• 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 irriation. Which of the following action would be appropriate?
    • A.
      Recommending that the flow be decreased to 2L/min
    • B.
      Adding a humidifer 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 transportaion (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 adn their larger counterparts?
    • A.
      Small gas cylinders do not unergo 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 divied by the density of are at STPD
    • D.
      The force requried 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 sylinders and their attachments?
    • A.
      PISS
    • B.
      DISS
    • C.
      ASSS
    • D.
      CGA system
  • 172.
    You must connect a large-volume nevulizer 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 aire 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 teh adjustable pressure-reducing valve is in combination with which of the following?
    • A.
      Flow restrictor
    • B.
      Thorpe tube flowmeter
    • C.
      Bourdon gague
    • 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 opne then close the valve
    • C.
      Blow into the valve outlet a few times
    • D.
      Wipe the valve outlet wiht 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 trasport. 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 positon (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 teh 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 continuosly. Precise FIO2 concentratons are not need. 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 lowe 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 form 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 throgh a bubble humidifier at 5L/min. you immediately notice that the humidifier pressure relief is popping off. which of the following actions whould 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 deliver tubing
    • D.
      Decrease the flow rate to 2L/min
  • 189.
    Which of the following is FALSE about the simple O2 mask?
    • A.
      It has no valving sustem 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 inspiratoin. 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.
      Chnage to a simple mask
  • 191.
    A patient receiving 35% O2 through an air entrainmetn 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 situaton?
    • A.
      Switch the patient to a 40% air entrainmetn mask
    • B.
      Increase the device’s input flow to 10L/min
    • C.
      Switch the patient to a 28% air entrainmetn mask
    • D.
      Decrease teh device’s input flow to 4L/min
  • 192.
    An O2 delivery device takes separate pressurized air and O2 sources as input, then mixes thes 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 concentratons availavle 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 consideratons 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 reciving 3L/min O2 through a nasal cannula has a meassured 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.
      Dicontinuing th 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.
      Sysemic vasodilation
  • 198.
    Physiologic effects of inhaled nitric oxide include all of th follwoing except:
    • A.
      Recruitment of collapsed alveoli
    • B.
      Improved blood flow to ventilated alveoli
    • C.
      Decreased pulmonary vascular resistance
    • D.
      Reduced inrapulmonary 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 suctioing 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 teh 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 patien, the respiratory care practitioner should initially do which of the following?
    • A.
      Mannually ventilate the patient with a resuscitator
    • B.
      Preoxygenate 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 teh 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 teh following can help to minimize the likelihood of mucosal trauma druring suctioning?
  • I use as large a catheter as possible
    II rotate teh catherter while withdraweing
    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.
      Larygoscope wiht MacIntosh and Miller blades
    • C.
      Oxygen delivery system
    • D.
      Bottle of steril 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. waht 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 bronshospasm
    • 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.
    Wich 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 translaryngeal intubation, the advantage of tracheostomy include 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 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.
    Waht is teh 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 clinicans 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 lenght markings on the curved body of the tube
    II imbedded 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 teh procedure of choice to establish a paten tracheal airway in an emergency?
    • A.
      Surgical tracheotomy
    • B.
      Orotracheal intubation
    • C.
      Nasotraccheal intubation
    • D.
      Cricothyrotomy
  • 222.
    Which of teh follwoing bedise methods can absolutely confirm proper endotracheal tube position in the trachea?
    • A.
      Ausculation
    • B.
      Observatoin of chest movement
    • C.
      Tube length
    • D.
      Fiberoptic laryngoscopy
  • 223.
    You are assisting a physician in teh emergency care of a patient with maxillofacial injuty 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.
      Preform 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 exhibis 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 techniquese or procedures should be used to help minimize infection of a tracheotomy stoma?
  • I regular aseptic stoma cleaning
    II adherence to sterile techniques
    III regulat 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 teh 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 ovstructed
    • 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 exibits signs of tube obstruction. which of the following are possible causes of this obstrucion?
  • I the tube cuff has herniated over teh tip of the tube
    II the tube is obstructed by a mucus plug or secreations
    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 sever 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 adn neack and deflationg the curff both fail. what should be your next step?
    • A.
      Immediately extubaste the patient
    • B.
      Try to pass a suction catherter
    • 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 funcion is adequate to protect the lower airway
    • C.
      The patient is at minimal risk for upper airway obstruction
    • D.
      The patient’s muscle strenght will provide an effective cough
  • 239.
    To minimize laryngeal swelling a physician orders ” continuous aerosol therapy” after teh 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 nevulizer 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 afer extubation begins to develop stridor. which of the following actions would you recommend?
    • A.
      Change from cool mist to heated aerosol
    • B.
      Reintubate teh patient immediately
    • C.
      Administer a racemic epinephrine treatment
    • D.
      Draw and analyze an aterial 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 form a tracheostomy tube?
  • I using profressively 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 secreation removal
    II protet 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 conditons should fiberoptic bronchoscopy NOT be performed if teh risks outweigh the potential benefits?
  • I uncorrected bleeding diorders
    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 inclyde 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 afer a fiberoptic bronchoscopy procedure, what would be recommend 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 systerm
    • C.
      Determine unresponsiveness and breathing
    • D.
      Restore circulation
  • 253.
    What is the most common cause of airway obstruction in uncoscious patients?
    • A.
      Foreign body lodged in the upper airway
    • B.
      Oral or nasal secreations 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 teh sternum at least 3 to 4 inches
    • B.
      Compression should occur at a rate of 100 per minute
    • C.
      Compression time sould 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 teh 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 ration of compressions to ventilation?
    • A.
      5:2
    • B.
      30:1
    • C.
      5:1
    • D.
      30:2
  • 262.
    How long will the apneic patient lake 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 apatient 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 insttruction 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 teh 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 ovese 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 teh 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 patients problem
    II setting specific individual clinical goals or objectives
    III conducting a baseline assessment of teh 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 secration 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 positins 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 continous 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 administration of a continouse positive airway pressure flow mask to a patient with atelectasis you find it difficult to maintain the prescrived 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 teh 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 teh 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 fbronchial hygiene therapy except:
    • A.
      Reverse the underlying diseas 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 application of chest physical therapy?
    • A.
      Patient with acute loaber atelectasis
    • B.
      Patient with copious amounts of secreations
    • C.
      Patient with an acute exacerbation of COPD
    • D.
      Patient with low V/Q due to unlateral 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 if the following is the only absolute contraindicaion 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 teh patient has unstable spinal cord injuries
  • 291.
    In which of teh 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 orhopnea
    • 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, wich of teh 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.
    Durign 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 dow 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.
      Decreae teh 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 teh 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 exiration
    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 he 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


For Part 1 of the Seminar Exam Review, Click Here