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Quiz Session - Attempts With Random Questions

NBRC RRT Exam Questions

Page 6 of 30

101.

Which of the following describes control mode ventilation?

  • Inspiration is only time-triggered

  • Inspiration is only patient-triggered

  • Inspiration is either patient-triggered or time-triggered

  • It permits spontaneous breathing

Correct answer: Inspiration is only time-triggered

Control mode overrides any patient effort and only delivers breaths at time-triggered intervals. 

Patient-triggered breathing does not occur with this form of ventilation. Control mode ventilation does not permit spontaneous breathing.

102.

Which of the following is NOT a potential danger of using ethylene oxide gas for sterilization?

  • It cannot be mixed with other gases

  • It is toxic

  • It can cause or increase the risk of cancer

  • It can explode

Correct answer: It cannot be mixed with other gases

Ethylene oxide gas is explosive, toxic, and carcinogenic. 

Ethylene oxide gas can, however, safely be mixed with other gases. It is often mixed with CO2 or Freon to reduce the risk of combustion and explosion.

103.

Use the following scenario to answer this question.

Which of the following interventions are MOST likely to be indicated for this patient?

(SELECT AS MANY as you consider indicated.)

  • Insertion of an arterial line

  • Lactic acid level

  • ABG

  • Limiting IV fluids

  • Recommending administration of sildenafil

The patient's changing condition is consistent with the development of septic shock. The interventions indicated for this suspected change in condition are insertion of an arterial line, checking a lactic acid level, and performing an ABG. 

Limiting IV fluids or administering sildenafil are not appropriate interventions for suspected septic shock.

104.

Use the following scenario to answer this question.

Which of the following definitions BEST describes a period of obstructive apnea during a laboratory-based sleep study?

(CHOOSE ONLY ONE.)

  • The absence of airflow for at least 10 seconds

  • A 80% or greater reduction in airflow for at least 10 seconds

  • A drop in O2 saturatation of 3% or more within a 10 second period

  • The absence of respiratory effort for at least 10 seconds

Correct answer: The absence of airflow for at least 10 seconds

Apnea in the context of obstructive sleep apnea is defined as the absence of airflow for at least 10 seconds. 

It is not described as the absence of respiratory effort for at least 10 seconds, as respiratory effort may be made but not result in airflow due to the obstruction. A reduction in airflow is described as hypopnea, not apnea. A drop in O2 saturatation is not used to define apnea.

105.

You are the respiratory therapist evaluating a patient who has just completed an overnight polysomnogram. The patient's apnea-hypopnea index (AHI) was reported to be 16. Which of the following statements is TRUE about this finding?

  • The patient has moderate sleep apnea

  • The patient has severe sleep apnea

  • The patient has mild sleep apnea

  • This finding is normal

Correct answer: The patient has moderate sleep apnea

The apnea-hypopnea index (AHI) represents the number of apneic and hypopneic episodes occurring per hour during a polysomnogram. An AHI interpretation depends on the following ranges:

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

This patient falls into the range of moderate sleep apnea.

106.

Which organ does an elevated BUN indicate is affected?

  • Kidneys

  • Heart

  • Lungs

  • Brain

Correct answer: Kidneys

Blood urea nitrogen (BUN) is a waste product that is filtered by the kidneys and is used to evaluate kidney function. 

While an elevated BUN can indicate impaired kidney function that can have an indirect effect on the heart, lungs, and brain, the abnormal level indicates that kidney function has been affected.

107.

Which of the following is NOT an important intervention when extubating a patient?

  • Have the patient inspire as the tube is withdrawn

  • Suction the ET tube prior to extubation

  • Suction the mouth and back of the throat prior to extubation

  • Increase the FiO2 prior to extubation

Correct answer: Have the patient inspire as the tube is withdrawn

The patient should inspire, and the tube should be withdrawn at peak inspiration, not during inspiration. 

The ET tube, mouth, and back of the throat should be suctioned prior to extubation. The FiO2 should also be increased prior to extubation.

108.

The respiratory therapist is examining the cuff pressure of a patient who has just been intubated. Which of the following can be caused by insufficient cuff pressure?

  • Ventilator-associated pneumonia (VAP)

  • Tube migration

  • Tracheoesophageal fistula

  • Cardiac arrhythmias

Correct answer: Ventilator-associated pneumonia (VAP)

Ventilator-associated pneumonia (VAP) can be caused if secretions that pool above the cuff are able to enter the airways distal to the cuff. This can occur when the cuff is inadequately inflated and is also called silent aspiration. 

The tube is not held in place by the cuff, and tube migration should not occur. Tracheoesophageal fistulas occur from overinflated cuffs, not underinflated cuffs. Cardiac arrhythmias are not caused by underinflated tracheal tube cuffs.

109.

Which of the following is NOT caused by malnutrition of a ventilated patient?

  • Increased surfactant production

  • Reduced response to hypercarbia

  • Pulmonary edema

  • Difficulty weaning

Correct answer: Increased surfactant production

Malnutrition causes decreased surfactant production, not increased surfactant production. 

Malnutrition does cause a reduced response to hypercarbia, pulmonary edema that is caused by decreased serum albumin levels, and difficulty weaning due to decreased strength of respiratory muscles.

110.

A patient who is being monitored using sidestream capnography suddenly has an increase in PETCO2 levels. Which of the following factors would NOT cause this to occur?

  • Hypoventilation

  • Injection of sodium bicarbonate

  • Release of a tourniquet that has been on for several minutes

  • Starting an aortic balloon pump

Correct answer: Hypoventilation

Hypoventilation would typically lead to a gradual increase in PETCO2 levels, not to a sudden increase. 

An injection of sodium bicarbonate and the release of a tourniquet could both cause a sudden increase in CO2 levels. Starting an aortic balloon pump would lead to a sudden increase in cardiac output, which would lead to a sudden increase in CO2 levels.

111.

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.

112.

When selecting between sidestream and mainstream capnography for monitoring a mechanically ventilated patient, the respiratory therapist understands that which of the following is a disadvantage to using sidestream capnography that mainstream capnography does not have?

  • A trap is required to remove water from the sample

  • There is a bulky sensor at the patient's airway

  • Secretions can interfere with capnography readings

  • It is difficult to use with non-intubated patients

Correct answer: A trap is required to remove water from the sample

Sidestream capnography requires a water trap to remove water from the sample, while mainstream capnography does not. 

Mainstream capnography requires a sensor that is at the patient's airway, while sidestream capnography does not. Secretions can interfere with capnography readings for both mainstream and sidestream capnography. Sidestream capnography is easier to use than mainstream capnography in non-intubated patients.

113.

Which of the following processes describes the process of autoclaving a piece of equipment?

  • The piece of equipment is heated with pressurized steam

  • The piece of equipment is immersed in hot water for several hours

  • The piece of equipment is exposed to ethylene oxide gas for a prolonged period

  • The piece of equipment is immersed in glutaraldehyde for several hours

Correct answer: The piece of equipment is heated with pressurized steam

Autoclaving a piece of equipment involves exposing the piece of equipment to heat by using pressurized steam. 

Immersing a piece of equipment in hot water for a period of time is called pasteurization. Chemicals like ethylene oxide gas and glutaraldehyde can be used to sterilize equipment, but this does not describe the process of autoclaving.

114.

Which of the following is NOT a side effect associated with the use of aerosolized acetylcysteine (Mucomyst)?

  • Pulmonary edema

  • Airway obstruction

  • Stomatitis

  • Bronchospasms

Correct answer: Pulmonary edema

Use of acetylcysteine has been declining in recent years due to the high number of side effects it produces. Acetylcysteine is irritating to the airways, and bronchospasms are the most serious side effect that this irritation can cause. Acetylcysteine can also cause rapid liquefaction of secretions, causing airway obstruction. Stomatitis is another acetylcysteine side effect. 

While acetylcysteine can rapidly liquify sections causing fluids in the airway, these fluids are not due to edema, and pulmonary edema is not a side effect of acetylcysteine use.

115.

The respiratory therapist is called to evaluate a patient who has just arrived in the emergency room. The respiratory therapist determines the patient is ventilating adequately, but is oxygenating poorly. The healthcare team would like the respiratory therapist's recommendation on starting to mechanically ventilate the patient. 

Which of the following is the BEST advice for this patient?

  • Mechanical ventilation should be started if the poor oxygenation is related to the patient's respiratory effort.

  • Mechanical ventilation should be started regardless of other considerations.

  • The patient will not need mechanical ventilation.

  • High-flow nasal cannula would not be a better initial treatment than mechanical ventilation.

Correct answer: Mechanical ventilation should be started if the poor oxygenation is related to the patient's respiratory effort.

Patients who are ventilating well may still be started on mechanical ventilation if they are poorly oxygenated and their poor oxygenation is related to the patient's respiratory effort or to their ventilatory pattern. 

Mechanical ventilation should not be started regardless of other considerations. Mechanical ventilation cannot be ruled out as a potential intervention for this patient. High-flow nasal cannula or CPAP should generally be considered first for patients who are ventilating well but oxygenating poorly.

116.

Which of the following is NOT an indication for aerosolized glucocorticoid use?

  • Acute asthma exacerbation

  • Persistent asthma

  • Severe COPD

  • Allergic rhinitis

Correct answer: Acute asthma exacerbation

An acute asthma exacerbation should be treated with bronchodilators, not with aerosolized glucocorticoids. Glucocorticoids act slowly and will not provide the immediate relief needed in an acute asthma exacerbation. 

Persistent asthma and severe COPD will both benefit from the use of inhaled glucocorticoids. Nasal aerosolized glucocorticoids are used to suppress hyperactive immune responses in the nasal passages and can be used to treat allergic rhinitis.

117.

Which muscles are used for normal ventilation?

  • The intercostal muscles and the diaphragm

  • Only the diaphragm

  • The diaphragm, intercostal muscles, and the scalene

  • The diaphragm, intercostal muscles, and the pectoralis major muscles

Correct answer: The intercostal muscles and the diaphragm

The intercostal muscles and the diaphragm are the major muscles used during normal ventilation. 

Accessory muscles are not used during normal ventilation, and include the scalene, the pectoralis major muscles, and the sternomastoid muscles.

118.

Which of the following aerosolized mucolytics is unstable at room temperature, requiring additional storage considerations that include refrigeration and protection from light?

  • Dornase alfa (Pulmozyme)

  • Acetylcysteine (Mucomyst)

  • Sodium bicarbonate (2% NaHCO3)

  • Mannitol (Bronchitol)

Correct answer: Dornase alfa (Pulmozyme)

Dornase alfa is an enzyme that selectively cleaves DNA found in mucus. This makes the mucus less viscous and easier to mobilize. This enzyme is fragile compared to many other molecules used in aerosolized mucolytics and requires additional storage considerations including refrigeration and protection from light.

119.

Why is a post-term infant at a greater risk of meconium aspiration syndrome?

  • There is less amniotic fluid

  • Their inspiratory muscles are more developed

  • Preterm, not post-term, infants are at a greater risk of meconium aspiration

  • They are more likely to have hypoxia prior to birth

Correct answer: There is less amniotic fluid

A post-term infant has less amniotic fluid than term or preterm infants, making meconium more concentrated. 

While a post-term infant's inspiratory muscles may be more developed, this does not increase the risk of meconium aspiration syndrome. Preterm infants are not significantly more likely to have hypoxia prior to birth; this typically depends on factors that are not related to gestational age.

120.

The respiratory therapist is selecting an in-line suction catheter for a 7.5mm ET tube. Which sized suction catheter should be used?

  • 14 Fr

  • 16 Fr

  • 12 Fr

  • 10 Fr

Correct answer: 14 Fr

To estimate the proper suction catheter size, the internal diameter of the ET should be doubled, then the next smallest catheter size should be used. In this scenario, 7.5 x 2 = 15. The next smallest size is 14 Fr.

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