RT Board Review Questions and Answers graded A+

RT Board Review Questions and Answers graded A+ ABG and alveolar oxygen tension A respiratory therapist is considering a patient's readiness to wean from mechanical ventilation. To determine the A-aDO2, the therapist will need which of the following? Examine the ventilator circuit for proper connections During a pre-operational test of the ventilator with a test lung, the respiratory therapist notes a return tidal volume of 600 cc. Ventilator settings are: Mode Assist/control FIO2 0.50 Mandatory rate 10 VT 750 mL What action should the therapist take? disconnected thermistor line (If you have a low pressure or low exhaled volume ventilator alarm, you must look for the problem that could cause that specific type of alarm. For this question this was the most appropriate answer.) While monitoring a patient receiving mechanical ventilation, the respiratory therapist notices the low-pressure and low exhaled volume alarms are sounding. What could be the cause? a kink in the endotracheal tube, a herniated endotracheal tube cuff, Excess water in the limbs of the circuit, would cause what type of alarm to sound would cause a high-pressure alarm a fracture in the plastic wye, a leak or a disconnection or by the patient if he or she is inhaling at a higher inspiratory demand than that being delivered by the ventilator A patient receiving positive pressure ventilation has a low-pressure alarm sounding. what would be the cause? provide manual ventilation (The NBRC knows that in real life, when you hear a ventilator alarm, you're tempted to cancel the alarm or attempt to immediately solve the problem. Our first action should be to stabilize the ventilatory status of the patient, and then troubleshoot the problem.) The high pressure alarm is sounding on a patient receiving volume controlled ventilation. The respiratory therapist should FIRST Anectine (succinylcholine chloride) Which of the following medications is shown to have sufficient affect when facial muscle twitching is observed? 25/8 mmHg Which of the following pressures is most consistent with a normal pulmonary artery pressure (PAP)? A. 25/8 mmHg B. 120/80 mmHg C. 12/8 mmHg D. 25/4 mmHg change to an 80%20% heliox mixture (This patient is receiving 30% oxygen though a Heliox mixture. One look at the blood gas shows a PaO2 of 110 mmHg. This over oxygenation state indicates a need to lower supplemental oxygen. Changing to an 80-20% Heliox mixture is most appropriate.) A patient receiving heliox therapy at 70%/30% mixture by non-rebreathing mask has the following arterial blood gas results: pH 7.35 PaCO2 45 mmHg PaO2 110 mmHg HCO3- 24 mEq/L BE 0 mEq/L Which of the following actions is appropriate? Place patient on non-rebreathing mask (This patient has profound hypoxemia even with supplemental oxygen. It is evident that a small increase in oxygen will not be sufficient. 100% oxygen by a non-rebreather mask is the most appropriate option.) A patient in the emergency room is receiving oxygen by nasal cannula at 3 L/min. Blood gases reveal the following: pH 7.53 PaCO2 30 mmHg PaO2 51 torr HCO3- 23 mEq/L BE -1 mEq/L The respiratory therapist should immediately epinephrine (The installation of epinephrine down the bronchoscope to an actively bleeding site will help to immediately stop the bleeding. This should be the first step in treating a bleed in the bronchial tree. The next step should be to compress the site with the bronchoscope followed by the insertion of the Fogarty catheter to tamponade the bleeding site.) While assisting a physician during a bronchoscopy procedure, the therapist notices bright red blood in the specimen tube. The therapist should prepare which of the following NEXT? cancerous mass in the lung For which of the following is the respiratory therapist observing if obtaining a series of oblique chest radiographs? A. pleural effusion B. pneumonia C. cancerous mass in the lung D. pneumothorax radiologist reports the ET tube is 1 inch above the carina Which of the follow data, if observed, would indicate proper positioning of an oral endotracheal tube? A. end of ET tube 2 cm below the aortic knob B. radiologist reports the ET tube is 1 inch above the carina C. poor left chest symmetry D. end of ET tube is 6 cm above the carina combined metabolic and respiratory acidosis Arterial blood gases on a patient in the cardiac intensive care unit are as follows: pH 7.10 PaCO2 52 mmHg PaO2 65 mmHg HCO3- 15 mEq/L BE -9 mEq/L Which of the following represents an accurate interpretation of these results? A. metabolic compensated respiratory acidosis B. metabolic acidosis C. combined metabolic and respiratory acidosis D. respiratory acidosis report the problem to the supervisor a respiratory therapist is unable to obtain successful quality control values on a blood gas analyzer. The therapist should administer 2 units of blood Four hours after a quadruple coronary artery bypass graft, a patient's blood pressure is 90/50 mmHg and the patient is ashen in color. The following data is also available: PAP 10 mmHg PCWP 5 mmHg CVP 1 mmHg The patient could benefit most from which of the following? decrease EPAP only A patient is receiving non-invasive positive pressure ventilation by mask with an IPAP of 16 cmH2O and an EPAP of 8 cmH2O. Corresponding blood gas data is as follows: pH 7.29 PaCO2 51 mmHg PaO2 108 mmHg HCO3- 24 mEq/L BE -0 mEq/L Which adjustment is most appropriate? A. increase IPAP only B. decrease EPAP and IPAP C. decrease EPAP only Pressure Controlled ventilations ARDS patients benefit from which type of ventilation? Pulmonary Hypertension A patient in the cardiac intensive care unit has a Swan-Ganz pulmonary artery catheter in place. The following data is available: CVP 6 torr mPAP 18 torr PCWP 8 torr C.I. 2.0 L/min/m2 Which of the following most likely represents the patient's condition? A. pulmonary hypertension B. left heart failure C. dehydration D. cor pulmonale cardiac output and wedge pressure Left heart failure would be manifested in which of the following values? BP and FIO2 Which of the following is needed to calculate alveolar oxygen tension? To increase expiratory time what must be decreased inspiratory time increased CVP, decreased PAP Which of the following is most indicative of right heart failure? confirm asystole in a second lead A patient in the emergency department (ED) becomes unconscious and has a cardiac rhythm consistent with asystole. The respiratory therapist should IMMEDIATELY TLC - FRC calculations will determine inspiratory capacity (IC)? C(a-v)O2 What would be most helpful at identifying optimal PEEP? increasing pressure support Low tidal volume can be adjusted by... the cardiac stress and prevent PVCs during the suctioning procedure. Decreasing the suction duration is an appropriate method to reduce... "flipped" T waves and elevation of S-T segments myocardial ischemia and infarction in mixed venous oxygen saturation A left-to-right cardiac shunt, due to a leak in the septum wall of the heart, would be best indicated by an increase perforation in the lung tissue Excessive bubbling in the water seal compartment, in addition to low return volume during mechanical ventilation indicates... distal end of the pulmonary artery catheter A respiratory therapist is preparing to obtain a mixed venous sample for the purpose of PvO2 measurement. From which of the following locations should the sample be taken? Decreasing pulmonary compliance 6 am 9 am Ppeak(cm H2O) 20 32 Pplat (cm H2O) 13 25 Set VT (L) 0.6 0.6 PEEP (cm H2O) 5 5 Which of the following is most consistent with these data? poor patient effort The following pulmonary function data is obtained from a 32-year-old male with a history of pulmonary fibrosis: Percent (%) of Predicted SVC 62 FVC 69 FEV1.0 80 FEF25-75 79 FEF DLCO 91 The respiratory therapist should interpret this data as... epinephrine While performing a biopsy of a tissue extracted from a patient's right mainstem bronchus with a bronchoscope, the physician reports sudden bleeding from the site. Which of the following should the respiratory therapist have ready to instill? decrease rate and/or increase flow A physician is concerned about autoPEEP developing in a patient receiving volume-controlled ventilation on the following settings: Mode Assist/control VT 600 mL Rate 16 FIO2 1.0 PEEP 10 cm H2O Insp flow 50 L/min I:E 1:2 Which of the following adjustments will reduce autoPEEP? emphysema: (This is associated with patients who have obstructive lung defect and is commonly seen in patients with COPD. To find the correct answer, one must pick the disease that is obstructive. In this question in, emphysema is the only obstructive disease offered.) The flow volume loop is short and fat indicating diminished flows but normal volumes. decreased PAO2 A mountain hiker is air-lifted off a mountain from an altitude of 19,000 ft. The patient was found complaining of shortness of breath. The patient is anxious, cyanotic, and is exhibiting signs of pulmonary edema. The most likely explanation for these signs and symptoms is Altitude causes hypoxemia because of the decreased barometric pressure, which results primarily in decreased alveolar oxygen tension or PAO2 Magnetic resonance imaging (MRI) diagnostic procedures should RT recommend to more clearly identify what looks like a mass in the upper right lung field? Ballard Which of the following should be used to determine the gestational age of a neonate? proximal to the tip The balloon on a balloon-tipped, flow-directed pulmonary artery catheter may be found mixed venous-arterial blood A patient has a balloon-tipped, flow-directed catheter in place in the pulmonary artery. Which of the following will be obtained when extracting blood from the distal lumen of the pulmonary artery catheter? normal A patient in a body box performs a maneuver that shows airway resistance (Raw) to be 1.2 cmH2O/L/sec. Which of the following conditions most likely represents the patient's condition? non-invasive positive pressure ventilation (NPPV) A 33-year-old female has been rehabilitated from a motor vehicle accident where she suffered a spinal injury. She has been admitted to the emergency department with flu-like symptoms, is febrile, and is expectorating yellow sputum.