Registered Respiratory Therapist (RRT-TMC) Practice Exam

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• A patient has been participating in Pulmonary Rehabilitation for the past 5 weeks. Results show a steady increase in 6-minute walk distance. These results are consistent with
• A 58-year-old male patient is hypoxic on volume-control ventilation and is receiving 15 cm H2O of PEEP on an FiO2 of 0.60. After increasing the PEEP to 18 cm H2O, the patient becomes hypotensive with a drop in cardiac output. What is the most appropriate action?
• What is the primary beneficial effect of PEEP in mechanically ventilated patients?
• Which formula gives alveolar minute volume?
• A patient on noninvasive positive pressure ventilation has an arterial blood gas with pH 7.31 and PaCO2 56 torr. Which adjustment should the respiratory therapist recommend?
• Which formula will determine the total flow being delivered to a patient with a 28% venturi mask running at 6 L/min?
• Which test is most appropriate to evaluate partial vocal cord paralysis in a patient with difficulty swallowing?
• Which cuff pressure range is generally recommended to minimize tracheal injury while maintaining an adequate airway seal?
• A 75 kg patient is being mechanically ventilated in VC, SIMV mode with Set Rate 12 br/min, Total Rate 32 br/min, Tidal Volume 600 mL, PIP 35 cm H2O, Exhaled minute volume 9.2 L, FiO2 0.45, PEEP 8 cm H2O. The ABG shows pH 7.36, PaCO2 45 torr, PaO2 89 torr, HCO3- 22 mEq/L. The respiratory therapist should which of the following actions be taken?
• Which criterion would not be used to determine an acceptable level of PEEP?
• Which of the following is an indication for high frequency jet ventilation?
• A 2-year-old child with croup has been intubated and the physician asks you to evaluate readiness for extubation. Which finding would most strongly indicate readiness?
• The FRC measured by body plethysmography is 30% larger than that measured by helium dilution. This difference is best explained by
• During a PEEP trial, a rise in PEEP from 10 to 15 cm H2O caused a significant drop in BP. This hemodynamic change is best explained by which physiological mechanism?
• Which test is most appropriate to confirm a suspected pulmonary embolism?
• The flow-volume loop is most helpful in diagnosing which condition?
• Following administration of oxygen, what additional therapy should be recommended for a patient with decompression sickness?
• Increasing PEEP can improve oxygenation but may reduce cardiac output due to decreased venous return. Which statement best describes this trade-off?
• A patient with a size 8.5 mm ID oral endotracheal tube is transported from the Emergency Department to the Intensive Care Unit. The respiratory therapist suspects the tube has changed position during transport. Which of the following is the first step to assess the tube position?
• Pulmonary capillary wedge pressure primarily reflects which of the following pressures?
• Which techniques measure total lung capacity?
• In the ED, a 55-year-old patient with chest pain and hypertension is evaluated. The respiratory therapist’s first response should be to:
• A respiratory therapist is transporting a patient with multiple trauma to a regional trauma center in a fixed wing aircraft. Which of the following should the therapist be most concerned about during the transport?
• A balloon-tipped, flow-directed catheter is positioned in the pulmonary artery with the balloon deflated. Which of the following pressures will be measured by the distal lumen?
• A patient is in full cardiopulmonary arrest and after several attempts, the patient is orally intubated with a size 7 mm ID endotracheal tube. The nurse is unable to establish IV access. The ECG monitor shows sinus bradycardia. Which of the following drugs should be administered through the endotracheal tube?
• Which AHI value corresponds to mild sleep apnea?
• How should the respiratory therapist assemble a Bird Mark 7 respirator to deliver 40% oxygen during an intermittent positive pressure breathing treatment?
• PA catheter results: CVP 10, PAP 33/27, PCWP 20, BP 108/72; Which condition could be associated?
• To reduce the chance of cross contamination when delivering bronchodilator therapy with albuterol, the therapist should
• In a patient with a balloon-tipped, flow-directed catheter, the following measurements are noted: CVP 2 cmH2O, mean PAP 12 torr, PCWP 3 torr, CI 1.2 L/min/m2, and BP 110/90 mm Hg. Which parameter would be decreased EXCEPT?
• A fireman is brought to the Emergency Department after being knocked unconscious in a burning office building. What is the best way to improve the oxygenation status of this patient?
• A patient has been admitted to the emergency department via ambulance. The cardiac monitor indicates sinus tachycardia. The patient is orally intubated with a size 7.5 mm ID endotracheal tube and is being manually ventilated. What other point of care monitoring should the respiratory therapist recommend for this patient?
• Over the last hour a patient on a volume-cycled ventilator has had urine output decrease from 35 mL/hour to 10 mL/hour. The most likely cause is an increase in the
• Which observation would indicate an air leak into the pleural space when monitoring a chest drainage unit?
• During home management of pediatric asthma, which device is most appropriate to monitor daily changes in airflow after a bronchodilator?
• A patient in the ICU has pH 7.54, PaCO2 48 torr, PaO2 78 torr, CaO2 18.9 vol%, K+ 2.1 mEq/L, Cl- 82 mEq/L, Na+ 142 mEq/L. Based on these results, the respiratory therapist should recommend administration of:
• A patient is receiving continuous mechanical ventilation through an oral endotracheal tube. The high pressure alarm sounds continuously during inspiration and the patient appears to be biting down on the ET tube. Which intervention should the therapist recommend?
• In the ED, a patient with nausea has an NG tube placed and is being treated with Lasix. Which parameter should the respiratory therapist monitor?
• When resistance is encountered passing a suction catheter through an endotracheal tube, which action is most appropriate?
• A patient is receiving IPPB with a Bird Mark-7. The patient generates negative pressure at the beginning of inspiration although the machine does not switch into the inspiratory phase. The respiratory therapist should
• Which of the following best describes the rationale for choosing a smaller tidal volume on the right lung during differential lung ventilation after a right lower lobectomy?
• A 48-year-old woman presents with chest pain, hypotension (60/40), respirations 20/min. The cardiac monitor shows sinus rhythm at 50/min with frequent multifocal PVC. The respiratory therapist should recommend administration of
• During nasal bronchoscopy, the most common complication is
• An ICU ventilated patient with Mode VC, SIMV; Mandatory rate 12 b/min; Total rate 18 b/min; VT 800 mL; FIO2 0.60; PIP 31 cm H2O; PEEP 10 cm H2O; pH 7.41; PaCO2 40 torr; PaO2 95 torr; SaO2 96%; HCO3- 23 mEq/L; BE +1 mEq/L; PECO2 30 torr. What should the respiratory therapist report as the VD/VT ratio?
• Which ventilator parameter is most directly used to assess the adequacy of alveolar ventilation?
• Which measurement directly quantifies the amount of blood the heart pumps per minute?
• Which measure is most directly used to assess right atrial preload?
• Which statement about the effect of inhaled nitric oxide on the pulmonary circulation is true?
• An adult patient is intubated with a 7.0 mm ID endotracheal tube. What size suction catheter should be used to suction this patient?
• Which instrument is NOT required to perform a nasal endotracheal intubation?
• A patient’s ABG shows pH 7.50 with PaCO2 30; Which acid-base disturbance is present?
• During right heart catheterization, inflating the balloon in the pulmonary artery yields a wedge pressure measurement that is used as an estimate of left atrial pressure. Which pressure is being measured?
• Adjusting the inspiratory flow during an IPPB treatment will result in a change in
• If hypoxemia is observed during suctioning, which intervention is acceptable for the therapist to recommend?
• Pulmonary capillary wedge pressure is most closely associated with which preload condition?
• After completing oxygen rounds, the respiratory therapist must clean flowmeters that were removed from rooms where no patients were receiving oxygen therapy. Which disinfection method is most appropriate?
• Postoperative ICU patient on VC-SIMV with VT 500 mL, f 12, FiO2 0.50; ABG indicates severe hypoxemia; The therapist should increase
• A neonate weighing 1600 g is receiving oxyhood oxygen at FiO2 0.60 with a flow of 5 L/min, and FiO2 readings vary at different hood locations. What should be done to correct this?
• In the noninvasive ventilation patient, which ABG value demonstrates hypercapnic respiratory failure?
• Which test is used to diagnose sleep apnea most definitively?
• Which test result best identifies an obstructive pattern in spirometry?
• A patient who is suspected of having a flail chest has been intubated and mechanically ventilated with PEEP therapy. The patient has just received pancuronium bromide. Which of the following ventilator alarms would be most important to set correctly for this patient?
• Which of the following would indicate that the lung compliance of a patient on a volume-cycled ventilator is increasing?
• With the balloon inflated in the pulmonary artery, which pressure is measured by the distal lumen?
• Regarding positive expiratory pressure (PEP) therapy, which statement is true?
• A 30-year-old male weighing 68 kg has a minute ventilation of 9 L/min and a respiratory rate of 20/min. What is his alveolar minute volume?
• During a 12-lead ECG, if the V2 electrode has fallen off, where should the electrode be placed?
• In chest tube drainage, what is the primary function of the water-seal chamber?
• Which measurement best reflects left-sided preload?
• Which ventilation device should be used to ventilate the affected lung 10 cm H2O lower than the normal lung in unilateral lung disease?
• In the described ventilator setup, based on the ABG and ventilator settings, which adjustment should be made?
• In a patient on volume ventilation, an increase in peak airway pressure is most likely to contribute to reduced urine output due to increased intrathoracic pressure. Which option best reflects this relationship?
• An elderly patient presents with shortness of breath, basilar crackles, +2 edema and a chest radiograph showing a butterfly pattern. These findings are most consistent with which diagnosis?
• A heat moisture exchanger is indicated for humidification in which of the following situations?
• A patient has 2 mediastinal chest tubes following a thoracotomy. The respiratory therapist notes that there is continuous bubbling in the water seal chamber of the chest drainage system. The therapist should
• What is the primary purpose of a spontaneous breathing trial (SBT) during weaning from mechanical ventilation?
• For a 60-year-old patient undergoing cardiopulmonary stress testing, what is the maximum heart rate?
• During an optimal PEEP trial, increasing PEEP from 10 to 15 cm H2O caused a significant rise in heart rate with a severe drop in blood pressure. The therapist should conclude the patient is suffering from
• A patient with ascites and shortness of breath; where is tissue edema most likely to show up first?
• In a SIMV mode with a set rate of 10 and a total rate of 16, what accounts for the additional breaths beyond the set rate?
• All of the following are TRUE statements about spacers and holding chambers, EXCEPT
• The peak inspiratory pressure on a pressure-cycled ventilator is 30 cm H2O. The respiratory therapist decreases the inspiratory flow. This change would affect the
• Which statement correctly describes the normal dead space to tidal volume (VD/VT) ratio for a patient breathing room air?
• During cardioversion, the synchronized electrical shock is delivered on which ECG wave?
• Which intervention is most effective for reversing basilar atelectasis in a postoperative thoracotomy patient?
• A 4-year-old girl is admitted to the emergency department with persistent dry coughing. Chest radiograph results reveal normal inspiration with the right lung remaining expanded on expiration. Which of the following should the respiratory therapist recommend at this time?
• During pulmonary function testing, a forced vital capacity of 2.4 L and a slow vital capacity of 2.18 L were obtained. Which statement is true?
• During recovery from resection of an aortic aneurysm, a patient develops severe substernal chest pain with grave dyspnea. The physician describes basilar moist crackles and the patient appears pale and diaphoretic. Which initial assessment should the respiratory therapist perform?
• Heliox therapy is indicated for treatment of patients with post extubation stridor because of the
• While weaning a patient from inhaled nitric oxide therapy, a recent dose reduction is followed by an increase in pulmonary artery pressure. The therapist should:
• To reduce PaCO2 from 40 torr to 32 torr, all of the following could be increased EXCEPT
• Which technique is NOT used to measure total lung capacity?
• Which pulmonary function measurement would have the smallest predicted normal value?
• In a patient with bilateral pneumonia on pressure-control ventilation, the following parameters are recorded: Set rate 12 breaths/min, total rate 12, VE 8.6 L, FiO2 0.60, PIP 31 cm H2O, PEEP 10 cm H2O, pH 7.41, PaCO2 40 torr, PaO2 95 torr, SaO2 96%, HCO3- 23 mEq/L, BE +1 mEq/L, PAO2 370 torr. The respiratory therapist should report the A-aDO2 as:
• The respiratory therapist receives an order for postural drainage and vibration. With the bed flat, the therapist places the patient in a prone position with pillows under his hips. Which lung segments are being treated with this position?
• An Raw of 1.8 cm H2O/L/sec on a patient receiving mechanical ventilation suggests which of the following?
• Left atrial preload is best estimated by which measurement?
• Which statement describes the effect of positive end-expiratory pressure (PEEP) on venous return?
• In hemodynamic readings from a pulmonary artery catheter, the QT value represents which parameter?
• A 17 year-old patient is receiving 40% oxygen via a Venturi mask following a motor vehicle accident. He suddenly develops acute shortness of breath, is diaphoretic and SpO2 is 85%. Breath sounds are vesicular on the right and extremely diminished on the left. The respiratory therapist should evaluate the patient for the presence of
• A patient has a tracheostomy tube in place. The measured cuff pressure is 24 mm Hg. Which of the following statements is true of this situation?
• Indirect calorimetry is performed on a 65-year-old patient to evaluate his nutritional status. It is determined that the patient’s RQ is 1.00. This would indicate that the patient’s diet consists mostly of
• In a patient with end-stage emphysema who is sleeping and has a pulse of 20 bpm, the respiratory therapist should immediately:
• A full E cylinder of oxygen is used at a flow rate of 10 L/min until empty. Approximately how long will it last?
• Following 15 minutes of CPR, ABG results show pH 7.02, PaCO2 47 torr, HCO3- 11 mEq/L, PaO2 196 torr, SaO2 94% on FiO2 1.0. Which of the following should the respiratory therapist recommend?
• Treatment for obstructive sleep apnea might include
• A patient with high body weight is referred for sleep apnea; which diagnostic study is most appropriate?
• Postoperative thoracotomy patient in the PACU on 60% oxygen via non-rebreather has ABG values with pH 7.43, PaCO2 34 torr, PaO2 56 torr. To improve pulmonary status, which intervention should be instituted?
• For a patient enrolled in a smoking cessation program, which of the following would indicate that the patient is non-compliant?
• In a patient in the ICU with the following hemodynamic measurements: CVP 12 mm Hg; PAP 48/16 mm Hg; PCWP 15 mm Hg; MAP 99 mm Hg; Cardiac Output 8.0 L/min; Cardiac Index 4.7 L/min/m2. Which therapy should the respiratory therapist recommend?
• A 7 year old child suspected of having epiglottitis would exhibit which of the following signs?
• Hyperresonant percussion note is associated with which of the following pathologies?
• All of the following could cause a patient's right-hemidiaphragm to be elevated, EXCEPT
• Which formula determines physiologic deadspace?
• Which statement about PaO2/FiO2 ratio is most accurate?
• Which parameter is commonly used to quantify dead space ventilation and is relevant in pulmonary embolism assessment?
• Which electrolyte abnormality is indicated by a potassium level of 2.1 mEq/L?
• A 19-year-old patient has a size 7 mm ID nasotracheal tube placed through the right nare. While attempting to suction the patient with a size 12 Fr catheter, resistance is met as the catheter is introduced into the endotracheal tube. The respiratory therapist should
• A post-operative thoracotomy patient is receiving incentive spirometry therapy Q2H. Breath sounds are diminished in the bases of the lungs with scattered crackles. The patient's inspiratory capacity has decreased over the past 2 days. A chest radiograph indicates thin-layered basilar densities. Which of the following has most likely occurred?
• A patient is on SIMV with a mandatory rate of 12/min, total rate 12, FiO2 0.50, tidal volume 700 mL, peak flow 50 L/min, and PEEP 5 cm H2O. Based on the observed volume-pressure loop, which change should the respiratory therapist recommend?
• Which of the following would be most important to evaluate for a patient who is entering a smoking cessation program?
• In independent lung ventilation after thoracotomy, which tidal volume distribution would be most protective of the remaining healthy lung?
• A patient's QS/QT ratio is calculated to be 20%. Based on this information, the respiratory therapist would inform the physician that the patient has
• A 32-week gestational age infant receiving mechanical ventilation for pulmonary interstitial emphysema develops a suspected pneumothorax. Which diagnostic procedure should be recommended to confirm this diagnosis?
• If during mechanical ventilation the patient initiates a breath and the ventilator completes the rest of the breath, this breath is described as?
• In the ED evaluation of chest pain, what is the respiratory therapist’s initial step?
• A 2-year-old child recently diagnosed with laryngotracheobronchitis requires the administration of 40% oxygen. What is the most appropriate method for delivering the oxygen?
• What is the air-to-oxygen ratio for an air entrainment device delivering 60% oxygen?
• Fine crepitant crackles are most commonly associated with which condition?
• The results of a patient's spirometry are recorded as follows: Predicted FVC 3.5 L, Observed FVC 2.1 L; Predicted FEV1 2.7 L, Observed FEV1 2.6 L; Predicted FRC 2.5 L, Observed FRC 1.7 L; Predicted TLC 5.6 L, Observed TLC 4.2 L. These results are indicative of
• Which adjustment would modify the expiratory time and change the I:E ratio during IPPB therapy?
• Which sign is least consistent with epiglottitis?
• The most common complication associated with fiberoptic bronchoscopy via the nasal route is
• In a patient weighing 60 kg, the expected spontaneous tidal volume during weaning is within which range?
• Which of the following would NOT cause a high pressure alarm on a volume-cycled ventilator?
• Which hemodynamic parameter best reflects left atrial preload?
• Pulse pressure is the difference between systolic and diastolic blood pressure. If a patient has a blood pressure of 130/70 mm Hg, what is the pulse pressure?
• A tracheostomy tube has just been changed and the patient suddenly becomes dyspneic with crepitus around the tracheostomy stoma. The respiratory therapist should
• A patient with a history of cardiovascular disease is intubated and manually ventilated. The ECG monitor shows a sinus rhythm with a rate of 50 beats per minute. The patient’s pulse is weak and irregular, and a venous catheter cannot be placed. The respiratory therapist should recommend endotracheal instillation of
• In a patient with ascites and dyspnea, which region is most likely to show edema first?
• To confirm endotracheal tube position at the bedside, what is the quickest initial assessment?
• Which therapy would NOT be recommended for a patient with severely decreased static lung compliance?
• In outpatient pulmonary function testing, the following values were measured: FVC 3.3, 3.4, 3.5, 3.4 L; FEV1 2.3, 2.5, 2.3, 2.4 L; FEF25-75% 1.4, 1.2, 1.3, 1.3 L/s. Which trial should be recorded as the best test?
• A 45-year-old preoperative patient has the following pulmonary function data: TLC 5.4 L, RV 1.0 L, IRV 2.6 L, VC 4.2 L, ERV 1.0 L, VT 0.6 L, FRC 2.0 L, IC 3.2 L. Which capacity is incorrect?
• A patient on mechanical ventilation with a PEEP of 10 cm H2O needs an MRI. Before transport, the respiratory therapist should obtain
• A patient is receiving 60% oxygen at a flow of 8 L/min via a large volume nebulizer and aerosol mask. The inspiratory flowrate is 35 L/min. Which of the following should the respiratory therapist recommend?
• Which therapy would decrease pulmonary vascular resistance in a patient with pulmonary hypertension?
• A patient in cardiac arrest with no IV access is intubated; which drug should be administered via the endotracheal tube to treat bradycardia?
• What is the correct formula to calculate the static lung compliance of a patient receiving mechanical ventilation?
• A patient receiving a loop diuretic such as furosemide would most likely need what type of electrolyte replacement?
• A patient involved in a motor vehicle crash presents with tachypnea, tracheal deviation to the right, splinting, asymmetric chest movement, and reduced breath sounds on the left. The respiratory therapist should initially:
• Which hemodynamic parameter represents left atrial pressure (wedge pressure) in the given measurements?
• During an intermittent positive pressure breathing treatment, the ventilator self-cycles between patient breaths; The therapist should adjust
• In independent lung ventilation, which of the following is an appropriate rationale for delivering a smaller tidal volume to the operated lung?
• Pressure-cycled ventilation would be LEAST appropriate for a patient with which condition?
• Blood gas results from a seemingly healthy patient reveal pH 7.37, PaCO2 15 torr, PaO2 140 torr on room air. Which conclusion is most appropriate?
• In the context of oxygenation, which statement best describes the A-a gradient?
• A newborn infant has an APGAR score of 8 one minute after birth. The most appropriate initial action is to
• During a cardiopulmonary stress test, the following changes are observed: heart rate increases, blood pressure increases, VD/VT decreases, and respiratory rate increases. What should the therapist do next?
• A 64-year-old man with severe COPD is receiving independent (differential) lung ventilation following thoracotomy and right lower lobectomy. Which of the following setting combinations would be most appropriate for this patient?
• An acceptable level of PEEP therapy can be identified by all of the following EXCEPT
• Which spirometric pattern is most characteristic of a restrictive lung disease such as sarcoidosis?
• Which IPPB-related parameter is most affected when you adjust the inspiratory flow?
• A Venturi mask delivering 40% oxygen is adjusted from 8 L/min to 12 L/min. What happens to FiO2?
• While suctioning a patient who is being mechanically ventilated, the patient develops an ECG pattern. Which drug should be given FIRST?
• Which device would produce the greatest humidity output for a patient?
• Which parameter would you monitor to assess oxygen delivery in a patient on mechanical ventilation?
• In a patient on SIMV with pressure support, the primary purpose of pressure support (PS) is to
• If polysomnogram indicates obstructive sleep apnea, treatment might include
• A patient on home oxygen via nasal cannula at 1 L/min with 50 ft extension tubing; The patient reports insufficient flow. The therapist should recommend
• If a patient's PvO2 decreased from 30 torr to 20 torr, which of the following should the respiratory therapist assess?
• The most common complication during insertion of a central venous catheter is?
• During calibration of a polarographic oxygen analyzer, the device reads 21% on room air but 64% on 100% oxygen. The most appropriate action is to:
• A patient who had his chest tube clamped for 18 hours with no apparent respiratory distress is now tachypneic, diaphoretic and complaining of dyspnea. The respiratory therapist should
• During evaluation of a chest drainage system after thoracotomy, bubbling in the water-seal chamber during inspiration would indicate
• To reduce the risk of volutrauma during mechanical ventilation, which adjustment should be made?
• In volume-controlled ventilation, what is the primary purpose of positive end-expiratory pressure (PEEP)?
• Air bronchograms on a chest radiograph most strongly indicate which condition?
• A preoperative high-risk patient should be evaluated by obtaining the results of which test?
• Which device is appropriate for delivering bronchodilators to an intubated and mechanically ventilated patient?
• A patient recently underwent a thoracotomy and is receiving IPPB QID. The inspiratory capacity has diminished and the patient is short of breath. Chest radiography shows left lower lobe radiodensity with a concave upper border. The respiratory therapist would conclude that the patient has developed
• Which PA catheter value best estimates left atrial pressure?
• Polysomnography results show an Apnea Hypopnea Index (AHI) of 25. How should this value be categorized?
• Which artifact could explain an ABG showing a PaCO2 of 15 mm Hg with normal pH and PaO2 of 140 mm Hg?
• A naso-tracheal tube is correctly positioned but there is no chest movement; cuff rupture during intubation is the most likely cause.
• After oxygen rounds, which disinfection method is most appropriate for flowmeters that were removed from rooms with no patients?
• After a patient undergoes a thoracentesis, the pleural fluid is clear with a slight straw color. This fluid is most likely the result of which condition?
• A 44 week gestational age infant delivered by C-section is gasping, grunting, and has tachycardia and tachypnea. At one minute his Apgar score is 4 and at 5 minutes the score is 5. The infant is most likely suffering from which condition?
• During oral endotracheal intubation, where should the Macintosh laryngoscope blade tip be placed to optimize the laryngeal view?
• What is the primary advantage of using a double-lumen endobronchial tube in unilateral lung disease?
• During inline suctioning with 100% oxygen, several PVCs observed; The therapist should
• When initiating mechanical ventilation for a patient with chronic CO2 retention, the therapist must assure adequate inspiratory flow to prevent
• A patient with end-stage pulmonary fibrosis uses a transtracheal oxygen catheter and experiences increased work of breathing. The respiratory therapist should:
• Which factor most directly improves the uniformity of FiO2 in an oxyhood system?
• A 62-year-old female patient on SIMV ventilation with ABG showing pH 7.50, PaCO2 30; The therapist should
• Which option best defines a shunt in pulmonary physiology?
• In a patient with pneumoconiosis undergoing spirometry, a measured SaO2 of 85% with a pulse oximetry of 97% and an ABG indicating SaO2 85% would be most consistent with which condition?
• Which description best defines an assisted breath on a mechanical ventilator?
• During bedside monitoring, the respiratory therapist notices a dampened arterial line waveform. To restore the graphic to normal, the therapist should first:
• The respiratory therapist is calibrating a spirometer and checking the volume with a 3.0 liter super syringe. The volumes recorded are: 2.85 L, 2.8 L, and 2.8 L. Based upon the information obtained which of the following is a correct statement?
• Which investigation is most appropriate to assess baseline ventilatory function in a high-risk preoperative patient?
• What is the normal VD/VT ratio for a patient breathing room air?
• After oxygen therapy for decompression sickness, which therapy is recommended to maximize treatment effectiveness?
• A neonatal case: A 44-week gestational age neonate with grunting and tachypnea, Apgar scores 4 at 1 minute and 5 at 5 minutes, is most likely suffering from which condition?
• Which statement about an oxygen concentrator is incorrect?
• A patient receiving 40% oxygen via a Venturi mask at 8 L/min has the flowmeter changed to 12 L/min. How does this change affect the FiO2?
• A 43-year-old female patient has just undergone a total abdominal hysterectomy. The patient arrives obtunded with minimal response to painful stimulus. What treatment should the respiratory therapist recommend?
• Given a cardiac output of 8 L/min and a cardiac index of 4.7 L/min/m2, what is the approximate body surface area (m2)?
• A patient in the ICU has the following hemodynamic measurements: CVP 4, PAP 48/16, PCWP 8, MAP 92, CO 5 L/min, CI 2.5 L/min/m2. These results are most consistent with
• A TcPO2 reading of 53 torr at 40°C, while arterial PO2 is 73 torr. What best explains this difference?
• A nasally intubated patient on a volume-cycled ventilator has a high pressure alarm, appears cyanotic, heart rate 48 bpm, and a suction catheter cannot pass through the tube. What should the therapist do?
• Which action is NOT recommended when mist disappears during inspiration in a T-piece aerosol trial?
• A patient with chronic hypercapnia is brought into the ED. The history reveals a near-fatal episode with a PA catheter showing PAP 25/10 mm Hg, BP 76/50 mm Hg, PCWP 4 mm Hg, SVR 1360 dynes, CVP 0 mm Hg, CI 1.8 L/min/m2. Which of the following is the most likely cause for his condition?
• Before performing a vital capacity maneuver, the patient should be instructed to:
• Which of the following would NOT be required to perform a nasal intubation?
• In a motor vehicle accident patient with a long bone fracture in traction who suddenly complains of chest pain and develops tachypnea and tachycardia, the respiratory therapist should
• A patient with a pulmonary artery catheter has the following values: CVP 1 mm Hg; mean PAP 10 mm Hg; PCWP 8 mm Hg; CI 1.6 L/min/m2; BP 110/90 mm Hg. Which parameter would be decreased EXCEPT?
• Following surgery to correct an abdominal aortic aneurysm, a 54-year-old female patient suddenly develops intense substernal chest pain with severe dyspnea. The pain does not appear to be aggravated by her respirations. Auscultation reveals bilateral, basilar, moist, crepitant rales. The patient appears pale, cold and clammy. Which of the following should the respiratory therapist recommend for initial assessment of this patient?
• Which of the following best describes the effect of increasing PEEP on hemodynamics?
• Which formula best estimates the dead space fraction (VD/VT) using PaCO2 and PECO2 values?
• A patient is being ventilated with a high frequency ventilator. The ABG shows pH 7.29, PaCO2 68 torr, PaO2 73 torr, HCO3- 25 mEq/L, BE +1 mEq/L. The respiratory therapist should increase the
• Which finding could NOT cause a capnography reading to change from 36 torr to 30 torr?
• A patient with chronic CO2 retention has ABG results showing pH 7.35, PCO2 52 torr, HCO3- 30 mEq/L. Which description best fits the acid-base status?
• A 62-year-old patient with a history of emphysema requires mechanical ventilation. Arterial blood gas results show pH 7.37, PCO2 56 torr, PO2 65 torr, HCO3- 32 mEq/L with a VC SIMV mode and total rate 16 br/min. The therapist should
• A 2000 g neonate is breathing spontaneously on 28% oxygen via an oxyhood with the following arterial blood gas results: pH 7.37, PaCO2 37 torr, PaO2 46 torr, HCO3- 22 mEq/L. Based upon the above information, the respiratory therapist should recommend which of the following?
• Hyperresonant percussion is most commonly associated with which condition?
• In spirometry, a reduced FEV1/FVC ratio with relatively preserved FVC most likely indicates which condition?
• The physician requests assistance in establishing a patent airway for a conscious patient who requires frequent suctioning. The respiratory therapist should recommend insertion of a/an
• What is the normal range for central venous pressure in an adult?
• The ABG pattern pH 7.02, PaCO2 47, HCO3- 11 indicates which acid-base disturbance?
• Transcutaneous monitoring of PO2 values will correlate well with arterial blood gas PO2 values in which of the following situations?
• Which measurement reflects left heart pressures and filling pressures?
• A patient recently underwent a coronary artery bypass and is now receiving Incentive Spirometry QID. The patient's inspiratory capacity has diminished over the past several days and the patient is becoming increasingly short of breath. Chest radiograph shows left lower lobe consolidation with air bronchograms. The respiratory therapist would conclude that the patient has developed
• Which therapy is commonly used to help clear thick secretions in chronic bronchitis?
• For a patient with chronic bronchitis who needs help clearing thick purulent secretions, which therapy is most effective?
• A spontaneous breathing trial has been initiated for a patient on a T-piece with aerosol delivery. The aerosol mist disappears from the reservoir outlet during inspiration. The therapist should consider all the following EXCEPT
• Which of the following will give the most accurate measurement of volume and flow for spirometry?