TMC

During bedside monitoring, the respiratory therapist notices a dampened waveform on the arterial line graphic. To restore the graphic to normal, the therapist should first
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Terms in this set (37)
During bedside monitoring, the respiratory therapist notices a dampened waveform on the arterial line graphic. To restore the graphic to normal, the therapist should first
attempt to draw blood from the arterial line.
An optimal PEEP study is initiated for a patient receiving mechanical ventilation. The respiratory therapist initiates PEEP of 10 cm H2O for 20 minutes with no adverse effects. The PEEP is increased to 15 cm H2O and the patient's heart rate rises significantly with a severe fall in the blood pressure. Based upon the above information, the therapist should conclude that the patient is suffering from
hypovolemia.
Which of the following would be the most appropriate test to evaluate partial vocal cord paralysis in a patient complaining of difficulty swallowing?
Flow volume loop
In order to reduce a patient's PaCO2 from 40 torr to 32 torr, all of the following could be increased EXCEPT
Deadspace
While examining the chest drainage system of a mechanically-ventilated patient following thoracotomy, the respiratory therapist observes bubbling in the water-seal chamber during inspiration. This would indicate
A.a leak in the chest drainage system.
B.air leaving the pleural space.
C.excessive pressure from the suction regulator.
D.inadequate water level in the water-seal chamber.
B
A patient develops ascites and shortness of breath. Where is tissue edema most likely to show up first?
.Ankles
B.Abdomen
C.Thorax
D.Hands
B. Abdomen
Adjusting the inspiratory flow during IPPB will primarily result in a change in
A.respiratory rate.
B.peak pressure.
C.tidal volume.
D.inspiratory time.
D. Inspiratory Time
A patient with a flail chest is intubated and mechanically ventilated with PEEP therapy. Pancuronium bromide has been administered. Which of the following ventilator alarms would be most important to set correctly for this patient?
A.Peak pressure alarm
B.Low pressure alarm
C.I:E ratio alarm
D.Low exhaled volume alarm
B. Low pressure alarm
During recovery from resection of an aortic aneurysm, a 65-year-old female patient suddenly develops severe substernal chest pain with grave dyspnea. The physician describes the bilateral breath sounds as basilar moist crepitant crackles. The patient appears pale, cool and diaphoretic. Which of the following should the respiratory therapist recommend as part of the initial assessment of this patient?
A.ECG
B.CBC
C.Serum electrolytes
D.Lateral decubitus radiograph
A. ECG
A 30-year-old male who weighs 68 kg (150 lb) has a minute ventilation of 9 L/min. and a respiratory rate of 20/min. What is his alveolar minute volume?
A.4 L/min.
B.6 L/min.
C.8 L/min
D.12 L/min.
B. 6 L/M ( VE/R)= VT , Alveolar VE ( VT- deadspace 1 ml/lb) x R
Which of the following is a FALSE statement about self-inflating resuscitation devices? A.A reservoir is utilized to increase the delivered oxygen concentration. B.The respiratory therapist can sense changes in the p atient's lung compliance and airway resistance. C.A compressed gas source is necessary for the device to operate.D.Excessive gas flow may cause the valve to malfunction.C. A compressed gas source is necessary for the device to operateThe following pulmonary function data was reported for a 45 year old patient:TLC - 5.4L RV - 1.0L IRV - 2.6L VC - 4.2L ERV - 1.0L VT - 0.6L FRC - 2.0L IC - 3.2L Which of the above capacities is incorrect? A.TLC B.VC C.FRC D.ICA. TLCThe peak inspiratory pressure on a pressure-cycled ventilator used for IPPB is 30 cm H2O. The respiratory therapist decreases the inspiratory flow. This change would affect the A.rate. B.PEEP. C.expiratory time. D.I:E ratio.D. I:E RatioThe respiratory therapist receives an order for postural drainage and vibration. With the bed flat, the therapist places the patient in a prone position with pillows under his hips. Which lung segments are being treated with this position? A.Anterior segments of the upper lobes B.Superior segments of the upper lobes C.Posterior basal segments of the lower lobes D.Superior segments of the lower lobesD. Superior Segments of the lower lobe.Which of the following devices would produce the greatest humidity output for a patient? A.Bubble humidifier B.Wick-type humidifier C.Large reservoir nebulizer D.Ultrasonic nebulizerD. Ultrasonic NebulizerA spontaneous breathing trial has been initiated for a 64-year-old, intubated, post-op patient. Oxygen is being administered by T-piece at an FIO2 of 0.50 via heated air-entrainment nebulizer at a flow of 12 L/min and a temperature of 37.0oC. The respiratory therapist notices that the aerosol mist disappears from the reservoir outlet during the patient's inspiration. The therapist should consider all the following EXCEPT A.lenghtening the reservoir tubing. B.adding an additional nebulizer. C.increasing the flow to 15 L/min. D.increasing the temperature to 39.0oC.D.increasing the temperature to 39.0oC.While delivering IPPB therapy with a Bird Mark 7 ventilator, the respiratory therapist observes that the pressure does not rise consistently during inspiration. This is most likely the result of A.poor patient effort. B.improper trigger setting. C.bronchial secretions. D.insufficient flow.insufficient flow.A patient receives mechanical ventilation via high frequency oscillation. The results of an arterial blood gas analysis are as follows: pH7.18 PaCO2 68 torr PaO273 torr HCO3-26 mEq/L BE+2 mEq/L The respiratory therapist should increase the A.amplitude. B.frequency. C.bias flow. D.I:E ratio.A. AmplitudeA patient with a size 8.5 mm ID oral endotracheal tube is transported from the Emergency Department to the Intensive Care Unit. The respiratory therapist suspects the tube has changed position during transport. Which of the following is the first step to assess the tube position? A.Chest radiograph B.Bilateral chest auscultation C.Verify symmetrical chest movement D.Diagnostic chest percussionC. Verify Symmetrical chest movementA patient performs both a forced vital capacity and a slow vital capacity maneuver with the following results: FVC 2.40 L SVC 2.18 L Which of the following statements is TRUE regarding these results? A.The data meets ATS-ERS standards and should be reported. B.The SVC shows poor effort and should be repeated. C.The FVC shows poor effort and should be repeated. D.The patient has obstructive lung disease.B. The SVC shows poor effort and should be repeated.How long will a full E cylinder of oxygen last if run until empty with a flowrate of 10 L/min? A.1 hourB.10 hoursC.33 hoursD.66 hoursA. 1 hourDuring oral endotracheal intubation, the tip of the Macintosh laryngoscope blade should be placed A.between the soft palate and tongue. B.in the vallecula. C.under the epiglottis. D.between the vocal cords.B. In the valleculaA patient with chronic bronchitis is to receive therapy to help remove a large amount of thick purulent secretions. Which of the following would be most helpful? A.Incentive Spirometry B.IPPB C.Postural drainage and percussion D.Small volume nebulizer with normal salineC. Postural Drainae and percussionDuring mechanical ventilation, a patient initiates the breath and then the ventilator controls the remaining variables for that breath. This describes a/an A.spontaneous breath.B.assisted breath.C.mandatory breath.D.supported breathB. Assisted breathA 1600 g neonate receives oxygen by oxyhood at an FIO2 of 0.60. The flowmeter is set at 5 L/min. While analyzing the oxygen, the respiratory therapist notices varying FIO2 readings at different locations inside the oxyhood. The therapist should A.re-calibrate the oxygen analyzing device. B.increase the flow to the oxyhood. C.place the neonate in an isolette at an FIO2 of 0.60. D.check the water level of the humidifier.B. Increase the flow to the oxyhoodA patient receives 60% oxygen via large volume nebulizer and aerosol mask at a flow of 8 L/min. The patient's inspiratory flowrate is 35 LPM. Which of the following should the respiratory therapist recommend? A.Decrease the flow setting to 5 L/minB.Maintain the current flow settingC.Increase the flow setting to 15 L/minD.Use two nebulizers at a flow of 10 L/min eachD. Use two nebulizers at a flow of 10 l/ min eachA patient with chronic hypercapnia is brought to the ED after losing consciousness at home. A pulmonary artery catheter has been placed with the following measurements obtained:PAP25/10 mm HgBP76/50 mm HgPCWP4 mm HgSVR1360 dynesCVP0 mm HgCI1.8 L/min/m2Which of the following is the most likely cause for his condition? A.HypovolemiaB.Drug overdoseC.Cor pulmonaleD.High FIO2 vasodilationA. HypovolemiaWhich of the following will give the most accurate measurement of volume and flow for spirometry? A.Collins water-sealed spirometerB.Vortex-shedding pneumotachometerC.Wright respirometerD.Dry-rolling spirometerA. collins water-sealed spirometerIf a patient's CvO2 decreased from 15 vol% to 10 vol%, which of the following should the respiratory therapist assess? A.Cardiac outputB.Venous blood gasC.Capillary wedge pressureD.Pulmonary vascular resistanceA. Cardiac outputThe following results are obtained from the pulmonary artery catheter of a patient who collapsed during a visit with a friend in the hospital:CVP10 cm H2OPAP33/27 mm HgPCWP20 mm HgBP108/72 mm HgWhich of the following conditions could be associated with these results? A.Tricuspid valve stenosisB.Right ventricular failureC.Cardiogenic pulmonary edemaD.Fluid overloadD. fluid overloadA patient reports to the pulmonary function clinic for evaluation of disability as a result of pneumoconiosis. Pulse oximetry is performed with a result of 97% on room air. Arterial blood gases are obtained and the measured SaO2 is 85%. These results are most consistent with A.restrictive disease.B.cigarette smoking.C.nocturnal asthma.D.obstructive exacerbation.A.Following a thoracotomy, a patient in the PACU receives 60% oxygen via a non-rebreather mask. A pulmonary diagnostic assessment reveals the following information: pH7.43 PaCO234 torr PaO256 torr HCO3-22 mEq/L BE-1 SaO290% f25/min. PAP49/28 mmHg PWP5 mmHg PVR400 dynes SVR1150 dynes To improve the patient's pulmonary status, the respiratory therapist should institute A.mechanical ventilation.B.CPAP.C.nitric oxide therapy.D.heliox therapy.B. CpapWhich of the following would modify the expiratory time and change the I:E ratio for a patient receiving PEP therapy? A.Expiratory resistance valveB.Inspiratory flowC.Rate controlD.Volume controlA. Expiratory resistance valve.A respiratory therapist enters a patient's room during oxygen rounds. The patient has end-stage emphysema and appears to be sleeping. The patient doesn't respond to questions and his pulse is 20 bpm. The therapist should immediately A.confirm DNR status.B.go get help.C.begin rescue ventilation.D.begin chest compressions.A. Confirm DNR statusA 55 year-old patient admitted to the Emergency Department has a history of hypertension. The patient is conscious, diaphoretic and complaining of chest pain. The respiratory therapist's first response should be to A.administer oxygen.B.place the patient on a cardiac monitor.C.administer nitroglycerin sublingual.D.insert a peripheral intravenous line.A. Administer oxygenWhile attempting to calibrate a polarographic oxygen analyzer, the respiratory therapist notices that the analyzer reads 21% when exposed to room air but only reads 64% when exposed to 100% oxygen. The most appropriate action at this time would be to A.reset the zero point.B.replace the battery.C.replace the fuel cell.D.add electrolyte solution.B. Replace the battery.All of the following strategies are likely to decrease the likelihood of damage to the tracheal mucosa EXCEPT A.maintaining cuff pressures between 20 and 25 mm Hg.B.using the minimal leak technique for inflation.C.using a low-residual-volume, low-compliance cuff.D.monitoring intracuff pressures.C