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Quiz Session - Attempts With Random Questions

NBRC RRT Exam Questions

Page 10 of 30

181.

What are some of the possible side effects that a respiratory therapist should anticipate when administering an anticholinergic bronchodilator?

  1. Palpitations
  2. Nervousness
  3. Dizziness
  4. Nausea
  5. Dry mouth

  • 1, 2, 3, 4 & 5

  • 2, 3, & 5

  • 2 & 5

  • 3 & 5

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

The symptoms of administering an anticholinergic bronchodilator can include palpitations, nervousness, dizziness, nausea, and dry mouth. These symptoms are likely to occur with any type of anticholinergic bronchodilator.

182.

Use the following scenario to answer this question.

Which of the following findings reinforces the idea that the recent change in the patient's condition was due to a pulmonary embolism?

(CHOOSE ONLY ONE.)

  • He has remained in bed during his hospitalization

  • He has traveled outside of the country within the last 30 days

  • A family member brought his pet parrot in to visit him

  • He snuck outside to smoke marijuana more than once during his hospitalization

Correct answer: He has remained in bed during his hospitalization

Immobility is a risk factor for developing pulmonary embolisms (PEs), and remaining in bed for two days would be a risk factor for a PE. 

Recent travel may increase the risk of tuberculosis or other respiratory complications, but is not more likely to increase the risk of a PE than recent immobility. Recent exposure to avian protein increases the risk of hypersensitivity pneumonitis exacerbation, not PE. Smoking marijuana does not significantly increase the risk of developing a PE.

183.

The respiratory therapist has a patient rinse their mouth out with water after administering an inhaled corticosteroid. What is the rationale behind this?

  • This reduces the risk of oral infections

  • This is not necessary

  • This is a normal part of oral hygiene after any inhaled medication

  • This gets rid of the taste of the medication

Correct answer: This reduces the risk of oral infections 

Inhaled corticosteroids can cause a localized reduction in immune response, leading to an increased risk of fungal infections in the oral cavity. Having the patient rinse their mouth removes medications from the oral cavity, reducing this risk. 

Having the patient rinse their mouth is necessary after using inhaled corticosteroids, but not for other inhaled medications. While rinsing may help get rid of the taste of the medication, this is not the rationale for this.

184.

The respiratory therapist is monitoring a patient who is known to have high levels of fetal hemoglobin in their blood. How will this impact their SpO2 reading?

  • It will not affect the patient's SpO2 reading

  • The patient's SpO2 reading will be falsely high

  • The patient's SpO2 reading will be falsely low

  • The patient's SpO2 reading will correctly read lower than normal

Correct answer: It will not affect the patient's SpO2 reading

While the presence of high levels of fetal hemoglobin may affect hemoximetry, it does not have any known effect on pulse oximetry. The patient's true SpO2 reading should not change, and it will not be falsely elevated or depressed.

185.

What is the simplest, most cost-effective method of preventing cross-contamination between patients?

  • Hand-washing

  • Correct use of gloves

  • Using private rooms for each patient

  • Wearing masks

Correct answer: Hand-washing

Hand-washing is a simple but incredibly effective method of preventing cross-contamination between patients. Hand-washing is considered one of the most elemental and one of the most essential components of infection prevention in a healthcare setting.

186.

In which of the following situations would it be BEST to extubate a patient to non-invasive ventilation?

  • The patient has hypercapnic respiratory failure, a tracheostomy, and is unlikely to tolerate weaning well

  • The patient is unable to tolerate the presence of the endotracheal tube

  • The patient is being ventilated using SIMV mode

  • The patient is weaning from a ventilator

Correct answer: The patient has hypercapnic respiratory failure, a tracheostomy, and is unlikely to tolerate weaning well

Transitioning to non-invasive ventilation (NIV) following mechanical ventilation is ideal for patients who are unable to tolerate weaning well and who have hypercapnic respiratory failure. 

If the patient is unable to tolerate the presence of the endotracheal tube, the patient should be medicated appropriately if mechanical ventilation is still necessary, not extubated to NIV. The use of synchronized intermittent mandatory ventilation (SIMV) mode does not indicate the patient should be extubated to NIV. NIV is not used for all patients weaning from a ventilator.

187.

What is the anatomical dead space of a 91-year-old male with a tracheostomy who is 6'0" and has an ideal body weight of 70kg?

  • 77 mL

  • 155 mL

  • 45 mL

  • This cannot be calculated based on the information given.

Correct answer: 77 mL

Anatomical dead space is calculated by using 1mL for every pound of the patient's ideal body weight (IBW). The value is adjusted for patients with tracheostomies by reducing it by 50%. 

70kg*2.2kg/lb = 154lb. 154lb*1mL/lb = 154mL. 

This value is reduced by half because the patient has a tracheostomy, giving a value of 77 mL.

188.

The respiratory therapist is called to the Emergency Department for a 42-year-old male who has a known heroin-use disorder. The patient is in respiratory arrest and "just passed out" according to a friend who was present when he arrested. The friend states that the patient had not used heroin in the last 24 hours. 

Which of the following medications is MOST important for the respiratory therapist to recommend?

  • Naloxone hydrochloride

  • Epinephrine

  • Atropine

  • Lidocaine

Correct answer: Naloxone hydrochloride

The patient may be experiencing an opioid overdose, and naloxone hydrochloride can reverse the effects of an opioid overdose. 

Even though the patient's friend states he has not used heroin, it is unknown if the friend is a reliable historian, and it is safe to administer naloxone hydrochloride even if the patient is not overdosing. Epinephrine, atropine, and lidocaine are used to treat cardiac arrest, not respiratory arrest.

189.

Which of the following factors is UNLIKELY to affect dry-powder inhaler drug delivery?

  • Patient's expiratory flow ability

  • Patient's inspiratory flow ability

  • Humid environment

  • Technique

Correct answer: Patient's expiratory flow ability

Drug delivery when using a Dry Powder Inhaler (DPI) depends on a variety of factors that all impact what percentage of the dose will actually reach the lower airway. The patient's inspiratory flow ability is a major contributing factor, and a peak flow inspiratory rate of at least 60L/min is necessary for most DPIs. The emitted dose of a DPI decreases in a humid environment, likely due to clumping of the powder. Technique is a major factor when utilizing a DPI, and poor technique can significantly impact drug delivery. 

Expiratory flow ability does not impact the degree of penetration of the powder during inspiration and is not a significant factor of DPI drug delivery.

190.

Use the following scenario to answer this question.

What BEST describes the rationale for ordering cool mist therapy?

(CHOOSE ONLY ONE.)

  • No evidence shows it to be effective in treating laryngotracheobronchitis

  • It has been shown to be effective in treating laryngotracheobronchitis; however, it is not known why

  • It decreases upper airway inflammation by decreasing the temperature of the tissues

  • The humidity it provides improves oxygenation

Correct answer: No evidence shows it to be effective in treating laryngotracheobronchitis

No evidence shows that cool mist therapy is actually effective in treating laryngotracheobronchitis. While the use of this form of therapy is not contraindicated, it has not been shown to be effective in treating croup.

191.

When determining the lower-limit alarm that should be used for a patient who is on an SpO2 monitor, which of the following considerations is CORRECT?

  • The lower limit will be patient-dependent

  • A lower limit of 88% should be used

  • A lower limit of 90-92% should be used on any patient without COPD

  • A lower-limit alarm is not necessary if there is a high amount of artifact

Correct answer: The lower limit will be patient-dependent

Each patient's oxygenation needs will be different, and the lower-limit alarm of a pulse oximeter should be set for the patient's specific needs. 

While a lower limit of 88% may be good for some patients, other patients will require a higher lower limit. Applying a limit of 90-92% for any patient without COPD may not be correct for some patients. A lower-limit alarm is necessary to detect hypoxia. If artifact is creating a monitoring problem, the probe should be adjusted and the monitoring should not be discontinued.

192.

Use the following scenario to answer this question.

Which of the following interventions should the respiratory therapist perform next?

(CHOOSE ONLY ONE.)

  • Begin chest compressions

  • Defibrillate the patient

  • Check for a pulse at another site

  • Prepare to intubate the patient

Correct answer: Begin chest compressions

If the patient does not have a palpable pulse after 10 seconds of evaluation, chest compressions should be initiated. 

Defibrillating the patient is not indicated unless they are in ventricular fibrillation or ventricular tachycardia. Further evaluation of the patient's pulse is not recommended if a pulse is not palpable. Intubating the patient is not the priority if they do not have a pulse.

193.

Use the following scenario to answer this question.

When providing education to the patient regarding his discharge, which of the following should the respiratory therapist do?

(CHOOSE ONLY ONE.)

  • Ask the patient his preferred learning method

  • Rely on written materials to support retention of education

  • Use video to provide educational materials

  • Have the patient's son present while giving information to the patient

Correct answer: Ask the patient his preferred learning method

Patients' learning preferences should be accommodated to ensure that patient education is most effective. 

Relying on written materials to support retention of education is only appropriate if the patient prefers this method and once the patient's ability to read has been evaluated. The use of videos to provide educational materials is only best if this is the preferred learning method. The patient does not necessarily need to have family present while receiving discharge instructions.

194.

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.

195.

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.

196.

The respiratory therapist is assisting a pulmonologist perform a bronchoscopy for a patient with pulmonary hemorrhage. Which of the following interventions would the respiratory therapist NOT expect to see during the bronchoscopy?

  • Stent placement over the site of bleeding

  • Visualization of the area of bleeding 

  • Instillation of epinephrine to the area of bleeding

  • Iced saline lavage at the bleeding site

Correct answer: Stent placement over the site of bleeding

While stents can be placed during bronchoscopy, this intervention is not used to control bleeding, but to maintain the patency of an airway. Bleeding can, however, be a side effect of stent placement. 

When treating pulmonary hemorrhage, bronchoscopy can be used to visualize the area of bleeding, instill epinephrine, and lavage the site with iced saline to cause localized vasoconstriction.

197.

Which of the following clinical situations can uncompensated flowmeters be used for?

  • They should not be used clinically

  • For measuring the flow of O2 when using a nasal cannula

  • When providing nebulizer treatments

  • For measuring the flow of O2 when using air-entrainment masks

Correct answer: They should not be used clinically

In uncompensated flowmeters, the needle valve is located proximal to the float, allowing atmospheric pressure in the Thorpe tube. Any back pressure in the tube affects the rise of the float. Only compensated flowmeters should be used clinically.

198.

Which of the following patients is MOST at risk for meconium aspiration syndrome (MAS)?

  • A post-term infant who was hypoxic in utero

  • A full-term infant whose mother has had four previous pregnancies

  •  A pre-term infant who was born at 33 weeks gestation

  • An infant who has respiratory distress syndrome (RDS)

Correct answer: A post-term infant who was hypoxic in utero

Hypoxia in utero causes breathing in utero that may cause meconium to be passed through the vocal cords and into the lungs. Post-term infants are more likely to pass meconium in utero, making MAS more likely for this patient. 

A full-term infant is more likely to have MAS than a preterm infant, but this infant has no other risk factors. Preterm infants are at low risk for MAS. RDS is normally associated with preterm birth and does not increase the risk of MAS.

199.

Which of the following is NOT a potential complication of mechanical ventilation?

  • Cardiomegaly

  • Atelectasis

  • Decreased venous blood return to the heart

  • Decreased urine output

Correct answer: Cardiomegaly 

Cardiomegaly is not a potential complication of mechanical ventilation that is normally encountered. 

Decreased venous blood return to the heart is a possible complication caused by positive airway pressures being transferred to the large veins returning to the heart, decreasing cardiac output. This can lead to decreased urine output as a secondary effect. Atelectasis can also be a complication of mechanical ventilation.

200.

Which of the following heart rhythms are considered lethal?

  1. Ventricular fibrillation
  2. Atrial fibrillation
  3. Supraventricular tachycardia
  4. Ventricular tachycardia

  • 1 & 4

  • 1, 3, & 4

  • Only 1

  • 1 & 2

Correct answer: 1 & 4

The rhythms listed here that are considered to be lethal arrhythmias are ventricular fibrillation and ventricular tachycardia. Both of these rhythms can cause inadequate or no contraction of the ventricles, leading to cardiac arrest. 

Atrial fibrillation causes no contraction of the atria, which may lead to decreased cardiac output, but this is not typically fatal. Supraventricular tachycardia is tachycardia that originates in the conduction system of the heart prior to the ventricles and may be harmful depending on the circumstances, but is not considered to be a lethal rhythm.

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