Assessment of the Respiratory Patient
1. The respiratory therapist is conducting an interview on a patient who has just
entered the emergency department. The patient states that he has difficulty
breathing when he is lying down and sleeps with three pillows at night. This is
indicative of which of the following breathing conditions?
A. tachypnea
B. orthopnea
C. euthopnea
D. dyspnea
2. A 24-year-old comatose woman enters the emergency department with the
following arterial blood gases:
pH 7.21
PaCO2 23 torr
PaO2 65 torr
HCO3 8 mEq/L
Which of the following breathing patterns is this patient most likely exhibiting?
A. Cheyne-Stokes
B. Biot’s
C. Kussmaul’s
D. hypopnea
3. A patient is coughing up purulent secretions. This is an indication of which of
the following?
A. pleural effusion
B. pneumothorax
C. bacterial pneumonia
D. hemoptisis
1
4. A hyperresonant lung sound is heard while the respiratory therapist is
percussing over the patient’s lower left lung field. This is indicative of which of
the following pulmonary conditions?
A. left lower lobe atelectasis
B. left-sided pneumothorax
C. pleural effusion
D. lobar pneumonia
5. While auscultating the chest of a patient in ICU you hear crackles in both lung
bases. This is most likely the result of which of the following?
A. pulmonary edema
B. tracheal stenosis
C. bronchoconstriction
D. glottic edema
6. A ventilator patient suddenly becomes restless and agitated and the high
pressure alarm begins sounding. The respiratory therapist auscultates
diminished breath sounds in the left lung and palpates the trachea right of midline.
Which of the following has most likely occurred?
A. right-sided pneumothorax
B. massive atelectasis of the left lung
C. ET tube slipped into right mainstem bronchus
D. left-sided tension pneumothorax
7. A patient states that she has been coughing up thick, green, foul-smelling
secretions. The respiratory care practitioner would conclude this patient has
A. pulmonary edema.
B. a Pseudomonas infection.
C. hemoptysis.
D. bronchial asthma.
2
8. A patient who seems unconscious but will awaken when stimulated is said to
be
A. lethargic.
B. comatose.
C. obtunded.
D. disoriented.
9. The respiratory therapist is evaluating a patient and observes a six second
capillary refill time. This indicates the patient
A. has pulmonary edema.
B. has inadequate perfusion to the extremities.
C. has adequate pulmonary perfusion.
D. has an increased cardiac output.
10. While conducting a pulmonary evaluation on a patient, the respiratory
therapist auscultates diminished breath sounds on the right side and palpates
the trachea being shifted toward the right side. The therapist should suspect
which of the following?
A. right-sided tension pneumothorax
B. massive atelectasis of the right lung
C. left-sided pneumothorax
D. pleural effusion of the left lung
11. Which of the following muscles are utilized during normal breathing?
I. scalenes
II. diaphragm
III. sternomastoid
IV. external intercostals
A. II only
B. I and III only
C. I and IV only
D. II and IV only
3
12. A 38-year-old woman presents in ER complaining of shortness of breath. A
CBC reveals a hemoglobin level of 6 gm%. The respiratory therapist
determines her SpO2 is 99%. Which of the following statements are true
regarding this patient’s condition?
I. The patient is hypoxic.
II. The patient is most likely cyanotic.
III. Oxygen is not indicated at this time.
A. I only
B. III only
C. I and II only
D. I and III only
13. A patient in the cardiac care unit is hemodynamically unstable with fluctuating
arterial blood pressures. Which of the following should the respiratory therapist recommend to best monitor this
patient’s hemodynamic status?
A. pulse oximeter
B. radial artery catheter
C. radial artery puncture for ABGs
D. echocardiogram daily
14. The respiratory therapist is reviewing the chart of a patient in ICU who has a
Swan-Ganz catheter in place. Which hemodynamic value would best determine the extent of the patient’s left
heart failure?
A. central venous pressure (CVP)
B. pulmonary artery pressure (PAP)
C. pulmonary capillary wedge pressure (PCWP)
D. mean arterial pressure
15. To most effectively monitor the hemodynamic status of a patient with ARDS
who is being mechanically ventilated, the respiratory therapist should recommend which of the following?
A. Swan-Ganz catheter
B. EKG monitor
C. peripheral arterial line
D. pulse oximeter
4
16. A 28-week-old neonate is suspected of having a pneumothorax. Which of
the following should the respiratory therapist recommend to help diagnose if
this condition is present?
I. transillumination of the chest
II. transcutaneous PO2 monitoring
III. chest x-ray
IV. arterial blood gases
A. I and III only
B. I, II and III only
C. II, III and IV only
D. I, III and IV only
17. While assessing a patient’s cardiac status, the respiratory therapist observes
the following EKG tracing on the cardiac monitor.
This would be interpreted as
A. sinus bradycardia.
B. ventricular fibrillation.
C. sinus rhythm with occasional PVCs.
D. sinus tachycardia.
18. The respiratory therapist is assessing a patient with emphysema and
observes pedal edema and jugular venous distention. The therapist should
note in the patient’s chart these signs are most likely the result of
A. systemic hypertension.
B. hypercapnia
C. pulmonary infection
D. right ventricular hypertrophy
19. The respiratory therapist is administering PEP therapy to a patient with
atelectasis. Which of the following would indicate the atelectasis is improving?
A. decreased late inspiratory crackles
B. decreased inspiratory wheezes
C. reduced inspiratory stridor
D. coarse crackles that clear with coughing
5
20. The following arterial blood gas results are recorded for a COPD patient who
is breathing spontaneously. It is not noted what FIO2 the patient is on.
pH 7.23
PaCO2 82 torr
PaO2 76 torr
HCO3 36 mEq/L
BE +12
The respiratory therapist should conclude from this information which of the
following?
A. The patient has acute respiratory acidemia and is breathing room air.
B. The patient is not a chronic CO2 retainer.
C. The patient is breathing supplemental oxygen.
D. The blood gas sample is most likely venous blood.
21. A patient with ARDS is receiving mechanical ventilation with PEEP. The
respiratory therapist has just increased the PEEP level from 8 cm H2O to 12
cm H2O. Which of the following should the therapist assess to determine the
patient’s response to this change?
I. blood pressure
II. Dynamic lung compliance
III. Heart rate
IV. Fluid intake and output
A. I and II only
B. I, II and III only
C. I, III and IV only
D. I, II, III and IV
22. The respiratory therapist palpates a “thready” and irregular pulse on a patient
with a history of atrial fibrillation. To further assess the patient’s condition, the
therapist should recommend which of the following?
A. chest radiograph
B. ECG
C. arterial blood gases
D. pulse oximetry
6
23. A patient is experiencing cardiac arrhythmias, muscle weakness and an
arterial blood gas determines the patient is in metabolic alkalosis. Which of
the following is the most appropriate laboratory value to assess at this time?
A. WBC
B. Hb and Hct
C. plasma protein
D. potassium
24. A 2-year-old patient presents in the emergency department coughing with
acute shortness of breath. A chest x-ray reveals a radiopaque density at the
level of the 5th thoracic vertebrae in the right lung field. The right lung is also
hyperinflated. Based on this information, the respiratory therapist should
suspect this x-ray is most likely the result of which of the following?
A. atelectasis of the right lower lobe
B. a foreign body lodged in the right mainstem bronchus
C. pneumothorax of the right lung
D. right lower lobe pneumonia
25. The respiratory therapist has just intubated a patient in respiratory failure. To
initially assess the position of the endotracheal tube, the therapist should
recommend which of the following?
A. measurement of PETCO2
B. arterial blood gas analysis
C. measurement of spontaneous tidal volume
D. measurement of SpO2
26. A severe COPD patient is admitted to the hospital with dyspnea. The patient
is unresponsive with a blood pressure of 170/110 mm Hg and a respiratory
rate of 38/min. The respiratory therapist should assess which of the following
next?
A. Hb and Hct
B. PaCO2
C. SpO2
D. chest x-ray
7
27. The respiratory therapist is performing a chest examination on a mechanical
ventilator patient and observes a dull percussion note over the right lower
lobe with decreased expansion of the right lung. The therapist’s
assessment may indicate the presence of
A. a right mainstem intubation.
B. a right-sided pneumothorax.
C. a left-sided tension pneumothorax.
D. atelectasis of the right lower lobe.
28. The respiratory therapist is assessing a patient who suffered smoke
inhalation as the result of a house fire. The patient is on a nonrebreathing
mask at 15 L/min and his ABG results are below.
pH 7.23
PaCO2 21 torr
PaO2 174 torr
HCO3 12 mEq/L
BE -13
SaO2 68%
From this data, which of the following is true regarding this patient’s condition?
I. The patient is hypoxic.
II. The FIO2 should be decreased.
III. The patient is hypoventilating.
IV. The blood gases reveal a partially compensated metabolic acidemia.
A. I and III only
B. I and IV only
C. II and III only
D. I, III and IV only
29. The respiratory therapist is assessing a patient prior to initiation of
bronchodilator therapy followed by CPT. The patient states “ I don’t feel short
of breath, but I seem to breathe fast and I raise my shoulders with each
breath. I sleep well at night using only one pillow.” The therapist can
conclude from this interview that the patient most likely has
A. orthopnea.
B. dyspnea.
C. increased work of breathing.
D. bradypnea.
8
30. The respiratory therapist percusses an area of hyperresonance on a patient
on mechanical ventilation. This percussion note is most likely the result of
which of the following?
A. pneumothorax
B. atelectasis
C. consolidation
D. pulmonary edema
31. The respiratory therapist is conducting a bedside assessment on a patient
with Guillain-Barre syndrome. Which of the following bedside pulmonary
function results indicates the need for ventilatory assistance?
A. maximum inspiratory pressure (MIP) of –28 cm H2O
B. decreased peak expiratory flow
C. vital capacity of 8 ml/kg of body weight
D. decreased FEV1
32. The respiratory therapist is assessing a patient in the cardiac ICU. Over the
past 36 hours, the patient has been complaining of increasing dyspnea. A
chest x-ray reveals diffuse infiltrates. The therapist notes inspiratory crackles
while auscultating the chest and observes jugular venous distension. Based
on this assessment, which of the following values would most likely be
increased?
I. central venous pressure
II. pulmonary capillary wedge pressure
III. cardiac output
A. I only
B. III only
C. I and II only
D. I, II and III
33. A patient enters the emergency department following a motor vehicle
accident. The respiratory therapist conducts a chest assessment and notes
the trachea is shifted to the left of midline and breath sounds are absent on
the right side. The patient’s respiratory rate is 38/min and has a SpO2 of
85%. The therapist should recommend which of the following at this time?
A. Obtain a chest radiograph.
B. Obtain stat ABGs.
C. Intubate and initiate mechanical ventilation.
D. Insert a chest tube on the right side.
9
34. The respiratory therapist is assessing a patient in the ICU with acute
pulmonary edema. Which of the following would best determine if this is
cardiogenic pulmonary edema?
A. pulmonary capillary wedge pressure
B. central venous pressure
C. pulmonary artery pressure
D. right atrial pressure
35. A physician has ordered hand-held nebulizer therapy q2h with 0.5 ml of
albuterol (Ventolin). The patient has a history of congestive heart failure and
currently has 3+ pitting edema. The patient has no history of asthma,
smoking or pneumonia. There is moderate respiratory distress with
expiratory wheezes. The respiratory therapist should recommend which of the
following?
I. furosemide (Lasix)
II. intubation
III. monitoring input/output
IV. discontinuing the hand-held nebulizer treatment
V. q4h nasal suctioning
A. I, II, and III only
B. I, III and IV only
C. I, III, IV and V only
D. II, III, and IV only
36. A patient is coughing up green, odorous secretions. This most likely
indicates which type of organism present in the secretions?
A. aerobic
B. anaerobic
C. viral
D. acid-fast
37. The respiratory therapist palpates subcutaneous emphysema over the lower
right lung segment. This is indicative of which of the following?
A. right lower lobe pneumonia
B. right pleural effusion
C. right pneumothorax
D. right lower lobe atelectasis
10
38. You observe digital clubbing while performing a pulmonary assessment on a
patient. This is a sign the patient most likely has which of the following?
A. asthma
B. emphysema
C. pneumonia
D. atelectasis
39. While assessing a patient’s lab report you note the patient has a potassium
level of 2.0 mEq/L. This patient is said to be
A. hypokalemic.
B. hypernatremic.
C. hypoxemic.
D. acidemic.
40. While assessing a patient’s chest radiograph you notice reduced vascular
markings and a flattened diaphragm. This indicates the patient most likely
has which of the following?
A. pneumothorax
B. pleural effusion
C. pulmonary edema
D. emphysema
41. Which of the following would be observed on a patient with cor pulmonale?
I. pedal edema
II. jugular venous distension
III. decreased CVP level
A. I only
B. I and II only
C. II and III only
D. I, II and III
11
42. While assessing the lab work on a patient in the ICU you notice a white blood
cell count of 6000. This indicates the patient has
A. a normal WBC count
B. an infection.
C. a pleural effusion
D. pneumonia.
43. While assessing the lab work on a patient in the ICU you notice a white blood
cell count of 22,000. This indicates the patient has
A. a decreased WBC count
B. an infection.
C. a pleural effusion
D. atelectasis.
44. While assessing a patient’s chest radiograph you observe an area of
hyperlucency. This may be the result of which of the following?
I. hyperinflation
II. atelectasis
III. emphysema
IV. pneumothorax
A. I and III only
B. II and III only
C. I, III and IV only
D. II, III and IV only
45. While performing a physical assessment on a patient in the ICU the
respiratory therapist notes paradoxical respirations. This is indicative of
which of the following conditions?
A. emphysema
B. pneumonia
C. atelectasis
D. flail chest
12
46. A patient experiencing deep, rapid breathing followed by apnea is exhibiting
which type of breathing pattern?
A. Kussmaul’s
B. Biot’s
C. bradypnea
D. Cheyne-Stokes
47. Which of the following represents the normal value for potassium?
A. 1.5 – 3.0 mEq/L
B. 3.5 – 5.0 mEq/L
C. 5.5 – 7.0 mEq/L
D. 7.0 – 8.5 mEq/L
48. While assessing the patient’s chart you observe a hemoglobin level of 7.5
gm/dL. This indicates the patient
A. has a decreased oxygen carrying capacity.
B. has a normal hemoglobin level.
C. has chronic lung disease.
D. has a normal red blood cell count.
49. A patient has a respiratory rate of 12/min. This indicates the patient is
A. tachypneic.
B. eupneic.
C. bradypneic.
D. dyspneic.
50. Which of the following is true regarding a patient is experiencing Kussmaul’s
respirations?
A. The patient’s PaCO2 would be increased.
B. The patient’s HCO3 would be increased.
C. The patient’s pH would be decreased.
D. The patient’s HCO3 would be normal.
13
Oxygen Therapy
1. A patient enters the emergency department complaining of shortness of
breath with a respiratory rate of 30 breaths/min and a tidal volume that
fluctuates between 300 ml and 450 ml. The physician orders the patient to be
placed on a moderate level oxygen. Which of the following devices should the
respiratory therapist recommend to deliver the oxygen?
A. nasal cannula at 4 L/min
B. 40% air entrainment mask
C. simple oxygen mask at 8 L/min
D. nonrebreathing mask at 15 L/min
2. The physician orders a 40% aerosol mask for a patient that has a total
inspiratory flow of 42 L/min. In order to meet this patient’s inspiratory flow
demands, what is the minimum flow the oxygen flowmeter must be set on?
A. 8 L/min
B. 10 L/min
C. 12 L/min
D. 14 L/min
3. While making oxygen rounds the respiratory therapist notices bubbling in a
humidifier that is attached to an oxygen flowmeter that is turned completely off.
The cause of this problem is most likely which of the following?
A. There is a leak in the humidifier jar.
B. The flowmeter is uncompensated for pressure.
C. The flowmeter has a faulty valve seat.
D. Water has entered the flowmeter.
4. The respiratory therapist is evaluating the oxygen set-up on a patient in the
ICU. The patient is on a non-rebreathing mask with an O2 flow of 10 L/min.
The therapist notices that the reservoir bag on a patient’s mask almost totally
collapses during the patient’s inspiration. Which of the following should be
done to correct this problem?
A. Change to a partial rebreathing mask.
B. Recommend placing the patient on a CPAP mask.
C. Instruct the patient to breathe more shallow.
D. Increase the flow to the mask.
14
5. Which of the following oxygen delivery devices are considered high-flow
devices?
I. venturi mask
II. partial rebreathing mask
III. simple oxygen mask
IV. aerosol mask
A. I only
B. I and II only
C. I and IV only
D. II and III only
6. You are preparing to transport a patient on a 5 L/min nasal cannula from ICU
to the Radiology Department for a CT scan. In order to ensure the E cylinder
has enough gas to run for at least one hour, what is the minimum pressure the
cylinder must contain?
A. 900 psig
B. 1200 psig
C. 1400 psig
D. 1700 psig
7. While making oxygen rounds the respiratory therapist notices that the bed
sheet is pulled up over the entrainment port of a patient’s venturi mask. What
effect will this have on the device?
A. The delivered oxygen percentage will remain the same, but the total flow
will decrease.
B. Less air entrainment will occur resulting in a decrease in the delivered
oxygen percentage.
C. The delivered oxygen percentage will increase as the total flow decreases.
D. The total flow from the device will increase with an increase in oxygen
percentage.
8. A patient arrives in the emergency department after being pulled from a
burning house. The respiratory therapist should recommend which of the
following to best determine the severity of the patient’s smoke inhalation?
A. Hb
B. COHb
C. PaO2
D. SpO2
15
9. The following data has been obtained from a 36-year-old patient in ICU with
pneumonia on a 50% venturi mask.
Arterial blood gases: pH 7.46
PaCO2 33 torr
PaO2 54 torr
HCO3 25 mEq/L
respiratory rate - 26 breaths/min
pulse - 110/min
Based on this data, the respiratory therapist should recommend which of the
following?
A. Place on a 70% aerosol mask.
B. Institute mechanical ventilation.
C. Place on a 100% nonrebreathing mask.
D. Place on CPAP.
10. The respiratory therapist is ask to set up 35% oxygen on an active 4-year-old
patient. The most appropriate oxygen delivery device to use in this situation
is which of the following?
A. oxygen tent
B. oxygen hood
C. nasal cannula
D. simple oxygen mask
11. The respiratory therapist notices that when a patient on a 40% aerosol masks
inhales, there is no mist exiting the exhalation ports of the mask. Which of
the following should be done to correct this problem?
A. No action is necessary. This is a normal occurrence.
B. Add a heater to the nebulizer.
C. Increase the oxygen percentage to 50%.
D. Increase the flowrate to the nebulizer.
12. A severe COPD patient enters the emergency department in respiratory
distress. Arterial blood gases are drawn on room air. Thirty minutes later
ABGs are drawn on 5 L/min nasal cannula. The data is recorded below.
ABGs on room air:
pH 7.34
ABGs on 5 L/min NC: pH 7.27
PaCO2 59 torr
PaCO2 70 torr
PaO2 42 torr
PaO2 53 torr
HCO3 36 mEq/L
HCO3 36 mEq/L
Which of the following should be recommended at this time?
A. Decrease the oxygen to 2 L/min.
B. Place on a nonrebreathing mask.
C. Institute mechanical ventilation.
D. Place on CPAP.
16
13. A patient on a 35% venturi mask running at 6 L/min is receiving how much
total flow from the device?
A. 24 L/min
B. 30 L/min
C. 36 L/min
D. 42 L/min
14. The physician has ordered oxygen to be set up on a patient with a
spontaneous tidal volume of 600 ml and an inspiratory time of one second.
Which of the following oxygen delivery devices will deliver a flow that meets
or exceeds this patient’s inspiratory flow?
A. 35% air entrainment mask at 6 L/min
B. 40% aerosol mask at 8 L/min
C. nasal cannula at 5 L/min
D. simple oxygen mask at 10 L/min
15. Room air WILL NOT be entrained through the exhalation ports of an aerosol
mask during inspiration if
A. inspiratory flow from the delivery device is inadequate.
B. the patient’s inspiratory flow exceeds the total flow from the device.
C. the patient’s inspiratory flow is 45 L/min and the total flow from the device
is 40 L/min.
D. the total flow from the device exceeds the patient’s inspiratory flow.
16. The following data is recorded on a patient who is on a 50% air entrainment
mask.
pH 7.38
PaCO2 43 torr
PaO2 90 torr
SaO2 95%
Hb 14 vol%
Heart rate - 76/min
Respiratory rate - 14/min
Based on this data, which of the following represents the patient’s total
oxygen content?
A. 12.3 vol%
B. 15.6 vol%
C. 18.1 vol%
D. 20.3 vol%
17
17. A patient on a 100% nonrebreathing mask at 15 L/min has a PaO2 of 600
torr. Which of the following should the respiratory therapist recommend at this time?
A. Place on a 40% air entrainment mask.
B. Decrease the flow to 10 L/min.
C. Place on a 4 L/min nasal cannula.
D. Discontinue oxygen therapy.
18. A 32-year-old female patient with pneumonia has a PaO2 of 57 torr and a
PaCO2 of 30 torr on a 50% air entrainment mask. Which of the following
statements is FALSE regarding this situation?
A. The patient has a decreased P(A-a)O2.
B. The patient is hypocapnic.
C. The patient’s arterial pH is most likely alkalotic.
D. The patient is hyperventilating in response to hypoxemia.
19. The respiratory therapy practitioner is preparing to monitor a neonate’s
TCPO2. With a barometric pressure of 747 torr, the monitor should be
calibrated to room air at which of the following values?
A. 0 torr
B. 100 torr
C. 147 torr
D. 157 torr
20. The following data has been collected on a patient in ICU on a 60% aerosol
mask.
pH 7.44
PaCO2 42 torr
PaO2 160 torr
PB 747 torr
Based on this information, which of the following represents this patient’s
P(A-a)O2?
A. 208 torr
B. 276 torr
C. 368 torr
D. 404 torr
18
21. A patient is on a 60% aerosol mask with the flow running at 8 L/min. The
patient is dyspneic with an SpO2 of 88%. Which of the following would be
most appropriate at this time?
A. Recommend administering a bronchodilator.
B. Increase the O2 to 70%.
C. Increase the flow to 15 L/min.
D. Place the patient on CPAP of 4 cm H2O and 60% O2.
22. The maximum liter flow to be used to deliver oxygen to a patient on a nasal
cannula is
A. 4 L/min.
B. 6 L/min.
C. 8 L/min.
D. 10 L/min.
23. Which one of the following oxygen delivery devices is not a low flow device?
A. nasal cannula
B. air entrainment mask
C. partial rebreathing mask
D. simple oxygen mask
24. When delivering oxygen using a simple oxygen mask, what is the minimum
flow required?
A. 3 L/min
B. 5 L/min
C. 7 L/min
D. 10 L/min
25. Provided the patient has a normal respiratory rate and tidal volume, the
oxygen percentage available with a simple oxygen mask is
A. 22-35%.
B. 30-40%.
C. 35-55%.
D. 55-70%.
19
26. When using an air entrainment mask with various jet sizes, the smaller the
diameter of the jet
A. the less room air entrainment.
B. the more room air entrainment.
C. the higher the delivered FIO2.
D. the less total flow delivered.
27. The air/O2 entrainment ratio for 30% is which of the following?
A. 25:1
B. 10:1
C. 8:1
D. 5:1
28. The respiratory therapist has received a verbal order from the physician to
set up a high percentage of oxygen on a patient. Which device has the
capability of delivering the highest oxygen percentage?
A. simple oxygen mask
B. air entrainment mask
C. partial rebreathing mask
D. nonrebreathing mask
29. Which of the following O2 delivery devices will meet the inspiratory flow
demands of a patient with an inspiratory flow rate of 40 L/min?
I. 40% aerosol mask at 8 L/min
II. 30% air entrainment mask at 5 L/min
III. 40% air entrainment mask at 12 L/min
IV. 35% aerosol mask at 6 L/min
A. I and III only
B. II and III only
C. III and IV only
D. I, II and IV only
30. Assuming a patient has an ideal breathing pattern, what is the approximate
oxygen percentage delivered with a nasal cannula at 4 liters/min?
A. 28%
B. 32%
C. 36%
D. 40%
20
31. The respiratory therapist has been asked to deliver a low percentage of
oxygen to a patient that is breathing 30 times per minute with an irregular
breathing pattern. Which device would be the best to set up on this patient?
A. air entrainment mask at 28%
B. nasal cannula at 2 L/min.
C. nasal catheter at 2 L/min.
D. simple oxygen mask at 6 L/min.
32. You have just completed setting up an oxygen cannula at 6 L/min. As you
kink the cannula tubing you notice no sound coming from the humidifier. This
could indicate which of the following?
I. a leak around the humidifier top
II. a cracked humidifier jar
III. no leaks are present
A. I only
B. II only
C. III only
D. I and II only
33. You are asked to set up a moderate percent of oxygen on a patient who is
breathing a consistent tidal volume of 450 milliliters at a respiratory rate that
fluctuates between 20 and 30. Based on this information, the respiratory
therapist should recommend setting up which oxygen delivery device?
A. partial rebreathing mask
B. nonrebreathing mask
C. venturi mask
D. nasal cannula
34. The oxygen percent on a nebulizer is decreased from 60% to 40%. After this
oxygen change, which one of the following statements is true?
A. Less room air will be entrained into the nebulizer.
B. The aerosol density will increase.
C. A higher total flow will be delivered to the patient.
D. The liter flow must be decreased.
21
35. Which of the following statements are correct about venturi oxygen dilution
systems?
I. The FIO2 will decrease when the internal diameter of the jet is decreased.
II. The FIO2 will increase when the size of the entrainment port is increased.
III. The total flow will increase when the size of the entrainment port is
increased.
A. I only
B. II only
C. I and III only
D. II and III only
36. While making oxygen rounds you discover that the 6-inch reservoir tubing on
a T-piece (Briggs adaptor) set up has fallen off. What may result from this
situation?
I. The FIO2 could decrease.
II. The total flow to the patient could increase.
III. More room air entrainment could occur.
A. I only
B. II only
C. I and III only
D. II and III only
37. While preparing to analyze the oxygen percentage coming from a patient's
aerosol mask, you notice water in the large bore aerosol tubing. What effect
would this have on the operation of this aerosol set-up?
A. decreased FIO2
B. increased FIO2
C. increased air entrainment into the nebulizer
D. increased gas flow to the patient
38. After setting up a nonrebreathing mask on a patient, you remove a one way
valve from one of the exhalation ports on the mask. This is done for what
purpose?
A. To increase the FIO2.
B. To increase the humidity.
C. To increase the flow to the reservoir bag.
D. To allow air to enter the mask should oxygen flow become interrupted.
22
39. Which of the following are believed to be an advantage of the nasal cannula
as compared with an air entrainment mask?
I. The cannula needn't be removed while patient is eating.
II. It may be safely used on patients with irregular breathing patterns.
III. It is generally more comfortable for the patient.
IV. It eliminates fluctuations in inspired oxygen concentrations.
A. I and II only
B. I and III only
C. II and III only
D. III and IV only
40. Choose the false statement regarding pulse-dose oxygen systems.
A. This device can deliver oxygen to the patient on inspiration only.
B. This device conserves oxygen by delivering a “pulse” of oxygen at higher
flow rates than conventional flowmeters do.
C. The device is attached to a 50 psi oxygen wall outlet or gas cylinder.
D. This system may be used in conjunction with a reservoir cannula.
41. An order is written by the physician to put a patient on a 40% aerosol mask
and he wants to meet the patient's inspiratory flow demand of 36 L/min. What
would be the minimum flow rate to use to achieve this?
A. 6 L/min
B. 8 L/min
C. 10 L/min
D. 12 L/min
42. A patient with a broken nose and cheekbone who has thick pulmonary
secretions is ordered to be placed on 40% oxygen. Based on this information
which oxygen delivery device would be most indicated for this patient?
A. nasal cannula at 5 L/min
B. face tent
C. simple mask at 8 L/min
D. aerosol mask
23
43. Which piece of equipment is most commonly used for the set up of a
tracheostomy collar?
A. bubble humidifier
B. impeller nebulizer
C. ultrasonic nebulizer
D. jet nebulizer
44. You notice after setting up a partial rebreathing mask on a patient that the
reservoir bag totally collapses during inspiration. The respiratory therapist
should recommend which of the following?
A. Increase the flowrate.
B. Place a one-way valve on the exhalation port..
C. Tighten the mask around the patient's face.
D. Increase the flowrate.
45. The physician has ordered oxygen to be set up on a patient with a
spontaneous tidal volume of 500 ml (0.5 L) and an inspiratory time of 1
second. Which of the following O2 devices will provide sufficient flow to meet
this patient’s inspiratory flow demands.
A. 35% air entrainment mask at 6 L/min
B. 40% aerosol mask at 7 L/min
C. simple oxygen mask at 10 L/min
D. partial rebreathing mask at 15 L/min
46. A patient is placed on a 35% venturi mask at 8 L/min. What is the total flow
being delivered to the patient?
A. 36 L/min
B. 42 L/min
C. 48 L/min
D. 54 L/min
47. The respiratory therapist is called to a patient’s room to check the oxygen
setup. The flow to the patient’s mask is supplied by an air flowmeter running
at 15 L/min and an O2 flowmeter running at 15 L/min. The delivered oxygen
percentage from this device is
A. 24%
B. 35%
C. 40%
D. 60%
24
48. Which of the following are considered oxygen-conserving (reservoir)
devices?
I. partial rebreathing mask
II. reservoir cannula
III. pendant cannula
IV. nasal cannula
A. I and II only
B. II and III only
C. I, II and III only
D. I, III and IV
49. A patient is set up on a 40% aerosol mask running at 10 L/min of oxygen.
There is a 10 L/min air bleed in downstream. What percent oxygen is this set
up delivering?
A. 45%
B. 40%
C. 36%
D. 30%
50. Inadequate alveolar ventilation caused by atelectasis resulting in hypoxia is
an example of which type of hypoxia?
A. anemic hypoxia
B. stagnant hypoxia
C. hypoxemic hypoxia
D. histotoxic hypoxia
51. An example of histotoxic hypoxia would be
A. carbon monoxide poisoning.
B. upper airway obstruction.
C. pulmonary embolism.
D. alcohol poisoning.
25
52. Hypoxemic hypoxia may result from which of the following:
I. hypoventilation
II. ventilation/perfusion mismatch
III. carbon monoxide poisoning
A. I only
B. II only
C. I and II only
D. II and III only
53. Cyanosis will be detected when
A. the patient's PaO2 drops below 80 torr.
B. there is 7 gm/dL of unsaturated hemoglobin.
C. the patient's heart rate increases 20 beats/minute.
D. the patient's SaO2 drops to 93%.
54. A patient on 50% oxygen has a PaO2 of 252 torr. Which of the following
should the respiratory care practitioner recommend?
A. Decrease the oxygen to 40%.
B. Decrease the oxygen to 30%.
C. Discontinue oxygen therapy.
D. Repeat the blood gases as the PaO2 is not possible on this FIO2.
55. Which of the following statements is true regarding a patient who has a Hb
level of 8 gm/dL and a SpO2 of 98%?
A. The patient will not be cyanotic.
B. Hypoxia is most likely not present.
C. Oxygen is not indicated at this time.
D. The patient is polycythemic.
56. Which statement about circulatory hypoxia is true?
A. Tissue cells are unable to utilize oxygen due to an impairment of cellular
oxidative enzymes.
B. The O2 content and O2 carrying capacity are normal but blood flow
through the
capillaries is diminished.
C. The hemoglobin levels in the blood are decreased.
D. Tissue perfusion is adequate but the PaO2 is reduced.
26
57. Anemic hypoxia may be the result of
A. carbon monoxide poisoning.
B. right to left intrapulmonary shunting.
C. pulmonary embolism.
D. congestive heart failure.
58. Which one of the following is not an acute symptom of hypoxia?
A. cyanosis
B. dyspnea
C. headache
D. bradycardia
59. A patient has a PaO2 of 54 torr on a 40% aerosol mask. After the oxygen is
increased to 60%, the PaO2 is 56 torr. This poor response to O2 therapy is
most likely the result of which of the following?
I. pulmonary edema
II. hypoventilation
III. atelectasis
IV. diffusion defect
A. I and III only
B. III and IV only
C. I, II and IV only
D. II, III and IV only
60. Which of the following plays a role in the development of cor pulmonale in a
severe COPD patient?
I. pulmonary vasoconstriction
II. increased red blood cell count
III. anemic hypoxia
A. I only
B. II only
C. III only
D. I and II only
27
61. Which of the following is characteristically observed with cor pulmonale?
A. right ventricular hypertrophy
B. left ventricular hypertrophy
C. atelectasis
D. decreased hemoglobin levels
62. Given the following data, calculate total oxygen content.
pH 7.41
PaCO2 43 torr
PaO2 94 torr
Hb 14 gm/dL
SaO2 96%
A. 13.4 vol.%
B. 15.6 vol.%
C. 17.8 vol.%
D. 18.3 vol.%
63. A severe COPD patient is on a 28% air entrainment mask and has a PaO2 of
61 torr. Which of the following should the respiratory therapist recommend at
this time?
A. Place on CPAP.
B. No changes are required at this time.
C. Increase to O2 to 40%.
D. Place on a nonrebreathing mask.
64. A patient is brought into the emergency department after being pulled from a
burning house. The patient's ABG results on a nonrebreathing mask are pH
7.21, PaCO2 19 torr, PaO2 187 torr, HCO3 10 mEq/L, SaO2 65%. From this
information, which of the following are true about this patient?
I. The patient should be placed on a simple O2 mask at 10 L/min.
II. The SpO2 should be measured due to the discrepency in the PaO2 and
SaO2.
III. The patient is hyperventilating due to severe hypoxia.
IV. The blood gases reveal a partially compensated respiratory acidemia.
A. III only
B. I and IV only
C. III and IV only
D. II, III and IV only
28
65. In order to prevent neonatal retinopathy, the PaO2 should not exceed what
level?
A. 50 torr
B. 60 torr
C. 70 torr
D. 80 torr
66. A physician orders a nonrebreathing mask on a severe chronic lung patient
with a PaO2 of 59 torr. The patient seems to be in no acute distress. The
respiratory therapist should do which of the following?
A. Set up the mask as ordered.
B. Ask the nurse for clarification.
C. Notify the physician before setting up the mask and ask for clarification.
D. Set up the mask and notify your supervisor at shift change.
67. Which of the following are not hazards of oxygen therapy?
I. atelectasis
II. respiratory depression
III. pneumothorax
IV. increased surfactant production
A. I and II only
B. III and IV only
C. I, II and IV only
D. II, III and IV only
68. A 28-year-old male presents with pneumonia and is placed on a 60% aerosol
mask. His PaO2 is 51 torr and his PaCO2 is normal indicating he is ventilating
adequately. The respiratory therapist should recommend which of the
following?
A. Place the patient on CPAP.
B. Increase the aerosol mask to 70%.
C. Place the patient on a nasal cannula at 2 L/min.
D. Place the patient on a nonrebreathing mask.
29
69. A patient is brought into the emergency room having been pulled from a
burning house. He is receiving oxygen through a nasal cannula at 4 l/min.
Which of the following would you recommend at this time?
A. Get a stat arterial blood gas.
B. Remove the cannula and replace with a nonrebreathing mask.
C. Increase the liter flow on the cannula to 6 l/min.
D. Obtain an arterial blood gas on room air.
70. A patient presents in the emergency room after being rescued from a house
fire. Which of the following devices would you recommend to most accurately
determine the severity of the patient's carbon monoxide blood level?
A. pulse oximeter
B. co-oximeter
C. oxygen analyzer
D. capnometer
71. An alert, spontaneously breathing patient has a PaCO2 of 33 torr and a PaO2
of 55 torr while receiving an FIO2 of 0.70. Which of the following is the most
appropriate way to increase the patient's PaO2?
A. Increase the FIO2 only.
B. Intubate and increase the FIO2.
C. Apply CPAP at 60% oxygen.
D. Apply CPAP at 100% oxygen.
72. CPAP is appropriate in the treatment of patients with which of the following?
A. spontaneous breathing without hypoxemia
B. spontaneous breathing with intrapulmonary shunting
C. apnea
D. a PaO2 of 90 torr on 25% oxygen
73. A patient has just been resuscitated following carbon monoxide poisoning.
Which of the following values would best determine this patient's oxygen
carrying capacity?
A. SaO2
B. Hb level
C. arterial oxygen content
D. PaO2
30
74. The following blood gases have been obtained from a patient on a 40% airentrainment
mask.
pH 7.47
PaCO2 32 torr
PaO2 58 torr
Based on this data, the respiratory therapist should recommend to
A. place the patient on CPAP.
B. place the patient on a 60% aerosol mask.
C. place the patient on a nonrebreathing mask.
D. continue the current oxygen therapy and get a blood gas in one hour.
75. The following data has been collected on a patient.
pH 7.42
PaCO2 42 torr
PaO2 62 torr
SaO2 91%
Hb 13 gm/dL
Based on this data, which of the following represents the amount of oxygen
bound to hemoglobin?
A. 0.23 vol%
B. 10.8 vol%
C C. 15.9 vol%
D. 18.2 vol%
76. Which of the following is the most appropriate range to maintain a COPD
patient’s PaO2 who is chronically hypercapnic?
A. 45-55 torr
B. 55-65 torr
C. 65-75 torr
D. 75-85 torr
77. Approximately how many hours will an H cylinder run at 5 L/min until empty if
it contains a pressure of 1500 psi?
A. 5 hours
B. 10 hours
C. 15 hours
D. 20 hours
31
78. The respiratory care practitioner is setting up a portable liquid oxygen system
for a chronic lung patient who attends church each week. The patient is on a
2 L/min nasal cannula and the portable oxygen container holds 4 lbs of
oxygen. The practitioner should explain to the patient the oxygen supply will
last for approximately what length of time?
A. 4.5 hours
B. 8 hours
C. 11.5 hours
D. 14 hours
79. Choose the FALSE statement(s) concerning the proper storage of medical
gas cylinders.
I. Cylinders shouldn't be stored in areas where the temperature exceeds
125oF.
II. Flammable and non-flammable gases may be stored together.
III. Cylinders must be stored with protective caps in place.
IV. Full and empty cylinders should be segregated in the storage area.
A. I only
B. II only
C. II and III only
D. III and IV only
80. Which of the following represents the cylinder factor for a cylinder that has a
filling pressure of 2000 psig and contains 50 cubic feet of gas?
A. .28 L/psig
B. .70 L/psig
C. 1.41 L/psig
D. 3.14 L/psig
81. A molecular sieve oxygen concentrator is capable to delivering a maximum
oxygen percentage of which of the following?
A. 40%
B. 65%
C. 95%
D. 100%
82. Which statement about liquid oxygen storage is FALSE?
A. It is stored at a higher pressure than gaseous oxygen.
B. It is more economical and convenient than gaseous oxygen.
C. The container in which it is stored is similar to a large thermos bottle
keeping the temperature fairly constant.
D. More oxygen may be stored in liquid form.
32
Humidity and Aerosol Therapy
1. Which of the following devices is capable of delivering gas to the patient that
is fully saturated at body temperature?
A. bubble humidifier
B. heated Cascade humidifier
C. passover humidifier
D. heat moisture exchanger
2. While on rounds you notice that a bubble humidifier connected to a simple
oxygen mask is not bubbling. Which of the following may be causing this
problem?
I. crack in the humidifier jar
II. plugged capillary tube
III. loose diffuser
A. I only
B. II only
C. I and III only
D. II and III only
3. After setting up a nasal cannula on 4 L/min, the respiratory therapist kinks the
cannula tubing and a high-pitched whistling noise is heard coming from the
humidifier. Which of the following is true regarding this situation?
A. The liter flow is too high.
B. The cannula tubing may have a crack in it.
C. The oxygen setup is functioning properly.
D. The humidifier should be replaced.
4. An immunocompromised patient is to be placed on oxygen with a
humidity/aerosol device. Which of the following devices is most likely to
deliver contaminated water to the patient?
A. heated Cascade humidifier
B. bubble humidifier
C. heated wick humidifier
D. heated jet nebulizer
33
5. While analyzing the oxygen on a patient that is set up on a heated 40%
aerosol mask, you observe the analyzer reading 75%. Which of the following
may be causing this high reading?
A. There is water in the aerosol tubing.
B. The liter flow to the nebulizer is too high.
C. The air-entrainment port is opened more than it should be.
D. The heater has malfunctioned.
6. A patient is on a ventilator with a heat moisture exchanger (HME) being used
to humidify the inspired air. You notice that suctioning the patient has become
more difficult due to the increase in the thickness of the secretions. Which of
the following should the respiratory care practitioner recommend at this time?
A. Replace the heat moisture exchanger with a heated humidifier.
B. Increase the suction level.
C. Use a larger suction catheter.
D. Suction the patient more frequently.
7. A heated humidifier is delivering 100% body humidity to a patient’s airway.
What volume of water is being delivered?
A. 24 mg/L
B. 37 mg/L
C. 44 mg/L
D. 47 mg/L
8. The respiratory therapist is instructing a patient on the proper use of a
metered-dose inhaler. To deliver the optimal amount of medication, the
patient should be instructed to activate the MDI
A. after a deep inspiration.
B. just before the patient begins to inhale.
C. just after the patient has started to inhale.
D. after a normal inspiration.
34
9. A patient in ICU with bronchiectasis has very thick, hard to mobilize pulmonary
secretions. A bronchodilator has been ordered by the physician. Which of the
following devices should the respiratory care practitioner recommend to deliver
the medication?
A. hand-held nebulizer
B. metered-dose inhaler
C. impeller nebulizer
D. ultrasonic nebulizer
10. While making oxygen rounds, the respiratory care practitioner notices very
little mist being produced by a nebulizer attached to an aerosol mask. Which
of the following may be the cause of this?
I. The liter flow is too low.
II. The jet is obstructed.
III. The capillary tube filter is clogged.
A. I only
B. I and II only
C. II and III only
D. I, II and III
11. Which of the following is not a hazard of aerosol therapy?
A. overhydration
B. bradycardia
C. bronchospasm
D. contaminated aerosol delivery
12. While administering an ultrasonic nebulizer treatment, the respiratory care
practitioner notices that the couplant chamber light comes on. If this is not
corrected, this may result in which of the following?
A. The mist output will decrease.
B. The temperature of the mist will increase.
C. The electrical power will shut off.
D. The vibration frequency will increase.
35
13. Absolute humidity is defined as
A. the amount of moisture in a given volume of gas.
B. the percent of water in the air at body temperature.
C. the ratio of the amount of water in the air to the total amount that can be
held at a given temperature.
D. the amount of water the body's humidification process produces in the
airway.
14. A patient is placed on an aerosol mask with a non-heated nebulizer that is
delivering 18 mg of water/liter of gas. This patient has a humidity deficit of
which of the following?
A. 10 mg/L
B. 16 mg/L
C. 23 mg/L
D. 26 mg/L
15. A volume of air at 22oC can hold 19 mg of water/liter of gas. What is the
relative humidity of the air if it is holding 12 mg/liter at this temperature?
A. 32%
B. 48%
C. 63%
D. 74%
16. A patient's heated nebulizer is delivering 38 mg of water/liter of gas. What
percent body humidity is being delivered with this device?
A. 35%
B. 54%
C. 86%
D. 93%
17. Tracheal secretions tend to dry in an intubated patient when the inspired air
has which of the following characteristics?
I. an absolute humidity of 22 milligrams of water/L of air
II. a water vapor pressure of 47 mm Hg (torr)
III. 52 milligrams of particulate water per liter of gas
IV. a relative humidity of 100% at 25oC
A. I and III only
B. I and IV only
C. II and III only
D. III and IV only
36
18. In order to minimize an increased airway resistance produced by high density
aerosol inhalation, the respiratory therapist should recommend which of the
following?
A. Administer a bronchodilator along with the aerosol.
B. Instruct the patient to breathe through their nose.
C. Use a heated nebulizer to deliver the aerosol..
D. Perform chest physiotherapy following the aerosol treatment.
19. Which of the following are considered indications for aerosol therapy?
I. mobilization of retained secretions
II. overhydration
III. deliver a bronchodilator
IV. following extubation to reduce swelling of the airway
A. I and II only
B. II and III only
C. I and IV only
D. I, III and IV only
20. A patient the respiratory therapist has just extubated complains his throat
feels swollen and is sore when he swallows. Which of the following should
the therapist recommend at this time?
A. Deliver warm humidity to the patient’s airway.
B. Deliver cool aerosol to the patient’s airway.
C. Deliver warm aerosol to the patient’s airway.
D. No therapy is recommended, but the patient should be told the symptoms
should subside in a couple of days.
21. When an aerosol particle is termed hygroscopic, it means the particle
A. is less than .1 microns in size.
B. is influenced by gravity.
C. is dry.
D. retains moisture.
37
22. Which type of breathing pattern will improve aerosol delivery to a patient's
lungs?
A. fast rate and large volume
B. slow rate, large volume and exhale through pursed lips
C. fast paced inspiration with moderately deep volume and 3 second breath
hold at end inspiration
D. slow inspiration with moderately deep volume and a 2-3 second breath
hold at end inspiration
23. Which of the following are not clinical uses of humidity?
I. to humidify dry gases
II. to provide 100% body humidity to intubated patients
III. to deliver particulate water particles to the airway
A. I only
B. I and II only
C. II and III only
D. I, II and III
24. A gas mixture composed of three gases exerts a pressure of 747 mm Hg.
The fractional concentrations of the gases are:
Gas # 1 - 0.31
Gas # 2 - 0.52
Gas # 3 - 0.17
Correcting for water vapor pressure, what is the partial pressure of gas # 3?
A. 104 mm Hg
B. 119 mm Hg
C. 217 mm Hg
D. 364 mm Hg
25. The reason that a patient with thick retained secretions should have a heated
nebulizer attached to the oxygen delivery device is to
A. ensure that the patient doesn't become overhydrated.
B. deliver more moisture to the airway thereby decreasing the thickness of the
secretions.
C. decrease the total water output in the inspired air.
D. decrease the relative humidity in the inspired air.
38
26. The secretions of a tracheotomized patient are thick and difficult to mobilize.
Which of the following should the respiratory therapist recommend?
A. Add a heater to the nebulizer.
B. Suction the patient every hour.
C. Restrict fluid intake.
D. Suction with a pressure of –140 mm Hg.
27. The respiratory therapist is asked to recommend a humidifier that will be able
to provide the highest water vapor content to the patient’s airway. Which of
the following humidifiers should the therapist select?
A. passover
B. heat moisture exchanger
C. heated wick
D. bubble
28. A patient receiving mechanical ventilation has a heat moisture exchanger
attached at the circuit wye(Y). While making ventilator checks the respiratory
therapist notes an increased dynamic lung compliance with no change in the
static compliance. The therapist should recommend which of the following?
A. Change to a heated wick humidifier.
B. Suction the patient every hour.
C. Initiate chest physiotherapy.
D. Increase the patient’s tidal volume.
29. After administering a bland aerosol treatment to a patient, the respiratory
therapist auscultates bilateral rhonchi. The therapist should recommend
which of the following?
A. Discontinue the treatment and initiate IPPB therapy.
B. Encourage the patient to deep breath and cough.
C. Initiate bronchodilator therapy.
D. Discontinue the therapy.
30. The respiratory therapist is called to check the operation of a patient’s 35%
aerosol mask. As you enter the room you notice the mist is being delivered
intermittently, in short puffs of mist. The therapist should
A. replace the nebulizer with a new one.
B. drain the water from the aerosol tubing.
C. increase the temperature to the nebulizer heater.
D. increase the oxygen to 40%.
39
31. Which of the following would be able to provide the highest relative humidity
to a patient on mechanical ventilation?
A. HME
B. bubble humidifier
C. heated passover humidifier
D. heated cascade humidifier
40
Equipment Troubleshooting and Decontamination
1. Which of the following methods is most commonly used to sterilize bacteria
filters?
A. autoclave
B. ethylene oxide gas exposure
C. pasteurization
D. glutaraldehyde immersion
2. A patient is diagnosed with pulmonary tuberculosis. Which of the following
isolation precautions should the respiratory care practitioner recommend?
A. strict isolation
B. reverse isolation
C. respiratory isolation
D. enteric isolation
3. Which of the following is the most cost-effective method for preventing cross
contamination of a tracheostomy patient?
A. Suction no more frequently than every four hours.
B. Wash hands after each patient.
C. Use sterile technique when suctioning.
D. Change tracheosotomy dressing every eight hours.
4. Which of the following organisms is most frequently responsible for
contamination of respiratory care equipment?
A. Klebsiella
B. Serratia
C. E. coli
D. Pseudomonas
5. The respiratory therapist is instructing a patient who is about to be discharged
from the hospital the proper method for cleaning equipment in the home.
Which of the following should be included in the procedure?
A. The equipment should be towel dried immediately after it is removed from
the liquid disinfectant.
B. After rinsing the equipment in a vinegar solution for 30 minutes, it should be
rinsed and allowed to air dry.
C. The equipment should be disinfected after each use.
D. An autoclave should be purchased to ensure adequate cleaning of the
equipment
41
6. Which of the following cleaning methods or solutions does not have the
capability of sterilizing equipment?
I. autoclave
II. pasteurization
III. glutaraldehyde
A. I only
B. II only
C. I and III only
D. II and III only
7. Following a bronchoscopy, the respiratory care practitioner should clean the
bronchoscope using which of the following cleaning methods?
A. Wipe down with alcohol.
B. Soak for thirty minutes in a glutaraldehyde solution.
C. Place in an autoclave for fifteen minutes.
D. Soak in acetic acid for one hour.
8. The respiratory therapist is calibrating a blood gas analyzer using a gas
mixture containing 8% CO2 and 15% O2. The barometric pressure is 747 torr.
The PCO2 should be set at which of the following values?
A. 8 torr
B. 24 torr
C. 56 torr
D. 60 torr
9. A patient is receiving cool mist entrained through a 30% venturi mask. The
FIO2 measured at the mask is 35%. The respiratory therapist should do which
of the following?
A. Calibrate the analyzer and re-analyze the FIO2.
B. Check the entrainment port setting.
C. Check for condensation in the aerosol tubing.
D. Check the flow to the venturi.
10. The respiratory therapist is calibrating a transcutaneous oxygen monitor to be
set up on a two-day-old neonate. The barometric pressure is 747 torr. The
PO2 should be set at which of the following values?
A. 0 torr
B. 21 torr
C. 147 torr
D. 157 torr
42
11. The respiratory therapist is having difficulty calibrating a transcutaneous
oxygen electrode. Which is the most likely cause of this problem?
A. The sensor is not attached to the patient properly.
B. The membrane is damaged.
C. The sensor is warm.
D. Perfusion to the sensor site is poor.
12. While delivering IPPB to a tracheostomized patient air can be heard leaking
around the patient’s mouth and the machine will not cycle off. The therapist
should
A. add air to the tube cuff.
B. increase the flow.
C. increase the sensitivity.
D. decrease the inspiratory pressure.
13. The high pressure alarm is activated on a patient’s volume ventilator. Which
of the following could be causing this problem?
I. secretions in the airway
II. bronchospasm
III. leak around the chest tube
IV. static compliance is increasing
A. I and II only
B. II and III only
C. III and IV only
D. I, II and IV only
14. The physician has ordered 35% oxygen via an oxygen hood and blender for
a 5-day-old neonate. The flowmeter on the blender is reading 10 L/min and
is attached to a nebulizer set on 40%. The blender is set at 35%. When
analyzing the O2 concentration, the respiratory therapist observes the
analyzer reading 25%. The therapist should do which of the following to
correct this problem?
A. Increase the flow to 12 L/min.
B. Set the blender to 100% oxygen.
C. Set the nebulizer’s entrainment port to 35%.
D. Set the nebulizer’s entrainment port to 100%.
43
15.. The inverse I:E ratio alarm is sounding on a patient’s volume ventilator.
Which of the following should the respiratory therapist recommend to correct
this problem?
A. Decrease the tidal volume.
B. Increase the rate.
C. Increase the flow.
D. Set a 1 second inspiratory pause.
16. The respiratory therapist is analyzing the oxygen concentration from a heated
40% nebulizer running at 15 L/min. The analyzer reads 75%. The therapist
should
A. decrease the flow to 10 L/min.
B. recalibrate the O2 analyzer.
C. drain the condensation from the aerosol tubing.
D. shorten the aerosol tubing.
17. While checking a volume ventilator that is to be set up on a postoperative
cardiac bypass patient, the exhaled tidal volume display reads 300 ml less
than the machine’s set tidal volume. The respiratory therapist should do
which of the following to determine what is causing this problem?
I. Measure the volume at the exhalation valve.
II. Measure the volume leaving the ventilator outlet.
III. Calculate the tubing compliance.
A. I only
B. I and II only
C. II and III only
D. I, II and III only
18. A patient is receiving volume-controlled ventilation. The respiratory therapist
receives an order to increase the patient’s tidal volume from 600 to 800 ml.
After changing the tidal volume, the therapist should adjust which of the
following alarm settings?
I. high minute volume alarm
II. low exhaled tidal volume alarm
III. high pressure alarm
A. II only
B. I and II only
C. II and III only
D. I, II, and III
44
19. While assessing a ventilator patient with a pneumothorax, the respiratory
therapist observes a blood clot occluding the patient’s chest tube. The first
action the therapist should take would be to
A. clamp off the drainage tube.
B. “milk” the drainage from the chest tube.
C. insert a new chest tube.
D.get a stat chest x-ray.
20. While transporting a patient on oxygen the cannula tubing becomes kinked
between the mattress and bedrail. What affect will this have on the reading
on the Bourdon gauge flowmeter attached to the e cylinder?
A. The gauge will read lower.
B. The gauge will read slightly higher.
C. The gauge reading will remain the same.
D. The gauge reading will increase at least 4 L/min.
21. An oxygen analyzer is reading inaccurately. To calibrate the analyzer which
of the following gases should be used?
I. oxygen
II. room air
III. nitrogen
A. I only
B. II only
C. I and II
D. II and III only
22. The mist exiting the aerosol mask attached to an ultrasonic nebulizer is
minimal. Which of the following should be done to correct this problem?
I. Drain the aerosol tubing.
II. Decrease the amplitude.
III. Add water to the couplant chamber.
A. I only
B. I and III only
C. II an III only
D. I, II and III
45
23. Which of the following could result in the high pressure alarm being triggered
on a volume ventilator?
I. patient experiencing bronchospasm
II. patient disconnected from the ventilator
III. increased lung compliance
IV. decreased static pressure
A. I only
B. I and IV only
C. II and III only
D. III and IV only
24. The respiratory therapist notices very little mist exiting the reservoir tubing of
a T-piece flow-by set-up as the patient inspires. The therapist should
A. Increase the flow to the nebulizer.
B. Instruct the patient to breathe deeper.
C. Instruct the patient to breathe slower.
D. Analyze the oxygen percentage.
25. The low volume alarm is triggered on a volume ventilator. Which of the
following may be causing this problem?
I. patient disconnection
II. leak around chest tube
III. excessive air in E-T tube cuff
IV. inappropriate alarm setting
A. I and II only
B. II and IV only
C. I, II and III only
D. I, II and IV only
26. A patient receiving IPPB therapy has difficulty cycling the machine into
exhalation. Which of the following should the respiratory therapist do first to
correct this problem?
A. Instruct the patient to breath deeper.
B. Increase the inspiratory pressure.
C. Instruct the patient to keep lips sealed tight around the mouthpiece.
D. Give the treatment with a mask.
46
27. A patient with a suspected drug overdose is on a volume ventilator on the
following settings.
Tidal volume 650 ml
Rate 12/min
Mode Assist/control
Inspiratory flow 25 L/min
Pressure limit 45 cm H2O
The I:E ratio alarm is triggered. Which ventilator adjustment should the
respiratory therapist make at this time?
A. Increase the pressure limit.
B. Increase the tidal volume.
C. Increase the inspiratory flow.
D. Increase the rate.
28. A polarographic oxygen analyzer is being used to monitor the oxygen on a
ventilator patient. The patient is on 100% oxygen and the analyzer is reading
102%. Which of the following should be done to correct this problem?
A. Replace the membrane on the electrode.
B. Calibrate the analyzer.
C. Reduce the inspiratory flow on the ventilator.
D. Change the batteries in the analyzer.
29. A patient is receiving 6 cm H2O of CPAP by mask at home but the CPAP
level can’t be maintained. Which of the following should the respiratory
therapist do?
A. Reposition the patient’s head and neck.
B. Make sure the tubing isn’t kinked.
C. Suction the patient.
D. Check for leaks in the set-up.
30. While administering IPPB to a patient the machine cycles without any effort
on the patient’s part. Which of the following controls should the respiratory
therapist check at this time?
A. flow
B. rate
C. pressure
D. oxygen
47
31. A patient is on a 70% T-piece with the oxygen flow to the nebulizer set at 15
L/min. The patient is dyspneic and no mist is visible exiting the T-piece
reservoir. The respiratory therapist should do which of the following at this
time?
A. Add a second nebulizer.
B. Increase the nebulizer setting to 100%.
C. Shorten the aerosol tubing.
D. Decrease the flow to the nebulizer.
32. Which of the following may result in inadequate mist output by a nebulizer?
I. obstructed capillary tube
II. inadequate flow
III. water in the aerosol tubing
A. I only
B. I and II only
C. II and III only
D. I, II and III
33. The exhaled tidal volume display on a patient’s volume ventilator consistently
reads lower than the set volume. Which of the following is the most likely
cause?
A. water in the tubing
B. inadequate flow rate
C. sensitivity control set too high
D. leak around th HME
34. The high pressure alarm suddenly sounds on a patient receiving volumecycled ventilation. The most
appropriate action to take is to
A. decrease the inspiratory flow.
B. increase the high pressure limit.
C. suction the patient.
D. Increase the inspiratory flow.
48
35. A patient receiving oxygen via concentrator at 2 L/min at home complains he
can’t feel oxygen coming out the prongs of the cannula. Which of the following should the respiratory therapist
do first?
A. Place the cannula under water and see if bubbling occurs.
B. Attach the cannula to a cylinder/flowmeter set-up.
C. Increase the flow to 5 L/min.
D. Replace the concentrator with a new one.
36. A demand-valve resuscitator is being used to ventilate an apneic patient in
the emergency department. Inadequate tidal volumes are being delivered.
The therapist should do which of the following first?
A. Place the patient on a mechanical ventilator.
B. Change to a manual resuscitator.
C. Determine the resuscitator’s problem.
D. Begin chest compressions.
37. While manually ventilating an intubated apneic patient with a manual
resuscitator there is very little resistance when the bag is compressed and the
patient’s chest rises only minimally. Which of the following may be the cause
of this problem?
A. Excessive E-T tube cuff pressure.
B. Exhalation valve jammed in the closed position.
C. The patient’s lungs are non-compliant.
D. Inadequate E-T tube cuff pressure.
38. Which of the following is the most appropriate method to prevent the crosscontamination of a Wright
respirometer that is being used on several
patients?
A. Place the respirometer is Cidex between patient use.
B. Use a one-way valve so that only exhaled air flows through the
respirometer.
C. Have the respirometer autoclaved after each patient use.
D. Wipe the respirometer with alochol after each patient use.
39. Which of the following is most likely responsible for a staphylcoccal outbreak
in ICU patients requiring respiratory care?
A. health care workers
B. ventilators
C. disposable humidifiers
D. MDIs
49
40. Pulse oximeters are inaccurate in which of the following situations?
I. carbon monoxide poisoning
II. hypotension
III. inadequate perfusion
A. I only
B. I and II only
C. II and III only
D. I, II and III
41. A respiratory care practitioner is called to a patient's room because oxygen is
leaking from an E cylinder. The practitioner should do which of the following?
I. Tighten all connections
II. Replace the washer between the cylinder and regulator connections
III. Knock the pins off the regulator to assure a tight fit
IV. Lubricate around the connection where the leak is occurring.
A. I and II only
B. I and III only
C. II and III only
D. III and IV only
42. Hydrostatic testing of a gas cylinder will determine which of the following?
I. cylinder expansion
II. leaks in the cylinder
III. cylinder wall stress
A. II only
B. I and III only
C. II and III only
D. I, II and III
43. The respiratory therapist is performing a routine home visit on a 58-year-old
emphysema patient. The patient receives continuous oxygen with a nasal
cannula at 2 L/min through an oxygen concentrator. The patient states that
when traveling in his car, he uses an E cylinder secured in the back seat of
his car and a spare cylinder in his trunk for especially long trips. The therapist
should explain the proper method of cylinder transport and inform him that
A. if he transports a cylinder in his trunk, he must make sure it is properly
secured.
B. he should leave the trunk open approximately 1 inch when transporting a
spare cylinder.
C. he should not transport cylinders in his car.
D. he should not transport the spare cylinder in the trunk, but secure it in the
back seat of the car.
50
44. The respiratory therapist is making a routine visit to the home of a 62-year-old patient who receives
continuous oxygen through a nasal cannula at 2 L/min
using an oxygen concentrator. The patient states she is going to start
bowling each week and wants to know the best method of oxygen delivery
while she bowls. The therapist should explain to the patient
A. to use a portable liquid system.
B. to use an E cylinder.
C. to use the oxygen concentrator.
D. she won’t be able to bowl while she is using oxygen.
45. It's important to "crack" a cylinder prior to the attachment of a regulator
because
A. the regulator won't function properly.
B. it clears the valve outlet of dust and debris.
C. it ensures the cylinder is full.
D. it makes for an easier attachment
46. Which of the following statements regarding oxygen concentrators is FALSE?
A. The concentrator is connected to an electrical wall outlet.
B. When the flow is increased, the delivered oxygen percent increases.
C. When using an oxygen enricher, it is recommended to triple the ordered O2
flow.
D. Concentrators are primarily devices used to administer oxygen in the home
setting.
47. Choose the FALSE statement regarding flow restrictors.
A. They generally are used in delivery of oxygen in the home.
B. They operate off a 50 psig gas source.
C. The flow generally varies from 5-10 L/min.
D. They are a fixed-orifice, constant-pressure flow metering device.
48. A Bourdon gauge regulator indirectly measures gas flow by directly
measuring
A. pressure
B. liters per minute
C. liters per second
D. flow velocity
51
49. A flowmeter has a completely closed needle valve and the float jumps when
the flowmeter is plugged into a wall gas outlet. Which of the following
statements are true?
I. This is a normal function in an uncompensated flowmeter.
II. The flowmeter must have a restriction on it's outlet.
III. This is a normal function in a compensated flowmeter.
A. I only
B. III only
C. I and II only
D. II and III only
50. You turn a flowmeter completely off in a patient's room following a treatment
but hear gas leaking out of it. What is the most likely cause of this?
A. The flowmeter is uncompensated.
B. This is normal when using a compensated flowmeter.
C. The flowmeter housing is cracked.
D. The flowmeter has a faulty valve seat.
51. Reinserting a flowmeter into an oxygen wall outlet has failed to correct a
massive gas leak in a patient's room. Which of the following should be done
NEXT?
A. Evacuate the patients from the floor.
B. Provide necessary supplemental oxygen to patients in the area and close
the zone valve.
C. Have engineering shut off the hospital's master oxygen valve.
D. Check the pressure relief valve on the patient's bubble humidifier.
52. The respiratory care practitioner needs to transport a patient on oxygen from
ICU to the Radiology Department to have a CAT scan performed. In order to
place an E cylinder in the bed in a horizontal position, which type of device
should be used on the cylinder to measure the flow?
A. uncompensated Thorpe tube flowmeter
B. compensated Thorpe tube flowmeter
C. Bourdon gauge flowmeter
D. kinetic flowmeter
52
53. While making oxygen rounds the respiratory therapist discovers the reservoir
tubing on a T-piece set-up has fallen off. Which of the following is true
regarding this situation?
A. The FIO2 may decrease.
B. The total flow to the device will decrease.
C. The FIO2 may increase.
D. Less room air will be entrained.
54. After setting up a nonrebreathing mask the respiratory therapist removes one
of the one-way valves covering the exhalation port. This is done to
A. increase the FIO2.
B. make sure the patient will get air should the oxygen flow be disrupted.
C. increase the humidity output.
D. increase the flow to the reservoir bag.
55. A polarographic oxygen analyzer is being used to analyze the oxygen on a
nebulizer set on 40%. The analyzer reads 28%. Which of the following
could be causing this inaccurate reading?
I. weak batteries
II. water on the membrane
III. inappropriate nebulizer setting
A. I only
B. I and II only
C. II and III only
D. I, II and III
56 The respiratory care practitioner is making equipment rounds and hears the
relief valve on a humidifier. Which of the following could be causing this
problem?
I. a loose tubing connection
II. an excessive oxygen flow setting
III. an obstruction in the attached tubing
A. I only
B. I and II only
C. II and III only
D. I, II, and III
53
57. The respiratory care practitioner opens the valve on an E cylinder that has a
regulator attached and hears a loud hissing noise. The flowmeter is turned
off. Which of the following actions might correct this problem?
I. Tighten the regulator connection.
II. Replace the regulator washer.
III. Turn the flowmeter on.
A. I only
B. I and II only
C. II and III only
D. I, II, and III
58. A 20-month-old infant is to receive 35% oxygen by mist tent. While
performing a routine equipment check, the respiratory therapist notices that
the oxygen analyzer inside the tent reads 30%. After calibrating the analyzer,
it still indicates 30%. The therapist should
I. add sterile water to the nebulizer reservoir.
II. check for leaks.
III. check for water condensation in the aerosol tubing.
A. II only
B. I and II only
C. II and III only
D. I, II and III
59. A patient is receiving oxygen at home from a liquid oxygen reservoir at 1
L/min. He complains he does not feel gas coming out of the nasal cannula.
Possible reasons for this complaint include which of the following?
I. The electrical system has failed.
II. The tubing is not connected properly.
III. The system is delivering a relatively low flow.
A. I only
B. III only
C. II and III only
D. I, II and III
60. While checking an oxygen tent, the respiratory care practitioner is unable to
detect any aerosol particles in the tent. The practitioner should do which of
the following?
A. Add a heater to the nebulizer.
B. Decrease the flow from the nebulizer.
C. Decrease the FIO2 setting on the nebulizer.
D. Check the patency of the jet and capillary tube on the nebulizer.
54
61. While performing oxygen rounds you have difficulty obtaining an accurate
reading with a polarographic oxygen analyzer. Which of the following would
not help correct this problem?
A. Changing the membrane.
B. Drying the water off the membrane.
C. Replacing the fuel cell.
D. Adding electrolyte gel.
62. A patient is set up on a 40% aerosol mask which when analyzed reads 65%.
What is the appropriate action to take?
A. Increase the nebulizer flow.
B. Decrease the nebulizer flow.
C. Drain the water from the aerosol tubing.
D. Shorten the length of the aerosol tubing.
55
Management of the Airway
1. The physician wants to begin weaning a patient from a tracheostomy tube.
Which of the following should the respiratory therapist recommend?
A. Change to a tracheostomy tube with a foam cuff.
B. Change to a fenestrated tracheostomy tube.
C. Change to a smaller tracheostomy tube.
D. Change to a metal tracheosotomy tube.
2. The maximum amount of time a suction catheter should remain in the airway is
A. 5 seconds.
B. 10 seconds.
C. 15 seconds.
D. 20 seconds.
3. The respiratory therapist is using a 12 French suction catheter to suction a
female patient who is intubated with a 7.0 mm E-T tube and is having difficulty
removing the thick secretions. Which of the following should be recommended
to correct this problem?
A. Increase the suction pressure to -140 mm Hg.
B. Instill 5 ml of normal saline down the E-T tube.
C. Change to a 14 French suction catheter.
D. Change to a coude-tipped suction catheter.
4. Immediately following extubation, the patient begins experiencing inspiratory
stridor and difficulty breathing. The respiratory care practitioner should
suspect which of the following?
A. glottic edema
B. tracheal stenosis
C. vocal cord ulceration
D. laryngeotracheal web
5. Immediately following intubation, which of the following should the respiratory
therapist recommend first to determine proper tube placement?
A. Order a stat chest x-ray.
B. Palpate for symmetrical chest movement.
C. Listen over the proximal end of the E-T tube for air movement.
D. Auscultate the chest for equal breath sounds.
56
6. An oropharyngeal airway is indicated in which of the following situations?
I. To prevent an unconscious patient from biting the E-T tube.
II. To prevent upper airway obstruction in a conscious patient with
neuromuscular disease.
III. To prevent upper airway obstruction in a semicomatose patient with closedhead
trauma.
A. I only
B. I and II only
C. II and III only
D. I, II and III
7. A patient has just been intubated and the CO2 detector placed on the
proximal end of the E-T tube reads 1.5%. The respiratory care practitioner
should suspect which of the following?
A. The tube is in the trachea.
B. The tube is in the right mainstem bronchus and should be withdrawn 4 cm.
C. The tube is in the esophagus.
D. The tube is at the level of the carina and should be withdrawn 2 cm.
8. An oral endotracheal tube is inserted into an adult patient. A leak is heard
after 35 cm H2O is placed in the cuff. This would suggest which of the
following?
A. The E-T tube is too long.
B. The E-T tube’s outside diameter is too small.
C. The E-T tube’s inside diameter is too large.
D. The E-T tube is too short.
9. A patient’s pulse drops from 86/min to 56/min when a suction catheter is
inserted into the oral pharynx. The most likely cause is
A. coughing.
B. hypoxemia.
C. hypocarbia.
D. vagal stimulation.
57
10. The respiratory therapist is preparing to extubate a patient. The patient
should be told the tube will be removed
A. immediately following exhalation.
B. after a strong cough effort.
C. when the patient reaches the point of maximal inspiration.
D. just as the patient begins to inhale.
11. While preparing to intubate a patient, the respiratory care practitioner
attaches the laryngoscope blade to the handle and the light bulb fails to light.
Which of the following should the practitioner do first?
A. Tighten the light bulb.
B. Replace the laryngoscope blade.
C. Replace the batteries in the handle.
D. Proceed to intubate without a light source.
12. Which of the following will increase the possibility of the E-T tube cuff causing
tracheal mucosa damage?
I. maintaining intracuff pressure of 28 mm Hg
II. using minimal leak technique
III. using a low volume, high pressure cuff
IV. using minimal occluding volume technique
A. I and III only
B. II and IV only
C. I, III and IV only
D. II, III and IV
13. Which of the following is not an immediate complication of a tracheostomy
tube?
A. airway obstruction
B. pneumothorax
C. bleeding
D. air embolism
14. The respiratory therapist has instilled air into a ventilator patient’s E-T tube
cuff so that a slight leak is heard with a stethoscope at peak inspiration. The
58
peak pressure manometer on the ventilator reads 42 cm H2O at the time.
Two hours later, the patient is suctioned and the peak inspiratory pressure
drops to 25 cm H2O. Which of the following is now true regarding this
situation?
I. The leak around the cuff has increased.
II. Minimal leak technique should be done at 25 cm H2O.
III. The cuff pressure on the trachea wall has increased.
A. I only
B. II only
C. I and II only
D. II and III only
15. A frail, 76-year-old woman on a 2 L/min nasal cannula with retained
secretions complains of pain and discomfort as the respiratory care
practitioner performs percussion and postural drainage. The practitioner
should recommend which of the following?
A. Decrease the frequency of the treatment from QID to BID.
B. Place the patient on BiPAP ventilation during the treatment.
C. Increase the patient’s oxygen to 4 L/min during the treatment.
D. Discontinue the therapy and begin intrapulmonary percussive ventilation.
16. A patient receiving positive expiratory pressure (PEP) therapy through a
mouthpiece at 10 cm H2O has minimal secretion production. The respiratory
therapist should recommend which of the following?
A. Decrease the PEP to 5 cm H2O.
B. Discontinue the treatment and begin percussion and postural drainage.
C. Increase the PEP to 15 cm H2O.
D. Administer the treatment with a mask in place of the mouthpiece.
17. Following suctioning of a ventilator patient’s ET tube, the following EKG
tracing is observed on the cardiac monitor.
NEED STRIP OF SINUS BRADYCARDIA
The respiratory therapist should
A. discontinue suction and increase the patient’s FIO2.
B. recommend stat ABGs.
C. continue suctioning but monitor the patient closely.
D. recommend a stat chest x-ray.
59
18. A 34-year-old patient on a 40% aerosol mask has right lower lobe
pneumonia. He becomes short of breath and his SpO2 drops from 96% to
89% when lying on his right side. What should the respiratory therapist
recommend?
A. Increase the O2 to 80%.
B. Place the patient on his left side.
C. Place the patient on CPAP.
D. Suction the patient.
19. The respiratory therapist has instilled air into a ventilator patient’s ET tube
cuff so that a slight leak is heard with a stethoscope at peak inspiration. The
pressure manometer on the ventilator is reading 38 cm H2O at the time.
Three hours later, the peak inspiratory pressure reading is 24 cm H2O.
Which of the following is now true regarding this situation?
I. Minimal leak technique should be done at 24 cm H2O.
II. The leak around the cuff has increased.
III. The cuff pressure on the trachea wall has increased.
A. I only
B. I and III only
C. II and III only
D. I, II and III
20. Following extubation, the patient develops inspiratory stridor and shortness of
breath. The respiratory therapist should recommend which of the following?
A. Reintubate the patient.
B. Administer aerosolized racemic epinephrine.
C. Begin IPPB with albuterol.
D. Get a stat chest x-ray.
21. The respiratory therapist is using a 12 French suction catheter to suction a
female patient who is intubated with a 6.5 mm ET tube and is having
difficulty removing the thick secretions. Which of the following is the most
appropriate action to take?
A. Change to a coude-tip suction catheter.
B. Increase the suction pressure to –150 mm Hg.
C. Change to a 14 French suction catheter.
D. Instill 4 ml of normal saline down the ET tube.
60
22. The respiratory therapist auscultates diminished breath sounds with little air
movement on a patient presenting in the emergency department with acute
asthma. After administering aerosolized albuterol, the therapist observes
audible wheezing. Which of the following statements is true regarding this
situation?
A. The patient should be intubated immediately.
B. The patient’s ventilatory status is improving.
C. The patient most likely has developed glottic edema.
D. The bronchodilator therapy is ineffective.
23. The following EKG rhythm is observed during the suctioning of a patient’s
endotracheal tube.
Strip shows sinus bradycardia
Which of the following should the respiratory therapist do at this time?
A. Decrease the suction pressure.
B. Limit suction time to 20 seconds.
C. Continue suctioning and monitor closely.
D. Discontinue suctioning and hyperoxgenate the patient.
24. The respiratory therapist is called to pediatric ICU to suction an 8-year-old
ventilator patient with pneumonia who is intubated with a 6.0 ET tube. Which
of the following represents the most appropriate catheter size and suction
pressure to use on this patient?
A. 8 French catheter, -100 mm Hg
B. 10 French catheter, -120 mm Hg
C. 12 French catheter, - 80 mm Hg
D.10 French catheter, -100 mm Hg
25. Which of the following increases the potential for damage to the tracheal
mucosa by the endotracheal tube?
I. Maintaining cuff pressure at 26 mm Hg.
II. Use of a low volume, high pressure cuff.
III. Maintaining cuff pressure at 27 cm H2O.
A. I only
B. I and II only
C. II and III only
D. I, II and III
61
26. Prior to nasally intubating an adult patient, which of the following should the
respiratory therapist have available?
I. suction catheter
II. Magill forceps
III. stylet
IV. lubricating gel
A. I and II only
B. I, II and IV only
C. II, III and IV
D. I, II, III and IV
27. An intubated patient begins exhibiting severe respiratory distress and the
respiratory therapist auscultates no breath sounds and determines there is no
gas flow passing through the end of the ET tube. The high pressure alarm is
sounding on the ventilator. Which of the following should the therapist do at
this time?
A. Instill 5 ml of saline down the ET tube and suction.
B. Extubate and manually ventilate the patient.
C. Obtain an arterial blood gas.
D. Recommend a stat chest x-ray.
28. A patient on a volume ventilator is intubated with a 7.5 mm ET tube. The
respiratory therapist has pre-oxygenated the patient and begins suctioning
with a 12 Fr catheter and notes the patient is becoming bradycardic along
with a drop in the SpO2. Which of the following should the therapist
recommend at this time?
A. Change to a closed-suction system.
B. Instill Lidocaine down the ET tube.
C. Change to a 14 Fr catheter.
D. Increase the suction pressure to –140 mm Hg.
29. The respiratory therapist has received an order for postural drainage and
percussion for a 34-year-old patient whose chest x-ray shows atelectasis of
the posterior basal segment of the right lower lobe. The patient should be
placed in which of the following positions to help drain this segment?
A. lying on left side with bed flat
B. prone, with head of bed down
C. lying on left side with head of bed down
D. supine, with head of bed down
62
30. The respiratory therapist is called to the emergency department to evaluate a
patient suspected of a drug overdose. A Miller laryngoscope blade is
selected to orally intubate the patient. When properly positioned, the blade
will rest
A. in the valeculla.
B. 1 cm past the vocal cords.
C. directly under the epiglottis.
D. directly above the epiglottis.
31. The respiratory therapist is called to the ICU to change the tracheostomy
tube of a ventilator patient due to a leak in the cuff. After replacing the tube
and connecting it to the ventilator, the patient becomes cyanotic, tachycardic
and the high pressure alarm begins sounding on the ventilator. The therapist
notes subcutaneous emphysema around the upper chest and neck. Which of
the following should the therapist do at this time?
A. Increase the high pressure limit and increase the FiO2 to 1.0.
B. Instill 5 ml of saline and suction the patient.
C. Ensure there is adequate air in the cuff.
D. Deflate the cuff, reposition the tube and attempt manual ventilation.
32. A 25-year-old patient with cystic fibrosis wants to continue his pulmonary
hygiene program while working at his full-time job. Which of the following
devices would be the most appropriate to recommend for this patient?
A. MDI with bronchodilator
B. ultrasonic nebulizer with bronchodilator
C. intermittent percussive ventilation (IPV)
D. Flutter mucous clearance device
33. Five minutes after extubating a patient, the respiratory therapist observes
marked inspiratory stridor, intercostal retractions, labored breathing and a
decreasing SpO2 value. Aerosolized racemic epinephrine has been
administered with no affect. Which of the following should the therapist
recommend at this time?
A. an aerosol treatment with beclomethasone (Vanceril)
B. a cool aerosol treatment
C. manual ventilation with bag and mask
D. reintubation
63
34. Which of the following represents the appropriate size suction catheter to use
with a 6.0 mm endotracheal tube?
A. 8 Fr
B. 10 Fr
C. 12 Fr
D. 14 Fr
35. Which of the following is the most appropriate suction catheter size and
suction pressure to use on an adult with an 8.0 mm ET tube.
A. 10 Fr, -120 torr
B. 14 Fr, -100 torr
C. 12 Fr, -60 torr
D. 14 Fr, -140 torr
64
IPPB Therapy/Incentive Spirometry
1. A patient is receiving IPPB therapy with a bronchodilator. At the start of the
treatment the patient’s heart rate is 76/min and increases to 92/min after five
minutes of the treatment. The respiratory therapist should do which of the
following?
A. Stop the treatment and notify the physician.
B. Recommend decreasing the dose of the bronchodilator.
C. Recommend changing the treatment to a hand-held nebulizer.
D. Continue the treatment as ordered.
2. During IPPB, the patient complains the machine is having difficulty cycling into
the expiratory phase. Which of the following may be causing this problem?
I. The sensitivity is set too low.
II. There is a leak around the patient’s mouthpiece.
III. The exhalation valve is malfunctioning.
A. I only
B. I and II only
C. II and III only
D. I, II and III
3. While administering IPPB, the patient suddenly complains of chest pain and
difficulty breathing. Upon further assessment of the patient, the respiratory
care practitioner observes asymmetrical chest movement and tachycardia.
The patient has most likely developed which of the following?
A. pneumothorax
B. pulmonary edema
C. massive atelectasis
D. pleural effusion
4. Incentive spirometry is most effective in which of the following conditions?
A. treating preexisting atelectasis
B. treating pneumonia
C. preventing postoperative atelectasis
D. emphysema
65
5. A patient is receiving IPPB therapy at a peak inspiratory pressure of 20 cm
H2O. The patient begins having bronchospasms during the treatment. Which
of the following is true regarding this situation?
I. The peak inspiratory pressure will increase.
II. The delivered tidal volume will decrease.
III. The inspiratory time will increase.
A. I only
B. II only
C. I and III only
D. II and III
6. A patient complains during an IPPB treatment that he is having difficulty
cycling the machine on. Which of the following should the respiratory care
practitioner do to correct this problem?
A. Decrease the machine sensitivity.
B. Decrease the inspiratory pressure.
C. Increase the machine sensitivity.
D. Increase the inspiratory flow.
7. Five minutes into an IPPB treatment the patient begins coughing up a
moderate amount of fresh blood. The respiratory care practitioner should do
which of the following at this time?
A. Decrease the inspiratory pressure.
B. Stop the treatment and notify the physician.
C. Stop the treatment for five minutes and continue if there are no other
complications.
D. Continue the treatment and have the nurse notify the physician.
8. While administering IPPB to a patient on air mix with the Bird Mark-7, the
respiratory therapist adjusts the control so that 100% oxygen is now being
delivered. Which of the following statements is true after this change is made?
A. The inspiratory flow will decrease.
B. The inspiratory pressure will increase.
C. The inspiratory time will decrease.
D. The sensitivity will increase.
66
9. While evaluating a postoperative patient for which incentive spirometry has
been ordered, the respiratory therapist obtains a vital capacity of 6 ml/kg of
body weight. The practitioner should do which of the following?
A. Recommend IPPB in place of incentive spirometry.
B. Start the treatment as ordered.
C. Measure the patient’s tidal volume.
D. Recommend a bronchodilator using a hand-held nebulizer.
10. While administering IPPB, the respiratory care practitioner increases the
inspiratory flow. Which of the following would be true after this change is
made?
I. The inspiratory time will decrease.
II. The tidal volume will decrease.
III. The inspiratory pressure will increase.
A. I only
B. III only
C. I and II only
D. II and III only
11. During the administration of IPPB, the respiratory care practitioner notices the
machine repeatedly cycles on shortly after the patient has begun expiration.
In order to correct this problem, the practitioner should check which of the
following controls?
I. sensitivity control
II. flow control
III. inspiratory pressure control
IV. rate control
A. I only
B. I and II only
C. II and III only
D. I and IV only
12. Which of the following is not a complication of IPPB?
A. barotrauma
B. increased cardiac output
C. excessive ventilation
D. gastric insufflation
67
13. The respiratory therapist is administering sustained maximal inspiratory
maneuvers to a patient with postoperative atelectasis. The practitioner
should expect all of the following results EXCEPT
A. decreased functional residual capacity.
B. increased lung compliance.
C. reduced right-to-left shunting.
D. improved distribution of ventilation.
14. Which of the following would be the most appropriate recommendation to
help prevent postoperative atelectasis after a hypotensive patient’s
abdominal surgery?
A. IPPB
B. incentive spirometry
C. blow bottles
D. CPAP
15. A severe COPD patient is on a 28% air entrainment mask. While taking
IPPB on oxygen with air-mix in use, the patient’s respiratory rate decreases
from 16/min at the start of the treatment, to 6/min five minutes into the
treatment. Which of the following is the most appropriate recommendation at
this time?
A. Turn on the oxygen control to 100%.
B. Place the patient on a nasal cannula at 2 L/min and administer the
treatment on room air.
C. Increase the inspiratory pressure.
D. Increase the sensitivity level.
16. A patient is receiving IPPB therapy with a peak inspiratory pressure of 22 cm
H2O following abdominal surgery. He has a vital capacity of 2.2 L. The
respiratory therapist should recommend which of the following?
A. Decrease the peak pressure to 18 cm H2O.
B. Discontinue IPPB and begin deep breathing and coughing exercises.
C. Continue IPPB as ordered.
D. Obtain an arterial blood gas.
68
17. Which of the following would help reduce the potential of cardiac side effects
caused by IPPB?
I. Increase the flow.
II. Increase the pressure.
III. Increase the inspiratory time..
IV. Decrease the pressure.
A. I and II only
B. I and IV only
C. II and III only
D. III and IV only
18. While administering IPPB the patient begins experiencing bronchospasms.
Which of the following will decrease as a result of this?
A. inspiratory pressure
B. FIO2
C. inspiratory time
D. sensitivity
69
CPR/Manual Resuscitators
1. The respiratory care practitioner begins manually ventilating an apneic patient
and the resuscitator bag malfunctions. Which of the following should the
practitioner do first?
A. Go find another resuscitator bag.
B. Try to repair the bag.
C. Perform mouth-to-mask ventilation.
D. Call for a stat IPPB treatment.
2. While manually ventilating a patient with a manual resuscitator, arterial blood
gas results show a PaO2 of 46 torr. Which of the following would increase the
oxygen being delivered by the bag?
I. Increase the ventilation rate.
II. Add a reservoir to the bag.
III. Increase the oxygen flow to the bag.
A. II only
B. I and II only
C. II and III only
D. I, II and III
3. You enter a patient’s room to administer an IPPB treatment and find the
patient unconscious and apneic. After calling for help, which of the following
should be done next?
A. Administer two breaths.
B. Check for a pulse and call for help.
C. Place the patient in the fowler’s position.
D. Open the patient’s airway.
4. Which of the following is the most appropriate method to open a patient’s
airway who is suspected of having a neck fracture?
A. jaw thrust maneuver
B. head-tilt chin lift
C. hyperextension of the neck
D. place the patient in trendelenburg
70
5. The compression to ventilation ratio for single rescuer CPR on an infant is
which of the following?
A. 15:1
B. 5:2
C. 5:1
D. 15:2
6. While bagging a patient who has a tracheostomy tube, the respiratory care
practitioner hears air leaking around the patient’s mouth and observes
minimal chest excursion. Which of the following should the practitioner do at
this time?
A. Increase flow to the bag.
B. Add more air to the tracheostomy tube cuff.
C. Replace the resuscitator bag.
D. Begin mouth-to-tube ventilation.
7. The respiratory care practitioner enters a patient’s room to administer an IPPB
treatment and finds the patient unresponsive and not breathing. After two
breaths are delivered, what should the practitioner do next?
A. Begin chest compressions.
B. Administer five abdominal thrusts.
C. Administer IPPB for five minutes and assess for spontaneous breathing.
D. Check for a pulse.
8. The respiratory care practitioner palpates no pulse on a patient but observes
QRS complexes on the cardiac monitor. Which of the following should the
practitioner do at this time?
A. Obtain a 12-lead EKG .
B. Begin cardiac compressions.
C. Get a stat arterial blood gas.
D. Recommend insertion of a Swan-Ganz catheter.
9. While ventilating a patient with a manual resuscitator, the respiratory care
practitioner notices when the bag is squeezed, it collapses with little
resistance and there is no chest movement. Which of the following could be
causing this problem?
A. excessive gas flow
B. jammed exhalation valve
C. reservoir attachment is loose
D. leak around oxygen inlet valve
71
10. An infant in respiratory failure has just been delivered by a woman who states
she has ingested a narcotic three hours ago. Which of the following
medications should the respiratory care practitioner recommend for the infant
at this time?
A. epinephrine
B. Narcan
C. sodium bicarbonate
D. Lidocaine
11. The respiratory therapist is performing bag-mask ventilation on a severe
COPD patient during CPR. Which of the following describes the best method
for ventilating this patient?
A. The bag should be connected to an air wall outlet.
B. The flow to the bag should be 10 L/min with no reservoir attachment.
C. The bag should be connected to an O2 blender set at 30%.
D. The bag should have a reservoir attachment and a flow of 15 L/min.
12. While participating in the resuscitation of a patient, the EKG monitor shows
ventricular fibrillation after ten minutes of CPR. The arrhythmia does not
reverse after the patient is defibrillated with 200 joules. The respiratory
therapist should recommend which of the following at this time?
A. Administer dopamine.
B. Repeat defibrillation with 350 joules.
C. Administer sodium nitroprusside.
D. Implement cardioversion at 300 joules.
13. The physician is having difficulty placing an IV line in a patient with a pulse of
32/min. Which of the following medications should the respiratory therapist
recommend instilling through the endotracheal tube?
A. lidocaine (Xylocaine)
B. sodium bicarbonate
C. epinephrine
D. atropine
72
14. A drug overdose patient who is unresponsive and intubated begins
developing frequent PVCs. Attempts at placing peripheral or central
catheters are unsuccessful. The respiratory therapist should recommend
which of the following?
A. endotracheal atropine
B. endotracheal lidocaine (Xylocaine)
C. defibrillation
D. endotracheal epinephrine
15. The respiratory therapist is called to the emergency department to assess a
3-year-old male brought in after being pulled from the bottom of a swimming
pool. He is unresponsive and pale with peripheral cyanosis. Vital signs are
below:
Heart rate 52/min
Blood pressure 56/24 mm Hg
Respiratory rate 10/min with intercostal retractions
Temperature 33oC (91.4oF)
Which of the following treatments are appropriate?
I. endotracheal intubation
II. heated aerosol mask at 100% O2
III. manual ventilation with 100% O2
IV. chest compressions
A. I and III only
B. II and IV only
C. I and IV only
D. I, III and IV only
16. The respiratory therapist assigned to NICU is called back to the delivery room
to attend the delivery of a full term infant. The infant presents with the
following vital signs after delivery:
Heart rate 72/min
Respiratory rate 22/min
Color peripheral cyanosis
The most appropriate treatment at this time should include which of the
following?
A. chest compressions and manual ventilation with 100% O2
B. endotracheal intubation
C. oxyhood with 100% O2
D. administer Narcan
73
17. Sinus bradycardia is observed on the EKG monitor during the resuscitation of
a 63-year-old female who was admitted to the emergency department
following an episode of severe chest pain. The patient has no peripheral
pulse and blood pressure cannot be measured. Which of the following should
the respiratory therapist recommend?
A. Defibrillate the patient with 200 joules.
B. Cardiovert the patient.
C. Administer atropine.
D. Initiate chest compressions.
18. The respiratory therapist is asked to assist a physician performing
cardioversion on a spontaneously breathing patient with atrial fibrillation. The
patient is awake and alert. To prepare for this procedure, the therapist should
do which of the following?
I. Intubate the patient.
II. Set up oxygen therapy equipment.
III. Set up a manual resuscitator.
IV. Assemble suction and airway care equipment.
A. I and II only
B. II and III only
C. II, III and IV only
D. I, II , III and IV
19. The respiratory therapist enters a patient’s room to administer IPPB and is
unable to arouse the patient. The therapist should do which of the following
first?
A. open the patient’s airway
B. call for help
C. administer oxygen
D. check for a pulse
20. The respiratory therapist enters a patient’s room to initiate incentive
spirometry and finds the patient slumped over in bed and unresponsive to
verbal and tactile stimuli. After calling for help, which of the following should
the therapist do next?
A. check for a pulse
B. determine if the patient is breathing
C. administer a precordial thump
D. administer oxygen
74
21. An unconscious, apneic patient has just been intubated and the respiratory
therapist begins ventilating with a manual resuscitator. Air can be heard
leaking around the patient’s mouth and there is minimal chest during
inspiration. The therapist should do which of the following?
A. Check the ET tube cuff pressure.
B. Make sure the reservoir is attached to the bag.
C. Increase the flow to the bag.
D. Suction the patient.
22. While providing ventilation with a manual resuscitator the reservoir
attachment falls off the bag. This will result in which of the following?
A. Decreased flow to the patient.
B. Decreased ventilatory pressure.
C. Decreased FIO2 delivery.
D. A massive leak in the ventilating system.
23. Which of the following are complications of chest compressions?
I. fractured ribs
II. lacerated liver
III. fat embolism
A. I only
B. I and II only
C. II and III only
D. I, II and III
24. A patient with a history atrial fibrillation which is normally controlled by
medication enters the emergency department complaining of palpitations and
shortness of breath. An EKG reveals atrial fibrillation. Which of the following
is indicated?
A. cardioversion with 200 joules
B. defibrillation with 350 joules
C. cardiovesion with 100 joules
D. external pacemaker
75
25. A patient’s EKG monitor indicates ventricular fibrillation. Which of the
following is most appropriate initial treatment?
A. Cardioversion with 100 joules.
B. Defibrillation with 350 joules.
C. Defibrllation with 150 joules.
D. Defibrillation with 200 joules.
76
Arterial Blood Gas Interpretation
1. A patient exhibiting Kussmaul’s breathing would have which of the following
arterial blood gas results?
A. pH 7.21, PaCO2 56 torr, PaO2 66 torr, HCO3 25 mEq/L
B. pH 7.53, PaCO2 27 torr, PaO2 107 torr, HCO3 24 mEq/L
C. pH 7.22, PaCO2 21 torr, PaO2 70 torr, HCO3 10 mEq/L
D. pH 7.55, PaCO2 42 torr, PaO2 81 torr, HCO3 31 mEq/L
2. To best determine how well a patient is ventilating, the respiratory care
practitioner should assess which of the following?
A. pH
B. SpO2
C. PaCO2
D. PaO2
3. Arterial blood gas values for a patient on a 40% venturi mask are below:
pH 7.28
PaCO2 41 torr
PaO2 88 torr
HCO3 16 mEq/L
These blood gases would be interpreted as which of the following?
A. Uncompensated metabolic acidosis
B. Compensated respiratory acidosis
C. Partially compensated metabolic alkalosis
D. uncompensated respiratory acidosis
4. Which of the following arterial blood gas results, drawn on room air, would you
expect to observe on a 23-year-old asthmatic who has been in moderate
respiratory distress for the past thirty minutes?
A. pH 7.26, PaCO2 51 torr, PaO2 58 torr, HCO3 25 mEq/L
B. pH 7.43, PaCO2 42 torr, PaO2 92 torr, HCO3 24 mEq/L
C. pH 7.52, PaCO2 28 torr, PaO2 104 torr, HCO3 23 mEq/L
D. pH 7.51, PaCO2 30 torr, PaO2 58 torr, HCO3 25 mEq/L
77
5. A patient on a volume ventilator has the following arterial blood gas results:
pH 7.27
PaCO2 28 torr
PaO2 88 torr
HCO3 27 mEq/L
Based on this data, the respiratory care practitioner should recommend which
of the following?
A. Increase the tidal volume.
B. Decrease the ventilator rate.
C. Get repeat blood gases since these results indicate a lab error.
D. Decrease the FiO2.
6. A severe COPD patient arrives in the emergency department on a 2 L/min
nasal cannula. Arterial blood gas results are below:
pH 7.34
PaCO2 57 torr
PaO2 46 torr
HCO3 35 mEq/L
Based on this data, the most appropriate recommendation is which of the
following?
A. Increase the liter flow to 3 L/min.
B. Place the patient on CPAP mask of 4 cm H2O and an FiO2 of 0.60.
C. Intubate and institute mechanical ventilation.
D. Place on a nonrebreathing mask at 12 L/min.
7. A patient on a 35% venturi mask has the following arterial blood gas values:
pH 7.45
PaCO2 27 torr
PaO2 87 torr
HCO3 16 mEq/L
The correct interpretation of these ABGs is which of the following?
A. partially compensated metabolic alkalosis
B. fully compensated respiratory alkalosis
C. uncompensated respiratory alkalosis
D. fully compensated metabolic alkalosis
78
8. The following blood gases are obtained on a severe, cyanotic COPD patient
on a 2 L/min nasal cannula.
pH 7.53
PaCO2 27 torr
PaO2 160 torr
HCO3 35 mEq/L
Which of the following most likely accounts for these ABG values?
A. The patient’s cannula flow was higher than 2 L/min at the time of the
arterial stick.
B. There is air in the blood sample.
C. The blood was inadvertently obtained from a vein.
D. These represent normal blood gases for a severe COPD patient.
9. A 32-year-old male patient on a 2 L/min nasal cannula in no apparent
respiratory distress and no cyanosis present has arterial blood gases drawn.
The results are below.
pH 7.36
PaCO2 45 torr
PaO2 43 torr
Which of the following should the respiratory care practitioner recommend at
this time?
A. Repeat the arterial stick, as these most likely represent venous blood.
B. Place the patient on a non-rebreathing mask.
C. Increase the liter flow to 4 L/min.
D. Place the patient on CPAP.
10. The following blood gases have been obtained from a ventilator patient in
ICU.
pH 7.26
PaCO2 51 torr
PaO2 70 torr
HCO3 15 mEq/L
These ABGs would be interpreted as which of the following?
A. partially compensated respiratory acidosis
B. compensated metabolic acidosis
C. combined metabolic and respiratory acidosis
D. partially compensated metabolic acidosis
79
11. A patient on a 24% venturi mask has the following arterial blood gas values:
pH 7.50
PaCO2 27 torr
PaO2 87 torr
HCO3 24 mEq/L
BE +2
The correct interpretation of these ABGs is which of the following?
A. uncompensated metabolic alkalosis
B. partially compensated respiratory alkalosis
C. uncompensated respiratory alkalosis
D.partially compensated metabolic alkalosis
12. A patient on a 50% aerosol mask has the following arterial blood gas values:
pH 7.26
PaCO2 54 torr
PaO2 77 torr
HCO3 16 mEq/L
The correct interpretation of these ABGs is which of the following?
A. partially compensated metabolic alkalosis
B. fully compensated respiratory acidosis
C. uncompensated respiratory acidosis
D. combined metabolic and respiratory acidosis
13. A COPD patient on a 30% venturi mask has the following arterial blood gas
values:
pH 7.37
PaCO2 58 torr
PaO2 64 torr
HCO3 36 mEq/L
BE +12
The correct interpretation of these ABGs is which of the following?
A. partially compensated metabolic alkalosis
B. fully compensated respiratory acidosis
C. uncompensated respiratory acidosis
D. partially compensated respiratory acidosis
80
14. A patient on a 40% venturi mask has the following arterial blood gas values:
pH 7.49
PaCO2 27 torr
PaO2 55 torr
HCO3 25 mEq/L
The respiratory therapist increases the oxygen percent to 50%. Which of the
following blood gas values should increase after this change?
I. pH
II. PaCO2
III. PaO2
IV. HCO3
A. III only
B. II and III only
C. I, II and III only
D. II, III and IV only
15. The following ABGs are observed on a 70 kg (154 lb) ventilator patient on a
tidal volume of 800 ml.
pH 7.19
PaCO2 27 torr
PaO2 75 torr
HCO3 15 mEq/L
Which statement is true regarding this clinical scenario?
A. The patient is hyperventilating.
B. The blood gases reveal a respiratory alkalosis.
C. The acidotic pH is a result of the decreased PaCO2.
D. The patient’s ventilator tidal volume should be decreased.
16. Which of the following ABG results represents a partially compensated
respiratory alkalosis?
A. pH 7.37, PCO2 25 torr, HCO3 18 mEq/L, BE - 6
B. pH 7.52, PCO2 42 torr, HCO3 31 mEq/L, BE +6
C. pH 7.50, PCO2 28 torr, HCO3 25 mEq/L, BE 0
D. pH 7.51, PCO2 29 torr, HCO3 18 mEq/L, BE -5
81
17. Which of the following ABG results represents a partially compensated
respiratory acidosis?
A. pH 7.31, PCO2 55 torr, HCO3 18 mEq/L, BE -8
B. pH 7.29, PCO2 57 torr, HCO3 31 mEq/L, BE +6
C. pH 7.38, PCO2 60 torr, HCO3 35 mEq/L, BE +10
D. pH 7.31, PCO2 29 torr, HCO3 18 mEq/L, BE -5
18. Which of the following ABG results represents a partially compensated
metabolic alkalosis?
A. pH 7.49, PCO2 49 torr, HCO3 32 mEq/L, BE +5
B. pH 7.52, PCO2 40 torr, HCO3 33 mEq/L, BE +7
C. pH 7.50, PCO2 28 torr, HCO3 23 mEq/L, BE -2
D. pH 7.51, PCO2 29 torr, HCO3 19 mEq/L, BE -6
19. Which of the following ABG results represents an uncompensated respiratory
alkalosis?
A. pH 7.52, PCO2 48 torr, HCO3 34 mEq/L, BE +8
B. pH 7.50, PCO2 31 torr, HCO3 25 mEq/L, BE +1
C. pH 7.50, PCO2 28 torr, HCO3 32 mEq/L, BE +6
D. pH 7.51, PCO2 29 torr, HCO3 20 mEq/L, BE -5
20. Which of the following ABG results represents a fully compensated
respiratory alkalosis?
A. pH 7.35, PCO2 25 torr, HCO3 18 mEq/L, BE –10
B. pH 7.52, PCO2 40 torr, HCO3 33 mEq/L, BE +6
C. pH 7.50, PCO2 28 torr, HCO3 25 mEq/L, BE 0
D. pH 7.44, PCO2 29 torr, HCO3, 18 mEq/L, BE -5
21. Which of the following values would be increased with a patient in chronic
respiratory acidemia?
A. pH
B. HCO3
C. SaO2
D. PaO2
82
22. A patient on a 40% aerosol mask has the following arterial blood gas values:
pH 7.54
PaCO2 31 torr
PaO2 77 torr
HCO3 24 mEq/L
The correct interpretation of these ABGs is which of the following?
A. partially compensated metabolic alkalosis
B. fully compensated respiratory alkalosis
C. uncompensated respiratory alkalosis
D. combined metabolic and respiratory alkalosis
23. A patient receiving 25% oxygen with an air-entrainment mask has the
following arterial blood gas values:
pH 7.45
PaCO2 35 torr
PaO2 96 torr
HCO3 25 mEq/L
BE 0
The correct interpretation of these ABGs is which of the following?
A. fully compensated metabolic alkalosis
B. fully compensated respiratory alkalosis
C. uncompensated respiratory acidosis
D. normal acid-base status
24. A patient on a 50% venturi mask has the following arterial blood gas values:
pH 7.26
PaCO2 43 torr
PaO2 81 torr
HCO3 29 mEq/L
The correct interpretation of these ABGs is which of the following?
A. partially compensated metabolic acidosis
B. A lab error must exist.
C. uncompensated respiratory acidosis
D. combined metabolic and respiratory acidosis
83
25. Which of the following ABG values would most likely be decreased in a
diabetic ketoacidosis patient?
I. pH
II. PCO2
III. HCO3
A. I only
B. II only
C. II and III only
D. I, II and III
26. A patient’s PaCO2 is 43 torr with a pH of 7.51. Which of the following is true
regarding these data?
A. Bicarbonate must be increased.
B. Hyperventilation is occurring.
C. Base excess must be decreased.
D. Respiratory alkalosis is present.
27. Which of the following ABG results represents a severe COPD patient in
acute ventilatory failure?
A. pH 7.25, PCO2 87 torr, PO2 62 torr, HCO3 32 mEq/L, BE +8
B. pH 7.35, PCO2 65 torr, PO2 64 torr, HCO3 33 mEq/L, BE +7
C. pH 7.41, PCO2 81 torr, PO2 70 torr, HCO3 38 mEq/L, BE +12
D. pH 7.37, PCO2 90 torr, PO2 67 torr, HCO3 39 mEq/L, BE + 14
28. A patient has a pH of 7.18 and a PaCO2 of 24 torr. Which of the following
can be concluded regarding this blood gas data?
A. Respiratory acidosis is present.
B. The patient is hypoventilating.
C. Metabolic acidosis is present.
D. The base excess must be increased.
84
29. A patient receiving 35% oxygen with an air-entrainment mask has the
following arterial blood gas values:
pH 7.49
PaCO2 32 torr
PaO2 96 torr
HCO3 29 mEq/L
BE +5
The correct interpretation of these ABGs is which of the following?
A. partially compensated metabolic alkalosis
B. combined metabolic and respiratory alkalosis
C. uncompensated respiratory alkalosis
D. A lab error must exist.
30. A patient receiving 28% oxygen with an air-entrainment mask has the
following arterial blood gas values:
pH 7.37
PaCO2 49 torr
PaO2 75 torr
HCO3 31 mEq/L
BE +5
The correct interpretation of these ABGs is which of the following?
A. fully compensated metabolic alkalosis
B. combined metabolic and respiratory alkalosis
C. fully compensated respiratory acidosis
D. normal acid/base status
31. Which of the following represents a normal capillary PO2 on a 4-week-old
neonate?
A. 35 torr
B. 45 torr
C. 55 torr
D. 65 torr
32. Which of the following represents the normal PaO2 on a 2-week-old
neonate?
A. 40 torr
B. 60 torr
C. 80 torr
D. 100 torr
85
Ventilator Management
1. The following data is collected from a 75 kg (165 lb) patient on a volume
ventilator.
VT - 650 ml ABG results: pH 7.28
mode - assist/control PaCO2 53 torr
ventilator rate - 12/min PaO2 68 torr
FiO2 - 0.40 HCO3 25 mEq/L
Based on these data, the most appropriate recommendation is which of the
following?
A. Increase the FiO2 to 0.60.
B. Add PEEP at 4 cm H2O.
C. Increase VT to 750 ml.
D. Add 50 ml of deadspace.
2. Optimal PEEP is indicated by which of the following data?
Peak Inspiratory Plateau Tidal
PEEP Pressure Pressure
Volume
(cm H2O) (cm H2O
(cm H2O)
(ml)
________ ______________ ________ _______
A. 5
37
22
500
B. 8
41
26
500
C. 11
45
27
500
D. 14
48
31
500
3. The following data is collected from a 75 kg (165 lb) patient on a 40% aerosol
mask.
VT - 500 ml
respiratory rate - 12
This patient’s alveolar minute ventilation is which of the following?
A. 4.0 L
B. 5.0 L
C. 6.0 L
D. 7.0 L
86
4. The following arterial blood gases have been collected from a 42 year-old
patient on a 60% aerosol mask with a diagnosis of lobar pneumonia.
pH 7.45
PaCO2 34 torr
PaO2 57 torr
HCO3 25 mEq/L
The most appropriate recommendation is which of the following?
A. Intubate and place on mechanical ventilation.
B. Increase oxygen to 70%.
C. Place on CPAP mask of 4 cm H2O and 60% oxygen.
D. Place on nonrebreathing mask.
5. A 65 kg (143 lb) female patient arrives in the emergency department intubated
and being manually ventilated with 100% oxygen. The respiratory therapist
should select which of the following ventilator settings to best ventilate this
patient?
A. mode - assist/control, VT - 700 ml, rate - 12
B. mode - control, VT - 600 ml, rate - 12
C. mode - SIMV, VT - 700 ml, rate - 6
D. mode - SIMV, VT - 650 ml, rate - 14
6. The following data has been collected from a patient on a volume ventilator.
VT - 750 ml ABG results: pH 7.41
mode - SIMV PaCO2 42 torr
ventilator rate - 12/min PaO2 157 torr
FiO2 - 0.80 HCO3 24 mEq/L
PEEP - 10 cm H2O
Based on this data, the most appropriate recommendation is which of the
following?
A. Decrease PEEP to 8 cm H2O.
B. Decrease SIMV rate to 6/min.
C. Decrease VT to 650 ml.
D. Decrease FiO2 to 0.70.
87
7. Which of the following is the most important alarm in a CPAP system?
A. high respiratory rate
B. low pressure
C. high FiO2
D. I:E ratio
8. The I:E ratio alarm is activated on the Bennett 7200 ventilator. The most
appropriate action to correct this situation is which of the following?
A. Increase the high pressure limit.
B. Increase the flow.
C. Decrease the tidal volume.
D. Decrease the flow.
9. Which of the following ventilation parameters indicate a ventilator patient is
most likely ready to be weaned from the ventilator?
I. MIP of -28 cm H2O
II. VC of 8 ml/kg
III. A-a gradient of 170 torr on 100% oxygen
A. I only
B. I and III only
C. II and III only
D. I, II and III
10. The following data has been obtained from a patient on a volume ventilator
and a tidal volume of 800 ml.
Time
1 PM
2 PM
3 PM
peakpressure
(cm H2O)
38
42
46
plateau pressure
(cm H2O)
18
23
26
Which of the following statements regarding these data are true?
A. Lung compliance is decreasing.
B. Airway resistance is decreasing.
C. The lungs are becoming easier to ventilate.
D. Lung compliance is increasing.
88
11. A patient on a volume ventilator is on the following settings:
SIMV mode ABG results: pH 7.29
VT - 700 ml PaCO2 50 torr
ventilator rate - 4/min PaO2 72 torr
FiO2 - 0.30
Based on this data, which of the following is the most appropriate
recommendation at this time?
A. Increase VT to 800 ml.
B. Increase FiO2 to 0.40.
C. Change to assist/control mode, rate of 12.
D. Increase SIMV rate to 6/min.
12. A patient on a volume ventilator has a PaO2 of 56 torr on a PEEP of 8 cm
H2O and an FiO2 of 0.50. After increasing the PEEP to 12 cm H2O, the
cardiac output decreases from 5.1 L/min to 4.1 L/min. The most appropriate
recommendation is to
A. discontinue PEEP and increase the FiO2 to 0.70.
B. increase PEEP to 15 cm H2O.
C. decrease PEEP to 8 cm H2O and increase the FiO2 to 0.60.
D. maintain the current settings and measure cardiac output in one hour.
13. A premature infant on a pressure ventilator has a PaCO2 of 54 torr. Which of
the following ventilator settings should be increased to correct this situation?
A. FiO2
B. tidal volume
C. PEEP
D. inspiratory pressure
14. The respiratory care practitioner is called to a ventilator patient’s room and
finds the high pressure alarm sounding. Which of the following could the
practitioner do to help correct this problem?
I. Suction the patient.
II. Drain water from the tubing.
III. Check high pressure limit for appropriateness of set level.
A. I and II only
B. I and III only
C. II and III only
D. I, II and III
89
15. A 42-year-old postoperative patient is on the following ventilator settings.
Mode – SIMV
Ventilator rate – 6/min
Tidal volume – 700 ml
FIO2 – 0.35
Peak flow – 50 L/min
Pressure support – 25 cm H2O
During weaning trials using a T-piece, the patient becomes tachypneic,
agitated and short of breath, and must be placed back on the ventilator.
Based on this information, the respiratory therapist should recommend which
of the following to wean this patient?
A. Increase the peak flow.
B. Increase the FIO2.
C. Decrease the pressure support.
D. Decrease the tidal volume.
16. A patient on a volume ventilator is set on a tidal volume of 800 ml but the
exhaled volume display is reading 500 ml. The respiratory care practitioner
wants to determine the volume that the ventilator is actually delivering. To
most accurately measure this volume, the practitioner should place a
respirometer
A. at the exhalation valve.
B. at the patient wye connector.
C. at the ventilator outlet.
D. at the humidifier outlet.
17. After PEEP is initiated on a patient, the respiratory therapist should expect
which of the following to occur?
I. increased FRC
II. increased plateau pressure
III. increased lung compliance
IV.decreased A-a gradient
A. I and II only
B. III and IV only
C. I, III and IV only
D. I, II, III and IV only
90
18. A premature infant is ventilated with a pressure ventilator in the NICU. The
infant’s lung compliance begins to decrease. Which of the following
statements is true regarding this situation?
A. Peak inspiratory pressure will increase.
B. The delivered tidal volume will decrease.
C. The infant’s lungs will be easier to ventilate.
D. The infant’s PaCO2 should begin to decrease.
19. Venous return is least impaired by which of the following ventilator settings?
A. SIMV mode, rate 12/min
B. Control mode, rate 10/min
C. Assist/control mode, rate 10/min
D. SIMV mode, rate 8/min
20. The following data is collected from a 4-day-old neonate on a pressure
ventilator in the NICU.
IMV mode
Rate - 30/min
Inspiratory pressure - 26 cm H2O
FIO2 - 0.50
PEEP - 4 cm H2O
pH 7.29
PaCO2 53 torr
PaO2 51 torr
Which of the following should the respiratory care practitioner recommend to
increase?
A. FIO2
B. PEEP
C. inspiratory pressure
D. inspiratory flow
21. A patient is in the control mode on a volume ventilator. Which of the
following should be increased in order to most effectively increase alveolar
ventilation?
A. FIO2
B. ventilator rate
C. tidal volume
D. inspiratory flow
91
22. The following data is collected on a 75 kg (165 lb) patient being ventilated in
the pressure-control mode.
Peak inspiratory pressure - 22 cm H2O
PEEP - 5 cm H2O
Rate - 12/min
FIO2 - 0.50
Exhaled tidal volume - 500 ml
ABG results:
pH 7.27
PaCO2 54 torr
PaO2 68 torr
HCO3 24 mEq/L
The respiratory therapist should recommend which of the following?
A. Increase the PIP to 26 cm H2O.
B. Increase the FIO2 to 0.70.
C. Increase PEEP to 10 cm H2O.
D. Increase rate to 15/min.
23. A 70 kg ( 154 lb) patient in ICU is being mechanically ventilated on a volume
ventilator in the assist-control mode, rate of 12/min, tidal volume of 750 ml
and 40% oxygen. Arterial blood gases are below.
pH 7.50
PaCO2 31 torr
PaO2 54 torr
HCO3 25 mEq/l
Which of the following ventilator changes is most appropriate at this time?
A. Increase the oxygen to 50%.
B. Decrease the tidal volume to 700 ml.
C. Place the patient on 4 cm H2O PEEP.
D. Increase the ventilator rate to 15/min.
92
24. The following data is collected from a 65 kg (143 lb) patient with a closedhead injury and elevated
intracranial pressure levels receiving volume-cycled ventilation.
Mode - SIMV
Mandatory rate - 10/min
Total rate - 10/min
Tidal volume - 650 ml
FIO2 - 0.50
pH 7.36
PaCO2 44 torr
PaO2 110 torr
HCO3 25 mEq/L
Which of the following is the most appropriate ventilator change at this time?
A. Decrease the FIO2 to 0.40.
B. Increase the rate to 15/min.
C. Decrease the inspiratory flow.
D. Decrease the tidal volume to 600 ml.
25. The following arterial blood gas results are obtained from a patient on volume
ventilation in the SIMV mode.
pH 7.56
PaCO2 27 torr
PaO2 128 torr
HCO3 23 mEq/L
Which of the following ventilator changes should the respiratory therapist
make first?
A. Decrease the FIO2.
B. Decrease the inspiratory flow.
C. Increase the pressure support.
D. Decrease the tidal volume.
93
26. A 54-year-old patient with pneumonia is being mechanically ventilated in the
pressure-control mode. Over the past several hours, his exhaled tidal volume
has increased from 350 ml to 550 ml. Other data is recorded below.
Peak inspiratory pressure - 28 cm H2O
Rate - 12/min
FIO2 - 0.50
PEEP - 6 cm H2O
ABG results:
pH 7.50
PaCO2 27 torr
PaO2 96 torr
HCO3 23 mEq/L
Based on this data, the respiratory therapist should recommend which of the
following?
A. Decrease the FIO2 to 0.40.
B. Decrease PIP to 24 cm H2O.
C. Increase the inspiratory flow.
D. Decrease PEEP to 4 cm H2O.
27. A patient with ARDS is being mechanically ventilated on 80% oxygen. The
PEEP level is increased from 8 cm H2O to 12 cm H2O resulting in the PaO2
increasing from 52 torr to 91 torr and a drop in the cardiac output from 4.6
L/min to 3.2 L/min. Which of the following is the most appropriate
recommendation?
A. Maintain PEEP at 12 cm H2O.
B. Decrease PEEP to 8 cm H2O.
C. Decrease PEEP to 10 cm H2O.
D. Maintain PEEP at 12 cm H2O and decrease FIO2 to 0.70.
28. A patient is on a 750 ml tidal volume and a mandatory respiratory rate of
12/min in the control mode on a volume ventilator. An arterial blood gas
reveals a PaCO2 of 31 torr. The respiratory therapist is asked to adjust the
minute volume to maintain a PaCO2 of 40 torr. Which of the following
ventilator settings should the therapist use to achieve the desired PaCO2?
A. tidal volume - 750 ml, rate - 8/min
B. tidal volume - 700 ml, rate - 10/min
C. tidal volume - 650 ml. rate - 12/min
D. tidal volume - 600 ml, rate - 16/min
94
29. A 34-year-old patient in the ICU is receiving noninvasive positive pressure
ventilation by mask. The settings and ABG results are below.
Inspiratory positive airway pressure (IPAP) 14 cm H2O
Expiratory positive airway pressure (EPAP) 5 cm H2O
Respiratory rate 12/min
pH 7.29
PaCO2 51 torr
PaO2 63 torr
HCO3 23 mEq/L
BE -1
Which of the following should be recommended to improve the patient’s
ventilatory status?
A. Increase the EPAP to 10 cm H2O.
B. Decrease the IPAP to 12 cm H2O.
C. Decrease the EPAP to 3 cm H2O.
D. Increase the IPAP to 18 cm H2O.
30. A 26-year-old male patient is brought to the recovery room following
abdominal surgery. The patient is intubated and has normal pulmonary
function. The patient is 5’5” and weighs 150 kg (330 lb). Which of the
following ventilator settings should the respiratory therapist recommend?
A. rate - 10/min, tidal volume - 500 ml
B. rate - 12/min, tidal volume - 700 ml
C. rate - 12/min, tidal volume - 950 ml
D. rate - 8/min, tidal volume - 1500 ml
31. A patient receiving mechanical ventilation is placed on a PEEP of 6 cm H2O.
Which of the following will most likely decrease?
I. FRC
II. P(A-a)O2
III. static lung compliance
A. I only
B. II only
C. I and III only
D. I, II and III
95
32. The data below have been collected from a 70 kg (154 lb) male patient on a
volume ventilator.
Mode – A/C ABGs: pH 7.27
Ventilator rate – 12/min PaCO2 52 torr
Tidal volume – 600 ml PaO2 62 torr
FIO2 – 0.40 HCO3 25 mEq/L
BE +1
Based on these data, the most appropriate ventilator change is which of the
following?
A. Increase tidal volume to 700 ml.
B. Increase FIO2 to 0.50.
C. Initiate PEEP at 5 cm H2O.
D. Add 50 ml of mechanical deadspace.
33. Which of the following would most likely indicate that a ventilator patient is
ready to be weaned.
I. MIP of –25 cm H2O
II. VC of 8 ml/kg
III. P(A-a)O2 of 275 torr on 100% oxygen
IV. VD/VT of 0.65
A. I only
B. I and III only
C. I, III and IV only
D. II, III and IV only
34. A 36-year-old, 75 kg (165 lb) man is receiving mechanical ventilation on the
settings below.
Mode – A/C
Ventilator rate – 10/min
Tidal volume – 850 ml
FIO2 – 0.35
Flow – 20 L/min
Pressure limit – 40 cm H2O
The pressure limit alarms with each breath and wide fluctuations are observed
on the pressure manometer. The most appropriate action to take at this time
would be to
A. increase the ventilator rate to 15/min.
B. increase the pressure limit to 50 cm H2O.
C. decrease the tidal volume to 750 ml.
D. increase the flow to 40 L/min.
96
35. The following data are collected from a 75 kg (165 lb) female patient with
ARDS on a volume ventilator.
Mode – SIMV
Ventilator rate – 12/min
Tidal volume – 700 ml
FIO2 – 0.55
PEEP – 8 cm H2O
ABGS:
pH 7.36
PaCO2 43 torr
PaO2 57 torr
HCO3 26 mEq/L
BE +2
Based on these data, the most appropriate recommendation is which of the
following?
A. Increase tidal volume to 750 ml.
B. Increase FIO2 to 0.65.
C. Increase ventilator rate to 15/min.
D. Increase PEEP to 12 cm H2O.
36. The respiratory therapist notes the following data while reviewing the
patient’s chart:
Dynamic compliance – 34 ml/cm H2O
Static compliance – 28 ml/cm H2O
The therapist should conclude which of the following?
A. Airway resistance is 6 cm H2O/L/sec.
B. A pneumothorax has likely developed.
C. The data is erroneous.
D. The patient has severe obstructive disease.
37. A three-day-old neonate is on a pressure ventilator in the NICU. Ventilator
settings and arterial blood gases are recorded below.
Mode – IMV
pH 7.51
Ventilator rate – 40/min
PaCO2 30 torr
Inspiratory pressure – 24 cm H2O PaO2 54 torr
FIO2 – 0. 50
HCO3 22 mEq/L
PEEP – 4 cm H2O
BE 0
Based on these data, which of the following is the most appropriate
recommendation?
A. Decrease the ventilator rate to 35/min.
B. Increase the FIO2 to 0.60.
C. Increase the inspiratory pressure to 28 cm H2O.
D. Increase the PEEP to 6 cm H2O.
97
38. A two-month-old infant is receiving mechanical ventilation with a pressure
ventilator. Ventilator settings and capillary blood gases are recorded below.
pH 7.36
Mode - IMV
PcCO2 44 torr
Ventilator rate – 35/min
PcO2 55 torr Inspiratory pressure – 24 cm H2O
HCO3 23 mEq/L
PEEP – 6 cm H2O
BE +1
FIO2 – 0.50
The most appropriate recommendation at this time is which of the following?
A. Increase the FIO2 to 0.60.
B. Decrease PEEP to 4 cm H2O.
C. Increase inspiratory pressure to 28 cm H2O.
D. Maintain the current settings.
39. A 42-year-old postoperative patient is on the following ventilator settings.
Mode – SIMV
Ventilator rate – 6/min
Tidal volume – 700 ml
FIO2 – 0.35
Peak flow – 50 L/min
Pressure support – 25 cm H2O
During weaning trials using a T-piece, the patient becomes tachypneic,
agitated and short of breath, and must be placed back on the ventilator.
Based on this information, the respiratory therapist should recommend which
of the following to wean this patient?
A. Increase the peak flow.
B. Increase the FIO2.
C. Decrease the pressure support.
D. Decrease the tidal volume.
98
40. The following data are collected on an 80 kg (176 lb) man receiving
mechanical ventilation with a volume ventilator.
Mode – SIMV
ABGS:
pH 7.50
Ventilator rate – 8/min
PaCO2 29 torr
Tidal volume – 800 ml
PaO2 57 torr
FIO2 – 0.40
HCO3 26 mEq/L
Pressure support – 10 cm H2O
BE 0
Based on these data, the respiratory therapist should recommend which of
the following ventilator changes at this time?
A. Decrease the ventilator rate to 6/min.
B. Increase the FIO2 to 0.50.
C. Decrease the pressure support to 5 cm H2O.
D. Decrease the tidal volume to 700 ml.
41. While reviewing a ventilator patient’s chart, the respiratory therapist notes
increasing plateau pressures over the past six hours while the tidal volume
setting has remained unchanged. Which of the following is the most likely
cause of this?
A. The patient is experiencing bronchospasm.
B. Secretions are present in the upper airways.
C. The patient’s lungs are becoming stiffer
D. The patient’s FRC is increasing.
42. Which of the following indicates optimal PEEP?
PEEP
4
6
8
10
PIP
34
37
42
45
Plateau
22
23
26
29
VT (ml)
600
600
600
600
A. 4 cm H2O
B. 6 cm H2O
C. 8 cm H2O
D. 10 cm H2O
99
43. The following data are collected from a patient receiving mechanical
ventilation.
PEEP (cm H2O) PvO2 (torr)
PaO2 (torr)
3
35
65
6
37
70
9
39
74
12
35
79
Based on these data, which of the following would be the most appropriate
level of PEEP?
A. 3 cm H2O
B. 6 cm H2O
C. 9 cm H2O
D. 12 cm H2O
44. Cardiac output would most likely be affected least by which of the following
ventilator settings?
A. SIMV, rate 8/min, PEEP 4 cm H2O
B. Assist control, rate 8/min, PEEP 4 cm H2O
C. SIMV, rate 12/min, PEEP 6 cm H2O
D. Control mode, rate 14/min, PEEP 4 cm H2O
45. A 36-year-old patient with aspiration pneumonia is receiving mechanical
ventilation. The chest x-ray indicates complete opacification of the right lung.
The left lung appears normal. The patient’s blood pressure is 114/80 mm Hg
and PIP is 50 cm H2O. Ventilator settings and ABGs are recorded below.
Mode – SIMV
Ventilator rate – 18/min
Tidal volume – 900 ml
FIO2 – 1.0
PEEP – 18 cm H2O
pH 7.37
PaCO2 43 torr
PaO2 45 torr
HCO3 25 mEq/L
BE +1
Which of the following should the respiratory therapist recommend at this
time?
A. Increase the tidal volume to 1.0 L.
B. Decrease the ventilator rate to 12/min.
C. Increase the PEEP to 24 cm H2O.
D. Initiate independent lung ventilation.
100
46. A 70 kg (154 lb) patient is receiving mechanical ventilation in the pressurecontrol
mode. Ventilator settings and ABG results are below.
Peak inspiratory pressure – 26 cm H2O
pH 7.28
Ventilator rate – 10/min
PaCO2 54 torr
Total rate – 28/min
PaO2 67 torr
FIO2 – 0.50
HCO3 27 mEq/L
Exhaled VT – 250 ml
BE +3
Based on these data, which of the following is the most appropriate
recommendation?
A. Increase ventilator rate to 12/min.
B. Increase inspiratory pressure to 30 cm H2O.
C. Increase FIO2 to 0.60.
D. Initiate PEEP of 4 cm H2O.
47. A 5’6” female patient who weighs 130 kg (286 lb) has just been transported to
SICU following abdominal surgery. Which of the following initial ventilator
settings are most appropriate?
A. SIMV, rate – 12/min, tidal volume – 500 ml
B. SIMV, rate – 10/min, tidal volume – 650 ml
C. SIMV, rate – 12/min, tidal volume – 900 ml
D. SIMV, rate – 8/min, tidal volume – 1300 ml
48. The following data were collected from a patient on a volume ventilator in the
control mode.
Tidal volume – 700 ml (0.7 L)
Ventilator rate – 10/min
FIO2 – 0.50
Flow – 50 L/min
ABGs:
pH 7.27
PaCO2 58 torr
PaO2 72 torr
HCO3 25 mEq/L
BE 0
The physician wants to reduce the patient’s PaCO2 to 45 torr. Which of the
following ventilator settings would accomplish this?
A. tidal volume – 700 ml, rate – 12/min
B. tidal volume – 750 ml, rate – 12/min
C. tidal volume – 800 ml, rate – 10/min
D. tidal volume – 800 ml, rate – 12/min
101
49. A 34-year-old patient in the ICU is receiving noninvasive positive pressure
ventilation by mask. The settings and ABG results are below.
Inspiratory positive airway pressure (IPAP) 14 cm H2O
Expiratory positive airway pressure (EPAP) 5 cm H2O
Respiratory rate 12/min
pH 7.29
PaCO2 51 torr
PaO2 63 torr
HCO3 23 mEq/L
BE -1
Which of the following should be recommended to improve the patient’s
ventilatory status?
A. Increase the EPAP to 10 cm H2O.
B. Decrease the IPAP to 12 cm H2O.
C. Decrease the EPAP to 3 cm H2O.
D. Increase the IPAP to 18 cm H2O.
50. The following data are collected from a patient on a volume ventilator.
Tidal volume – 600 ml
Peak inspiratory pressure – 35 cm H2O
Plateau pressure – 25 cm H2O
PEEP – 5 cm H2O
This patient’s static lung compliance is which of the following?
A. 17 ml/cm H2O
B. 20 ml/cm H2O
C. 24 ml/cm H2O
D. 30 ml/cm H2O
51. A patient is receiving mechanical ventilation with a volume-cycled ventilator.
The respiratory therapist hears the low volume alarm and notices that the
manometer is reading a system pressure of 3-4 cm H2O during the inspiration
phase. The therapist should do which of the following?
A. Reconnect the expiratory drive line.
B. Suction the patient’s ET tube.
C. Drain the water out of the inspiratory line.
D. Straighten the kink in the inspiratory line.
102
52. A patient is receiving mechanical ventilation with the following ventilator
parameters:
SIMV mode
Ventilator rate 8
Total rate 32
Ventilator Vt 700 ml
Spontaneous Vt 200 ml
The physician asks the respiratory therapist to recommend a ventilator mode
that would augment the patient’s spontaneous breathing efforts. Which of the
following should the therapist select?
A. pressure-controlled ventilation (PCV) and titrate the PCV level to achieve
a spontaneous Vt of about 10 ml/kg or greater.
B. pressure-support ventilation (PSV) and titrate the PSV level until the
spontaneous rate is less than 15/min.
C. pressure-controlled ventilation (PCV) and titrate PCV until the
spontaneous rate is less than 20/min.
D. pressure-support ventilation (PSV) and titrate the PSV level until the
spontaneous Vt is about 8-10 ml/kg.
53. The following data has been collected on a patient receiving continuous
mechanical ventilation.
1:00 PM
3:00 PM
Delivered VT
700 ml
700 ml
Peak airway pressure 43 cm H2O 54 cm H2O
Static airway pressure
28 cm H2O 39 cm H2O
Inspiratory flow
50 L/min
50 L/min
PEEP
5 cm H2O
5 cm H2O
Which of the following is the best interpretation of these data?
A. The peak airway pressure increased as a result of increased airway
resistance.
B. The peak airway pressure increased as a result of decreased lung
compliance.
C. The patient’s lung compliance is improving.
D. The patient’s dynamic compliance is increasing.
103
54. A 27-week gestational age neonate with severe IRDS is receiving high
frequency oscillation ventilation (HFOV). The neonate has a heart rate of
150/min and a blood pressure of 66/42 mm Hg. Arterial blood gases drawn
thirty minutes after initiation of HFOV are recorded below.
pH 7.24
PaCO2 62 torr
PaO2 60 torr
HCO3 23 mEq/L
BE -1
The respiratory therapist should recommend which of the following?
A. increasing the oscillatory amplitude
B. increasing the FIO2
C. initiating conventional ventilation
D. decreasing the mean airway pressure
55. The following information is from a patient receiving pressure-control
ventilation.
9:00 AM
11:00 AM
Rate
14/min
14/min
Peak pressure 30 cm H2O
30 cm H2O
PEEP
5 cm H2O
5 cm H2O
Exhaled VT 700 ml
500 ml
This information is consistent with a decreased
A. lung compliance.
B. A-a gradient.
C. airway resistance.
D. VD/VT ratio.
56. The following data is collected from a 65 kg (143 lb) patient with a closedhead injury and elevated
intracranial pressure levels receiving volume-cycled ventilation.
Mode - SIMV
Mandatory rate - 10/min
Total rate - 10/min
Tidal volume - 800 ml
FIO2 - 0.50
pH 7.48
PaCO2 28 torr
PaO2 98 torr
HCO3 25 mEq/L
Which of the following should the respiratory therapist recommend at this
time?
A. Decrease the FiO2 to 0.40.
B. Decrease the tidal volume to 700 ml.
C. Maintain the ventilator settings.
D. Add 100 ml of deadspace.
104
57. The following data are collected on an 80 kg (176 lb) man receiving
mechanical ventilation with a volume ventilator.
Mode – SIMV
ABGS:
pH 7.50
Ventilator rate – 8/min
PaCO2 26 torr
Total rate 18/min
PaO2 92 torr
Tidal volume – 800 ml
HCO3 26 mEq/L
FIO2 – 0.40
BE +2
Pressure support – 25 cm H2O
Which of the following ventilator changes are appropriate at this time?
A. Decrease the pressure support.
B. Add deadspace.
C. Decrease the SIMV rate
D. Make no changes at this time.
58. The following data are collected on a 70 kg (154 lb) female receiving
mechanical ventilation with a volume ventilator.
Mode – SIMV
ABGS:
pH 7.28
Ventilator rate – 10/min
PaCO2 53 torr
Total rate 22/min
PaO2 72 torr
Tidal volume – 700 ml
HCO3 23 mEq/L
FIO2 – 0.40
BE -2
Pressure support – 7 cm H2O
Deadspace – 100 ml
PEEP – 5 cm H2O
Which of the following ventilator changes are appropriate at this time?
A. Increase the pressure support to 10 cm H2O.
B. Remove the deadspace.
C. Increase the SIMV rate to 15/min.
D. Increase the PEEP to 10 cm H2O.
105
59. The following data are collected on a 70 kg (154 lb) female receiving
mechanical ventilation with a volume ventilator.
Mode – SIMV
ABGS:
pH 7.48
Ventilator rate – 12/min
PaCO2 30 torr
Total rate 24/min
PaO2 62 torr
Tidal volume – 800 ml
HCO3 23 mEq/L
FIO2 – 0.65
BE -2
Pressure support – 7 cm H2O
PEEP – 5 cm H2O
Which of the following ventilator changes are appropriate at this time?
A. Increase the PEEP to 10 cm H2O.
B. Decrease the tidal volume to 700 ml.
C. Decrease the SIMV rate to 8/min.
D. Decrease the pressure support to 5 cm H2O.
60. The following data are collected on a 70 kg (154 lb) female receiving
mechanical ventilation with a volume ventilator.
Mode – SIMV
ABGS:
pH 7.43
Ventilator rate – 10/min
PaCO2 43 torr
Total rate 14/min
PaO2 125 torr
Tidal volume – 700 ml
HCO3 26 mEq/L
FIO2 – 0.40
BE +2
Pressure support – 10 cm H2O
PEEP – 10 cm H2O
Which of the following ventilator changes should the respiratory therapist
recommend?
A. Decrease the pressure support to 5 cm H2O.
B. Decrease the FIO2 to 0.30.
C. Decrease the SIMV rate to 6/min.
D. Decrease the PEEP to 5 cm H2O.
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61. The following data are collected on a 70 kg (154 lb) female with bibasilar
atelectasis receiving mechanical ventilation with a volume ventilator.
Mode – SIMV
Ventilator rate – 10/min
Total rate 24/min
Tidal volume – 600 ml
FIO2 – 0.40
PEEP – 5 cm H2O
ABGS:
pH 7.29
PaCO2 53 torr
PaO2 65 torr
HCO3 27 mEq/L
BE +3
Which of the following ventilator changes should the respiratory therapist
recommend?
A. Increase the SIMV rate to 15/min.
B. Increase the FIO2 to 0.50.
C. Increase the tidal volume to 700 ml.
D. Increase the PEEP to 10 cm H2O.
62. The following data are collected on a 65 kg (143 lb) female with severe
COPD receiving mechanical ventilation with a volume ventilator.
Mode – SIMV
ABGS:
pH 7.35
Ventilator rate – 10/min
PaCO2 63 torr
Total rate 14/min
PaO2 62 torr
Tidal volume – 600 ml
HCO3 36 mEq/L
FIO2 – 0.40
BE +12
Pressure support – 10 cm H2O
PEEP – 4 cm H2O
Which of the following ventilator changes should the respiratory therapist
recommend?
A. Increase the pressure support to 15 cm H2O.
B. Increase the FIO2 to 0.50.
C. Increase the tidal volume to 700 ml.
D. Maintain the current ventilator settings.
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63. The following data are collected on a patient receiving mechanical ventilation
with a volume ventilator.
Mode – A/C
ABGS:
pH 7.43
Ventilator rate – 10/min
PaCO2 43 torr
Tidal volume – 700 ml
PaO2 125 torr
FIO2 – 0.80
HCO3 26 mEq/L
PEEP – 12 cm H2O
BE 0
Which of the following ventilator changes should the respiratory therapist
recommend?
A. Decrease the PEEP to 8 cm H2O.
B. Decrease the FIO2 to 0.70.
C. Increase the rate to 15/min.
D. Decrease the tidal volume to 600 ml.
64. A patient in the ICU is receiving noninvasive positive pressure ventilation by
mask. The settings and ABG results are below.
Inspiratory positive airway pressure (IPAP) 15 cm H2O
Expiratory positive airway pressure (EPAP) 5 cm H2O
Respiratory rate 12/min
pH 7.28
PaCO2 53 torr
PaO2 73 torr
HCO3 24 mEq/L
BE -1
Which of the following changes are appropriate at this time?
A. Increase the EPAP to 8 cm H2O.
B. Decrease the IPAP to 12 cm H2O.
C. Decrease the EPAP to 3 cm H2O.
D. Increase the IPAP to 18 cm H2O.
65. Which of the following would most likely indicate that a ventilator patient is
ready to be weaned?
I. MIP of –17 cm H2O
II. VC of 18 ml/kg
III. P(A-a)O2 of 475 torr on 100% oxygen
IV. VD/VT of 0.50
A. I and II only
B. II and IV only
C. II, III and IV only
D. I, II, III and IV
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66. The respiratory therapist is assessing a ventilator patient to determine if
weaning is appropriate. Which of the following parameters indicate weaning
will most likely be successful?
I. VC – 14 ml/kg
II. Rapid shallow breathing index – 70
III. MIP – -32 cm H2O
A. I only
B. III only
C. II and III only
D. I, II and III
67. A patient receiving mechanical ventilation is placed on a PEEP of 5 cm H2O.
Which of the following will most likely increase?
I. FRC
II. P(A-a)O2
III. static lung compliance
A. I only
B. II only
C. I and III only
D. I, II and III
68. A two-month-old infant is receiving mechanical ventilation with a pressure
ventilator. Ventilator settings and capillary blood gases are recorded below.
pH 7.38
Mode - IMV
PcCO2 46 torr
Ventilator rate – 25/min
PcO2 45 torr Inspiratory pressure – 20 cm H2O
HCO3 22 mEq/L
PEEP – 4 cm H2O
BE -1
FIO2 – 0.40
The most appropriate recommendation at this time is which of the following?
A. Increase the FIO2 to 0.50.
B. Increase PEEP to 6 cm H2O.
C. Increase inspiratory pressure to 24 cm H2O.
D. Maintain the current settings.
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69. The following data are collected from a patient on a volume ventilator.
Tidal volume – 800 ml
Peak inspiratory pressure – 50 cm H2O
Plateau pressure – 30 cm H2O
PEEP – 10 cm H2O
This patient’s static lung compliance is which of the following
A. 16 ml/cm H2O
B. 20 ml/cm H2O
C. 27 ml/cm H2O
D. 40 ml/cm H2O
70. The following data are collected from a patient receiving mechanical
ventilation.
PEEP (cm H2O)
SvO2 SaO2
4
75% 93%
6
78% 94%
8
73% 96%
10
72% 96%
Based on these data, which of the following would be the most appropriate
level of PEEP?
A. 4 cm H2O
B. 6 cm H2O
C. 8 cm H2O
D. 10 cm H2O
71. A patient on a volume ventilator has a PaO2 of 62 torr on a PEEP of 6 cm
H2O and an FiO2 of 0.50. After increasing the PEEP to 10 cm H2O, the
cardiac output decreases from 5.1 L/min to 4.1 L/min. The most appropriate
recommendation is to
A. discontinue PEEP and increase the FiO2 to 0.60.
B. increase PEEP to 10 cm H2O.
C. decrease PEEP to 6 cm H2O and increase the FiO2 to 0.60.
D. maintain the current settings and measure cardiac output in one hour.
110
72. A patient is receiving mechanical ventilation with a volume-cycled ventilator.
The low pressure alarm is activated and the manometer is reading a system
pressure of 2-3 cm H2O during the inspiration phase. The respiratory
therapist should do which of the following?
A. Check to function of the expiratory valve.
B. Suction the patient’s ET tube.
C. Drain the water out of the inspiratory line.
D. Straighten the kink in the inspiratory line.
73. The respiratory therapist notes the following data while reviewing the
patient’s chart:
Dynamic compliance – 44 ml/cm H2O
Static compliance – 32 ml/cm H2O
The therapist should conclude which of the following?
A. Airway resistance is 12 cm H2O/L/sec.
B. A pneumothorax has likely developed.
C. The data is erroneous.
D. The patient has severe restrictive disease.
74. The following data has been obtained from a patient on a volume ventilator
and a tidal volume of 700 ml.
Time
2 PM
3 PM
4 PM
peak pressure
(cm H2O)
30
36
40
plateau pressure
(cm H2O)
18
18
18
Which of the following statements regarding these data are true?
A. Lung compliance is decreasing.
B. Airway resistance is increasing.
C. The lungs are becoming easier to ventilate.
D. Lung compliance is increasing.
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75. The following data has been obtained from a patient on a volume ventilator
and a tidal volume of 650 ml.
Time
6 PM
7 PM
8 PM
peak pressure plateau pressure
(cm H2O)
(cm H2O)
34
16
38
20
41
24
Which of the following statements regarding these data are true?
A. Static lung compliance is decreasing.
B. Airway resistance is increasing.
C. The lungs are becoming easier to ventilate.
D. Dynamic lung compliance is increasing.
76. A 49-year-old postoperative patient is on the following ventilator settings.
Mode – SIMV
Ventilator rate – 6/min
Tidal volume – 600 ml
FIO2 – 0.40
Peak flow – 60 L/min
Pressure support – 24 cm H2O
A weaning trial is started with the patient being placed on a T-piece. The
patient becomes tachypneic and short of breath, and must be placed back on
the ventilator. Based on this information, the respiratory therapist should
recommend which of the following?
A. Increase the peak flow.
B. Increase the FIO2 to 0.50 while on the T-piece.
C. Decrease the pressure support to 10 cm H2O.
D. Increase the tidal volume to 650 ml.
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77. A two-day-old neonate is on a pressure ventilator in the NICU. Ventilator
settings and arterial blood gases are recorded below.
Mode – IMV
pH 7.43
Ventilator rate – 40/min
PaCO2 42 torr
Inspiratory pressure – 20 cm H2O PaO2 44 torr
FIO2 – 0. 60
HCO3 22 mEq/L
PEEP – 4 cm H2O
BE 0
Based on these data, which of the following is the most appropriate
recommendation?
A. Decrease the ventilator rate to 35/min.
B. Increase the FIO2 to 0.70.
C. Increase the inspiratory pressure to 24 cm H2O.
D. Increase the PEEP to 6 cm H2O.
78. A five-day-old premature neonate is on a pressure ventilator in the NICU.
Ventilator settings and arterial blood gases are recorded below.
Mode – IMV
pH 7.29
Ventilator rate – 30/min
PaCO2 51 torr
Inspiratory pressure – 20cm H2O
PaO2 50 torr
FIO2 – 0. 40
HCO3 24 mEq/L
PEEP – 6 cm H2O
BE +2
Based on these data, which of the following is the most appropriate
recommendation?
A. Increase the ventilator rate to 35/min.
B. Increase the FIO2 to 0.50.
C. Decrease the inspiratory pressure to 18 cm H2O.
D. Increase the PEEP to 8 cm H2O.
79. A drug overdose patient is being transferred to the ICU. The patient weighs
60 kg (132 lb) and is being bagged with 100%. Which of the following
represents the most appropriate initial ventilator settings?
A. mode – A/C, tidal volume – 600 ml, rate – 6/min, FIO2 – 0.60
B. mode – control, tidal volume – 800 ml, rate – 12/min, FIO2 – 0.60
C. mode – A/C, tidal volume – 650 ml, rate – 16/min, FIO2 – 1.0
D. mode – SIMV, tidal volume – 600 ml, rate – 12/min, FIO2 – 1.0
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80. A premature infant on a pressure-controlled ventilator has a PaCO2 of 28 torr. Which of the following
ventilator settings should be decreased to correct this
situation?
A. FiO2
B. tidal volume
C. PEEP
D. inspiratory pressure
81. The following data are collected on a patient receiving mechanical ventilation
with a volume ventilator.
Mode – A/C
ABGS:
pH 7.28
Ventilator rate – 10/min
PaCO2 53 torr
Tidal volume – 700 ml
PaO2 75 torr
FIO2 – 0.50
HCO3 25 mEq/L
PEEP – 8 cm H2O
BE 0
Which of the following ventilator changes should the respiratory therapist
recommend?
A. Increase the PEEP to 10 cm H2O.
B. Increase the FIO2 to 0.60.
C. Increase the tidal volume to 800 ml..
D. Add 100 ml of deadspace.
82. The following data are collected on a patient receiving mechanical ventilation
with a volume ventilator.
Mode – SIMV
Ventilator rate – 8/min
Tidal volume – 700 ml
FIO2 – 0.40
PEEP – 4 cm H2O
ABGS:
pH 7.48
PaCO2 33 torr
PaO2 95 torr
HCO3 24 mEq/L
BE -1
Which of the following ventilator changes should the respiratory therapist
recommend?
A. Add mechanical deadspace.
B. Decrease the FIO2 to 0.25.
C. Decrease the rate to 6/min.
D. Decrease the tidal volume to 600 ml.
114
83. The following data are collected on a 70 kg (154 lb) ventilator patient who has
suffered head trauma as a result of a motor vechicle accident. The patient
has an ICP of 18 mm Hg.
Mode – A/C
Ventilator rate – 10/min
Tidal volume – 700 ml
FIO2 – 0.40
ABGS:
pH 7.31
PaCO2 47 torr
PaO2 95 torr
HCO3 24 mEq/L
BE -1
Which of the following ventilator changes should the respiratory therapist
recommend?
A. Increase the tidal volume to 800 ml.
B. Decrease the FIO2 to 0.30.
C. Maintain current ventilator settings.
D. Increase the rate to 15/min.
84. A 27-year-old male weighing 65 kg (143 lb) is receiving mechanical
ventilation after being diagnosed with a drug overdose. Her chest radiograph
is consistent with pulmonary edema. Pertinent data are listed below.
Mode – SIMV
ABGs:
pH 7.41
Rate – 12/min
PaCO2 38 torr
Tidal volume – 650 ml
PaO2 49 torr
FIO2 – 0.60
HCO3 26
PEEP – 8 cm H2O
BE +1
PIP – 54 cm H2O
SaO2 83%
Plateau pressure – 45 cm H2O Which of the following changes should the respiratory therapist recommend at
this time?
I. Change mode to pressure control at 35 cm H2O.
II. Increase the FIO2 to 0.70.
III. Increase the PEEP to 12 cm H2O.
IV. Increase the rate to 20/min.
A. I and III only
B. II and IV only
C. I, III and IV only
D. II, III and IV only
115
85. The following data are collected on a patient receiving mechanical ventilation
with a volume ventilator.
Mode – A/C
ABGS:
pH 7.38
Ventilator rate – 10/min
PaCO2 42 torr
Tidal volume – 700 ml
PaO2 131 torr
FIO2 – 0.70
HCO3 26 mEq/L
PEEP – 10 cm H2O
BE +2
Which of the following ventilator changes should the respiratory therapist
recommend?
A. Decrease the PEEP to 8 cm H2O.
B. Decrease the FIO2 to 0.60.
C. Increase the rate to 15/min.
D. Decrease the tidal volume to 600 ml.
86. The following data are collected on a 7-year-old child who weighs 30 kg (66
lb) and is receiving mechanical ventilation.
Mode – A/C
ABGS: pH 7.48
Ventilator rate – 22/min
PaCO2 31 torr
Tidal volume – 300 ml
PaO2 57 torr
FIO2 – 0.80
HCO3 21 mEq/L
BE -2
Which of the following ventilator changes should the respiratory therapist
recommend?
A. Initiate 5 cm H2O PEEP.
B. Decrease the rate to 18/min.
C. Increase the FIO2 to 0.90.
D. Decrease the tidal volume to 250 ml.
116
87. The following data are collected on a 55-year-old COPD patient receiving
mechanical ventilation with a volume ventilator.
Mode – A/C
ABGS:
pH 7.36
Ventilator rate – 10/min
PaCO2 58 torr
Tidal volume – 900 ml
PaO2 67 torr
FIO2 – 0.35
HCO3 35 mEq/L
BE +10
Which of the following ventilator changes should the respiratory therapist
recommend?
A. Maintain the current settings.
B. Increase the FIO2 to 0.45.
C. Increase the rate to 15/min.
D. Decrease the tidal volume to 750 ml.
88. The blood gas results below are for a 75 kg (165 lb) COPD patient who is
breathing room air.
pH 7.26
PaCO2 75 torr
PaO2 40 torr
HCO3 38 mEq/L
BE +12
Which of the following ventilator settings is most appropriate for this patient?
A. tidal volume – 900 ml, rate – 10/min, FIO2 – 0.60
B. tidal volume – 700 ml, rate – 12/min, FIO2 – 0.40
C. tidal volume – 750 ml, rate – 15/min, FIO2 – 0.50
D. tidal volume – 800 ml, rate – 8/min, FIO2 - 0.80
117
89. The following data are collected on a 60 kg (132 lb) patient receiving
mechanical ventilation with a volume ventilator.
Mode – A/C
Ventilator rate – 10/min
Tidal volume – 700 ml
FIO2 – 1.0
PEEP – 12 cm H2O
PIP – 55 cm H2O
SpO2 – 83%
A chest radiograph indicates diffuse bilateral infiltrates. Which of the following
ventilator changes should the respiratory therapist recommend?
A. Increase the PEEP to 16 cm H2O.
B. Increase the ventilator rate.
C. Change to pressure-control ventilation.
D. Decrease the tidal volume to 600 ml.
90. Which of the following flow settings is required to maintain an I:E ratio of 1:2
with a respiratory rate of 20/min and a tidal volume of 700 ml?
A. 28 L/min
B. 36 L/min
C. 42 L/min
D. 48 L/min
91. The following data has been collected on a mechanical ventilator patient.
A/C mode
rate – 15/min
flowrate – 60 L/min
FIO2 – 0.40
PIP – 30 cm H2O
plateau pressure – 15 cm H2O
Based on this information, which of the following represents the patient’s
airway resistance (Raw)?
A. 5 cm H2O/L/sec
B. 10 cm H2O/L/sec
C. 15 cm H2O/L/sec
D. 20 cm H2O/L/sec
118
92. Which of the following indicates the patient’s static lung compliance is
increasing?
A. increasing peak pressure
B. increasing plateau pressure
C. decreasing peak pressure
D. decreasing plateau pressure
93. Which of the following pressures below indicate the best static lung
compliance?
A. PEEP – 4 cm H2O plateau – 24 cm H2O Vt – 700 ml
B. PEEP – 8 cm H2O plateau – 26 cm H2O Vt – 700 ml
C. PEEP – 12 cm H2O plateau – 34 cm H2O Vt – 700 ml
D. PEEP – 15 cm H2O plateau - 38 cm H2O Vt – 700 ml
94. The physician wants to help reduce cerebral blood flow to a closed-head
injury patient by using the ventilator. Which of the following PaCO2 levels
would be most appropriate to maintain on this patient?
A. 20 torr
B. 30 torr
C. 40 torr
D. 50 torr
95. A four-day-old neonate on CPAP of 6 cm H2O and 60% oxygen is
experiencing nasal flaring, grunting and retractions with a respiratory rate of
72/min. The SpO2 is 82%. Which of the following should the respiratory
therapist recommend?
A. Increase CPAP to 10 cm H2O.
B. Intubate and initiate mechanical ventilation.
C. Place on 100% oxygen hood.
D. Administer a bronchodilator.
119
Disorders of the Respiratory System
1. Which of the following should be taught to the COPD patient to help relieve
dyspnea?
I. diaphragmatic breathing
II. increased accessory muscle use
III. pursed lip breathing
A. I and II only
B. I and III only
C. II and III only
D. I, II and III
2. The respiratory care practitioner is assessing a patient in the emergency room
who states he has had a cough off and on for the past three years which often
produces thick secretions. The practitioner should suspect this patient most
likely has
A. asthma.
B. emphysema.
C. chronic bronchitis.
D. pulmonary edema.
3. The respiratory therapist obtains a sputum sample from a patient and the lab
report determines it contains acid-fast bacilli. This is indicative of which of the
following lung conditions?
A. tuberculosis
B. asthma
C. emphysema
D. bronchiectasis
4. Which of the following should the respiratory therapist recommend as the
most effective treatment for an obese patient with obstructive sleep apnea?
A. Have the patient sleep on their right side.
B. Recommend a tracheotomy be done.
C. Have the patient sleep sitting up in a chair.
D. Sleep using nasal CPAP.
120
5. The respiratory care practitioner is evaluating a ventilator patient with ARDS.
Which of the following findings is commonly assessed with this lung disorder?
I. increased lung compliance
II. refractory hypoxemia
III. decreased P(A-a)O2
A. II only
B. I and II only
C. I and III only
D. II and III only
6. A patient enters the emergency department following a motor vehicle accident
in severe respiratory distress. Upon assessment of the patient, the
respiratory care practitioner observes asymmetrical chest movement with
absent breath sounds on the right and the trachea shifted toward the left.
Which of the following should the practitioner recommend first?
A. Obtain a stat chest x-ray.
B. Intubate and manually ventilate the patient.
C. Evacuate air from the pleural space.
D. Administer a stat IPPB treatment.
7. The respiratory care practitioner is assessing a patient in the emergency
department who presents with shortness of breath and is coughing up large
amounts of pink, frothy secretions. The practitioner auscultates crackles
throughout all lung fields. This patient’s most likely diagnosis is which of the
following?
A. pulmonary embolism
B. bacterial pneumonia
C. bronchiectasis
D. pulmonary edema
8. A 77-year-old patient is recovering on the orthopedic floor from a broken hip.
After being moved to a bedside chair the patient suddenly becomes dyspneic,
cyanotic and tachycardic. This sudden deterioration in the patient’s condition
is most likely the result of which of the following?
A. pulmonary edema
B. pneumonia
C. pneumothorax
D. pulmonary embolism
121
9. A 16-year-old patient enters the emergency department in moderate
respiratory distress. She states she suffered an asthma attack less than one
hour ago with no improvement using her routine medication regimen. Which
of the following arterial blood gas results on room air would you expect at this
time?
A. pH 7.26, PaCO2 56 torr, PaO2 52 torr, HCO3 25 mEq/L
B. pH 7.54, PaCO2 40 torr, PaO2 78 torr, HCO3 36 mEq/L
C. pH 7.47, PaCO2 31 torr, PaO2 57 torr, HCO3 25 mEq/L
D. pH 7.28, PaCO2 43 torr, PaO2 81 torr, HCO3 15 mEq/L
10. While evaluating a patient’s chest x-ray, the respiratory care practitioner
observes areas of hyperinflated lung markings, a flattened diaphragm and
reduced vascular markings. This x-ray is indicative of which of the following?
A. emphysema
B. pleural effusion
C. pneumothorax
D. pulmonary edema
11. Cor pulmonale is an indication of
A. an elevated PCWP.
B. right ventricular hypertrophy.
C. systemic hypertension.
D. decreased pulmonary vascular resistance.
12. While assessing the patient’s laboratory results, the respiratory care
practitioner notices an elevated eosinophil level in the patient’s sputum. The
practitioner should suspect the patient most likely has which of the following
lung conditions?
A. carcinoma of the lung
B. bronchiectasis
C. asthma
D. emphysema
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13. Pulmonary vascular congestion caused by congestive heart failure may result
in which of the following?
I. pneumothorax
II. orthopnea
III. paroxysmal nocturnal dyspnea
IV. Kussmaul’s respirations
A. I and II only
B. II and III only
C. II, III and IV only
D. I, II, III and IV
14. The most common initial treatment for a patient with pulmonary
thromboembolic disease is which of the following?
A. heparin
B. Lasix
C. Lidocaine
D. Atropine
15. The respiratory therapist is evaluating a chest radiograph on a patient with a
pulmonary embolism and observes an elevated right hemidiaphragm. This is
most likely the result of which of the following?
A. pneumothorax
B. pleural effusion
C. atelectasis
D. infiltrates
16. Which of the following would you expect to observe on a 25-year-old female
patient with cystic fibrosis?
I. digital clubbing
II. increased A-P chest diameter
III. pedal edema
A. I only
B. I and II only
C. II and III only
D. I, II and III
123
17. The respiratory therapist observes jugular venous distension (JVD) during a
patient evaluation on a patient with chronic bronchitis. The JVD is most likely
the result of which of the following?
A. cor pulmonale
B. atelectasis
C. pulmonary hyperinflation
D. decreased CVP level
18. Which of the following are common findings for patients with acute respiratory
distress syndrome (ARDS)?
I. decreased V/Q mismatch
II. decreased lung compliance
III. PaO2/FIO2 < 150
IV. normal PCWP
A. I and II only
B. II and III only
C. I, II and IV only
D. II, III and IV only
19. The most common causative organism of epiglottitis is
A. pseudomonas aeruginosa.
B. Streptococcus.
C. type B Haemophilus influenza.
D. parainfluenza virus.
20. The physician has ordered 30% oxygen for a 3-year-old boy with croup.
Which of the following devices would be most appropriate to deliver the
oxygen?
A. nasal cannula
B. nonrebreathing mask
C. oxygen tent
D. oxyhood
21. A flail chest is most commonly associated with
A. pleural effusion
B. chest trauma
C. pneumonia
D. emphysema
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22. Which of the following conditions may result in a decreased lung compliance?
I. atelectasis
II. pneumonia
III. pulmonary edema
IV. emphysema
A. I and II only
B. III and IV only
C. I, II and III only
D. I, II, III and IV
23. A patient is suspected of having a pulmonary embolus. Which of the
following should the respiratory therapist recommend to aid in the diagnosis?
A. chest radiograph
B. lung scan
C. bronchoscopy
D. pulmonary angiography
24. A polysomnogram shows no air flow with abdominal and chest movement.
This is indicative of which of the following?
A. obstructive sleep apnea
B. normal polysomnogram
C. central sleep apnea
D. mixed apnea
25. Which of the following characteristics are common in patients with severe
COPD?
I. pulmonary hypertension
II. decreased lung compliance
III. right ventricular hypertrophy
IV. decreased Hb level
A. I and III only
B. II and IV only
C. I, II and III only
D. II, III and IV only
125
26. Which of the following should the respiratory therapist suggest to a long term
smoker with COPD prior to discharge from the hospital?
I. nicotine patches
II. smoking cessation program
III. breathing exercise training
A. I only
B. I and II only
C. II and III only
D. I, II and III
27. Purulent, foul-smelling secretions are most commonly associated with which
of the following?
I. bronchiectasis
II. pulmonary edema
III. lung abscess
IV. asthma
A. I and II only
B. I and III only
C. II and IV only
D. I, III and IV only
28. A patient brought into the emergency department was found unconscious
and lying on his back. He is suspected to have vomited and aspirated.
Which of the following lungs segments would most likely be involved in the
aspiration event?
A. anterior segment of right upper lobe
B. lateral segment of left lower lobe
C. posterior segment of right upper lobe
D. anterior segment of left upper lobe
29. Which of the following are common pathological consequences of aspiration
pneumonitis?
I. severe hypoxemia
II. reduced intrapulmonary shunting
III. ventilation-perfusion mismatch
A. I only
B. I and III only
C. II and III only
D. I, II and III
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30. Which of the following could result in a transudative pleural effusion?
A. bacterial infection
B. metastatic lung disease
C. pulmonary embolism
D. congestive heart failure
31. It is noted in the patient’s chart that during that pus is removed from the
pleural space of a patient during a thoracentesis. This is indicative of which
of the following?
A. pyothorax
B. hemothorax
C. pneumothorax
D. chylothorax
32. The most common presenting symptom with pulmonary embolism is
A. dyspnea.
B. anxiety.
C. hemoptysis.
D. cough.
33. Postoperative pneumonia can be the result of which of the following?
I. ineffective cough
II. abnormal mucus transport
III. aspiration of upper airway secretions
A. I only
B. I and II only
C. II and III only
D. I, II and III
34. It is noted in the patient’s chart that the patient has recurrent and unresolved
pulmonary emboli. This may directly result in which of the following clinical
conditions?
A. hypertension
B. right ventricular hypertrophy
C. left ventricular hypertrophy
D. mitral valve stenosis
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35. Cardiogenic pulmonary edema would be indicated by which of the following
values?
A. PAP – 26/14
B. PCWP – 28 mm Hg
C. CVP – 5 mm Hg
D. Cardiac output – 4.8 L/min
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Respiratory Medications
1. A 12-year-old patient with cystic fibrosis is having difficulty expectorating his
thick pulmonary secretions. The respiratory care practitioner should
recommend administering which of the following medications to treat this
condition?
A. normal saline
B. Mucomyst
C. aminophylline
D. cromolyn sodium
2. The respiratory therapist is having difficulty intubating a combative patient. To
temporarily paralyze the patient to facilitate tracheal intubation, which of the
following medications should be administered?
A. succinylcholine
B. Valium
C. Pavulon
D. Versed
3. Immediately following extubation, the patient becomes short of breath and
inspiratory stridor is heard. The respiratory care practitioner should
recommend which of the following to reduce the upper airway edema?
A. Terbutaline
B. Atrovent
C. Mucomyst
D. Racemic epinephrine
4. A 12-year-old asthmatic patient is being release from the hospital following a
2-day stay to treat her condition. Upon discharge, the respiratory care
practitioner should recommend which of the following medications to help
prevent further attacks?
A. cromolyn sodium (Intal)
B. Theophylline
C. metaproteronol (Alupent)
D. terbutaline sulfate (Brethine)
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5. To help stimulate a cough in order to obtain a sputum culture from a patient,
the respiratory care practitioner should recommend aerosol therapy with the
administration of which of the following?
A. sterile water
B. hypotonic saline
C. normal saline
D. hypertonic saline
6. A 6-month-old infant is diagnosed with respiratory syncytial virus (RSV). The
respiratory care practitioner should recommend which of the following
aerosolized medications?
A. beclovent
B. ribavirin
C. pentamidine
D. amphotericin B
7. A patient in cardiogenic shock has a blood pressure of 70/40. The
respiratory therapist should recommend which of the following medications to
treat this patient’s hypotension?
A. Dopamine (Intropin)
B. Lidocaine (Xylocaine)
C. Nitroprusside (Nipride)
D. Furosemide (Lasix)
8. Oral candidiasis is a potential side effect of which of the following
medications?
I. Ipratropium bromide (Atrovent)
II. Flunisolide (AeroBid)
III. Beclomethasone (Beclovent)
A. II only
B. I and II only
C. II and III only
D. I, II and III
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9. Atrovent is characterized as which type of respiratory medication?
A. beta adrenergic bronchodilator
B. anticholinergic bronchodilator
C. steroid
D. mucolytic
10. The physician wants to add a medication to a cystic fibrosis patient’s aerosol
therapy treatment that will help reduce the viscosity of his pulmonary
secretions. Which of the following would be the most appropriate drug to
recommend?
A. atrovent
B. serevent
C. pulmozyme
D. albuterol
11. A 24-year-old asthmatic is being mechanically ventilated. His rate is 38/min
and he appears very agitated. The high pressure alarm is frequently being
triggered. The patient’s breath sounds are equal bilaterally with few wheezes.
Which of the following should the respiratory therapist recommend at this
time?
A. succinylcholine (Anectine)
B. cromolyn sodium (Intal)
C. midazolam (Versed)
D. flunisolide (Aerobid)
12. A patient has been diagnosed with aspergillosis. Which of the following
medications should the respiratory therapist recommend to treatment this
condition?
A. amphotericin B
B. ribavirin
C. pentamidine
D. gentamicin
13. A patient experiencing bronchospams is receiving metaproterenol sulfate
(Alupent) and his heart rate increases by 40 beats/min with each treatment.
Which of the following medications should the respiratory therapist
recommend in place of Alupent?
A. beclomethasone (Vanceril)
B. cromolyn sodium (Intal)
C. albuterol (Proventil)
D. acetylcysteine (Mucomyst)
131
14. Thick, tenacious secretions are best mobilized from the airway using which of
the following medications?
I. beclomethasone
II. pulmozyme
III. Mucomyst
A. I only
B. I and II only
C. II and III only
D. I, II and III
15. The following hemodynamic data is recorded for a patient:
heart rate 86/min
cardiac output 3.9 L/min
SVR 3200 dynes. sec. cm-5
Blood pressure 162/98
Which of the following medications is the most appropriate recommendation?
A. albuterol (Proventil)
B. furosemide (Lasix)
C. dopamine (Intropin)
D. nitroprusside (Nipride)
16. A patient is brought into the emergency department following a motor
vechicle accident. The patient is in shock with a blood pressure of 72/42.
Which of the following medications is most appropriate to recommend at this
time?
A. furosemide (Lasix)
B. dopamine (Intropin)
C. nitroprusside (Nipride)
D. beclomethasone (Vanceril)
17. A patient with status asthmaticus is being mechanically ventilated. Over the
past two hours, the patient’s dynamic compliance has dramatically
decreased. Which of the following drugs should be recommended to help
improve this situation the fastest?
A. beclomethasone (Vanceril)
B. albuterol (Proventil)
C. racemic epinephrine (Vaponefrin)
D. cromolyn sodium (Intal)
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18. The physician wants to paralyze an agitated, combative asthmatic patient
who is being mechanically ventilated. Which of the following would the most
appropriate drug to utilize at this time?
A. vecuronium (Norcuron)
B. succinylcholine (Anectine)
C. d-tubocurarine (Curare)
D. midazolam (Versed)
19. The physician is preparing to perform a bronchoscopy on a patient with
suspected lung cancer. The Doctor wants to accomplish conscious sedation
for the procedure. The respiratory therapist should recommend which of the
following medications?
A. midazolam (Versed)
B. vecuronium (Norcuron)
C. succinylcholine (Anectine)
D. pancuronium (Pavulon)
20. An HIV positive patient has been diagnosed with Pneumocystis carinii
pneumonia. Which of the following medications should the respiratory
therapist recommend to treat this pneumonia?
A. pancuronium (Pavulon)
B. gentamicin
C. pentamidine (NebuPent)
D. rifampin (Rifadin)
21. A patient being mechanically ventilated in the asist/control mode and a rate of
12/min is cycling the ventilator at a rate of 34/min. The patient is anxious and
agitated and has the following ABG results:
pH 7.55
PaCO2 25 torr
PaO2 96 torr
HCO3 25 mEq/L
BE +1
Which of the following medications should the respiratory therapist
recommend at this time?
A. albuterol (Proventil)
B. nitroprusside (Nipride)
C. theophyilline (Aminophylline)
D. midazolam (Versed)
133
22. The physician is preparing to perform a bronchoscopy on a patient and wants
to make sure the airway is dry prior to beginning the procedure. Which of the
following drugs shold the respiratory therapist administer to accomplish this?
A. atropine sulfate (Atropisol)
B. midazolam (Versed)
C. albuterol (Proventil)
D. furosemide (Lasix)
23. Following extubation the patient begins experiencing inspiratory stridor and
shortness of breath. The respiratory therapist should recommend
administering which of the following medications?
A. terbutaline (Breathine)
B. metaproterenol sulfate (Alupent)
C. racemic epinephrine (Vaponefrin)
D. ipratropium bromide (Atrovent)
24. A patient is receiving 0.5 ml of albuterol (Proventil) in 2.5 ml of NaCl through
a small-volume nebulizer. The patient’s heart rate increases from 82/min at
the start of the treatment to 128/min half way through the treatment. The
patient is also experiencing tremors. The respiratory therapist should
recommend which of the following at this time?
A. Instruct the patient to breath in deeper breaths.
B. Decrease the dosage of the albuterol.
C. Instruct the patient to breath slower.
D. Recommend changing to Alupent.
25. During a fiberoptic bronchoscopy, the patient’s airway begins to bleed
following tissue biopsy. Which of the following should be instilled down the
bronchoscope to help stop the bleeding?
A. epinephrine
B. xylocaine
C. hypertonic saline
D. isoproteronol
134
Pulmonary Function Testing
1. The FEF 25-75 is measured using which of the following pulmonary function
tests?
A. FRC
B. FVC
C. TLC
D. MVV
2. Which of the following pulmonary function values are increased in patients
with emphysema?
A. FVC
B. FEF 200-1200
C. FRC
D. MVV
3. To best determine an asthmatic’s response to a bronchodilator, which of the
following tests should be performed before and after the use of a
bronchodilator?
A. tidal volume
B. minute volume
C. peak flow
D. maximal inspiratory pressure
4. The respiratory care practitioner explains to the patient at his bedside to take
the deepest breath he can and exhale completely as fast and forcefully as
possible. From this instruction, the practitioner will be able to measure the
patient’s
A. FVC.
B. FRC.
C. MVV
D. tidal volume.
135
5. Below are the results of a patient’s spirometry test before and after a
bronchodilator is administered.
Before
After
FEV1 38% of predicted
55% of predicted
FVC 40% of predicted
59% of predicted
FEV1 / FVC 42%
61%
Which of the following is the correct interpretation of these results?
A. severe restrictive disease with significant bronchodilator response
B. severe obstructive disease with significant bronchodilator response
C. mild restrictive disease with no significant bronchodilator response
D. severe obstructive disease with no significant bronchodilator response
6. Vital capacity is defined as the sum of which of the following?
A. VT + IRV + ERV
B. IRV + RV + FRC
C. IC + ERV
D. VT + FRC + ERV
7. Below are the results of a PFT performed on a 52-year-old male patient.
VC 2.1 L
FRC 1.4 L
TLC 2.8 L
RV .84 L
FEV1%
FEF25-75
Actual Predicted
%Predicted
3.2 L
66%
2.2 L
64%
4.3 L
65%
1.2 L
70%
84%
76%
4.2 L
4.5 L 93%
These results indicate which of the following?
A. obstructive disorder
B. restrictive disorder
C. combined restrictive and obstructive disorder
D. small airway obstruction
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8. Below are PFT values obtained on a 47-year-old female patient.
Actual Predicted
%Predicted
VC 2.24 L
3.5 L
64%
TLC 3.51 L 5.4 L
65%
FEV/FVC
68%
75%
These results are indicative of which of the following?
A. restrictive lung disorder
B. obstructive lung disorder
C. combined restrictive and obstructive lung disorder
D. normal PFT values
9. The following PFT values have been obtained on a 57-year-old male.
Actual Predicted
%Predicted
FEV1 1.4 L 3.0 L
47%
FEV/FVC
48%
70%
VC 2.1 L
3.8 L
55%
TLC 6.4 L
4.8 L
133%
FRC 3.4 L
2.5 L
136%
Which of the following pulmonary disorders is consistent with these findings?
A. pulmonary fibrosis
B. pneumonia
C. atelectasis
D. emphysema
10. Functional residual capacity (FRC) may be measured using which of the
following techniques?
I. helium dilution test
II. simple spirometry
III. nitrogen washout test
A. I only
B. I and III only
C. II and III only
D. I, II and III
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Answer Key
Pulmonary Patient Assessment
1. B 7. B 13. B 19. A 25. A 31. C 37. C
2. C 8. A 14. C 20. C 26. B 32. C 38. B
3. C 9. B 15. A 21. C 27. D 33. D 39. A
4. B 10. B 16. A 22. B 28. B 34. A 40. D
5. A 11. D 17. C 23. D 29. C 35. B 41. B
6. D 12. A 18. D 24. C 30. A 36. B 42. A
43. B 47. B
44. C 48. A.
45. D 49. B
46. D 50. C
Oxygen Therapy
1. B 8. B 15. D 22. B 29. B 36. C
2. C 9. D 16. C 23. B 30. C 37. B
3. C 10. A 17. D 24. B 31. A 38. D
4. D 11. D 18. A 25. C 32. D 39. B
5. C 12. C 19. C 26. B 33. C 40. B
6. B 13. C 20. A 27. C 34. C 41. C
7. C 14. A 21. C 28. D 35. C 42. B
43. D 50. C 57. A 64. A 71. C 78. C
44. A 51. D 58. D 65. D 72. B 79. B
45. A 52. C 59. A 66. C 73. C 80. B
46. C 53. B 60. D 67. A 74. A 81. C
47. D 54. B 61. A 68. A 75. D 82. A
48. B 55. B 62. D 69. B 76. B
49. D 56. B 63. B 70. B 77. C
Humidity and Aerosol Therapy
1. B 7. C 13. A 19. D 25. B 31. D
2. B 8. C 14. D 20. B 26. A
3. C 9. D 15. C 21. D 27. C
4. D 10. D 16. C 22. D 28. A
5. A 11. B 17. B 23. B 29. B
6. A 12. A 18. A 24. B 30. B
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Equipment Decontamination/Infection Control
1. A 8. C 15. C 22. B 29. D 36. B 43. D 50. D
2. C 9. B 16. C 23. A 30. B 37. D 44. D 51. B
3. B 10. C 17. B 24. A 31. A 38. B 45. B 52. C
4. D 11. B 18. D 25. D 32. D 39. A 46. B 53. A
5. B 12. A 19. B 26. C 33. D 40. D 47. C 54. B
6. B 13. A 20. B 27. C 34. C 41. A 48. A 55. D
7. B 14. D 21. C 28. B 35. A 42. D 49. B 56. C
57. B
58. A
59. C
60. D
61. C
62. C
Management of the Airway
1. B 8. B 15. D 22. B 29. B
2. C 9. D 16. C 23. D 30. C
3. B 10. C 17. A 24. D 31. D
4. A 11. A 18. B 25. B 32. D
5. D 12. A 19. B 26. B 33. D
6. A 13. A 20. B 27. B 34. B
7. C 14. D 21. D 28. A 35. B
IPPB/Incentive Spirometry
1. D 8. A 15. B
2. C 9. A 16. B
3. A 10. C 17. B
4. C 11. D 18. C
5. B 12. B
6. C 13. A
7. B 14. B
CPR/Manual Resuscitators
1. C 6. B 11. D 16. A 21. A
2. C 7. D 12. B 17. D 22. C
3. D 8. B 13. D 18. C 23. D
4. A 9. D 14. B 19. B 24. C
5. C 10.B 15. D 20. B 25. D
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ABG Interpretation
1. C 8. B 15. A 22. C 29. B
2. C 9. A 16. D 23. D 30. C
3. A 10. C 17. B 24. B 31. B
4. D 11. C 18. A 25. D 32. B
5. C 12. D 19. B 26. A
6. A 13. B 20. D 27. A
7. B 14. B 21. B 28. C
Ventilator Management
1. C 10. A 19. D 28. B 37. A 46. B 55. A 64. D
2. C 11. D 20. C 29. D 38. B 47. B 56. C 65. B
3. A 12. C 21. C 30. B 39. C 48. B 57. A 66. D
4. C 13. D 22. A 31. B 40. B 49. D 58. B 67. C
5. A 14. D 23. A 32. A 41.C 50. D 59. A 68. D
6. D 15. C 24. B 33. B 42. B 51. A 60. D 69. D
7. B 16. C 25. D 34. D 43. C 52. D 61. C 70. B
8. B 17. C 26. B 35. D 44. A 53. B 62. D 71. C
9. B 18. B 27. C 36. C 45. D 54. A 63. A 72. A
73. C 81. C 89. C
74. B 82. C 90. C
75. A 83. D 91. C
76. C 84. C 92. D
77. D 85. B 93. B
78. A 86. A 94. B
79. D 87. A 95. B
80. D 88. B
Disorders of the Respiratory System
1. B 6. C 11. B 16. D 21. B 26. D 31. A
2. C 7. D 12. C 17. A 22. C 27. B 32. A
3. A 8. D 13. B 18. D 23. D 28. C 33. D
4. D 9. C 14. A 19. C 24. A 29. B 34. B
5. A 10. A 15. C 20. C 25. A 30. D 35. B
Respiratory Medications
1. B 6. B 11. C 16. B 21. D
2. A 7. A 12. A 17. B 22. A
3. D 8. C 13. C 18. A 23. C
4. A 9. B 14. C 19. A 24. B
5. D 10. C 15. D 20. C 25. A
Pulmonary Function Testing
1. B 6. A
2. C 7. B
3. C 8. C
4. A 9. D
5. B 10. B
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