Question 1

A 150-lb (IBW) patient has a tidal volume of 500 ml and a ventilatory rate of 12 breath/minute Calculate the patient’s alveolar minute ventilation. Assume the absence of dead-space disease.

  1. 1.8 liters/minute
  2. 4.2 liters/minute
  3. 2.3 liters/minute
  4. 6.0 liters/minute

 

Question 2

A 164-lb patient has a measured tidal volume of 600 ml and is breathing 18 times per minute. What is the estimated alveolar minute ventilation for this patient?

  1. 7848 ml
  2. 6920 ml
  3. 5965 ml
  4. 4130 ml

 

Question 3

A 40-year-old patient recovering from ARDS is receiving mechanical ventilation with a tidal volume of 650 ml. The patient has pulmonary artery catheter and capnometry for monitoring. The following information is collected; PaCO2 – 43 torr, PaO2 – 79 torr, PvO2 – 32 torr, and PeCO2 – 22 torr. Calculate the patient’s Vd (physiologic dead space volume).

  1. 273 ml
  2. 317 ml
  3. 338 ml
  4. 384 ml

 

Question 4

A 55 year-old man was admitted to the hospital for shortness of breath. The following results were obtained: PaCO2 = 50 mmgH, PECO2 = 30 mmHg and tidal volume of 600 ml. What is the patientls physiologic deadspace (Vd)?

  1. 150 ml
  2. 175 ml
  3. 240 ml
  4. 310 ml

 

Question 5

A 70 kg patient receiving mechanical ventilation has a tidal volume of 900 ml, frequency of 12, PIP of 45 and PEEP of 10. When an inspiratory hold plateau of .5 sec is activated, the static pressure is 35 cmH2O. Determine the patient’s static compliance.

  1. 36.18 ml/cmH2O
  2. 30.48 ml/cmH2O
  3. 22.65 ml/cmH2O
  4. 15.72 ml/cmH2O

 

Question 6

A 70 kg patient receiving mechanical ventilation has a tidal volume of 900 ml, frequency of 12, PIP of 45 and PEEP of 10. When an inspiratory hold plateau of .5 sec is activated, the static pressure is 35 cmH2O. Determine the patient’s dynamic compliance.

  1. 15.21 ml/cmH2O
  2. 25.71 ml/cmH2O
  3. 29.46 ml/cmH2O
  4. 32.09 ml/cmH2O

 

Question 7

A 70-kg patient with asthma is receiving mechanical ventilation and is not responding favorably to routine therapy. The vent settings are: Mode: control, Rate; 12/min, Vt: 850 ml, Vi: 60 L/min and FiO2 30%. The ventilator is displaying the volume-pressure loop below. What should the RRT do at this time to correct the situation? (Figure 6)

  1. Decrease the peak inspiratory flow rate
  2. Add PEEP
  3. Decrease the patient’s tidal volume
  4. Do nothing, this condition is acceptable

 

Question 8

A patient complains of the following symptoms:

Excessive daytime fatigue
Headaches upon awakening
Decreased ability to concentrate
Memory loss

Which of the following test is appropriate for this patient?

  1. Bronchoscopy
  2. Pre and post bronchodilator study
  3. Sleep study with overnight pulse oximetry
  4. Bronchoprovocation testing

 

Question 9

A patient is being mechanically ventilated in a volume-controlled, time-cycled mode. The flow waveform shown below is displayed on ventilator’s monitor. Which of the following ventilator adjustments would be appropriate at this time? (Figure 5)

  1. Decrease the tidal volume
  2. Decrease the peak inspiratory flow
  3. Decrease the ventilatory rate
  4. Decrease the expiratory time

 

Question 10

A patient receiving mechanical ventilation with the following settings:

FiO2 40%
PIP 55 cmH2O
PEEP 10 cmH2O
Peak inspiratory flow rate: 60 L/min
Tidal volume: 800 ml
Plateau pressure: 35 cm H2O

Calculate the airway resistance for this patient:

  1. 10 cmH2O/L/sec
  2. 20 cmH2O/L/sec
  3. 30 cmH2O/L/sec
  4. 40 cmH2O/L/sec

 

Question 11

A patient suspect of having carbon monoxide poisoning presents to the ER. CO-oximeter results reveal the following:

17.5 g total HB
4.7 g COHb
1.0 g MetHb

Based on this information, the patient’s saturation of arterial blood should be:

  1. 95%
  2. 67%
  3. 75%
  4. 55%

 

Question 12

A patient who is on a volume ventiltaor has the following measurments: corrected tidal volume = 780 ml, peak airway pressure = 55 cmH2O, plateau pressure = 35 cmH20, and PEEP of 10 cmH2O. What is the dynamic compliance?

  1. 17.3 ml/cmH2O
  2. 22.3 ml/cmH2O
  3. 14.2 ml/cmH2O
  4. 31.2 ml/cmH2O

 

Question 13

All of the following are methods to reduce auto-PEEP EXCEPT:

  1. Decreasing the inspiratory time
  2. Decreasing the tidal volume
  3. Increasing the flow rate
  4. Increasing the rate

 

Question 14

Below is a volume waveform form a patient receiving mechanical ventilation with a volume ventilator (Figure 8). This waveform indicates which of the following?

  1. It represents a normal volume waveform
  2. The patient has obstructive lung disease
  3. There may be a leak around the ET tube cuff
  4. The patient is coughing or agitated

 

Question 15

Calculate the estimated airway resistance of a patient whose peak airway pressure is 25 cmH2O, plateau pressure of 10 cmH2O, and ventilator flow rate is set at 60 L/min.

  1. 15 cmH2O/L/sec, normal
  2. 15 cmH2O/L/sec, abnormal
  3. 10 cmH2O/L/sec, normal
  4. 10 cmH2O/L/sec,ab normal

 

Question 16

Calculate the alveolar oxygen tension (PAO2) given the following values: PB = 750 mmHg, FiO2 – 30%, and PaCO2 – 40.

  1. 100 mmHg
  2. 130 mmHg
  3. 161 mmHg
  4. 190 mmHg

 

Question 17

Calculate the static compliance by using the data from the tracings presented in Figure 9.

  1. 15 ml/cmH2O
  2. 23 ml/cmH2O
  3. 30 ml/cmH2O
  4. 40 ml/cmH2O

 

Question 18

Exhaled volumed are collected from a patient over a 1 minute interval; during this time it is determined that the average tidal volume is 714 ml with a total minute ventilation of 10 L. What is the patient’s frequency?

  1. 10 breaths per minute
  2. 14 breaths per minute
  3. 18 breaths per minute
  4. 24 breaths per minute

 

Question 19

Given the data below, calculate the patient’s dead space/tidal volume ratio:
FiO2 40%
pH 7.38
PaO2 75 torr
PaCO2 49 torr
PeCO2 32 torr

  1. 21%
  2. 35%
  3. 47%
  4. 68%

 

Question 20

Given the following values for room air: PAO2 – 105 mmHg, PaO2 – 70 mmHg, what is the P(A-a)O2? Is it normal?

  1. 70 mmHg; normal
  2. 70 mmHg; abnormal
  3. 35 mmHg; normal
  4. 35 mmHg; abnormal


Question 21

Given the following ventilation parameters; corrected tidal volume of 700 ml, plateau pressure of 30 cmH2O, peak inspiratory pressure of 50 cmH2O, and 10 cmH2O PEEP, calculate the patient’s static lung compliance.

  1. 20 ml/cm H2O
  2. 35 ml/cm HO
  3. 15 ml/cm H2O
  4. 23 ml/cm H2O

 

Question 22

Given the follwoing measurements: Spontaneous tidal volume = 247 ml/min, spontaneous respiratory rate = 17/min. What is the calculated RSBI? Does the RSBI indicate a successful outcome when weaning?

  1. 24 breaths/min/L, yes
  2. 24 breaths/min/L, no
  3. 69 breaths/min/L, yes
  4. 69 breaths/min/l, no

 

Question 23

Heavy smokers commonly have HbCO levels as high as:

  1. 10%
  2. 20%
  3. 30%
  4. 40%

 

Question 24

If a patient has a minute ventilation of 9.6 L/min and a ventilator frequency of 10 breaths/min, what is the patient’s tidal volume?

  1. 9.6L
  2. 96.0 L
  3. 96.0 ml
  4. 960 ml

 

Question 25

If a patient weighing 140 lbs has a tidal volume of 400 and a ventilatory frequency of 14 breaths/minute what is the patient’s minute ventilation?

  1. 5.6 L
  2. 560 ml
  3. 56.0 L
  4. 4.0 L

 

Question 26

If a patient’s PaO2 is 540 mmHg and PAO2 is calcualted to be 642 mmHg, what is the alveolar-arterial oxygen tension difference? The patient is on 100% FiO2.

  1. 102 mmHg
  2. 540 mmHg
  3. 320 mmHg
  4. 265 mmHg

 

Question 27

The RRT is asked to evaluate the results of a diagnostic sleep study. Which of the following guidelines would the RRT use to determine the existence of sleep apnea?

  1. Three or more apneic episodes per hour, each lasting at least 6 seconds
  2. Five or more apneic episodes per hour, each lasting at least 10 seconds
  3. Five or more apneic episodes per hour, each lasting at least 3 seconds
  4. Eight or more apneic episodes per hour, each lasting at least 8 seconds

 

Question 28

The flow-time waveform below was obtained from a patient who was receiving mechanical ventilation. How should the RCP interpret this waveform? (Figure 7)

  1. It is normal
  2. The patient has to exert a large negative pressure to initiate inspiration
  3. Auto-PEEP is present
  4. The patient-ventilator system has a leak somewhere in it

 

Question 29

The following data is collected from a patient; PaCO2 – 40 mmHg, and PeCO2 – 30 mmHg. Which of the following is correct concerning his information?

  1. The Vd/Vt ratio is 45% and normal
  2. The Vd/Vt ratio is 45% and abnormal
  3. The Vd/Vt ratio is 25% and normal
  4. The Vd/Vt ratio is 25% and abnormal

 

Question 30

The pressure volume was obtained from a patient on a mechanical ventilator. Identify the point on the curve that coincides with the patient’s tidal volume. (Figure 2)

  1. A
  2. B
  3. C
  4. D

 

Question 31

The spontaneous minute ventilation and respiratory rate of a mechanically ventilated patient are 6.2 L/in and 30/min. Calculate the average spontaneous tidal volume and the RSBI. Does the calculated RSBI indicate a successful weaning outcome?

  1. Spontaneous Vt = .207 L; RSBI = 90/breaths/min/L; Yes
  2. Spontaneous Vt = .207 L; RSBI = 145 breaths/min/L; No
  3. Spontaneous Vt = .319 L; RSBI = 90 breaths/min/L; Yes
  4. Spontaneous Vt = .319; RSBI = 137 breaths/min/L; No

 

Question 32

The volume-pressure curve shown below was obtained from a patient who was receiving positive pressure mechanical ventilation. What interpretation can the RCP make about the patient based on the graph? (Figure 4)

  1. The patient’s airway resistance has increased
  2. The patient’s lung compliance has decreased
  3. The patient has recently been suctioned
  4. The patient has an endotracheal tube cuff leak

 

Question 33

When a volume-limited ventilator is used, the peak airway pressure is directly related to the:

  1. Patient’s airway resistance
  2. Patient’s lung compliance
  3. Respiratory rate
  4. FiO2

 

Question 34

When a volume-limited ventilator is used, the plateau (lung) pressure is directly related to the:

  1. Patient’s airway resistance
  2. Patient’s lung compliance
  3. Respiratory rate
  4. FiO2

 

Question 35

Which of the following are indications that home apnea monitoring should be initiated for an infant?

  1. Infant has experienced two apparent life-threatening events (ALTE)
  2. Infant born at 38 weeks of gestation with an occasional 5-second apnea period
  3. Infant is a sibling of three SIDS victims

 

Question 36

Which of the following measurements must be made to provide for the calculation of the Vt/Vd ratio?

  1. PvCO2
  2. PeCO2
  3. PACO2
  4. PaCO2

 

Question 37

Which of the following waveforms represent an inspiratory hold? (Figure 3)

  1. A
  2. B
  3. C
  4. D

 

Question 38

While reviewing the chart of a patient who is receiving mechanical ventilation, the RCP notices the following volume-pressure curve. The static compliance curve is in a normal position, but which of the following could cause the position of the dynamic compliance curve? (Figure 1)

  1. Mucus plugging
  2. Atelectasis
  3. Pneumothorax
  4. Bronchospasm

 

Question 39

While using continuous apnea monitoring for infants, the low heart rate should be set to alarm if the heart rate decreases to _____ and an apneic period of _____ seconds occurs.

  1. 80, 5 subglottic
  2. 80, 10
  3. 130, 30
  4. 100, 20

 

Question 40

You just finished analyzing an arterial blood sample in the laboratory and the co-oximeter shows total hemoglobin of 15 grams/100ml with a carboxyhemoglobin of 2 grams and methemoglobin of 2 grams. The amount of functional hemoglobin in this sample would be _____ grams.

  1. 15
  2. 13
  3. 11
  4. 9

 

Question 41

given; PB = 760 mmHg, FiO2 = 70%, and PaCO2 = 40 mmHg. What is the calculated alveolar oxgyen tension (PAO2)?

  1. 449 mmHg
  2. 370 mmHg
  3. 100 mmHg
  4. 268 mmHg

 

Question 42

Which of the following parameters indicate readiness for weaning a patient from mechanical ventilation?

  1. RSBI of 65 L/min
  2. VE of 13 L
  3. MIP of -30 cmH2O
  4. Raw of 12 cmH2O/L/sec

 

Question 43

You are monitoring a mechanically ventilatied patient with ARDS in the SIMV mode. At 7:00am the following is noted; PIP of 30 cmH2O and Plateau pressure of 25 cmH2O. At your next check, you note that the PIP is now 42 cmH2O and Plateau is 30 cmH2O. What action would you recommend?

  1. Change to pressure control mode
  2. Suction the patient’s airway
  3. Continue SIMV mode and reduce the tidal volume
  4. Recommend that a bronchodilator be administerd

 

Question 44

What action should be taken to correct the ventilator graph in figure 10?

  1. Adjust sensitivity
  2. Sedate the patient
  3. Suction patient’s airway
  4. Check for possible leak

 

Question 45

Which of the following statements are true regarding figure 11?

  1. The patient is receving 10 cmH2O PEEP
  2. The patient is initiating the breath
  3. The patient has decreased lung compliance

 

Question 46

It is determined that a patient has a tidal volume of 750 ml and a respiratory rate of 16. What is the patient’s minute ventilation?

  1. 12 L
  2. 11.2 L
  3. 9.75 L
  4. 7.5 L

 

Question 47

What types of hemoglobin are analyzed when usning hemoximetry:

  1. Oxyhemoglobin
  2. Methemglobin
  3. Carboxyhemoglobin
  4. Sickle cell hemoglobin

 

Question 48

Which of the following graphs are commonly monitored during mechanical ventilation?

  1. Flow
  2. Pressure
  3. Volume
  4. Time

 

Question 49

Increased dynamic compiance and stable static compliance would indicate:

  1. A problem in the airway
  2. Stiff lung tissue due to atelectasis
  3. A pneumothorax
  4. Patient has developed pulmonary edema


Question 50

A mechanically ventilated patient has previously had both increased peak and plateau pressures. The next ventilator check reveals a decrease in both peak and plateau pressures. What does this indicate about the patient’s lung characteristics?

  1. Dynamic and static compliance have improved
  2. Dynamic and static compliance have worsened
  3. Only dynamic compliance has improved
  4. Only static lung compliance has improved

 

Question 51

A 53-year-old male enters the ER complaining of the following: acute Orthopnea, Parsoxysmal noctural dyspnea, Syncope, and Diaphoresis. The RCP should initially recommend:

  1. An electrocardiogram
  2. An arterial puncture
  3. A pulmonary artery catheterization
  4. Pulmonary function testing
  5. Blood pressure

 

Question 52

A COPD patient is being cared for via home health visits. A RCP visits the patient and determines that the patient is losing muscle mass and weight. Which of the following recommendations should the RCP make to this patient to prevent further muscle wasting?

  1. Eat several small meals a day
  2. Eat only when you feel hungry
  3. Wear your nasal cannula at 2 lpm while you eat

 

Question 53

A RCP is assessing a patient with chronic bronchitis. The patient states that his secretions are thick and pale yellow in color. The RCP would chart this finding as:

  1. Mucoid
  2. Frothy
  3. Purulent
  4. Mucopurlent

 

Question 54

A RCP is called to assess a patient with chest pain. Auscultation reveals a pleural friction rub. The patient has been hospitalized for 2 days and has shown no improvement. The RCP should consider which of the following as possible diagnosis for this patient?

  1. The patient has developed pleurisy
  2. The patient is experiencing angina pectoris
  3. The patient has broken ribs
  4. The patient has developed an area of atelectasis

 

Question 55

A loud, continuous, high-pitched sound heard during auscultation of the larynx and trachea is called:

  1. Rhonchi
  2. Wheezing
  3. Stridor
  4. Crackles

 

Question 56

A near-drowning patient is brought to the ER. The RCP is asked to assist in assessing the patient for immediate care. A neurological assessment is performed. It is determined that during pain stimulus the patient opens his eyes and exhibits limb extension to painful stimuli. The patient responds with inappropriate word usage. According to this information, what Glasgow coma scale score should be assigned to the patient?

  1. 3
  2. 9
  3. 12
  4. 7