Download Mechanical Ventilation and Pulmonary Function Assessment and more Exams Nursing in PDF only on Docsity!
Lindsey Jones TMC A Questions with Answers
- A patient Who has mild strider following endotracheal extubation would benefit most from which of the following?: Racemic epinephrine 2.Which of the following is most indicative of a pulmonary embolism: Increase PAP, decreased PCWP
- A patient receiving mechanical ventilation has receive Halcion in the last 20 minutes. The physician orders the institution of spontaneous breathing trial to commence immediately. Which of the following medications would be helpful to the patients?: Romazicon (Flumazenil) 4. A patient with an ideal body weight of 80 kg (176 lbs) Is being evaluated for sensation of mechanical ventilation. The following weaning parameters and clinical data are available. Vital capacity- 2.2L RSBI- Spont VT- 200ml Resp Rate- 33/min Which of the parameters is the most reliable indicator that the patient is ready for ventilator liberation?: Vital capacity
- In preparation for pulmonary function testing the respiratory therapist in-
terviews the patient to investigate the use of tobacco products. The patient reports smoking five packs a day for 10 years and 1.5 packs a day for 20 years. What is the pack year history of smoking for these patients.?: 80 6.During the difficult intubation, the emergency room physician request an en- dotracheal tube that is smaller than recommended for the patient's height and ideal body weight. As a result, the respiratory therapist should anticipate?: An increase in RAW
- In preparation for ventilator weaning the physician request a VD/VT ratio assessment. Which of the following is needed to determine the dead space tidal volume ratio?: Arterial blood gases and capnographic data
- A respiratory therapist is determining a VD/VT ratio. Which of the following is needed to complete this analysis?: PetCO2 and PaCO
- Which of the following is least likely to promote the spread of nosocomial infection in a hospital?: Use of unit dose medication 10. Which of the following can be used to estimate the level of hemoglobin?- : RBC 11.Which of the following alarms would be most important for a patient receiving positive pressure ventilation via pressure Cycled ventilator?: Low volume
resuscitation 19.Prior to the removal of chest tubes, which of the following should be done: clamp the chest tube for 24 hours 20.Which of the following will help a patient to speak while intubatedwith a tracheostomy tube?: Passy-Muir valve 21.Prior to obtaining an MEP value with a pressure manometer, the respiratory therapist notes the needle is pointing at a positive pressure of - cmH2O prior to the maneuver. During the MEP maneuver, the needle reaches 32 cmH2O. The therapist should: Record an MEP of 36CMH 22.What would occur on a time cycle ventilator with the fixed rate if the inspiratory flow rate was increased?: Increased in tidal volume 23.Why should a respiratory therapist first open the airway of a patient who is apneic?: The patient may be experiencing upper airway occlusion 24.Which of the following is a strategy that may help reduce or prevent auto peep in a patient with ARDS?: High flow rates 25.A pediatric patient has a nonproductive cough. A chest radiograph reveals a foreign body in the right mainstem Bronchi. Which of the following should be used to alleviate the problem?: Bronchoscope
26.An adult male is being section through an 8.0 MM ET tube with a 12 FR. Suction catheter at a pressure of 90 MMHG. Secretions removal have been ineffective. Which of the following modification should be recommended?: In- crease suction pressure to 110 MMHG 27.Which of the following is the most significant Complication of bron- choscopy?: Laryngospasms 28.Which of the following can be instructed to a COPD patient to help reduce FRC?: Pursed lip breathing 29.A bronchogram would be most helpful in evaluating and diagnosing which of the following?: Bronchiectasis 30.An infant who is 35 weeks of gestation require supplemental oxygen at 40%. Which of the following modalities is most appropriate?: Oxygen hood with an air/oxygen blender 31.What is the respiratory therapist Observing if monitoring the total amount of gas exhaled in 60 seconds after excluding dead space?: Alveolar minute ventilation 32.Which of the following instruction should be given to a patient in prepara- tion for incentive spirometry with a volume type device?: Inhale as deeply as possible
An increase in RAW 39.A respiratory therapist is monitoring a patient's maximal inhalation and exhalation repeatedly over a period of 15 seconds. The therapist is attempting to observe which of the following?: MVV 40.A patient is on 70%/30% heliotherapy by nonrebreathing mask. It's flowing through an oxygen flow meter, what is the actual flow of the make sure if the flow meter indicates 10 L/minute: 16 L/min
41. A seven-year-old female patient receiving PEP therapy I mouthpiece. In spite of repeating coaching, the child does not keep the mouthpiece in her mouth. The therapist should respond by doing which of the following?: Add a mask to the pep device 42.A respiratory therapist is providing chest physiotherapy and postural drainage on a cystic fibrosis patient with pneumonia in the right lateral seg- ment. The patient was in high Fowlers prior to therapy. The patient experiences arrhythmias And dyspnea after five minutes of therapy. What should the therapist recommend?: Stop therapy, return to high Fowlers, provide oxygen, call the physician 43.A patient is receiving 40% aerosol with the oxygen flow meter running
at 8L/min. What is the total flow of gas to the patient?: 32L/min 44.And 80kg (176lbs), 5'9" adult male is Orly into baited with an 8.0 MM endotracheal tube and a 12 FR. Catheter. During suctioning the patient demon- strates sinus tachycardia with frequent PVCs on the EKG monitor. The ther- apist should do which of the following for future section and attempts?: De- crease section time 45.A therapist palpates a popping Sensation in the upper chest and neck within hours after the insertion of an 8.0 MM standard tracheostomy tube. Which of the following is most likely the cause?: Mal- positioned trach tube 46.Which of the following devices is most helpful in performing a safe and proper nasal intubation?: Magill forceps 47.A patient who has mild Strider following endotracheal excavation would benefit most From which of the following?: Racemic epinephrine 48.After performing minimal including volume technique with a 65 kg patient who is early into baited with a 7.0 MM ET tube the respiratory therapist should next: Check ET tube cuff pressure 49.A pulse ox symmetry reading is significantly less than oxygen saturation by blood gas. Which of the following could be the cause?: Marked
increased atelectasis. Blood gases show signs of refractory hypoxemia. Which of the following is an appropriate change for this patient?: Decrease inspiratory flow rate 56.Which of the following must be done to transition a patient with a fenes- trated tracheotomy tube, who is receiving positive pressure ventilation, to a speak configuration?: Deflate the cuff install the cap 57.A pressure volume loop ventilator graphic show no rise in pressure for the first 200 mL of delivered volume. The therapist should: Increase PEEP 58.A patient is receiving oxygen by nasal cannula for L/min. After 24 hours of use with a properly functioning bubble humidifier the patient complains of nosebleeds. The therapist would do which of the following to modify thera- py?: Switch to an air entrainment mask at FIO2 to 35% 59.Which of the following airway clearance therapy should be administered first in the order of therapy?: Aerosolized Acetylcysteine (Mucomyst) 60.Which of the following best describes the function of digitalis?: Increase strength of cardiac contractility 61.Which of the following is an important strategy when caring for a patient with COPD receiving volume control mechanical ventilation?: Prolonged
Expi- ratory time 62.Which of the following is most indicative of pulmonary embolism?: In- crease PA P and decrease PCWP 63.After making the universal sign of choking a person collapses the observer should first?: Perform abdominal thrusts 64.Which of the following should NOT be included in the goals of a pulmonary rehabilitation program for a COPD patient?: Return the patient normal life 65.An adult patient with asthma is receiving Albuterol by small volume nebu- lizer Q.I.D. at a dosage of 0.5 mL. The patient complains of dizziness, tingling in his fingers, and anxiety with each treatment. The therapist should: Switch to Xopenex 0.63 mg 66.A patient with a 90-pack year smoking history is receiving volume con- trolled ventilation in the SIMV mode. Sedation has been discontinued to facil- itate weaning. The patient seems increasingly anxious. Which of the following would most beneficial to the patient?: Apply a nicotine dermal patch to the patient 67.A chest radiograph indicates the presence of fluffy infiltrates. This finding is most closely associated with which of the following?: Pulmonary
73.A patient is in the ER with an oxygen saturation of 86% on a non rebreath- ing mask. The respiratory therapist observes paradoxical chest movement on the left side. Trachea is mid-line. Which of the following can the therapist conclude?: The patient has fractured ribs on the left side 74.The therapist notes in medical record of a 65 year old male that the patient is ordered to receive bronchodilator therapy with albuterol. The therapist also notes the patient is receiving beta blocker medication. The therapist should recommend: Switch to albuterol to ipratropium bromide ( Atrovent) 75.The results of a V/Q scan is inconclusive following what appears to be the development of a pulmonary embolus. What further testing should the therapist recommend?: Pulmonary angiography 76.A 32-week gestational age infant is in respiratory distress following a cesarean section birth. A chest xray shows a reticulogranular pattern. Which of the following would be most helpful to the patient?: Exosurf 77.Immediately following a puncture of the right radial artery, the therapist notices a purplish swelling over the puncture site. This is mostly likely caused from which of the following?: Inadequate time holding pressure on the site
78.A physician suspects a patient has an obstruction pulmonary defect. Which of the following tests would be most helpful at determining this?:
- FEV1.0/FVC% 79.Which of the following would be the most effective, appropriate method for resolving atelectasis in a spontaneously breathing, post operative patient who is under the influence of sedation and will not respond to verbal stimuli?: IPPB 80.A 6-year-old male is brought to the emergency room with uncontrollable coughing. Auscultation reveals unilateral wheezing. SpO2 is 88%. Which of the following would be most helpful at resolving the underlying problem?: bron- choscope 81.The respiratory therapist working in a clinic receives a call from a patient who has asthma and is only able to achieve 40% of their normal baseline peak flow measurement. The therapist should advise the patient to: call the doctor immediately 82.A newborn infant experiences apnea when breast feeding, but recovers quickly when breast feeding is discontinued. Which of the following mostly likely explains the condition?: Choanale atresia 83. A patient who has an 80-pack-year history of smoking and is chronically
87.A 24-year-old patient is receiving mechanical ventilation. The following pressure - volume graph is available. What can accurately be stated about this information?: this breath was patient-triggered 88.A respiratory therapist is analyzing the blood gas results of a capillary blood sample taken from an infant. Which of the following would not be considered a reliable or accurate value?: PO 89.A patient is receiving volume-controlled ventilation. The ventilator graphic screen shows flow graphs that do not return to baseline before inspiration starts. This will cause the development of: autoPEEP 90.Which of the following would best decrease the work of breathing for a spontaneously breathing patient with a fixed upper airway obstruction?: heliox therapy 91.An ECG is performed on a patient in the emergency room (ER) who is complaining of chest pain. The respiratory therapist notices flipped T waves on the ECG tracing. Which of the following best remedies this finding?: oxygen therapy 92.While performing endotracheal suctioning with a 10 French catheter on a patient who is orally intubated with an 8.0 ET tube, the respiratory therapist notices it is sometimes difficult to withdraw the suction catheter. To correct
this issue without sacrificing efficacy, the therapist should: applying water- sol- uble lubricant to the catheter 93.A respiratory therapist responds to a low tidal volume alarm. A quick glance reveals the tidal volume is set to 650 mL and the exhaled tidal volume is 610 mL. The therapist should make which of the following adjustments?: - decrease low tidal volume alarm 94.For a patient receiving volume-controlled mechanical ventilation, the lower inflection point on a pressure-volume loop can best be described as:: amount of pressure required to keep the alveoli and small airways open 95.A patient is receiving volume-controlled ventilation following bariatric surgery for obesity. Which of the following medications should the respiratory therapist recommend to ensure the patient's comfort and assist in ventilator management?: morphine sulfate 96.A 5-ft, 2-inch (157-cm), 208-lb (95-kg) male patient has just been diagnosed with obstructive and central sleep apnea. Which of the following will provide most help to the patient?: bi-level therapy with a back up rate 97.Thirty minutes following the insertion of a tracheostomy tube, the res- piratory therapist palpates the skin around the site and notes a crackling sensation. The therapist should recommend which of the following?:
- A patient's chest radiograph reveals an enlarged heart whose shadow occupies two thirds of the chest cavity from side-to-side. With which of the following findings would this finding be most closely associated?: morbid obesity
- In preparation for pulmonary function testing, the respiratory therapist interviews the patient to investigate use of tobacco products. The patient reports smoking 5 packs a day for 10 years and 1.5 packs a day for 20 years. What is the pack-year history of smoking for this patient?: 80
- A 5-year-old child is brought to the emergency room (ER) with a fever and difficulty breathing. The patient is drooling but is making no vocal sounds. Which of the following procedures should the respiratory therapist recom- mend?: lateral neck radiograph
- Which of the following finding is most closely associated with increased airway resistance?: accessory muscle use
- A neonatal patient exhibits a heart murmur upon auscultation one hour after birth. The respiratory therapist is having difficulty maintaining adequate oxygenation saturation in spite of increasing FIO2. Which of the following should the respiratory therapist recommend?: echocardiography
- A respiratory therapist is caring for a patient with asthma.
Bronchodilator therapy has been initiated and some relief is observed. Which of the following should the therapist recommend to further assess the degree of improve- ment?: peak flow
- A patient is undergoing a transport of 100 miles in a non- pressurized helicopter. The patient is breathing spontaneously and is receiving oxygen by non-rebreather mask. As the helicopter ascends above 5,000 ft, the patient begins to exhibit cyanosis and shortness of breath. The most likely reason for this is: decreased PAO
- A patient who is receiving VC A/C ventilation has been experiencing climbing peak inspiratory and mean airway pressures due to decreasing pulmonary compliance. Additionally, greater FIO2 is required to maintain adequate PaO2 levels. To further investigate the effectiveness of oxygen ad- ministration, the therapist should evaluate which of the following?: oxygen index
- A patient complains of shortness of breath only upon exertion. There is no significant smoking history or family history of lung disease. What should the respiratory therapist recommend?: cardiopulmonary stress testing
- Which of the following data would provide the most information
