NBRC Practice Test #2 Questions and Answers, Exams of Occupational therapy

Download NBRC Practice Test #2 Questions and Answers and more Exams Occupational therapy in PDF only on Docsity! NBRC Practice Test #2 Questions And Answers After a patient undergoes a thoracentesis, the respiratory therapist notes that the obtained pleural fluid is clear with a slight straw color. This fluid is most likely the result of A. empyema. B. congestive heart failure. C. lung carcinoma. D. hemothorax. - correct answer Congestive Heart Failure The respiratory therapist is calibrating a spirometer and checking the volume with a 3.0 liter super syringe. the volumes recorded are 2.85L, 2.8L and 2.8L. Based upon the information obtained, which of the following is a correct statement? A. Another syringe needs to be used B. Spirometer is accurate C. The plunger was advanced too slowly D. Spirometer may have a leak - correct answer D. Spirometer may have a leak Which of the following is an indication for high frequency jet ventilation? NBRC Practice Test #2 Questions And Answers A. Bronchopleural fistula B. Wilson Mikity syndrome C Necrotizing lesion of right lung D. Centrilobular emphysema - correct answer Bronchopleural Fistula **(because it uses mean airway pressures & low tidal volumes to improve oxygenation and we do not want to worsen bp fistula) A 43 y/o female patient has just undergone a total abdominal hysterectomy. The pt arrives in the post anesthesia care unit obtunded with minimal response to painful stimulus. what treatment should the RT recommend for this pt? - correct answer Insert OPA (b/c they are unresponsive) What is the normal VD/VT ratio for a patient breathing room air? - correct answer 20-40% All of the following could cause a patient's right- hemidiaphragm to be elevated, EXCEPT: A. right lower lobe atelectasis B. right side hyperlucency, absent vascular markings NBRC Practice Test #2 Questions And Answers D. Emphysema - correct answer A. Pulmonary edema (and CHF!) Which of the formula will determine the total flow being delivered to a pt with a 28% venturi mask running at 6 L/min? - correct answer Total flow = 6 x 11 (flow factor for 28% = 10:1 = 11) A pt with end-stage pulmonary fibrosis is receiving O2 at 2L/min via a transtracheal oxygen catheter. The pt experiences an increased WOB and shortness of breath. The RT should do what? - correct answer Flush the transtracheal device with isotonic saline During bedside monitoring the RT notices a dampened waveform on the arterial line graphic. To restore the graphic to normal, what should the RT do? - correct answer Check the transducer dome for air bubbles An optimal PEEP study is initiated on a pt receiving mechanical ventilation. The RT first places the pt on a PEEP of 10 cm H20 for 20 mins with no adverse effects. The PEEP is increased to 15cm H20 and the pt's HR rises significantly with a severe fall in the BP. Based upon the NBRC Practice Test #2 Questions And Answers above info, what should the RT conclude that the pt is suffering from? - correct answer Hypovolemia A post-op thoracotomy pt is receiving incentive spirometry therapy Q2H. Breath sounds are diminished in the bases of the lungs with scattered crackles. the pt's inspiratory capacity has decreased over the past 2 days. A chest X-ray indicates thin-layered basilar densities. Which of the following has most likely occured? A. Atelectasis B. Pneumonia C. Pulmonary Edema D. Consolidation - correct answer A. Atelectasis The RT is in charge of transporting a pt with multiple trauma to a regional trauma center in a fixed wing aircraft. Which of the following should the RT be most concerned about during the transport? A. Tissue oxygenation B. Pneumothorax C. Pulmonary embolus NBRC Practice Test #2 Questions And Answers D. Humidification of the inspired gas - correct answer Tissue oxygenation Transcutaneous monitoring of PO2 values will correlate well with ABG PO2 values in which of the following situations? (Pick all that apply) A. Hypotension B. Hypothermia C. Pneumonia - correct answer Pneumonia only What is the air-to-oxygen ratio for an air entrainment device delivering 60% oxygen? - correct answer 1:1 Following surgery to correct an abdominal aortic aneurysm, a 54 y/o female pt suddenly develops intense substernal chest pain with severe dyspnea. the pain does not appear to be aggravated by her respiratioins. Auscultation reveals bilateral, basilar, moist, crepitant rales. The pt appears pale, cold and clammy. which of the following should the RT recommend for initial assessment of this pt? NBRC Practice Test #2 Questions And Answers microatelectasis, some investigators once recommended that periodic machine breaths that were 1.5-2 times the preset tidal volume be given 6-8 times per hour. However, the peak pressure often needed to deliver such a volume was high enough to predispose the patient to barotrauma. At present, accounting for sighs is not recommended if the patient is receiving tidal volumes of 10-12 mL/kg or if the patient requires PEEP. When a low tidal volume is used, sighs are preset at 1.5-2 times the tidal volume and delivered 6-8 times an hour if the peak and plateau pressures are within acceptable limits. A patient has just been intubated with a naso- tracheal tube and is being manually ventilated. As the therapist ventilates the patient, he notices that there is no chest movement, minimal breath sounds and air escaping from the mouth as the bag is squeezed. A chest x-ray has determined that the endotracheal tube is in the correct position. What is the most likely cause of this situation? - correct answer The cuff ruptured during intubation The therapist receives an order for postural drainage and vibration. With the bed flat, the therapist places the patient in a prone position with pillows under his hips. Which lung segments are being treated with this position? - correct answer Superior segment of the lower lobes NBRC Practice Test #2 Questions And Answers While using a pressure-cycled ventilator, an increase in the patient's static lung compliance will do what? - correct answer Increase the volume A patient is receiving controlled ventilation via a Bird Mark 7 ventilator. Suddenly, the ventilator will not cycle into expiration. This problem may be caused by: 1. development of pneumothorax. 2. disconnected expiratory valve. 3. leak in the patient tubing. 4. ruptured endotracheal tube cuff. - correct answer 2. disconnected expiratory valve. 3. leak in the patient tubing. 4. ruptured endotracheal tube cuff. Which of the following will increase the volume delivered to a patient on a pressure limited ventilator? 1. Decreasing the sensitivity 2. Increasing the flow setting 3. Decreasing the flow setting 4. Increasing the pressure setting - correct answer 3. Decreasing the flow setting 4. Increasing the pressure setting NBRC Practice Test #2 Questions And Answers A patient has been weaned from mechanical ventilation. The physician would like the patient's respiratory muscle strength evaluated to determine further weanability. The therapist should evaluate which of the following? 1. VDNT 2. VE 3. MIP 4. CST 5. VC - correct answer 3. MIP 5. VC A patient has reduced lung compliance. Which of the following approaches to ventilation would decrease the risk of barotrauma? - correct answer Flow cycled, pressure limited A change in airway resistance would be reflected by a change in what? - correct answer Dynamic Compliance NBRC Practice Test #2 Questions And Answers D. hydrochlorothiazide (Hydrodiuril) - correct answer A. sodium nitroprusside (Nipride) All of the following statements are true concerning NPPV ventilation EXCEPT: A. breaths are pressure controlled. B. two levels of CPAP are applied. C. breaths are flow triggered. D. it can be used for non-invasive ventilation. - correct answer A. breaths are pressure controlled. What is the correct formula to measure the static lung compliance of a patient on a volume-limited ventilator? - correct answer tidal volume + (plateau pressure - PEEP) Which artery should a therapist palpate when deciding whether to initiate chest compressions on an adult patient? - correct answer carotid The distribution of ventilation in the lungs is measured by: 1. Phase III of the SBN2 Elimination Test 2. N2 wash out time NBRC Practice Test #2 Questions And Answers 3. Ventilation lung scan - correct answer 1. Phase III of the SBN2 Elimination Test 2. N2 wash out time 3. Ventilation lung scan Measurement of the PD20% is significant for which of the following? - correct answer Airway hyperreactivity A patient's chest x-ray reveals increased vascular engorgement emanating from the hilar area in a bat-wing pattern. What is the most likely cause of this finding? - correct answer Fluid overload During bedside assessment, the therapist auscultates the patient's chest and determines that the patient has bilateral inspiratory and expiratory wheezing. This would imply the patient has - correct answer bronchospasm. Which of the following pieces of equipment would be LEAST appropriate for the victim of a house fire? A. Pulse oximeter B. Non-rebreather mask C. Arterial blood gas kit NBRC Practice Test #2 Questions And Answers D. CPAP system - correct answer A. Pulse oximeter A therapist obtains the following information from a patient: - Age 35 - HR 98 - f 22/min - Vt 200 mL - 68 kg/mL - Ht 5'11" A. has an increased deadspace to tidal volume ratio. B. has a 30% intrapulmonary shunt. C. is breathing effectively. D. should be started on oxygen therapy - correct answer A. has an increased deadspace to tidal volume ratio. When the FI02 setting on a large volume nebulizer is changed from 40% to 60%, which of the following will occur? 1. Total flow to the patient will increase NBRC Practice Test #2 Questions And Answers A patient with an artificial airway in place is being ventilated with a pressure cycled ventilator that will not cycle off at end- inspiration. What is the most likely problem? - correct answer the cuff has ruptured A change in airway resistance would be reflected by a change in: A. dynamic compliance. B. thoracic compliance. C. lung compliance. D. static compliance. - correct answer A. dynamic compliance. The first parameter to measure when a mechanically ventilated patient is placed on PEEP is: A. respiratory rate and cardiac rate. B. compliance. C. airway resistance. D. Pa02. - correct answer B. compliance. Which of the following would NOT occur when increasing the flowrate on a constant flow, volume-cycled ventilator that is in the control mode? NBRC Practice Test #2 Questions And Answers A. inspiratory time would decrease B. the I:E ratio would change C. the expiratory time would increase D. The minute ventilation would increase - correct answer D. The minute ventilation would increase During resuscitation efforts, the therapist notes that the resuscitation bag collapses easily when squeezed and there is no evidence of chest expansion. What would cause this to occur? A. A decrease in compliance B. An increase in airway resistance C. The endotracheal tube is in the right mainstem bronchus D. Malfunctioning inlet valve - correct answer D. Malfunctioning inlet valve A patient has been sent to Radiology for a PET scan. The patient is on oxygen at 5L/min. from an E cylinder reading 1500 psi. How long will the E cylinder last if run until empty? - correct answer 90 minutes A patient being weaned from mechanical ventilation has had his minute ventilation reduced from 12 L/min to 8 NBRC Practice Test #2 Questions And Answers L/min. Which of the following would be the best indicator that this patient should not be weaned at this time? A. Hyperventilation reducing PaC02 level B. Patient becomes agitated and combative C. Low pressure alarm is activated D. Low exhaled volume alarm sounds every breath - correct answer D. Low exhaled volume alarm sounds every breath To reduce the chance of transmitting an infection from patient to patient, the therapist should: A. wear gloves when dealing with patients. B. wear goggles when dealing with body fluids. C. wipe stethoscope with alcohol between patients. D. sterilize equipment with ethylene oxide. - correct answer C. wipe stethoscope with alcohol between patients. The respiratory therapist has analyzed the FI02 of a patient receiving 40% O2 via an aerosol mask. The therapist notes that the analyzed FI02 is 38%. The therapist should: A. re-analyze the F102. NBRC Practice Test #2 Questions And Answers ordered tidal volume is 750 mL. The cuff pressure is 5 mmHg. After insertion of 10 cc of air, the cuff pressure is still 5 mmHg. Which of the following should the therapist do at this time? A. Obtain a stat chest x-ray B. Extubate and reintubate C. Increase the FI02 to 1.0 D. Insert 10 cc of air into the cuff - correct answer B. Extubate and reintubate A patient's x-ray shows diffuse infiltrates in the lower lobes, auscultation reveals coarse rhonchi and rales bilaterally, and has a slight temperature is noted. Which of the following should the therapist recommend to improve her ventilation? A. Ultrasonic nebulizer B. Pulmonary drainage and percussion C. Continuous ventilation D. Oxygen therapy - correct answer B. Pulmonary drainage and percussion NBRC Practice Test #2 Questions And Answers The peak inspiratory pressure on a pressure-cycled ventilator is 30 cm H20. The RT decreases the inspiratory flow. This change would affect the: A. Respiratory Rate B. PEEP C. Expiratory time D. I:E ratio - correct answer I:E ratio A patient recently underwent a coronary artery bypass and is now receiving Incentive Spirometry QID. The patient's inspiratory capacity has diminished over the past several days and the patient is becoming increasingly short of breath. Chest radiograph shows left lower lobe consolidation with air bronchograms. What would the RT conclude that the patient has developed? - correct answer Pneumonia Which device would produce the greatest humidity output for a patient? - correct answer Ultrasonic nebulizer A patient is receiving continuous mechanical ventilation though an oral ETT. the RT notes that the high pressure alarm sounds continuously during inspriation and the pt NBRC Practice Test #2 Questions And Answers appears to be biting down on the ETT. Which of the following should the RT recommend? A. Change to a nasal ETT B. Add air to the cuff C. Add water to the humidifier D. Insert an OPA - correct answer D. Insert an OPA the physician informs the patient that the results of his polysomnogram indicate obstructive sleep apnea. Treatment for this disorder might include: A. Bronchial hygiene therapy B. Respiratory stimulants C. Tracheostomy D. Negative pressure ventilation - correct answer C. Tracheostomy Heliox therapy is indicated for treatment of patients with post extubation stridor because of the: A. Ability to effectively deliver NBRC Practice Test #2 Questions And Answers D. Chronic bronchitis - correct answer C. Tension Pneumothorax D. Chronic bronchitis How should the RT assemble a Bird Mark 7 respirator to deliver 40% O2 during an intermittent positive pressure breathing treatment? - correct answer Air-mix off and attached to a blender set at 40% A patient is being ventilated with a high frequency ventilator. The results of an ABG are as follows. pH: 7.29 PaCO2: 68 torr PaO2: 73 torr HCO3-: 25 mEq/L BE: +1 mEq/L What should the RT increase the: A. Driving Pressure B. Frequency C. Bias flow NBRC Practice Test #2 Questions And Answers D. I:E ratio - correct answer A. Driving Pressure Which of the following could NOT cause a capnography reading to change from 36 torr to 30 torr? A. Tachypnea B. Hyperventilation C. Pulmonary emboli D. ETT positioned in the right mainstem bronchus - correct answer D. ETT positioned in the right mainstem bronchus A tracheostomy tube has just been changed on a patient receiving continuous volume-cycled ventilation. The patient suddenly becomes dyspneic and develops crepitus around the tracheostomy stoma. the RT should: A. suction the patient B. insert a larger tracheostomy tube C. reposition the tracheostomy tube D. recommend an antihistamine - correct answer C. reposition the tracheostomy tube The most common hazard associated with insertion of a central venous catheter is: NBRC Practice Test #2 Questions And Answers A. PE B. Hypoxemia C. Rupture of the RA D. Pneumothorax - correct answer D. Pneumothorax During mechanical ventilation, a patient initiates the breath and then the ventilator controls the remaining variables for that breath. This describes a/an: A. Spontaneous breath B. Assisted breath C. Mandatory breath D. Supported breath - correct answer B. Assisted breath A 1600g neonate is receiving O2 by oxyhood at an FiO2 of 0.60. the flowmeter is set at 5L/min. While analyzing the O2, the RT notices varying FiO2 readings at a different locations inside the oxyhood. Which of the following should the RT do to correct the problem? A. Re-calibrate the O2 analyzing device B. Increase the flow to the oxyhood C. Place the neonate in an isolette at an FiO2 of 0.60 NBRC Practice Test #2 Questions And Answers is met as the catheter is introduced into the ETT. The RT should: A. Lubricate the catheter with petroleum jelly prior to suctioning B. Instill acetylcysteine into the ETT C. Switch to a 10 Fr suction catheter D. Extubate the patient and reintubate with a size 9 mm ID ETT - correct answer C. Switch to a 10 Fr suction catheter A patient is receiving oxygen at home via NC at 1 L/min. He has 50 feet of extension tubing attached to his oxygen concentrator. The patient complains that there does not seem to be enough oxygen flow reaching the cannula. The RT should recommend: A. Decreasing the length of the extension tubing B. Increasing the concentrator flow C. Changing to a liquid system D. Analyzing the FiO2 - correct answer A. Decreasing the length of the extension tubing A 58 y/o male patient is hypoxic on volume control ventilation and is receiving 15 cm H20 of PEEP on an FiO2 NBRC Practice Test #2 Questions And Answers 0.60. Shortly after increasing the PEEP therapy to 18 cm H20, the RT notes that the systemic blood pressure has fallen from 110/72 mm Hg to 94/50 mm Hg and the cardiac output has fallen from 4.3 L/min to 2.5 L/min. The most appropriate action at this time would be to: A. maintain the present therapy and re-evaluate the patient in thirty minutes B. decrease the PEEP to 15 cm H20 and increase the FiO2 to 0.70 C. decrease the PEEP to 12 cm H20 and maintain the FiO2 at 0.60 D. discontinue the PEEP and increase the FiO2 to 0.80 - correct answer B. decrease the PEEP to 15 cm H20 and increase the FiO2 to 0.70 What is the correct formula to calculate the static lung compliance of a patient receiving mechanical ventilation? - correct answer Tidal volume / (plateau pressure - PEEP) All of the following statements regarding an O2 concentrator are correct EXCEPT: A. provides an unlimited supply of oxygen B. increases alveolar oxygen tension NBRC Practice Test #2 Questions And Answers C. provides 100% oxygen at high flow rates D. removes nitrogen from the room air - correct answer C. provides 100% oxygen at high flow rates