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CRT Exam E
Resp Therapist
| Question | Answer |
|---|---|
| Which of the following positions is most appropriate for a patient being treated for? extremely low blood pressure? | Trendelenburg |
| A respiratory therapist is assisting with a bronchoscopy for a patient with a right middle lobe consolidation. Which of the following should be routinely monitored during the procedure? | ECG pattern, pulse oximetry |
| lmmediately after initiating VC ventilation, an inverse l:E ratio is noted. Which of the following does this indicate? | Inspiratory flow is low |
| A 24-year-old female presents with seasonal nasal stuffiness and episodes of daytime dyspnea and cough. Which of the following drug classifications should the respiratory therapist recommend to control the patient's symptoms? | leukotriene inhibitor |
| Following endotracheal intubation, which of the following should a respiratory therapist use to confirm proper tube placement? | colorimetric capnometer |
| Following insertion of a (CVP) catheter, a chest radiograph is taken to evaluate the position of the catheter. A respiratory therapist notes the tip of the catheter is in the lower portion of the superior vena cava.Therapist should conclude the catheter | Is in the proper position |
| Which of the following findings indicate a patient who is weaning from mechanical ventilation has decreased muscle strength? | 1. reduced maximum inspiratory pressure (MlP) 2. decreased tidal volume 3. decreased vital capacity |
| A patient is receiving 80% to120% heliox using a standard oxygen flowmeter. Which of the following is the correction factor to determine the accurate flow? | 1.8 |
| Which of the following is the best device to administer a controlled oxygen concentration for a patient with a variable respiratory pattern? | air-entrainment mask |
| The following arterial blood gas results are available for a patient 15 minutes after the initiation of oxygen therapy: Fi02 0.60, pH 7.19, PaCO2 23 torr, Pa02 98torr HCO3 8mEq/L,BE -18mEq/L, Sa02 92% | lactic acidosis |
| A respiratory therapist is instructing an outpatient in the care of respiratory equipment. Which of the following steps should be included in the cleaning procedure? | Remove soap by rinsing with water. Soak in a vinegar solution for 20 minutes. Drain dry without wiping |
| A patient with a tracheostomy is receiving heated aerosol therapy. A respiratory therapist finds the Fi0₂ is 0.60 by oxygen analyzer when the air-entrainment setting is 0.40. What could cause these findings? | The analyzer could be improperly calibrated. Water in the tubing could be reducing the gas flow. |
| Patient who is afebrile receiving VC ventilation with a heat moisture exchanger for the past 24 hours. There is a progressive increase in peak inspiratory pressure. Auscultation reveals scattered coarse crackles, and thick secretions are obtained during s | Change to a heated humidifier. |
| The best way to check the accuracy of a water-seal spirometer is to use: | 3-L syringe |
| A physiologic goal of CPAP in atelectasis is to increase= | functional residual capacity |
| A respiratory therapist notes an adverse change in a patient's condition during the administration of routine therapy. Which of the following should the therapist do? | Notify the nurse who is responsible for the patient. 2.Record the patient's reactions in the chart. 3. Contact the physician if a change in therapy seems warranted. |
| A patient with multiple trauma is intubated and receiving mechanical ventilation. The patient is extremely anxious, tachypneic, and complaining of severe pain. Which of the following drugs would decrease the total rate and provide pain control? | morphine sulfate |
| Which of the following should a respiratory therapist use to collect a sputum specimen for culture and sensitivity from an intubated patient? | Luken's trap |
| A patient was awakened by shortness of breath. He has fine inspiratory crackles bilaterally and a history of hypertension. Which of the following should a respiratory therapist recommend? | furosemide (Lasix) |
| Moderate amounts of thin, white sputum are obtained during the suctioning procedure. Which of the following should the respiratory therapist do with the next suction procedure? | Suction the patient without saline instillation |
| A 44-year-old patient presents to the emergency department with diabetic ketoacidosis. Which of the following respiratory patterns is most consistent with this diagnosis? | rapid, deep breathing (Kussmauls) |
| Which of the following is associated with the administration of aerosolized pentamidine isethionate (NebuPent)? | bronchospasm |
| A 28-year-old man has noticed an increase in urine output and periods of insatiable thirst. The patient's arterial blood gas results are as follows with an FiO2 of 0.21:pH 7.24, PaCO2 20 torr, PaO2 112 torr. HCO3 8. What is most likely the explanation? | diabetic ketoacidosis |
| A patient is receiving 35% oxygen through an air-entrainment mask. With an appropriate flow, the oxygen concentration measured in the mask is 42%. Which of the following should a respiratory therapist do FIRST? | Assess the patency of the air-entrainment port |
| Patient is receiving continuous mechanical ventilation.RT finds by auscultation that the patient's ET tube is in the right mainstem bronchus. After withdrawing the tube until breath sounds are equal bilaterally, the therapist should FIRST | record this action in the patient's chart. |
| An adult patient in the ICU is receiving beta-blocker medication and requires bronchod¡lator therapy. Which of the following should a respiratory therapist recommend? | ipratropium bromide (Atrovent) |
| lntracuff pressures on the tracheal wall in excess of 30 torr will cause obstruction of | capillary flow. 2. venous flow. 3. lymphatic flow |
| While manually ventilating an intubated patient during transport, a respiratory therapist observes a significant decrease in SpO.. Which of the following should the therapist do FIRST? | Verify oxygen delivery to the resuscitator |
| 21y/o male pt with a dx of status asthmaticus is intubated and has been on mechanical ventilation. There is a sudden increase in airway pressures. Pt.is hemodynamically stable and breath sounds are clear, but decreased on the rt. What should RT recommend? | Order a portable chest radiograph |
| A respiratory therapist is preparing to administer pentamidine (NebuPent) to a patient. Which of the following devices should the therapist select for this treatment? | filtered exhalation nebulizer |
| An adult patient is receiving mechanical ventilation. Which of the following should be recommended to improve oxygenation and recruit collapsed alveoli? | PEEP |
| A new blood gas analyzer is calibrated by the manufacturer at sea level. Upon receiving the new analyzer at a higher altitude, a respiratory therapist should | recalibrate the blood gas analyzer |
| While receiving an Fi0₂ of 1.0 and a tidal volume of 400 mL during VC ventilation, a 60-kg (132-lb) pt is having difficulty achieving adequate oxygenation. To improve oxygenation, a RT should manipulate ventilator settings to increase what? | mean airway pressure |
| A patient is receiving postural drainage, lung expansion therapy, and directed cough to treat obstructive atelectasis. Which of the following diagnostic procedures should be recommended to evaluate the patient's response to respiratory care? | chest radiograph |
| Which of the following would limit the usefulness of pulse oximetry? | methemoglobin 2. carboxyhemoglobin |
| A chest tube has been placed in the rt. pleural space of a pt receiving VC ventilation and there is vigorous bubbling in water seal chamber. The low exhaled volume alarm begins to sound. The exhaled tidal volume is 2/3rds of the set tidal volume.What s | Recommend a chest radiograph. |
| A RT is setting up a blender to administer 40% 0₂ in the PICU.When the oxygen hose is connected to the wall outlet, the blender alarm is activated.When the air hose is attached to the outlet, the alarm continues. What should RT do? | Remove the blender from service. |
| Which of the following should a respiratory therapist select to determine the rapid shallow breathing index? | vane respirometer |
| To assess the effectiveness of CPR, a respiratory therapist should periodically | check for carotid pulse |
| What is a major advantage of a heated wick humidifier compared with other types of humidifiers? | A relative humidity of 100% is easily produced. |
| A patient is receiving noninvasive positive pressure ventilation. Pulmonary compliance has decreased over the past 4 hours. To increase the patient's tidal volume, it would be most appropriate to | increase the IPAP |
| Which of the following indicates a physical conditioning program has been effective for a patient with COPD? | Level-walking distance has increased by 15%. |
| A pt with a 7.0 mm lD et tube has copious, thin secretions. 2 hrs later, despite unchanged physical findings, only small amounts of sputum are aspirated when the pt is suctioned with a 14 Fr catheter and a pressure of -120 mm Hg. What is the best action? | Evaluate patency of the suction system. |
| A respiratory therapist is reviewing a chest radiograph and notes the presence of a chest tube. The patient has a hemothorax. Which of the following locations is most appropriate for this chest tube to be placed. | fifth intercostal space in mid_axillary line |
| Which of the foilowing should apnea monitoring be used for an infant? | night time and naps |
| Which pharmacological agents should the respiratory therapist recommend for a patient with a temperature of 40" C (104" F)? | acetaminophen 2. ibuprofen |
| A physician orders an Fi0₂ of 0.40 for a premature infant in an open bed with a radiant warmer. Which of the following delivery devices should a respiratory therapist select? | oxygen hood |
| A patient with COPD is receiving mechanical ventilation. The patient continues to wheeze despite treatment with albuterol. Peak airway pressure is increased with no change in plateau pressure. A respiratory therapist should recommend | administering ipratropium bromide (Atrovent). |
| Prior to immersing equipment in alkaline glutaraldehyde, a respiratory therapist checks the solution with a test strip. The test strip indicates a failure when compared to the color chart on the container. The therapist should | replace the solution |
| Which of the following should be used to determine the return of a postoperative patient's ability to breathe adequately after anesthesia? | MIP |
| A respiratory therapist is asked to position a patient for orotracheal intubation. The therapist should place the patient's head | in the sniffing position. |
| A spontaneously breathing adult patient is intubated with a 6.0 mm lD endotracheal tube. Which of the following will decrease the patient's work of breathing imposed by the endotracheal tube? | pressure support |
| Which of the following agents is appropriate to recommend for use in the cleaning of home respiratory care equipment? | acetic acid |
| Pt is orally intubated with 7.0mm ID ET tube. RT uses a 14 Fr suction catheter to suction. The suction setting is -100mmHg. The RT notices thee pt's secretions are thick and sticky and will not aspirate through the suction catheter. What should be done. | Change the suction setting to -120 mm Hg. |
| A physician orders an FIO2 of 0.40 for a premature infant in an incubator. Which of the following delivery devices should the respiratory therapist select? | Oxygen hood |
| A 5 yr old,is receiving MV the following settings: Fi02 0.21, Mandatory rate 25, VT 250mL,A heat moisture exchanger is attached at the circuit Y and the peak pressure increases while the plateau presure remains stable. What should be recommended? | Change to a heated humdifier |
| While assessing a patient who is receiving oxygen at 2 L/min through a transtracheal catheter, the patient complains the supply tubing keeps popping off of the catheter. Which of the following actions should a RT take to correct this problem? | Check the catheter for obstruction |
| Digital clubbing can be most easily assessed by | inspecting the angulation of the nail bed. |
| Auscultation of the chest over a pneumothorax is most likely to reveal | Diminished breath sounds |
| adult pt. is intubated after being pulseless for several minutes. An exhaled CO2 monitor indicates 0.03% CO2 despite confirmation of tracheal placement with bilateral breath sounds and chest rise. What should RT recommend to confirm correct placement? | direct laryngoscopy |
| Which of the following activities must occur as part of tracheostomy decannulation in a 3-month-old infant? | Document airway patency during sleep and activity and verify the time of last feeding |
| A respiratory therapist is assisting with an intubation of a morbidly obese patient. Intubation is difficult and the airway is secured only after many attempts. Which of the following medications should be administered? | dexamethasone (Decadron) |
| A physician orders smoking cessation counseling for a 60-year-old male newly diagnosed with COPD. He has returned for a 1 month follow-up visit with the following ABG results: ph 7.38 paco2 45 pao2 56 hco3 26 Hb 16 O2hb 82.1 Cohb 5.5 methb 1.0 | Results Reflects smoking or environmental exposure |
| Which of the following should a respiratory therapist use to determine a neonate's gestational age? | Dubowitz |
| A 20 y/o pt with an acute asthma exacerbation is receiving 2.5 mg of albuterol by hand held nebulizer. During the tx, the pt complains of palpitations and has a heart rate of 140/min. Which of the following should the RT recommend for the next treatment? | Change to 0.63 mg of levalbuterol (Xopenex) |
| Which of the following is the most common side effect of aerosolized albuterol? | Tremor |
| While interviewing a patient prior to starting therapy, a respiratory therapist notes a patient arouses easily. This will help the therapist determine the patient's | level of consciousness |
| A pt with asthma presents in severe respiratory distress. The patient has tachypnea and demonstrates accessory muscle use. Breath sounds reveal bilateral expiratory wheezes and SpO2 is 87%. A respiratory therapist should recommend a bronchodilator by | hand held nebulizer powered by oxygen |
| Noninvasive positive pressure ventilation is most likely indicated for a patient with respiratory failure from | COPD |
| A respiratory therapist is evaluating a patient receiving pressure-controlled ventilation with a mandatory rate of 18/min. The patient's total respiratory rate is 32/min. Which of the following should slow this patient's breathing frequency? | Decreasing Expiratory pressure |
| A 32-week gestational age newborn presents to the NICU with the following findings: -Decreased breath sounds on the rt side -Hyperresonance on the rt side of the chest -Lt Mediastinal shift -Mod dyspnea and central cyanosis What tx is appropriate? | chest tube placemnt on the rt side and 100% oxygen |
| While administering an IPPB treatment at 20 cm H2O to a patient with COPD, a respiratory therapist notes the patient has suddenly become very short of breath and cyanotic. The therapist's most appropriate action is to | terminate the treatment |
| 2 hrs after extubation, a pt develops inspiratory stridor and respiratory distress. A treatment with aerosolized racemic epinephrine decreases the inspiratory stridor and relieves the patient's distress. The most likely source of the airway problem is | subglottic edema |
| While assisting a physician using a synchronous defibrillator for cardioversion, the unit does not discharge. A respiratory therapist should check the | charge level of the defibrillator, chest lead connections and contact gel on the paddles |
| A patient who had a stroke missed a bronchodilator treatment because he was in the physical therapy department. To assure that the patient receives future treatments, a respiratory therapist should | coordinate the treatment schedules. |
| A respiratory therapist auscultates a patient's chest and identifies the presence of diffuse expiratory wheezing. This indicates | bronchospasm. |
| At an FIO2 of 0.21, arterial blood gas results below are reported for a patient with COPD and dyspnea: pH 7.30, PaC02 60 torr, Pa02 48torr, HCO3 29mEq/L,BE 2mEq/L The most appropriate oxygen therapy for this patient is | 28% air-entrainment mask. |
| Which of the following devices is required for airborne precautions? | N-95 face mask |
| During IPPB therapy, a patient complains of dizziness and tingling sensations in her fingers. Which of the following should a respiratory therapist record in the patient's chart? | the patient's vital signs before and after the tx, the pts symptoms, medications administered during the tx |
| Tracheal secretions tend to dry in an intubated patient when inspired air has which of the following characteristics? | An absolute humidity of 25mg\L and a relative humidity of 100% at 22degrees (71.6F) |
| Which of the following is the maximum amount of air that can be exhaled from the maximum inspiratory level? | Vital capacity is the maximum volume exhaled after a maximum inhalation. |
| What maximum inspiratory pressure (MIP) should a patient be able to generate before attempting extubation? | -20 cm H2O |
| IPPB therapy is initiated for a pt with a fenestrated trach tube. A RT notes the IPPB machine will not cycle into the expiratory phase. Which of the following actions will most effectively correct this problem and achieve therapeutic goals for this pt? | Insert the nonfenestrated inner cannula and inflate the cuff. |
| A patient receiving mechanical ventilation who has a total rate of 20/min and an I:E of 1:1.5 will have which of the following inspiratory and expiratory times? Inspiratory Expiratory Time (sec) sec) | 1.2 ,1.8 1+1.5=2.5 divide this by TCT 60/20= 3 (3/2.5=1.2sec) subtract I time from TCT 3.0 - 1.2=1.8 secs |
| A respiratory therapist observes a patient has no chest excursion during the initial attempt to ventilate a patient while performing CPR. The therapist should FIRST | reposition the patient's head and attempt to ventilate again. |
| While analyzing an arterial blood gas sample from a patient breathing air, the measured PaO2 value is 170 torr. Which of the following should a respiratory therapist do FIRST? | Recalibrate the blood gas analyzer. |
| An increase in which of the following will decrease the work of breathing associated with spontaneous breathing through a ventilator circuit? | pressure support |
| Waht is consistent with adequate respiratory muscle strength for weaning from ventilatory support? | maximum inspiratory pressure (MIP) of -48 cm H2O |
| An adult pt is receiving volume-controlled ventilation and has a tidal volume of 700 mL. The pt's pH is 7.38. The pt is switched to pressure-controlled ventilation. Exhaled tidal volume is now approximately 850 mL. A RT should recommend | decreasing the pressure setting. |
| A pt with a laryngeal tumor is presently receiving 80%/20% helium-oxygen by a nonrebreathing mask at 5 L/min. The pt is alert, but appears agitated. Vital signs indicate a HR of 130/min, RR at 30/min, and a BP of 140/90 mm Hg. Appropriate action to take? | Increase the gas flow to the mask. |
| When coordinating the sequence of the following therapies in bronchopulmonary clearance, which of the following should a respiratory therapist administer concurrently with high-frequency chest wall oscillation? | bronchodilator aerosol therapy |
| A comatose pt is found in a car with the engine running in an enclosed garage. Upon arrival in the ER the pt has a RR of 36/min, HR of 147/min, and an SpO2 of 100% with 02 at 15 L/min by nonrebreathing mask. Which of the following should the RT do? | arterial blood gas analysis and hemoximetry |
| A respiratory therapist examines a patient and notes coarse crackles. Which of the following does this most likely indicate? | secretions |
| The primary purpose of cleaning and sterilizing nondisposable respiratory care equipment after each use is to | prevent crossinfection and reinfection of patients. |
| The repeated administration of beclomethasone (Vanceril) by inhalation is associated with which of the following adverse effects? | oral candidiasis |
| While reviewing a chest radiograph, proper positioning of a flow-directed balloon-tipped catheter to obtain a mixed venous sample is confirmed when the tip is located in the | pulmonary artery. |
| Administration of racemic epinephrine after extubation is used to | stimulate alpha-receptors. |
| A nurse contacts a respiratory therapist to initiate chest physiotherapy for a newly admitted patient. Which of the following should the therapist do FIRST? | Confirm the order in the patient's chart |
| #106 |
Created by:
ldrozd