KETTERING CSE PRACTICE QUESTIONS AND CORRECT VERIFIED ANSWERS

KETTERING CSE PRACTICE QUESTIONS
AND CORRECT VERIFIED ANSWERS
YouA2areA2theA2respiratoryA2therapistA2workingA2inA2aA2600-
bedA2urbanA2medicalA2centerA2andA2yourA2assignmentA2includesA2providingA2careA2toA2pat
ientsA2onA2theA2generalA2medicalA2floor.A2YouA2areA2askedA2toA2assistA2inA2theA2careA2ofA2
aA2recentlyA2admittedA232-year-
oldA2maleA2patientA2whoA2isA2180A2cmA2(5'11")A2tallA2andA2weighsA253A2kgA2(117A2lb).A2The
A2patientA2isA2paleA2andA2complainsA2ofA2persistentA2coughA2andA2feverA2forA2overA2aA2we
ek.A2TheA2hospitalistA2asksA2youA2toA2evaluateA2theA2patientA2andA2reportA2yourA2findings.
A2YouA2arriveA2inA2theA2patient'sA2room,A2introduceA2yourself,A2andA2explainA2theA2purpose
A2ofA2yourA2visit.A2WhichA2ofA2theA2followingA2shouldA2youA2includeA2inA2yourA2assessment
?A2-A2Ans--VitalA2Signs/A2PulseA2oximetry/A2BreathA2sounds/A2RespiratoryA2pattern/
A2GeneralA2appearance/A2PastA2medicalA2history/A2DiagnosticA2chestA2percussion/
A2HistoryA2ofA2presentA2illness


YouA2reportA2yourA2findingsA2toA2theA2hospitalist,A2whoA2asksA2forA2yourA2recommendatio
n.A2BasedA2onA2yourA2assessment,A2whichA2ofA2theA2followingA2wouldA2youA2recommend?
A2-A2Ans--AdministerA2oxygenA2byA2nasalA2cannulaA2atA25A2L/min


TheA2hospitalistA2asksA2whatA2additionalA2testingA2mayA2beA2indicated.A2YouA2shouldA2rec
ommendA2-A2Ans--ArterialA2bloodA2gas/A2CompleteA2bloodA2count/A2chestA2radiograph/
A212-leadA2ECG/A2SputumA2culture/A2SputumA2acid-fastA2stain/A2drugA2toxicology/
A2serumA2electrolytes/A2urinalysis/


AnA2ELISAA2testA2confirmsA2aA2diagnosisA2ofA2HIVA2andA2aA2sputumA2acidA2fastA2stainA2isA
2negative.A2SputumA2cultureA2confirmsA2theA2presenceA2ofA2PneumocystisA2jiroveci.A2Wh
atA2additionalA2therapyA2wouldA2youA2recommendA2atA2thisA2time?A2-A2Ans--Pentamidine

FourA2hoursA2later,A2arterialA2bloodA2gasA2analysisA2onA240%A2oxygenA2reveals:A2pHA27.2
0,A2PaCO2A260A2torr,A2PaO2A264A2torr,A2HCO3-A224A2mEq/
L,A2BEA2Zero,A2SaO2A2(calc)A291%.A2BreathA2soundsA2areA2diminishedA2withA2bilateralA2w
heezing.A2WhichA2ofA2theA2followingA2wouldA2youA2recommend?A2-A2Ans--
InitiateA2mechanicalA2ventilation

TheA2physicianA2asksA2youA2toA2recommendA2initialA2ventilatorA2settings.A2WhichA2ofA2theA
2followingA2wouldA2youA2suggest?A2-A2Ans--VC/SIMV,A2VTA2450A2mL,A2fA212/
min,A2FIO2A20.50,A2PEEPA23A2cmA2H2O

YouA2areA2theA2respiratoryA2therapistA2workingA2atA2aA2330-
bedA2suburbanA2medicalA2center.A2YouA2areA2calledA2toA2LaborA2andA2DeliveryA2toA2assist
A2inA2theA2careA2ofA2aA21500A2gA2(3.3A2lb)A2femaleA2neonateA2bornA2atA230A2weeksA2ofA2ge
station.TheA2neonateA2hasA2beenA2driedA2andA2placedA2onA2aA2radiantA2warmer.A2HerA2he
artA2rateA2isA2120/min,A2respiratoryA2rateA2isA245/

, min,A2thereA2isA2noA2activityA2orA2responseA2toA2suctioning,A2andA2sheA2isA2cyanotic.A2You
A2shouldA2nowA2-A2Ans--AdministerA2oxygen


TwoA2hoursA2laterA2youA2areA2calledA2toA2theA2NICUA2toA2evaluateA2theA2neonate.A2SheA2i
sA2currentlyA2receivingA250%A2oxygenA2viaA2oxyhood.A2VitalA2signsA2are:A2temperatureA23
6.3°A2CA2(97.3°A2F),A2pulseA2166/min,A2respirationsA240/
min,A2BPA275/59A2mmA2Hg,A2SpO2A281%.A2AuscultationA2revealsA2diminishedA2breathA2so
unds.A2UmbilicalA2arteryA2bloodA2gasA2resultsA2are:A2pHA27.32,A2PaCO2A245A2torr,A2PaO2A
249A2torr,A2HCO3-A223A2mEq/L,A2BEA2-
1,A2SaO2A2(calc)A279%.A2WhichA2ofA2theA2followingA2shouldA2youA2nowA2recommendA2toA2
theA2neonatologist?A2-A2Ans--InitiateA2nasalA2CPAP

AnA2A-
PA2chestA2radiographA2revealsA2aA2groundA2glassA2appearanceA2withA2diffuseA2bilateralA2r
adiopacities.A2WhichA2ofA2theA2followingA2wouldA2youA2recommendA2atA2thisA2time?A2-
A2Ans--SurfactantA2replacementA2therapy


FourA2hoursA2later,A2youA2areA2askedA2toA2reassessA2theA2neonate.A2SheA2isA2currentlyA2r
eceivingA24A2cmA2H2OA2CPAPA2therapyA2viaA2nasalA2prongsA2withA250%A2oxygen,A2Umbil
icalA2arteryA2bloodA2gasA2resultsA2are:A2pHA27.19,A2PaCO2A257A2torr,A2PaO2A241A2torr,A2H
CO3-A222A2mEq/L,A2BEA2-2,A2SaO2A2(calc)A273%.A2YouA2shouldA2nowA2recommendA2-
A2Ans--InitiateA2mechanicalA2ventilation


TheA2neonatologistA2asksA2forA2yourA2recommendationA2forA2initialA2ventilatorA2settings.A2
YouA2shouldA2nowA2recommendA2-A2Ans--PC/SIMV,A2PIPA227A2cmA2H2O,A2rateA229/
min,A2FIO2A20.50,A2PEEPA24A2cmA2H2O

YouA2areA2theA2respiratoryA2therapistA2workingA2atA2aA2350-
bedA2suburbanA2hospital.A2YouA2receiveA2aA2callA2fromA2theA2EmergencyA2DepartmentA2to
A2assistA2inA2theA2careA2ofA2aA253A2year-
oldA2femaleA2patientA2whoA2droveA2herselfA2toA2theA2EDA2afterA2completingA2aA2highA2inte
nsityA2exerciseA2class.A2TheA2patientA2presentsA2withA2shortnessA2ofA2breath,A2nausea,A2li
ghtheadednessA2andA2anA2uncomfortableA2fullnessA2inA2theA2centerA2ofA2herA2chest.A2She
A2isA2163A2cmA2(5'A24")A2tallA2andA2weighsA270A2kgA2(154A2lb).A2TheA2EDA2physicianA2asksA
2youA2toA2evaluateA2theA2patientA2andA2reportA2yourA2findings.A2-A2Ans--
LevelA2ofA2consciousness/A2VitalA2signs/A2Electrolytes/A2PulseA2oximetry/
A2GeneralA2appearance/A2ECGA2monitor/A2BreathA2sounds/A2ABGA2results/
A2DiagnosticA2chestA2percussion/A2CBC/A2Troponin/A2CXR


TheA2EDA2physicianA2asksA2forA2yourA2recommendation.A2WhichA2ofA2theA2followingA2woul
dA2youA2recommend?A2-A2Ans--40%A2O2A2viaA2air-entrainmentA2mask/
A2ContinuousA2ECGA2monitor/A2AspirinA2therapy


TheA2patientA2hasA2beenA2transferredA2toA2theA2CardiacA2CathA2LabA2whereA2aA2percutan
eousA2cardiacA2catheterizationA2hasA2beenA2performed.A2TheA2resultA2ofA2theA2catheteriza
tionA2indicatedA2twoA2blockedA2coronaryA2vesselsA2thatA2haveA2beenA2stented.A2DuringA2t