Kettering TMC Exam (2026/2027 Update) | Verified Questions & Answers | 100% Pass Guarantee | A+ Grade

Kettering TMC Exam (2026/2027 Update) | Verified Questions & Answers | 100% Pass Guarantee | A+ Grade Q: Fine crepitant crackles are most commonly associated with which of the following conditions? a. bronchiectasis b. congestive heart failure c. pneumonia d. croup b. congestive heart failure Q: A patient is found in full cardiopulmonary arrest. CPR is started and the patient is orally intubated with an EtCO2 monitor attached. Which of the following EtCO2 patterns would the respiratory therapist expect to observe on the monitor? a. Initially high, then falling b. Initially low, then rising c. Initially high, stays high d. Initially low, stays low b. Initially low, then rising Q: The blood pressure obtained from the arterial line is higher than the blood pressure obtained from a sphygmomanometer. Based upon this information, the respiratory therapist should conclude that a. non-compliant tubing is being used b. the transducer is placed too low. c. the patient was lying flat during the measurement of the arterial line pressure d. the transducer dome contained air bubbles b. the transducer is placed too low Q: A 2 year old child enters the emergency room. The mother states that the child was playing with friends and developed violent coughing and unilateral wheezing. Physical examination reveals a hyperresonant percussion note on the left and resonant percussion note on the right. Inspiratory and expiratory chest films indicate air trapping with no foreign bodies noted. The respiratory therapist should suspect that the child has a. a pneumothorax b. orthopnea c. aspirated a foreign object d. tachyphylaxis c. aspirated a foreign object Q: A patient is admitted to the ICU complaining of nausea and chest pain. A nasogastric tube has been inserted to help relieve the nausea. The patient was started on lasix and nitroglycerin. Which of the following should the respiratory therapist monitor closely to identify side effects at this time? a. Cardiac enzymes b. Serum electrolytes c. Arterial blood gases d. Digitalis levels b. Serum electrolytes Q: While reviewing a patient's medical record, the respiratory therapist notes that the patient has a Hb level of 6g and a SpO2 of 94%. The patient is receiving oxygen by simple mask and is complaining of shortness of breath. The respiratory therapist would conclude that the patient has a. hemophilia b. hypernatremia c. anemia d. hypokalemia c. anemia Q: Which of the following will determine the aortic pulse pressure? a. systolic + diastolic + diastolic / 3 b. diastolic + pulse pressure / 3 c. systolic pressure - diastolic pressure d. stroke volume x heart rate x 10 c. systolic pressure - diastolic pressure Q: A male infant born at 36 weeks gestation was delivered by Cesarean section. The newborn is exhibiting signs of respiratory distress including nasal flaring and mild retractions. Physical examination reveals HR 160/min, RR 52/min, BP 60/40 mmHg. The chest radiograph indicates some scattered densities. The respiratory therapist should recommend a. nasal CPAP at 5cmH2O b. BiPAP ventilation c. 40% oxygen via hood d. arterial blood gases d. arterial blood gases Q: A patient in the intensive care unit has the following hemodynamic measurements: CVP 6 mmHg Mean PAP 13 mmHg PCWP 7 mmHg MAP 86 mmHg Cardiac output 4.0L/min Cardiac index 2.1L/min2 Q: What is the systemic vascular resistance? a. 800 dynes/s/cm5 b. 1300 dynes/s/cm5 c. 1600 dynes/s/cm5 d. 2400 dynes/s/cm5 c. 1600 dynes/s/cm5` (MAP - CVP) / CO X 80 Q: The chest X-ray show increased retro-sternal air, flat hemidiaphragm, decreased movement, and no vascular markings on the right side. These signs would be most likely associated with: a. pneumothorax b. pleaural effusion c. pneumonia d. flail chest a. pneumothorax Q: A 32-week gestational age infant is receiving mechanical ventilation for hyaline membrane disease. The patient required a chest tube for a persistent pneumothorax. Two days later the chest radiograph reveals bilateral radiolucency, midline mediastinum, and the right hemidiaphragm slightly elevated. This would indicate a. atelectasis b. bronchopulmonary dysplasia c. fluid overload d. resolution of a pneumothorax d. resolution of a pneumothorax Q: What is the normal range for the pulmonary artery systolic pressure in an adult? a. 2-6 mm Hg b. 4-12 mm Hg c. 9-18 mm Hg d. 21-28 mm Hg d. 21-28 mm Hg Q: A 4-year-old child has been brought to the emergency room with an acute infection, high fever, marked stridor and drooling. Which of the following should the therapist recommend at this time? a. Arterial blood gas b. Oral intubation c. Lateral neck X-ray d. 40% oxygen via cool mist tent b. Oral intubation Q: While assisting the pulmonary physician with rounds in the intensive care unit, the physician comments that he would like to make a change to the patient's ventilator settings. The therapist's most appropriate action should be a. initiate the changes immediately. b. write a verbal order for the change. c. ask the patient. d. ask the physician to write the order. d. ask the physician to write the order. Q: A 6-year-old child involved in a swimming pool accident is in cardiac arrest. The patient has been intubated with a size 5.5 mm endotracheal tube and has an end-tidal CO2 monitor connected to the airway. During cardiac compression the respiratory therapist notes that the end-tidal CO2 is increasing. This would indicate that a. cardiac output is increasing. b. compression depth is too low. c. endotracheal tube is too large. d. ventilation should be increased a. cardiac output is increasing. Q: While assessing a patient's breath sounds the respiratory therapist notes that when the patient is instructed to say the letter "E", it comes through the stethescope sounding like "aaaahhh". This change in the sound is associated with which of the following conditions? a. Pleuritic inflammation b. Pneumonia c. Bronchospasm d. Epiglotitis b. Pneumonia Q: An 1800 g neonate in the NICU is being monitored with a TcPO2 electrode. The TcPO2 electrode is reading 42 torr with the temperature set at 38oC. The PO2 from an umbilical artery sample is 72 torr. Which of the following would best explain the difference in these readings? a. There was an error in the arterial blood gas results. b. The TcPO2 electrode needs to be repositioned. c. The TcPO2 electrode temperature setting is too low. d. The TcPO2 electrode has been dislodged. c. The TcPO2 electrode temperature setting is too low. Q: A multiple trauma victim with internal hemorrhage is being monitored via pulse oximetry. Which of the following conditions would affect the accuracy of her SpO2 readings? a. hypotension b. hyperoxia c. hypocarbia d. hyperthermia a. hypotension Q: A patient with COPD has been admitted for possible pneumonia. The patient is producing moderate amounts of thick yellow sputum and breath sounds are decreased in the right middle lobe. Sputum culture indicates a staphylococcal infection. Which of the following therapies should the respiratory therapist recommend? a. chest physical therapy b. antibiotic therapy c. incentive spirometry d. IPPB b. antibiotic therapy A premature baby is receiving an FIO2 of .40 and CPAP at 5 cmH2O. As the respiratory therapist increases the CPAP to 7 cmH2O, the baby's respiratory rate increases to 58 per minute and the TcPCO2 reading increases with a stable SpO2 monitor reading. The respiratory therapist should recommend which of the following? a. Discontinue the CPAP b. Draw an arterial blood gas sample c. Increase the CPAP to 10 cmH2O d. Place the baby in an oxyhood at an FIO2 0.45 b. Draw an arterial blood gas sample A patient is suspected of having a pleural effusion. Before performing a thoracentesis, what should the therapist recommend? a. lateral decubitus chest radiograph b. arterial blood gas analysis c. ventilation and perfusion scans d. flexible bronchoscopy a. lateral decubitus chest radiograph A patient in the intensive care unit has the following hemodynamic measurements: CVP (mm Hg): 12 PAP (mm Hg): 48/25 PCWP (mm Hg): 18 MAP (mm Hg): 69 Cardiac output (L/min): 3.1 Cardiac index (L/min/m2): 1.7 These results are consistent with: a. Hypervolemia b. Congestive heart failure c. Pulmonary hypertension d. Cor pulmonale b. Congestive heart failure A 44-year-old woman has just undergone a cholecystectomy. Over the last 48 hours the patient has the following laboratory findings: K+: 3 mEq/L Na+: 115 mEq/L Cl-: 80 mEq/L HCO3-: 24 mEq/L Urine output: 60 mL/hour BP: 125/95 mm Hg Based upon this information the respiratory therapist would conclude a. the patient is hyperkalemic b. the patient requires decreased fluid intake c. the patient is polycythemic d. the patient has a metabolic alkalosis b. the patient requires decreased fluid intake What would the therapist palpate when assessing a patient with a tension pneumothorax? a. hyperresonance b. tracheal deviation c. absent breath sounds d. increased work of breathing b. tracheal deviation A patient in the intensive care unit has the following lab results: pH: 7.41 PaCO2: 39 torr PaO2: 96 torr HCO3-: 24 mEq/L SaO2: 97% Hb: 8 g/dL Which of the following would have the greatest impact on this patient's ability to deliver oxygen to the body tissue? a. pH b. PaO2 c. SaO2 d. Hb d. Hb A 55-year-old patient is admitted to CCU with chest pain. While assembling an oxygen mask, the respiratory therapist notes the following ECG pattern: The patient is now unconscious, unresponsive and has no palpable pulse. The therapist's first response should be to a. administer oxygen by non-rebreather mask. b. deliver a pre-cordial thump. c. recommend intravenous amiodarone. d. perform synchronized cardioversion b. deliver a pre-cordial thump. The respiratory therapist notices a dampened waveform on a pulmonary arterial line. The therapist's first action should be to a. attempt to draw blood from the line. b. check the transducer dome for air bubbles. c. flush the catheter with heparin solution. d. check the position of the transducer. b. check the transducer dome for air bubbles. A bilateral wheeze would most likely indicate which of the following? a. Asthma b. Atelectasis c. Foreign body aspiration d. Epiglottitis a. Asthma A patient in the intensive care unit is suffering left heart failure. Which of the following drugs will increase the strength of contraction and improve cardiac output? a. digitalis b. atropine c. isuprel d. lidocaine a. digitalis A patient in the intensive care unit has the following hemodynamic measurements: CVP: 16 mm Hg Mean PAP: 30 mm Hg PCWP: 5 mm Hg MAP: 81 mm Hg Cardiac output (QT): 4.0 L/min Cardiac index (QI): 2.1 L/min/m2 What is the pulmonary vascular resistance? a. 200 dynes/sec/cm-5 b. 300 dynes/sec/cm-5 c. 400 dynes/sec/cm-5 d. 500 dynes/sec/cm-5 d. 500 dynes/sec/cm-5 The respiratory therapist is assessing a patient's vital signs and notes that the pulse feels weak and thready. This would most likely be associated with which of the following conditions? a. Hypervolemia b. Shock c. Increased cardiac output d. Increased systemic vascular resistance b. Shock A patient who recently underwent a total abdominal hysterectomy is complaining of chills and purulent sputum. Breath sounds reveal coarse rales and rhonchi. The results of the CBC indicate a WBC count of 19,000. The most likely diagnosis is that the patient has developed: a. atelectasis b. pneumonia c. hemothorax d. bacterial infection d. bacterial infection After injecting a small amount of air into the balloon of a pulmonary artery catheter, the respiratory therapist sees a small amplitude change with the mean pressure reading 2 points below the PA end-diastolic pressure. Based upon this information, the therapist should conclude that a. there is pressure dampening. b. the transducer is placed too high. c. there is an obstruction in the catheter. d. this is a normal wedge tracing. d. this is a normal wedge tracing. A patient with a history of myasthenia gravis has just been admitted for increased muscle weakness. The respiratory therapist should recommend which of the following diagnostic tests to monitor the patient's drug therapy? a. polysomnography b. electroencephalography c. tensilon challenge test d. methacholine challenge test c. tensilon challenge test A 32-week gestational age infant is receiving mechanical ventilation for hyaline membrane disease. The respiratory therapist suspects that a pneumothorax has developed and performs transillumination, which reveals a brightly illuminated left thorax. The respiratory therapist's FIRST action should be to a. insert a chest tube and connect to a pleural suction system. b. perform a fiberoptic bronchoscopy. c. obtain a STAT chest film. d. suction the infant. a. insert a chest tube and connect to a pleural suction system. The results of a patient's chest radiograph reveal the presence of a left basilar free fluid accumulation with a meniscus formation. Physical examination of the chest indicates a dull percussion note on the left and trachea shifted to the right. These results are consistent with which of the following conditions? a. Pleural effusion on the left b. Basilar pneumonia of the left lung c. Atelectasis of the left lung d. Pneumothorax in the left lung a. Pleural effusion on the left A tympanic percussion note is usually present in which of the following conditions? 1. gastric distension 2. pleural effusion 3. pneumothorax 4. endocarditis a. 1 & 3 only b. 2 & 4 only c. 3 & 4 only d. 1, 2 & 3 only a. 1 & 3 only A fireman is brought into the emergency room after being pulled from a burning warehouse and is found to be unconscious. What is the best way to assess the oxygenation status of this patient? a. Arterial blood gas results b. Hb & Hct levels c. CO-oximetry results d. SpO2 monitoring c. CO-oximetry results A patient in the intensive care unit has the following hemodynamic measurements: CVP (mm Hg): 12 PAP (mm Hg): 48/25 PCWP (mm Hg): 18 MAP (mm Hg): 104 Cardiac output (L/min): 7.1 Cardiac index (L/min/m2): 3.7 These results are consistent with: a. Hypervolemia b. Congestive heart failure c. Pulmonary hypertension d. Cor pulmonale a. Hypervolemia The respiratory therapist is assisting the physician with the insertion of a pulmonary artery catheter. The therapist and physician have proper sterile gloves and gown, and a sterile field is arranged. As the therapist hands the pulmonary artery catheter to the physician, the therapist drops the catheter onto the sterile field. The respiratory therapist should a. run to get another sterile catheter. b. proceed with the insertion of the catheter. c. rinse the catheter with sterile water. d. visually inspect the catheter for any debris. b. proceed with the insertion of the catheter. The respiratory therapist has been paged to the ICU to assist in the treatment of a 98 kg (215 lb) man. The patient is pale, diaphoretic, and suddenly loses consciousness. No palpable pulse or blood pressure is measured. The ECG monitor displays the following: The respiratory therapist should a. confirm the ECG in another lead. b. begin chest compressions. c. perform cardioversion. d. perform defibrillation. b. begin chest compressions. While assessing a patient's breath sounds the respiratory therapist notes that when the patient says "ninety-nine", it sounds very loud through the stethescope. This would be associated with which of the following conditions? a. Pneumothorax b. Pneumonia c. Pleural effusion d. Epiglottitis b. Pneumonia What is the normal range for cardiac index in an adult? a. 0 - 2 L/min/m2 b. 2 - 4 L/min/m2 c. 4 - 6 L/min/m2 d. 6 - 8 L/min/m2 b. 2 - 4 L/min/m2 A patient in the intensive care unit has the following hemodynamic measurements: CVP (mm Hg): 12 PAP (mm Hg): 49/25 PCWP (mm Hg): 18 MAP (mm Hg): 99 Cardiac output (L/min): 7.1 Cardiac index (L/min/m2): 3.7 What is the mean pulmonary artery pressure? a. 14 mm Hg b. 21 mm Hg c. 33 mm Hg d. 40 mm Hg c. 33 mm Hg A 47-year-old patient admitted for sepsis has a CaO2 value of 12.5 vol%. The patient does not appear cyanotic. Which of the following would be the most important to further evaluate the patient's oxygenation status? a. PaO2 b. SaO2 c. Hb d. PAO2 c. Hb A patient in the intensive care unit has the following hemodynamic measurements: CVP (cm H2O): 12 PAP (mm Hg): 48/25 PCWP (mm Hg): 8 MAP (mm Hg): 93 Cardiac output (L/min): 6.1 Cardiac index (L/min/m2): 3.2 These results are consistent with: a. Hypervolemia b. Congestive heart failure c. Pulmonary hypertension d. Cor pulmonale c. Pulmonary hypertension The tip of a catheter used to measure the wedge pressure should be positioned in the: a. superior vena cava b. right atrium c. pulmonary artery d. pulmonary vein c. pulmonary artery A 64-year-old patient is being resuscitated for full cardiopulmonary arrest. After several unsuccessful attempts, the patient is orally intubated with a size 7.0 mm endotracheal tube. The physician is unable to establish a peripheral or central intravenous line. The ECG monitor now shows the following rhythm: The respiratory therapist should recommend administration of a. lidocaine by small volume nebulizer. b. atropine through the endotracheal tube. c. epinephrine by intra-cardiac injection. d. amiodarone by intraosseous injection. b. atropine through the endotracheal tube. A patient involved in a motor vehicle accident has sustained a long bone fracture and remains in traction. The patient suddenly complains of chest pain, and becomes tachypneic and tachycardiac. To determine the cause of the problem the respiratory therapist should recommend a. administering 100% oxygen. b. a V/Q scan. c. streptokinase. d. a STAT chest x-ray. b. a V/Q scan. The respiratory therapist is assessing a patient's vital signs and notes that the pulse feels weak and thready. This would most likely be associated with which of the following conditions? a. hypoxemia b. hypovolemia c. increase cardiac index d. increase systemic vascular resistance b. hypovolemia What is the normal range for the mean arterial pressure in an adult? a. 2-6 mm Hg b. 10-20 mm Hg c. 60-80 mm Hg d. 85-100 mm Hg d. 85-100 mm Hg A patient who recently underwent a total abdominal hysterectomy is complaining of chills and producing yellow purulent sputum. Breath sounds reveal scattered crackles. The results of the CBC indicate a WBC count of 3,000 mill/mm3. The most likely diagnosis is that the patient has developed a. atelectasis. b. viral pneumonia. c. influenza. d. pleural effusion. b. viral pneumonia. The respiratory therapist is called to the emergency department to evaluate a patient who was brought in via an ambulance due to a motor vehicle accident. The patient is cold and clammy with a blood pressure of 82/46 mm Hg. The ECG monitor shows sinus tachycardia with occasional PVC. Which of the following should the therapist evaluate at this time? a. Serum electrolytes b. Cardiac enzymes c. Hb and Hct levels d. 12 lead ECG c. Hb and Hct levels Which of the following drugs should the respiratory therapist recommend to lower a patient's blood pressure as well as decrease his ventricular after load? a. Norepinephrine b. Propranolol c. Procainamide d. Sodium nitroprusside d. Sodium nitroprusside A patient in the intensive care unit has the following hemodynamic measurements: CVP (mm Hg): 5 PAP (mm Hg): 29/8 PCWP (mm Hg): 8 BP (mm Hg): 130/70 Cardiac output (L/min): 5.1 Cardiac index (L/min/m2): 2.7 What is the mean arterial pressure? a. 15 mm Hg b. 21 mm Hg c. 33 mm Hg d. 90 mm Hg d. 90 mm Hg A 26-year-old patient with shortness of breath is admitted to the emergency room. The patient states that he was running in Central Park with a friend and could not catch his breath. Bedside assessment reveals the following data: Pulse: 134 Respirations: 35 Color: pale SpO2: 91% on room air Breath sounds: diminished on the right The respiratory therapist should: a. request a STAT chest x-ray. b. recommend a V/Q scan c. insert a large bore needle into the 2nd intercostal space on the right side in the midclavicular line. d. insert a chest tube into the 2nd intercostal space on the right side in the midclavicular line a. request a STAT chest x-ray. A 40-year-old patient who smokes 2 packs of cigarettes per day has a carboxyhemoglobin level of 6.4%. These results are most consistent with a. Severe COPD b. History of dyspnea on exertion c. Need for supplemental oxygen d. Expected level for this patient d. Expected level for this patient A pleural friction rub is associated with all of the following conditions EXCEPT a. pneumonia. b. tuberculosis. c. pleurisy. d. pulmonary edema. d. pulmonary edema. The results of a patient's chest radiograph reveal the presence of a right side consolidation with a concave-shape appearance and a mediastinal shift to the left. Physical examination of the chest reveals decreased movement, flat percussion, and absent breath sounds over the right lower chest. These results are consistent with which of the following conditions? a. right side pleural effusion b. basilar pneumonia of the right lung c. atelectasis of the right lower lobe d. right side tension pneumothorax a. right side pleural effusion The following data has been obtained from a 28-week gestational age infant who was born premature: Color: Cyanotic Chest x-ray: Cardiac enlargement Chest Sounds: Systolic murmur Respiratory rate: 55 Br/min. SpO2: 80% Which of the following diagnostic tests should the respiratory therapist recommend? a. Pre- and post-ductal blood gas studies b. L/S ratio c. New Ballard Score d. Capillary blood gas a. Pre- and post-ductal blood gas studies A patient is on a continuous flow CPAP system. The respiratory therapist notes that the pressure drops to zero during inspiration. The therapist should: a. Initiate mechanical ventilation b. Change to an IPAP/EPAP system c. Increase the flow d. Decrease the threshold resistor c. Increase the flow A chronic hypercapnic patient enters the emergency room complaining of shortness of breath. The patient is coughing up inspissated, pale, yellow secretions. Which of the following would you recommend at this time? a. Sputum culture and sensitivity b. Oxygen at 2 LPM via nasal cannula c. A-P and lateral chest x-ray d. Arterial blood gases b. Oxygen at 2 LPM via nasal cannula A patient with known reversible airway disease takes two puffs of albuterol from his metered-dose inhaler. The respiratory therapist measures the patient's peak flow following the administration of the medication and determines that the peak flow has increased only minimally. The therapist should a. add a spacer to the metered-dose inhaler. b. change the medication to levalbuterol c. administer the medication by small volume nebulizer. d. contact the physician concerning the care of this patient. a. add a spacer to the metered-dose inhaler. An H cylinder of oxygen has 1200 psi remaining in the tank. How long will it take to decrease to 200 psi if the flow is 5 LPM? a. 1 hour b. 10 hours c. 60 hours d. 600 hours b. 10 hours A patient is receiving IPPB with a Bennett PR-2. The therapist notes that the patient is not reaching the pre-set pressure in an adequate amount of time. The respiratory therapist should a. increase the flow. b. increase the sensitivity. c. adjust the apnea timer. d. decrease the pressure. a. increase the flow. A 32-week gestational age neonate is receiving CPAP by nasal prongs at 4 cm H2O. The respiratory therapist notices that the pressure manometer is now reading zero. The therapist should a. confirm placement of the nasal prongs. b. recalibrate the pressure manometer. c. remove condensation from the circuit. d. increase the flow to the neonate. a. confirm placement of the nasal prongs. The respiratory therapy supervisor is paged STAT to the operating room to respond to an alarm. The operating room nurse informs the therapist that the nitrogen zone valve alarm is sounding. The nitrogen system to the OR is supplied by a manifold system. Which of the following should the respiratory therapist look for FIRST? a. a leak b. an obstruction in piping system c. a back up bank of cylinders d. the alarm switch a. a leak While receiving postural drainage and percussion to her right lower lobe, a 44-year-old patient suddenly vomits and aspirates. The respiratory therapist should immediately a. place the patient in Fowlers position. b. encourage the patient to take deep breaths. c. suction the patient. d. administer acetylcysteine by SVN. c. suction the patient. An air flowmeter and an oxygen flowmeter are being used to deliver 40% oxygen to a patient via a non-rebreathing mask. A total flow of 12 LPM is required to prevent the non-rebreathing bag from deflating. How many liters of air and how many liters of oxygen should the therapist use? a. 2 LPM air, 6 LPM oxygen b. 4 LPM air, 8 LPM oxygen c. 6 LPM air, 6 LPM oxygen d. 9 LPM air, 3 LPM oxygen d. 9 LPM air, 3 LPM oxygen A patient has been admitted to the emergency department after being rescued from a house fire. The patient has second-degree burns on his neck and chest. The respiratory therapist should administer the oxygen therapy via a. non-rebreather mask. b. aerosol mask. c. face tent. d. transtracheal oxygen catheter. a. non-rebreather mask. A patient with CO poisoning is receiving oxygen therapy by a non-rebreather mask at 10 L/min. The respiratory therapist notices that the reservoir bag on the mask is emptying completely on inspiration. The therapist should a. increase the flow. b. switch to a partial rebreather mask. c. initiate mask CPAP therapy. d. switch to a venturi-mask. a. increase the flow. During an incentive spirometry treatment using a flow-sensing device, the float will not rise during inspiration. This may be due to all of the following EXCEPT a. a crack in the casing. b. an obstructed mouthpiece. c. inspiratory effort is too strong. d. inspiratory flow is too slow. c. inspiratory effort is too strong. A three day postoperative laryngectomy patient is receiving 50% oxygen with a cool aerosol via a tracheostomy collar. The secretions being suctioned by the therapist are thick and difficult to aspirate. The therapist should recommend: a. Increase the frequency of suctioning b. Instill 2 mL of normal saline prior to suctioning c. Decrease the oxygen to 45% d. Add a heating element to the aerosol d. Add a heating element to the aerosol A 26-week gestational age infant requires intensive monitoring and care in the NICU. Which device would be most appropriate for maintaining a neutral thermal environment for this infant? a. radiant warmer b. isolette c. croupette d. bassinet a. radiant warmer A patient is receiving oxygen via a Venturi mask at an FIO2 of 0.45. The nurse is complaining that the patient keeps removing the Venturi mask from his face. The respiratory therapist should do which of the following at this time? a. Tape the Venturi mask to the patient's face b. Restrain the patient c. Switch to a nasal cannula at 6 L/min. d. Intubate the patient orally c. Switch to a nasal cannula at 6 L/min. A 5-year-old patient requires low-flow oxygen therapy. Which of the following devices should the respiratory therapist recommend? a. Oxygen tent b. Simple oxygen mask c. Oxygen hood d. Nasal cannula d. Nasal cannula Which of the following formulas will calculate the number of hours an E cylinder will provide oxygen to a patient? a. tank pressure (PSI) x 0.3 / flowrate (LPM) b. flowrate (LPM) x 0.3 / tank pressure (PSI) c. [tank pressure (PSI) x 0.3 / flowrate (LPM)] / 60 d. [flowrate (LPM) x 0.3 / tank pressure (PSI)] / 60 c. [tank pressure (PSI) x 0.3 / flowrate (LPM)] / 60 A patient is on a 28% Venturi mask with the bed covers pulled up over the mask. Arterial blood gas results on the 28% Venturi mask show the PaO2 is 168 torr. The physician asks the respiratory therapist for a recommendation. Which of the following should the therapist recommend? a. Pull the covers down away from the mask and repeat the arterial blood gas in 30 minutes b. Discontinue the oxygen therapy c. Switch the patient to a nasal cannula at 2 L/min d. Report the arterial blood gas results as is a. Pull the covers down away from the mask and repeat the arterial blood gas in 30 minutes A 26-year-old patient with shortness of breath is admitted to the emergency room. The patient states that he was running in Central Park with a friend and could not catch his breath. Bedside assessment reveals the following data: Pulse: 120 Respirations: 25 br/min Color: pale SpO2: 89% on room air Breath sounds: slightly diminished on the right The respiratory therapist should: a. request a STAT chest x-ray. b. administer 100% oxygen. c. insert a large bore needle into the 2nd intercostal space on the right side in the midclavicular line. d. insert a chest tube into the 2nd intercostal space on the right side in the midclavicular line. b. administer 100% oxygen. During an incentive spirometry treatment using a volume-oriented device, the patient inhales to TLC and exhales slowly to FRC. What other instructions would you give to improve distribution? a. continue with the current instructions b. switch to a flow orientated device c. initiate IPPB d. inspiratory hold d. inspiratory hold A patient is receiving CPAP therapy and the pressure is fluctuating between +5 and -8 cmH2O. What should the therapist do to stabilize the CPAP therapy? a. increase the flowrate b. decrease the pressure c. check for system leaks d. check for sticking valves a. increase the flowrate An air/oxygen proportioner is used to provide an FIO2 of 0.55 by a non-rebreather mask. The blender alarm is sounding. Which of the following is the most likely cause? a. Low oxygen inlet pressure b. High air inlet pressure c. Faulty humidifier bottle connection d. Excessive flow to the non-rebreather mask a. Low oxygen inlet pressure Which of the following supply pressures would be appropriate for an air/oxygen proportioner? a. 30 psi b. 50 psi c. 100 psi d. 760 psi b. 50 psi A patient is receiving IPPB by mouthpiece. The therapist notes that the machine fails to cycle into the expiratory phase. The respiratory therapist should a. increase the flow. b. decrease the sensitivity. c. adjust the apnea timer. d. increase the pressure. a. increase the flow. Which of the following would indicate that a patient is benefiting from PEP therapy? a. PaO2 increases b. Decreased work of breathing c. Breath sounds clear with coughing d. Minute ventilation decreases c. Breath sounds clear with coughing A 2-year-old child has been admitted to the pediatric unit with a barking cough and mild stridor at rest. The pulse oximeter displays an SpO2 of 87% on room air. The physician asks the respiratory therapist to recommend the most appropriate oxygen delivery device for this child. The therapist should recommend a/an a. aerosol mask. b. nasal cannula. c. oxygen hood. d. venturi-mask. a. aerosol mask. What total flow is delivered to a patient if the air entrainment mask is set at 35% oxygen and the flowmeter is set at 6 L/min? a. 20 - 25 L/min b. 30 - 35 L/min c. 40 - 45 L/min d. 50 - 55 L/min b. 30 - 35 L/min A mask CPAP system using a threshold resistor valve is not maintaining the desired pressure. To correct this problem, the respiratory therapist should do all of the following EXCEPT: a. check the valve for proper function. b. reduce gas inlet flow. c. reposition the mask and check the seal. d. add a reservoir to the system. b. reduce gas inlet flow. While performing routine ventilator parameter checks on a patient on a microprocessor ventilator with a wick humidification system, the respiratory therapist notices there is very little condensation in the tubing. The most likely explanation is that the a. temperature probe is placed distal to the wye adapter. b. room temperature is lower than normal. c. heating element is not functioning properly. d. water level is just slightly above the refill line. c. heating element is not functioning properly. A 34-week gestation age infant has just been delivered. The one and five minute apgar scores are 4 and 6. The physician has written an order for 40% humidified oxygen. Which of the following would be the most appropriate device? a. an incubator set at 40% oxygen b. a radient warmer set at 40% c. a oxygen hood set at 40% d. a high humidity oxygen tent set at 40% c. a oxygen hood set at 40% What tank factor is used to calculate how long an H cylinder will last when the pressure (PSI) and flowrate (LPM) are given? a. .003 b. .03 c. 0.3 d. 3.0 d. 3.0 A patient admitted to the emergency room for an acute exacerbation of asthma requires oxygen therapy. The patient has an irregular respiratory rate and pattern and is dyspneic. Which of the following oxygen administration devices would be the most appropriate? a. 40% air entrainment mask b. nasal cannula at 5 L/min. c. simple oxygen mask at 6 L/min. d. 40 % aerosol mask a. 40% air entrainment mask Which of the following would be the best method to deliver oxygen therapy to a full term newborn? a. nasal cannula at 2 LPM b. croup tent at 30-40% oxygen c. oxyhood with a blender to adjust the FIO2 d. isolette with an oxygen bleed-in with a heated nebulizer c. oxyhood with a blender to adjust the FIO2 A patient will be away from their room for two hours while undergoing a special procedure in the radiology department. They will be using a full E cylinder. What is the maximum flow that the therapist could use without running out of oxygen? a. 2 LPM b. 5 LPM c. 8 LPM d. 10 LPM b. 5 LPM Which of the following devices would provide adequate humidity with minimal condensation in the ventilator tubing? a. heated cascade humidifier b. heated wick humidifier c. heat moisture exchanger d. ultrasonic nebulizer c. heat moisture exchanger While reviewing a patient's medical record the respiratory therapist notes that the patient has a Hb level of 14g/dL and an SpO2 of 94%. The patient is receiving oxygen by simple mask at 6 L/min. The respiratory therapist should recommend: a. Non-rebreather mask at 10 LPM b. A unit of whole blood c. CPAP therapy d. Maintain current therapy d. Maintain current therapy A physician asks the respiratory therapist to deliver a precise FIO2 of 0.45 to a patient. Which of the following should the therapist recommend? a. Nasal cannula at 6 L/min b. Simple mask at 5 L/min c. Partial rebreather mask at 8 L/min d. Non-rebreathing mask and blender d. Non-rebreathing mask and blender What total flow is delivered to a patient if the nebulizer is set to 40% oxygen and the flowmeter is set at 9 L/min? a. 15 - 20 L/min b. 25 - 30 L/min c. 35 - 40 L/min d. 45 - 50 L/min c. 35 - 40 L/min A 24-year-old post-operative male patient is receiving intermittent positive pressure therapy at 20 cm H2O. The patient complains that the machine is cycling off too soon. The patient's post-operative spontaneous vital capacity is 3.5 L. Which of the following should the respiratory therapist recommend? a. Increase the pressure to 25 cm H2O b. Discontinue therapy, encourage deep breathing and coughing frequently on his own c. Switch to a volume incentive spirometry device d. Recommend decreasing the flow b. Discontinue therapy, encourage deep breathing and coughing frequently on his own Following exploratory laparotomy, a 51-year-old man has retained secretions in his left lower lobe. The respiratory therapist should recommend a. blow bottles. b. NIPPV (BiPAP®). c. albuterol MDI with spacer. d. PEP therapy. d. PEP therapy. A patient with a history of COPD is receiving 28% oxygen therapy via air-entrainment mask. While performing oxygen rounds, the respiratory therapist notes that the device is delivering 40% oxygen. Which of the following conditions is the most likely cause? a. increase in oxygen flow to the dilution jet b. increase in size of air entrainment ports c. obstruction in the face mask d. decrease in size of jet orifice c. obstruction in the face mask The respiratory therapist notices that a mask CPAP system is unable to maintain the desired level of pressure. Which of the following might be causing the level to not be maintained? 1. Sticking valve in the system 2. Loose fitting mask 3. Faulty humidifier connection 4. Leak around the airway cuff a. 2 only b. 1 & 2 only c. 1, 2 & 3 only d. 1, 2, 3 & 4 c. 1, 2 & 3 only Which of the following therapies would be most appropriate for a spontaneously breathing patient who has atelectasis with a low SpO2 on an FIO2 of 1.0? a. Intermittent Positive Pressure Breathing (IPPB) b. Continuous Positive Airway Pressure (CPAP) c. Continuous Mechanical Ventilation (CMV) d. Intrapulmonary Percussive Ventilation (IPV) b. Continuous Positive Airway Pressure (CPAP) While performing oxygen rounds, the respiratory therapist enters a patient's room and hears a high pressure pop-off alarm sounding from a bubble humidifier. Which of the following is the most likely explanation for this? a. Obstruction in the connecting line b. Leak in the humidifier c. Problem with the valve seat in the flowmeter d. Flowmeter is uncompensated for back pressure a. Obstruction in the connecting line A 53-year-old patient with a history of chronic bronchitis is expected to have difficulty clearing secretions during the post-op recovery days. The respiratory therapist should recommend which of the following to assist the patient with mobilization of their secretions? a. Deep breathing and coughing techniques b. IPPB with albuterol c. Aerosol therapy with racemic epinephrine d. MDI therapy with beclomethasone (Vanceril) a. Deep breathing and coughing techniques A nasopharyngeal airway is indicated for which of the following patients? a. unconscious patient with a closed head injury b. conscious patient with an ineffective cough c. alert patient who is expectorating a large amount of secretions d. uncooperative patient b. conscious patient with an ineffective cough A 43-week gestational age infant has just been delivered and is stained with meconium. The physician has asked that the baby be intubated and suctioned immediately. The respiratory therapist should recommend intubating the baby with which of the following size endotracheal tubes? a. 2.0 mm b. 2.5 mm c. 3.0 mm d. 4.0 mm c. 3.0 mm An 18-month-old child admitted to the pediatric unit is playing with marbles. The child suddenly develops violent coughing and inspiratory stridor. The respiratory therapist has administered back blows and chest thrusts without success. Which of the following should the respiratory therapist now recommend? a. Chest compressions b. Rigid bronchoscopy c. Blind finger sweep d. Mouth to mouth resuscitation b. Rigid bronchoscopy Which of the following is the most appropriate technique for insertion of a nasopharyngeal airway? a. insert the airway in the opposite direction of its shape and rotate 180 degrees b. insert the airway in the opposite direction of its shape and rotate 90 degrees c. insert the airway in the same direction of its shape into the airway and do not rotate d. insert the airway in the same direction of its shape and rotate 180 degrees c. insert the airway in the same direction of its shape into the airway and do not rotate Which of the following describes the proper technique when using a stylet? a. The distal end should be recessed at least 1 cm from the tip of the endotracheal tube b. The distal end should be positioned at the level of the beveled end c. The distal end should be proximal to the "Murphy's Eye" d. The distal end should be positioned proximal to the cuff a. The distal end should be recessed at least 1 cm from the tip of the endotracheal tube A tracheostomy tube has just been changed on a patient receiving continuous ventilation. The patient suddenly becomes dyspneic and develops subcutaneous emphysema. This is most likely due to: a. Patient needs to be suctioned immediately b. Patient is having an allergic reaction to the Teflon tube c. Tracheostomy tube is malpositioned d. A larger tracheostomy tube needs to be inserted c. Tracheostomy tube is malpositioned A patient being mechanically ventilated requires endotracheal suctioning. The patient is on high levels of PEEP therapy and has periods of hypotension. The respiratory therapist hyperoxygenates the patient before beginning the procedure. As the therapist disconnects the patient from the ventilator circuit, the following pattern is seen on the ECG monitor: Which of the following could be the cause of this patient's ECG pattern? a. loss of PEEP b. inadequate hyperoxygenation time c. vagus nerve stimulation d. normal response to suctioning a. loss of PEEP A patient is diagnosed with a necrotizing pulmonary fistula in the right lung. The physician has requested that the right lung be ventilated at a pressure 10 cmH2O lower than the left lung. The respiratory therapist should recommend providing this type of ventilation via a: a. Transtracheal catheter device b. Double-lumen endobronchial tube c. Cricothyroidotomy d. 14 gauge endotracheal catheter b. Double-lumen endobronchial tube A patient has been intubated in order to receive volume control ventilation. To inflate the endotracheal tube cuff, the respiratory therapist should add air to the cuff a. until no leak is heard during inspiration. b. and then remove it until a slight leak is heard at peak inspiration. c. to establish a pressure of 20 mmHg. d. to establish a pressure of 40 cmH2O. c. to establish a pressure of 20 mmHg. A 16-year-old male patient involved in a motorcycle accident presents to the ER with massive maxillary and nasal trauma. Which of the following devices would be most appropriate for maintaining the patient's airway? a. nasal endotracheal tube b. fenestrated tracheostomy tube c. oral pharyngeal airway d. oral endotracheal tube b. fenestrated tracheostomy tube Shortly after extubating a patient, the therapist notes an increase in the patient's work of breathing, intercostal retractions, marked stridor and a decreased SpO2. The therapist should recommend: a. Cool aerosol therapy with 50% oxygen b. Assisted ventilation with a resuscitation bag and mask c. CPAP therapy with 40% oxygen d. Reintubate orally d. Reintubate orally A 48-year-old postoperative patient in the recovery room is still unconscious. Vital signs are all stable and the SpO2 is 95%. Which of the following should the therapist recommend to prevent a soft tissue obstruction from occurring? a. Oropharyngeal airway b. Nasopharyngeal airway c. Laryngeal mask airway d. Esophageal obturator airway a. Oropharyngeal airway What is the function of the one-way valve on a mouth-to-valve mask resuscitation device? a. Increase the delivered FIO2 b. Prevent the patient from exhaling back c. Prevent the patient from breathing room air d. Control the flow of gas to the patient b. Prevent the patient from exhaling back A 57-year-old post-op patient is receiving volume control ventilation. The respiratory therapist is having difficulty removing secretions when suctioning. The patient weighs 85 kg (187 lb), is orally intubated with a size 9.0 mm ID endotracheal tube, the vacuum level is set at 90 mm Hg and the suction catheter being used is a size 14 Fr. The therapist should a. switch to a larger catheter size. b. increase the vacuum level. c. switch to a Coude catheter. d. instill normal saline prior to suctioning. b. increase the vacuum level. A 2800 g neonate has just been orally intubated with a size 3.0 mm ID endotracheal tube. The respiratory therapist is preparing to suction the neonate and notices that there are size 6 French suction catheters at the bedside. The therapist should a. use the size 6 French catheters. b. obtain a size 4 French catheter. c. obtain a size 8 French catheter. d. obtain a size 10 French catheter. b. obtain a size 4 French catheter. While suctioning an adult patient, the respiratory therapist notes that the vacuum regulator is set at 120 mm Hg but only registers 70 mm Hg on the manometer. Which of the following is the LEAST likely cause? a. Leak in the system b. Thumb not completely covering the port c. Loose connection in the collection bottle d. Additional length of suction tubing d. Additional length of suction tubing Which of the following items should the respiratory therapist select prior to performing orotracheal intubation? 1. Various sizes of endotracheal tubes 2. Water-soluble lubricant 3. Stylet 4. Magill forceps a. 1 and 2 only b. 2 and 4 only c. 1 and 3 only d. 3 and 4 only c. 1 and 3 only While performing nasotracheal suctioning on a 64-year-old patient with pneumonia, the respiratory therapist notes that the patient's nares have developed redness and swelling. To prevent further irritation, the respiratory therapist should recommend? a. switching to orotracheal suctioning b. inserting an orotracheal tube c. administering an antibiotic to the site d. inserting a nasopharyngeal airway d. inserting a nasopharyngeal airway A 14-year-old patient has a size 7 mm endotracheal tube placed orally. While suctioning this patient with a size 12 French catheter you meet resistance while attempting to pass the catheter through the tube. The respiratory therapist should a. extubate and reintubate with a size 8 mm endotracheal tube. b. switch to a size 10 French catheter. c. instill mucomyst down the endotracheal tube. d. lubricate the catheter with K-Y jelly prior to suctioning. b. switch to a size 10 French catheter. A respiratory therapist working in the intensive care unit would use a stylet to: a. assist with phonation b. facilitate orotracheal intubation c. maintain a stoma opening d. provide protection to the unaffected lung b. facilitate orotracheal intubation A 58-year-old female patient who weighs 165 lb (75 kg) is orally intubated with a size 6.0 mm endotracheal tube and is receiving volume-control ventilation. The tube is taped at the 23 cm mark at the patient's lips. The tube cuff pressure measures 38 mm Hg. When the respiratory therapist reduces the cuff pressure, the low exhaled volume alarm on the ventilator begins to sound. The therapist should a. replace the endotracheal tube with a larger size. b. maintain the cuff pressure at 38 mm Hg. c. deflate the cuff and advance the tube. d. adjust the low exhaled volume alarm. a. replace the endotracheal tube with a larger size. During cardiopulmonary resuscitation of a 78-year-old patient, the respiratory therapist provides ventilation with a manual resuscitation bag attached to the patient's endotracheal tube. While squeezing the bag, the therapist observes inadequate chest movement. Which of the following is the LEAST likely cause? a. Missing inlet valve b. Defective endotracheal tube cuff c. Incorrect tube placement d. Excessive oxygen flow d. Excessive oxygen flow A patient with a size 8.5 mm oral endotracheal tube is transported from the ED to the ICU. The respiratory therapist suspects that the endotracheal tube has changed position during transport. Which of the following is the quickest way to assess the position of the tube? a. Chest radiograph b. Auscultation of the chest c. Observation of chest movement d. Diagnostic chest percussion c. Observation of chest movement A respiratory therapist is in the cafeteria when an adult visitor begins to choke. The therapist has administered 7 subdiaphragmatic thrusts without clearing the patient's airway, although the patient remains conscious. The therapist should a. administer 5 back blows. b. continue subdiaphragmatic thrusts. c. attempt to ventilate. d. check for presence of a pulse. b. continue subdiaphragmatic thrusts. A patient is receiving continuous mechanical ventilation with 100% oxygen. While suctioning the patient, the respiratory therapist observes the following ECG pattern on the monitor. The therapist should a. decrease the suction time per pass. b. increase the oxygenation time. c. use a smaller suction catheter. d. decrease the suction pressure. a. decrease the suction time per pass. A patient being mechanically ventilated requires endotracheal suctioning. The patient is on high levels of PEEP therapy and has periods of hypotension. The respiratory therapist hyperoxygenates the patient before beginning the procedure. As the therapist disconnects the patient from the ventilator circuit, the above pattern is seen on the ECG monitor. Which of the following could the respiratory therapist recommend to prevent the patient's ECG pattern? a. increase the oxygenation time b. utilize an inline suction catheter c. perform nasotracheal suctioning d. discontinue suctioning the patient b. utilize an inline suction catheter Which of the following is the best way to determine the patency of a nasopharyngeal airway? a. instill 5mL of normal saline into the airway b. attempt to pass a suction catheter through the airway c. listen for air flow through the airway d. recommend a sinus x-ray b. attempt to pass a suction catheter through the airway While performing orotracheal intubation for a patient in respiratory arrest, the respiratory therapist notices that the stylet has advanced from its original position. The respiratory therapist should a. continue with the intubation procedure. b. stop the procedure, manually ventilate the patient, and reposition the stylet. c. retract the stylet immediately. d. remove the stylet and continue with the procedure. b. stop the procedure, manually ventilate the patient, and reposition the stylet. Which of the following is the best method to minimize damage to the tracheal wall caused by an endotracheal tube cuff? a. Measuring the volume used to inflate the cuff b. Palpating the inflation of the pilot balloon c. Utilizing a cuff pressure manometer d. Using minimal occluding volume to seal the airway c. Utilizing a cuff pressure manometer Which of the following statements is/are true regarding an Esophageal Tracheal Combitube? 1. Used for pre-hospital airway management. 2. Placed in the trachea with a laryngoscope. 3. It should be replaced with an endotracheal tube as soon as possible. a. 3 only b. 2 and 3 only c. 1 and 3 only d. 1 and 2 only c. 1 and 3 only A respiratory therapist is performing spirometry on a patient with chronic bronchitis. Which of the following equipment would the respiratory therapist need? a. ergometer b. water seal spirometer c. pneumogram d. turbine pneumotachometer b. water seal spirometer When performing a bronchoscopy on an intubated patient, which of the following CANNOT be visualized? a. Trachea b. Bronchus intermedius c. Carina d. Vocal cords d. Vocal cords What is the normal PAO2 for a patient breathing room air at sea level? a. 50 - 65 torr b. 90 - 100 torr c. 120 - 140 torr d. 250 - 350 torr b. 90 - 100 torr The results of a patient's spirometry are reported as follows: FVC 3.00 1.90 FEV 2.09 1.85 FEF 4.10 3.90 FRC 2.50 1.70 TLC 4.70 3.00 Which of the follow is the most appropriate interpretation? a. Normal b. Pulmonary Fibrosis c. Emphysema d. Chronic Bronchitis b. Pulmonary Fibrosis A "broken" flow/volume loop and/or volume/pressure loop will occur with: a. airway resistance b. overdistension c. auto PEEP d. airway leak d. airway leak A patient has come to the pulmonary function lab for pre-op testing. The patient performs a maximum inspiration followed by a maximum forceful expiration. This procedure would measure: a. RV b. FRC c. TLC d. FVC d. FVC While reviewing a patient's medical record the respiratory therapist notes that the patient has a Hb level of 6 g and SpO2 of 94%. The patient is receiving oxygen by simple mask & is complaining of shortness of breath. The respiratory therapist should recommend a. Changing to a non-rebreather mask b. Administering whole blood c. Initiating PEEP therapy d. Discontinuing oxygen therapy b. Administering whole blood The results of spirometry performed on a patient before and after the administration of aerosolized albuterol are as follows: FVC 80% 93% FEV1 80% 92% FEF25-75 78% 91% FEF200- 84% 95% PEAK FL 71% 83% Based upon these results, your interpretation would be a. mild obstructive with no reversibility. b. mild restrictive with reversibility. c. mild obstructive with reversibility. d. normal pulmonary function. d. normal pulmonary function. A patient complaining of dyspnea has the following arterial blood gas results: pH: 7.36 PaCO2: 56 torr PaO2: 49 torr HCO3-: 34 mEq/L SaO2: 80% FIO2: .21 These results are best described as: a. acute respiratory acidosis b. acute metabolic alkalosis c. chronic respiratory acidosis d. chronic metabolic alkalosis c. chronic respiratory acidosis A patient in the intensive care unit has the following blood gas results: Arterial pH: 7.42 PaCO2: 39 torr PaO2: 90 torr SaO2: 97% HCO3-: 25 mEq/L BE: +1 mEq/L Hb: 14 g/dL Venous pH: 7.39 PvCO2: 46 torr PvO2: 50 torr SvO2: 80 % HCO3-: 25 mEq/L BE: +1 mEq/L What should the respiratory therapist report as the patient's C(a-v)O2? a. 1.8 vol% b. 3.3 vol% c. 5.2 vol% d. 7.3 vol% b. 3.3 vol% A respiratory therapist is performing spirometry on a patient with chronic bronchitis. Which of the following equipment would produce an unreliable measurement? a. body plethysmograph b. water seal spirometer c. wright respirometer d. pressure differential pneumotachometer c. wright respirometer A patient in the intensive care unit has the following data obtained: pH: 7.41 PaCO2: 40 torr PaO2: 235 torr SaO2: 99% HCO3-: 23 mEq/L BE: +1 mEq/L FIO2: 1.0 VD/VT: 0.35 Hb: 15 g/dL RER: 0.8 PB: 747 What should the respiratory therapist report as the P(A-a)O2? a. 210 torr b. 415 torr c. 535 torr d. 620 torr b. 415 torr A 2-month-old infant is receiving 40% oxygen via an oxygen hood. While performing oxygen rounds, the respiratory therapist analyzes the FIO2 inside the hood and discovers that the FIO2 is registering 0.50. The respiratory therapist calibrated the oxygen analyzer at the beginning of the shift. The respiratory therapist should a. check to see that the hood is sealed tightly around the infant's neck. b. decrease the flow to the hood. c. check to see that the temperature setting on the humidifier is at 34oC. d. recalibrate the oxygen analyzer. d. recalibrate the oxygen analyzer. A patient is being ventilated with a Servo 300 ventilator in the intensive care unit. The following data is obtained: Mode: SIMV Mandatory rate: 12 b/min Total rate: 12 b/min VE: 8.6 L FIO2: 0.60 PIP: 31 cm H2O PEEP: 10 cm H2O pH: 7.41 PaCO2: 40 torr PaO2: 95 torr SaO2: 96% HCO3-: 23 mEq/L BE: +1 mEq/L A-aDO2: 300 torr C(a-v)O2: 3.6 vol% What should the therapist report as the QS/QT? a. 15% b. 18% c. 20% d. 25% c. 20% The following data was collected for a patient in the intensive care unit: pH: 7.38 PaCO2: 40 torr PaO2: 90 torr HCO3-: 25 mEq/L BE: +1 mEq/L SaO2: 98% FIO2: .30 Hb: 15g/dl RER: 0.8 PB: 747 torr PECO2: 10 torr What should be reported as the patient's VD/VT ratio? a. 20% b. 35% c. 50% d. 75% d. 75% Which of the following statements are true concerning capillary blood gas sampling versus arterial blood gas analysis? a. Capillary pH will be lower than the arterial pH b. Capillary PO2 will be lower than the arterial PO2 c. Capillary PCO2 will be higher than the arterial PCO2 d. Capillary HCO3 will be higher than the arterial HCO3 b. Capillary PO2 will be lower than the arterial PO2 The FRC (functional residual capacity) is measured on a patient using the helium dilution technique and the result is 3.0 liters. The same patient is then tested in a body box and the result is 4.5 liters. Which of the following would account for the difference? a. The patient has significant non-ventilated lung volume b. There was a leak during the helium dilution procedure c. The patient did not perform the maneuver properly d. Hysteresis is present a. The patient has significant non-ventilated lung volume What is the PAO2 for a patient breathing 30% oxygen at sea level? a. 100 - 105 torr b. 120 - 140 torr c. 155 - 170 torr d. 210 - 220 torr c. 155 - 170 torr Prior to performing spirometry on a pre-op patient, the respiratory therapist calibrates the spirometer using a 3.0 L super syringe. The three volumes achieved are: 2.80 L, 2.80 L, 2.79 L. Based upon the information obtained the therapist should conclude that the 1. spirometer is precise. 2. spirometer is accurate. 3. super syringe was advanced too slowly. 4. spirometer may have a leak. a. 1 and 3 only b. 1 and 4 only c. 2 and 3 only d. 2 and 4 only b. 1 and 4 only A patient is observed to have an increased respiratory rate and depth of breathing. Their breath has a fruit-like aroma. This would most likely be associated with: a. head trauma b. metabolic acidosis c. drug overdose d. chronic obstructive lung disease b. metabolic acidosis A 3-year-old child is admitted to the emergency room with a sudden, persistent, dry cough. Chest x-ray results reveal a normal inspiration with only one lung expanded on expiration. Which of the following would you recommend at this time? a. Endobronchial intubation b. Bronchoscopy c. Arterial blood gas analysis d. Lateral neck x-ray b. Bronchoscopy Pre- and post-bronchodilator spirometry study is performed on a patient with the following results: FVC 69% 70% FEV1 83% 81% FEF200 85% 82% FEF25 81% 82% MVV 70% 75% PEAK 82% 82% These results can best be described as a. normal spirometry. b. obstructive only. c. restrictive only. d. both obstructive and restrictive. c. restrictive only. What would be the oxygen consumption (VO2) for a patient with the following data: pH: 7.45 PaCO2: 39 torr PaO2: 94 torr HCO3-: 29 mEq/liter BE: +1 SaO2: 96% Hb: 15.8 gms QT: 5.2 LPM CaO2: 19.3 vol% CvO2: 14.3 vol% a. 150 mL/min b. 210 mL/min c. 260 mL/min d. 380 mL/min c. 260 mL/min A patient is on a ventilator and is in the process of being weaned. What is the best way to continuously monitor the minute ventilation? a. Chest transducers b. Thermistors c. Water seal spirometer d. Pneumotachometer d. Pneumotachometer A patient is being mechanically ventilated in the intensive care unit. The following data is obtained: Mode: VC, SIMV Mandatory rate: 12 b/min Total rate: 18 b/min VT: 800 mL FIO2: 0.60 PIP: 31 cm H2O PEEP: 10 cm H2O pH: 7.41 PaCO2: 40 torr PaO2: 95 torr SaO2: 96% HCO3-: 23 mEq/L BE: +1 mEq/L PECO2: 30 torr Hb: 15 g/dL What should the respiratory therapist report as the CaO2? a. 18.40 vol% b. 18.60 vol% c. 19.30 vol% d. 19.59 vol% d. 19.59 vol% Which of the following would equal the vital capacity (VC)? a. VT + IRV b. ERV + RV c. IRV + VT + ERV d. IRV + VT + ERV + RV c. IRV + VT + ERV The following data was collected for a patient in the intensive care unit: pH: 7.39 PaCO2: 40 torr PaO2: 90 torr HCO3-: 24 mEq/L BE: +1 mEq/L SaO2: 95% FIO2: .50 Hb: 15g/dl RER: 0.8 PB: 747 torr PECO2: 20 torr What should be reported as the patient's VD/VT ratio? a. 20% b. 35% c 50% d. 75% c 50% The best way to check the accuracy of an air/oxygen proportioner is by using: a. polarographic electrode analyzer b. precision geisler tube analyzer c. infrared absorption analyzer d. teflon membrane analyzer a. polarographic electrode analyzer Pre- and post-bronchodilator spirometry study is performed on a patient with the following results: FVC 89% 90% FEV1 81% 82% FEF200 80% 81% FEF25 81% 82% MVV 85% 85% PEAK 86% 80% These results can best be described as: a. normal spirometry. b. obstructive only. c. restrictive only. d. both obstructive and restrictive. a. normal spirometry. The following data was collected for a patient in the intensive care unit: pH: 7.38 PaCO2: 40 torr PaO2: 90 torr HCO3-: 25 mEq/L BE: +1 mEq/L SaO2: 98% FIO2: .30 Hb: 15g/dl RER: 0.8 PB: 747 torr PECO2: 10 torr What should be reported as the patient's P(A-a)O2? a. 70 torr b. 160 torr c. 210 torr d. 350 torr a. 70 torr Which of the following will determine the partial pressure of oxygen in the alveolus? a. (Hb x 1.34 x SaO2) + (PaO2 x .003) b. (PaCO2 - PECO2) / PaCO2 c. (PAO2 - PaO2) .003 / [(PAO2 - PaO2) .003] + C(a-v)O2 d. (PB - PH2O) FIO2 - (PaCO2 / 0.8) d. (PB - PH2O) FIO2 - (PaCO2 / 0.8) Which of the following would be the best test to evaluate a patient's partial vocal cord paralysis? a. Flow volume loop b. MVV c. SB nitrogen elimination d. DCO a. Flow volume loop Which of the following will determine the oxygen gradient between the alveolus and the arterialized blood? a. PAO2 - PaO2 b. CaO2 - CvO2 c. (PaCO2 - PECO2) / PaCO2