RCP 170 Final Exam| 108 questions| with
complete solutions
Course
RCP 170
1. Question – Oxygen Delivery
A patient with COPD has SpO₂ 88%. The physician orders oxygen therapy via nasal cannula.
What is the appropriate flow rate to start?
A. 1 L/min
B. 2 L/min
C. 4 L/min
D. 6 L/min
Answer: B
Solution/Rationale:
For COPD patients, oxygen should be titrated carefully to avoid hypercapnia. A nasal cannula at
2 L/min typically raises SpO₂ to 90–92% safely. Starting at 4–6 L/min risks suppressing hypoxic
drive.
2. Question – ABG Interpretation
ABG values: pH 7.30, PaCO₂ 55 mmHg, HCO₃⁻ 26 mEq/L. What is the primary disorder?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
Answer: B
Solution/Rationale:
pH < 7.35 → acidemia
PaCO₂ elevated → primary respiratory problem
HCO₃⁻ normal → minimal compensation
Conclusion: Acute respiratory acidosis.
3. Question – Mechanical Ventilation
,A patient on volume-controlled ventilation has a peak airway pressure of 40 cm H₂O. The
previous reading was 25 cm H₂O. What is the first action?
A. Increase tidal volume
B. Assess for obstruction or kink
C. Decrease respiratory rate
D. Sedate the patient
Answer: B
Solution/Rationale:
A sudden rise in peak pressure usually indicates airway obstruction, kinked tubing, or
bronchospasm. Immediate assessment prevents barotrauma. Increasing tidal volume or sedating
without checking is unsafe.
4. Question – Incentive Spirometry
Which patient is the best candidate for incentive spirometry?
A. Intubated ICU patient
B. Post-operative abdominal surgery patient
C. Patient with severe COPD exacerbation
D. Patient in respiratory failure on BiPAP
Answer: B
Solution/Rationale:
Incentive spirometry is used to prevent atelectasis post-operatively. Intubated or BiPAP patients
cannot perform it effectively; severe COPD patients may have difficulty achieving target
volumes.
5. Question – Aerosol Therapy
A patient receives a bronchodilator via nebulizer. How can you maximize drug deposition?
A. High inspiratory flow
B. Slow deep breaths with breath-hold
C. Rapid shallow breaths
D. Remove mask intermittently
Answer: B
Solution/Rationale:
Slow, deep breaths with 2–3 second breath-hold allow particles to deposit in lower airways.
Rapid shallow breathing decreases alveolar delivery.
,6. Question – Suctioning
A patient with an artificial airway has coarse crackles. Suctioning is needed. Maximum suction
pressure for adults?
A. 50–80 mmHg
B. 80–120 mmHg
C. 100–150 mmHg
D. 150–200 mmHg
Answer: B
Solution/Rationale:
Adult suction pressure: 80–120 mmHg. Excessive pressure may cause trauma or hypoxia;
inadequate pressure will not clear secretions.
7. Question – Non-Invasive Ventilation
A patient with acute pulmonary edema is started on CPAP. Which is the main expected benefit?
A. Reduces preload and afterload, improves oxygenation
B. Increases cardiac output by 50%
C. Lowers blood pressure to normal immediately
D. Eliminates need for diuretics
Answer: A
Solution/Rationale:
CPAP increases intrathoracic pressure → reduces venous return (preload) and left ventricular
afterload, improving oxygenation in pulmonary edema.
8. Question – Endotracheal Tube Placement
After intubation, which is the most reliable method to confirm placement?
A. Chest auscultation
B. Observing chest rise
C. Capnography (ETCO₂)
D. Patient verbal response
Answer: C
Solution/Rationale:
, Capnography provides continuous and accurate confirmation. Auscultation and chest rise can be
misleading, especially in emergency situations.
9. Question – Humidification
Which patient requires heated humidification of inspired gases?
A. Patient on nasal cannula at 2 L/min
B. Patient on 100% O₂ via non-rebreather mask
C. Patient on mechanical ventilation
D. Patient receiving room air
Answer: C
Solution/Rationale:
Mechanical ventilation bypasses upper airway humidification; heated humidification prevents
mucosal drying and thick secretions.
10. Question – Chest Physiotherapy
Which condition benefits most from postural drainage and percussion?
A. Pulmonary embolism
B. Pneumothorax
C. Cystic fibrosis with mucus plugging
D. Acute asthma attack
Answer: C
Solution/Rationale:
Chest physiotherapy helps mobilize thick secretions in conditions like cystic fibrosis. It is
contraindicated in pneumothorax and not indicated for asthma exacerbations or PE.
11. Question – Arterial Blood Gas
ABG values: pH 7.25, PaCO₂ 60 mmHg, HCO₃⁻ 28 mEq/L. What is the acid-base disturbance?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
Answer: B
Solution/Rationale:
pH < 7.35 → acidemia
complete solutions
Course
RCP 170
1. Question – Oxygen Delivery
A patient with COPD has SpO₂ 88%. The physician orders oxygen therapy via nasal cannula.
What is the appropriate flow rate to start?
A. 1 L/min
B. 2 L/min
C. 4 L/min
D. 6 L/min
Answer: B
Solution/Rationale:
For COPD patients, oxygen should be titrated carefully to avoid hypercapnia. A nasal cannula at
2 L/min typically raises SpO₂ to 90–92% safely. Starting at 4–6 L/min risks suppressing hypoxic
drive.
2. Question – ABG Interpretation
ABG values: pH 7.30, PaCO₂ 55 mmHg, HCO₃⁻ 26 mEq/L. What is the primary disorder?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
Answer: B
Solution/Rationale:
pH < 7.35 → acidemia
PaCO₂ elevated → primary respiratory problem
HCO₃⁻ normal → minimal compensation
Conclusion: Acute respiratory acidosis.
3. Question – Mechanical Ventilation
,A patient on volume-controlled ventilation has a peak airway pressure of 40 cm H₂O. The
previous reading was 25 cm H₂O. What is the first action?
A. Increase tidal volume
B. Assess for obstruction or kink
C. Decrease respiratory rate
D. Sedate the patient
Answer: B
Solution/Rationale:
A sudden rise in peak pressure usually indicates airway obstruction, kinked tubing, or
bronchospasm. Immediate assessment prevents barotrauma. Increasing tidal volume or sedating
without checking is unsafe.
4. Question – Incentive Spirometry
Which patient is the best candidate for incentive spirometry?
A. Intubated ICU patient
B. Post-operative abdominal surgery patient
C. Patient with severe COPD exacerbation
D. Patient in respiratory failure on BiPAP
Answer: B
Solution/Rationale:
Incentive spirometry is used to prevent atelectasis post-operatively. Intubated or BiPAP patients
cannot perform it effectively; severe COPD patients may have difficulty achieving target
volumes.
5. Question – Aerosol Therapy
A patient receives a bronchodilator via nebulizer. How can you maximize drug deposition?
A. High inspiratory flow
B. Slow deep breaths with breath-hold
C. Rapid shallow breaths
D. Remove mask intermittently
Answer: B
Solution/Rationale:
Slow, deep breaths with 2–3 second breath-hold allow particles to deposit in lower airways.
Rapid shallow breathing decreases alveolar delivery.
,6. Question – Suctioning
A patient with an artificial airway has coarse crackles. Suctioning is needed. Maximum suction
pressure for adults?
A. 50–80 mmHg
B. 80–120 mmHg
C. 100–150 mmHg
D. 150–200 mmHg
Answer: B
Solution/Rationale:
Adult suction pressure: 80–120 mmHg. Excessive pressure may cause trauma or hypoxia;
inadequate pressure will not clear secretions.
7. Question – Non-Invasive Ventilation
A patient with acute pulmonary edema is started on CPAP. Which is the main expected benefit?
A. Reduces preload and afterload, improves oxygenation
B. Increases cardiac output by 50%
C. Lowers blood pressure to normal immediately
D. Eliminates need for diuretics
Answer: A
Solution/Rationale:
CPAP increases intrathoracic pressure → reduces venous return (preload) and left ventricular
afterload, improving oxygenation in pulmonary edema.
8. Question – Endotracheal Tube Placement
After intubation, which is the most reliable method to confirm placement?
A. Chest auscultation
B. Observing chest rise
C. Capnography (ETCO₂)
D. Patient verbal response
Answer: C
Solution/Rationale:
, Capnography provides continuous and accurate confirmation. Auscultation and chest rise can be
misleading, especially in emergency situations.
9. Question – Humidification
Which patient requires heated humidification of inspired gases?
A. Patient on nasal cannula at 2 L/min
B. Patient on 100% O₂ via non-rebreather mask
C. Patient on mechanical ventilation
D. Patient receiving room air
Answer: C
Solution/Rationale:
Mechanical ventilation bypasses upper airway humidification; heated humidification prevents
mucosal drying and thick secretions.
10. Question – Chest Physiotherapy
Which condition benefits most from postural drainage and percussion?
A. Pulmonary embolism
B. Pneumothorax
C. Cystic fibrosis with mucus plugging
D. Acute asthma attack
Answer: C
Solution/Rationale:
Chest physiotherapy helps mobilize thick secretions in conditions like cystic fibrosis. It is
contraindicated in pneumothorax and not indicated for asthma exacerbations or PE.
11. Question – Arterial Blood Gas
ABG values: pH 7.25, PaCO₂ 60 mmHg, HCO₃⁻ 28 mEq/L. What is the acid-base disturbance?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
Answer: B
Solution/Rationale:
pH < 7.35 → acidemia
