CSE 1 Exam 45 Questions with Verified Answers
A) A respiratory therapist assigned to the coronary intensive care unit (CICU) is evaluating a post-op
... [Show More] 74-year-old, 69 kg (152 lb.), 160 cm (5 ft., 3 in.) tall female patient who had mitral valve replacement surgery. The patient is intubated and one hour into a spontaneous breathing trial with PSV, FIO2 0.40, PS 5 cmH20, PEEP 5 cmH20. The patient is alert and resting comfortably. Which of the following should be recommended?
(CHOOSE ONLY ONE unless you are directed to "Make another selection in this Section.")
-Current Section
-Simulation History
-Attempt a T-piece trial
-Obtain arterial blood gases and perform a physical assessment
-Maintain the current settings and continue to observe
-Set the pressure support at 0 and re-assess in 30 mins
-Switch back to mechanical ventilation with pre-trial settings and re-assess in 24hrs
-Extubate and administer supplemental oxygen at 40% - CORRECT ANSWERS -Obtain arterial blood gases and perform a physical assessment
A) Which of the following should be assessed?
-Respiratory exchange ratio
-Exhaled Vt
-VD/VT ratio
-RR
-pH of tracheal aspirate
-HR
-Intrapulmonary shunt (Qs/Qt)
-BP
-ECG via cardiac monitor
-SpO2
-General appearance
-Optimal compliance
-Breath sounds
-Peripheral pulses
-Color - CORRECT ANSWERS -Exhaled Vt
-RR
-HR
-BP
-ECG via cardiac monitor
-SpO2
-General appearance
-Breath sounds
-Color
B) A respiratory therapist is asked to assess a 61-year-old, 73 kg (160 lb.), 180 cm (5 ft., 11 in.) tall male who was just admitted to the ED for acute exacerbation of COPD. The patient is currently receiving oxygen via nasal cannula at 2 L/min.
During assessment, it is noted that the patient is febrile and in obvious respiratory distress. Vital signs are: heart rate 118/min, blood pressure 134/86 mmHg, and respirations 32/min. Chest auscultation reveals diffuse expiratory wheezes with coarse crackles throughout the left lower lung field.
Which of the following should initially be recommended?
-Mask CPAP 5 cmH20 with an FIO2 of 0.40
-35% oxygen via air-entrainment mask
-Continue to closely monitor the patient's condition
-Aerosol fluticasone (Flovent) treatment concurrent with PEP therapy
-Oxygen at 12 L/min via nonrebreathing mask
-Aerosol albuterol (Ventolin) - CORRECT ANSWERS -Aerosol albuterol (Ventolin)
B) The physician asks for recommendations of diagnostic and lab studies to further assess the patient. Which of the following should be evaluated?
-Ventilation-perfusion scan
-Electrolytes
-12-lead ECG
-Sputum culture and sensitivity
-P50 (measured)
-Theophylline level
-Carboxyhemoglobin level
-Chest x-ray
-RV/TLC ratio
-ABG analysis
-CT scan of the chest
-CBC
-Serum lactate level
-Toxin screen
-Upper airway x-ray - CORRECT ANSWERS -Electrolytes
-Sputum culture and sensitivity
-Theophylline level
-Chest x-ray
-ABG analysis
-CBC
C) A 27-year-old, 52 kg (115 lb.), 160 cm (5 ft., 3 in.) tall female patient is undergoing surgery for removal of a large mediastinal tumor. Following surgery, the patient is stabilized and transferred to the recovery room. You are asked to assist in the ventilator management of this patient while in the recovery room. After arriving in the recovery room, you would evaluate which of the following?
-Position of ET tube
-Ventilator settings
-ECG via cardiac monitor
-Urinary output
-Breath sounds
-Intracranial pressure
-End-tidal CO2
-Bowel sounds
-Blood pressure
-Hemodynamic status
-Heart rate
-Respirations
-Pulse oximetry (Sp02)
-Ventilator alarm settings
-Pupillary response - CORRECT ANSWERS -Position of ET tube
-Ventilator settings
-ECG via cardiac monitor
-Breath sounds
-End-tidal CO2
-Blood pressure
-Hemodynamic status
-Heart rate
-Respirations
-Pulse oximetry (Sp02)
-Ventilator alarm settings
C) You now obtain an ABG and the results are pH 7.35, PaCO2 43, HCO3 23, PaO2 139, SaO2 99%. The physician asks for your next recommendation. Which of the following would you suggest?
-Maintaining current therapy
-Lowering the FiO2 to 0.50
-Implementing PEEP at 5cmH2O
-Increasing the inspiratory pressure to 14cmH2O
-Increasing the ventilator rate to 14/min
-Administering sodium bicarbonate - CORRECT ANSWERS -Lowering the FiO2 to 0.50
D) You are a respiratory therapist working in a respiratory clinic. A 48-year-old male with a history of COPD and a 21 pack year smoking history presents to the clinic with complaints of increasing shortness of breath on exertion of 6 months duration.
To evaluate the patient's shortness of breath on exertion, you would recommend which of the following?
-Performing oximetry during sleep
-Simulation History
-Performing an exercise thallium stress test
-Performing cardiopulmonary exercise testing
-Obtaining a ventilation-perfusion scan
-Obtaining a resting 02 consumption
-Performing cardiac stress testing - CORRECT ANSWERS -Performing cardiopulmonary exercise testing
D) Which of the following would be appropriate to assess and/or evaluate during the patient's exercise test?
Simulation History
Airway resistance
02 consumption
Body temperature
Vital capacity
Pulse oximetry (Sp02)
Respirations
ECG
Central venous pressure (CVP)
Work load
Heart rate
Blood pressure
Arterial blood gases
Maximum inspiratory pressure
CO2 production
Tidal volume - CORRECT ANSWERS 02 consumption
Pulse oximetry (Sp02)
Respirations
ECG
Heart rate
Blood pressure
Arterial blood gases
CO2 production
Tidal volume
E) A respiratory therapist is reporting for work and assigned to the ICU. Shortly after arriving in the ICU, the therapist is asked to assist in transporting an intubated, mechanically ventilated, post-op blunt chest trauma adult male patient from the recovery room to the ICU.
The patient is transported to his room in the unit without incident. When the therapist connects the patient to the
ventilator, the low pressure alarm on the ventilator activates. Which of the following actions would be appropriate at this time?
Current Section
Simulation History
Auscultate the patient's chest
Set the F102 at 1.0 and assess the patient/ventilator
system
Disconnect the patient from the ventilator and manually
ventilate
Increase the inspiratory flow setting
Adjust the low pressure alarm setting
Increase the mandatory rate setting - CORRECT ANSWERS Disconnect the patient from the ventilator and manually ventilate
E) The nurse is now manually ventilating the patient while the therapist inspects the ventilator. Which of the following should the therapist do and/or evaluate?
-Simulation History
-Check the ventilator tubing for kinks
-Check the integrity of the endotracheal tube's cuff
-Analyze the ventilator FIO2
-Check the oxygen and air line pressure
-Tighten all ventilator circuit connections
-Check all ventilator settings and alarms
-Measure the peak inspiratory flow
-Occlude the Y and activate the ventilator - CORRECT ANSWERS -Check the integrity of the endotracheal tube's cuff
-Tighten all ventilator circuit connections
-Check all ventilator settings and alarms
-Occlude the Y and activate the ventilator
F) You are an evening shift respiratory therapist reporting for duty and assigned to the ICU. During report, you are informed that the patient in bed 4 is an intubated, mechanically ventilated 60-year-old, 67 kg (148 lb.), 180 cm (5 ft., 11 in.) tall male who was admitted to the ICU 3 days prior due to respiratory failure secondary to exacerbation of COPD.
The reporting therapist tells you that a spontaneous breathing trial had been attempted earlier in the day, but the patient did not tolerate the change in therapy. Mechanical ventilation had been re-instituted with the following settings: VC-A/C, rate 8/min, tidal volume 500 ml, FIO2 0.30, and PEEP 5 cmH20. After arriving in the ICU, you would assess and/or evaluate which of the following?
-Ventilator tubing compliance
-Heart rate and blood pressure
-Peripheral reflexes
-Urine output
-Chest x-ray
-12-lead ECG
-ECG via cardiac monitor
-Arterial blood gases
-Characte - CORRECT ANSWERS -Heart rate and blood pressure
-Chest x-ray
-ECG via cardiac monitor
-Arterial blood gases
-Character of respiratory secretions
-Position of endotracheal tube
-Ventilator alarms
-Ventilator settings
-Breath sounds
G) You are a respiratory therapist assigned to the pediatric intensive care unit (PICU) of a 500-bed community hospital. One of your patients is a 9-year-old, 29 kg (64 lb.), 119 cm (3 ft., 11 in.) tall female admitted three days prior for community-acquired pneumonia (CAP). She is currently receiving IV antibiotics and oxygen via 28% air-entrainment mask.
When you arrive in the patient's room, you find her restless and agitated. You would assess and/or evaluate which of the following?
-Breath sounds
-ECG via cardiac monitor
-Pulse and blood pressure
-Arterial blood gas analysis
-CBC
-Chest x-ray
-Maximum inspiratory pressure
-Response to painful stimuli
-General appearance
-Position of trachea
-Maximum voluntary ventilation
-BUN
-Closing volume
-Vital capacity
-Respiratory rate and pattern - CORRECT ANSWERS -Breath sounds
-ECG via cardiac monitor
-Pulse and blood pressure
-Arterial blood gas analysis
-CBC
-Chest x-ray
-General appearance
-Position of trachea
-Respiratory rate and pattern
H) A respiratory therapist assigned to the ICU is managing the cardiopulmonary care of a 43-year-old female patient diagnosed with ARDS secondary to sepsis and nosocomial pneumonia. The patient is intubated and receiving PC-A/C, FI02 1.0, mandatory rate 14, PIP 28 cmH20, PEEP 8 cmH20, 1-time 1.5 sec. A pulmonary artery (PA) catheter and an arterial line are in place.
The physician requests assistance in evaluating the current clinical condition of the patient. Which of the following
should be assessed and/or evaluated?
CVP
Heart sounds.
Chest x-ray
Calculated Qs/Qt
PCWP
Sensorium
Cardiac Output
Static compliance
PAP
Respiratory rate
pH of tracheal aspirate
Blood pressure
Arterial blood gas analysis
Heart rate
Breath sounds - CORRECT ANSWERS CVP
Chest x-ray
Calculated Qs/Qt
PCWP
Sensorium
Cardiac Output
Static compliance
PAP
Respiratory rate
Blood pressure
Arterial blood gas analysis
Heart rate
Breath sounds
I) You are a night shift respiratory therapist assigned to the ED of a 400-bed community hospital. At 3:15 A.M., the ED physician requests your assistance in assessing a 24-year-old male with dyspnea and a complaint of chest tightness who was brought to the ED by his brother. Which of the following would you assess and/or evaluate?
Ability to swallow
General appearance
Bowel Sounds
CBC
Color of mucous membranes
Breath sounds
Familial history
SpO2
Heart Sounds
ABG
Peak Expiratory Flow
Vital Signs
Chest X-Ray
Medical History
Ability to complete a sentence - CORRECT ANSWERS General appearance
CBC
Breath sounds
SpO2
ABG
Vital Signs
Chest X-Ray
Medical History
Ability to complete a sentence
I) Oxygen via nonrebreathing mask at 12 L/min is initiated. Admission arterial blood gas results on room air reveal pH 7.49, PaCO2 30 mmHg, HCO3 23 mEq/L, PaO2 54 mmHg.
Which of the following would you now recommend?
Inhaled salmeterol every 20 minutes for the first hour
IV epinephrine
Inhaled salbutamol every 20 minutes for the first hour
Inhaled fluticasone every 20 minutes for the first hour
IV aminophylline
IV atropine - CORRECT ANSWERS Inhaled salbutamol every 20 minutes for the first hour
I) Arterial blood gases are obtained and the results are: pH 7.31, PaCO2 57 mmHg, HCO3 24 mEq/L, Pa02 59 mmHg. On the basis of the arterial blood gas results and the patient's fatigued state, the ED physician orders a trial of noninvasive positive pressure ventilation (NPPV) and requests your recommendation for initial settings. Which of the following initial settings would you recommend?
IPAP 15 cmH20; EPAP 3 cmH20; FIO2 1.0
IPAP 15 cmH20; EPAP 5 cmH20; FIO2 0.50
IPAP 10 cmH20; EPAP 3 cmH20; FI02 0.50
IPAP 8 cmH20; EPAP 8 cmH20; FIO2 0.80
IPAP 5 cmH20; EPAP 5 cmH20; FIO2 0.50 - CORRECT ANSWERS IPAP 10 cmH20; EPAP 3 cmH20; FI02 0.50
I) On the basis of your assessment, you would now recommend which of the following?
Set the EPAP at 5 cmH2O and set the FIO2 at 0.40
Discontinue NPPV and administer oxygen via 50% air- entrainment mask
Maintain current settings and continue to monitor
Titrate the FIO2 downward to maintain a SpO2 > 92%
Set the IPAP at 8 cmH20 and set the EPAP at 2 cmH20
Discontinue NPPV and initiate mask CPAP at 3 cmH20 - CORRECT ANSWERS Titrate the FIO2 downward to maintain a SpO2 > 92%
J) A respiratory therapist is reporting for work and assigned to the ICU. Shortly after arriving in the ICU, the therapist is asked to assist in transporting an intubated, mechanically ventilated, post-op blunt chest trauma adult male patient from the recovery room to the ICU.
The patient is transported to his room in the unit without incident. When the therapist connects the patient to the
ventilator, the low pressure alarm on the ventilator activates. Which of the following actions would be appropriate at
this time?
Increase the mandatory rate setting
Auscultate the patient's chest
Set the FIO2 at 1.0 and assess the patient/ventilator system
Adjust the low pressure alarm setting
Increase the inspiratory flow setting
Disconnect the patient from the ventilator and manually
ventilate - CORRECT ANSWERS Disconnect the patient from the ventilator and manually
ventilate
J) The nurse is now manually ventilating the patient while the therapist inspects the ventilator. Which of the following should the therapist do and/or evaluate?
Measure the peak inspiratory flow
Check the integrity of the endotracheal tube's cuff
Analyze the ventilator FI02
Check the ventilator tubing for kinks
Check the oxygen and air line pressure
Tighten all ventilator circuit connections
Check all ventilator settings and alarms
Occlude the Y and activate the ventilator - CORRECT ANSWERS Check the integrity of the endotracheal tube's cuff
Tighten all ventilator circuit connections
Check all ventilator settings and alarms
Occlude the Y and activate the ventilator
J) The heat moisture exchanger is replaced and mechanical ventilation is resumed without any further problems.
Over the next 4 days, the patient's condition improves and he is extubated. He is currently receiving mask CPAP 7 cmH20 with an FIO2 of 0.40. During this last hour, the patient has become restless and agitated. The physician requests the assistance of the respiratory therapist in evaluating the patient.
Which of the following should now be assessed and/or evaluated?
Muscle tone
Arterial blood gases General appearance
Vital signs
Respiratory pattern
Breath sounds
ECG via cardiac monitor
Pulse oximetry (Sp02) - CORRECT ANSWERS Arterial blood gases General appearance
Vital signs
Respiratory pattern
Breath sounds
ECG via cardiac monitor
Pulse oximetry (Sp02)
K) You are an evening shift respiratory therapist assigned to the surgical floor of a 250-bed community hospital. During your evening rounds, you are called to evaluate a 47-year-old female patient with a 37-year history of myasthenia gravis. You are informed by the patient's nurse that the patient is complaining of increasing dyspnea, fatigue, and cough. After arriving in the patient's room, you would assess and/or evaluate which of the following?
History of present illness
Skin color
Muscle strength
Chest symmetry
Corneal reflex
Sensorium
Pulse oximetry (Sp02)
Vital signs
History of past illnesses
Facial muscle tone
Diagnostic chest percussion
Ability to swallow
Maximum voluntary ventilation
Character of cough
Breath Sounds - CORRECT ANSWERS History of present illness
Skin color
Muscle strength
Chest symmetry
Sensorium
Pulse oximetry (Sp02)
Vital signs
History of past illnesses
Facial muscle tone
Diagnostic chest percussion
Ability to swallow
Character of cough
Breath Sounds
L) You are a respiratory therapist working in a 350-bed community hospital. You have just received a page to come to the medical floor and assess a 77-year-old male patient who has a long-standing history of COPD. When you arrive in the patient's room, you would assess and/or evaluate which of the following?
Muscle tone
Pupillary response
General appearance
Vital signs
Pulse oximetry (Sp02)
Chest inspection
Breath sounds
Peripheral pulses
Peripheral reflexes
Respiratory pattern - CORRECT ANSWERS General appearance
Vital signs
Pulse oximetry (Sp02)
Chest inspection
Breath sounds
Respiratory pattern
M) A respiratory therapist is evaluating a 27-year-old male with a medical history of asthma and exercise-induced bronchospasm (EIB) who presented to the respiratory clinic for a scheduled appointment. His current medication is an albuterol rescue inhaler administered on an as needed basis. When questioned about his symptoms, the patient states he has been using his rescue inhaler 3-4 times per week during this past year and during this time he has had nocturnal shortness of breath and wheezing that interferes with his sleep 3 - 4 times per month.
The therapist notes that the patient's medical record indicates he has had three unscheduled asthma visits for mild exacerbation over this last year. A PEF is obtained which shows a measurement of 470 L/min (74% of predicted).
On the basis of this information, which of the following asthma severity classifications would be applicable?
Moderate persistent asthma
Mild persis - CORRECT ANSWERS Moderate persistent asthma
M) As a result of the patient's frequent symptoms, he is prescribed treatment with a low-dose inhaled corticosteroid (ICS)
of fluticasone 44 mcg at 2 puffs administered twice per day.
During a follow-up visit two weeks later, the patient remains symptomatic and continues to frequently use his rescue
inhaler.
Which of the following should be assessed to evaluate the patient's current condition?
ABG analysis
Use of rescue inhaler
Breath sounds
Activities of daily living
General appearance
Pulse oximetry (Sp02)
Complete pulmonary function testing
Patient concerns and questions
Known allergies - CORRECT ANSWERS Use of rescue inhaler
Breath sounds
Activities of daily living
General appearance
Pulse oximetry (Sp02)
Patient concerns and questions
Known allergies
N) A respiratory therapist is assigned to the coronary intensive care unit (CICU). The patient in bed 6 is an 84-year-old, 78 kg (172 lb.), 183 cm (6 ft.) tall male with a history of coronary artery disease (CAD) who was admitted to the unit 4 hours prior following coronary artery bypass graft (CABG) surgery. The patient is intubated and receiving supplemental oxygen via 35% T-adapter.
The physician requests assistance in evaluating the patient's readiness to be extubated. Which of the following should be assessed and/or evaluated?
Maximum inspiratory pressure
Response to painful stimuli
Spontaneous tidal volume
Arterial blood gases
12-lead ECG
Pulse oximetry (Sp02)
Chest x-ray
Breath sounds
Character of sputum
Vital signs
Pupillary response
Sensorium - CORRECT ANSWERS Maximum inspiratory pressure
Spontaneous tidal volume
Arterial blood gases
Pulse oximetry (Sp02)
Chest x-ray
Breath sounds
Character of sputum
Vital signs
Sensorium
O) A respiratory therapist is assigned to the cardiopulmonary care of a 56-year-old, 61 kg (134 lb.), 165 cm (5 ft., 5 in.) tall female patient who was intubated with initiation of mechanical ventilation 2 days prior secondary to post-op respiratory failure.
The current ventilator settings are: VC-SIMV, FIO2 0.30, PS 8 cmH2O, mandatory rate 6/min, tidal volume 450 mL, PEEP 5 cmH20. The arterial blood gas results obtained two hours earlier are: pH 7.42, PaCO2 38 mmHg, HCO3 24 mEq/L, PaO2 87 mmHg, Sa02 96%. The current chest x-ray shows improved clearing with bilateral inflation. The patient is alert and oriented. Which of the following should be assessed to further evaluate this patient's current clinical condition?
Repeat arterial blood gas analysis
Pulse oximetry (SpO2)
Heart rate
Vital capacity
Spontaneous tidal volume
Spontaneous respiratory rate
Breath sounds
Blood pressure
Lactic acid level
Sensorium
Maximum vo - CORRECT ANSWERS Pulse oximetry (SpO2)
Heart rate
Vital capacity
Spontaneous tidal volume
Spontaneous respiratory rate
Breath sounds
Blood pressure
Sensorium
Maximum voluntary ventilation
Skin color
P) A 30 weeks' gestational age, 1350 g, infant female with resolving respiratory distress syndrome (RDS) is currently intubated and receiving CPAP 4 cmH20 with an FIO2 of 0.60.
During the last five minutes, the infant has become increasingly dusky with periods of apnea and bradycardia. Arterial blood gases are obtained and the results are: pH 7.11, PaCO2 67 mmHg, HCO3 19 mEq/L, PaO2 39 mmHg. Which of the following should be recommended?
Set the CPAP at 6 cmH20 and set the FIO2 at 0.70
Set the FIO2 at 0.70
PC-A/C; FI02 0.60; PIP 20 cmH20; mandatory rate 40; PEEP 4 cmH20; I-time 0.4 sec
PC-SIMV; FI02 1.0; PIP 30 cmH20; mandatory rate 30;
PEEP 4 cmH20; I-time 0.2 sec Set the CPAP at 6 cmH20
PC-A/C; FI02 0.60; PIP 25 cmH20; mandatory rate 50; PEEP 4 cmH20; I-time 0.3 sec - CORRECT ANSWERS PC-A/C; FI02 0.60; PIP 20 cmH20; mandatory rate 40; PEEP 4 cmH20; I-time 0.4 sec
P) Twenty minutes later, arterial blood gases are obtained and the results are: pH 7.36, PaCO2 38 mmHg, HCO3 20 mEq/L, Pa02 47 mmHg. Which of the following should be recommended?
Maintain present settings
Set the mandatory rate at 45
Set the FIO2 at 0.70
Sedate the infant and continue to monitor
Set the PEEP at 5 cmH20
Set the PIP at 22 cmH20 - CORRECT ANSWERS Set the PEEP at 5 cmH20
P) During the next twenty-four hours, the infant's course of therapy remains uneventful. The physician now requests recommendations for data that would help to evaluate the patient's current clinical condition. Which of the following should be evaluated?
Urinalysis
Transillumination of the chest
ECG via cardiac monitor
Head ultrasound
Arterial blood gas analysis
Serum bilirubin
Ventilator settings and alarms
Breath sounds
Vital signs
12-lead ECG
Chest x-ray
Heart sounds - CORRECT ANSWERS ECG via cardiac monitor
Arterial blood gas analysis
Ventilator settings and alarms
Breath sounds
Vital signs
Chest x-ray
Heart sounds
Q) The labor and delivery (L&D) charge nurse has requested the assistance of the respiratory therapist in the
delivery of an infant approximately 31 weeks' gestation.
Which of the following supplies should the therapist ensure is available in case of need?
Tonsil suction (Yankauer tube) Oropharyngeal airways
One-inch tape
Curved/straight laryngoscope blades
Foam donut head rest
Sizes 5-: 6-: 8-Fr. suction catheters
Stylet
2.5- to 4.0-mm ID cuffed ET tubes
Laryngoscope handles
Resuscitator bag and mask
Suction set-ups
2.5- to 4.0-mm ID uncuffed ET tubes - CORRECT ANSWERS Oropharyngeal airways
One-inch tape
Curved/straight laryngoscope blades
Foam donut head rest
Sizes 5-: 6-: 8-Fr. suction catheters
Stylet
Laryngoscope handles
Resuscitator bag and mask
Suction set-ups
2.5- to 4.0-mm ID uncuffed ET tubes
Q) Which of the following resuscitative drugs should be available?
Gentamicin
Epinephrine
Furosemide (Lasix)
Sodium bicarbonate
Atropine
Lidocaine - CORRECT ANSWERS Epinephrine
Q) Thirty minutes later, a male infant is delivered. He is immediately dried, orally suctioned, and placed under a radiant
warmer. Which of the following should now be assessed and/or evaluated?
Heart rate
Lecithin/sphingomyelin ratio
Weight
Reflex irritability
Muscle tone
Chest excursion
Transillumination of the chest
Color
Respiratory rate and pattern
Arterial blood gas analysis
Breath sounds
Thoracic compliance
12-lead ECG
Blood pressure
Position of trachea - CORRECT ANSWERS Heart rate
Weight
Reflex irritability
Muscle tone
Chest excursion
Color
Respiratory rate and pattern
Breath sounds
Blood pressure
R) A respiratory therapist is asked to assist the pulmonary specialist during a bronchoscopic procedure to diagnose, rule out, the presence of Pneumocystis Carinii Pneumonia (PCP) in a 42-year-old male with a history of AIDS.
Which of the following supplies and equipment should be available during the procedure?
An appropriately sized bronchoscope
Vacuum system
ECG machine with 12-lead monitoring
Oxygen and related delivery equipment
Transbronchial aspiration needles
A chronotropic agent (atropine)
A topical anesthetic (lidocaine) Resuscitation equipment
Bronchoscopic light source
Syringe for medication delivery
Uncuffed ET tubes of various sizes
Syringe for bronchoalveolar lavage
Specimen-collection devices
A vasoconstrictor for bleeding control
Pulse Ox - CORRECT ANSWERS An appropriately sized bronchoscope
Vacuum system
Oxygen and related delivery equipment
Transbronchial aspiration needles
A chronotropic agent (atropine)
A topical anesthetic (lidocaine) Resuscitation equipment
Bronchoscopic light source
Syringe for medication delivery
Syringe for bronchoalveolar lavage
Specimen-collection devices
A vasoconstrictor for bleeding control
Pulse Ox
R) Which of the following should be assessed during the procedure?
Lavage volumes
Patient's subjective response to the procedure
Site of biopsies
Patient's respirations Patient's blood pressure
Patient's level of consciousness
Patient's vital capacity
Patient's heart rate
Medications administered
FIO2
Patient's temperature
Pulse oximetry (SpO2) - CORRECT ANSWERS Lavage volumes
Patient's subjective response to the procedure
Site of biopsies
Patient's respirations Patient's blood pressure
Patient's level of consciousness
Patient's heart rate
Medications administered
FIO2
Pulse oximetry (SpO2)
R) Following the bronchoscopic procedure, the patient is taken to the respiratory ward and placed in respiratory isolation.
He is started on IV trimethoprim/sulfamethoxazole (TMP/SMX) and oral prednisone, 40 mg b.i.d. His vital signs are stable and his SpO2 is 94% while on 35% oxygen via air-entrainment mask. The results from the bronchoalveolar lavage revealed Pneumocystis carinii and the biopsy revealed Pneumocystis carinii as well as Cryptococcus neoformans. Which of the following should be recommended next?
Discontinue oxygen therapy
Add amphotericin B to the patient's treatment regimen
Maintain current therapy and continue to monitor
Obtain an induced sputum sample to test for the presence of acid-fast bacteria (AFB)
Obtain an arterial blood gas sample
Switch the patient from oral prednisone to IV methylprednisolone - CORRECT ANSWERS Add amphotericin B to the patient's treatment regimen
R) Initially, the patient responded well to treatment. On hospital day 3, the patient develops a skin rash and experiences episodes of severe nausea and vomiting. His physician suspects that the patient is allergic to the sulfa in trimethoprim/sulfamethoxazole (TMP/SMX) and asks for a recommendation in an appropriate replacement drug. Which of the following should be recommended?
IV clindamycin
IV atropine
IV pentamidine
IV dapsone
IV isoniazid - CORRECT ANSWERS IV pentamidine
R) Over the next 4 days, the patient's condition improves significantly. He has tolerated therapy well and a follow-up
chest x-ray shows resolution of the reticular opacification that was noted on the admission chest x-ray. An arterial blood gas is obtained while on oxygen at 1 L/min by nasal cannula, the results are: pH 7.38, PaCO2 40 mmHg, HCO3 24 mEq/L, PaO2 102 mmHg. The patient's physician asks for a recommendation of further therapy or support. Which of the following should be recommended?
Discontinue oxygen therapy
Discontinue IV pentamidine
Switch the patient from oral prednisone to aerosol
flunisolide (AeroBid)
Discontinue all therapy
Continue the present therapy - CORRECT ANSWERS Discontinue oxygen therapy
R) During the next 7 days, the patient's course of therapy is uneventful. The patient is discharged on hospital day 14 and scheduled for follow-up in the hematology/oncology clinic for treatment of cutaneous and pulmonary Kaposi's sarcoma (KS). At this time, the patient's physician is concerned about the possible recurrence of PCP and would like to initiate a treatment regimen for prevention and suppression of PCP. Which of the following should be recommended to the physician?
Oral TMP/SMX (20 mg TMP; 400 mg SMX); administered once every 6 hours
Aerosolized pentamidine (300 mg); administered once
every 4 weeks
Aerosolized ribavirin (6 g/300 mL); administered via
face mask while sleeping
MDI flunisolide (2 puffs per treatment); administered 4
times a day
Oral prednisone (20 mg); administered twice a day
IV pentamidine (3 mg/kg); administered once a day - CORRECT ANSWERS Aerosolized pentamidine (300 mg); administered once
every 4 weeks
S) A respiratory therapist working in the respiratory care clinic is asked to assist the pulmonologist in evaluating a 34- year-old male who was referred to the clinic with a history of increasing hemoptysis. Which of the following should be assessed?
Chief medical complaints
Breath sounds
Facial muscle tone
Social history
Past medical history
Marital status
Family history
Deep tendon reflexes
Vital signs
hypertension.
Palpation of abdomen
General Appearance
Condition or oral and nasal mucosa
Color of lips and nail beds
Height and weight
Pulse oximetry (Sp02)
Family history - CORRECT ANSWERS Chief medical complaints
Breath sounds
Social history
Past medical history
Vital signs
General Appearance
Height and weight
Pulse oximetry (Sp02)
Family history
S) After the therapist reports the assessment findings to the pulmonologist, he requests recommendations of diagnostic and laboratory data that may be helpful to further evaluate the patient's condition and make a diagnosis. Which of the following should be evaluated?
Sweat chloride test
Coagulation studies
CBC
Blood culture and sensitivity
Cardiac biomarkers
ELISA and Western blot test
Arterial blood gas analysis
Echocardiogram
Sputum culture and sensitivity
Chest CT Scan
Chest x-ray
Bedside spirometry - CORRECT ANSWERS Sweat chloride test.
Coagulation studies
CBC
Sputum culture and sensitivity
Chest CT Scan
Chest x-ray
Bedside spirometry
T) A respiratory therapist is asked to assess a 61-year-old, 73 kg (160 lb.), 180 cm (5 ft., 11 in.) tall male who was just admitted to the ED for acute exacerbation of COPD. The patient is currently receiving oxygen via nasal cannula at 2 L/min. During assessment, it is noted that the patient is febrile and in obvious respiratory distress. Vital signs are: heart rate
118/min, blood pressure 134/86 mmHg, and respirations 32/min. Chest auscultation reveals diffuse expiratory
wheezes with coarse crackles throughout the left lower lung field.
Which of the following should initially be recommended?
35% oxygen via air-entrainment mask
Aerosol fluticasone (Flovent) treatment concurrent with
PEP therapy
Mask CPAP 5 cmH20 with an FIO2 of 0.40
Continue to closely monitor the patient's condition
Oxygen at 12 L/min via nonrebreathing mask
Aerosol albuterol (Ventolin) treatment - CORRECT ANSWERS Aerosol albuterol (Ventolin) treatment
T) The physician asks for recommendations of diagnostic and laboratory studies to further assess the patient. Which of the following should be evaluated?
P50 (measured) Carboxyhemoglobin level
Arterial blood gas analysis
Ventilation-perfusion scan
Upper airway x-ray
Sputum culture and sensitivity
Electrolytes
CT scan of the chest
CBC
Chest x-ray
12-lead ECG
Toxin screen
Theophylline level
RV/TLC ratio
Serum Lactate level - CORRECT ANSWERS Arterial blood gas analysis
Sputum culture and sensitivity
Electrolytes
CBC
Chest x-ray
Theophylline level
U) The respiratory therapist assigned to the ED is asked to evaluate and recommend care for a 7-year-old asthmatic female in acute respiratory distress who was brought to the ED by her mother. The mother states that the child has had a "bad cold and stuffy nose" for the last two days.
Which of the following should the therapist assess and/or evaluate?
Past medical history
History of present illness
Pulse oximetry (Sp02)
Arterial blood gases
Peripheral pulses
Ability to swallow
General appearance
Home medications
Breath sounds
Chest inspection
Peak expiratory flow (PEF)
Character of cough and sputum production
Ability to complete a sentence
Vital signs
Chest x-ray - CORRECT ANSWERS Past medical history
History of present illness
Pulse oximetry (Sp02)
General appearance
Home medications
Breath sounds
Chest inspection
Character of cough and sputum production
Ability to complete a sentence
Vital signs
V) A respiratory therapist assigned to a 12-bed neurological intensive care unit (NICU) is managing the cardiopulmonary
care of a 31-year-old, 52 kg (115 lb.), 160 cm (5 ft., 3 in.) tall female patient who sustained severe trauma to the
head, face, and chest during a mugging.
An ICP line is present and the patient's intracranial pressure is 14 mmHg. The patient is nasally intubated and receiving mechanical ventilation. Current ventilator settings are: VC-A/C, FIO2 1.0, mandatory rate 14, tidal volume 400 mL, PEEP 5 cmH20. Arterial blood gases on these settings are: pH 7.31, PaCO2 47 mmHg, HCO3 23 mEq/L, PaO2 79 mmHg, Sa02 94%. Which of the following should be recommended?
Maintain current settings and continue to monitor
Set the mandatory rate at 16
Set the tidal volume at 500 mL
Increase the inspiratory flow rate by 20 L/min
Add an inspiratory pause of 1 second
Set the PEEP at 10 cmH20 - CORRECT ANSWERS Set the mandatory rate at 16
V) Twenty minutes later, the patient's physician requests assistance in evaluating the patient's response to the ventilator
adjustment. Which of the following should be assessed and/or evaluated?
12-lead ECG
Intracranial pressure
Breath sounds
Pulse and blood pressure
Maximum inspiratory pressure (MIP)
Forced expiratory time
Arterial blood gases
Chest x-ray - CORRECT ANSWERS Intracranial pressure
Breath sounds
Pulse and blood pressure
Arterial blood gases [Show Less]