crt 2

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crt 2
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  1. A pulse-dose oxygen device does not respond to a patient's inspiratory effort. To maintain oxygenation, a respiratory therapist's initial response should be to

    A.increase the pulse volume setting.
    B.recommend an arterial blood gas analysis.
    C.switch the unit to the continuous flow mode.
    D.decrease the sensitivity setting.
    C. Temporarily switching to continuous flow will provide the needed oxygen until the device can be evaluated.
    (this multiple choice question has been scrambled)
  2. The exhaled tidal volume of a patient receiving volume-controlled ventilation through an oral endotracheal tube has decreased from 450 to 380 mL. The respiratory therapist auscultates a gurgling sound over the upper part of the sternum. Which of the following should the therapist do NEXT?

    A.Extubate the patient.
    B.Advance the tube.
    C.Add air to the cuff.
    D.Continue current therapy.
    C. In this clinical setting, the most likely reason for a leak is an underinflated cuff.
    (this multiple choice question has been scrambled)
  3. An adult patient is receiving volume-controlled ventilation. The patient's peak airway pressure is 35 cm H2O and the plateau pressure is 25 cm H2O. The respiratory therapist should recommend setting the high pressure alarm at

    A.45 cm H2O.
    B.40 cm H2O.
    C.25 cm H2O.
    D.35 cm H2O.
    A. The high airway pressure alarm must be set above the peak airway pressure to ensure set tidal volume delivery. The guideline is 10 to 15 cm H2O ABOVE the peak inspiratory pressure.
    (this multiple choice question has been scrambled)
  4. A patient's cardiac output decreases from 4 to 2 L/min after 15 cm H2O PEEP is initiated. Which of the following should a respiratory therapist recommend?

    A.Perform an arterial blood gas analysis to check the patient's oxygenation.
    B.Maintain the present settings and check arterial blood gases in 1 hour.
    C.Decrease the respiratory rate to extend cardiac filling time.
    D.Decrease PEEP to 10 cm H2O and recheck the cardiac output.
    D. The sudden reduction in cardiac output of 50% is critical and should be addressed by an immediate reduction in PEEP. The initiation of 15 cm H2O PEEP appears to be the cause of the decreased cardiac output.
    (this multiple choice question has been scrambled)
  5. A patient is receiving volume-controlled, flow-limited ventilation. An inverse I:E visual alert is observed during a routine ventilator check. Which of the following adjustments is most appropriate to correct the problem?

    A.Decrease the tidal volume.
    B.Increase the flow.
    C.Increase the frequency setting.
    D.Activate the ratio limit control.
    B. Increasing the flow will shorten the inspiratory time and lengthen the expiratory time, which will restore an acceptable I:E and turn off the inverse ratio alert.
    (this multiple choice question has been scrambled)
  6. A patient has ventricular fibrillation with pre-existing metabolic acidosis. Which of the following medications should be administered after one defibrillation attempt, effective chest compressions, intubation, and hyperventilation with 100% oxygen?

    A.furosemide (Lasix)
    B.nitroprusside sodium (Nipride)
    C.epinephrine
    D.sodium bicarbonate
    C. Epinephrine is the first line medication for ventricular fibrillation.
    (this multiple choice question has been scrambled)
  7. An adult patient with ARDS has been receiving mechanical ventilation for 2 weeks. Nitric oxide therapy is in use at a dose of 10 ppm. The patient's PVR has recently changed from 190 to 150 dynes.s.cm-5, and the PaO2 is 90 torr with an FIO2 of 0.50. The nitric oxide dose should be changed to

    A.15 ppm.
    B. 0 ppm.
    C. 5 ppm.
    D.20 ppm.
    C. The patient's PVR has improved and may tolerate reduction in the nitric oxide dose. The concentration should be gradually decreased.
    (this multiple choice question has been scrambled)
  8. Which of the following questions should a respiratory therapist ask to determine whether a patient has orthopnea?

    A."Do you sleep with more than one pillow?"
    B."Do you wake up short of breath in the morning?"
    C."Do you have any chest pain?"
    D."Can you climb one flight of stairs?"
    A. A patient who props himself up with more than one pillow is exhibiting signs associated with orthopnea.
    (this multiple choice question has been scrambled)
  9. Stair climbing ability would provide information on
    exertional dyspnea
  10. A previously healthy 30-year-old patient is hospitalized with chills and fever. A chest radiograph is consistent with right upper lobe pneumonia. Which of the following is most likely to aid in the patient's management?

    A.coached coughing and deep breathing
    B.in-exsufflation
    C.spirometry before and after a bronchodilator
    D.bland aerosol therapy
    A. Coached coughing and deep breathing will assist the patient with secretion removal and help open the consolidated area.
    (this multiple choice question has been scrambled)
  11. During a bedside interview of a patient with COPD, a respiratory therapist asks the patient how he accepts the limitations of his daily activities. Which of the following is the therapist most likely assessing?

    A.emotional state
    B.level of cooperation
    C.exercise tolerance
    D.work of breathing
    A. The emotional state can be assessed by evaluating the patient's attitudes, thoughts, and motivational characteristics as part of the affective domain.
    (this multiple choice question has been scrambled)
  12. An air-entrainment mask will deliver an FIO2 higher than intended if

    A.the air-entrainment ports have been blocked.
    B.nebulized water is being added through the air-entrainment ports.
    C.the flow is set too high.
    D.corrugated tubing was added between the air-entrainment adapter and mask.
    A. If the air-entrainment ports have been blocked, room air cannot be entrained and the patient will receive a higher FIO2than expected.
    (this multiple choice question has been scrambled)
  13. A respiratory therapist determined that a patient receiving mechanical ventilation developed auto-PEEP due to dynamic airflow obstruction. Which of the following should the therapist do?

    A.Add mechanical dead space.
    B.Add an inspiratory plateau.
    C.Decrease the mandatory rate.
    D.Decrease the inspiratory flow.
    C. Decreasing the mandatory rate will decrease air trapping, causing a decrease in auto-PEEP by increasing expiratory time.
    (this multiple choice question has been scrambled)
  14. What is the approximate total flow that would be delivered from a 40% air-entrainment mask receiving 12 L/min of oxygen?

    A.12 L/min
    B.48 L/min
    C.52 L/min
    D.72 L/min
    • B. A 40% air-entrainment mask entrains air at a ratio of (3)air:(1)O2.
    • Let x = O2 flow in L/min3x = air entrained3x + x = total flow3(12) + 12 = total flow= 48 L/min.
  15. A neonate is receiving oxygen therapy by a hood. Which of the following should a respiratory therapist select to check the accuracy of the air-oxygen blender?

    A.pulse oximeter
    B.pneumotachometer
    C.line pressure manometer
    D.galvanic cell
    D. A galvanic cell can be used to monitor oxygen concentration inside the hood and check the accuracy of the blender.
    (this multiple choice question has been scrambled)
  16. A 50-year-old patient with a tracheostomy is receiving volume-controlled ventilation. The high pressure alarm is sounding intermittently and the exhaled tidal volume is reduced. Which of the following should a respiratory therapist do?

    A.Administer a beta-agonist.
    B.Increase the high pressure alarm setting.
    C.Suction the tracheostomy tube.
    D.Change the mode of ventilation.
    C. Suctioning the patient will allow delivery of the set tidal volume by decreasing airway resistance.
    (this multiple choice question has been scrambled)
  17. A 55-year-old patient has the following examination results:
    -dullness to percussion
    -decreased tactile fremitus-dry non-productive cough
    -diminished breath sounds
    -dyspnea

    Which of the following could produce these findings?
    A.pleural effusion
    B.consolidation
    C.pneumothorax
    D.atelectasis
    A- dullness
  18. Bilateral rhonchi are heard when examining a patient's chest. Which of the following procedures should a respiratory therapist perform after the patient coughs to determine the effectiveness of the cough?

    A.forced vital capacity
    B.auscultation
    C.maximum expiratory pressure (MEP)
    D.sputum culture
    B. Auscultation would provide evidence of the effectiveness of the cough in mobilization and expectoration of secretions.
    (this multiple choice question has been scrambled)
  19. Which of the following is the best aerosolized bronchodilator for a patient with an acute asthma exacerbation?

    A.salmeterol (Serevent)
    B.tiotropium (Spiriva)
    C.ipratropium bromide (Atrovent)
    D.albuterol (Proventil)
    D. A fast-acting beta2-agonist is the appropriate treatment for acute bronchospasm.
    (this multiple choice question has been scrambled)
  20. A respiratory therapist wants to change the I:E on a volume-controlled ventilator delivering a constant flow. Which of the following controls can be adjusted to accomplish this change?

    1. volume
    2. mandatory rate
    3. sensitivity
    4. inspiratory flow
    • 1
    • 2
    • 4
  21. A respiratory therapist is reviewing the plan of care for a patient diagnosed with cystic fibrosis. The patient uses an albuterol HFA as needed, inhales nebulized 7% NaCl two times daily, and used the HFCWO vest three times daily. The patient was hospitalized three times in the past year due to pneumonia. Which of the following should the therapist recommend be added to the care plan for the patient?

    A.aerosolized acetylcysteine (NAC)
    B.dornase alfa (Pulmozyme)
    C.postural drainage with percussion
    D.positive expiratory pressure
    B. Dornase alfa has been shown to decrease viscosity of sputum in persons with cystic fibrosis and to decrease the frequency of exacerbations requiring hospitalization.
    (this multiple choice question has been scrambled)
  22. A patient who is receiving mechanical ventilation is breathing asynchronously with the ventilator. Breath sounds are absent on the left, with dullness to percussion and a left shift of the trachea. Which of the following is the most likely explanation for these findings?

    A.A tension pneumothorax has developed on the left.
    B.The patient is experiencing diffuse bronchospasm.
    C.A tracheoesophageal fistula has developed.
    D.The endotracheal tube is in the right mainstem bronchus.
    D. The described signs and symptoms are consistent with right endobronchial intubation and subsequent left atelectasis.
    (this multiple choice question has been scrambled)
  23. Monitoring serum electrolytes is indicated in patients who are receiving

    A.analgesics
    B.sedatives.
    C.diuretics.
    D.surfactants.
    C. Diuretics may lower serum electrolyte levels, so it is important to monitor electrolyte levels in patients receiving diuretic therapy.
    (this multiple choice question has been scrambled)
  24. Which of the following is the best method to monitor the effectiveness of equipment sterilization?

    A.heat sensitive tape
    B.time and temperature graphs
    C.biologic indicators
    D.chemical sensitive indicators
    C. Biologic indicators are actual indicators that microorganisms have been killed in the package.
    (this multiple choice question has been scrambled)
  25. A respiratory therapist notes a patient has a heart rate of 150/min prior to beginning bronchodilator therapy. The therapist should

    A.recommend obtaining an arterial blood gas sample.
    B.notify the patient's nurse and inform the physician.
    C.administer the treatment as prescribed.
    D.record the patient's heart rate and return in 1 hour.
    B. Communicating with the physician and nurse is appropriate. They may provide more information about the patient, and the physician may consider changing the prescription.
    (this multiple choice question has been scrambled)
  26. Which of the following are indications of sudden upper airway obstruction?

    1. retraction of intercostal spaces
    2. marked use of the accessory muscles of ventilation
    3. an elevation in body temperature
    4. panic
    • 1
    • 2
    • 4
  27. A 32-week-gestational age neonate has apneic episodes with bradycardia. A respiratory therapist should recommend

    A.methylprednisolone sodium succinate (Solu-Medrol).
    B.caffeine citrate.
    C.albuterol.
    D.indomethacin (Indocin).
    B. Caffeine citrate stimulates the immature central nervous system and reduces the frequency of episodes of apnea of prematurity.
    (this multiple choice question has been scrambled)
  28. Two hours after placing a 30-week gestational age infant in an oxygen hood with an FIO2 of 0.28, a respiratory therapist observes an SpO2 of 98%. Which of the following should the therapist do?

    1. Wean the FIO2.
    2. Recommend initiation of nasal CPAP.
    3. Recommend administration of a surfactant.
    4. Verify that the oximeter and ECG heart rates correlate.
    • 1
    • 4
  29. A respiratory therapist is called to evaluate a patient in moderate respiratory distress. The patient is tachypneic and using supplemental oxygen by nasal cannula at 2 L/min. Pulse oximetry shows SpO2 82%. Which of the following should be the therapist's first intervention?

    A.Increase the nasal cannula flow to 4 L/min.
    B.Obtain a chest radiograph.
    C.Administer oxygen by a nonrebreathing mask.
    D.Obtain an arterial blood gas analysis.
    C. The significant hypoxemia indicated by the SpO2 should be treated immediately.
    (this multiple choice question has been scrambled)
  30. Which of the following values is most commonly used to evaluate an individual's response to inhaled bronchodilators?

    A.diffusing capacity
    B.FEV1
    C.FEF200-1200
    D.FVC
    B. FEV1 is the best indicator of reversible airway obstruction in response to inhaled bronchodilators.
    (this multiple choice question has been scrambled)
  31. A patient who is receiving mechanical ventilation requires an FIO2 of 0.70 and a PEEP of 10 cm H2O to maintain an acceptable PaO2. The patient is restless and has become disconnected from the ventilator circuit several times, during which she experiences cardiac rhythm disturbances. A respiratory therapist should recommend

    A.sedating the patient.
    B.decreasing the PEEP level.
    C.extubating the patient to a nonrebreathing mask.
    D.attempting to wean the patient with a T-piece.
    A. Sedation is required to eliminate excessive activity so that the patient's cardiopulmonary status can be properly evaluated and treated.
    (this multiple choice question has been scrambled)
  32. ______ is a primary treatment for CHF. Oxygen content is maximized at a pO2 of 100.
    cpap
  33. A patient with asthma is to receive small volume nebulizer treatments with 5 mg albuterol every 4 hours. After the first treatment, the patient's heart rate increased from 80 to 130/min, respiratory rate increased from 18 to 22/min, and blood pressure increased from 130/80 to 150/90 mm Hg. Which of the following is most appropriate for the second treatment?

    A.Add 4 mL of normal saline to the nebulizer.
    B.Decrease the albuterol dose to 2.5 mg.
    C.Change the frequency of treatments to every 6 hours.
    D.Continue the treatments as ordered.
    B. The patient is experiencing an adverse reaction to the current dose of beta-agonist therapy. The dose should be reduced before continuing treatments.
    (this multiple choice question has been scrambled)
  34. Three liters of air are injected into a spirometer from a certified-volume standard syringe. The measured value is 2.6 L. Which of the following should the respiratory therapist conclude about the disparity?

    A.The difference is within the acceptable error range.
    B.The time scale was incorrectly calibrated.
    C.The plunger was pushed too slowly.
    D.There was a leak in the system.
    D. A leak is the likely cause for the difference of 400 mL and is one of the reasons for checking spirometers with a calibrated syringe.
    (this multiple choice question has been scrambled)
  35. An oropharyngeal airway is LEAST appropriate for a

    A.conscious patient.
    B.postoperative patient.
    C.heavily sedated patient.
    D.patient who requires bag-and-mask ventilation.
    A. A conscious patient would not usually be able to tolerate an oropharyngeal airway due to the gag reflex.
    (this multiple choice question has been scrambled)
  36. A patient is receiving oxygen by a nonrebreathing mask. The reservoir bag completely empties during inspiration. A respiratory therapist should

    A.adjust the flow until the reservoir bag remains partially inflated at end-inspiration.
    B.remove leaflet valves from exhalation ports.
    C.remove the one-way valve between the reservoir bag and the mask.
    D.increase the oxygen liter flow by 5 L/min.
    A. The flow should be increased to ensure adequate volume in the reservoir bag throughout each breath.
    (this multiple choice question has been scrambled)
  37. A patient receiving volume-controlled ventilation develops a marked increase in peak pressure while the plateau pressure remains unchanged. Which of the following is the most likely explanation?

    A.pneumothorax
    B.increased dynamic compliance
    C.pulmonary edema
    D.bronchospasm
    D. An increase in peak pressure is associated with a narrowing in the conducting airways. With pure bronchospasm, plateau pressure remains unchanged.
    (this multiple choice question has been scrambled)
  38. Pulmonary edema and pneumothorax cause a decrease in _____ lung compliance
    static
  39. A patient receiving mechanical ventilation had a total fluid intake of 4200 mL and a total fluid output of 1200 mL over a 24-hour period. Which of the following might increase in this situation?

    1. lung compliance
    2. peak inspiratory pressure
    3. P(A-a)O2
    4. hematocrit
    • 2
    • 3
  40. A patient is receiving an FIO2 of 0.40 by a heated nebulizer connected to a T-piece. Five hours later, the FIO2 analyzed at the nebulizer side of the T-piece is 0.45. Which of the following should the respiratory therapist do to correct the problem?

    A.Replace the nebulizer.
    B.Increase the flow to the nebulizer.
    C.Clear the nebulizer jet.
    D.Empty the condensate from the aerosol tubing.
    D. Condensate in the tubing would cause a higher FIO2 by increasing back pressure to the air entrainment port, therefore reducing the dilution of oxygen with air.
    (this multiple choice question has been scrambled)
  41. A patient complains of a chronic cough usually accompanied by sputum production. Which of the following conditions does the patient most likely have?

    A.pneumonia
    B.bronchitis
    C.asthma
    D.emphysema
    B. Bronchitis is characterized by cough and sputum production.
    (this multiple choice question has been scrambled)
  42. Following intubation with an 8.0-mm ID endotracheal tube, how much air should be placed into the cuff?

    A.enough to prevent a leak at peak inspiration
    B.a minimum of 8 mL
    C.enough to produce a pressure of 25 cm H2O
    D.enough to provide tension to the pilot balloon
    A. The cuff should be inflated to the lowest pressure and volume required to prevent minimal loss of volume during positive pressure breaths. Ideally, pressure should be less than 25 cm H2O.
    (this multiple choice question has been scrambled)
  43. A patient had a tracheostomy for several weeks and was recently weaned from ventilatory support. Which of the following devices will allow decannulation of the trachea and maintain the patency of the stoma?

    A.transtracheal catheter
    B.oropharyngeal airway
    C.laryngeal mask airway (LMA)
    D.tracheostomy button
    D. A tracheostomy button maintains a stoma and allows decannulation of the trachea.
    (this multiple choice question has been scrambled)
  44. Which of the following would provide the most information about a patient's orientation to time and place?

    1. The patient knows she is in a hospital.
    2. The patient knows her diagnosis.
    3. The patient recognizes her physician.
    4. The patient correctly states the year.
    • 1
    • 4
  45. A 28-year-old victim of a motor vehicle crash is in the ICU receiving mechanical ventilation with 10 cm H2O PEEP. The PEEP is increased to 15 cm H2O. Which of the following indicates an adverse effect?

    A.increased FRC
    B.hypertension
    C.increased peripheral perfusion
    D.decreased urinary output
    D. PEEP may cause decreased venous return, which will decrease both the cardiac output and the urinary output.
    (this multiple choice question has been scrambled)
  46. Which of the following values for arterial carbon dioxide tension is consistent with alveolar hyperventilation?

    A.50 torr
    B.60 torr
    C.40 torr
    D.30 torr
    D. An arterial carbon dioxide tension of 30 torr reflects alveolar hyperventilation as it results in a decreased arterial carbon dioxide tension in the blood.
    (this multiple choice question has been scrambled)
  47. The reason a capnographic tracing starts low and then increases is

    A.ventilation/perfusion.
    B.dead space ventilation.
    C.mixed alveolar ventilation.
    D.alveolar ventilation.
    B. At the beginning of exhalation, dead space volume contains very little CO2 because it contains the inhaled gas. As exhalation progresses, the dead space volume will be exhaled first, followed by alveolar gas containing more CO2.
    (this multiple choice question has been scrambled)
  48. Which of the following findings indicate a patient who is weaning from mechanical ventilation has decreased muscle strength?

    1. reduced maximum inspiratory pressure (MIP)
    2. decreased tidal volume
    3. decreased PaCO2
    4. decreased vital capacity
    • 1
    • 2
    • 4
  49. When evaluating a patient receiving mechanical ventilation, a respiratory therapist notes secretions in the expiratory limb of the ventilator circuit. The therapist should

    A.immediately extubate the patient.
    B.manually ventilate the patient and change the circuit.
    C.suction the patient and obtain a sputum sample.
    D.suggest diuresis for the patient.
    B. Because the circuit is soiled, it must be changed.
    (this multiple choice question has been scrambled)
  50. Three days postoperatively, a patient is febrile and the white blood cell count is 18,000/mm3. A chest radiograph shows patchy bilateral infiltrates with air bronchograms. Which of the following is the most probable diagnosis?

    A.atelectasis
    B.pulmonary edema
    C.pneumonia
    D.pleural effusion
    C. Pneumonia presents with the described symptoms
    (this multiple choice question has been scrambled)
  51. Which of the following are characteristic findings in patients with emphysema?

    1. ventilatory accessory muscle atrophy
    2. flattening of the hemidiaphragms
    3. an increased AP diameter on a chest radiograph
    4. a decreased FEV1
    • 2
    • 3
    • 4
  52. When suctioning a 3-year-old child who is intubated, the negative pressure should be set to

    A.-80 to -100 mm Hg.
    B.-180 to -200 mm Hg.
    C.maximum negative pressure.
    D.-30 to -50 mm Hg.
    A. Correct. Suction pressures are as follows: Infant: -60 to -80 mm Hg; Child: -80 to -100 mm Hg; Adult: -100 to -120 mm Hg.
    (this multiple choice question has been scrambled)
  53. A patient with chronic hypercapnia is to receive oxygen at home by nasal cannula at 2 L/min. A respiratory therapist should advise the patient to ensure the oxygen flow does not exceed 2 L/min because excessive oxygenation may

    A.dry secretions.
    B.decrease breathing.
    C.trigger retinopathy.
    D.cause oxygen toxicity.
    B. Patients with chronic hypercapnia breathe in response to hypoxic stimulation of aortic and carotid receptors. Excessive supplemental oxygen may suppress the hypoxic ventilatory drive and result in hypoventilation.
    (this multiple choice question has been scrambled)
  54. Which of the following should the respiratory therapist do when a physician has written orders for respiratory care that do not meet facility policies?

    A.Ignore the order and not administer the therapy
    .B.Carry out the order without questions.
    C.Carry out the order with modifications.
    D.Ask the physician to clarify the order.
    D. It is the physician's responsibility to clarify and supply all elements of the order.
  55. Which of the following may be caused by the administration of aerosolized pentamidine isethionate (NebuPent)?

    A.bronchospasm
    B.bradycardia
    C.hypotension
    D.tachycardia
    A. Bronchospasm is the most frequently reported adverse effect associated with the use of NebuPent.
    (this multiple choice question has been scrambled)
  56. A patient who is receiving volume-controlled ventilation has a sudden increase in airways resistance. Which of the following will change?

    A.peak inspiratory pressure
    B.PEEP
    C.oxygen concentration
    D.rate
    A. Attempting to deliver the set volume at the set flow with an increase in airways resistance will result in the ventilator generating greater inspiratory pressures.
    (this multiple choice question has been scrambled)
  57. A patient vomits during manual resuscitation (bag-valve-mask) ventilation. The respiratory therapist resumes bag-mask ventilation after suctioning the patient's upper airway. However, squeezing the resuscitator results in little volume delivery to the patient, as evidenced by diminished chest movement, very little resistance to squeezing the resuscitator, and a "hissing" sound during inspiration. The therapist should

    A.reposition the patient.
    B.increase the depth and frequency of ventilation.
    C.suction the patient again.
    D.replace the manual resuscitator (bag-valve-mask).
    D. The bag-valve device is not functioning properly and must be replaced.
    (this multiple choice question has been scrambled)
  58. Activity of respiratory accessory muscles most likely indicates

    A.normal ventilation
    .B.increased pulmonary compliance.
    C.increased airways resistance
    .D.decreased work of breathing.
    C. Increased airways resistance requires the patient to use accessory muscles to move air through narrowed airways.
  59. A 58-year-old male with a history of bronchiectasis arrives in the emergency department complaining of severe chest pain. Arterial blood gas values on air reveal chronic respiratory acidosis with hypoxemia. Which of the following should the respiratory therapist recommend?

    A.nasal cannula at 2 L/min
    B.40% air-entrainment mask at 8 L/min
    C.partial rebreathing mask at 10 L/min
    D.simple oxygen mask at 10 L/min
    A. Administering oxygen at 2 L/min by a nasal cannula would treat the hypoxemia with minimal risk of hypoventilation.
    (this multiple choice question has been scrambled)
  60. A patient has a mandibular fracture and must be suctioned. Which of the following is best to use in this situation?

    A.oropharyngeal airway
    B.laryngeal mask airway
    C.nasopharyngeal airway
    D.tracheostomy
    C. The nasopharyngeal airway facilitates suctioning and does not require opening the patient's mouth.
    (this multiple choice question has been scrambled)
  61. A physician has ordered lung expansion therapy for a patient with atelectasis. The patient had a recent right lower lobectomy. Upon examination, the patient is alert, is oriented, and has a nonproductive cough. Which of the following should a respiratory therapist recommend?

    A.chest physiotherapy and postural drainage
    B.IPPB
    C.vibratory PEP
    D.incentive spirometry
    D. Incentive spirometry provides a visual cue to enhance deep breathing and patient cooperation.
    (this multiple choice question has been scrambled)
  62. A patient is receiving ventilation from a bag-valve-mask resuscitator. Although little chest movement by the patient is noted, the bag fills rapidly and collapses on minimal pressure. Which of the following may be the cause of the problem?

    A.plugged endotracheal tube
    B.missing inlet valve
    C.excessive oxygen flow
    D.occluded oxygen reservoir
    B. The condition described would be caused by a missing inlet valve.
    (this multiple choice question has been scrambled)
  63. A respiratory therapist attaches a test lung to the circuit of a ventilator during a pre-use check. Which of the following is BEST for the therapist to measure prior to initiating volume-controlled ventilation to evaluate the function of the ventilator and circuit?

    A.pressure at the Y connector
    B.volume distal to the exhalation valve
    C.volume at the humidifier outlet
    D.pressure at the proximal airway
    B. This procedure will ensure that the circuit is tight and delivering the desired tidal volume.
    (this multiple choice question has been scrambled)
  64. The most likely cause of bilateral fluffy infiltrates on a chest radiograph is

    A.pulmonary edema.
    B.hemothorax.
    C.pleural effusion.
    D.neoplasm.
    A. The fluffy-appearing infiltrates in both lungs are consistent with the increased interstitial and alveolar fluid in pulmonary edema.
    (this multiple choice question has been scrambled)
  65. A 78-year-old patient suffers an unwitnessed respiratory arrest. As a first responder, a respiratory therapist is unable to deliver two breaths. Which of the following is the therapist's next action?

    A.Reposition and attempt to ventilate the patient.
    B.Perform up to five abdominal thrusts.
    C.Perform a finger sweep.
    D.Administer up to five back blows.
    A. The patient should be repositioned and ventilation attempted again to assure that the airway is properly opened. This step helps to rule out poor head-tilt, chin-lift technique.
    (this multiple choice question has been scrambled)
  66. Which of the following statements supports the use of a heated humidifier instead of a nebulizer to provide high humidity therapy in an oxygen hood for an infant?

    A.Total gas flow to the patient can be increased.
    B.A higher FIO2 can be maintained.
    C.More uniform particle size is produced.
    D.There is decreased risk of nosocomial infection.
    D. Transport of bacteria through aerosol droplets is more likely than transport of airborne bacteria via humidifier.
    (this multiple choice question has been scrambled)
  67. A pH less than 7.30 with a corresponding PaCO2 greater than 50 torr in the absence of metabolic compensation is interpreted as
    acute respiratory acidosis.
  68. Which of the following controls, when adjusted independently, can increase expiratory time during time-triggered, volume-controlled ventilation?

    1. sensitivity
    2. rate
    3. flow
    4. volume
    • 2
    • 3
    • 4
  69. A v/q scan reveals ventilation and perfusion are EQUALLY decreased in the right mid-lung field. With which of the following is this finding compatible?

    1. acute pulmonary embolus
    2. bronchogenic carcinoma
    3. pneumonia
    4. atelectasis
    • 2
    • 3
    • 4
  70. A respiratory therapist is calibrating a thermal conductivity helium analyzer. What should the analyzer read when calibrated in air?

    A.100%
    B. 0%
    C. 79%
    D. 21%
    B. Air contains essentially no helium; therefore, it should read zero.
    (this multiple choice question has been scrambled)
  71. A respiratory therapist cannot arouse a previously alert patient. The therapist's next action should be to

    A.call for help.
    B.check for a pulse
    .C.open the patient's airway.
    D.determine whether the patient is breathing.
    A. The first step after determining a person has become unresponsive is to call for help.
  72. _______ should follow calling for help, checking for breathing, opening the airway, and beginning rescue breathing.
    checking for pulse
  73. An endotracheal tube cuff fails to inflate after injection of 20 mL of air prior to an emergent intubation. A respiratory therapist should

    A.inject another 10 mL of air.
    B.replace the tube.
    C.check the valve on the pilot tube.
    D.check the cuff for tears.
    B. Replacing the tube allows the emergent intubation to take place in a timely manner. The potentially defective tube can be evaluated after the emergency is over.
    (this multiple choice question has been scrambled)
  74. A patient who is comatose is receiving mechanical ventilation. The PaCO2 can be increased by increasing the

    A.tidal volume.
    B.respiratory rate.
    C.mechanical dead space.
    D.inspiratory time.
    C. Adding mechanical dead space increases rebreathed volume, elevating PaCO2.
    (this multiple choice question has been scrambled)
  75. While checking a patient's progress notes, a respiratory therapist reviews a physician's treatment plan that includes changes in respiratory care. The therapist's most appropriate action is to

    A.confer with the patient's nurse about when to implement the changes.
    B.review the planned changes with the shift supervisor.
    C.check to see whether there are new respiratory care orders.
    D.initiate the physician's changes immediately.
    C. Despite notation in the physician's progress notes, treatment changes require a physician's order.
    (this multiple choice question has been scrambled)
  76. Which of the following is the best emergency back-up for a hospital's bulk liquid oxygen system?

    A.portable E cylinders
    B.oxygen concentrators
    C.secondary liquid supply
    D.portable liquid system
    C. A secondary liquid supply is the best choice for back-up in case of failure of a bulk liquid O2 system.
    (this multiple choice question has been scrambled)
  77. A gas is saturated with 100% relative humidity at 32.2° C (90° F). As the gas cools to 26.7° C (80° F), the relative humidity will

    A.decrease as a result of cooling of the gas.
    B.remain 100% and excess water will rain out.
    C.decrease as water condenses.
    D.increase by 10%.
    B. Reduction in temperature will result in a constant 100% relative humidity and cause water vapor to condense ("rain out").
    (this multiple choice question has been scrambled)
  78. Which of the following is the best way to communicate a patient's clinical status to the appropriate members of the healthcare team?

    A.Record information in the patient's chart.
    B.Report information to the respiratory care supervisor.
    C.Record information in the respiratory therapy department records.
    D.Report information to the next shift of the respiratory care staff.
    A. By recording the information in the patient's legal record, it will be available to all appropriate members of the healthcare team.
    (this multiple choice question has been scrambled)
  79. Prior to suctioning the endotracheal tube of a patient who is being ventilated with an FIO2 of 0.40, a respiratory therapist should do which of the following FIRST?

    A.Lubricate the catheter.
    B.Increase the FIO2 to 1.0
    .C.Cleanse the catheter with water.
    D.Administer an FIO2 of 0.40 via T-piece.
    B. A patient should be hyperoxygenated prior to each suctioning attempt to minimize hypoxemia.
  80. A respiratory therapist assesses a patient receiving supplemental oxygen by a transtracheal oxygen catheter. The patient is diaphoretic, has a higher than normal respiratory rate, and appears cyanotic. Which of the following is a possible explanation?

    A.The flow going to the transtracheal catheter is too high.
    B.There is excess humidity in the transtracheal system.
    C.The transtracheal catheter is obstructed by a mucus plug.
    D.The transtracheal catheter is advanced too far into the airway.
    C. Mucus plugging would decrease or stop oxygen flow to the patient, resulting in hypoxia and related symptoms and signs.
    (this multiple choice question has been scrambled)
  81. A respiratory therapist observes the activation of the low exhaled tidal volume alarm on the ventilator of a patient receiving volume-controlled ventilation. A gurgling sound is heard with each inhalation. The therapist should

    A.evaluate the endotracheal tube cuff.
    B.decrease the inspiratory flow.
    C.increase the tidal volume.
    D.change the endotracheal tube.
    A. Loss of volume in the cuff can be easily assessed and corrected in seconds.
    (this multiple choice question has been scrambled)
  82. Which of the following is the most significant factor leading to the development of tracheomalacia?

    A.cuff pressure on the tracheal wall
    B.tube length
    C.intracuff volume
    D.trauma during intubation
    A. Excessive pressure on the tracheal wall by the cuff would inhibit mucosal blood flow resulting in necrosis, which is the most significant factor leading to tracheomalacia.
    (this multiple choice question has been scrambled)
  83. Which of the following medications administered in the therapeutic range is most likely to interfere with a patient's ability to cooperate?

    A.cortisone
    B.phenobarbital
    C.furosemide (Lasix)
    D.theophylline (Aminophylline)
    B. Phenobarbital is a long-acting barbiturate of the sedative/hypnotic class and can interfere with a patient's ability to cooperate.
    (this multiple choice question has been scrambled)
  84. Stridor is noted immediately after extubation of a patient. A respiratory therapist should recommend

    A.administering nebulized steroids.
    B.administering nebulized racemic epinephrine.
    C.initiating cool bland aerosol therapy.
    D.inserting a nasopharyngeal airway.
    B. Racemic epinephrine is often used for its strong alpha-adrenergic vasoconstricting effects to reduced airway swelling after extubation.
    (this multiple choice question has been scrambled)
  85. A postoperative patient suddenly develops stabbing right-sided chest pain with decreased right-sided breath sounds. Which of the following is indicated?

    A.vital capacity measurement
    B.VD/VT ratio
    C.shunt study
    D.chest radiograph
    D. These symptoms are characteristic of a pneumothorax. A chest radiograph is the most appropriate initial diagnostic study.
    (this multiple choice question has been scrambled)
  86. A patient who is obese is receiving aerosol by tracheostomy collar 48 hours post-tracheostomy. A respiratory therapist notices acute respiratory distress after the patient is turned from side to side for a bath. The therapist is unable to pass a suction catheter. Which of the following should the therapist do next?

    A.Irrigate the airway with normal saline.
    B.Ventilate with a bag-valve-mask resuscitator.
    C.Reposition the tracheostomy tube.
    D.Suction the airway using a smaller catheter.
    B. The tracheostomy tube has been displaced. Ventilating with a bag-valve-mask will permit sufficient time to reinsert the tube under controlled conditions.
    (this multiple choice question has been scrambled)
  87. The urine output of a critically ill patient may be directly affected by which of the following?

    1. antidiuretic hormone (ADH) levels
    2. arterial blood pressure
    3. antibiotic therapy
    4. the use of PEEP
    • 1
    • 2
    • 4
  88. Which of the following is the most effective for destroying all microorganisms?

    A.acetic acid
    B.pasteurization
    C.isopropyl alcohol
    D.autoclave
    D. Autoclaving uses super-heated steam under pressure and will kill almost all microorganisms.
    (this multiple choice question has been scrambled)
  89. ____ is a process of high level disinfection, and is not designed to kill all microorganisms.
    Pasteurization
  90. ____ is effective in killing bacteria, but has variable viricidal capabilities and is not sporicidal.
    Isopropyl alcohol
  91. Which of the following pharmacologic agents should be recommended for a patient who is intubated, receiving mechanical ventilation, and experiencing severe pain from a flail chest?

    A.midazolam HCl (Versed)
    B.lorazepam (Ativan)
    C.morphine sulfate
    D.oxycodone (Percocet)
    C. Morphine sulfate is a narcotic analgesic indicated for moderate to severe pain and is the appropriate choice.
    (this multiple choice question has been scrambled)
  92. Which of the following drugs is the most appropriate to sedate a 30-year-old patient with status asthmaticus and hypotension who is receiving mechanical ventilation?

    A.morphine
    B.vecuronium bromide (Norcuron)
    C.cisatracurium (Nimbex)
    D.lorazepam (Ativan)
    D. Lorazepam is the appropriate sedative in this case.
    (this multiple choice question has been scrambled)
  93. muscle paralyzing agent.
    Vecuronium bromide
  94. Which of the following best reflects the adequacy of ventilation?

    A.FEF25-75%
    B.PaCO2
    C.vital capacity
    D.PaO2
    B. The arterial level of CO2 reflects the alveolar CO2 and is the best indication of the adequacy of ventilation.
    (this multiple choice question has been scrambled)
  95. A patient is suspected of having an upper airway obstruction. Which of the following tests should the respiratory therapist recommend to best detect this abnormality?

    A.nitrogen washout
    B.flow-volume loops
    C.FEF25-75%
    D.RV/TLC
    B. The ability to measure and display both inspiratory and expiratory flows is the best way to detect upper airway obstruction.
    (this multiple choice question has been scrambled)
  96. A patient's heart rate drops from 82 to 40/min immediately after a suction catheter is inserted into the trachea and before suction is applied to the airway. Which of the following is the most probable cause?

    A.hypoxemia
    B.vagal reflex
    C.mucosal trauma
    D.hypercapnia
    B. Stimulation of vagal receptors in the tracheobronchial tree causes abrupt reflex slowing of the heart rate.
    (this multiple choice question has been scrambled)
  97. A respiratory therapist is unable to pass a 14 Fr suction catheter through a 7.5-mm ID nasotracheal tube. Repositioning the head of the patient does not allow passage of the catheter. Which of the following should the respiratory therapist do?

    A.Recommend reintubation orally.
    B.Perform subglottic suction.
    C.Suction with a 12 Fr catheter.
    D.Instill normal saline into the tube.
    C. Use of a smaller suction catheter may permit clearance of airway secretions.
    (this multiple choice question has been scrambled)
  98. While assembling a laryngoscope and blade for intubation, it 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 replaced.
    B.The light bulb should be checked to ensure it is tight.
    C.The laryngoscope batteries should be replaced.
    D.The laryngoscope blade should be exchanged.
    B. The first step to attempt to correct the light malfunction is to make sure the light bulb is tight.
    (this multiple choice question has been scrambled)
  99. A patient who is postoperative and is still under the effects of anesthesia is snoring loudly. The SpO2 has been decreasing. A respiratory therapist repositions the patient's head but the problem persists. Which of the following devices is the most appropriate to use next?

    A.nasal cannula
    B.laryngeal mask airway
    C.nasopharyngeal airway
    D.endotracheal tube
    C. A nasopharyngeal airway can be used to relieve the airway obstruction and is less invasive than a laryngeal mask airway or endotracheal tube.
    (this multiple choice question has been scrambled)
  100. A 27-year-old male patient has mild asthma. The patient's pulse is 80/min before administration of an aerosolized bronchodilator. The patient's pulse rises and stabilizes at 92/min during the treatment. Which of the following should a respiratory therapist do?

    A.Terminate the treatment and notify the head nurse.
    B.Continue the treatment as ordered.
    C.Continue the treatment with normal saline.
    D.Terminate the treatment and document in the progress notes.
    B. The heart rate response is within normal limits.
    (this multiple choice question has been scrambled)
  101. A physician orders 1 mg of medication to be administered by aerosol. If the concentration of a stock solution is 0.04%, how many mL of the solution must be administered?

    A.0.80
    B.0.40
    C.0.25
    D.2.50
    D. 0.04% = 0.4 mg/mL;

    divide the desired dosage (1 mg) by the actual concentration: 1 mg/0.4 mg/mL = 2.5 mL
    (this multiple choice question has been scrambled)
  102. During manual bag-valve ventilation through an endotracheal tube, inadequate ventilation is noted. This may be caused by

    1. a deflated endotracheal tube cuff.
    2. lack of oxygen reservoir.
    3. high pulmonary compliance.
    4. incorrect tube placement.
    • 1
    • 4
  103. A 1-month-old infant who is receiving pressure-limited, time-cycled ventilation has a peak pressure of 36 cm H2O and a mean airway pressure of 21 cm H2O. A respiratory therapist shortens the inspiratory time. Which of the following responses is expected?

    A.increased tidal volume
    B.increased compliance
    C.decreased expiratory time
    D.decreased mean airway pressure
    D. Shortening inspiratory time will decrease the length of time the pressure is applied to the airway, thereby decreasing mean airway pressure.
    (this multiple choice question has been scrambled)
  104. A 58-year-old male presents to the emergency department with bilateral expiratory wheezes, unresponsive to aerosolized beta-agonists. Which of the following is the most appropriate for acute management of this patient?

    A.subcutaneous epinephrine
    B.80%/20% heliox
    C.fluticasone/salmeterol (Advair)
    D.systemic steroids
    D. According to NHLBI Guidelines, systemic steroids are the medication of choice in patients unresponsive to short-acting beta-agonists.
    (this multiple choice question has been scrambled)
  105. Common complications associated with arterial punctures include

    1. fistula formation.
    2. hematoma formation.
    3. spasm of the vessel.
    4. pulmonary embolism.
    • 2
    • 3
  106. To assess the movement of the diaphragm by inspection, a respiratory therapist should look for which of the following with each breath?

    A.anteroposterior chest diameter
    B.intercostal retraction
    C.chest wall movement
    D.abdominal movement
    D. The contraction and descent of the diaphragm displaces the abdominal contents causing an outward movement of the abdominal wall.
    (this multiple choice question has been scrambled)
  107. A patient is receiving non-invasive positive pressure ventilation by full-face mask. Initial measurements are:

    IPAP 15 cm H2O
    EPAP 5 cm H2O
    Oxygen 3 L/min
    Measured tidal volume 460-600 mL

    Three hours later, the measured tidal volume is 300-400 mL with the same settings. Which of the following could explain the decreased tidal volume?

    1. inadequate oxygen flow
    2. gastric distension
    3. decreased compliance
    4. increased diuresis
    • 2
    • 3
  108. Which of the following medications should the respiratory therapist recommend to anesthetize a patient's airway prior to a flexible bronchoscopy procedure?

    A.ketamine
    B.lidocaine HCl (Xylocaine)
    C.midazolam HCl (Versed)
    D.vecuronium bromide (Norcuron)
    B. Lidocaine is a topical anesthetic and will reduce airway reflexes during the procedure.
    (this multiple choice question has been scrambled)
  109. Addition of an inspiratory hold (plateau) during volume-controlled ventilation will result in

    A.increased mean airway pressure.
    B.increased tidal volume.
    C.decreased inspiratory time.
    D.decreased inspiratory flow.
    A. Mean airway pressure is increased with an inspiratory hold.
    (this multiple choice question has been scrambled)
  110. Expiratory grunting in a 32-week gestational age neonate who is in respiratory distress will

    A.decrease apneic episodes
    .B.decrease atelectasis.
    C.increase the PaCO2.
    D.increase blood flow to the vena cava.
    B. An expiratory grunt occurs when the infant exhales against a partially closed glottis in an attempt to increase functional residual capacity and promote end-expiratory alveolar stability.
  111. Which of the following drugs is most appropriate to recommend as a substitute for albuterol?

    A.pirbuterol acetate (Maxair)
    B.beclomethasone (Vanceril)
    C.acetylcysteine
    D.racemic epinephrine (Vaponefrin)
    A. Pirbuterol acetate is a beta2 agonist that may be an appropriate substitute for albuterol.
    (this multiple choice question has been scrambled)
  112. A respiratory therapist notes a patient who is receiving mechanical ventilation has thick, mucoid secretions. The therapist observes that the servo-controlled humidifier is set at 31° C. Which of the following should the therapist do?

    A.Increase the flow through the humidifier.
    B.Increase the temperature setting.
    C.Shorten the tubing between the ventilator and the humidifier inlet.
    D.Remove the excess water in the humidifier.
    B. Increasing the temperature of the gas increases the ability of gas to hold water.
    (this multiple choice question has been scrambled)
  113. While assessing a patient receiving oxygen by transtracheal oxygen catheter, a respiratory therapist notes that the patient appears cyanotic and the SpO2 is 70%. The therapist should immediately

    A.decrease the oxygen flow.
    B.initiate oxygen by nasal cannula.
    C.advance the catheter 2 cm.
    D.flush the catheter with 1 mL sterile water.
    B. The safest course of action is to initiate oxygen by nasal cannula. This will provide adequate oxygenation while the therapist further evaluates the function of the transtracheal catheter.
    (this multiple choice question has been scrambled)
  114. While performing postural drainage on a patient who is in a head-down position, the patient appears dyspneic due to severe prolonged coughing. A respiratory therapist should

    A.place the patient in Fowler's position.
    B.turn the patient.
    C.administer oxygen.
    D.perform percussion.
    A. Taking the patient out of the head-down position is a simple intervention that would likely alleviate the patient's distress.
    (this multiple choice question has been scrambled)
  115. Mechanical ventilation was initiated on a patient, and the PaCO2 decreased from 53 to 40 torr. Which of the following should a respiratory therapist expect will increase due to the change in PaCO2?

    A.pH
    B.VD/VT
    C.PET CO2
    D.HCO3-
    A. Carbon dioxide and pH move in opposite directions, so a decrease in carbon dioxide will result in an increase in pH.
    (this multiple choice question has been scrambled)
  116. Which of the following is the major function of the baffle in a nebulizer?

    A.mixing aerosol particles with the main gas flow
    B.providing aerosol particles that are consistently small
    C.promoting laminar inspiratory flow
    D.entraining water from the capillary tube
    B. An object that is in the path of the aerosol stream can function as a baffle to cause larger particles to return to the liquid reservoir and only allow small particles to travel on to the patient through the gas stream.
    (this multiple choice question has been scrambled)
  117. Which of the following is the most probable cause of insufficient aerosol output in a mist tent?

    A.compressor switch in the off position
    B.overfilled condensate bottle
    C.a clogged capillary tube in the nebulizer
    D.decreased temperature within the canopy
    C. If the capillary tube in the nebulizer is not drawing liquid, the mist will be decreased.
    (this multiple choice question has been scrambled)
  118. A patient receiving continuous heated aerosol therapy with air by a T-piece develops subcutaneous emphysema around the tracheostomy site, neck, and chest. After noting unequal breath sounds, the most appropriate diagnostic procedure is

    A.an arterial blood gas analysis.
    B.a maximum inspiratory pressure (MIP) measurement.
    C.a chest radiograph.
    D.timed-forced expiratory volumes.
    C. A chest radiograph is the most appropriate initial diagnostic test when a pneumothorax is suspected.
    (this multiple choice question has been scrambled)
  119. A respiratory therapist instructed a patient to take a deep breath and then exhale as quickly as possible. The therapist observed a recording of the fastest air movement. Which of the following was measured?

    A.FEF25-75%
    B.peak flow
    C.FEV1
    D.vital capacity
    B. Peak flow is the maximum flow during a forced expiratory maneuver.
    (this multiple choice question has been scrambled)
  120. A respiratory therapist is preparing to suction the endotracheal tube of a 6-year-old child. When the therapist tests the negative suction pressure, the manometer goes to a maximum of -120 cm H2O. Which of the following is the most appropriate action?

    A.Consult the physician for the negative pressure he would like ordered.
    B.Use the negative pressure as it is now adjusted.
    C.Lower the negative pressure to -80 cm H2O.
    D.Raise the negative pressure to -150 cm H2O.
    B. The correct negative pressure to use when suctioning the airway of a child is -80 to -100 mm Hg, or -109 to -136 cm H2O. The negative pressure of -120 cm H2O is the safe range for a child.
    (this multiple choice question has been scrambled)
  121. A patient who is receiving mechanical ventilation is scheduled for a fiberoptic bronchoscopy. Which of the following are important considerations regarding the operation of the ventilator during this procedure?

    1. Resistance to flow will increase.
    2. Close monitoring of tidal volume is essential.
    3. The inspiratory pressure will increase.
    4. Extrinsic PEEP will increase.
    • 1
    • 2
    • 3
  122. A 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. Which of the following should the therapist instruct the patient to do FIRST?

    A.Check for obstructions in the tubing.
    B.Decrease the liter flow to 1 L/min.
    C.Add water to the humidifier.
    D.Change over to his back-up O2 source.
    A. Whistling is most likely caused by kinks in the tubing.
    (this multiple choice question has been scrambled)
  123. A respiratory therapist observes low exhaled volumes during volume-controlled ventilation. To determine if the low volumes are caused by an inaccurate ventilator volume control, the therapist should measure the tidal volume at the

    A.machine outlet.
    B.exhalation valve.
    C.humidifier outlet.
    D.patient connector.
    A. Measurement at the machine outlet eliminates all other variables such as the patient circuit and the patient airway as sources of malfunction.
    (this multiple choice question has been scrambled)
  124. A patient who was isolated due to an infection with multiple drug resistant Clostridium difficile was receiving aerosol therapy from a reusable, large volume nebulizer. Following removal from the room, which of the following procedures should the respiratory therapist select to process the nebulizer before placing it back into service?

    A.immersion in alkaline glutaraldehyde for 10 minutes
    B.steam autoclaving at 112° C
    C.pasteurization at 60° C for 20 minutes
    D.soaking in 70% ethyl alcohol for 15 minutes
    B. Steam autoclaving is a sterilization process and will kill all vegetative forms of the C. difficile organism along with the spores it may form.
    (this multiple choice question has been scrambled)
  125. While administering acetylcysteine and albuterol with a hand-held nebulizer, a respiratory therapist notes a patient is developing marked congestion with copious sputum production. The therapist's most appropriate action is to

    A.administer the acetylcysteine with a positive-pressure breathing machine.
    B.increase the dose of acetylcysteine to help thin the secretions.
    C.pause the therapy to clear secretions.
    D.dilute the acetylcysteine with saline.
    C. Secretions have been mobilized and the airway must be cleared before continuing treatment.
    (this multiple choice question has been scrambled)
  126. When explaining the purpose of incentive spirometry to a patient after abdominal surgery, a respiratory therapist should tell the patient the procedure is performed to

    A.shorten the time for wound healing.
    B.prevent areas of the lung from collapsing.
    C.treat pneumonia in addition to antibiotics.
    D.reduce the pain associated with breathing.
    B. Achieving and sustaining maximum inspiration prevents atelectasis.
    (this multiple choice question has been scrambled)
  127. For a spontaneously breathing patient, which of the following will provide the physiologic effects of PEEP?

    A.PEP
    B.IPAP
    C.CPAP
    D.IPPB
    C. CPAP will provide an elevated pressure at the end of exhalation, like PEEP.
    (this multiple choice question has been scrambled)
  128. A patient receiving oxygen at 15 L/min by a nonrebreathing mask has a PaO2 of 500 torr. Which of the following should a respiratory therapist recommend?

    A.Remove the valve from the mask outlet.
    B.Switch to a different oxygen delivery device
    C.Decrease the oxygen flow setting.
    D.Discontinue oxygen therapy.
    B. A PaO2 of 500 torr indicates the patient does not have a significant shunt. The oxygen therapy should be changed.
    (this multiple choice question has been scrambled)
  129. A patient refuses to be placed in the Trendelenburg position for postural drainage to the lower lobes. Which of the following should a respiratory therapist do?

    A.Administer the treatment anyway and record that it was done.
    B.Leave the patient's room and discontinue the therapy.
    C.Notify the nurse in charge and record the patient's refusal in the record.
    D.Change therapy to incentive spirometry and record a verbal order for the change.
    C. If a patient refuses therapy, the therapist must communicate the indications for it to the patient. If the patient continues to refuse, the therapist should record the patient's refusal in the medical record and communicate with the patient's nurse.
    (this multiple choice question has been scrambled)
  130. Appropriate infection control procedures in the home include

    1. disinfecting equipment every 96 hours
    .2. rinsing and drying equipment before storage.
    3. handwashing before and after therapy.
    4. soaking nondisposable equipment in isopropyl alcohol.
    • 2
    • 3
  131. A patient who is receiving mechanical ventilation has an 8.0-mm ID endotracheal tube in place. Using a standard 14 Fr catheter kit, the patient requires frequent suctioning due to copious, thick secretions and develops tachycardia and oxygen desaturation during suctioning. A respiratory therapist should recommendA.

    a 12 Fr catheter.
    B.a closed-suction system.
    C.a 14 Fr Coudé tip catheter.
    D.suctioning the patient once per hour.
    B. A closed-suction system will allow for continuation of ventilation and oxygenation during suctioning.
  132. Which of the following clinical observations is most commonly associated with right heart failure?

    A.tracheal deviation
    B.muscle wasting
    C.peripheral edema
    D.skin flushing
    C. Right heart failure inhibits venous return and results in edema in the periphery.
    (this multiple choice question has been scrambled)

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