Welcome to your Respiratory Therapy Name: Email: [A physician has ordered an aerosol treatment with 4 mL acetylcysteine (Mucomyst), 20% concentration. The patient develops end-expiratory wheezes. You should:] administer 10 mg beclomethasone (Vanceril) discontinue therapy and notify the physician administer the treatment as ordered change to 2.5 mg albuterol (Proventil) None . [To avoid thermal injury with transcutaneous blood gas monitor sensors, you should:] place sensor over thick skin areas apply hydrocortisone cream under the sensor regularly rotate the sensor site calibrate sensor q4h None . [A doctor orders bronchodilator therapy via inline small-volume nebulizer (SVN) to a pediatric patient receiving volume control ventilation. After initiating therapy with 100% O2 at a flow of 8 L/min, the ventilator’s high pressure alarm keeps sounding with each breath. Which of the following should you do?] Increase the ventilator high pressure alarm setting Decrease the SVN input flowrate to 2 L/min Power the SVN with compressed air, not oxygen Switch to a vibrating mesh or ultrasonic nebulizer None . [A small child is admitted to the Emergency Department with fever, difficulty swallowing, drooling, and stridor. An AP X-ray of the neck area is negative, but a lateral neck film indicates supraglottic swelling. Which of the following is the most likely diagnosis?] asthma croup foreign body obstruction epiglottitis None . [Your are in CMV PC mode and the I:E ratio is set to maintain a constant I:E ratio of 1:1. The rate is set to 16 and the inspiratory flow is returning to baseline. You decrease rate to 12 breath which of the following will occur] MV increase and mean airway pressure increases Vt decreases and mean airway pressure is unchanged Vt decreases and mean airway pressure decreases MV decreases and mean airway pressure is unchanged None . [A patient receiving 30% O2 has a PaO2 of 66 torr and PaCO2 of 32 torr. Which of the following best describes this patient’s oxygenation status?] A mild disturbance of oxygenation consistent with hypoventilation A mild disturbance of oxygenation consistent with a V/Q imbalance A moderate disturbance of oxygenation consistent with acute lung injury A severe disturbance of oxygenation consistent with ARDS None . [Amphotericin B is used to treat:] Systemic bacterial infections Systemic Fungal infections Pulmonary fungal infections B and C only None . [To assist in preventing ventilator-acquired pneumonia (VAP), you should:] use the minimal leak technique to inflate tracheal tube cuffs change the ventilator circuit and humidifier every 24 to 48 hours maintain the patient in the prone position whenever possible implement daily sedation vacations/spontaneous breathing trials None . [During the administration of chest percussion, you observe the patient producing sputum containing a moderate amount of fresh red blood when coughing. You should:] continue treatment but soften the percussion strokes discontinue the treatment and notify the physician wait 10 minutes and then continue the treatment turn the patient to perform percussion on the opposite lung None . [If an oxygen blender pressure alarm sounds, which of the following should be your first action?] verify that the O2 and air lines are providing the required pressure check for loose connection or leaks between the gas source and blender separately disconnect the O2 and air lines to see if the alarm stops verify 100% and 21% O2 settings with a calibrated oxygen analyzer None . [A pulmonologist asks you to assess airway responsiveness during a pulmonary function exam. He wants to rule out asthma from chronic bronchitis in a patient complaining of nocturnal wheezing. Which of the following test should you recommend?] bronchoprovocation test cardiopulmonary stress test nitrogen washout challenge thoracic gas volume None . [Which of the following is added to a local anesthetic to prolong its duration of action and reduce bleeding] Epinephrine Phenylephrine Ephedrine Atropine None . [Hypoxia can occur without cyanosis in patients with what disorder?] hypothermia hyperthermia polycythemia anemia None . [Albumin plays many essential roles in the body. 2 of these roles include:] Maintaining osmotic pressure gradients, and molecular transport Molecular transport, and metabolizing denatured proteins Opposing osmotic pressure gradients, and combating liver disease Maintaining renal output, and supporting molecular transport None . [To calibrate a portable bedside spirometer you need which of the following equipment?] a U-tube water column manometer a mechanical (vane-type) respirometer a large volume (3 L) calibration syringe a precision calibrated flowmeter None . [Which of the following would create the waveform pictured above: pic 51] Bronchospasm Saturated CO2 absorber Hypoventilation Increasing metabolic rate None . [To maximize the FIO2 delivered by a manual bag-valve resuscitator you would:] attach a PEEP valve decrease bag refill time remove the inlet valve increase bag refill time None . [To remove accumulations of subglottic secretions from above the cuff of intubated patients, you should recommend which of the following?] intrapulmonary percussive ventilation (IPV) use of a tracheal tube with a suction port above the cuff aggressive tracheal suctioning with saline lavage frequent oropharyngeal suctioning with a Yankauer tip None . [After bedside measurement, you note that a patient's slow and forced vital capacity are approximately equal and both are less than 60% of the predicted values. Which of the following diagnoses is LEAST likely?] lung resection interstitial fibrosis myasthenia gravis COPD None . [As an RRT on the Outreach Team, which of the following would you NOT do without a Physician’s order] Meet a patient’s increasing oxygen requirements by starting optiflow Intubate a patient Start chest compressions on pulseless patient Puncture an obtunded patient for an ABG None . Time's up
