Partial preview of the text
Download NBRC TMC Pretest Exam Review Q&A and more Exams Nursing in PDF only on Docsity!
Science/ Medicinc/ Pulmonology Chest x-ray of a paticnt shows multilobar infiltrates in the right lung. SPO2 is 80% despite using 80% O2 by venturi mask. Ta better improve patient oxygenation the therapist should recommend? — ANS-WwPlace patient in left A respiratory therapist enters the room of a 65 year old post op female patient. The patient is less responsive with a pulse of 132 and respiratory rate of 8 per minute. She is currently on 21./min NC with SPO2 of 87%. The respiratory therapist best action at this point will be to: - ANS-WW Aetivate rapid response A neuromuscular paticnt is receiving oxygen and humidification by heated acrosol 40% O2 via T piece. The T—piccc is often become disconnected. To fix this issue the therapist should ~ ANS-vwlixchange the T-picce with an tracheostomy collar. For an 80 kg patient receiving invasive mechanical ventilalion, which of the following contraindicatcs weaning? — ANS-VWMinute ventilation of 1.76 L To assess respiratory muscle strength in a paticnt with a suspected neuromuscular disorder, a respiratory therapist should sclect a: - ANS-Wv Which of the following is most likely responsible when a pressure—cycled ventilator fails to cycle to expiration? — ANS-WVWpaticnt circuit leak The radial artery is the site of choice when performing an arterial puncture for which of the following reasons? — ANS-VVWClotting time is usually less than A 24-year-old male, who is HIV-positive, is recciving dapsone (Aczonc) for Pneumocystis pneumonia. [le complains of increased dyspnea. SpO2 is 86% and the nail beds appear dusky with a brownish color. A respiratory therapist should review the patient's — ANS-Wv methemoglobin Duc to progressive deterioration in ABG values and continucd respiratory muscle weakness, a physician decides to intubate a 50-year-old, 77—-kg (170—lb) male patient. Alter allaching a CO2 colorimetric device, a respiratory therapist should observe — ANS—W wa purple color in the viewing A 67-year-old female is recciving VC, A/C ventilation. A respiratory therapist is unable to advance a 14 I’r suction catheter through the patient's 8.0-mm cuffed tracheostomy tube. The therapist should? — ANS-wW replace the inner cannula To optimize particle deposition during bronchodilator therapy with a DPI, a respiralory therapist should instruct a patient in which of the following breathing patterns? — ANS-WW Inspiratory flow inspiratory volume cnd inspiratory hold Which of the following should a respiratory therapist do to improve manual ventilation of an unconscious patient with a suspected neck injury ? — ANS-Vv acceptable range. The therapist should - ANS-We perform a two-point calibration and rerun the control A mini—bronchoalveolar lavage procedure is recommended for diagnosing of — ANS-WVWventilator—associaled pneumonia Humidification for a hypothermic patient who has a tracheostomy should — ANS— Vv provide 100% relative humidity at 37° C (98.6° I). A respiratory therapist views a chest radiograph in which the clavicles are asymmetrically spaced around the sternum. The therapist should conclude that — ANS-W wv the paticnt was rotated. Prior to transport of a patient who is recciving mechanical ventilation, a respiratory therapist decides to add 5 cm H20 PEEP to a pneumatically powered transport ventilator. Which of the following should the therapist do? — ANS-Wv Add a threshold resistor to the exhalation . A respiratory therapist observes the low exhaled volume and low pressure alarms activating with cach breath. The following data are available: - ANS-Vv Advance the endotracheal tube to 22 cm A chest radiograph for a 58—ycar—old female shows atclectasis of posterior segments of right lawer lobe . Which of the following positions should a respiratory therapist recommend te improve oxygenation? — ANS-WVWPronc Which of the following characteristics is least typical for plcuritic chest pain? — ANS-VWRadiatcs to the arm Mr. Smith is monitored by central venous catheter. His chest x—ray indicates that the tip of the catheter is in lower portion of the superior vena cava. The therapist should recommend to: —- ANS-—WVW leave it in place which of the following PCWP values can be associated with CHI*? — ANS-WW18 mmHg In listening Lo a patient's lungs, you natice bronchial breath sounds in her right lower lobe. This would indicate which of the follawing? — ANS—WW consolidation in her lower lobe A patient who is 80 kg (176 Ibs) and is 165 cm (5 ft 5 in) tall is receiving IPPB therapy for atelectasis has a tidal volume of 550 ml at a pressure of 12 cm H20, Which of the following should the therapist recommend? — ANS-WWSet the pressure to achieve a tidal volume of 800 ml Prior to removal of a trachcostomy tube, a paticnt praduced approximatcly 100 ml of clear sputum cach day. The patient is now decannulated and has an open stoma. Her cough has become weak with minimal sputum production but increased in rhonchi, Which of the follawing procedures will assist the patient to clear secretions? — ANS-WWVCPT with postural drainage to both lungs A 59 ycar—old patient with poor dental hygiene becomes acutely ill with fever, hemoptysis and chest pain. After a period of dry cough, the patient all the sudden coughs up a large quantity of dark brown, malodorous and mucopurulent sputum, These characteristics is mast consistent with: - ANS-VWWLung abscess Observing decreased PaO2 and increased P(A—a)02 during exercise Lesting indicates: —- ANS-WW Decreased 02 consumption Which of the followings can be used to correctly confirm [fT tube placement? — ANS-WWv Chest x-ray A truma patient who has been on mechanical ventilation for the past 24 hrs, the high pressure alarm is sounding with cach breath. Which of the following will be the best first action to take? — ANS-WWManually ventilate the patient A patient has green purulent sputum, The sputum is separated into Lhree layer and has a foul odor. The patient most likely has - ANS-WwWBronchicctasis A physician has attempted on scveral occasions to insert a central vcnous catheter into the right subclavian vein of a mechanically ventilated patient. Suddenly, the ventilator's high-pressure alarm sounds off, the patient's blood pressure draps, and the SpO2 value draps from 95% to 82%. Breath saunds are greatly diminished over the right lung ficld. What should the respiratory therapist recommend? — ANS-WW Insert a drainage tube into the right pleural space. A patient in the Intensive Care Unit is being monitored for pneumonia. Which of the following values best indicates that a patient is experiencing tissuc hypoxia? — ANS-¢#W#PvO2 of 25 torr To determine whether the patient's diaphragm moves with each breath, the respiratory therapist should: - ANS-WWLook for the use of the stcrnoclcidomastoid muscles with cach inspiration. A 30-weck gcstational—age nconate needs to have an artcrialized capillary blood sample taken for analysis. Which of the following arc important in this procedure? — ANS-#WW1.The puncture site is warmed. 3.The puncture site is the outer side of the heel. 5.Pressure is applied after the puncture. A patient known to have advanced COPD has been hospitalized and is recciving oxygen at 5 I./min to a simple face mask. It is noticed that she is becoming lethargic and her breathing more shallow. Her SpO2 reading is 98%. What should the respiratory therapist recommend be dane at this time? — ANS-WWChange her to a nasal cannula adjust flow to maintain SPO2 88-92% An adult paticnt has recently had a central venous pressure catheter inserted. A chest radiograph has been taken. Where should the tip of the catheter be scen to indicate proper positioning? — ANS-WW Lower portion of superior vena cava A patient is ordered to start breathing treatments with pentamidince iscthionate (NebuPent). To minimize the possibility that medication may be released into the air, which of the following should be donc? — ANS-WWUsc a small—volume nebulizer with a scavenging system, When performing routine equipment rounds, the respiratory therapist notices that a patient wearing an acrosol mask is having "puffs" of acrosol delivered instead of a continuous acrosol stream. What could be causing this? - ANS-WW Water has collected at a low point in the acrosol tubing. After a patient has inhaled hypertonic saline from an ultrasonic nebulizer for 10 minutes, he begins to wheezc. What should be done at this time? — ANS-Wv Discontinue the treatment and notify the physician. A patient is improving, and the physician wants to begin weaning proccdurcs. Originally she was receiving VC, A/C at a rate of 12 times/min and a tidal volume af 600 ml. Now she is to be placed on pressure support ventilalion. The pressure support level is set at 10 em H20,. On PSV, but after 20 minutes she complains of breathing difficulty. Her Vt is 250 ml and RR of 30/min. What would a respiratory could be recommended to help prevent pulmonary complications during the treatment? — ANS-WW Have the patient get a Pncumovax 23 vaccination. 
