rt103 final

  1. 1. The definition of “syllabus” is:



    A. A summary for a course of study
  2. 2. T or F The first Student Learning Outcome (SLO) revolves around the principles, indications, hazards, and monitoring of negative pressure ventilation.
    False
  3. 3. T or F The Student Learning Outcome(SLO) for this class includes an introduction to in monitoring of cardiac functions
    True
  4. 4. T or F The Mid Term and Final constitute approximately 40% of the grade for this class.
    True
  5. 5. According to the institutional classroom Standards, if you are going to be absent you are to


    C. contact the instructor by SJVC email prior to your absence
  6. 6. Missing deadline for homework and projects may result in
    I. a 10% reduction in points
    II no credit
    III void the need for turning in the project


    A. I or II or at the instructors discretion
  7. 7. Missed quizzes, including “pop” quizzes
    A. Can be taken late in accordance with college policies
    B. May not be taken later; you will get a zero for that quiz
    B. May not be taken later; you will get a zero for that quiz
  8. 8. To F It is okay to have coffee or soda in the classroom during lectures
    False
  9. 9. In the article “Competencies Needed by Graduate Respiratory Therapist in 2015 and Beyond” how many competencies were identified and agreed upon as being needed by both new grads and existing work force



    C. 69
  10. 10. All of the following competencies were identified as being needed except



    B. They must fully understand the tenets of evidence based medicine including the ability to critically read and critique the medical literature and discuss the meaning of stastical anaylsis
  11. 11. In Table 12, the responders evaluated the relative importance of the following categories of skills, which did they indicate most important



    A. Critical care
  12. 12. The importance of documenting competence and quality of care by administering national board speciality certifications examinations was first identified by other professions as early as



    C. 1917
  13. 13. Which of the following participant groups identified that ther is a perfect storm of healthcare issues in our society, and that the respiratory care prefession is in a good position to assume new or expanding roles



    A. Hospital Administrators
  14. 14. Based on your reading of this article do you think that the ability to research apply and adapt to respiratory care patient care protols to specific patients needs will be of value


    C. Very useful — because it’s at the bedside where the real issue of patiend safety and treatment efficacy are most important
  15. 15. “RTs in 2015 must assume greater responsibility for ______ in order to reduce the cost of healthcare.”



    A. education of other healthcare workers in RT procedures
  16. 1. A diagnosis of respiratory failure can be made if which of the following are present
    I. PaO2 of 55, FiO2 .21 Pb 760
    II. PaCO2 57, FiO2 .21 Pb 760
    III. P(A-a) O2 45, FiO2 1.0 Pb 760
    IV. PaO2/FiO2 400 Pb 750



    A. I and II
  17. 2. What is respiratory failure due to inadequate ventilation?



    D. hypercapnic
  18. 3. Hypercapnic (type II) respiratory fail terms?



    B. ventilatory failure
  19. 4. Hypoxemia can be caused by which of the following
    I. diffusion impairment
    II. alveolar hypoventilation
    III. V/Q mismatch
    IV. Intrapulmonary shunting



    C. I, II, III, and IV
  20. 5. Which of the following best describes t e difference between V/Q mismatch and shunt when supplemental oxygen is administered?



    C. V/Q mismatch will respond well but shunt will not.
  21. 6. Which of the following clinical signs is most often associated with hypoxemia due to shunt?
    • a. diffuse wheezing
    • b. “white” chest radiograph
    • c. stridor
    • d. loud P2

    b. “white” chest radiograph
  22. 7. A patient with interstitial lung disease ho presents with hypoxemia due to diffusion def have which of the following clinical signs?
    I. fine bibasilar crackles
    II. clubbing of the finger nail beds
    III. jugular venous distention
    IV. increased P2



    C. I, II, III, and IV
  23. 8. What type of disease is associated with perfusion/diffusion impairment?



    D. vascular disease
  24. 9. What is the most common cause of low mixed venous oxygen?



    A. cardiac disease, with low cardiac output
  25. 10. What is the normal P (A—a) 02 range while breathing room air?



    C. l0 mmHg to 25 mmHg
  26. 11. What is the normal P (A—a) 02 with V/Q mismatch and shunt?



    C. increases with both V/Q mismatch and shunt
  27. 12. What is the optimal treatment of intrapulmonary shunt?



    B. alveolar recruitment
  28. 13. A patient with an opiate drug overdose blood gas results breathing room air: pH 7.19, PCO2 89, HCO3 27, PO2 48
    Which of the following best describe the patient’s condition?



    A. acute hypersonic respiratory failure
  29. 4. All of the following would tend to cause hypersonic respiratory failure except



    A. smoke inhalation
  30. 15. Which of the following are associate with hypercapnic respiratory failure due to decreased ventilatory drive?
    I. brainstem lesions
    II. encephalitis
    III. hypothyroidism
    IV. asthma



    D. I, II, and III
  31. 16. All of the following are associated with respiratory muscle weakness or fatigue



    B. hyperthyroidism
  32. 17. Which of the following is a feature of Guillian Barre



    C. ascending muscle weakness
  33. 18. All of the following are associated with increased work of breathing except:



    A. myasthenia gravis
  34. 19. Which of the following information be respiratory failure from acute hypercapnea



    C. kidneys retaining bicarbonate to elevate the blood pH
  35. 20. Which of the following is the cardinal sign of increased work of breathing



    D. tachypnea
  36. 21. In patients suffering from acute respiratory failure below what pH level is intubation and ventilatory support generally considered



    B. 7.20
  37. 22. Which of the following patients has the most serious problem with the adequacy of oxygenation?



    B. 1.00 85
  38. 23. A need for some form of ventilatory support is usually indicated when an adult’s rate
    of breathing rises above what level?



    A. 35/mm
  39. 24. Which of the following measures is useful indicators in assessing the adequacy of a patient’s oxygenation?
    I. PAO2 – PaO2
    II. PaO2 to FiO2 ratio
    III. VD/VT



    D. I and II
  40. 25. Which of the following measures taken on adult patients indicate unacceptably high demands or work of breathing?



    A. VE of 17 L/min
  41. 26. Ventilatory support may be indicated when the VC falls below what level?



    C. 10ml/kg
  42. 27. What is the normal range of maximum inspiratory pressure, or MIP (also called negative inspiratory force, or NIF), generated by adults?
    A -80 to –l00
    B. -50 to -80
    C. -30 to -50
    D. -20 to -30
    A -80 to –l00
  43. 8. Which of the following MIP measure taken on an adult patient indicates inadequate
    respiratory muscle strength?



    B. –l5
  44. 29. Common bedside measures used to assess the adequacy of lung expansion include all of the following except



    A. VD/VT
  45. 30. You determine that an acutely ill patient can generate an MIP of -18. Based on this information, what might you conclude?



    D. The patient has inadequate respiratory muscle strength.
  46. 31. Breathing 100% 02, a patient has a PA 2 of 60mm Hg. Based on this information, what might you conclude?



    B. The patient has acceptable oxygenation.
  47. 32. What is the normal range for Pa02?



    A. >400
  48. 33. Which of the following measures should be used in assessing the adequacy of a patient’s alveolar ventilation?
    1. Pa02
    II. arterial pH
    III. PaC0



    C. II and III
  49. 34. A patient with a 10-year history of chronic bronchitis for, with an acute viral pneumonia for the last 3 days now exhibits the following blood gas pH= 7.22; PCO =67; HCO= 26 PCO2 = 60 which of the following best describes the patient’s condition?



    D. acute hypercapnic respiratory failure
  50. 35. cause an elevated PaCO2 increases ventilatory drive in normal subjects , the clinical presence of hypercapnia indicates which of the following?
    I. inability of the stimulus to get to the muscles
    II. weak or missing central nervous system
    III. pulmonary muscle fatigue



    A. I, or II, or III
  51. 36. Which of the following indicators are useful in assessing respiratory muscle strength
    I. maximum voluntary ventilation (MVV)
    II. forced vital capacity (FVC)
    III. dead space to tidal volume ratio (VD/VT)
    IV. Maximum inspiratory pressure (MIP)



    C. I, II, and IV
  52. 37. A reversible impairment in the response of an overload best describes which of the following



    D. contractile respiratory muscle fatigue
  53. 38. Which of the following modes of ventilatory support would you recommend for a mild hypoxemic patient from congestive heart



    B. continuous positive airway pressure
  54. 39. Which of the following patients are at greatest risk for developing auto PEEP during mechanical ventilation?



    A. those with COPD
  55. 40. What are some causes of dynamic hyperinflation.
    I. increased expiratory time
    II. increased airway resistance
    III. decreased expiratory flow rate



    B. II and III
  56. 26. It is important to monitor ventilatory parameters in addition to arterial blood gases because:



    B. changes will occur in ventilator parameters before they are seen in arterial blood gases.
  57. 27.Ventilatory measurements routinely monitored at the bedside include all of the following except:



    A. oxygen consumption and carbon dioxide production.
  58. 28. It is important to monitor lung volumes in patients on ventilators because they:
    a affect gas exchange in the lung.
    b. reflect changes in the patient’s clinical status.
    c. indicate response to therapy and any problems that may arise.
    d. All of the above
    c. indicate response to therapy and any problems that may arise.
  59. 29. Which of the following is/are true about the tidal volume?



    C. It is made up of two components: alveolar volume and dead space volume.
  60. 30. In healthy, spontaneously breathing patients, an occasional increase in tidal volume to three or four times the normal level, which normally occurs about six to ten times each hour is the defnition of a:



    D. sigh.
  61. 31. If intubated and mechanically ventilated patients are given shallow tidal volumes without sighs, which of the following is most likely to occur?



    D. Atelectasis
  62. 32. In mechanically ventilated patients, normal tidal volumes are not usually used without positive end-expiratory pressure (PEEP) because they will cause:



    D. All of the above
  63. 33. The “stacking” of breaths, often seen in mechanically ventilated patients with severe obstruction, can be caused by:



    C. an insufficient expiratory time.
  64. 34. The amount of force needed to maintain a mechanical tidal volume breath in the patient’s lungs is known as:



    D. static pressure.
  65. 35. Compliance is defined as:



    C. volume change per unit of pressure.
  66. 36. ARDS, pneumonia, and pulmonary edema are likely to cause a decrease in lung compliance. This is evidenced in a mechanically ventilated patient by:



    D. an increase in static pressure.
  67. 37. If auto-PEEP is present, it is most likely to be detected if the expiratory limb of th patient circuit is occluded at what point in the cycle?
    a. At the end of exhalation
    b. In the middle of inhalation
    c. In maximal inhalation
    d. All of the above
  68. 38. In the ICU, the airway resistance (Raw) of a mechanically ventilated patient can b easily estimated by which of the following formulas?



    A. (peak pressure - static pressure)/flow
  69. 39. All of the following are likely to increase the mean airway pressure (MAP) except
    a. an increase in flow rate.
    b. an increase in PEEP levels.
    c. an increase in peak pressure.
    d. an increase in expiratory time.
  70. 40. When a patient’s mechanical ventilator has a graphic display screen, which of the following waveforms could be used to determine whether there is any leak in the
    system and the amount of the leak?



    C. Volume/time
  71. 41. A pre-use check on the Servo i contains which of the following:




    D. All of the above are correct
  72. 42. How long will the Oxygen Breath button deliver 100% 02 on the Servo i?



    d Until you turn it off
    C. 2 minutes
  73. 43. The Servo i has the option of compensating for circuit compressible volume (aka. Tube Compliance Factor, TCF).
    a. True
    b. False
    a. True
  74. 44. Which of the following is NOT controlled by a direct access knob on the user interface in Volume Control mode:
    a. Fi02
    b. Respiratory Rate
    c Inspiratory Time
    d. PEEP
    e. All of the above can be directly controlled in Volume Control mode.
    c Inspiratory Time
  75. 45. When the Automode is activated it will allow the patient to increase the inspiratory flow rate above the set flow rate, and shorten the Ti.
    a. True
    b. False
    a. True
  76. 46. The criteria for the clinical diagnosis of brain death includes all of the following except:
    a. Doll’s eyes
    b. no cough response to deep tracheal suction
    c .intact spinal reflexes
    d. persistent apnea after 7-10 minutes
    c .intact spinal reflexes
  77. 47. For the end results of the APNEA TEST to be valid, the PaCO2 must be greatei than:
    a. 30torr
    b. 40torr
    c. 50torr
    d 60torr
    d 60torr
  78. 48. Apnea Test “exclusion criteria” to rule out potentially reversible causes of coma thai mimic brain death, include all of the following except:



    B. Hypertension
  79. 49. Acute dyspnea can be caused by which of the following ventilator setting:
    I. High pressure control setting
    II. Setting the tidal volume low enough that the peak airway pressure is kept <30 cm H20
    III The assist-control back-up rate is set so that the patient must trigger th ventilator
    IV. A long inspiratory time



    A. I, II, IV
  80. 50. True or False
    Ventilator settings that “exercise” the patient can cause patient-ventilator dys synchrony.
    True
  81. 51. pH 7.46 PCO 25 HCO 17




    B. Chronic Respiratory Alkalosis
  82. 52. pH 7.33 PCO 70 HCO 36




    B. Chronic Respiratory Acidosis
  83. 53. pH 7.11 PCO 16 HCO 5




    D. Acute Metabolic Acidosis

    • 54. pH 7.55 PCO 35 HCO 33
    • a. Chronic Respiratory Alkalosis
    • b. Mixed Metabolic & Respiratory Alkalosis
    • c. Acute Metabolic Acidosis
    • d. Chronic Respiratory Acidosis
    • e. Combined Respiratory & Metabolic Acidosis

    b. Mixed Metabolic & Respiratory Alkalosis
  84. 55. pH 7.15 PCO 50 HCO 17




    E. Mixed Metabolic & Respiratory Alkalosis
  85. 56. pH 7.61 PCO 33 HCO 29




    E. Combined Respiratory & Metabolic Acidosis
  86. 57. pH 7.35 PCO 20 HCO 12




    A. Respiratory Alkalosis correcting Metabolic Acidosis
  87. 58. pH7.30 PCO31 HCO15




    B. Combined Metabolic & Respiratory Alkalosis
  88. 59. pH 7.40 PCO 33 HCO 50




    A. Respiratory Alkalosis correcting Metabolic Acidosis
  89. 60. pH 7.26 PCO 50 HCO 22




    B. Combined Respiratory & Metabolic Acidosis
  90. 61. While monitoring patients, signals, or values are susceptible to variability due to all of the following, except



    A. seasonal variation
  91. 62. Temporary variation in pulmonary artery pressure readings due to movement of the hemodynamic monitoring line is an example of what type of variability?



    C. artifact
  92. 63. Which of the following are the reasons monitors are needed?
    I. continuous assessment
    II. analysis of vital signs
    III. measurement of values that caregivers cannot detect



    C. I and III
  93. 64. Which of the following parameters is NOT a major factor in determining tissu oxygenation?



    C. R/Q ratio
  94. 65. In low-perfusion patients, what site would be best for monitoring Sp0



    C. finger
  95. 66 The setting of the alarm threshold for the minute ventilation (Ve) may be too high if it allows the natient to double their current Ve.
    A. True
    B. False
    A. True
  96. 67. Which of the following is NOT likely to cause errors in SpO2 readings?



    A. significant tachycardia
  97. 68. What is the normal approximate value for oxygen consumption?



    B. 250 ml/mm
  98. 69. What method(s) is/are used to measure oxygen consumption?
    I. Fick method
    II. analysis of inspired and expired gases
    III. V/Q scans



    B. I and II
  99. 70. What is the best measure of the efficiency of gas exchange in the lung?



    B. VD/VT
  100. 71. In which of the following disorders would an increased VD/VT ratio be likely?



    D. hypothalamus tumor
  101. 72. What is the normal range for lung compliance?



    A. 60 to 100
  102. 73. Which of the following conditions is associated with an increased lung compliance measurement?



    C. emphysema
  103. 74. Which of the following is NOT a cause of increased airway resistance?



    B. suctiomng
  104. 75. What is the upper limit for plateau airway pressure that is recommended during mechanical ventilation?



    B. less than 30
  105. 76. Which of the following factors is not associated with an increased risk for auto-PEEP
    A. mechanical ventilation of a patient with obstructive lung disease
    B. high minute volume during mechanical ventilation
    C. acute respiratory distress syndrome (ARDS) patients
    D pulmonary fibrosis
    D pulmonary fibrosis
  106. 77. Which of the following is NOT associated with auto-PEEP?



    A. effective trigger sensitivity
  107. 78. What is the normal range for the percent of oxygen consumption consumed by the , muscles?
    A 2% to 5%
    B. 5%tolO%
    C. l0%tol5%
    D. 20%to25%
    A 2% to 5%
  108. 79. Which of the following breathing patterns suggests respiratory muscle decompensation?



    A. rapid and shallow breaths
  109. 80. Which of the following is NOT a common purpose of using ventilator graphics?



    C. to determine best FIO
  110. 81. What medication is associated with dilated and fixed pupils in the intensive care unit patient?



    C. atropine
  111. 82. At what level of intracranial pressure will venous drainage be impeded and cerebral edema develop in uninjured tissue?



    C. 30 to 35mmHg
  112. 83. What is the Glasgow Coma Scale (GCS) score that requires intracranial
    pressure monitoring?
    A less than 8
    B. less than 9
    C. less than l0
    D. less than 11
    A less than 8
  113. 84. Which of the following should be considered if medical and mechanical problems have been e and the patient continues to fight the ventilator or exhibit high levels of agitation or distress?



    A. sedatives
  114. 85. What type of internal compressor is used by the Cardinal AVEA ventilator?



    A. Scroll pump
  115. 86. On the Cardinal AVEA, the pressure-support ventilation (PSV) Tmax setting provides which of the following?




    (APRV)
    A. Time-cycling for spontaneous breaths
  116. 87. Which of the following represent the neonatal modes of ventilation available
    on the Cardinal AVEA?
    I. Pressure-regulated volume control (PRVC) A/C
    II. Time-cycled, pressure-limited (TCPL) SIMV
    III. APRV/BiPhasic
    IV. CPAP PSV



    D. II and IV
  117. 88. The Cardinal AVEA can deliver which of the following gases to a patient?
    I. Room air
    II. Nitrous oxide
    III. 70/30 heliox
    IV. 80/20 heliox



    D. I and IV
  118. 89. The respiratory mechanics maneuver on the Cardinal AVEA ventilator that is used to determine a patient’s work of breathing is:



    A. Esophageal pressure
  119. 90. To achieve the set volume in the PRVC mode, the Cardinal AVEA will increase or decrease the pressure by ____ cm H



    A. 3

    • 1. When transporting a patient on a transport ventilator it isn’t necessary to bring a self-inflating bag and mask of appropriate size.
    • A. True
    • B. False

    B. False
  120. 2. Transport ventilators have not been shown to provide a more constant minute ventilation than manual ventilation during short term in-house patient transports.
    A. True
    B. False
    B. False
  121. 3. Contraindications to in-house transports include:
    I. inability to provide adequate oxygenation
    II. inability to maintain acceptable hemodynamic performance during transport
    III. inability to adequately monitor patient cardiopulmonary status during transport,
    IV. inability to maintain artificial airway control



    A. I, II, III, IV
  122. 4. Loss of the artrncial airway is potential risk during in-hospital transport.
    A. True
    B. False
    A. True
  123. 5. In one major study regarding in-hospital transport, approximately 70% of the in-hospital transports caused significant physiologic events lasting at least 5 minutes.
    A. True
    B. False
    A. True
  124. 1. PRVC uses what flow pattern to deliver a breath?




    B. Decelerating wave
  125. 2. A pre-use check on the Servo i contains which of the following:




    D. All of the above are correct
  126. 3. How long will the Oxygen Breath button deliver 100% 02 on the Servo I?



    d Until you turn it off
    A. 2 minutes
  127. 4 The Servo i has the option of compensating for circuit compressible volume (aka. Tube Compliance Factor, TCP).
    A. True
    B. False
    A. True
  128. 5. Which of the following is NOT controlled by a direct access knob on the user interface in Volume Control mode:




    C. Inspiratory Time
  129. 6. Which of the following statements is true about the Servo I?



    C. The ventilator can be used for transport with gas cylinder attached
  130. 7. Which mode of ventilation on the Servo i adjusts the pressure support level automatically for the spontaneously breathing patient?



    B. Pressure Regulated Volume Control
  131. 8. The Servo i has the option for monitoring the end-tidal PCO2 (PetCO2), and calculating the VCO2, which is half of the respiratory quotient.
    A. True
    B. False
    A. True
  132. 9. When the Automode is activated it will allow the patient to increase the inspiratory flow rate above the set flow rate, and shorten the Ti.
    A. True
    B. False
    A. True
  133. 10. The default flow pattern in all volume modes is a decelerating waveform;
    A. True
    B. False
    B. False
  134. 1. What was the initial stated purpose for using Adaptive Pressure Control mode of ventilation?



    A. To be used as an Auto-wean mode in the post-OP population
  135. 2. Which of the following ventilators dropped to Ojoules of support as the patient’s work of breathing increased?
    a PB 840 VC+
    b. Drager Auto Flow
    c. Hamilton Galileo
    d. Servo-i
    d. Servo-i
  136. 3. From this, and other, articles we now know the following:


    A. If the ventilator shows a measured Vt higher than the set Vt, the patient is not receiving much (if any) pressure support, and may be inspiratory flow starved.
  137. 4. According to another article quoted, which of the following modes was the least comfortable for spontaneous breathing normal patients?


    C. APC
  138. 5. Among ARDS patients, which of the following modes of ventilation supported the patient’s WOB best?


    A. Volume control
  139. 1. List 3 medical conditions which have been confirmed to have an association with obstructive sleep apnea.
    • Hypertension
    • Stroke
    • Nocturnal Angina
  140. 2. Compared with data of the general US population, patients with obstructive sleep apnea/hypopnea syndrome may have _______ as much hypertension, ______as much ischemic heart diease, and ______as much cerebrovascular disease.
    • 2x
    • 3x
    • 4x
  141. 3. Hypertrophy of the right and left ventricles of the heart tends to occur with obstructive sleep apnea. What is the suspected mechanism?
    Repeated hypoxemic events
  142. 4. Patients with obstructive breathing disorders are more prone to depression, anxiety, and sexual dysfunction.
    A. True
    B. False
    A. True
  143. 5. (Fill in the blank) Studies demonstrate excess mortality rates due to obstructive sleep apnea of ____ % over 5-8 years, with most deaths attributed to _________________
    • 6
    • Vascular Disease

    • 1. Our multidisciplinary goal is to maintain pam control at a level 5 or above on a Wong Baker scale (scale of 0 — 10).
    • A. True
    • B. False

    B. False
  144. 2. Pleuritic chest pain is often sharp, localized pain, most often at the periphery of the chest, and increases with deep breathing, coughing, sneezing or movement. Musculoskeletal trauma would be a good example.
    A. True
    B. False
    A. True
  145. 3. Unrelieved pain has no relationship to the pulmonary signs of decreased flows and volumes, atelectasis, shunting & hypoxemia, decreased effectiveness of cough, or sputum retention.
    A. True
    B. False
    B. False
  146. 4. We should notify the physician or nurse if the initial, or subsequent, pain medication orders are inadequate or breakthrough pain occurs.
    A. True
    B. False
    A. True
  147. 5. FLACC scale (face-legs-activity-cry-consolability) can be used for children 0-5 years of age or children who cannot self-report pain.
    A. True
    B. False
    A. True
  148. 6. Morphine is often used to treat dyspnea, but it can depress the central respiratory center.
    A. True
    B. False
    A. True
  149. 7. Pain increases gastric and bowel motility.
    A. True
    B. False
    B. False
  150. 8. Aggressive Respiratory Care, in the form of frequent moving of the patient and encouraging coughing, should be avoided in chest trauma patients.
    A. True
    B. False
    B. False
  151. 9. Visceral chest pain often leads us to the conclusion that the pain is gastric in origin, even though the exact cause of this type of pain remains poorly understood.
    A. True
    B. False
    A. True
  152. 10. Morphine and fentanyl both can cause rigidity of the chest wall muscles at high doses.
    A. True
    B. False
    A. True
  153. What is the most common cause of pleural effusion in the clinical setting?
    a. acute renal failure
    b. congestive heart failure
    c, liver disease
    d. lungcancer
    b. congestive heart failure
  154. 2. The pleural effusions associated with heart failure are rarely drained.
    a. true
    b. false
    a. true
  155. 3. What is a common complication of pleurodynia (pleural pain)?



    C. atelectasis
  156. 4. what is the most common cause of hemothorax?



    B. chest trauma
  157. 5. what is a common clinical finding even with small pleural effusions?



    B. dyspnea
  158. 6. What are the functions of a chest tube in a patient with chest trauma that causes bleeding and pneumothorax?
    I. to measure the rate of bleeding
    II. to improve ventilation
    III. to allow lung re-expansion



    C. I, II and III
  159. 7. Chest tubes should be directed toward the base of the lung to evacuate a pneumothorax.
    a. true
    b. false
    b. false
  160. 8. At what anatomic position should an 18-gauge IV catheter be placed to relieve a tension pneumothorax?



    A. just superior to the second rib
  161. 9. A quick diagnosis based on clinical presentation can significantly improve the survival rates in patients with tension pneumothorax.
    a. true
    b. false
    a. true
  162. 10. What complication often occurs following rapid lung re-expansion due to the evacuation of air or fluid from the pleural space?



    B. pulmonary edema
  163. 11. The administration of oxygen to a patient with a pneumothorax will speed the rate at which resolution occurs once the leak has stopped.
    a. true
    b. false
    a. true
  164. 12. What method of chest tube removal has been associated with the lowest level of pneumothorax recurrence?



    A. Remove the chest tube 48 hours after the air leak resolves.
  165. 13. Which type of chest tube has the least complication rate?
    a. Small tubes
    b. Large tubes.
    b. Large tubes.
  166. 14. Which of the following complications is present both early and late in the clinical use of chest tubes?



    C. Nonfunctional tubes.
  167. 15. Signs of broncho-pleural fistula may include which of the following?
    Loss of returned tidal volumes
    I Actively bubbling Pleur-evac device
    II Life-threatening respiratory acidosis
    IV Auto-cycling of the ventilator
    V Persistent atelectasis



    D. I, II, IV, V
  168. 1. A patient-ventilator system check must include both the set and observed ventilator frequency, and the delivered tidal volume (either measured or calculated).
    a. true
    b. false
    a. true
  169. 2. All of the following complications are possible if you disconnect a patient, except



    D. Hyperventilation
  170. 3. When should you drain the ventilator tubing?



    D. Before the ventilator check so the condensation doesn’t influence the readings and calculations.
  171. 4. What is the minimum time that it takes to begin to gel an accurate plateau pressure?



    D. 2.0 seconds
  172. 5. Which of the following are reasons to do a Patient-Ventilator Check?
    I. Routine — Q 2-4 hrs.
    II. Before each ABO.
    III. With ventilator orders/settings changes.
    IV. With any acute change in patient conditions
    V. Upon arrival back from a transport to MIRJ for 2 lirs.
    VI. Whenever the ventilator performance is questionable.



    D. I, II, III, IV, V, VI
  173. 6. Patient vital signs belong p in the Nursing Notes, not in our Patient-Ventilator Check charting.
    a. true
    b. false
    b. false
  174. 7. An ‘error of omission” in charting can be grounds for malpractice.
    a. true
    b. false
    a. true
  175. 8. Spelling errors and math errors have no effect on the perception of our professionalism; the other Healthcare Workers understand the complexities and time constraints.
    a. true
    b. false
    b. false
  176. 9. Brief narratives regarding the clinical observations of the patient’s response to the current mechanical ventilator settings are not necessary, according to the AARC — CPG on Patient- Ventilator Check.
    a. true
    b. false
    b. false
  177. 10. All of the following are direct complications of suctioning except:




    E. Mesenteric isehemia
  178. 11. All of the following are considered evidence of effective suctioning, except:




    D. Decreased static compliance
  179. 12. One of the stated reasons for doing a Patient-Ventilator Systems Check, according to the AARC CPG, is to verify and document that the ventilator alarms are appropriate and active.
    a. true
    b. false
    a. true
  180. 13. According to the AARC CPG, an acceptable order for mechanical ventilation cannot be solely based on the desired blood gas results or ranges, leaving you to manipulate the settings to obtain these desired results.
    a. true
    b. false
    b. false
  181. l4 According to the AARC CPG, the volume monitoring devices should have an accuracy of within ± 10% of the set Vt, and the oxygen analyzer accuracy should be within ±3% of actual concentrations.
    a. true
    b. false
    a. true
  182. 15. According to the AARC CPG, the routine patient-ventilator check should do which of the following?
    I. Prevent untoward incidents
    II. Warn of impending events
    III. Assure proper ventilator functioning
    IV. Match the physician’s orders



    C. I, II, III, IV
  183. 1. Acute dyspnea can be caused by which of the following ventilator setting:
    I. High pressure control setting
    II Setting the tidal volume low enough that the peak airway pressure is kept <30 cm H20
    III The assist-control back-up rate is set so that the patient must trigger the ventilator
    IV. A long inspiratory time



    D. all of the above can cause dyspnea
  184. 2. Venilator settings that “exercise” the patient can cause patient-ventilator dys-synchrony.
    a. true
    b. false
    a. true
  185. 3. The setting of the alarm threshold for the minute ventilation (ye) may be too high if it allows the patient to double their current ye.
    a. true
    b. false
    a. true
  186. 4. Delirium can cause patient distress sufficient to cause adverse patient- ventilator interactions.
    a. true
    b. false
    a. true
  187. 5. Ventilator alarm systems will always alert you to a ventilator malfunction.
    a. true
    b. false
    b. false
  188. 6. Malposition of the ETT down the mainstem bronchus will always trigger a high peak airway alarm.
    a. true
    b. false
    b. false
  189. 7. Slow cuff leaks most often lead to which of the following problems?
    I. Hypoventilation
    II. Hypoxemia
    III. Aspiration
    IV. High peak airway pressures



    D. I, II, III
  190. 8. Assuming normal pulmonary compliance and resistance, and properly set alarms, a new onset of Kussmaul’s breathing while on a ventilator should cause a low minute ventilation alarm.
    a. true
    b. false
    b. false
  191. 9. One of the first steps in responding to high peak airway pressures alarms is to confirm that the artificial airway is not obstructed by trying to suction down the tube.
    a. true
    b. false
    a. true
  192. 10. The ventilator alarms will always alert us to increasing expiratory airway resistance due to HMEs.
    a. true
    b. false
    b. false
  193. 11. Which of the following is not a potential cause of dyspnea?



    B. central apnea
  194. 12. Tachypnea (rapid breathing) is always a good indicator that the patient is dyspnic.
    a. true
    b. false
    b. false
  195. 13 Most patients’ can sense the magnitude of inspiratory effort neces5 to take a breath, which becomes the basis for their sense of breathlessness.
    a. true
    b. false
    a. true
  196. 14. Dyspnea is an objective sign, which is easy to measure and treat.
    a. true
    b. false
    b. false
  197. 15. Our “hypoxic drive” is mediated through our central chemoreceptors.
    a. true
    b. false
    b. false
  198. 16. Morphine is the drug of choice to treat a dyspnic emphysema patient.
    a. true
    b. false
    b. false
  199. 17 Paroxysmal nocturnal dyspnea (PND) is most often associated with congestive heart failure I pulmonary edema.
    a. true
    b. false
    a. true
  200. 18. In addition to history taking, it is often necessary to do both pulmonary function tests and a cardiac stress test to quantify the severity of dyspnea on exertion (DOE), particularly if the patient is seeking disability insurance.
    a. true
    b. false
    a. true
  201. 19. In patients with cardiogenic pulmonary edema (CPE), dyspnea is seldom a major symptom at the time of presentation in ER.
    a. true
    b. false
    b. false
  202. 20. Fanning air across the patient’s face is totally ineffective for the relief of dyspnea in COPD and cancer patients.
    a. true
    b. false
    b. false
Author
noah.aisner
ID
36093
Card Set
rt103 final
Description
rt103 final
Updated