×

Quiz Session - Attempts With Random Questions

NBRC CRT Exam Questions

Page 8 of 25

141.

The respiratory therapist anticipates providing treatments to a 53-year-old male with active tuberculosis. These treatments are anticipated to induce coughing. Which of the following considerations for this patient is INCORRECT?

  • Precautions should be maintained until the procedure is over

  • Cough-inducing treatments should be performed in air-tight enclosures when possible

  • Cough-inducing treatments can be done in a negative pressure room if it meets airborne infection control standards

  • Cough-inducing treatments should be avoided when possible

Correct answer: Precautions should be maintained until the procedure is over

Precautions for this patient should be maintained until the procedure is over and the patient is no longer coughing. 

Cough-inducing treatments should be performed in air-tight enclosures when possible for patients with airborne respiratory illnesses, but can be performed in negative pressure rooms that meet airborne infection control standards. Cough-inducing treatments should be avoided when possible for this patient, but may still be necessary.

142.

You are a respiratory therapist providing deep suctioning using an in-line suction catheter to a ventilated patient who has thick secretions they are unable to mobilize. While providing suction, you notice that the patient's blood pressure reading from their arterial line shows the patient's blood pressure is 55/30. 

Which of the following responses is BEST?

  • Stop suctioning and administer O2 and ventilation

  • Finish suctioning, then administer O2 and ventilation

  • Continue suctioning; this is an expected aberrant reading during suctioning

  • Increase the FiO2 and PEEP while finishing suctioning

Correct answer: Stop suctioning and administer O2 and ventilation

When hypotension occurs during suctioning, suctioning should be stopped and O2 and ventilation should be administered. 

Finishing suctioning is not appropriate. Lower blood pressure readings from an arterial line are not an aberrant reading caused by suctioning and are not expected. Increasing the FiO2 and PEEP while finishing suctioning is not a correct response; suctioning should be stopped immediately to prevent prolonged hypotension and to allow the patient to recover.

143.

A patient has an SpO2 of 90%, a PaO2 of 70 mm Hg, and an FiO2 of 50%. What is this patient's P/F ratio?

  • 140

  • 180

  • 350

  • 71

Correct answer: 140

The P/F ratio, also called the PaO2/FiO2 ratio, measures the patient's oxygenation compared to the FiO2 provided. This value is found by dividing the PaO2 by the FiO2, keeping in mind that the percentage of the FiO2 should be expressed as a fraction. 

For this situation, the equation would be 70/0.5 = 140. The patient's SpO2 is not a factor for this ratio.

144.

A 28-year-old female with asthma is 31 weeks pregnant. Which of the following is NOT a consideration for this patient?

  • Many asthma medications can be harmful to the fetus when used by the pregnant mother

  • Patients who are pregnant may have worse control of their asthma during pregnancy 

  • Patients who are pregnant may have better control of their asthma during pregnancy 

  • Pregnant mothers tend to reduce asthma medication use during pregnancy

Correct answer: Many asthma medications can be harmful to the fetus when used by the pregnant mother

Beta-2 agonists, inhaled corticosteroids, and oral corticosteroids can be used during pregnancy without significant risk for fetal abnormalities. 

About one-third of pregnant patients have worse control of their asthma during pregnancy and one-third have better control of their asthma during pregnancy, making both statements true. Studies do show that pregnant mothers tend to reduce asthma medication use during pregnancy.

145.

Which of the following are normal heart sounds?

  1. S1
  2. S2
  3. S3
  4. S4

  • 1 and 2 only

  • 2 and 3 only

  • 1, 2, 3, and 4

  • 1, 2, and 3 only

Correct answer: 1 and 2 only

The S1 and S2 heart sounds are normal and expected. S1 represents the closure of the atrioventricular valves, while S2 represents the closing of the semilunar valves. 

S3 is thought to result from blood rushing into the ventricles during early ventricular diastole. S4 is thought to result from atrial contraction. S3 and S4 are not normally heard in healthy adults.

146.

Which of the following factors does NOT affect normal pulmonary function values?

  • Socioeconomic status

  • Age

  • Height

  • Ethnicity

Correct answer: Socioeconomic status

Age, height, ethnicity, gender, and, sometimes, weight can affect normal pulmonary function values. 

While an individual's socioeconomic status can make them more prone to diseases that can affect pulmonary function values, it does not have a direct impact on them.

147.

Which method of transport describes the means of transport used for most of the CO2 in blood?

  • Ionized as bicarbonate in erythrocytes

  • Dissolve in physical solution

  • Chemically combined with protein

  • Ionized as bicarbonate in plasma

Correct answer: Ionized as bicarbonate in erythrocytes 

Somewhere between 65% and 80% of CO2 is transported as bicarbonate in erythrocytes. Carbonic anhydrase found within erythrocytes catalyzes the hydrolysis of CO2, making this reaction occur at significantly higher levels within erythrocytes than in plasma. 

CO2 can chemically combine with proteins in plasma or dissolve into the plasma, but these are not the transportation method used for most of the CO2 in blood.

148.

Which of the following is NOT a benefit to teaching pursed lip breathing to a respiratory patient who will be receiving home pulmonary rehab?

  • It teaches the patient to use diaphragmatic, not accessory muscles 

  • It provides better control and depth of respiration

  • It aids conscious control of dyspnea

  • It prevents premature airway collapse

Correct answer: It teaches the patient to use diaphragmatic, not accessory muscles

Diaphragmatic breathing teaches patients to use diaphragmatic, not accessory muscles, when breathing. 

Pursed lip breathing does provide better control and depth of respiration, aids in the control of dyspnea, and prevents premature airway collapse.

149.

When interpreting an EKG, the respiratory therapist recognizes that the P wave represents which of the following?

  • Depolarization of the atria

  • Depolarization of the ventricles

  • Repolarization of the atria

  • Repolarization of the ventricles

Correct answer: Depolarization of the atria

The P wave represents depolarization of the atria and correlates with atrial contraction. 

Depolarization of the ventricles is indicated by the QRS complex. Repolarization of the atria occurs concurrently with depolarization of the ventricles, and the electrical signal this causes it is obscured by the QRS complex. Repolarization of the ventricles is indicated by the T wave.

150.

Which of the following complications is NOT associated with use of an umbilical artery catheter (UAC)?

  • Aortic rupture

  • Infection

  • Air embolism

  • Thromboembolism

Correct answer: Aortic rupture

Aortic rupture is not a complication that is normally associated with use of a UAC. 

Infection and thromboembolism can occur due to the presence of a foreign body in the arterial system. An air embolism can occur if air is allowed to enter the catheter. Due to the small vascular volume of these patients, much less air is required to create an air embolism than would be in an adult patient.

151.

The respiratory therapist is reviewing a patient's chart and notes that the patient has "infrequent PVCs." Which of the following does this mean for this patient?

  • This does not require treatment or indicate any serious disease.

  • The patient is likely to have a serious cardiac disease, but does not require treatment at this time.

  • The patient is likely to need a pacemaker.

  • The patient should be started on an antiarrhythmia drug.

Correct answer: This does not require treatment or indicate any serious disease.

Infrequent premature ventricular contractions (PVCs) are technically abnormal but present in many patients. This incidental finding is not a cause for concern and does not require treatment if the PVCs are infrequent. 

PVCs are unlikely to indicate a serious cardiac disease. Pacemakers are not used to treat PVCs. Patients with frequent PVCs may be treated with an antiarrhythmia drug, but this is not necessary for infrequent PVCs.

152.

The respiratory therapist is evaluating a 54-year-old female without a history of cardiopulmonary disease. Which of the following clinical characteristics is LEAST likely to indicate that this patient has a pulmonary embolism (PE)?

  • Jugular venous distension

  • Dyspnea at rest or with exercise

  • Tachypnea

  • Cough

Correct answer: Jugular venous distension

Jugular venous distention (JVD) is only present in 14% of patients without cardiopulmonary disease who have a PE. Dyspnea at rest or with exercise is present in 73% of these patients, tachypnea is present in 54%, and a cough is present in 34%. 

JVD is the least likely to be present in these patients.

153.

Pulse oximetry can be prone to interfering factors that can affect the precision of readings. Which of the following factors is MOST likely to interfere with SpO2 readings?

  • Black fingernail polish

  • Green fingernail polish

  • Clear coating on the fingernail

  • Onycholysis

Correct answer: Black fingernail polish

While fingernail polish is not likely to have much of an effect on SpO2 readings, black fingernail polish may have some effect. Black fingernail polish in particular will absorb more wavelengths of light, making it more interfering than other colors. 

Green and clear polishes are less likely to interfere than black polishes. Onycholysis, the detachment of a fingernail from the nail bed, is unlikely to create significant interference. 

154.

An intubated patient is inspiring air that contains 31 mg H2O/L. What is this patient's humidity deficit?

  • 30%

  • 70%

  • 31 mg H2O/L

  • 9 mg H2O/L

Correct answer: 30%

A patient's humidity deficit is calculated by subtracting the absolute humidity they are inhaling from the body humidity. Body humidity is 44 mg H2O/L. Humidity deficit can be expressed as an absolute value or as a percentage. 

For this question, the equation would be 44 mg/L - 30 mg/L = 14 mg/L. This can also be expressed as 30%: (13mg/L÷44mg/L).

155.

When a piece of equipment is being cleaned using ethylene oxide gas, which of the following considerations is TRUE?

  • The piece of equipment must be completely dry before exposure to ethylene oxide gas.

  • Ethylene oxide gas is only used to disinfect equipment, never to sterilize it.

  • The gas used must be warmed above room temperature.

  • Equipment can be used immediately after exposure to ethylene oxide gas.

Correct answer: The piece of equipment must be completely dry before exposure to ethylene oxide gas.

When equipment that is wet is exposed to ethylene oxide gas, the ethylene oxide gas can be converted to ethylene glycol, which is an irritant. This reaction should be avoided.

Ethylene oxide gas is used to sterilize equipment, not to disinfect it. Ethylene oxide gas can be used warmed above room temperature in shorter cycles or can be used at room temperature for more sensitive equipment with a longer cycle. Equipment should be aerated for two hours after exposure to ethylene oxide gas and should not be used immediately after exposure to the gas.

156.

Which of the following is NOT a cause of vocal cord ulceration in an intubated patient?

  • Excessive cuff pressure

  • Allergic reaction to tube material

  • Traumatic intubation

  • Excessive movement of the tube

Correct answer: Excessive cuff pressure

Vocal cord ulceration can be caused by anything that causes trauma to the vocal cords during or after intubation. This includes a traumatic intubation, an allergic reaction to the tube materials, or excessive movement of the tube. 

Excessive cuff pressure can cause damage to the trachea but is not likely to affect the vocal cords if the tube is correctly positioned.

157.

Which of the following classes of drugs should be used to stimulate receptors that respond to norepinephrine?

  • Adrenergic medications

  • Antiadrenergic medications

  • Cholinergic medications

  • Anticholinergic medications

Correct answer: Adrenergic medications

Adrenergic medications are medications that work by stimulating receptors that respond to norepinephrine or to epinephrine. 

Antiadrenergic medications block receptors that respond to norepinephrine or to epinephrine. Cholinergic medications and anticholinergic medications both act on acetylcholine receptors, with cholinergic medications stimulating them and anticholinergic medications inhibiting them.

158.

The respiratory therapist is helping nursing staff identify the correct way to apply airborne precautions. Which of the following is NOT a correct part of instituting airborne precautions?

  • Placing the patient in a positive-pressure room

  • Using regular hand-washing

  • Using an N-95 respirator or higher level of protection

  • Placing the patient in a private room

Correct answer: Placing the patient in a positive-pressure room

Patients who are on airborne precautions should be placed in a room where the airflow goes into the room, not out of the room. This is achieved by placing the patient in a negative-pressure room, not a positive-pressure room. 

Using regular hand-washing, using an N-95 respirator or higher level of protection, and placing the patient in a private room are all correct components of instituting airborne precautions. Patients may also be cohorted with patients with the same condition; however, this is not recommended if a private room is available.

159.

Cough-inducing procedures can have infection control considerations. Which of the following is NOT a cough-inducing procedure?

  • Ventilator weaning

  • Bronchoscopy

  • Pentamidine therapy

  • Closed endotracheal suctioning

Correct answer: Ventilator weaning

Ventilator weaning is not a procedure that will stimulate a cough and does not increase the risk of spreading infectious agents. 

Even though endotracheal suctioning through a closed system decreases the risk of spreading infection when the patient coughs, it does still induce coughing. Bronchoscopy and pentamidine therapy are both cough-inducing procedures.

160.

Which of the following methods for diagnosing obstructive sleep apnea is considered the "gold standard"?

  • A full-night polysomnogram (PSG) in a sleep laboratory monitored by a sleep technologist

  • A full-night polysomnogram (PSG) that is monitored by a sleep technologist regardless of the location

  • Any direct observation of OSA by a clinician, whether in a sleep laboratory or while a patient is sleeping in a hospital setting

  • A home sleep apnea test (HSAT)

Correct answer: A full-night polysomnogram (PSG) in a sleep laboratory monitored by a sleep technologist

The "gold standard" for diagnosing OSA is a polysomnogram (PSG) that covers the patient's entire night of sleep and is administered in a sleep lab and monitored by a sleep technologist. 

Having a PSG that is administered in a sleep laboratory is considered superior to other locations; thus, location is a factor. Direct observation of OSA could be used to diagnose it but, typically, a more comprehensive study is used. A home sleep apnea test (HSAT) may be used to diagnose OSA and is becoming increasingly common due to its convenience over other, more complicated tests. An HSAT is, however, not the  "gold standard" for diagnosing OSA.

×