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Quiz Session - Attempts With Random Questions

NBRC CRT Exam Questions

Page 4 of 25

61.

What is the anatomical dead space for a 54-year-old female with an ideal body weight of 50 kg?

  • 110 mL

  • 50 mL

  • 220 mL

  • 95 mL

Correct answer: 110 mL

Anatomical dead space is calculated by taking 1mL for every pound. 

50kg*2.2lb/kg = 110lb. 

At 1mL/lb, this would give an anatomical dead space of 110 mL.

62.

Which of the following is an advantage of using a dry powder inhaler (DPI) over a pressurized metered-dose inhaler (pMDI)?

  • It does not require hand-breath coordination

  • It does not require the patient to generate a high inspiratory flow

  • It can be administered to patients using mechanical ventilation

  • It provides a more reliable dose

Correct answer: It does not require hand-breath coordination

A dry powder inhaler (DPI) does not require hand-breath coordination like a pressurized metered-dose inhaler (pMDI) does. 

A DPI does require that a patient be able to generate a high inspiratory flow to aerosolize the medication while a pMDI does not. A pMDI can be administered to ventilated patients while a DPI cannot. DPIs and pMDIs provide equally reliable doses.

63.

When reviewing the chart of a patient with COPD, the respiratory therapist notes that the patient's CODP stage is documented as GOLD 3. Which of the following can be inferred from this?

  1. The patient's FEV1/FVC is less than 50% but equal to or greater than 30%
  2. The patient's FEV1/FVC is less than 70%
  3. The patient's FEV1/FVC is less than 50%
  4. The patient's FEV1 is less than 50% but equal to or greater than 30% predicted
  5. The patient's FEV1 is less than 29% predicted

  • 2 & 4 only

  • 3 & 5 only

  • 1, 3, & 5 only

  • 1 only

Correct answer: 2 & 4 only

The GOLD standard is used to stage COPD and is based on the FEV1 (forced expiratory volume over 1 second) for patients who have an FEV1/FVC that is less than 70%. The range for GOLD 3 is an FEV1 less than 50% but equal to or greater than 30% predicted.

64.

Which of the following processes or cleaning solutions can be used to sterilize equipment?

  • Ethylene oxide gas 

  • Acetic acid 

  • Alcohol wipes

  • Pasteurization

Correct answer: Ethylene oxide gas 

Sterilization kills spores that may cause infection but are less likely to cause infection than vegetative organisms. Disinfection kills only vegetative organisms but can leave spores intact. Ethylene oxide gas can be used to sterilize respiratory equipment. 

Acetic acid, alcohol wipes, and pasteurization are routinely used to clean respiratory equipment in specific situations, but will only disinfect equipment.

65.

Which of the following considerations is MOST important for a patient who has a high prothrombin time (PT)?

  • Greater care must be taken when performing nasotracheal suctioning

  • The patient is at a greater risk for developing a pulmonary embolism (PE)

  • Arterial punctures should never be performed

  • A high PT does not create any additional considerations for the respiratory therapist

Correct answer: Greater care must be taken when performing nasotracheal suctioning

A high prothrombin time (PT) indicates that the patient is at a higher risk for bleeding. This means that greater care should be taken with interventions that can cause bleeding, such as performing nasotracheal suctioning or an arterial puncture. 

The patient is not at greater risk of developing clotting problems such as a pulmonary embolism; the opposite is actually true. While care should be taken with arterial punctures, and pressure may need to be applied for longer, they are not contraindicated in every situation where a patient has an elevated PT.

66.

Which of the following is NOT an advantage of using liquid O2 systems at home?

  • They are inexpensive

  • They are more portable than cylinder O2 storage systems

  • They have increased storage capacity over other systems

  • They offer safer storage

Correct answer: They are inexpensive

Liquid O2 storage options can be more costly than other systems. 

Liquid O2 storage does offer increased storage capacity, as 1L of liquid O2 is equal to 860L of gaseous O2. The increased storage capacity makes these systems more portable. Liquid O2 storage does not create the same hazards that gaseous O2 cylinders do, making them a safer option.

67.

The respiratory therapist is treating a patient with an air-entrainment mask delivering 60% O2. The patient has the following ABG values after starting the air-entrainment mask:

  • pH 7.41
  • PaCO2 38 mm Hg
  • PaO2 51 mm Hg
  • HCO3- 25 mEq/l
  • BE -0.9

Which of the following interventions is BEST for this patient?

  • Start CPAP

  • Increase to 70% O2

  • Intubate and begin mechanical ventilation

  • No intervention is needed for this patient

Correct answer: Start CPAP

The patient has a normal acid-base status, normal ventilation, and a normal metabolic status. The patient does, however, have moderate hypoxemia. As the patient is already on 60% O2, providing positive pressure using continuous positive airway pressure (CPAP) will be the most effective intervention for this patient. 

Increasing the O2 is unlikely to be more effective than providing positive pressure. Intubation may be necessary, but CPAP should be attempted first.

68.

The respiratory therapist is evaluating a 23-year-old female who attempted to kill herself by leaving her car running in a poorly ventilated garage but was found before losing consciousness. 

Which of the following is NOT an early clinical feature of carbon monoxide poisoning?

  • Coma

  • Anxiety

  • Tachycardia

  • Headache

Correct answer: Coma

Coma is a clinical feature of carbon monoxide poisoning, but is not an early clinical feature. 

Anxiety, tachycardia, and headaches are all considered early clinical features of carbon monoxide poisoning.

69.

Which of the following patients would NOT be an ideal patient for receiving pulmonary rehab?

  • A GOLD stage I COPD patient

  • A patient with cystic fibrosis

  • A patient with asthmatic bronchitis

  • A patient with bronchiectasis

Correct answer: A GOLD stage I COPD patient

COPD patients who are symptomatic, usually GOLD stage III and IV, but sometimes GOLD stage II, are ideal candidates for receiving pulmonary rehab. 

Patients with cystic fibrosis,  asthmatic bronchitis, and bronchiectasis can also be good candidates for pulmonary rehab.

70.

You are helping care for a 24-year-old male who has an abnormal respiratory pattern that is caused by diabetic ketoacidosis (DKA). Which of the following breathing patterns would you expect to see?

  • Rapid, deep breaths at regular intervals

  • Rapid, shallow breaths at regular intervals

  • Deep breaths that are irregularly spaced, but still tachypneic 

  • Irregular breathing with varied depth and rate with periods of apnea

Correct answer: Rapid, deep breaths at regular intervals

Kussmaul breathing is an abnormal breathing pattern that occurs with severe metabolic acidosis as can occur with DKA. Kussmaul breathing attempts to compensate for hypercapnia with deep, rapid breaths. 

Rapid, shallow breathing is typically associated with lung inflammation or stiffness. Deep breaths that are irregularly spaced, but still tachypneic, is considered a type of periodic breathing. Irregular breathing with varied depth and rate with periods of apnea describes Cheyne-Stokes respiration.

71.

Which of the following respiratory rates is normal for an unstimulated newborn?

  • 35-45 breaths per minute

  • 35-70 breaths per minute

  • 20-30 breaths per minute

  • 50-70 breaths per minute

Correct answer: 35-45 breaths per minute

A normal respiratory rate for an unstimulated newborn is 35 to 45 breaths per minute. A newborn's respiratory rate may go up to 70 breaths per minute with stimulation. Respiratory rates outside of these ranges are not normal and may require intervention.

72.

How does dark skin pigmentation affect pulse oximetry readings?

  • It could cause falsely high readings

  • It could cause falsely low readings

  • It never affects pulse oximetry readings

  • Pulse oximetry may not be usable for these patients

Correct answer: It could cause falsely high readings

Dark skin pigmentation can affect how the different wavelengths of light a pulse oximeter uses are absorbed. This can lead to an oximetry reading that is falsely high by 3 to 5%. While in rare circumstances it may cause falsely low readings, this is not common. 

Dark skin pigmentation may have no effect; however, this is not "never" the case. Pulse oximetry can still be used on patients who have dark skin pigmentation.

73.

Which of the following radiographic findings indicates the presence of laryngotracheobronchitis?

  • Steeple sign

  • Thumb sign

  • Air-bronchograms

  • Atelectasis

Correct answer: Steeple sign

Steeple sign is caused by a sharply sloped, wedge-shaped narrowing of the trachea and is an indicator of laryngotracheobronchitis (croup). 

Thumb sign is caused by a swollen epiglottis and indicates epiglottitis. Air-bronchograms are caused by an alveolar process and are seen in a variety of lung conditions, but are not specific to laryngotracheobronchitis or normally present with laryngotracheobronchitis. Atelectasis is collapsed alveoli and indicates an alveolar process that is not seen with laryngotracheobronchitis.

74.

Which of the following can be adverse consequences of obstructive sleep apnea (OSA)?

  1. Nocturnal arrhythmias
  2. Stroke
  3. Excessive daytime sleepiness
  4. Insulin resistance
  5. Personality changes

  • 1, 2, 3, 4, & 5

  • Only 3

  • 1, 3, & 5

  • 3, 4, & 5

Correct answer: 1, 2, 3, 4, & 5

OSA can lead to many potential adverse consequences. These may include nocturnal arrhythmias, stroke, excessive daytime sleepiness, insulin resistance, and adverse personality changes.

75.

How frequently is a two-point calibration usually performed on a blood gas analyzer?

  • Every 8 hours

  • Every 12 hours

  • Before each blood gas sample is run

  • Every 24 hours

Correct answer: Every 8 hours

Two-point calibrations are usually performed every eight hours on a blood gas analyzer. 

One-point calibrations should be performed before each blood gas sample is run unless the analyzer automatically performs the calibration at programmed intervals.

76.

The respiratory therapist is preparing to administer 34 mcg of ipratropium bromide (Atrovent HFA) using a Metered-Dose Inhaler (MDI). What will the duration of this medication be?

  • 6 hrs

  • 2 hrs

  • 12 hrs

  • 24 hrs

Correct answer: 6 hrs

Ipratropium bromide is an anticholinergic bronchodilating agent that has an onset of 15 to 30 minutes, a peak of 1 to 2 hours, and a duration of 6 hours.

77.

The respiratory therapist is providing treatment for a patient who has an influenza A infection. Which of the following is NOT necessary when maintaining this patient's isolation precautions?

  • Keeping the patient's door closed

  • Wearing a mask when in the room

  • Having the patient wear a mask when outside the room

  • Limiting transportation of the patient outside the room

Correct answer: Keeping the patient's door closed

Influenza A is transmitted via droplets, and droplet precautions must be instituted to prevent transmission of the infection. Droplets travel for six feet and are not considered infectious beyond this range. Having the patient's door closed is not necessary to prevent the spread of droplets. 

Wearing a mask while in the room, having the patient wear a mask when outside the room, and limiting transportation of the patient outside their room are all part of droplet precautions.

78.

There are a variety of factors that can affect the performance of a small volume nebulizer (SVN). Which of the following is NOT one of these factors?

  • Mechanism of action of the drug being administered

  • Baffle design

  • Temperature of the gas being administered

  • Pressure and flow through the nebulizer

Correct answer: Mechanism of action of the drug being administered

There are characteristics of the drug formulation that will affect the performance of a small volume nebulizer (SVN). These include the drug's viscosity, its surface tension, and its homogeneity. The mechanism of action, however, does not have a meaningful effect on SVN performance. 

The baffle design, the temperature of the gas being administered, and the pressure and flow of the gas through the nebulizer will all affect its performance.

79.

A patient is receiving O2 via nasal cannula at 4 L/min from a liquid O2 tank containing 4lb of liquid O2. How long will the O2 last for this patient?

  • 5.7 hrs

  • 7.2 hrs

  • 0.7 hrs

  • 11.5 hrs

Correct answer: 5.7 hrs

The gas remaining in a liquid O2 tank can be calculated using the following equation:

(Liquid weight (lb)*860) / 2.5 L/lb

For this question, the calculation would be:

(4 lb*860) / 2.5 L/lb = 1376L

The time remaining can be found by dividing the volume left by the flow rate:

1376L / 4 L/min = 344 min = 5.7 hrs

80.

The respiratory therapist is evaluating a patient whose medical history is suspicious for an infection of M. tuberculosis, but this diagnosis has not yet been made. Which of the following precautions should the respiratory therapist follow?

  1. Standard
  2. Contact
  3. Contact plus
  4. Droplet
  5. Airborne

  • 1 & 5

  • 4

  • 1, 2, 3, & 5

  • 1 & 4

Correct answer: 1 & 5

A patient who is suspected of a potentially infectious organism should be treated as if they have it until the diagnosis is verified or excluded. A patient with M. tuberculosis should be on airborne precautions; however standard precautions should also be followed.

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