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Quiz Session - Attempts With Random Questions

NBRC RRT Exam Questions

Page 3 of 30

41.

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.

42.

The respiratory therapist has just extubated a patient when the patient is suddenly unable to speak. The respiratory therapist recognizes that which of the following is TRUE?

  • This is likely due to a sudden airway obstruction.

  • This is likely due to sudden central apnea.

  • This is normal after extubation.

  • This is a complication of extubation, but is not a serious complication.

Correct answer: This is likely due to a sudden airway obstruction.

Inability to speak is a symptom of laryngospasm and indicates that further treatment is necessary. Laryngospasm is an obstruction of the airway and requires treatment with high FiO2 concentrations and application of positive pressure. If the laryngospasm is not transient, reintubation may be necessary. 

Central apnea would cause an inability to speak, but would not be likely to occur in connection with extubation. Sudden inability to speak is not normal after intubation and is a serious complication.

43.

The respiratory therapist is screening a patient for obstructive sleep apnea (OSA). Which of the following questions is NOT a part of the STOP-BANG questionnaire?

  • Do you notice that you suddenly wake up in the night?

  • Do you snore loudly?

  • Has anyone observed you stop breathing during sleep?

  • Do you have high blood pressure?

Correct answer: Do you notice that you suddenly wake up in the night?

The STOP-BANG questionnaire consists of eight points that can indicate OSA if a patient scores positive on three or more. These eight points include:

  • Do you Snore loudly?
  • Do you often feel Tired, fatigued, or sleepy during the daytime?
  • Has anyone Observed you stop breathing during sleep?
  • Do you have or are you being treated for high blood Pressure?
  • Is your BMI greater than 35?
  • Is your Age older than 50 years?
  • Is your Neck circumference greater than 40 cm?
  • Is your Gender male?

44.

Use the following scenario to answer this question.

Which of the following tests could help reveal if the change in the patient's condition was due to an MI?

(SELECT AS MANY as you consider indicated.)

  • Troponin I

  • EKG

  • Chest CT with contrast

  • Chest MRI

  • ABG

Checking a troponin level and doing an EKG could both reveal if the cause of the change in the patient's condition could be due to an MI. 

A CT with contrast, chest MRI, and ABG may all be indicated to evaluate other potential causes of the change. However, they are not likely to indicate if an MI was the cause of the change.

45.

The respiratory therapist is evaluating a 12-year-old with cystic fibrosis. Which of the following findings is NOT expected for this patient?

  • Frequent, dry cough

  • Increased A-P chest diameter

  • Digital clubbing

  • Intercostal retractions

Correct answer: Frequent, dry cough

The pathophysiology of cystic fibrosis causes thick mucus to be secreted into the airways, leading to airway obstruction and the promotion of bacterial growth. While a cough is common in patients with cystic fibrosis, the cough typically results in thick mucus production. 

An increased A-P chest diameter, digital clubbing, and intercostal retractions are all common findings for patients who have cystic fibrosis.

46.

Which organism should be suspected if a patient with pneumonia expectorates sputum that is green and foul smelling?

  • Pseudomonas aeruginosa

  • Mycoplasma pneumoniae

  • Staphylococcus aureus

  • Haemophilus influenzae

Correct answer: Pseudomonas aeruginosa

Pseudomonas is an encapsulated, gram-negative, rod-shaped bacterium that can cause pneumonia and is associated with a higher mortality rate than many other forms of pneumonia. Pseudomonas should be suspected when green, foul-smelling sputum is present. 

Other organisms causing pneumonia typically cause yellow, tan, or rust-colored sputum that may or may not have a foul odor, but are unlikely to be as odiferous as Pseudomonas.

47.

When performing deep suctioning of a tracheal tube, which of the following principles is NOT correct?

  • Suction should only be applied as long as the respiratory therapist can hold their breath

  • The suction catheter should be inserted until the patient coughs or resistance is felt

  • The suction catheter should be withdrawn 1-2 cm from the maximum length of insertion before suction is applied

  • The most important intervention after suctioning is to re-oxygenate the patient

Correct answer: Suction should only be applied as long as the respiratory therapist can hold their breath

Suction should only be applied for 15 seconds at the most. Applying suction as long as the therapist can hold their breath is not an appropriate way to measure the length of time used for suctioning. 

The suction catheter should be inserted until the patient coughs or resistance is felt and should then be withdrawn 1-2 cm before suction is applied. It is true that the most important intervention after suctioning is re-oxygenation of the patient.

48.

Which of the following is the MOST concerning condition that should be monitored for in a patient with a penetrating chest trauma?

  • Tension pneumothorax

  • Hemothorax

  • Acute costochondritis

  • Traumatic brain injury (TBI)

Correct answer: Tension pneumothorax

A tension pneumothorax occurs when the pleural lesion of a penetrating chest trauma acts as a one-way valve, allowing air to enter into the pleural space and progressively expanding the pleural cavity. The unilateral increase in pressure can result in a mediastinal shift and lead to cardiovascular collapse and death. 

A hemothorax is an accumulation of blood in the pleural cavity and may be caused by penetrating chest trauma. While concerning, it is not as serious as a tension pneumothorax. Acute costochondritis is inflammation of the cartilage that connects the ribs to the sternum and, while uncomfortable, is not a serious concern. Traumatic brain injury (TBI) is a serious concern that could lead to depression of respiratory centers, but is not a condition that should be monitored for in patients with a penetrating chest trauma unless other traumatic injuries have also occurred.

49.

When evaluating a pulmonary function study of a patient with bronchiectasis, which of the following would NOT be an expected finding?

  • Decreased RV

  • Decreased FRC

  • Decreased FVC

  • Decreased FEF25%-75%

Correct answer: Decreased RV

If the RV (residual volume) is affected by bronchiectasis, it will be increased, not decreased. 

FVC (forced vital capacity), FRC (functional residual capacity), and FEF25%-75% (forced expiratory flow at 25% to 75%) will all be decreased by bronchiectasis.

50.

The respiratory therapist is performing a two-point calibration on a blood gas analyzer when one result is outside the control limits. What is the BEST action to take?

  • Rerun the calibration and compare to previous control media analyses

  • Have the analyzer serviced

  • If none of the other controls are outside the control limits, continue to use the analyzer

  • Change the frequency of two-point calibrations to once every four hours until the result is within the control limits

Correct answer: Rerun the calibration and compare to previous control media analyses

Random errors can occur when an isolated result is outside the control limits, and it does not mean that there is an error with the control media or with the analyzer. The calibration can be rerun, but the record of previous analyses should be evaluated to ensure that the frequency of random errors is not increasing. 

The analyzer should be serviced if the repeat calibration continues to be outside the control limits or if previous control media analyses indicate an increasing frequency of errors. The analyzer should not continue to be used until it is verified that this was a random error. Calibrating more frequently is not correct.

51.

Use the following scenario to answer this question.

Which of the following are MOST likely to be potential causes of COPD?

(SELECT AS MANY as you consider indicated.)

  • Cigarette smoking 

  • Alpha-1 antitrypsin deficiency

  • Vaping

  • Exposure to asbestos

  • Having a history of pulmonary hypertension

Cigarette smoking and alpha-1 antitrypsin deficiency are the two most common causes of COPD. 

While vaping may exacerbate COPD, there is insufficient evidence to say that it actually causes COPD. Exposure to asbestos increases the risk of lung cancer, not COPD. Having a history of pulmonary hypertension does not significantly increase the risk of COPD.

52.

When using a pressurized Metered Dose Inhaler (pMDI), which of the following is NOT a potential benefit of using a spacer?

  • It increases the dose that the pMDI provides

  • It eliminates hand-breathing coordination problems

  • It reduces oropharyngeal deposition of the drug

  • It helps patients with small tidal volumes to get the full dose

Correct answer: It increases the dose that the pMDI provides

While a spacer increases the percentage of small particles that are produced by a dose, it does not actually increase the dose that a pMDI provides. 

Use of a spacer does eliminate hand-breathing coordination problems by eliminating the need to synchronize inhalation and attenuation. It also reduces oropharyngeal deposition of the drug and helps patients with small tidal volumes to get the full dose.

53.

Meconium-stained amniotic fluid is noted during the delivery of a term infant. The patient's one-minute APGAR score is 10. Which of the following interventions should the respiratory therapist recommend?

  • Only routine interventions are necessary

  • Through suctioning of the infant

  • Intubation

  • Intubation and suctioning

Correct answer: Only routine interventions are necessary

A patient who has a heart rate of > 100 beats/min, a strong respiratory effort, and good muscle tone does not require suctioning after birth. Intubation and/or suctioning may be necessary if the patient does not meet any of these criteria after birth.

54.

Use the following scenario to answer this question.

Which of the following are NOT likely potential causes of the patient's pneumonia?

(SELECT AS MANY as you consider indicated.)

  • Staphylococcus aureus

  • Mycodacterium tuberculosis

  • Pseudomonas aeruginosa

  • Sterptococcus pneumoniae

  • Haemophilus influenzae

Community-acquired pneumonia is likely to be caused by either Sterptococcus pneumoniae or Haemophilus influenzae. 

Mycodacterium tuberculosis and Staphylococcus aureus are both typically causative organisms for hospital-acquired pneumonia. Pseudomonas aeruginosa is most commonly associated with ventilator-acquired pneumonia.

55.

Which of the following is NOT a technique used to perform a physical examination?

  • Palpitation

  • Percussion

  • Auscultation

  • Inspection

Correct answer: Palpitation

The four components of a physical examination are inspection, palpation, percussion, and auscultation. 

Palpitation is a cardiac term used to describe a noticeably strong, rapid, or irregular heartbeat and is not a technique used to perform a physical examination.

56.

Which of the following BEST describes colorimetric capnography?

  • A pH indicator detects changes in CO2 concentrations

  • A sensor positioned in the ventilatory circuit detects CO2 levels using infrared light

  • A gas sample is pumped to an analyzer that determines CO2 levels

  • An optimal luminescent tissue probe provides continuous readings of localized CO2 levels

Correct answer: A pH indicator detects changes in CO2 concentrations

Colorimetric capnography is almost exclusively used to determine if a tracheal tube is positioned correctly by detecting expired CO2. Colorimetric capnography works by using pH-sensitive paper that changes color based on CO2 concentrations. 

A sensor positioned in the ventilatory circuit that detects CO2 levels using infrared light describes mainstream capnography. A gas sample that is pumped to an analyzer that determines CO2 levels describes sidestream capnography. An optimal luminescent tissue probe that provides continuous readings of localized CO2 levels describes an optode.

57.

The respiratory therapist is present at a delivery. One minute after the delivery, the patient has a heart rate of 143 and a strong cry with stimulation. The patient's body is pink, but his extremities are blue. The patient is limp. 

What would be this patient's APGAR score?

  • 7

  • 6

  • 5

  • 4

Correct answer: 7

The APGAR score is used to assess the general condition of a newborn after birth and is assessed at 1 minute and 5 minutes after birth. The APGAR score uses a score of 0-10 and evaluates:

  • Appearance (0 for generalized pale and blue, 1 for pink body but blue extremities, and 2 for completely pink)
  • Pulse (0 for no pulse, 1 for < 100 beats/minute, and 2 for > 100 beats/minute)
  • Grimace (0 for no response to irritation, 1 for grimace, and 2 for a sneeze, cough, or cry)
  • Activity (0 for limp, 1 for some flexion, and 2 for active flexion)
  • Respiration (0 for absent respiration, 1 for slow and irregular respirations, and 2 for strong cry)

For this patient, their appearance provides a score of 1, their pulse provides a score of 2, their grimace provides a score of 2, their activity provides a score of 0, and their respiration provides a score of 2.

58.

Use the following scenario to answer this question.

Which of the following conditions should the respiratory therapist MOST suspect based on the patient's symptoms?

(SELECT AS MANY as you consider indicated.)

  • Tuberculosis

  • Pneumonia

  • Pulmonary hypertension

  • Myocardial infarction

  • Cellulitis

Tuberculosis and pneumonia are both pulmonary infections that may be potential causes of the patient's symptoms. 

A persistent cough and fever are not typically symptoms of pulmonary hypertension, myocardial infarction, or cellulitis. While cellulitis may cause a persistent fever, it is not likely to result in respiratory complaints in most situations.

59.

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.

60.

Use the following scenario to answer this question.

What factors should serve as the foundation for the healthcare team's decision to withdraw care while providing CPR?

(SELECT AS MANY as you consider indicated.)

  • A request to stop CPR by the patient's designated decision maker

  • A signed DNR order on the patient's chart

  • Further care is determined to be futile

  • A request to stop CPR by the patient's girlfriend

  • CPR has been provided for 40 minutes without return of circulation

CPR should be discontinued by the healthcare team if further care is determined to be futile. It may also be discontinued at the request of the patient's designated decision maker or if a signed DNR is active. 

A request to stop CPR by the patient's girlfriend would not be honored unless she is the patient's designated decision maker. The length of time CPR is performed may be an indicator of whether further care may be futile, but should not be the sole criterion on which the decision to discontinue care is made.

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