1. Prior to intubation in an emergency, infection of air into a pilot line fails to inflate the cuff.  You should: 

    A. replace the ET tube 
  2. Which of the following alarm conditions indicates a potential system leak when delivering volume oriendted ventilatory support? 

    A. Low volume + low pressure 
  3. While a patient is being ventilated with a bag resuciator the bag fills rapidly and collapses on minimal pressure, although little chest movement by the patient noted. The cause of the problem may be which of the following?

    B. Absence of inlet valve 
  4. During CPR oxygen reservoir bag of bag vlave manula resuscitator collapses during the refill phase. you can corret this problem by: 

    D. Increasing O2 flow to the bag 
  5. What of the following is the most probable cause of insufficinet mist in a croup tent?

    A. clogged capillary tube in nebulizer
  6. You observe the reservoir bag on a patient receivn oxygen at 10 L/min does not display at all when the patient inspires what should you do first? 

    C. Check the mask for snug fit
  7. To continuously monitor the adequacy of ventiatlion of a patient in the ICU being supported by the mask BiPAP, you would recommend which of the following? 

    D. Transcutaneous Pco2
  8. Which of the following test of lung mechanics would you recommend to use to test the presence of auto peep on a patient receving then to ventiatory support? 

    C. Flow volume loop
  9. An AP X-ray of a 3 yr old child ith wheezing and striodr shows an area of prominet subglottic edema, but the lateal neck x-ray appears normal. What is th emost likely problem?

    D. Croup
  10. During an interview with your patient you discover that he gest SOB when he lays down so he often sleeps with several pillows to prop his head up. what symptom is present? 

    D. Orthopnea
  11. Resistance is encountered whiel suctioning through a size 6 mm ID ET tube with 14FR catheter. Which of the following is th emost appropriate action for you to take? 

    D. use a 10 Fr cathther 
  12. While obtaining an arterial sample for analysis using a point of care analyzer, you should do all ofthe following except: 

    A. place the sample in ice slush 
  13. A 2 yr old is admitted to the ED with severe asthmatic symptoms. The attending physican orders a bornchodilator that is availabe in both solution and MDI preprations. Which of the following is the best delievery system for this drug to this patient? 

    C. MDI with holding chamber and mask 
  14. All of the following help minimize the risk of cross contaminiation during suctioning except:

    A. instilling 10 mL sterile saline before suctioning attempt 
  15. If sterilaztion is not feasible, which of the following are acceptable alternatives for processing a specialzied resuable plastic airway? 
      I. Exposure to high level chemical disinfectant
     II. surface disinfection with 70% ethyl alchol 
    III. Pasteuriztion at 63 C for 30 min 

    D. I and III
  16. On checking a ventialtor pts progress notes, you see that hte attending physicans treatment plan includes starting spontaneous breathing trails. Your most appropriate action is to do which of the following? 

    B. check to verify that valid phyhsicans order is present 
  17. after completing a ventialtor check, you note tht you incorrectly computed the pts complaince in prior entry. Which of the following is the msot apporpriate course of action?

    D. line out the error, write the word "error" correct and inital it 
  18. The best way to routinely communicate a pts clinical status to the appropraite members of the health care team is by reproting information: 

    B. pts chart
  19. If you are giving routine theapry and note adverse chagne sint he pts condition,  you should do which of the followin?
          I. Notify the nurse who is responsible for the        patient 
          II. contact the phsyican if a change in thepary seems warranted 
          III. Record the pts recations in the chart 

    B. I, II, III
  20. Midway thorugh an aerosol drug treatment via IPPB, a patient complains of dizziness and tingling in her fingers. After stoppoing the therapy and adjusting the equipment to correct the problem and completing the treatment, you should recor which of the follwoing in chart? 
          I. Medicastion used during the treatment 
          II. The patients pulse and BP and after the treatment 
         III. Naure of the probelm and the way in which it was corrected 

    B. I and III 
  21. When a patient refues to take a treatment, yo should do which of the following? 

    A. notify the nurse in charge and chart pts refusal 
  22. A patient suddenly loses consciousness. which of the following is the first procedure you should perform to maintain an open airway in this patient? 

    B. Appplying the head tilt/chin lift maneuver 
  23. A pt is in ICU exhibits signs of acute upper airway obstrcution & concurrently having severe seizuers that make it impossible to open the mouth. In this case, what is the adjucnt airway of choice? 

    C. Nasopharyngeal airway
  24. Which of the following should be prescribed in order to privde adequate humidification to an intubated pt?

    A. Inspried gas with an absolute humidity greater than 30 mg.L 
  25. All of the following are needed for an effective cough except :

    A. a closed glottis 
    B. compresison phase 
    C, explosive exhalation 
    D. low inspriatory volumes 
    D. low inspriatory volumes 
  26. A morning X-ray confirms bilateral infiltrates in the posterior segments of the upper lobe sof 30 yr old female pt. what postural drainge postion should you use to drain these segments?

    A. sitting position leaning forward on a pillow 
  27. Which of the following should you do in order to properly perform nasotrachela suctioning on an adult pt?

       I. lubricate the cathther 
      II. apply suction for less than 15 sec 
      III. preoxygneat and postoxgenate the patient 
      IV. instruct pt to exhale and hold breathe 

    D. I, II, III 
  28. Adult male requres postural drainage of the posterior basal segments bilaterally. docotrs order is ocmpelte and you have performed all pre treatment assessments and takena ll needed precaustions. to properly position this patient you should: 
      I. elevate food of bed 30 degrees 
     II. keep bed flat but put pillow under pts hips
     III. have pt lie supine with pillow under hips 
      IV. have pt lie prone with pillow under hips 

    C. I and IV 
  29. While suctioning a pt receiving ventialtory support, you note the HR increases abrupty form 92 to 145 BPM. which of the following actiosn could help prevent or minimzie this problem? 

    A. incrase oxgyen concentriaon immeidatley before suctioning 
  30. A pt with CHF is coughing up large amounts of pink, fothty sputum. ABG vlaues on simple mask O2 of 7L/min follows:
    pH            7.44
    PaCO2    29 torr
    HCO        20 
    BE          -3
    PaO2      46
    SaO2      76%
    which would you recommend 

    C. Maks CPAP with 80% O2
  31. During pt-ventiator check in the ICU, you observe the following settings and monitored paramets on 70 kg (154lb) patient receving vent support: 
    MODE                    SIMV
    VT                          600 ml
    Mandatory rate    10
    total rate               38
    PEEP                      8
    Minute volume     10 L/min 
    what actions would you recommend?

    C. add pressure support 
  32. which of the following best describes the way a patient should perfomr IS?

    A. pt should hold max insp cpaicyt (IC) breath for at least 5 sec
  33. pt rececivng BiPAP for actue resp failure has PaO2 of 48 torr on 65% O2 with IPAP=20 cm h2O and EPAP=5 cm H2O. To raise pts PaO2 yo should recommend? 

    B. increasing EPAP to 10
  34. Pt receving mechanical vent has following vent settings and ABG results 
    vent settings 
    MODE             SIMV        pH         7.26
    vT                    750          PacO2   56
    Set rate            4             HCO3     22
    Spont rate       0              PaO2     92
    FiO2                0.55          SaO2      96
    which to recommend 

    B. increasing SIMV rate
  35. A new medical resident asks for your help in calculating the static lung complaince for an ICU patient receivng voluem cycled ventilation. the patient has the following settings and monitoring data: 
    Vt                                          700
    Rate                                       12/min
    Peak pressure                     50
    Plateau Pressure                 30
    PEEP                                     10
    Mechanical deadspace       100
    What is the pts static lung complaince ?

    • A. 35
    • 700/ (30-10)=700/20=35
  36. A patient with a size 8 tracheostomy tube is being suctioned by the nurse. While suctioning the patient you obsrve several PVCs on the pts monitor. You should recommend that the nurse: 

    C. preoxygenate the patient with 100 O2
  37. You need to provide continuous monitoring of the FIO2 for a ventiatlor that uses a heated humdifer delivery systme. the only analyzer avialbe is a galvanic cell analyzer. Where should you place the analzyers sensor?

    • C. Proximal to the heated humidifer
    • proximal is before the humidifer to any humidification device
  38. After perfroming a modified Allens test on the left hand of a patient, you note that his palm and fingers do not beocme pink for more than 15 sec after releasing pressure on the ulanr artery. At this point you should: 

    C. repeate the tes ton the right hand 
  39. While suctioning a pt, you observe an abrupt chagne in the ECG waveform being displayed on the cardiac monitor and drop in Spo2. which of the following actions should be taken?

    C. Stop suctioning and immediately administer oxygen 
  40. after initationg a bronchodilator aerosol via IPPB to an asthmatic, the pt complains of fatigue and SOB. on inspection of the pt, you note increased use of accessory msucles, an incrase in HR from 90 to 122, and other signs of mild to moderate distress. which of the following is the appropriate action at this time?

    A. stop the treatment and stay with the pt until she improves 
  41. A pt is receving appropriate oxgyen thearpy via simple mask at 5 L/min but coplains that hte mask is confiving and interferes with eating. Which of the following oxygen delviery devices is a subitalbe alternative?

    B. nasal cannula 4-5L
  42. You notice that the air entrainment porst of a ventuire mask are occulbed by a pts bedding. what effect would this have on total flow and FiO2?

    D. decrease total output flow and incrase Fio2 
  43. To prevent hypoxemia during suctioning an orally intiubated pt, you should do which of the following?

    D, maintain set FIO2 and increase PEEP prior to suctioning 
    A. admisinister 100 oxygen through the ventiltor for 1-2 min before suctioning 
  44. Physican prescribes IS for postoperative pt who complains of dizziness when performing five insp maneuvers in a row. what action should be taken? 

    B. begin CPR on the inftant
  45. College student is brought to the ED following a motor vehicle accident. He is tachypneci and tachycardic. He is receiving oxyen via a nonrebreathing mask at 10 L/min. You observe that the maks bag fully deflates on each inspriation. what action should be taken

    B. incrase the flow rate to 12-15
  46. 48 yr old is orally intubated, receiving mechanical ventilation with a #7.0 endotracheal tube secured in place. cuff pressure is foudn to be 34 during peak inspriation using ht eminimal occluding volume technique. you should suggest 

    A. Replacing ET with larger size
  47. Pt recving IPPB thearpy for atelectasisi wtih set pressure 25. druing thearpy the pt pusle becomes thready and the BP dropts form  120/80 to 90/50.

    A. D/c the treatment and notifty the physican 
  48. Prior to beginning an adrenergic aerosol bronchodilator tx on ana adult pt, you record a resting HR of 132 beats/min. Which of the following is the correct action in this case? 

    D. postpone tharpy unitl you are able to contact the ordering physican 
  49. Following administration of bland aerosol tx, auscultation revels rhonchi throughout middle and upper lung fields: 

    C. encourage pt to cough 
  50. While monitoring a pt during a T-tube weaing trial, you note increased HR from 85 to 110 and RR from  15 to 34 and PVCs increasing to an average of 4 per min. 

    D. Reconnet pt to the ventialtor with prior settings
  51. Pt with acute bornchities is receving mechanhical vent. Wheezing is heard over all lung fields, & rhonchi are heared over the central airways. Previously suctioned secretiosn ahve been quite thick. Pts peak pressure is 45, and Pplat 20. all of the following would be useful to treat pts condition except: 

    B. Pancuronium bromide (pavulon)
  52. 75 yer old female pt with a factured hip has been bedridden for at least one week. The pt has clear breath sounds, but they are diminished slightly in the bases. The pt has nomrla pulmonary fuction based on bedside spirometyr. which would you recommend?
         I. bronchodilator thearpy 
         II. deep suctioning 
         III. incentive spirometry treatments 
         IV. coughing and deep breathing 

    D. III and IV
  53. An intubated pt in the ICU needs to undergo bedside bronchoscopy and is in need of short term modrate sedation. which of the foloowing agents wouldyou reocmmend for this procedure?

    C. propofol (diprivan)
  54. You are assisting a medical resent performing an emergent inutabtion on a somewhat combative pt. The resident wants to breifly paralyze the pt to facilitate this procedure. What would you propose?

    C. Succinylocholine (anectine)
  55. Which of the following conditions is an indication for the use of CPAP?

    A. pulmoanry edema
  56. you would initiate O2 theapry in all of the following causes except: 

    C. Treating absorption atelectasis 
  57. which of the following would you recommend for a patient that has emphysema iwth chronic PacO2 reteniton who expericnes hypoxemia at rest? 

    A. low flow oxygen
  58. During a "code blue" or other medical emergency, a physican is having trouble starting an intravenous line. Which of the follow drugs can be placed down an ET during emergeny life support? 
                 I. Naloxone 
                 II. Lidocaine 
                 III. Atropine 
                 IV. Epinephrine 

    B. I, II, III, IV  
  59. Which of the following techniques can be used to determine effectiveness of ventialtion? 
       I. Looking for the rise and fall of the victims chest 
      II. Feeling for air exchange near the victims mouth and nose 
       III. Listening for audbile breathing efforst from the victim 

    B. I, II, III
  60. At the oneset of adult mouth to mouth or mouth to mask ventilation, you should provide: 

    B. two normal breaths, thne assess the pulse 
  61. When transporting criticually ill pts who are receivng supplemental oxgyen in unpressurized aircraft, it is often necessary to make which adjustmen tin FiO2 in order to maintain adequte oxygenation?

    D. increased FiO2 
  62. The essential goals of pulmonary rehabilitation inculde all of the following except:

    D. Reverse lung damage 
  63. 90 kg male pt with flail chest injury is being mechanically ventialtied the A/C mode with FiO2 of 0.5, set rate of 18, and tidal volume of 600mL. he is involuntary brething above the set rate for total resp rate of 28-30. results of arterial blood gas analysis are:
    ph                  7.52
    PaCo2            27
    HCO3              21
    BE                   -2
    PaO2                81
    SaO2              96%
    On the basis of these results, th emost appropriate action is to: 

    A. Add mechanical deadspace
  64. 87 yr old nursing home pt is admitted with PNA. On assessment the pt presents with 103.2 F temp, dry mucous membrances, ruine outptu of 10 mL/hr for the past two hours, mild hypotension, and incrased hematocrit on his CBC. You shoudl recomend the ER physican all of the following except:

    B. beginning diuretic thearpy
  65. Which of the following airway routes would you recommend to immediatley ventilate a trauma pt in a neck brace w/ suspcted cervical spine injyr who was admitted to the ED/
       I. orotrachela intubation
      II. nasotracheal intubation 
      III. Laryngeal mask airway 

    C. II or III
  66. COPD pt being mechanically ventilated appears to be developing auto peep. which of the following should you recommend to improve this situation?

    D. decrase I:E ratio
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CRT Practice Questions