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Quiz Session - Attempts With Random Questions

NBRC CRT Exam Questions

Page 6 of 25

101.

The respiratory therapist uses the CURB-65 scoring system to evaluate the severity of Community-Acquired Pneumonia (CAP). Which of the following is NOT a criteria of this score?

  • Respiratory rate > 20 breaths/minute

  • Confusion

  • Systolic blood pressure < 90 mm Hg

  • Urea > 20 mg/dL

Correct answer: Respiratory rate > 20 breaths/minute

The CURB-65 uses five criteria to evaluate the severity of Community-Acquired Pneumonia (CAP). These criteria include:

  • Confusion
  • Urea > 20 mg/dL
  • Respiratory rate > 30 breaths/minute
  • Blood pressure of < 90 mm Hg systolic or < 60 mm Hg diastolic
  • Age of 65 years or older

A respiratory rate of > 20 breaths/minute is too low a threshold for the CURB-65 score.

102.

The respiratory therapist obtains a capillary blood gas sample that shows a PcO2 of 45 mm Hg. What intervention is necessary to correctly treat the patient's oxygenation status?

  • Draw an ABG to determine the PaO2

  • No interventions are needed, as the PcO2 level shows the patient's oxygenation is normal

  • Place the patient on a non-rebreathing and prepare to intubate

  • Redraw the capillary blood gas sample, as this value is likely incorrect

Correct answer: Draw an ABG to determine the PaO2

The PcO2 level indicated by the capillary blood gas sample is normal, but PcO2 levels do not correlate well with PaO2 levels. To correctly treat the patient's oxygenation status, a PaO2 is needed. 

The value does not necessarily mean that the patient's oxygenation is normal. The patient should not be intubated based on this value. Redrawing the specimen will not be helpful.

103.

A disposable small volume nebulizer (SVN) should only be reused in which of the following situations?

  • It should not be reused

  • Only after being thoroughly washed with soap and water

  • Only after being autoclaved

  • Only after disinfection, but only for patients who are not immunocompromised

Correct answer: It should not be reused

Disposable disposable small volume nebulizers (SVNs) have a high risk of serving as reservoirs of infection, as they have moist, warm environments that are routinely exposed to respiratory secretions. A disposable SVN should not be reused and should be disposed of after use. 

Attempting to disinfect and reuse a disposable SVN is not recommended.

104.

The respiratory therapist is teaching a student respiratory therapist how to use continuous positive airway pressure (CPAP). Which of the following is TRUE about CPAP?

  • Low level pressure alarms are necessary

  • CPAP cannot be used if the patient is intubated

  • CPAP delivers positive pressure breaths

  • CPAP will help patients avoid hypoventilation

Correct answer: Low level pressure alarms are necessary

When using CPAP, low level pressure alarms are necessary to allow for intervention if there is a disconnection in the circuit. 

CPAP can be used if a patient is intubated. CPAP does not deliver positive pressure breaths, it continuously applies positive pressure to the airway regardless of the patient's respiratory cycle. CPAP does not address hypoventilation, as it does not control respiration.

105.

The respiratory therapist performed a blood gas analysis of a preterm infant that was born one hour prior to obtaining the sample. The patient has a PaO2 of 59 mm Hg. Which of the following interventions is necessary for this patient?

  • No intervention is needed

  • Start an oxygen hood, delivering 40% O2

  • Start O2 via nasal cannula at 3 L/min

  • Intubate the patient and begin mechanical ventilation

Correct answer: No intervention is needed

For a preterm infant, a normal ABG value for the PaO2 can range from 52-68 mm Hg. A value of 59 mm Hg would be normal, given the fact that this patient is preterm and given that delivery was very recent; no additional intervention is necessary. 

Providing O2 therapy could actually cause retinopathy of prematurity and should be avoided.

106.

Which of the following is NOT one of the basic ways used to determine the need for oxygen therapy?

  • Radiographic findings

  • Clinical assessment

  • Laboratory measurements

  • Presence of specific clinical problems

Correct answer: Radiographic findings

Radiographic findings may be used to diagnose clinical problems that would require oxygen therapy, but are not typically used to directly determine the need for oxygen therapy. 

Laboratory measurements, such as ABGs, are often used to determine the need for oxygen therapy. Clinical assessments and the presence of specific clinical problems are also two common methods of determining the need for oxygen therapy.

107.

Which of the following is NOT a common complication after extubation?

  • Laryngospasms

  • Hoarseness

  • Coughing

  • Sore throat

Correct answer: Laryngospasms

Laryngospasms are a rare potential complication of extubation and are unlikely to occur. 

Hoarseness, coughing, and a sore throat are all common complications that are experienced after extubation but are unlikely to cause any serious or lasting problems. Laryngospasms may be transient, but may also require reintubation if they are not transient.

108.

Which of the following devices is NOT a type of pass-over humidifier?

  • Bubble type

  • Simple reservoir type

  • Membrane type

  • Wick type

Correct answer: Bubble type

Pass-over humidifiers are active humidifiers in which the air passes over, not through, the reservoir. Bubble humidifiers do pass gas through the reservoir. 

Simple reservoir pass-over humidifiers pass gas over the open fluid. Wick pass-over humidifiers have wicks that increase the surface area that the gas passes over. Membrane pass-over humidifiers have a hydrophobic membrane that has pores that allow water vapor to pass through without allowing liquid water to pass through.

109.

Which of the following is NOT a direct injury that can trigger acute respiratory distress syndrome (ARDS)?

  • Transfusion-related acute lung injury (TRALI)

  • Near-drowning

  • Gastric aspiration

  • Smoke inhalation

Correct answer: Transfusion-related acute lung injury (TRALI)

While transfusion-related acute lung injury (TRALI) can trigger acute respiratory distress syndrome (ARDS), it is an indirect, not a direct, injury. 

Near-drowning, gastric aspiration, and smoke inhalation are all direct lung injuries that can trigger ARDS.

110.

Which of the following is an example of a vector-borne illness?

  • Lyme disease

  • Polio

  • Rhinovirus

  • Diptheria

Correct answer: Lyme disease

A vector-borne illness is an infectious disease that is transmitted through an animal. The most common vectors are ticks, fleas, mosquitoes, and small rodents. Lyme disease is transmitted through ticks and is the only one of the diseases listed that is a vector-borne disease.

111.

Palpating the patient's thorax while asking them to repeat "ninety-nine" is an example of evaluating for which of the following?

  • Tactile fremitus

  • Vocal fremitus

  • Subcutaneous emphysema

  • Asymmetrical chest expansion

Correct answer: Tactile fremitus

Tactile fremitus describes vibrations that can be palpated on the chest wall while the patient is vocalizing. Typically, the phrase "ninety-nine" is used to elicit and assess tactile fremitus. 

Vocal fremitus refers to vibrations created by the vocal cords during speech. Subcutaneous emphysema is assessed solely by palpating tissues for a crackling sensation and may cause a crackling sound. Asymmetrical chest expansion can be appreciated by visualization and palpation while having the patient take a deep breath.

112.

Which of the following radiographic patterns indicates a viral, not a bacterial, community-acquired pneumonia (CAP)?

  • Interstitial infiltrates

  • Pleural effusion

  • Bronchopneumonia

  • Lobar consolidation

Correct answer: Interstitial infiltrates

Interstitial infiltrates are a radiographic finding that is consistent with viral pneumonia. 

Pleural effusions, bronchopneumonia, and lobar consolidation are all examples of radiographic findings that are indicators of bacterial community-acquired pneumonia (CAP).

113.

The respiratory therapist is setting up a non-heated humidifier and deliberately kinks the tubing to activate the pressure valve, ensuring that there are no leaks in the system. At which of the following pressures will the pop-off valve typically be activated?

  • 2.0 psi

  • 0.5 psi

  • 5.0 psi

  • The max pressure must be set by the respiratory therapist

Correct answer: 2.0 psi

The pop-off valve of non-heated humidifiers will be activated at pressures of greater than 2.0 psi. The pop-off valve of a non-heated humidifier is manufactured to release pressure at that pressure, and the valve cannot be adjusted to release at other pressures by the respiratory therapist.

114.

Which of the following is NOT a possible cause of a false high-temperature reading for a heated humidifier?

  • Temperature overshoot due to flow changes

  • Thermistor probe too close to the Y adapter

  • Damaged or defective thermistor probe

  • Thermistor probe is in a radiant warmer

Correct answer: Temperature overshoot due to flow changes

A temperature overshoot due to flow changes is a true high temperature and may indicate the need for intervention, or may be transient, depending upon the circumstances. 

A thermistor probe too close to the Y adapter, a damaged or defective thermistor probe, or a thermistor probe that is in a radiant warmer would all cause false high-temperature readings.

115.

The physician elects to establish an airway in a patient who requires mechanical ventilation using a double-lumen airway (Combitube). Which of the following is TRUE when preparing for insertion of this airway?

  • The airway will be inserted blindly

  • The airway may be inserted through one of the nares

  • A laryngoscope is needed to place the airway correctly

  • This airway is designed to allow for independent ventilation of each lung

Correct answer: The airway will be inserted blindly

A double-lumen airway (Combitube) is designed to be inserted blindly through the oropharynx and can provide ventilation when it is placed into either the trachea or the esophagus. 

This airway is inserted into the oropharynx, and not into one of the nares. The airway is inserted blindly and a laryngoscope is not needed. A double-lumen endotracheal tube is designed to allow for independent ventilation of each lung but is a different type of airway than a double-lumen airway (Combitube).

116.

A patient asks the respiratory therapist how to tell how many doses are left in a pressurized meter-dose inhaler (pMDI) that does not have a dose counter. How can the respiratory therapist determine the number of doses left?

  • Calculate an estimate using the frequency of use and length of use

  • It is impossible to estimate how many doses may be left

  • Place the pMDI in water. The more buoyant it is, the more medication it contains.

  • Place the pMDI in water. The less buoyant it is, the more medication it contains.

Correct answer: Calculate an estimate using the frequency of use and length of use

The exact number of doses left cannot be determined without a dose counter. However, the respiratory therapist can calculate how many doses the patient is likely to have used by evaluating how many doses a day are routinely used and how many days it has been used. 

A pressurized Meter-Dose Inhaler (pMDI) should not be immersed in water, as this can affect aerosol delivery. It is possible to estimate, but not to know exactly, the number of doses left.

117.

A patient apnea-hypopnea index (AHI) indicates that the patient has mild sleep apnea. In what range is this patient's AHI?

  • 5-15

  • 0-5

  • 15-30

  • 30-45

Correct answer: 5-15

A patent's AHI represents the number of apneic and hypopneic episodes occurring per hour while a patient is sleeping. An AHI interpretation depends on the following ranges:

  • < 5, normal
  • 5-15, mild sleep apnea
  • 15-30, moderate sleep apnea
  • > 30, severe sleep apnea

A patient with mild sleep apnea will have an AHI between 5 and 15.

118.

The respiratory therapist is caring for a patient whose respiratory rate has doubled, but their minute ventilation is the same. The physiologic dead space is unchanged. What does this imply?

  • V̇A is decreasing

  • VT is increasing

  • This is not possible, the minute ventilation should be reassessed

  • V̇A is increasing

Correct answer: V̇A is decreasing

For the minute volume to remain unchanged with an increasing respiratory rate, the tidal volume (VT) must be decreasing. This means that alveolar ventilation (V̇A) is decreasing, not increasing.

VT cannot be increasing. The finding described in the question prompt is certainly possible.

119.

Which of the following contraindications of chest physical therapy (CPT) is an absolute contraindication?

  • Active hemorrhage with hemodynamic instability

  • Bronchopleural fistula

  • Empyema

  • Distended abdomen

Correct answer: Active hemorrhage with hemodynamic instability

Active hemorrhage with hemodynamic instability is an absolute contraindication for CPT in all circumstances. 

CPT is generally contraindicated in patients with a bronchopleural fistula or empyema, but the contraindication is relative and there may be times when CPT can still safely be performed. Patients with a distended abdomen can still receive CTP, but the Trendelenburg position is typically contraindicated for these patients.

120.

The respiratory therapist is evaluating a four-year-old female who is suspected to have epiglottitis. Which of the following is the BEST method of diagnosing this condition?

  • Lateral neck x-ray

  • Visualization of the epiglottis

  • Testing for impaired swallowing

  • Test peak expiratory flow using a peak flow meter

Correct answer: Lateral neck x-ray

A lateral neck x-ray will reveal a swollen epiglottis. This radiographic finding is known as the thumb sign because the epiglottis resembles the distal end of a thumb. 

Visualization of the epiglottis should be avoided, as it can exacerbate the patient's condition and lead to complete airway obstruction. Testing for impaired swallowing should be avoided due to the risk of aspiration and exacerbating the inflammation. Testing peak expiratory flow could yield some clinical information, as expiratory flow will be suppressed with narrowing of the upper airway, but this is not the best method of diagnosing epiglottitis.

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