TMC Exam A EXAM NEW VERSION LATEST UPDATE 2024-2025 WITH ACCURATE ANSWERS GUARANTEED, Exams of Nursing

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TMC Exam A EXAM NEW VERSION LATEST

UPDATE 2024-2025 WITH ACCURATE

ANSWERS GUARANTEED PASS BEST

STUDYING MATERIAL WITH 100+

QUESTIONS

Which of the following descriptions most typifies the sound a therapist might here on a patient with a pleural friction rub? a. Grating sound b. Scattered crackles c. Sonorous d. Egophany

• ANSWER a. Grating sound 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? a. Beri beri b. Morbid obesity c. Cardiac ischemia d. Myocardial infarction
• ANSWER b. 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? a. 110

b. 30 c. 80 d. 195

• ANSWER c. 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 recommend? a. Bronchoscopy b. Lateral neck radiograph c. CBC d. Inspection of the pharyngeal area with a tongue depressor
• ANSWER b. Lateral neck radiograph Which of the following finding is most closely associated with increased airway resistance? a. Increased PetCO b. Altered P c. Reduced SpO d. Accessory muscle use
• ANSWER d. 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? a. Cardiac angioplasty b. Diagnostic chest percussion c. Echocardiography d. Transillumination

• ANSWER c. 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 improvement? a. Peak flow b. SBN c. DLCO d. FRC
• ANSWER a. 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 a. Decreased PAO b. Hyperoxemia c. Altitude sickness d. Hypercapnia
• ANSWER a. 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 FIO is required to maintain adequate PaO2 levels. To further investigate the effectiveness of oxygen administration, the therapist should evaluate which of the following? a. Vd/Vt b. C(a-v)O c. A-aDO d. Oxygen index
• ANSWER d. Oxygen index

A patient with COPD who has been receiving mechanical ventilation for 3 weeks has been weaned down to the following settings: FIO2: 0. Mandatory rate: 8 Mode: SIMV VT(set): 400 mL VT(spont): 320 mL PEEP: 3 cmH2O PS: 4 cmH2O On these settings, the following laboratory data is observed: pH 7.36 / PaCO2 65 / PaO2 70 / HCO3 30 / BE - 1 The respiratory therapist should recommend a. NAVA b. SBT c. APRV d. PRVC

• ANSWER b. SBT 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? a. 6-minute walk test b. Peak flow measurement every 1 hr for 24 hours c. Cardiopulmonary stress testing d. 14 hour Holter monitoring
• ANSWER c. Cardiopulmonary stress testing

Which of the following data would provide the most information about arterial oxygenation relative to administered supplemental oxygen? a. P/F ratio b. PD c. C(a-v)O d. SvO2/FIO

• ANSWER a. P/F ratio A respiratory therapist is called to the emergency waiting room to offer advice on the cleanup method of liquid oxygen that was ejected from a faulty portable liquid oxygen device. The therapist will instruct which of the following? a. Evacuate the surrounding area, mop the liquid while wearing a mask b. Stay clear of the area for a few minutes, nothing else is required c. Spread a liquid absorbent sand over the spilled area, then sweep d. Place a silver barrier blanket over the affected area, allow the area to dry
• ANSWER b. Stay clear of the area for a few minutes, nothing else is required While preparing to perform oral intubation by direct laryngoscopy to a patient who is experiencing a complete cardiopulmonary collapse, the respiratory therapist notices the laryngoscope light does not illuminate when the blade is snapped into place. The therapist should FIRST a. Ensure the bulb is tightened b. Replace the handle batteries c. Attach a fiberoptic blade to the handle d. Examine the battery compartment contacts
  • ANSWER a. Ensure the bulb is tightened

While setting up for oxygen administration with an air/oxygen blender and a heated large volume nebulizer for an infant who has orders for 30% oxygen via oxyhood, the respiratory therapist notices a loud continuous sound emanating from the blender. The most likely cause is a. The dial on the blender has been turned below 21% b. The blender is in need of calibration c. Oxygen and air gas source pressure is greater than 60 PSI d. The air hose is not seated properly into the 50 PSI source

• ANSWER d. The air hose is not seated properly into the 50 PSI source A patient is being monitored with a PA catheter. The PA waveform shows a missing dicrotic notch. The respiratory therapist should consider a. A possible clot in the PA catheter b. The wave form to be normal in all respects c. The possibility the catheter has been inadvertently retracted d. The possibility the catheter has been advanced accidentally
• ANSWER a. A possible clot in the PA catheter A 10-year-old child does not seem to be performing incentive spirometry well with a flow- oriented device. The patient says the device is boring and difficult to get all three balls floating. The respiratory therapist should a. Replace the device with a volume-oriented incentive spirometer b. Obtain a new incentive spirometer with lighter balls c. Test the incentive spirometer with a clean mouthpiece d. Provide encouragement and instruct the patient to continue efforts
  • ANSWER a. Replace the device with a volume-oriented incentive spirometer A home care patient calls into the clinic and complains that his oxygen concentrator is not working even though the machine is plugged in and the switch is in the 'on'. Position. After ensuring the patient is receiving oxygen from a reliable alternate source, the therapist should advise the patient to

a. Check and replace the internal in-line fuse b. Ensure the circuit breaker is in the on position c. Find the reset switch in the machine and press it d. Change the filters and cycle the machine of then on again

• ANSWER b. Ensure the circuit breaker is in the on position In preparation for pulmonary function testing, a therapist performs calibration of the PFT machine. After injecting gas from a certified 3.0-L super syringe, the following results are obtained: First: 2.85 L Second: 3.14 L Third: 2.99 L Which of the following can be accurately stated? a. The PFT machine is accurate b. The super syringe requires calibration c. The PFT machine lack accuracy but maintains precision d. The PFT machine is not accurate and requires calibration
• ANSWER a. The PFT machine is accurate Which of the following requires a quality control assessment? a. Flexible endotracheal tube b. Close oxygen flowmeter c. Point-of-care blood gas analyzer d. Air-oxygen blender
• ANSWER c. Point-of-care blood gas analyzer

A freshly cleaned and assembled adult ventilator is undergoing pre-operational quality control with an adult circuit. The therapist observes a failure in the delivered and returned volume data. Which of the following is most likely the cause? a. Low ambient temperature b. High ambient temperature c. Dysfunctional exhalation valve d. Loose circuit connection

• ANSWER d. Loose circuit connection A COPD patient that requires intubation and VC SIMV ventilation has a Mallampati classification of 1. Which of the following methods and/or equipment should the respiratory therapist expect to utilize for oral intubation? a. Direct laryngoscopy b. Intubation with a video-assist device c. Bougie device d. Bronchoscopic intubation - ANSWER a. Direct laryngoscopy A 42-year-old patient has undergone a laryngectomy for the removal of laryngeal cancer. A laryngectomy tube is in place. For the first 12 hours after surgery, the therapist should expect which of the following? a. Atelectasis b. Periodic expectoration of blood c. Slight hypoventilation d. Decreased RAW - ANSWER b. Periodic expectoration of blood A patient with an ideal body weight of 80-kg (176-lb) is being evaluated for cessation of mechanical ventilation. The following weaning parameters and clinical data are available: Vital Capacity: 2.2 L RSBI: 134

Spont VT: 200 mL RR: 33/min Which of the parameters is the most reliable indicator that the patient is ready for ventilator liberation? a. Spont VT b. VC c. RSBI d. RR - ANSWER b. VC A respiratory therapist has provided Xopenex treatments via hand-held nebulizer to a patient in the emergency room for shortness of breath. The patient now has bleeding gums and epistaxis. What should the physician check? a. Prothrombin time b. Incompatibility to Xopenex c. Arterial blood gas d. Sinus x-ray - ANSWER b. Incompatibility to Xopenex Which of the following is an important strategy when caring for a patient with adult respiratory distress syndrome? a. Keep FIO2 higher than 0. b. Promote AutoPEEP c. Ventilate in control mode with paralytics d. Keep FIO2 below 0.60 when possible - ANSWER d. Keep FIO2 below 0.60 when possible A respiratory therapist is providing instruction to a home-care patient regarding different methods of increasing the effectiveness of airway clearance. The therapist may suggest all of the following techniques EXCEPT a. Serial coughing b. Huff coughing

c. Pursed-lip breathing d. Autogenic drainage - ANSWER c. Pursed-lip breathing A patient receiving mechanical ventilation has received Halcion in the last twenty minutes. The physician orders the institution of spontaeneous breathing trials to commence immediately. Which of the following medications would be most helpful to the patient? a. Meperidine b. Valium c. Romazicon (Flumazenil) d. Morphine Sulfate - ANSWER c. Romazicon (Flumazenil) In preparation for ventilator weaning the physician requests a VD/VT ratio assessment. Which of the following is needed to determine the deadspace-tidal volume ratio? a. Single breath nitrogen elimination and caponographic data b. Helium dilution study and an arterial blood gas c. Arterial blood gases and capnographic data d. Helium dilution study and single breath nitrogen elimination - ANSWER c. 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? a. VT and VA b. PetCO2 and PaCO c. FIO2 and PaO d. PECO2 and PaO2 - ANSWER b. PetCO2 and PaCO Which of the following is LEAST likely to promote the spread of nosocomial infection in a hospital? a. Poor hand washing among staff

b. Frequent disconnection of a ventilator circuit c. Changing small volume nebulizer equipment every 48 hours d. Use of unit dose medication - ANSWER d. Use of unit dose medication Which of the following can be used to estimate the level of Hemoglobin? a. C(a-v)O b. PAO c. Theophylline level d. RBC - ANSWER d. RBC Which of the following alarms would be most important for a patient receiving positive pressure ventilation by a pressure-cycled ventilator? a. Low volume b. I:E ratio c. Low FIO d. High pressure - ANSWER a. Low volume Patients with large necks who experience frequent dislodging of their tracheostomy tubes need (a) a. Longer tracheostomy tube b. Shorter tracheostomy tube c. Larger tracheostomy tube d. Nasal intubation - ANSWER a. Longer tracheostomy tube Which of the following would be most effective at resolving a humidity deficit for a patient who is intubated with an 8.0-mm endotracheal tube? a. Large volume nebulizer b. Concha heated humidifier

c. HME d. Bubble humidifier - ANSWER b. Concha heated humidifier A patient with suspected myasthenia gravis in the emergency room should receive which of the following to confirm a diagnosis? a. Norcuron b. Edrophonium bromide c. Neostigmine d. Meperidine (Demerol) - ANSWER b. Edrophonium bromide Which of the following is an important action when drawing an arterial blood gas sample? a. Choose a radial site with adequate ulnar circulation b. Use a 16 gauge needle c. Compress the site prior to puncture d. Run the sample within 15 minutes - ANSWER a. Choose a radial site with adequate ulnar circulation Which of the following would be most helpful for a patient with fixed upper airway obstruction? a. Aerosolized epinephrine b. Beta II agonist medication c. Corticosteroids d. Heliox therapy - ANSWER d. Heliox therapy Which of the following oxygen modalities would be appropriate for a 220-lb (100-kg) male with diabetic ketoacidosis who requires 40% supplemental oxygen? a. Air-entrainment mask b. Non-rebreathing mask c. Nasal cannula

d. Simple mask - ANSWER a. Air-entrainment mask While administering a treatment with Albuterol to a patient with COPD, the therapist notes a sudden change in the patient's color to marked cyanosis. The patient appears apneic and the heart rate on the pulse oximeter indicates 30/min. The therapist should FIRST a. Administer oxygen by non-rebreathing mask b. Auscultate breath sounds c. Begin mouth-to-mouth resuscitation d. Go get help - ANSWER c. Begin mouth-to-mouth resuscitation A 70-kg (154-lb) female patient is receiving mechanical ventilation on the following settings: Mode: assist/control Mandatory rate: 14 Total rate: 14 VT: 500 mL FiO2: 0. PEEP: 12 cmH2O Arterial blood gases revel pH 7.49 / PaCO2 32 / PaO2 109 / HCO3 24 / BE 0 The respiratory therapist should a. Decrease mandatory rate b. Decrease FIO c. Increase mandatory rate d. Decrease PEEP - ANSWER d. Decrease PEEP Prior to the removal of chest tubes, which of the following should be done?

a. The chest tube should be expose to normal atmospheric pressure b. Clamp the chest tube for 24 hours c. Flush the chest tube with normal saline d. Suction pressure should be increased temporarily - ANSWER b. Clamp the chest tube for 24 hours Which of the following will help a patent to speak while intubated with a tracheostomy tube? a. Pass-Muir valve b. Inner cannula c. Double lumen endotracheal tube d. Obturator - ANSWER a. Pass-Muir valve Prior to obtaining an MEP value with a pressure manometer, the respiratory therapist notes the needle is pointing at a positive pressure of - 4 cmH2O prior to the maneuver. During the MEP maneuver, the needle reaches 32 cmH2O. The therapist should a. Report the problem to the medical director b. Record an MEP of - 28 cmH2O c. Record an MEP of 28 cmH2O d. Record an MEP of 36 cmH2O - ANSWER d. Record an MEP of 36 cmH2O A 70-kg (154-lb) male patient is receiving mechanical ventilation. After increasing PEEP, the following data is available: Arterial blood gases reveal pH 7.32 / PaCO2 47 / PaO2 80 / HCO3 26 / BE+ C.I. 2.5 / PAP 14 / CVP 4 / PCWP 8 The respiratory therapist should do which of the following? a. Administer sodium bicarbonate b. Decrease mandatory rate

c. Remove 100 mL of deadspace d. Decrease FIO2 - ANSWER c. Remove 100 mL of deadspace What would occur on a time-cycled ventilator with a fixed rate if the inspiratory flow rate were increased? a. Decrease in tidal volume b. Increase in inspiratory time c. Decrease in inspiratory time d. Increase in tidal volume - ANSWER d. Increase in tidal volume Why should a respiratory therapist FIRST open the airway of a patient who is apneic? a. To protect the neck if the patient has experience physical trauma b. The patient may be experiencing upper airway occlusion c. The physical contact may help to trigger a spontaneous breath d. To facilitate the placement of an oropharyngeal airway - ANSWER b. The patient may be experiencing upper airway occlusion Which of the following is a strategy that may help reduce or prevent autoPEEP in a patient with ARDS? a. Sedation of the patient b. Increasing minute ventilation c. Matching PEEP d. High flow rates - ANSWER d. High flow rates A pediatric patient has a non-productive cough. A chest radiograph reveals a foreign body in the right mainstem bronchi. Which of the following should be used to alleviate the problem? a. Tonsil suction device b. Bronchoscope

c. Suction catheter d. Laryngoscope - ANSWER b. Bronchoscope An adult male is being suctioned though an 8.0-mm ET tube with a 12 Fr. suction catheter at a pressure of 90 mmHg. Secretion removal has been ineffective. Which of the following modifications should be recommended? a. Decrease suction pressure to 80 mmHg b. Increase suction catheter size to 14 FR c. Increase suction pressure to 110 mmHg d. Change to a 10-mm ET tube - ANSWER c. Increase suction pressure to 110 mmHg Which of the following is the most significant complication of bronchoscopy? a. Laryngospasms b. Coughing c. Hypotension d. Vagal nerve stimulation - ANSWER a. Laryngospasms Which of the following can be instructed to a COPD patient to help reduce FRC? a. Serial coughing b. Autogenic drainage c. Pursed-lip breathing d. Incentive spirometry - ANSWER c. Pursed-lip breathing A Bronchogram would be most helpful in evaluating and diagnosing which of the following? a. ARDS b. Myoplasma pneumonia c. Chronic bronchitis d. Bronchiectasis - ANSWER d. Bronchiectasis

An infant who is 35 weeks of gestation requires supplemental oxygen at 40%. Which of the following modalities is most appropriate? a. Croup tent b. Nasal cannula at 2 L/min c. Oxygen hood with an air/oxygen blender d. Nasal CPAP mask - ANSWER c. Oxygen hood with an air/oxygen blender What is the respiratory therapist observing if monitoring the total amount of gas exhaled in 60 seconds after excluding dead space? a. Dead space ventilation b. Alveolar minute ventilation c. Maximum voluntary ventilation d. Minute ventilation - ANSWER b. Alveolar minute ventilation Which of the following instructions should be given to a patient in preparation for incentive spirometry with a volume-type device? a. "breathe in complete inspiratory capacity" b. "exhale to expiratory reserve volume" c. "inhale as deeply as possible" d. "breathe in to total lung capacity" - ANSWER c. "inhale as deeply as possible" In providing a patient with education and direction for the performance of positive expiratory pressure (PEP) therapy, the respiratory therapist will include which of the following directives? a. Inhale deeply and exhale actively b. Exhale forcefully and inhale to normal tidal volume c. Inhale to normal tidal volume and exhale actively d. Inhale quickly and exhale quickly - ANSWER a. Inhale deeply and exhale actively

Which of the following equations would help determine cardiac output? a. Ejection fraction b. Fick c. Oxygen consumption d. A-aDO2 - ANSWER b. Fick A patient in the emergency room expectorates thick, yellow sputum. A CBC shows the following: RBC 6.0 mill/cu mm Hb 17 g/dl HCT 64% WBC 22,000cu mm The patient could benefit most from which of the following? a. Sputum culture and sensitivity b. Aerosolized Amphotericin B c. Aerosolized Nystatin d. Acetylcysteine - ANSWER a. Sputum culture and sensitivity A patient has a sleep study (PSG) which shows an AHI of 50 and an average oxygen desaturation of 10%. Which of the following should the respiratory therapist recommend? a. Surgical insertion of a tracheostomy b. CPAP/BIPAP nocturnal titration study c. Nocturnal supplemental oxygen d. Weight loss - ANSWER b. CPAP/BIPAP nocturnal titration study A patient has the following input/output history and other clinical information: Yesterday/Today

IN - 1900cc / 1600 cc OUT - 2200 cc / 1900 cc CO - 5.1 / 3. BP - 110/80 / 110/ CVP - 5 / 5 These data would result in which of the following? a. Decrease in PVR b. Increase in PAP c. Increase in PCWP d. Increase in SVR - ANSWER d. Increase in SVR Which of the following would result in an increase in pulmonary capillary wedge pressure? a. Mitral valve stenosis b. Dehydration c. Decrease in pulmonary vascular resistance (PVR) d. Cor pulmonale - ANSWER a. Mitral valve stenosis The results of a V/Q scan shows poor perfusion with adequate ventilation. A chest radiograph shows a wedge-shaped infiltrate over the right lung field. The patient most likely has a. A pulmonary embolism b. Fluid overload c. ARDS d. Pneumonia - ANSWER a. A pulmonary embolism During a difficult intubation, the emergency room physician requests an endotracheal tube that is smaller than recommended for the patient's height and ideal body weight. As a result, the respiratory therapist should anticipate a. Increase in PAW

b. A decrease in static compliance c. Increased I:E ratio d. An increase in RAW - ANSWER d. An increase in RAW 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? a. Minute ventilation b. Inspiratory capacity c. MVV d. Alveolar ventilation - ANSWER c. MVV A patient is on 70%/30% heliox therapy by nonrebreathing mask. If flowing through an oxygen flow meter, what is the actual flow of the mixture if the flow meter indicates 10 L/min? a. 16 L/min b. 5 L/min c. 18 L/min d. 8 L/min - ANSWER a. 16 L/min A 7-year old female patient is receiving PEP therapy by mouthpiece. In spite of repeated coaching, the child does not keep the mouthpiece in her mouth. The therapist should respond by doing which of the following? a. Switch to aerosolized Albuterol b. Add a mask to the PEP device c. Help support the patient's lip closure around the mouthpiece d. Discontinue therapy - ANSWER b. Add a mask to the PEP device A respiratory therapist is providing chest physiotherapy and postural drainage on a cystic fibrosis patient with pneumonia in the right lateral segment. The patient was in high fowlers

prior to therapy. The patient experiences arrhythmias and dyspnea after 5 minutes of therapy. What should the therapist recommend? a. Place bed flat, continue therapy, monitor b. Stop percussion, provide 100% oxygen c. Stop therapy, place the patient in semi-fowlers, monitor d. Stop therapy, return to high-fowlers, provide oxygen, call the physician - ANSWER d. Stop therapy, return to high-fowlers, provide oxygen, call the physician A patient is receiving 40% aerosol with the oxygen flow meter running at 8 L/min. What is the total flow of gas to the patient? a. 80 L/min b. 16 L/min c. 32 L/min d. 24 L/min - ANSWER c. 32 L/min An 80-kg (176-lb), 5-ft, 9-in (175-cm) adult male is orally intubated with an 8.0-mm endotracheal tube and a 12 Fr. catheter. During suctioning the patient demonstrates sinus tachycardia with frequent PVCs on the ECG monitor. The therapist should do which of the following with future suctioning attempts? a. Decrease ET tube size to 7.0-mm b. Increase suction catheter size c. Decrease suction catheter size d. Decrease suction time - ANSWER d. Decrease suction time 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 the most likely cause? a. Loss of alveolar surface tension b. Trach tube is too long c. Trach tube diameter is too long

d. Mal-positioned trach tube - ANSWER d. Mal-positioned trach tube Which of the following devices is most helpful in performing a safe and proper nasal intubation? a. Magill forceps b. Bodai adapter c. Bronchoscope d. Stylet - ANSWER a. Magill forceps A patient who has mild stridor following endotracheal extubation would benefit most from which of the following? a. Heated aerosol b. Reintubation c. Tracheostomy d. Racemic epinephrine - ANSWER d. Racemic epinephrine After performing minimum occluding volume technique with a 65-kg (143-lb) patient who is orally intubated with a 7.0-mm ET tube, the respiratory therapist should NEXT a. Perform tracheal palpation b. Order a chest radiograph c. Check ET tube cuff pressure d. Document ET tube markings at the lips - ANSWER c. Check ET tube cuff pressure A pulse oximeter reading is significantly less than oxygen saturation by blood gas. Which of the following could be the cause? a. Marked hypotension b. Increased SVR c. Decreased QsQt d. Decreased CVP - ANSWER a. Marked hypotension

A patient is orally intubated with a 7.0-mm ET tube. Immediately following the procedure, the respiratory therapist will FIRST do which of the following to check for proper positioning of the airway? a. Auscultate breath sounds b. Obtain a chest radiograph c. Observe the color of the CO2 detector d. Palpate the trachea - ANSWER c. Observe the color of the CO2 detector A hospital has an extremely low incidence of ventilator-associated pneumonia. To which of the following reasons may this be attributed? a. Periodic discontinuation of sedation b. Broad use of prophylactic antibiotics c. Use of respiratory precautions with the population d. Diversion of infectious patients to other facilities - ANSWER a. Periodic discontinuation of sedation An adult post-op patient is unable to get any of the balls to rise on an incentive spirometer, in spite of reports of her best effort. The therapist should a. Switch to postural drainage and percussion b. Switch to IPPB by mask c. Discontinue therapy and report the problem to the physician d. Switch to a volume-type incentive spirometry - ANSWER d. Switch to a volume-type incentive spirometry Which of the following would be a sufficient reason to discontinue an SBT (spontaneous breathing trial)? a. SPO2 decreases from 98% to 94% b. Heart rate increases from 80 to 96 bpm

c. Respiratory rate increases from 18 to 26 per minute d. Blood pressure increases from 11070 to 132/90 mmHg - ANSWER d. Blood pressure increases from 11070 to 132/90 mmHg A decreasing A-aDO2 is mostly closely related to which of the following? a. Hypoxemia b. Increased atelectasis c. Increasing venous admixture d. Decreasing pulmonary shunting - ANSWER d. Decreasing pulmonary shunting A patient with decreasing pulmonary compliance is receiving volume-controlled ventilation with an I:E ratio of 1:2. A chest radiograph shows increased atelectasis. Blood gases show signs of refractory hypoxemia. Which of the following is an appropriate change for this patient? a. Decrease PEEP b. Decrease inspiratory flow rate c. Increase expiratory time d. Increase inspiratory pressure limit - ANSWER b. Decrease inspiratory flow rate Which of the following must be done to transition a patient with a fenestrated tracheostomy tube, who is receiving positive pressure ventilation, to a speaking configuration? a. Change the tracheostomy tube b. Sever the pilot valve line c. Deflate the cuff, install the cap d. Insert the inner cannula - ANSWER c. Deflate the cuff, install the cap A pressure-volume loop ventilator graphic shows no rise in pressure for the first 200 mL of delivered volume. The therapist should a. Decrease tidal volume b. Increase inspiratory flow rate

c. Decrease inspiratory flow rate d. Increase PEEP - ANSWER d. Increase PEEP A patient is receiving oxygen by nasal cannula at 4 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 therapy? a. Decrease flow to 2 L/min b. Switch to an air-entrainment mask at FIO2 35% c. Provide a heated bubble humidifier d. Switch to a simple mask at 4 L/min - ANSWER b. Switch to an air-entrainment mask at FIO2 35% Which of the following airway clearance therapies should be administered first in the order of therapy? a. Nasal tracheal suctioning b. Postural drainage and percussion c. Aerosolized Acetylcysteine (Mucomyst) d. Verbal coaching for coughing - ANSWER c. Aerosolized Acetylcysteine (Mucomyst) Which of the following best describes the function of digitalis? a. Increase blood pressure b. Lowers blood pressure c. Increases strength of cardiac contractility d. Increases heart rate - ANSWER c. Increases strength of cardiac contractility Which of the following is an important strategy when caring for a patient with COPD receiving volume-controlled mechanical ventilation? a. Prolonged inspiratory time b. Prolonged expiratory time