A 43-year-old female patient in the emergency department was just orally
intubated with an endotracheal tube. Which of the following would you
INITIALLY recommend in order to confirm that the tube is in the proper
position?
A. Auscultate the patient's chest and abdomen
B. Perform a STAT chest x-ray
C. Use capnography to verify exhaled CO2
D. Observe chest wall movement - ANS ✓A. Auscultate the patient's chest and
abdomen
While assisting with the delivery of a newborn infant, the physician asks for
you to obtain an Apgar score on the patient. Which of the following ranges
is considered to be a normal score?
A. 1-4
B. 4-7
C. 7-10
D. 10-13 - ANS ✓C. 7-10
After orally intubating an adult patient in the ICU, you are asked to confirm
that the tube is in the correct place. Upon auscultation, you note that the
breath sounds are absent on the patient's left side. Which of the following is
the most appropriate action to take at this time?
TMC EXAM
, 2
TMC
A. Obtain a stat chest radiograph
B. Withdraw the endotracheal tube by 1-2 cm
C. Reintubate the patient
D. Insert a large bore needle in the left upper chest - ANS ✓B. Withdraw the
endotracheal tube by 1-2 cm
A 58-year-old female patient has arrived in the emergency department
with an extremely deep and fast breathing rate. Which of the following best
classifies this type of breathing?
A. Apneustic breathing
B. Kussmaul breathing
C. Biot's breathing
D. Cheyne-Stokes breathing - ANS ✓B. Kussmaul breathing
A 71-year-old male patient is receiving ventilatory support and it was noted
that his secretions are yellow and have gotten thicker over the past 24
hours. The patient has a white blood cell count of 17,000/mm3 and a
temperature of 102 °F. Which of the following would you suggest?
A. Decrease the humidifier temperature
B. Administer an aerosolized bronchodilator
C. Schedule suctioning twice per hour
D. Obtain a sputum sample for culture and sensitivity - ANS ✓D. Obtain a
sputum sample for culture and sensitivity
While reviewing the medical record of a 55-year-old female patient, you
note that her FEV1/FVC ratio was reported as being severely decreased.
Which of the following conditions would you expect to be present with this
finding?
TMC EXAM
, 3
TMC
A. Pulmonary hypertension
B. Morbid obesity
C. Chronic asthma
D. Pneumonia - ANS ✓C. Chronic asthma
A 60-year-old female patient who is orally intubated is going through a
spontaneous breathing trial. Which of the following would indicate the
need to stop the trial and return the patient back to full ventilatory
support?
A. An increase in heart rate from 96 to 114/min
B. An increase in respiratory rate from 17 to 27/min
C. An increase in arterial PCO2 from 44 to 52 torr
D. A decrease in SpO2 from 92% to 83% - ANS ✓D. A decrease in SpO2 from
92% to 83%
The physician has requested the dynamic compliance measurement for an
adult patient who is receiving mechanical ventilation. This value can be
obtained by dividing the patient's tidal volume by which of the following:
A. (Pplat - PEEP)
B. (PIP - PEEP)
C. (PIP - Paw)
D. (Paw - Pplat) - ANS ✓B. (PIP - PEEP)
A 63-year-old male patient was admitted to the ICU. Upon auscultation, you
note that bronchial breath sounds are present over the right lower lobe.
This finding indicates which of the following?
A. The patient has normal lungs
B. A pneumothorax is present in the right lung
TMC EXAM
, 4
TMC
C. A pleural effusion is present in the right lower lobe
D. Consolidation is present in the right lower lobe - ANS ✓D. Consolidation is
present in the right lower lobe
An alert 59-year-old male patient is orally intubated with an endotracheal
tube. During a weaning trial, the patient was switched to CPAP mode with
an FiO2 of 40%. Within the first 5 minutes, the patient's respiratory rate
has increased from 22 to 31 breaths/min with increased usage of accessory
muscles while breathing. Which of the following would you recommend?
A. Return the patient to full ventilatory support
B. Increase the FiO2 to 50%
C. Apply 5-10 cm H2O of pressure support
D. Extubate the patient and reassess - ANS ✓C. Apply 5-10 cm H2O of pressure
support
After the administration of aerosolized albuterol to a 38-year-old female
patient, which of the following side effects would you expect?
A. Hypotension
B. Bradycardia
C. Bronchospasm
D. Shaking and tremors - ANS ✓D. Shaking and tremors
A 23-year-old male patient with a severe head cold is receiving oxygen via
nasal cannula at 4 L/min. The pulse oximeter reveals an SpO2 of 85%.
Which of the following would you recommend?
A. Increase the oxygen flow until the SpO2 equals or exceeds 90%
B. Decrease the oxygen flow until the patient is more comfortable
C. Switch to a simple mask
TMC EXAM
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