TMC EXAM A

TMC EXAM A A 48 year-old female is admitted to the ED with diaphoresis, jugular venous distension, and 3+ pitting edema in the ankles. These findings are consistent with A patient is admitted to the ED following a motor vehicle accident. On physical exam, the respiratory therapist discovers that breath sounds are absent in the left chest with a hyperresonant percussion note. The trachea is shifted to the right. The patient's heart rate is 45/min, respiratory rate is 30/min, and blood pressure is 60/40 mm Hg. What action should the therapist recommend first? All of the following strategies are likely to decrease the likelihood of damage to the tracheal mucosa EXCEPT A 52 year-old post-operative cholecystectomy patient's breath sounds become more coarse upon completion of postural drainage with percussion. The respiratory therapist should recommend A 65 kg spinal cord injured patient develops atelectasis. His inspiratory capacity is 30% of his predicted value. What bronchial hygiene therapy would be most appropriate initially? A healthy adult female can exhale what portion of her forced vital capacity in the first second? A patient on VC ventilation demonstrates auto-PEEP on ventilator graphics. Which of the following controls, when adjusted independently, would increase expiratory time? 1. Tidal volume 2. respiratory rate 3. inspiratory flow 4. sensitivity Which of the following would be the most appropriate therapy for a dyspneic patient who has crepitus with tracheal deviation to the left and absent breath sounds on the right? Following cardiac surgery, a 55 year-old patient has the following ABG results: pH 7.50, PaCO2 30 torr, PaO2 62 torr, HCO3 25 mEq/L, SaO2 92%, HB 14 g/dL, BE +2. Venous blood gas results are pH 7.39, PvCO2 43 torr, PvO2 37 torr, and SvO2 66%. Calculate the patient's C(a-v)O2. A patient on VC, SIMV with a VT of 500 mL has a PIP of 25 cm H2O, Pplat of 15 cm H2O and PEEP of 5 cm H2O. What is the patient's static lung compliance? Immediately after extubation of a patient in the ICU, the respiratory therapist observes increasing respiratory distress with intercostal retractions and marked stridor. The SpO2 on 40% oxygen is noted to be 76%. Which of the following would be most appropriate at this time? Which of the following patients would most likely benefit from pressure support ventilation? A patient receiving mechanical ventilation has developed a temperature of 99.9° F with purulent secretions over the last 12 hours. The respiratory therapist has also noted a steady increase in peak inspiratory pressure. What initial recommendation should be made to address these changes? Which of the following information may be obtained from a FVC maneuver during bedside pulmonary function testing? 1. FEV1 2. PEFR 3. FRC 4. RV The respiratory therapist provides education for a patient who is being discharged home on aerosol therapy. The most important reason for the patient to follow the recommended cleaning procedures using a vinegar/water solution is that this solution will A patient who complains of dyspnea is noted to have a dry, non-productive cough. On physical examination, breath sounds are diminished on the right, tactile fremitus is decreased and there is dullness to percussion over the right lower lobe. The respiratory therapist should suspect that the patient is suffering from Which of the following suction catheters would be appropriate to use for a patient with a size 8.0 mm ID endotracheal tube? A patient who is receiving continuous mechanical ventilation is fighting the ventilator. His breath sounds are markedly diminished on the left, there is dullness to percussion on the left, and the trachea is shifted to the left. The most likely explanation for the problem is that The respiratory therapist notes a developing hematoma after an arterial blood gas was drawn from the right radial artery. The immediate response is to A patient's breathing pattern irregularly increases and decreases and is interspersed with periods of apnea up to 1 minute. Which of the following conditions is the most likely cause of this problem? What value for the apnea-hypopnea index (AHI) is consistent with mild obstructive sleep apnea? While monitoring a newborn utilizing a transcutaneous monitor, the respiratory therapist notices a change in PtcO2 from 60 to 142 torr and simultaneously the PtcCO2 changes from 37 to 2 torr. What is the most likely explanation for these changes? A patient on the general medical ward receives oxygen via 28% air entrainment mask with the flowmeter set at 5 L/min. What is the total flow delivered to the patient? Which of the following measurements is most indicative of congestive heart failure? Sleep apnea can be defined as repeated episodes of complete cessation of airflow for A patient in the ICU receiving mechanical ventilation underwent fiberoptic bronchoscopy during which a tissue biopsy was collected. Immediately following the procedure, the respiratory therapist notes that the peak inspiratory pressure on the ventilator has increased. Potential causes for this include all of the following EXCEPT What size endotracheal tube would be appropriate for an adult female patient? The respiratory therapist is asked to evaluate the presence of Auto-PEEP on a patient receiving mechanical ventilation. In order to do this, the therapist should A patient who suffered trauma in an ATV accident is being monitored in the ICU. A pulmonary artery catheter has been placed and the following data is available: PCWP 4 mm Hg PAP (mean) 8 mm Hg CVP 2 cm H2O Cardiac Output 3L/min The respiratory therapist should recommend What is the primary advantage of volume-controlled ventilation as compared to pressure-controlled ventilation?