A patient with cystic fibrosis who usually expectorates sputum c/o increased dough and dark yellow sputum production over the past week. She is febrile and a chest CXR reveals a RML infiltrate. These clinical findings suggest:
C) pneumonia
After an oxygen concentrator has been used in a patient's home, a therapist must complete which of the following maintenance procedures?
B) change the filters
A therapist is checking a jet nebulizer with an entrainment setting of 35%. A properly calibrated oxygen analzyer measures the concentration at 45%. Which of the following best explains this finding?
C) water in the tubing
When performing bedside spirometry on a patient, the following FEV1 values (L) are obtained from three maneuvers: 3.13, 3.75 and 2.85. What should you conclude?
C) the effort was inconsistent
Which of the following bedside PFT results for a patient with Guillain-Barré most strongly indicates the need for mechanical ventilation?
D) VC of 5ml/kg
A 45 YO, 70kg (154 lb) adult patient is receiving VC, SIMV.A CXR reveals a moderate degree of bilateral, plate-like atelectasis in the lung bases. Current ventilator settings and ABG's are as follows: FiO2 0.40, MRate 12, Vt 450, PEEP 5. pH 7.34, pCO2 46, pO2 70, HCO3 24, BE -1. In which of the following should an increase be recommended?
D) PEEP & Vt
A 7 YO who is intubated with a 6.0mm ETT has copious secretions.Difficulty in suctioning the sputum trhough a 10 Fr suction catheter with a pressure of -60 mm Hg has been experienced. You should:
A) change the suction pressure to -80 mm Hg
Which of the following should be used for high level disinfection of nondispsable ventilator tubing?
C) pasteurization
A 45 YO man with a diagnosis of bilateral pneumonia is receiving VC, A/C ventilation. Despite an adequate minute ventilation, his PaO2 falls below 60 torr with and FiO2 of 0.60 and a PEEP of 5 cm H2O. Which of the following do you recommend?
B) increase PEEP
When reviewing therapy for a homecare patient who has asthma, the therapist notes that every time the patient performs his daily peak flow measurement, it consistently reveals 100 lpm. Which of the following is an approrpriate initial action?
D) recheck the patient's peak flow with a new prsk flow meter
A therapist reviews the following ABG results for a patient who is breathing 30% oxygen: pH 7.36 pCO2 43 pO2 288 HCO3 23 BE -1. These results most likely indicate:
A) laboratory error
When reading a chart, you note a 2 YO child with a history of asthma was admitted with severe respiratory distress. Wheezing is auscultated over the right lung only. These findings are consistent with:
D) foreign body aspiration
A therapist is administering a mixture of helium and oxygen through a nonrebreathing mask to a 40 YO patient during an acute asthmatic episode. The patient is still showing signs of moderate respiratory distress. The SpO2 is 92%. THe therapist observes the reservoir bag on the mask nearly collapses with each breath. Which of the following is the most appropriate initial response?
C) increase the flow of the gas mixture into the mask
A therapist is performing a high calibration on a nitric oxide analyzer. The expected value (ppm) is:
A) 45
A sedated 152cm (5') 42kg (93 lbs) patient with pneumonia has been receiving VC, A/C ventilation for three days and has a worsening CXR. The following information is available: FiO2 0.85 MRate 24 Rate 24 Vt 400 PEEP 14 pH 7.25 pCO2 62 pO2 68 HCO3 27 BE -2 What changes should you make?
C) mode to PC, A/C
When preparing to assist with a chest tube insertion, you learn that pleurodesis will follow. What additional equipment should you provide?
A) hemostat and 3-way stop cock
SpO2 decreases from 98% to 87% in a 70 kg (154 lb), 183 cm (6') patient who is receiving mechanical ventilation. The right hemothorax is expanding more than the left and the breath sounds are clear on the right side, but decreased on the left. THe patient's ETT is at the 28 cm mark and the lip. Which of the following is the most appropriate action?
B) pull the tube back to 23 cm
A patient had abdominal surgery yesterday. The spontaneous Vt is 300 ml. With minimal coaching, the patient is able to reach an IS goal of 700 ml. The therapist should set an initial goal of:
B) 900 ml
An adult patient's DLCO is 20 ml/min/mm Hg. To further evaluate this patient, you should next:
B) perform lung volume measurements by plethysmography
A patient is receiving VC ventilation. You note peak pressure has increased from 20 to 30 cm H2O after 6 hours. Which of the following could explain this change?
C) compliance decreased & RAW increased
Immediately following an arterial puncture to a patient's radial artery, the therapist should:
C) compress the site
According to ATS Standards, a patient's FEV1 must increase by a minimum of what percent to demonstrate significant post-bronchodilator improvement?
D) 12%
A therapist has an order to deliver 1.25mg of 0.5% albuterol to a patient with a SVN. How many ml of albuterol should the therapist administer?
B) 0.25 ml
A patient with Duchenne Muscular Dystrophy has a VC of 625 ml. Which of the following should be done first?
A) Maximum Inspiratory Pressure
When performing MVV maneuvers, a patient repeatedly terminates the test between 8 and 10 seconds. You should:
B) reschedule the test at a later time
A patient who is 193 cm (6'4") is intubated with an 8.0 ETT that is secured with a 17 cm mark adjacent to the incisor. A therapist hears a gurgling sound with each inhalation and observes the exhaled Vt is 300 ml less than the inhaled Vt. The therapist increases the cuff pressure from 16 cm H2O to 29 cm H2O. There is no change in the sound of the exhaled Vt. You should:
C) advance the tube 5 cm
A therapist notices a prolonged inspiratory time and irregular cycling to exhalation for a patient receiving pressure-cycled ventilation during intra-hospital transport. In addition to checking the integrity of the circuit, which of the following should be evaluated?
D) ETT cuff
A 1200 g, 27 week gestational age infant was delivered after a precipitous vag delivery to a mother who has diabetes. THe infant is receiving 100% oxygen during transfer to the NICU. Which of the following is the most important next course of treatment?
A) surfactant replacement therapy
A 68 YO man with a history of COPD is admitted to the hospital for increasing SOB and a nonproductive cough. Chest auscultation reveals expiratory wheezes. Which of the following is most appropriate to improve the patient's clinical condition?
C) ipratropium bromide (atrovent)
Which of the following is the best index of oxygen transport for a patient who has been resuscitated after carbon monoxide poisoning?
B) arterial blood oxygen content
A therapist is called to the ED to assist with intubation of an alert, agitated patient in respiratory failure. Two intubation attempts were unsuccessful. In addition to a neuromuscular block, which of the following drugs will best facilitate intubation?
A) midazolam (versed)
A 78 YO woman who has a femur fracture had a CT scan with contrast due to increased SOB. The CT scan showed multiple areas of decreased perfusion. What do you recommend?
D) oxygen therapy
A patient's sputum specimen is purulent green in appearance, has separated into layers and has a foul odor. Which of the following is the most likely causing the patient to produce this type of sputum?
C) bronchiectasis
Following thoracic surgery for a lobectomy, a patient is receiving PC ventilation. The exhaled Vt suddenly drops from 800 ml to 600 ml. Which of the following should be checked?
A) tracheal position & breath sounds & drainage system
Which of the following can increase methemoglobin?
B) topical silver nitrate & nitroglycerin & inhaled NO
The primary reason to aerosolize corticosteroids to treat some diseases of the airways is to:
A) minimize systemic side effects
A recent ABG analysis on an intubated patient reveals pH 7.37 pCO2 32 pO2 88 HCO3 19 BE -5. THe most likely interpretation is:
A) compensated metabolic acidosis
A physician asks the therapist to change settings to reduce a patient's pCO2. Current SIMV parameters are: FiO2 0.40 Rate 8 TtlR 12 Vt 700 PEEP 8 cm PS 5 cm. The physician wants to keep the mandatory rate at 8. Which of the following options should the therapist offer?
D) increase pressure support
A therapist will assist a physician in performing a cardioversion for a spontaneously breathing patient with supraventricular tachycardia. THe patient is awake and alert. Which of the following are critical for this procedure?
D) sdation & supplemental O2 & airway care
Which of the following is the best instruction for a patient receiving SVN bronchodilator therapy?
C) breathe normally with an occasional deep inspiratory hold
To produce capillary vasodilation, electrodes to TC monitoring must be heated to:
B) 42-45 degrees C
A therapist observes that the peak inspiratory pressure of an intubated patient has increased from 24 to 35 cm H2O and the pressure limit alarm is intermittently activating. The therapist notes that the Pplat and PEEP have not changed. The therapist should:
C) suction the airway
While assessing a 33 YO male patient for implementation of an assess-and-treat protocol, a therapist obtains the following information: HR 100 RR 22 SpO2 93% RA. Breath sounds are decreased bilaterally in the bases and there is decreased resonance to percussion bilaterally in the bases. A CXR indicates atelectasis in both bases. The therapist should initiate:
B) incentive spirmotery
A therapist is monitoring a patient with myasthenia gravis and finds that the maximum inspiratory pressure has changed from -36 cm H2O to -16 cm H2O in the last four hours. The therapist should recommend:
D) measuring the patient's VC
A previously healthy 35 YO male has been admitted to the hospital for unknown neuromuscular weakness. The patient is 178 cm (5'10") and weighs 73kg (160 lbs). THe following data has been obtained over the last four hours: 9am: RR 14 Vt 500 VC 2000; 10am: RR 12 Vt 520 VC 450; 11 am: RR 15 Vt 490 VC 1300; 12 pm: RR 18 Vt 450 VC 850. The patient is having trouble clearing oral secretions. The therapist should initiate:
B) mechanical ventilation
A patient in the ICU complains of light headedness, nausea and chest pain. THe patient is diaphoretic and has a BP of 90/60. The therapist observes the following ECG pattern. The therapist should recommend:
C) cardioversion
A family arrives at the ED c/o severe headache and nausea. Carbon monoxide poisoning is suspected. Which of the following should be included in the care plan?
C) high FiO2
While palpating the anterior chest of a patient receiving continuous ventilatory support, a therapist finds a reduction in the chest expansion on the left side. The therapist should first:
C) compare breath sounds between each side of the chest
Which of the following should be recommended to reduce system arterial blood pressure and reduce ventricular preload?
D) sodium nitroprusside (nipride)
HFOV is initiated for a 25-week premature neonate with severe RDS. The neonate has a HR of 160 and a BP of 64/40. An ABG obtained 20 minutes after intubation shows pH 7.26 pCO2 64 pO2 60 HCO3 29 BE 0. The therapist should recommend:
C) increasing the oscillatory amplitude
A 29 YO female with progressive dyspnea over the past 3 months presents to the pulmonary laboratory. The therapist notes a history of Guillain-Barré requiring prolonged endotracheal intubation. The following flow-volume loop is obtained. Which of the following procedures should the therapist anticipate being performed?
B) CT scan of the head and thorax
A 60 YO female with a diagnosis of bilateral basilar pneumonia is in the ICU. She is receiving VC, A/C ventilation. A therapist observes that her PaO2 has dropeed significantly from 65 to 52. Her current FiO2 is 0.60 and PEEP is 5 cm H2O. She is agitated and showing signs of respiratory distress. Her PaCO2 values have remained within normal range. What do you recommend?
A) increase the PEEP to 10 cm H2O
A patient is receiving mechanical ventilation in the SIMV mode. A therapist is completing a ventilator check and auscultates bilateral coarse crackles. The total rate displayed by the ventilator is 24, which is up from 14 at the last check. The patient's SpO2 is the same as it was on the last check. Which of the following should the therapist do?
C) suction the airway
A 71 YO female with a history of COPD is brought to the ED for respiratory distress. The patient is receiving oxygen by nasal cannula at 3 lpm. A therapist notes the patient has shallow breathing and has become progressively more difficult to arouse. To evaluate this patient's respiratory status, the therapist should:
C) obtain an ABG
A 73 kg (162 lbs) 170 cm (5'7") man is receiving VC, SIMV following open heart surgery. Initial ventilator settings and blood gas results are below: FiO2 0.40 R 8 TtlR 10 Vt 700 Vtspon 400 PS 5 cm H2O PEEP 5 cm H2O pH 7.28 pCO2 52 pO2 81 HCO3 24 BE -2. The therpist should first recommend increasing the:
B) mandatory rate to 12
Which of the following are potential complications associated with obtaining a blood sample through an indwelling radial arterial catheter?
A) infection & dislodging a clot
Immediately following intubation, a therapist notes decreased breath sounds on the patient's left side and asymmetrical chest movement. Which of the following should the therapist recommend first?
B) reposition the ETT
A tracheostomy should be cleaned with:
A) soap & water
A patient is admitted to the ED for asthma and auscultation reveals loud wheezing. A therapist administers two aerosolized bronchodilator treatments. Breath sounds and wheezing are now markedly diminished. It can be concluded that the patient's bronchospasm has:
B) worsened
Which of the following PFT's measures the FRC, RV and TLC?
A) body plethysmography
A patient arrives in the ED 1 hour after exposure to a chemical release from an industrial accident. The patient's SpO2 is 93% while receiving 4 lpm of oxygen by nasal cannula. Auscultation reveals normal air movement with bilateral expiratory wheezes. Which of the following is the most appropriate next step in the care of this pateint?
B) initiate a short acting bronchodilator by aerosol
While a patient is receiving VC ventilation, the ventilator suddenly begins to pressure limit with every breath. The patient's vital signs are deteriorating and the SpO2 is dropping. On PE, it is noted that the patient's trachea has shifted to the right and breath sounds are absent on the left side of the thorax. The physician at the bedside asks for the therapist's input. Which of the following is the proper course of action at this time?
A) perform needle decompression
The primary function of the respiratory therapy department in a disaster is providing:
C) sufficient numbers of trained personnel
Which of the following transdermal preparations can be used to assist a patient in a smoking cessation program?
D) nicoderm
A 20 YO female is admitted to the ED after she was pulled from a burning building. She is receiving oxygen by nonrebreathing mask and is breathing 30 times a minute with a normal skin color and a heart rate of 145. SpO2 is 100%. The therapist should:
D) recommend carboxyhemoglobin testing
A pateint experiences increasing SOB and a rapid, shallow breathing pattern after abdominal surgery. The patient is receiving oxygen by air-entrainment mask with a FiO2 of 0.50. The most recent ABG is pH 7.44 pCO2 33 pO2 45 HCO3 22 BE -2. You should initiate:
C) NIPV
Which of the following indicates a deficit in fluid balance?
C) poor skin turgor
Results of a sleep study reveal a patient has obstructive sleep apnea with marked oxygen desaturation. Which of the following therapies should be recommended for this patient?
D) nasal CPAP
A patient with an ideal body weight of 68 kg is receiving VC ventilation with the following settings: Ttl Rate 18 Vt 600 Peak Flow 45 lpm Pplat 22 PEEP 3 cm H2O. What is the patient's minute ventilation?
A) 10.8
While transporting a sedated patient using a portable ventilator, a therapist notes the patient's SpO2 has dropped from 97% to 84% and the heart rate has increased from 87 to 126. The therapist should first:
D) manually ventilate the patient
PEP therapy will be performed at home by a 6 YO girl who has been diagnosed with cystic fibrosis. Which of the following should a therapist do when instructing the child and caregiver?
D) assess the caregiver's understanding of how the child should perform the therapy
A patient is receiving SIMV following surgery. The vital signs are stable. Which of the following should the therapist recommend as the patient awakens?
A) initiate weaning
A therapist auscultates vesicular sounds throughout the periphery of the lung. This should be documented in the chart as:
B) normal
A 188 cm (6'2") patient who weighs 100 kg (220 lbs) is receiving SIMV with the following settings: FiO2 0.80 MRate 10 TtlR 32 Vt 750 Spon Vt 100 PEEP 12 PS 5. Which of the following should the therapist increase?
D) pressure support
A therapist is performing quality control on a blood gas analyzer. To be accepted, result must occur within how many standard deviations from established limits?
D) 2
A 55 YO patient is in moderate respiratory distress when receiving oxygen therapy. Blood gas results are pH 7.46 pCO2 33 pO2 54 HCO3 23 BE 0. Which of the following should be suspected?
C) acute respiratory alkalosis with moderate hypoxemia
Which of the following will lower mean airway pressure in a patient receiving VC ventilation?
B) decrease the inspiratory time
A 16 YO female was brought to the ED with a suspected drug overdose. She is intubated and receiving A/C ventilation. The following data are available: R 14 Vt 550 Insp Flow 20 Pressure Limit 50. A physician notices the I:E ratio indicates 1:1.2 and asks the therapist to adjust it so the I:E will be 1:3. The therapist should increase the:
B) inspiratory flow
A 48 YO patient with polyneuropathy has received mechanical ventilation for 73 days.For the past week, the patient has been receiving an FiO2 of 0.40 by trach collar for progressively longer periods of time. Data collected over a 4-hour weaning trial are: 30 minutes: HR 98 RR 22 SpO2 96 VC 1.6 MIP -28; 2 hrs: HR 102 RR 24 SpO2 95 VC 1.6 MIP -26; 4 hrs: HR 124 RR 34 SpO2 89 VC 0.9 MIP -16. A therapist should recommend:
D) continuing trials of 2 hours duration
A chest radiograph for a newly admitted patient shows honycombing. While assessing the patient, the therapist notes a dry, non-productive cough and mild tachypnea. Which of the following diagnostic tests should the therapist recommend?
D) high resolution CT Scan
Tracheal suctioning should be discontinued immediately with the occurrence of:
B) bradycardia
Quality control results using a 3.0 L calibration syringe spirometer are as follows: V1 2.67L; V2 2.70L; V3 2.69L. According to ATS/ERD Standards, the spirometer is:
D) inaccurate
A patient has been intubated for 4 days. When suctioning, it is noted that the secretions are becoming more tenacious. THe therapist should:
C) ensure proximal airway temperature is at least 35 degrees C
A patient in the ICU has been receiving mechanical ventilation for 2 weeks. The sputum has changed from white to green and is foul smelling. Smear of the sputum reveals gram positive cocci. The patient's WBC is 13,500. Which of the following therapies are recommended?
C) antibiotics
Which of the following should be recommended for a suspected cystic fibrosis patient?
D) sweat chloride test
A therapist is assisting a physician with a needle biopsy of a lung mass during a bronchoscopy. The biopsy site begins to hemorrhage. Which of the following should the therapist have ready for instillation?
A) vitamin K
B) lidocaine
C) cold, sterile normal saline
D) eoinephrine
a patient with a trachesotomy tube is receiving a heated aerosol with an FiO2 of 0.30 by T-piece. A nurse informs the therapist that the T-piece often becomes disconnected from the trach tube. THe following recommendation should be made:
B) exchange the T-piece with a trach collar
A first line of therapy for the treatment & management of obstructive sleep apnea is:
B) CPAP
A therapist returns to the room of a 62 YO patient and finds him unresponsive. The patient has a RR of 8, HR of 154 and a weak pulse. He is currently on a cannula of 2 lpm. The therapist should first:
D) activate the medical response team
In a normal, healthy adult, which of the following pulmonary measurements is the largest?
C) VC
A manometer is being used to monitor a continuous flow CPAP mask device set at 10 cm H2O. Each time the patient inhales, the pressure decreases to 2 cm H2O and then returns to 10 cm on exhalation. Which of the following is the most likely cause?
A) the flow of gas to the system is insufficient
A patient with an acute exacerbation of COPD is receiving VC, SIMV. THe following ABG's are obtained: pH 7.58 pCO2 67 pO2 67 HCO3 57 BE +30. The therapist should:
C) decrease the mandatory rate
While observing a patient performing incentive spirometry, it is noticed that the patient is not exhaling completely before beginning the next breath. The therapist should instruct the patient to:
A) allow a longer time before the next breath
A capillary BG sample is drawn for a 3-day old female and reveals the following: pH 7.37 pCO2 67 pO2 46 SpO2 97% PtcCO2 42/ Over the last 24 hours the TC monitor values consistently correlate with the CBG values. Which of the following is the most likely cause of the discrepancy in this patient's results?
C) the sample site was warmed to 36 degrees C
Which of the following provides the best indication of alveolar ventilation?
B) ABG
Lung fields appear whiter on a CXR when the imaging technique is:
C) underexposed
A patient who weighs 62 kg requires a minute ventilation of 15 lpm to maintain a PaCO2 of 36 while receiving mechanical ventilation. Which of the following could explain these requirements?
B) high Vds & febrile & excessive caloric intake
Static compliance is obtained by dividing Vt by:
C) (Pplat-PEEP)
A patient receiving mechanical ventilation has a BP of 60/40. The patient is currently on a continuous dopamine HCl infusion and the SpO2 monitor does not consistently display a waveform of saturation value. Which of the following is the best course of action?
B) change to a reflective forehead sensor
A patient who weighs 70 kg is receving mechanical ventilation in the SIMV mode. The following data are available: FiO2 0.40 MR 8 TtlR 30 Vt 550 Exhaled Minute Voume 6.6L. pH 7.43 pCO2 33 pO2 95 HCO3 21 BE +2 SaO2 98%. What do you recommend
C) Adding pressure support at 5 cm H2O
A patient with pulmonary emphysema has been receiving 24% oxygen for 30 minutes. PaCO2 has risen from 45 to 48 and PaO2 has rised from 45 to 60. What should be done next?
A) continue current oxygen therapy
The following capillary blood gases are obtained for a 34-233k gestational age infant receiving 35% oxygen per hood. pH 7.34 PcCO2 45 pO2 83 GCO3 23 BE -1, What do you recommend?
B) decrease the oxygen
A patient with a bronchopleural fistula remains hypoxemic while receiving VC ventilation. Which of the following should be recommended?
B) high frequency oscillatory ventilation
A patient with a tracheostomy tube has been transitioned from a heat moisture exchanger to a heated aerosol. Acute dyspnea has developed. Which of the following is the most likely explanation?
A) secretions expanded as they became hydrated
Which of the following can provide 100% humidity at body temperature?
B) heated wick humidifier
A suction canister from the bronchoscopy suite was used for a patient with HIV. How should the canister be disposed?
C) place it in a biohazard bag
A patient receiving a nebulizer treatment with 3% saline c/o SOB. You should:
C) d/c therapy
Which of the following findings indicate clinical improvement of atelectasis?
C) decrease in inspiratory crackles
A 75 kg patient had a cardiac arrest and is admitted to the ICU. The patient is apneic and is receiving 100% O2 by a bag valve resuscitator and has a SpO2 of 95%. Which of the following are the most appropriate settings?
B) A/C FiO2 1.0 Rate 10 Vt 400 PEEP 3
A patient is receiving mechanical ventilation at home. Which of the following devices should be available to provide temporary support in the event of a power failure?
C) bag valve resuscitator
A patient hospitalized with LLL atelectasis has received PD&D four times daily for 5 days. Auscultation of the chest now reveals vesicular breath sounds. You should recommend:
C) d/c therapy
Heated humidification should be used with:
D) ETT
The corect placement for a needle during decompression of a tension pneumothorax is:
A) over the third rib in the mid-clavicular line
Which of the following serum sodium values is typical for a normal healthy adult?
C) 138
Trendelenberg's position for postural drainage is contraindicated after a patient has had:
D) intracranial surgery
A patient is receiving continuous mechanical ventilation. To monitor and assess lung compliance and airway resistance, the following data are collected:
8 am 10 am
del Vt 800 800
PEEP/CPAP 5 5
Peak AWP 30 40
Stat AWP 20 30
Insp Flow 60 60
Which of the following should the therapist do next?
A) request a CXR
A patient is being valuated following a MVA.The therapist palpates crepitus near the patient's right clavicle. This most likely indicates:
A) subcutaneous emphysema
A 58 YO male patient is admitted to the ED following an MVA. THe HR is 100 and spontaneous RR is 32. ABG's are pH 7.44 pCO2 35 pO2 52 HCO3 23 BE 0. Which of the following should the therapist recommend first?
D) H&H
A 183 cm (6'), 80 kg patient was receiving PSV with an FiO2 of 0.35 before surgery. After the patient returns from surgery, the following data are collected: FiO2 0.75 RR 16 Vt 600 PEEP 8 pH 7.32 pCO2 45 pO2 50 HCO3 23 BE-3 SpO2 88%. THe therapist should recommend:
D) a lung recruitment maneuver
What volume remains in the lung at the end of a normal exhalation?
D) FRC
A 38 YO male presents to the ED with a complaint of frequent vomiting. ABG's RA pH 7.52 pCO2 38 pO2 102 HCO3 31 BE+8. Which of the following electrolyte disturbances most likely account for this anomaly?
B) K 3.2 Cl 82
A therapist is concerned that the ETT of a stable patient may have moved during transport. Which of the following should be used to determine the position of the tube?
A) CXR
A 68 YO chronically hypercapneic male with a 105 pack year history of smoking is admitted to the ED with SOB and tachypnea. He appears mildly confused and is given oxygen by 28% air entrainment mask. Within minutes his SpO2 is 85%. Which of the following should the therapist recommend as the next step while monitoring SpO2?
C) 36% air entrainment mask
A physician ordered heliox therapy for an infant with a tracheal obstruction. The treatment will be administered with an oxygen hood using 80/20 heliox. An oxygen calibrated flowmeter is used to control gas flow and is set at 10 lpm. What is the actual gas flow to the patient?
A) 18 lpm
When assisting a physician with a synchronized cardioversion, a therapist should ensure the defibrillator is synchronized to which of the following waves on the ECG?
D) R
An MDI is ordered for a patient receiving mechanical ventilation. Which of the following is the most appropriate way to administer the bronchodilator?
B) place the MDI adaptor in the inspiratory limb, close to the Y
The following PFT results were obtained: VC 3.6 FRC 6.0 ERV 1.0 What is the patient's TLC?
B) 8.6
A patient with ARDS is receiving A/C, PC ventilation. Radial & PA Catheters are placed for monitoring. Which of the following should be used to evaluate oxygen delivery in the determination of PEEP for this patient?
D) mixed venous blood gas
A 28-week gestational age neonate who is intubated has developed consolidation of the left lung. In which position should the patient be placed?
B) right side down
A patient requies frequent nasotracheal suctioning. The patient begins to cough violently after the nasopharyngeal airway is placed. Which of the following should be recommended?
D) insert an airway that has a shorter length
In which of the following patient discharge situations should a therapist recommend an apnea monitor for home use?
A) preterm infant who has been treated with caffeine
A 201 kg (442 lbs) patient who underwent a gastric bypass and tracheotomy 2 weeks ago remains in the ICU receiving VC ventilation. After the patient is rolled to the supine position, the ventilator high pressure alarm sounds with each breath. The suction catheter can be passed 10 cm into the trach and no secretions are evident. Which of the following should be done first?
A) reposition the tube in the trachea
A 36 YO male who suffered a C4 spinal injury 2 years ago received rehab and was able to resume spontaneous ventilaiton. He has had flu like symptoms, increased respiratory distress and increased pulmonary secretions over the past day. On presentation in the ED, ABG's are pH 7.28 pCO2 51 pO2 68 HCO3 24 BE -3 SpO2 90%. What do you recommend?
B) NPPV
A postopoerative patient is receiving supplemental oxygen through a nasal cannula at 2 lpm. Which of the following is the most appropriate method for a therapist to evaluate the patient's response to the oxygen therapy?
