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Air Methods Critical Care Final Exam 2023 – Questions With Detailed Solutions
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Air Methods Critical Care Final Exam 2023 –Questions With Detailed Solutions
Before PFT's how long should a patient refrain from smoking? Using an
inhaler? Correct Ans - smoking: 6-8 h
inhaler: 4-6 h
What test must you do before performing an arterial puncture? Correct
Ans - Allen's test; patency of the ulnar artery- if blood returns to hand in
15s, then the radial artery can be used for the puncture
How long should one apply pressure after an arterial puncture? Correct
Ans - 5 minutes (20 min if the patient is on anticoagulant therapy)
What are the normal ranges for ABG's?
(pH, PAO2, PACO2, HCO3, and SAO2) Correct Ans - pH: 7.35-7.45
PAO2: 80-100 mm Hg
PACO2: 35-45 mm Hg
HCO3: 21-28 mEq/L
SAO2: 95-100%
In what position should you place a patient if air embolism is expected?
Correct Ans - left side in trendelenburg
How long must a patient be NPO before a bronchoscopy? Correct Ans -
4-8 hr
What types of medications might one administer prior to a bronchoscopy?
Correct Ans - anxiolytics
atropine (to treat bradycardia)
viscous lidocaine
local anesthetic throat spray
What should you be monitoring a patient for after a bronchoscopy?
Correct Ans - significant fever (mild is ok up to 24 hrs after the procedure),
productive cough, significant blood in sputum (small amounts are to be
expected), hypoxemia, laryngspasm
,Prior to a thoracentesis what diagnostic procedure must be done? Correct
Ans - CXR
What position should the patient be in for a thoracentesis? Correct Ans -
sitting up over the bedside table
What are possible complications of a thoracentesis? How do we tell patients to
identify pneumothorax? Correct Ans - mediastinal shifts
pneumothorax (deviated trachea, pain at the end of inhalation or exhalation,
affected side not moving with breath, increased HR, shallow respirations,
nagging cough, air hunger)
In what chest tube chamber (ONLY) should you see bubbling? Correct Ans
- suction
What is excessive drainage from a chest tube? Correct Ans - more than
70 ml/hr
How should the nurse document for care following a chest tube? How often?
Correct Ans - color and amount of drainage qh for 24h after insertion, then
q8h
mark date, hour, and drainage level on the container at the end of each shift
What supplies should be kept at the side of a bed for a patient with a chest
tube? Correct Ans - 2 enclosed hemostats, sterile water, occlusive
dressing
What should the nurse instruct the patient to do during chest tube removal?
Correct Ans - valsalva maneuver
What should the nurse do in the case that a chest tube is disconnected?
Correct Ans - 1. have the client exhale as much as they can to remove air
from the pleural space
2. immerse the end of the chest tube in sterile water to restore the water seal
3. apply dry sterile gauze
What is the FiO2 and the flow rate for a nasal cannula? at what rate do we
need to administer humidification? Correct Ans - 24-44%
1-6 L/min
,humidification at 4 L/min
What is the FiO2 and the flow rate for a simple face mask? Correct Ans -
40-60%
5-8 L/min (less than this causes the patient to rebreathe CO2)
What is the FiO2 and the flow rate for a partial rebreather mask? Correct
Ans - 40-75%
6-11 L/min
What is the FiO2 and the flow rate for a non-rebreather? Correct Ans -
80-95%
10-15 L/min
What is the FiO2 and the flow rate for a venturi mask? Correct Ans -
24-50%
4-10 L/min
What is the FiO2 and the flow rate for a aerosol face mask, face tent, t-piece,
and trach collar? Correct Ans - 24-100%
10 L/min at least
*** Humidification requires frequent monitoring
What does hypercarbia look like? Correct Ans - restlessness,
hypertension, HA
What does oxygen toxicity look like? Correct Ans - non-productive
cough, substernal pain, nasal stuffiness, n/v, fatigue, HA, sore throat,
hypoventillation
How does assist control (AC) work related to respiratory support? Correct
Ans - overtakes breathing for an intubated client
How does synchronized intermittent mandatory ventilation (SIMV) work
related to respiratory support? Correct Ans - used in weaning;
increases the work of breathing
ventilator and patient work together
, How does assist inverse ratio ventillation (IVR) work related to respiratory
support? Correct Ans - prolongs the inspiration phase to maximize
oxygenation
HIGH RISK FOR VOLUTRAUMA
How does airway pressure release ventilation (APRV) work related to
respiratory support? Correct Ans - patient and ventilator work
together
breath expelled by the lung's own natural recoil
How does independent lung ventilation work related to respiratory support?
Correct Ans - lungs are ventilated separately
need: 2 ventilators, sedation, neuromuscular blocking agents
How does PEEP work related to respiratory support? Correct Ans -
preset pressure on expiration
added to treat persistent hypoxemia
How does pressure support ventilation (PSV) work r/t respiratory support?
Correct Ans - greater oxygenation, makes the work of breathing easier,
prevents alveolar collapse
How do you document the placement of a tube for mechanical ventilation?
Correct Ans - in cm at the client's teeth or lips
What do the three ventilator alarms indicate? (volume, pressure, and apnea
alarms) Correct Ans - volume (low pressure): low exhaled volume due
to a disconnection, cuff leak, or tube displacement
pressure (high pressure): excess secretions, client biting the tube, kinks in the
tubing, coughing, pulmonary edema, bronchospasm, and pneumothorax
apnea: ventilator does not detect spontaneous respiration in a set time period
For an ET tube what should the cuff be set at? how often should you adjust the
cuff pressure? Correct Ans - 20 mm Hg
q8h
How long should you recommend that clients take decongestants? Correct
Ans - no longer than 3-4d (rebound decongestion)
ex: phenylephrine
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