NBRClTMClExaml(LatestlUpdate)l
QuestionslandlVerifiedlAnswers|l100%l
Correct|lGradelA
Q:lAlpatientlinlthelemergencyldeptlhaslfrothylsecretions,lmoistlcrackles,landltachypnea.lThelp
atientlhaslmarkedldyspnealandlalhistoryloflheartldisease.lWhichloflthelfollowinglshouldlthelres
piratoryltherapistlrecommend.
1.suctionlimmediately
2.administerl100%loxygen
3.placelinlFowlerslposition
4.administerlfurosemide
Answer:
Thislislanlemergency,ltheylarelhavinglheartlproblems,ldyspnea,lfrothylsecretionslindicatinglseve
relpulmonaryledema,letc.lsol100%loxygenlimmediately,lhavinglthelpatientlinlthelFowlerslpositi
onl(anluprightlposition)lwilllhelplpulllfluidldownlawaylfromlthellungs,lfurosemidelislallasixl(lo
opldiuretic)lwhichlgetslridloflexcesslfluid.lYouldolNOTlsuctionlsomeonelwithlfrothylsecretionsl
andlheartlproblems,lthisljustldelayslappropriateltherapy.lSolANSWERlisl2,3,4
Q:lFinelcrepitantlcrackleslarelmostlcommonlylassociatedlwithlwhichloflthelfollowinglconditio
ns.
a.lBronchiectasis
b.lCongestivelheartlfailure
c.lPneumonia
d.lCroup
Answer:
Crackleslarelassociatedlwithlfluidlsola,lb,landlclwouldlbelgoodlanswers,lbutl"finelcrepitant"lcra
ckleslindicateslfluidlenteringlalveolil(pulmonaryledema)lwhichlislmostloftenlcausedlbylheartlfai
lurelsolthelbestlANSWERlislB.l(withlcrouplyoulwouldlhearlmoreloflalstridorlsound).
,Q:lAlpatientlislfoundlinlfulllcardiopulmonarylarrest.lCPRlislstartedlandlthelpatientlislorallylint
ubatedlwithlanlEtCO2lmonitorlattached.lWhichloflthelfollowinglEtCO2lpatternslwouldlthelresp
iratoryltherapistlexpectltolobservelonlthelmonitor?
a.lInitiallylhigh,lthenlfalling
b.lInitiallyllow,lthenlrising
c.lInitiallylhigh,lstayslhigh
d.lInitiallyllow,lstaysllow
Answer:
FulllcardiaclarrestlwilllcauselthelCO2linlthellungsltolslowlyldissipateloutlbecauselnolbloodlislfl
owing,lthenlduringlCPRlwhenlyoulgetlbloodlflowing,lthelCO2lshouldlslowlylriselbacklup;l
solANSWERlislB
Q:lIflthelbloodlpressurelobtainedlfromlthelarterialllinelislhigherlthanlthelbloodlpressurelobtain
edlfromlalsphygmomanometerl(cufflpressure).lBasedluponlthislinformation,lthelrespiratorylther
apistlshouldlconcludelthat.
a.lNon-compliantltubinglislbeinglused
b.lTransducerlislplacedltoollow
c.lPatientlwasllyinglflatlduringlthelmeasurementloflthelarterialllinelpressure
d.lTransducerldomelcontainedlairlbubbles
Answer:
ArterialllinelBPlandlcufflpressurelshouldlbelthelsame,lsoltherelislalproblem.lNon-
compliantltubinglislalgoodlthinglbecauselit'slalstiffltubing,lifltransducerlislplacedltoolhighl(abov
elthelheart),lthelfloodlwilllhaveltolgoluphilllandlyoulwilllgetlallowerlpressure;ltransducerldomel
containedlairlbubbleslwouldlgivelyoulerraticlreadingslbutlnotlalhigherlreading,lbutlifltheltransd
ucerlislplacedltoollowl(belowlheart),lthelbloodlislflowingldownhilll&lwilllgivelalhigherlpressur
elreading,lsolANSWERlislB
Q:lAl2-
yearloldlchildlenterslthelemergencylroom.lThelmotherlstateslthatlthelchildlwaslplayinglwithlfrie
ndslandldevelopedlviolentlcoughinglandlunilaterallwheezing.lPhysicallexaminationlrevealslalhy
perresonantlpercussionlnotelonlthelleftlandlresonantlpercussionlonlthelright.lInspiratorylandlexp
iratorylchestlfilmslindicatelairltrappinglwithlnolforeignlbodiesl"noted."lThelrespiratoryltherapist
lshouldlsuspectlthelchildlhas.
a.pneumothorax
,b.orthopnea
c.aspiratedlalforeignlobject
d.tachyphylaxis
Answer:
Unilaterallwheezinglindicateslaspiratedlobjectlandlfactlthatlthelchildlwaslplayinglwithlfriendslca
useslyoultolbelievelthelchildlinhaledlalsmallltoylorlsomething,lhyperresonantlpercussionlindicat
eslairltrapping,lsolyoularelthinkinglforeignlobjectlbutlx-
raylsayslnolforeignlbodiesl"noted."lJustlbecauselitlsaysl"noted"ldoeslnotlmeanlsomethinglislnotl
there,litljustlmeanslitlcouldlnotlbelseenlonlthelxray,lalsoliflthelchildlhadlswallowedlalsmalllplast
icltoy,l"plastic"ldoeslnotlshowluplonlxraysl(radiolucent).lThelANSWERlislC
Q:lAlpatientlisladmittedltolthelICUlcomplainingloflnausealandlchestlpain.lAlnasogastricltubel
haslbeenlinsertedltolhelplrelievelthelnausea.lThelpatientlwaslstartedlonlLasixlandlnitroglycerin.l
Whichloflthelfollowinglshouldlbelmonitoredltolcloselylidentifylsideleffectslatlthisltime.
a.lCardiaclenzymes
b.lSerumlelectrolytes
c.lArteriallbloodlgases
d.lDigitalisllevels
Answer:
SincelthelpatientlreceivedlLasixlandlnasogastricltube,ltheylarellosinglfluids,landlalsideleffectlofl
fluidllosslislaldecreaselinlelectrolytes,lsolANSWERlislBl(therelisn'tlenoughlevidenceloflheartlat
tackltoljustifylcardiaclenzymes,lalsoltheylarelusedltolconfirmlalheartlattack).
Q:lWhichloflthelfollowinglwillldeterminelaorticlpulselpressure.
a.lsystolicl+lsystolicl+ldiastolic/3
b.ldiastolicl+lpulselpressure/3
c.lsystoliclpressurel-ldiastoliclpressure
d.lstrokelvolumelxlheartlratelxl10.
Answer:
Aorticlpulselpressurelisljustltheldifferencelbetweenlsystoliclandldiastoliclpressure,lsolANSWER
lislC
, Q:lAl32-
weeklgestationallagelinfantlislreceivinglmechanicallventilationlforlhyalinelmembraneldisease.lT
helpatientlrequiredlalchestltubelforlalpersistentlpneumothorax.lTwoldaysllaterlthelchestlradiogra
phlrevealslbilaterallradiolucency,lmidlinelmediastinum,landlthelrightlhemidiaphragmlslightlylele
vated.lThislwouldlindicate
A.latelectasis.
B.lbronchopulmonaryldysplasia.
C.lfluidloverload.
D.lresolutionloflalpneumothorax.
Answer:
bilaterallmeanslbothlsides,lradiolucencylrefersltoldark,lmidlinelmediastinumlislrightlwherelislsh
ouldlbe,lthelrightlhemidiaphragmlslightlylelevatedlislnormal;lsolthislactuallylindicatesleverythin
glislnormal.lWithlatelectasislwelwouldlseelpatchylinfiltrates,llossloflvolume,lwithlbronchopulm
onaryldysplasialitlwouldllooklsimilarltolARDS,lwithlfluidloverloadlyoulwouldlseelpatternlsimil
arltolbutterflylorlbatwinglsimilarltolpulmonaryledema,lsolthelbestl
ANSWERlislDlandlthelpneumothoraxlhaslresolved.
Q:lAlchestlX-raylshowslincreasedlretro-
sternallair,lflatlhemidiaphram,ldecreasedlmovement,landlnolvascularlmarkingslonlthelrightlside.
lTheselsignslwouldlbelmostllikelylassociatedlwith:
A.lpneumothorax
B.lpleuralleffusion
C.lpneumonia
D.lflaillchest
Answer:
Thelflatlhemidiaphramlindicateslpneumothorax,lsolthelANSWERlislA.
Q:lWhatlislthelnormallrangelforlthelpulmonarylarterylsystoliclpressurelinlanladult?
A.l2-6lmmlHg
B.l4-12lmmlHg
C.l9-18lmmlHg
