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203 FINAL
| Question | Answer |
|---|---|
| The position that facilitates the greatest chest expansion is | fowlers |
| __________ is a technique used in surgical patients by supporting the incision with a pillow, a blanket, or your hands. This is meant to reduce _________during coughing | splinting, pain |
| Which of the following is/are indications for Vibratory PEP therapy? I. retained secretions II. bronchospasm III. atelectasis IV. upper airway inflammation | I, III |
| When should the EzPAP be used on a patient who had just undergone abdominal surgery? | When IS has failed to produce effective results |
| PEP stands for | Positive Expiratory Pressure |
| Goals of incentive spirometry include which of the following? I. medication delivery II. improvement of cough mechanism III. reversal of atelectasis IV. reversal of hypocapnea | II, III |
| Which of the following is a hazard associated with incentive spirometry? | hypocapnia |
| Of the following, which is the most important aspect of incentive spirometry? | thorough patient instruction |
| Tingling and numbness of the extremities during incentive spirometry is called ? | pareshesia |
| A patient complains of lightheadedness while performing incentive spirometry. Which of the following actions would you take? | ask the patient to take a break between breathes |
| An incentive spirometer measures | maximal inspiratory volumes |
| A resonant percussion note would be normally heard over the | lungs |
| Breath sound resulting from bronchoconstriction; | wheezing |
| Term for temperature of 102 degrees F: | hyperthermia/febrile |
| Normal breath sound heard over the lung peripheries: | vesicular |
| One of the first signs of hypoxemia | increased heart rate |
| Assessment technique that involves just touching the patient with your hands: | palpitation |
| Assessment technique that involves just looking or observing the patient: | observation/inspection |
| What is the purpose of doing a capillary refill check? | check perfusion |
| Normal range for heart rate is | 60 - 100 |
| Low oxygen level in the blood is termed? | hypoxemia |
| Bradypnea is the term for? | low respiratory rate |
| Breath sounds resulting from sudden opening of peripheral airways: | crackles |
| When is it advisable to count the pulse for 1 minute rather than 15 seconds? | irregular rhythm |
| What is another name for the Venturi mask? | AEM, air entrainment mask |
| What is the first step you should take if you arrive in a patient's room and determine that the patient is not breathing? | check for a pulse |
| The Fio2 range for a nasal cannula is: | 0.24-0.44 |
| A confused 8-year-old patient presents to the emergency department with a high fever, tachycardia, tachypnea, and blue lips. The physician would like for you to set up oxygen. Which of the following devices will you place the patient on? | Nonrebreather |
| What is the minimum flow for a simple mask? | 5 LPM |
| what is the purpose of having a minimum flow for the simple mask? | to prevent rebreathing of C02 |
| What is the estimated Fio2 for a nasal cannula running at 2 lpm | 0.28 |
| A patient is receiving oxygen therapy via a non-rebreather mask. The respiratory therapist noticed that the bag fully collapses with each inspiration and that the oxygen saturation is at 90%. What should the respiratory therapist do? | increase the flow to the device until the bag collapses just slightly on inspiration |
| A patient who is receiving oxygen via venturi mask at 40% desires to eat his spam musubi. What level of oxygen would the RCP administer via nasal cannula? | 5 L |
| Mr. Caban is a patient with COPD who is on home oxygen. He wants to go to watch a movie that is 2 ½ hours long. If he takes a full E cylinder and uses 4 Lpm, will he be able to finish the movie without running out of oxygen? Why? | no will not have enough for travel |
| Which of the following is/are (a) high-flow device(s)? I. simple mask II. air entrainment mask III. non-rebreather mask IV. heated aerosol by trach collar | II, IV |
| A low-flow oxygen device meets all of the patient’s inspiratory needs. | false |
| The minimum liter flow for a non-rebreather mask is | enough to keep reservoir bag from collapsing during inspiration |
| Name disadvantages of using a simple mask | can't eat, uncomfortable, risk of aspiration |
| In a compressed gas storage area, oxygen should not be stored with: | flammable anesthetics |
| Name advantages of using a nasal cannula. | can use on adults, children, infants, easy to use, disposable, low cost, well tolerated |
| When should you use a bubble humidifier? | patients request, 4 Lpm or higher |
| Subjective manifestations of disease are termed as: | Symptoms |
| Your patient has a "DNR" label on his chart and at the head of his bed. This indicates: | The patient should not be resuscitated if cardiac arrest occurs |
| Difficulty breathing in the upright position | Platypnea |
| difficulty breathing when lying down | Orthopnea |
| difficulty breathing | Dyspnea |
| Absence of breathing | Apnea |
| A patient presents in the emergency department with blood-tinged sputum. The term associated with such sputum is: | Hemoptysis |
| Chest pain is the cardinal symptom of which of the following diseases? | Heart Disease |
| Above normal respiratory rate (greater than 20) | Tachypnea |
| In what space is the patient assessment conducted? | Intimate Space |
| In what space is the patient interview conducted by the clinician? | Personal Space |
| In what space is rapport conducted? | Social Space |
| Oxygen Toxicity | -Atelectasis -Nitrogen Washout -Retinopathy of Prematurity -O2 Induced Hypoventilation (COPD), reduce hypoxic drive |
| Creaking or grating sound from roughened, inflamed surfaces of the pleura rubbing together | Pleural Friction Rub |
| Which of the following findings suggest the patient is orientated? | awareness of the correct date and ability to correctly state their name |
| Which of the following is least likely to cause tachycardia? A. Fever B. Severe pain C. Hypotension D. Hypothermia | Hypothermia |
| What artery is most often used to assess arterial blood pressure? | Brachial Artery |
| What is the advantage of COPD patients breathing through pursed-lips during exhalation? | Promotes more complete emptying of the lungs |
| A patient with atelectasis will exhibit which type of breathing pattern? | Tachypnea |
| Which of the following will you find upon assessment of a patient with emphysema? | Decreased tactile fremitus, Hyperresonance to percussion |
| Lower than normal temperature | Hypothermia |
| lower than normal heart rate | Bradycardia |
| Normal Respiratory Rate | 12-20BPM |
| Lower than normal blood pressure | Hypotension |
| What breathing pattern is associated with metabolic acidosis or diabetic ketoacidosis? | Kussmaul Breathing |
| During auscultation of a patient's chest, you hear coarse crackles throughout both inspiration and expiration. These sound clear when the patient coughs. Which of the following is the most likely cause of these adventitious sounds? | movement of excessive secretions in the airway |
| An RCP enters a patient room to find the woman in distress. She has hyperresonance and decreased motion on the left side of the chest, dyspnea, and tracheal deviation to the right. Based on these findings, the most likely cause is: | Pneumothorax on the left |
| A patient with asthma exacerbation will exhibit which type of breathing pattern? | prolonged exhalation, possible retractions |
| Your patient has an abnormal sensorium. Which of the following is most likely true? | He is confused about where he is |
| While observing a patient's breathing, you note a regular pattern: the depth and rate first increase, then decrease, followed by a period of apnea. Which of the following terms would you use in charting this observation? | Cheyne-Stokes breathing |
| Vesicular breath sounds are normal lung sounds heard over the: | Lung Peripheries |
| A goal of incentive spirometry is: | To provide means of using a patient's muscles to hyperinflate the lungs |
| A sign that your patient may be hyperventilating during incentive spirometry is: | light headedness, dizziness, tingling sensation |
| Of the following, which is the most important aspect of the incentive spirometry? | thorough patient instruction |
| A short-term application of inspiratory positive pressure to a spontaneously breathing patient best defines which of the following? | intermittent positive-pressure breathing (IPPB) |
| How do modes of lung expansion therapy aid lung expansion? | Increasing the transpulmonary gradient |
| While testing the IPPB machine before patient use, you notice that it turns on at a rate of 30 times per minute. Which of the following is most likely the cause? | the machines SENSITIVITY is inappropriately set |
| Which of the following modes of lung expansion therapy is physiologically most normal? | Incentive Spirometry |
| Which of the following are contraindications for continuous positive airway pressure (CPAP) I. esophageal resection II. hypoventilation III. facial trauma IV. low intracranial pressures | I, II, and III |
| Lung expansion methods that increase transpulmonary pressure gradients by increasing alveolar pressure include which of the following: I. IS II. PEP III. IPPB IV. CPAP | PEEP, IPPB, CPAP, PAP |
| All of the following are hazards of positive airway pressure therapies (CPAP, PEP, CPAP) EXCEPT: | epistaxis |
| Persistent breathing at small tidal volumes can result in which of the following? | compression atelectasis |
| Which of the following patient categories are at high risk for developing atelectasis? 1. those who are heavily sedated 2. those with abdominal or thoracic pain 3. those with neuromuscular disorders | 1, 2, and 3 |
| How can the transpulmonary gradient be increased? | Increasing alveolar pressure and decreasing pleural pressure |
| Which of the following mechanisms contribute to the beneficial effects of continuous positive airway pressure (CPAP) in treating atelectasis? | recruitment of collapsed alveoli, decreased WOB, improved distribution of ventilation, increase efficiency of secretion removal |
| In teaching a patient to perform the sustained maximal inspiration maneuver during incentive spirometry, what would you say? | exhale normally, then inhale as deeply as you can, then hold your breath for 5-10 sec |
| What are the normal cough reflex phases? | irritation, inspiration, compression, and expulsion |
| The RT receives an order to perform PD on the ANTERIOR SEGMENT of the pt’s upper lobes. How should the patient be positioned? | bed flat, patient supine, pillow supporting knees |
| The RT receives an order to perform PD on the RIGHT MIDDLE LOBE of the patient. How should the patient be positioned? | foot of bed elevated 12", patient lying on left side (right side up), pillows supporting back. |
| The RT receives an order to perform PD on the SUPERIOR SEGMENT of the pt’s lower lobes. How should the patient be positioned? | bed flat, patient prone, pillow under abdomen |
| The RT receives an order to perform PD on the POSTERIOR BASAL SEGMENT of the pt’s lower lobes. How should the patient be positioned? | foot of bed elevated 18", patient prone, pillow under abdomen |
| Which of the following can provoke a cough? | foreign bodies, infection, irritating gases |
| A patient with abdominal muscle weakness is having difficulty developing an effective cough. Which of the following phases of the cough reflex are primarily affected in this patient? | Inspiration, Compression, and Expulsion |
| What factors can hinder effective coughing? | artificial airways, neuromuscular disease, systemic dehydration, pain or fear of pain, use of expectorants |
| A patient recovering from abdominal surgery is having difficulty developing an effective cough. Which of the following actions would you recommend to aid this patient in generating a more effective cough? | coordinating coughing with pain medication, forced expiratory technique (FET), splinting the operative site |
| While reviewing the chart of a patient receiving CPT/PD QID, the patient tends to undergo mild desaturation during therapy (a drop in SpO2 from 94% to 89% to 92% while on 2 lpm NC). Which of the following would you recommend to manage this problem? | increase the patients FIO2 during therapy |
| In theory, how does (PEP) help to move secretions into the larger airways? | filling underrated segments through collateral ventilation, preventing airway collapse during expiration |
| Patients can control a flutter valve’s pressure by changing what? | their expiratory flow |
| During chest physical therapy, a patient has an episode of hemoptysis. Which of the following actions would be appropriate at this time? | stop therapy, sit patient up, give O2, contact physician |
| Contraindications for positive airway pressure therapies include all of the following EXCEPT: | air-trapping/pulmonary overdistention in chronic obstructive pulmonary disease |
| FET stands for: | forced expiratory technique |
| All of the following are goals of bronchial hygiene therapy EXCEPT: | reverse the underlying disease process |
| What are the goals of bronchial hygiene therapy? | help mobilize secretions, improve pulmonary gas exchange, reduce work of breathing |
| When using a metered-dose inhaler without a holding chamber or a spacer, the patient should be instructed to fire the device at what point? | immediately after beginning a slow inspiration |
| patient suffering from acute exacerbation of asthma is not responding to the standard dose & frequency of an aerosolized BD and is now receiving SVN therapy every 15-30 min. Which of the following would you recommend to the patient's doctor at this time? | consider continuous nebulization of the drug |
| which of the following can be used to decrease the effects of environmental exposure to ribavirin or pentamidine? | isolation booth/tent with HEPA-filtered exhaust, healthcare personnel wear a HEPA-filtered mask, Use (-) pressure room with adequate air exchange. |
| Where do most aerosol particles that are less than 3 um deposit? | parenchyma |
| What is the primary mechanism for deposition of large, high-mass particles (greater than 5 microns) in the respiratory tract? | inertial impaction |
| Advantages of small-volume ultrasonic nebulizers for drug delivery include all of the following EXCEPT: | decreased cost |
| When done appropriately, what percentage of the drug dose delivered by a simple metered-dose inhaler (MDI) deposits in the lungs? | about 20% |
| For which of the following patient groups is use of a DPI for bronchodilator administration recommended? | Children > 5-6 years of age, Patients requiring maintenance therapy |
| All of the following drugs or drug categories have been associated with increased airway resistance and bronchospasm during aerosol administration EXCEPT which one? | albuterol |
| Which of the following describes the output produced by a nebulizer? | emitted dose |
| Where do most aerosol particles in the 5-10 um range deposit? | upper airways |
| What are some benefits of using a holding chamber with MDI? | Usage of MDI can be adapted to children & elderly, decrease in need for hand breath coordination |
| Which of the following statements about atomizers is FALSE? | atomizers are useful for bronchospasms |
| What is the major problem with using large-volume nebulizers for continuous aerosol drug therapy? | drug reconcentration and toxicity |
| aerosol drug delivery(SVN) set at 8 LPM, patient asks to be lowered to a semi-Fowler’s position. After, you observe a significant ↓ in SVN aerosol output, despite at least 3 ml of solution left in the reservoir. What would you do to correct this problem? | reposition the patient so that the SVN is more upright |
| Which of the following is/are necessary for normal airway clearance? | Patent airway, Functional mucociliary escalator, Effective cough |
| Which of the following occurs during the compression phase of a cough? | expiratory muscle contraction |
| A patient recovering from anesthesia rafter abdominal surgery is having difficulty developing an effective cough. Which of the following phase of the cough reflex are primarily affected in this patient? | irritation |
| All of the following drug categories can impair mucociliary clearance in intubated patients except A) General anesthetics B) Bronchodilators C) Opiates D) narcotics | bronchodilators |
| The application of gravity to achieve specific clinical objectives in respiratory care best describes which of the following? | postural drainage |
| What is the major contributing factor in the development of postoperative atelectasis? | repetitive shallow breathing |
| Which of the following is an absolute contraindication for using intermittent positive-pressure breathing? | tension pneumothorax |
| The contraindications to PEP therapy may include: | acute sinusitis, ICP>20 mmHg, Hemodynamically unstable, Hemoptysis, epistaxis, Unresolved ptx, Surgery (face, oral, gastric bypass), Middle ear problem, Nausea, Unable |
| You should never percuss: | bony areas, breast tissue, surgical areas, ribs |
| Which of the following is/are (an) indication(s) for Flutter valve therapy? | retained secretions, atelectasis, cystic fibrosis |
| A patient in position for draining the posterior basal segments of both lungs complains of a headache when coughing. The most likely cause is: | increased intercranial pressure |
| The CoughassistTM Mechanical In-Exsufflator: | provides positive pressure during inhalation and exhalation, intermittent use, secretion removal |
| Which of the following should be included in a complete physician’s order for IPPB? | medication and dilution, frequency, and duration of therapy |
| an airway clearance maneuver that combines breathing control, thoracic expansion control and forced expiration technique | active cycle of breathing |
| a technique that aims to achieve the highest possible airflow in different generations of bronchi to move secretions | autogenic drainage |
| technique used to help remove mucus and fluid from the lungs. Conventional forms include postural drainage, percussion, and vibration | Chest physiotherapy (CPT) |
| A breathing manuever that consists of one or two forced expirations or huff combined with a period of controlled breathing | forced expiratory technique |
| An airway clearance that uses a vest to compress the chest externally with short, rapid expiratory flow pulses; relies on chest wall elastic recoil to return lungs to FRC | high-frequency chest wall compression |
| forced expiratory technique that is preformed by sharply exhaling from high to mid-lung volumes through an open glottis; used for patients unable to generate effective cough | huff coughing |
| used to mimic natural sighing or yawning maneuvers; sustained maximal inspiration | IS |
| A person climbs up Mt. Everest. What type of hypoxia is she most likely to develop? | Hypoxic hypoxia |
| A rapid breathing pattern is called (RR greater than 20) | Tachypnea |
| Why do oxygen masks require minimum flow rate for operation? | to provide a way to wash out carbon dioxide |
| Which of the following is NOT a common cause of tachypnea? | Narcotic overdose |
| Two large-volume all purpose nebular are set in tandem at an FIO2 of 50% and a flow rate of 10LPM to deliver humidified oxygen to a patient with a tracheostomy. The nebulizer are producing very little mist. What could be done to improve aerosol output? | Check water level in the nebulizers, drain condensate from the supply tubing, and increase the flow rate to each LVN |
| A humidifier produces 21 mg of water per liter gas delivered. In terms of the lung, what humidity deficit is produced? | 44-21 = 23 mg |
| factors affecting a humidifiers performance include all of the following EXCEPT: | outlet size |
| Inhalation of dry gases can do which of the following? | Increase viscosity of secretions, impair mucocilliary motility, increase irritability |
| The AARC CPG states that HME's may be used in which of the following situations? | Minute volumes greater or equal to 10 LPM, Body temperature > 37 Celsius |
| Which of the following characteristics is LEAST typical for pleuritic chest pain? | Radiates to the arm |
| What is the entrainment ratio for an FIO2 of 28%? | 10:1 |
| Which of the following changes is consistent with a fever? | increase pulse rate, increase oxygen consumption, increase CO2 production |
| A patient is receiving oxygen via 3 L nasal cannula The order for oxygen is >92%. Her SpO2 is 93% and has no clinical signs of hypoxemia. At this point, what should you recommend? | maintaining the therapy as is and rechecking the SpO2 on the next shift. |
| What are the hazards of aerosol therapy? | burns, cross contamination, bronchospasm |
| to protect against obstructed tubing, simple bubble humidifiers incorporate: | pressure relief valve |
| Which if the following patients would you NOT recommend bland aerosol therapy administration? | patient with active bronchoconstriction, history of hyperresponsiveness |
| simple unheated bubble humidifiers are commonly used to humidify gases with what type of systems? | nasal oxygen delivery |
| Pt receiving ventilatory support is being provided with humidification via HME, physician ordered a MDI via ventilatory circuit. Which of the following should be performed to ensure delivery of drug to patient? | HME must be removed from the circuit during MDI use |
| Inhalation of dry gases can do which of the following? | increase viscosity of secretions, impair mucociliary motility, increase airway irritability |
| Which of the following is an advantage of using a passover humidifier? | it can be used where high flow rates are needed |
| Indications for warming inspired gases | patient whose airways are reactive to cold, providing humidification when upper airway is bypassed, treat hypothermia |
| What is NOT an indication for warming inspired gases? | to reduce upper inflammation or swelling |
| What is a 3 L flow meter commonly used for? | Pediatrics and COPD patients |
| What are 4 different names of nebulizers | SVN, Acorn, Med neb, handheld (HHN) |
| your patient is using VPEP and expiratory time is 2 seconds, what should you do to achieve an expiratory time of 4 seconds? | increase resistance |
| ______ is NOT a common cause of tachypnea | narcotic overdose |
| What is the advantage of COPD pts breathing through pursed lip during exhalation? | promotes more emptying of the lungs |
| Which of the following is a common cause of pulsus paradoxus? | acute asthma attack |
| HME indications | minute volumes > 10 lpm, body temperature >37 Celsius |
| Which of the following are true about AEM? | good for mouth breathers, provides FIO2 0.24-0.60, meets patients inspiratory needs |
| HME contraindications | thick, copious, bloody secretions, low exhaled tidal volumes |
| FALSE about chest pain? | non-pleuritic is usually sharp and stabbing |
| What is the simplest way to increase humidity output? | increase temperature of the water or gas |
| Which of the following would cause the greatest deviation in FIO2 on an AEM? | bed sheet pulling over entrainment ports of mask |
| What may cause a tracheal deviation to the right? | right upper lobe atelectasis |
| Which of the following can be assessed by palpation? | crepitus, tracheal deviation, pulse |
| The FIO2 of a venti mask is affected by: | size of jet and size of entrainment port |
| What breathing pattern is an indication for intubation and mechanical ventilation? | apnea |
| A physician orders bland aerosol administration to pt w/intact upper airway. Which of the following airway appliances could you use to meet this goal? | face tent or aerosol mask |
| Complete airway obstruction: | flaring of the nostrils, supraventricular retractions, inability to speak |
| Indications for bland aerosol administration | upper airway edema, bypassed upper airway |
| heated passover humidifiers are commonly used to humidify | mechanical ventilators |
| edema of ankles is commonly associated with | heart failure |
| __________ commonly causes a bilateral decrease in thoracic expansion | COPD |
| bradypnea can be caused by: | hypothermia, narcotic overdose, head injury |
| When would you select a heated humidifier? | O2 through bypassed upper airway, long term mechanical ventilation |
| When using an MDI w/holding chamber, patient should be instructed to fire this device at what point? | immediately before beginning a slow inspiration |
| For which of the following patients would you recommend bland aerosol therapy via USN? | patient who must provide a sputum specimen |
| Soon after you initiate PD in a Trendelenburg position, patient develops a vigorous and productive cough. Which of the following actions would be appropriate at this time? | move the patient to a sitting position until cough subsides |
| Indications for PD: | chronic bronchitis, bronchiectasis |
| What patient is commonly seen with barrel chest? | emphysema |
| Contraindications for PAP: | ICP > 20 mmhg, hemodynamic instability, pre-existing barotrauma/pneumothorax |
| Water has accumulated in the corrugated tubing of a pt's aerosol set up. This will result in.... | decrease aerosol output, increase in FIO2, increase back pressure |
| most common complication of IPPB | respiratory alkalosis (decreased CO2) |
| Intubated pt is on 50% O2, SAT 90%. What is the predicted PAO2? | 300 mmhg |
| Why would you use MDI vs DPI? | MDI requires less coordination. DPI patient needs to generate at least 40 LPM |
| Which of the following factors affect pulmonary deposition? | size of particles, shape and motion of particles, and physical characteristics of the airways |
| FALSE about IPPB | during inspiration, pressure in alveoli decreases |
| What should you do when IPPB fails to cycle off? | tighten circuit connections, tell patient to keep a tight seal around mouthpiece |
| An accident victim comes in ED. Patient is SOB and hypoxic. BP 80/45 | stagnant hypoxia |
| The short term application of inspiratory positive pressure to a spontaneously breathing patient best defines which of the following? | Intermittent Positive Pressure Breathing (IPPB) |
| What can I adjust on IPPB if patient is not reaching pressure target? | make sure there are no leaks or ensure patient has a tight seal around mouthpiece |
| Too much CO2 can cause | altered mental status |
| Water accumulated in the corrugated tubing. This will result in all of the following EXCEPT | increased total flow |
| a rounded costophrenic angle indicates | pleural effusion |
| What is the most common complication of IS? | dizziness |
| ways to prevent thrush | rinse mouth, use chmaber |
| how do you calibrate analyzer? | 21% room air and 100% O2 |
| PRIMARY way people mobilize secretions | cough |
| IPPB machine wont start | check if plugged in sensitivity to low |
| inadequate flow, active inhalation | -Large negative pressure swings at early inspiration -Large negative pressure swings after machine turns on |
| premature cycling off | flow is too high, airflow obstruction (tongue in mouth piece), pressure is set too low |
| auto triggering | too sensitive, rate control on |
| prolonged inspiration | leaks, flow rate too low, pressure too high |
| Which of the following clinical findings indicate the development of atelectasis? | opacified areas on the chest x-ray film, tachypnea, diminished or bronchial breath sounds |
| How can the transpulmonary pressure gradient be increased? | increasing the alveolar pressure, decreasing pleural pressure |
| Lung expansion methods that increase transpulmonary pressure gradients by decreasing pleural pressure include? | Incentive spirometery |
| A postop pt using incentive spirometry complains of dizziness & numbness around the mouth after therapy sessions. What is the most likely cause of these symptoms? | hyperventilation |
| Successful application of incentive spirometry depends on | the effectiveness of pt. teaching |
| A patient that came into the ER with RR 38. Shows signs of Respiratory Distress. What device would you recommend for this patient? | CPAP |
| While observing a patient's breathing, you note a regular pattern: the depth and rate first increase, then decrease, followed by a period of apnea. Which of the following terms would you use in charting this observation? | Cheyne stokes |
| Nurse calls you and tells you doctor put in order for treatment. What do you do FIRST? | Check patient's chart to verify |
| Chest pain is the cardinal symptom of which of the following diseases? | Heart Disease |
| All of the following are likely to cause errors in Sp02 readings, EXCEPT: | significant tachycardia |
| A problem that arises due to improper placement of the pulse oximeter probe on the finger is false high or false low readings. This limitation is due to what problem? | Penumbra affect |
| Which of the following can cause false high readings when using a pulse oximeter? | carboxyhemoglobin |
| An alert outpatient awaiting bronchoscopy has an SpO2 reading of 81% breathing room air. The patient appears in no distress and exhibits no signs of hypoxemia. Which of the following would be the best initial action to take in this situation? | switch sites or replace sensor probe |
| At the beginning of exhalation, the PETC02 normally should be at what level? | 0 mm Hg |
| The transcutaneous pressure of CO2 may be written as: | TcPCO2, PtcCO2 |
| What is the best single measure of effective ventilation in the intensive care unit patient? | PaCO2 |
| You immediately begin monitoring the oxygenation status of an infant admitted to the emergency department in severe respiratory distress. Which of the following approached would you select? | pulse oximetry |
| Continuous Sp02 monitoring (verses a spot check) is indicated in all of the following situations EXCEPT: | O2 therapy |
| All of the following are common sites for transcutaneous blood gas electrode placement EXCEPT the: | thigh |
| Which of the following are considered benefits of NIM devices in comparison to an ABG? | Continuous monitoring, Real-time displayed data, Blood sample is not needed |
| The usage of pulse oximetry in neonates and CO2 retainers is limited due to its inability to detect | hyperoxemia |
| A pulse oximeter is being used to monitor a patient who was admitted for attempted suicide. The SpO2 is 92% on room air; patient is unconscious, tachypneic and tachycardic. What additional test should the RT recommend? | Co-oximetry |
| Which of the following is FALSE about transcutaneous blood gas monitoring? | transcutaneous blood gas monitoring is most accurate when use with older adults |
| What is the greatest hazard of pulse oximetry? | false results leading to incorrect decisions |
| Which of the following are common sites for transcutaneous blood gas electrode placement | chest, abdomen, and lower back |
| What is TRUE about transcutaneous blood gas monitoring? | provides a reasonable estimate of PaO2 and PaCO2, accurate estimates are difficult in patients with shock, uses heated skin electrodes to arterialize blood |
| continuous monitoring SPO2 is indicated: | exercise testing, sleep studies, and bronchoscopy |
| Which of the following are likely to cause errors in SPO2 readings? | anemia, deeply pigmented skin, motion due to shivering |
| A male patient who is standing upright with his back to the x-ray tube, his anterior thorax pressed against a metal cassette containing the film, and his arms positioned out of the way is positioned for what x-ray view? | Posterior anterior view (PA) |
| A PA film, what number of posterior ribs visible above the diaphragm indicates a good inspiratory effort? | 10 |
| Which of the following would suggest that a patient has congestive heart failure? | increased cardiothoracic ratio |
| Three days post-op, a pt is febrile and the WBC count is 18,000/cu mm (H). A CXR shows patchy bilateral infiltrates with air bronchograms. Based on this info, which of the following is the most probable diagnosis? | pneumonia |
| A post-operative patient develops stabbing, right-sided chest pain upon inspiration with decreased right-sided breath sounds. Which of the following is indicated? | chest x-ray |
| Which of the following is the most appropriate radiographic technique to confirm the presence of free pleural fluid? | lateral decubitus |
| Which of the following indicates the presence of a pneumothorax on a CXR? | a dark area with no lung markings present |
| While looking at a CXR, the RT observes increased hyperlucency on one side, vascular markings are not visible and the pt’s trachea and mediastinum have moved away from the affected side. How would the RT interpret these findings? | pneumothorax |
| Air-filled airways surrounded by consolidated alveoli are called | Air bronchograms |
| Which of the following would appear to be most radiopaque on a chest radiograph? | bone |
| Which of the following terms defines low-density tissues on the x-ray film? | radiolucent |
| A portable x-ray machine is ordered for a patient to rule-out pneumonia. What x-ray view would be taken with the machine? | AP |
| A three-year old patient shows up in the ED in mild respiratory distress. A lateral neck x-ray shows the presence of laryngotracheobronchitis. Which of the following statements are true with regards to LTB? | it involves inflammation in the subglottic area, a steeple sign will be seen |
| A patient with CHF exacerbation has a left sided pleural effusion. Which of the following statement/s is/are true with regards to his problem? | lateral decubitus CXR would verify the extent of his effusion, the left costophrenic angle will be blunted, engorgement of the pulmonary vasculature will be visible |
| What are the reasons for obtaining a portable film immediately after a CVP catheter is placed via the subclavian vein? | to ensure proper placement of the catheter, to rule out the presence of a pneumothorax |
| The accuracy of pulse oximetry is | ±4% |
| Pulse oximetry readings below ___% may be deemed unreliable. | 80% |
| What does the plateau indicate? | alveolar gas |
| During capnography monitoring of a mechanically ventilated patient, you note that the PETCO2 has dropped to 0 mm Hg. Which of the following is the most likely problem? | ventilator disconnect |
| An example of anemic hypoxia | Carbon monoxide poisoning |
| An example of histotoxic hypoxia | Cyanide poisoning |
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