Respiratory Therapy 09 Nov Welcome to your Respiratory Therapy Name: Email: [Which of the following best defines acute lung injury] P(A-a)O2 <5 despite an Fio2 greater than or equal to 0.50 PaO2 <60 mmHg despite an FiO2 greater than or equal to 0.50 P/F ratio <300 pH >7.40 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 . [Your patient has severe persistent asthma which would be appropriate] Salbutamol 100 - 200 mcg prn, Advair (Flu!casone 100 mcg/50 mcg Salmeterol) 1 puff BID, Prednisone 5 mg/day Salbutamol 100 - 200 mcg prn, Formoterol 6 mcg BID, Budesonide 100 mcg BID, Prednisone 15 mg/day Salbutamol 100 - 200 mcg prn, Salmeterol 50 mcg/dose 1 puff BID, Ciclesonide 100 mcg OD, Prednisone 5 mg/day Salbutamol 100 - 200 mcg prn, Salmeterol 50 mcg/dose 1 puff BID, Flu!casone 500 mcg, 1 puff BID, Prednisone 10 mg/day None . [Volatile agents stop moving into the body when:] Ventilation is increased to desired MV Partial pressure gradients are absent Renal output starts eliminating agent Diaphragmatic paralysis begins None . [A neonatal patient is ventilated on the sensorimedics 3100A. If the patient’s ETT were to become kincked you would expect:] The SpO2 to decrease The adjustable high MAP alarm to be activated The adjustable low MAP alarm to be activated The dump valve to open None . [The decision is made to switch the flow waveform from a decelerating pattern to a square pattern. With this change you would expect:] Ti to decrease I:E ratio to increase Risk of air trapping to increase Decrease in PiP None . [You are working in the OR as an AA. The circulating Anesthetist comes in to seek your advice on the next case. Patient is 77 yo, nonsmoker, morbidly obese man (200 kg) who is suffering from severe unstable angina. This man was noted to be a difficult intubation during a previous OR case. The planned case is a triple CABG Which pre-surgical test was likely performed?] Spirometry ABG CT head Bronchoscopy None . [Due to her patient's minimal response to the standard prescription for an aerosolized bronchodilator, a doctor asks your advice on how best to adjust the dosage. You would recommend:] peak expiratory flow rate monitoring helium dilution functional residual capacity carbon monoxide diffusing capacity pre/post bronchodilator spirometry None . [Which of the following medications is associated with PVCs? (cause PVCs) ] Lidocaine Amiodarone Epinephrine Phenylephrine None . [Plane 3 of surgical anesthesia occurs:] From the return of regular respirations to the cessation of REM From the cessation of REM to onset of paralysis of the intercostal muscles From partial intercostal to full None of the above None . [Verification of safety equipment by the bedside] Confirming contents in the intubation buckets and difficult airway carts Reviewing vent monitoring record for the patient for their entire ICU stay All of the above A and B None . [Which of the following is not a contraindication for pulmonary function testing?] Pneumothorax Recent eye surgery Pulmonary embolism Coughing Recent myocardial infarction None . [Which of the following tests would you recommend in order to identify the cause of dyspnea and factors limiting a patient's exercise tolerance?] 6-minute walking distance overnight oximetry assessment peak expiratory flow rate comprehensive exercise test None . [An exercise test can help determine the cause of which of the following?] chronic cough hemoptysis wheezing on exertion rhonchial fremitus None . [When reviewing the chart of a patient who presents with evidence of acute pulmonary infection, which of the following laboratory studies would provide the most useful information?] sputum culture and sensitivity blood culture sputum acid fast stain sputum Gram stain None . [When suctioning an adult intubated with a 8 mm endotracheal tube, you suddenly lose vacuum pressure. Which of the following is the likely cause?] displacement of the ET tube suction tubing disconnection clearance of secretions a mucus plug in the ET tube None . [You note on inspection of an AP chest radiograph that the right hemidiaphragm is elevated above normal. Which of the following is the most likely cause of this abnormality?] right pleural effusion right tension pneumothorax right phrenic nerve paralysis right lower lobe pneumonia None . [After three minutes of peak activity during an oxygen titration test, a patient's SpO2 drops from 90% to 87%. Which of the following actions is indicated?] continue the test for another three minutes at the same liter flow increment the O2 flow by 1 liter per minute and continue the test immediately terminate the test and assess the patient's vital signs increment the O2 flow by 1 liter per minute and terminate the test None . [Dry mucous membranes and decreased U/O are characteristics of what degree of fluid deficit] Mild Moderate Severe V. severe None . [A doctor orders BiPAP for a patient with CHF and acute pulmonary edema just admitted to the Emergency Department. What FIO2 would you set for this patient?] 0.4 0.6 0.8 1 None . Time's up