question

Which of the following is not classified as a classic vital sign?

answer

Sensorium

question

How often should vital signs be recorded in a patient who is hospitalized but is not in intensive care?

answer

Every 4 to 6 hours

question

Which of the following statements regarding vital signs is most accurate?

answer

Trends in vital signs are far more important than a single measurement.

question

Which of the following statements best reflects the importance of comparing changes in vital signs?

answer

It allows detection of additional symptoms.

question

When vital signs are compared with other signs and symptoms to arrive at a conclusion about what is wrong with a patient, this is known as the:

answer

differential diagnosis.

question

If dehydration is suspected in a patient, which of the following parameters should be monitored often?

answer

Fluid intake and output

question

A patient's general clinical presentation indicates to the respiratory therapist (RT) that the patient is in distress. The RT's first step should be to:

answer

evaluate the problem quickly and intervene or locate someone to assist the patient.

question

A well-written description of an RT's initial observations is beneficial to other healthcare providers because it:

answer

helps them know how to plan care and relate to the patient's needs.

question

Assessing the patient's level of consciousness is important because it:

answer

evaluates the adequacy of cerebral perfusion and oxygenation.

question

Which of the following scales is the gold standard for assessing trends in the neurologic function of patients who have suffered head trauma?

answer

Glasgow scale

question

The normal range for oral body temperature in most people is _____ to _____° F.

answer

97; 99.5

question

Fever is defined as an:

answer

elevation of body temperature above normal because of disease.

question

What is the most common cause of fever above 102° F?

answer

Infection

question

For every elevation in body temperature of 1° C, oxygen consumption and carbon dioxide production increase by approximately ____%.

answer

10

question

Which of the following conditions causes hypothermia?

answer

Damage to the hypothalamus

question

Which of the following is not considered a typical site for temperature measurement?

answer

Fingertip

question

What site is used to measure body temperature in comatose patients?

answer

Rectal

question

Which of the following is the method of choice for measuring temperature in neonates?

answer

Axillary

question

Which of the following statements is true regarding oral temperature measurements?

answer

They are the most convenient to obtain and are most readily accepted by alert adults.

question

What is the main advantage of tympanic thermometry over the classic forms of temperature measurement?

answer

It is fast, clean, and noninvasive.

question

Which of the following reasons has been listed as the number one concern regarding use of the tympanic site for body temperature measurement?

answer

Accuracy

question

The normal pulse rate range for adults is _____ beats/min.

answer

60 to 100

question

A pulse rate above the normal range is the definition of which of the following terms?

answer

Tachycardia

question

What is an important reason to monitor the heart rate in patients with lung disease?

answer

Tachycardia is a common finding when hypoxemia is present.

question

Which of the following characteristics should be included in the assessment of a patient's pulse?

answer

Rate, rhythm, and strength

question

Which of the following arteries is most appropriate for measuring the pulse of a patient with very low blood pressure?

answer

Femoral artery

question

Which of the following terms is used to describe a significant decrease in pulse pressure during spontaneous inspiration?

answer

Pulsus paradoxus

question

An alternating succession of strong and weak pulses that usually is not related to respiratory disease is known as pulsus:

answer

alternans

question

A respiratory rate of greater than _____ breaths/min is considered abnormal at any age.

answer

60

question

In postoperative patients, the degree of tachypnea typically is related to the degree of:

answer

atelectasis.

question

Which of the following breathing patterns describes Kussmaul breathing?

answer

Fast and deep

question

Bradypnea may be caused by which of the following?

answer

Hypothermia Narcotic overdose Head injury

question

Which of the following techniques is not useful in measuring the respiratory rate in patients who are spontaneously breathing and alert?

answer

Ask the patient to breathe normally.

question

The diastolic blood pressure is a reflection of:

answer

the pressure exerted during left ventricular relaxation.

question

Which of the following is not true about pulse pressure?

answer

It is calculated from the 12-lead electrocardiographic printout.

question

Which of the following organs is not at risk for disease in the presence of systemic hypertension?

answer

Pancreas

question

Which of the following is not a cause of hypotension?

answer

Right heart failure

question

When the blood pressure is measured, the sounds that are heard through the stethoscope between the systolic and diastolic pressures are known as _____ sounds.

answer

Korotkoff

question

What is the most probable cause for the significant decrease in blood pressure that occurs during inhalation in some patients?

answer

Negative intrathoracic pressure that diminishes blood flow out of the left ventricle

question

Which of the following conditions is not associated with the presence of pulsus paradoxus?

answer

Hypervolemia

question

A 42-year-old male patient with a history of poorly controlled asthma is seen in the emergency department by the respiratory therapist (RT). The patient is seated in a chair and clearly is in extreme respiratory distress, with inspiratory and expiratory wheezing throughout. He reports that he has had a fever for the past 2 days and has eaten and drunk very little. He also reports some chest pain, and his blood pressure is 95/55 mm Hg. At one point, the patient stands to move from the chair to the stretcher and has an episode of syncope. The differential diagnosis for this patient should include all of the following except:

answer

Cerebrovascular accident (CVA; stroke).

question

An RT attempts to take the blood pressure of the patient in question 42. The RT notes that the pulse intensity determined from palpation of the radial artery decreases during inspiration. The most likely explanation for this would be:

answer

an acute asthma exacerbation

question

An RT is called to the emergency department on New Year's Eve to assist in the treatment of a 5-year-old child pulled from under the ice of a local pond. When the child arrives, he has been intubated and has a weak, irregularly irregular pulse of 55 beats/min, no spontaneous respiratory effort, and a body temperature of 30o C. The normal practice in this hospital is to use heat-moisture exchangers (HMEs) for all mechanically ventilated patients. Which of the following should the therapist suggest for the ventilator setup?

answer

Heated humidity in place of the HME

question

An RT has just finished administering an aerosol treatment by a small-volume nebulizer to a patient who has a serious case of pneumonia. For the past 24 hours, the patient has had a fever of 39 to 40o C. Just as the therapist is finishing, a nursing aide comes in to record the vital signs. She uses an electronic thermometer to record an oral temperature of 36.5o C and comments to the patient, "Well, Mr. Jones, you must be getting better because your fever is completely gone." The therapist should:

answer

go to the nursing aide after she leaves the room and tell her that the temperature she recorded is probably not accurate and should be repeated.

question

An RT is taking the blood pressure in the arm of a 12-year-old girl. The only sphygmomanometer available has a cuff in which the ends overlap slightly when it is inflated. The pressure that the RT records:

answer

should be accurate if the measurement is otherwise done properly.

question

What structure in the body is responsible for regulating the body temperature?

answer

hypothalamus

question

What is the most common cause of hypothermia?

answer

exposure to cold temperatures

question

Which of the following sites is closest to core body temperature?

answer

rectal

question

Which of the following is least likely to cause tachycardia?

answer

hypothermia

question

What two factors determine cardiac output?

answer

stroke volume and heart rate

question

Which of the following is a common cause of pulsus paradoxus?

answer

acute asthma attack

question

Which of the following is NOT a common cause of tachypnea?

answer

narcotic overdose

question

What is the normal range for systolic blood pressure in the adult patient?

answer

90-140 mmHg

question

What is the normal range for diastolic blood pressure in the adult patient?

answer

60-90 mm Hg

question

What is the normal range for pulse pressure?

answer

30- 40 mm Hg

question

Which of the following is a TRUE statement about the cause of systemic hypertension in adult patients?

answer

cause is often unknown

question

Which of the following is NOT a cause of hypotension?

answer

mild tachycardia

question

What artery is most often used to assess arterial blood pressure?

answer

brachial

question

Why should the respiratory therapist perform a blood pressure assessment fairly quickly?

answer

The procedure cuts off blood flow to the forearm temporarily.

question

Which of the following is/are advantages of the digital blood pressure measurement devices?

answer

reduce the risk of human error

question

What is indicated by the presence of central cyanosis?

answer

respiratory failure

question

What is the advantage of COPD patients breathing through pursed-lips during exhalation?

answer

promotes more complete emptying of the lungs

question

Which of the following may cause the trachea to shift to the right?

answer

right upper lobe atelectasis

question

What is the most common cause of jugular venous distention (JVD)?

answer

right-sided heart failure

question

Which of the following is the least likely cause of lymphadenopathy in the neck?

answer

congestive heart failure

question

Physiologic effects of hyperbaric oxygen (HBO) therapy include all of the following except:

answer

systemic vasodilation

question

Which of the following conditions can be treated with hyperbaric oxygen (HBO) therapy? I. Carbon monoxide poisoning II. Septic shock III. Air embolism IV. Clostridial gangrene

answer

I, III, and IV

question

What is the most common complication of hyperbaric oxygen therapy?

answer

Ear or sinus barotrauma

question

Physiologic effects of inhaled nitric oxide (NO) include which of the following? I. Recruitment of collapsed alveoli II. Improved blood flow to ventilated alveoli III. Decreased pulmonary vascular resistance IV. Reduced intrapulmonary shunting

answer

II, III, and IV

question

Which of the following is an indication for the use of helium-O2 mixtures?

answer

Large-airway obstruction

question

A physician requests that you provide a patient with exactly 40% O2 at a flow of 60 L/min. Lacking a blender, you must manually mix air and O2 to achieve the desired mixture at the prescribed flow. Which of the following air and O2 flows would you select?

answer

45 15

question

A 45-year-old patient with congestive heart failure is receiving O2 through a 35% air-entrainment mask. With an O2 input of 6 L/min, what is the total output gas flow?

answer

36 L/min

question

You connect an intubated patient to an air-entrainment nebulizer system through a T tube set at 60% with an input flow of 15 L/min. Toward the middle of inspiration, you observe that mist stops exiting from the open end of the T tube. What does this indicate?

answer

Patient is not receiving 60% O2

question

What is the maximum FiO2 expected to be delivered by most air-entrainment masks?

answer

50%

question

To minimize the risk of retinopathy of prematurity (ROP), the American Academy of Pediatrics recommends keeping the PaO2 below what level?

answer

80 mm Hg

question

Infection control is primarily concerned with which of the following? I. Preventing the spread of venereal diseases II. Disinfecting disposable hospital equipment III. Decontaminating reusable patient-care equipment IV. Preventing the spread of surface-borne pathogens

answer

I, III, and IV

question

Which of the following is typically associated with tuberculosis?

answer

Mycobacterium

question

An agent that destroys a pathogenic organism is best described as a:

answer

Germicide

question

Sterilization differs from pasteurization in that sterilization destroys:

answer

All microbes

question

Alcohols such as ethyl and isopropyl are unable to kill which of the following?

answer

Bacterial spores

question

The household item that is useful for disinfection of respiratory home care equipment is which of the following?

answer

Vinegar

question

To ensure that an autoclave is functioning properly, manufacturers routinely use which of the following: I. Pressure-sensitive tape II. Biological indicators III. Chemical indicators IV. Heat-sensitive tape

answer

II and IV only

question

Which of the following is considered to be the most important infection control procedure for anyone having direct patient contact?

answer

Handwashing

question

Droplet isolation precautions require all of the following except:

answer

Special air handling

question

Which isolation precaution requires the patient to be placed in a separate room?

answer

Contact

question

Which of the following terms is used for red blood cells?

answer

Erythrocytes

question

Which of the following is a formed element found in circulating blood?

answer

platelets

question

Which of the following terms is used for white blood cells?

answer

leukocytes

question

Which of the following terms is used for blood platelets?

answer

thrombocytes

question

What type of white blood cell typically is most prevalent in the circulating blood?

answer

neutrophil

question

Which of the following terms describes the immature neutrophil?

answer

band

question

Which of the following types of white blood cells fights bacterial infection?

answer

Neutrophil

question

Which of the following types of white blood cells is useful against allergic reactions and defends against parasitic infestations?

answer

eosinophil

question

Which of the following types of white blood cells exists as two types—the B cell and the T cell?

answer

Lymphocyte

question

Which of the following types of white blood cells is physically the largest?

answer

Monocyte

question

Which of the following types of white blood cells is responsible for phagocytosis?

answer

Monocyte

question

Which of the following terms describes the change in white blood cell count that often occurs in patients with tuberculosis?

answer

Monocytosis

question

Which of the following terms describes an overall abnormal decrease in white blood cell count?

answer

Leukopenia

question

Which of the following types of leukocytosis is typically seen in patients with viral infection?

answer

Lymphocytosis

question

What cells proliferate in patients with leukemia?

answer

Blasts

question

What substance is responsible for carrying red blood cell oxygen on to the tissues?

answer

Hemoglobin

question

What substance is a vital constituent of the heme portion of hemoglobin?

answer

Iron

question

Which of the following terms describes an abnormal decrease in red blood cell count?

answer

anemia

question

The most common type of anemia worldwide is the result of:

answer

Iron deficiency

question

Heavy smokers are prone to what change in the red blood cell count?

answer

Secondary polycythemia

question

What problem is associated with an abnormal international normalized ratio (INR) value?

answer

Bleeding

question

Which of the following is considered the major cation of the extracellular fluid?

answer

sodium

question

Which of the following symptoms is commonly seen with hyponatremia?

answer

Confusion

question

What electrolyte abnormality is associated with irregular pulse, muscle weakness, and abdominal distention?

answer

Hypokalemia

question

Elevation of blood urea nitrogen (BUN) and creatinine levels in the blood suggests what type of problem?

answer

Renal failure

question

What disease is associated with elevations in sodium and chloride in sweat?

answer

cystic fibrosis

question

During evaluation of the enzymes, what disorder is associated with elevation of the CK-MB on electrophoresis?

answer

myocardial infarction

question

Hypoalbuminemia may result in what pulmonary problem?

answer

pulmonary edema

question

The purpose of performing the sensitivity test on sputum samples is to:

answer

determine the antibiotic to prescribe

question

Which of the following organisms is responsible for most cases of bacterial pneumonia?

answer

Streptococcus pneumoniae

question

A practitioner forgets to ice an ABG sample and leaves it at room temperature for 45 min. Which of the following parameters can you predict will increase in this sample during that period? I. PCO2 II. pH III. PO2

answer

I

question

When analyzing an ABG sample from a patient with acute respiratory distress syndrome and refractory hypoxemia, you notice a PaO2 of 141 mm Hg and a PaCO2 of 14 mm Hg. Which of the following analytic errors should you suspect?

answer

Exposure of blood sample to air

question

Which of the following changes would occur if an arterial blood sample of a patient breathing room air were exposed to a large air bubble? I. Decreased PCO2 II. Decreased pH III. Increased PO2

answer

I and III

question

A PaO2 below what value would be considered moderate hypoxemia?

answer

55 mm Hg

question

What is a normal level for CaO2?

answer

18 to 20 ml/100 ml

question

To assess gas exchange at the tissues, you would obtain a blood sample from which of the following?

answer

Pulmonary artery (balloon-inflated)

question

Under ideal conditions, electrochemical oxygen (O2) analyzers have approximately what degree of accuracy?

answer

2%

question

How does the Clark polarographic O2 electrode function?

answer

It uses O2 to produce a reduction-oxidation reaction

question

Which of the following is false about the galvanic fuel cell O2 analyzer?

answer

It requires an external power source (alternating current line or batteries).

question

While checking a polarographic (Clark) electrode, you determine that the device fails to read 100% when exposed to pure O2. Which of the following actions would be the proper first step?

answer

replace the analyzers batteries

question

What lung problem is ventilation/perfusion (mc001-1.jpg) scanning used to detect?

answer

Pulmonary embolism

question

Which of the following structures will result in the most radiopaque shadow on the chest radiograph?

answer

ribs

question

The right heart shadow is not visible on your patient's chest radiograph. Which of the following pathologies may explain this?

answer

right middle lobe pneumonia

question

In which of the following situations is obtaining a chest radiograph least useful?

answer

When the static pressure drops by 2 cm H2O during CMV

question

In what pulmonary condition does the chest radiograph often "lag behind" the clinical status of the patient?

answer

Pneumonia

question

Which radiographic view of the chest allows the physician to read the best quality film?

answer

Posteroanterior

question

Your patient just had an anteroposterior chest film taken. When you view the film, what may be a consideration?

answer

The heart may appear larger than it really is.

question

What abnormality may appear to be present on the chest x-ray but is simply due to abnormal rotation of the patient during production of the film?

answer

Widened mediastinum

question

What problem exists when interpreting an overexposed chest film?

answer

There is difficulty in seeing the peripheral blood vessels.

question

In the standard posteroanterior chest film, the heart shadow should be less than what proportion of the chest width?

answer

50%

question

Computed tomography (CT) scanning of the chest would be least useful for which of the following?

answer

To evaluate patients with asthma

question

Which of the following diseases are typically evaluated using high-resolution CT? I. Emphysema II. Asthma III. Bronchiectasis IV. Interstitial lung disease

answer

I, III, and IV

question

CT angiography is most often used to evaluate the patient for which of the following conditions?

answer

Pulmonary emboli

question

Which of the following is a major limitation of magnetic resonance imaging (MRI) of the chest?

answer

Cannot be used in patients with pacemakers

question

Which of the following structures in the chest is typically examined using MRI? I. Lung parenchyma II. Hilar structures III. Large vessels in the lung IV. Structures in the mediastinum

answer

II, III, and IV

question

Which of the following statements is false regarding the use of ultrasound to image the chest?

answer

It is useful to image lung tissue.

question

Blunting of the costophrenic angles seen on the posteroanterior or lateral chest film typically indicates:

answer

excess pleural fluid.

question

Which chest x-ray view is best used to identify excess pleural fluid?

answer

Lateral decubitus

question

What is the earliest sign of a left-sided pleural effusion on an upright chest radiograph?

answer

An increased distance between the inferior margin of the left lung and the stomach gas bubble

question

An air-fluid level in the pleural space typically indicates

answer

hydropneumothorax

question

What is the primary indication for tracheal suctioning?

answer

Retention of secretions

question

What is the most common complication of suctioning?

answer

hypoxemia

question

Complications of tracheal suctioning include which of the following? I. Bronchospasm II. Hyperinflation III. Mucosal trauma IV. Elevated intracranial pressure

answer

I, III and IV

question

How often should patients be suctioned?

answer

when physical findings support the need

question

What is the normal range of negative pressure to use when suctioning an adult patient?

answer

-100 to -150 mm Hg

question

What is the normal range of negative pressure to use when suctioning children?

answer

-100 to -120 mm Hg

question

You are about to suction a 10-year-old patient who has a 6-mm (internal diameter) endotracheal tube in place. What is the maximum size of catheter that you would use in this case?

answer

10 Fr

question

You are about to suction a female patient who has an 8-mm (internal diameter) endotracheal tube in place. What is the maximum size of catheter you would use in this case?

answer

14 Fr

question

To prevent hypoxemia when suctioning a patient, the respiratory care practitioner should initially do which of the following?

answer

Preoxygenate the patient with 100% oxygen.

question

To maintain positive end expiratory pressure (PEEP) and high FiO2 when suctioning a mechanically ventilated patient, what would you recommend?

answer

Use a closed-system multiuse suction catheter.

question

Auscultation of the chest over a pneumothorax would most likely reveal

answer

diminished breath sounds

question

an RT osculates a patients chest over the major airways and identifies the presence of diffuse wheezing. this would indicate which of the following?

answer

bronchospasm

question

while the RT osculates a patients chest the patient repeats the words one two three. an increase in vocal clarity and intensity is noted in the right lower lobe compared to the other lung fields, which most likely indicates

answer

consolidation

question

digital clubbing can be most easily assessed by

answer

inspecting the angulation of the nail bed

question

while interviewing a patient prior to starting therapy, an RT notices that the patient arouses easily and responds appropriately. This information will help the therapist determine the patients

answer

level of consciousness

question

a patient receiving o2 therapy with a nasal cannula and o2 concentrator needs a delivery system to use when outside of the home for short periods of time, what should they recommend?

answer

E cylinder

question

which of the following allows immediate determination of the lowest FiO2 needed to achieve satisfactory oxygenation?

answer

pulse ox

question

which of the following is the best device to administer a controlled oxygen concentration for a patient who has a tidal volume of 500 mL and a respiratory rate that fluctuates between 12 and 25/min

answer

air entrainment mask

question

a respiratory therapist notices frequent build-up of liquid in the large- bore aerosol tubing during oxygen delivery by heated aerosol mask to a trach collar. which of the following is the most likely cause of this problem?

answer

the temperature of the inspired gas is too high

question

which of the following is the most effective in destroying all microorganisms?

answer

ethylene oxide

question

which of the following agents is appropriate to recommend for use in the cleaning of home respiratory equipment?

answer

acetic acid (vinegar)

question

which of the following is the best method to monitor equipment sterilization?

answer

biologic indicators

question

during an aerosol treatment with albuterol, a patient complains of dizziness and lightheadedness. the patients pulse increases from 70 to 85 ppm during the treatment. which of the following notes should be recorded in the patients chart?

answer

I. the patient was instructed to breathe more slowly during therapy II. the reaction was most likely a result of increase respiratory rate and depth during therapy III. the nurse was notified of the patients response to therapy

question

a 20 year old asthma patient is receiving .5 mL of albuterol and 4 mL normal saline by hand held nebulizer. During treatment the patient complains of tremors and palpitations. which of the following should the RT recommend?

answer

decrease the amount of ventolin to .25 mL

question

an RT is administering a neb treatment of .3 mL albuterol. the patients heart rate increases from 110 to 140 5 minutes after the treatment is started. which of the following should the therapist do?

answer

terminate treatment and monitor the patients heart rate

question

Which of the following is the best aerosolized bronchodilator for a patient with an acute asthma attack?

answer

albuterol (proventil)

question

a RT notes vesicular sounds throughout the periphery of the lung during auscultation, which should be documented in the chart?

answer

normal breath sounds

question

activity of respiratory accessory muscles most likely indicates

answer

increased airway resistance

question

a physiologic goal of CPAP in atelectasis is to increase

answer

functional residual capacity

question

common complications associated with arterial punctures include which of the following?

answer

hematoms formation and spasm of the vessel

question

which of the following id indicated by a popping of whistling sound when the water bottle of a humidifier is tested by obstructing the gas outlet with the finger?

answer

expected function

question

which of the following best reflects the adequacy of ventilation?

answer

PaCO2

question

which of the following most consistently delivers the highest water vapor content to a patients airway?

answer

heated wick

question

which of the following is a high flow oxygen delivery system in which the gas flow of the apparatus is sufficient to meet all inspiratory flow requirements of a patient?

answer

24% air entrainment mask

question

a 44 year old patient present to the ED with diabetic ketoacidosis. which of the following respiratory patterns is most consistent with this diagnosis?

answer

rapid, deep breathing

question

which of the following is an indication for an oropharyngeal airway?

answer

prevention of upper airway obstruction in an unconscious patient

question

a gas is saturated with 100% relative humidity at 32.2 degrees celsius. as the gas cools to 26.7 degrees celsius the relative humidity will

answer

remain 100% and excess water will rain out

question

while performing postural drainage on a patient who is in a head down position, the patient appears dyspneic due to severe prolonged coughing. the RT should

answer

place the patient in semi-fowlers postion

question

three days postoperatively a patient is febrile and the white blood cell count is 18,000. a chest XR shows patchy infiltrates with air bronchograms. which of the following is the most probable diagnosis?

answer

pneumonia

question

activity of respiratory muscles most likely indicates

answer

increased airway resistance

question

which of the following are indications of sudden upper airway obstruction?

answer

retraction of intercostal spaces, panic, marked use of accessory muscles of ventilation

question

which of the following devices can provide the greatest total fluid output?

answer

ultrasonic nebulizer

question

a patient is receiving chest percussion, lung expansion therapy and directed coughing to treat obstructive atelectasis. which of the following should the RT do to assess responses to care?

answer

chest radiograph

question

the purpose of cleaning and sterilizing non disposable respiratory care equipment after each use is to

answer

prevent cross infection and reinfection of patients

question

during initial assessment of a patient with a closed head injury, the patient opens his eyes only in response to painful stimuli. on a follow up exam, patient opens on verbal commands

answer

the level of consciousness is increased

question

a patient who is oxygen dependent travels using an e cylinder, he carries the are in the trunk of his car. Rt should inform the patient he should

answer

secure the spare cylinder in the back seat

question

patient says "i seem to breathe fast and lift my shoulders a lot, but i feel like i am getting enough air." therapist can conclude that the patient likely has

answer

increased work of breathing

question

which of the following devices should be used to deliver a 70% helium/ 30% oxygen mixture most effectively to a patient?

answer

nonrebreathing mask

question

while evaluating a patient for bronchodilator therapy a respiratory therapist notes that the patient does not respond to verbal commands. has no cough or gag reflexes. conclude

answer

patient is comatose

question

Which of the following autonomic or protective neural responses represent potential hazards of emergency airway management? I. Hypotension II. Bradycardia III. Cardiac arrhythmias IV. Laryngospasm

answer

I, II , III and IV

question

Which of the following indicate an inability to adequately protect the airway?I I. Wheezing II. Coma III. Lack of gag reflex IV. Inability to cough

answer

2 3 4

question

Which of the following types of artificial airways are inserted through the larynx? I. Pharyngeal airways II. Tracheostomy tubes III. Nasotracheal tubes IV. Orotracheal tubes

answer

2 and 4

question

Compared with the nasal route, the advantages of oral intubation include which of the following? I. Reduced risk of kinking II. Less retching and gagging III. Easier suctioning IV. Less traumatic insertion

answer

1 3 4

question

Compared with the oral route, the advantages of nasal intubation include which of the following? I. Reduced risk of kinking II. Less retching and gagging III. Less accidental extubation IV. Greater long-term comfort

answer

2 3 4

question

Compared with translaryngeal intubation, the advantages of tracheostomy include which of the following? I. Greater patient comfort II. Reduced risk of bronchial intubation III. No upper airway complications IV. Decreased frequency of aspiration

answer

1 2 3

question

What is the standard size for endotracheal or tracheostomy tube adapters?

answer

15 mm external diameter

question

What is the purpose of the additional side port (Murphy eye) on most modern endotracheal tubes?

answer

Ensure gas flow if the main port is blocked.

question

What is the purpose of a cuff on an artificial tracheal airway?

answer

To seal off and protect the lower airway

question

What is the purpose of the pilot balloon on an endotracheal or a tracheostomy tube?

answer

to monitor cuff status and pressure

question

Total application time for endotracheal suction in adults should not exceed which of the following?

answer

10 to 15 seconds

question

While suctioning a patient, you observe an abrupt change in the electrocardiogram waveform being displayed on the cardiac monitor. Which of the following actions would be most appropriate?

answer

stop suctioning and immediately administer oxygen

question

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 as short a period of time as possible.

answer

I, II and III

question

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.

answer

II and IV

question

Absolute contraindication for nasotracheal suctioning includes which of the following? I. Epiglottitis II. Croup III. Irritable airway

answer

I and II

question

Which of the following equipment is needed to perform nasotracheal suctioning?

answer

I, III and IV

question

After repeated nasotracheal suctioning over 2 days, a patient with retained secretions develops minor bleeding through the nose. Which of the following actions would you recommend?

answer

Stop the bleeding and use a nasopharyngeal airway for access.

question

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?

answer

The patient has hyperactive airways and has developed bronchospasm.

question

What general condition requires airway management? I. Airway compromise II. Respiratory failure III. Need to protect the airway

answer

I, II and III

question

Which of the following conditions require emergency tracheal intubation? I. Upper airway or laryngeal edema II. Loss of protective reflexes III. Cardiopulmonary arrest IV. Traumatic upper airway obstruction

answer

I, II, II and IV

question

What size endotracheal tube would you select to intubate an adult female?

answer

7 mm

question

What is the purpose of an endotracheal tube stylet?

answer

It adds rigidity and shape to ease insertion.

question

To make oral intubation easier, how should the patient's head and neck be positioned?

answer

Neck flexed, with head supported by towel and tilted back

question

What should be the maximum time devoted to any intubation attempt?

answer

30 sec

question

Which of the following statements are true about methods used to displace the epiglottis during oral intubation? I. Regardless of the blade used, the laryngoscope is lifted up and forward. II. The curved (MacIntosh) blade lifts the epiglottis indirectly. III. The straight (Miller) blade lifts the epiglottis directly. IV. Levering the laryngoscope against the teeth can aid displacement.

answer

I, II and III

question

During oral intubation of an adult, the endotracheal tube should be advanced into the trachea about how far?

answer

Until its cuff has passed the cords

question

Immediately after insertion of an oral endotracheal tube on an adult, what should you do? I. Stabilize it with your right hand. II. Inflate the tube cuff. III. Provide ventilation or oxygenation.

answer

1 2 3

question

Ideally, the distal tip of a properly positioned endotracheal tube (in an adult man) should be positioned approximately how far above the carina?

answer

2 to 4 cm

question

Which of the following bedside methods can absolutely confirm proper endotracheal tube position in the trachea?

answer

Fiberoptic laryngoscopy

question

What is the average distance from the tip of a properly positioned oral endotracheal tube to the incisors of an adult man?

answer

21 to 23 cm

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