Review Tests

Question 1

Which of the following is the recommended care of the ventilator circuit for prevention of VAP?

1. The vent circuit must be changed every 4 days
2. Closed sx systems are recommended
3. Circuit condensate should be used to instill the patient
4. Passive humidifiers can be safely used for 48 hours

Answer 1

2 and 4

The ventilator circuit should be changed every 7 days. Closed suction is recommended as you do not have to break the circuit in order to suction. Only distilled water should be used to instill the patient/ Passive humidifier can be used for 48 hours.

Question 2

2. Which of the following is the most common cause of community acquired pneumonia?
3. Staphylococcus aureus
4. Pseudomonas aeruginosa
5. Escherichia coli
6. Diplococcus pneumonia

Answer 2

Diplococcus pneumonia

Question 3

3. What question does ethics try to answer

Who is right

What treatment is best

Who benefits the most

How should we act

Answer 3

How should we act

Question 4

4. A patient on mechanical ventilation has a compliance of 90 mL/cmH2O and an airway resistance of 5.0 cmH2O/L/sec. what is the calculated time constant?
5. 45 sec

B.1.35 sec

C. 4.5 sec

D. 450 sec

Answer 4

a. 0.45 sec
5. 0 cmH2O/L/sec x 0.09 L/cmH2O= 0.45 seconds

Question 5

Time Constant Equation

Answer 5

Compliance x Resistance

Question 6

Which of the following best defines the term sterilization?

a. Use of chemicals to destroy pathogens
b. Process that destroys all forms of microbial life
c. Process of sanitization
d. Use of soap and water to aid in removal of soil/body secretions

Answer 6

b. Process that destroys all forms of microbial life

Question 7

During an allergic reaction there is an increase in circulating antibody

a. IgA
b. IgD
c. IgE
d. IgG
e. IgM

Answer 7

c. IgE

Question 8

3. Which of the following is incorrect in regards to the body’s normal flora
   a. They will not cause harm as long as they stay in the expected site
   b. They are different from person to person for a given site
   c. If they are removed from a site, opportunistic microorganism may take over
   d. They are found on the skin and some mucous membranes

Thrush is an example of abnormal flora

Answer 8

a. They will not cause harm as long as they stay in the expected site
b. They are different from person to person for a given site

Thrush is an example of abnormal flora

Question 9

Which of the following statement is/are true regarding pressure differences

a. The apical alveoli resting volume is less than basal
b. Pleural pressure at the base is more negative than at the apex
c. Transpulmonary pressure gradient is greatest at apex
d. All state are true

Answer 9

c. Transpulmonary pressure gradient is greatest at apex

Apical should be more negative than the basal.

Question 10

Which of the following could result in a higher than normal SvO2

a. Decreased CO -would increase SvO2, more time to pull O2 out
b. Pyrexia - increase in metabolic rate, increase O2
c. Decreased oxygen extraction ratio
d. All of the above

Answer 10

c. Decreased oxygen extraction ratio

A higher than normal SvO2 means you are not extracting so a decrease CO means you have more time to pull it out.

Question 11

Which of the following best defines the term sterilization?

a. Use of chemicals to destroy pathogens
b. Process that destroys all forms of microbial life
c. Process of sanitization
d. Use of soap and water to aid in removal of soil/body secretions

Answer 11

b. Process that destroys all forms of microbial life

Question 12

During an allergic reaction there is an increase in circulating antibody

a. IgA
b. IgD
c. IgE
d. IgG
e. IgM

Answer 12

c. IgE

Question 13

Tank Calculation

Answer 13

Duration of Flow =

Oxygen Tank Conversion Factor * Remaining Tank Pressure (psi) / Continuous Flow Rate (L/min)

Question 14

Oxygen Cylinder Conversion Factors

D Tank

Answer 14

D Tank = 0.16

Question 15

Oxygen Cylinder Conversion Factors

E Tank

Answer 15

E Tank = 0.28

Question 16

Oxygen Cylinder Conversion Factors

G Tank

Answer 16

G Tank = 2.41

Question 17

Oxygen Cylinder Conversion Factors

H/K Tank

Answer 17

H/K Tank = 3.14

Question 18

Oxygen Cylinder Conversion Factors

M Tank

Answer 18

M tank = 1.56

Question 19

Total Arterial O2 Content

Answer 19

CaO2= (1.34 x Hb x SpO2) + (PaO2 x 0.003)

Question 20

How to Determine Pt Inspiratory Flow

Answer 20

Flow= Volume (L)/time (min)

Question 21

Determining the total flow in a high flow delivery device

Answer 21

If air/O2 is for example 30 then it is 8:1 so for every 1 litre of oxygen 8 L is being entrained into the device

for total flow add the two toegther (=9) and then multiple by the set flow

Question 22

Calculating Flow in Liquid Oxygen System

Answer 22

Gas Remaining= (Liquid Weight [lb]) x 860/ 2.5 L/Ib

Duration of Contents (min)= Gas Remaining (L)/ Flow (L/min)

Remeber 1 L of Liquid O2 = 2.5 lb

Question 23

P_AO₂ Calculation

Answer 23

[(P_baro-47) x FiO₂] - (PCO₂*1.25)

P_baro in Calgary is 670mmHg

Question 24

P_A-aO₂ Calculation

Answer 24

PAO₂- PaO₂

Normal in a young adult >4 (5-10)

The A–a gradient will increase with age. For every decade a person has lived, their A–a gradient is expected to increase by 1 mmHg.

A conservative estimate of normal A–a gradient is less than [age in years/4] + 4.

Question 25

PAO2/ PaO2

Answer 25

PAO2/ PaO2 Normal \>0.60

Question 26

P/F Ratio

Answer 26

PaO2/FiO2 Normal 400-500

Question 27

CaO2 Vol%

Answer 27

(Hb x 1.34 x (SO2/100)) + (PO2\*0.003) Normal 16-20

Question 28

CvO2 Vol%

Answer 28

(Hb x 1.34 x (Sv2/100)) + (Pv2\*0.003) Normal 12-15

Question 29

C(a-v)O2

Answer 29

CaO2-CvO2 Normal = 5

Question 30

CcO2

Answer 30

(Hb\*1.34) + (P_AO2\* 0.003) Normal = 20

Question 31

VO2 ml/min

Answer 31

CO x Ca-vO2 x 10 Normal 200-300

Question 32

VO2/ml/kg/min

Answer 32

(VO2/ml/min) / Pt body wieght in kg Normal 3.5-4

Question 33

O2 Del ml/min

Answer 33

CaO2 Vol% \* CO \* 10 Normal 1000

Question 34

O2 Del/kg/min

Answer 34

(O2 Del ml/min) / Pt weight in Kg Critical is 8-10

Question 35

Qs/Qt% Classic

Answer 35

(CcO2-CaO2)/ (CcO2-CvO2 vol%) Normal \<10

Question 36

Qt (Fick) L/min

Answer 36

250/ (Ca-vO2\*10) Normal 5-8

Question 37

Normal Hemoglobin Levels

Answer 37

Men 13.8-17.2 Women 12.1- 15.1

Question 38

Compliance Calculation

Answer 38

Complicance (ml/cmH2O) = Vt / (Pplat-PEEP) Normal 60 to 100 ml/cm H2O

Question 39

Resistance Calculation

Answer 39

R= (PIP- Pplat)/ Flow Use L/sec for flow

Question 40

Minute Ventilation Calculation

Answer 40

MV = Rate \* Vt On a ventilator try to aim for 10 x IBW

Question 41

FiO2 Required

Answer 41

FiO2 required = (PaO2 Desired \* FiO2 Present) / PaO2 initial ABG PaO2 Desired is usually established to give a safe SpO2 of between 90% - 95%

Question 42

New PaCO2 Desired

Answer 42

New PaCO2 Desired = Present PaCO2 – [ (pH Goal – pH Present) / 0.01} pH Goal: is usually established with the physicians orders but should be above 7.25 Note: this equation is used usually to correct for accidosis and is only an approximation

Question 43

MV Required

Answer 43

MV required = (PaCO2 Initial \* MV) / PaCO2 desired

Question 44

I:E

Answer 44

I:E = Ti/Ti : Te/Ti - given has whole numbers ex: 1:4.5

Question 45

TCT

Answer 45

TCT = 60/Rate

Question 46

Ti

Answer 46

Ti = Vt/Flow Use L for Vt, and L/sec for flow

Question 47

Te

Answer 47

Te = TCT – Ti

Question 48

Ideal Body Weight​

Answer 48

Men: Kg = 50 +2.3(height in inches – 60) Women: Kg = 45.5 + 2.3(height in inches – 60)

Question 49

PA-aO2

Answer 49

A measure of the difference between alveolar concentration of oxygen and the arterial concentration of oxygen. It is used to diagnose the source of hypoxemia. The measurement helps isolate the location of the problem as either intrapulmonary (within the lungs) or extrapulmonary (elsewhere in the body). Ex. In high altitude arterial oxygen (PaO2) is low due to the fact that alveolar oxygen PAO2 is also low, where with V/Q mismatch (pulmonary embolism or right to left shunt oxygen is not effectively transferred for alveoli

Question 50

Increased P_A-aO₂

Answer 50

An increased PA-aO2 suggests a **defect in diffusion, V/Q mismatch, or right to left shunt** A high A–a gradient could indicate a patient breathing hard to achieve normal oxygenation, a patient breathing normally and attaining low oxygenation, or a patient breathing hard and still failing to achieve normal oxygenation. If lack of oxygenation is proportional to low respiratory effort, then the A–a gradient is not increased; a healthy person who hypoventilates would have hypoxia, but a normal A–a gradient.

Question 51

A–a gradient and Respiratory Effort

Answer 51

CO₂ is easily exchanged in the lungs and a **low PCO₂ directly correlates with high minute ventilation**; therefore a low PaCO2 indicates that extra respiratory effort is being used to oxygenate the blood. A low PaO2 indicates that the patient's current minute ventilation (whether high or normal) is not enough to allow adequate oxygen diffusion into the blood. Therefore, the A–a gradient essentially demonstrates a high respiratory effort (low arterial PCO2) relative to the achieved level of oxygenation (arterial PO2). At an extreme, high CO2 levels from hypoventilation can mask an existing high A-a gradient. This mathematical artifact makes A-a gradient more clinically useful in the setting of hyperventilation.

Question 52

What RR to Set

Answer 52

Inital MV Goal/ Vt Goal

Question 53

What Should Be You Inital Goal in MV

Answer 53

IBW x 100

Question 54

. What type of lung unit(s) would result in a long time constant a. Decreased airway resistance b. Decrease Elastance c. Decrease Compliance - causes a decrease in TC d. Decreased Surfactant - causes a decrease in C TC = R\*C

Answer 54

**b. Decrease Elastance-Will increase compliance** TC = R\*C Decrease Compliance - causes a decrease in TC Decreased Surfactant - causes a decrease in C

Question 55

Mechanical ventilation is indicated for which of the following blood gases done on room air? a. pH 7.23, PaCO2 56 mmHg, PaO2 76 mmHg, HCO3 23 mmol/L b. pH 7.34, PaCO2 46 mmHg, PaO2 51 mmHg, HCO3 24 mmol/L c. pH 7.31, PaCO2 50 mmHg, PaO2 46 mmHg, HCO3 24 mmol/L d. All of the above e. A and B only

Answer 55

a. pH 7.23, PaCO2 56 mmHg, PaO2 76 mmHg, HCO3 23 mmol/L We are just looking at the cut off of pH of \< 7.25

Question 56

Regarding the thoracic pump, which of the following isnot true a. During PPV there is an increase cardiac stroke volume b. During spontaneous breathing there is increase venous return c. During PPV there is an increased central venous pressure d. During spontaneous breathing the thoracic pump is most effective during inspiration

Answer 56

a. During PPV there is an increase cardiac stroke volume During PPV we have an increase thoracic pressure and decreased venous return so we fill up less and then via Starling Law we contract less

Question 57

10. Positive pressure ventilation results in a. Increase dead-space ventilation b. Decreased dead-space ventilation c. Decreased intrathoracic pressure d. A and C e. B and C

Answer 57

a. Increase dead-space ventilation

Question 58

The phase variable that begins the inspiratory phase is called ___________ that ends in the inspiratory phase called the \_\_\_\_\_\_\_\_\_ a. Trigger, limit b. Trigger, cycle c. Cycle, trigger d. Limit, cycle

Answer 58

b. Trigger, cycle

Question 59

In a volume controlled breath, as the patient’s compliance increases the pressure _______ and the tidal volume \_\_\_\_\_\_\_\_\_ a. Decrease, Decrease b. Increase, Remain the Same c. Decrease, Increase d. Decrease, Remains the Same

Answer 59

d. Decrease, Remains the Same

Question 60

Starling Law of Capillaries state that a. The volume of fluid and solutes reabsorbed is normally nearly as large as the volume filtered b. The volume of fluid and solutes reabsorbed is normally larger than the volume filtered c. The volume of fluid and solutes filtered at the arterial end is less than the volume of fluid and solutes filtered at the venous end d. The pressure of the fluids and solutes filtered is normally less than the pressure reabsorbed.

Answer 60

a. The volume of fluid and solutes reabsorbed is normally nearly as large as the volume filtered

Question 61

Which of the following represents the correct pathway of impulse conduction through the heart a. AV Node, SA Node, Conduction Myofibers, purkinje fibres b. AV Node, Bundle Branches, SA Node, Purkinje Fibers c. SA Node, AV Node, Bundle Branches, Conduction fibres d. SA Node, Bundle Branches, AV Node, Conduction myofibers

Answer 61

c. SA Node, AV Node, Bundle Branches, Conduction fibres

Question 62

The T-Wave in lead II ECG represents a. Onset of atrial depolarization- P wave b. Onset of ventricular depolarization-QRS c. Atrial repolarization-Will get lost in QRS complex d. Ventricular repolarization

Answer 62

d. Ventricular repolarization

Question 63

main pressure promoting reabsorption of fluid into the capillaries is the: a. Osmotic pressure of interstitial fluid b. Hydrostatic pressure of the interstitial fluid c. Osmotic pressure of the capillary d. Hydrostatic pressure of capillary e. Oncotic pressure of interstitial fluid

Answer 63

**c.** **Osmotic** **pressure of the capillary** ## Footnote Hydrostatic pressure of capillary - pressure due to fluid - will push fluid out Osmotic pulls fluid in (caused by solute concentration); oncotic pushes fluid out (due to difference in protein concentration)

Question 64

Pursed lip breathing when done properly, may result in which of the following a. Equal pressure point moves down to smaller airways-Will move to the larger airways b. Decreased early airway collapse c. Increase expiratory flow rates-We are adding an obstruction to the flow d. B and C

Answer 64

b. Decreased early airway collapse

Question 65

A blending device is mixing 11.3 L of air with 4.7 L of oxygen. What FiO2 is the device producing? a. 0.4 b. 0.45 c. 0.5 d. 0.55

Answer 65

b. 0.45 ## Footnote (11.3 L (air) \* 0.21 + 4.7 L (O2)) / 16 = 0.44

Question 66

When we are using a full “D” tank oxygen cylinder for transport. The clinician set the flow rate on prongs to deliver 4 LPM; the approximate duration of flow would be a. ~15 min b. ~30 min c. \>1 hour d. \>2 hour

Answer 66

c. \>1 hour ## Footnote D = 0.16 L/psi 2200 psi or (subtract 500 for safety buffer) = 1700 psi → answer works for both

Question 67

Which of the following statement is/are true regarding cyanosis a. Polycythemia patient may show signs of cyanosis but may not be hypoxemic b. All polycythemic patient that show signs of cyanosis are hypoxemic c. In anemic patients, cyanosis is an early indicator of hypoxemia d. All of the above are true

Answer 67

a. Polycythemia patient may show signs of cyanosis but may not be hypoxemic

Question 68

A patient has been admitted to the coronary care unit after a myocardial infarction involving left side of the heart. The following information is collected from ABG while the patient is on room air. Hb 154 g/L pH 7.48, PaCO2 31 mmHg, PaO2 54 mmHg, HC3 22 mmol/L, BE -1, SaO2 87% What are the indications for O2 therapy for this patient? i) Hypoxemia ii) Hypercarbia iii) To decrease myocardial workload iv) Anxiety

Answer 68

1 and 3

Question 69

A young man presents to ER in Red Deer (667 mmHg) with neck trauma after bike crash. Given O2 via mask (FiO2 0.8). Initial ABG: 7.32/54/ A-a DO2? 388 348 362 484

Answer 69

362

Question 70

Keeping the absolute humidity constant. As the temperature of the air ___ the relative humidity will \_\_\_\_\_\_. Increase, increase Increase, decrease Decrease, decrease A & C None of the above

Answer 70

Increase, decrease ## Footnote Temp increase can hold more water, but abs. Is constant

Question 71

# Choose the true statements regarding Bourdon pressure gauges. i) a coiled metal tube has a sub-atmospheric pressure introduced to it ii) the display needle should periodically be “zeroed” iii) are used to measure changes in pressure iv) will straighten in response to an increase in pressure

Answer 71

ii, iii, iv

Question 72

The CARTA code of Ethics instructs us to “guard against conflicts of professional interest” and to specifically consult the _______________________ to prevent a real or perceived conflict of interest? Who is the individual/or department that Alberta RRTs are to consult? The Alberta Health The CARTA Registrar The alberta department of justice Your employer

Answer 72

The CARTA Registrar

Question 73

To maintain your clinical competency in Alberta you must complete _______ hours of practice over a five year period. How many hour of practice are needed? a. 48 b. 500 c. 720 d. 1600

Answer 73

c. 720

Question 74

Bess is a 73 year old woman who has come into the emergency department complaining of severe chest pain and SOB. SpO2 is 77% on room air. You put her on 5 LPM oxygen via nasal cannula and begin your assessment. You observe that she is a heavy set woman who is currently sitting up with her arms pressed straight down on the mattress. She has obvious accessory muscle use and is markedly cyanotic around the lips. She has a productive cough, and is bringing up thick yellow sputum. When you ask her is she normally has a productive cough, she says usually she cough up about a half a cup of grey sputum in the morning. Her cough is generally more prevalent through the winter months. She has a RR of 37 bpm and a pulse rate of 130 bpm. Her temp is 38.8 C and SpO2 is now 87%. Bess describes her chest pain as “sharp and stabbing” and gets worse with inhalation. She is speaking in 2 word sentences. 28. Based on your finding so far, what is most likely to be Bess’ underlying diagnosis a. COPD, Chronic Bronchitis b. COPD, emphysema c. COPD, asthma d. COPD, bronchiectasis e. Cystic Fibrosis

Answer 74

a. COPD, Chronic Bronchitis ## Footnote Sputum is grey, which is often seen in chronic bronchitis. Grey in the sputum indicates dead cells. Bronchiectasis can have a dry cough or a lot of sputum The fever hints more towards chronic bronchitis Ways to make this question better- Add in a ABG to show and acute on chronic condition. Add into case stem that the sputum is smelling. And/or include and x-ray report which will not show any dilation. Your will mostly find the difference between chronic bronchitis and bronchiectasis in the x-ray

Question 75

skeptical of her asthma diagnosis. Why? i. Asthma is usually diagnosed before the age of 40 ii. The cough she describes is a cardinal sign of bronchiectasis iii. If she had asthma, swallowing the little pills would help iv. The grey puffer is not usually prescribed to asthmatics v. Cigarette smoking is not causal for asthma

Answer 75

I, IV, V

Question 76

What is the root cause of the distended neck veins, severely clubbedfingers and pitting peripheral edema? a. Severe chronic hypercapnia B. Severe chronic acidemia C. Severe chronic hypoxemia D. Severe chronic hypocapnia

Answer 76

C. Severe chronic hypoxemia

Question 77

Bess likely has: Left ventricular insufficiency Cor pulmonale Right sided heart failure None of the above b and c

Answer 77

b and c

Question 78

Once the CVP is in place, the transducer is leveled appropriately and zeroed. The monitor is showing a good waveform, with an a wave, … Volume overload Pulmonary hypertension VSD Pulmonary embolism

Answer 78

Pulmonary hypertension

Question 79

As you are monitoring Bess you notice that her “a” wave has disappeared from her CVP waveform. This is an indication that: a. The transducer is sitting below the level of the right atrium b. Bess has stopped breathing c. The tricuspid valve is incompetent causing regurgitation of blood into right atrium d. The atria are not contracting, Bess is in atrial fibrillation

Answer 79

d . The atria are not contracting, Bess is in atrial fibrillation

Question 80

Intrepret this ABG ABG: pH 7.56, PaCO2 26 mmHg, PaO2 61 mmHg, HCO3 22 mmol/L, BE 1, SaO2 90

Answer 80

c. Uncompensated respiratory alkalosis

Question 81

Minimum flow rate for simple mask

Answer 81

5 LPM is the minimum flow rate for a simple mask so that it can flush out the CO2.

Question 82

) Which of the follow is recommended for initial mechanical ventilator settings? Pt is unconscious, sedated and medically paralyzed a. CMV VC, f 16 br/min, Vt 550 mls, PEEP 5 b. IMV VC, f 14 br/min, Vt 750 mls, PEEP 5 c. CMV APV, f 18 br/min, Vt 600 mls, PEEP 3 d. CSV PC, pressure support 10 cmH2O, CPAP 5

Answer 82

a. CMV VC, f 16 br/min, Vt 550 mls, PEEP 5

Question 83

It is determined the patient has a refractory hypoxemia, which of the following would be the course of action at this time a. Increase FiO2 b. Increase RR c. Increase the tidal volume d. Increase the PEEP

Answer 83

d. Increase the PEEP

Question 84

You are paged to the ED to assess a patient brought in VS: Bp 158/108 mmHg, pulse 137 bpm and irregular. Her oxygen 38. Which of the following is the correct action given the patients oxygen status. 1. Apply a 50% air entrainment ventimask system to maximize forward flow 2. Apply a 70% large vol neb bc she is breathing so rapidly, she will soon become dehydrated 3. Apply a nrb bc it’s quick and easy to set up 4. Do not start O2, she may be a CO2 retainer

Answer 84

1. Apply a nrb bc it’s quick and easy to set up

Question 85

Her elevated HR may be due to Stimulation of the parasympathetic branch of the autonomic nervous system Secondary to the pain she is in Due to an attempt by her heart to maintain cardiac output All of the above b & c

Answer 85

b & c

Question 86

The CXR in addition to confirming the flail, shows a large white area obscuring the lower half of the left lung and blunting of the costophrenic angle. The ED physician also makes note of these findings and asks you to assist with the insertion of a chest tube. 40. What could cause blunting of the costophrenic angle in this case? Pneumothorax Pneumomediastinum Hemothorax All of the above A & B

Answer 86

Hemothorax

Question 87

Give the substance to be drained, it is more probable that the physician will insert a large bore chest tube Into the 2nd intercostal space, mid-clavicular line Superiorly, as air rises Inferiorly, as fluid is gravity dependent Along the inferior surface of any rib

Answer 87

Inferiorly, as fluid is gravity dependent

Question 88

You set up a drythoracic drainage unit. How much water will you put into the suction control chamber? a. None b. Fill it to 2 cm c. Fill it to the 20 cm mark d. Start at 10 cm and slowly

Answer 88

a. None

Question 89

The patient is intubated and placed on a mechanical ventilator, during a mandatory inspiration you observe tidaling in the underwater seal of the thoracic drainage unit. Which direction is it observed? Move towards the suction control chamber Moves toward the patient Moves away from the patient Tidaling should never be observed in the underwater seal

Answer 89

Moves away from the patient

Question 90

What is the mode of action of singulair a. B2 Selective Bronchodilator b. Anti-inflammatory Leukotriene Receptor c. Oral Corticosteroid d. IgI Blocker

Answer 90

b. Anti-inflammatory Leukotriene Receptor

Question 91

A 25 year old female was admitted to the emergency department in hemorrhagic shock following a gunshot wound. She received fluid administration to treat her bleeding and was stabilized. Following placement of a pulmonary artery catheter the following data was collected. Interpret the hemodynamic data. PAP 48/32 mmHg PCWP 22 mmHg CVP 15 mmHg C(a-v)O2 2.6% 1. Cor pulmonale 2. Pulmonary hypertension 3. Hypervolemia 4. Hypovolemia

Answer 91

Hypervolemia ## Footnote PAP is high PCWP is high CVP is high (backing up to right side of the heart). C(a-v)O2 is low. Her blood is diluted because she was given too much fluid.

Question 92

Which of the following is/are the major characteristic of increased alveolar dead=space Minute ventilation out of proportion to PaCO2 Decreased WOB Hyperoxemia FiO2 \>0.50 and PaO2 \<50 mmHg A and C only

Answer 92

Minute ventilation out of proportion to PaCO2 Increase amount of air that is not participating in gas exchange so you are moving more air in and less air out, you would have increased WOB, you would have hypoxemia not hyperoxemia.

Question 93

Which of the following is the body’s main means of heat loss at high environmental temperatures? Evaporation Conduction Convection Radiation

Answer 93

Evaporation

Question 94

Which of the following statements refer to EF? The portion of EDV ejected on each beat Amount of blood in the ventricle at end of diastole Amount of blood ejected into the ventricle after each atrial contraction All of the above A and C only

Answer 94

The portion of EDV ejected on each beat Most of atrial contraction is passive which is why the amount of blood ejected into the ventricle after the atrial contraction will not be equal to portion EDV ejected.

Question 95

Amphotericin B is used to treat: Systemic bacterial infections Systemic Fungal infections Pulmonary fungal infections B and C only

Answer 95

B and C only

Question 96

Which of the following describes a mode of ventilation that would best preserve tidal volume when a patient’s lung/thorax compliance increases? Pressure cycled Pressure limited, time cycled mode Volume limited, time cycled mode Pressure limited, flow cycled mode

Answer 96

Volume limited, time cycled mode If compliance decreased the answer would be the same.

Question 97

Which of the following does not cause an increase in measured pcwp? Hypervolemia Left ventricular failure Mitral stenosis 3rd spacing

Answer 97

3rd spacing ## Footnote 3rd spacing would result in a lower wedge pressure

Question 98

You have a liquid system and a patient that requires a flow of 4 LPM. The liquid oxygen unit weighs 4100g. How long does the patient have for their oxygen usage? Approximately 8.3 hours Approximately 9.5 hours Approximately 11 hours Approximately 13.3 hours None of the above

Answer 98

Approximately 13.3 hours ## Footnote 1 L(liq) = 1.1 kg(liq); 1L liq = 860 L gas

Question 99

In the face of significant back-pressure, which of the following devices would read accurately? A device with a needle valve and a multiple orifice flowmeter. A device with a needle valve and a variable orifice flowmeter. A regulator with a bourdon gauge pressure and flowmeter. A regulator with a set pressure and multiple orifice flowmeter.

Answer 99

A device with a needle valve and a variable orifice flowmeter. Thorpe tube

Question 100

Which of the following cannot easily be configured to be a fixed performance device at low FiO2’s? 1. Nasal cannula 2. Large volume cold neb 3. Air entrainment mask/ventimask 4. Simple mask

Answer 100

1, 4

Question 101

Of the following, the proper device to supply humidified oxygen for a spontaneously breathing patient with an endotracheal tube in place is? Venti mask with entrained aerosol/humidity Venti mask with trach adaptor LVN with a trach cradle LVN with a t-piece

Answer 101

LVN with a t -piece

Question 102

. A patient is breathing a rate of 12 br/min. Their tidal volume is 450 mL/breath, and they are on a large volume nebulizer at an FiO2 of 0.35 with a set O2 flow of 12 LPM. Is this likely to be a fixed performance device AND what approximate FiO2 is the patient receiving? Yes/=0.35 No/\<0.35 No/\>0.35 Cannot calculate Yes/\<0.35

Answer 102

Yes/=0.35 ## Footnote Magic box: 64 lpm total flow rate, TCT = 5, if I:E = 1:2 (assumed), ti = 1.67s .450L / 1.67s = 0.28L/s = 16.9 lpm If the flow being delivered (64 lpm) is higher than the flow the patient is generating (16.9 lpm), it is a fixed device. \* When information is given to us about a patient’s breathing pattern, it is more than just determining a fixed performance device using the “rule of 60”. We must consider how they are breathing. This patient is breathing at a slower rate, indicating that he’s not that air hungry, and so giving us a better idea that the flows that they are generating are not that high (and therefore, the flows being delivered are likely higher than what the patient is generating). If the patient was breathing at a faster rate, this would change their I:E, therefore changing the flow the patient is generating, potentially changing whether or not the device is fixed for them.

Question 103

Patients on high FiO2s that suddenly experience mucous plugging of a large airway are in danger of: Increased dead-space ventilation Decreased CO Absorption atelectasis

Answer 103

Absorption atelectasis

Question 104

Entering a patient care room you see the cold neb (CN) is set to deliver 28% oxygen and the oxygen flow meter is set at 6 LPM. The total flow from the CN is: 24 LPM 32 LPM 48 LPM 60 LPM 72 LPM

Answer 104

60 LPM

Question 105

What is the RH when the AH is 15 mg H2O/L and the capacity of a gas is 20.6 mg H2O/L? 15% 20% 30% 72%

Answer 105

72%

Question 106

Regarding the cardiac waveform below, please identify where the distal port of the PAC catheter is sitting at the section of the waveform labeled “A”?

Answer 106

Pulmonary artery Proximal port would be R. atrium

Question 107

Application of nasal CPAP to neonates can: Be used to treat apnea associated with intraventricular hemorrhage Treat babies with necrotizing enterocolitis Be used immediately post-extubation Used immediately post-delivery in babies with congenital diaphragmatic hernia None of the above

Answer 107

Be used immediately post-extubation

Question 108

Defibrillation: Results in depolarization of just the ventricles Is an effective electrical treatment for ventricular fibrillation Can be used to treat asystole B and C only

Answer 108

Is an effective electrical treatment for ventricular fibrillation

Question 109

What effect do glucocorticoids have on beta adrenergic receptors? No effect Stimulates B2 receptors to relax bronchial smooth muscles restores/enhances responsiveness of B2 receptors to B2 specific agents Inhibits mast cell release

Answer 109

restores/enhances responsiveness of B2 receptors to B2 specific agents

Question 110

COPD pts who have OSA: Have worse nocturnal desats compared to someone with only OSA Often have nocturnal hypoventilation due to impaired ventilatory mechanics during sleep Have a higher rate of mortality then someone who has only OSA All of the above A and C only

Answer 110

All of the above

Question 111

Which of the following is a contraindication to hyperbaric therapy? Cleft palate Pleural effusion Pneumothorax Restrictive lung disease

Answer 111

Pneumothorax

Question 112

Which of the following is considered the main mechanism by which hypertonic aerosols aid mucociliary clearance? Increased stimulation of the irritant cough reflex Alterations of peak insp airway resistance Enhanced sensory somatic nervous impulses Altering the pH level

Answer 112

Increased stimulation of the irritant cough reflex

Question 113

Any device used for chest drainage must have which basic component: A separate underwater seal chamber Continuous low suction Collection chamber placed below the insertion site to facilitate gravity drainage A suction control chamber filled with water

Answer 113

A separate underwater seal chamber Water seal is a one way valve

Question 114

Which of the following statement is true regarding DPI? They are good for all age groups They do not require a spacing device Laminar flow from the use during inspiration is needed to create an aerosol They are cumbersome to carry

Answer 114

They do not require a spacing device

Question 115

A 79 year old male presents to the ER, he is currently sitting on the edge of the bed leaning forward. On exam: he has an increased AP thoracic diameter, a prolonged expiratory phase, is using his accessory muscles and is pursed lip breathing. He complains of shaking chills last evening and SOB at rest. He states that he smoked 1.5 packs/day of cigarettes for 35 years but that he quit smoking 10 years ago. 30. Which of the following should be assessed first? Sputum collection for C&S RR ABG Auscultation

Answer 115

RR

Question 116

Based on his initial presentation, what type of lung disease is predominate in this patient? Restrictive lung disease due to suspected pneumonia Obstructive lung disease due to apparent pneumonia Infectious lung disease due to apparent pneumonia Obstructive lung disease secondary to cigarette smoking Restrictive lung disease secondary to cigarette smoking

Answer 116

Obstructive lung disease secondary to cigarette smoking

Question 117

Coronary artery disease may be diagnosed with which of the following? Cardiac enzymes V/Q scan Cardiac angiogram All of the above a and c only

Answer 117

Cardiac angiogram

Question 118

In compensating for heart failure, the body will: Increase blood volume Dilate the peripheral vasculature Decrease the HR Increase the urine output

Answer 118

Increase blood volume

Question 119

Which of the following is a risk factor for the development of an aortic aneurysm? Systemic HTN COPD Family history of AAA All of the above a and c only

Answer 119

a and c only

Question 120

Your patient has a severe tricuspid valve stenosis. A hemodynamic profile consistent with this would be: CVP 14 mmHg, PAP 35/29 mmHg, PCWP 4 mmHg CVP 2 mmHg, PAP 10/6 mmHg, PCWP 4 mmHg CVP 14 mmHg, PAP 11/6 mmHg, PCWP 3 mmHg CVP 16 mmHg, PAP 33/26 mmHg, PCWP 21 mmHg CVP 19 mmHg, PAP 19/12 mmHg, PCWP 7 mmHg

Answer 120

CVP 14 mmHg, PAP 11/6 mmHg, PCWP 3 mmHg

Question 121

The major pathophysiology seen in a near, wet-drowning is: Non-cardiogenic pulmonary edema Cardiogenic pulmonary edema Hypovolemic shock Laryngospasm

Answer 121

Non-cardiogenic pulmonary edema

Question 122

Hyperventilation as a therapy for an acute head injury is used for its _____ effects and _____ cerebral blood flow. Vasodilatory, increases Vasoconstrictory, increases Vasodilatory, decreases Vasoconstrictory, decreases

Answer 122

Vasoconstrictory , decreases

Question 123

Given the following data: Mode: PRVC FiO2: 0.80 Set Vt: 600 mL RRset: 12 PEEP: 5 Ti: 1.20 sec Vtexhaled: 540 mL RRmeasured: 16 PIP: 36 cmH2O Pplat: 26 cmH2O The patient’s static compliance is: 17. 4 mL/cmH2O 23. 1 mL/cmH2O 25. 7 mL/cmH2O 28. 6 mL/cmH2O

Answer 123

25.7 mL/cmH2O ## Footnote Vtexhaled is measured back at the ventilator, and because of the change in temperature that the exhaled gas undergoes leads to a change in volume, which is why the Vtexhaled is always lower than the Vtset. We SHOULD use the Vtset.

Question 124

# Define volatile anesthetic agent Molecules of a liquid that break away and enter the space at the top of the vaporizer Pressure created when the molecules bombard the walls of the container Molecules entering the liquid phase Liquid that has a tendency to change to a vapor at standard temperature and pressure

Answer 124

Liquid that has a tendency to change to a vapor at standard temperature and pressure

Question 125

Which of the following additives to spinal anesthesia will help provide postoperative analgesic properties? Lidocaine Bupivicaine Cocaine Fentanyl

Answer 125

Fentanyl

Question 126

What stage of sleep is characterized by deep, restorative sleep? Stage 1 NREM Stage 2 NREM Stage 3 NREM REM

Answer 126

Stage 3 NREM

Question 127

A rigid bronchoscope is the preferred type of scope for/if: The removal of a large foreign body A difficult intubation is expected Examination of the lung apices are needed Visualization of the lower portions of the respiratory tract is required

Answer 127

The removal of a large foreign body

Question 128

Which of the following is considered therapeutic bronchoscopy? BAL Bronchial samples for C & S Bronchial toileting Needle aspiration

Answer 128

Bronchial toileting -same as lavage C&S, Needle aspiration are to collect samples. Bronchial toileting is therapeutic

Question 129

Albumin plays many essential roles in the body. 2 of these roles include: Maintaining osmotic pressure gradients, and molecular transport Molecular transport, and metabolizing denatured proteins Opposing osmotic pressure gradients, and combating liver disease Maintaining renal output, and supporting molecular transport

Answer 129

Maintaining osmotic pressure gradients, and molecular transport

Question 130

The electrolyte most closely tied to cardiac arrhythmias when its level is out of normal range (either too high or low) is: Sodium Chloride Potassium Hydrogen ion

Answer 130

Potassium

Question 131

Assessment of an area of consolidation in the lung would most likely reveal: Dull percussion Tracheal deviation Decreased fremitus Late inspiratory crackles

Answer 131

Dull percussion ## Footnote Could be late inspiratory crackles too

Question 132

In which of the following modes of ventilation will effective tidal volume vary the most with changes in patient resistance of compliance? Pressure-regulated volume control CMV with autoflow Volume support Pressure support

Answer 132

Pressure support

Question 133

Aerosol deposition in the distal airways can be improved with: Deep, slow insp flow breaths Deep, fast insp flow breaths Shallow, slow insp flow breaths Shallow, fast insp flow breaths

Answer 133

Deep, slow insp flow breaths ## Footnote MDI The slower the movement, the less inertial impaction

Question 134

The following pressure-time waveform indicates:

Answer 134

High airway resistance

Question 135

Exercise training in patients wiht COPD improves: Exercise capacity Psychologic state Pulmonary function A and B All of the above

Answer 135

A and B ## Footnote Lung mechanics wouldn’t actually change

Question 136

Tank Calculation

Answer 136

Duration of Flow = Oxygen Tank Conversion Factor \* Remaining Tank Pressure (psi) / Continuous Flow Rate (L/min)

Question 137

Oxygen Cylinder Conversion Factors D Tank

Answer 137

D Tank = 0.16

Question 138

Oxygen Cylinder Conversion Factors E Tank

Answer 138

E Tank = 0.28

Question 139

Oxygen Cylinder Conversion Factors G Tank

Answer 139

G Tank = 2.41

Question 140

Oxygen Cylinder Conversion Factors H/K Tank

Answer 140

H/K Tank = 3.14

Question 141

Oxygen Cylinder Conversion Factors M Tank

Answer 141

M tank = 1.56

Question 142

Total Arterial O2 Content

Answer 142

CaO2= (1.34 x Hb x SpO2) + (PaO2 x 0.003)

Question 143

How to Determine Pt Inspiratory Flow

Answer 143

Flow= Volume (L)/time (min)

Question 144

Determining the total flow in a high flow delivery device

Answer 144

If air/O2 is for example 30 then it is 8:1 so for every 1 litre of oxygen 8 L is being entrained into the device for total flow add the two toegther (=9) and then multiple by the set flow

Question 145

Calculating Flow in Liquid Oxygen System

Answer 145

Gas Remaining= (Liquid Weight [lb]) x 860/ 2.5 L/Ib Duration of Contents (min)= Gas Remaining (L)/ Flow (L/min) Remeber 1 L of Liquid O2 = 2.5 lb

Question 146

How long should it take to complete on circuit of the NRP algorithm? (from birth to administration of first dose of epinephrine? 30 sec 60 sec 90 sec 120 sec 150 sec

Answer 146

90 sec

Question 147

How often should you be evaluating the patient according to the NRP algorithm? Ever minutes Every 2 minutes Every 15 sec Every 30 sec Whenever there is a change in the patient’s status

Answer 147

Every 30 sec

Question 148

Restoration of adequate ventilation usually will result in _______ improvement in heart rate? Rapid Gradual Slow

Answer 148

Rapid

Question 149

a term newborn is apneic with a HR of 55 bpm you should? Give supplemental oxygen Provide positive pressure ventilation Administer chest compressions Both b and c All of the above

Answer 149

All of the above

Question 150

If a newborn has meconium stained amniotic fluid and has been vigorous since delivery you should? Suction mouth and trachea Clear mouth and nose of secretions Dry, stimulate and reposition Both b and c All of the above

Answer 150

Both b and c

Question 151

A newborn that is born at term, has no meconium in the amniotic fluid or on the skin, is breathing well, and has good muscle tone\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ need resuscitation. Does Does Not

Answer 151

Does Not

Question 152

If a newborn is still not breathing after a few seconds of stimulation. The next action should be to administer\_\_\_\_\_\_\_\_\_\_ Additional stimulation Positive Pressure ventilation Compressions Only b and c All of the above

Answer 152

Positive Pressure ventilation

Question 153

Which of these would be your first actions if the HR remains below 60 bpm, despite administration of ventilation and chest compressions? Ensure ventilation is being given properly Ensure chest compressions are being given optimally Ensure that you are using 100% oxygen Give the patient epinephrine. Only a,b, and c.

Answer 153

Only a,b, and c.

Question 154

What concentration of epinephrine should you use during resuscitation? 1: 10 1: 100 1: 1,000 1: 10,000 None of the above.

Answer 154

1:10,000

Question 155

What dose of epinephrine should you instill through the ETT during resuscitation? 0. 1 ml/kg 0. 01 mg/kg 10 ml/kg 1.0 ml/kg Both a and b

Answer 155

Both a and b

Question 156

If you have a 4.1 kg newborn patient requiring epinephrine how much should you instill through the ETT? (type in the amount to one decimal place no need to state ml)

Answer 156

0.3

Question 157

How often can you repeat the dose of epinephrine if the patient does not respond with an increased HR? Every 30 seconds Every minute Every 3 minutes Every 5 minutes Both c and d

Answer 157

Both c and d

Question 158

How soon should you check the HR after administration of epinephrine? Every 30 seconds Every minute Every 3 minutes Every 5 minutes Both c and d

Answer 158

Every 30 seconds

Question 159

What should you do if you suspect a patient’s airway is blocked due to Robin Syndrome? Intubate the trachea Prone position the baby Provide PPV with increased pressures Both b and c

Answer 159

Prone position the baby

Question 160

Which of these is a contraindication for giving Naloxone? Mother is addicted to narcotics Mother has been given narcotics within the last 4 hours Baby has normal HR and color with PPV Baby presents with recurrent respiratory depression

Answer 160

Mother is addicted to narcotics

Question 161

A 38 week gestation neonate (2750 g) is ventilated on the Hamilton G5. Settings: Mode: P-CMV PCset: 18 cmH2O PEEP: 7 cmH2O VtE: 14 mL Ti: 0.40 sec RRset: 40 bpm RRtotal: 47 bpm FiO2: 0.55 ABG: 7.34 / 40 / 68 / 21 / -4.2 / 94% Based on this information, the best change to the vent settings would be: Increase RR Increase PC level Decrease PC level and decrease FiO2 Decrease PC level and decrease PEEP Decrease RR and decrease FiO2

Answer 161

Decrease PC level and decrease FiO2 ABG goals for term babies → pH 7.25, CO2 45-55 Decrease PCset → 18+7 = 25, would want to decrease to a total of 18 to reach into the weaning parameters

Question 162

You are ventilating an adult patient (IBW 75 kg) who had H1N1 pneumonia. Normal ABGs and SpO2 \>/= 90% are currently targeted Mode: APRV PHigh: 28 cmH2O Plow: 0 cmH2O Thigh: 5.5 s Tlow: 0.5s FiO2: 0.60 VTE: 610 ml ABG: 7.28/52/61/24/0/91% Based on the information the best change to the ventilator settings would be: Increase Thigh Decrease Thigh Increase Phigh Decrease Phigh

Answer 162

Decrease Thigh

Question 163

You are ventilating an adult patient (IBW 70 kg) in APRV. The patient had developed ARDS secondary to sepesis and is now resolving. Normal ABGs and SpO2 \>/= 90% are being targeted. Mode: APRV Phigh: 26 cmH2O Plow: 0 cmH2O Thigh: 5.0 s Tlow: 0.5 s FiO2: 0.40 VTE: 575 ml ABG: 7.46/33/97/24/0/98% Based on the information, when weaning this patient within APRV the strategy would include: Decreasing Thigh, decreasing Phigh Increasing Thigh, decreasing Phigh Increasing TLow, decreasing Phigh Increasing Thigh, increasing Tlow

Answer 163

Increasing Thigh, increasing Tlow

Question 164

A neonatal patient is ventilated on the sensorimedics 3100A. If the patient’s ETT were to become kincked you would expect: The SpO2 to decrease The adjustable high MAP alarm to be activated\ The adjustable low MAP alarm to be activated The dump valve to open B and d

Answer 164

The SpO2 to decrease No alarms for obstructed tubes on oscillators.

Question 165

A 27 week neonate is ventilated on the Sensormedics 3100A Frequency: 13 Hz MAP: 11 cmH2O Amplitude (change in P): 18 cmH2O I time %: 33% FiO2: 0.60 ABG: 7.22/58/46/23/82% Which of the following changes to the oscillating settings would help to return the blood gas values to goal ranges? Increased amplitude, decreased MAP Decreased amplitude, decreased MAP Increased amplitude, increased MAP Decreased amplitude, increased MAP

Answer 165

Increased amplitude, increased MAP

Question 166

You are ventilating a patient on the 3100 oscillator and increase frequency control how will that change tidal volume

Answer 166

Decrease

Question 167

You are ventilating a patient on the 3100 oscillator and increase frequency control how will that change Minute volume

Answer 167

Decrease

Question 168

You are ventilating a patient on the 3100 oscillator and increase frequency control how will that change PaCO2

Answer 168

Increase

Question 169

You are ventilating a patient on the 3100 oscillator and increase frequency control how will that change PaO2

Answer 169

No Change

Question 170

Prone positioning may be part of a ventilation strategy for which of the following patient conditions: ARDS Pneumonia Severe asthma exacerbation All of the above a and b only

Answer 170

a and b only

Question 171

You are ventilating a 70 kg patient with the following settings: Mode: MMV RRset: 12 RRtotal: 26 Vtset: 560 mL Vtspont: 280 mL PEEP: 10 cmH2O FiO2: 0.45 PS: 10 cmH2O Current orders: ventilate to pH 7.35 - 7.45, PaCO2 35 - 45, keep SpO2 \> 90% Current ABG: 7.29 / 56 / 64 / 26 / -1 / 91% What changes could be made to correct this ABG? Increase RRset to 15 Increase Vtset to 690 mL Increase PEEP to 12 cmH2O Increase PS to 17 cmH2O

Answer 171

Increase PS to 17 cmH2O

Question 172

For a healthy individual, the expected difference between points C & D (on the above diagram is 3-5mmHg of CO2, what does point D represent?

Answer 172

The partial pressure of CO2 dissolved in arterial blood

Question 173

What Does the Shaded Area Represent

Answer 173

CO2 from alveoli experiencing decreased capillary blood flow Not all cells of the lung participate in gas exchange, but still need O2 for metabolism, so CO2 from these cells add to the CO2 level. Shunt and alveolar deadspace contribute to the PaCO2. Everything below dotted line is due to alveolar deadspace, above the line is shunt Vd/Vt = (PaCO2 - PECO2)/ PaCO2 → enghoff (all the shaded area) Vd/Vt = (PACO2 - PECO2) / PACO2 --\>bohr (true alv. Deadspace -assumes gas exchange did occur)

Question 174

Answer 174

Increase the % support

Question 175

You have a pt that is complaining of chest pain and on 4 LPM O2 and nitroglycerin. He has been stable and comfortable for the last hour when you assess him he is responsive alert RR 16 and BP 138/87 with the following rhythm what should you do

Answer 175

Should request cardiology consult

Question 176

A patient is symptomatic with the following rhythm what should you do

Answer 176

Cardiovert

Question 177

Your patient is currently on an SBT. Approx 15 minutes into the trial you observe that his RR has increased from 18 to 25 and he seems to be working using more accessory muscles to breathe. In that same amount of time your volumetric capnograph has shown an increase in VtCO2. What should you do for patient? This is a normal response to the imposed WOB of the SBT. Continue SBT This is an abnormal response to the imposed WOB of the SBT. Discontinue the SBT The increase in VtCO2 correlates with an increase in PaCO2 and the patient is failing. Discontinue the SBT The VtCO2 is an indication of how much CO2 is present in exhaled gas at any given time and normally increases from the start of exhalation to the end of exhalation. Continue the SBT

Answer 177

This is a normal response to the imposed WOB of the SBT. Continue SBT Workload goes up, CO2 goes up → appropriate change (if CO2 decreased, patient is tiring out → stop) D. doesn’t explain the changes we saw. It’s true for every breath.

Question 178

Calculating deadspace volume

Answer 178

Use Vd/Vt = (PaCO2 - PECO2)/ PaCO2 PECO2 = (Pbaro - 47) \* FECO2 → FECO2 from etCO2 Vd/Vt \* Vt = Vd

Question 179

You have stabilized a bradycardic patient in third degree heart block using TCP at a rate of 60 bpm. Mechanical capture has been confirmed. The patient remains hypotensive. Your next action would be to: Increase the mA setting Increasing the rate of pacing Start an infusion of epinephrine Cardiovert the patient at 50 J

Answer 179

Increasing the rate of pacing

Question 180

A neonate is being managed immediately post-delivery. They are receiving ventilaion by mask with a good technique and are not improving after 2 min. The mask seal is verified yet the heart rate remains 85 bpm and there is poor chest movement. The next action should be: Perform endotracheal intubation Perform chest compressions Give epinephrine All the above

Answer 180

Perform endotracheal intubation

Question 181

A baby is born and placed on the radiant warmer. You immediately note no crying, limp tone, and gasping respirations. Your first action should be to: Dry and stimulate the baby Provide PPV Perform intubation Provide O2 therapy

Answer 181

Dry and stimulate the baby

Question 182

A 28 year old female is delivering a 39 week infant, pre-natal care was followed. The membranes ruptured 5 hours ago and the fluid is clear, she has received fentanyl 30 minutes prior to delivery. Baby is placed under the warmer, positioned, airway cleared, dried and stimulated. HR is 110, no tone, no respiratory effort. Which of the following is the next action? Give narcan Intubate Provide tactile stimulation PPV Initiate chest compressions

Answer 182

PPV

Question 183

A 2 year old child is seen in the ER of a local hospital and diagnosed with croup. The physician orders a dose of aerosolized epinephrine via small volume nebulizer. What size aerosol particle is most likely to provide the greatest therapeutic benefit to the patient? Particles \> 10 um Particles 5 - 10 um Particles 2 - 5 um Particles 0.8 - 3 um

Answer 183

Particles 5 - 10 um

Question 184

You are delivering a mixture of 30:70 heliox continuously to a patient with a non-rebreather. The O2 flowmeter reads 12 lpm. What flow is being delivered to the patient? 12 lpm 22 lpm 19 lpm 8 lpm

Answer 184

19 lpm

Question 185

A 10 kg child requires salbutamol; the order is for 0.03 mL/kg. How many mL of solution will you need? 0. 3 mL 0. 03 mL 3 mL 30 mL

Answer 185

0.3 mL

Question 186

Common uses for inhaled nitric oxide include all of the following except: ARDS PPHN Primary pulmonary hypertension Status asthmaticus

Answer 186

Status asthmaticus

Question 187

An asthmatic girl has been using a SVN for Ventolin treatment for the past few years. Her prescription was to use 2.5 mg. How many puffs with an MDI and spacer should she use? 2 5 8 10

Answer 187

5

Question 188

Nebulized epinephrine has been ordered for a child with croup in the ED. You draw up 5 mL from a multidose vial that reads 1:1000 epinephrine. How many mg of epi is in the solution that is drawn up? 10 mg 5 mg 2. 5 mg 0. 5 mg

Answer 188

5 mg

Question 189

One of these statements about methemoglobinemia is NOT correct Causes blood to appear rusty brown Causes SpO2 to be erroneously high Is defined as metHg of over 10% Can be treated with methylene blue

Answer 189

Is defined as metHg of over 10%

Question 190

Deadspace Equation

Answer 190

Question 191

Shunt Equation

Answer 191

Question 192

Mean Airway Pressure Formula

Answer 192

Question 193

Which of the following best defines the term sterilization? a. Use of chemicals to destroy pathogens b. Process that destroys all forms of microbial life c. Process of sanitization d. Use of soap and water to aid in removal of soil/body secretions

Answer 193

b. Process that destroys all forms of microbial life

Question 194

During an allergic reaction there is an increase in circulating antibody a. IgA b. IgD c. IgE d. IgG e. IgM

Answer 194

c. IgE

Question 195

Which of the following statement is/are true regarding pressure differences a. The apical alveoli resting volume is less than basal b. Pleural pressure at the base is more negative than at the apex c. Transpulmonary pressure gradient is greatest at apex d. All state are true

Answer 195

c. Transpulmonary pressure gradient is greatest at apex Apical should be more negative than the basal.

Question 196

Which of the following could result in a higher than normal SvO2 a. Decreased CO b. Pyrexia c. Decreased oxygen extraction ratio d. All of the above

Answer 196

c. Decreased oxygen extraction ratio ## Footnote SvO2 (O2 stays in blood ) A higher than normal SvO2 means you are not extracting so a decrease CO means you have more time to pull it out. Decreased CO -would increase SvO2, more time to pull O2 out Pyrexia - increase in metabolic rate, increase O2

Question 197

arterial oxygen content Calculation

Answer 197

CaO2 = (Hb x 1.34)SpO2 + PaO2 x 0.003

Question 198

What type of lung unit(s) would result in a long time constant a. Decreased airway resistance b. Decrease Elastance-increased compliance c. Decrease Compliance - causes a decrease in TC d. Decreased Surfactant

Answer 198

b. Decrease Elastance ## Footnote TC = R\*C Decrease Elastance will increased compliance Decrease Compliance will causes a decrease in TC Decreased Surfactant - causes a decrease in C

Question 199

. (Invasive) Mechanical ventilation is indicated for which of the following blood gases done on room air? a. pH 7.23, PaCO2 56 mmHg, PaO2 76 mmHg, HCO3 23 mmol/L b. pH 7.34, PaCO2 46 mmHg, PaO2 51 mmHg, HCO3 24 mmol/L c. pH 7.31, PaCO2 50 mmHg, PaO2 46 mmHg, HCO3 24 mmol/L d. All of the above e. A and B only

Answer 199

a. pH 7.23, PaCO2 56 mmHg, PaO2 76 mmHg, HCO3 23 mmol/ L ## Footnote We are just looking at the cut off of pH of \< 7.25

Question 200

Regarding the thoracic pump, which of the following isnot true a. During PPV there is an increase cardiac stroke volume b. During spontaneous breathing there is increase venous return c. During PPV there is an increased central venous pressure d. During spontaneous breathing the thoracic pump is most effective during inspiration

Answer 200

a. During PPV there is an increase cardiac stroke volume ## Footnote During PPV we have an increase thoracic pressure and decreased venous return so we fill up less and then via Starling Law we contract less

Question 201

Positive pressure ventilation results in a. Increase dead-space ventilation b. Decreased dead-space ventilation c. Decreased intrathoracic pressure d. A and C e. B and C

Answer 201

a . Increase dead-space ventilation

Question 202

The phase variable that begins the inspiratory phase is called ___________ that ends in the inspiratory phase called the \_\_\_\_\_\_\_\_\_ a. Trigger, limit b. Trigger, cycle c. Cycle, trigger

Answer 202

b. Trigger, cycle

Question 203

. In a volume controlled breath, as the patient’s compliance increases the pressure _______ and the tidal volume \_\_\_\_\_\_\_\_\_ a. Decrease, Decrease b. Increase, Remain the Same c. Decrease, Increase d. Decrease, Remains the Same

Answer 203

d. Decrease, Remains the Same

Question 204

Starling Law of Capillaries state that a. The volume of fluid and solutes reabsorbed is normally nearly as large as the volume filtered b. The volume of fluid and solutes reabsorbed is normally larger than the volume filtered c. The volume of fluid and solutes filtered at the arterial end is less than the volume of fluid and solutes filtered at the venous end d. The pressure of the fluids and solutes filtered is normally less than the pressure reabsorbed.

Answer 204

a. The volume of fluid and solutes reabsorbed is normally nearly as large as the volume filtered

Question 205

Which of the following represents the correct pathway of impulse conduction through the heart a. AV Node, SA Node, Conduction Myofibers, purkinje fibres b. AV Node, Bundle Branches, SA Node, Purkinje Fibers c. SA Node, AV Node, Bundle Branches, Conduction fibres d. SA Node, Bundle Branches, AV Node, Conduction myofibers

Answer 205

c. SA Node, AV Node, Bundle Branches, Conduction fibres

Question 206

The T-Wave in lead II ECG represents a. Onset of atrial depolarization b. Onset of ventricular depolarization c. Atrial repolarization d. Ventricular repolarization

Answer 206

d. Ventricular repolarization ## Footnote Onset of atrial depolarization- P wave Onset of ventricular depolarization-QRS Atrial repolarization-Will get lost in QRS complex

Question 207

The main pressure promoting reabsorption of fluid into the capillaries is the: a. Osmotic pressure of interstitial fluid b. Hydrostatic pressure of the interstitial fluid c. Osmotic pressure of the capillary d. Hydrostatic pressure of capillary e. Oncotic pressure of interstitial fluid

Answer 207

c. Osmotic pressure of the capillary ## Footnote Hydrostatic pressure of capillary - pressure due to fluid - will push fluid out Osmotic pulls fluid in (caused by solute concentration); oncotic pushes fluid out (due to difference in protein concentration)

Question 208

Pursed lip breathing when done properly, may result in which of the following a. Equal pressure point moves down to smaller airways-Will move to the larger airways b. Decreased early airway collapse c. Increase expiratory flow rates d. B and C

Answer 208

b. Decreased early airway collapse ## Footnote Increase expiratory flow rates-We are adding an obstruction to the flow

Question 209

A blending device is mixing 11.3 L of air with 4.7 L of oxygen. What FiO2 is the device producing? a. 0.4 b. 0.45 c. 0.5 d. 0.55

Answer 209

0.45 ## Footnote (11.3 L (air) \* 0.21 + 4.7 L (O2)) / 16 = 0.44

Question 210

When we are using a full “D” tank oxygen cylinder for transport. The clinician set the flow rate on prongs to deliver 4 LPM; the approximate duration of flow would be a. ~15 min b. ~30 min c. \>1 hour d. \>2 hour

Answer 210

c. \>1 hour ## Footnote D = 0.16 L/psi 2200 psi or (subtract 500 for safety buffer) = 1700 psi → answer works for both

Question 211

Which of the following statement is/are true regarding cyanosis a. Polycythemia patient may show signs of cyanosis but may not be hypoxemic b. All polycythemic patient that show signs of cyanosis are hypoxemic c. In anemic patients, cyanosis is an early indicator of hypoxemia d. All of the above are true

Answer 211

a. Polycythemia patient may show signs of cyanosis but may not be hypoxemic

Question 212

A patient has been admitted to the coronary care unit after a myocardial infarction involving left side of the heart. The following information is collected from ABG while the patient is on room air. Hb 154 g/L pH 7.48, PaCO2 31 mmHg, PaO2 54 mmHg, HC3 22 mmol/L, BE -1, SaO2 87% What are the indications for O2 therapy for this patient? i) Hypoxemia ii) Hypercarbia iii) To decrease myocardial workload iv) Anxiety

Answer 212

i and iii

Question 213

The amount of air entrained in a Venturi device is ________ proportional to the size of the entrainment port and _______ to the jet orifice?

Answer 213

a. Directly, inversly

Question 214

Keeping the absolute humidity constant. As the temperature of the air ___ the relative humidity will \_\_\_\_\_\_.

Answer 214

a. Increase, decrease

Question 215

# Choose the true statements regarding Bourdon pressure gauges. i) a coiled metal tube has a sub-atmospheric pressure introduced to it ii) the display needle should periodically be “zeroed” iii) are used to measure changes in pressure iv) will straighten in response to an increase in pressure

Answer 215

a. ii, iii, iv

Question 216

The CARTA code of Ethics instructs us to “guard against conflicts of professional interest” and to specifically consult the _______________________ to prevent a real or perceived conflict of interest? Who is the individual/or department that Alberta RRTs are to consult? a. The Alberta Health b. The CARTA Registrar c. The alberta department of justice d. Your employer

Answer 216

b . The CARTA Registrar

Question 217

To maintain your clinical competency in Alberta you must complete _______ hours of practice over a five year period. How many hour of practice are needed? a. 48 b. 500 c. 720 d. 1600

Answer 217

c. 720

Question 218

Once the CVP is in place, the transducer is leveled appropriately and zeroed. The monitor is showing a good waveform, with an a wave, … a. Volume overload b. Pulmonary hypertension c. VSD d. Pulmonary embolism

Answer 218

b. Pulmonary hypertension

Question 219

As you are monitoring Bess you notice that her “a” wave has disappeared from her CVP waveform. This is an indication that: a. The transducer is sitting below the level of the right atrium b. Bess has stopped breathing c. The tricuspid valve is incompetent causing regurgitation of blood into right atrium d. The atria are not contracting, Bess is in atrial fibrillation

Answer 219

d . The atria are not contracting, Bess is in atrial fibrillation

Question 220

Which of the follow is recommended for initial mechanical ventilator settings? Pt is unconscious, sedated and medically paralyzed a. CMV VC, f 16 br/min, Vt 550 mls, PEEP 5 b. IMV VC, f 14 br/min, Vt 750 mls, PEEP 5 c. CMV APV, f 18 br/min, Vt 600 mls, PEEP 3 - PEEP too low d. CSV PC, pressure support 10 cmH2O, CPAP 5

Answer 220

a. CMV VC, f 16 br /min, Vt 550 mls , PEEP 5

Question 221

It is determined the patient has a refractory hypoxemia, which of the following would be the course of action at this time a. Increase FiO2 b. Increase RR c. Increase the tidal volume d. Increase the PEEP

Answer 221

Increase PEEP

Question 222

VS: Bp 158/108 mmHg, pulse 137 bpm and irregular. Her oxygen 38. Which of the following is the correct action given the patients oxygen status. a. Apply a 50% air entrainment ventimask system to maximize forward flow b. Apply a 70% large vol neb bc she is breathing so rapidly, she will soon become dehydrated c. Apply a nrb bc it’s quick and easy to set up d. Do not start O2, she may be a CO2 retainer

Answer 222

c. Apply a nrb bc it’s quick and easy to set up

Question 223

Her elevated HR may be due to a. Stimulation of the parasympathetic branch of the autonomic nervous system b. Secondary to the pain she is in c. Due to an attempt by her heart to maintain cardiac output d. All of the above e. b & c

Answer 223

e. b & c

Question 224

The CXR in addition to confirming the flail, shows a large white area obscuring the lower half of the left lung and blunting of the costophrenic angle. The ED physician also makes note of these findings and asks you to assist with the insertion of a chest tube. 40. What could cause blunting of the costophrenic angle in this case? a. Pneumothorax b. Pneumomediastinum c. Hemothorax d. All of the above e. A & B

Answer 224

c. Hemothorax

Question 225

Give the substance to be drained, it is more probable that the physician will insert a large bore chest tube a. Into the 2nd intercostal space, mid-clavicular line b. Superiorly, as air rises c. Inferiorly, as fluid is gravity dependent d. Along the inferior surface of any rib

Answer 225

c. Inferiorly, as fluid is gravity dependent

Question 226

You set up a dry thoracic drainage unit. How much water will you put into the suction control chamber? a. None b. Fill it to 2 cm c. Fill it to the 20 cm mark d. Start at 10 cm and slowly

Answer 226

a. None

Question 227

The patient is intubated and placed on a mechanical ventilator, during a mandatory inspiration you observe tidaling in the underwater seal of the thoracic drainage unit. Which direction is it observed? a. Move towards the suction control chamber b. Moves toward the patient c. Moves away from the patient d. Tidaling should never be observed in the underwater seal

Answer 227

c. Moves away from the patient

Question 228

What is the mode of action of singulair a. B2 Selective Bronchodilator b. Anti-inflammatory Leukotriene Receptor c. Oral Corticosteroid d. IgI Blocker

Answer 228

b. Anti-inflammatory Leukotriene Receptor

Question 229

Which of the following is the recommended care of the ventilator circuit for prevention of VAP? The vent circuit must be changed every 4 days Closed sx systems are recommended Circuit condensate should be used to instill the patient Passive humidifiers can be safely used for 48 hours

Answer 229

2, 4

Question 230

Which of the following is the most common cause of community acquired pneumonia? Staphylococcus aureus Pseudomonas aeruginosa Escherichia coli Diplococcus pneumonia

Answer 230

Diplococcus pneumonia

Question 231

What question does ethics try to answer Who is right What treatment is best Who benefits the most How should we act

Answer 231

How should we act

Question 232

A patient on mechanical ventilation has a compliance of 90 mL/cmH2O and an airway resistance of 5.0 cmH2O/L/sec. what is the calculated time constant? a. 0.45 sec B.1.35 sec C. 4.5 sec D. 450 sec

Answer 232

a. 0.45 sec ## Footnote Time Constant (seconds)=Compliance (mL/cmH2O) x Resistance (cmH2O/L/sec) 5.0 cmH2O/L/sec x 0.09 L/cmH2O= 0.45 seconds

Question 233

A 25 year old female was admitted to the emergency department in hemorrhagic shock following a gunshot wound. She received fluid administration to treat her bleeding and was stabilized. Following placement of a pulmonary artery catheter the following data was collected. Interpret the hemodynamic data. PAP 48/32 mmHg PCWP 22 mmHg CVP 15 mmHg C(a-v)O2 2.6% Cor pulmonale Pulmonary hypertension Hypervolemia

Answer 233

Hypervolemia ## Footnote PAP is high PCWP is high CVP is high (backing up to right side of the heart). C(a-v)O2 is low. Her blood is diluted because she was given too much fluid.

Question 234

Which of the following is/are the major characteristic of increased alveolar dead=space Minute ventilation out of proportion to PaCO2 Decreased WOB Hyperoxemia FiO2 \>0.50 and PaO2 \<50 mmHg A and C only

Answer 234

Minute ventilation out of proportion to PaCO2 ## Footnote Increase amount of air that is not participating in gas exchange so you are moving more air in and less air out, you would have increased WOB, you would have hypoxemia not hyperoxemia.

Question 235

Which of the following is the body’s main means of heat loss at high environmental temperatures? Evaporation Conduction Convection Radiation

Answer 235

Evaporation

Question 236

Which of the following statements refer to EF? The portion of EDV ejected on each beat Amount of blood in the ventricle at end of diastole Amount of blood ejected into the ventricle after each atrial contraction All of the above A and C only

Answer 236

The portion of EDV ejected on each beat ## Footnote Most of atrial contraction is passive which is why the amount of blood ejected into the ventricle after the atrial contraction will not be equal to portion EDV ejected.

Question 237

Amphotericin B is used to treat: Systemic bacterial infections Systemic Fungal infections Pulmonary fungal infections B and C only

Answer 237

B and C only

Question 238

Which of the following describes a mode of ventilation that would best preserve tidal volume when a patient’s lung/thorax compliance increases? Pressure cycled Pressure limited, time cycled mode Volume limited, time cycled mode Pressure limited, flow cycled mode

Answer 238

Volume limited, time cycled mode

Question 239

Which of the following does not cause an increase in measured pcwp? Hypervolemia Left ventricular failure Mitral stenosis 3rd spacing

Answer 239

3rd spacing

Question 240

You have a liquid system and a patient that requires a flow of 4 LPM. The liquid oxygen unit weighs 4100g. How long does the patient have for their oxygen usage? Approximately 8.3 hours Approximately 9.5 hours Approximately 11 hours Approximately 13.3 hours None of the above

Answer 240

Approximately 13.3 hours ## Footnote 1 L(liq) = 1.1 kg(liq); 1L liq = 860 L gas

Question 241

In the face of significant back-pressure, which of the following devices would read accurately? A device with a needle valve and a multiple orifice flowmeter. A device with a needle valve and a variable orifice flowmeter. A regulator with a bourdon gauge pressure and flowmeter. A regulator with a set pressure and multiple orifice flowmeter.

Answer 241

A device with a needle valve and a variable orifice flowmeter.

Question 242

Which of the following cannot easily be configured to be a fixed performance device at low FiO2’s? 1. Nasal cannula 2. Large volume cold neb 3. Air entrainment mask/ventimask 4. Simple mask

Answer 242

1 and 4

Question 243

Of the following, the proper device to supply humidified oxygen for a spontaneously breathing patient with an endotracheal tube in place is? Venti mask with entrained aerosol/humidity Venti mask with trach adaptor LVN with a trach cradle LVN with a t-piece

Answer 243

LVN with a t-piece

Question 244

A patient is breathing a rate of 12 br/min. Their tidal volume is 450 mL/breath, and they are on a large volume nebulizer at an FiO2 of 0.35 with a set O2 flow of 12 LPM. Is this likely to be a fixed performance device AND what approximate FiO2 is the patient receiving? Yes/=0.35 No/\<0.35 No/\>0.35 Cannot calculate Yes/\<0.35

Answer 244

Yes/=0.35 ## Footnote Magic box: 64 lpm total flow rate, TCT = 5, if I:E = 1:2 (assumed), ti = 1.67s .450L / 1.67s = 0.28L/s = 16.9 lpm If the flow being delivered (64 lpm) is higher than the flow the patient is generating (16.9 lpm), it is a fixed device. \* When information is given to us about a patient’s breathing pattern, it is more than just determining a fixed performance device using the “rule of 60”. We must consider how they are breathing. This patient is breathing at a slower rate, indicating that he’s not that air hungry, and so giving us a better idea that the flows that they are generating are not that high (and therefore, the flows being delivered are likely higher than what the patient is generating). If the patient was breathing at a faster rate, this would change their I:E, therefore changing the flow the patient is generating, potentially changing whether or not the device is fixed for them.

Question 245

Patients on high FiO2s that suddenly experience mucous plugging of a large airway are in danger of: Increased dead-space ventilation Decreased CO Absorption atelectasis

Answer 245

Absorption atelectasis

Question 246

Entering a patient care room you see the cold neb (CN) is set to deliver 28% oxygen and the oxygen flow meter is set at 6 LPM. The total flow from the CN is: 24 LPM 32 LPM 48 LPM 60 LPM 72 LPM

Answer 246

60 LPM

Question 247

What is the RH when the AH is 15 mg H2O/L and the capacity of a gas is 20.6 mg H2O/L? 15% 20% 30% 72%

Answer 247

72%

Question 248

Regarding the cardiac waveform below, please identify where the distal port of the PAC catheter is sitting at the section of the waveform labeled “A”?

Answer 248

Pulmonary artery

Question 249

What is the RH when the AH is 15 mg H2O/L and the capacity of a gas is 20.6 mg H2O/L? 15% 20% 30% 72%

Answer 249

72%

Question 250

Common causes of weaning/liberation failure include all of the following except: Myocardial ischemia Ventilatory demand in excess of capacity Psychological dependence Secondary polycythemia

Answer 250

Secondary polycythemia

Question 251

Application of nasal CPAP to neonates can: Be used to treat apnea associated with intraventricular hemorrhage Treat babies with necrotizing enterocolitis Be used immediately post-extubation Used immediately post-delivery in babies with congenital diaphragmatic hernia None of the above

Answer 251

Be used immediately post-extubation

Question 252

Defibrillation: Results in depolarization of just the ventricles Is an effective electrical treatment for ventricular fibrillation Can be used to treat asystole B and C only

Answer 252

Is an effective electrical treatment for ventricular fibrillation

Question 253

What effect do glucocorticoids have on beta adrenergic receptors? No effect Stimulates B2 receptors to relax bronchial smooth muscles restores/enhances responsiveness of B2 receptors to B2 specific agents Inhibits mast cell release

Answer 253

restores/enhances responsiveness of B2 receptors to B2 specific agents

Question 254

COPD pts who have OSA: Have worse nocturnal desats compared to someone with only OSA Often have nocturnal hypoventilation due to impaired ventilatory mechanics during sleep Have a higher rate of mortality then someone who has only OSA All of the above A and C only

Answer 254

All of the above

Question 255

Which of the following is a contraindication to hyperbaric therapy? Cleft palate Pleural effusion Pneumothorax Restrictive lung disease

Answer 255

Pneumothorax

Question 256

Which of the following is considered the main mechanism by which hypertonic aerosols aid mucociliary clearance? Increased stimulation of the irritant cough reflex Alterations of peak insp airway resistance Enhanced sensory somatic nervous impulses Altering the pH level

Answer 256

Increased stimulation of the irritant cough reflex

Question 257

Any device used for chest drainage must have which basic component: A separate underwater seal chamber Continuous low suction Collection chamber placed below the insertion site to facilitate gravity drainage A suction control chamber filled with water

Answer 257

A separate underwater seal chamber

Question 258

Which of the following statement is true regarding DPI? They are good for all age groups They do not require a spacing device Laminar flow from the use during inspiration is needed to create an aerosol They are cumbersome to carry

Answer 258

They do not require a spacing device

Question 259

Which of the following should be assessed first? Sputum collection for C&S RR ABG Auscultation

Answer 259

RR

Question 260

Based on his initial presentation, what type of lung disease is predominate in this patient? Restrictive lung disease due to suspected pneumonia Obstructive lung disease due to apparent pneumonia Infectious lung disease due to apparent pneumonia Obstructive lung disease secondary to cigarette smoking Restrictive lung disease secondary to cigarette smoking

Answer 260

Obstructive lung disease secondary to cigarette smoking

Question 261

Coronary artery disease may be diagnosed with which of the following? Cardiac enzymes V/Q scan Cardiac angiogram All of the above a and c only

Answer 261

Cardiac angiogram

Question 262

In compensating for heart failure, the body will: Increase blood volume Dilate the peripheral vasculature Decrease the HR Increase the urine output

Answer 262

Increase blood volume

Question 263

Which of the following is a risk factor for the development of an aortic aneurysm? Systemic HTN- due to extra stress on arteries COPD Family history of AAA All of the above a and c only

Answer 263

a and c only

Question 264

Your patient has a severe tricuspid valve stenosis. A hemodynamic profile consistent with this would be: CVP 14 mmHg, PAP 35/29 mmHg, PCWP 4 mmHg CVP 2 mmHg, PAP 10/6 mmHg, PCWP 4 mmHg CVP 14 mmHg, PAP 11/6 mmHg, PCWP 3 mmHg CVP 16 mmHg, PAP 33/26 mmHg, PCWP 21 mmHg CVP 19 mmHg, PAP 19/12 mmHg, PCWP 7 mmHg

Answer 264

CVP 14 mmHg, PAP 11/6 mmHg, PCWP 3 mmHg

Question 265

The major pathophysiology seen in a near, wet-drowning is: Non-cardiogenic pulmonary edema Cardiogenic pulmonary edema Hypovolemic shock Laryngospasm

Answer 265

Non-cardiogenic pulmonary edema

Question 266

Hyperventilation as a therapy for an acute head injury is used for its _____ effects and _____ cerebral blood flow. Vasodilatory, increases Vasoconstrictory, increases Vasodilatory, decreases Vasoconstrictory, decreases

Answer 266

Vasoconstrictory , decreases

Question 267

Given the following data: Mode: PRVC FiO2: 0.80 Set Vt: 600 mL RRset: 12 PEEP: 5 Ti: 1.20 sec Vtexhaled: 540 mL RRmeasured: 16 PIP: 36 cmH2O Pplat: 26 cmH2O The patient’s static compliance is: 17. 4 mL/cmH2O 23. 1 mL/cmH2O 25. 7 mL/cmH2O 28. 6 mL/cmH2O

Answer 267

25.7 mL/cmH2O ## Footnote Vtexhaled is measured back at the ventilator, and because of the change in temperature that the exhaled gas undergoes leads to a change in volume, which is why the Vtexhaled is always lower than the Vtset. We SHOULD use the Vtset.

Question 268

# Define volatile anesthetic agent Molecules of a liquid that break away and enter the space at the top of the vaporizer Pressure created when the molecules bombard the walls of the container Molecules entering the liquid phase Liquid that has a tendency to change to a vapor at standard temperature and pressure

Answer 268

Liquid that has a tendency to change to a vapor at standard temperature and pressure

Question 269

Which of the following additives to spinal anesthesia will help provide postoperative analgesic properties? Lidocaine Bupivicaine Cocaine Fentanyl

Answer 269

Fentanyl

Question 270

What stage of sleep is characterized by deep, restorative sleep? Stage 1 NREM Stage 2 NREM Stage 3 NREM REM

Answer 270

Stage 3 NREM

Question 271

. A rigid bronchoscope is the preferred type of scope for/if: The removal of a large foreign body A difficult intubation is expected Examination of the lung apices are needed Visualization of the lower portions of the respiratory tract is required

Answer 271

The removal of a large foreign body

Question 272

Which of the following is considered therapeutic bronchoscopy? BAL Bronchial samples for C & S Bronchial toileting -same as lavage Needle aspiration

Answer 272

Bronchial toileting -same as lavage

Question 273

Albumin plays many essential roles in the body. 2 of these roles include: Maintaining osmotic pressure gradients, and molecular transport Molecular transport, and metabolizing denatured proteins Opposing osmotic pressure gradients, and combating liver disease Maintaining renal output, and supporting molecular transport

Answer 273

Maintaining osmotic pressure gradients, and molecular transport

Question 274

The electrolyte most closely tied to cardiac arrhythmias when its level is out of normal range (either too high or low) is: Sodium Chloride Potassium Hydrogen ion

Answer 274

Potassium

Question 275

Assessment of an area of consolidation in the lung would most likely reveal: Dull percussion Tracheal deviation Decreased fremitus Late inspiratory crackles

Answer 275

Dull percussion

Question 276

In which of the following modes of ventilation will effective tidal volume vary the most with changes in patient resistance of compliance? Pressure-regulated volume control CMV with autoflow Volume support Pressure support

Answer 276

Pressure support

Question 277

Aerosol deposition in the distal airways can be improved with: Deep, slow insp flow breaths Deep, fast insp flow breaths Shallow, slow insp flow breaths Shallow, fast insp flow breaths

Answer 277

Deep, slow insp flow breaths

Question 278

Answer 278

High airway resistance

Question 279

Exercise training in patients wiht COPD improves: Exercise capacity Psychologic state Pulmonary function A and B All of the above

Answer 279

A and B

Question 280

Relative Humidity Equation

Answer 280