151. Inhalation of dry gases can do which of the following? I Increase viscosity of secretions, II Impair mucociliary motility, III Increase airway irritability
A. I and II
B. III
C. I and III
D. All the above

152. To protect against obstructed or kinked tubing, simple bubble humidifiers incorporate which of the following?
A. HEPA outlet filter
B. Pressure relief valve
C. Automatic hygrometer
D. Electronic alarm system

153. What are some types of passover humidifiers? I simple reservoir, II membrane, III wick
A. I and II
B. II and III
C. I and III
D. All the above

154. Heat-moisture exchangers are mainly used to do what?
A. Warm and humidify gases delivered to the trachea via ventilator circuits
B. Humidify therapeutic gases delivered at high flows to the lower airway
C. Provide extra humidity for dry therapeutic gaes delivered to the upper airway

155. Which of the following is FALSE about heated humidifier condensate?
A. It can block or obstruct the delivery circuit
B. It must be treated as contaminated waste
C. It requires that circuits be drained frequently
D. It poses minimal infection risk

156. Hazards and complications of bland aerosol therapy include all of the following except:
A. Bronchospasm
B. Overhydration
C. Infection
D. Hemoconcentration

157. A patient receiving nasal oxygen at 3L/min complains of nasal dryness and irritation. Which of the following action would be appropriate?
A. Recommending that the flow be decreased to 2L/min
B. Adding a humidifier to the delivery system
C. Recommmending that the flow be increased to 4L/min
D. Switching to a simple mask at 3L/min

158. Air for medical use in a hospital should be which of the following? I particle-free, II oil-free, III dry
A. I and II
B. I and III
C. II and III
D. I , II, and III

159. Which of the following statements about CO2 is FALSE?
A. It does not support animal life
B. It is a flammable gas
C. It is odorless and colorless
D. It is heavier than air

160. What key property of He makes it useful as a therapeutic gas?
A. Low solubility
B. Chemical inertness
C. Low cost
D. Low density

161. Department of transportation (DOT) regulations require compressed gas cylinder to be hydrostatically tested for leaks and expansion every how often?
A. 1 to 2 years
B. 3 to 5 years
C. 6 to 8 years
D. 5 to 10 years

162. What is the key difference between small compressed gas cylinders and their larger counterparts?
A. Small gas cylinders do not undergo regular DOT testing
B. Small gas cylinders are always filler to lower pressures
C. Small gas cylinders cannot be used for anesthetic gases
D. Small gas cylinders use a yoke connector

163. Which of the following mechanisms do all compressed gas cylinder use to avoid excessively high buildup of cylinder pressure?
A. Internal convection cooling mechanism
B. Pressure-relief mechanism on the valve stem
C. Automatic cylinder breech mechanism
D. Pressure-relief mechanism on the cylinder body

164. The measured pressure in a gas-filled cylinder is equivalent to which of the following?
A. Its filling density divided by the cylinder gas factor
B. Gas temp times its coefficient of expansion
C. Gas density divided by the density of are at STPD
D. The force required to compress its volume within the cylinder

165. What is the usual method of monitoring the remaing contents in a gas-filled cylinder?
A. Weigh the cylinder
B. Read the pressure gague
C. Compute the gas density
D. Read the cylinder label

166. To accurately determine the remaining contents of a liquid-filled CO2 cylinder, what would you do?
A. Multiply the pressure by the cylinder factor
B. Divide the pressure by the cylinder factor
C. Weigh the contents of the cylinder
D. Empty the cylinder while timing its flow

167. What cylinder factor is used to compute the duration of flow for a 22cu/ft O2 or air E cylinder?
A. .28
B. 1.34
C. 2.41
D. 3.14

168. The pressure of O2 or air in a bulk supply system is reduced to what standard working pressure?
A. 10 psig
B. 14 psig
C. 25 psig
D. 50 psig

169. Why are zone valves incorporated into a hospital’s central gas piping systems? I to terminate O2 delivery to an area in case of fire, II to allow selective maintenance without shutting the system down, III to allow variable pressure reduction throughout the system
A. I and II
B. I and III
C. II and III
D. I II and III

170. What is the primary purpose of indexed connector systems?
A. To prevent inadvertent misconnections between equipment
B. To speed making connections between equipment
C. To allow US equipment to “mate” with foreign equipment
D. To provide universal connections among all equipment

171. What is the indexed safety system for threaded high-pressure connections between large compressed gas cylinders and their attachments?
A. PISS
B. DISS
C. ASSS
D. CGA system

172. You must connect a large-volume nebulizer to a bedside compressed-air outlet through a flowmeter. You have only standard O2 flowmeters available. which of the following actions is appropriate? You must connect a large-volume nebulizer to a bedside compressed-air outlet through a flowmeter. You have only standard O2 flowmeters available. which of the following actions is appropriate?
A. Connect the O2 flowmeter to the air outlet with piping tape
B. Use an O2 to air DISS adapter to join the flowmeter and outlet
C. Connect the O2 flowmeter to the air outlet with a petroleum jelly seal
D. Try to cross thread an O2 flowmeter directly on the air outlet

173. What device is used to reduce the pressure and control the flow of compressed medical gas?
A. Bourdon gauge
B. Regulator
C. Flowmeter
D. Reducing valve

174. A very common application of the adjustable pressure-reducing valve is in combination with which of the following?
A. Flow restrictor
B. Thorpe tube flowmeter
C. Bourdon gauge
D. Uncompensated flowmeter

175. To clean a cylinder valve outlet of foreign material, what should you do?
A. Wipe the valve outlet with a light oil
B. Quickly open then close the valve
C. Blow into the valve outlet a few times
D. Wipe the valve outlet with an alcohol swab

176. You are preparing to conduct a complex transport of a patient receiving O2, and you expect to have to alter O2 flows during the transport. Which of the following devices would best meet your needs?
A. Uncompensated thorpe tube
B. Flow restrictor
C. Compensated thorpe tube
D. Bourdon gauge

177. If you have to deliver O2 to a patient directly from a bedside outlet station, which of the following devices would you select?
A. Thorpe tube flowmeter
B. Bourdon type gauge
C. Pressure-reducing valve
D. Medical gas regulator

178. When used to control the flow of medical gages to a patient, how is a thorpe tube classified?
A. Variable orifice, constant pressure flowmeter device
B. Fixed orifice, constant pressure flowmeter device
C. Variable orifice, variable pressure flowmeter device
D. Fixed orifice, variable pressure flowmeter device

179. What is the only major factor limiting the use of pressure-compensated thorpe tube flowmeter?
A. Downstream resistance
B. Effect of position (gravity)
C. DISS connector availability
D. Use with gases other than O2

180. What can properly applied O2 therapy decrease? I venilatory demand, II work of breathing, III cardiac output
A. II and III
B. I and II
C. I, II and III
D. I and III

181. Which of the following would indicate a need for O2 therapy for an adult or child? I SaO2 less than 90%, II PaCO2 greater than 45 mmHg, III PaO2 less than 60 mmHg
A. II and III
B. I and II
C. I,II and III
D. I and III

182. You start a COPD patient on a nasal O2 cannula at 2L/min/ what is the max time that should pass before assessing this patient’s PaO2 or SaO2?
A. 2 hours
B. 8 hours
C. 12 hours
D. 72 hours

183. When determining a need for O2 therapy, the respiratory therapist should asses which of teh following? I neurologic status, II pulmonary status, III cardiac status
A. I and II
B. II and III
C. I and III
D. I, II, and III

184. To ensure a stable FIO2 under varying patient demands, what must an O2 delivery system do?
A. Have a reservoir system at least equal to the Vt
B. Provide all the gas needed by the patient during inspiration
C. Maintain flow that are at least equal to the patient’s peak flows
D. Be able to deliver any O2 concentration from 21% to 100%

185. A cooperative an alert postoperative patient taking food orally requires a small increment in FIO2, to be provided continuously. Precise FIO2 concentrations are not needed. Which of the following devices would best achieve this end?
A. Simple mask
B. Air-entrainment mask
C. Nasal cannula
D. Nonrebreathing mask

186. Which of the following factor will decrease the FIO2 delivered by a low flow O2 system? I short inspiratory time, II fast rate of breathing, III low O2 input, IV large minute ventilation
A. II and IV
B. I, II and III
C. III and IV
D. I, II, III, and IV

187. A 27-year-old woman received from the emergency department is on a nasal cannula at 5L/min. Approximately what FIO2 is this patient receiving?
A. 28%
B. 32%
C. 35%
D. 40%

188. You enter the room of a patient who is receiving nasal O2 through a bubble humidifier at 5L/min. you immediately notice that the humidifier pressure relief is popping off. which of the following actions would be most appropriate in this situation?
A. Check and tighten all connections
B. Replace the humidifier with a new one
C. Look for a crimped or twisted delivery tubing
D. Decrease the flow rate to 2L/min

189. Which of the following is FALSE about the simple O2 mask? Which of the following is FALSE about the simple O2 mask?
A. It has no valving system or reservoir bag
B. It can easily deliver high FIO2 values
C. It requires a minimal input flow of 5L/min
D. It functions as a variable-performance system

190. A patient is receiving O2 through a nonrebreathing mask set at 8L/min. you notice that the mask’s reservoir bag collapses completely before the end of each inspiration. Which of the following actions is appropriate in this case?
A. Change to a partial rebreather
B. Decrease the liter flow
C. Increase the liter flow
D. Change to a simple mask

191. A patient receiving 35% O2 through an air entrainment mask set at 6L/min input flow becomes tachypneic. Simultaneously, you notice that the SpO2 ha fallen from 91% to 87%. which of the following action would be most appropriate in this situation?
A. Switch the patient to a 40% air entrainment mask
B. Increase the device’s input flow to 10L/min
C. Switch the patient to a 28% air entrainment mask
D. Decrease the device’s input flow to 4L/min

192. An O2 delivery device takes separate pressurized air and O2 sources as input, then mixes the gases through a precision valve. What does this describe?
A. O2 blending system
B. Reservoir system
C. Air entrainment system
D. Low flow system

193.
What is the upper limit of O2 concentrations available through tents?
A. 60% to 70%
B. 50% to 60%
C. 40% to 50%
D. 30% to 40%

194. A physician wants a stable FIO2 of 0.5 for a newborn infant with severe hypoxemia. Which of the following system would you select?
A. O2 hood with blender and heated humidifier
B. Pediatric tent with O2 input of 8L/min
C. O2 hood with blender and unheated humidifier
D. Infant incubator with O2 input of 10L/min

195. What are some key patient considerations in selecting O2 therapy equipment? I type of airway, II severity and cause of the hypoxemia, III age group, IV stability of the minute ventilation
A. II and IV
B. I II and III
C. III and IV
D. I II III and IV

196. A patient receiving 3L/min O2 through a nasal cannula has a measured SpO2 of 93% and no clinical signs of hypoxemia. At this point, what should you recommend?
A. Decreasing the flow to 2L/min and rechecking th SpO2
B. Maintaining the therapy as is and rechecking the SpO2 on the next shift
C. Increasing the flow to 4L/min and rechecking the SpO2
D. Discontinuing the O2 therapy

197. Physiologic effects of hyperbaric oxygen therapy include all of the following except:
A. Neovascularization
B. Bubble reduction
C. Enhanced immune function
D. Systemic vasodilation

198. Physiologic effects of inhaled nitric oxide include all of the following except:
A. Recruitment of collapsed alveoli
B. Improved blood flow to ventilated alveoli
C. Decreased pulmonary vascular resistance
D. Reduced intrapulmonary shunting

199. Which of the following is an indication for the use of heliumO2 mixtures?
A. Large airway obstruction
B. Small airway obstruction
C. Restrictive diseases
D. Physiologic shunting

200. What is the primary indication for tracheal suctioning?
A. Presence of pneumonia
B. Presence of atelectasis
C. Ineffective coughing
D. Retention of secretions

201. What is the most common complication of suctioning?
A. Hypoxemia
B. Hypotension
C. Arrhythmias
D. Infection

202. Complications of tracheal suctioning include all of the following except:
A. Bronchospasm
B. Hyerinflation
C. Mucosal trauma
D. Elevated intracranial pressure

203. What is the normal range of negative pressure to use when suctioning an adult patient?
A. 100 to 120 mmhg
B. 80 to 100 mmhg
C. 60 to 80 mmhg
D. 20 to 30 mmhg

204. What is the normal range of negative pressure to use when suctioning children?
A. 60 to 80 mmhg
B. 80 to 100 mmhg
C. 100 to 120 mmhg
D. 150 to 200 mmhg

205. You are about to suction a 10-year-old patient who has a 6mm(internal diameter) endotracheal tube in place. what is the max size of catheter that you would use in this case?
A. 6 Fr
B. 8 Fr
C. 10 Fr
D. 14 Fr

206. You are about to suction a female patient who has an 8mm(internal diameter) endotracheal tube in place. what is the max size catheter you would use in this case?
A. 8 Fr
B. 10 Fr
C. 12 Fr
D. 14 Fr

207. To prevent hypoxemia when suctioning a patient, the respiratory care practitioner should initially do which of the following?
A. Manually ventilate the patient with a resuscitator
B. Pre-oxygenate the patient with 100% oxygen
C. Give the patient a bronchodilator treatment
D. Have the patient hyperventilate for 2 mins

208. Which of the following methods can help to reduce the likelihood of atelectasis due to tracheal suctioning? I limit the amount of negative pressure used, II hyperinflate the patient before and after the procedure, III suction for a short a period of time as possible
A. I and II
B. I and III
C. II and III
D. I II and III

209. Which of the following can help to minimize the likelihood of mucosal trauma during suctioning? I use as large a catheter as possible, II rotate the catheter while withdrawing, III use as rigid a catheter as possible, IV limit the amount of negative pressure
A. I and II
B. II and IV
C. III and IV
D. I II and IV

210. Which of the following equipment is NOT needed to perform nasotracheal suctioning?
A. Suction kit
B. Laryngoscope with MacIntosh and Miller blades
C. Oxygen delivery system
D. Bottle of sterile water or saline solution

211. Before the suctioning of a patient, auscultation reveals coarse breath sounds during both inspiration and expiration. after suctioning, the coarseness disappears, but expiratory wheezing is heard over both lung fields. what is most likely the problem?
A. Secretions are still present and the patient should be suctioned again
B. The patient has hyperactive airways and has developed bronchospasm
C. A pneumothorax has developed and the patient needs a chest tube
D. The patient has developed a mucous plug and should undergo bronchoscopy

212. What general condition requires airway management? I airway compromise, II respiratory failure, III need to protect the airway
A. I and II
B. I and III
C. II and III
D. I II and III

213. All of the following indicate an inability to adequately protect the airway except:
A. Wheezing
B. Coma
C. Lack of gag reflex
D. Inability to cough

214. Which of the following types of artificial airways are inserted through the larynx? I pharyngeal airways, II tracheostomy tube, III nasotracheal tubes, IV orotracheal tubes
A. I and IV
B. I II and III
C. III and IV
D. I II III and IV

215. Compared with trans-laryngeal intubation, the advantage of tracheostomy includes all of the following except:
A. Greater patient comfort
B. Reduced risk of bronchial intubation
C. No upper airway complications
D. Decreased frequency of aspiration

216. What is the standard size for endotracheal or tracheostomy tube adapters?
A. 22 mm external dimeter
B. 15 mm external diameter
C. 15 mm internal diameter
D. 22 mm internal diameter

217. What is the purpose of the additional side port on most modern endotracheal tubes?
A. Protect the airway against aspiration
B. Help ascertain proper tube position
C. Minimize mucosal trauma during insertion
D. Ensure gas flow if the main port is blocked

218. What is the purpose of a cuff on an artificial tracheal airway?
A. Seal off and protect the lower airway
B. Stabilize the tube and prevent its movement
C. Provide a means to determine tube position via radiograph
D. Help clinicians determine the depth of tube insertion

219. Which of the following features incorporated into most modern endotracheal tubes assist in verifying proper tube placement? I length markings on the curved body of the tube, II embedded radiopaque indicator near the tube tip, III additional side port near the tube tip
A. I and II
B. I and III
C. II and III
D. I II and III

220. The removable inner cannula commonly incorporated into modern tracheostomy tube serves which of the following purposes? I aid in routine tube cleaning and tracheostomy care, II prevent the tube from slipping into the trachea, III provide a patent airway should it become obstructed
A. I and III
B. II and III
C. III only
D. I II and III

221. In the absence of neck or facial injuries, what is the procedure of choice to establish a patent tracheal airway in an emergency?
A. Surgical tracheostomy
B. Orotracheal intubation
C. Nasotracheal intubation
D. Cricothyrotomy

222. Which of the following beside methods can absolutely confirm proper endotracheal tube position in the trachea?
A. Auscultation
B. Observation of chest movement
C. Tube length
D. Fiberoptic laryngoscopy

223. You are assisting a physician in the emergency care of a patient with maxillofacial injury who will require short term ventilatory support. which of the following airway approaches would you recommend?
A. Intubate via the oral route
B. Insert an oropharyngeal airway
C. Perform an emergency tracheotomy
D. Intubate via the nasal route

224. What is the most common sign associated with the transient glottic edema or vocal cord inflammation that follows extubation?
A. Difficulty in swallowing
B. Wheezing
C. Orthopnea
D. Hoarseness

225. Soon after endotracheal tube extubation, an adult patient exhibits a high pitched inspiratory noise, heard without a stethoscope. which of the following actions would you recommend?
A. STAT heated aerosol treatment with saline
B. STAT racemic epinephrine aerosol treatment
C. Careful observation of the patient for 6 hours
D. Immediate reintubation via the nasal route

226. After removal of an oral endotracheal tube, a patient exhibits hoarseness and stridor that do not resolve with racemic epinephrine treatments. what is the most likely problem?
A. Vocal cord paralysis
B. Tracheoesophageal fistula
C. Glottic edema or cord inflammation
D. Tracheomalacia

227. Which of the following injuries are NOT seen with tracheostomy tubes? I tracheomalacia, II tracheal stenosis, III glottic edema, IV vocal cord granulomas
A. I and IV
B. II and IV
C. III and IV
D. I II and III

228. Tracheal stenosis occurs in as many as 1 in 10 patients after prolonged tracheostomy. at what sites does this stenosis usually occur?I cuff site, II tip of the tube, III stoma site
A. I and II
B. I and III
C. II and III
D. I II and III

229. Which of the following techniques or procedures should be used to help minimize infection of a tracheotomy stoma? I regular aseptic stoma cleaning, II adherence to sterile techniques, III regular change of tracheostomy dressing
A. I and II
B. I and III
C. II and III
D. I II and III

230. To ensure adequate humidification for a patient with an artificial airway, inspired gas at the proximal airway should be 100% saturated with water vapor and at which of the following temp?
A. 32 to 35
B. 37 to 40
C. 30 to 32
D. 40 to 42

231. Tracheal airways increase the incidence of pulmonary infections for all of the following reasons except:
A. Lower levels of humidification
B. Increased aspiration of pharyngeal material
C. Contaminated equipment or solutions
D. Ineffective clearance through cough

232. What is the max recommended range for tracheal tube cuff pressure?
A. 15 to 20 mmHg
B. 20 to 25 mmHg
C. 25 to 30 mmHg
D. 30 to 35 mmHg

233. An adult man on ventilatory support has just been intubated with a 7 mm oral endotracheal tube equipped with a high residual volume, low-pressure cuff. when sealing the cuff to achieve a minimal occluding volume you not a cuff pressure of 45 cm H2O. what is most likely the problem?
A. The tube chosen is too small for the patient
B. The cuff pilot balloon and line are obstructed
C. The tube is in the right mainstem bronchus
D. The cuff has herniated over the tube tip

234. Which of the following statements is false about the potential for aspiration in patient with cuffed tracheal tubes?
A. Periodic oropharyngeal suctioning can help to minimize aspiration
B. Aspiration is least likely in spontaneously breathing patients
C. The methylene blue test can help detect leakage-type aspiration
D. Aspiration is more likely with tracheostomy tubes than with endotracheal tubes

235. A patient with a tracheal airway exhibits signs of tube obstruction. which of the following are possible causes of this obstruction? I the tube cuff has herniated over the tip of the tube, II the tube is obstructed by a mucus plug or secretions, III the tube is kinked, or the patient is biting the tube, IV the tube orifice is impinging on the tracheal wall
A. II and IV
B. III and IV
C. I II and III
D. I II III and IV

236. A patient with a tracheal airway exhibits severe respiratory distress. on quick examination, you notice the complete absence of breath sounds and no gas flowing through the airway. what is most likely the problem?
A. Partial tube obstruction
B. Right sided pneumothorax
C. Complete tube obstruction
D. Vocal cord paralysis

237. After coming on a patient with complete obstruction of an oral endotracheal tube, your efforts to relieve the obstruction by moving the patient’s head and neck and deflating the cuff both fail. what should be your next step?
A. Immediately extubate the patient
B. Try to pass a suction catheter
C. Call for an emergency tracheotomy
D. Apply manual positive pressure

238. What does a positive cuff leak test indicate?
A. The patient has significant upper airway edema
B. The patient’s neuromuscular function is adequate to protect the lower airway
C. The patient is at minimal risk for upper airway obstruction
D. The patient’s muscle strength will provide an effective cough

239. To minimize laryngeal swelling a physician orders ” continuous aerosol therapy” after the extubation of a patient. which of the following specific approaches would you recommend?
A. Heated mist therapy through a jet nebulizer and aerosol mask
B. Cool mist therapy through a jet nebulizer and aerosol mask
C. Oxygen therapy through a vent-mask and bubble humidifier
D. Racemic epinephrine or saline through a small jet nebulizer

240. You have been asked to monitor a patient who has just been extubated. which of the following parameter would you monitor? I color, II breath sounds, III vital signs, IV inspiratory force
A. I II and III
B. II and IV
C. III and IV
D. II III and IV

241. An adult patient receiving cool mist therapy after extubation begins to develop stridor. which of the following actions would you recommend?
A. Change from cool mist to heated aerosol
B. Reintubate the patient immediately
C. Administer a racemic epinephrine treatment
D. Draw and analyze an arterial blood gas

242. What is a rare but serious complication associated with endotracheal tube extubation?
A. Bradycardia
B. Aspiration
C. Infection
D. Laryngospasm

243. Which of the following approaches may be used in “weaning a patient from a tracheostomy tube? I using progressively smaller tubes, II using a fenestrated tube, III using a tracheostomy button
A. I and II
B. I and III
C. II and III
D. I II and III

244. For which of the following purposes is a tracheal button appropriate? I facilitate secretion removal, II protect the airways from aspiration, III relieve airway obstruction, IV aid in positive pressure ventilation
A. I and III
B. II and IV
C. III and IV
D. I II III and IV

245. Therapeutic indications for fiberoptic bronchoscopy include which of the following? I inspect the airways, II retrieve foreign bodies, III obtain specimens for analysis, IV aid endotracheal intubation
A. II and IV
B. III and IV
C. I II and III
D. I II III IV

246. In which of the following conditions should fiberoptic bronchoscopy NOT be performed if the risks outweigh the potential benefits? I uncorrected bleeding disorders, II presence of lung abscess, III refractory hypoxemia, IV unstable hemodynamic status
A. II and III
B. II and IV
C. I III and IV
D. I II III and IV

247. Key points to consider in planning fiberoptic bronchoscopy include which of the following? I equipment preparation, II premedication, III airway preparation, IV monitoring
A. II and IV
B. III and IV
C. I II and III
D. I II III and IV

248. Equipment required for patient support and monitoring during a fiberoptic bronchoscopy procedure includes all of the following except:
A. Pulse oximeter
B. Oxygen cannula
C. Electrocardiographic monitor
D. Capnometer

249. During fiberoptic bronchoscopy a patient’s SpO2 drops from 91% to 87%. which of the following actions would be appropriate? I apply suction through the scope’s open channel, II give oxygen through the scope’s open channel, III increase the cannula or mask oxygen flow
A. I and II
B. II and III
C. I and III
D. I II and III

250. To avoid the risk of aspiration after a fiberoptic bronchoscopy procedure, what would be recommended that the patient do?
A. Be placed in the supine Trendelenburg position for 2 hours
B. Remain in a sitting position and NPO until sensation returns
C. Receive additional aerosolized lidocaine by nebulizer
D. Be continuously monitored for oxygenation through pulse oximetry

251. A patient exhibits persistent stridor after a fiberoptic bronchoscopy procedure. which of the following would recommend?
A. Aerosol therapy with albuterol
B. Administration of a benzodiazepine
C. Aerosol therapy with racemic epinephrine
D. Administration a narcotic antagonist

252. What is the first step in basic life support?
A. Open the airway
B. Activate the EMS system
C. Determine unresponsiveness and breathing
D. Restore circulation

253. What is the most common cause of airway obstruction in unconscious patients?
A. Foreign body lodged in the upper airway
B. Oral or nasal secretions blocking the pharynx
C. Tongue falling back into the pharynx
D. Sever spasm of the laryngeal musculature

254. Which of the following arteries should be palpated in pulseless adults and children older than 1 year of age?
A. Brachial
B. Radial
C. Carotid
D. Femoral

255. For chest compressions to be effective, in what position must the patient be placed?
A. Horizontal prone, on firm surface
B. Horizontal supine, on a firms surface
C. Horizontal supine, on a soft surface
D. Sitting with the neck fully extended

256. Which of the following statements are true about adult external cardiac compression?
A. Compressions should displace the sternum at least 3 to 4 inches
B. Compression should occur at a rate of 100 per minute
C. Compression time should be less than upstroke phase
D. Compression can be safely interrupted for up to 50 seconds

257. During properly performed external chest compression on children under 8 years or on large toddlers, how much should the sternum be compressed?
A. 0,5 inch
B. 1.0 inch
C. 1.5 inch
D. 2.0 inch

258. What is the proper rate of external chest compressions for children up to puberrty?
A. 80/min
B. 100/min
C. 120/min
D. 140/min

259. What is the proper ratio of external chest compressions to ventilation for infants?
A. 5:1
B. 3:1
C. 15:2
D. 30:5

260. During single rescuer adult CPR, what is the proper ratio of compressions to ventilation?
A. 30: 1
B. 30:2
C. 5:1
D. 5:2

261. During two person CPR applied to an adult, what is the proper ratio of compressions to ventilation?
A. 5:2
B. 30:1
C. 5:1
D. 30:2

262. How long will the apneic patient take to die without intervention?
A. 1 min
B. 3 to 5 min
C. 4 to 6 min
D. 10 to 20 min

263. To help open the airways of a conscious adult with complete airway obstruction, what would you do?
A. Apply back blows followed by chest thrusts
B. Try to ventilate the victim at a high rate
C. Decompress the stomach with epigastric pressure
D. Apply repeated strong abdominal thrusts

264. What is the major contributing factor in the development of postoperative atelectasis?
A. Uncontrolled hyperpyrexia
B. Central nervous system overstimulation
C. Decreased cardiac output
D. Repetitive, shallow breathing

265. Which of the following clinical finding indicate the development of atelectasis? I opacified areas on the chest xray film, II inspiratory and expiratory wheezing, III tachypnea, IV diminished or bronchial breath sounds
A. I III and IV
B. I II III V
C. I and IV
D. I III and IV

266. An alert and cooperative 28-year-old women with no prior history of lung disease under went cesarean section 16 hours earlier. her xray film currently is clear. which of the following approaches to preventing atelectasis would you recommend for this patient?
A. Incentive spirometry
B. PEEP therapy
C. Deep breathing exercises
D. Intermittent positive pressure breathing therapy

267. Which of the following is FALSE about flow oriented incentive spirometry devices?
A. Inspired volume is estimated as product of flow and time
B. Motivation is based on keeping the indicator balls elevated
C. They have proved less effective than volumetric systems
D. They provide only an indirect measure of inspired volume

268. Which of the outcomes would indicate improvement in a patient previously diagnosed with atelectasis who has been receiving incentive spirometry? I improved PaO2, II decreased respiratory rate, III improved chest radiograph, IV decreased forced vital capacity, V tachycardia
A. I II and III
B. I III and IV
C. I II III IV and V
D. III IV and V

269. Correct instruction in the technique of incentive spirometry should include which of the following?
A. Use of accessory muscles
B. Diaphragmatic breathing at slow to moderate flows
C. Panting at volume approaching total lung capacity
D. Use of accessory muscles at low inspiratory flows

270. In performing the sustained maximal inspiration maneuver during incentive spirometry should be instructed to sustain the breath for at least how long?
A. 10 to 15 sec
B. 5 to 10 sec
C. 3 to 5 sec
D. 1 to 2 sec

271. For patients receiving incentive spirometry, what is the minimum number of sustained maximal inspiration per hour that you would recommend?
A. 25 to 30
B. 15 to 20
C. 5 to 10
D. 1 to 2

272. Which of the following patient groups should be considered for lung expansion therapy using IPPB? I patients with clinically diagnosed atelectasis who are not responsive to other therapies, II patients at high risk for atelectasis who cannot perform other methods, III all obese patients who have undergone abdominal surgery
A. I and II
B. II and III
C. I and III
D. I II and III

273. What is the optimal breathing pattern for IPPB treatment of atelectasis?
A. Slow, deep breaths held at end inspiration
B. Rapid deep breaths help at end inspiration
C. Slow shallow breaths held at end inspiration
D. Rapid shallow breaths held at end inspiration

274. Which of the following is not a potential hazard of IPPB?
A. Increased cardiac output
B. Respiratory alkalosis
C. Pulmonary barotrauma
D. Gastric distention

275. Preliminary planning for IPPB should include which of the following? I evaluating alternative approaches to the patient’s problem, II setting specific individual clinical goals or objectives, III conducting a baseline assessment of the patient
A. I and III
B. I and II
C. I II and III
D. II and III

276. Which of the following are potential desirable outcomes of IPPB therapy?
I improved oxygenation, II increased cough and secretion clearance, III improved breath sounds, IV reduced dyspnea
A. II and IV
B. I II and III
C. III and IV
D. I II III and IV

277. Which of the following positions is ideal for IPPB therapy?
A. Semi fowler’s
B. Standing
C. Supine
D. Prone

278. Which of the following should be charted in the patient’s medical record after completion of an IPPB treatment? I results of pre and post treatment assessment, II any side effects, III duration of therapeutic session
A. II and III
B. I and III
C. I and II
D. I II and III

279. Which of the following are contraindications for continuous CPAP therapy? I hemodynamic instability, II hypoventilation, III facial trauma, IV low intracranial pressure
A. I and III
B. II and III
C. I II and III
D. II IIi and IV

280. During the administration of a continuous positive airway pressure flow mask to a patient with atelectasis, you find it difficult to maintain the prescribed airway pressure. which of the following is the most common explanation?
A. System or mask leaks
B. Outflow obstruction
C. Inadequate system flow
D. Inadequate trigger

281. Which of the following is/are necessary for normal airway clearance? I patent airway, II functional mucociliary escalator, III effective cough
A. I and II
B. I II and III
C. II and III
D. II

282. Which of the following can provoke a cough? I anesthesia, II foreign bodies, III infection, IV irritating gases
A. II and IV
B. I II and III
C. III and IV
D. II III and IV

283. A patient recovering from anesthesia after abdominal surgery is having difficulty developing an effective cough/ which of the following phases of the cough reflex are primarily affected in this patient?
A. Irritation
B. Inspiration
C. Compression
D. Expulsion

284. Which of the following conditions alter normal mucociliary clearance? I bronchospasm, II cystic fibrosis, III ciliary dyskinesia
A. I II and III
B. I and II
C. I and III
D. II and III

285. All of the following are goals o of bronchial hygiene therapy except:
A. Reverse the underlying disease process
B. Help mobilize retained secretion
C. Improve pulmonary gas exchange
D. Reduce the work of breathing

286. Which of the following acutely ill patients is LEAST likely to benefit from the application of chest physical therapy?
A. Patient with acute lober atelectasis
B. Patient with copious amounts of secretions
C. Patient with an acute exacerbation of COPD
D. Patient with low V/Q due to unilateral infiltrates

287. Which of the following conditions are associated with chronic production of large volumes of sputum? I bronchiectasis, II pulmonary fibrosis, III cystic fibrosis, IV chronic bronchitis
A. I III and IV
B. II and IV
C. I II III and IV
D. III and IV

288. All of the following are considered bronchial hygiene therapies except:
A. Postural drainage and percussion
B. Incentive spirometry
C. Positive airway pressure
D. Percussion vibration and oscillation

289. Which of the following is NOT a hazard or complication of postural drainage therapy?
A. Cardiac arrhythmias
B. Increased intracranial pressure
C. Acute hypotension
D. Pulmonary barotraumas

290. Which of the following is the only absolute contraindication of turning?
A. When the patient cannot or will not change body position
B. When poor oxygenation is associated with unilateral lung disease
C. When the patient has or is at high risk for atelectasis
D. When the patient has unstable spinal cord injuries

291. In which of the following patients would you consider modifying any head down positions used for postural drainage? I a patient with unstable blood pressure, II a patient with a cerebrovascular disorder, III a patient with systemic hypertension, IV a patient with orthopnea
A. I II III and IV
B. II and IV
C. II III and IV
D. II and IV

292. In setting up a postural drainage treatment for a postoperative patient, which of the following information would you try to obtain from the patient’s nurse? I patient’s medication schedule, II patient’s meal schedule, III location of surgical incision
A. I and II
B. II and III
C. I and III
D. I II and III

293. During chest physical therapy a patient has an episode of hemoptysis. which of the following actions would be appropriate at this time?
A. Put the patient in a sitting position and have him or her cough strenuously
B. Place the patient in a head down position and call the nurse
C. Immediately perform nasotracheal suctioning of the patient
D. Stop therapy sit the patient up give O2 and contact the physician

294. While reviewing the chart of a patient receiving postural drainage therapy, you notice that the patient tend to undergo mild desaturation during. which of the following would you recommend to manage this problem?
A. Increase the patient’s FIO2 during therapy
B. Discontinue the postural drainage therapy entirely
C. Discontinue the percussion and vibration only
D. Decrease the frequency of treatments

295. All of the follwoing would indicate a successful outcome for ostural drainage therapy except:
A. Decresed sputum production
B. Normalization in ABGS
C. Improved breath sounds
D. Improvement in chest radiograph

296. Which of the following should be charted after completing a postural drainage treatment? I amount and consistency of sputum produced, II patient tolerance of procedure, III positions used (including time), IV any untoward effects observed
A. I II and III
B. II and IV
C. I II III and IV
D. III and IV

297. Directed coughing is useful in helping to maintain bronchial hygiene in all of the following cases except:
A. Bronchiectasis
B. Acute asthma
C. Cystic fibrosis
D. Spinal cord injury

298. Key consideration in teaching a patient to develop an effective cough regimen includes which of the following? I strengthening of the expiratory muscles, II instructin in breathing control, III instruction in proper positioning
A. II and III
B. I and II
C. I II and III
D. I and III

299. A patient recovering from abdominal surgery is having difficulty developing an effective cough. which of the following actions would you recommend to aid this patient in generating a more effective cough? I coordinating coughing with pain medication, II using the forced expiration technique, III supplying manual epigastric compression, IV splinting the operative site
A. I II and IV
B. I II and III
C. III and IV
D. II III and IV

300. A physician orders positive expiratory pressure therapy for a 14 year old child with cystic fibrosis. all of the following responses should be monitored on the patient except:
A. Peak flow or forced expiratory bolume in 1 sec per forced vital capacity percentage
B. Patient’s minute volume
C. Quantity and character of sputum
D. Breath sounds

301. In theory how does PEP help to move secretions into the larger airways? I filling underaerated segments through collateral ventilation, II preventing airway collapes during expiration, III causing bronchodilation during inspiration
A. II and III
B. I and II
C. I II and III
D. I and III

302. All of the following are typical of high frequency external chest wall compression therapy except:
A. 30 min therapy sessions
B. Oscillations at 5 to 25 Hz
C. One to six sessions per day
D. Long inspiratory oscillations

303. Patients can control a flutter valves pressure by changing what?
A. Their inspiratory flow
B. The angle of the device
C. Their expiratory flow
D. The expired volume

304. Which of the following airway clearance techniques would recommend for a 15 month old infant with cystic fibrosis?
A. Postural drainage percussion and vibration
B. Positive expiratory pressure therapy
C. Mechanical insufflation exsufflation
D. Intrapulmonary percussive ventilation

 

You can find Part 1 of the Seminar Exam Review by clicking here.