RCP160 midterm 163 questions with complete solutions

RCP160 midterm| 163 questions with complete solutions 100% Verified 12) Patient whom is 40 years old (89kg) with respiratory acidosis and currently on mechanical ventilation. Patient has no history of pulmonary disease. Patient in on VC/CMV, VT 550, RR 17. ABG shows PaCO2 50mm Hg and ph 7.31. Which setting would you adjust first?

• Ti
• RR
• Te
• Vt - Correct Answer Vt

12) Acute respiratory acidosis is associated with which of the following?

• Parenchymal lung problems
• ketoacidosis
• biots breathing
• gout - Correct Answer parenchymal lung problems

12) Common causes of respiratory alkalosis include all except which of the following?

• Hypoxia with compensatory hyperventilation
• Anxiety
• Metabolic problems
• Chest wall abnormalities - Correct Answer chest wall abnormalities

12) What is the most likely patient situation in which respiratory acidosis persists even after alveolar ventilation has been increase?

• metabolic acidosis
• increased physiologic dead space
• normal Vd/Vt
• hyperoxia - Correct Answer increased physiologic dead space 1 / 4

12) Increased metabolism and carbon dioxide production commonly occurs in which of the following patient situations except?

• Fever
• Sepsis
• appropriate MV settings
• those who have undergone multiple surgical procedures - Correct Answer appropriate MV settings

12) Airway clearance should be performed when?

• Routinely
• Whenever Ppl is increased
• Only when necessary
• As a last resort when the patient is coding - Correct Answer only when necessary

12) What is the correct catheter size for a patient with an ETT ID of 8.0?

A. 16F

B. 14F

C. 14F

• 12F - Correct Answer 12F

12) Indication for aerosols in the mechanically ventilated patient include which of the following?

• Increased airway resistance
• Coarse breath sounds
• Treatment of excessive secretions
• Peripheral inflammatory disease - Correct Answer increased airway resistance

12) During MV MDI's should be:

• Placed in the expiratory limb circuit
• Placed in the inspiratory limb circuit
• In line with the HME 2 / 4

• Placed between the ventilator and heated humidifier - Correct Answer placed in the inspiratory limb

circuit 12) A patient with pneumonia and underlying COPD is being mechanically ventilated in the VC-CMV mode with VT650 mL. The resulting PaCO2 is 62 mm Hg. What change should be made to the VT to obtain a desired PaCO2 of 50 mm Hg for this patient?

• 400 mL
• 800 mL
• 1000 mL
• 1200 mL - Correct Answer 800 mL

12) A male patient (80-kg IBW) with no history of pulmonary disease is brought to the emergency department for treatment of a drug overdose. He is intubated and placed on mechanical ventilation with VC-CMV, f = 12/min, VT = 500 mL. The resulting arterial blood gas values are: pH 7.32, PaCO2 53 mm Hg, and HCO3- 25 mEq/L. The most appropriate action to correct the acid-base disturbance is which of the following?

• Increase VT to 600 mL.
• Increase VT to 700 mL.
• Increase frequency to 17/min.
• Decrease frequency to 10/min. - Correct Answer Increase VT to 600 mL.

12) A male patient (74-kg IBW) is being ventilated with PC-CMV, f = 12/min, PIP = 20 cm H2O, TI = 1.5 seconds; the resulting flow-time scalar is shown below. The patient's measured VT is 435 mL. ABG results on these settings are: pH 7.32, PaCO2 54 mm Hg, HCO3- 25 mEq/L. The most appropriate action to take is which of the following? Image question **

• Increase f to 16/min.
• Increase TI to 2.5 sec.
• Increase PIP to 27 cm H2O.
• Decrease flow rate to 40 L/min. - Correct Answer Increase PIP to 27 cm H2O

12) A 59-kg IBW female patient is being mechanically ventilated in the CMV mode, f = 12/min, VT = 400 mL, PEEP = 5 cm H2O, FIO2 = 0.5. The ABG results on these settings show a respiratory acidosis and severe hypoxemia. The respiratory therapist increases the set VT and increases the PEEP to 12 cm H2O. 3 / 4

The resulting ABGs show improved oxygenation, but the patient still has a respiratory acidosis. The respiratory acidosis may be due to which of the following?

• Tissue hypoxia
• Increased dead space
• Increased cardiac output
• Continued hypoventilation - Correct Answer increased dead space

12) Advantages of closed suctioning include which of the following?

• No need to prehyperoxygenate or posthyperoxygenate.
• No need to prehyperventilate or posthyperventilate.
• Decreased risk of infection for caregiver.
• No loss of PEEP during the procedure.
• 1 and 2 only
• 3 and 4 only
• 1, 2, and 4 only
• 2, 3, and 4 only - Correct Answer 3 and 4 only

12) During a closed suctioning procedure, the patient's heart rate changes from 95 to 58 beats/min. The respiratory therapist should take what immediate action?

• Continue the procedure until secretions are removed.
• Stop the procedure and switch to the open suctioning method.
• Stop the procedure and use the ventilator to hyperoxygenate the patient with 100% oxygen.
• Remove the patient from the ventilator and ventilate the person with a resuscitator bag. - Correct

Answer Stop the procedure and use the ventilator to hyperoxygenate the patient with 100% oxygen.12) A mechanically ventilated patient continues to have rhonchi after deep suctioning. The respiratory therapist should recommend which of the following?

• Prone position

B. CPT

• Prone position with the foot of the bed elevated 12 inches
• / 4