TMC Practice Questions A- Kettering exam 2022/2023 with complete solutions

A 13 year-old patient in the ED is complaining of dyspnea, chest tightness, and a loose productive cough. The patient has a respiratory rate of 28 breaths/minute and bilateral wheezing in the lungs. What treatment should ...

A 13 year-old patient in the ED is complaining of dyspnea, chest tightness, and a loose productive cough. The patient has a respiratory rate of 28 breaths/minute and bilateral wheezing in the lungs. What treatment should the respiratory therapist initiate? A. levalbuterol B. oxygen C. salmeterol D. PEP - ANSWER B. oxygen A 16 year-old patient with cystic fibrosis attends public high school. Which of the following bronchial hygiene therapies would be most appropriate for this patient? A. intrapulmonary percussive ventilation B. dornase alpha therapy C. vibratory / oscillatory PEP D. postural drainage and manual percussion - ANSWER C. vibratory / oscillatory PEP A 19-year-old patient is brought to the emergency department after taking a handful of pills. The patient is obtunded but is making regular, sonorous respiratory efforts. Auscultation reveals coarse rhonchi bilaterally. Which of the following should be done FIRST to assess this patient? A. Obtain a sputum specimen. B. Obtain an ABG. C. Measure peak expiratory flow. D. Determine the Glasgow Coma Score. - ANSWER B. Obtain an ABG. A 28 year-old female has just been admitted through the ED with suspected CO poisoning. She is receiving oxygen by non-rebreather mask at 10 L/min. Upon entering the patient's room, the respiratory therapist notes that the reservoir bag of the mask collapses during inspiration. This is most likely the result of A. faulty one-way valves. B. tight seal between the mask and the patient's face. C. presence of a bubble humidifier. D. insufficient flow to the reservoir bag. - ANSWER D. insufficient flow to the reservoir bag. A 30 year old male with bronchitis has coarse bilateral rales with a SpO2 of 90%. Despite a good cough effort, he has great difficulty in removing his thick secretions. The respiratory therapist should initiate A. aerosol treatments with 3 cc normal saline every 4 hours. B. sputum induction for gram stain. C. a heated humidifier and oxygen therapy. D. continuous ultrasonic via aerosol mask. - ANSWER C. a heated humidifier and oxygen therapy. A 33 year-old patient with trauma has been ventilated at the current settings for 24 hours. While reviewing ventilator data from the patient, the respiratory therapist notes the following: 0800 1000 1200 Peak Inspiratory Pressure (cm H2O) 28 35 50 Plateau Pressure (cm H2O) 23 25 25 This information would indicate that A. airway resistance is decreasing. B. lung compliance is increasing. C. the patient needs suctioning. D. the patient can begin weaning. - ANSWER C. the patient needs suctioning. A 36 year-old fireman was trapped and subsequently rescued from the collapse of a burning building. Which of the following devices would be appropriate to accurately assess his oxygenation status? A. capnograph B. pulse oximeter C. blood gas analyzer D. hemoximeter - ANSWER D. hemoximeter A 36 year-old patient is admitted to the ED with a temperature of 38.5° C and suspected pneumonia. The patient has no history of pulmonary disease. Auscultation reveal medium crackles throughout both lungs. Which of the following should be recommended for management of this patient? A. Pre/post bronchodilator study B. Ultrasonic nebulizer treatments C. Manually assisted coughing D. Regular coughing and deep breathing - ANSWER D. Regular coughing and deep breathing A 42 year-old trauma patient in the ED has been intubated with a 6.5 mm oral endotracheal tube equipped with a high-residual-volume, low-pressure cuff. The respiratory therapist notes that a cuff pressure of 42 cm H2O is necessary to achieve a minimal occluding volume. This would indicate that the A. tube is not of the appropriate size. B. pilot balloon and line are obstructed. C. pressure manometer is defective. D. cuff has herniated over the tip of the tube. - ANSWER A. tube is not of the appropriate size. A 44 year-old patient who suffered a cerebral vascular accident has been moved from Neuro-ICU to the step-down unit. He becomes diaphoretic and his SpO2 suddenly drops from 95% to 88% on a 32% tracheostomy collar. His heart rate is 115/min, respiratory rate is 42/min and his breath sounds are very diminished. The respiratory therapist is unsuccessful in attempting to pass a 12 Fr suction catheter. The therapist should A. increase the suction pressure to 120 mm Hg. B. change to a 10 Fr suction catheter. C. replace the tracheostomy tube. D. orally intubate the patient. - ANSWER C. replace the tracheostomy tube. 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. liver failure. B. pulmonary embolism. C. heart failure. D. electrolyte imbalances. - ANSWER C. heart failure. A 50 kg (110 lb) patient is being mechanically ventilated with the following settings: VC, A/C, VT 400 mL, respiratory rate 14/min, FIO2 0.60 and 10 cm H2O PEEP. The chest radiograph demonstrates diffuse bilateral radiopacity. ABG results are: pH 7.36, PaCO2 47 torr, PaO2 50 torr, and HCO3- 28 mEq/L. The respiratory therapist should increase the A. PEEP. B. FIO2. C. expiratory time. D. respiratory rate - ANSWER A. PEEP 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. continuing the therapy until breath sounds improve. B. administering dornase alpha. C. administering albuterol therapy.