Bundle
BUNDLE FOR TMC EXAM VERIFIED
8 Items
NBRC Mock TMC Exam Review latest 2023 correctly answered
A patient is receiving O2 from an E cylinder at 4 L/min through a nasal cannula. The cylinder pressure is 1900 psig. How long will the cylinder run until i... [Show More] t is empty? A. 47 min B. 1.7 h C. 2.2 h D. 3.6 h E cylinder = 0.28 1900x0.28/4 = 133/60 = 2.21 Answer: C. 2 hours, 21 minutes After the Respiratory Therapist sets up a nonrebreathing mask on a patient at a flow rate of 10 L/min, the reservoir bag collapses before the patient finishes inspiring. The RT should do which of the following? A. Change to a simple mask at a flow rate of 10 L/min B. Remove the one-way valve from the exhalation port. C. Place the patient on continuous positive airway pressure (CPAP) D. Increase the flow rate to 15 L/min D. Increase the flow rate to 15 L/min A patient with carbon monoxide (CO) poisoning can best be treated with which of the following therapies? A. Nasal Cannula at 6 L/min B. Simple O2 mask at 10 L/min C. CPAP and 60% O2 D. Nonrebreathing mask D. Nonrebreathing mask The following blood gas levels have been obtained from a patient using a 60% aerosol mask. pH: 7.47 PaCO2: 31 mmHg PaO2: 58 mmHg What should the RT recommend at this time? A. Place the patient on CPAP B. Increase the O2 to 70% C. Intubate and place the patient on mechanical ventilation D. Change to a nonrebreathing mask A. Place the patient on CPAP Given the following data, what is the patient's total arterial O2 content? pH: 7.41 PaCO2: 37 mmHg PaO2: 88 mmHg HCO3: 26 mEq/L SaO2: 95% Hb: 14 g/dL A. 12 mL/dL B. 14 mL/dL C. 16 mL/dL D. 18 mL/dL (Hb x 1.36 x SaO2) + (0.003 x PaO2) (14 x 1.36 x 0.95) + (0.003 x 88) 18.088 + 0.264 = 18.352 Answer: D. 18 mL/dL The respiratory therapist receives an order to set up a moderate level of O2 on a patient who arrives in the ED breathing at a rate of 35 breaths/min. Which of the following O2 delivery devices is most appropriate to use in this situation? A. Simple O2 mask at 10 L/min B. Nasal cannula at 4 L/min C. NRB Mask at 15 L/min D. Air-entrainment mask at 40% O2 D. Air-entrainment mask at 40% O2 A severe COPD patient arrives in the emergency department on a 2 L/min nasal cannula. Arterial blood gas results follow: pH: 7.32 PaCO2: 67 mmHg PaO2: 62 mmHg HCO3: 38 mEq/L Which of the following is the most appropriate recommendation? A. Increase the liter flow to 4 L/min B. Maintain the current O2 level C. Institute noninvasive positive pressure ventilation (NPPV) D. Place on a NRB mask at 12 L/min B. Maintain the current O2 level The physician has ordered O2 to be set up on a patient who has a spontaneous tidal volume of 500 mL and an inspiratory time of 1 second. Which of the following O2 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. 60% aerosol mask at 12 L/min C. NRB mask at 15 L/min D. Simple O2 mask at 10 L/min 500 mL = 0.5 L 0.5/1 = 0.5 L/s (change L/s to ?/min by multiplying by 60 0.5 L x 60= 30 L/min Select the device that delivers a flow of at least 30L/min A. 35% air-entrainment mask at 6 L/min A patient breathing 50% oxygen has a PaO2 of 248 torr. Which of the following should the RT recommend? A. Discontinue O2 therapy B. Decrease the oxygen to 30% C. Titrate oxygen to maintain an SpO2 > 93% D. Repeat the blood gases because the PaO2 is not possible on this FiO2. C. Titrate oxygen to maintain an SpO2 > 93% Explanation: A PaO2 of 250 torr is normal on 50% O2. Remember, to determine the normal PaO2 on any given O2%, multiply the O2% by 5. This is an approximation. If titrate was not a choice, then you would discontinue the oxygen. A patient is receiving 30% oxygen via an air-entrainment mask at a flow of 5 L/min. The total flow delivered by this device is which of the following? A. 36 L/min B. 45 L/min C. 54 L/min D. 60 L/min (*Use 21 with O2 % less than 40%) (100- 30%)/ (30%-*21) = 70/9 = 8/1 or 8:1 ratio 8+1= 9 9x5 = 45 L/min B. 45 L/min Secretions tend to become thicker if the inspired air has which of the following characteristics? A. A relative humidity of 100% at body temperature B. 32 mg H2O per liter of gas C. A water vapor pressure of 47 mmHg D. 48 mg H2O per liter of gas B. 32 mg H2O per liter of gas A patient receiving 38 mg H2O per liter of gas from a nebulizer has a humidity deficit of which of the following? A. 6 mg/L B. 9 mg/L C. 12 mg/L D. 18 mg/L 44-38= 6 A. 6 mg/L After connecting a nasal cannula to the humidifier outlet, you kink the tubing and hear a whistling noise coming from the humidifier. Which of the following most likely has caused this? A. The humidifier jar is cracked B. The capillary tube in the humidifier is disconnected C. The humidifier has no leaks D. The top of the humidifier is not screwed on tightly C. The humidifier has no leaks You notice that the patient's secretions have become thicker and more difficult to suction since the ventilator humidifier was replaced with an HME. The RT should recommend which of the following? A. Increase inspiratory flow B. Decrease the temperature to the HME C. Replace with a new HME D. Replace the HME with a conventional heated humidifier D. Replace the HME with a conventional heated humidifier [Show Less]
- Exam
- $16.45
- 0
- 241
tmc exam correctly answered rated A
Romazicon (flumazenil) -antidote for benzodiazepines such as -GABA receptor antagonist - It can treat drowsiness caused by sedatives following surgery o... [Show More] r drug overdose. Which of the following can be used to estimate the level of Hemoglobin? RBC -RBC X 3 = hemoglobin with the use of pressure control the most important alarm is low volume -because the ventilator does not care about volume, the practitioner must. The most important alarm on a volume-cycled ventilator would be high pressure alarm Which of the following would be most effective at resolving a humidity deficit for a patient who is intubated with an 8.0-mm endotracheal tube wick or concha Which of the following would be most helpful for a patient with fixed upper airway obstruction? A. beta II agonist medication B. heliox therapy C. aerosolized epinephrine D. corticosteroids B. heliox therapy Heliox therapy is most appropriate. Helium, when combined with oxygen, is less viscous than pure oxygen or room air, which is made up mostly of nitrogen. This allows patients to breathe in gases with less airway resistance. -fixed obstruction means it cannot be resolved simply with bronchodilators or other immediate methods. which one should be treated first, ventilation or oxygenation ventilation the patient is over oxygenating AND hyperventilating which one should you treat first? over oxygenation -To address over-oxygenation one can either change the PEEP or the FIO2. You will always want to lower the FIO2 below 60% before changing PEEP. ways to decrease CO2 increase the Vt increase the rate remove dead space What would occur on a time-cycled ventilator with a fixed rate if the inspiratory flow rate were increased? A. increase in tidal volume B. decrease in inspiratory time C. decrease in tidal volume D. increase in inspiratory time A. increased in tidal volume On a time-cycled ventilator inspiratory time is predetermined. So, if the flow rate is increased while the mandatory rate is unchanged, the result would be an increase in tidal volume. Which of the following is the most significant complication of bronchoscopy? A. laryngospasms B. hypotension C. vagal nerve stimulation D. coughing A. laryngospasm -This tendency may be reduced by administering aerosolized Lidocaine or any other tissue numbing agent prior to the procedure. What is the respiratory therapist observing if monitoring the total amount of gas exhaled in 60 seconds after excluding dead space? A. minute ventilation B. dead space ventilation C. alveolar minute ventilation D. maximum voluntary ventilation c. alveolar minute ventilation Examining the breathing rate over a period of 60 seconds and multiplying it times the tidal volume gives you minute ventilation. If deadspace is subtracted from that volume then what is being observed is alveolar minute ventilation. education and direction for the performance of positive expiratory pressure (PEP) therapy Proper instructions for the use of a PEP therapy device includes "inhaling deeply and exhaling actively". equations to determine cardiac output fick equation co= SVxHR Which of the following would result in an increase in pulmonary capillary wedge pressure? A. decrease in pulmonary vascular resistance (PVR) B. cor pulmonale C. dehydration D. mitral valve stenosis D. mitral valve stenosis If mitral valve stenosis is present, blood would have difficulty transitioning the left ventricle. This would result in a backup pressure occurring and an elevation of the PCWP. A patient is on 70%/30% heliox therapy by nonrebreathing mask. If flowing through an oxygen flow meter, what is the actual flow of the mixture if the flow meter indicates 10 L/min? A. 5 L/min B. 8 L/min C. 18 L/min D. 16 L/min D. 16 When helium-oxygen mixtures are run through flow meters that are intended for oxygen only, the indicated flow on the flow meter is inaccurate. This is because the helium-oxygen mixture is less viscous and does not push the indicator ball up as much as does oxygen. In this case, a correction factor must be used depending upon the mixture percentage. For an 80/20% mixture a correction factor of 1.8 must be used. A 70/30% mixture has a correction factor of 1.6 and a 60/40% mixture has a correction factor of 1.4. In this problem the 70/30% mixture factor of 1.6 must be multiplied by the indicated flow on the oxygen flow meter to calculate actual total gas flow. When we do this we get a total gas flow of 16 L/min. Popping sensations, also referred to as crackling sensations, during palpation of the tissues of the upper chest and neck are related to subcutaneous emphysema, which is a condition of air entering the dermal and subdermal spaces. It is usually caused by a mal-positioned tracheostomy tube. Pulse oximeters are also known as single wavelength spectrophotometers. There are multiple reasons why they may read inaccurately. Those reasons include: high ambient light, the use of fingernail polish, poor peripheral perfusion, and marked hypotension The incidence of ventilator-associated pneumonia, or VAP, is lowered by using a closed system suction catheter, periodically discontinuing sedation, keeping the patient and semi-Fowler's position, and proper handwashing among caregivers Which of the following airway clearance therapies should be administered first in the order of therapy? A. postural drainage and percussion B. nasal tracheal suctioning C. aerosolized Acetylcysteine (Mucomyst) D. verbal coaching for coughing C -aerosolized Acetylcysteine (Mucomyst) the first most logical step would be to thin secretions through use of the medication Mucomyst. The next step, would be postural drainage and percussion followed by verbal coaching for coughing and possibly nasal tracheal suctioning. Digitalis strengthens the contraction of the heart muscle, slows the heart rate, and helps eliminate fluid from body tissues Which of the following is most indicative of a pulmonary embolism? A. increased CVP, decreased PAP B. decreased CVP, decreased cardiac output C. increased PAP, decreased PCWP D. increased PCWP, decreased cardiac output C. increased PAP, decreased PCWP An increased PAP followed by a decreased PCWP indicates that blood is having difficulty flowing through the lung. When we need to raise CO2 there are three choices - decreasing tidal volume, decreasing rate, or adding dead space The use of PEP therapy is contraindicated by epistaxis and a middle ear infection. Paradoxical chest movement is an indication individual ribs are fractured in two or places, which causes the area of the rib cage to move in with inhalation while the rest of the chest moves out. Exosurf CLASS: ARTIFICIAL SURFACTANT IMMATURE NEONATAL LUNGS A left-to-right shunt, due to a leaking septum wall in the heart, is best determined by an increase in mixed venous oxygen saturation. From what location would the respiratory therapist recommend blood extraction for analysis to determine mixed venous oxygen saturation? A. pulmonary artery B. vena cava C. pulmonary vein D. aorta A. pulmonary artery Mixed venous blood, for the assessment of oxygen saturation, is taken from the distal port of the pulmonary artery catheter, or the pulmonary artery [Show Less]
- Exam
- $17.95
- 0
- 126
TMC Respiratory Care Boards Study Guide #1 correctly answered 2023
4 critical life functions 1. Ventilation 2. Oxygenation 3. Circulation 4. Perfusion Findings that indicate patient's fluid intake exceeds urine ... [Show More] output 1. Weight gain 2. Electrolyte imbalance 3. Increased hemodynamic pressures 4. Decreased lung compliance Reading that indicates hypovolemia CVP < 2 mmHg Reading that indicates hypervolemia CVP > 6 mmHg Semicomatose Responds only to painful stimuli Lethargy or somnolence Sleepy Obtunded Drowsy state, may have decreased cough or gag reflex Orthopnea Difficulty breathing in upright position (heart problem, CHF) General malaise Run down feeling, nausea, weakness, fatigue, headache (electrolyte imbalance) Dyspnea Feeling of SOB/difficulty breathing Dysphagia Difficulty swallowing, hoarseness Peripheral edema Pitting edema in arms and ankles Causes of peripheral edema Fluid accumulation from CHF and renal failure Ascites Accumulation of fluid in the abdomen Causes ascites Fluid accumulation from liver failure Clubbing Angling of nail bed of thumbs, first finger and toes Causes of clubbing Effects of chronic hypoxemia on fingers and toes Venous distention Engorged jugular veins during exhalation Causes of venous distention Engorged jugular veins from CHF and COPD Capillary refill Indicates peripheral circulation Diaphoresis Profuse, heavy sweating Causes of diaphoresis Heart failure, fever, infection, anxiety, nervousness, TB Ashen/pallor skin Skin color caused by anemia or blood loss Erythema Redness of skin Causes of erythema Skin colore caused by capillary congestion, inflammation, infection Causes of Cyanosis Skin color caused by hypoxia from increased amount of reduced hemoglobin Kyphosis Convex curvature of spine (lean forward) Scoliosis Lateral curvature of spine (side to side) Eupnea Normal RR, depth, rhythm Causes of tachypnea Hypoxia, fever, pain CNS problems Cheyne-Stokes Gradual increase in RR, then gradual decrease in RR and depth Causes of Cheyne-Stokes Breathing pattern caused by increased ICP, meningitis, narcotic OD Kussmaul's Increased RR, increased depth, irregular rhythm, labored breathing Causes of Kussmaul's Breathing pattern caused by metabolic acidosis, renal failure, diabetic ketoacidosis Normal muscles of ventilation Diaphragm, external intercostals, passive exhalation Accessory muscle used to increase ventilation Intercostal, scalene, sternocleidomastoid, pectoralis major, abdominal muscles (oblique, rectus abdominus) Disease that causes hypertrophy of the accessory muscles COPD effects on accessory muscles Signs of respiratory distress in infants Retractions, nasal flaring Pulsus paradoxus Pulse and blood pressure varies with respirations Causes of tracheal shift toward pathology Atelectasis, pulmonary fibrosis, pneumonectomy, diaphragmatic paralysis Causes of tracheal shift away from pahtology Massive pleural effusion, tension pneumothorax, neck/thyroid tumors, large mediastinal mass Tactile fremitus Vibrations felt by hand on chest wall Resonant percussion note Hollow sound, normal Flat percussion note Heard over sternum, muscles, or areas of atelectasis Dull percussion note Thudding sound heard over fluid filled organs like the heart and liver, pleural effusion, PNA Tympanic percussion note Drum-like sound heard over air filled spaces like stomach. Heard over lungs= air trapping Hyperresonant percussion note Booming sound indicates pneumothorax or emphysema Egophony Patient instructed to say "E", but sound like "A". [Show Less]
- Exam
- $12.45
- 0
- 248
TMC EXAM 2 graded A+ TO Pass!
A patient with CHF has the following input/output history Yesterday Today IN 1900 mL 2100 mL OUT 1000 mL 1100 mL Which of the following clinical fi... [Show More] ndings is most likely to be observed? A. bronchial wheezing B. friction rub C. decreased egophony D. moist crepitant rales The correct answer is : D Explanation : This CHF patient is obviously retaining fluid because he is receiving more fluid in that he is putting out. The clinical finding most associated with fluid retention is moist crepitant rales. Fine rales are associated with atelectasis but moist rales is associated with fluid retention, especially congestive heart failure (CHF). An infant born 24 hours prior is experiencing frequent periods of apnea lasting more than 60 seconds. Which of the following medications would be helpful in stimulating the infant's respiratory drive? A. Aminophylline B. Fluticasone C. hormone D. Exosurf The correct answer is : A Explanation : An infant who experiences apnea periods greater than 60 seconds may need respiratory stimulation. This may be accomplished by administering the medication Aminophylline. Aminophlylline is only intended for ventilatory stimulation in infants. The same medication is used for long-term bronchodilation in adults. A respiratory therapist is having difficulty advancing a suction catheter down a fenestrated tracheostomy tube while the inner cannula is removed. The cannula appears to meet resistance within a few inches from insertion. The therapist should A. remove the tracheostomy tube B. twist the catheter while attempting to advance C. inflate the cuff D. obtain a smaller suction catheter The correct answer is : B Explanation : When suctioning somebody with a fenestrated tracheostomy tube, it must be remembered that the suction catheters can sometimes get stuck on the fenestration hole inside the tube. The best remedy for this is to twist the suction catheter until the end is clear of the hole. The following flow volume loop (loop is tall and skinny) is obtained from a 62-year-old factory worker. Which of the following could represent the patient's diagnosis? A. pulmonary fibrosis B. emphysema C. cystic fibrosis D. chronic bronchitis The correct answer is : A Explanation : The flow volume loop is tall and skinny, indicating normal flows but abnormal volumes. This is consistent with a restrictive lung defect. The best answer is the disease that is restrictive in nature. In this case, only pulmonary fibrosis qualifies. Which of the following should be monitored for a ventilator-dependent newborn with IRDS? A. gas distribution (SBN2) in the lungs B. urine specific gravity C. pH D. fluid input and output The correct answer is : D Explanation : All choices are indicated while monitoring a critically ill neonate receiving mechanical ventilation. I & O fluid monitoring is essential. Managing acid-base balance and the artificial airway are also essential. Which of the following is an important element of instruction to a home care patient who will be receiving continuous oxygen therapy at 2 L/min by nasal cannula? A. check oxygen concentrator flow rate once a week B. run a flow calibration check once monthly C. do not change flow rate without a physician order D. increase flow rate during exercise The correct answer is : C Explanation : When instructing a home care patient on the use of their oxygen concentrator, and using oxygen in general, the respiratory therapist must include those things that are appropriate for the patient. In this question no open flames, use of grounded plugs only, and a restriction on changing the flow rate without a physician order are appropriate instructions. It is inappropriate to ask the patient to check or calibrate the concentrator's flow rate once a week. This sort of maintenance should be done by a respiratory therapist. Which of the following parameters is NOT consistent with weaning from mechanical ventilation? A. A-aDO2 of 320 mmHg B. VT to 500 mL C. VD/VT of 0.50 D. RSBI of 86 The correct answer is : A Explanation : In order to wean from a ventilator, the patient's dead space-tidal volume ratio must be below 60% or .60. The rapid shallow breathing index must be below 106. Spontaneous tidal volume must be greater than 5 mL per kilogram. The alveoli-arterial oxygen difference (A-a gradient) must be less than 300 mmHg. In this case, the dead space-tidal volume ratio is too high and the alveoli-arterial oxygen difference is too wide. These are the two criteria that indicate the patient is not ready to wean from the ventilator. A respiratory therapist is alerted by a low-volume ventilator alarm on a patient who has a chest tube drainage system in place. Set tidal volume is 600 mL while return tidal volume is 190 mL. The therapist should FIRST A. increase tidal volume to compensate B. insert an additional chest tube C. clamp the chest tube near the patient D. disconnect the chest tube from wall suction pressure The correct answer is : C Explanation : A patient who is receiving mechanical ventilation, and has a chest tube drainage system in place, must be monitored carefully for lost volume through the lung through the chest tube drainage system. The clinical evidence of this is found in the return tidal volumes. If the volume administered is far greater than the return volume, volume must be being lost in the system somewhere. A loss of volume may be noticed by the excessive bubbling in the water seal compartment. To determine how it is being lost, the first step would be to clamp the chest tube near the patient. If bubbling in the water seal compartment stops, the volume being lost is most likely coming from a perforation in the lung. The patient requires surgery to repair this. While performing routine oxygen rounds, the respiratory therapist notes a COPD patient who is receiving supplemental oxygen at 2 L/min is markedly cyanotic and has a heart rate of 30/min. The therapist should FIRST A. switch to FIO2 1.0 B. increase flow to 4 L/min by nasal cannula C. obtain an arterial blood gas D. go get help The correct answer is : A Explanation : Even though a COPD patient should rarely receive more than 2 L/min oxygen, there are emergency circumstances that would dictate more supplemental oxygen. The use of the word "markedly" is an indication of an emergency. In this case the patient is markedly cyanotic and therefore has an oxygenation emergency. Switching to 100% oxygen is appropriate. A respiratory therapist notices the cuff pressure on an endotracheal tube is 10 cm H2O. After introducing 10.0 mL of air, the cuff pressure is 5 cm H2O. The patient is receiving positive pressure ventilation. The therapist should recommend A. replacing the ET tube B. clamping the pilot tube C. monitoring the patient D. initiating high frequency jet ventilation The correct answer is : A Explanation : The ET tube cuff that fails to increase in pressure after introducing additional air is most likely damaged. When a part of an ET tube is damaged, the only acceptable option is to replace it. Which of the following laboratory examinations would be helpful in further assessing a patient with diabetic ketoacidosis? A. creatinine B. PD50 C. glucose level D. P50 The correct answer is : C Explanation : A patient with diabetic ketoacidosis primarily has a problem with the blood glucose level. Further assessment therefore can be done by examining the glucose level. What would most likely be indicated by an elevated CVP? A. pulmonary embolism B. fluid overload C. left heart failure D. increased pulmonary vascular resistance The correct answer is : B Explanation : Hypervolemia (fluid overload) is shown hemodynamically by an increase in all hemodynamic values including CVP, PAP, PCWP, and cardiac output. Among these values CVP is the first and most significant indicator when fluid levels in the body are high or low. Remember, CVP may be known by other names such as, right atrial pressure, right side preload, right ventricular filling pressure, and right ventricular end-diastolic pressure. For which of the following conditions is PEP therapy most beneficial? A. Postoperative recovery B. ARDS C. pneumonia D. myasthenia gravis The correct answer is : C Explanation : PEP therapy is beneficial at removing secretions. Of the options given, only pneumonia is a disease where secretions are a primary concern. Which of the following would be most helpful in determining if a patient regularly smokes tobacco products? A. COHb B. end-tidal carbon dioxide C. DLCO D. pulse oximetery The correct answer is : A Explanation : The most reliable data that indicates the degree to which the patient has recently been smoking comes from a COHb analysis. A 32-year-old 81-kg (178-lb) adult male is receiving mechanical ventilatory support. Settings are as follows: Mode Assist/control Mandatory rate 10 Total rate 18 Tidal volume 450 mL FIO2 0.6 PEEP 5 cm H2O The patient is cyanotic and anxious. The respiratory therapist will recommend which of the following? A. decrease mandatory rate B. increase tidal volume C. increase inspiratory flow rate D. increase FIO2 The correct answer is : B Explanation : All of the answers offered indicate a change in the ventilator settings. However, the question shows no evidence of arterial blood gas analysis. This is because a close examination of the ventilator settings will show that there is something wrong. The patient weighs 81 kg which would suggest a minimum tidal volume of 500 mL. (6 x 81 kg = 486 mL). The patient's set tidal volume is only 450 mL. This should be corrected. The following graphic (shows fluttering expiratory flow) from an orally intubated patient receiving mechanical ventilation is most likely caused by A. vocal cord paralysis B. condensate in the tubing C. fixed upper airway obstruction D. PEP therapy The correct answer is : B Explanation : Condensate in the tubing will show up as a fluttering expiratory flow. Which of the following patients would benefit most from an inverse I:E ratio ventilation? A. ARDS B. chronic bronchitis C. kyphoscoliosis D. COPD The correct answer is : A Explanation : An inverse I:E ratio is a term that indicates a longer inspiratory time than expiratory time. The patient with adult respiratory distress syndrom is an example of a patient who can benefit from an inverse I:E ratio. Their lungs are noncompliant and therefore require more inspiratory time to allow for better gas distribution. The respiratory therapist is making a plan of care for a patient with mycoplasma pneumonia who needs assistance with airway clearance of secretions. In which order should therapy be performed? A. coach coughing, bronchodilator, percussion, postural drainage B. postural drainage, percussion, bronchodilator, coach coughing C. percussion, postural drainage, bronchodilator, coach coughing D. bronchodilator, percussion, postural drainage, coach coughing The correct answer is : D Explanation : There is an oder at which procedures should be done to mobilize and remove secretions. The first steps are to open the airway, dislodge the sputum, move dispute into the upper airway, and then remove the sputum through coughing or suctioning. A pulmonary rehabilitation patient is having difficulty complying with a smoking cessation program. A physical and psychological screen reveals a heavy physiological dependence and a low psychological dependence on smoking. Which of the following is appropriate? A. Valium B. psychological counseling C. Versed D. nicotine replacement therapy The correct answer is : D Explanation : A physiological dependence on nicotine can be overcome slowly by having the patient use nicotine replacement therapy. This may include chewing gum with nicotine or transdermal preparations. A 31-week-gestional age infant has a respiratory rate of 30/min and a heart rate of 70/min while breathing room air. Five minutes after birth, the infant is acrocyanotic and has a weak cry. Following suctioning of the oropharynx the respiratory therapist should A. administer Atropine sulfate B. provide manual ventilation with the bag-valve C. begin chest compressions D. place the infant in an oxyhood at FIO2 0.40 The correct answer is : B Explanation : Five minutes after birth this infant is still showing signs of significant respiratory distress. Supporting ventilation with a bag-valve is appropriate. Which of the following equations would determine cardiac index? A. C.O. / ejection fraction B. C.O. / BSA C. C.O. x BSA D. stroke volume x heart rate The correct answer is : B Explanation : Cardiac index can be calculated by dividing the cardiac output by the body surface area. The body surface area is given in units of millimeters squared. Body surface area rarely deviates from about 2 m², regardless of the size of the patient. So essentially, we could take cardiac output and divide it by two to get cardiac index. This can be done even if the body surface area of the patient is unknown. For example, if the cardiac output is 4 L/min, the cardiac index is about 2. Conversely, if cardiac index is 1.8, cardiac output could be estimated to be 3.6 L/min. What is the primary purpose for a nitrogen washout test? A. determine closing volume B. determine FRC C. evaluate evenness of pulmonary gas distribution D. directly measure TLC The correct answer is : B Explanation : A nitrogen washout test is used to determine three different lung volumes: TLC, RV, and FRC. For the NBCR exam the most important of those volumes is the FRC. Thus, when asked what a nitrogen washout test is for (or helium dilution test), the correct answer is FRC. While transporting a patient from a helicopter landing pad to the emergency department (ED), the respiratory therapist notices the ET tube has become unsecured. To best confirm to location of the ET tube, the therapist should recommend A. observe chest rise B. palpate the trachea C. chest radiograph D. auscultate breath sounds The correct answer is : C Explanation : One may quickly determine the location of an endotracheal tube by observing chest rise and auscultating breath sounds. However, neither of these methods are conclusive. The only way to confirm proper placement is through a chest x-ray. A patient receives postural drainage and percussion. During the treatment, the patient develops rhonchi. The respiratory therapist should NEXT A. administer an IPPB treatment B. perform nasal tracheal suctioning C. discontinue treatment D. switch to PEP therapy The correct answer is : B Explanation : The development of rhonchi during postural drainage and percussion is an indication that the therapy is working - is mobilizing secretions effectively and moving them upward where they can be expectorated or suctioned. A respiratory therapist is preparing for defibrillation on a patient with pulseless ventricular tachycardia. Which of the following should NOT be part of that preparation? A. set the defibrillator to deliver 360 joules B. prepare to administer supplemental oxygen C. set up for manual ventilation with a bag/valve D. set the defibrillator's synchronization to ON The correct answer is : D Explanation : Pulseless ventricular tachycardia should be treated with defibrillation. When defibrillating a deadly cardiac rhythm, the synchronization setting on the defibrillator should be set to "off". A 62-year-old male has ventricular tachycardia. The patient is not alert and will not respond to verbal stimuli. A pulse is palpable. The respiratory therapist will respond by A. administering methyl prednisone, IV B. administering Isuprel (Isoproterenol) C. defibrillating the patient D. performing cardioversion The correct answer is : D Explanation : The treatment for ventricular tachycardia without a pulse is defibrillation at 300-360 W. Cardioversion, however, is used with atrial arrhythmias and ventricular tachycardia where there is a pulse present. A patient shows signs of hypoxemia while on a heated aerosol set at 40% with the flow rate set to 8 L/min. The patient's minute ventilation is 38.0 L. Which of the following changes should be made? A. decrease FIO2 to 28%, maintain flow rate B. increase FIO2 to 0.5, maintain flow rate C. increase to FIO2 to 1.0 with a flow rate to 15 L/min D. increase flow rate to 10 L/min The correct answer is : D Explanation : This question requires one to recognize that the flow rate is not meeting the patient's ventilatory demand. It requires a little math to determine how much total flow the patient is receiving. In this case the ratio for 40% is 3:1. If you add 3+1, you get 4. Then, if you multiply 4 times 8 L/min. you get a total flow of 32 L per minute. The patient's reported minute ventilation is 38 L per minute. This would cause the patient to entrain extra air and would ultimately lower FIO2, resulting in an increase in hypoxemia. The respiratory therapist should respond to the following graph (wave form shows a sudden fall to Zero end-tidal CO2) by checking for which of the following? A. disconnection in the patient-ventilator interface B. poor alveolar perfusion C. hypercarbia D. hypercapnia The correct answer is : A Explanation : The capnograph wave form shows a sudden fall to Zero end-tidal CO2. This is most likely caused from a disconnection of the ventilator circuit. Which of the following is considered subjective information? A. dyspnea B. breath sounds C. chest movement symmetry D. vital capacity The correct answer is : A Explanation : Subjective information are those data that must be reported by the patient. This kind of data is also known as symptoms. Data that can be observed independent of the patient's input is known as objective information, otherwise called signs. Of the options here, dyspnea must be reported by the patient and therefore is the only subjective information offered. Which of the following transdermal nicotine preparations might the respiratory therapist recommend to help a patient stop smoking? A. gum B. patch C. MDI D. spray The correct answer is : B Explanation : The question is asking for a transdermal nicotine preparation. "Transdermal" means "through-the-skin". A patch is the appropriate preparation were looking for. Which of the following most effectively makes up the humidity deficit for a patient who is orally intubated and receiving mechanical ventilation? A. bubble humidifier B. heated humidity C. HME D. centrifugal nebulizer The correct answer is : B Explanation : A patient who is intubated cannot provide 100% humidity to their lungs because the ET tube bypasses the natural humidification processes of the body. In such case a humidification device is needed to make up the entire humidity deficit. Of the devices listed in the options, only a heated humidifier can accomplish this. A bubble humidifier is used with a nasal cannula and an HME device does not provide sufficient humidity. A centrifugal nebulizer is not used in conjunction with a mechanical ventilator. A pulmonary function study reveals a forced vital capacity (FVC) that is greater than a slow vital capacity (SVC). To which of the following can this be attributed? A. partial diaphragmatic paralysis B. poor patient effort on the SVC maneuver C. chronic air-trapping D. excessive effort on the FVC maneuver The correct answer is : B Explanation : When the patient exhales slowly they are able to breathe out more air than if they were to exhale quickly. For this reason, and FVC should always be less than an SVC. If FVC is noted to be higher than the SVC, this is clear evidence that the patient's effort during the SVC maneuver was poor or insufficient. Arterial blood gases on a patient in the cardiac intensive care unit are as follows: pH 7.31 PaCO2 50 mmHg PaO2 81 mmHg HCO3- 24 mEq/L BE 0 mEq/L Which of the following represents an accurate interpretation of these results? A. respiratory acidosis with no hypoxemia B. partially compensated metabolic acidosis C. metabolic acidosis D. left ventricular heart failure The correct answer is : A Explanation : A CO2 of 50 mmHg is above its normal range and therefore presents acidosis. A quick glance at the pH shows no compensation. Therefore respiratory acidosis is present. Further, the patient's PO2 is normal so hypoxemia is not present. The correct interpretation is respiratory acidosis with no hypoxemia. A written teaching plan for a pediatric patient with chronic asthma should include A. proper titration of bronchodilator dosage B. titration of oxygen C. PEFR monitoring and proper MDI use D. determination of oxygen saturation The correct answer is : C Explanation : Monitoring one's peak flow, using a metered-dose inhaler correctly, and learning to detect early symptoms of oncoming bronchoconstriction are all important aspects of a teaching plan for a pediatric asthma patient. A patient should never be encouraged or instructed to adjust their prescribed frequency for any type of therapy by the respiratory therapist. Which of the following parameters could be used to calculate tidal volume? A. PetCO2 and alveolar ventilation B. minute ventilation and alveolar ventilation C. minute ventilation and respiratory rate D. PECO2 and VD/VT The correct answer is : C Explanation : If you take a minute ventilation and divide it by the respiratory rate you get tidal volume. While running quality control material through a blood gas analyzer, the therapist notes that 4 consecutive data points are beyond 2 SD from the mean. The therapist will A. monitor the machine closely for several days B. report the problem to the medical director C. remove the machine from service D. continue running quality control material until corrected The correct answer is : C Explanation : When monitoring the quality control data for an arterial blood gas machine the points on the graph, which show the actual values of the quality control material, should be between the upper control limit and the lower control limit (two standard deviations above and below the mean for a total of a 4 standard deviation range). In this case there are several consecutive points that are beyond the two standard deviations and therefore the machine is considered out of control and should not be placed in service but removed. Blood gases should not be run on that machine until the problem has been resolved. More importantly, blood gas data should not be reported as part of the patient's medical record because they are likely inaccurate. A patient with a history of asthma reports to the emergency department after self-treating bronchoconstriction for the past 3 days. Periodic relief has been achieved but the patient is in current distress and is wheezing bilaterally. Which of the following treatment actions would be most appropriate? A. sildenafil, IV B. administer Sublimaze, PO C. full pulmonary function testing with DLCO measurement D. continuous aerosolized bronchodilator at 7 mg/hr The correct answer is : D Explanation : The patient shown in this question obviously demonstrates lack of response to bronchodilator therapy. Of the options offer, IV methylprednisolone and continuous aerosolized bronchodilators are appropriate. Quality control data for an arterial blood gas analyzer is plotted on a graph that has a range of 4 standard deviations (2 SD up and 2 SD down). Points on the graph show a gradual rise from below the mean to above the mean. All points are within 2 SD of the mean. The respiratory supervisor should A. replace the electrodes B. remove this machine from service C. monitor this machine closely D. call the medical director for direction The correct answer is : C Explanation : Because all points on the blood gas graphs are within two standard deviations of the mean, the blood gas machine is technically in control. But the use of the word gradual rise means that there is a trend upward. Whenever there's a trend you need to monitor that machine because the trend may ultimately rise above the two standard deviations. You do not need to remove the machine from service or perform any kind of maintenance when a trend is observed - only monitor. A 75-kg (165-lb) male is receiving mechanical ventilation by a volume-controlled ventilator in the assist/control mode on the following settings: Mandatory rate 12/min VT 500 mL FIO2 0.6 PEEP 8 cm H2O Arterial blood gas results: pH 7.30 PaCO2 52 mm Hg PO2 65 mm Hg HCO3- 27 mEq/L BE +3 mEq/L Which of the following represents the most appropriate action? A. increase rate to 14 B. increase tidal volume to 600 mL C. increase PEEP to 10 cmH2O D. increase FIO2 to 1.0 The correct answer is : A Explanation : Arterial blood gases show the patient is not ventilating and is under oxygenating. Because ventilation should be corrected first it is appropriate to either increase the tidal volume or increase the rate. In this case the PaCO2 is off by more than 4 mmHg and therefore should be addressed only with an increase in rate. The following pulmonary function data is obtained from a 65-year-old adult male who is 5 ft 2 in (157-cm) tall and weighs 120-lbs (55-kg). Percent (%) of Predicted SVC 75 FVC 72 FEV1.0 39 FEF25-75 52 FEF200-1200 76 DLCO 89 Which of the following most accurately represents the patient's condition? A. moderate obstructive defect B. normal spirometry C. severe restrictive defect only D. mild restriction with severe obstructive defect The correct answer is : D Explanation : A slow vital capacity of 75% indicates a mild restriction. An FEV1 of 39% of predicted indicates a severe obstruction. A patient receiving volume-controlled ventilation has a balloon-tipped pulmonary artery catheter in place. The respiratory therapist notices the PA waveform is ascending and descending with inflection points at 25 and 2 mmHg. Based on this information, the therapist should recommend A. advancing the catheter B. monitoring the patient closely C. rotating the catheter D. deflating the catheter balloon The correct answer is : A Explanation : The pulmonary artery catheter waveform that has a high inflection point of 25 and a low inflection point of 0-2 mmHg is an indication that the tip of the catheter is in the right ventricle of the heart. The proper placement of this catheter is in the pulmonary artery. Therefore, advancing the catheter is indicated. This is done by inflating the balloon and allowing the catheter to sail into a proper position in the pulmonary artery. A patient is receiving volume-controlled mechanical ventilation. Which of the following adjustments are appropriate to reduce autoPEEP? A. increase inspiratory flow rate B. decrease expiratory time C. increase tidal volume D. increase PEEP The correct answer is : A Explanation : To reduce autoPEEP, expiratory time must be increased. This may be done by decreasing inspiratory time, which is accomplished by increasing inspiratory flow rate. A respiratory therapist is measuring the gas volume from a patient who exhales maximally after inhaling to inspiratory reserve volume. Which of the following volumes is the respiratory therapist attempting to observe? A. inspiratory reserve volume B. expiratory reserve volume C. total lung capacity D. vital capacity The correct answer is : D Explanation : The volume exhaled maximally after a maximum inhalation is called vital capacity. Which of the following is needed to calculate minute alveolar ventilation? A. PAO2 and tidal volume B. VD/VT and PAO2 C. tidal volume, weight, respiratory rate D. C(a-v)O2 and VT The correct answer is : C Explanation : There are three items you need to calculate a patient's minute alveolar ventilation- tidal volume, respiratory rate, and the patient's weight in pounds. If the tidal volume is not given you may need to calculate the tidal volume by looking at minute ventilation and dividing it by the rate first. A 30-weeks of gestation infant is receiving mechanical ventilatory support with a time-cycled, pressure limited ventilator at the following settings: PIP 35 cm H2O Rate 28 FIO2 0.4 PEEP 4 cm H2O I-time 0.75 sec The respiratory therapist notices the pressure manometer is not rising to the set pressure during each inspiration. Which of the following is the mostly likely cause? A. internal flow rate is too high B. rate is insufficient C. set pressure exceeds the pressure capability of the ventilator D. the pressure-limiting pop-off valve is set to low The correct answer is : D Explanation : When the pressure manometer is not rising to the set pressure, the cause may be one of two sources. First, the problem may be that the operational flow in the ventilator is too low. Next, there is a possibility the pressure-limiting pop off valve is set too low. This is the most likely answer, of the options given. A patient with a history of hyper-reactive airway disease is having difficulty expectorating because the sputum is thick and tenacious. Which of the following medications should the respiratory therapist recommend? A. Solu-Mederol B. Beclamethasone (Beclovent) C. Acetylcysteine (mucomyst) D. Spiriva (tiotropium bromide) The correct answer is : C Explanation : Hyperactive airway disease is associated with diseases such as asthma and consist of bronchoconstriction and inflammation. This patient appears to have difficulty with bronchoconstriction and thick secretions. Therefore, a mucolytic, such as acetylcysteine, and Solu-Medrol are appropriate. A physician has ordered administration of 80% / 20% heliox therapy to a spontaneously breathing patient. Which of the following gas delivery devices should the respiratory therapist plan on using? A. air-entrainment mask B. simple mask C. nasal cannula D. nonrebreathing mask The correct answer is : D Explanation : The proper modality to administer Heliox therapy is a non-rebreathing mask. An infant is delivered and has a one-minute APGAR score of 5. The infant is placed on the radiant warmer. What other equipment would be most helpful at this time? A. non-rebreathing mask B. croup tent C. nasal cannula D. oxygen hood The correct answer is : D Explanation : From examining Apgar scores one can determine the best therapy for the patient. An Apgar score of 1 to 3 requires CPR. An Apgar score of 4 to 6 necessitates supplemental oxygen and general stimulation. An Apgar score of 7 to 10 requires only routine care of the infant. No supplemental oxygen is required in this case, one must know that an oxygen hood is the most desirable method to deliver supplemental oxygen to the patient who has an Apgar score of five. [Show Less]
- Exam
- $27.45
- 0
- 175
TMC Exam C correctly answered latest 2023
a. manual dexterity The respiratory therapist should evaluate which of the following to develop a teaching plan for a patient who will be using a small vo... [Show More] lume nebulizer at home? a. manual dexterity b. highest grade level achieved in school c. spousal support d. English speaking proficiency d. bronchoscopy Which of the following would be most beneficial in resolving microatelectasis? a. chest tubes b. percutaneous ventilation c. thoracentesis d. bronchoscopy b. oropharyngeal airway A 45 year-old patient is recovering in the intensive care unit after undergoing a surgical procedure to repair a hernia. The patient remains unconscious. To prevent soft tissue obstruction, the respiratory therapist should recommend a(n) a. double-lumen endobronchial tube b. oropharyngeal airway c. bite block d. nasopharyngeal airway d. Run 2 only Quality control material has published values for pH of 7.20, PO2 of 65 mmHg. Documentation indicates the range of pH is 0.5% and is 3% for PO2. Machine results are as follows: Run 1: pH 7.19, PO2 64 Run 2: pH 7.10, PO2 69 Run 3: pH 7.21, PO2 65 Which quality control run(s) indicate the machine is out of control? a. Run 1 and 2 b. Run 2 and 3 c. Run 3 only d. Run 2 only a. ABG and alveolar oxygen tension A respiratory therapist is considering a patient's readiness to wean from mechanical ventilation. To determine the A-aDO2, the therapist will need which of the following? a. ABG and alveolar oxygen tension b. VD/VT and PAO2 c. CaO2 and PAO2 d. VD/VT and ABG c. heliox therapy A patient with increased airway resistance from a fixed upper airway obstruction would benefit most from which of the following? a. bronchodilator therapy b. epinephrine c. heliox therapy d. aerosolized atropine d. inspiratory muscle strength Evaluating MIP (maximum inspiratory pressure) is most useful in evaluating which of the following? a. presence of a restrictive pulmonary defect b. effectiveness of cough c. presence of obstructive pulmonary defect d. inspiratory muscle strength b. excess water in the tubing An air-entrainment jet nebulizer is set at 50%. The respiratory therapist analyzes the oxygen coming from the end of the tubing and finds it is 60%. Which of the following most likely explains this finding? a. poorly calibrate analyzer b. excess water in the tubing c. low flow through the jet orifice d. leak in the tubing a. examine the ventilator circuit for proper connections During a preoperational test of the ventilator with a test lung, the respiratory therapist notes a return tidal volume of 600 cc. Ventilator settings are: Mode: Assist/control FiO2: 0.50 Mandatory rate: 10 VT: 750 mL What action should the therapist take? a. examine the ventilator circuit for proper connections b. obtain a larger test lung c. increase the set tidal volume to 900 mL d. obtain a smaller test lung d. change the fuel cell During the preoperational test of the ventilator, the respiratory therapist notices the galvanic analyzer on the ventilator is reading erroneously low. Which of the following can the respiratory therapist do to correct the problem? a. replace the analyzer batteries b. replace the electrolyte solution in the analyzer c. tag the ventilator as non-functional and avoid placing it in service d. change the fuel cell b. poor hand washing among staff Which of the following is most likely to increase nosocomial infection in a hospital? a. use of an HME for 48 hours b. poor hand washing among staff c. frequent disconnection in the ventilator circuit d. use of alcohol-based hand cleaners b. disconnected thermistor line While monitoring a patient receiving mechanical ventilation, the respiratory therapist notices the low-pressure and low exhaled volume alarms are sounding. Which of the following could be the cause? a. kinked endotracheal tube b. disconnected thermistor line c. excess water in the inspiratory limb of the circuit d. herniated endotracheal tube cuff a. a fracture in the plastic wye A patient receiving positive pressure ventilation has a low-pressure alarm sounding. Which of the following could be the cause? a. a fracture in the plastic wye b. herniated cuff c. excess secretions in the airway d. kinked ET tube a. provide manual ventilation The high pressure alarm is sounding on a patient receiving volume controlled ventilation. The respiratory therapist should FIRST a. provide manual ventilation b. suction the patient c. observe the alarm panel to determine source d. cancel the alarm d. Anectine (succinylcholine chloride) Which of the following medications is shown to have sufficient affect when facial muscle twitching is observed? a. Halcion b. Curare (d-turbo curare) c. Romazicon d. Anectine (succinylcholine chloride) d. respirometer A respiratory therapist is preparing to measure SVC on a patient in the emergency department. Which of the following equipment is required? a. Collins water-seal spirometer b. Geissler tube c. Wheatstone bridge d. respirometer b. pressure manometer A respiratory therapist is asked to determine a patient's inspiratory muscle strength. Which of the following equipment is required for this evaluation? a. Fleisch pneumotrachometer b. pressure manometer c. respirometer d. peak flow meter b. peak flow meter A respiratory therapist is ordered to do a bedside assessment of the effectiveness of a bronchodilator on a patient with an acute asthmatic episode. Which of the following equipment will be needed to perform this evaluation? a. maximum inspiratory pressure manometer b. peak flow meter c. Collins water-seal spirometer d. respirometer a. 25/8 mmHg Which of the following pressures is most consistent with a normal pulmonary artery pressure (PAP)? a. 25/8 mmHg b. 12/8 mmHg c. 120/80 mmHg d. 25/4 mmHg d. change to an 80%/20% heliox mixture A patient receiving heliox therapy at 70%/30% mixture by non-rebreathing mask has the following arterial blood gas results: pH 7.35 / PaCO2 45 / PaO2 110 / HCO3 24 / BE 0 Which of the following actions is appropriate? a. change to a heliox mixture of 60%/40% b. discontinue heliox therapy c. switch to a partial rebreathing mask d. change to an 80%/20% heliox mixture c. use an air-entrainment mask set at 28% A COPD patient complains of shortness of breath while exercising with a 2 L/min nasal cannula. During exercise, SPO2 is noted to fall to 84%. Which of the following would be most helpful to the patient during exercise? a. decrease flow to 1 L/min nasal cannula b. avoid exercising c. use an air-entrainment mask set at 28% d. use a non-rebreathing mask a. place the patient on a non-rebreathing mask A patient in the emergency room is receiving oxygen by nasal cannula at 3 L/min. Blood gases reveal the following: pH 7.53 / PaCO2 30 / PaO2 51 / HCO3 23 / BE -1 The respiratory therapist should immediately a. place the patient on a non-rebreathing mask b. decrease flow to 1 L/min c. increase flow to 5 L/min d. place the patient on a Venturi mask at 40% d. increase PEEP to 22 cmH2O An 80-kg (176-lb) female patient is receiving mechanical ventilation on the following settings: Mode: assist/control Mandatory rate: 14/min Total rate: 14/min VT: 550 mL FiO2: 0.60 PEEP: 20 cmH2O ABG: pH 7.38 / PaCO2 42 / PaO2 62 / HCO3 26 / BE +2 The respiratory therapist should a. increase the FIO2 to 0.7 b. order a chest radiograph c. increase FiO2 to 1.0 d. increase PEEP to 22 cmH2O b. increase flow to 15 L/min A patient is showing signs of respiratory distress with a respiratory rate to 30/min and a spontaneous tidal volume of 800 mL. The patient is receiving oxygen at 60% by large volume nebulizer with the flow set at 10 L/min. The respiratory therapist should suggest to a. increase FiO2 to 1.0 and the flow to 15 L/min b. increase flow to 15 L/min c. sedate the patient d. decrease the FiO2 to 0.50 d. decrease inspiratory time The physician orders a change in I:E ratio from 1:2 to 1:4 for a COPD patient receiving volume-cycled mechanical ventilation. Which of the following accommodates the physician's request if the mandatory rate is not changed? a. increase the inspiratory time b. decrease the inspiratory flow rate c. decrease expiratory time d. decrease inspiratory time a. autoPEEP For a patient receiving volume-controlled ventilation in the assist/control mode, the starting of the inhalation cycle before the expiratory flow rate returns to zero would result in which of the following? a. autoPEEP b. atelectasis c. alveolar collapse d. decreased FRC c. epinephrine While assisting a physician during a bronchoscopy procedure, the therapist notices bright red blood in the specimen tube. The therapist should prepare which of the following NEXT? a. Heparin b. atropine c. epinephrine d. cold normal saline d. Bodai adapter A respiratory therapist is asked to assist a physician with a bronchoscopy procedure on a patient who is ventilator dependent and requires high levels of PEEP. Which of the following equipment should be used? a. closed in-line suction catheter b. manual PEEP valve c. Magill forceps d. Bodai adapter b. reduce future treatment dosage to 0.25 mL A patient receiving 0.5 mL Albuterol by small volume nebulizer complains of tingling fingers, nervousness, and heart palpitations. The therapist should a. decrease dosage to 0.15 mL b. reduce future treatment dosage to 0.25 mL c. have the patient pause at the top of each breath d. instruct the patient in performing shallow inspirations a. cancerous mass in the lung For which of the following is the respiratory therapist observing if obtaining a series of oblique chest radiographs? a. cancerous mass in the lung b. pneumonia c. pneumothorax d. pleural effusion d. mass in the left lobe A spiral CT scan would be most helpful in evaluating which of the following? a. atelectasis b. asbestosis c. pneumonia d. mass in the left lobe [Show Less]
- Exam
- $17.45
- 0
- 175
TMC Practice Exam A + B latest 2023 correctly answered
A 52 year-old post-operative cholecystectomy patient's breath sounds become more coarse upon completion of postural drainage with percussion. The respirato... [Show More] ry therapist should recommend: A. Continuing the therapy until breath sounds improve. B. administering dornase alpha. C. administering albuterol therapy. D. deep breathing and coughing to clear secretions. D. deep breathing and coughing to clear secretions. See Patient Assessment A healthy adult female can exhale what portion of her forced vital capacity in the first second? 70% Following cardiac surgery, a 55 year-old patient has the following ABG results: pH 7.50, PaCO2 30 torr, PaO2 62 torr, HCO3 25 mEq/L, SaO2 92%, HB 14 g/dL, BE +2. Venous blood gas results are pH 7.39, PvCO2 43 torr, PvO2 37 torr, and SvO2 66%. Calculate the patient's C(a-v)O2. 5% volume What value for the apnea-hypopnea index (AHI) is consistent with mild obstructive sleep apnea? 5 to 15 The respiratory therapist is asked to evaluate the presence of Auto-PEEP on a patient receiving mechanical ventilation. In order to do this, what should the RT do? Initiate an expiratory hold just prior to the next ventilator-delivered breath What do bronchial breath sounds heard over the lung periphery indicate? lung consolidation (pneumonia) Rationale: should be vesicular in periphery A 60 kg (132 lb) patient is mechanically ventilated at the following settings: VC, A/C; VT 500 mL, respiratory rate 12/min, FIO2 1.00 and 10 cm H2O PEEP. The patient's peak airway pressure is 60 cm H2O and his SpO2 is 85%. A current chest x-ray shows diffuse bilateral infiltrates. Which of the following is the most appropriate action in order to reduce peak airway pressure? A. Increase the frequency. B. Change to airway pressure release ventilation. C. Decrease the inspiratory time. D. Increase PEEP to 15 cm H2O. B. Change to airway pressure release ventilation. A 19-year-old patient is brought to the Emergency Department after taking a handful of pills. The patient is obtunded but is making regular, sonorous respiratory efforts. Auscultation reveals coarse rhonchi bilaterally. Which of the following should be done FIRST to assess this patient? A. Obtain a sputum specimen. B. Obtain an ABG. C. Measure peak expiratory flow. D. Determine the Glasgow Coma Score. B. Obtain an ABG. A young healthy adult with complaints of intermittent wheezing is seen in the pulmonary clinic. A pre/post bronchodilator spirometry reveals a normal study with no reversibility. Which of the following should the respiratory therapist recommend? A. Helium dilution study B. DLCO C. Plethysmography D. Bronchial provocation D. Bronchial provocation Following abdominal surgery, a 70 year-old patient receives mechanical ventilation in the ICU at the following settings: VC, A/C; VT 550 mL, respiratory rate 14/min, FIO2 0.50 and 10 cm H2O PEEP. Bedside monitoring results demonstrate that the PvO2 is 35 torr and the SpO2 is 90%. The patient is alert and oriented with stable vital signs. Which of the following should the respiratory therapist recommend? A. Decrease the PEEP. B. Increase the FIO2. C. Initiation diuretic therapy. D. Continue to monitor closely. B. Increase the FIO2. The respiratory therapist obtains a blood gas sample from the patient's radial artery and applies pressure to the site for 10 minutes. After removing any excess air from the syringe, the next step for proper handling of the blood sample is: A. adding liquid heparin to the sample. B. placing the syringe in an ice bath. C. shaking the sample continuously. D. applying a pressure bandage. B. placing the syringe in an ice bath. Rationale: it's been over 10 mins and the sample will continue to metabolize/eat up O2 otherwise A 72 year-old female post stem cell transplant patient in the ICU complains of difficulty breathing and is noted to have diffuse fluffy infiltrates on chest X-ray. The B-type Natriuretic Peptide (BNP) test result demonstrates 700 pg/mL. What is the patient's possible condition? A. Severe heart failure B. Respiratory distress syndrome C. Severe renal failure D. Moderate heart failure D. Moderate heart failure Which of the following values for arterial carbon dioxide tension is consistent with significant alveolar hypoventilation? 50 torr A patient has mild stridor immediately after extubation. This finding is most often associated with: A. lower airway obstruction. B. secretions in the large airways. C. upper airway obstruction. D. bronchial spasm. C. upper airway obstruction. A 60 kg (132 lb) female patient with congestive heart failure receives NPPV with an IPAP of 16 cm H2O, EPAP of 10 cm H2O, and FIO2 of 0.70. Available laboratory data includes: pH 7.40, PaCO2 42 torr; PaO2 145 torr; HCO3 26 mEq/L, SaO2 99%, CVP 10 cm H2O. Breath sounds reveal a few fine bibasilar crackles. This situation should be described as: A. shunting. B. hypoventilation. C. hyperoxygenation. D. fluid overload. C. hyperoxygenation. A mechanically ventilated patient with a tracheostomy tube is on the following settings:PC, SIMV, PIP 30 cm H2O, f 20/min, FIO2 0.60, PEEP 5 cm H2O. The ventilator alarm suddenly begins to sound and on quick examination, the respiratory therapist notices a generalized decrease in breath sounds and a reduction in delivered tidal volume from 650 mL to 500 mL. Which of the following conditions is most likely? A. The patient has been disconnected. B. Complete obstruction of the tracheostomy tube. C. Development of a left-sided pneumothorax. D. Partial obstruction of the tracheostomy tube. D. Partial obstruction of the tracheostomy tube [Show Less]
- Exam
- $13.45
- 0
- 149
TMC Practice Exam B Kettering questions correctly answered latest 2023
After a patient undergoes a thoracentesis, the respiratory therapist notes that the obtained pleural fluid is clear with a slight straw color. This fluid i... [Show More] s most likely the result of A. empyema. B. congestive heart failure. C. lung carcinoma. D. hemothorax. B. congestive heart failure. Which of the following would be most important to evaluate for a patient who is entering a smoking cessation program? A. Height B. Smoking history C. Weight D. Diet B. Smoking history The respiratory therapist is calibrating a spirometer and checking the volume with a 3.0 liter super syringe. The volumes recorded are: 2.85 L, 2.8 L, and 2.8 L. Based upon the information obtained which of the following is a correct statement? A. Another syringe needs to be used B. Spirometer is accurate C. The plunger was advanced too slowly D. Spirometer may have a leak D. Spirometer may have a leak Which of the following is an indication for high frequency jet ventilation? A. Bronchopleural fistula B. Wilson Mikity syndrome C. Necrotizing lesion of right lung D. Centrilobular emphysema A. Bronchopleural fistula A 43-year-old female patient has just undergone a total abdominal hysterectomy. The patient arrives in the post anesthesia care unit obtunded with minimal response to painful stimulus. What treatment should the respiratory therapist recommend for this patient? A. Initiate assisted ventilation B. Insert oropharyngeal airway C. Obtain positron emission tomography D. Initiate noninvasive capnography B. Insert oropharyngeal airway A 44 week gestational age infant has just been delivered via C-section and is gasping, grunting, and has tachycardia and tachypnea. At one minute his Apgar score is 4 and at 5 minutes the score is 5. The infant is most likely suffering from A. transient tachypnea of the newborn. B. meconium aspiration. C. bronchopulmonary dysplasia. D. apnea of prematurity. B. meconium aspiration. What is the normal VD/VT ratio for a patient breathing room air? A. 5 - 15% B. 20 - 40% C. 45 - 55% D. 65 - 75% B. 20 - 40% A heat moisture exchanger is indicated for humidification in which of the following situations? A. Mechanical ventilation in a long-term care facility. B. Transport to a tertiary care center. C. Patient with tenacious secretions. D. Delivery of aerosolized bronchodilators. B. Transport to a tertiary care center. All of the following could cause a patient's right-hemidiaphragm to be elevated, EXCEPT A. right lower lobe atelectasis. B. right side hyperlucency, absent vascular markings. C. hepatomegaly. D. right lower lobe consolidation with air bronchograms. B. right side hyperlucency, absent vascular markings A 64-year-old, 70 kg (154 lb) man with severe COPD is receiving independent (differential) lung ventilation following thoracotomy and right lower lobectomy. Which of the following setting combinations would be most appropriate for this patient? A. Right lung 50 mL; left lung 650 mL B. Right lung 150 mL; left lung 550 mL C. Right lung 350 mL; left lung 350 mL D. Right lung 550 mL; left lung 150 mL B. Right lung 150 mL; left lung 550 mL A patient in the intensive care unit has the following hemodynamic measurements: CVP (mm Hg) 5 PAP (mm Hg) 29/8 PCWP (mm Hg) 8 BP (mm Hg) 130/70 Cardiac output (L/min) 5.1 Cardiac index (L/min/m2) 2.7 What is the pulse pressure? A. 15 mm Hg B. 21 mm Hg C. 60 mm Hg D. 90 mm Hg C. 60 mm Hg A 2-year-old child with croup has been intubated for 4 days with a 4 mm ID uncuffed endotracheal tube. Heated aerosol at an FIO2 of 0.30 has been delivered to the patient. The physician asks the respiratory therapist to evaluate the patient for possible extubation. Which of the following would most likely indicate that the patient is ready for extubation? A. The patient is making normal quiet ventilatory efforts. B. A negative sputum culture and sensitivity has been reported. C. The patient's ABG are within normal range. D. Breath sounds are heard around the tube on auscultation. D. Breath sounds are heard around the tube on auscultation. A patient is seen in the Emergency Department for complaints of nausea and vomiting. A nasogastric tube has been inserted and the patient is started on lasix. Which of the following should the respiratory therapist monitor? A. Cardiac enzymes B. Serum electrolytes C. Arterial blood gases D. Cell hydration level B. Serum electrolytes While instructing a patient prior to a vital capacity maneuver, the respiratory therapist should direct the patient to A. exhale to residual volume and inhale to inspiratory capacity. B. inhale to total lung capacity then exhale to residual volume. C. exhale normally then inhale to total lung capacity. D. inhale normally then exhale to functional residual capacity. B. inhale to total lung capacity then exhale to residual volume. A patient involved in an automobile accident is brought to the ED with tachypnea, tracheal deviation to the right, splinting, asymmetrical chest movement, and decreased breath sounds on the left side. The respiratory therapist should initially A. insert a chest tube. B. administer 100% oxygen via mask. C. perform endotracheal intubation. D. initiate non-invasive positive pressure ventilation. B. administer 100% oxygen via mask. A 77-year-old male patient is admitted to the emergency room with shortness of breath, fine basilar crackles, +2 pitting edema and a chest radiogram with a butterfly pattern. These results are most consistent with which of the following? A. Pulmonary edema B. Pulmonary interstitial emphysema C. Pneumothorax D. Emphysema A. Pulmonary edema Which of the following formulas will determine the total flow being delivered to a patient with a 28% venturi mask running at 6 L/min? A. total flow = 6 x 2 B. total flow = 6 x 4 C. total flow = 6 x 5 D. total flow = 6 x 11 D. total flow = 6 x 11 Fine crepitant crackles are most commonly associated with which of the following conditions? A. Bronchitis B. Pulmonary edema C. Pneumonia D. Foreign body aspiration B. Pulmonary edema A patient with end-stage pulmonary fibrosis is receiving oxygen at 2 L/min via a transtracheal oxygen catheter. The patient experiences an increased work of breathing and shortness of breath. The respiratory therapist should A. manually ventilate the patient with a resuscitation bag. B. increase the flow to the transtracheal catheter to 6 L/min. C. evaluate the SpO2 with a pulse oximeter. D. flush the transtracheal device with isotonic saline. D. flush the transtracheal device with isotonic saline. [Show Less]
- Exam
- $20.95
- 0
- 147
TMC Practice Exam correctly answered latest 2023
A 48 year-old female is admitted to the ED with diaphoresis, jugular venous distension, and 3+ pitting edema in the ankles. These findings are consistent w... [Show More] ith A. liver failure. B. pulmonary embolism. C. heart failure. D. electrolyte imbalances Heart failure A patient is admitted to the ED following a motor vehicle accident. On physical exam, the respiratory therapist discovers that breath sounds are absent in the left chest with a hyperresonant percussion note. The trachea is shifted to the right. The patient's heart rate is 45/min, respiratory rate is 30/min, and blood pressure is 60/40 mm Hg. What action should the therapist recommend first? A. Call for a STAT chest x-ray. B. Insert a chest tube into the left chest. C. Needle aspirate the 2nd left intercostal space. D. Activate the medical emergency team to intubate the patient. Needle aspirate the 2nd left intercostal space. All of the following strategies are likely to decrease the likelihood of damage to the tracheal mucosa EXCEPT A. maintaining cuff pressures between 20 and 25 mm Hg. B. using the minimal leak technique for inflation. C. using a low-residual-volume, low-compliance cuff. D. monitoring intracuff pressures. monitoring intracuff pressures. A 52 year-old post-operative cholecystectomy patient's breath sounds become more coarse upon completion of postural drainage with percussion. The respiratory therapist should recommend A. continuing the therapy until breath sounds improve. B. administering dornase alpha. C. administering albuterol therapy. D. deep breathing and coughing to clear secretions. deep breathing and coughing to clear secretions. A 65 kg spinal cord injured patient has developed atelectasis. His inspiratory capacity is 30% of his predicted value. What bronchial hygiene therapy would be most appropriate initially? A. IS / SMI B. IPPB with normal saline C. postural drainage and percussion D. PEP therapy IPPB with normal saline A patient on VC ventilation has demonstrated auto-PEEP on ventilator graphics. Which of the following controls, when adjusted independently, would increase expiratory time? 1. Tidal volume 2. Respiratory Rate 3. Inspiratory flow 4. Sensitivity 1, 2, and 3 only Which of the following would be the most appropriate therapy for a dyspneic patient who has crepitus with tracheal deviation to the left and absent breath sounds on the right? A. Perform chest physiotherapy B. Administer an IPPB treatment C. Insert an endotracheal tube D. Insert a chest tube Insert a chest tube A 55 year-old post cardiac surgery patient has the following ABG results: pH 7.50, PaCO2 30 torr, PaO2 62 torr, HCO3 25 mEq/L, SaO2 92%, HB 14 g/dL, BE +2. Venous blood gas results are pH 7.39, PvCO2 43 torr, PvO2 37 torr, and SvO2 66%. Calculate the patient's C(a-v)O2. A. 2.5 vol% B. 4.0 vol% C. 5.0 vol% D. 5.5 vol% 5.0 vol% A patient on VC, SIMV with a VT of 500 mL has a PIP of 25 cm H2O, Pplat of 15 cm H2O and PEEP of 5 cm H2O. What is the patient's static lung compliance A. 25 mL/cm H2O B. 35 mL/cm H2O C. 45 mL/cm H2O D. 50 mL/cm H2O 50 mL/cm H2O Immediately after extubation of a patient in the ICU, the respiratory therapist observes increasing respiratory distress with intercostal retractions and marked stridor. The SpO2 on 40% oxygen is noted to be 86%. Which of the following would be most appropriate at this time? A. cool mist aerosol treatment B. aerosolized racemic epinephrine C. manual ventilation with resuscitation bag and mask D. reintubation reintubation [Show Less]
- Exam
- $20.45
- 1
- 331
Purchase the bundle to get the full access instantly
- 3 Million+ Study Documents
- 100% Money Back Guarantee
- Immediate Download Access
Add To Cart
Reviews 0
Bundle Details
$50.45
- Trusted by 800,000+ Students
- 24/7 Money Back Guarantee
- Download is directly available
238
1
Seller Details
