aarc mc

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n1297f
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307175
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aarc mc
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2015-10-06 15:23:47
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multiple choice
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  1. When reviewing a chart, the comment, öriented x 3" is noted. This means:

    A) Normal Sensorium
    B) normal vital signs
    C) appropriate vision
    D) normal perfusion
    A) Normal Sensorium
    (this multiple choice question has been scrambled)
  2. Who may change an Advanced Directive?

    A) the patient and the person with power of attorney
    B) the patient
    C) the physician
    D) the person with power of attorney
    A) the patient and the person with power of attorney
    (this multiple choice question has been scrambled)
  3. Which should be asked while interviewing a pt to determine dyspnea?

    A) How many hours a day do you use oxygen?
    B) How far can you walk before you need to rest?
    C) Are you SOB?
    D) Do you get dizzy when arising from a sitting position?
    C) Are you SOB?
    (this multiple choice question has been scrambled)
  4. A pt is receiving O2 at 3 lpm by cannula. Upon inspection, you note central cyanosis. Where do you notice this?

    A) on the neck region & lips
    B) in the feet & ankles
    C) in the hands, fingers & wrists
    D) from the knees to the ankles
    A) on the neck region & lips
    (this multiple choice question has been scrambled)
  5. A male COPD pt is being assessed in the ICU. You note his jugular vein is distended to the jaw line. This finding would indicate:

    A) Polycythemia
    B) RH Failure
    C) Anemia
    D) Kidney Failure
    B) RH Failure
    (this multiple choice question has been scrambled)
  6. Upon inspection of the head, neck & thorax, you note the pt has respiratory distress & increased WOB. Which of the following would be present?

    A) nasal flaring
    B) intercostal retractions
    C) nasal flarring & intercostal retractions
    D) pitting edema
    C) nasal flarring & intercostal retractions
    (this multiple choice question has been scrambled)
  7. 19. A 23-yo male is in the ED for contusions sustained from a fall while pruning a tree. He is receiving 40% O2 by air-entrainment mask. It is noted that the patient's right chest sinks in during inspiration while the rest of the chest rises. What type of breathing pattern is this?

    A) Pneumonic
    B) Kussmaul's
    C) Cheyne-Stokes
    D) Paradoxical
    B) Kussmaul's
    (this multiple choice question has been scrambled)
  8. 21. A 67 yo pt is in the ED complaining of pain & SOB following a coughing episode. Percussion reveals a tympanic sound emitted from the L lung & a resonant sound emitted from the R lung. Which of the following is present?

    A) R-Sided Pleureal Effusion
    B) R-Sided Pleurisy
    C) L-sided Pneumothorax
    D) L-Sided Atelectasis
    C) L-sided Pneumothorax
    (this multiple choice question has been scrambled)
  9. 23. When admitted to the ICU for status asthmaticus, you note on the heart monitor the pt's BP drops during inspiration & increases during expiration. This is referred to as:

    A) pulsus bigeminus
    B) pulsus paradoxus
    C) pulsus bisferiens
    D) pulsus alternans
    B) pulsus paradoxus
    (this multiple choice question has been scrambled)
  10. 25. A 76 yo male has been admitted to the ICU with a dx of pulmonary edema from CHF. Which of the following breath sounds would you expect to hear during auscultation?

    A) late crackles
    B) stridor
    C) early crackles
    D) bronchial
    A) late crackles
    (this multiple choice question has been scrambled)
  11. 27. Upon reviewing the chart prior to Rx, you note an entry that states the pt has a loud P2 heart sound. This would indicate the presence of:

    A) tricuspid valve stenosis
    B) aortic valve stenosis
    C) pulmonary hypertension
    D) mitral valve stenosis
    C) pulmonary hypertension
    (this multiple choice question has been scrambled)
  12. 29. During PE using palpation, an abnormal bilateral expansion of the chest wall is assessed. This would indicate:

    A) R-Sided Atelectasis
    B) COPD
    C) L-Sided Pleural Effusion
    D) R-Sided Lobular Consolidation
    B) COPD
    (this multiple choice question has been scrambled)
  13. 31. Which of the following would be associated with an underexposed PA CXR?

    A) loss of mid-thoracic intervertebral spaces
    B) stomach gas bubble is more radiopaque
    C) lung fields appear more radiopaque
    D) heart appears larger than normal
    A) loss of mid-thoracic intervertebral spaces
    (this multiple choice question has been scrambled)
  14. 33. A pt in ICU from a MVA is receiving MV. An AP CXR shows the L hemidiaphragm higher than the right. Which of the following is the result of these findings?

    A) L-sided Pneumothorax
    B) Hepatomegaly
    C) L-Sided atelectasis
    D) R-Sided Pleureal Effusion
    C) L-Sided atelectasis
    (this multiple choice question has been scrambled)
  15. 35. An AP CXR has returned on an adult, orally intubated pt with MV. It is noted the tip of the ET tube is 5cm above the carina. What should be recommended?

    A) insert ET tube additional 4 cm
    B) insert ET tube additional 5 cm
    C) retract ET tube 3 cm
    D) maintain current position
    D) maintain current position
    (this multiple choice question has been scrambled)
  16. 37. A 64 yo female is dx with bronchiectasis has been admitted for exacerbation of condition. PA CXR shows infiltrates along the R heart border. THe pt has lung drainage ordered. Upon which areas should the Rx be concentrated?

    A) R posterior LL
    B) R anterior LL
    C) RUL
    D) RML
    D) RML
    (this multiple choice question has been scrambled)
  17. 39. A frontal neck XR of a 4 yo child shows subglottic narrowing below the vocal cords. Based on this finding, the child should be Rx'd for:

    A) epiglottis
    B) tonsillitis
    C) croup
    D) asthma
    C) croup
    (this multiple choice question has been scrambled)
  18. 41. An 18 month old child is seen in the ED & croup is dx. A dose of racemic epinephrine via SVN. What size particle is likely to deposit in the subglottic region?

    A) < 10 micron
    B) 0.8 to 1 micron
    C) 2-5 micron
    D) 5-10 micron
    D) 5-10 micron
    (this multiple choice question has been scrambled)
  19. 43. Your are treating a pt with Pneumocystis pneumonia. What type of delivery device should you choose to administer the dose of pentamidine ordered by the physician?

    A) DPI
    B) Pari LC
    C) Respirgard II
    D) MDI
    C) Respirgard II
    (this multiple choice question has been scrambled)
  20. 44. A pt carries an Albuterol MDI, which she claims to use every few weeks. She complains that her first dose actuated from the device seems to have no effect. What suggestions do you make?

    A) use SVN
    B) discharge a waste dose before using
    C) administer 3 actuations instead of ordered 2
    D) replace the device
    B) discharge a waste dose before using
    (this multiple choice question has been scrambled)
  21. 46. A pt with ARDS is ventilated with Vt = 6ml/kg (380ml). Pplat is 37cm H2O. RR is set at 35 bpm. The PaCO2 is 65 mm Hg & the pH is 7.22. Which of the following would you recommend?

    A) increase the Vt
    B) administer an aerosolized bronchodilator
    C) decrease the RR
    D) remove the deadspace from the circuit
    D) remove the deadspace from the circuit
    (this multiple choice question has been scrambled)
  22. 48. A pt with COPD is being ventilated using pressure support ventilation. When a jet nebulizer is placed into the circuit, the pt is unable to trigger. What is the most likely cause?

    A) flow from the nebulizer
    B) Auto PEEP
    C) insensitive trigger setting
    D) insufficient PEEP setting
    A) flow from the nebulizer
    (this multiple choice question has been scrambled)
  23. 49. You are attempting to suction a pt with COPD. It is difficult to pass the catheter. Which of the following changes would you suggest?

    A) instill saline
    B) replace the ET tube
    C) replace the HME with a heated humidifier
    D) administer an aerosolized bronchodilator
    C) replace the HME with a heated humidifier
    (this multiple choice question has been scrambled)
  24. 50. You are managing a pt per the ARDSnet Protoctol. Ventilator mode is VCV, RR = 28, Vt = 360ml (6.2 mL/kg), PEEP = 10 cm H2O, FiO2 = 0.5. ABG's are pH 7.18, PaCO2 = 73 mm Hg, PaO2 = 74 mm Hg. What ventilatory change would you make?

    A) decrease PEEP to 8 cm H2O
    B) increase Vt to 400 ml
    C) increase RR to 32 bpm
    D) change mode to pressure control
    C) increase RR to 32 bpm
    (this multiple choice question has been scrambled)
  25. 52. You are managing a pt with NIV. The pt complains of dry mouth. You note the presence of auto-triggering. Which of the following is your most appropriate response?

    A) change heated humidifier to HME
    B) decrease IPAP setting
    C) change nasal mask to oronasal mask
    D) adjust trigger sensitivity
    C) change nasal mask to oronasal mask
    (this multiple choice question has been scrambled)
  26. 54. You are managing a pt with cardiogenic pulmonary edema using NIV. The SpO2 is 87%. The pt's RR is 30 bpm. Ventilator settings are IPAP 8cm H2O, EPAP 4 cm H2O, FiO2 0.8. Which of the following is the most appropriate?

    A) change FiO2 to 1: IPAP/EPAP unchanged
    B) change mode to CPAP 4 cm H2O
    C) change EPAP to 6 cm H2O and keep IPAP @ 8 cm H2O
    D) change EPAP to 8 cm H2O & IPAP to 12 cm H2O
    D) change EPAP to 8 cm H2O & IPAP to 12 cm H2O
    (this multiple choice question has been scrambled)
  27. 56. You receive an order to administer IS on a 64 yo woman who is recovering from heart surgery. Even after through instructions, the pt is unable to accomplish a proper sustained inspiratory maneuver. Her predicted IC is 2.2 L & her achieved is 700 cc. Which is the most appropriate

    A) administer IPPB
    B) no action
    C) D/C RT
    D) administer PD&P
    A) administer IPPB
    (this multiple choice question has been scrambled)
  28. 58. A 44 yo female pt is recovering from gallbladder surgery. She has been using her IS as instructed. You notice that she initiates a new breath before the piston plate returns to the bottom of the spirometer.

    A) instruct her to take deeper breaths
    B) instruct her to hold breath for longer time
    C) instruct her to slow breathing & pause between breaths
    D) stop the rx & chart adverse reaction
    C) instruct her to slow breathing & pause between breaths
    (this multiple choice question has been scrambled)
  29. What is the appropriate psoition of the ETT on a chest radiograph?

    A) just below the glottis, 5-7 cm above the carina
    B) mid-trachea (2-3 cm above the carina)
    C) at the tip of the carina
    D) either the right or left main stem bronchus
    A) just below the glottis, 5-7 cm above the carina
  30. Which of the following is NOT a sign of fluid overload?

    A) pitting edema
    B) bounding pulse
    C) dry mucus membranes
    D) increased blood pressure
    C) dry mucus membranes
    (this multiple choice question has been scrambled)
  31. Capnography can help assess which of the following?

    A) All of the above
    B) ventilation status
    C) circulatory status
    D) metabolic status
    A) All of the above
    (this multiple choice question has been scrambled)
  32. The volume of the anatomic deadspace is located in the:

    A) 1st to 15th generation of airways
    B) respiratory bronchioles & alveoli
    C) nose & sinus cavaties
    D) mouth & pharynx
    D) mouth & pharynx
    (this multiple choice question has been scrambled)
  33. Cardiopulmonary rehab optimally incorporates:

    A) starting a jogging, bicycling, and heavy weightlifting program
    B) only a nutritious diet
    C) a shift from sedentary lifestyle to strenuous exercise
    D) nutritious diet & incremental increase of exercise over time
    D) nutritious diet & incremental increase of exercise over time
    (this multiple choice question has been scrambled)
  34. In a patient who is SOB, which position does NOT facilitate comfort?

    A) Semi-Fowler's
    B) HOB elevated at 30-40 degrees
    C) Trendelenberg
    D) Sleeping with two pillows under the head/shoulders
    C) Trendelenberg
    (this multiple choice question has been scrambled)
  35. Which of the following is an example of a condition that would cause an exudative pleural fluid?

    A) lymphatic obstruction
    B) nephrotic syndrome
    C) bacterial infection
    D) CHF
    C) bacterial infection
    (this multiple choice question has been scrambled)
  36. A patient sustained a pneumothorax as a result of an MVA. A chest tube is in place & it is noted that there is bubbling in the water seal chamber of the chest tube drainage system. What is the appropriate action?

    A) obtain a stat CXR
    B) Do nothing. This is the normal function of the system when a pneumo is present
    C) look for kinks on the chest tube
    D) remove the chest tube
    B) Do nothing. This is the normal function of the system when a pneumo is present
    (this multiple choice question has been scrambled)
  37. A patient sustains a closed head injury. The patient's ICP is 22 mm Hg and the CPP is 62 mm Hg. What is the most appropriate action at this time?

    A) reduce ICP to increase CPP
    B) reduce systolic BP to reduce CPP
    C) administer a fluid bolus
    D) nothing - the levels are within normal limits
    A) reduce ICP to increase CPP
    (this multiple choice question has been scrambled)
  38. The Respiratory Quotient is:

    A) the ratio of PETCO2 to PaCO2
    B) the ratio of PaO2 to FiO2
    C) the ratio of REE to TEE
    D) the ratio of VCO2 to VO2
    D) the ratio of VCO2 to VO2
    (this multiple choice question has been scrambled)
  39. Acceptable Spirometry:

    A) Anemia
    B) change mode to CPAP 4 cm H2O
    C) croup
    D) requires an expiratory effort of at least 10 seconds
    D) requires an expiratory effort of at least 10 seconds
    (this multiple choice question has been scrambled)
  40. Peak Flow measurements to determine a "personal best" for monitoring asthma should be:

    A) done first thing in the morning
    B) done first thing in the morning; the hghest measurement over a 3-week period, and done before using an inhaled bronchodilator
    C) done without using an inhaled bronchodilator
    D) the highest measured over a 3-week period
    B) done first thing in the morning; the hghest measurement over a 3-week period, and done before using an inhaled bronchodilator
    (this multiple choice question has been scrambled)
  41. The ATS/ERS standard for spirometry recommends use of reference equations from:

    A) NHANES III
    B) ITS/CRAPO
    C) NHLBI
    D) ITS/MORRIS
    A) NHANES III
    (this multiple choice question has been scrambled)
  42. Which of the following are used as PFT's?

    A) Shuttlewalk Test
    B) Cardiopulmonary Exercise Test
    C) all of the above
    D) 6-Minute Walk Test
    C) all of the above
    (this multiple choice question has been scrambled)
  43. Which of the following equipment is required for the Six-Minute Walk Test?

    A) Pulse Oximeter
    B) Capnograph
    C) Countdown Timer
    D) Spirometer
    C) Countdown Timer
    (this multiple choice question has been scrambled)
  44. Which of the following results in an increased VD/VT ratio?

    A) all answers correct
    B) Decreased Pulmonary Blood Flow
    C) Pulmonary Embolism
    D) low VT
    A) all answers correct
    (this multiple choice question has been scrambled)
  45. You note the inspiratory pressure waveform varies breath-by-breath during VCV. Which is the most likely cause?

    A) Mucus Plugging
    B) Auto PEEP
    C) Pulmonary Edema
    D) Asynchrony
    D) Asynchrony
    (this multiple choice question has been scrambled)
  46. What is the most rapid way to decrease Pplat?

    A) administer a bronchodilator
    B) increase peak flow
    C) decrease tidal flow
    D) use PCV
    C) decrease tidal flow
    (this multiple choice question has been scrambled)
  47. You note a decrease in VT during PCV. Which of the following are potential causes of this?

    A) all of the above
    B) Increase in Airway Resistance
    C) Decrease in Pressure Control Setting
    D) Decrease in Compliance
    A) all of the above
    (this multiple choice question has been scrambled)
  48. Neck Vein Distension is most commonly associated with which of the following disorders?

    A) CVA
    B) ARDS
    C) asthma
    D) CHF
    D) CHF
    (this multiple choice question has been scrambled)
  49. Your patient has a mixed venous PO2 of 25 mm Hg (mixed venous O2 Sat of 55%). This is consistent with:

    A) low cardiac output
    B) Hyperventilation
    C) Polycythemia
    D) ARDS
    A) low cardiac output
    (this multiple choice question has been scrambled)
  50. Which of the following trach tube cuffs are filled with water?

    A) tight-to-shaft
    B) dual cannula
    C) high pressure
    D) foam-filled
    A) tight-to-shaft
    (this multiple choice question has been scrambled)
  51. What is the effect of spontaneous respiratory effort on alveolar distending pressure during PCV?

    A) none, spontaneous breathing does not affect alveolar pressure
    B) alveolar pressure is increased by spontaneous breathing
    C) it depends on how stiff is the chest wall
    D) alveolar distending pressure is decreased
    B) alveolar pressure is increased by spontaneous breathing
    (this multiple choice question has been scrambled)
  52. You are caring for a patient with ARDS. The patient's compliance is 20 mL/cm H2O. PEEP is increased from 12 to 15 cm H2O and compliance decreases to 15 mL/cm H2O. What is the best explanation for this?

    A) alveolar overdistension
    B) asynchrony
    C) Vt increase
    D) alveolar recruitment
    D) alveolar recruitment
    (this multiple choice question has been scrambled)
  53. Which of the following affects peak inspiratory pressure during VCV?

    A) all answers are correct
    B) Vt
    C) Compliance
    D) Resistance
    A) all answers are correct
    (this multiple choice question has been scrambled)
  54. A sputum sample is obtained for gram staining. The stain used for a gram stain is:

    A) methylene blue
    B) iodine
    C) red dye safronin counterstain
    D) crystal violet dye
    C) red dye safronin counterstain
    (this multiple choice question has been scrambled)
  55. Which of the following microbial organisms is identified as an acid-fast stain?

    A) neiseria meningitides
    B) klebsiella
    C) staphalococcus aureus
    D) mycobacterium tuberculosis
    D) mycobacterium tuberculosis
    (this multiple choice question has been scrambled)
  56. The term used to identify bacteria that are rod-shaped is:

    A) vibrio
    B) bacilli
    C) spirochetes
    D) cocci
    B) bacilli
    (this multiple choice question has been scrambled)
  57. A capnometer is not working. What alternative diagnostic monitor could be suggested?

    A) arterial line
    B) none
    C) Pulse Oximeter
    D) transcutaneous monitor
    D) transcutaneous monitor
    (this multiple choice question has been scrambled)
  58. A 10 YO is in the ED & was rescued from a house fire. THe chid is on 100% non-rebreather, but is tachypnic (RR=44bpm) and tachycardiac (HR = 168). His SaO2 reads 100%. What do you conclude?

    A) the child may have a cardiac defect which has been exacerbated by the fire
    B) the SaO2 reading may be faulty due to the child's light skin color
    C) the child is frightened, hence the tachypnea & tachycardia
    D) There may be significant HBCO due to CO exposure in the fire
    D) There may be significant HBCO due to CO exposure in the fire
    (this multiple choice question has been scrambled)
  59. How is dyspnea assessed during the Six-Minute Walk Test?

    A) Therapist assessment
    B) Pulse oximetry
    C) Patient narrative
    D) Borg Scale
    D) Borg Scale
    (this multiple choice question has been scrambled)
  60. To decrease the risk of ventilator-induced lung injury, the Pplat should be kept less than:

    A) 40 cm H2O
    B) 20 cm H2O
    C) 30 cm H2O
    D) 50 cm H2O
    C) 30 cm H2O
    (this multiple choice question has been scrambled)
  61. Which of the following is a normal arterial blood pressure for an adult?

    A) 140mmHg/100mmHg
    B) 160mmHg/110mmHg
    C) 70mmHg/40mmHg
    D) 120mmHg/80mmHg
    D) 120mmHg/80mmHg
    (this multiple choice question has been scrambled)
  62. Which of the following can be measured by a pulmonary artery catheter?

    A) CVP
    B) all of the answers
    C) PA Wedge Pressure
    D) Cardiac Output
    B) all of the answers
    (this multiple choice question has been scrambled)
  63. Monitoring of esophageal pressure is used for which of the following?

    A) confirmation of tidal volume
    B) evaluation of pleural pressure
    C) calculation of compliance
    D) estimation of airway resistance
    B) evaluation of pleural pressure
    (this multiple choice question has been scrambled)
  64. You should consider changing from CPAP to bilevel PAP in adults if the pressure exceeds ___?

    A) 12 cm H2O
    B) 20 cm H2O
    C) 10 cm H2O
    D) 15 cm H2O
    B) 20 cm H2O
    (this multiple choice question has been scrambled)
  65. The Helium Dilution method for FRC requires all of the following EXCEPT?

    A) 100% Oxygen
    B) CO2 Removal
    C) Closed System
    D) 10% He
    A) 100% Oxygen
    (this multiple choice question has been scrambled)
  66. Vt + IRV =

    A) IC
    B) FRC
    C) TLC
    D) VC
    A) IC
    (this multiple choice question has been scrambled)
  67. Lung volumes differ from lung capacities because:

    A) lung capacitieis change in hyperreactive airway disease, but lung volumes do not
    B) lung volumes are composed of more than one capacity
    C) lung capacities are composed of more than one lung volume
    D) lung volumes change in hyperreactive airway disease, but lung capacities do not
    C) lung capacities are composed of more than one lung volume
    (this multiple choice question has been scrambled)
  68. The following test results are obtained. What is the next step?: Trial 1: FEV1 2.87L, FVC 3.22L; Trial 2: FEV1 1.90L, FVC 2.35L; and Trial 3: FEV1 2.84L, FVC 2.99L.

    A) Nothing. The acceptability standard of 2 tests has been met.
    B) Nothing. The best effort was obtained on the first trial.
    C) Nothing. The reproducibility standard of three tests has been met.
    D) Perform another rest to meet reproducibility
    D) Perform another rest to meet reproducibility
    (this multiple choice question has been scrambled)
  69. Nitric oxide is used to measure the:

    A) closing volume
    B) airway inflammation
    C) bronchospasm
    D) diffusing capacity
    B) airway inflammation
    (this multiple choice question has been scrambled)
  70. A bacterial gram stain that results in purple staining on the sample is identified as:

    A) gram positive
    B) gram negative
    C) acid-fast
    D) normal flora
    A) gram positive
    (this multiple choice question has been scrambled)
  71. A 63 YO Female is admitted to the ED having been found unresponsive at the bottom of her stairs at home. She is intubated and the first exhalation after ventilation from the resuscitation bag indicates a normal end tidal CO2. You should:

    A) obtain an ABG 30 minutes after mechanical ventilation has been initiated
    B) delay interpretation of the end tidal CO2 until after 6 breaths
    C) secure the tube, noting placement
    D) mildly hyperventilate in order to reduce ICP
    B) delay interpretation of the end tidal CO2 until after 6 breaths
    (this multiple choice question has been scrambled)
  72. The following measurements are consistent with what condition? PAP 18/5mmHg, PCWP 12mmHg, BP 85/45, CO 8.5lpm.

    A) hypovolemic shock
    B) pulmonary hypertension
    C) septic shock
    D) cardiogenic shock
    C) septic shock
    (this multiple choice question has been scrambled)
  73. Thedistance walked during a Six-Minute Walk Test is:

    A) not as important as oxygen saturation
    B) predicted, based on age, gender & height
    C) one part of a cardiopulmonary exercise test
    D) used to compare pre- and post- Rx
    D) used to compare pre- and post- Rx
    (this multiple choice question has been scrambled)
  74. Bedside monitoring of a 6 YO with ARDS being mechanically ventilated reveals: PtcCO2 50mmHg, PetCO2 30mmHg, SpO2 85%. An appropriate interpretation includes

    A) transcutaneous sensor hyperperfusion
    B) mechanical ventilator malfunction
    C) decreased cardiac output
    D) MetHb suspicion
    C) decreased cardiac output
    (this multiple choice question has been scrambled)
  75. Indications for home apnea monitoring include: I apnea of prematurity, II apparent life threatening event, III familial hx of SIDS, IV technology dependency.
    a. I, II, III
    b. I, II, IV
    c. I, III, IV
    d. II, III, IV

    A) b. I, II, IV
    B) a. I, II, III
    C) c. I, III, IV
    D) d. II, III, IV
    A) b. I, II, IV
  76. Evaluation of a properly placed ETT: a colorimetric end tidal CO2 detector will display:

    A) yellow, regardless of perfusion
    B) purple, with good perfusion
    C) purple, regardless of perfusion
    D) yellow with good perfusion
    D) yellow with good perfusion
    (this multiple choice question has been scrambled)
  77. A cardiac stress test is used to evaluate:

    A) interstitial lung disease
    B) CAD
    C) cardiac ejection fraction
    D) pulmonary hypertension
    B) CAD
    (this multiple choice question has been scrambled)
  78. An exercise bronchial challenge indicates airway hypersensitivity when the post exercise:

    A) FVC is 10-15% less than the pre-exercise FVC
    B) FEV1 is 10-15% less than the pre-exercise FEV1
    C) O2 Uptake is 10-15% less than expected
    D) VO2 is less than predicted and the VCO2 is greater than predicted
    B) FEV1 is 10-15% less than the pre-exercise FEV1
    (this multiple choice question has been scrambled)
  79. The following measurements are consistent with what condition? PAP 15/5, PCWP 3 mm, BP 75/40, CO 2 LPM.

    A) hypovolemic shock
    B) cardiogenic shock
    C) pulmonary hypertension
    D) hypovolemic shock
    D) hypovolemic shock
    (this multiple choice question has been scrambled)
  80. True or False? a patient c/o chest pain radiating into the lower jaw & left arm should always have an ECG.
    True
  81. True or False? Transcutaneous monitoring of an adult undergoing general anesthesia has been shown to be reliable & accurate/
    True
  82. An ECG showing V-Fib exhibits occasional normal, P, QRD, & T waves.
    False
  83. What is the effect of spontaneous inspiratory effort on alveolar distending pressure during PCV?

    A) alveolar distensing pressure is decreased
    B) none. spontaneous breathing does not affect alveolar distending pressure
    C) alveolar distending pressure is increased by spontanous inspiratory efforts
    D) it depends on how stiff is the chest wall
    C) alveolar distending pressure is increased by spontanous inspiratory efforts
    (this multiple choice question has been scrambled)
  84. According to the recent literature, ____ is the preferred Rx for OSA.

    A) uvalopaletopharyngoplasty
    B) positive airway pressure
    C) silfenatil citrate
    D) oral appliances
    B) positive airway pressure
    (this multiple choice question has been scrambled)
  85. Bi-level PAP titration should start with IPAP/EPAP levels of:

    A) 4-4cm H2O
    B) 4-8cm H2O
    C) 8-4cm H2O
    D) 8-8cm H2O
    C) 8-4cm H2O
    (this multiple choice question has been scrambled)
  86. The minimal difference in bilevel PAP between IPAP & EPAP should be:

    A) 6cm H2O
    B) 8cm H2O
    C) 2cm H2O
    D) 4cm H2O
    D) 4cm H2O
    (this multiple choice question has been scrambled)
  87. CXR can be used to measure:

    A) FRC
    B) TLC
    C) VC
    D) Vt
    B) TLC
    (this multiple choice question has been scrambled)
  88. The most common way to measure FRC in a person with severe lung disease is:

    A) CO transfer factor
    B) N2 washout
    C) He dilution
    D) body plethysmography
    C) He dilution
    (this multiple choice question has been scrambled)
  89. A patient with severe obstructive lung disease will most likely have the following finding:

    A) decreased ERV
    B) normal RV
    C) Increased RV/TLC
    D) increased TLC
    C) Increased RV/TLC
    (this multiple choice question has been scrambled)
  90. Acceptable Spirometry:

    A) may include a cough if it is not within the first second
    B) is not effort dependent
    C) requires only one good effort
    D) requires an expiratory effort of at least 10 seconds
    D) requires an expiratory effort of at least 10 seconds
    (this multiple choice question has been scrambled)
  91. The ATS/ERS standard for spirometry recommends use of reference equations from:

    A) NHLBI
    B) ITS/MORRIS
    C) NHANES III
    D) ITS/CRAPO
    C) NHANES III
    (this multiple choice question has been scrambled)
  92. Prior to a bronchoprovocation test, the baseline FEV1 should be greater than:

    A) 95% of predicted
    B) 50% of predicted
    C) 90% of predicted
    D) 70% of predicted
    D) 70% of predicted
    (this multiple choice question has been scrambled)
  93. Diffusing capacity is NOT affected by:

    A) RBC cytoplasm
    B) capillary thickness
    C) anemia
    D) respiratory rate
    D) respiratory rate
    (this multiple choice question has been scrambled)
  94. FENO can be artificially elevated by

    A) using noseclips
    B) eating sausage
    C) performing spirometry
    D) increased cardiac output
    D) increased cardiac output
    (this multiple choice question has been scrambled)
  95. To assure that values have reached a steady state, a blood gas should be done ____ minutes following a change in oxygen or ventilator settings.

    A) 3-10 minutes
    B) 20-30 minutes
    C) 30-40 minutes
    D) 10-20 minutes
    D) 10-20 minutes
    (this multiple choice question has been scrambled)
  96. A 45 YO male is admitted to the ED c/o chest discomfort with deep inspiration. His ABG's on RA are: ph 7.50, pCO2 30, pO2 75, HCO3 23, sat 95%. The first intervention should be:

    A) furosemide
    B) nitroglycerin
    C) O2 Rx
    D) acetazolamide
    C) O2 Rx
    (this multiple choice question has been scrambled)
  97. A smoke-inhalation victim c/o dyspnea & nausea is admitted to the ED. THe pulse ox displays a good waveform, SpO2 98%, pulse 126. What should you recommend?

    A) reduce systolic BP to reduce CPP
    B) carboxyhemoglobin testing
    C) change mode to pressure control
    D) use SVN
    B) carboxyhemoglobin testing
    (this multiple choice question has been scrambled)
  98. Bedside monitoring with a 6 YO child with ARDS being mechanically ventilated reveals PtcO2 of 50mm Hg SpO2. An appropriate interpretation includes:

    A) ventilator malfunction
    B) TC sensor performance issues
    C) decreased cardiac output
    D) METHb suspicion
    C) decreased cardiac output
    (this multiple choice question has been scrambled)
  99. Indications for home apnea monitoring include all EXCEPT:

    A) apparent life threatening event
    B) technology dependency
    C) apnea of prematurity
    D) family hx of SIDS
    D) family hx of SIDS
    (this multiple choice question has been scrambled)
  100. On exhalation, with a properly placed ETT, a colorimetric end tidal CO2 monitor will display:

    A) yellow, with good perfusion
    B) yellow, regardless of perfusion
    C) purple, with good perfusion
    D) purple, regardless of perfusion
    A) yellow, with good perfusion
    (this multiple choice question has been scrambled)
  101. Neck vein distension is most consistent with which of the following?

    A) CHF
    B) Asthma
    C) CVA
    D) COPD
    A) CHF
    (this multiple choice question has been scrambled)
  102. Your patient has a mixed venous pO2 of 25mm Hg and a mixed venous Saturation of 55%. This is most consistent with:

    A) ARDS
    B) Polycythemia
    C) Hyperventilation
    D) Low Cardiac Output
    D) Low Cardiac Output
    (this multiple choice question has been scrambled)
  103. Which of the following tracheostomy cuffs are filled with water?

    A) dual cannula
    B) tight-to-shaft
    C) foam-filled
    D) high pressure
    B) tight-to-shaft
    (this multiple choice question has been scrambled)
  104. You are evaluating a patient for TB. THe patient has a hx of conversion of skint tests. Which of the following is the most appropriate tool to determine TB in this patient?

    A) IGRA
    B) AFB
    C) Mantoux Test
    D) CXR
    D) CXR
    (this multiple choice question has been scrambled)
  105. Which of the following is NOT an indication for TB skin testing?

    A) persistent, productive cough
    B) night sweats
    C) hemoptysis
    D) excessive vomiting
    D) excessive vomiting
    (this multiple choice question has been scrambled)
  106. Which of the following allergens can be identified via allergy skin testing?

    A) food allergies
    B) animal dander
    C) all are correct
    D) pollens
    C) all are correct
    (this multiple choice question has been scrambled)
  107. A 22 YO female comes to the ED c/o pleuritic pain. What diagnostic test would be most useful for this patient?

    A) MRI
    B) CT
    C) CXR
    D) PET Scan
    C) CXR
    (this multiple choice question has been scrambled)
  108. True or False. THe diagnostic test which best assesses the cause of daytime fatigue is PFT?
    False.
  109. True or False. A diagnostic bronchoscopy can be used to remove a sample of tissue from a suspected lung tumor.
    True
  110. True or False. BUN.Creatinine are blood chemistry tests that assess renal function.
    True
  111. True or False. The most efficient way to assess ventilation & oxygenation in mechanically-ventilated newborn infants is via a combination of pulse oxymetry and capnography.
    False
  112. True or False. The D-dimer test can be used to R/O the presence of a pulmonary emboli?
    True.
  113. A _____ should be recommended for diagnosis of a possible pulmonary emboli.

    A) PFT
    B) CXR
    C) Arterial Blood Gas
    D) V/Q Scan
    D) V/Q Scan
    (this multiple choice question has been scrambled)
  114. A patient is admitted to the ED with a high fever, coughing up green sputum, with a white count which is significantly elevated. The most likely diagnosis for this patient is?

    A) acute asthma exacerbation
    B) bacterial pneumonia
    C) empyema
    D) pulmonary embolis
    B) bacterial pneumonia
    (this multiple choice question has been scrambled)
  115. A patient has an MRI, which shows a mass of unknown composition present on the border of a RUL segmental bronchus. What would be the preferred way to attempt a diagnosis of this tumor?

    A) diagnostic bronchoscopy
    B) open biopsy
    C) needle biopsy
    D) CT
    A) diagnostic bronchoscopy
    (this multiple choice question has been scrambled)
  116. A patient recovering from 3rd degree burns, has been hospitalized on a ventilator for 24 hours. The physician wishes to start feeding the patient using TPN. In order to accomplish this, what procedure is necessary?

    A) place two peripheral IV lines
    B) insert a CVP line
    C) place an arterial line
    D) insert a pulmonary artery catheter
    B) insert a CVP line
    (this multiple choice question has been scrambled)
  117. A patient has just returned from the Cath Lab with placement of 3 stents. The physician is concerned about low output cardiac failure. What should be recommended to enable monitoring of cardiac output?

    A) placement of a CVP line
    B) placement of a radial artery line
    C) a daily ECG
    D) placement of a pulmonary artery catheter
    D) placement of a pulmonary artery catheter
    (this multiple choice question has been scrambled)
  118. A patient is admitted with a sharply elevated BUN/Creatinine. The most likely explanation for this is:

    A) renal failure
    B) CHF
    C) dehydration
    D) ventilatory failure
    A) renal failure
    (this multiple choice question has been scrambled)
  119. Your patient requires an ET cuff pressure of 40cm H2O to maintain a seal. Which of the following are likely causes?

    A) small diameter tube
    B) tracheal dilation
    C) tube misplaced
    D) all are correct
    D) all are correct
    (this multiple choice question has been scrambled)
  120. Which of the following can be measured from a pulmonary artery catheter?

    A) Cardiac Output
    B) CVP
    C) Wedge Pressure
    D) all are correct
    D) all are correct
    (this multiple choice question has been scrambled)
  121. Mantoux skin test has been administered to a patient. The test shows a 17 mm diameter wheal. this result indicates:

    A) a negative test for pertussis
    B) a negative test for TB
    C) a positive test for pertussis
    D) a positive test for TB
    D) a positive test for TB
    (this multiple choice question has been scrambled)
  122. Which of the following best describes a heart rate of 120 bpm in an adult?

    A) bradycardia
    B) block
    C) fibrillation
    D) tachycardia
    D) tachycardia
    (this multiple choice question has been scrambled)
  123. In the OR, you are told that a capnograph is not working. What alternative diagnostic monitor should the therapist suggest to monitor arterial CO2?

    A) Pulse Oximeter
    B) an arterial line with an ABG q 15 minutes
    C) none, since there is no other satisfactory way to monitor arterial CO2
    D) transcutaneous monitor
    D) transcutaneous monitor
    (this multiple choice question has been scrambled)
  124. A 10 YO is being treated in the ED following a house fire. The child is on a 100% non-breather. but is tachypnic (RR = 44bpm) & tachycardic (HR = 168) and appears to be in distress. His SaO2 reads 100%. What do you conclude?

    A) the child is frightened
    B) the SaO2 reading may be faulty due to the child's light skin color
    C) the child may have a cardiac defect which has been exacerbated by the fire
    D) the child may have sdignificant HbCO due to CO exposure in the fire
    D) the child may have sdignificant HbCO due to CO exposure in the fire
    (this multiple choice question has been scrambled)
  125. A patient with COPD is being ventilated using pressure support ventilation. When a jet nebulizer is placed into the ventilator circuit, the patient is unable to trigger. What is the most likely cause?

    A) insufficient trigger setting
    B) Auto PEEP
    C) insufficient PEEP setting
    D) flow from the nebulizer
    D) flow from the nebulizer
    (this multiple choice question has been scrambled)
  126. A patient at home calls to say his H cylinder reads 800 psi and he is using O2 at 2 lpm continuously. You inform the patient that:

    A) he needs to decrease the flow & you will have O2 delivered the next day
    B) you will have O2 delivered to him by 2 pm the next day
    C) he should switch to his backup cylinder
    D) you will have O2 delivered to him before 6 pm that same day
    D) you will have O2 delivered to him before 6 pm that same day
    (this multiple choice question has been scrambled)
  127. The transducer on a pulmonary artery catheter system is leveled at the phlebostatic axis while the patient is supine. THe nurse raises the HOB to 45 degrees. The result CYP reading is now:

    A) accurate as this is the proper level
    B) inaccurately higher
    C) impossible to determine
    D) inaccurately lower
    B) inaccurately higher
    (this multiple choice question has been scrambled)
  128. The vacuum suddenly stops when you are suctioning a young patient. THe vacuum pressure reads 140 torr. Your first response is to:

    A) increase the vacuum pressure to 160 torr
    B) decrease the vacuum pressure to 100 torr
    C) check to assure the power cord is plugged in
    D) empty the collection container
    D) empty the collection container
    (this multiple choice question has been scrambled)
  129. Which of these is not a method of determining orotracheal intubation?

    A) request end tidal CO2 or colorimetric CO2 indicator
    B) secure tube in adults at 30-32 cm at the tip
    C) assure equal, bilateral chest rise and breath sounds
    D) secure airway and allow positive pressure ventilation
    B) secure tube in adults at 30-32 cm at the tip
    (this multiple choice question has been scrambled)
  130. Which describes the calculation of relative humidity?

    A) water vapor content minus water vapor capacity, x 100 at a certain temperature
    B) water vapor content times water vapor capacity, x 100 at a certain temperature
    C) water vapor content plus water vapor capacity, x 100 at a certain temperature
    D) water vapor content over water vapor capacity, x 100 at a certain temperature
    D) water vapor content over water vapor capacity, x 100 at a certain temperature
    (this multiple choice question has been scrambled)
  131. The most efficient artificial noses, HME's & HCH's achieve about ____ mg/ml.

    A) 12-24 mg/L
    B) 32-34 mg/L
    C) 20-22 mg/L
    D) 40-44 mg/L
    B) 32-34 mg/L
    (this multiple choice question has been scrambled)
  132. A face mask (versus nasal mask) would not be recommended in which of the following CPAP candidates?

    A) bearded patients
    B) edentulous patients
    C) patients whose facial features do not allow a nasal mask
    D) patients who experience claustrophobia
    D) patients who experience claustrophobia
    (this multiple choice question has been scrambled)
  133. Which of the following is considered a low-flow O2 device?

    A) partial rebreather mask
    B) venturi mask
    C) non-rebreather mask
    D) nasal cannula
    D) nasal cannula
    (this multiple choice question has been scrambled)
  134. Which of the following does not apply to bronchoscopy tests?

    A) non-invasive
    B) invasive
    C) therapeutic
    D) diagnostic
    A) non-invasive
    (this multiple choice question has been scrambled)
  135. For a spirometry test to obtain repeatability criteria, the largest and second FVC and FEV1 manuevers must be within?

    A) 15 ml
    B) 150% of each other
    C) 150 ml
    D) 15% of each other
    C) 150 ml
    (this multiple choice question has been scrambled)
  136. Which of the following can be corrected with PD&P?

    A) empyema & pleural effusion
    B) retained secretions & mucus plugging
    C) empyema & mucus plugging
    D) empyema & retained secretions
    B) retained secretions & mucus plugging
    (this multiple choice question has been scrambled)
  137. You are teaching a patient the proper technique for taking an ExPAP rx. Proper instructions would include:

    A) exhale thru pursed lips & force as much air out as possible
    B) do not let your cheeks balloon out & force as much out of your lungs as possible
    C) breathe in normally thru the mouthpiece & force as much air out as possible
    D) breathe in normally thru the mouthpiece & do not let your cheeks balloon out
    B) do not let your cheeks balloon out & force as much out of your lungs as possible
    (this multiple choice question has been scrambled)
  138. Which of the following is a part of Stnadard Precautions?

    A) wearing scrubs for all patient interactions
    B) eye protection for all patient contact
    C) gowns for all patient contact
    D) hand hygiene before & after patient contact
    D) hand hygiene before & after patient contact
    (this multiple choice question has been scrambled)
  139. Which of the following is a disinfectant?

    A) all of the answers are correct
    B) alcohols & iodophors
    C) household bleach
    D) pasteurization
    A) all of the answers are correct
    (this multiple choice question has been scrambled)
  140. Risk of ventilator-associated pneumonia can be reduced with which of the following practices?

    A) frequent mouth care
    B) elevate the HOB
    C) use of PEEP
    D) all of the answers are correct
    D) all of the answers are correct
    (this multiple choice question has been scrambled)
  141. To reduce the risk of ventilator-associated pneumonia, cuff pressures in the artificial airway should be kept at what level?

    A) <10 cm H2O
    B) 20-30 cm H2O
    C) whatever is required for minimal leak
    D) 12-18 cm H2O
    B) 20-30 cm H2O
    (this multiple choice question has been scrambled)
  142. From the perspective of VAP, how often should in-use ventilator circuits be changed?

    A) q 40 hrs
    B) when soiled or broken
    C) q 24 hrs
    D) q week
    B) when soiled or broken
    (this multiple choice question has been scrambled)
  143. Quality control limits come from two distinct areas:

    A) manufacturer's recommendations, known standards & arbitrarily established
    B) known standards & arbitrarily established
    C) manufacturer's recommendations & known standards
    D) manufacturer's recommendations & arbitrarily established
    C) manufacturer's recommendations & known standards
    (this multiple choice question has been scrambled)
  144. Which of the following is not assessed by co-oximetry?

    A) oxyhemoglobin
    B) carboxyhemoglobin
    C) acid-base balance
    D) methemoglobin
    C) acid-base balance
    (this multiple choice question has been scrambled)
  145. Most 3rd & 4th generation ventilators require _____ before being placed on a patient.

    A) biomedical engineering
    B) quality control analysis
    C) two point calibration
    D) operational verification procedure (OVP)
    D) operational verification procedure (OVP)
    (this multiple choice question has been scrambled)
  146. All of the following are considered non-invasive, except:

    A) bronchoscopy
    B) transcutaneous monitoring
    C) capnography
    D) calorimetry
    A) bronchoscopy
    (this multiple choice question has been scrambled)
  147. The high and low end of a range of quality processes are known as:

    A) statistical analysis
    B) process improvement
    C) arbitrary range values
    D) control limits
    D) control limits
    (this multiple choice question has been scrambled)
  148. Which is the correct way to determine the appropriate nasal pharyngeal airway size for placement?

    A) measure from the tip of the nare to the thyroid membrane
    B) by the patient's height & weight
    C) measure from the ear tarsus to the corner of the lip
    D) measure the length of the right nare
    C) measure from the ear tarsus to the corner of the lip
    (this multiple choice question has been scrambled)
  149. Which of the following are important in the evaluation prior to performing endotracheal intubation?

    A) airway anatomy and presence of tumors
    B) all answers are correct
    C) last meal eaten
    D) history of difficult intubation
    B) all answers are correct
    (this multiple choice question has been scrambled)
  150. Which of the following is NOT an advantage of orotracheal intubation?

    A) quicker to perform
    B) allow for larger patent airway
    C) limited neck mobility
    D) A) increases gag reflex
    D)  increases gag reflex
    (this multiple choice question has been scrambled)
  151. Which of the following is NOT a reliable assessment in determining proper verification of endotracheal intubation?

    A) change in function of the resuscitation hand-bag
    B) bilateral chest expansion
    C) condensation in moisture in the ETT
    D) positive CO2 detection after 6 breaths
    A) change in function of the resuscitation hand-bag
    (this multiple choice question has been scrambled)
  152. Which of the following are clinical indications for tracheostomy?

    A) all answers are correct
    B) removal of secretions
    C) reduced WOB
    D) prolonged mechanical ventilation
    A) all answers are correct
    (this multiple choice question has been scrambled)
  153. A patient is assessed prior to intubation for routine surgery. The patient is relatively healthy and the Mallampati score is 1. Which of the following can be expected?

    A) a very complicated intubation
    B) closing volume
    C) all answers correct
    D) an uncomplicated intubation
    D) an uncomplicated intubation
    (this multiple choice question has been scrambled)
  154. A pateint is assessed and assigned a Mallampati score of 4. Which of the following is the most appropriate?

    A) perform a cricothyroidotomy
    B) use an LMA instead
    C) intubate via the nasopharyngeal route
    D) utilize fiberoptic intubation or video laryngoscopy
    D) utilize fiberoptic intubation or video laryngoscopy
    (this multiple choice question has been scrambled)
  155. An 18 YO has been admitted to the ICU for 4 days following smoke inhalation and facial burns from a house fire. He is intubated with a 6.5 ETT. There is a large leak around the inflated cuff. Which of the following is appropriate?

    A) increase the air in the cuff
    B) administer an albuterol rx
    C) exchange the 6.5 ETT with a tube exchanger for an 8.0 ETT
    D) increase inspiratory flow on the ventilator
    C) exchange the 6.5 ETT with a tube exchanger for an 8.0 ETT
    (this multiple choice question has been scrambled)
  156. Which of the following are significant precautions that should be used during use of a speaking valve?

    A) ensure the cuff is not a foam cuff
    B) all answers are correct
    C) monitor the patient & remove the valve if signs of distress are noted
    D) ensure the cuff is deflated
    B) all answers are correct
    (this multiple choice question has been scrambled)
  157. Which of the following is a viable method of preventing VAP in COPD patients?

    A) always use an HME for humidification
    B) extubate ASAP
    C) low doses of anticiotics throughout the ICU stay
    D) keep the HOB elevated 10 degrees
    C) low doses of anticiotics throughout the ICU stay
    (this multiple choice question has been scrambled)
  158. In patients spontaneously triggering the ventilator, mechanical dead space should be added in what situation?

    A) when the RR is >30 bpm
    B) never
    C) in the presence of respiratory or metabolic acidosis
    D) in the presence of low plateau pressure
    B) never
    (this multiple choice question has been scrambled)
  159. Each 6 inches of adult ventilator circuit tubing, when placed in between the wye piece of the ventilator and the ETT, accounts for how much mechanical dead space?

    A) 50 ml
    B) 25 ml
    C) 75 ml
    D) 100 ml
    A) 50 ml
    (this multiple choice question has been scrambled)
  160. Inappropriate application of mechanical ventilation can result in all of the following EXCEPT:

    A) VAP
    B) biochemical damage to the lung
    C) multi-system organ failure
    D) biophysical injury to the lung
    B) biochemical damage to the lung
    (this multiple choice question has been scrambled)
  161. A 68 YO man presents in the ED with pneumonia. RA Gases/VS are PaO2 47; PaCO2 49; pH 7.30; RR 38; HR 128; BP 160-110. NIV is started at PEEP 8; pressure support 10; FiO2 1.0. THe pt has a hard time tolerating NIV and 2 hours after initiation his Gases/VS are PaO2 70; PaCO2 50; pH 7.29; RR 36; Vt 320ml; HR 130; BP 168/112. He continues to use accessory muscles. The correct management is to:

    A) increase PEEP to 12 and pressure support to 12
    B) intubate and invasively ventilate
    C) continue and reassess in another two hours
    D) increase PEEP to 12
    B) intubate and invasively ventilate
    (this multiple choice question has been scrambled)
  162. A 5'9" tall 73 YO males has CHF & acute pulmonary edema but no hx of COPD. His RA gases on admission were pO2 65; pCO2 52; pH 7.28. Sixty minutes after the initiation of NIV, his gases are pO2 110; pCO2 44; and pH 7.34; RR 34 bpm; Vt 600ml. He appears to mistrigger many breaths on a regular basis and the ventilator rate is 26. THe correct decision is to:

    A) intubate and invasively ventilate
    B) sedate
    C) decrease the FiO2 setting
    D) decrease the pressure support level
    D) decrease the pressure support level
    (this multiple choice question has been scrambled)
  163. To evaluate the presence of retrosternal air, which view should be obtained?

    A) anterior-posterior
    B) posterior-anterior
    C) left lateral
    D) lateral decubitus
    C) left lateral
    (this multiple choice question has been scrambled)
  164. A fluffy infiltrate with an enlarged heart & increased hilar markings are seen in the CXR of a patient with:

    A) emphysema
    B) CHF
    C) consolidation
    D) ARDS
    B) CHF
    (this multiple choice question has been scrambled)
  165. The silhouette sign obscures the R diaphragm. What does this indicate?

    A) RML atelectasis
    B) pericardial effusion
    C) RUL consolidation
    D) RLL atelectasis
    D) RLL atelectasis
    (this multiple choice question has been scrambled)
  166. During NIPPV, the Delta-P is 9 cm. Initial Vt on this pressure is 5-6ml/kg. 12 hours later the Vt is 8-10ml/kg. The most likely cause of the volume change is:

    A) lung characteristics have improved
    B) the pt has been sedated
    C) the pt is making less inspiratory effort
    D) the Delta-P has changed
    A) lung characteristics have improved
    (this multiple choice question has been scrambled)
  167. A pt on NIPPV has an IPAP at 12 cm. The P-T Waveform spikes to 14 cm at the end of inspiration & the ventilator immediately cycles to exhalation. The graphic may indicate:

    A) the pt is actively inspiring
    B) the ventilator is time-cycling out of inspiration
    C) there is a large leak
    D) the pt is actively exhaling
    D) the pt is actively exhaling
    (this multiple choice question has been scrambled)
  168. A male pt has been ventilated for 5 days for ARF 2o to sepsis. THe patient has been repositioned in the bed. THe lower SpO2 alarm and the high heart rate alarm activate. What do you check first?

    A) increase the FiO2
    B) increase volume delivery
    C) check for ventilator disconnect
    D) increase the PEEP
    C) check for ventilator disconnect
    (this multiple choice question has been scrambled)
  169. The high pressure alarm repeatedly ctivates and inspiration ends, during ventilation of an ICU pt. SpO2 decreases from 95% to 85%. What should you do first?

    A) check for autoPEEP
    B) increase the RR
    C) check the cuff pressure
    D) attempt to pass a suction catheter through the artificial airway to check for obstruction
    D) attempt to pass a suction catheter through the artificial airway to check for obstruction
    (this multiple choice question has been scrambled)
  170. A pt presents to the ED c/o SOB. Upon auscultation, you id diminished breath sounds & faint wheezing. Which of the following meds is indicated?

    A) albuterol sulfate
    B) formoterol
    C) theophylline
    D) colistin
    A) albuterol sulfate
    (this multiple choice question has been scrambled)
  171. A pt with CF is having difficulty clearing his sputum. What is the most appropriate for this pt?

    A) n-acetylcysteine
    B) dornase alfa
    C) omalizumab
    D) hypertonic saline
    B) dornase alfa
    (this multiple choice question has been scrambled)
  172. A newborn is diagnosed with a lethal heart condition. The physician wishes to reduce the PaO2 to keep the PDA open. It will be necessary to reduce the FiO2 below 0.21 to accomplish that. What is the most appropriate gas to deliver?

    A) carbon dioxide
    B) heliox
    C) nitrogen
    D) nitric oxide
    C) nitrogen
    (this multiple choice question has been scrambled)
  173. What should be done to increase the Vt delivered during IPPB?

    A) encourgage a breath hold
    B) encourage the pt to let the ventilator deliver all of the volume
    C) decrease tidal flow
    D) increase peak pressure
    D) increase peak pressure
    (this multiple choice question has been scrambled)
  174. A ventilated pt has a Vt of 500ml. The rate is 15 bpm and the Ti is 1.0 sec. Flow is constant. What is the rate of flow?

    A) 60 lpm
    B) 40 lpm
    C) cannot be determined
    D) 30 lpm
    D) 30 lpm
    (this multiple choice question has been scrambled)
  175. A pt is ventilated on A/C volume ventilation. Vt = 600ml (7ml/kg), rate is 12 bpm. During inspiration, the P/T graphic has a concave appearance. BG's are OK. An appropriate action is:

    A) increase rate to 12
    B) increase flow
    C) decrease Vt to 600ml
    D) change to an accelerating flow curve
    B) increase flow
    (this multiple choice question has been scrambled)
  176. The physician would like to decrease Ti for an apenic ventilated pt to allow more Te without changing the minute ventilation. How do you accomplish this?

    A) increase I:E for 1:2 to 1:3
    B) add inspiratory pause
    C) increase PEEP by 3 cm
    D) increase flow
    A) increase I:E for 1:2 to 1:3
    (this multiple choice question has been scrambled)
  177. What might a productive morning cough be indicative of?

    A) pneumonia
    B) Abcess
    C) smoking or COPD
    D) TB
    C) smoking or COPD
    (this multiple choice question has been scrambled)
  178. During a pressure-controlled breath, a high flow causes the pt discomfort dur to the peak pressure being reached quickly. What can be adjusted?

    A) expiratory flow trigger
    B) peak flow
    C) rise time
    D) Ti
    C) rise time
    (this multiple choice question has been scrambled)
  179. Upon observing a new arrhythmia, you should: I  assure adequate oxygenation; II  evaluate the need for the treatment performed prior to the arrhythmia;  III prepare for the potential to perform CPR;  IV continue to perform ordered rx.

    A) I, II, III
    B) I. II. IV
    C) I, III, IV
    D) II, III, IV
    A) I, II, III
    (this multiple choice question has been scrambled)
  180. What factors should be considered to DC O2 rx in an adult?  I  decreased RR form 36 to 22; II  SpO2 increased from 88 to 95;  III  sputum changed from thick brown to yellow;  IV breath sounds change from wheezing to clear.

    A) II, III, IV
    B) I, II, IV
    C) I, II, III
    D) I, III, IV
    B) I, II, IV
    (this multiple choice question has been scrambled)
  181. A pt with acute bronchiectasis has breath sounds that have cleared from wheezing & is no longer in respiratory distress. What should be DC'd?

    A) aerosol bronchodilator
    B) IPPB
    C) O2
    D) IS
    A) aerosol bronchodilator
    (this multiple choice question has been scrambled)
  182. Which of the following meds is most appropriate as a maintenance med?

    A) formotorol
    B) levalbuterol
    C) pirbuterol
    D) albuterol
    A) formotorol
    (this multiple choice question has been scrambled)
  183. After inhaling corticosteroids from a metered dose inhaler, it is important for the pt to:

    A) rinse mouth with water
    B) take inhaled beta-agonist
    C) call physician
    D) perform peak flow maneuver
    A) rinse mouth with water
    (this multiple choice question has been scrambled)
  184. 2.5mg albuterol is ordered to be given by nebulizer with diluent. How many ml ofactive med would you add to the diluent?

    A) 0.5 ml
    B) 1.25 ml
    C) 0.05 ml
    D) 5 ml
    A) 0.5 ml
    (this multiple choice question has been scrambled)
  185. The primary key to successful NIV is:

    A) correct ventilation
    B) knowlegeable therapist
    C) full face mask
    D) settings which allow the pt to slowly accept NIV
    A) correct ventilation
    (this multiple choice question has been scrambled)
  186. During NIV, peak pressures are usually limited to 20 cm to:

    A) avoid ventilator-induced lung injury
    B) avoid barotrauma
    C) avoid gastric distension
    D) avoid fighting the ventilator
    C) avoid gastric distension
    (this multiple choice question has been scrambled)
  187. The ideal interface  for the initial application of NIV for an acute hypercapneic respiratory failure pt is:

    A) nasal pillows
    B) full face mask
    C) helmet
    D) standard face mask
    D) standard face mask
    (this multiple choice question has been scrambled)
  188. Initial ventilator settings in ARDS should include all of the following except:

    A) maintain Vt between 4-8 ml/kg
    B) set PEEP 12-20
    C) maintain Pplat >40
    D) maintain FiO2 between 0.5 and 1.0
    C) maintain Pplat >40
    (this multiple choice question has been scrambled)
  189. The single most important factor that is different between ventilator management of asthma & COPD is:

    A) a higher FiO2 is required in COPD
    B) inspiratory time, which in asthma must be >1.0
    C) synchrony, asthmatics always have more asynchronous breathing
    D) applied PEEP, higher PEEP is needed in asthma
    B) inspiratory time, which in asthma must be >1.0
    (this multiple choice question has been scrambled)
  190. Post extubation after successful trial of SBT, NIV should be applied to which of the following:

    A) any pt who is at risk of reintubation
    B) to post op pts developing hypoxemic respiratory failure after extubation
    C) only to pts with a hx of COPD
    D) all pts for 8-24 hours
    A) any pt who is at risk of reintubation
    (this multiple choice question has been scrambled)
  191. Which of the following are indications for intubation?

    A) bypass upper airway obstruction
    B) protect airway from aspiration
    C) all
    D) aid clearance of secretions
    C) all
    (this multiple choice question has been scrambled)
  192. For which of the following reasons would you recommend a trach tube with extra proximal length?

    A) tracheomalecia
    B) to faciliatate speaking
    C) large neck
    D) aid in removal of secretions
    C) large neck
    (this multiple choice question has been scrambled)
  193. A pt develops an arrhythmia during an inhaled bronchodilator treatment. Which would you recommend?

    A) stop treatment until the arrhythmia resolves, then resume
    B) instruct pt to breathe at a lower rate
    C) stop therapy & notify the physician
    D) switch to lower dose & continue
    C) stop therapy & notify the physician
    (this multiple choice question has been scrambled)
  194. Which of the following decreases oxygen carrying capacity?

    A) MetHb
    B) anemia
    C) all
    D) COHb
    C) all
    (this multiple choice question has been scrambled)
  195. An elevation in which of the following is an increased in the presence of hypoxia?

    A) sodium
    B) potassium
    C) lactate
    D) bicarb
    C) lactate
    (this multiple choice question has been scrambled)
  196. Which of the following results in an increase in the anion gap?

    A) lactate
    B) all
    C) ketones
    D) renal failure
    B) all
    (this multiple choice question has been scrambled)
  197. A pt is receiving furosemide. Which side effects do you expect?

    A) all
    B) hypotension
    C) electrolyte imbalance
    D) dehydration
    A) all
    (this multiple choice question has been scrambled)
  198. Selective pulmonary vasodilators are preferred over systemic vasodilators because:

    A) systemic vasodilators are controlled substances
    B) pulmonary vasodilators are easier to obtain
    C) systemics are more expensive
    D) they have fewer side effects
    D) they have fewer side effects
    (this multiple choice question has been scrambled)
  199. Which of the following in NOT an indication for pulmonary vasodilators?

    A) heart transplantation
    B) RDS with V/Q mismatch
    C) primary pulmonary hypertension
    D) CHF
    D) CHF
    (this multiple choice question has been scrambled)
  200. Which of the following is an inhaled antibiotic to control p. aeruginosa in CF?

    A) aztreonam
    B) piravirin
    C) zanamivir
    D) pentamidine
    A) aztreonam
    (this multiple choice question has been scrambled)
  201. Which of the following is used for vasodilation & pain?

    A) morphine
    B) midazolam
    C) diazepam
    D) lorazadam
    A) morphine
    (this multiple choice question has been scrambled)
  202. The nebulizer used to aerosolize ribavirin is the:

    A) Respirgard II
    B) Ultrasonic nebulizer
    C) SPAG
    D) SVN
    C) SPAG
    (this multiple choice question has been scrambled)
  203. T/F  Pts who use inhaled corticosteroids must rinse their mouths after treatment to avoid oral candidiasis.
    True
  204. T/F  Corticosteroids increase the action of beta-agonists?
    True
  205. A low dose of this drug results in renal artery vasodilation.

    A) dopamine
    B) isoproterenol
    C) norepinenephrine
    D) epinephrine
    A) dopamine
    (this multiple choice question has been scrambled)
  206. This receptor is located in the bronchial smooth muscles & causes bronchodilation when stimulated.

    A) beta-1
    B) beta-2
    C) alpha
    D) muscarenic-1
    B) beta-2
    (this multiple choice question has been scrambled)
  207. A pt is experiencing moderate stridor following extubation. What do you recommend?

    A) salmeterol
    B) ipratopium bromide
    C) racemic epinephrine
    D) albuterol
    C) racemic epinephrine
    (this multiple choice question has been scrambled)
  208. This receptor is located in the bronchial smooth muscle & causes bronchodilation when it is blocked.

    A) beta-2
    B) alpha
    C) beta-1
    D) muscarinic-3
    D) muscarinic-3
    (this multiple choice question has been scrambled)
  209. A 78 YO pt with COPD is seen in the ED. ABG's on RA  PaO2 68 PCO2 60. Based onb this what do you recommend?

    A) administer low flow O2 and observe
    B) deliver CO2 therapy for 15 minutes
    C) place pt on NRBM @ 15 lpm
    D) hydrate
    A) administer low flow O2 and observe
    (this multiple choice question has been scrambled)
  210. In setting up a blender, the alarm sounds when the O2 hose is connected. When the air hose is connected, the alarm stops. What should you do?

    A) replace O2 hose
    B) remove blender from service
    C) set blender to 100% O2
    D) no action
    D) no action
    (this multiple choice question has been scrambled)
  211. You are caring for a pt with a severe L-sided infiltrate. Positioning pt on the R side would likely cause:  I drainage of affected segments; II  decreased PaO2; III  increased V/Q mismatch; IV  increased PaO2

    A) I, II, IV
    B) I, II
    C) I, II & IV
    D) II, III
    C) I, II & IV
    (this multiple choice question has been scrambled)
  212. A heavily-sedated pt is on A/C volume vent with the following settings: Vt 350 (4ml); RR 12; FiO2 0.35. ABG'd are pH 7.31 pCO2 59 HCO3 25 PaO2 98. What changes would you make?

    A) decrease Vt to 300
    B) increase rate to 20
    C) decrease FiO2 to 0.25
    D) increase Vt to 550
    D) increase Vt to 550
    (this multiple choice question has been scrambled)
  213. A 12" piece of corregated tubing is positioned between the Y-connector and the ETT. Without this additional tubing, the ABG's were normal. After adding it, the gases were:
    pH 7.34, pCO2 49, HCO3 25, PaO2 88. What do you do?

    A) increase the Vt
    B) increase Ti
    C) remove the device
    D) increase the FiO2
    C) remove the device
    (this multiple choice question has been scrambled)
  214. The PEEP level on an ALI pt is increased from 12 to 15. In what parameter might you expect to see adverse effects?

    A) decrease in shunt
    B) decrease in BP
    C) increase in CaO2
    D) increase in CO
    B) decrease in BP
    (this multiple choice question has been scrambled)
  215. Which agent is the best short-acting agent used in bronchoconstricting disorders such as asthma?

    A) epinephrine (adrenalin)
    B) ipratropium bromide (atrovent)
    C) albuterol sulfate (ventolin)
    D) salmeterol (serevent)
    C) albuuterol sulfate (ventolin)
    (this multiple choice question has been scrambled)
  216. All of the following are long-acting beta agonists EXCEPT:

    A) arformoterol (brovana)
    B) levalbuterol (xopenex)
    C) formotoral (perforomist)
    D) indacterol (arcapta)
    B) levalbuterol (xopenex)
    (this multiple choice question has been scrambled)
  217. Digoxin (lanoxin) is used:

    A) to decrease the number of beats of the heart
    B) to increase the number of beats of the heart
    C) to vasoconstrict the peripheral veins
    D) to increase the force of the contraction of the heart
    D) to increase the force of the contraction of the heart
    (this multiple choice question has been scrambled)
  218. All of the following are alernatives to corticosteroids EXCEPT:

    A) montelukast (singulair)
    B) mometasone/formoterol (dulera)
    C) zafirlukast (accolate)
    D) zileuton (zyflo)
    B) mometasone/formoterol (dulera)
    (this multiple choice question has been scrambled)
  219. This agent can be used to treat a patient with an acetaminophen (tylenol) OD.

    A) n-acetylcysteine (mucomyst)
    B) ciclesonide (alvesco)
    C) cromolyn sodium (nasalcrom)
    D) methyl-prednisolone (solu-medrol)
    A) n-acetylcysteine (mucomyst)
    (this multiple choice question has been scrambled)
  220. All of the following are used to prevent or treat RDS EXCEPT:

    A) ribavirin (virazole)
    B) poractant alfa (curosurf)
    C) calfactant (infasurf)
    D) beractant (survanta)
    A) ribavirin (virazole)
    (this multiple choice question has been scrambled)
  221. You are conducting rounds on the ortho floor. You note a post-op knee-replacement pt breathing shallow and slow. You determine the pt has OD'd on morphine. You recommend administration of:

    A) alprazolam (xanax)
    B) succinylcholine (anectine)
    C) propofol (diprivan)
    D) naloxone (narcan)
    D) naloxone (narcan)
    (this multiple choice question has been scrambled)
  222. A pt is experiencing SOB & diaphonresis. The pt is mildly xyanotic with 2 lpm O2 via nasal cannula & you note mild expiratory wheezes and fine crackles upon auscultation. The HR is tachycardic and her extremities display +2 pitting edema. What is the most appropriate med at this time?

    A) norepinephrine
    B) furosemide
    C) dopamine
    D) albuterol sulfate
    B) furosemide
    (this multiple choice question has been scrambled)
  223. The physician wishes to deliver a nebulized pulmonary vasodilator. Which of the following should you recommend?

    A) budesonide
    B) cayston
    C) aldactone
    D) iloprost
    D) iloprost
    (this multiple choice question has been scrambled)
  224. Which of the following hemoglobin concentrations is consistent with anemia?

    A) 17 g/dL
    B) 14 g/dL
    C) 20 g/dL
    D) 10 g/dL
    D) 10 g/dL
    (this multiple choice question has been scrambled)
  225. Which of the follow are increased with infection?

    A) lactate
    B) WBC Count
    C) potassium
    D) bicarbonate
    B) WBC Count
    (this multiple choice question has been scrambled)
  226. Which of the following serum electrolyte concentrations are affected by high doses of albuterol?

    A) chloride
    B) bicarbonate
    C) sodium
    D) potassium
    D) potassium
    (this multiple choice question has been scrambled)
  227. You are assessing humidification for an intubated, mechanically ventilated pt. Which of the following would indicate that the humidification is sufficient?

    A) water bottle in the himidifier requires frequent changes
    B) suctioning required once per shift
    C) temperature in the circuit is 37 degrees C
    D) condensation in the proximal ETT
    D) condensation in the proximal ETT
    (this multiple choice question has been scrambled)
  228. A hospitalized pt with a hx of asthma is receiving albuterol nebulizer qid. The pt's peal flow is normal & the chest is clear to auscultation. Which of the following do you recommend?

    A) d/c albuterol & replace with inhaled anti-cholinergic
    B) chg frequency of albuterol to prn & add inhaled controller med
    C) d/c albuterol & administer controller med prn for wheezing
    D) continue the rx based on pt's hx
    B) chg frequency of albuterol to prn & add inhaled controller med
    (this multiple choice question has been scrambled)
  229. Which criteria should a pt meet to conduct a SBT?  I  adequate oxygenation at a low FiO2 & PEEP; II  ability to breathe spontaneously; III  be receiving minimal non-continuous doses of sedatives; IV  has a ph > 7.25;  V  is hemodynamically stable.

    A) I, II, IV & V
    B) I,II, III, IV & V
    C) I, II, III, & IV
    D) II, III, IV, & V
    A) I, II, IV & V
    (this multiple choice question has been scrambled)
  230. What sputum characteristics should be monitored?  I  quantity; II  taste; III consistency; IV  color?

    A) I, III & IV
    B) I, II, IV
    C) II, III & IV
    D) I, II, III
    A) I, III & IV
    (this multiple choice question has been scrambled)
  231. Missed trigger efforts during controlled mechanical ventilation are often the result of: I  an inapporpriate senisitvity setting; II  presence of auto-PEEP; III low peak flow setting; IV a high mandatory rate.

    A) III & IV
    B) II & IV
    C) II & III
    D) I & II
    D) I & II
    (this multiple choice question has been scrambled)
  232. The Vt for a ventilated pt is 250 ml. The flow is 60 lpm. The rate is 12 bpm. What is the inspiratory time in seconds?

    A) 0.75 second
    B) 0.25 seconds
    C) 0.5 second
    D) 1.0 second
    B) 0.25 seconds
    (this multiple choice question has been scrambled)
  233. During volume ventilation, the set flow rate is increased. Which of the following is likely to occur?

    A) low pressure alarms will activate
    B) RR will decrease
    C) Pplat will increase
    D) Ti will increase
    C) Pplat will increase
    (this multiple choice question has been scrambled)
  234. A male pt with COPD & chronic CO2 retention is placed on ventilator support due to a pneumonia leading to ARF. He is 72" tall, weights 240 lbs. His PBW= 81kg. He is placed on SIMV volume ventilation with the following settings: Vt 550ml; rate 15 bpm total rate; PS 8 cm.  ABG's are: pH 7.58; PaCO2 45; HCO3 41; PaO2 83 on 0.3 FiO2. Which of the following should be recommended?

    A) increase the PS to 10
    B) increase the FiO2
    C) reduce the RR to 12 bpm
    D) maintain current settings
    C) reduce the RR to 12 bpm
    (this multiple choice question has been scrambled)
  235. Following OH Surgery, a 75 kg male is on the following settings: SIMV-VC; Vt 600ml; rate 10bpm, spontaneous rate is 5 bpm; PSV 8; spontaneous Vt 250; PEEP 5cm; FiO2 0.5. ABG's are pH 7.27; PaCO2 61; HCO2 27; PaO2 83. What changes should be made?

    A) increase Vt to 850
    B) increase PEEP to 10
    C) increase PS to 12
    D) increase FiO2 to 0.6
    C) increase PS to 12
    (this multiple choice question has been scrambled)
  236. A woman (62" tall) involved in an MVA is on SIMV ventilation. Initial settings are: Vt 700; RR 10 bpm; total bpm of 15. ABG's are pH 7.50; PaCO2 30; HCO3 22.5. What should be changed?

    A) change mode to PSV
    B) reduce rate to 8 bpm
    C) reduce Vt to 400
    D) evaluate CV status
    C) reduce Vt to 400
    (this multiple choice question has been scrambled)
  237. A pt is on a nasal cannula at a flow rate of 2 lpm with a RR of 30 bpm and is anxious & taking shallow breaths. The current PaO2 is 45. What O2 delivery device & flow would likely be necessary to increase her FiO2?

    A) non-rebreather mask
    B) 50% venturi mask
    C) 3 lpm nasal cannula
    D) 7 lpm high-flow nasal cannula
    D) 7 lpm high-flow nasal cannula
    (this multiple choice question has been scrambled)
  238. Which of the following may be used in place of a 35% ventimask, assuming normal breathing pattern & rate?

    A) 7 lpm simple mask
    B) 4 lpm nasal cannula
    C) 14 lpm high flow nasal cannula
    D) 2 lpm nasal cannula
    B) 4 lpm nasal cannula
    (this multiple choice question has been scrambled)
  239. You are assisting with R CVP placement for a mech vent pt in the ICU. During the procedure you note an acute drop in the SaO2 and increased peak pressures on the ventilator. Auscultation reveals absent breath sounds on the R. You should prepare for a?

    A) cardioversion
    B) chest tube placement
    C) bronchoscopy
    D) tracheostomy
    B) chest tube placement
    (this multiple choice question has been scrambled)
  240. You are assisting with a bronch of a pt with suspected lung CA. He presents to the suite with extreme anxiety & nervousness regarding the procedure. The physician elects to use conscious sedation during the procedure. All of the following meds would assist in sedation mgmt EXCEPT:

    A) diazapam (valium)
    B) midazolam (versed)
    C) flumazenil (romazicon)
    D) budesonide (pulmicort)
    D) budesonide (pulmicort)
    (this multiple choice question has been scrambled)
  241. Which of the following methods is best for checking ETT placement immediately post-intubation?

    A) obtain CXR
    B) determine if pt can speak
    C) listen for bilateral, equal breath sounds
    D) watch for stomach rise & fall
    C) listen for bilateral, equal breath sounds
    (this multiple choice question has been scrambled)
  242. In which of the following situations would you terminate the exercise test?

    A) the ECG demonstrates ischemic changes
    B) the HR increases by 10 during the test
    C) the pt starts to sweat
    D) the SpO2 drops by 2% during the test
    A) the ECG demonstrates ischemic changes
    (this multiple choice question has been scrambled)
  243. To determine brain death, the pt must exhibit which of the following signs?

    A) absence of gag & cough reflex
    B) coma of known irreversible cause
    C) normal body temperature
    D) all
    D) all
    (this multiple choice question has been scrambled)
  244. How much fluid per bolus per kg does the AHA suggest for adult & pediatric pts?

    A) 10 ml/kg
    B) 20 ml/kg
    C) 25 ml/kg
    D) 15 ml/kg
    B) 20 ml/kg
    (this multiple choice question has been scrambled)
  245. The mathematical equation pV=k (where p stands for pressure, V for volume and k equals constant) is the formula for which gas law?

    A) Henry's Law
    B) Charles' Law
    C) Gat-Lussac's Law
    D) Boyle's Law
    D) Boyle's Law
    (this multiple choice question has been scrambled)
  246. Which one of the following shock states is referred to as "warm shock"?

    A) obstructive shock
    B) hypovolemic shock
    C) cardiogenic shock
    D) septic shock
    D) septic shock
    (this multiple choice question has been scrambled)
  247. When Return of Spontaneous Circulation occurs, significant increases in EtCO2 should occur in what range?

    A) 34-45
    B) 10-20
    C) 15-25
    D) 20-30
    A) 34-45
    (this multiple choice question has been scrambled)
  248. Q 26-week infant is born & the weight is noted to be 1 kg. Where should you initially secure the ETT at the lip?

    A) 8 cm
    B) 7 cm
    C) 6 cm
    D) 7.5 cm
    B) 7 cm
    (this multiple choice question has been scrambled)
  249. You are going to intubate a 40-week infant prior to going to the OR. The consultant wants you to place an uncuffed tube. What size would you use?

    A) 4.0 mm
    B) 4.5 mm
    C) 3.5 mm
    D) 3.0 mm
    A) 4.0 mm
    (this multiple choice question has been scrambled)
  250. You ar
  251. Your are preparing to intubate a 6 YO for respiratory distress. What size uncuffed ETT us correct for this pt?

    A) 4.5
    B) 5.0
    C) 5.5
    D) 6.0
    B) 5.0
    (this multiple choice question has been scrambled)
  252. Most cases of RDS are seen in babies born before ___ weeks gestation.

    A) 34
    B) 32
    C) 30
    D) 28
    D) 28
    (this multiple choice question has been scrambled)
  253. Which of the following describes the medical emergency team?

    A) to respond to a cardiac arrest
    B) to intervene at the time of pt deterioration to prevent an adverse outcome
    C) to transfer the pt to a lower level of care
    D) to recover the pt after a cardiac arrest event
    B) to intervene at the time of pt deterioration to prevent an adverse outcome
    (this multiple choice question has been scrambled)
  254. Which of the following is NOT a primary concern when selecting a ventilator for use by a medical emergency team or for use in a mass casualty/disaster situation?

    A) extended battery life
    B) presence of apnea alarms
    C) lightweight and portable design
    D) ability to deliver pressure support ventilation
    D) ability to deliver pressure support ventilation
    (this multiple choice question has been scrambled)
  255. A pt with asthma that is not well-controlled takes fluticasone/salmeterol 100/50 bid/ What nonpharmacologic changes to the plan of care should the therapist recommend?  I the pt should receive a written asthma action plan; II  the pt should attend pulmonary rehab; III the pt should receive instruction on peak flow monitoring; IV a review of environmental controls in the pt's home.

    A) II, III, IV
    B) I, II, IV
    C) I, II & III
    D) I, II, IV
    B) I, II, IV
    (this multiple choice question has been scrambled)
  256. Which of the following from a H&P would lead the therapist to conclude that a pt has myasthenia gravis?  I  ptosis; II  presence of thymoma; III ascending paralysis; IV positive endophonium test?

    A) I, II & III
    B) I, III & IV
    C) II, III, IV
    D) I, II & IV
    D) I, II & IV
    (this multiple choice question has been scrambled)
  257. A pt with bronchiectasis is having difficulty mobilizing secretions. Until the presend time, the pt has been instructed to use huff coughing, but that is no longer effective. What do you recommend?

    A) wait until the physician makes rounds & get a new order
    B) institute the bronchial hygiene protocol
    C) check the pt's SpO2
    D) begin IPPB
    C) check the pt's SpO2
    (this multiple choice question has been scrambled)
  258. What is an example of an interdisciplinary care plan?

    A) the implementation of an O2 therapy protocol
    B) a ventilator bundle to help prevent VAP
    C) the periodic check of the pt-ventilator system
    D) a physician consulting her colleague on a difficult case
    B) a ventilator bundle to help prevent VAP
    (this multiple choice question has been scrambled)
  259. What is the goal of an interdisciplinary care plan?

    A) decrease time needed to chart the results of procedures
    B) minimize care delay & resource use for a particular disorder
    C) provide a chat room for providers to discuss pt care
    D) increase hospital revenue
    B) minimize care delay & resource use for a particular disorder
    (this multiple choice question has been scrambled)
  260. In pts with COPD, which of the following are primary concerns during invasive ventilatory support?  I severe hypoxemia; II development of autoPEEP; III hemodynamic compromise; IV pt-ventilator synchrony; IV VAP

    A) II & IV
    B) I, II,III, IV & V
    C) I, III & IV
    D) I & II
    B) I, II,III, IV & V
    (this multiple choice question has been scrambled)
  261. The use of a spontaneous awakening trial in association with a spontaneous breathing trial results in which of the following?  I shorter time of ventilatory support; II shorter time in the hospital; III shorter time in the ICU; IV a decrease in mortality.

    A) I, II, III
    B) I, II, IV
    C) I, II, III & IV
    D) II & III
    C) I, II, III & IV
    (this multiple choice question has been scrambled)
  262. When should prone positioning be used in the management of severe ARDS?

    A) only in pts with a PaO2/FiO2 ratio of <100 mm="" hg="" br="">D) patients unresponsive to rx with nitric oxide
    B) on all pts with an FiO2 of 0.6 or more
    C) As soon as the pt is stabilized on invasive ventilatory support
    A) only in pts with a PaO2/FiO2 ratio of <100 mm Hg
    (this multiple choice question has been scrambled)
  263. Initial ventilatory setting in ARDS should include all of the following EXCEPT:

    A) maintain FiO2 between 0.5 and 1.0
    B) set PEEP 12-20
    C) maintain Pplat <40
    D) maintain Vt between 4-8 ml/kg
    C) maintain Pplat <40
    (this multiple choice question has been scrambled)
  264. Which of the following is most important to evaluate the home after discharge of a pt receiving 2 lpm continuous O2 with a concentrator?

    A) access to the 911 system
    B) assure bedroom is on 1st floor
    C) storage space
    D) evaluate the electrical system
    D) evaluate the electrical system
    (this multiple choice question has been scrambled)
  265. Which of the following results is most likely to occur as a result of pulmonary rehab?

    A) uncontrolled dyspnea & panic tests
    B) decreased exercise tolerance
    C) improvement in the quality of life
    D) reversal of pulmonary function decline
    C) improvement in the quality of life
    (this multiple choice question has been scrambled)
  266. What is the most cost effective method of supplemental O2 when nasal O2 at 2 lpm is ordered for a bed-bound pt in a one story home?

    A) concentrator
    B) bank of H cylinders
    C) portable liquid reservoir
    D) E cylinders
    A) concentrator
    (this multiple choice question has been scrambled)
  267. A pt arrives for a cardiopulmonary exercise test. After assessment, it is noted that the pt is experiencing an acute asthma exacerbation. What is the appropriate action?

    A) administer IV methylprednisolone and conduct the test
    B) notify the physician, escort the pt to the ED and reschedule the test
    C) administer albuterol and conduct the test
    D) perform the test
    B) notify the physician, escort the pt to the ED and reschedule the test
    (this multiple choice question has been scrambled)
  268. A pt is participating in a cardiopulmonary exercise test. After 3 minutes, the pt demonstrates a loss of color and c/o dizziness, the SpO2 drops from 91 to 78 & the ECG shows ischemic changes. What do you do?

    A) stop the test, let the pt rest, then resume
    B) continue the test
    C) immediately stop the test & notify the physician
    D) slow down the treadmill until the pt recovers
    C) immediately stop the test & notify the physician
    (this multiple choice question has been scrambled)
  269. A 31 YO female is being mechanically ventilated in the ICU. She is not sedated or paralyzed but is unresponsive to verbal or painful stimuli. There is an absence of of motor, pupillary, gag & cough reflexes/ Her temperature is 34.5 degrees Celsius. EEG shows no activity. What is the most appropriate action?

    A) withdraw mechanical ventilation
    B) continue curative treatments
    C) return pt to normal temperature & then perform tests
    D) conduct brain perfusion study or apnea test
    C) return pt to normal temperature & then perform tests
    (this multiple choice question has been scrambled)
  270. Which of the following is the most important hazard associated with CVL insertion?

    A) air embolism
    B) death
    C) severe hemorrhage
    D) pneumothorax
    D) pneumothorax
    (this multiple choice question has been scrambled)
  271. Checking the pleural drainage system after chest tube placement, the water seal compartment reveals bubbling: you should:

    A) check for loops or kinks in the tubing
    B) take no action: this is normal
    C) replace system as it is malfunctioning
    D) inspect insertion site for leaks
    B) take no action: this is normal
    (this multiple choice question has been scrambled)
  272. While assisting at a bedside percutaneous trach, after the tube is placed, you note acute onset of sub-q emphysema in the neck & the pt becomes dyspneic. Your assessment, the tube is:

    A) occluded
    B) too small
    C) malpositioned
    D) too large
    C) malpositioned
    (this multiple choice question has been scrambled)

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