be made to address these changes?
2/
39
,A.
Initiate bronchial hygiene therapy.
B.
Obtain a sputum gram stain.
C.
Administer
IPV. D.
Insert a CASS tube.
ANS B.
Obtain a sputum gram stain
6.What value for the apnea-hypopnea index (AHI) is consistent with
mild obstructive sleep apnea?
ANS B.
5 to 15
7.While monitoring a newborn utilizing a transcutaneous monitor,
the respiratory therapist notices a change in PtcO2 from 60 to 142 torr and
simultaneously the PtcCO2 changes from 37 to 2 torr. What is the most
likely explanation for these changes?
3/
39
, ANS Air leak around the sensor
8.Which of the following measurements is most indicative of congestive
heart failure?
ANS pulmonary capillary wedge pressure of 30 mmHg
9.Sleep apnea can be defined as repeated episodes of complete cessation
of airflow for
A. 5 seconds or longer.
B. 10 seconds or longer.
C. 15 seconds or longer.
D. 20 seconds or longer.
ANS B 10 seconds or longer
10.A patient in the ICU receiving mechanical ventilation underwent
fiberoptic bronchoscopy during which a tissue biopsy was collected.
Immediately fol- lowing the procedure, the respiratory therapist notes that
the peak inspiratory pressure on the ventilator has increased. Potential
causes for this include all of the following EXCEPT
ANS hypoxemia
11.What is the primary advantage of volume-controlled ventilation as com-
pared to pressure-controlled ventilation?
ANS VC provides a constant minute ventilation.
4/
39
