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The physician orders a 35% aerosol mask to be set up for a patient who requires an inspiratory flow of 42 L/min. What is the minimum flow rate to which the flowmeter must be set to meet this patient's inspiratory flow demands? - correct answer ✅B. 8 L/min A premature 3-week-old infant is receiving 2 L/min of O2 via a nasal cannula and has a PaO2 of 43 torr and a PaCO2 of 40 torr. The respiratory therapist should recommend which of the following? - correct answer ✅A. Increase the cannula flow to 2 L/min. A patient arrives in the emergency department after being pulled from a burning house. The respiratory therapist should recommend obtaining which of the following measurements to best determine the severity of the patient's smoke inhalation? - correct answer ✅B. HbCO The physician has ordered O2 to be administered to an active 3-year-old with an SpO2 of 86%. Which of the following delivery devices would you recommend? - correct answer ✅A. 1-2 L nasal cannula The ability of the patient to follow instructions would be indicated by which of the following? - correct answer ✅B. Performance of tasks when asked You suspect a patient may have a pulmonary embolism. Which of the following would be most appropriate recommendation for diagnosis of this condition? - correct answer ✅B. V/Q lung scan
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To most effectively increase a sedated, paralyzed patient's alveolar minute ventilation while the patient is on volume-controlled ventilation in the assist- control mode, you would recommend increasing which of the following? - correct answer ✅C. VT Failure to hyperoxygenate a patient on a ventilator before ET suction may result in
- correct answer ✅A. Hypoxemia The most reliable method of determining whether the lungs of a patient receiving mechanical ventilation are getting stiffer and harder to ventilate is by measuring the - correct answer ✅A. Static lung compliance A 60-kg (132lb) 52-year-old man is admitted to the ICU for the treatment of refractory hypoxemia. He is currently on volume-controlled ventilation and pressure support of 10 cm H2O with an FiO2 of .60. Other pertinent data are below: ABG's pH 7. PaCO2 30 torr PaO2 59 torr Heart Rate 120/min Respiratory Rate 26/min Spontaneous Vt 400 mL Which of the following should the respiratory therapist recommend at this time? - correct answer ✅B. Increase PEEP to 8 cm H2O
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Delivered VT 600 mL, PIP 44 cm H2O, Static Airway Pressure 25 cm H2O, Inspiratory flow 40 L/min, PEEP 5 cm H2O 3:00 PM Delivered VT 600 mL, PIP 52 cm H2O, Static Airway Pressure 33 cm H2O, Inspiratory flow 40 L/min, PEEP 5 cm H2O Which of the following is the best interpretation of these data? - correct answer ✅B. The peak airway pressure increased as a result of decreased lung compliance. Tracheal secretions tend to dry out in an intubated patient when inspired air has which of the following characteristics? - correct answer ✅C. An absolute humidity of 24 mg/L of gas It is important to monitor plateau pressure in a patient receiving mechanical ventilation because it best reflects - correct answer ✅A. Lung compliance The respiratory therapist palpates no pulse on a patient, but the ECG monitor shows QRS complexes on the tracing. The therapist should - correct answer ✅C. Begin cardiac compresions
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A patient has received volume-controlled ventilation, and the low-pressure alarm suddenly sounds. The corrective action is to - correct answer ✅D. Determine whether the patient is disconnected from the ventilator After a patient has received bronchodilator therapy, the respiratory therapist attempts to perform nasotracheal suction on a patient. As the catheter enters the oropharynx, the following ECG waveform is observed on the ECG monitor. This ECG pattern is most likely the result of which of the following? - correct answer ✅C. Vagal nerve stimulation A 6-day-old premature infant of 30 weeks' gestational age is experiencing frequent periods of apnea with desaturation. Which of the following medications should the respiratory therapist recommend? - correct answer ✅C. Theophylline ET tube cuff pressure should be maintained at which of the following levels? - correct answer ✅B. 20-30 cm H2O A postoperative 46-year-old, 80-kg (176 lb) patient is breathing spontaneously at a rate of 30/min with an FiO2 of 0.50. The following ABG results are obtained: pH 7.29, PaCO2 62 torr, PaO2 64 torr, HCO3- 29 mEq/L, BE + Mechanical ventilation is instituted with a VT of 600 mL and an FiO2 of .5. The SIMV rate should be set on - correct answer ✅C. 15/min The respiratory therapist is setting up a portable liquid O2 system for a patient with COPD. The patient is on a 2-L/min cannula, and the portable O2 container
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An 8-day-old neonate is receiving pressure-controlled ventilation. Over the past 36 hours, the neonate's PaO2 has decreased from 58 torr to 47 torr. The physician wants to increase the mean airway pressure. Which of the following should the respiratory therapist recommend increasing?
- Inspiratory pressure
- Expiratory Time
- Inspiratory Time - correct answer ✅C. 1 and 3 only While assessing a patient with chest trauma in the ICU, the respiratory therapist observes that the patient's chest tube, which is connected to an underwater seal drainage system, is outside the chest wall. Which of the following statements are correct about the situation? - correct answer ✅B. A complete pneumothorax is possible Adminstration of high O2 concentrations to a neonate for a prolonged period of time may result in which of the following? - correct answer ✅B. Retinopathy of prematurity (ROP) The data below pertain to an adult receiving mechanical ventilation: PIP 50 cm H2O, Plateau pressure 40 cm H2O, VT 600 mL, PEEP 10 cm H2O On the basis of this information, this patient's static lung compliance is approximately which of the following? - correct answer ✅B. 20 mL/cm H2O
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A patient recovering postoperatively is receiving ventilation in the SIMV mode. The patient has normal ABG levels with the use of 35% O2 but is still drowsy. The respiratory therapist should recommend decreasing the - correct answer ✅A. SIMV rate The respiratory therapist is transporting a patient with a nasal cannula running at 6 L/min. For the E cylinder to last at least 1 hour, what is the minimum amount of pressure it must contain? - correct answer ✅C. 1400 psig An 80-kg (176-lb) patient with ARDS is intubated and is receiving mechanical ventilation with the following settings: Mode SIMV, Rate 10, Vt 700 mL, PEEP 10cm H2O, FiO2. The respiratory therapist notes that the patient's SpO2 has dropped from 98% to 85% over the past 2 hours. The therapist notes the PIP as increased from 36 cm H2O to 46 cm H2O, and the plateau pressure has increased from 28 cm H2O to 38 cm H2O. Which of the following should the therapist recommend? - correct answer ✅C. Increase the PEEP to 12 cm H2O Which one of these drugs would be best to use to temporarily paralyze a patient to facilitate tracheal intubation? - correct answer ✅B. Succinylcholine (Anectine) To begin the weaning process from the ventilator, a patient should be able to obtain an MIP of at least - correct answer ✅B. -20 cm H2O
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The most appropriate recommendation for O2 therapy is which of the following? - correct answer ✅C. Air-entrainment mask at 28% During CPR, the physician is preparing to administer lidocaine intravenously and discovers the IV is infiltrated. The most appropriate action to take at this time is to
- correct answer ✅A. Instill the lidocaine down the ET tube A patient in the cardiac ICU is intubated and is receiving mechanical ventilation with 40% O2 and a PEEP of 5 cm H2O. The following data have been collected: pH 7.41, PaCO2 37 torr, PaO2 81 torr, HCO3- 23 mEq/L, BE -2, C(a-v)O2 8.1 vol%, PCWP 2 mm hg On the basis of these data, the respiratory therapist should recommend which of the following - correct answer ✅C. Administer fluids All of the following are low-flow O2 devices EXCEPT the - correct answer ✅B. Air- entrainment mask The respiratory therapist is instructing a patient about the proper procedure for using an MDI. The patient should be told to activate the medication in the inhaler
- correct answer ✅B. Just after inspiration has begun After the intubation of a patient, the respiratory therapist is assessing the chest x- ray for proper tube placement. The tip of the tube is at the level of the fourth rib.
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This indicates which of the following? - correct answer ✅A. The tube position is too low While suctioning through a patient's 7.0 ET tube using a 10-Fr catheter, the respiratory therapist begins having difficulty removing the thick secretions. Which of the following is the appropriate measure to take? - correct answer ✅B. Switch to a 12-Fr catheter The following ABG levels are collected from a patient on a 50% air-entrainment mask: pH 7.37, PaCO2 40 torr, PaO2 70 torr If the barometric pressure is 747 torr, which of the following represents this patient's P(A-a) O2? - correct answer ✅B. 230 torr A patient has just been intubated, and the CO2 detector on the proximal end of the ET tube reads near zero. Which of the following is true? - correct answer ✅B. The tube is in the esophagus The following data are collected for a neonate receiving pressure-controlled ventilation: Mode PC-SIMV, Vent. rate 40/min, Inspiratory pressure 28 cm H2O, FiO2 0.70, PEEP 4 cm H2O
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Which of the following is a true statement regarding these ABG results? - correct answer ✅A. The results appear to be accurate and consistent with the FiO A 75-kg (165 lb) male patient is receiving mechanical ventilation in the SIMV mode and has the following ABG's: pH 7.29, PaCO2 59 torr, PaO2 75 torr, HCO3- 27 mEq/L, BE + The ventilator settings are as follows: FiO2 0.35, SIMV rate 8/min, Spontaneous rate 24/min, VT 500 mL Which of the following could be increased to correct this acid-base abnormality? - correct answer ✅B. VT The following ABG results are obtained from a patient recently removed from a house fire receiving O2 with a nonrebreathing mask pH 7.23, PaCO2 25 torr, PaO2 250 torr, HCO3- 15 mEq/L, BE -10, SaO2 65% The patient's acidosis is most likely the result of - correct answer ✅A. Severe hypoxia
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The physician wants to liberate a patient from a ventilator. Which of the following parameters obtained by the respiratory therapist indicate liberation will most likely be successful? - correct answer ✅D. RSBI of 65 A 43-year-old patient in the ICU is receiving 40% O2 by air-entrainment mask. His PaO2 is 58 torr, and his shunt has been calculated to be 6%. Which of the following is most likely causing the hypoxemia? - correct answer ✅D. Hypoventilation The following spontaneous ventilation parameters are collected from a 68-kg (150-lb) patient with a 2-L/min nasal cannula: VT 500 mL RR 10/min This patient's alveolar minute ventilation is which of the following? - correct answer ✅B.3.5 L While performing postural drainage and percussion, the respiratory therapist palpates subcutaneous emphysema in the patient. The therapist should postpone the therapy and recommend which of the following? - correct answer ✅C. Obtain a chest radiograph A patients PaO2 increases after mechanical ventilation is initiated at 21% O2. What accounts for the improved oxygenation status?
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While making ventilator checks, the respiratory therapist measures the ET-tube cuff pressure to be 40 cm H2O. At PIP, air is passing around the cuff. Which of the following actions should the therapist take at this time? - correct answer ✅C. Recommend changing to a larger tube If the respiratory therapist chooses an E to transport a patient within the hospital and it contains 650 psig of O2, how long will the cylinder last if the flow is run at 10 L/min? - correct answer ✅A. 18 minutes Which of the following will decreased delivered VT during pressure-control ventilation? - correct answer ✅D. Decreased lung compliance The respiratory therapist is asked to assess a 30-week gestational age infant with persistent pulmonary hypertension of the newborn (PPHN). Which of the following would you recommend to help treat this condition? - correct answer ✅C. Nitric oxide A patient eith COPD on a 50% air-entrainment mask becomes drowsy and unresponsive. The patient's reaction most likely is the result of - correct answer ✅C. Increased PaCO While performing chest physical therapy on a ventilator patient, the respiratory therapist percusses an area of hyperresonance. This assessment is consistent with which of the following conditions? - correct answer ✅B. Pneumothorax
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The following data are collected from an infant receiving pressure-controlled ventilation: Mode PC-SIMV, Vent. rate 35/min, Inspiratory pressure 26 cm H2O, PEEP 6 cm H2O, FiO2 0. pH 7.27, PaCO2 52 torr, PaO2 47 torr, HCO3- 22 mEq/L On the basis of these data, the respiratory therapist should recommend which of the following? - correct answer ✅B. Increase the ventilator rate to 40/min After setting up a simple O2 mask, you kink the O2 tubing and the humidifier produces a high-pitched whistling sound. This indicates which of the following? - correct answer ✅A. There are no leaks in the setup The following pulmonary function results are obtained on a patient: FEV1/FVC 90% of predicted FVC 55% of predicted These data indicate the patient could have which of the following? - correct answer ✅D. Pulmonary Fibrosis You are asked to deliver a low percentage of O2 to a patient whose respiratory rate is 30/min with an irregular breathing pattern. Which device would be the best choice? - correct answer ✅B. Air-entrainment mask at 28%
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Which of the following situations would result in the high-pressure alarm being activated during volume-control ventilation? - correct answer ✅C. Increased airway resistance Which of the following values will best indicate airway inflammation in asthmatics? - correct answer ✅A. FENO After a cardiac arrest, a 48-year-old female begins receiving mechanical ventilation. A pulmonary artery catheter is in place. The following data are obtained: BP 94/52 mm Hg, Pulse 116/min, 6 mm Hg, PAP 40/22 mm Hg, QT 3.5 L/min Based on the following data, which of the following has increased? - correct answer ✅A. Pulmonary vascular resistance A diabetic patient enters the emergency department breathing deeply at a respiratory rate of 32/min. This type of breathing pattern is referred to as - correct answer ✅A. Kussmaul respiration A 43-year-old male patient is brought to the ED with benzene exposure as a result of the industrial accident. Which of the following should the respiratory therapist suggest? - correct answer ✅D. Hemoximetry
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The following data are obtained from a 32-year-old patient with pneumonia in the ICU on a 60% aerosol mask: Respiratory rate 28/min, Pulse 108/min ABGS: pH 7.47, PaCO2 32 torr, PaO2 55 torr Which of the following would you recommend at this time? - correct answer ✅B. Initiate CPAP The polarographic O2 analyzer being used to analyze a patient's aerosol mask is reading inaccurately. This could be caused by all of the following EXCEPT - correct answer ✅D. Dead fuel cell Which of the following processes or agents can sterilize equipment? - correct answer ✅D. Ethylene oxide If a patient has an ideal breathing pattern, what is the approximate percentage of O2 delivered with a nasal cannula at 5 L/min? - correct answer ✅C. 40% A tall, thin, otherwise healthy 24-year-old man enters the emergency department complaining of chest pain with mild respiratory distress. A chest radiograph reveals a spontaneous pneumothorax of approximately 10%. Which of the following should the respiratory therapist recommend? - correct answer ✅B. O therapy
