Lindsay Jones Questions
1. A patient demonstrates signs of air-hunger while receiving mechanical ventilatory
support. The most recent chest radiograph shows the end the ET tube 1 inch above
the carina. The respiratory therapist should
A. advance the ET tube 1 cm.
B. replace the ET tube.
C. evaluate for other causes of air-hunger.
D. withdraw the ET tube by 2 inches < Ans > C. evaluate for other causes of air-hunger.
2. Which of the following would result in an increase in anatomical airway
resistance?
A. water build up in the ventilator circuit
B. autoPEEP
C. an undersized endotracheal tube
D. pulmonary secretions < Ans > D. pulmonary secretions
Explanation ; Airway resistance is increased in the presence of pulmonary secretions and
bronchoconstriction. The other examples listed are not anatomically related.
3. A patient with pneumococcal pneumonia is having difficulty expectorating sputum
that is thick and tenacious. Which of the following would most effec- tively help thin
secretions?
A. aerosolized albuterol treatments
B. aerosolized acetylcysteine, once daily
C. instillation of saline into the airway
D. IV fluids < Ans > D. IV fluids
Explanation ; The most effective way to thin secretions is by increasing the overall fluid
status of the patient.This is most effectively done through IV fluid administration and by oral
,consumption of water (and other fluids).
4. Two hours after abdominal surgery, an orally intubated patient with no history of
pulmonary disease is alert and agitated and is repeatedly attempting to pull on on the
ET tube. Current ventilator settings are: SIMV, rate 10/min, VT 450 mL, FIO2 0.4,
PEEP 5 cm H2O, PS 5 cm H2O. The respiratory therapist should consider
A. sedation of the patient.
B. application of a soft hand restraint system.
C. spontaneous breathing trials.
D. extubation < Ans > D. extubation.
5. A respiratory therapist is transporting a closed biohazard container of used,
disposable needles for sterilization. Which method is most appropriate to sterilize the
used needles?
A. Irradiation followed by ethylene oxide
B. Acid Gluteraldehyde
,C. Incineration
D. Alkaline Gluteraldehyde < Ans > C. Incineration
Explanation ; Incineration is the best sterilizing technique for non-disposable equip- ment
such as blood-laden needles. Incineration, of course, will destroy the equip- ment but will
sterilize the material.
6. Which of the following methods can be used to assess the anticipated difficulty
level for oral intubation on an adult patient?
A. Miller
B. Henderson
C. Mallampati
D. Fick < Ans > C. Mallampati
Explanation ; The Mallampati classification system can be used to assess potential intubatio
difficulty on an adult patient.
7. Despite three days of antibiotic therapy for the treatment of a pneumonia patient
who has a gram-positive pulmonary infection, white blood cell count is not
significantly decreasing and consolidation in the lungs remains largely unchanged.
Which of the following would be most helpful toward diminishing the patient's
infection?
A. begin ambulation, 3 times a day for 10 minutes
B. administer anti-viral medication as well
C. initiate chest physiotherapy
D. sputum culture and sensitivity studies < Ans > D. sputum culture and
sensitivity studies
8. During the placement of a pulmonary artery catheter, the respiratory thera- pist
observes the waveform on the monitor and notices it is repeatedly rising and falling
, from 0 mmHg to 25 mmHg, which is an indication that the tip of the catheter is in the
right ventricle of the heart. Based on this information, the respiratory therapist will
recommend
A. rotate the catheter to achieve a dicrotic notch in the waveform
B. inflate the catheter balloon to sail the tip to the proper location
C. withdraw the catheter back to the upper vena cava
D. suture the catheter in place < Ans > B. inflate the catheter balloon to sail the tip to
the proper location
Explanation ; The pulmonary catheter should be terminated in the pulmonary artery, which is
beyond the right ventricle. Therefore, advancing the catheter is appropriate. The catheter may
be advanced by sailing it into position, which is done by inflating the catheter balloon and
allowing blood flow to carry the catheter into position and then deflating the balloon once i
is in the proper position.
1. A patient demonstrates signs of air-hunger while receiving mechanical ventilatory
support. The most recent chest radiograph shows the end the ET tube 1 inch above
the carina. The respiratory therapist should
A. advance the ET tube 1 cm.
B. replace the ET tube.
C. evaluate for other causes of air-hunger.
D. withdraw the ET tube by 2 inches < Ans > C. evaluate for other causes of air-hunger.
2. Which of the following would result in an increase in anatomical airway
resistance?
A. water build up in the ventilator circuit
B. autoPEEP
C. an undersized endotracheal tube
D. pulmonary secretions < Ans > D. pulmonary secretions
Explanation ; Airway resistance is increased in the presence of pulmonary secretions and
bronchoconstriction. The other examples listed are not anatomically related.
3. A patient with pneumococcal pneumonia is having difficulty expectorating sputum
that is thick and tenacious. Which of the following would most effec- tively help thin
secretions?
A. aerosolized albuterol treatments
B. aerosolized acetylcysteine, once daily
C. instillation of saline into the airway
D. IV fluids < Ans > D. IV fluids
Explanation ; The most effective way to thin secretions is by increasing the overall fluid
status of the patient.This is most effectively done through IV fluid administration and by oral
,consumption of water (and other fluids).
4. Two hours after abdominal surgery, an orally intubated patient with no history of
pulmonary disease is alert and agitated and is repeatedly attempting to pull on on the
ET tube. Current ventilator settings are: SIMV, rate 10/min, VT 450 mL, FIO2 0.4,
PEEP 5 cm H2O, PS 5 cm H2O. The respiratory therapist should consider
A. sedation of the patient.
B. application of a soft hand restraint system.
C. spontaneous breathing trials.
D. extubation < Ans > D. extubation.
5. A respiratory therapist is transporting a closed biohazard container of used,
disposable needles for sterilization. Which method is most appropriate to sterilize the
used needles?
A. Irradiation followed by ethylene oxide
B. Acid Gluteraldehyde
,C. Incineration
D. Alkaline Gluteraldehyde < Ans > C. Incineration
Explanation ; Incineration is the best sterilizing technique for non-disposable equip- ment
such as blood-laden needles. Incineration, of course, will destroy the equip- ment but will
sterilize the material.
6. Which of the following methods can be used to assess the anticipated difficulty
level for oral intubation on an adult patient?
A. Miller
B. Henderson
C. Mallampati
D. Fick < Ans > C. Mallampati
Explanation ; The Mallampati classification system can be used to assess potential intubatio
difficulty on an adult patient.
7. Despite three days of antibiotic therapy for the treatment of a pneumonia patient
who has a gram-positive pulmonary infection, white blood cell count is not
significantly decreasing and consolidation in the lungs remains largely unchanged.
Which of the following would be most helpful toward diminishing the patient's
infection?
A. begin ambulation, 3 times a day for 10 minutes
B. administer anti-viral medication as well
C. initiate chest physiotherapy
D. sputum culture and sensitivity studies < Ans > D. sputum culture and
sensitivity studies
8. During the placement of a pulmonary artery catheter, the respiratory thera- pist
observes the waveform on the monitor and notices it is repeatedly rising and falling
, from 0 mmHg to 25 mmHg, which is an indication that the tip of the catheter is in the
right ventricle of the heart. Based on this information, the respiratory therapist will
recommend
A. rotate the catheter to achieve a dicrotic notch in the waveform
B. inflate the catheter balloon to sail the tip to the proper location
C. withdraw the catheter back to the upper vena cava
D. suture the catheter in place < Ans > B. inflate the catheter balloon to sail the tip to
the proper location
Explanation ; The pulmonary catheter should be terminated in the pulmonary artery, which is
beyond the right ventricle. Therefore, advancing the catheter is appropriate. The catheter may
be advanced by sailing it into position, which is done by inflating the catheter balloon and
allowing blood flow to carry the catheter into position and then deflating the balloon once i
is in the proper position.
