TMC 9 Exam Questions

TMC 9 Exam Questions

A 70-kg (154-lb) COPD patient who was started on mechanical ventilation due to a severe pulmonary infection has the following weaning parameters & clinical data three

days after initiation of mechanical ventilation:

MIP -25 cmH20 Spont VT 360 mL RR 27 WBC 8,000 per cu mmHb 16 gm/dL Based on the calculated RSBI, the respiratory therapist should recommend - ✔✔discontinuing mechanical ventilation RSBI= RR/VT

Which of the following patient conditions would CONTRAINDICATE the use of Trendelenburg's position? - ✔✔Increased intracranial pressures

Which of the following defibrillator settings is appropriate for treating a patient with ventricular tachycardia? - ✔✔synchronization set to OFF

A physician requests the presence of a respiratory therapist for an intubation to deliver Exosurf to a newborn. Which of the following clinical finding is most likely? - ✔✔L/S ratio

less than 2:1

A 40-week gestational age neonate is receiving time-cycled, pressure-limited ventilation with an I-time of 0.4 seconds, PIP 28 cm H2O, RR of 25/min, FIO2 0.45 and PEEP 5 cm H2O. As the flowrate is increased, what will happen to the I:E ratio? - ✔✔No change

A respiratory therapist is assigned to monitor a mechanically ventilated male patient

with the following settings and clinical data:

Mode Pressure/control Mandatory Rate 20/min

FIO2 0.75

PIP 30 cm H20 I:E ratio 2:1 PEEP 22 cm H20 pH 7.35 PaCO2 50 torr PaO2 60 torr Based on this data, which of the following conditions is most likely? - ✔✔Acute Respiratory Distress Syndrome

Which of the following actions would most likely resolve a high-pressure alarm on a volume-cycled adult ventilator? - ✔✔suction the patient

Which of the following medications should the respiratory therapist recommend to provide a neurmuscular blockade and facilitate intubation? - ✔✔Pavulon

A patient receiving oxygen by nasal cannula at 5 L/min complains of dryness of the nasal passages. The respiratory therapist notices the patient is using a bubble humidifier and that the reservoir is one quarter full. The respiratory therapist should help the patient by - ✔✔Adding sterile water to the reservoir

A patient's radiological image is reported to have hyperlucency with diffuse dry crackles auscultated throughout the chest. These findings are most closely associated with - ✔✔subcutaneous emphysema

After a motor vehicle accident causing blunt trauma to the chest, a male patient in the emergency room has air beneath the skin about the chest, neck and face. What would the respiratory therapist expect to auscultate in the affected areas? - ✔✔Dry crackles throughout

Which of the following could be a cause of a low-pressure ventilator alarm - ✔✔improved pulmonary compliance

A patient is being paralyzed and intubated in preparation to receive positive pressure ventilation with a volume-cycled ventilator in the control mode. Which of the following alarm settings is most important? - ✔✔low PEEP alarm

What radiographic findings are associated with active, untreated tuberculosis? - ✔✔Upper lobe cavitations

Which of the following weaning parameters would NOT be useful in determining whether the patient is ready for cessation of mechanical ventilation for a 75-kg (165-lb) male patient? - ✔✔MVV of 75 L in 15 seconds

A local college basketball team collapsed during a pre-game warm up after leaving a newly-constructed dressing room with an improperly-vented furnace. Multiple wavelength spectrophotometer readings suggest CO poisoning. To confirm this a respiratory therapist would evaluate - ✔✔COHb

A patient has a pulmonary artery catheter in place. The following data is obtained: PAP 10 torr CVP 1 torr PCWP 4 torr C.I. 1.8 L/min/m2 Which of the following is an accurate interpretation of this data? - ✔✔decreased right atrial filling pressure

A known COPD patient presents to the emergency room with extreme shortness of breath and copious amounts of thick, yellow sputum produced over the past three days.

Respiratory rate is 32/min. ABGs on 1 L/min nasal cannula are:

pH 7.45 PaCO2 47 torr PaO2 49 torr HCO3- 33 mEq/L BE +4.1 mEq/L The proper interpretation for the arterial blood gas is - ✔✔compensated respiratory acidosis

What is the humidity deficit for patient who is intubated if the relative humidity of the inspired gas is 25%? - ✔✔33 mg/L

A bronchoscope has been used on a patient with a staphylococcus infection. To properly sterilize the equipment, perform a - ✔✔15 minute soak in 13-day-old Cidex

The respiratory therapist should gather which of the following equipment in preparation for the administration of heliox therapy? - ✔✔non-rebreathing mask

Two days prior an 85 kg (187-lb), 168-cm (5-ft 6-in) female patient was placed on mechanical ventilation for acute respiratory failure secondary to pulmonary hypertension. She has the following data after a one-hour spontaneous breathing trial at an FIO2 of 0.40.pH 7.35 PaCO2 45 torr PaO2 75 torr HCO3- 24 mEq/L Respiratory Rate 34VT 375 ml What should the respiratory therapist do FIRST - ✔✔Place the patient on PCV

Which if the following is appropriate regarding suctioning? - ✔✔Increase suction duration within limits for thick secretions

A routine screening blood gas performed on an asymptomatic patient prior to surgery

shows the following:

pH 7.38 PaCO2 42 mm Hg PaO2 80 mm Hg HCO3- 26 mEq/L SaO2 96% COHb 24% What should the respiratory therapist do? - ✔✔Run quality control material and evaluate the accuracy of the Co-oximeter

A respiratory therapist should open the airway by using the jaw-thrust maneuver for a patient experiencing - ✔✔a serious motor vehicle accident

A newborn is experiencing nasal flaring, declining oxygen saturation values, tachypnea, and diminished breath sounds in the left lung following a meconium delivery. One possible cause of these findings is - ✔✔pneumothorax

Arterial blood gases on a patient in the emergency department are as follows:

pH 7.29 PaCO2 51 mmHg PaO2 70 mmHg HCO3- 25 mEq/L BE +4 mEq/L Which of the following represents an accurate interpretation of these results? - ✔✔uncompensated respiratory acidosis with mild hypoxemia

Which of the following is the best reason for reducing the high-pressure alarm limit for a patient who is receiving volume-cycled mechanical ventilation? - ✔✔increased lung compliance

A patient has an Hb level of 6.0 g/dL and the following blood gas results:

pH 7.55 PaCO2 27 mmHg PaO2 110 mmHg HCO3- 24 mEq/L BE 0 mEq/L Which of the following is an accurate statement? - ✔✔hyperventilation secondary to hypoxemia is present

What is the maximum negative pressure that should be used to suction a 4-year-old patient who is intubated with a 5.0 mm endotracheal tube? - ✔✔-100 mm Hg

After 15 seconds following birth, a neonate presents with vigorous crying and a strong cough. Obvious secretions and amniotic fluids are present from the airway and stomach. The baby has peripheral cyanosis. You would FIRST - ✔✔suction the mouth

A 3-year-old patient is demonstrating ventilatory difficulty with use of intercostal accessory muscles. The patient is febrile and is drooling. A softened inspiratory stridor is audible. Which of the following mostly likely represents the patient's condition? - ✔✔Acute epiglottitis

Which of the following assessment criteria all relate to APGAR scores? - ✔✔grimace, pulse, appearance, color