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1.  A 65-year-old woman walked into the emergency department complaining of tightness on her chest with radiating left shoulder pain. She has a 40-pack per year smoking history and physical signs of COPD. You should:

 

A. start O2 with a nonrebreathing mask at 12 L/min
B. recommend a STAT chest radiograph
C. start low-flow O2 via nasal cannula at 2 L/min
D. obtain an arterial blood gas sample

 

2.  After initiating mouth-to-mouth ventilation on a five-year old child in respiratory arrest, you confirm the presence of a good pulse. At this point you would continue ventilation at a rate of:

 

A. 6-12 breaths/min
B. 12-20 breaths/min
C. 20-25 breaths/min
D. 25-30 breaths/min

 

3.  You enter a room alone and find a patient unresponsive and without pulse. You call for help and a defibrillator but no one responds. Which of the following actions would be appropriate in this case?

 

A. immediately deliver three precordial thumps
B. wait for an AED/defibrillator to arrive
C. intubate and begin mechanical ventilation
D. immediately begin chest compressions

 

4.  After removing a patient with an oral endotracheal tube in acute respiratory distress from a ventilator, you find it difficult to provide manual ventilation via bagging. Your next step should be to:

 

A. deflate the ET tube cuff
B. remove the bite block
C. try to pass a suction catheter
D. extubate the patient

 

5.  Which of the following statement about chest compressions during neonatal resuscitation is correct?

 

A. compressions and ventilations should be delivered simultaneously
B. the compression to ventilation ratio should be 3:1
C. compressions should exceed 1/2 the AP chest diameter
D. compressions should be delivered on the top 1/3 the sternum

 

6.  During resuscitation of an adult patient with ventricular fibrillation, sodium bicarbonate should be considered:

 

A. for severe hypoxemia
B. if hyperkalemia is present
C. if the patient has respiratory acidosis
D. immediately before attempting defibrillation

 

7.  During CPR, the O2 reservoir bag of a bag-valve manual resuscitator collapses during the refill phase. You can correct this problem by

 

A. shortening the bag refill time
B. increasing oxygen flow to the bag
C. increasing the ventilatory frequency
D. increasing tidal volume delivery

 

8.  Which of the following would be appropriate adjunct equipment for ventilating an infant during in-hospital emergency life support?

 

A. A
B. B
C. C
D. D

 

9.  After repositioning a patient’s head and neck, you still find it difficult to provide manual ventilation without leakage when using a self-inflating bag-valve-mask (BVM). Which of the following actions would you take next to help resolve this problem?

 

A. have a colleague hold the mask with two hands
B. perform a series of five blows to the patient’s back
C. replace the self-inflating BVM with a flow-inflating system
D. immediately implement manual inline stabilization

 

10.  In order to assess the circulatory status of an infant during basic life support, which of the following pulses would you palpate?

 

A. brachial
B. ulnar
C. carotid
D. popliteal

 

11.  You are about to initiate bag-valve-mask ventilation on an unconscious patient and discover the presence of full dentures. The appropriate action at this time would be to:

 

A. remove the dentures and begin bag-valve-mask ventilation
B. use the mouth-to-mouth method of ventilation instead
C. remove the dentures and inset a oropharyngeal airway
D. keep the dentures in and begin bag-valve-mask ventilation

 

12.  A patient in ventricular fibrillation should receive IV epinephrine (1 mg) every:

 

A. 1-2 min
B. 3-5 min
C. 6-8 min
D. 9-10 min

 

13.  After inspecting the rhythm strip of a patient under your care in ICU, you note the occurrence of 8-10 premature atrial contractions (PACs) per minute. What action would you recommend at this time?

 

A. administration of an antiarrhythmic drug like lidocaine
B. administration of an adrenergic agent like isoproterenol
C. administration of an anticholinergic agent like atropine
D. cardioversion with a direct current discharge of 100 joules
14.  Which of the following drugs can be administered via the endotracheal tube during emergency life support?

 

Lidocaine         Naloxone         Epinephrine     Atropine
A.         No                   Yes                  Yes                  No
B.         Yes                  No                   Yes                  Yes
C.         Yes                  Yes                  No                   Yes
D.         Yes                  Yes                  Yes                  Yes

 

A. A
B. B
C. C
D. D

 

15.  During resuscitation of an adult patient in CCU, the physician in charge asks for a short pause in compressions and ventilations in order to obtain a good ECG tracing. During this pause, you cannot palpate any pulse, but observe following rhythm on the patient’s ECG monitor. Which of the following actions should you take at this time?

 

A. Continue cardiac compressions and ventilation
B. Discontinue compressions and monitor the patient
C. Recommend cardioversion at 100 Joules
D. Recommend lidocaine (Xylocaine) administration
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16.  The respiratory therapist’s role in disaster management is most crucial in which of the following phases?

 

A. emergency phase
B. rehabilitation phase
C. warning phase
D. reconciliation phase

 

17.  You are setting up transport of an intubated patient who requires frequent endobronchial suctioning to a procedure room that does not have a piped vacuum source. To manage this patient during transport you will need which of the following items:

 

A. a Yankauer suction tip
B. a Lukens sputum collection trap
C. a battery- or hand-powered suction pump
D. a closed suction system

 

18.  You are asked to transport a patient with a tracheostomy to the radiology department for a chest radiograph. The patient is spontaneously breathing through a T-piece receiving 40% oxygen via an air-entrainment nebulizer. You should:

 

A. attach an air entrainment device to a trach collar
B. place the patient on a 4 L/min nasal cannula
C. bag the patient with 100% O2 during transport
D. place the patient on a nonrebreathing mask at 12 L/min

 

19.  A patient complains of left-sided chest pain while receiving mechanical ventilation. Inspection, palpation and auscultation reveal tachypnea, a weak and thready pulse, tracheal deviation to the right, and decreased breath sounds and hyperresonance on the left. Which of the following would you recommend?

 

A. bronchoscopy
B. chest tube insertion
C. thoracentesis
D. suctioning

 

20.  After 3 cycles of shocks and IV epinephrine, a patient continues to exhibit ventricular fibrillation. Which of the following drugs should be considered at this time?

 

A. amiodarone
B. atropine
C. dopamine
D. adenosine

 

21.  During properly chest compression on infants, the sternum should be compressed:

 

A. 1/3 the AP diameter of the chest
B. at least 2 inches (5 cm)
C. 1/2 the AP diameter of the chest
D. no more than 1/2 inch

 

22.  Which of the following would represent the most feasible plan to deal with the simultaneous admission of several dozen adult, infant and child disaster victims who require immediate ventilatory support?

 

A. keep several dozens ventilators available on backup for emergencies/disasters
B. ask your equipment company to keep several dozens ventilators on emergency reserve
C. provide all hospital personnel with bag-valve mask systems and train them in their use
D. triage the patients and provide only the most seriously ill with ventilatory support

 

23.  You are trying to apply mouth-to-mouth ventilation to an unconscious adult patient, but are unable to maintain a tight seal at the lips. At this point you should:

 

A. place a handkerchief over the victim’s mouth and continue
B. use the jaw thrust maneuver instead of the head tilt/chin lift
C. apply mouth-to-nose ventilation instead of mouth-to-mouth
D. immediately apply a series of strong back blows to the victim

 

24.  An ICU nurse suspects that her orally intubated patient has partially extubated himself. After confirming significant leakage around the patient’s mouth your next step should be to:

 

A. measure the cuff pressure
B. push the tube down 2-3 cm
C. insert a supraglottic airway
D. fully withdraw the tube

 

25.  CPR is being performed in a 9-year-old child following a motor vehicle accident. After 15 minutes, the following arterial blood gas results are obtained:

 

pH        7.21
PaCO2 67 torr
PaO2   263 torr
HCO3   26 mEq/L
BE        -1.3 mEq/L

 

Which of the following should you do first?

 

A. administer sodium bicarbonate
B. administer epinephrine
C. increase the ventilation rate
D. decrease the delivered tidal volume

 

26.  When an adult develops acute upper airway obstruction likely due to foreign body aspiration, you should immediately:

 

A. establish an airway and begin cardiopulmonary resuscitation
B. apply a series of strong, external subdiaphragmatic compressions
C. apply a forceful blow to the sternum
D. lean the person forward and instruct him to inhale slowly

 

27.  At the onset of adult mouth-to-mouth or mouth-to-mask ventilation, you should provide:

 

A. two breaths over 1 sec each that make the chest rise
B. four consecutive breaths delivers without pause
C. two consecutive breaths delivers without pause
D. four breaths over 1 sec each that make the chest rise


28.  Which of the following arrhythmias are considered potentially lethal?

 

A. A
B. B
C. C
D. D

 

29.  During transport of an orally intubated patient to the radiology department you note a drop in SpO2 to 85%, gurgling sounds coming out of the patient’s mouth, and mild respiratory distress. Which of the following actions would be appropriate at this time?

 

A. A
B. B
C. C
D. D

 

30.  Before advanced life support is available, the best way to maintain a patent airway would be to

 

A. attempt to pass a nasotracheal tube blindly
B. put a pillow under the patient’s head
C. perform a cricothyrotomy
D. extend the patient’s neck and elevate his chin

 

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