Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
129 Cards in this Set
- Front
- Back
|
(A-a)DO2 gradient can be widened by:
a. increasing the FiO2 b. reducing capillary shunt c. Improving ventilation to perfusion matching d. Increasing the Hemoglobin |
a. increasing the FiO2
Yes. A natually occurring and expected phenomena |
|
|
When auscultating an awake, spontaneously breathing patient it is important to:
a. ideally auscultate from the apices down b. compare equal positions bilaterally c. listen only to the inspiratory phase of breathing d. A and B |
b. compare equal positions bilaterally
Yes. Always... everyone hear's something a little different. It is essential to compare sides yourself |
|
|
Cor pulmonale will clinically manifest with:
a. hepatomegaly b. JVD c. pulmonary edema d. A and B e. A,B and C |
d. A and B
Yes. Both may manifest in the presence of RV failure (cor pulmonale is just a specific form of RV failure primarily due to pulmonary hypertension) |
|
|
The hallmark(s) of a barrel chest include:
a. widened AP diameter b. steep oblique rib angle c. spine with abnormal AP curvature d. A and B |
a. widened AP diameter
Yes. AP diameter is typicaly widened. |
|
|
Drugs that can be instilled down an endotracheal tube include:
a. Morphine b. Versed c. Narcan d. Adenosine e. All of the above |
c. Narcan
Yes. Narcan is the N in NAVEL |
|
|
The oxygen hemoglobin dissociation curve is shifted to the right when:
a. pH increases b. pO2 decreases c. pCO2 increases d. Temperature decreases |
c. pCO2 increases
Yes. this would cause a shift to the right |
|
|
Paradoxical breathing:
a. is a sign of severe respiratory fatigue b. manifests with the abdomen protruding on inspiration c. always occurs with asthmatic attacks d. A and B |
a. is a sign of severe respiratory fatigue
Yes. The diaphragm is done. Very fatigued and not functioning correctly. |
|
|
_________ is expected to decrease in the PFT results of a severe COPD patient.
a. FEV1 b. FEV1/FVC c. FRC d. A and B e. A,B and C. |
a. FEV1
b. FEV1/FVC d. A and B Yes. Both parameters should be abnormally low. |
|
|
_________ is expected to decrease in the PFT results of a patient with severe pulmonary fibrosis:
a. FEV1 b. FVC. c. FRC. d. A and B. e. A, B and C |
a. FEV1
b. FVC. c. FRC. e. A, B and C Yes. This is it. All values presented above should be very low. |
|
|
What occurs at a lung volume equivalent to the functional residual capacity (FRC)? I. The forces of the chest wall and lungs are in balance. II. Chest wall expansion is offset by lung contraction. III. Opposing chest wall-lung forces generate negative Ppl.
a. I, II, III b. I, II c. I, III d. II, III |
a. I, II, III
|
|
|
Which of the following statements about alveolar pressure (Palv) during normal quiet breathing is true?
a. It is positive during inspiration, negative during expiration. b. It is the same as intrapleural pressure (Ppl). c. It is negative during inspiration, positive during expiration. d. It always remains less than atmospheric pressure. |
c. It is negative during inspiration, positive during expiration.
|
|
|
Which of the following lung units would empty and fill most slowly?
a. A unit with low resistance and high compliance b. A unit with high resistance and high compliance c. A unit with high resistance and low compliance d. A unit with low resistance and low compliance |
b. A unit with high resistance and high compliance
|
|
|
Which of the following pressure gradients is responsible for maintaining alveolar inflation?
a. Transthoracic pressure gradient (Ppl –Pbs) b. Transpulmonary pressure gradient (Palv – Ppl) c. Transcanadian pressure gradient (Pca – Pks) d. Transrespiratory pressure gradient (Palv – Pao) |
b. Transpulmonary pressure gradient (Palv – Ppl)
|
|
|
At body temperature, how much O2 will physically dissolve in plasma at a PO2 of 40 mm Hg?
a. A. 0.12 mL/dL b. B. 0.30 mL/dL c. C. 1.20 mL/dL d. D. 1.34 g/dL |
a. A. 0.12 mL/dL
|
|
|
Which of the following pathogens is believed to be the most common cause of community-acquired pneumonia?
a. Streptococcus pneumoniae b. Haemophilus influenzae c. Mycoplasma pneumoniae d. Mycobacterium tuberculosis |
a. Streptococcus pneumoniae
|
|
|
A potentially life threatening dysrhythmia which is characterized by a wide and bizarre QRS complex constantly repeating rapidly with no discernible P waves is and was demonstrated in class.
a. Atrial Tachycardia b. Atrial Fibrillation c. Ventricular Tachycardia d. Ventricular Fibrillation |
c. Ventricular Tachycardia
|
|
|
Treatment based on careful review of available literature is known as:
a. Protocol-based medicine b. Review-based medicine c. Team health care d. Evidence-based medicine |
d. Evidence-based medicine
|
|
|
What term is used to describe the process in which a government agency gives an individual permission to practice an occupation?
a. Certification b. Licensure c. Registry d. Credentialing e. None of the above |
b. Licensure
|
|
|
What is the primary source of conflict in complex organizations?
a. failed communication b. language barriers c. role conflict d. personal behaviour |
a. failed communication
|
|
|
Legally, what is the meaning of a lack of documentation of respiratory care on the medical record?
a. Staff was very busy. b. Staff is incompetent. c. Care was not given. d. Patient is status quo. |
c. Care was not given.
|
|
|
To determine the most recent medical status of a patient whom you are about to start treating, you would go to which section of the medical record?
a. History and physical b. Physician's orders c. Nurses' notes d. Progress sheet |
d. Progress sheet
|
|
|
Which of the following factors contributes to the high incidence of nosocomial pneumonias in postsurgical patients? I. Impaired swallowing or respiratory clearance II. Postoperative surgical pain III. Use of narcotics and sedatives IV. Instrumentation of the respiratory tract
a. III and IV b. II, III, and IV c. I, III, and IV d. I, II, III, and IV |
d. I, II, III, and IV
|
|
|
What is the most frequent route for transmission of nosocomial infections?
a. Vehicle b. Airborne c. Droplet d. Contact |
d. Contact
|
|
|
The equipment-processing method that destroys all forms of microorganisms best describes which of the following?
a. Cleaning b. Sterilization c. High-level disinfection d. Decontamination |
b. Sterilization
|
|
|
Which of the following disinfectants would you select to clean up a blood spill?
a. Ethyl alcohol b. Phenol c. Glutaraldehyde d. A 1:10 dilution of bleach |
d. A 1:10 dilution of bleach
|
|
|
In most professions, specific guidance in resolving ethical dilemmas is provided by which of the following?
a. An ethical theory b. Civil statutes c. Criminal statutes d. A code of ethics |
d. A code of ethics
|
|
|
A health professional who withholds the truth from a patient, saying it is for her own good, is engaged in what practice?
a. Fraud b. Infidelity c. Benevolent deception d. Nonmaleficence |
c. Benevolent deception
|
|
|
A Bourdon gauge regulator:
a. Is gravity dependent b. Measures pressure c. Is calibrated to flow d. B and C |
b. Measures pressure
c. Is calibrated to flow d. B and C Yes. A bourdon gauge mesasures pressure but is callibrated to flow. Good work. |
|
|
You are operating nasal prongs with a back-pressure compensated Thorpe tube flowmeter at 4 Lpm. A moderate resistance develops when the oxygen tubing becomes partially kinked. This will cause:
a. The float to drop and display actual flow. b. The float to drop, but have no effect on delivered flow. c. No change to the float position, but diminish actual flow. d. The float to drop and deliver a higher flow than displayed. |
a. The float to drop and display actual flow.
Yes. Flow always drops in the presence of back pressure. Back pressure compensated thorpe tubes always read acurately. |
|
|
How long will a full E cylinder of oxygen last if you are running it at 15 Lpm? (give yourself a 500 psi safety)
a. 48 minutes b. 42 minutes c. 37 minutes d. 32 minutes |
d. 32 minutes
Yes - Good Math!! |
|
|
Your patient is on a FiO2 of 0.35 via a Venti Mask. The O2 flowmeter is set to 6 Lpm. Their SpO2 is only 86% and you decide to increase the FiO2 to 0.40. You would
a. Increase the O2 flowmeter setting. b. Change the Venti mask diluter c. Widen the air entrainment port. d. A and B |
a. Increase the O2 flowmeter setting.
b. Change the Venti mask diluter d. A and B Yes. You need to change the diluter outright and increase flow to help guarantee fixed performance. |
|
|
You set up a cold nebulizer on a patient. The order was for a FiO2 0.40. You set the O2 flowmeter to 8 Lpm. At the mask, you notice the mist created disappears completely on inspiration and reappears on expiration.
a. Make no adjustments as this is appropriate. b. Increase the air entrainment port until the mist is seen continuously throughout the respiratory cycle. c. Increase the O2 flowmeter setting until the mist is seen continuously throughout the respiratory cycle. d. Ask your patient to slow their breathing. |
c. Increase the O2 flowmeter setting until the mist is seen continuously throughout the respiratory cycle.
Yes. This guarantees Fixed performance in terms of FiO2 |
|
|
In a cold nebulizer set-up to deliver a FiO2 of 0.60, water in the corrugated tube will:
a. Decrease the delivered flow. b. Decrease the delivered FiO2 c. Increase the air entrained d. Have no effect on performance |
a. Decrease the delivered flow.
Yes. Total output flow will diminish. Back pressure caused by the water will cause the jet work less efficiently thereby decreasing air entrained, increaseing FiO2 and reducing total output flow. |
|
|
To set up a 100% non-rebreathe mask appropriately, you should:
a. Ensure one exhalation port is open and the other is covered with a single one-way valve b. Ensure the bag collapses during inspiration. c. Set the flow precisely to 5 Lpm d. Open all air entrainment ports. |
a. Ensure one exhalation port is open and the other is covered with a single one-way valve
Yes. Even though two flap valves would provide even higher FiO2, it is considered a safety issue when there is no gas flow to the mask. |
|
|
Running a cold nebulizer setup, if the FiO2 is set to 0.28 and the flowmeter is set to 5 Lpm, the total flow output is:
a. 45 Lpm b. 50 Lpm c. 55 Lpm d. Unable to calculate |
c. 55 Lpm
Yes. 5 Lpm of oxygen and 50 Lpm of Air = 55 Lpm Total Flow |
|
|
Inhalation of dry gases can do which of the following? I. Increase viscosity of secretions II. Impair mucociliary motility III. Increase airway irritability
a. I, II b. III c. I, III d. I, II, III |
d. I, II, III
|
|
|
Clinical indications for delivering cool humidified gas include which of the following? I. Postextubation edema II. Upper airway inflammation III. Croup (laryngotracheal bronchitis) IV. History of airway hyperresponsiveness
a. II, III, IV b. I, II, III c. I, II, III, IV d. II, III |
b. I, II, III
|
|
|
Factors affecting a humidifier's performance include all of the following except which one?
a. Surface area b. Temperature c. Time of contact d. Outlet size |
d. Outlet size
|
|
|
What is the preferred method for delivering bronchodilators to spontaneously breathing and intubated, ventilated patients?
a. DPI b. SVN c. MDI d. Hand-bulb atomizer |
c. MDI
|
|
|
All of the following drugs or drug categories have been associated with increased airway resistance and bronchospasm during aerosol administration except which one?
a. Steroids b. Salbutamol c. Acetylcysteine d. Antibiotics |
b. Salbutamol
|
|
|
Advantages of the DPI drug delivery systems include all of the following except which one?
a. Low relative cost b. No propellants required c. No hand–breath coordination necessary d. Unaffected by humidity |
d. Unaffected by humidity
|
|
|
Specific clinical objectives of O2 therapy include which of the following? I. Decrease the symptoms caused by chronic hypoxemia II. Decrease the workload hypoxemia imposes on the heart and lungs III. Correct documented arterial hypoxemia
a. I, II b. II, III c. I, III d. I, II, III |
d. I, II, III
|
|
|
In which of the following conditions would you initially seek to provide the highest possible FIO2? I. CO poisoning II. Cyanide poisoning III. Severe shock or trauma
a. II, III b. I, II c. I, II, III d. I, III |
c. I, II, III
|
|
|
What can properly applied O2 therapy decrease? I. Ventilatory demand II. Work of breathing III. Cardiac output
a. II, III b. I, II c. I, II, III d. I, III |
c. I, II, III
|
|
|
Identify the ‘reliever’ medication(s):
a. Salbutamol Sulphate b. Salmeterol Sulphate c. Fluticasone proprionate d. Tiatropium Bromide |
a. Salbutamol Sulphate
Yes. The onset is very short and the peak is within the hour. |
|
|
Atrovent:
a. is a parasympatholytic b. blocks the cholinergic response in airway smooth muscle c. is also known as ipratropium bromide d. A and C e. A,B and C |
a. is a parasympatholytic
b. blocks the cholinergic response in airway smooth muscle c. is also known as ipratropium bromide e. A,B and C Yes. You got it!!! |
|
|
To minimize complications associated with deep suctioning:
a. pre-oxygenate the patient for 10 seconds b. Apply suction while advancing the catheter c. Keep total suction time to about 60 seconds d. Ellicit a carinal cough |
d. Ellicit a carinal cough
Yes. A cough will help with secretion mobilization and hepfully improve therapeutic outcomes. |
|
|
Regarding MDI or SVN delivery, particle inertial impaction increases when:
a. velocity is high b. particle size is less than 5 micrometres c. flow is turbulent d. A and C |
a. velocity is high
c. flow is turbulent d. A and C |
|
|
Given the following ranges, an appropriate initial adult tracheal suctioning level range is:
a. –60 to –80 mmHg b. –60 to –100 mmHg c. –100 to –120 mmHg d. –100 to –140 mmHg |
c. –100 to –120 mmHg
Yes. By the book |
|
|
You are delivering 5 mg Ventolin and 250 mcg of Atrovent in 3cc N/S via small volume nebulizer (SVN). You set the flowmeter to 6Lpm and immediately, the SVN sputters intermittently creating an aerosol. Your next action(s) should include:
a. gently flicking the SVN reservoir cup b. ensuring the patient is supine c. increase the output flow until aerosol production is smooth and constant d. A and C e. A,B and C |
c. increase the output flow until aerosol production is smooth and constant
Yes. Smooth aerosol production is important for proper nebulization. You can either do this be increasing the flow OR first making sure you have no leaks in the system (the O2 nipple is renoun for causing lots of grief in this situation) |
|
|
Ventolin:
a. is a sympatholytic. b. Peaks in about 30 min.--> 1 hour c. is given for its beta 1 specificity d. Is an anticholinergic |
b. Peaks in about 30 min.--> 1 hour
Yes. If taken correctly of course. |
|
|
In delivering bronchodilators using a MDI, effective drug delivery is enhanced when:
a. puffs are taken 5 seconds apart b. a spacer is used. c. Patient is to take in one breathe only. d. A and B |
b. a spacer is used.
Yes. This slows down velocity, improving laminar flow and improves hand breath cooridination. |
|
|
Racemic epinephrine
a. is indicated in the event of upper airway swelling b. is given for its beta 1 effects c. is an adrenergic d. A and C e. A,B and C |
a. is indicated in the event of upper airway swelling
c. is an adrenergic d. A and C Yes. It is a single isomer of epinephrine and indicated for airway swelling. A dangerous drug and requires monitoring due to the potential for rebound a few hours later. Note: no longer available use epinephrine. |
|
|
If suctioning a #8.0 ETT, what size catheter should you select:
a. 6 fr. b. 8 fr. c. 12 fr. d. 16 fr. |
c. 12 fr.
Yes. By our formula, ETT x3/2 = Suction catheter in fr. Also accept a 14 fr. This is what you will see clinically, rule of thumb in Egan's page 655. ETT I.D * 2 then next smallest size. 8 * 2 = 16 use 14 fr. |
|
|
What is the most common complication of suctioning?
a. Infection b. Arrhythmias c. Hypotension d. Hypoxemia |
d. Hypoxemia
|
|
|
While suctioning a patient, you observe an abrupt change in the electrocardiogram (EKG) waveform being displayed on the cardiac monitor. Which of the following actions would be most appropriate?
a. Change to a smaller catheter and repeat the procedure. b. Stop suctioning and immediately administer oxygen. c. Stop suctioning and report your findings to the nurse. d. Decrease the amount of negative pressure being used. |
b. Stop suctioning and immediately administer oxygen.
|
|
|
Which of the following devices are most commonly used to deliver aerosols by the inhalation route? I. Dry powder inhaler II. Metered dose inhaler III. Small-volume nebulizer IV. Slip-stream nebulizer
a. I and III b. II and IV c. I, II, and III d. I, II, III, and IV |
c. I, II, and III
|
|
|
Short-acting non-catecholamine agents can be given on a qid schedule because their duration of action is approximately how long?
a. 1 to 2 hours b. 2 to 3 hours c. 4 to 6 hours d. 6 to 8 hours |
c. 4 to 6 hours
|
|
|
What are some potential adverse effects with use of adrenergic bronchodilators? I. Hypokalemia II. Dizziness III. Worsening ventilation/perfusion ratio (V/Q) IV. Bradycardia
a. I and IV only b. II and III only c. I, II, and III d. I, II, III, and IV |
c. I, II, and III
|
|
|
What are some common side effects seen with Ipratropium bromide (Atrovent)?
a. tachycardia b. blood pressure increase c. cough and dry mouth d. tolerance |
c. cough and dry mouth
|
|
|
Which of the following are indications for use of acetylcysteine (Mucomyst)? I. Treatment of acetaminophen overdose II. Treatment of excessive, viscous mucus secretions III. Treatment of aspirin overdose IV. Treatment of purulent mucus secretions by breaking up DNA
a. I and II only b. II and IV only c. I, II, and III d. I, II, III, and IV |
a. I and II only
|
|
|
How does cromolyn sodium work?
a. Producing antiinflammatory enzymes within cells b. Inhibiting degranulation of mast cells c. Preventing arachidonic acid formation from activation of mast cell membrane phospholipase A2 d. Leukotriene inhibition |
b. Inhibiting degranulation of mast cells
|
|
|
You need to intubate a 12 y.o. patient. An appropriate size ETT to prepare is:
a. #3.0 b. #5.0 c. #7.0 d. #9.0 |
c. #7.0
Yes. Use the (Age/4) +4 rule as a guide |
|
|
A patient is ready for extubation if:
a. The patient meets traditional weaning criteria after a spontaneous breathing trial. b. A gag reflex is intact. c. No leak is confirmed when the cuff is fully deflated. d. A and B e. A,B and C |
a. The patient meets traditional weaning criteria after a spontaneous breathing trial.
b. A gag reflex is intact. d. A and B Yes. 2 of the 4 indications. You still need to confirm risk of obstruction and secretion mobilization. |
|
|
Endotracheal tube cuff pressures
a. Should ideally fall between 18 and 30 mmHg. b. Should be the lower pressure required to obtain a satisfactory seal. c. Can be adjusted using the minimum occlusion volume technique. d. B and C e. A, B and C |
b. Should be the lower pressure required to obtain a satisfactory seal.
c. Can be adjusted using the minimum occlusion volume technique. d. B and C LOVE YOU MORE!!! |
|
|
When intubating a patient with a #3 Macintosh blade, correct procedure includes:
a. Holding the laryngoscope in the left hand b. Sweeping the tongue from the left to the right c. Direct lifting of the epiglottis with the tip of the blade d. A and C e. A,B and C |
a. Holding the laryngoscope in the left hand
GOOD LUCK!!! |
|
|
Heat and moisture exchangers should NOT be used if:
a. The patients body core temperature as < 32 deg. Celcius b. The patient exhibits productive copious thick secretions. c. The patient has a cuffless tube d. A and B e. A, B and C |
a. The patients body core temperature as < 32 deg. Celcius
b. The patient exhibits productive copious thick secretions. c. The patient has a cuffless tube e. A, B and C |
|
|
Proper positioning of a patient during basic oroendotracheal intubation requires:
a. Flexion of the neck b. Alignment on the mouth, pharynx and larynx. c. Slight backwards head tilt. d. All of the above. |
d. All of the above.
Only do this if C-spines are clear of course. |
|
|
Airway obstruction in a tracheostomy tube can be caused by:
a. Biting on the tube b. Mucus plugging c. Rupture of the pilot line d. Removal of the obturator |
b. Mucus plugging
|
|
|
While weaning a patient from an airway, if you are using a cuffed fenestrated tracheostomy tube:
a. Ensure the cuff is deflated. b. Ensure a non-fenestrated inner cannula is in place. c. Ensure the fenestration is patent. d. A and C |
a. Ensure the cuff is deflated.
c. Ensure the fenestration is patent. d. A and C This will optimize use of the larynx as an airway as opposed to the stoma. |
|
|
Indication(s) for an artificial airway include:
a. Apnea b. Hypoxemia c. Obstruction d. All of the above |
c. Obstruction
If someone obstructs their airway, they will need an artificial airway |
|
|
During the actual re-insertion of a tracheostomy tube, ensure:
a. The inner cannula is in place. b. The fenestration is patent. c. The obturator is in place. d. A and C |
c. The obturator is in place.
This is require or you may cause stoma or trachel damage during insertion. LOVE YOU MORE!!!! |
|
|
After an intubation attempt, an expired capnogram indicates a CO2 level of 5.1%. What does this finding probably indicate?
a. An abnormally high V/Q b. Placement of the ET in the esophagus c. Placement of the ET in the lungs d. Failure of the cuff to properly seal the airway |
c. Placement of the ET in the lungs
|
|
|
What is the average distance from the tip of a properly positioned oral ET to the incisors of an adult man?
a. 15 -17 cm b. 18 - 20 cm c. 21 - 23 cm d. 25 - 27 cm |
c. 21 - 23 cm
|
|
|
Which of the following bedside methods can absolutely confirm proper ET position in the trachea?
a. Auscultation b. Observation of chest movement c. Tube length (cm to teeth) d. Fiberoptic laryngoscopy |
d. Fiberoptic laryngoscopy
|
|
|
A practitioner forgets to ice an ABG sample and leaves it at room temperature for 45 minutes. Which of the following increases can you predict will occur to this sample in that period? I. PCO2 II. pH III. PO2
a. I only b. I and II c. II and III d. I, II, and III |
a. I only
|
|
|
Which of the following is a volatile acid of physiological significance?
a. Hydrochloric b. Carbonic c. Phosphoric d. Lactic |
b. Carbonic
|
|
|
Based on the following measures, what is the most likely acid–base diagnosis? pH = 7.31 PCO2 = 77 mm Hg HCO3 = 37 mEq/L A. Partially compensated respiratory acidosis B. Fully compensated respiratory acidosis C. Acute (uncompensated) respiratory acidosis D. Partially compensated metabolic alkalosis
a. Partially compensated respiratory acidosis b. Fully compensated respiratory acidosis c. Acute (uncompensated) respiratory acidosis d. Partially compensated metabolic alkalosis |
a. Partially compensated respiratory acidosis
|
|
|
Based on the following measures, what is the most likely acid–base diagnosis? pH = 7.41, PCO2 = 20 mm Hg, HCO3 = 12 mEq/L
a. Partially compensated respiratory alkalosis b. Acute (uncompensated) metabolic alkalosis c. Acute (uncompensated) respiratory alkalosis d. Fully compensated respiratory alkalosis |
d. Fully compensated respiratory alkalosis
|
|
|
When analyzing an ABG sample from a patient with acute respiratory distress syndrome (ARDS) and refractory hypoxemia, you notice a PaO2 of 141 mm Hg and a PaCO2 of 14 mm Hg. Which of the following analytic errors should you suspect?
a. Excessive time since sample collection b. Exposure of the blood sample to air c. Excessive heparin in the sample d. Sample admixture with venous blood |
b. Exposure of the blood sample to air
|
|
|
AutoPEEP:
a. is the sum of extrinsic and intrinsic PEEP b. promotes patient ventilator asynchrony c. reduces mean airway pressure d. Reduces PEEP set |
b. promotes patient ventilator asynchrony
Yes. Sensistivity mechanisms are tuned to PEEP set... not PEEP total. AutoPEEP will increase PEEP total thereby making sensitivity mechanisms insensitive.. promoting vent/pt dysynchrony. |
|
|
Steps to troubleshoot an oral endotracheal tube occlusion include:
a. repositioning the head and checking the mouth b. attempting to pass a suction catheter c. deflating the cuff d. A, B and C |
d. A, B and C
|
|
|
While performing rounds on a patient who is mechanically ventilated in volume control, you notice the peak inspiratory pressure (PIP) has increased by 5 cmH2O since the morning. Measurement of plateau pressure (Pplat) shows an identical increase. No autopeep is present. This finding suggests:
a. an increase in airways resistance b. a decrease in compliance c. an increase in compliance d. Autopeep |
b. a decrease in compliance
Yes. The lungs are stiffer and exact a greater pressure for a given volume. |
|
|
Which of the following is NOT a common cause of high pressure alarms while ventilating a pt in in volume control:
a. biting the airway b. mucus plugging c. increased compliance d. coughing |
c. increased compliance
Yes. Looser lungs mean lower pressures for a given volume |
|
|
An indication for mechanical ventilation is:
a. apnea b. chronic ventilatory failure c. hypoxemia d. Atelectasis |
a. apnea
|
|
|
You are called to an ICU bed to troubleshoot an alarm condition. The patient is being ventilated in assist control volume control. The Low Pressure alarm, Low tidal volume alarm, low minute volume alarm are ringing. Possible causes for this condition are:
a. Cuff leak b. accidental extubation c. the ETT migrated down the right mainstem bronchus d. A and B e. A, B and C |
a. Cuff leak
b. accidental extubation d. A and B Yes. Low pressures, low volumes usually equal leak or extubation |
|
|
Which statement(s) is/are true regarding measured (exh) tidal volume while ventilating in CMV(PCV) for FVS strategies and relatively normal lungs. (adult)
a. ideally, it should be 8-10 cc/kg b. is variable with changes in compliance c. decreases in the presence of autopeep d. all of the above |
a. ideally, it should be 8-10 cc/kg
b. is variable with changes in compliance c. decreases in the presence of autopeep d. all of the above LOVE YOU MORE |
|
|
While mechanically ventilating a patient, a severe leak around an ETT can:
a. promote auto-triggering (aka. auto-cycling). b. prevent flow cycling in certain modes. c. prevent time cycling. d. A and B . e. A,B and C |
a. promote auto-triggering (aka. auto-cycling).
b. prevent flow cycling in certain modes. d. A and B . Yes. Good thinking!! Inspiratory Flows will not diminish well and may not promote flow cycling and whether is pressure based or flow based, the sensitivity mechnism will cause auto-triggering |
|
|
Signs of inadequate pressure support ventilation include:
a. accessory muscle use b. high PIP c. high tidal volumes d. Low RR |
a. accessory muscle use
|
|
|
During an SBT, an acceptable weaning parameter is:
a. Tidal Volume ~ 5 cc/kg b. Vd/Vt > 0.60 c. FiO2 > 0.60 d. Tobin >105 |
a. Tidal Volume ~ 5 cc/kg
Yes. Vt's of 5cc/kg are very acceptable for a +ve SBT... provided other parameters are in line such as RR. |
|
|
Which of the following indicate severely impaired oxygenation requiring high FIO2s and positive end expiratory pressure (PEEP)? I. PAO2 – PaO2 greater than 350 mm Hg on 100% O2 II. VC less than 10 mL/kg III. PaO2/FIO2 less than 200
a. I and II b. I and III c. II and III d. I, II, and III |
b. I and III
|
|
|
Which of the following measures taken on adult patients indicate unacceptably high ventilatory demands or work of breathing?
a. VE of 17 L/min b. Breathing rate of 22/min c. VD/VT of 0.45 d. MIP of –40 cm H2O |
a. VE of 17 L/min
|
|
|
An adult patient suffering from altered mental status brought on by acute brain injury exhibits an irregular respiratory pattern with episodes of apnea. Which of the following would you recommend for this patient? I. CMV assist-control II. CPAP III. SIMV with adequate backup rate
a. I and II b. I and III c. II and III d. I, II, and III |
b. I and III
|
|
|
Patients with which of the following respiratory diseases are least likely to benefit from NPPV?
a. COPD b. Community-acquired pneumonia c. Acute cardiogenic pulmonary edema d. Pneumonia in a COPD patient |
b. Community-acquired pneumonia
|
|
|
Which of the following modes is not commonly seen on noninvasive ventilators?
a. CPAP b. Spontaneous (pressure assist) c. Timed (pressure limited, time cycled) d. Volume control |
d. Volume control
|
|
|
Your patient is being ventilated with a nasal mask to relieve dyspnea. He has a long history of COPD and hypercarbia. What is the goal of NPPV in this setting with regard to the ABG?
a. Return the PaCO2 to 40 to 45 mm Hg b. Return the pH to near normal c. Return the PaCO2 to less than 60 mm Hg d. Return the bicarb level to near normal |
b. Return the pH to near normal
|
|
|
After starting volume-cycled mechanical ventilation on a patient in respiratory failure with a VT of 10 mL/kg, you measure and obtain a plateau pressure of 45 cm H2O. Which of the following actions would you recommend to the patient's doctor?
a. Decrease the inspiratory flow. b. Add PEEP. c. Administer a bronchodilator. d. Lower the delivered VT. |
d. Lower the delivered VT.
|
|
|
Which of the following benefits can be realized when applying PPV to patients with congestive heart failure (CHF)? I. Decreased left ventricular preload II. Increased left ventricular afterload III. Improved arterial oxygenation
a. I and II b. I and III c. II and III d. I, II, and III |
b. I and III
|
|
|
A Bourdon gauge regulator:
a. Must be kept upright to accurately read flow b. Directly measures flow c. Is calibrated to flow d. A and C |
c. Is calibrated to flow
|
|
|
You need to intubate a 7 y.o. patient. An appropriate size ETT to prepare is:
a. #3.5 b. #5.5 c. #7.5 d. #9.5 |
b. #5.5
LOVE YOU MORE! |
|
|
One indication for extubation is:
a. A Tobin score of 106 from a spontaneous breathing trial. b. The absence of a gag reflex c. No leak is confirmed when the cuff is fully deflated. d. Scant secretions with a strong cough |
d. Scant secretions with a strong cough
|
|
|
Recommended endotracheal tube cuff pressures
a. Should be set at 30 mmHg. b. Require at least 20 cc's of air. c. Can be adjusted using the minimum occlusion volume technique. d. A and C |
c. Can be adjusted using the minimum occlusion volume technique.
|
|
|
Recommended endotracheal tube cuff pressures
a. Should be set at 30 mmHg. b. Require at least 20 cc's of air. c. Can be adjusted using the minimum occlusion volume technique. d. A and C |
c. Can be adjusted using the minimum occlusion volume technique.
|
|
|
Heat and moisture exchangers can be used if:
a. The patients body core temperature is < 32 deg. Celcius b. The patient exhibits productive copious thick secretions. c. The patient has a cuffed endotracheal tube. d. A and C |
c. The patient has a cuffed endotracheal tube.
|
|
|
Proper positioning of a patient during basic oroendotracheal intubation requires:
a. Extension of the neck b. Alignment on the mouth, pharynx and larynx axes. c. Ensuring the head is tilted down and forward d. All of the above. |
b. Alignment on the mouth, pharynx and larynx axes.
|
|
|
While weaning a patient from an airway, if you are using a cuffed fenestrated tracheostomy tube:
a. Ensure the cuff is deflated. b. Ensure a non-fenestrated inner cannula is in place. c. Ensure the fenestration is patent. d. A and C |
a. Ensure the cuff is deflated.
c. Ensure the fenestration is patent. d. A and C |
|
|
During the actual re-insertion of a tracheostomy tube, ensure:
a. The inner cannula is in place. b. The fenestration is patent. c. The obturator is in place. d. A and C |
c. The obturator is in place.
|
|
|
Which of the following is/are indications for oxygen therapy?
a. To reduce workload on the myocardium b. To reduce work of breathing. c. To reduce hypoxemia d. All are correct. |
a. To reduce workload on the myocardium
b. To reduce work of breathing. c. To reduce hypoxemia d. All are correct. |
|
|
To set up a 100% non-rebreathe mask appropriately, you should:
a. Ensure both exhalation ports are covered with one-way valves b. Ensure the bag does not completely collapse during inspiration. c. Set the flow precisely to 5 Lpm d. A and B |
b. Ensure the bag does not completely collapse during inspiration.
|
|
|
(A-a)DO2 gradient can be widened by:
a. increasing the FiO2 b. reducing capillary shunt c. Improving ventilation to perfusion matching d. Increasing the Hemoglobin |
a. increasing the FiO2
|
|
|
Cor pulmonale will clinically manifest with:
a. Left axial deviation. b. JVD c. pulmonary edema d. A and B |
b. JVD
|
|
|
Paradoxical breathing:
a. is a sign of mild respiratory distress b. manifests with the abdomen sinking on inspiration c. always occurs with asthmatic attacks d. Leads to Kussmal breathing |
b. manifests with the abdomen sinking on inspiration
|
|
|
_________ is expected to decrease in the PFT results of a severe COPD patient.
a. FEV1 b. RV c. FRC d. A and B e. A,B and C. |
a. FEV1
|
|
|
Identify the ‘reliever’ medication(s):
a. Ipratropium Bromide b. Salmeterol Sulphate c. Fluticasone proprionate d. Budesonide |
a. Ipratropium Bromide
|
|
|
Atrovent:
a. is a parasympathomimetic b. blocks the cholinergic response in airway smooth muscle c. is also known as Tiotropium bromide d. Is an adrenergic |
b. blocks the cholinergic response in airway smooth muscle
|
|
|
Given the following ranges, an appropriate initial neonatal tracheal suctioning level range is:
a. –60 to –80 mmHg b. –20 to –40 mmHg c. –100 to –120 mmHg d. –80 to –120 mmHg |
a. –60 to –80 mmHg
|
|
|
Which of the following is an inhaled steroid medication?
a. Intal b. Singular c. Oxeze d. Fluticasone |
d. Fluticasone
|
|
|
Ventolin:
a. is a sympatholytic. b. Peaks in about 30 min.--> 1 hour c. is given for its alpha 1 specificity d. Is an anticholinergic |
b. Peaks in about 30 min.--> 1 hour
|
|
|
Racemic epinephrine:
a. is indicated in the event of a classic asthma attack b. is given for its beta 1 effects c. is an adrenergic d. Obliterates disulphide bonds |
c. is an adrenergic
|
|
|
If suctioning a #6.0 ETT, what size catheter should you select:
a. 5 fr. b. 6 fr. c. 10 fr. d. 12 fr. |
c. 10 fr.
|
|
|
AutoPEEP:
a. is the sum of extrinsic and intrinsic PEEP b. promotes patient ventilator asynchrony c. reduces mean airway pressure d. Reduces PEEP set |
b. promotes patient ventilator asynchrony
|
|
|
While performing rounds on a patient who is mechanically ventilated in volume control, you notice the peak inspiratory pressure (PIP) has increased by 5 cmH2O since the morning. Measurement of plateau pressure (Pplat) shows an identical increase. No autopeep is present. This finding suggests:
a. an increase in airways resistance b. a decrease in compliance c. an increase in compliance d. Autopeep |
b. a decrease in compliance
|
|
|
Which of the following is NOT a common cause of high pressure alarms while ventilating a pt in in volume control:
a. biting the airway b. mucus plugging c. increased compliance d. coughing |
c. increased compliance
|
|
|
Indication(s) for mechanical ventilation include:
a. apnea b. acute ventilatory failure c. refractory hypoxemia d. All of the above. |
a. apnea
b. acute ventilatory failure c. refractory hypoxemia d. All of the above. |
|
|
Which statement(s) is/are true regarding measured tidal volume while ventilating in CMV(PCV) for FVS strategies and relatively normal lungs.
a. ideally, it should be 6-10 cc/kg b. is variable with changes in compliance c. decreases in the presence of autopeep d. all of the above |
a. ideally, it should be 6-10 cc/kg
b. is variable with changes in compliance c. decreases in the presence of autopeep d. all of the above |
|
|
While mechanically ventilating a patient, a severe leak around an ETT can:
a. promote auto-triggering (aka. auto-cycling). b. prevent flow cycling in certain modes. c. prevent time cycling. d. A and B . |
a. promote auto-triggering (aka. auto-cycling).
b. prevent flow cycling in certain modes. d. A and B . |
|
|
During an SBT, an acceptable weaning parameter is:
a. Tidal Volume ~ 2 cc/kg b. Vd/Vt < 0.60 c. FiO2 > 0.60 d. Tobin >105 |
b. Vd/Vt < 0.60
|
|
|
Which of the following is true regarding alveolar pressures?
a. is always negative during quiet breathing b. is positive during inspiration c. is negative during inspiration d. does not change during breathing |
c. is negative during inspiration
LOVE YOU MORE!! |
|
|
Which of the following is true in the legal sense regarding a respiratory therapy procedure that was not documented?
a. staff were too busy to chart b. staff were not required to document the procedure c. procedure was not done d. patients vitals did not change, therefore not required |
c. procedure was not done
|
