NBRC Practice Test #2, Questions and answers, Graded A+. 2022/2023

NBRC Practice Test #2, Questions and answers, Graded A+. 2022/2023 After a patient undergoes a thoracentesis, the respiratory therapist notes that the obtained pleural fluid is clear with a slight straw color. This ...

NBRC Practice Test #2, Questions and answers, Graded A+. 2022/2023 After a patient undergoes a thoracentesis, the respiratory therapist notes that the obtained pleural fluid is clear with a slight straw color. This fluid is most likely the result of A. empyema. B. congestive heart failure. C. lung carcinoma. D. hemothorax. - ✔✔Congestive Heart Failure The respiratory therapist is calibrating a spirometer and checking the volume with a 3.0 liter super syringe. the volumes recorded are 2.85L, 2.8L and 2.8L. Based upon the information obtained, which of the following is a correct statement? A. Another syringe needs to be used B. Spirometer is accurate C. The plunger was advanced too slowly D. Spirometer may have a leak - ✔✔D. Spirometer may have a leak Which of the following is an indication for high frequency jet ventilation? A. Bronchopleural fistula B. Wilson Mikity syndrome C Necrotizing lesion of right lung D. Centrilobular emphysema - ✔✔Bronchopleural Fistula **(because it uses mean airway pressures & low tidal volumes to improve oxygenation and we do not want to worsen bp fistula) A 43 y/o female patient has just undergone a total abdominal hysterectomy. The pt arrives in the post anesthesia care unit obtunded with minimal response to painful stimulus. what treatment should the RT recommend for this pt? - ✔✔Insert OPA (b/c they are unresponsive) What is the normal VD/VT ratio for a patient breathing room air? - ✔✔20-40% All of the following could cause a patient's right-hemidiaphragm to be elevated, EXCEPT: A. right lower lobe atelectasis B. right side hyperlucency, absent vascular markings C. hepatomegaly D. right lower lobe consolidation with air bronchograms - ✔✔B. right side hyperlucency, absent vascular markings (pneumothorax) A 2 y/o child with croup has been intubated for 4 days with a 4mm ID uncuffed ETT. Heated aerosol at an FiO2 of 30% has been delivered to the patient. The physician asks the RT to evaluate the pt for possible extubation. Which of the following would most likely indicate that the pt is ready for extubation? A. Pt is making normal quiet ventilatory efforts B. Negative sputum culture and sensitivity has been reported C. Pt's ABG are within normal range D. Breath sounds are heard around the tube on auscultation - ✔✔D. Breath sounds are heard around the tube on auscultation A pt is senn inthe ER for complaints of nausea and vomiting. A NGT has been inserted and the pt is started on lasix. Which of the following should the RT monitor? A. Cardiac enzymes B. Serum electrolytes C. ABG D. Cell hydration level - ✔✔B. Serum electrolytes (because of loss of fluids) While instructing a pt prior to a vital capacity maneuver, the RT should direct the pt to: A. exhale to RV and inhale to IC B. inhale to TLC then exhale to RV C. exhale normally then inhale to TLC D. inhale normally then exhale to FRC - ✔✔B. inhale to TLC then exhale to RV A 77 y/o male patient is admitted to the ER with shortness of breath, fine basilar crackles, +2 pitting edema and a chest X-ray with a butterfly pattern. These results are most consistent with which of the following? A. Pulmonary edema B. Pulmonary interstitial emphysema C. Pneumothorax D. Emphysema - ✔✔A. Pulmonary edema (and CHF!) Which of the formula will determine the total flow being delivered to a pt with a 28% venturi mask running at 6 L/min? - ✔✔Total flow = 6 x 11 (flow factor for 28% = 10:1 = 11) A pt with end-stage pulmonary fibrosis is receiving O2 at 2L/min via a transtracheal oxygen catheter. The pt experiences an increased WOB and shortness of breath. The RT should do what? - ✔✔Flush the transtracheal device with isotonic saline During bedside monitoring the RT notices a dampened waveform on the arterial line graphic. To restore the graphic to normal, what should the RT do? - ✔✔Check the transducer dome for air bubbles An optimal PEEP study is initiated on a pt receiving mechanical ventilation. The RT first places the pt on a PEEP of 10 cm H20 for 20 mins with no adverse effects. The PEEP is increased to 15cm H20 and the pt's HR rises significantly with a severe fall in the BP. Based upon the above info, what should the RT conclude that the pt is suffering from? - ✔✔Hypovolemia A post-op thoracotomy pt is receiving incentive spirometry therapy Q2H. Breath sounds are diminished in the bases of the lungs with scattered crackles. the pt's inspiratory capacity has decreased over the past 2 days. A chest X-ray indicates thin-layered basilar densities. Which of the following has most likely occured? A. Atelectasis B. Pneumonia C. Pulmonary Edema D. Consolidation - ✔✔A. Atelectasis The RT is in charge of transporting a pt with multiple trauma to a regional trauma center in a fixed wing aircraft. Which of the following should the RT be most concerned about during the transport? A. Tissue oxygenation B. Pneumothorax C. Pulmonary embolus D. Humidification of the inspired gas - ✔✔Tissue oxygenation Transcutaneous monitoring of PO2 values will correlate well with ABG PO2 values in which of the following situations? (Pick all that apply) A. Hypotension B. Hypothermia C. Pneumonia - ✔✔Pneumonia only What is the air-to-oxygen ratio for an air entrainment device delivering 60% oxygen? - ✔✔1:1 Following surgery to correct an abdominal aortic aneurysm, a 54 y/o female pt suddenly develops intense substernal chest pain with severe dyspnea. the pain does not appear to be aggravated by her respiratioins. Auscultation reveals bilateral, basilar, moist, crepitant rales. The pt appears pale, cold and clammy. which of the following should the RT recommend for initial assessment of this pt? A. Serum electrolytes B. Chest X-ray C. Complete blood count D. Elecrocardiograph - ✔✔D. Electrocardiograph An adult pt is intubated with 7.0mm ID ETT. What size suction catheter should be used to suction this pt? - ✔✔10 Fr (7/2 x3) A pt who is suspected of having a flail chest has been intubated and mechanically ventilated with PEEP therapy. The pt has just received pancuronium bromide. Which of the following ventilator alarms would be most important to set correctly for this pt? A. Peak pressure alarm B. Low PEEP pressure alarm C. I:E ratio alarm D. Low exhaled volume alarm - ✔✔B. Low PEEP pressure alarm A balloon-tipped, flow directed catheter is positioned in the pulmonary artery with the balloon DEFLATED. Which of the following pressures will be measured by the DISTAL lumen? - ✔✔PAP the RT receives an order to administer bronchodilator therapy with albuterol. To reduce the chance of cross contamination, the RT should - ✔✔Select a meter dose inhaler Which of the following is a FALSE statement about self-inflating resuscitation devices? A. A reservoir is utilized to increase the delivered oxygen concentration B. The RT can sense changes in the pt's lung compliance and airway resistance C. A compressed gas source is necessary for the device to operate. D. Excessive gas flow may cause the valve to malfunction. - ✔✔A compressed gas source is necessary for the device to operate How are spontaneous sighs accounted for in mechanical ventilation? - ✔✔Because a spontaneously breathing individual typically sighs 6-8 times each hour to prevent microatelectasis, some investigators once recommended that periodic machine breaths that were 1.5-2 times the preset tidal volume be given 6-8 times per hour. However, the peak pressure often needed to deliver such a volume was high enough to predispose the patient to barotrauma. At present, accounting for sighs is not recommended if the patient is receiving tidal volumes of 10-12 mL/kg or if the patient requires PEEP. When a low tidal volume is used, sighs are preset at 1.5-2 times the tidal volume and delivered 6-8 times an hour if the peak and plateau pressures are within acceptable limits. A patient has just been intubated with a naso- tracheal tube and is being manually ventilated. As the therapist ventilates the patient, he notices that there is no chest movement, minimal breath sounds and air escaping from the mouth as the bag is squeezed. A chest x-ray has determined that the endotracheal tube is in the correct position. What is the most likely cause of this situation? - ✔✔The cuff ruptured during intubation The therapist receives an order for postural drainage and vibration. With the bed flat, the therapist places the patient in a prone position with pillows under his hips. Which lung segments are being treated with this position? - ✔✔Superior segment of the lower lobes While using a pressure-cycled ventilator, an increase in the patient's static lung compliance will do what? - ✔✔Increase the volume A patient is receiving controlled ventilation via a Bird Mark 7 ventilator. Suddenly, the ventilator will not cycle into expiration. This problem may be caused by: 1. development of pneumothorax. 2. disconnected expiratory valve. 3. leak in the patient tubing. 4. ruptured endotracheal tube cuff. - ✔✔2. disconnected expiratory valve. 3. leak in the patient tubing. 4. ruptured endotracheal tube cuff. Which of the following will increase the volume delivered to a patient on a pressure limited ventilator? 1. Decreasing the sensitivity 2. Increasing the flow setting 3. Decreasing the flow setting 4. Increasing the pressure setting - ✔✔3. Decreasing the flow setting 4. Increasing the pressure setting A patient has been weaned from mechanical ventilation. The physician would like the patient's respiratory muscle strength evaluated to determine further weanability. The therapist should evaluate which of the following? 1. VDNT 2. VE 3. MIP 4. CST 5. VC - ✔✔3. MIP 5. VC A patient has reduced lung compliance. Which of the following approaches to ventilation would decrease the risk of barotrauma? - ✔✔Flow cycled, pressure limited A change in airway resistance would be reflected by a change in what? - ✔✔Dynamic Compliance The first parameter to measure when a mechanically ventilated patient is placed on PEEP is? - ✔✔Compliance A patient with tachypnea and a history of COPD is in the Emergency Room complaining of dyspnea. The ER physician orders oxygen therapy at an FI02 of 0.28. Which of the following devices would be most appropriate for this patient? - ✔✔Venturi Mask (AEM) A patient has been sent to Radiology for a PET scan. The patient is on oxygen at 5 Llmin. from an E cylinder reading 1500 psi. How long will the E cylinder last if run until empty? - ✔✔90 mins