PRE TEST Flashcards by Courtney King

you are transporting a patient who is receiving supplemental oxygen from an “E” cylinder. the pressure gauge on the cylinder indicates 1600 psi. the flowrate needed to provide the patient with oxygen is 4 L/m. how long will the “E” cylinder last (DO NOT REGARD 500 psi AS EMPTY)

40 minutes
55 minutes
1 hour 20 minutes
1 hour 30 minutes
1 hour 52 minutes

1 hour and 52 minutes

(tank factor x psi) / flow

How well did you know this?

Not at all

Perfectly

when selecting a flowmeter for oxygen delivery, the preferred type of flowmeter for clinical use is a(an):

uncompensated flowmeter
compensated flowmeter
bourdon gauge
upright flowmeter

compensated flowmeter

How well did you know this?

Not at all

Perfectly

the nasal cannula is designed to provideFiO2 in which of the following ranges when the patient is breathing a normal ventilatory pattern

22 to 0.40
40 to 0.60
22 to 0.90
28 to 0.50

0.22 to 0.40

How well did you know this?

Not at all

Perfectly

Jewel Potts has advanced fibrotic lung disease and requires moderate to high FiO2. she is currently on a 40% air-entrainment mask but becomes short of breath when she removed the mask to eat. what would you recommend as a supplemental form of O2 while eating

nasal cannula at 2 L/min
nasal catheter at 4 L/min
nasal cannula at 10 L/min
nasal cannula at 5 L/min
nasal catheter at 6 L/min

nasal canula at 5 L/min

4 x L/min + 21 = approximate FiO2

How well did you know this?

Not at all

Perfectly

while delivering an 80-20% helium-oxygen mixture using an oxygen flowmeter at 12 L/m, the total flow going to the patient is:

22 L/m
19 L/m
25 L/m
21 L/m

22L/min

How well did you know this?

Not at all

Perfectly

the percentage of oxygen delivered by a nasal cannula depends on which of the following factors

I. the flowrate from oxygen flowmeter
II. the patients minute ventilation (depth and rate) (VE)
III. the patients hemoglobin level
IV. the patients heart rate

I and II

I. the flowrate from oxygen flowmeter
II. the patients minute ventilation (depth and rate) (VE)

How well did you know this?

Not at all

Perfectly

in setting up a home care patient with COPD for continuous low0flow oxygen therapy via an oxygen concentrator. which of the following additional equipment must you provide

a pressure reducing valve
an emergency generator
a bag-mask resuscitator
a back-up gas cylinder
a back-up concentrator

a back-up gas cylinder

How well did you know this?

Not at all

Perfectly

which of the following are correct “air” to “oxygen” entrainment ratios

I. 80% = 0.3:1
II. 70% = 0.6:1
III. 60% = 1:1
IV. 31% = 10:1

I, II, and III

I. 80% = 0.3:1
II. 70% = 0.6:1
III. 60% = 1:1

How well did you know this?

Not at all

Perfectly

the respiratory care practitioner can reasonable suggest the use of an FiO2 above 21% for which of the following

I. treat hypoxemia
II. decrease the work of breathing
III. increase myocardial work
IV. provide physiological support

I and II

I. treat hypoxemia
II. decrease the work of breathing

How well did you know this?

Not at all

Perfectly

A patient in ER is in severe respiratory distress. The patient is a known COPD patient who is normally on home oxygen at 1 I/m. The patient is placed on a nasal cannula at 4 L/min. After 4 hours, the patient is lethargic and breathing slow and shallow. ABGs reveal a Ph of 7.25, PaCo2 of 70 and a Pa02 of 80 mmHg. The patient is most likely suffers from:

absorption atelectasis
oxygen-induced hypoventilation
retinopathy of prematurity
oxygen toxicity

oxygen-induced hypoventilation

How well did you know this?

Not at all

Perfectly

A patient in ER is in severe respiratory distress. The patient is a known COPD patient who is normally on home oxygen at 1I/m. The patient is placed on a nasal cannula at 4 L/min. After 4 hours, the patient is lethargic and breathing slow and shallow. ABGs reveal a Ph of 7.25, PaCo2 of 70 and a Pa02 of 80 mmHg. The patient is most likely suffers from:

For the above patient, what is recommended?

change to a simple mask at 6 L/min
change to nasal cannula at 6 L/min
change to partial rebreather mask
change to 28% air-entrainment mask
change to nasal catheter at 4 L/min

change to 28% air-entrainment mask

How well did you know this?

Not at all

Perfectly

A patient is brought to the ER and is lethargic and has the scent of smoke on her clothes. which of the following is the best evaluative tool to evaluate her respiratory status?

continuous pulse oximetry
bronchoscopy
carboxyhemoglobin
arterial blood gas

carboxyhemoglobin

How well did you know this?

Not at all

Perfectly

Which of the following should a respiratory therapist use to determine a neonate’s gestational age?

Dubowitz
Silverman
APGAR
Babinski

Dubowitz

How well did you know this?

Not at all

Perfectly

21 year old male patient with a diagnosis of status asthmatics is intubated and has been receiving mechanical ventilation. There is a
sudden increase in airway pressures. The patient is hemodynamically stable and breath sounds are clear but significantly decreased on the right. Which of the following should the respiratory therapist recommend?

insert a right-sided chest tube
order a portable chest radiograph
draw an arterial blood gas
call the physician

order a portable chest radiograph

How well did you know this?

Not at all

Perfectly

When coordinating the sequence of the following therapies in bronchopulmonary clearance, which of the following should a respiratory therapist administer prior to high-frequency chest wall oscillation (Vest)?

xyanthine
B2 adrenergic
mucolytic
hypertonic saline

B2 adrenergic

How well did you know this?

Not at all

Perfectly

A patient with a tracheostomy tube is receiving heated aerosol therapy. A respiratory therapist finds the FiO2 is 0.60 by oxygen analyzer when the air-entrainment setting is 0.40. Which of the following could cause these findings?

I. the analyzer could be improperly calibrated
II. the tracheostomy tube could be partially occulded with secretions
lll. the water level in the nebulizer could be too low
IV. water in the tubing could be reducing the gas flow

I and IV

I. the analyzer could be improperly calibrated
IV. water in the tubing could be reducing the gas flow

How well did you know this?

Not at all

Perfectly

Which of the following activities must occur as part of tracheostomy decannulation in a patient?

I. document airway patency during sleep and activity
II. add a Passey-Muir valve
Ill. insert a fenestrated tracheostomy tube
IV. verify the time of food intake

I and IV

I. document airway patency during sleep and activity
IV. verify the time of food intake

How well did you know this?

Not at all

Perfectly

What volume of a 1:200 dilution should a respiratory therapist use to administer 2.5 mg of a medication?

0.5 mL
0.75 mL
0.25 mL
1 mL

0.5 mL

1/200 = _/2.5

How well did you know this?

Not at all

Perfectly

An increase in which of the following will decrease the work of breathing associated with spontaneous breathing through a ventilator circuit?

increasing the flow
pressure support
setting the inspiratory time at 1.2
inspiratorv pressure setting

pressure support

How well did you know this?

Not at all

Perfectly

Auscultation of the chest over a pneumothorax is most likely to reveal which of the following?

bronchial breath sounds
diminished breath sounds
vesicular breath sounds
hyperressonance

diminished breath sounds

How well did you know this?

Not at all

Perfectly

A respiratory therapist observes the following on the volume-time graphic (does not come to baseline) during a ventilatior check. Which of
the follwing is the therapist’s most appropriate action?

make sure the patient circuit is not kinked
look for the source of a leak
insert a bite block
check suction pressure is set correctly

look for the source of a leak

How well did you know this?

Not at all

Perfectly

A nursing home patient admits to MICU due to pneumonia and dehydration. If therapeutic gases are delivered dry for a period of time, what consequences will this have on the patient’s airway?

decrease the viscosity of the secretions
impair mucocilliary clearance
lessen airway resistance
decrease the risk of pulmonary infections

impair mucocilliary clearance

How well did you know this?

Not at all

Perfectly

Which of the following devices would be contraindicated for a patient whose upper airway has been bypassed (as in intubated
with an ET tube or tracheostomy tube)

heated wick humidifier
simple bubble humidifier
heated large volume jet nebulizer
HME
cascade humidifier

simple bubble humidifier

How well did you know this?

Not at all

Perfectly

A 40% aerosol runs at 13 L/m. What is the total flow output?

40 L/min
52 L/min
78 L/min
26 L/min

52 L/min

How well did you know this?

Not at all

Perfectly

Given an MD for drug administration, which of the following techniques will increase aerosol deposition by sedimentation in the lungs? high inspiratory flow short inspiratory flow 10 second breath hold utilizing aerochamber and hearing a whistle

10 second breath hold

You are to give a patient a bronchodilator with a small volume nebulizer. Aerosol deposition in the lower respiratory tract will be enhanced by: I. normal tidal volume breathing II. aerosol droplets are in the 2- 5 micron range III. high inspiratory flowrate IV. respiratory rate › 20 bpm

I and II I. normal tidal volume breathing II. aerosol droplets are in the 2- 5 micron range

You are to instruct a patient in MDI therapy for the administration of bronchodilator. The patient's prescrition reads; "MDI bronchodilator 2 puffs qid.” How much time should you instruct the patient to wait minimally in between each puff? 2-3 minutes 30 seconds 5-10 seconds 15 seconds

30 seconds

patient with an endotracheal tube requires an Fi02 of 0.45. Which of the following oxygen-administration devices would be most appropriate: aerosol mask T-piece face tent trach collar

T-piece

A COD patient is receiving a bronchodilator agent via a small volume nebulizer. The respiratory therapist notes that the patient's heart rate has increased from 98 beats per minute to 110 beats/minute during the treatment. What should the therapist do at this time? recommend switching to another bronchodilator continue the treatment and monitor the patient terminate the treatment and notify the physician have the patient use an MDI instead of a small volume nebulizer

continue the treatment and monitor the patient

You walk into a patient's room to check a ventilator and note the temperature of the humidified gas going to the patient is only 26 C. Which of the following factors could cause this decrease in the temperature of the delivered gas? I. the heater setting is too low or has been turned off II. the circuit length is too short Ill. the water level is too low IV. the room temperature is too hot

I and III I. the heater setting is too low or has been turned off Ill. the water level is too low

Use of a DPI for the administration of a bronchodilator should NOT be used in which of the following patient groups? I. Infants and children less than 4 years old II. Patients suffering an acute bronchospastic episode Ill. Patients requiring maintenance therapy

I and II I. Infants and children less than 4 years old II. Patients suffering an acute bronchospastic episode

What type of nebulizer synchronizes nebulization of the medication with the patient's inspiratory effort and results in greater aerosol delivery to the patient? Respigard Il nebulizer Breath Actuated nebulizer Pari Neb Standard small volume nebulizer

Breath Actuated nebulizer

Which of the following bronchopulmonary segments are being drained if a patient is lying on his stomach, with pillows under his hips and the foot of the bed is elevated? ``` inferior segment of the upper lobe posterior basal segments of the lower lobes apical segment of the left upper lobe lateral segment of the right lobe left anterior segment of the upper lobe ```

posterior basal segments of the lower lobes

Chest x-rays reveal an infiltrative process in the right middle lobe of a patient. How should this patient be positioned to have postural drainage applied to that lung region? right side down, feet elevated, with a three-quarter turn toward the supine side Supine Trendelenburg position left side down, feet elevated, with a three-quarter turn toward the supine side left side down, flat

left side down, feet elevated, with a three-quarter turn toward the supine side

Postural drainage and percussion would be indicated in all of the following disorders EXCEPT: ``` chronic bronchitis active TB (tuberculosis) bronchiectasis penumonia cystic fibrosis ```

active TB (tuberculosis)

During the initial treatment, a PEP device is set to deliver a pressure of 15 cmH20 on exhalation. The patient complains of dyspnea and can only maintain exhalation for a short period. Which of the following should the respiratory therapist recommend? decrease the PEP level to 10 cmH20 increase the PEP level to 20 cmH20 discontinue the PEP therapy add a bronchodilator to the PEP therapy

decrease the PEP level to 10 cmH20

Chest assessment indicates that retained secretions have caused atelectasis of the right middle lobe in a 45-year old non-smoking patient. The patient has received postural drainage therapy and directed cough technique, but both have been ineffective. What should now be recommended to help remove secretions and reverse atelectasis? encourage the patient to cougn more vigorously initiate incentive spirometry increase the patiet's FiO2 hydrate the patient and use positive expiratory pressure

hydrate the patient and use positive expiratory pressure

``` The patient in the diagram below is positioned so that which lobes are being drained? I. right lower lobe II. left lower lobe III. left upper lobe IV. right upper lobe ```

I. right lower lobe | II. left lower lobe

You are summoned to evaluate a 45-year old female, who is two days post abdominal surgery and is conscious, oriented and dyspneic. Her vital signs reveal a HR of 115 b/m, Respiratory rate of 30 bpm, and Temperature of 37 C. The patient has been performing flow-oriented incentive spirometry for the last two days at a frequency of TID and 10 sustained deep breaths each treatment. Auscultation of the patient's lungs reveal diminished breath sounds in both bases accompanied by a few late inspiratory crackles. Which of the following modifications to therapy would you recommend for this patient? Administer volume-oriented IPPB TID implement flutter therapy TID increase the frequency of the incentive spirometry treatments to Q1 hour have the patient perform active cycle breathing, followed by aerosol therapy Q6 hours

increase the frequency of the incentive spirometry treatments to Q1 hour

For which of the following types of pogt-operative surgical patients would the Trendelenburg position during postural drainage be contraindicated? thoracic surgery abdominal surgery orthopedic surgery spinal surgery

spinal surgery

A recent post-operative thoracotomy patient is experiencing intense incisional pain as the therapist is discussing the goals of incentive spirometry with the patient. What patient NEED must first be addressed before learning can take place? The patient must understand the disease process that warranted the surgery The patient must know the difference between a flow-oreinted and a volume-oriented spirometer The patient needs pain medication The patient must know how the incentive spirometzy will improve his condition

The patient needs pain medication

Which of the following clinical findings indicate the development of atelectasis? I. Opacified areas on the chest x-ray II. Inspiratory and expiratory wheezing III. Tachypnea IV. Diminished or bronchial breath sounds

I, III and IV I. Opacified areas on the chest x-ray III. Tachypnea IV. Diminished or bronchial breath sounds

A 55 year old post-op thoracic surgery patient has been receiving PEP therapy with a bronchodilator QID for the past three days. Which of the following would be considered positive outcomes of the PEP therapy? I. increased soutum productior II. increased respiratory rate III. resolution of hypoxemia IV. diminished breath sounds that now become adventitious over larger airways

I, III and IV I. increased soutum productior III. resolution of hypoxemia IV. diminished breath sounds that now become adventitious over larger airways

The physician asks you to assess a patient to determine the possibility of retained secretions. While performing your assessment, all of the following could indicate retained secretions EXCEPT: ``` diffuse wheezing on auscultation weak ineffective cough tachypnea and tachycardia presence of atelectasis on chest x-ray bronchial breath sounds ```

diffuse wheezing on auscultation

An oropharyngeal airway is LEAST appropriate for which of the following? patient who requires bag/mask ventilation a post-operative patient in recovery room a conscious patient heavily sedated patient patient who is orally intubated

a conscious patient

Immediately following intubation of a patient, you note that the tube is located at the 23 cm at the patients teeth. One hour later, the tube is now located at the 20 cm marking at the patients teeth. This would most likely indicate: Correct placement of endotracheal tube Movement of endotracheal tube into the right mainstem bronchus Movement of endotracheal tube into the left mainstem bronchus Rupture of endotracheal tube cuff Movement of endotracheal tube towards or above glottis

Movement of endotracheal tube towards or above glottis

After a physician intubates a patient in the emergency room, your partner begin manual resuscitation with an MRB bag and 100% 02. On auscultation, you note the absence of breath sounds, but hear gurgling over the epigastrum. Which of the following has most likely occurred? ``` a right-sided tension pneumothorax intubation of the left mainstem bronchus intubation of the patient's esophagus intubation of the right mainstem bronchus a left-sided tension pneumothorax ```

intubation of the patient's esophagus

A patient has an oral endotracheal tube in place and is being mechanically ventilated. A respiratory therapy practitioner hears a gurgling sound coming from the patient's mouth throughout the inspiratory phase of the ventilator. The practitioner should: monitor the patient extubate the patient and insert a larger tube withdraw 10 ml of air from the cuff until no noise can be heard during the inspiratory cycle add air to the cuff just until no noise can be heard during the inspiratory cycle add air to the cuff to maintain 30mmig pressure

add air to the cuff just until no noise can be heard during the inspiratory cycle

A patient is being maintained on mechanical ventilator with a peak pressure of 40 cmH20, and a tidal volume of 600 ml. Suddenly, the pressure increases to 55 cmH20. This could be related to all of the following EXCEPT: ``` herniated cuff over the end of the tube right mainstem bronchial intubat ion mucus plugging a cuff leak the patient biting the ET tube ```

a cuff leak

Which conditions represent complications of tracheobronchial suctioning? ``` I. tachycardia I. cardiac arrythmias Ill. bradycardia IV. hyperventilation V. aphonia ```

I, II and III I. tachycardia I. cardiac arrythmias Ill. bradycardia

The first sign of hypoxia in a patient who is being suctioned would be: grunting cyanosis bradycardia tachycardia

tachycardia

An adult female requires mechanical ventilation and is intubated with a 8.5mm ID endotracheal tube. What is the maximum size suction catheter that would be allowable for safe tracheal suctioning? 10 Fr 12 Fr 14 Fr 16 Fr

The most common problem following extubation is: ``` vocal cord polyps mucosal ulceration tracheomalacia trancheostenosis glottic edema ```

glottic edema

While cutting the tape to resecure the endotracheal tube of a patient who is being mechanically ventilated, the respiratory therapist accidently severs the cuff inflation line. Whatl should the therapist do at this time? immediately remove the endotracheal tube insert a blunted needle attached to a syringe into the severed line and inject some air clamp the severed cuff inflation line with hemostats and leave the tube in place recommend a STAT portable cnest x-ray to assess the status of the tube

insert a blunted needle attached to a syringe into the severed line and inject some air

A patient has just been endotracheally intubated. the chest x-ray assessing the placement of the endotracheal tube was obtained while the patient's neck was flexed and shows that the tubes distal tip is 1 cm below the carina on the right. What should the therapist do at this time? request another chest radiograph add 1 cm of air Into the cuff of the endotcracheal tube withdrawl the tube 2 to 3 cm and resecure the tube place the patient neck in the neutral position

Request another cxr

after intubating a patient in respiratory failure, a physician orders continuous mechanical ventilation, before connecting the ventilator to the patient, you must: I. verify proper functioning of the ventilator II. establish the initial ventilator settings III. draw and analyze arterial blood gases IV. ensure ETT is secure and in proper placement

I and II I. verify proper functioning of the ventilator II. establish the initial ventilator settings

you place a patient on SIMV with a preset rate of 8/min, a Vt of 500 ml and 10 of PEEP. you notice a peak pressure of 25 for each breath. which of the folloiwng alarm settings would be appropriate I. low exhaled minute ventilation alarm at 5 II. low PEEP/CPAP pressure alarm at 5 III. high inspiratory pressure limit at 40 IV. low exhaled volume at 500

II and III II. low PEEP/CPAP pressure alarm at 5 III. high inspiratory pressure limit at 40

after setting up a patient on MV, which of the following supplementary equipment would you require to be available at (or near) the bedside I. a suction source and catherter II. a backup artifical airway III. a manual resuscitator with O2

I, II, and III I. a suction source and catherter II. a backup artifical airway III. a manual resuscitator with O2

a patient on MV is ordered to recieve Updraft nebulizers with albuterol every 4 hours. the RT places an external nebulizer in-line an connects it to a flowmeter on the wall. all of the following may occur except I. lower exhaled volume readings II. increased patient effort necessary to trigger III. increased peak inspiratory pressure IV. decreased tidal volume delivery

IV only IV. decreased tidal volume delivery

which of the following clinical situations are considered indication for MV I. apnea II. hyperventilation III. progressive neuromuscular disease IV. impending respiratory failure

II, III, IV II. hyperventilation III. progressive neuromuscular disease IV. impending respiratory failure

the following abgs are obtained on five patients. which of these is most in need of MV support ``` pH 7.34, PaCO2 64, HCO3 32 pH 7.39, PaCO2 72, HCO3 34 pH 7.21, PaCO2 64, HCO3 25 pH 7.36, PaCO2 78, HCO3 47 pH 7.42, PaCO2 67, HCO3 36 ```

pH 7.21, PaCO2 64, HCO3 25

all of the following would indicate a need for MV support except a P/F ratio of 223 while breathing 30% O2 significant intra-pulmonary shunting acute on chronic respiratory failure with a pH of 7.28 refractory hypoxemia on 70% oxygen

a P/F ratio of 223 while breathing 30% O2

in order to estimate the airway resistance of a patient receiving MV support, which of the following measures would you use (Plateau - baseline) pressure during end-inspiratory pause (peak + plateau) pressure during end-inspiratory pause plateau pressure after end-inspiratory pause (peak - plateau) pressure during end-inspiratory pause

(peak - plateau) pressure during end-inspiratory pause

a ventilator is set at a rate of 20/min and an I/E ratio of 1:3. the length of inspiration will be which of the following 0.5 sec 0.75 sec 1.25 sec 3 sec

0.75 sec

what VT listed below would provide a breath of approximately 8ml/kg of IBW for the patietn listed above. 5'10" male ``` 350 600 750 700 800 ```

600 mL

a ventilator circuit hasa tibing compliance of 1.5 mL/cmH2O. if the set VT is 200 and the peak pressure is 35. what is the VT actually recieved by patient 140 148 155 53

148 mL

a patient is receiving MV and has just received Pavulon a neuromuscular blocking (paralyzing) agent. the most important alarm to monitor at this time would be ``` I:E ratio high minute alarm high pressure low pressure and low VE high respiratory rate ```

low pressure and low VE

which of the following modes of MV would provide all of the patients VE with mandatory pressure targeted breaths ``` VC-CMV PC-CMV PSV CPAP PC-SIMV ```

PC-CMV

PRE TEST Flashcards

(68 cards)