RRT Test 1
2010-10-16 22:14:47
RRT Test

RRT Test 1
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  1. A patient's chest radio-graph shows diffuse alveolar infiltrates. The PCWP_is 16mm Hg, CVP is 7mm Hg, mean PAP (Ppa) is 15 mm Hg, right atrial pressure is 8mm Hg, and the cardiac index is 3.5 L/min/m2. Which of the following should be used to differentiate between cardiac and non-cardiac etiology?

    A. Right atrial pressure
    B. Central venous pressure
    C. Mean pulmonary artery pressure
    D. Pulmonary capillary wedge pressure
  2. The urine output of a critically ill patient may be affected by which of the following?

    I. Anti diuretic hormone (ADH) levels
    II. The arterial blood pressure
    III. Infusion of IV fluids
    IV. The use of PEEP

    A. I and IV only
    B. I, II, and III only
    C. II, III, and IV only
    D. I, II, III and IV
  3. Clinical signs and symptoms of a right-sided pneumothorax include which of the following?

    I. Diminished breath sounds on the right side of the chest
    II. Hyper-resonance on percussion of the right side of the chest
    III. Increased chest motion on the right side of the chest
    IV. Increased vocal fremitus on the right side of the chest

    A. III only
    B. I and II only
    C. I and IV only
    D. II, III, and IV only
  4. Which of the following would indicate that the physical conditioning regimen has been effective for a patient with COPD?

    A. The resting pulse rate remains the same as 1 month prior.
    B. The patient has increased his level-walking distance by 15%
    C. The patient's vital capacity has increased by 5%
    D. There is an increase in respiratory rate by 2 breaths/min
  5. While monitoring a patient who is receiving 70%/30% heliox therapy by nonrebreathing mask, the respiratory therapist discovers that the reservoir bag completely deflates near the end of inspiration. Which of the following is the most probable cause of the problem?

    A. The one-way valves on the mask are malfunctioning.
    B. The density of the 70%/30% heliox mixture is too high.
    C. The helium/oxygen flow to the reservoir bag is too low.
    D. The mask is not tightly sealed around the patient's face.
  6. A patient with chronic hypercapnia is to recieve oxygen at home by nasal cannula at 2 L/min. The patient should be told to set the flow no higher than 2 L/min primarily because

    A. Excessive oxygen can be dangerous.
    B. An increased flow til be of no benefit.
    C. Excessive oxygen will take the place of CO2 in the body.
    D. Excessive oxygen may lead to lung damage and oxygen toxicity.
  7. A patient using a transdermal nicotine patch complains of local skin irritation and insomnia. The respiratory therapist should recommend which of the following?

    A. Discontinue use of the patch.
    B. Apply topical steroids to the skin and change the site.
    C. Frequently rotate the patch and discontinue use during sleep.
    D. Use the patch for only 8 hours daily and drink 1 to 2 oz of alcohol at bedtime.
  8. A 14kg (30lb) child with croup is treated with 0.25mL of 2.25% racemic epinephrine by aerosol mask. After the treatment, the respiratory therapist notes a decrease in stridor. On ausculation, breath sounds are diminished bilaterally, and the Sp02 has decreased from 99% to 95%. Which of the following should the therapist do?

    I. Request an increase in the dose of racemis epinephrine.
    II. Notify the physician that the patient's condition is worsening.
    III. Call for a stat chest radiography.
    IV. Recommend a tracheotomy.

    A. I and II only
    B. I, II and III only
    C. I, III and IV only
    D. II, III and IV only
  9. A patient with postoperative lobar atelectasis is receiving incentive spirometry. The patient is very congested and has been unable to cough and mobilize secretions since therapy was started. Which of the following would be indicated to improve the patient's condition and mobilize secretions?

    A. Perform nasotracheal suctioning.
    B. Add aerosolized albuterol (Proventil).
    C. Add chest percussion with postural drainage.
    D. Administer a bronchodilator by metered dose inhaler (MDI)
  10. An infant in an oxyhood is receiving 24% oxygen by a large volume nebulizer at a flow of 10L/min. The infant is restless. The SpOz is 97%. To calm the infant, the respiratory therapist should

    A. Increase the FiO2.
    B. Increase the flow to 12L/min
    C. Decrease the flow to 8 L/min
    D. Use a blender to administer the correct FiO2
  11. After the respiratory therapist zeros a helium analyzer, a standard gas mixture containing 10% helium is introduced. The analyzer displays a concentration of 9% helium. The therapist should do which of the following to correct this problem?

    A. Increase the sample flow.
    B. Change the CO2 absorber.
    C. Adjust the analyzer span control.
    D. Subtract 1% from all subsequent readings.
  12. A 75kg (165lb) adult male with a severe right-sided pneumonia requires independent (differential) lung ventilation. Which of the following may be necessary in order to initiate the independent lung ventilation for this patient?

    I. Intubation with a double lumen endotracheal tube.
    II. Use of two adult ventilators, one for each lung.
    III. Use of independent tidal volumes in the range of 750 to 900 mL.

    A. II only
    B. III only
    C. I and II only
    D. I, II and III
  13. The respiratory therapist has just capped the tracheostomy tube of a patient. The patient's respiratory rate, heart rate, and blood pressure are increasing. SpO2 is 90% and falling. The therapist should do which of the following?

    A. Ask the patient to speak.
    B. Ask the patient if she is choking.
    C. Inflate the tracheostomy tube pilot balloon.
    D. Remove the tracheostomy tube and reinsert a new tube.
  14. Which of the following situations would be an indication for independent lung ventilation?

    A. Severe hypoxemia secondary to cardiogenic pulmonary edema.
    B. Left lower lobe pneumonia in patient with COPD.
    C. Postoperative unilateral lung transplantation.
    D. Bilateral pneumococcal pneumonia.
  15. While assessing a patient with an aterial line, the respiratory therapist discovers a large wet area in the bed under a tubing connection. Which of the following would be the most likely effect on the patient's measured pressure readings before this condition is corrected?

    A. Higher than actual readings.
    B. Inaccurately low readings.
    C. No effect on readings.
    D. Higher readings followed by lower readings.
  16. A heat-moisture exchanger can be used in which of the following situations?

    I. Transport the patient who requires mechanical ventilation.
    II. Ventilate the patient who has copious amounts of sputum.
    III. Deliver aerosolized bronchodilators.

    A. I only
    B. II only
    C. I and III only
    D. I, II and III
  17. A neonate is receiving CPR. Chest compressions are discontinued and a heart rate of 30/min is noted. Which of the following should the respiratory therapist do?

    A. Defibrillate the neonate.
    B. Resume chest compression at 125/min.
    C. Assure that the oxygen delivery system is working properly.
    D. Resume chest compressions and increase the depth to 1 1/2 inches.
  18. A 13 year old, 42 kg (92lb) boy is brought to the emergency department (ED) of a 60-bed community hospital following an approximately 10 minute submersion after falling through thin ice on a pond. The patient's rectal temperature is 29C (84F) and Glasgow coma scale rating is 4. He currently has no spontaneous respirations, mottled color, pupils are fixed and dilated, and breath sounds reveal crackles bilaterally. Which of the following should the respiratory therapist recommend?

    A. Intubate, hyperventilate, and transport to a trauma facility.
    B. Heat the IV fluids to 75C (167F) prior to administration.
    C. Administer oxygen by a nonrebreathing mask and monitor the saturation on the right index finger.
    D. Intubate, initiate mechanical ventilation, and heat the inspiratory gas to 44C (111F)
  19. After intubating a patient, the respiratory therapist notices breath sounds are present in the right long, but extremely diminished in the left lung. Which of the following is the most appropriate action at this time?

    A. Reintubate the patient.
    B. Obtain a stat chest radiograph.
    C. Withdraw the endotracheal tube by 2 cm.
    D. Insert a large bore needle in the left upper chest.
  20. When giving a patient an IPPB treatment, the respiratory therapist is notices during inspiration that the inspiratory pressure gauge initially rises, then falls slightly, and finally rises rapidly to the cycling pressure. Based on this information, the therapist should take which of the following actions?

    A. Coach the patient to continue taking the treatment in this manner.
    B. Coach the patient to inspire more actively and deeply.
    C. Decrease the inspiratory pressure setting.
    D. Increase the inspiratory flow setting.
  21. A patient is seen in the emergency department (ED) with shortness of breath. The respiratory therapist is performing chest assesement and finds a dull percussion note over the right lower lobe. This is a clinical sign of which of the following?

    A. Asthma
    B. Pneumothorax
    C. Emphysema
    D. Pneumonia
  22. A critically ill patient requires transport from a hospital 300 miles away from the medical center. Which of the following transport methods should be considered?

    A. Automobile
    B. Ambulance
    C. Helicopter
    D. Fixed-wing aircraft
  23. The respiratory therapist arrives at the resuscitation of a 71 year old patient with COPD and takes over manual ventilation from the first responder. The therapist notes increasing resistance in the ventilation efforts, decreased chest excursion, and absence of breath sounds on the right. The next action that should be taken is to:

    A. Insert a nasogastric tube.
    B. Perform a needle thoracotomy.
    C. Increase ventilatory pressures.
    D. Reposition the endotracheal tube.
  24. During ACLS, the monitored ventricular heart rate is 220/min. The victim has no palpable pulse. Which of the following should the respiratory therapist do next?

    A. Prepare for cardioversion at 200 joules.
    B. Prepare for transcutaneous pacing.
    C. Administer lidocaine (Xylocaine).
    D. Administer epinephine 1 mg IV
  25. During PALS resuscitation of a 17 kg (37,4 lb), 3year old child in full arrest, the respiratory therapist notices extremely low end-tidal CO2, readings during noninvasive respiratory monitoring. The therapist rechecks the endotracheal tube (size 4.5) and confirms correct position. Which of the following should the therapist conclude is the cause of the low end tidal CO2

    A. Large manual ventilation volumes.
    B. Slow manual ventilation rates.
    C. An air leak around the endotracheal tube.
    D. Low cardiac output.
  26. Which of the following should the respiratory therapist consider in order to achieve the maximum flutter during PEP therapy?

    A. Deliver Fi02.
    B. Bronchodilator dosage.
    C. Expiratory resistance setting.
    D. Total 02 flow to the PEP device.
  27. The respiratory therapist is performing spirometry on a patient with pulmonary fibrosis. Which of the following devices would be damaged by this procedure?

    A. Wright respirometer.
    B. Wright peak flowmeter.
    C. Vortex shedding device.
    D. Collins water seal spirometer.
  28. While administering an IPPB treatment to a patient with a right hip fracture, the respiratory therapist notices that the patient turns on his side resulting in decreased inspired volumes. The therapist should place the patient in which of the following positions?

    A. Supine
    B. Fowler's
    C. Recovery
    D. Standing upright
  29. The pulmonary capillary wedge pressure is reflective of the mean left atrial pressure in which of the following conditions?

    I. Severe mitral valve dysfunction.
    II. Normal health patient.
    III. Pulmonary hypertension.

    A. I and II only
    B. I and III only
    C. II and III only
    D. I, II and III
  30. The respiratory therapist is performing transducer calibrations while preparing for a pulmonary artery catheter insertion. The mercury column rose to 100 mm Hg and gradually returned to zero. The best corrective action is which of the following?

    A. Reposition the transducer at the mid-axilarry line.
    B. Ensure the transducer is fluid-filled with no air bubbles.
    C. Tighten all stopcock connections.
    D. Replace the transducer.
  31. Which of the following is the most appropriate treatment for a patient with a tension pneumothorax?

    A. Intubate and initiate mechanical ventilation.
    B. Initiate an FiO2 of 1.0 by a nonrebreathing mask.
    C. Perform a needle tap in the 7th or 8th posterior intercostal space with the patient sitting up and leaning forward.
    D. Place the patient supine and perform a needle tap in the 2nd or 3rd anterior intercostal space, mid-clavicular line.
  32. Low cardiac output states can result from which of the following cardiovascular situations?

    A. Hypertension
    B. Left ventricular failure
    C. Hypervolemia
    D. Mitral prolapse
  33. A patient is on the treadmill and cardiopulmonary parameters are being monitored during an exercise stress test. Which of the following requires immediate attention?

    A. Increased psychological dead.
    B. Increased respiratory quotient.
    C. Decreased cardiac output.
    D. Decreased vd/vt radio
  34. If no PEEP is used for a patient receiving mechanical ventilation, which of the following parameters are needed to estimate mean airway pressure?

    I. PIP
    II. Inspiratory time
    III. Expiratory time
    IV. Frequency

    A. II and IV only
    B. I, II and III only
    C. I, III and IV only
    D. I, II, III and IV
  35. While assisting a physician with transtracheal aspiration, correct needle insertion has been confirmed. To facilitate assessment for anearobic bacteria, the respiratory therapist should now recommend which of the following?

    A. Irrigate the needle with 0.9% saline solution.
    B. Insert an aspirating catheter through the needle.
    C. Withdraw fluid through the needle.
    D. Replace the needle with a 10 Fr suction catheter.
  36. The respiratory therapist is evaluating a patient with an ineffective cough. The therapist should initiate nasotracheal suctioning if physical examination reveals which of the following?

    A. Rhonchi on auscultation.
    B. Crackles on ausculation.
    C. Hyperresonance on percussion.
    D. Dullness on percussion.
  37. Which following a patient-driven protocol, the respiratory therapist has observed the patient self-administer a hand-held nebulizer treatment with unit dose albuterol (Ventolin) for two treatments. The therapist is confident in the patient's ability to follow directions correctly and to safely take his treatments unsupervised. The appropriate action is to:

    A. Allow the patient to begin self-treating and monitor him periodically.
    B. Advice the physician of the recommendation to prior to initiation of the plan.
    C. Contact the supervisor and get approval before proceeding.
    D. Delegate this patient's respiratory care to the nursing staff.
  38. The respiratory therapist notes that a patient's PETCO2 is elevated from its previous reading. To identify the cause of this change, the therapist should assess all of the following EXCEPT

    A. Temperature
    B. Cardiac output
    C. Alveolar ventilation
    D. Hemoglobin and hematocrit
  39. A patient who is receiving mechanical ventilation is monitored with continuous pulse oximetry. The patient's SpO2 decreases from 96% to 89% when removed from the ventilator for routine suctioning and bronchial hygiene. To correct this problem, which of the following should be done?

    A. Initiate PEEP at 10cm H2O
    B. Administer bronchodilators.
    C. Perform bedside hemodymanic monitoring.
    D. Change to a closed-system suctioning device.
  40. A patient with chronic bronchitis develops an infection and begins expectorating about 70 mL of sputum per day. Which of the following is the preferred therapy to improve this patient's bronchial hygiene?

    A. CPAP
    B. PEP
    C. IPPB with bronchodilator
    D. Small volume nebulizer with bronchodilator
  41. Which of the following might explain why patients using reusable nebulizers processed by pasteurization have had an increased infection rate with Pseudomonas aeruginosa?

    A. The wash cycle time is set at 30 minutes.
    B. The pasteurization temperature setting is 63C (145.4F)
    C. The equipment was not completely disassembled prior to processing.
    D. The nebulizer parts were interchanged during the reassembly process.
  42. A recently extubated patient receiving 2 L nasal 02 exhibits coughing spasms and tachypnea. On auscultation the patient has obvious signs of retained secretions. The SP02 is 94%. The appropriate action would be to:

    A. Reintubate the patient
    B. Increase 02 to 4 L/min
    C. Switch to heated aerosol mask at 28%
    D. Initiate noninvasive positive airway pressure ventilation.
  43. Upon entering a patient's room, the respiratory therapist notes an ultrasonic nebulizer with a continuous feed system. There is no aerosol output from the nebulizer patient outlet. Which of the following actions should be taken?

    I. Fill the couplant chamber to the recommended level.
    II. Secure the tubing between the fan and the solution cup.
    III. Assure the patency of the feed tube from the reservoir bag.
    IV. Increase the frequency setting of the ultrasonic nebulizer.

    A. I and II only
    B. III and IV only
    C. I, II and III only
    D. II, III and IV only
  44. The arterial blood gas results for a patient who is not cyanotic reveal an arterial oxygen tension of 32 torr. To evaluate the patient's oxygenation status further, it is most important to review the patient's:

    A. Sa02
    B. HB.
    C. Pv02
    D. P(A-a)02.
  45. A postoperative patient receiving incentive spirometry complains to the respiratory therapist that he became acutely short of breath. A chest radiograph shows a peripheral wedge-shaped infiltrate. This would be associated with all of the following EXCEPT:

    A. Secretions
    B. Tachypnea
    C. Hemoptysis
    D. Pleuritic Pain
  46. During the 24 hours following gastric resection, a 41-year old woman received continuous intravenous infusions. Blood chemistry results identified decreased in BUN, sodium, and hemoglobin values. The hourly urine output has been 60 mL/hr for the past 3 hours. Based on this information, assesment would most likely reveal which of the following?

    A. Coarse crackles
    B. Arterial hypotension
    C. Hyperresonant percussion notes
    D. Hypoventilation
  47. If the PaC02 is 60 torr, the PEc02 40 torr, and tidal volume 750 mL, what is the physiologic dead space volume?

    A. 150 mL
    B. 250 mL
    C. 333 mL
    D. 375 mL
  48. A patient presents in the emergency department (ED) following a motor vehicle crash. Physical assessment and chest radiography indicate significant air and fluid in the pleural space. The FIRST action should be to:

    A. Obtain a 12-lead ECG
    B. Intubate the patient and institute mechanical ventilation.
    C. Insert a chest tube and connect to a pleural suction system.
    D. Recommend a therapeutic fiberoptic bronchoscopy.
  49. During a home visit, a patient tells the respiratory therapist that she does no feel any oxygen coming from the cannula and that the concentrator is making unusual noises. The therapist determines that no flow is coming from the cannula. In this situation, the therapist should do all of the following EXCEPT:

    A. Refill the humidifier bottle.
    B. Tighten all equipment connections.
    C. Confirm the flow from the concentrator.
    D. Temporarily switch the patient to a high-pressure oxygen system.
  50. The respiratory therapist is administering an aerosolized bronchodilator by hand held nebulizer to a patient with pulmonary emphysema. During the course of therapy, the patient coughs vigorously several times in succession and become very dyspneic. To assist the patient in catching his breath, the therapist should instruct the patient to:

    A. Take a deep breath and forcibly exchale.
    B. Perform pursed-lip breathing.
    C. Perform paradoxical breathing.
    D. Perform forced abdominal breathing.
  51. A patient with severe COPD is admitted to the emergency department (ED). He is receiving oxygen by nasal cannula at 4L/min. The patient is lethargic and his respirations are shallow at a rate of 20/min. The pulse oximeter is reading 94%. Which of the following should the respiratory therapist recommend?

    A. Initiate IPPB therapy q2h.
    B. Institute mechanical ventilation.
    C. Increase the oxygen flow to 5L/min.
    D. Change to a 28% air-entrainment mask.
  52. Chest physiotherapy with postural drainage is being performed on a 55 year old patient. The patient becomes tachypneic after 10 minutes of therapy. The respiratory therapist should do which of the following?

    A. Administer a bronchodilator immediately.
    B. Omit the segment of therapy requiring a head-down position.
    C. Change the duration of the postural drainage position to 5 minutes.
    D. Instruct the patient to hold his breath while in the head-down position.
  53. The normal value for pulmonary artery pressure is

    A. 15/6 mm Hg.
    B. 25/8 mm Hg.
    C. 90/40 mm Hg.
    D. 120/80 mm Hg.
  54. A patient who has completed bronchodilator therapy by hand-held nebulizer using an air compressor complains of extreme dyspnea. The respiratory therapist should do which of the following?

    I. Question the patient about the nature of the dyspnea.
    II. Administer another treatment immediately.
    III. Call the physician and recommend additional therapy.
    IV. Review the patient's medical record.

    A. IV only
    B. I and III only
    C. II and III only
    D. I, II and IV only
  55. After measuring the PAP and PCWP, the respiratory therapist observes a minimally fluctuating pattern with a mean valued of 10 mm Hg on the patient's pulmonary artery tracing. The therapist should do which of the following?

    A. Take no action.
    B. Deflate to balloon.
    C. Recalibrate the system.
    D. Recommend a fluid challenge.
  56. Which of the following would be useful in preventing atelectasis in a postoperative patient?

    A. Bronchodilator therapy
    B. Ultrasonic nebulizer
    C. Chest percussor
    D. PEP therapy
  57. During initial assesment of a patient with a closed-head injury, the patient opens his eyes only in response to painful stimuli. On a follow-up examination, the patient opens his eyes to verbal commands. These observations indicate which of the following?

    A. The level of consciousness is increased.
    B. Intracranial pressure has increased.
    C. Cerebal perfusion has decreased.
    D. Seizure activity is increased.
  58. A chest radiograph of a premature neonate displays air bronchograms and a diffuse reticulogranular pattern. The neonate receives surfactant replacement therapy. Two hours later, the neonate's Fi02 requirements have decreased from 0.70 to 0.35 and a repeat chest radiograph is performed. The repeat chest radiograph would show:

    A. A decrease in atelectasis.
    B. Resolution of a pneumothorax
    C. Improvement in a pleural effusion
    D. A decrease in size of the cardiac shadow
  59. A spontaneously breathing patient with COPD is receiving oxygen therapy through an transtracheal catheter at 2L/min. The pulse oximetry reading has gradually decreased from 95% to 90% over the past 2 hours. The patient is not complaining of shortness of breath and the insertion sites are clean, normal color, and not tender. Which of the following should the respiratory therapist do to correct the problem?

    A. Replace the catheter with a 12 Fr catheter.
    B. Lavage the catheter with distilled water to clear it debris.
    C. Use a cleaning rod to clear the the catheter lumen of mucus.
    D. Change to a conventional nasal cannula with sufficient oxygen flow to achieve an Sp02 of 95%
  60. Attempts to manually ventilate a patient who has collapsed are unsuccessful. An endotracheal tube cannot be placed. The next step to assure ventilation should be which of the following?

    A. Perform a cricothyrotomy
    B. Use a laryngeal mask airway
    C. Insert an oropharyngeal airway
    D. Initiate nasal noninvasive positive pressure
  61. While reviewing a patient's chart, the respiratory therapist reads that the patient had a sudden onset of shortness of breath, a PAP of 35/22 mm Hg, and a PCWP of 8mm Hg. Which of the following would be the most likely cause of these findings?

    A. Fluid overload
    B. Congestive heart failure
    C. Cardiac tamponade
    D. Pulmonary emboli
  62. A small particle aerosol generator (SPAG) may be required in the treatment of which of the following patients?

    I. a 4 year old child with asthma
    II. a 6 month old infant with viral bronchiolitis
    III. a 7 year old child with cystic fibrosis

    A. I only
    B. II only
    C. I and III only
    D. II and III only
  63. The respiratory therapist receives a call from a homebound patient who is receiving humidified oxygen by nasal cannula at 2 L/min. The patient hears a high pitched whistle sound while the oxygen is running. The therapist should instruct the patient to:

    A. Change over to this back-up 02 source.
    B. Decrease the liter flow to 1 L/min.
    C. Increase the length of the tubing.
    D. Check for kinks in the tubing.
  64. A 44-week gestational age male is born by C-Section. During delivery, meconium is noted and suctioned from the airway. Initial assessment shows a heart rate of 80/min, respiratory rate of 15, and temperature of 35C (95F). The 1 minute Apgar score is 3. Which of the following should the respiratory therapist do?

    A. Perform chest compressions at a depth of 1 inch and a rate of 80/min
    B. Administer positive pressure ventilation with 100% oxygen.
    C. Apply tactile stimulation to the neonate.
    D. Administer atropine.
  65. The main purpose of transtracheal aspiration in a nonintubated patient is to:

    A. Evacuate airways secretions.
    B. Irrigate and thin, airways secretions.
    C. Avoid vocal cord trauma during suctioning.
    D. Obtain an uncontaminated sputum specimen.
  66. What is the normal range for central venous pressure in the adult?

    A. Less than 8 mm Hg
    B. 9 to 12 mm Hg
    C. 13 to 18 mm Hg
    D. 19 to 25 mm Hg
  67. While assembling a laryngoscope and blade for intubation, is is noted that the light source does not function. Which of the following actions should the respiratory therapist take FIRST?

    A. The light bulb should be checked to insure it is thight.
    B. The light bulb should be replaced.
    C. The laryngoscope batteries should be replaced.
    D. The laryngoscope blade should be exchanged.
  68. Transthoracic needle aspiration may be useful in diagnosing which of the following?

    A. Bronchogenic carcinoma
    B. Acute pulmonary edema
    C. ARDS
    D. Bronchial asthma
  69. In order to ensure the accuracy of the inspired oxygen concentration delivered by an adult mechanical ventilator, the respiratory therapist should:

    A. Rely on the manufacturer's calibration of the internal blender.
    B. Use continuous pulse oximetry.
    C. Use a calibrated oxygen analyzer in line with the ventilator circuit.
    D. Use an external blender as bias flow.
  70. After applying tactile stimulation to a neonate in cardio respiratory distress, the response achieved includes gasping ventilations and a stable heart rate of 85/min. The respiratory therapist should quickly move to support the neonate by doing which of the following?

    A. Performing chest compressions.
    B. Initiating bag-mask ventilation.
    C. Performing further tactile stimulation.
    D. Administering free-flow oxygen to the nares.
  71. During a pre-clinical check of an open circuit high frequency jet ventilator, the respiratory therapist discovers abnormally low peak inspiratory airway pressures. The therapist's first corrective response is to check the:

    A. Drive pressure
    B. Inlet pressure
    C. Exhalation valve
    D. Expiratory pressure
  72. Which of the following would the respiratory therapist recommend for providing stable neonates with a neutral thermal environment immediately following birth?

    A. Bassinet
    B. Incubator
    C. Open crib
    D. Nasal CPAP
  73. A 78 year old patient suffers an unwitnessed respiratory arrest. As a first responder, the respiratory therapist is unable to deliver the initial two breaths. Which of the following is the therapist's next action?

    A. Perform a finger sweep.
    B. Administer up to five back blows.
    C. Perform up to five abdominal thrusts.
    D. Reposition and attempt to ventilate the patient.
  74. Which of the following statements regarding a laryngeal mask airway is true?

    A. It is used to intubate the trachea and permit manual ventilation.
    B. The cuff should be partially inflated prior to insertion.
    C. It has the capability of aspirating gastric secretions.
    D. It provides an airtight seal only when airway pressures are <20 cm H20
  75. At what point in the respiratory cycle should the PA and PCWP pressures be read when a patient is receiving mechanical ventilation?

    A. Mid inspiration
    B. End exhalation
    C. During a plateau breath
    D. At peak inspiration
  76. At 1 minute after birth, a neonate appears to be acrocyanotic with a slow and irregular respiratory effort. The neonate's heart rate is 88 beats/min and the neonate grimaces during nasal catheter stimulation. Some flexion of the extremities is evident. The Apgar score for this neonate would be:

    A. 3
    B. 5
    C. 7
    D. 9
  77. Asystole continues despite CPR efforts in a 5 year old child. Which of the following should be done immediately?

    A. Discontinue CPR
    B. Defibrillate up to three times if needed
    C. Obtain IV access to administer IV epinephrine
    D. Administer lidiocaine HCI (Xylocaine) and consider administration of bretylium (Bretylol)
  78. A physician has requested that the respiratory therapist increase the ventilatory volume for a patient receiving high frequency oscillation ventilation (HFOV). Which of the following settings should the therapist adjust?

    A. P
    B. Bias flow
    C. Tidal volume
    D. Frequency
  79. The respiratory therapist is reviewing the most recent report from a patient's AP chest radiograph. The report states that the silhouette sign is present at the right heart border. How should the patient be positioned for postural drainage and percussion over the affected segments?

    A. A semi Fowler's position.
    B. Lying on left side with head down 15 degrees and twisted a 1/4 turn backwards.
    C. Lying on the right side with head down 15 degrees and twisted a 1/4 turn backwards.
    D. In prone position with head down 25 degrees.
  80. Which of the following would be most useful to distinguish between asthma and emphysema in a patient with obstructive lung disease?

    A. Chest radiograph
    B. Arterial blood gas analysis
    C. Sputum culture and sensitivity testing
    D. Spirometry before and after a bronchodilator
  81. On the follow up visit to patient previously instructed to use an incentive spirometer, the respiratory therapist notes the following behavior: the patient voluntarily demonstrates the proper techniques. She almost achieves the volume goals that the therapist had set at the end of the last session. The therapist should note in the patient's chart that the patient:

    I. Needs to be monitored more closely
    II. Is compliant
    III. Exceeds safe limit of care
    IV. Accepts responsibility for her own care

    A. I and III only
    B. I and IV only
    C. II and IV only
    D. II, III and IV only
  82. Following extubation of a patient, the respiratory therapist notes that the endotracheal tube cuff was not fully deflated. Which of the following would be most important to assess?

    A. Sp02
    B. Presence of stridor
    C. Chest excursion
    D. Presence of bilateral breath sounds
  83. During the administration of an aerosol treatment with 2.5 mg albuterol (Ventolin) and 2.5 mL normal saline to a 56 year old patient with right lower lobe pseumonia, the patient complains of numbness in the fingertips. The respiratory rate is 12/min and he is breathing slowly and deeply with an inspiratory hold with each breath. Which of the following should the respiratory therapist do?

    A. Instruct the patient to slow the respiratory rate to 8/min.
    B. Instruct the patient to perform slow tidal breathing with no breath hold.
    C. Recommend reducing the dosage of Albuterol with future treatments.
    D. Stop the treatment and check the patient's blood pressure.
  84. Which of the following quality control measures should be performed first when assessing a dampened arterial line waveform?

    A. Measure blood pressure with a sphygmomanometer.
    B. Perform a lead II rhythm strip.
    C. Raise the transducer above the level of the right atrium.
    D. Replace the transducer.