C&S TMC Exam 1| 158 QUESTIONS| 23 PAGES|
WITH COMPLETE SOLUTION
- An infant is being mechanically ventilated via a time-cycled, pressure-limited ventilator. Which
of the following would occur if PEEP were increased without a corresponding increase in peak
pressure? Correct Answer: The tidal volume would decrease
- A physician requests the respiratory therapist to assess the upper airway function of a patient
with a fenestrated tracheostomy tube. The therapist should: Correct Answer: Remove the inner
cannula, deflate the cuff, plug the outer cannula
- A patient receiving sustained maximal inspiratory (SMI) treatments with a volume-oriented
incentive spirometer device begins to inhale through the device 18 times per minute. Which of
the following best explains this situation? Correct Answer: The patient needs re-instruction
regarding the SMI therapy
- After initiating mechanical ventilation in the A/C mode for an adult male patient, the
respiratory therapist observes that the patient is agitated and having difficulty in cycling the
ventilator. Which of the following should the therapist do? Correct Answer: Increase the
sensitivity setting
- Data recorded for a 52 kg (110 lb) mechanically ventilated patient who has a long standing
history of chronic hypercapnia are as follows:
Ventilator Settings Arterial Blood Gases
Mode: SIMV
pH: 7.36
VT: 400 mL
PaCO2: 62 mmHg
Rate: 8/min
HCO3: 34 mEq/L
FiO2: 0.35
PaO2: 61 mmHg
On the basis of this information, the respiratory therapist should: Correct Answer: Maintain
current settings
- A respiratory therapist is manually ventilating a patient during a cardiopulmonary resuscitation
attempt. An arterial blood gas is drawn and the results are as follows:
pH: 7.27
PaCO2: 38 mmHg
HCO3: 17 mEq/L
PaO2: 44 mmHg
,Based on this information, the respiratory therapist should do which of the following? Correct
Answer: Ensure that the manual resuscitator is connected to an oxygen source
- A COPD patient is brought to the ED after several days of increasing respiratory distress.
Baseline blood gases are drawn and the patient is placed on oxygen at 2 LPM via nasal cannula.
Data from the original and a subsequent arterial blood sample are as follows:
Room Air Sample
pH: 7.23
PaCO2: 82 mmHg
HCO3: 33 mEq/L
PaO2: 49 mmHg
2L nasal O2
pH: 7.33
PaCO2: 66 mmHg
HCO3: 34 mEq/L
PaO2: 54 mmHg
Based on the above information, the respiratory therapist should: Correct Answer: Increase the
oxygen flow to 3L/min and continue to monitor.
- A 16-year-old female has just been admitted to the ED following a bicycling accident. She is
receiving supplemental oxygen via nonrebreathing mask. While standing at the bedside, the
respiratory therapist notes the onset of ataxic breathing. Which of the following should the
therapist do? Correct Answer: Begin manual ventilation
- A respiratory therapist is performing a chest examination on an adult male patient. The
therapist notes the trachea is deviated to the right with flatness to percussion on the right. Which
of the following best explains these findings? Correct Answer: Right sided atelectasis
- A patient in the intensive care unit is receiving supplemental oxygen via 40% air-entrainment
mask. Current arterial blood gas results are as follows:
pH: 7.43
PaCO2: 54 mmHg
HCO3: 34 mEq/L
PaO2: 88 mmHg
Which of the following is the correct interpretation for these results? Correct Answer:
Compensated metabolic alkalosis
- While a respiratory therapist is checking the oxygen setup of a patient on 2L/min nasal cannula,
the patient complains of not being able to detect any oxygen flow from the cannula. Which of the
following actions is appropriate at this time? Correct Answer: Tighten all connections
, - One hour after the initiation of volume-controlled ventilation in the A/C mode for a 21-year-
old, 178 cm ( 5 ft 10 in) tall adult male patient who sustained severe lung contusions following a
motor vehicle accident, an arterial blood gas sample was obtained. Pertinent data are as follows:
Ventilator Settings:
FiO2: 0.60
Rate: 16/min
VT: 500 mL
PEEP: 5 cmH2O
Arterial blood gases:
pH: 7.46
PaCO2: 30 mmHg
HCO3: 21 mEq/L
PaO2: 111 mmHg
The respiratory therapist should suggest which of the following? Correct Answer: Decrease the
mechanical rate
- The data below were obtained from 4 separate patients who are intubated and being
mechanically ventilated. Which of the following patients IS a candidate for weaning?
VD/VT Qs/Qt MIP
Patient A: 0.63 0.12 -60cmH2O
Patient B: 0.25 0.17 -16cmH2O
Patient C: 0.51 0.27 -30cmH2O
Patient D: 0.32 0.11 -36cmH2O Correct Answer: Patient D
- Following a traumatic nasal intubation, the patient begins to bleed profusely from the
nasopharynx. The respiratory therapist should: Correct Answer: Keep the nasotracheal tube's
cuff inflated and suction the pharynx as needed.
- A patient's ECG rhythm consistently reverts to the rhythm shown above. The respiratory
therapist should recommend: Correct Answer: Cardioversion
- While preparing a patient for a thoracentesis, the patient asks the respiratory therapist why he
must be sitting upright. The respiratory therapist would explain to the patient that sitting upright:
Correct Answer: Lowers the diaphragm and reduced the possibility of its puncture.
- During the administration of a fluid challenge on a 74-year-old patient with an indwelling
pulmonary artery catheter, the pulmonary capillary wedge pressure abruptly rises from 7 mmHg
to 14 mmHg. Which of the following would be an appropriate action at this time? Correct
Answer: Stop fluid administration
- A respiratory therapist is interviewing a 19-year-old female patient about her asthma
symptoms. The patient states she is able to work normally most of the time and uses her reliever
WITH COMPLETE SOLUTION
- An infant is being mechanically ventilated via a time-cycled, pressure-limited ventilator. Which
of the following would occur if PEEP were increased without a corresponding increase in peak
pressure? Correct Answer: The tidal volume would decrease
- A physician requests the respiratory therapist to assess the upper airway function of a patient
with a fenestrated tracheostomy tube. The therapist should: Correct Answer: Remove the inner
cannula, deflate the cuff, plug the outer cannula
- A patient receiving sustained maximal inspiratory (SMI) treatments with a volume-oriented
incentive spirometer device begins to inhale through the device 18 times per minute. Which of
the following best explains this situation? Correct Answer: The patient needs re-instruction
regarding the SMI therapy
- After initiating mechanical ventilation in the A/C mode for an adult male patient, the
respiratory therapist observes that the patient is agitated and having difficulty in cycling the
ventilator. Which of the following should the therapist do? Correct Answer: Increase the
sensitivity setting
- Data recorded for a 52 kg (110 lb) mechanically ventilated patient who has a long standing
history of chronic hypercapnia are as follows:
Ventilator Settings Arterial Blood Gases
Mode: SIMV
pH: 7.36
VT: 400 mL
PaCO2: 62 mmHg
Rate: 8/min
HCO3: 34 mEq/L
FiO2: 0.35
PaO2: 61 mmHg
On the basis of this information, the respiratory therapist should: Correct Answer: Maintain
current settings
- A respiratory therapist is manually ventilating a patient during a cardiopulmonary resuscitation
attempt. An arterial blood gas is drawn and the results are as follows:
pH: 7.27
PaCO2: 38 mmHg
HCO3: 17 mEq/L
PaO2: 44 mmHg
,Based on this information, the respiratory therapist should do which of the following? Correct
Answer: Ensure that the manual resuscitator is connected to an oxygen source
- A COPD patient is brought to the ED after several days of increasing respiratory distress.
Baseline blood gases are drawn and the patient is placed on oxygen at 2 LPM via nasal cannula.
Data from the original and a subsequent arterial blood sample are as follows:
Room Air Sample
pH: 7.23
PaCO2: 82 mmHg
HCO3: 33 mEq/L
PaO2: 49 mmHg
2L nasal O2
pH: 7.33
PaCO2: 66 mmHg
HCO3: 34 mEq/L
PaO2: 54 mmHg
Based on the above information, the respiratory therapist should: Correct Answer: Increase the
oxygen flow to 3L/min and continue to monitor.
- A 16-year-old female has just been admitted to the ED following a bicycling accident. She is
receiving supplemental oxygen via nonrebreathing mask. While standing at the bedside, the
respiratory therapist notes the onset of ataxic breathing. Which of the following should the
therapist do? Correct Answer: Begin manual ventilation
- A respiratory therapist is performing a chest examination on an adult male patient. The
therapist notes the trachea is deviated to the right with flatness to percussion on the right. Which
of the following best explains these findings? Correct Answer: Right sided atelectasis
- A patient in the intensive care unit is receiving supplemental oxygen via 40% air-entrainment
mask. Current arterial blood gas results are as follows:
pH: 7.43
PaCO2: 54 mmHg
HCO3: 34 mEq/L
PaO2: 88 mmHg
Which of the following is the correct interpretation for these results? Correct Answer:
Compensated metabolic alkalosis
- While a respiratory therapist is checking the oxygen setup of a patient on 2L/min nasal cannula,
the patient complains of not being able to detect any oxygen flow from the cannula. Which of the
following actions is appropriate at this time? Correct Answer: Tighten all connections
, - One hour after the initiation of volume-controlled ventilation in the A/C mode for a 21-year-
old, 178 cm ( 5 ft 10 in) tall adult male patient who sustained severe lung contusions following a
motor vehicle accident, an arterial blood gas sample was obtained. Pertinent data are as follows:
Ventilator Settings:
FiO2: 0.60
Rate: 16/min
VT: 500 mL
PEEP: 5 cmH2O
Arterial blood gases:
pH: 7.46
PaCO2: 30 mmHg
HCO3: 21 mEq/L
PaO2: 111 mmHg
The respiratory therapist should suggest which of the following? Correct Answer: Decrease the
mechanical rate
- The data below were obtained from 4 separate patients who are intubated and being
mechanically ventilated. Which of the following patients IS a candidate for weaning?
VD/VT Qs/Qt MIP
Patient A: 0.63 0.12 -60cmH2O
Patient B: 0.25 0.17 -16cmH2O
Patient C: 0.51 0.27 -30cmH2O
Patient D: 0.32 0.11 -36cmH2O Correct Answer: Patient D
- Following a traumatic nasal intubation, the patient begins to bleed profusely from the
nasopharynx. The respiratory therapist should: Correct Answer: Keep the nasotracheal tube's
cuff inflated and suction the pharynx as needed.
- A patient's ECG rhythm consistently reverts to the rhythm shown above. The respiratory
therapist should recommend: Correct Answer: Cardioversion
- While preparing a patient for a thoracentesis, the patient asks the respiratory therapist why he
must be sitting upright. The respiratory therapist would explain to the patient that sitting upright:
Correct Answer: Lowers the diaphragm and reduced the possibility of its puncture.
- During the administration of a fluid challenge on a 74-year-old patient with an indwelling
pulmonary artery catheter, the pulmonary capillary wedge pressure abruptly rises from 7 mmHg
to 14 mmHg. Which of the following would be an appropriate action at this time? Correct
Answer: Stop fluid administration
- A respiratory therapist is interviewing a 19-year-old female patient about her asthma
symptoms. The patient states she is able to work normally most of the time and uses her reliever
