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RET 2714, Lee > RET 2714 MID term > Flashcards

RET 2714 MID term Flashcards

1
Q
  1. The respiratory therapist is evaluating a newborn with mild respiratory distress due to tracheal stenosis. During which period of lung development did this problem develop?
    a. Alveolar
    b. Embryonal
    c. Canalicular
    d. Saccular
A

a. Alveolar

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2
Q
  1. Which of the following mechanisms is (are) responsible for the possible association between oligohydramnios and lung hypoplasia?

I. Abnormal carbohydrate metabolism

II. Mechanical restriction of the chest wall

III. Interference with fetal breathing

IV. Failure to produce fetal lung liquid

a. I and III only
b. II, III, and IV only
c. II and III only
c. I, II, and IV only

A

b. II, III and IV

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3
Q

How long after birth should it take for the ductus arteriosus to close completely?

a. 96 hours
b. 1 week
c. 48 hours
d. 24 hours

A

a. 96 hours
* (20% will be close in 24 hrs, 80% in 48 hrs and 100% in 96 hrs)*

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4
Q

A pregnant woman is coming for an early prenatal evaluation and wants to know if she can listen to the baby’s heartbeat. How early can the fetal heartbeat be detected?

a. Day 22
b. Day 60
c. Day 8
d. Day 45

A

a. Day 22

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5
Q

What is the function of Wharton’s jelly inside the umbilical cord?

a. To prevent the vessels inside the cord from kinking
b. To help protect the fetus
c. To regulate the temperature between the fetus and the mother
d. To help provide nutrition to the fetus

A

a. To prevent the vessels inside the cord from kinking

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6
Q

A therapist treating a newborn with hypoxemia due to hypothermia should also be aware of which of the following conditions?

a. Hypercarbia
b. Left-to-right shunt
c. Hypoglycemia
d. Hypocalcemia

A

c. Hypoglycemia

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7
Q

Which of the following conditions are associated with preeclampsia?

I. Multiparity

II. Proteinuria

III. Generalized edema

IV. Hypertension

a. II, III, and IV
b. II and III
c. I, III, and IV
d. I, II, and III

A

a. II, III, and IV

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8
Q

Which of the following conditions is a significant problem in post term pregnancy?

a. Obesity
b. Infection
c. Fetal anencephaly
d. Meconium aspiration

A

d. Meconium aspiration

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9
Q

A woman 41-weeks pregnant is at high risk for complication in the postpartum period. Which of the following agents will be more appropriate to induce labor?

a. Terbutaline
b. Aspirin
c. Oxytocin
d. Magnesium sulfate

A

c. Oxytocin

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10
Q

Which of the following microorganisms often affect pregnancy outcome?

a. Mycobacterium tuberculosis
b. Haemophilus influenzae
c. Hepatitis C virus
d. Group B Streptococcus

A

d. Group B Streptococcus

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11
Q

A fetus is undergoing a contraction stress test. Uterine contractions are stimulated by the intravenous infusion of oxytocin into the mother. The fetal PO2 drops below 12 mm Hg and causes the fetal heart rate to slow. Which of the following conditions is likely indicated by this occurrence?

a. Nuchal cords
b. Uteroplacental insufficiency
c. Placenta abruption
d. Oligohydramnios

A

b. Uteroplacental insufficiency

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12
Q

A pregnant woman has been diagnosed with pregestational diabetes. Which of the following risk factors should the therapist be aware at the time of delivery?

a. Fetal malformations
b. Microcephaly
c. Oligohydramnios
d. Unexplained abruption placenta

A

c. Oligohydramnios

(This is a condiction during pregnancy characterized by deficiency of omniotic fluid)

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13
Q

What is the most common invasive procedure to assess the fetal condition?

a. Scalp fetal pH
b. Amniocentesis
c. Stress test
d. Needle ultrasound

A

b. Amniocentesis

(Is a medical procedure used in prenatal diagnosis of chromosomal abnormalities and fetal infections, and also for sex determination, in which a small amount of amniotic fluid, which contains fetal tissues, is sampled from the amniotic sac surrounding a developing)

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14
Q

Which of the following components of a patient’s medical history is intended to determine the presence of symptoms not identified in the history of present illness and may be related or contribute to the child’s underlying condition?

a. Review of systems
b. History of present illness
c. Chief complaint
d. Past medical history

A

a. Review of systems

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15
Q

. While auscultating a young child’s thorax, the therapist hears bilateral fine crackles.

Which of the following conditions can produce these adventitious sounds?

a. Pulmonary edema
b. Croup
c. Bronchitis
d. Asthma

A

a.Pulmonary edema

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16
Q

While percussing the thorax of a child during a physical examination, the therapist hears a dull percussion note over the child’s right lung. Which of the following conditions may cause this physical finding?

I. Atelectasis

II. Pneumothorax

III. Pleural effusion

IV. Consolidation

a. I, II, III, and IV
b. I, III, and IV only
c. I and II only
d. II, III, and IV only

A

b.I, III, and IV only

(Dull BS are normally heard over dense areas)

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17
Q

After the umbilical cord has been cut in the delivery room during the delivery of an infant who is large for gestational age, the therapist notices that the umbilical cord is large and fat. Which of the following maternal conditions is likely present?

a. Hypertension
b. Diabetes mellitus
c. Renal insufficiency
d. Congestive heart failure

A

b.Diabetes mellitus

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18
Q

The therapist has completed a 1-minute Apgar score. The following evaluations were obtained:

(1) the infant is pale;
(2) the heart rate is 90 beats/minute;
(3) the respiratory effort is irregular;
(4) some muscle tone is noted; and
(5) no response to nasal suctioning is found.

On the basis of these findings, what Apgar score should be assigned to this neonate?

a. 1
b. 5
c. 2
d. 3

A

d.3

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19
Q

What measures can the therapist take to prevent heat loss and cold stress before performing resuscitation on a preterm neonate?

I. Dry the infant’s skin.

II. Wrap the infant in pre-warmed blankets.

III. Remove wet linens from around the infant.

IV. Measure the neonate’s body temperature.

a. I, II, and IV only
b. I, II, and III only
c. I and II only
d. IV only

A

b.I, II, and III only

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20
Q

Which of the following pieces of information represent components of patient history for a new pediatric patient?

I. Chief complaint

II. History of present illness

III. Past medical history

IV. Occupational history

a. I, II, III, and IV
b. I, II, and III only
c. I and II only
d. III and IV only

A

b.I, II, and III only

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21
Q

Which of the following components compose the past medical history section of the patient’s medical history?

I. Birth weight

II. Previous mechanical ventilation

III. Recurrence of symptoms based on season

IV. Emergency department visits

a. II only
b. II and IV only
c. I, II, III, and IV
d. I, II, and IV only

A

c.I, II, III, and IV

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22
Q

. Which of the following white blood cell counts constitutes the condition leukopenia?

a. 5000 to 10,000/mm3
b. Less than or equal to 3500/mm3
c. 10,000 to 20,000/mm3
d. Greater than or equal to 25,000/mm3

A

b.Less than or equal to 3500/mm3

(Is a low WBC counts, normal range is between 4,000 to 11,000 per microliter of blood)

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23
Q

As the head of a neonate contaminated with meconium emerges at birth, the heart rate monitor indicates 120 beats/minute, and the physician notices that the infant has good muscle tone and a strong respiratory effort. What should the physician do at this time to provide airway care?

a. Perform tracheal suctioning only at this time.
b. Intubate the infant immediately.
c. Only routine monitoring of respiratory vital signs is needed at this time.
d. Perform pharyngeal and tracheal suctioning immediately.

A

c.Only routine monitoring of respiratory vital signs is needed at this time.

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24
Q

What type of X-ray view is obtained when the radiographic plate is placed behind the patient’s back with the x, and the side up may better define ____________________.

a. Posteroanterior view
b. Anteroposterior view
c. Lateral view
d. Frontal view

A

b.Anteroposterior view

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25
Q

. The respiratory therapist is evaluating a child with suspected foreign body aspiration. The radiographer gently adds pressure to the abdomen during expiration to take the chest radiograph. If an obstruction is confirmed, what changes should the RT expect to see?

a. The size of both lungs will decrease.
b. The size of the affected lung will decrease.
c. The size of the unaffected lung will increase.
d. The size of the affected lung will remain the same or the lung will be hyper-expanded.

A

d.The size of the affected lung will remain the same or the lung will be hyper-expanded.

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26
Q

While viewing an anteroposterior view of a chest radiograph of a 24-month-old intubated child, a therapist notices that the endotracheal tube has now migrated right above the inferior clavicular border. What could explain this new location of the endotracheal tube?

a. Rotation of the head to the left
b. Flexion of the head
c. Rotation of the head to the right
d. Extension of the head

A

b.Flexion of the head

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27
Q

Which of the following are criteria to order a chest radiograph in a pediatric patient who does not have chest symptoms?

I. Fever

II. Oxygen saturation < 95%

III. White blood cell count > 20,000/mm3

IV. Creatinine > 2 mg/dL

a. I and IV only
b. III only
c. II and III only
d. I, II, and III only

A

d.I, II, and III only

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28
Q

A mother has just given birth to a 42-week infant who is small for his gestational age. A chest radiograph of this neonate reveals coarse, patchy opacities secondary to atelectasis from bronchial obstruction alternating with areas of hyperinflation. Which of the following clinical disorders does this infant likely have?

a. Meconium aspiration syndrome
b. Acute respiratory distress syndrome
c. Pulmonary interstitial emphysema
d. Transient tachypnea of the newborn

A

a.Meconium aspiration syndrome

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29
Q

Which of the following methods is acceptable for delivering a drug via a pMDI to an intubated neonate receiving mechanical ventilation?

A

Through a resuscitation bag

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30
Q

Why are pass-over humidifiers preferred over pneumatic nebulizer humidifiers?

A

Pass-over humidifiers transmit fewer pathogens than pneumatic nebulizers

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31
Q

An 18-month-old patient brought to the emergency department is exhibiting signs and symptoms consistent with an acute asthma episode and is administered a beta-2 agonist to which the patient does not respond favorably. Which of the following conditions could be responsible for this patient’s problem?

A

Aspiration of a foreign object

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32
Q

Where in the ventilator circuit should a continuous jet nebulizer be placed to improve efficiency of aerosol delivery?

A

30 cm from the ETT in the inspiratory limb

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33
Q

For which of the following types of patients would using a dry powder inhaler (DPI) for medication delivery likely be contraindicated?

A

A 4-year-old child

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34
Q

Which of the following considerations is most important when using a large-volume nebulizer to provide oxygen and humidification to an infant in an incubator?

A

Preventing a high noise level from developing

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35
Q

The respiratory therapist is administering a nebulizer with a mask to a 2-year-old child. The mask is being held away from the child’s face (“blow-by”) due to excessive crying. What should the RT consider doing to improve aerosol lung deposition?

A

Comfortably hold the mask close to the face to minimize the leak.

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36
Q

Pneumatic nebulizers operate according to which of the following physical tenets?

a. Law of conservasion of energy
b. Law of continuity
c. Bernoulli principle
d. Venturi principle

A

c. Bernoulli principle

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37
Q

When a conventional jet nebulizer is operated at a flow of 10 L/min versus 5 L/min, what should the respiratory therapist expect?

A

The particle size remains stable

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38
Q

An aerosol treatment is being administered via a jet nebulizer. After 8 minutes the nebulizer starts “sputtering.” What should the therapist do at this point?

a. Allow the nebulizer to continue the treatment for 2 more minutes.
b. Terminate the treatment at this time.
c. tap the nebulizer cup until no more mist is produced.
d. Add more diluent to the nebulizer cup.

A

b. Terminate the treatment at this time.

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39
Q

In order to guarantee the same performance of the nebulizer after repeated use, what should be suggested to the user?

a. Rinse with sterile water and air dry
b. Rinse with sterile water and dry with a clean paper towel.
c. Rinse with vinegar and air dry.
d. Rinse with a mixture of vinegar and sterile water.

A

a. Rinse with sterile water and air dry

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40
Q

Which of the following organs is considered to be the first to form?

a. Heart
b. Lungs
c. Brain
d. Kidneys

A

a. Heart

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41
Q

Which of the following functions are served by spacer and holding chambers in conjunction with pMDIs?

I. Reduction in oropharyngeal deposition of drug

II. Elimination of the “cold Freon effect”

III. Improvement in lower respiratory tract deposition

IV. Decrease in treatment time without sacrificing efficacy

A

I,II,III

42
Q

Why should pMDIs containing steroids in particular be used with a valved holding chamber?

A

To reduce the risk of oral yeast infections

43
Q

The physician in the emergency department is attending to a 12-year-old child who has an exacerbation of asthma. The physician asks the therapist to recommend a medication that has a synergistic effect with beta-2 agonists during asthma exacerbations. Which of the following medications should the therapist recommend1?

a. Montelukast
b. Fluticasone
c. Triamcinolone
d. Ipratropium bromide

A

d. ipratropium bromide

(Synergistic effect is when chemical substances or biological structures interact resulting in an overall effect that is greater than the sum of individual effects of any of them)

44
Q

. By what percentage can breath holding increase particle deposition in the lungs?

a. 15%
b. 20%
c. 10%
d. 5%

A

c. 10%

45
Q

Where does the fetal oxyhemoglobin dissociation curve reside in comparison with the normal adult oxyhemoglobin dissociation curve?

A

The fetal oxyhemoglobin dissociation curve lies to the left of the adult curve

46
Q

. Which of the following problems occurs as a result of absorption atelectasis?

a. Increase partial pressure of Nitrogen in the blood
b. Pulmonary vasodilation
c. Decrease alveolar pressure
d. Increase intrapulmonary shunting.

A

d. Increase Intrapulmonary Shunting

47
Q

. For which of the following condition(s) is a high-flow nasal cannula contraindicated?

I. Pneumothorax

II. Apnea of prematurity

III. Severe upper airway obstruction

IV. Lack of spontaneous breathing

A

II. Apnea of prematurity

48
Q

Which of the following ranges of oxygen flow need to be set when administering oxygen to an infant via a simple mask?

a. 1 to 6 L/m
b. < 1 L/m
c. > 1 L/m
d. 6 to 10 L/m

A

d. 6-10 L/m

49
Q

What is the minimum level of oxygen tension in a child that requires oxygen administration?

A

Pa02 of 80 mmHg

50
Q

The therapist notices that the reservoir bag on a partial rebreathing mask being worn by a pediatric patient collapses completely during each inspiration. What should the therapist do at this time?

a. Continue monitoring the patient as the devise is operating correctly
b. Switch to nonrebreathing mask
c. Increase the oxygenflow
d. Decrease the oxygen flow.

A

C. Increase the flow of the device

51
Q

A child with an exacerbation of asthma is a candidate for the administration of heliox. Which of the following gas delivery devices is most suitable for its administration?

A

Nonrebreathing

52
Q

In order to decrease the risk of nasal irritation in newborns, what is the maximum flow rate recommended?

a. 2L/m
b. 0.5L/m
c. 1 L/m
d. 3 L/m

A

a. 2L/m

53
Q

Which of the following devices would be most appropriate to use for a 3-year-old patient who experiences immediate postextubation hypoxemia?

A

Aerosol Mask

54
Q

Which of the following disorders can develop in neonates as a result of receiving concentrations of oxygen that produce a high PaO2?

A

Retinopathy of prematurity

55
Q

In which of the following conditions is the oxygen-carrying capacity reduced despite the presence of a normal arterial oxygen tension?

a. Carbon monoxide poisoning
b. polycytemia
c. Heart Failure
d. Cyandide poisoning

A

b. Polycythemia

Polycythemia vera is due to abnormally increased red cell production in the bone marrow.

56
Q

When weaning an infant receiving oxygen from a nasal cannula attached to a low-flow flow meter set at 100%, what range represents the recommended oxygen flow reduction from the flow meter?

A

0.1% - 0.2%

57
Q

How will excess condensate present in aerosol tubing affect the delivered FiO2?

a. It will produce an unpredictable effect on the FiO2
b. It will only affect FiO2 if is excess of 2 L/m
c. It will decrease FiO2
d. It will increase the FiO2

A

d. It will Incease the FiO2

58
Q

Which of the following oxygen-delivery devices would be most suitable for an infant being treated for choanal atresia?

a. Oxygen Hood
b. Nasal catheter
c. Nasal cannula
d. Oxygen mask

A

a. Oxygen Hood

  • (An oxygen hood is used for babies who can breathe on their own but still need extra oxygen. A hood is a plastic dome or box with warm, moist oxygen inside)*
  • (Choanal atresia is a congenital disorder where the back of the nasal passage (choana) is blocked, usually by abnormal bony or soft tissue)*
59
Q

59. What is the concern when administering oxygen to a sedated infant who is wearing a nasal cannula?

a. The patient may stop breathing.
b. Too low of an FiO2 may be delivered.
c. Gastric distention may develop.
d. Too high of an FiO2 may be given.

A

b. Too low of an FiO2 may be delivered.

60
Q

60. The respiratory therapist is treating a hypoxemic child with a nasal cannula at 3 L/min. However, after few hours the child becomes tachypneic, demonstrates shallow breathing, and becomes hypoxemic. What should the therapist do at this time?

a. Switch to a partial rebreathing mask.
b. Increase flow rate on the cannula to 4 L/min.
c. Switch to an air-entrainment mask.
d. Apply positive pressure ventilation

A

c. Switch to an air-entrainment mask.

61
Q

62. The respiratory therapist verifies an order to administer albuterol 1.25 mg to a 2-kg infant. Why does this dose have the same safety and efficacy profile as a 2.5-mg dose in the adult?

a. The deposition efficiency in the infant results in a similar lung dose per kg of the adult patient.
b. The liver of the infant metabolizes 95% of the drug. Therefore, the lung deposition is similar to that of the adult.
c. Albuterol targets only a minimal number of beta-2 receptors in the infant’s airways.
d. The infant gets a higher lung dose, but it does not produce side effects.

A

a. The deposition efficiency in the infant results in a similar lung dose per kg of the adult patient.

62
Q

63. What is volumetric capnography able to determine?

I. Airway dead space

II. Alveolar tidal volume

III. Shunt fraction

IV. Alveolar minute volume

a. I, II, and IV only
b. I only
c. II, III, and IV only
d. I, II, III, and IV

A

a. I, II, and IV only

63
Q

64. The therapist has applied a bandage-type pulse oximetry probe too tightly to an infant’s finger. What problem can be expected to occur in this situation?

a. The SpO2 will read erroneously low.
b. The monitor will display a message indicating inadequate pulse.
c. The SpO2 will read erroneously high.
d. The monitor will display fluctuating SpO2 values between being erroneously low and high.

A

d. The monitor will display fluctuating SpO2 values between being erroneously low and high

64
Q

65. A therapist is monitoring a child on the mechanical ventilator who is hemodynamically stable. The PetCO2 is 48 mm Hg. If accurate, what should be the PaCO2?

a. 43-48 mm Hg
b. Exactly the same as PetCO2
c. 50-53 mm Hg
d. 45-48 mm Hg

A

c. 50-53 mm Hg

65
Q

66. What clinical parameter is critically important to monitor when mechanical ventilation is administered?

a. Heart rate
b. Blood pressure
c. Respiratory rate
d. Temperature

A

b. Blood pressure

66
Q

67. While attending to a neonatal patient in the neonatal intensive care unit (NICU), the therapist notices that a transcutaneous electrode is affixed to the upper chest of the neonate. What should the therapist do at this time?

a. The therapist should relocate the electrode on the sternum as close as possible to the heart.
b. The therapist should reposition the electrode on the neonate’s abdomen.
c. The therapist needs to move the transcutaneous electrode to the infant’s right shoulder.
d. The therapist should only continue monitoring the patient since the transcutaneous electrode is properly placed.

A

d. The therapist should only continue monitoring the patient since the transcutaneous electrode is properly placed.

67
Q

68. Which of the following features or characteristics apply to mainstream capnography?

I. The mainstream capnograph contains narrow tubing that can become occluded with mucus.

II. Mainstream capnography generally employs infrared spectrometers.

III. The mainstream capnograph does not add much weight to the breathing circuit.

IV . The mainstream capnograph is placed at the proximal end of the endotracheal tube.

I, II, and III only

I, III, and IV only

I and II only

II and IV only

A

II and IV

68
Q

69. The therapist has been asked to measure preductal oxygen saturation. Where could the therapist place the pulse oximeter probe?

a. Left thumb
b. Left earlobe
c. Forehead
d. Left hand

A

c. Forehead

69
Q

70. The therapist is assessing a mechanically ventilated infant and observes that the transcutaneous electrode temperature is set between 41° C and 44° C. What action does the therapist need to take at this time?

a. The therapist should increase the temperature range to 47° C to 48° C.
b. The temperature of the transcutaneous electrode needs to be reduced to 36° C to 38° C.
c. The electrode needs to be repositioned and maintained at the same temperature.
d. The temperature range set is appropriate; therefore, no action is necessary.

A

d. The temperature range set is appropriate; therefore, no action is necessary.

(41º C and 44°C are normal for infants)

70
Q

71. How should the therapist evaluate this capnogram?

a. Airway obstruction
b. Increased dead space ventilation
c. Hyperventilation
d. Hypoventilation

A

a. Airway obstruction

71
Q

72. How would tricuspid stenosis be expected to influence a patient’s CVP value?

a. Have no effect in the CVP value
b. Produce fluctuations in the CVP value
c. Elevate it above normal
d. Cause it to fall below normal

A

c. Elevate it above normal

(Tricuspid stenosis is a narrowing of the tricuspid valve opening. Tricuspid stenosis restricts blood flow between the upper and lower part of the right side of the heart, or from the right atrium to the right ventricle, elevating CVP)

72
Q

73. Which of the following factors would adversely affect the correlation between arterial puncture measurements and those from a capillary sample?

a. Hyperventilation
b. Hyperthermia
c. Hypoxemia
d. Hypotension

A

d. Hypotension

(Hypotension is abnormally low blood flow affecting the extrimities areas for punture measurements)

73
Q

74. The neonatal intensive care unit (NICU) respiratory therapy supervisor is observing a therapist obtain an arterial blood sample from an infant’s radial artery and notices that the therapist has the bevel of the needle pointed upward, entering the patient’s skin at a 45-degree angle and in a direction against the arterial flow. What should the supervisor do at this time?

a. Tell the therapist to penetrate the infant’s skin at about a 60-degree angle.
b. Inform the therapist to turn the bevel downward.
c. Advise the therapist to insert the needle in the same direction as the blood flows.
d. Continue to observe the procedure

A

d. Continue to observe the procedure

74
Q

75. Which of the following is one of the most common arrhythmias observed as a complication from the insertion of a pulmonary artery catheter?

a. Premature ventricular contraction
b. Atrial fibrillation
c. Paroxysmal atrial contraction
d. S3 gallop

A

a. Premature ventricular contraction

75
Q

76. In addition to the dorsalis pedis, which of the following arteries is involved when the modified Allen’s test is performed using a foot as the potential arterial puncture site?

a. Posterior tibial artery
b. Dorsalis pedis
c. Axillary artery
d. Femoral artery

A

a. Posterior tibial artery

76
Q

77. In addition to applying direct pressure to the puncture site immediately after the arterial puncture procedure, what can the therapist do to minimize the risk of hematoma formation in a patient who requires frequent radial arterial punctures?

a. Have the patient shake the arm periodically throughout the day.
b. Apply a bandage to the puncture site.
c. Have the patient maintain the arm in an elevated position for a couple of hours after the radial puncture.
d. Alternate arms used for arterial puncture and use other sites as well.

A

d. Alternate arms used for arterial puncture and use other sites as well.

77
Q

78. As the therapist applies a pulse oximeter finger probe to a neonate who is receiving supplemental oxygen, she notices that the SpO2 reading is 100%. What should the therapist do in this situation?

a. The therapist should obtain an arterial blood sample to confirm PO2 level.
b. The therapist should continue monitoring the patient because the reading is accurate.
c. The therapist should switch to using a capnometer.
d. The therapist should reduce the fraction of inspired oxygen.

A

a. The therapist should obtain an arterial blood sample to confirm PO2 level

78
Q

79. Why do transcutaneous oxygen tension (PO2) and carbon dioxide tension (PCO2) values differ from PaO2 and PaCO2 measurements?

a. Because oxygen is consumed, and carbon dioxide is produced in transit from the left ventricle to the electrode site
b. Because of the lag time between the cardiac output and the time the blood reaches the transcutaneous electrode site
c. Because metabolism in the tissue consumes oxygen and produces carbon dioxide at the site of the electrode
d. Because the skin is much more permeable to oxygen than carbon dioxide

A

c. Because metabolism in the tissue consumes oxygen and produces carbon dioxide at the site of the electrode

79
Q

79. Which of the following is the main physiologic factor responsible for deriving accurate transcutaneous data?

a. Minute ventilation
b. Heart rate
c. Ventilation-perfusion ratios
d. Peripheral perfusion

A

d. Peripheral perfusion

80
Q

80. How is the percentage of functional hemoglobin that is saturated with oxygen determined via pulse oximetry?

a. The sum of the amount of red and infrared absorbed by the tissue determines the SpO2.
b. The percentage of red light that lands on the photodiode represents the SpO2 (oxygen saturation as determined by pulse oximetry).
c. The ratio of the red and infrared light that reaches the photodiode signifies the SpO2.
d. The percentage of infrared light that reaches the photodetector reflects the SpO2.

A

c. The ratio of the red and infrared light that reaches the photodiode signifies the SpO2.

81
Q

81. The therapist has applied a bandage-type pulse oximetry probe too tightly to an infant’s finger. What problem can be expected to occur in this situation?

a. The monitor will display a message indicating inadequate pulse.
b. The monitor will display fluctuating SpO2 values between being erroneously low and high.
c. The SpO2 will read erroneously high.
d. The SpO2 will read erroneously low.

A

a. The monitor will display a message indicating inadequate pulse.

82
Q

82. Which of the following conditions can cause methemoglobinemia?

a. High fraction of inspired oxygen
b. Inhalation of nitric oxide (NO)
c. Anemia
d. Use of dobutamine

A

b. Inhalation of nitric oxide (NO)

(Methemoglobinemia (MetHb) is a blood disorder in which an abnormal amount of methemoglobin is produced)

(Nitric oxide oxidizes heme iron to the ferric state, resulting in the formation of methemoglobin)

83
Q

83. A patient has a systolic blood pressure of 80 mm Hg and a diastolic pressure of 50 mm Hg. What is this patient’s mean arterial pressure?

a. 130 mm Hg
b. 60 mm Hg
c. 30 mm Hg

A

b. 60 mm Hg

  • MAP= 2 Diastolic + Systolic/3*
  • MAP= 2(50)+ 80/3*
  • MAP= 100+80/3*
  • MAP= 180/3*

MAP= 60 mm Hg

84
Q

85. A respiratory therapist has been ordered to obtain a blood gas sample from a nonintubated premature baby. After selecting the best site to obtain the sample, what should the RT suggest ameliorating the pain associated with the procedure?

a. Administer a lidocaine drip
b. Inject lidocaine at the injection site
c. Give a pacifier dipped in 24% sucrose
d. Administer a small dose of fentanyl

A

c. Give a pacifier dipped in 24% sucrose

(Lidocane and creame anesthetics can only be given to >4 months old infant, < 4 months we use a sucrose solution)

85
Q

86. Which of the following factors influence the central venous pressure (CVP) measurement?

I. Bicuspid valve function

II. Right ventricular pressure

III. Intravascular volume

IV. Systemic venous return

II and IV only

II and III only

I and III only

II, III, and IV only

A

II, III, and IV only

86
Q

87. Which of the following conditions will preclude the use of indirect calorimetry?

I. Cuffed endotracheal tubes

II. Circuit leaks

III. FiO2 40%

IV. HFOV

a. II and IV only
b. I, II, and III only
c. II and III only
d. I, III, and IV only

A

a. II and IV only

87
Q

89. A 12-hour-old infant is experiencing respiratory distress, and the neonatologist orders a heel stick to assess the infant’s oxygenation status. What action should the therapist take at this time?

a. Explain to the doctor that an arterial puncture procedure is appropriate.
b. Instead of using the newborn’s heel, the therapist should use a finger as the site.
c. Inform the physician that this procedure is inappropriate at this time.
d. Perform the heel stick as ordered.

A

c. Inform the physician that this procedure is inappropriate at this time.

88
Q

92. When performing endotracheal suctioning on a neonate, why should the therapist routinely avoid advancing the catheter tip beyond the distal end of the endotracheal tube?

a. To minimize the risk of oxygen desaturation
b. To prevent the development of bronchial stenosis and granulomas
c. To decrease the chance of removing too much lung volume
d. To reduce the risk of inadvertent extubation with the suction catheter

A

b. To prevent the development of bronchial stenosis and granulomas

89
Q

93. What are the main components of the traditional airway clearance techniques?

I. Palpation of the chest wall

II. Postural drainage

III. Percussion

IV. Coughing

a. I and III only
b. II, III, and IV only

A

b. II, III, and IV only

90
Q

94. Which of the following maneuvers is characterized by having a patient forcibly exhale, from a middle to low lung volume, through an open glottis?

a. Active cycle of breathing
b. Directed cough
c. Autogenic drainage
d. Positive expiratory pressure

A

a. Active cycle of breathing

91
Q

95. A patient with an excessive amount of secretions and atelectasis has been receiving ACT. What is the most commonly cited complication of ACT?

a. Hypercapnia
b. Alterations of blood pressure
c. Tachycardia
d. Hypoxemia.

A

d. Hypoxemia.

92
Q

96. A respiratory therapist has been assigned to administer FET to a 5-year-old patient. Since small children are typically unable to perform such a maneuver, what should the RT do at this time?

a. Apply gentle chest wall compression during the expiratory phase.
b. Try to instruct the child on how to perform FET.
c. Ask the child to forcefully cough after a deep breath.
d. Request to cancel the order and change therapy.

A

a. Apply gentle chest wall compression during the expiratory phase.

93
Q

97. A respiratory therapist has been assigned to administer ACT to a number of patients on the ward. In which of the following conditions may ACT be contraindicated?

I. Foreign body aspiration

II. Frank hemoptysis

III. Empyema

IV. Untreated pneumothorax

A

I, II, III, IV

(Hemoptysis, is the coughing up of blood or blood-stained mucus from the bronchi, larynx, trachea, or lungs)

94
Q

98. Which of the following clinical parameters are important to determine a positive response to ACT?

I. Changes in sputum color

II. Breath sounds

III. Vital signs

IV. Lung mechanics

a. II, III and IV only
b. I, II, and III only
c. II and III only
d. III and IV only

A

a. II, III and IV only

95
Q
  1. A respiratory therapist has been assigned to administer ACT to a patient with acute lobar atelectasis. What should the RT consider to determine the length and frequency of the treatment?

I. Most pediatric patients require ACTs for at least 45 minutes.

II. ACT is rarely needed more than every 4 hours.

III. ACT orders should be evaluated at least every 48 hours for patients in the ICU.

IV. ACT for patients with atelectasis due to CF requires at least 30 to 45 minutes.

a. II, III and IV only
b. I, II, and III only
c. III and IV only
d. II and III only

A

a. II, III and IV only

96
Q

100. During autogenic drainage, at which of the following levels does the patient begin breathing?

a. Total lung capacity
b. Inspiratory reserve volume
c. Tidal volume
d. Expiratory reserve volume

A

d. Expiratory reserve volume

97
Q

101. Which of the following effects is related to activation of b-adrenergic receptor sites?

a. Skeletal muscle contraction
b. Release of inflammatory mediators
c. Bronchial smooth muscle relaxation
d. Activa

A

c.Bronchial smooth muscle relaxation

98
Q

102. When should the therapist administer short-acting bronchodilators to improve penetration of inhaled antibiotics?

a. Immediately after the antibiotic
b. At the same time as the administration of the antibiotic
c. 15 minutes to 4 hours before each dose
d. No more than 4 hours after administration of the antibiotic tion of guanyl cyclase

A

c. 15 minutes to 4 hours before each dose

99
Q

103. A patient with status asthmaticus has been admitted to the emergency department. The physician would like to try a b2-agonist that can be administered parenterally. Which of the following drugs should the therapist suggest?

a. Pirbuterol
b. Levalbuterol
c. Epinephrine
d. Terbutaline

A

d. Terbutaline

(Terbutaline is approved to prevent and treat bronchospasm (narrowing of airways) associated with asthma, bronchitis, and emphysema)

100
Q

104. Which of the following responses are considered adverse effects of inhaled corticosteroids?

I. Oropharyngeal candidiasis

II. Dry mouth

III. Wheezing

IV. Dysphonia

I, III, and IV only

II and IV only

II and III only

I and II only

A

I, III, and IV only

101
Q
A

RET 2714, Lee (3 decks)

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