480+ Respiratory Therapy Multiple Choice Questions (2024)

Respiratory therapy is a challenging yet rewarding field that requires a deep understanding of pulmonary anatomy, physiology, patient care, and clinical procedures.

Preparing for exams and certifications can be daunting, which is why practicing multiple-choice questions is essential for reinforcing knowledge and boosting confidence.

In this guide, you’ll find a curated list of respiratory therapy multiple-choice practice questions designed to help you master key concepts and assess your readiness for various exams.

If you want to access the correct answers and take multiple quizzes to further test your knowledge, be sure to check out the link provided below.

Whether you are a student preparing for the TMC Exam or an experienced respiratory therapist seeking to refresh your skills, these practice questions will serve as a valuable resource.

Respiratory Therapy Exam Practice Questions

1. An adult male patient on ventilatory support has just been intubated with a 7.0 mm oral endotracheal tube equipped with a high residual volume low-pressure cuff. When sealing the cuff to achieve a minimal occluding volume, you note a cuff pressure of 45 cmH2O. What is the most likely problem?
A. The cuff pilot balloon and line is obstructed
B. The pressure manometer is out of calibration
C. The tube chosen is too small for the patient
D. The tube is in the right mainstem bronchus

2. To achieve the highest O2 concentration, you would select which of the following devices?
A. Venturi mask
B. Face tent
C. Nonrebreathing mask
D. Simple oxygen mask

3. You are asked to position a patient for orotracheal intubation. You should place the patient’s head:
A. In the sniffing position
B. Straight with the torso, with the neck hyperextended
C. Tilted forward toward the chest
D. Turned to the right, with the neck hyperextended

4. What maximum flow would you apply to an 8-year-old child receiving O2 therapy via a high-flow nasal cannula?
A. 5 L/min
B. 10 L/min
C. 15 L/min
D. 20 L/min

5. A patient is intubated with an appropriate size endotracheal tube and is being ventilated with a positive pressure ventilator. During inspiration, air is heard at the mouth. Which of the following should be done?
A. Check the cuff inflation
B. Suction the patient
C. Order a chest X-ray
D. Replace the tube

6. A galvanic oxygen analyzer is being used to monitor a mechanically ventilated patient. The patient is receiving 100% oxygen, and the analyzer registers 104%. Which of the following is the most likely cause for this?
A. The analyzer requires calibration
B. The analyzer probe has water condensation on its surface
C. The ventilator’s blending unit requires adjustment
D. The batteries in the analyzer need to be changed

7. A patient has a pH of 7.58 and a PaCO2 of 25 torr. Based on these data, what is the primary acid-base disturbance?
A. Respiratory alkalosis
B. Metabolic acidosis
C. Respiratory acidosis
D. Metabolic alkalosis

8. To change the level of negative pressure delivered by a pleural drainage system, you would:
A. Adjust the vacuum level on the suction regulator
B. Adjust the water level in the suction control chamber
C. Adjust the water level in the water seal chamber
D. Adjust the size of the atmospheric vent

9. During a single-breath capnogram, the sharp downstroke and return to baseline that normally occurs after the end-tidal point indicate:
A. Exhalation of mainly deadspace gas
B. Inspiration of fresh respiratory gas
C. Exhalation of mixed alveolar/deadspace gas
D. Exhalation of mainly alveolar gas

10. Bedside spirometry performed on a patient reveals the following: respiratory rate = 22, tidal volume = 360 mL, dead space = 150 mL, and inspiratory capacity = 1.0 L. Based on this data, what is the patient’s minute ventilation?
A. 3.3 L/min
B. 4.6 L/min
C. 7.9 L/min
D. 22.0 L/min

11. You are monitoring a recent postoperative craniotomy patient who is being mechanically ventilated and has an ICP of 22 mm Ng_ The latest ABG results are as follows: pH 7.35, PaCO2 47 mmHg, HCO3 25 mEq/L, BE 0, PaO2 89 mmHg, and SaO2 96%. Based on this information, which of the following is the most acceptable action?
A. Maintain the current settings
B. Decrease the tidal volume
C. Increase the minute ventilation
D. Add 10 cmH2O PEEP

12. Oropharyngeal and nasopharyngeal airways help restore airway patency by:
A. Providing a secure route into the larynx and trachea
B. Separating the tongue from the posterior pharyngeal wall
C. Isolating/protecting the lower airway from aspiration
D. Displacing the soft palate and uvula posteriorly

13. In patients with chronic respiratory disease, pedal edema is a sign of:
A. Impaired pulmonary diffusion
B. Hypercapnia (impaired CO2 removal)
C. Right ventricular hypertrophy
D. Systemic hypertension

14. To avoid preanalytic errors associated with air contamination of a blood gas sample, all of the following are appropriate EXCEPT:
A. Fully expel any bubbles
B. Mix only after bubbles are expelled
C. Cap the syringe quickly
D. Place the sample in an ice slush

15. Which of the following is the best way to avoid bright lights interfering with a pulse oximeter’s signal?
A. Recheck and clean the site
B. Shield or cover the probe
C. Apply the probe more tightly
D. Replace the probe

16. You hear a high-pitched sound coming from the pressure relief valve on a patient’s bubble-type humidifier. Gas can be felt coming from the valve. Which of the following could cause this problem?
1. The O2 delivery tubing is obstructed
2. The O2 flow is too high
3. The water reservoir jar lid is screwed on too tightly
4. The water reservoir jar lid is missing an O-ring
A. 1 and 3 only
B. 2 and 4 only
C. 1 and 4 only
D. 1 and 2 only

17. A patient rescued from a house fire is being monitored in the intensive care unit. Due to suspected CO poisoning, the patient is on a nonrebreathing mask at 12 L/min. A pulse oximeter reveals an Sp02 of 99%. An arterial blood sample is obtained and sent to the laboratory for gas analysis and hemoximetry (CO-oximetry). The lab results are as follows: pH 7.26, PaCO2 34 mmHg, PaO2 350 mmHg, HCO3 10 mEq/L, SaO2 100%, and BE 13 mEq/L. Hemoximetry reveals: HbO2% 79%, COH1D% 19%, and MetH1D% 2%. Which result give the best indication of the patient’s oxygenation?
A. SaO2
B. HbO2%
C. SpO2
D. PaO2

18. Normally, an individual can maintain about what percent of their maximum voluntary ventilation (MVV) on maximum exercise?
A. 60-70%
B. 70-80%
C. 80-90%
D. 90-100%

19. Which one of the following is NOT required on a patient’s drug prescription?
A. Patient’s name
B. Drug name and dose
C. Frequency of administration
D. Contraindications

20. To minimize the risk of aspiration of glottic secretions or cord damage during the removal of an oral endotracheal tube, you should:
A. Have the patient cough while you quickly pull the tube
B. Provide 100% oxygen for 1-2 minutes before extubation
C. Keep the tube cuff pressure below 25-30 cmH2O
D. Fully occlude the ET tube while you quickly it out

21. Which of the following would provide the best bedside assessment of the need for mechanical ventilation in a patient with Guillain-Barre syndrome?
A. FRC
B. VC
C. Airway resistance
D. TLC

22. Which of the following is false regarding switching from an esophageal-tracheal Combitube® (ETC) to an oral endotracheal tube?
A. The equipment needed is the same as for endotracheal intubation
B. The patient’s stomach contents should be aspirated through the 42 tube
C. The body of the tube normally must be positioned in the trachea
D. The large 41 pharyngeal cuff must be deflated before laryngoscopy

23. The radial site is preferred for arterial puncture or cannulation because:
A. The radial artery is the most superficial artery available
B. Other available arteries are too small to easily puncture
C. The radial artery has the highest systolic pressure available
D. Collateral circulation is provided through the ulnar artery

24. Directed coughing is useful in helping maintain bronchial hygiene in all of the following patient categories EXCEPT:
A. Bronchiectasis
B. Acute asthma
C. Cystic fibrosis
D. Spinal cord injury

25. While using an ICU ventilator with its optional air compressor running, you note that the low air pressure alarm suddenly sounds. Which of the following would be the best initial action in this situation?
1. Adjust and analyze FIO2
2. Connect to a 50 psig air source
3. Replace the air compressor filters
4. Replace the air compressor
A. 1 only
B. 2 only
C. 2 and 4 only
D. 3 and 4 only

26. The normal apical impulse (PMI) is usually identified where?
A. 3rd right intercostal space, left sternal border
B. 3rd left intercostal space, anterior axillary line
C. 5th right intercostal space, midclavicular line
D. 5th left intercostal space, midclavicular line

27. Proper technique in the auscultatory method of measuring blood pressure includes which of the following?
1. Inflate the cuff to 30 mmHg above the brachial pulse stoppage
2. Place the lower cuff edge 3 inches above the antecubital fossa
3. Deflate the cuff at a rate of 2-3 mmHg per second
4. Place the bell of the stethoscope over the brachial artery
A. 1 and 3 only
B. 1, 2, and 3 only
C. 1, 3, and 4 only
D. 1, 2, 3, and 4

28. In reviewing the chart of a 55-year-old male patient, you note the following symptoms: obesity, loud snoring, and insomnia. These findings are most consistent with which of the following diagnoses?
A. Pulmonary emphysema
B. Acute asthma
C. Gullian-Barre syndrome
D. Obstructive sleep apnea

29. During oral intubation of an adult, the endotracheal tube should be advanced into the trachea about how far?
A. Until the proximal (mouth) end of the tube is at the teeth
B. Just far enough so that the tube cuff is no longer visible
C. Until its cuff has passed the cords by two to three inches
D. Until its cuff has passed the cords by two to three centimeters

30. Which of the following endotracheal tube malfunctions could require extubation and reintubation with a new tube to allow effective positive pressure ventilation of the patient?
1. A large leak in the cuff of the tube
2. Obstruction of the tube that is unrelieved by suctioning
3. Separation of the pilot tube from the endotracheal tube cuff
A. 1 and 2 only
B. 1 and 3 only
C. 2 and 3 only
D. 1, 2, and 3

31. When inspecting the x-ray of an out-patient with nephrotic syndrome, you note a homogeneous area of increased density that obscures the left costophrenic angle. Which of the following is the most likely problem?
A. Pleural effusion
B. Bacterial pneumonia
C. Pulmonary edema
D. Atelectasis

32. Which of the following is the most common problem associated with the removal of an esophageal obturator airway?
A. Tracheomalacia
B. Gastric insufflation
C. Aspiration
D. Esophageal bleeding

33. On a pneumatically-powered IPPB device, switching the air-mix control to 100% oxygen will have which of the following effects on flow?
A. Make the flow dependent on patient effort
B. Decrease the flow to a lower level
C. Increase the flow to a higher level
D. The change will have no effect on the flow

34. A patient’s response to an interview question is initially vague or unclear. Which of the following responses on your part would be most appropriate?
A. “Please go on”
B. “You seem to be anxious”
C. “I see why you are so upset”
D. “Please explain that to me again”

35. Which of the following humidification devices would be appropriate for a patient receiving nasal oxygen therapy at 6 L/min?
A. Unheated bubble humidifier
B. Heated wick-type humidifier
C. Heat and moisture exchanger (HME)
D. Large volume jet nebulizer

36. A 68-year-old female patient with severe COPD has been provided with educational materials describing essential self-management activities to help her control her disease. Which of the following additional support measures would you consider recommending?
1. Counseling/behavior modification interventions
2. Telephonic follow-up and/or home health visits
3. Social services to address self-management barriers
A. 1 only
B. 1 and 2
C. 2 and 3
D. 1, 2, and 3

37. Which of the following best describes the key rationale for intubating nasally rather than orally’?
A. Nasal tubes are less likely to cause trauma
B. Nasal tubes offer less resistance to gas flow
C. Nasal tubes are less likely to cause infection
D. Nasal tubes are better tolerated by the patients

38. A patient’s respirations are characterized by a gradual increase and then a gradual decrease in the depth of breathing, followed by a period of apnea. This pattern is known as:
A. Blot’s breathing
B. Cheyne-Stokes breathing
C. Kussmaul’s breathing
D. Apneustic breathing

39. All of the following would be essential medication history information to obtain for a patient admitted for an acute exacerbation of asthma EXCEPT:
A. Frequency of rescue inhaler usage
B. Use of generic vs. brand name medications
C. Patient understanding of controllers vs. relievers
D. Self-administration techniques

40. The use of pursed-lip breathing during exhalation would be most common among which of the following patient groups?
A. Diffuse interstitial fibrosis
B. Consolidation of lung tissue
C. Chronic airway obstruction
D. Acute upper airway obstruction

41. Which of the following are acceptable changes in patient status during a traditional T-tube weaning trial?
I. An increase in respiratory rates of 20/min
II. An increase in cardiac rate of 15/min
III. A 5 mmHg rise in the arterial PCO2
IV. The development of paradoxical breathing
A. II and IV only
B. I, ll, and Ill only
C. II and III only
D. I, II, Ill, and IV

42. What happens if the rate of breathing increases without any change in total minute ventilation?
A. The alveolar ventilation per minute will increase
B. The alveolar ventilation per minute will decrease
C. The deadspace ventilation per minute will decrease
D. The alveolar ventilation per minute will remain constant

43. All of the following can cause falsely high SpO2 readings when using a pulse oximeter EXCEPT:
A. Dark nail polish
B. Intravenous dyes
C. Carboxyhemoglobin
D. Bright ambient light

44. Which of the following is the most common problem associated with the removal of an esophageal obturator airway?
A. Tracheomalacia
B. Gastric insufflation
C. Aspiration
D. Esophageal bleeding

45. A COPD patient is receiving sustained-release theophylline. Adverse effects of this therapy that you should be on guard for include all of the following EXCEPT:
A. Cardiac arrhythmias
B. Nausea/vomiting
C. Hyperkalemia
D. Restlessness and tremors

46. Incentive spirometry is ordered for a female patient after abdominal surgery. Which of the following statements would be the most appropriate initial explanation of the therapy?
A. “Your doctor has ordered this therapy to prevent atelectasis“
B. “We are trying to improve your lung volume”
C. “This therapy will help you take deep breaths and expand your lungs”
D. “You may experience pain and lightheadedness from this therapy”

47. Following a myocardial infarction, a 60-year-old patient with congestive heart failure is being mechanically ventilated. The patient’s blood pressure is 95/60 mmHg. Ventilator settings are as follows: FiO2 0.45, rate 12, tidal volume 600 mL, PEEP 12 cmH2O. While awaiting blood gas results, you obtain an SpO2 of 78%. Which of the following actions would you take at this time?
A. Increase the FiO2 to 1.0
B. Decrease the rate to 6
C. Increase the PEEP to 16 cmH2O
D. Initiate inverse ratio ventilation

48. Which of the following statements regarding central cyanosis is FALSE?
A. It is an unreliable indicator of hypoxemia and hypoxia
B. It is best observed in the capillaries of the lips and gums
C. It results from excessively reduced Hb in the venous blood
D. It may occur even in the presence of adequate O2 delivery

49. Which of the following are FALSE regarding oropharyngeal airways?
A. Incorrect placement can worsen airway obstruction
B. They are contraindicated for use with infants and children
C. They all consist of a flange, body, and channels
D. They should only be used by trained personnel

50. Which of the following is the most common problem associated with the removal of an esophageal obturator airway?
A. Tracheomalacia
B. Gastric insufflation
C. Aspiration
D. Esophageal bleeding

51. A patient has a minute volume of 7.50 L/min and is breathing at a rate of 16 breaths/min. What is his average tidal volume?
A. 120 mL
B. 215 mL
C. 350 mL
D. 470 mL

52. To minimize the risk of aspiration of glottic secretions or cord damage during the removal of an oral endotracheal tube, you should:
A. Have the patient cough while you quickly pull the tube
B. Provide 100% oxygen for 1-2 minutes before extubation
C. Keep the tube cuff pressure below 25-30 cmH2O
D. Fully occlude the ET tube while you quickly pull it out

53. Which of the following is false regarding switching from an esophageal-tracheal Combitube® (ETC) to an oral endotracheal tube?
A. The equipment needed is the same as for endotracheal intubation
B. The patient’s stomach contents should be aspirated through the #2 tube
C. The body of the tube normally must be positioned in the trachea
D. The large #1 pharyngeal cuff must be deflated before laryngoscopy

54. All of the following are common causes of fluid overload in patients EXCEPT:
A. Congestive heart failure
B. Hemorrhage
C. Renal failure
D. Overinfusion of fluids

55. At rest, the normal tidal movement of the diaphragm is approximately:
A. 6-10 cm
B. 1-2 cm
C. 30-40 cm
D. 6-10 in

56. A physician has requested your assistance in extubating an orally intubated patient. Which of the following should be done BEFORE the tube itself is removed?
1. Suction the pharynx
2. Preoxygenate the patient
3. Confirm cuff inflation
4. Suction the ET tube
A. 2 and 4 only
B. 1, 2, and 4 only
C. 3 and 4 only
D. 1, 2, 3, and 4

57. A patient suddenly loses consciousness. Which of the following is the first procedure you should perform to maintain an open airway?
A. Inserting a laryngeal mask airway
B. Applying the “jaw thrust” maneuver
C. Inserting an oropharyngeal airway
D. Applying the “head-tilt/chin-lift” maneuver

58. When open to the atmosphere, a manometer calibrated in cmH2O units should read:
A. 0 cmH2O
B. 1 atmosphere
C. 760 cmH2O
D. 1,034 cmH2O

59. A patient has a pH of 7.58 and a PaCO2 of 25 torr. Based on these data, what is the primary acid-base disturbance?
A. Respiratory alkalosis
B. Metabolic acidosis
C. Respiratory acidosis
D. Metabolic alkalosis

60. The methylene blue test is used to confirm:
A. Tracheal granuloma
B. “Leakage” type aspiration
C. Infection with pneumococcus
D. Artificial airway obstruction

61. Bronchial breath sounds heard over the periphery indicate:
A. Normal lungs
B. Lung consolidation
C. Small airway obstruction
D. Acute bronchospasm

62. A patient is admitted to the emergency department following a motor vehicle accident. On physical exam, the respiratory therapist discovers that breath sounds are absent in the left chest with a hyperresonant percussion note. The trachea is shifted to the right. The patient’s heart rate is 45/min, respiratory rate is 30/min, and blood pressure is 60/40 mmHg. What action should the respiratory therapist recommend first?
A. Call for a STAT chest x-ray
B. Insert a chest tube into the left chest
C. Needle aspirate the 2nd left intercostal space
D. Activate the medical emergency team to intubate the patient

63. While assessing the endotracheal tube cuff pressure in an intubated patient, you confirm a leak at 18 cmH2O throughout most of inspiration. You should:
A. Add air to the cuff until a minimal leak is heard
B. Reassess the cuff pressure during expiration
C. Replace the endotracheal tube with a larger size
D. Inflate cuff until the leak ceases at < 25-30 cmH2O

64. A patient has a minute volume of 7.50 L/min and is breathing at a rate of 16 breaths/min. What is his average tidal volume?
A. 120 mL
B. 215 mL
C. 350 mL
D. 470 mL

65. In most blood gas analyzers, what media is used to calibrate the pH electrode?
A. Tonometered whole blood samples
B. Commercial calibration control media
C. Precision gas mixtures
D. Standardized buffer solutions

66. Which of the following is the approximate total output flow delivered from a 40% air-entrainment mask operating at 12 L/min?
A. 12 L/min
B. 48 L/min
C. 52 L/min
D. 72 L/min

67. Which of the following parameters is affected when the air-mix control is changed to 100% oxygen on a pneumatically-powered IPPB device?
A. Pressure
B. Sensitivity
C. Peak flow
D. Nebulization

68. The proper positioning of an endotracheal tube in an adult patient is confirmed by which of the following?
A. 21-23 cm marks at the teeth
B. Adequate airway seal
C. Chest x-ray
D. Neutral head position

69. When inspecting the x-ray of a patient in the ICU, you note a large area of radiolucency between the left lung border and chest wall and increased density of the left lung. Which of the following is the most likely problem?
A. Pleural effusion
B. Pneumomediastinum
C. Pneumothorax
D. Interstitial infiltration

70. Which of the following would deliver the most particulate water to a patient’s airway?
A. A bubble humidifier
B. A wick humidifier
C. An ultrasonic nebulizer
D. A jet nebulizer

71. Within one second after initiating a forced vital capacity (FVC) maneuver, a patient with normal lungs should be able to exhale what percent of the FVC?
A. 35-50% of the FVC
B. 50-70% of the FVC
C. 70-83% of the FVC
D. 84-93% of the FVC

72. Simple spirometry CAN NOT be used to measure which of the following?
A. Vital capacity
B. Residual volume
C. Tidal volume
D. Inspiratory reserve volume

73. Which of the following approaches can be used to obtain a medication history from a patient with a depressed level of consciousness or who is severely agitated?
A. Obtain and review the patient’s past medical history
B. Ask the patient’s nurse about the patient’s prescriptions
C. Request that the lab run a comprehensive blood drug screen
D. Obtain the patient’s current prescription vials from the family

74. Which of the following thoracic ultrasound findings is consistent with the presence of a pneumothorax?
A. Presence of gliding sign
B. Absence of A-lines
C. Presence of barcode sign
D. Presence of seashore sign

75. Which of the following would tend to increase insensible water loss?
A. Hypothermia
B. Bypassed upper airway
C. Hypoventilation
D. Diuretic administration

76. Which of the following would tend to decrease a patient’s energy expenditure?
A. Hypothermia
B. Inflammation
C. Major trauma
D. Agitation/pain

77. A patient has acute respiratory acidosis. You would expect the base excess (BE) to range between:
A. + 6 mEq/L
B. – 6 mEq/L
C. +/- 2 mEq/L
D. +/- 8 mEq/L

78. Which of the following arterial blood gas results would most likely be reported for a patient who is having a mild asthma attack?
A. pH = 7.31 PCO2 = 50 torr PO2 = 60 torr
B. pH = 7.40 PCO2 = 50 torr PO2 = 50 torr
C. pH = 7.47 PCO2 = 32 torr PO2 = 60 torr
D. pH = 7.47 PCO2 = 40 torr PO2 = 50 torr

79. The Apgar score for a normal newborn infant ranges between:
A. 1-4
B. 4-7
C. 7-10
D. 10-13

80. On inspection of a patient’s ECG strip, you note no identifiable P waves, rapid, irregular undulations of the isoelectric line, and an irregular ventricular rhythm. In addition, the precordial cardiac rate is greater than the peripheral pulse rate. The most likely problem is:
A. 2nd degree (Wenckebach) heart block
B. Ventricular fibrillation
C. Atrial fibrillation
D. Ventricular tachycardia

81. In inspecting an elderly female patient, you note that her spine has an abnormal anteroposterior (AP) curvature. Which of the following terms would you use in charting this observation?
A. Kyphosis
B. Scoliosis
C. Kyphoscoliosis
D. Pectus excavatum

82. During auscultation of a patient’s chest, you hear intermittent “bubbling” sounds at the lung bases. Which of the following chart entries best describes this finding?
A. “Bronchial sounds heard at lung bases”
B. “Wheezes heard at lung bases”
C. “Rhonchi heard at lung bases”
D. “Crackles (rales) heard at lung bases”

83. While assessing a patient’s radial pulse, you note that the pulse feels full and bounding. Which of the following conditions would be the most probable cause of this finding?
A. Hypovolemia
B. Hypertension
C. Cardiovascular shock
D. Low cardiac output

84. A patient is cachexic, exhibits generalized edema and dry skin, and appears listless. The most likely problem is:
A. Heart failure
B. Addison’s disease
C. Renal failure
D. Malnutrition

85. Prior to giving an aerosol treatment, you find a note in the chart that states your patient had pink frothy secretions on admission to the ED. This is most indicative of:
A. Cor pulmonale
B. Left ventricular failure
C. An electrolyte imbalance
D. ARDS

86. A doctor orders a changeover to CPAP for a patient receiving bi-level positive airway pressure (BiPAP) via a device with separate IPAP and EPAP controls. To effect this change, you would:
A. Set IPAP less than EPAP
B. Set IPAP greater than EPAP
C. Set EPAP = 0 cmH2O
D. Set IPAP equal to EPAP

87. How would you characterize the degree of dyspnea of a patient who walks slower than people of the same age because of breathlessness?
A. Slight
B. Moderate
C. Severe
D. Very severe

88. Upon the exam of an acutely dyspneic and hypotensive patient, you note the following – all on the left side of the chest: reduced chest expansion, hyperresonance to percussion, absent of breath sounds and tactile fremitus, and a tracheal shift to the right. These findings suggest:
A. Left-sided pneumothorax
B. Left-sided consolidation
C. Left lobar obstruction/atelectasis
D. Left-sided pleural effusion

89. A patient’s response to an interview question is initially vague or unclear. Which of the following responses on your part would be most appropriate?
A. “Please go on”
B. “You seem to be anxious”
C. “I see why you are so upset”
D. “Please explain that to me again”

90. A patient is asked to inhale as deeply as possible and blow out all his air as hard as they can until empty. What test is being performed?
A. FVC
B. IC
C. TLC
D. MVV

91. When a patient is receiving positive-pressure ventilation, you should strive to keep the alveolar (plateau) airway pressure below:
A. 20 cmH2O
B. 30 cmH2O
C. 40 cmH2O
D. 50 cmH2O

92. On inspection of an ECG rhythm strip from an adult patient, you note the following: rate of 150; regular rhythm; normal P waves, P-R intervals, and QRS complexes. The most likely problem is:
A. Atrial flutter
B. Sinus tachycardia
C. Ventricular tachycardia
D. Atrial fibrillation

93. On inspection of a 12-lead ECG, you note the absence of P waves and a variable R-R interval (> 0.12 sec). Which of the following is the most likely problem?
A. Atrial hypertrophy
B. First-degree heart block
C. Atrial fibrillation
D. Sinus arrhythmia

94. What percent decrease in FEV1 needs to occur to conclude that a methacholine challenge is positive for airway hyperreactivity?
A. 10%
B. 15%
C. 20%
D. 25%

95. A patient is receiving ventilatory support after thoracic surgery. You measure the patient’s maximum inspiratory pressure (MIP/NIF) as -33 cmH2O. Based on this value, the patient has:
A. A need for continued ventilatory support
B. A large leak in their endotracheal tube cuff
C. A normal maximum inspiratory pressure
D. Adequate muscle strength to consider weaning

96. During a single-breath capnogram, the sharp downstroke and return to baseline that normally occurs after the end-tidal point indicates:
A. Exhalation of mainly deadspace gas
B. Inspiration of fresh respiratory gas
C. Exhalation of mixed alveolar/deadspace gas
D. Exhalation of mainly alveolar gas

97. A patient is considered as having sufficient respiratory muscle strength to maintain adequate ventilation and prevent secretion retention when the maximum inspiratory pressure (MIP; NIF) is more negative than:
A. -5 cmH2O
B. -10 cmH2O
C. -15 cmH2O
D. -20 cmH2O

98. Over a 3-hour period, the plateau pressure of a patient receiving volume-controlled ventilation has remained stable, but her peak pressure has been steadily increasing. Which of the following is the best explanation for this observation?
A. The patient’s airway resistance has increased
B. The patient is developing atelectasis
C. The patient’s compliance has decreased
D. The patient is developing pulmonary edema

99. On inspection of an adult patient’s 12-lead ECG, you note a regular R-R interval of 0.40 sec, with no other apparent abnormalities. Which of the following is the most likely problem?
A. Ventricular tachycardia
B. Sinus bradycardia
C. Atrial fibrillation
D. Sinus tachycardia

100. Under ideal conditions, pulse oximeter readings patients usually fall with what percent of those obtained via invasive hemoximetry?
A. ±1-2%
B. ±2-3%
C. ±3-5%
D. ±5-7%

101. Prior to intubation in an emergency, the injection of air into the pilot line fails to inflate the cuff. You should:
A. Check the cuff for leaks
B. Check the valve on the pilot line
C. Replace the endotracheal tube
D. Inspect the pilot line for patency

102. A 15-year-old with cystic fibrosis is receiving pressure control SIMV with pressure support due to severe bilateral pneumonia. The pulmonologist asks you to administer aerosolized dornase alfa (Pulmozyme, DNase) in-line with the ventilator. Which of these devices would you select to administer this therapy?
A. Dry powder inhaler (DPI)
B. Vibrating mesh nebulizer
C. Metered dose inhaler (MPI)
D. Small volume nebulizer

103. Which of the following conditions will cause a DECREASE in the FiO2 delivered to a patient receiving oxygen at 4 L/min via a nasal cannula?
A. Decrease in the patient’s inspiratory flow
B. Increase in the patient’s inspiratory time
C. Increase in the patient’s minute ventilation
D. Decrease in the patient’s tidal volume

104. You notice that a disposable nebulizer is delivering large water droplets down the large bore tube. To correct this problem, you should:
A. Add a heating collar to the nebulizer
B. Replace the nebulizer
C. Add water to the nebulizer
D. Dismantle and clean the nebulizer

105. Shortly after you replace a jet nebulizer and tubing on a patient who has a tracheostomy, the SpO2 drops from 98% to 90%. Aerosol is visible throughout inspiration and expiration in the tracheostomy collar. Which of the following should you do first to resolve the situation?
A. Decrease the input flow to the nebulizer
B. Ask the patient to breathe slower and deeper
C. Check the entrainment setting on the nebulizer
D. Obtain an arterial blood gas sample for analysis

106. Which of the following would you expect to occur AFTER an unheated bubble diffusion humidifier is set up and operating?
A. The reservoir will be warmer than room temperature
B. The reservoir will be cooler than room temperature
C. The reservoir temperature will equal room temperature
D. Water will condense on the inside of the delivery tubing

107. During the computerized setup of a ventilator, you are prompted to enter a circuit compliance factor. This information is needed to:
A. Calibrate the flow sensors
B. Complete the automated leak test
C. Calibrate the pressure transducer
D. Compensate for compressed volume loss

108. A bubble humidifier is connected to a flowmeter set and running at 5 L/min. When you obstruct the outlet of the small-bore delivery tubing, the pressure pop-off does NOT sound. Which of the following is the most likely cause of this observation?
A. Excessive flow through the humidifier
B. A leak in the humidifier/delivery system
C. The diameter of the delivery tubing is too small
D. The flowmeter is not pressure-compensated

109. Which of the following analyzers would you select if your objective were to continuously measure changes in the FiO2 in a ventilator circuit with the fastest possible response time?
A. Physical (paramagnetic) analyzer
B. Thermal conductivity analyzer
C. Galvanic fuel cell analyzer
D. Polarographic (Clark) analyzer

110. To maximize the duration of flow/runtime outside the home, liquid portable O2 systems:
A. Hold about three liters of liquid oxygen
B. Can be refilled from a liquid O2 base unit
C. Incorporate a pulse-dose delivery system
D. Include a battery-powered contents indicator

111. You run a control solution through a blood gas analyzer as part of daily quality control. The measured high PO2 value is 9 torr outside of the acceptable range. Prior runs were all in range. You should:
A. Report results after compensating for the deviation
B. Replace the PO2 electrode and recalibrate the analyzer
C. Analyze another control solution for comparison
D. Perform a two-point calibration and rerun the control

112. Which of the following is true regarding the calibration of exhaled nitric oxide (NO) gas analyzers?
A. Inlet flows should mimic breathing (variable flow/pressure)
B. Daily 2-point (zero/high %NO) calibration is required
C. Room air can be used as the ‘zero’ calibrating gas
D. Daily 1-point using a standardized NO% is sufficient

113. When reviewing statistical quality control data on a blood gas analyzer, you note a single pH measurement among 30 that falls below the ± 2 SD “in control” standard for your lab. Which of the following is the most likely cause of this error?
A. Statistical probability/chance
B. Contaminated buffer solutions
C. Incorrect analysis procedures
D. Failure of the pH electrode

114. You are analyzing quality control samples on a blood gas analyzer as part of a routine quality control program. Multiple but not successive PaCO2 values fall above and below the two standard deviation limit. You should:
A. Record the results as an acceptable
B. Record the results as acceptable after correcting for the difference in measurements
C. Record the results as acceptable if they are within +/- 2 SD of the mean
D. Perform a two-point calibration and reanalyze the control sample

115. Which of the following blood gas quality control procedures is designed to assure that the output of the analyzer is both accurate and linear across the range of measured values?
A. Statistical quality control.
B. Performance validation
C. Control media verification
D. Automated calibration

116. When calibrating a portable computerized spirometer, its volume readings consistently fall outside the ± 3% range. Which of the following is the most likely cause of this problem?
A. Flow sensor misassembled or damaged
B. Failure to remove the bacterial filter before calibration
C. Flow sensor tubing not connected to the computer
D. Incorrect selection of prediction equations

117. When reviewing statistical quality control data on a blood gas analyzer, you note a single PCO2 measurement among 30 that falls below the ± 2 SD “in control” standard for your lab. Which of the following is the most likely cause of this error?
A. Contamination of the sample
B. Incorrect calibrating gas %
C. Incorrect analysis procedures
D. Failure of the PCO2 electrode

118. Which blood gas analysis/hemoximetry quality control procedure involves plotting the results of control media analyses on a graph and comparing these plots against derived range limits?
A. Machine calibration
B. Statistical quality control
C. Preventive maintenance
D. Control media verification

119. The reference procedure used to establish accuracy for blood PO2 and PCO2 measurements is:
A. Hemolysis
B. Manometry
C. Equilibration
D. Tonometry

120. Which of the following can cause a hemoximeter’s HbO2 reading to be falsely low?
A. Dirty analysis chamber
B. High fetal Hb levels
C. Elevated bilirubin levels
D. Sickle-cell anemia

121. When suctioning an adult patient using a DISS wall-mounted regulator system with a collection bottle, you would initially set the vacuum pressure at:
A. -12 to -15 in Hg
B. -80 to -100 mm Hg
C. -5 to -7 in Hg
D. -100 to -120 mm Hg

122. In which of the following clinical situations would a patient benefit most from deep breathing exercises?
A. Myasthenic crisis
B. Postop cholecystectomy
C. Exacerbation of COPD
D. Status asthmatics

123. What size suction catheter would you select to suction a patient with a 9.0 mm ID tracheostomy tube?
A. 10 Fr
B. 12 Fr
C. 14 Fr
D. 16 Fr

124. During postural drainage therapy, a patient’s heart rate remains stable at 92/min, and the SpO2 is 97%. However, after you pre-oxygenate the patient and begin nasotracheal suctioning, the patient’s heart rate suddenly drops to 40/min. The most likely reason for this is:
A. Severe mucus plugging
B. Hypoxemia during suctioning
C. A vago-vagal reflex
D. Postural hypotension

125. If tolerated, a specified postural drainage position should be maintained for at least:
A. 3-5 minutes
B. 5-10 minutes
C. 10-20 minutes
D. 20-30 minutes

126. You are about to suction an infant who has a 3.0 mm (ID) endotracheal tube in place. What is the MAXIMUM size catheter you would use in this case?
A. 6 Fr
B. 8 Fr
C. 5 Fr
D. 10 Fr

127. If a patient’s chest x-ray shows infiltrates in the posterior segments of the lower lobes, postural drainage should be performed in which of the following positions?
A. Head down, patient prone with a pillow under her abdomen
B. Head down, patient supine with a pillow under her knees
C. Patient prone with a pillow under her head, bed flat
D. Patient supine with a pillow under her knees, bed flat

128. To increase a patient’s maximum expiratory flow when using a cough assist or mechanical in-exsufflation (MI-E) device, you would:
A. Increase the inspiratory time
B. Decrease the expiratory pressure
C. Increase the expiratory time
D. Increase the inspiratory pressure

129. Postural drainage would best be indicated for a patient with:
A. Pleural effusion
B. Asthma
C. Pneumonia
D. Cystic fibrosis

130. In discussing the goals of IPPB therapy with a postoperative patient, which of the following explanations would be most appropriate?
A. “This will prevent pneumonitis.”
B. “This will help you take deep breaths.”
C. This will prevent atelectasis.
D. “This will increase your intrathoracic pressure.”

131. A patient who is receiving an aerosol treatment with acetylcysteine (Mucomyst) and hypertonic saline via an SVN suddenly becomes dyspneic. The most likely cause of this problem is:
A. Hypercapnia
B. Bronchospasm
C. Pneumothorax
D. Fluid overload

132. A physician orders a 70% He/30% O2 mixture to be delivered to a patient having an acute asthmatic attack. Which of the following systems would be most appropriate to deliver this mixture?
A. Nebulizer set at 100% oxygen with aerosol mask
B. Tight-fitting nonrebreathing mask with competent valving
C. Simple oxygen mask set to deliver 15 L/min oxygen
D. Tight-fitting partial rebreathing mask at 12 L/min

133. A doctor orders aerosol therapy for a patient receiving mechanical ventilation who is being provided humidification with a heat and moisture exchanger (HME). To ensure effective therapy, you must:
A. Place the aerosol device proximal to the HME in the stream of flow
B. Remove the HME before aerosol therapy and replace it afterward
C. Place the aerosol device distal to the HME in the stream of flow
D. Switch from an HME to an active heated humidification system

134. Which of the following is associated with the administration of aerosolized epinephrine?
A. Tachycardia
B. Bradycardia
C. Laryngospasm
D. Bronchospasm

135. After completing an aerosol drug treatment, which of the following is the most appropriate chart notation for you to make?
A. Treatment given as ordered
B. Aerosol therapy given; pulse stable, no changes during therapy; well tolerated
C. Aerosol therapy given with 0.5 mL albuterol and 3 mL normal saline; vital signs stable; well tolerated
D. Aerosol therapy given with 0.5 mL albuterol and 3 mL normal saline; pulse stable at 72/min during therapy; B.P. stable at 120/80; respiratory rate 10/min; therapy well tolerated; chest clear on auscultation

136. A physician orders 2.5 mL ipratropium bromide (Atrovent) 0.2% TID for a COPD patient with recurrent bronchospasm. Which of the following methods would you use to deliver this drug?
A. Small volume nebulizer with mask
B. Ultrasonic nebulizer with mask
C. Small volume nebulizer with mouthpiece
D. MDI

137. Which of the following describes the ventilatory pattern that is best suited for maximum aerosol deposition in the small airways?
A. Slow inhalation, pause, slow exhalation
B. Slow inhalation, pause, rapid exhalation
C. Rapid inhalation, pause, slow exhalation
D. Rapid inhalation, pause, rapid exhalation

138. A doctor orders a metered dose inhaler (MDI) bronchodilator for a patient receiving mechanical ventilation via a dual-limb breathing circuit. To maximize aerosol deposition, you would:
A. Place the MDI directly in-line on the inspiratory side of the circuit
B. Recommend that a small-volume nebulizer be used instead of the MDI
C. Place the MDI plus a spacer in-line on the inspiratory side of the circuit
D. Place the MDI directly in-line on the expiratory side of the circuit

139. Which of the following patient instructions for using a dry powder inhaler (DPI) is correct?
A. Hold the device vertically after loading
B. Perform slow (3-4 sec) deep inhalation
C. Exhale back into the device
D. Seal lips tightly around the mouthpiece

140. An increase in a patient’s heart rate during aerosolized bronchodilator therapy is primarily a result of which of the following effects of the drug?
A. Alpha only
B. Beta 1 only
C. Beta 2 only
D. Beta 1 and Beta 2

141. A physician orders supplemental O2 for a patient via nasal cannula at a flow of 12 L/min. When you ask her what goal she has in mind, she states that she wants the patient to receive about 60% oxygen. Which of the following should you recommend?
A. That the cannula flow be set to 15 L/min instead of 12 L/min
B. That the O2 be given via a partial rebreathing mask at 10 L/min
C. That a nasal catheter at 12 L/min be used instead of the cannula
D. That the O2 be given via an air-entrainment mask set at 60%

142. A patient whose asthma was well-controlled using a short-acting beta-agonist inhaler PRN and low-dose inhaled corticosteroid BID reports that she recently has been experiencing shortness of breath almost daily and is awakened at night with wheezing episodes. Her peak flow, which had been 83% of her predicted normal, is now at 66% of the predicted value. Which of the following would you recommend to the patient’s doctor as possible changes to the current drug regimen?
A. Discontinue the short-acting beta agonist inhaler
B. Add a leukotriene modifier to the regimen
C. Switch the short-acting beta agonist from PRN to Q4H
D. Switch from inhaled to oral corticosteroid therapy

143. In assessing a patient receiving ventilatory support, you note that her white blood cell count is 18,000/mm3 and her temperature is 102 °F. In addition, her secretions have become more tenacious and yellow over the past 24 hours. Which of the following would you suggest to the attending physician?
A. That her humidifier temperature be lowered to below 30 °C
B. That a regimen of aerosolized carbenicillin be started ASAP
C. That a sputum sample be obtained for culture and sensitivity
D. That the frequency of suctioning be increased to every half hour

144. A clinical condition characterized by a history of a productive cough for at least three months a year for two consecutive years best describes:
A. Panlobular emphysema
B. Status asthmaticus
C. Centrilobular emphysema
D. Chronic bronchitis

145. After bronchodilator therapy, you record the following PFT data on a 67-year-old male COPD patient with chronic cough and sputum production: FEV1/FVC = 65%; FEV1 = 82% predicted. You would characterize the stage of the patient’s COPD as:
A. Mild
B. Moderate
C. Severe
D. Very severe

146. A doctor institutes volume control ventilation for a 70 kg ARDS patient with a targeted tidal volume of 420 mL. To maintain adequate ventilation with this tidal volume, you would allow a machine respiratory rate as high as:
A. 20/min
B. 25/min
C. 30/min
D. 35/min

147. Any sudden occurrence of pulmonary or cardiac distress in older, bed-ridden patients and those having undergone extensive abdominal or pelvic surgery suggests a diagnosis of:
A. Coronary artery disease
B. Pulmonary thromboembolism
C. Anaphylactic shock
D. Acute left ventricular failure

148. Which of the following is the most common indication for home CPAP therapy?
A. Sleep apnea-hypopnea syndrome (SAHS)
B. Bronchospasm associated with asthma
C. Chronic hypoxemia
D. Neuromuscular disorders

149. The doctor is concerned that his ARDS patient on pressure control ventilation has high plateau pressures (> 30 cmH2O) and that this may be causing further lung injury. Which of the following modes of ventilation would you consider as an alternative?
A. Volume control ventilation
B. Pressure support ventilation
C. Airway pressure release ventilation
D. Continuous positive airway pressure

150. Which of the following observations indicate that an infant’s work of breathing may be abnormally high?
A. Palor
B. Digital clubbing
C. Acrocyanosis
D. Nasal flaring

151. The primary aim in treating cardiogenic pulmonary edema is to:
A. Increase venous return to the heart
B. Decrease right heart and systemic venous pressures
C. Decrease left heart and pulmonary vascular pressures
D. Increase pulmonary fluid and blood volume

152. What is the most common arrhythmia seen with pulmonary disease?
A. Sinus bradycardia
B. Sinus tachycardia
C. Atrial fibrillation
D. Ventricular tachycardia

153. The primary purpose of oxygen administration in the management of heart failure is to:
A. Increase the force of ventricular contractions
B. Decrease resistance to ventricular ejection
C. Increase ventricular stroke volume
D. Decrease the workload on the myocardium

154. A doctor institutes volume control ventilation for an 80 kg ARDS patient. Which of the following is the maximum pressure you would aim to achieve in this patient?
A. 50 cmH2O peak pressure
B. 30 cmH2O plateau pressure
C. 40 cmH2O peak pressure
D. 50 cmH2O plateau pressure

155. You would recommend against using noninvasive positive pressure ventilation (NPPV) for a patient with:
A. Secretions requiring suctioning
B. The need for moderate sedation
C. Facial burns or trauma
D. FiO2 needs greater than 40%

156. An alert patient with emphysema and an elevated CO2 level is given 50% O2 by an air entrainment mask. One hour later, the nurse calls you to evaluate the patient. He is now very lethargic. Which of the following is the most likely cause of this?
A. Respiratory muscle fatigue
B. Cerebral hypoxia
C. Hypotension
D. O2-induced hypoventilation

157. Which of the following is a key therapeutic objective in the management of a patient who has closed head trauma and is receiving ventilatory support?
A. Increase the minute ventilation
B. Increase intrathoracic pressure
C. Assure patient-ventilator synchrony
D. Decrease cerebral perfusion pressure

158. In individuals with disorders characterized by an increase in airway resistance, such as emphysema, which of the following breathing patterns results in the minimum work?
A. Deep breathing
B. Slow breathing
C. Shallow breathing
D. Rapid breathing

159. Which of the following is true regarding patients in the early stages of an asthmatic attack?
A. They all exhibit respiratory alkalosis
B. They always have moderate hypoxemia
C. They have decreased expiratory flows
D. They never respond to beta adrenergics

160. A premature infant receiving positive pressure ventilation appears to be in acute respiratory distress with signs of hypotension and asymmetrical chest movement. Which of the following would you recommend first?
A. An arterial blood gas
B. A chest radiograph
C. A capillary heal stick
D. Chest transillumination

161. Maximum inspiratory pressure (MIP; NIF) measurement provides information about which of the following?
A. Airway resistance
B. Functional residual capacity
C. Inspiratory capacity
D. Respiratory muscle strength

162. Which of the following laboratory values is most consistent with a diagnosis of fluid depletion (dehydration)?
A. Increased hematocrit
B. Decreased BUN
C. Decreased serum osmolality
D. Decreased urine specific gravity

163. Which of the following would represent an abnormal V/Q scan suggesting pulmonary embolism?
A. Large segmental areas with normal ventilation and normal perfusion
B. Large segmental areas with no ventilation and no perfusion
C. Large segmental areas with normal ventilation but no perfusion
D. Large segmental areas with no ventilation but normal perfusion

164. During the administration of an aerosol treatment, the patient’s respiratory rate drops from 15 breaths/min to 6 breaths/min. This indicates which of the following?
A. Bradypnea
B. Biot’s breathing
C. Apnea
D. Hyperpnea

165. You measure the blood pressure of an adult patient as 88/53 mm Hg. Which of the following chart entries would you use to describe this finding?
A. Patient is hypertensive
B. Patient is hypotensive
C. Patient has low pulse pressure
D. Patient has high pulse pressure

166. While assisting a physician with a transthoracic ultrasound exam, you observe gliding or shimmering of the pleural layer during breathing. This observation:
A. Is consistent with the interstitial syndrome
B. Rules out an underlying pneumothorax
C. Indicates the presence of pleural adhesions
D. Confirms an underlying pneumothorax

167. Your review of a patient’s chart notes an admission diagnosis of fluid depletion/ dehydration. Which of the following findings would most likely be based on the patient’s bedside assessment?
A. Inspissated secretions
B. Pitting edema
C. Venous distension
D. Crackle on auscultation

168. A 65-year-old male presents with acute shortness of breath, pleuritic chest pain, and a history of deep vein thrombosis. His oxygen saturation is 85% on room air. Which of the following is the best initial test to diagnose his condition?
A. Chest X-ray
B. Arterial blood gas analysis
C. Computed tomography pulmonary angiography (CTPA)
D. Pulmonary function test

169. In observing a patient, you note that her breathing is extremely deep and fast. Which of the following terms would you use to chart this observation?
A. Kussmaul’s breathing
B. Biot’s breathing
C. Cheyne-Stokes breathing
D. Apneustic breathing

170. A peak flow measurement of 6.9 L/sec was obtained on a 41-year-old female who is 5’4”. This finding indicates which of the following?
A. The patient has poor gas distribution
B. The patient has decreased lung compliance
C. The patient’s peak flow is normal
D. The patient has an airflow obstruction

171. A patient is receiving aerosolized bronchodilator treatments with a small-volume nebulizer. If the patient develops a nosocomial infection of the trachea involving Escherichia Coli, which of the following is the most likely cause?
A. Failure to change the tubing frequently
B. Poor hand washing techniques by personnel
C. Placing unsterile water in the nebulizer
D. Contamination of disposable equipment

172. Vesicular breath sounds indicate which of the following?
A. Normal lungs
B. Lung consolidation
C. Small airways obstruction
D. Acute bronchospasm

173. Which of the following would provide the most information about a patient’s orientation to time and place?
I. The patient knows she is in a hospital
II. The patient knows her diagnosis
III. The patient recognizes her physician
IV. The patient correctly states the year
A. I and II only
B. I and IV only
C. I, II, and III only
D. II, III, and IV only

174. A dyspneic patient who is in the emergency department (ED) is coughing up large amounts of frothy, pink sputum, and audible crackles are heard. Which of the following would be the most appropriate treatment?
A. Performing repeated nasotracheal suctioning to clear the airways
B. Administering positive-pressure ventilation with air
C. Administering an FiO2 of 0.35 by air-entrainment mask and suctioning
D. Administering mask CPAP with an FiO2 of 1.0

175. Before attaching an oxygen regulator to a cylinder, the respiratory therapist can prevent foreign matter from entering the regulator by manipulating the cylinder valve in that way?
A. Clean it with water and carefully dry
B. Crack it open, then immediately close it
C. Lightly grease it with a non-petroleum product
D. Wipe it clean with a dry towel and visually inspect it

176. If a massive gas leak occurs from the wall oxygen outlet when a flowmeter is removed from the outlet, the first action would be to:
A. Reinsert the flowmeter into the outlet
B. Activate the fire alarm
C. Evacuate the patients from the room
D. Locate the zone valve and turn it off

177. A Wright respirometer has been used in the intensive care unit to monitor several patients. Cultures indicate that it is contaminated. Which of the following is the most practical way to prevent cross-contamination?
A. Sterilize the respirometer after each use
B. Replace the respirometer with a water-seal spirometer
C. Attach a one-way valve so that only expired gas passes through the respirometer
D. Place the respirometer in hydrogen peroxide between uses

178. During a 15-second suctioning procedure, a patient’s pulse decreases to 50/min, and his blood pressure decreases from 120/80 to 80/50 mm Hg. Which of the following is the most likely cause of these changes?
A. Abnormal ventilation/perfusion ratio
B. Transient hypoxemia
C. Sympathetic stimulation secondary to pain and trauma
D. Stimulation of vagal reflex

179. Which of the following is the most significant factor leading to the development of tracheostenosis?
A. Cuff pressure on the tracheal wall
B. Trauma during intubation
C. Intracuff volume
D. Tube length

180. Compared with other types of humidifiers, what is a major advantage of the wick humidifier?
A. Heating is not required
B. Both molecular and particulate water are produced
C. A 100% relative humidity is easily attainable
D. A baffle is not needed to produce the desired humidity

181. A patient with bacterial pneumonia has received chest physiotherapy to all lung segments q.i.d. for 1 week. The pneumonia has cleared in all segments, with the exception of the left lower lobe. At this time, which of the following should the respiratory therapist do?
A. Stop chest physiotherapy
B. Increase the frequency
C. Continue the present therapy regimen
D. Limit the therapy to the involved segments

182. When mouth-to-mouth resuscitation is being performed, it is most important to watch the patient’s:
A. Eyes
B. Chest
C. Abdomen
D. Tongue position

183. When adjusting the sensitivity control during pressure-cycled ventilation, the respiratory therapist would be altering the:
A. Volume of gas available to the patient on inhalation
B. Effort required to cycle the machine off as the patient exhales
C. Maximum amount of pressure to be delivered to the patient
D. Effort required to activate the machine as the patient inhales

184. The respiratory therapist notices that a nebulizer is delivering large water droplets down the large bore tube. To correct this problem, the therapist should:
A. Replace the nebulizer
B. Add water to the nebulizer
C. Dismantle and clean the nebulizer
D. Add a heating collar to the nebulizer

185. After completion of an aerosol bronchodilator treatment, which of the following is the most appropriate chart notation for the respiratory therapist to make?
A. Over 15 minutes, treatment given as ordered; no aftertaste noted; chest clear on auscultation
B. Aerosol therapy given; pulse stable, respiratory rate same as pretreatment, no changes during therapy; well-tolerated
C. Aerosol therapy given with 2.5 mg albuterol (Proventil) and 2 mL normal saline; vital signs stable; well tolerated
D. Aerosol therapy is given with 2.5 mg albuterol (Proventil) and 2 mL normal saline; pulse stable at 72/min during therapy; a nonproductive cough; respiratory rate 10/min; therapy well tolerated; chest clear on auscultation

186. A patient who is receiving an aerosol treatment with acetylcysteine (Mucomyst) and hypertonic saline by a hand-held nebulizer suddenly becomes dyspneic. The most likely cause of this problem is:
A. Hypercarbia
B. Bronchospasm
C. Pneumothorax
D. Fluid overload

187. The respiratory therapist reviews a ventilator flow sheet and finds that the peak inspiratory pressure has been gradually rising for the past several hours. Possible causes include which of the following?
I. Increasing pulmonary compliance
II. Bronchospasm
III. Accumulation of secretions
A. II only
B. I and II only
C. I and III only
D. II and III only

188. A patient with a laryngeal tumor is presently receiving 80%/20% helium-oxygen by a nonrebreathing mask at 5 L/min. The patient is alert but appears agitated. Vital signs indicate a pulse of 131/min, respirations 30/min, and blood pressure 140/90 mm Hg. Which of the following would be the most appropriate action to take?
A. Recommend a sedative
B. Recommend changing to an FiO2 of 1.0
C. Increase the gas flow to the mask
D. Administer racemic epinephrine

189. While using a Yankauer device to orally suction an adult patient, the respiratory therapist is having difficulty removing thick secretions. The regulator attached to the suction device displays a reading of -70 mm Hg. Which of the following should the therapist do at this time?
A. Perform nasotracheal suctioning
B. Replace the wall suction regulator
C. Change to a flexible catheter
D. Change the suction pressure to -120 mm Hg

190. A patient is receiving 0.40 oxygen by heated aerosol and a T-piece. During the breathing cycle, aerosol delivery is intermittently interrupted. To correct this situation, the respiratory therapist should:
A. Refill the reservoir jar
B. Shorten the reservoir tube
C. Replace the heating element
D. Empty the water in the large bore tubing

191. Palpable rhonchi in a patient who is being mechanically ventilated most likely indicate which of the following?
A. Secretions
B. Pneumothorax
C. Bronchospasm
D. Consolidation

192. After assisting the physician with a fiberoptic bronchoscopy and transbronchial lung biopsy on a patient receiving volume-controlled ventilation, the respiratory therapist notes a marked increase in peak inspiratory pressure. Possible causes of the pressure increase include which of the following?
I. Bronchospasm
II. Pneumothorax
III. Pulmonary hemorrhage
IV. Laryngospasm
A. I and IV only
B. II and III only
C. I, II, and III only
D. I, II, III, and IV

193. When attempting to obtain an arterial blood gas sample, an Allen’s test is performed on both of the patient’s wrists. The respiratory therapist finds that there is inadequate circulation through the patient’s left ulnar artery. The therapist should do which of the following?
A. Obtain the sample from the left radial artery
B. Obtain the sample from the right radial artery
C. Obtain the sample from the right ulnar artery
D. Obtain a pulse oximetry reading instead of the blood gas

194. The respiratory therapist opens the valve on an E cylinder that has a regulator attached and hears a loud hissing noise. The flow meter is turned off. Which of the following actions might correct the problem?
I. Turning on the flowmeter.
II. Tightening the regulator connection.
III. Changing the regulator washer
A. I only
B. I and II only
C. II and III only
D. I, II, and III

195. Common complications associated with arterial punctures include which of the following:
I. Fistula formation
II. Hematoma formation
III. Spasm of the vessel
A. I only
B. III only
C. I and II only
D. II and III only

196. A patient requires frequent suctioning of oral secretions. Which of the following should be made available at the patient’s bedside?
I. Vacuum system
II. Connecting tubing
III. Yankauer suction device
IV. Luken’s trap
A. I and II only
B. III and IV only
C. I, II, and III only
D. I, II, III, and IV

197. A patient is receiving a treatment with 2.5 mg of albuterol (Proventil) and 2.5 mL of normal saline in the emergency department (ED). Prior to therapy, the patient’s heart rate is 80/min, and at the end of therapy, it is 138/min. The respiratory therapist should:
A. Recommend decreasing the dosage of albuterol
B. Increase the amount of saline per treatment to 3 mL
C. Recommend changing to ipratropium bromide (Atrovent)
D. Recommend adding acetylcysteine (Mucomyst) to the treatment

198. A patient with severe facial trauma from a motor vehicle crash is brought into the emergency department (ED). The patient is obtunded and in respiratory distress due to swelling and blood in the naso– and oropharynx. Which of the following is indicated?
A. Oropharyngeal airway
B. Nasopharyngeal airway
C. Tracheostomy tube
D. Cricothyroid puncture

199. A patient who is being mechanically ventilated has just received vecuronium (Norcuron). Which of the following is the most important ventilator alarm to monitor to ensure patient safety?
A. I:E ratio
B. Circuit temperature
C. High pressure
D. Low pressure

200. A patient receiving continuous heated aerosol therapy with room air by a T-piece develops subcutaneous emphysema around the tracheostomy site, neck, and chest. After nothing unequal breath sounds, the most appropriate diagnostic procedure would be:
A. A chest radiograph
B. A maximum inspiratory pressure (MIP) measurement
C. Timed forced expiratory volumes
D. An arterial blood gas analysis

201. A patient with severe COPD who is receiving oxygen must be observed closely because which of the following may occur?
A. Hypoventilation
B. Pneumothorax
C. Bronchospasm
D. Pulmonary edema

202. During CPR in the emergency department (ED), a demand-valve resuscitator fails to deliver adequate tidal volumes. The respiratory therapist’s immediate response would be to:
A. Inspect the unit
B. Call for help
C. Use a mechanical ventilator
D. Change to a manual resuscitator

203. Which of the following pulmonary function parameters is LEAST dependent on patient effort?
A. FEF 25-75%
B. FEF 200-1200
C. FVC
D. PEF

204. A neonate is receiving oxygen therapy by a hood. Which of the following should the respiratory therapist select to check the accuracy of the air-oxygen blender?
A. Line pressure manometer
B. Galvanic cell analyzer
C. Pneumotachometer
D. Pulse oximeter

205. A patient is to receive incentive spirometry at home. When explaining the therapeutic goals to the patient’s family, the respiratory therapist should explain that the therapy:
A. Helps resolve pneumonia
B. Can decrease the chance of lung collapse
C. Should decrease the frequency of the patient’s cough
D. Should make breathing easier by causing bronchodilation

206. Extubation is performed during peak inspiration to:
A. Prevent laryngospasm
B. Ensure adequate oxygenation
C. Provide volume to clear secretions
D. Minimize vagal stimulation

207. A patient is receiving volume-controlled, flow-limited ventilation. An inverse I:E ratio visual alert is observed during a routine ventilator check. Which of the following adjustments would be most appropriate to correct the problem?
A. Increase the flow
B. Increase the frequency setting
C. Decrease the tidal volume
D. Activate the ratio limit control

208. When using an infrared carbon dioxide analyzer the, PetCO2 value will be affected by all of the following EXCEPT:
A. Moisture
B. Sensor temperature
C. Barometric pressure
D. Magnetic field interference

209. Which of the following would be most appropriate to recommend for a patient with dyspnea who has a 40% pneumothorax?
A. Administer a nebulized bronchodilator
B. Perform chest physiotherapy
C. Insert an endotracheal tube
D. Insert a chest tube

210. The respiratory therapist is explaining the objectives of a pulmonary rehabilitation program to a 55-year-old patient with emphysema. Which of the following outcomes would allow the patient to participate in evaluating the achievement of the therapeutic plan?
A. Reduction of airway resistance
B. Improvement in arterial blood gas values
C. Improvement in results of pulmonary function studies
D. Increased ability to perform activities of daily living

211. A patient who is being mechanically ventilated has insufficient time to exhale completely. Which of the following ventilator changes might be appropriate to correct this problem?
I. Increase the flow
II. Decrease the ventilator rate
III. Add mechanical dead space
IV. Add inspiratory hold
A. I and II only
B. II and III only
C. II, III and IV only
D. I, II, III and IV

212. The respiratory therapist observes low exhaled volumes during volume-cycled, pressure-limited mechanical ventilation. To determine if the low volumes are caused by inaccurate ventilator volume control, the therapist should measure the tidal volume at the:
A. Machine outlet
B. Patient connector
C. Exhalation valve
D. Spirometer

213. A patient with a head injury is heavily sedated. The patient requires positive pressure ventilation and has a moderately increased intracranial pressure and a pulmonary capillary wedge pressure of 23 mm Hg. Appropriate recommendations include which of the following?
I. Elevate the patient’s head to 30 degrees.
II. Decrease the ventilatory rate
III. Administer furosemide (Lasix)
A. I and II only
B. I and III only
C. II and III only
D. I, II, and III

214. An adult patient is receiving volume-controlled ventilation and has a tidal volume of 700 mL. The patient’s pH is 7.38. The patient is switched to pressure-controlled ventilation and a pressure limit of 50 cm H20. An exhaled tidal volume of 850 mL is now measured. The respiratory therapist should recommend which of the following?
A. Set the PEEP at 5 cm H2O
B. Maintain the current settings
C. Increase the inspiratory time
D. Decrease the pressure setting to obtain the previous tidal volume

215. A patient is receiving noninvasive positive pressure therapy. Pulmonary compliance has decreased over the past 4 hours. To increase the patient’s tidal volume, it would be most appropriate to:
A. Suction the patient
B. Change the CPAP
C. Increase the low-pressure level
D. Increase the high-pressure level

216. Which of the following would the respiratory therapist select to treat a patient who has obstructive sleep apnea?
A. Nasal cannula
B. Chest cuirass ventilator
C. Bilevel positive airway pressure
D. Airway pressure-release ventilation

217. Hemodynamic monitoring is initiated for a patient with multi-organ system failure. The patient is rapidly transfused with packed red blood cells. Following transfusion, the patient’s PvO2 increased from 33 torr to 38 torr. The respiratory therapist should conclude that:
A. Cardiac output has decreased
B. Intrapulmonary shunt has increased
C. Additional transfusions are required
D. Oxygen delivery to the tissues has improved

218. A manometer is being used to monitor a continuous flow CPAP device set at 10 cm H2O. Each time the patient inhales, the pressure decreases to 2 cm H2O, then returns to 10 cm H2O on exhalation. Which of the following is the most likely cause of the problem?
A. The flow of gas to the patient system is insufficient
B. There is a leak in the patient system
C. The patient’s endotracheal tube is too small for the inspiratory flow
D. The CPAP pressure valve is too small for the patient’s size and weight

219. A patient with congestive heart failure is intubated and receiving mechanical ventilation in the emergency department (ED). Appropriate pharmacologic therapy is implemented. To assure a constant tidal volume delivery, which of the following ventilators should the respiratory therapist select for this patient?
A. Pressure-cycled
B. Time-cycled
C. Patient-cycled
D. Volume-cycled

220. A home care patient receiving O2 at 2 L/min states that he does not feel any oxygen coming from the cannula that is connected to a concentrator. Which of the following should the respiratory therapist do FIRST?
A. Change the machine inlet filter
B. Turn the flow meter up to 4 L/min
C. Switch to a backup liquid oxygen system
D. Insert the cannula into the water and check for bubbles

221. An active 2-year-old is to receive 35% to 50% oxygen. Which of the following devices is likely to be best tolerated by the child?
A. Aerosol mask
B. Partial re-breathing mask
C. Air-entrainment mask
D. Oxygen tent

222. Which of the following should the respiratory therapist recommend to prevent Pneumocystis carinii pneumonia in patients infected with the human immunodeficiency virus (HIV):
A. Rifampin (Rifadin)
B. Pentamidine isethionate (NebuPent)
C. Vecuronium bromide (Norcuron)
D. Chloramphenicol palmitate (Chloromycetin Palmitate)

223. A spontaneously breathing patient is intubated with a 6.0 mm endotracheal tube. Which of the following would decrease the patient’s work of breathing imposed by the endotracheal tube?
A. CPAP
B. Pressure support ventilation
C. Flow-by ventilation
D. Inspiratory pause

224. Chest auscultation of a recently intubated patient who is in respiratory failure reveals diminished breath sounds on the left side. The most likely cause of this finding is:
A. Intubation of the right mainstem bronchus
B. Placement of the endotracheal tube at the carina
C. Lobar atelectasis on the right side
D. A pneumothorax on the left side

225. After a motor vehicle crash, a patient is brought to the emergency department (ED) in obvious shock and with internal injuries. The physician asks the respiratory therapist to administer oxygen immediately. The therapist should institute treatment with a:
A. Nasal cannula at 6 L/min
B. 40% air-entrainment mask
C. Nonrebreathing mask
D. Face tent

226. After a bland aerosol treatment, rhonchi is detected. The respiratory therapist should:
A. Encourage the patient to cough
B. Recommend administration of a bronchodilator
C. Recommend discontinuation of therapy
D. Discontinue the treatment and administer oxygen

227. Which of the following would be consistent with an obstruction in the endotracheal tube of a patient who is being mechanically ventilated?
I. High pressure is required to deliver the tidal volume
II. The low-pressure alarm is sounding
III. A suction catheter cannot be passed
A. I only
B. II only
C. I and III only
D. II and III only

228. Which of the following is indicated by a sound of popping and whistling when the water bottle of a humidifier is tested by obstructing the gas outlet with the finger?
A. No leakage
B. A worn gasket
C. Broken tubing
D. A cracked bottle

229. The primary purpose of cleaning and sterilizing non-disposable respiratory care equipment after each use is to:
A. Extend the life of the equipment
B. Prevent cross-infection and re-infection of patients
C. Prevent contamination of other equipment
D. Protect the personnel who are handling the equipment

230. Which of the following drugs would be the most appropriate to paralyze a sedated 30-year-old patient with status asthmaticus who is being mechanically ventilated?
A. D-tuborurarine
B. Morphine sulfate
C. Vecuronium (Norcuron)
D. Succinylcholine (Anectine)

231. Which of the following flow settings is required to maintain an I:E of 1:3 and a respiratory rate of 15/min status asthmaticus who is being mechanically ventilated?
A. 20 L/min
B. 27 L/min
C. 36 L/min
D. 72 L/min

232. The respiratory therapist is monitoring the effects of mechanical ventilation on a patient with congestive heart failure. The therapist’s IMMEDIATE concern should be to:
A. Obtain secretions for culture
B. Note changes in intracranial pressure
C. Check the patient’s blood pressure
D. Obtain serial chest radiographs

233. The respiratory therapist is preparing to suction a patient who has an endotracheal tube in place. Which of the following is a necessary step in the suctioning procedure?
A. Oxygenate the patient before and after suctioning
B. Rinse the catheter with water before suctioning
C. Instill 3 mL 0.9% NaCI before suctioning
D. Lubricate the catheter with water-soluble gel before suctioning

234. If a patient’s pulse rate increases by 40/min during a respiratory care treatment, the respiratory therapist should do which of the following?
A. Terminate the treatment and notify the physician of the patient’s reaction
B. Continue the treatment as ordered and monitor the patient’s pulse
C. Shorten the duration of the treatment
D. Let the patient rest for 5 minutes and then continue the treatment as ordered

235. To open an obstructed airway of a patient who has a possible cervical fracture, the respiratory therapist should:
A. Perform a cricothyroid puncture with a 13-gauge needle
B. Flex the patient’s head after a cervical collar is in place
C. Hyperextend the patient’s head after a cervical collar is in place
D. Perform the jaw thrust maneuver

236. When a patient develops an acute airway obstruction, the respiratory therapist should immediately do which of the following?
A. Establish an airway and begin CPR
B. Apply a series of strong, external sub-diaphragmatic compressions
C. Apply a forceful blow to the sternum
D. Lean the person forward and instruct him to inhale slowly

237. The respiratory therapist is interviewing a patient who is sitting in a chair. Which of the following terms should be used to record the patient’s comment that he is not currently having difficulty breathing but does have difficulty when lying down?
A. Hyperpnea
B. Orthopnea
C. Dyspnea
D. Hyperventilation

238. Oxygen administration devices that are most capable of meeting and/or exceeding a patient’s inspiratory flow include which of the following?
I. Air entrainment mask
II. Nasal cannula
III. Nonrebreathing mask
A. II only
B. III only
C. I and II only
D. I and III only

239. A patient is being mechanically ventilated. Several attempts to insert a central venous catheter into the patient’s right subclavian vein have been unsuccessful. The patient’s blood pressure suddenly drops, there is a significant increase in peak inspiratory pressure, and breath sounds are absent over the right upper chest. Which of the following should the respiratory therapist do?
A. Increase the pressure limit
B. Decrease the inspiratory flow
C. Recommend inserting a chest tube
D. Obtain an arterial blood gas sample

240. A patient is receiving volume-cycled mechanical ventilation. The high-pressure alarm suddenly begins to sound. The corrective action would be to:
A. Increase the pressure limit
B. Increase the flow
C. Suction the airway
D. Withdraw 5 mL of air from the endotracheal tube cuff

241. A patient who is intubated with an 8 mm ID endotracheal tube requires suctioning. A 14 Fr catheter and sterile tray are available. The vacuum setting is -120 mm Hg; however, the secretions are too thick to be aspirated effectively. The respiratory therapist should do which of the following?
A. Change the catheter to a 12 Fr
B. Change the catheter to an 18 Fr
C. Instill 4 mL of normal saline and then attempt suctioning
D. Increase the vacuum setting to -180 mm Hg

242. A patient complains of dizziness and a tingling sensation in the fingers during an IPPB treatment. Which of the following is the most likely cause?
A. Increased cardiac output
B. Increased CO2 retention
C. Excessive CO2 elimination
D. Excessive N2 elimination

243. A patient’s cardiac output decreases from 4 to 2 L/min after 15 cm H2O PEEP is initiated. Which of the following should the respiratory therapist recommend?
A. Perform an arterial blood gas analysis to check the patient’s oxygenation
B. Maintain the present settings, and check arterial blood gases in 1 hour
C. Decrease the respiratory rate to extend cardiac filling time
D. Decrease PEEP to 10 cm H2O and recheck the cardiac output

244. A 17-year-old patient has sustained a cervical spine injury. He is conscious and spontaneously breathing. The patient weighs approximately 50 kg (110 lb), and his head has been stabilized with sandbags. Arterial blood gas results indicate that the patient is in acute ventilatory failure. To secure the patient’s airway, the respiratory therapist should select which of the following?
A. 6.0 mm nasopharyngeal airway
B. 7.0 mm nasotracheal tube
C. 9.0 mm nasotracheal tube
D. 37 Fr Carlens orotracheal tube

245. A home care patient who has COPD returns to the pulmonary rehabilitation clinic. Which of the following would indicate that the physical conditioning program has been effective?
A. Resting pulse rate is the same after one month
B. Level-walking distance has increased by 15%
C. Vital capacity has increased by 5%
D. Respiratory rate has increased by 2/min

246. A 35-year-old postoperative is in no apparent distress and has clear breath sounds. Which of the following should the respiratory therapist select to prevent atelectasis?
A. IPPV
B. Incentive spirometer
C. Mechanical chest percussor
D. Aerosolized bronchodilator therapy

247. The respiratory therapist is reviewing a patient’s chart as part of the evaluation prior to tracheal extubation. Which of the following predicts the patient’s ability to cough effectively?
I. Vital capacity.
II. Maximum inspiratory pressure (MIP)
III. Tidal volume
A. I only
B. I and II only
C. II and III only
D. I, II, and III

248. A physician wants to provide a patient with the physiologic effect of end-expiratory positive pressure, yet allow the patient to set her own spontaneous minute ventilation. Which of the following should the respiratory therapist recommend?
A. EPAP
B. CPAP
C. IMV
D. IPPB

249. A neonate is having a seizure and requires heavy sedation. After intubation, which of the following should the respiratory therapist recommend?
A. CPAP
B. Pressure support ventilation
C. Pressure controlled ventilation
D. Volume controlled ventilation

250. Approximately how many hours will it take to empty an H cylinder of oxygen that contains 1,200 psig and is flowing at 12 L/min?
A. 3
B. 5
C. 7
D. 9

251. To demonstrate significant post-bronchodilator improvement, a patient’s FEV1 must increase by a minimum of which of the following?
A. 5%
B. 15%
C. 25%
D. 40%

252. During mouth-to-mouth resuscitation, bilateral ventilation is most easily assessed by:
A. Using a stethoscope
B. Observing chest excursion
C. Checking the patient’s pulse
D. Checking the patient’s pupillary reaction.

253. Which of the following suction devices is specifically designed to facilitate left mainstem bronchial entry?
A. Coude
B. Whistle-tip
C. Luken’s
D. Ring-tip

254. A patient with neuromuscular disease has been receiving ventilatory support for 4 months by tracheostomy. The patient is being weaned during the day, but still mechanically ventilated at night. Which of the following devices will best meet both needs of the patient?
A. Tracheostomy button
B. Bivona tracheostomy tube
C. Cuffed, fenestrated tracheostomy tube
D. Uncuffed, standard tracheostomy tube

255. In reviewing a patient’s record, the respiratory therapist will most likely find which of the following problems as a result of continuous positive pressure ventilation?
A. Hyperkalemia
B. Decreased urine output
C. Increased cardiac output
D. Increased insensible water loss

256. All of the following statements about endotracheal intubation of an adult are correct EXCEPT:
A. A curved blade is used to directly lift epiglottis
B. The patient’s head should be placed in the sniffing position
C. The patient should be hyper-oxygenated before each intubation attempt
D. An intubation attempt should be discontinued after 10-20 seconds if unsuccessful and manual ventilation resumed

257. A patient with multiple-trauma is intubated and receiving mechanical ventilation. The patient is extremely anxious, tachypneic, and complaining of severe pain. Which of the following drugs would slow the ventilatory rate and provide pain control:
A. Morphine sulfate
B. Diazepam (Valium)
C. Neostigmine bromide (Prostigmin)
D. Pancuronium bromide (Pavulon)

258. The best way to check the accuracy of a water-seal spirometer is to use a:
A. 3-L syringe
B. Pneumotachograph
C. Vortex sensor
D. Wright respirometer

259. A 25-year-old patient is brought to the emergency department (ED) with respiratory depression caused by an acute drug overdose. An arterial blood gas analysis indicates a pH of 7.20 and a PaCO2 of 80 torr. The respiratory therapist is asked to initiate continuous mechanical ventilation. Which of the following should the therapist do?
A. Recommend IPPB treatments q2h to reduce the patient’s PaCO2
B. Adjust the ventilator so that the patient’s PaCO2 will be decreased to 40 torr very gradually over 36 hours
C. Adjust the ventilator so that the patient’s PaCO2 will be decreased to 40 torr within 1 hour
D. Adjust the ventilator so that the patient’s PaCO2 will be decreased to 60 torr to prevent respiratory alkalosis

260. Which of the following should the respiratory therapist check to assess adequate cerebral perfusion during CPR?
A. Deep tendon reflexes
B. A Babinski reflex
C. Intracranial pressure of less than 20 mm Hg
D. Pupillary reactions to light

261. Appropriate infection control procedures in the home include which of the following?
I. Disinfecting equipment every 96 hours
II. Rinse and drying equipment before storage
III. Hand washing before and after therapy
A. I and II only
B. I and III only
C. II and III only
D. I, II, and III

262. During CPR, the oxygen reservoir bag of the manual resuscitator collapses during the refill phase. The respiratory therapist can correct this problem by:
A. Decreasing the bag refill time
B. Increasing oxygen flow to the bag
C. Increasing the ventilatory frequency
D. Performing mouth-to-mask resuscitation

263. A 1000 g neonate who is 6 hours old is receiving time-cycled, pressure-limited ventilation. The neonate has signs of developing RDS, as evidenced on the chest radiograph, and severe hypoxemia is noted with an FiO2 of 0.80. Which of the following should the respiratory therapist recommend?
A. Perform ECMO
B. Change to volume ventilation
C. Administer exogenous surfactant
D. Administer partial liquid ventilation (per fluorocarbon)

264. A physician orders an IPPB treatment with 35% oxygen. A properly functioning oxygen blender is attached to a Bennett PR-2 ventilator, and a properly functioning analyzer is used to measure the gas mixture. The blender is set for 35%, and the air dilution control is set a 100%. The mixture is analyzed, and it is found to be 30% instead of 35%. This finding is most likely caused by which of the following control settings?
A. Peak flow
B. Sensitivity
C. Terminal flow
D. Pressure limit

265. In which of the following patients should pressure support be initiated?
A. A patient with absent or depressed respiratory drives with an endotracheal tube in place
B. A patient receiving SIMV who exhibits signs of increased spontaneous ventilatory effort
C. A patient with low lung compliance, atelectasis, and severe refractory hypoxemia
D. A patient in the post-anesthesia care unit (PACU) who requires short-term ventilatory support

266. Which of the following is most effective in destroying all microorganisms?
A. Acetic acid
B. Pasteurization
C. Ethylene oxide
D. Isopropyl alcohol

267. Initiation of noninvasive positive pressure would be appropriate in a patient with which of the following?
A. Acute ARDS
B. Interstitial fibrosis
C. Cardiopulmonary arrest
D. Post-poliomyelitis syndrome

268. The respiratory therapist is calibrating a thermal conductivity type helium analyzer. When calibrated in room air, what should the analyzer read?
A. 0%
B. 21%
C. 79%
D. 100%

269. Which of the following indicates the presence of pneumothorax on a chest radiograph?
A. A “ground glass” appearance
B. A white butterfly-shaped pattern
C. Increased radio-opacity bilaterally
D. A dark area with no lung markings present

270. A 20-year-old patient with asthma is to receive 0.5 mL of Metaproterenol (Alupent) and 4 mL of normal saline by hand-held nebulizer. During the treatment, the patient complains of tremors and palpitations. Which of the following should the respiratory therapist recommend for the next treatment?
A. Change to 0.6 mL albuterol (Ventolin)
B. Decrease the Alupent to 0.2 mL
C. Change to 3 puffs of beclomethasone (Vanceril)
D. Administer the treatment with saline only

271. A 150-lb (IBW) patient has a tidal volume of 500 mL and a ventilatory rate of 12 breaths/minute. Calculate the patient’s alveolar minute ventilation.
A. 1.8 liters/minute
B. 4.2 liters/minute
C. 2.3 liters/minute
D. 6.0 liters/minute

272. 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?
A. 7848 mL
B. 6920 mL
C. 5965 mL
D. 4130 mL

273. A 40-year-old patient recovering from ARDS is receiving mechanical ventilation with a tidal volume of 650 mL. The patient has a 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 physiologic dead space volume.
A. 273 mL
B. 317 mL
C. 338 mL
D. 384 mL

274. A 55-year-old man was admitted to the hospital for shortness of breath. The following results were obtained: PaCO2 = 50 mmHg, PECO2 = 30 mmHg, and tidal volume of 600 mL. What is the patient’s physiologic deadspace (Vd)?
A. 150 mL
B. 175 mL
C. 240 mL
D. 310 mL

275. 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 0.5 sec is activated, the static pressure is 35 cmH2O. Determine the patient’s static compliance.
A. 36.18 mL/cmH2O
B. 30.48 mL/cmH2O
C. 22.65 mL/cmH2O
D. 15.72 mL/cmH2O

276. 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 0.5 sec is activated, the static pressure is 35 cmH2O. Determine the patient’s dynamic compliance.
A. 15.21 mL/cmH2O
B. 25.71 mL/cmH2O
C. 29.46 mL/cmH2O
D. 32.09 mL/cmH2O

277. Reviewing the chart of a newly admitted patient, the respiratory therapist finds that the patient has COPD, a 70 pack year smoking history, and was admitted for dyspnea. The patient is unresponsive and has a BP of 180/100 mm Hg and a respiratory rate of 40/min. Which of the following should the therapist review next?
A. Chest radiograph report
B. PaCO2
C. SpO2
D. ECG

278. A patient complains of the following symptoms:
Excessive daytime fatigue
Headaches upon awakening
Decreased ability to concentrate
Memory loss
Which of the following tests is appropriate for this patient?
A. Bronchoscopy
B. Pre and post-bronchodilator study
C. Sleep study with overnight pulse oximetry
D. Bronchoprovocation testing

279. 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:
A. 10 cmH2O/L/sec
B. 20 cmH2O/L/sec
C. 30 cmH2O/L/sec
D. 40 cmH2O/L/sec

280. A patient suspected 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:
A. 95%
B. 67%
C. 75%
D. 55%

281. A patient who is on a volume ventilator has the following measurements: corrected tidal volume = 780 mL, peak airway pressure = 55 cmH2O, plateau pressure = 35 cmH20, and PEEP of 10 cmH2O. What is the dynamic compliance?
A. 17.3 mL/cmH2O
B. 22.3 mL/cmH2O
C. 14.2 mL/cmH2O
D. 31.2 mL/cmH2O

282. All of the following are methods to reduce auto-PEEP EXCEPT:
A. Decreasing the inspiratory time
B. Decreasing the tidal volume
C. Increasing the flow rate
D. Increasing the rate

283. 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.
A. 15 cmH2O/L/sec, normal
B. 15 cmH2O/L/sec, abnormal
C. 10 cmH2O/L/sec, normal
D. 10 cmH2O/L/sec, abnormal

284. Calculate the alveolar oxygen tension (PAO2) given the following values: PB = 750 mmHg, FiO2 = 30%, and PaCO2 = 40.
A. 100 mmHg
B. 130 mmHg
C. 161 mmHg
D. 190 mmHg

285. Exhaled volumes 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?
A. 10 breaths per minute
B. 14 breaths per minute
C. 18 breaths per minute
D. 24 breaths per minute

286. 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
A. 21%
B. 35%
C. 47%
D. 68%

287. Given the following values for room air: PAO2 = 105 mmHg, PaO2 = 70 mmHg, what is the P(A-a)O2? Is it normal?
A. 70 mmHg; normal
B. 70 mmHg; abnormal
C. 35 mmHg; normal
D. 35 mmHg; abnormal

288. 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.
A. 20 mL/cm H2O
B. 35 mL/cm HO
C. 15 mL/cm H2O
D. 23 mL/cm H2O

289. Given the following 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?
A. 24 breaths/min/L, yes
B. 24 breaths/min/L, no
C. 69 breaths/min/L, yes
D. 69 breaths/min/l, no

290. Heavy smokers commonly have HbCO levels as high as:
A. 10%
B. 20%
C. 30%
D. 40%

291. 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?
A. 9.6L
B. 96.0 L
C. 96.0 mL
D. 960 mL

292. 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?
A. 5.6 L
B. 560 mL
C. 56.0 L
D. 4.0 L

293. If a patient’s PaO2 is 540 mmHg and PAO2 is calculated to be 642 mmHg, what is the alveolar-arterial oxygen tension difference? The patient is on 100% FiO2.
A. 102 mmHg
B. 540 mmHg
C. 320 mmHg
D. 265 mmHg

294. 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?
A. Three or more apneic episodes per hour, each lasting at least 6 seconds
B. Five or more apneic episodes per hour, each lasting at least 10 seconds
C. Five or more apneic episodes per hour, each lasting at least 3 seconds
D. Eight or more apneic episodes per hour, each lasting at least 8 seconds

295. Which of the following devices should be used to effectively deliver a 70% helium/ 30% oxygen mixture to a patient?
A. Simple mask
B. Oxygen hood
C. Nasal cannula
D. Nonrebreathing mask

296. 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?
A. Spontaneous Vt = .207 L; RSBI = 90/breaths/min/L; Yes
B. Spontaneous Vt = .207 L; RSBI = 145 breaths/min/L; No
C. Spontaneous Vt = .319 L; RSBI = 90 breaths/min/L; Yes
D. Spontaneous Vt = .319; RSBI = 137 breaths/min/L; No

297. When a volume-limited ventilator is used, the peak airway pressure is directly related to the:
A. Patient’s airway resistance
B. Patient’s lung compliance
C. Respiratory rate
D. FiO2

298. When a volume-limited ventilator is used, the plateau (lung) pressure is directly related to the:
A. Patient’s airway resistance
B. Patient’s lung compliance
C. Respiratory rate
D. FiO2

299. The respiratory therapist is participating in the resuscitation of a patient. After 5 minutes of CPR, the ECG shows ventricular fibrillation. Attempted defibrillation with 200 joules has been ineffective. The therapist’s next recommendation should be to:
A. Perform a precordial thump
B. Perform endotracheal intubation
C. Implement cardioversion with 300 joules
D. Implement defibrillation with 300 joules

300. A patient being mechanically ventilated is intubated with an 8mm endotracheal tube. While suctioning the patient with a 12 Fr catheter after pre-oxygenation, the respiratory therapist notes the patient shows bradycardia, and the oxygen saturation decreases. The therapist should recommend changing to a:
A. 10 mm catheter
B. Closed-suction system
C. 14 Fr whistle-tip catheter
D. Suctioning frequency of q4h

301. 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.
A. 80, 5
B. 80, 10
C. 130, 30
D. 100, 20

302. You just finished analyzing an arterial blood sample in the laboratory and the co-oximeter shows total hemoglobin of 15 grams/100 mL with a carboxyhemoglobin of 2 grams and methemoglobin of 2 grams. The amount of functional hemoglobin in this sample would be _____ grams.
A. 15
B. 13
C. 11
D. 9

303. Given the following results: PB = 760 mmHg, FiO2 = 70%, and PaCO2 = 40 mmHg. What is the calculated alveolar oxygen tension (PAO2)?
A. 449 mmHg
B. 370 mmHg
C. 100 mmHg
D. 268 mmHg

304. After obtaining an arterial blood sample from a patient’s artery, the respiratory therapist notes a purple subcutaneous wheal developing at the puncture site. Which of the following would be the FIRST action to take?
A. Perform an Allen’s test
B. Immediately notify the nurse
C. Apply pressure to the puncture site
D. Recommend subcutaneous epinephrine at the site

305. You are monitoring a mechanically ventilated patient with ARDS in the SIMV mode. At 7:00 am, 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?
A. Change to pressure control mode
B. Suction the patient’s airway
C. Continue SIMV mode and reduce the tidal volume
D. Recommend that a bronchodilator be administered

306. A 34-week gestational age infant is receiving mechanical ventilation and the chest is being transilluminated. The transillumination device produces a small halo appearance at the point of contact with the skin. This indicates which of the following?
A. Pneumothorax
B. Pneumomediastinum
C. Pneumopericardium
D. Normal lung appearance

307. A patient with an oral endotracheal tube is being suctioned using 80 mm Hg suction pressure. As suction is applied to the catheter, secretions enter the catheter but do not advance more than 3 cm. The respiratory therapist should:
A. Increase suction pressure
B. Instill saline down the suction catheter
C. Instruct the patient to cough during suctioning
D. Apply intermittent suction pressure to the catheter

308. 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?
A. 12 L
B. 11.2 L
C. 9.75 L
D. 7.5 L

309. The respiratory therapist is suctioning a mechanically ventilated patient q4h with a 12 Fr suction catheter. The patient has a 7.0 mm oral endotracheal tube in place. The amount of secretions seems to be increasing. Which of the following is the most appropriate action?
A. Suction more frequently
B. Use a Coude suction catheter
C. Use a size 14 Fr suction catheter
D. Increase the suction pressure to 150 mmHg

310. During the initial assessment of a patient with a closed-head injury, the patient only opens his eyes in response to pain. On a follow-up examination, the patient opens his eyes to verbal commands. These observations indicate which of the following?
A. The level of consciousness is increased
B. Intracranial pressure has increased
C. Cerebral perfusion has decreased
D. Seizure activity is increased

311. Increased dynamic compliance and stable static compliance would indicate:
A. A problem in the airway
B. Stiff lung tissue due to atelectasis
C. A pneumothorax
D. Patient has developed pulmonary edema

312. 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?
A. Dynamic and static compliance have improved
B. Dynamic and static compliance have worsened
C. Only dynamic compliance has improved
D. Only static lung compliance has improved

313. The respiratory therapist performs an assessment prior to initiating aerosol and chest physiotherapy. During the interview, the patient states, “I seem to breathe fast and lift my shoulders a lot, but I feel like I am getting enough air. I sleep through the night and only use one pillow.” The therapist can conclude that the patient likely has:
A. Dyspnea
B. Orthopnea
C. Increased work of breathing
D. A decreased level of consciousness

314. A COPD patient is being cared for via home health visits. A respiratory therapist visits the patient and determines that the patient is losing muscle mass and weight. Which of the following recommendations should the RT make to this patient to prevent further muscle wasting?
A. Eat several small meals a day
B. Eat only when you feel hungry
C. Wear your nasal cannula at 2 LPM while you eat
D. Lift heavy weights at the gym

315. A respiratory therapist is assessing a patient with chronic bronchitis. The patient states that his secretions are thick and pale yellow in color. The RT would chart this finding as:
A. Mucoid
B. Frothy
C. Purulent
D. Mucopurulent

316. A respiratory therapist is called to assess a patient with chest pain. Auscultation reveals a pleural friction rub. The patient has been hospitalized for two days and has shown no improvement. The RT should consider which of the following as a possible diagnosis for this patient?
A. The patient has developed pleurisy
B. The patient is experiencing angina pectoris
C. The patient has broken ribs
D. The patient has developed an area of atelectasis

317. A loud, continuous, high-pitched sound heard during auscultation of the larynx and trachea is called:
A. Rhonchi
B. Wheezing
C. Stridor
D. Crackles

318. A near-drowning patient is brought to the ER. The respiratory therapist 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?
A. 3
B. 9
C. 12
D. 7

319. When an oropharyngeal suction device becomes obstructed while suctioning vomitus from a patient’s mouth, the respiratory therapist should:
A. Increase the vacuum pressure
B. Change to a suction catheter
C. Clear the device of particulate matter
D. Check the wall outlet vacuum pressure

320. An afebrile patient who has been ventilated with a volume ventilator with a heat moisture exchanger for the past 24 hours is having progressive increases in peak inspiratory pressure. After suctioning the trachea and determining there is no pathological reason for the increased pressure, the respiratory therapist should do which of the following?
A. Reduce the tidal volume
B. Change the flow pattern of the ventilator
C. Replace the heat moisture exchanger
D. Increase the heat moisture exchanger temperature

321. The respiratory therapist is using a pulse oximeter to monitor SpO2 on a 54-year-old man who was rescued from a fire. The electrode is placed on the left ear lobe. The measured SpO2 is 90%. However, the patient’s SaO2, obtained from an arterial blood sample analyzed by a co-oximeter is 79%. Which of the following is the most likely explanation for the difference in saturation?
A. Operator error
B. Pigmentation of the patient’s skin
C. Presence of increased COHb
D. Oximeter out of calibration

322. A 21-year-old man arrives at the emergency department (ED) after being rescued from a house fire. Physical examination reveals burns on the upper chest and face and marked edema of the face and oropharynx. The results of an arterial blood gas example drawn while the patient was breathing room air are below:
pH – 7.55
PaCO2 – 26 torr
PaO2 – 105 torr
HCO3 – 22 mEq/L
BE – 0 mEq/l
The respiratory therapist is reviewing a postoperative patient’s care plan. The physician has changed the patient’s therapy from incentive spirometry to IPPB. What is the most likely goal for this change?
A. Delivery of aerosolized bronchodilators
B. Improvement in alveolar oxygenation
C. Prevention of lower lobe atelectasis
D. Promotion of airway clearance

323. Which of the following humidifiers would most consistently deliver the highest water vapor to a patient’s airway?
A. Passover
B. Bubble
C. Heated wick
D. Heat moisture exchanger

324. A physician orders an FiO2 of 0.40 for a premature infant in an Isolette. To deliver the prescribed FiO2, the respiratory therapist should select:
A. A 40% air entrainment mask
B. An oxygen hood
C. An infant nasal cannula at 1 L/min
D. A simple mask at 4 L/min

325. A 7-day-old infant of 28 weeks gestational age is having frequent periods of apnea with desaturations. The respiratory therapist should recommend which of the following?
A. Racemic epinephrine (Vaponefrin)
B. Naloxone (Narcan)
C. Surfactant (Survanta)
D. Theophylline (Aminophylline)

326. A conscious, spontaneously breathing patient is admitted to the emergency department (ED) with suspected carbon monoxide poisoning. The respiratory therapist’s most appropriate INITIAL action would be to:
A. Perform an arterial blood gas analysis
B. Intubate and apply CPAP with 50% oxygen
C. Administer oxygen with a 40% air-entrainment mask
D. Administer 100% oxygen with a nonrebreathing mask

327. A patient presents in the emergency department (ED) with massive facial trauma involving the nose and mouth. Which of the following is most appropriate for managing the patient’s airway?
A. Nasotracheal tube
B. Tracheostomy tube
C. Oral endotracheal tube
D. Laryngeal mask airway

328. Which of the following allows immediate determination of the lowest FiO2 needed to achieve satisfactory oxygenation?
A. Capillary refill
B. Pulse oximetry
C. Nail bed color
D. Shunt studies

329. The pressure control knob on a pressure-cycled ventilator will determine the:
A. Pressure at which inspiration ends
B. Gradient from the artificial airway to the alveoli
C. Effort required to initiate gas flow
D. Pressure required to activate the pop-off mechanism

330. An 18-year-old patient who is having a severe asthmatic episode is being mechanically ventilated. The pressure limit alarm is frequently sounding. The patient is very agitated, and his respiratory rate is 36/min. Bilateral breath sounds with minimal wheezing are noted. Which of the following should the respiratory therapist recommend?
A. Midazolam (Versed)
B. Beclomethasone (Vanceril)
C. N-acetylcysteine (Mucomyst)
D. Cromolyn (Intal)

331. All of the following are true concerning the use of a transcutaneous PO2 monitor EXCEPT:
A. A low calibration point is done with a “zero” solution or gas
B. The site should be changed every 3 to 4 hours
C. Skin temperature control should be set at 37 C
D. PtcO2 values should be correlated with arterial blood samples periodically

332. The respiratory therapist is working with a patient with COPD who is in a smoking cessation program. The patient complains of irritability, anxiety, difficulty concentrating, craving for tobacco, and weight gain. The therapist should recommend which of the following?
A. Using a sedative
B. Using nicotine patches
C. Returning to smoke, but only half as much as previously
D. Continuing the program because these complaints are expected

333. A patient with neuromuscular disease has been receiving ventilatory support for four months by tracheostomy. The patient is being weaned during the day but is still mechanically ventilated at night. Which of the following devices will best meet both needs of the patient?
A. Tracheostomy button
B. Bivona tracheostomy tube
C. Cuffed, fenestrated tracheostomy tube
D. Uncuffed, standard tracheostomy tube

334. When performing simple spirometry, which of the following results would best denote an obstructive pattern?
A. Decreased FEV1/FVC Ratio
B. Increased FEV1
C. Increased tidal volume
D. Decreased inspiratory reserve volume

335. During the weaning trial of a patient with a tracheostomy, the mist disappears at the T-piece early in inspiratory respiratory therapist should do which of the following?
A. Add dead space between the T-Piece and the patient
B. Direct the patient to inhale more slowly
C. Decrease the length of tubing from the aerosol generator
D. Increase the flow of the aerosol generator

336. Moist, crepitant crackles indicate which of the following?
A. Pulmonary edema
B. Atelectasis
C. Pleural effusion
D. Asthma

337. Which of the following would be most important to assess a patient’s ability to perform metered dose inhaler (MDI) therapy?
A. Ability to follow instructions
B. Overall general appearance
C. Adequacy of oxygenation
D. Exercise tolerance

338. While administering acetylcysteine (Mucomyst) with a hand-held nebulizer, the respiratory therapist notes that the patient is developing marked congestion with copious sputum production. The therapist’s most appropriate action would be to:
A. Dilute the acetylcysteine with saline
B. Terminate the therapy and clear secretions
C. Increase the dose of acetylcysteine to help thin the secretions
D. Administer the acetylcysteine with a positive-pressure breathing machine

339. The addition of an inspiratory plateau during continuous mechanical ventilation may be CONTRAINDICATED in patients with:
A. Hypoxemia
B. Hypotension
C. Poor gas distribution
D. Pulmonary edema

340. When the respiratory therapist initiates an IPPB treatment, the patient’s pulse is 80/min. Five minutes after the therapy is started, the patient’s pulse increases to 95/min. The therapist should:
A. Continue the treatment as ordered
B. Terminate the treatment and notify the charge nurse
C. Decreases the nebulizer output
D. Decrease the system pressure

341. During manual bag-valve ventilation by an endotracheal tube, inadequate ventilation is noted. This may be caused by which of the following:
I. Deflated endotracheal tube cuff
II. Excessive oxygen flow
III. Absent bag-valve diaphragm
IV. Improper tube placement
A. I and II only
B. I and III only
C. I, III, and IV only
D. II, III, and IV only

342. The respiratory therapist is assisting the physician with a tracheostomy on a patient who is receiving mechanical ventilation. The therapist notes an increase in peak respiratory pressure and heart rate, a decrease in exhaled tidal volume, and distant breath sounds over the right chest. This most likely indicates a:
A. Circuit air leak
B. Right pneumothorax
C. Lacerated blood vessel
D. Unilateral intubation

343. A 13-month-old infant is apneic and cyanotic. The physician asks the respiratory therapist to prepare a tray for oral intubation. The therapist should select all of the following equipment EXCEPT:
A. Magill forceps
B. A Macintosh (curved) laryngoscope blade
C. A Miller (straight) laryngoscope blade
D. A Yankauer suction tube

344. Which of the following is the most appropriate radiograph technique to confirm the presence of free pleural fluid?
A. Bronchogram
B. Apical projection
C. Decubitus projection
D. Oblique projection

345. The most common complication associated with the placement of a pulmonary artery catheter is:
A. Myocardial infarction
B. Pulmonary artery rupture
C. Pulmonary thrombosis
D. Arrhythmias

346. While checking a ventilator that has a wick humidifier, the respiratory therapist notes that there is very little condensation in the tubing. The most likely explanation is that he:
A. Minute ventilation is greater than 15 L/min
B. Heating element is not functioning
C. Flow is set too low
D. Room temperature is lower than normal

347. Which of the following drugs would be most appropriate to recommend as a substitute for metaproterenol sulfate (Alupent) for a patient who has bronchospasm and whose cardiac rate increases by 60/beats/min with each treatment?
A. Acetylcysteine (Mucomyst)
B. Beclomethasone (Vanceril)
C. Racemic epinephrine (Vaponephrin)
D. Albuterol (Proventil)

348. The respiratory therapist is explaining the objectives of a pulmonary rehabilitation program to a 55-year-old patient with emphysema. Which of the following outcomes would allow the patient to participate in evaluating the achievement of the therapeutic plan?
A. Reduction of airway resistance
B. Improvement in arterial blood gas values
C. Improvement in results of pulmonary function studies
D. Increased ability to perform activities of daily living

349. When administering an IPPB treatment with a pressure-cycled ventilator, the respiratory therapist observes that the patient’s tidal volume is adequate, but the inspiratory time is too long. To correct this situation, the therapist should:
A. Increase the flow
B. Increase the pressure
C. Adjust the sensitivity
D. Decrease the nebulizer flow

350. A patient is receiving oxygen by a nonrebreathing mask at 8 L/min. The respiratory therapist notices that the reservoir bag on the mask empties during inspiration. The therapist should immediately:
A. Change the partial rebreathing mask
B. Remove the mask
C. Increase the flow
D. Intubate the patient

351. A patient with an endotracheal tube in place is receiving oxygen enrichment by a heated all-purpose nebulizer. Water is collecting in the delivery hose. The respiratory therapist should:
A. Reduce the oxygen flow
B. Drain the tubing frequently
C. Unplug the theater
D. Position the tubing so that the condensate drains back into the reservoir

352. The patient with a head injury is being mechanically ventilated at a rate of 18 /min. The delivered tidal volume is 900 mL. The patient’s current arterial blood gas results are below:
pH: 7.50
PaCO2: 28 torr
PaO2: 90 torr
HCO3: 21 mEq/L
BE: -1 mEq/L
The most appropriate recommendation for this patient would be to:
A. Maintain the present settings
B. Decrease the ventilator rate
C. Decrease the tidal volume
D. Add mechanical dead space

353. At an FiO2 of 0.30, a pulse oximeter attached to the right index finger or a 6-week-old neonate displays an SaO2 of 87% and a pulse of 64/min. A heart monitor reads a simultaneous heart rate of 120/min. Which of the following would be the most appropriate action?
A. Suction the neonate
B. Increase the FiO2 to 0.40
C Reposition the pulse oximeter
D. Ventilate the neonate with 100% 02

354. A patient complains of sudden, right-sided chest pain. Breath sounds are absent over the right lung field and percussion reveals hyperresonance. The respiratory therapist should recommend:
A. Placing the patient on her right side and administering chest percussion
B. Initiating mechanical ventilation in the assist/control mode
C. Administering an IPPB treatment with a bronchodilator
D. Inserting a chest tube on the right side

355. The respiratory therapist is asked to assess a patient with sleep apnea who is receiving CPAP by a nasal mask. The patient’s snoring is becoming progressively louder with longer periods of apnea. The RT should initially do which of the following?
A. Obtain a blood gas sample
B. Decrease the gas flow
C. Reposition the nasal mask
D. Perform an ECG

356. A patient who is receiving mechanical ventilation requires an FiO2 of 0.70 and a PEEP of 10cm H2O to maintain an acceptable PaO2. The patient has become disconnected from the ventilator several times while trying to remove her restraints. During each period of disconnection, the patient experiences cardiac rhythm disturbances, which require additional treatment. The respiratory therapist should recommend:
A. Sedating the patient
B. Decreasing the PEEP level
C. Extubating the patient and using a rebreathing mask.
D. Attempting to wean the patient with a T-piece with an FiO2 of 0.80

357. The aerosol from an ultrasonic nebulizer is being produced in short, rapid puffs. To correct the problem, the respiratory therapist should:
A. Reduce the volume of water in the reservoir
B. Increase the blower flow
C. Clear the water from the delivery tube
D. Replace the corrugated tubing with smooth bore tubing

358. A 90 kg (198 lb) patient remains intubated in the post-anesthesia care unit (PACU) following abdominal surgery. The patient has not fully awakened from the anesthesia, although he is taking a few spontaneous breaths. The patient is currently being ventilated with a manual resuscitator. Which of the following should the therapist do?
A. Continue manual ventilation until the patient is awake
B. Initiate 5 cm H2O CPAP
C. Initiate mechanical ventilation in the SIMV mode
D. Initiate mechanical ventilation in the pressure support mode

359. A 1-week-old neonate with RDS is currently receiving 10 cmH2O CPAP through nasal prongs with a FiO2 of 0.60. Evaluation reveals intercostal and sternal retractions and an SpO2 of 88%. The neonate is breathing at a rate of 68/min. Which of the following should the respiratory therapist recommend?
A. Change to mask CPAP
B. Institute mechanical ventilation
C. Make no changes at the present time
D. Increase the CPAC level to 12cm H2O

360. Reinserting a flow meter into an oxygen wall outlet has failed to correct a massive gas leak in a patient’s room. Which of the following should be done NEXT?
A. Check the pressure relief valve on the humidifier reservoir
B. Evacuate the patients from the floor
C. Have engineering shut off the hospital’s master oxygen valve
D. Provide necessary supplemental oxygen and close the zone valve

361. While administering an IPPB treatment, the respiratory therapist notices that the pressure rises slowly toward the set pressure, but reaches the set pressure only when the patient actively exhales. Which of the following is the most likely explanation?
A. The inspiratory flow is too high
B. The nebulizer driveline is kinked
C. There is a leak in the expiratory valve
D. The expiratory valve sticks before opening

362. The administration of aerosolized acetylcysteine (Mucomyst) would be most appropriate for the treatment of which of the following?
A. Pulmonary thermal injury
B. Bronchospasm
C. Humidity deficit
D. Mucus plugs

363. A 25-year-old patient is brought to the emergency department (ED) with respiratory depression caused by an acute drug overdose. An arterial blood gas analysis indicates a pH of 7.20 and a PaCO2 of 80 torr. The respiratory therapist is asked to initiate continuous mechanical ventilation. Which of the following should the therapist do?
A. Recommend IPPB treatments q2h to reduce the patient’s PaCO2
B. Adjust the ventilators so that the patient’s PaCO2 will be decreased to 40 torr very gradually over 36 hours
C. Adjust the ventilator so that the patient’s PaCO2 will be decreased to 40 torr within 1 hour
D. Adjust the ventilator so that the patient’s PaCO2 will be decreased to 60 torr to prevent respiratory alkalosis

364. A neonate is receiving pressure-limited, time-cycled mechanical ventilation. The PaO2 decreases from 65 to 50 torr, and the physician requests an increase in mean airway pressure. The respiratory therapist should recommend increasing the:
I. Inspiratory time
II. Pressure limit
III. Expiratory time
A. I only
B. III only
C. I and II only
D. II and III only

365. When a Yankauer device becomes obstructed while suctioning vomitus from a patient’s mouth, the respiratory therapist should first:
A. Increase the vacuum pressure
B. Change to a suction catheter
C. Clear the device of particulate matter
D. Change the collection bottle

366. 60-year-old, 68 kg (150 lb) woman arrives in the ICU after coronary bypass surgery. She has a 54-pack-year history of smoking and currently smokes two packs a day. An order is written to initiate mechanical ventilation. Which of the following should the respiratory therapist adjust prior to initiating mechanical ventilation for the patient?
I. Respiratory rate
II. Expiratory resistance
III. Oxygen concentration
IV. Tidal volume
V. Sighs per hour
A. I and II only
B. III and V only
C. I, III, and IV only
D. II, IV, and V only

367. The respiratory therapist is reviewing a postoperative patient’s care plan. The physician has changed the patient’s therapy from incentive spirometry to IPPB. What is the most likely goal, for this change?
A. Delivery of aerosolized bronchodilators
B. Improvement in alveolar oxygenation
C. Prevention of lower lobe atelectasis
D. Promotion of airway clearance

368. An ultrasonic nebulizer, though showing aerosol in the chamber, is not delivering any aerosol to the patient. The most likely cause is:
A. The electrical cord is disconnected
B. There is insufficient fluid in the cup
C. The amplitude and frequency need adjustment
D. The fan moving air through the chamber is not functioning

369. A patient is receiving an IPPB treatment by mask. The desired preset pressure is not being achieved. The respiratory therapist should:
A. Increase the flow
B. Decrease the pressure
C. Decrease the terminal flow
D. Increase the sensitivity

370. A beta-adrenergic bronchodilator has been administered to a 56-year-old male patient. All of the following are side effects associated with this drug except:
A. Tachycardia
B. Palpitations
C. Tremors
D. Hypotension

371. A patient in the ICU has been on mechanical ventilation for 7 days. The respiratory therapist is asked to assess the patient’s readiness for weaning. Which of the following values would indicate the patient is ready to be weaned?
A. NIF greater than -20 cm H2O, spontaneous VT > 5 mL/kg, RR < 30 breaths/min
B. NIF less than -10 cm H2O, spontaneous VT > 3 mL/kg, RR > 35 breaths/min
C. NIF greater than -15 cm H2O, spontaneous VT < 5 mL/kg, RR < 25 breaths/min
D. NIF less than -20 cm H2O, spontaneous VT < 3 mL/kg, RR > 35 breaths/min

372. A 55-year-old male presents with chest pain that worsens with deep breaths. His SpO2 is 90% on room air, and he has tachypnea. What diagnostic test should be performed first to evaluate the patient?
A. Pulmonary function test
B. Chest X-ray
C. Echocardiogram
D. ABG analysis

373. A patient receiving mechanical ventilation has a plateau pressure of 35 cm H2O and a PEEP of 10 cm H2O. What is the patient’s static compliance if the tidal volume is set at 500 mL?
A. 12.5 mL/cm H2O
B. 20 mL/cm H2O
C. 25 mL/cm H2O
D. 50 mL/cm H2O

374. A patient with severe asthma presents with difficulty speaking, accessory muscle use, and a respiratory rate of 32 breaths per minute. Which of the following medications should be administered first?
A. Inhaled corticosteroids
B. Systemic corticosteroids
C. Short-acting beta agonist (SABA)
D. Long-acting beta agonist (LABA)

375. A patient receiving pressure support ventilation (PSV) has increased work of breathing and appears fatigued. What is the most appropriate adjustment to the ventilator settings?
A. Increase the FiO2
B. Increase the pressure support level
C. Decrease the PEEP
D. Increase the respiratory rate

376. A patient on a ventilator is triggering the high-pressure alarm frequently. Which of the following should the respiratory therapist check first?
A. Check for a pneumothorax
B. Assess for secretions or mucus plugging
C. Increase the inspiratory flow rate
D. Lower the PEEP setting

377. A 45-year-old male is admitted with severe community-acquired pneumonia. His ABG shows: pH 7.31, PaCO2 58 mmHg, PaO2 65 mmHg, HCO3 28 mEq/L. Which of the following is the best intervention?
A. Increase the FiO2
B. Initiate non-invasive ventilation (NIV)
C. Administer a bronchodilator
D. Perform bronchoscopy

378. A patient receiving bronchodilator therapy reports tremors and palpitations. Which of the following medications should the respiratory therapist suggest as an alternative?
A. Albuterol
B. Ipratropium bromide
C. Salmeterol
D. Levalbuterol

379. A 30-year-old male with myasthenia gravis has been admitted to the ICU. His ABG results show: pH 7.37, PaCO2 50 mmHg, PaO2 88 mmHg, HCO3 29 mEq/L. What should the respiratory therapist recommend to manage this patient’s ventilation?
A. Start mechanical ventilation
B. Monitor with frequent vital capacity measurements
C. Increase oxygen to 6 L/min via nasal cannula
D. Administer a bronchodilator

380. A 64-year-old male patient is receiving mechanical ventilation but appears to be breathing asynchronously with the ventilator. Which of the following medications would you recommend?
A. Fluoxetine (Prozac)
B. Diazepam (Valium)
C. Dextroamphetamine (Dexedrine)
D. Cisatracurium (Nimbex)

381. A 6-year-old girl presents to the emergency room with dyspnea and bilateral wheezing. Which of the following would you recommend?
A. Furosemide (Lasix)
B. Rigid bronchoscopy
C. Aerosolized albuterol
D. Aerosolized pulmicort

382. Which of the following complications is common in infants who receive prolonged mechanical ventilation at birth?
A. Renal failure
B. Bronchopulmonary dysplasia
C. Esophageal atresia
D. Hydrocephalus

383. Volume-controlled ventilation was initiated on a 64-year-old female patient in the ICU. How would you describe this mode of ventilation?
A. “Inspiration begins after a specific volume is inhaled.”
B. “Expiration ends after a preset volume is delivered.”
C. “Inspiration ends after a preset volume is delivered.”
D. “Inspiration ends after the patient exhales a preset volume.”

384. A respiratory therapist is assessing an adult patient with a history of lung cancer and congestive heart failure. The patient reports progressively worsening shortness of breath over the past 48 hours. On 15 L/min oxygen via a nonrebreather mask, the patient’s SpO₂ is 86%. Auscultation reveals clear and equal breath sounds in the upper and middle lung fields but diminished breath sounds at the bases bilaterally. What is the most likely cause of the patient’s respiratory distress?
A. Bilateral pneumonia
B. Tension pneumothorax
C. Lobar consolidation
D. Pleural effusions

385. A respiratory therapist is assisting a physician with the insertion of a chest tube for a patient with a large pleural effusion. During the procedure, the physician creates a 5 cm incision at the fifth intercostal space in the mid-axillary line. After connecting the chest tube to the suction system, the physician notices continuous bubbling in the water seal chamber. What should the respiratory therapist anticipate next?
A. Increase the water seal chamber level to 20 cm
B. Placement of additional sutures around the chest tube
C. Increase the suction regulator setting to greater than -100 cm H₂O
D. Insert a new chest tube at the incision site

386. A respiratory therapist is assisting a physician who is attempting to insert an arterial line in the radial artery using the over-the-wire technique. After puncturing the skin, blood enters the tubing, indicating proper placement in the artery. However, when the physician tries to advance the guidewire, they encounter resistance. What should the respiratory therapist expect the physician to do next?
A. Withdraw the needle
B. Advance the needle further
C. Adjust the angle of the needle
D. Choose a different insertion site

387. A respiratory therapist is assisting with a cardioversion procedure for a patient in the ICU who has sustained ventricular tachycardia. The patient is receiving supplemental oxygen through a nonrebreather mask and has been sedated with a dose of midazolam (Versed). After the shock is delivered, the patient’s heart rate converts to 76/min with normal sinus rhythm and a palpable pulse. However, the patient’s SpO₂ drops from 97% to 85%, and their respirations become slow and shallow. What should the respiratory therapist do next?
A. Activate the medical emergency team
B. Recommend another synchronized shock
C. Begin bag-valve-mask ventilation with 100% oxygen
D. Administer oxygen via high-flow nasal cannula (HFNC)

388. A respiratory therapist is preparing educational materials for patients who require home oxygen therapy using a stationary oxygen concentrator and nasal cannula. Which of the following backup equipment should be included in the materials to ensure continued oxygen supply during a power outage or equipment failure?
A. An emergency power generator
B. A bag-valve-mask resuscitator
C. Backup oxygen concentrators
D. Portable oxygen gas cylinders

389. Which of the following patients would you not recommend the use of noninvasive positive pressure ventilation?
A. The need for moderate sedation
B. The need for suctioning of secretions
C. The need for an FiO2 greater than 40%
D. A patient with active cardiac arrhythmias

390. The pulmonologist wants to run tests on a 67-year-old female patient to assess for the possible diagnosis of a pulmonary embolism. Which of the following imaging techniques would you recommend?
A. Ventilation/Perfusion Scan
B. Barium Swallow
C. Magnetic Resonance Imaging
D. Positron Emission Tomography

391. A 54-year-old female patient is receiving volume-controlled ventilation. Which of the following would cause her peak airway pressure to increase?
A. A leak in the ET tube cuff
B. A leak in the ventilator circuit
C. Increased secretions
D. Pulmonary edema that has improved 

392. A bedside peak flow was performed on a 41-year-old male patient who is 5 feet 10 inches tall. His results were 4.7 L/sec. Which of the following is the best interpretation of this test?
A. He has an expiratory flow obstruction
B. He has poor gas distribution
C. He has low compliance
D. His peak flow is normal

393. An adult patient with pneumonia was intubated and placed on pressure control ventilation with an FiO2 of 60% and a PEEP of 10 cm H2O. Their chest x-ray shows bilateral infiltrates. After being on the ventilator for 30 minutes, an ABG is obtained with the following results:
pH 7.47
PaCO2 33 torr
PaO2 55 torr
SaO2 90%
HCO3 25 mEq/L
BE +2 MEq/L
You would describe the patient’s condition as being consistent with which of the following:
A. Mild ARDS
B. Moderate ARDS
C. Severe ARDS
D. Moderate hypoxemia

394. Which of the following would most likely cause a misleading or incorrect pulse oximetry reading?
A. High cardiac output
B. Low Hb concentration
C. Low blood perfusion
D. Elevated body temperature

395. The physician requests the measurement results of a patient’s central venous pressure with a strain-gauge pressure transducer. While obtaining the results, you notice that the transducer appears to be positioned well below the middle of the patient’s lateral chest wall. What effect, if any, would this have on the measurement?
A. It would underestimate the CVP
B. It would overestimate the CVP
C. It would cause damping of the signal
D. It would not affect the measurement 

396. A 61-year-old male patient is scheduled to undergo cardiopulmonary exercise testing. In which of the following would you recommend extra precautions before performing the test?
A. A patient being evaluated for coronary artery disease
B. A patient recommended for cardiac rehabilitation
C. A patient being assessed for a cardiopulmonary disability
D. A patient with an SpO2 of 85% on room air

397. Which of the following EKG leads should be placed in the 4th intercostal space at the patient’s left sternum?
A. V1
B. V2
C. V3
D. V4

398. You are needed to perform a set of measurement tests on a 53-year-old female patient who is unconscious. All of the following can be obtained except?
A. Maximum inspiratory pressure
B. Vital capacity
C. Spontaneous respiratory rate
D. Spontaneous tidal volume

399. You are called to assess a 38-year-old male patient in the ER with an acute upper airway obstruction. Which of the following physical signs would you expect to see in this patient?
A. Dullness to percussion
B. Inspiratory crackles
C. Unilateral lung expansion
D. Dysphagia

400. While auscultating the chest of a 62-year-old patient, you hear diminished breath sounds. This may indicate the presence of which of the following?
A. Laryngospasm
B. Pneumothorax
C. Bronchoconstriction
D. Aspirated foreign body

401. A 52-year-old postoperative female patient is receiving volume control SIMV with the following settings:
Tidal volume 450 mL
Rate 10/min
FiO2 24%
PEEP 5 cm H2O
The patient is awake and appears to be alert but cannot communicate because the endotracheal tube is in place. Which of the following would you recommend for the patient’s spontaneous breathing trial?
A. Increase the sedation dosage
B. CPAP with pressure support via ET tube
C. T-piece therapy at 24%
D. Extubate and provide BiPAP via full face mask

402. A beta-adrenergic bronchodilator has been administered to a 56-year-old male patient. All of the following are side effects associated with this drug except:
A. Tachycardia
B. Palpitations
C. Tremors
D. Hypotension

403. An intubated 59-year-old male patient has arrived in the ER and is receiving resuscitative efforts. The physician requested for vasopressin to be given, but the nurses were unable to establish IV access. Which of the following routes of administration would you recommend?
A. Aerosolized via SVN
B. Nasogastric instillation
C. Intramuscular injection
D. Endotracheal instillation

404. A 21-year-old female patient was admitted to the emergency department for having an asthma attack. The patient is experiencing moderate to severe levels of dyspnea. Which of the following drugs would you recommend for administration via nebulization?
A. Montelukast
B. Beclomethasone
C. Magnesium sulfate
D. Metaproterenol

405. A 72-year-old postoperative female patient is intubated, and the physician orders pressure control A/C ventilation. Which of the following settings would you choose for this patient?
A. PIP = 30 cm H2O; FiO2 100%; Inspiratory time 1 second
B. PIP = 25 cm H2O; FiO2 40%; Inspiratory time 1 second
C. PIP = 40 cm H2O; FiO2 40%; Inspiratory time 1 second
D. PIP = 30 cm H2O; FiO2 50%; Inspiratory time 2 seconds

406. A 67-year-old male patient is receiving therapy with a pressure-cycled ventilator via a mouthpiece. In order to decrease the delivered tidal volume, you can do which of the following?
A. Decrease the pressure
B. Decrease the flow
C. Increase the sensitivity
D. Decrease the sensitivity

407. An adult patient is intubated and receiving volume control ventilation with an HME. Over the past 6 hours, you noticed that the patient’s peak pressure has been progressively increasing. After in-line suctioning was performed, you noted that the patient’s secretions were thick and copious. Which of the following would you recommend?
A. Increase the HME temperature
B. Decrease the respiratory rate
C. Change the HME
D. Change to a heated wick humidifier

408. A 64-year-old female patient is receiving volume control ventilation, and you note that the endotracheal tube has become obstructed. Which of the following findings would you expect?
A. Decreased peak pressure
B. High-volume alarm
C. Decreased lung compliance
D. Inability to pass the suction catheter

409. A 54-year-old female patient is receiving mechanical ventilation and has passed a spontaneous breathing trial. Before considering extubation, you need to evaluate all of the following criteria EXCEPT:
A. The ability to swallow
B. The ability to cough
C. The risk of aspiration
D. The presence of upper airway reflexes

410. A 65-year-old female patient is receiving volume control A/C mechanical ventilation. Which of the following would you recommend in order to help prevent ventilator-associated pneumonia?
A. Use heated humidification
B. Use disposable circuit components
C. Change the ventilator circuit every 24 hours
D. Elevate the head of the bed 30-45 degrees

411. An EKG was taken on a dyspneic 57-year-old female patient in the emergency department. In which of the following results should defibrillation be performed?
A. Atrial flutter
B. Ventricular Fibrillation
C. Supraventricular Tachycardia
D. Second-degree heart block

412. A blood gas was obtained on an adult patient, but the results appear to be erroneous. You suspect that the PaCO2 value is falsely low. Which of the following would cause this error?
A. Severe erythrocytosis
B. The use of a glass syringe
C. Air bubbles in the sample
D. Ongoing blood metabolism

413. The physician requests a circuit change for a 47-year-old male patient who is receiving volume control ventilation. After a new circuit is installed, the exhaled tidal volume is 175 mL less than before, and the PIP has decreased by 8 cm H2O as well. Which of the following is the most likely cause of these changes?
A. A leak in the humidifier connection
B. An obstruction of the expiratory line
C. A mucous plug in the patient’s ET tube
D. The patient’s lung compliance has decreased

414. A 2-week-old infant has a moderate amount of nasal and oral secretions. Which of the following devices would you recommend for suctioning?
A. Lukens trap
B. Coude catheter
C. Yankauer
D. Bulb suction

415. A 67-year-old male patient with pulmonary edema is breathing at an increased rate, rhythm, and depth. Which of the following best describes this condition?
A. Tachypnea
B. Hyperpnea
C. Orthopnea
D. Cheyne-stokes

416. It has been determined that a 69-year-old female patient has cystic fibrosis. This disorder can be classified as which of the following?
A. A restrictive disorder
B. An obstructive disorder
C. Both a restrictive and obstructive disorder
D. Neither a restrictive or obstructive disorder

417. A 59-year-old male patient with a hemothorax has a pleural drainage system in place. Upon assessment, the collection chamber appears full. Which of the following would you recommend?
D. Increase the vacuum suction pressure
B. Remove water for the suction control chamber
C. Check the connecting tubing for leaks or kinks
D. Clamp the chest tube and replace the full chamber

418. A diagnostic bronchoscopy is set to be scheduled on a 56-year-old patient. This procedure would be contraindicated in which of the following?
A. Unstable arrhythmia
B. Lung carcinoma
C. Unilateral wheezing
D. Active hemoptysis

419. Which of the following bedside measurements would you recommend in order to assess a patient’s respiratory muscle strength?
A. Physiologic deadspace
B. Minute ventilation
C. Spontaneous tidal volume
D. Maximum Expiratory Pressure

420. You are called to help obtain a pulmonary vascular resistance measurement on a patient in the ICU. Before the measurement is taken, the physician asks, “What is the normal value for PVR?” Which of the following would be your response?
A. Less than 2.5 mmHg/L/min
B. Greater than 2.5 mmHg/L/min
C. Less than 20 mmHg/L/min
D. Greater than 20 mmHg/L/min

421. An adult patient is receiving volume-control A/C ventilation with a set rate of 8/min. The physician put in a new order to increase the rate to 12 and add 5 of PEEP. After doing so, the patient suddenly becomes hemodynamically unstable. Which of the following is the best action to take at this time?
A. Increase the FiO2
B. Initiate chest compressions
C. Check the system for leaks
D. Return the patient to the previous settings

422. Chest physiotherapy with percussion has been ordered for a 64-year-old female patient who has a history of bronchiectasis. Immediately after starting the therapy, the patient begins to cough up a small amount of fresh blood. Which of the following would you recommend?
A. Provide supplemental oxygen and continue the therapy
B. Report the finding in the patient’s chart and continue the therapy
C. Immediately stop the therapy and notify the physician
D. Immediately stop the therapy and recommend mechanical ventilation

423. An upper airway inspection prior to the intubation of an adult patient revealed that there is no visibility of the soft palate. What is the Mallampati classification?
A. Class 1
B. Class 2
C. Class 3
D. Class 4

424. A 62-year-old female patient was administered midazolam (Versed) prior to a bronchoscopy procedure. Which of the following is the primary reason for administering this drug?
A. To provide moderate sedation
B. To provide topical anesthesia
C. To decrease vagal responses
D. To provide bronchodilation

425. Which of the following respiratory signs would be considered abnormal in an adult patient who is at rest under normal conditions?
A. Respiratory rate of 18 breaths per minute
B. Sternocleidomastoid muscle usage at rest
C. Costal angle of 90 degrees increases with inspiration
D. Ribs higher posteriorly than anteriorly at end-expiration

426. A respiratory therapist is preparing to initiate high-frequency oscillatory ventilation (HFOV) for a 12-year-old patient who is receiving PC, A/C ventilation due to acute respiratory distress syndrome (ARDS). The mean airway pressure is 28 cmH2O. To optimize alveolar recruitment and minimize the risk of volutrauma, the initial mean airway pressure setting on HFOV should be set at which of the following?
A. 26 cmH2O
B. 30 cmH20
C. 34 cmH2O
D. 38 cmH2O

427. A respiratory therapist is setting up a ventilator for a patient who has been admitted to the ICU after thoracic surgery. The initial PC, A/C ventilator settings are:
Mandatory rate: 16
PIP: 28 cmH2O
Inspiratory time: 1.2 seconds
PEEP: 12 cmH2O
The low PEEP alarm should be set at:
A. 6 cmH2O
B. 8 cmH2O
C. 10 cmH2O
D. 9 cmH2O

428. A 72-year-old patient is receiving invasive mechanical ventilation in the ICU. The patient’s condition is stable, with open eyes and responsive pupils, but they are not following commands. The patient’s family provides an advance directive that explicitly states the patient did not want prolonged mechanical ventilation. Which of the following physician orders would you expect?
A. Transition to comfort care only
B. Continue current ventilation settings and reassess in 48 hours
C. Initiate weaning protocols to gradually reduce ventilator support
D. Prepare for surgical tracheostomy placement

429. Which of the following is the preferred method for administering a continuously aerosolized bronchodilator through a ventilator circuit?
A. Vibrating-mesh nebulizer
B. Breath-actuated nebulizer
C. Small-volume nebulizer
D. Ultrasonic nebulizer

430. A respiratory therapist is having difficulty clearing thick secretions from a patient who has a permanent tracheostomy and is currently in a long-term care facility. The patient is spontaneously breathing through a tracheostomy collar connected to an HME for humidification. Which of the following interventions would you recommend?
A. Administer a mucolytic agent
B. Replace the HME with a new one
C. Switch to heated humidification
D. Increase the frequency of tracheostomy suctioning

431. A 30-year-old male is brought to the ER following a fall from a significant height. He is unconscious and intubated with manual ventilation provided via a bag-valve resuscitator. Upon assessment, no breath sounds are heard on the left side of the chest, and the patient’s neck veins are distended. His heart rate is 160 bpm, BP is 88/55 mm Hg, and his skin is cool and clammy. In this case, you should prepare for which of the following?
A. Transporting the patient for a chest x-ray
B. Needle decompression
C. Initiating IV fluids
D. Repositioning the endotracheal tube

432. A 50-year-old male sustained severe head trauma after a fall. He is intubated, sedated, and has an indwelling ICP monitor. He is diagnosed with syndrome of inappropriate antidiuretic hormone secretion (SIADH). His laboratory results are as follows:
Na⁺: 131 mEq/L
K⁺: 4.3 mEq/L
Cl⁻: 92 mEq/L
HCO₃: 23 mEq/L
Which of the following would you recommend?
A. Sodium chloride supplementation
B. Potassium chloride supplementation
C. Fluid restriction
D. Furosemide (Lasix) administration

433. A 33-year-old female with severe kyphoscoliosis must remain in a lateral decubitus position due to her spinal deformity. A respiratory therapist is preparing to secure the patient’s airway prior to mechanical ventilation for respiratory failure. Which of the following tools is recommended to assist with intubating the trachea while the patient remains in this position?
A. An intubating LMA
B. A lighted stylet
C. Direct visual laryngoscopy
D. Video laryngoscopy

434. CPAP is initiated at 8 cmH2O for a patient to treat post-operative atelectasis. Ten minutes later, the patient’s heart rate becomes irregular, and their blood pressure drops from 120/80 mmHg to 90/60 mmHg. Which of the following would you recommend?
A. Change to IPV therapy at 12 cmH2O
B. Change to BiPAP at 8/4 cmH2O
C. Decrease the CPAP to 4 cmH2O
D. Discontinue the CPAP therapy

435. A female patient weighing 60 kg (132 lb) and standing 165 cm (5 ft 5 in) tall is receiving invasive mechanical ventilation. VC, A/C ventilation settings are:
FIO₂: 0.40
Mandatory rate: 12
Total rate: 12
VT: 380 mL
PIP: 28 cm H₂O
PEEP: 5 cm H₂O
ABG results:
pH: 7.30
PCO₂: 50 mm Hg
PO₂: 80 mm Hg
HCO₃: 24 mEq/L
BE: -1 mEq/L
SO₂ (calc): 97%
Which of the following should be increased?
A. Mandatory rate to 16
B. VT to 480 mL
C. PEEP to 8 cm H₂O
D. FIO₂ to 0.50

436. During the assessment of a 66-year-old male patient, you noticed increased tactile fremitus in the left lower lobe. Which of the following conditions would you expect?
A. Pneumonia
B. Pneumothorax
C. COPD
D. Pleural effusion

437. During the assessment of a 71-year-old female patient, you noticed a tracheal shift to the right side. Which of the following conditions would you expect?
A. Pneumonia on the left side
B. Pleural effusion on the right side
C. Atelectasis on the right side
D. Pneumothorax on the right side

438. A 34-year-old male patient was admitted to the ER after a motor vehicle accident with pain in the thoracic region. Which of the following would you expect?
A. Symmetrical chest expansion
B. Dull percussion note
C. Flail chest
D. See-saw chest movement

439. You were called to assess a 69-year-old male patient who is hemodynamically unstable. Auscultation and percussion revealed distant breath sounds and hyperresonance on the left side. Which of the following would you recommend FIRST?
A. Needle decompression
B. Chest tube insertion
C. Analyze an ABG sample
D. Order a STAT chest X-ray

440. A 45-year-old male, 183 cm (6 ft) tall and weighing 85 kg (187 lb), is receiving volume-controlled, assist/control (VC, A/C) ventilation following emergency thoracic surgery. His initial ventilator settings are:
FIO₂: 0.40
Mandatory rate: 14/min
Total rate: 14/min
VT: 510 mL
Inspiratory time: 1.2 sec
PEEP: 8 cm H₂O
Several hours later, the high-pressure alarm on the ventilator is triggered. The patient appears agitated, with a heart rate of 125/min, respiratory rate of 30/min, blood pressure of 165/95 mm Hg, and oxygen saturation of 91%. Breath sounds are clear but diminished in the lower lung fields. Which of the following interventions should the respiratory therapist consider NEXT?
A. Administer an antihypertensive medication
B. Increase the tidal volume to 700 mL
C. Change the ventilator mode to SIMV
D. Administer an IV sedative or analgesic

441. An adult is brought to the emergency department after being found unresponsive. EMS reports that the patient may have taken an unknown substance. During the assessment, the patient exhibits irregular breathing and pinpoint pupils. What should the respiratory therapist recommend administering?
A. Lorazepam (Ativan)
B. Buprenorphine (Subutex)
C. Naloxone HCl (Narcan)
D. Flumazenil (Romazicon)

442. A 55-year-old patient with a history of chronic obstructive pulmonary disease (COPD) and heart failure is brought to the emergency department following a myocardial infarction. The patient has an advance directive stating that they do not want to be intubated. After confirming the directive and obtaining informed consent, noninvasive positive pressure ventilation (NPPV) is initiated with an inspiratory positive airway pressure (IPAP) of 18 cm H₂O, an expiratory positive airway pressure (EPAP) of 8 cm H₂O, and an FIO₂ of 1.0. After 20 minutes, the patient’s vitals are as follows:
HR: 98/min
RR: 14/min
BP: 88/62 mm Hg
SpO₂: 94%
pH: 7.26
PaCO₂: 56 mm Hg
PaO₂: 82 mm Hg
HCO₃⁻: 22 mEq/L
BE: -4 mEq/L
SaO₂ (calc): 95%
The patient’s family is present and is urging for intubation. What action should the respiratory therapist anticipate next?
A. Increase the mandatory rate to 16 breaths per minute
B. Switch to heated high-flow nasal cannula
C. Initiate invasive mechanical ventilation
D. Increase the EPAP to 10 cm H₂O

443. A respiratory therapist is assisting with a bronchoscopy for a 72-year-old patient diagnosed with pneumonia and acute respiratory failure. The patient is on invasive mechanical ventilation in a PC, A/C mode with the following settings:
FIO₂: 0.60
Mandatory rate: 14/min
ΔP: 14 cm H₂O
Tᵢ: 1.0 sec
PEEP: 6 cm H₂O
At the start of the procedure, the FIO₂ is increased to 1.0. A few minutes later, the ventilator alarm for low minute ventilation sounds, and the patient’s oxygen saturation drops from 93% to 85%. Which of the following actions should the therapist take?
A. Increase the ΔP (Pressure Support)
B. Switch to VC, A/C mode
C. Decrease the Tᵢ (Inspiratory Time)
D. Increase the PEEP level

444. A 75-year-old male presents to the ED with dyspnea and decreased breath sounds on the right side. A chest x-ray reveals a large pleural effusion. What is the most appropriate intervention?
A. Chest physiotherapy
B. Thoracentesis
C. Incentive spirometry
D. Bronchodilator therapy

445. A patient with COPD is receiving oxygen therapy via nasal cannula at 4 L/min. The patient complains of headache and confusion. An arterial blood gas shows the following: pH 7.35, PaCO2 65 mmHg, PaO2 85 mmHg, HCO3 30 mEq/L. Which of the following is the best course of action?
A. Decrease the flow rate to 2 L/min
B. Increase the flow rate to 6 L/min
C. Switch to a non-rebreather mask
D. Perform an emergency intubation

446. A 30-year-old patient with asthma presents to the clinic with worsening shortness of breath and wheezing. The patient has been using albuterol inhaler every 2 hours with minimal relief. What is the next best step in management?
A. Continue using albuterol every 2 hours
B. Administer systemic corticosteroids
C. Switch to a long-acting beta agonist (LABA)
D. Start oxygen therapy at 4 L/min via nasal cannula

447. A mechanically ventilated patient is being weaned from the ventilator. The patient’s spontaneous respiratory rate is 20 breaths per minute, tidal volume is 350 mL, and negative inspiratory force (NIF) is -25 cm H2O. Which of the following best indicates readiness for extubation?
A. Respiratory rate of 35 breaths per minute
B. Tidal volume less than 5 mL/kg
C. NIF greater than -20 cm H2O
D. Oxygen saturation of 85%

448. A 50-year-old female with a history of obstructive sleep apnea is started on CPAP therapy. She complains of nasal congestion and dryness after using the device. What is the best intervention to address this issue?
A. Increase the CPAP pressure setting
B. Add a heated humidifier to the CPAP circuit
C. Switch to bilevel positive airway pressure (BiPAP)
D. Decrease the CPAP pressure setting

449. A 64-year-old patient with a history of congestive heart failure presents to the emergency room with shortness of breath, bilateral crackles, and frothy sputum. The respiratory therapist should recommend which of the following therapies?
A. Albuterol therapy
B. Non-invasive positive pressure ventilation
C. Chest physiotherapy
D. Inspiratory muscle training

450. During a spontaneous breathing trial, a patient on CPAP develops tachypnea, accessory muscle use, and an SpO2 of 88%. What should the respiratory therapist recommend?
A. Continue the trial for 30 more minutes
B. Return to full ventilatory support
C. Administer a bronchodilator
D. Increase the FiO2 to 100%

451. A 28-year-old male presents to the clinic with complaints of chest tightness, cough, and shortness of breath during exercise. Spirometry results show a decreased FEV1/FVC ratio. Which of the following medications is the most appropriate initial treatment?
A. Inhaled corticosteroid
B. Leukotriene inhibitor
C. Short-acting beta-agonist (SABA)
D. Long-acting muscarinic antagonist (LAMA)

452. A 55-year-old male with a history of COPD is admitted to the hospital for pneumonia. He is on 2 L/min oxygen via nasal cannula. His ABG results are as follows: pH 7.30, PaCO2 70 mmHg, PaO2 55 mmHg, HCO3 32 mEq/L. What is the best intervention at this time?
A. Increase oxygen to 4 L/min
B. Initiate noninvasive ventilation (NIV)
C. Administer a diuretic
D. Perform a bronchoscopy

453. A patient presents to the ED with dyspnea and chest pain that worsens with inspiration. A chest x-ray reveals a wedge-shaped opacity in the right lower lobe. What is the most likely diagnosis?
A. Pleural effusion
B. Pulmonary embolism
C. Pneumothorax
D. Atelectasis

454. A 45-year-old male patient is being treated for acute respiratory distress syndrome (ARDS) with mechanical ventilation. Current settings include: VT 400 mL, FiO2 0.60, PEEP 12 cm H2O, and respiratory rate of 18 breaths/min. The patient’s SpO2 is 88% and PaO2 is 55 mmHg. Which of the following is the most appropriate intervention?
A. Increase the PEEP
B. Decrease the respiratory rate
C. Increase tidal volume to 600 mL
D. Switch to pressure control ventilation

455. A 23-year-old female patient is admitted with status asthmaticus. She has been given continuous albuterol and ipratropium nebulizer treatments for the past 30 minutes but still shows severe wheezing and accessory muscle use. What should the respiratory therapist recommend next?
A. Administer intravenous magnesium sulfate
B. Begin non-invasive ventilation
C. Administer inhaled corticosteroids
D. Increase the dose of albuterol

456. A mechanically ventilated patient suddenly develops high peak inspiratory pressures and a decreased SpO2. Auscultation reveals absent breath sounds on the left side. What is the most likely cause?
A. Right mainstem intubation
B. Bronchospasm
C. Pneumothorax
D. Mucus plugging

457. A 60-year-old male patient with COPD is placed on bilevel positive airway pressure (BiPAP) therapy. His settings are IPAP 12 cm H2O, EPAP 4 cm H2O, and FiO2 0.30. His ABG results are: pH 7.28, PaCO2 62 mmHg, PaO2 55 mmHg, HCO3 30 mEq/L. What change should the respiratory therapist make?
A. Increase EPAP to 8 cm H2O
B. Decrease IPAP to 10 cm H2O
C. Increase FiO2 to 0.40
D. Increase IPAP to 16 cm H2O

458. During routine monitoring of a patient on a ventilator, the respiratory therapist notices that the patient’s inspiratory flow pattern has changed from a square wave to a decelerating wave. What does this indicate?
A. A decrease in inspiratory time
B. A switch from volume control to pressure control mode
C. An increase in airway resistance
D. A decrease in tidal volume

459. A 70-year-old female with a history of congestive heart failure presents with frothy pink sputum, tachypnea, and bilateral crackles. An ABG reveals pH 7.29, PaCO2 55 mmHg, PaO2 48 mmHg, and HCO3 26 mEq/L. What is the most appropriate intervention?
A. Increase oxygen to 10 L/min via nasal cannula
B. Administer a bronchodilator
C. Initiate non-invasive ventilation (NIV)
D. Perform tracheostomy

460. A patient with a tracheostomy tube has thick, dry secretions, making it difficult to suction effectively. Which of the following interventions should the respiratory therapist recommend to help thin the secretions?
A. Instill 0.9% normal saline into the tracheostomy tube
B. Increase the suction pressure to 150 mmHg
C. Administer a bronchodilator via the tracheostomy
D. Change the tracheostomy tube to a larger size

461. A 48-year-old male is admitted to the ICU for acute exacerbation of COPD. He is placed on a non-rebreather mask at 12 L/min. His SpO2 is 95%, and he is drowsy and difficult to arouse. Which of the following should the respiratory therapist recommend?
A. Decrease the flow rate to 8 L/min
B. Switch to a Venturi mask at 28% FiO2
C. Begin mechanical ventilation
D. Increase the oxygen flow to 15 L/min

462. A mechanically ventilated patient is on the following settings: VC, A/C; FiO2 0.50; VT 450 mL; RR 12 breaths/min; and PEEP 5 cm H2O. The patient’s SpO2 is 92% and PaO2 is 58 mmHg. What change should the respiratory therapist recommend to improve oxygenation?
A. Increase the respiratory rate to 16
B. Increase FiO2 to 0.70
C. Increase PEEP to 10 cm H2O
D. Increase tidal volume to 600 mL

463. A patient in the ED is being treated for carbon monoxide poisoning. Which of the following is the most appropriate treatment?
A. Place the patient on a 50% Venturi mask
B. Administer 100% oxygen via non-rebreather mask
C. Initiate non-invasive positive pressure ventilation
D. Place the patient on CPAP with FiO2 0.40

464. A 65-year-old male with a history of smoking presents to the clinic with a chronic cough, hemoptysis, and weight loss. A chest X-ray reveals a mass in the right upper lobe. Which diagnostic test should the respiratory therapist recommend next?
A. Pulmonary function testing
B. Bronchoscopy with biopsy
C. Arterial blood gas analysis
D. Peak flow measurement

465. A 22-year-old female with cystic fibrosis is receiving chest physiotherapy (CPT) twice a day. She reports increased fatigue and shortness of breath during the treatments. What should the respiratory therapist do to modify the therapy?
A. Increase the duration of each session
B. Decrease the frequency of the sessions
C. Switch to high-frequency chest wall oscillation
D. Perform postural drainage only

466. A patient is receiving mechanical ventilation with the following settings: FiO2 0.40, VT 500 mL, RR 14, and PEEP 5 cm H2O. The patient’s spontaneous breaths show a sudden increase in tidal volume and a high-pressure alarm is triggered. Which of the following could be the cause?
A. Auto-PEEP
B. Bronchospasm
C. Patient-ventilator asynchrony
D. Circuit disconnection

467. A 55-year-old female with a recent diagnosis of pulmonary fibrosis is experiencing worsening dyspnea and desaturation with minimal activity. Her oxygen is set at 2 L/min via nasal cannula at rest. What should the respiratory therapist recommend?
A. Increase oxygen flow to 6 L/min
B. Switch to a high-flow nasal cannula
C. Start non-invasive ventilation at night
D. Administer bronchodilator therapy before activity

468. A patient is receiving oxygen via a 40% air-entrainment mask. The respiratory therapist notices that the patient is mouth-breathing and his SpO2 has dropped to 88%. What is the best intervention?
A. Increase the FiO2 to 60%
B. Switch to a simple mask at 8 L/min
C. Apply a nasal cannula at 4 L/min
D. Switch to a non-rebreather mask

469. A 70-year-old male with obstructive sleep apnea is complaining of poor sleep quality despite using CPAP. He states that he wakes up multiple times a night and feels congested. What should the respiratory therapist recommend to improve his CPAP therapy?
A. Lower the CPAP pressure setting
B. Add a heated humidifier to the CPAP circuit
C. Switch to bilevel positive airway pressure (BiPAP)
D. Decrease the mask size

470. A patient with Guillain-Barre syndrome is being monitored in the ICU. His MIP is -10 cm H2O and his VC is 7 mL/kg. What should the respiratory therapist recommend?
A. Initiate continuous positive airway pressure (CPAP)
B. Begin mechanical ventilation
C. Continue monitoring every 2 hours
D. Initiate incentive spirometry every hour

471. A patient is receiving bronchial hygiene therapy. During the treatment, the patient becomes nauseated and starts vomiting. What should the respiratory therapist do?
A. Discontinue the therapy
B. Increase the frequency of therapy
C. Continue therapy as ordered
D. Lower the frequency of the therapy

472. What is the preferred method to disinfect home respiratory equipment?
A. Water and hydrogen peroxide
B. Steam or boil equipment
C. Soak in acetic acid for 20 minutes
D. Use a diluted bleach solution

473. Which of the following settings would be adjusted to increase the mean airway pressure (MAP) in a neonate on mechanical ventilation?
A. Tidal volume and flow
B. Pressure limit and inspiratory time
C. Tidal volume and inspiratory time
D. PEEP and FiO2

474. A patient is on a ventilator with an FiO2 of 70% and is still hypoxic. What is the next best step to improve oxygenation?
A. Increase tidal volume
B. Increase PEEP gradually
C. Decrease respiratory rate
D. Change to a different circuit

475. A patient presents with sinus bradycardia and a heart rate of 40 bpm. Which initial treatments should the respiratory therapist recommend?
A. Oxygen and atropine
B. Lidocaine and digoxin
C. Oxygen and pacemaker
D. Digoxin and pacemaker

476. A neonate in the NICU is on mechanical ventilation. The physician wants to improve oxygenation by increasing the mean airway pressure (MAP). What two settings should be adjusted?
A. Increase I-time and pressure limit
B. Increase flow and tidal volume
C. Increase tidal volume and RR
D. Increase PEEP and FiO2

477. A patient with a tracheostomy has thick, tenacious secretions and is on a humidified ventilator circuit. What can be added to help thin the secretions?
A. Nebulized acetylcysteine
B. Albuterol nebulizer
C. Change the humidifier to a heated circuit
D. Instill 0.9% normal saline

478. A patient presents with crepitus in the neck region and chest. What is the most likely cause of this finding?
A. Pneumothorax
B. Subcutaneous emphysema
C. Pleural effusion
D. Tactile fremitus

479. What size endotracheal tube (ETT) is most appropriate for a 30-week gestational age neonate?
A. 2.5 mm
B. 3.0 mm
C. 3.5 mm
D. 4.0 mm

480. A patient with a pulmonary embolism is experiencing hypoxemia. What diagnostic test should be performed to confirm the presence of the embolism?
A. Ventilation-perfusion (V/Q) scan
B. Chest x-ray
C. Spiral/helical CT
D. ABG analysis

Final Thoughts

Becoming a respiratory therapist requires continuous learning and consistent practice. These multiple-choice questions are specifically designed to challenge your understanding, identify areas for improvement, and prepare you for real-world scenarios.

To further enhance your studies and access the correct answers, be sure to use this link, where you can take additional quizzes to test your knowledge.

With dedication and the right study tools, you’ll be equipped to pass the board exams and excel in your role as a skilled respiratory therapist.