random
What does AHI mean? (polysomnography)
A. Acute hip injury
B. Airway height index
C. Apnea hypopnea index
D. Apnea hypopnea index
bonus: an AHI greater than ___ indicates sleep apnea
10, 20, 30 or 40?
Thirty
Which of the following devices is most helpful in performing a safe and proper nasal intubation?
A. Magill forceps
B. Tube exchanger
C. Stylet
D. ETT
A. Magill forceps
An adult male is being suctioned through an 8.0-mm ET tube with a 12 French suction catheter at a pressure of 90mmHg. Secretion removal has been ineffective. Which of the following modifications should be recommended?
A. Sizing up
B. Sizing down
C. Increasing the pressure to 110 mmHg
D. Replace the catheter
C. Increase the pressure to 110 mmHg
Which of the following can be instructed to a COPD patient to help reduce FRC?
A. Not smoking
B. Pursed-lip breathing
C. Incentive spirometry
D. Frequent PFT
B. Pursed lip breathing.
since COPDers air trap often, the goal with them is to coach them to breathe in a way that can reduce FRC.
IS will increase it.
A 7 year old patient is receiving PEP therapy by mouthpiece. In spite of repeated coaching, the child doesn’t keep the mouthpiece in her mouth. The therapist should respond by doing which?
A. Stop therapy
B. Tell the nurse
C. Tell the parent to make them do it correctly
D. Add a mask to the device.
D. Add a mask to the device
The results of a V/Q scan shows poor perfusion with adequate ventilation. The CXR shows a wedge-shape infiltrate over the R lung field. The patient most likely has
A. Pleural effusion
B. PE
C. Atelectasis
D. Emphysema
B. Pulmonary Embolism (PE)
A patient in the ER expectorates thick, yellow sputum. A CBC shows the following:
RBC: 6.0 mill/cu mm
WBC: 22,000 cu mm
Hb:17 g/dL
Hct: 64%
The patient would benefit most from which of the following?
A. sputum culture and sensitivity
B. Antibiotics
C. PFT
D. Oxygen
A. Sputum culture and sensitivity
A COPD pt. That requires intubation and VC SIMV ventilation has a mallampati classification of 1. Which of the following methods or equipment should be used for oral intubation?
A. Glidescope
B. It is too difficult to intubate
C. Direct laryngoscopy
D. Tube exchanger
C. Direct laryngoscopy.
The score is a 1 and is considered to be non complex so normal direct laryngoscopy may be used.
A patient is receiving VCV following bark attic surgery for obesity. Which of the following medications should the respiratory therapist recommend to ensure the patient’s comfort and assist in ventilator management?
A. Ativan
B. Fentanyl
C. Morphine
D. Acetaminophen
C. Morphine.
One of the best medications to administer to help the patient rest pain free and to generally sedate and relax the pt.
The respiratory therapist is asked to estimate the alveolar minute ventilation on a spontaneously breathing 91kg (200lb) male who is receiving oxygen therapy by air-entrainment mask at FIO2 0.50. The following data is available.
exhaled VT: 500 mL
SPO2: 92%PetCO2: 30 torr
PaO2: 70 torr
VE: 10L/min
The therapist should report an alveolar VE of:
A: 12L/min
B. 8.2
C. 6.0
D. 4.0
C. 6.0
(VT-dead space) x RR = alveolar VE
Divide VE by VTe to get RR
Which of the following is the correct postural position for drainage of the anterior upper segment of lungs?
A. Trendelenburg
B. Supine
C. Upright leaning slightly forward
D. Semi Fowler’s
D. Semi Fowler’s
A patient complains of dyspnea only upon exertion. There is no significant smoking history or family history of lung disease. What should the respiratory therapist recommend?
A. CXR
B. Albuterol via SVN
C. Cardiopulmonary stress test
D. EKG
C. Cardiopulmonary stress testing
The patient may have a cardiac issue.
Which of the following must be done to transition a patient with a fenestrated tracheostomy tube who is receiving PPV to a speaking configuration?
A. Inflate the cuff
B. Deflate the cuff
C. Put on the cap
D. Change inner cannula
1. b & c
2. B only
3. B and D
4. D only
1. B and C
The purpose of fenestrated tracheostomy tube is to provide PPV and to allow the patient to speak when off ventilator support. the holes on outer cannula allow air to flow through tube and pass over vocal folds, allowing phonation.
What data would provide the most information about arterial oxygenation relative to administered supplemental O2?
A: f/Vt ratio
B. P/F ratio
C. Fev1/fvc ratio
B. P/F ratio.
It helps determine relationship between PaO2 and FiO2. It provides information related to the effectiveness of o2 administrations. If below 200, ARDS is likely
Which of the following is a significant indicator of negative effects from PPV?
A. Increased alveolar distention
B. Decrease urine output
C. Increase in physiological deadspace
D. Drying of pulmonary secretions
B. Decrease urine output.
Excessive pressures will cause decreased venous return. And the second most significant is decreased urine output
The following ABG result is observed on a pt. Who is admitted to the trauma unit after being involved in a Motor vehicle accident:
Hb: 8 gm/dL
Hct: 25%
PH 7.35/44/110/22/-1 on 50% FiO2
Based on this data the patient is:
A. Oxygenating appropriately
B. Hypoxic
C. Experiencing a significant VQ mismatch
B: hypoxic
Even though PaO2 is acceptable, the patient has a low hb ( could be from external or internal bleeding )
A patient is receiving volume controlled ventilation and has a balloon tipped pulmonary catheter in place. The following clinical data is available:
10 am and 2 pm
CVP: 4 5
PCWP: 12 28
C(a-v)O2: vol% 5 10
The patient is likely having an issue with the:
A. Lungs
B. Right heart
C. Chest wall
D. Left heart
D. Left heart.
PCWP had a drastic increase and cardiac output had a drastic decrease. ( increase in C(a-v)O2 is a direct indication of a decrease in CO) indicating a left heart issue
A RT is called STAT to the general floor where a patient with a tracheal button in place is unable to breathe. The RRT should:
A. Remove button and put a tracheostomy tube in through the stoma
B. Remove the inner cannula and deflate the cuff
C. Remove the cap and insert the cannula
D. Attempt to manually ventilate
D. Attempt to manually ventilate
A button shouldn’t be confused with a cap which would be normally used with a fenestrated tracheostomy tube. A button is inserted into the stoma as a placeholder so the patient should be treated as any other patient who can’t breathe by attempting to manually ventilate after opening the airway.
A trauma patient in the ED is experiencing a moderate level of ventilatory distress. A physical examination reveals paradoxical chest movement to the right and a tracheal shift to the left. Which of the following is an appropriate next step?
A. Ordering a CXRand preparing for chest tube inseetion
B. Implementing NIV 15/5
C. Begin hyperinflation therapy to resolve atelectasis
D. Applying oxygen by face mask at FiO2 .50
A. Ordering CXR and preparing for chest tube insertion.
The paradoxical chest movement with tracheal displacement and ventilatory distress is evidence of a pneumothorax.
Condensation has developed on the fuel cell of a galvanic oxygenation analyzer. Which of the following is true?
A. the fuel cell should be replaced.
B. the analyzer will still function properly
C. the gold grid in the analyzer should be replaced.
D. the reading will be erroneous
D. the reading will be erroneous
Condensation on the fuel cell of a galvanic-type oxygen analyzer may result in an erroneous reading of oxygen percentage
Following a series of lung recruitment maneuvers on a patient who is receiving VC A/C ventilation, the RT observed a pressure-volume waveform that shows a less pronounced “beak” after the maneuvers. The therapist should conclude:
A. Recruitment maneuvers have been successful
B. The patient is at higher risk for development of autoPEEP
C. Attempts to recruit alveoli have been unsuccessful
D. SIMV ventilation is more appropriate
A. Recruitment maneuvers have been successful
Increase in lung space or decrease in VT is what would cause a less pronounced beak on the graphic . Patient seemed to respond to lung recruitment maneuvers
The patient is undergoing a transport of 100 miles in a non-pressurized helicopter. The patient is breathing spontaneously and is recovering oxygen by a NRM. As the helicopter ascends above 5,000 feet, the patient begins to exhibit cyanosis and SOB. The most likely reason for this is:
A: decreased PAO2
B: decreased pH
C: decreased pao2
D: need more information
A: decreased PAO2
When a patient is in an aircraft that doesn’t maintain cabin pressure, any changes in arterial oxygenation result primarily from a chain from in alveolar oxygen tension. Barometric pressure can drastically change is altitude increases (if cabin isn’t pressurized).
A patient is receiving VC A/C ventilation at a rate of 18, VT 600, FiO2 0.6 PEEP 5 cm H2O, I:E of 1:1.8. A flow time ventilator graphic shows the exhalation phase fails to return to baseline prior to the initiation of the inspiratory phase, possibly promoting air-trapping. What additional data would be helpful in further assessing this problem?
A. P/F ratio
B. mPAP and CO comparison
C. OI oxygen index
D. Auto peep determination
D. autoPEEP determination
When air trapping is suspected, autoPEEP may develop. It is helpful to determine.
Which of the following represents the most appropriate interpretation of the spirometry results?
Predicted and Observed ( in Liters)TLC: 4.50 3.10
FRC: 2.45 1.70
SVC: 3.20 2.00
FEV1: 2.15 1.98
FEF50: 4.00 3.85
B. COPD - emphysema
C. Asthma
D. COPD- Chronic Bronchitis
A. Sarcoidosis
Reduced volumes (SVC) <80% predicted
Flows are nearly normal (FEV1) which means no obstructions
That’s associated with restrictive defect
a sputum gram stain report indicates the presence of a gram-positive organism (diplococcus) in the sputum. The following data is available:
WBC 28,000 cu mm
Hb 14.5 g/dL
RBC 4.6 g/dL
HCT 42%
Which of the following medication would be most appropriate?
A. Vancomycin
B. aspirin
c. any antibiotic
d. amoxicillin
d. amoxicillin
Gram positive organisms like diplococcus, staphylococcus, etc are treated using penicillin class antimicrobials. These include penicillin, amoxicillin, and others