C&S TMC EXAM ONE REVIEW QUESTIONS WITH REVISED AND UPDATED ANSWERS
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C&S TMC
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C&S TMC
C&S TMC EXAM ONE REVIEW QUESTIONS WITH REVISED AND UPDATED ANSWERS
When the ventilator rate of a mechanically ventilated patient is decreased from 8/min to 6/min, the patient becomes agitated and the etCO2 increases from 44 mm Hg to 51 mm Hg. Based on this change, the RT should conclude that: - A...
C&S TMC EXAM ONE REVIEW
QUESTIONS WITH REVISED AND
UPDATED ANSWERS
When the ventilator rate of a mechanically ventilated patient is decreased from 8/min to
6/min, the patient becomes agitated and the etCO2 increases from 44 mm Hg to 51 mm
Hg. Based on this change, the RT should conclude that: - Answer-- alveolar ventilation
has decreased
The high respiratory rate and I:E ratio ventilator alarms have activated on a
mechanically ventilated adult patient who has a long history of chronic CO2 retention.
Which of the following is most likely to occur as a result of this situation? - Answer--
increased hyperinflation and air trapping
Which of the following will occur when the high pressure limit is reached on a volume
ventilator? - Answer-- 3: no/yes/no
.While performing a ventilator check on a sedated and paralyzed patient, the RT notes
that the mechanical rate is set at 12/min, but the total rate reads 16/min. The RT should
- Answer-- adjust the sensitivity settings
To increase the VT of a patient receiving noninvasive positive pressure ventilation
(NPPV), the RT should - Answer-- increases the gradient between the EPAP and IPAP
levels
. During a routine ventilator check on a 75 kg adult male patient, the RT records the
following data: On the basis of these data, the RT should - Answer-- increase the flow
rate setting
. During the mechanical ventilation via a volume ventilator, the inspiratory threshold can
be adjusted by which of the following? - Answer-- the sensitivity settings
A RT has been assigned to monitor an intubated adult patient who is receiving an FIO2
of 0.70 via T- adapter. Current ABG values are as follows: ph: 7.28 PaO2: 54 PaCO2:
59 HCO3: 26. On the basis of this information, which of the following actions would be
most appropriate? - Answer--initiate mechanical ventilation with PEEP.
The ABG results for a patient receiving oxygen via nonrebreathing mask are as follows
ph: 7.35 paco2:45 pao2: 49 hco3: 24. Which of the following therapeutic interventions
would be most appropriate for this patient? - Answer-high-flow mask CPAP
,Supportive therapy to improve arterial oxygenation include all of the following EXCEPT:
- Answer-performing serial SaO2 measurements
An adulted intubated patient is receiving 35% oxygen via T-Piece adapter. After adding
a 6 inch flex tube between the endotracheal tube and T-piece adapter, the RT should
expect which of the following to occur? - Answer-- an increase in the PaCO2
A 30 yr patient with pneumonia is receiving oxygen via 40% air entrainment mask. Over
the 24 hrs, the patients secretions have become vicious and cannot be easily coughed
out. Which of the following should be the RT first recommendation? - Answer-40%
oxygen via aerosol mask
. Incentive spirometry q2h while awake has been ordered for a postoperative thoracic
surgery patient. After the RT explains the therapy to the patient, he firmly refuses the
procedure. Which of the following actions should the therapist take at this time? -
Answer-- ask the patient to explain the reason for refusal.
After initiation of PEP therapy, the RT observes that the patients I:E ratio is being
maintained at 1:2. The therapist should do which of the following? - Answer-- increase
the resistance to expiratory flow.
A RT is asked to assess a COPD patient who is in a pulmonary rehabilitation program.
During the interview, the patient tells the therapist that he has just started working with a
resistive training device, but he has only been able to use the device for 5 minutes per
session before tiring. What should the therapist do? - Answer-- instruct to patient to
continue present therapy.
While suctioning a patient, the RT notes the onset of sinus tachycardia with occasional
PVCs on the cardiac monitor. The therapist should do which of the following? - Answer--
stop suctioning and administer oxygen.
A RT has received orders to initiate postural drainage on a patient who underwent
surgery 16 hrs previously for a head injury accident. On reviewing the patients most
recent CXR, the therapist notes the presence of infiltrates in the left basal lung fields.
What should the RT do? - Answer-- inform the physician of possible hazards and ask for
further instructions
A spontaneously breathing semiconscious patient has just been admitted to the ED.
There are no evident signs of respiratory disease. To maintain airway patency, insertion
of which of the following would be preferred? - Answer-- nasopharyngeal airway
While manually ventilating an intubated neonate with a self- inflating resuscitator bag,
the RT notices that the neonates chest has suddenly stopped rising during bag
compression. The therapist also notes that resistance to bag compressions has
increased and that excess gas is leaving the bag through the pressure pop-off
, valve.Which of the following could the RT do that might correct the problem? - Answer-
ensure that the endotracheal tube has not become kinked or occluded.
A patient with a severe right lung contusion has been intubated with a double-lumen
endotracheal. The right lung is to receive continuous mechanical ventilation whereas
the left lung is to receive humidified air via T-adapter. When the patient is connected to
the ventilator via the right-lumen connection, the low inspiratory pressure alarm
activates. Which of the following is most likely the reason for this problem? - Answer-the
double-lumen endotracheal tube has not been inserted deep enough.
While attempting to suction a patient who has a tracheostomy tube, the RT experiences
difficulty in passing the catheter through the tracheostomy tube. The therapist should do
which of the following? - Answer-remove and inspect the inner cannula of the
Tracheostomy tube
A comatose patient has an oropharyngeal airway in place due to upper airway
obstruction from the hypopharynx. Over the last 2 hrs, the patient has become semi-
alert and is experiencing intermittent gagging episodes. Which of the following is the
most appropriate action at this time? - Answer-replace the oropharyngeal airway with a
nasopharyngeal airway.
Which of the following may result if a patient with a tracheostomy tube receives
inadequate humidification? - Answer-- tracheitis.
Which of the following best explains : the use of heat and moisture exchangers ( except
where contraindicated), rather than heated humidifiers, in reducing the incidence of
ventilator associated pneumonia (VAP) - Answer-. -They generate less condensate.
Upon entering the room of a spontaneously breathing intubated patient, the RT
observes that the endotracheal tube is 4 cm displaced from its correct placement and
that the patient is able to verbally communicate. The RT should do which of the
following? - Answer-- remove the endotracheal tube and manually ventilate,as needed.
A 45 yr old male has been admitted to the ED following a bee stinging to the back of the
throat. The patient is intensely cyanotic with severe suprasternal retractions. Attempts at
oral intubation have been unsuccessful. Which of the following would be appropriate for
this situation? - Answer-- cricothyroidotomy with placement of an endotracheal tube in
the opening.
Where cervical spine injury is not a concern, which of the following head positions is
considered optimal for direct laryngoscopy? - Answer-- neck flexed and head extended.
Calibrating an electronic spirometer is best performed by calibrating the primary signal:
flow. The procedure, however, is complex and not easily performed. Which of the
following is a satisfactory alternative? - Answer-- volume calibration
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