the post-test Feedback Report.
h = a response that could harm the patient
u = a response that is not correct
a = a response that could be acceptable, but is not the best among the four options
c = the response that is the best among the four options and credited as correct
X 1. When reviewing the chart of a newly admitted patient, a respiratory therapist
finds the patient has COPD and a 70-pack-year smoking history. The patient
was admitted for dyspnea. The patient is somnolent, can protect his airway,
and has a BP of 180/100 mm Hg. Which of the following should the therapist
recommend?
chest
A.X
radiograph
B.√ arterial blood gas
C. serum electrolytes
D. ECG
EXPLANATIONS:
(a) A. Reviewing a chest radiograph should not be the therapist's first
consideration since it would not determine needed respiratory care
intervention.
(c) B. Arterial blood gas analysis is critical to evaluate the need for
intubation, in addition to the other clinical indications for intubation and
ventilatory support.
(u) C. Serum electrolytes should not be the therapist's first consideration
since it would not determine needed respiratory care intervention.
, (u) D. An ECG will delay evaluation of the patient's respiratory status.
√ 2. An unpackaged HME is found lying on top of a ventilator. No condensate is
observed inside the HME. The patient has no other humidification device in
place. Which of the following should a respiratory therapist do?
Visually inspect the HME for mucus
A.
obstruction.
Open a new HME and attach it to the endotracheal
B.√
tube.
Discard the HME and monitor airway pressures over
C.
time.
Insert the HME between the patient Y and the endotracheal
D.
tube.
EXPLANATIONS:
(u) A. The HME is assumed to be contaminated because it is found exposed
on top of the ventilator.
(c) B. A clean HME is required.
(h) C. Discarding the HME leaves the patient without adequate
humidification.
(h) D. The position is correct, but the HME should be assumed to be
contaminated.
√ 3. A patient's blood pressure monitored through an arterial catheter is 126/78
mm Hg. The transducer is mounted on a free-standing IV pole. The bed is
lowered to permit routine patient care. How will this affect the measured
, blood pressure?
Systolic Diastolic
A. increased increased
B. increased decreased
C.√ decreased decreased
D. decreased increased
EXPLANATIONS:
(u) A. See explanation C.
(u) B. See explanation C.
(c) C. A fluid-filled transducer catheter system is zeroed to the patient's
position. Lowering the patient relative to the height of the transducer will
result in both a lower systolic and diastolic blood pressure reading
proportionate to the change in patient position.
(u) D. See explanation C.
√ 4. A 25-year-old patient with apnea is receiving PC ventilation. Blood gas
results are as follows:
Increases in which of the following could correct the arterial blood gas
, abnormalities?
1. pressure limit
2. sensitivity
3. mandatory rate
4. expiratory time
1 and 3
A.√
only
1 and 4
B.
only
2 and 3
C.
only
2 and 4
D.
only
EXPLANATIONS:
1. True. Increasing the pressure limit would increase tidal volume and
minute ventilation causing a decrease in PaCO2 and an increase in pH.
2. False. Increasing sensitivity will not increase ventilation in this patient.
3. True. Increasing the mandatory rate will increase minute ventilation
causing a decrease in PaCO2.
4. False. Increasing expiratory time will decrease tidal volume and minute
ventilation, potentially causing an increase in PaCO 2 and a further decrease
in pH.
(c) A. Correct response
(u) B. Incomplete and incorrect response
(u) C. Incomplete and incorrect response
h = a response that could harm the patient
u = a response that is not correct
a = a response that could be acceptable, but is not the best among the four options
c = the response that is the best among the four options and credited as correct
X 1. When reviewing the chart of a newly admitted patient, a respiratory therapist
finds the patient has COPD and a 70-pack-year smoking history. The patient
was admitted for dyspnea. The patient is somnolent, can protect his airway,
and has a BP of 180/100 mm Hg. Which of the following should the therapist
recommend?
chest
A.X
radiograph
B.√ arterial blood gas
C. serum electrolytes
D. ECG
EXPLANATIONS:
(a) A. Reviewing a chest radiograph should not be the therapist's first
consideration since it would not determine needed respiratory care
intervention.
(c) B. Arterial blood gas analysis is critical to evaluate the need for
intubation, in addition to the other clinical indications for intubation and
ventilatory support.
(u) C. Serum electrolytes should not be the therapist's first consideration
since it would not determine needed respiratory care intervention.
, (u) D. An ECG will delay evaluation of the patient's respiratory status.
√ 2. An unpackaged HME is found lying on top of a ventilator. No condensate is
observed inside the HME. The patient has no other humidification device in
place. Which of the following should a respiratory therapist do?
Visually inspect the HME for mucus
A.
obstruction.
Open a new HME and attach it to the endotracheal
B.√
tube.
Discard the HME and monitor airway pressures over
C.
time.
Insert the HME between the patient Y and the endotracheal
D.
tube.
EXPLANATIONS:
(u) A. The HME is assumed to be contaminated because it is found exposed
on top of the ventilator.
(c) B. A clean HME is required.
(h) C. Discarding the HME leaves the patient without adequate
humidification.
(h) D. The position is correct, but the HME should be assumed to be
contaminated.
√ 3. A patient's blood pressure monitored through an arterial catheter is 126/78
mm Hg. The transducer is mounted on a free-standing IV pole. The bed is
lowered to permit routine patient care. How will this affect the measured
, blood pressure?
Systolic Diastolic
A. increased increased
B. increased decreased
C.√ decreased decreased
D. decreased increased
EXPLANATIONS:
(u) A. See explanation C.
(u) B. See explanation C.
(c) C. A fluid-filled transducer catheter system is zeroed to the patient's
position. Lowering the patient relative to the height of the transducer will
result in both a lower systolic and diastolic blood pressure reading
proportionate to the change in patient position.
(u) D. See explanation C.
√ 4. A 25-year-old patient with apnea is receiving PC ventilation. Blood gas
results are as follows:
Increases in which of the following could correct the arterial blood gas
, abnormalities?
1. pressure limit
2. sensitivity
3. mandatory rate
4. expiratory time
1 and 3
A.√
only
1 and 4
B.
only
2 and 3
C.
only
2 and 4
D.
only
EXPLANATIONS:
1. True. Increasing the pressure limit would increase tidal volume and
minute ventilation causing a decrease in PaCO2 and an increase in pH.
2. False. Increasing sensitivity will not increase ventilation in this patient.
3. True. Increasing the mandatory rate will increase minute ventilation
causing a decrease in PaCO2.
4. False. Increasing expiratory time will decrease tidal volume and minute
ventilation, potentially causing an increase in PaCO 2 and a further decrease
in pH.
(c) A. Correct response
(u) B. Incomplete and incorrect response
(u) C. Incomplete and incorrect response
