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TMC exam test bank questions EXAM NEW VERSION LATEST UPDATE WITH ACCURATE ANSWERS GUARANTEED PASS BEST STUDYING MATERIAL WITH 150+ QUESTIONs$25.99
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TMC test bank questions EXAM NEW VERSION
LATEST UPDATE 2024-2025 WITH ACCURATE
ANSWERS GUARANTEED PASS BEST STUDYING
MATERIAL WITH 150+ QUESTIONS
A patient with a neuromuscular disorder who is breathing through an intact
upper airway is receiving external (vest) oscillation to help mobilize secretions
into the large airways, but is having difficulty clearing them. Which of the
following techniques would you recommend to facilitate clearance of this patient
secretions?
A. manually assisted ("quad") cough
B. postural drainage, percussion and vibration
C. positive expiratory pressure (PEP) therapy
D. acetylcysteine (Mucomyst) via aerosol
- ANSWER Patients with neuromuscular disorders can have trouble mobilizing and clearing
secretions. To help mobilize secretion in patients with a neuromuscular disorder and an
intact upper airway either postural drainage with percussion and vibration or external
(vest) or internal (IPV) oscillation are indicated. Once mobilized, the secretions need to
be cleared using one or more of the following methods: manually assisted cough,
mechanical insufflation-exsufflation or nasotracheal suctioning. In these patients PEP
therapy is not effective due to inadequate respiratory muscle strength (needed to
generate the expiratory pressure). And acetylcysteine (Mucomyst) via aerosol may help
thin/mobilize secretions, but does little to actually clear them from the large airways.
The correct answer is: manually assisted ("quad") cough
A 52 year-old male is admitted to the hospital emergency room with a chief
complaint of severe radiating chest pain and signs of central cyanosis. The
,attending physician orders STAT O2 therapy. Which of the following would you
recommend?
A. simple oxygen mask at 8 L/min
B. air entrainment mask at 40% O2
C. partial rebreathing mask at 10 L/min
D. nasal cannula at 5 L/min
- ANSWER When moderate to high FIO2s are needed quickly and for relatively short periods of
time, a partial or nonrebreathing mask should be used. As the emergency O2
equipment of choice, disposable versions of these devices can provide FIO2s up to 0.60
to 0.70.
The correct answer is: partial rebreathing mask at 10 L/m
A trauma patient has been receiving volume controlled SIMV via an endotracheal
tube for two days. The attending surgeon anticipates that the patient will likely
be on the ventilator for another 3 to 4 days. Which of the following actions would
you recommend?
A. switch from ET intubation to tracheostomy
B. switch to noninvasive positive pressure ventilation
C. switch to pressure control ventilation (PSV)
D. maintain the endotracheal tube in place
- ANSWER For a patient who has had an endotracheal tube in place for 1-3 days and for whom
extubation is anticipated within a week, it is normally best to continue support of the
patient with the ET tube in place (not perform tracheostomy).
The correct answer is: maintain the endotracheal tube in place
The nurse calls you over to examine the arterial blood gas results of a 50-kg (110
lb) patient who is receiving volume control A/C ventilation. Currently the patient
has a VT of 400 mL, rate of 10/min, and 35% O2. Her blood gas results are as
follows:
,pH 7.30
PaCO2 48 torr
HCO3 23 mEq/L
BE -2 mEq/L
PaO2 73 torr
SaO2 94%
Based on these values, which of the following changes is appropriate?
A. increase the VT
B. increase the FIO2
313
C. mantain settings
D. increase the set rate
- ANSWER The ABG indicates an acute (uncompensated) respiratory acidosis with satisfactory
oxygenation. To correct this, the PCO2 should be reduced by increasing the minute
volume. You could increase the minute volume by either increasing the respiratory rate
or the tidal volume. However, given that the VT is already about right for this patient
(400/50 = 8 mL/kg), it would probably be safer to increase the rate.
The correct answer is: increase the set rate
A doctor wants an outpatient with idiopathic pulmonary hypertension to self
administer an inhaled pulmonary vasodilator. Which of the following drugs would
you recommend?
A. epoprostenol (Flolan)
B. diltiazem (Cardizem)
C. iloprost (Ventavis)
D. bosentan (Tracleer)
- ANSWER Pulmonary vasodilators administered via the inhalation route currently include three
prostacyclins: epoprostenol (Flolan), treprostinil (Tyvaso) and iloprost (Ventavis). Only
treprostinil (Tyvaso) and iloprost (Ventavis) are approved for administration via the
, inhalation route, typically for use by outpatients. Inhaled epoprostenol (Flolan) is used
off-label in the acute care setting as an alternative to inhaled nitric oxide therapy and
typically administered via continuous nebulization using an IV drip into a jet nebulizer.
Both diltiazem (Cardizem; a calcium channel blocker) and bosentan (Tracleer; an
endothelin receptor antagonist) are used to treat pulmonary hypertension, but are
administered orally.
The correct answer is: iloprost (Ventavis)
At follow-up in a disease management program, a patient with severe (Stage IV)
COPD is diagnosed with pulmonary hypertension and cor pulmonale. Which of
the following would you recommend the doctor consider for this patient?
A. long-term O2 therapy
B. oral corticosteroids
C. systemic vasodilators
320
D. a long-acting beta agonist
- ANSWER Stage IV/Severe COPD is often characterized by the development of chronic hypoxemia
and its associated disorders, pulmonary hypertension and cor pulmonale. Long-term
oxygen therapy (LTOT) has proven effective in treating chronic hypoxemia in these
patients, while at the same time reducing the incidence of cardiopulmonary
complications and increasing survival
The correct answer is: long-term O2 therapy
A doctor orders a spontaneous breathing trial (SBT) for a 80 kg (176 lb) male
patient intubated with a 6.5 mm endotracheal tube. Which of the following
weaning strategies would you recommend?
A. CPAP
B. simple T-tube
C. pressure support
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