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Quiz Session - Attempts With Random Questions

NBRC RRT Exam Questions

Page 7 of 30

121.

Use the following scenario to answer this question.

Which of the following MOST likely explains the patient's change in condition?

(CHOOSE ONLY ONE.)

  • They have developed sepsis

  • They are having a stroke

  • Their pneumonia is causing respiratory failure

  • They are having an allergic reaction to levofloxacin

Correct answer: They have developed sepsis

The patient has an infection for which treatment was delayed. They also have a decreasing blood pressure, increasing temperature, and increasing heart rate. This indicates that the patient is likely developing septic shock. The decreased level of consciousness and decline in respiratory status is most likely sequela from septic shock.

122.

When providing endotracheal suctioning for a neonate, which negative pressure range should the respiratory therapist use?

  • 80-100 mm Hg

  • 60-80 mm Hg

  • 100-120 mm Hg

  • 120-150 mm Hg

Correct answer: 80-100 mm Hg

When providing endotracheal suctioning to a neonate, negative pressures of 80-100 mm Hg should be used. 

60-80 mm Hg would be insufficient for any population. 100-120 mm Hg is the range used for children, and 120-150 mm Hg is the range used for adults.

123.

Use the following scenario to answer this question.

While providing education to the patient, the respiratory therapist recommends the tennis ball technique. Which of the following is part of the tennis ball technique?

(CHOOSE ONLY ONE.)

  • A tennis ball is sown into the patient's sleepwear

  • The patient plays tennis at least three evenings a week

  • The patient places a tennis ball under their chin while sleeping

  • A tennis ball is held over the outlet of the CPAP to test its pressure prior to attaching the mask

Correct answer: A tennis ball is sown into the patient's sleepwear

The tennis ball technique involves sewing a tennis ball into the patient's sleepwear. Depending on the placement of the tennis ball, the patient will adjust their sleeping positions to ensure their comfort while sleeping. This will help the patient maintain sleeping positions that promote airway patency.

124.

The respiratory therapist is evaluating a patient's chest symmetry and observes unequal chest expansion. Which of the following is NOT likely to be a cause of unequal chest expansion?

  • Chronic obstructive pulmonary disease (COPD)

  • Flail chest

  • Chest deformities

  • Pneumothorax

Correct answer: Chronic obstructive pulmonary disease (COPD)

COPD can cause hyperinflation of the chest, also called a barrel chest. This hyperinflation, however, is bilaterally symmetrical with COPD and is not likely to cause unequal chest expansion. 

Flail chest, chest deformities, and pneumothorax are all potential causes of unequal chest expansion.

125.

Fomites are a common means of transmission for infectious pathogens. Which of the following is an example of a fomite?

  • A stethoscope

  • A pond

  • A tick

  • A turkey sandwich

Correct answer: A stethoscope

Fomites are inanimate objects that can transfer infectious pathogens when contaminated, such as clothes, surfaces, or equipment. 

A pond could be a source of a water-borne illness, and a turkey sandwich could be the source of a food-borne illness. While, technically, a pond and a sandwich are inanimate objects, both transfer infection when ingested. Fomites typically play a more passive role in transmission. A tick would be an example of a vector, not a fomite.

126.

The respiratory therapist is using the STOP-BANG questionnaire to screen a patient for obstructive sleep apnea (OSA) and the patient scores a 2 on this questionnaire. Which of the following is CORRECT about this patient?

  • This patient has a low probability of OSA

  • This patient does not have OSA

  • The patient has a high probability for some degree of OSA

  • The patient has a high probability for moderate to severe OSA

Correct answer: This patient has a low probability of OSA

The STOP-BANG questionnaire is a commonly used questionnaire to screen for OSA and tests eight factors. A score of 3 or greater indicates that OSA is probable, while a score of 5 or higher indicates that moderate to severe OSA is probable. A score lower than 3 indicates that the patient has a low probability of OSA, but can never absolutely rule it out.

127.

Use the following scenario to answer this question.

Which of the following facts would MOST reduce the healthcare team's suspicion that the patient had hypersensitivity pneumonitis?

(CHOOSE ONLY ONE.)

  • While the patient works in a store selling pet parrots, he is never actually exposed to the birds

  • The patient actually only ingests marijuana; he has not smoked it in years

  • The patient also has frequent exposure to wood pulp

  • The patient has a history of childhood asthma

Correct answer: While the patient works in a store selling pet parrots, he is never actually exposed to the birds

Exposure to avian proteins is a risk factor for hypersensitivity pneumonitis. If the patient is never actually exposed to avian proteins, hypersensitivity pneumonitis becomes a less likely diagnosis. 

The use of marijuana is not a significant risk factor for hypersensitivity pneumonitis. Frequent exposure to wood pulp suggests an additional irritant, strengthening the potential diagnosis of hypersensitivity pneumonitis. A history of asthma as a child does not affect the potential that the diagnosis will be hypersensitivity pneumonitis.

128.

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. 

129.

A patient is receiving O2 via nasal cannula at 4 L/min from a liquid O2 tank containing 4lb of liquid O2. How long will the O2 last for this patient?

  • 5.7 hrs

  • 7.2 hrs

  • 0.7 hrs

  • 11.5 hrs

Correct answer: 5.7 hrs

The gas remaining in a liquid O2 tank can be calculated using the following equation:

(Liquid weight (lb)*860) / 2.5 L/lb

For this question, the calculation would be:

(4 lb*860) / 2.5 L/lb = 1376L

The time remaining can be found by dividing the volume left by the flow rate:

1376L / 4 L/min = 344 min = 5.7 hrs

130.

Use the following scenario to answer this question.

Which of the following interventions is BEST given the patient's vital signs?

(CHOOSE ONLY ONE.)

  • Providing 2L of oxygen via nasal cannula

  • Applying a non-rebreather mask

  • Recommending IV fluids

  • Recommending IV antibiotics

Correct answer: Providing 2L of oxygen via nasal cannula

The patient's vital signs indicate that there could be some mild dyspnea, and supplemental oxygen may be helpful. A non-rebreather, however, is not necessary. 

IV fluids or IV antibiotics are not necessary based solely on the patient's vital signs.

131.

In which of the following situations would priming a pressurized meter-dose inhaler (pMDI) be UNNECESSARY?

  • Before a routine dose using the pMDI

  • When the pMDI has not been used for several days

  • Before the first use of the pMDI

  • When the operator is unsure if the pMDI is working

Correct answer: Before a routine dose using the pMDI

A pressurized meter-dose inhaler (pMDI) should always be primed before the first use and when it has not been used for several days. This helps to eliminate the dead space that may reduce the dosage of medication administered. The operator of the pMDI can also prime it to evaluate its function and ensure that a dose is still being delivered correctly. 

Priming a pMDI before a routine dose is not necessary if there is no indication for priming.

132.

What is the correct term for apnea that initially is caused by an airway obstruction but develops into the patient failing to initiate respiratory effort?

  • Mixed apnea

  • Obstructive apnea

  • Central apnea

  • Sleep apnea

Correct answer: Mixed apnea

Mixed apnea is a combination of obstructive and central apnea. 

Obstructive apnea is caused when effort to breathe occurs but the airway is obstructed, preventing airflow. Central apnea is apnea that occurs when there is no effort to breathe. Sleep apnea can be either obstructive or central, but it is not the apnea described in the question stem.

133.

A 55-year-old male with extensive burns over the chest wall and arms requires an emergent escharotomy. Which of the following is the reason for this procedure?

  • Reduction of chest wall stiffness

  • Promotion of wound healing by cleaning the wound bed

  • Reduction of potential fluid loss from the burns

  • This procedure should not be performed on a burn victim

Correct answer: Reduction of chest wall stiffness

Eschar is thick, fibrous tissue that forms in areas that have been severely burned. When eschar covers the circumference of the chest wall or even extensively covers the anterior chest and abdomen, it can decrease chest wall compliance to the extent that can lead to an inability to inspire. An escharotomy involves making an incision through the eschar to allow for unrestricted chest wall movement. 

An escharotomy does not involve cleaning the wound bed or reducing the potential loss of fluids. Escharotomies are primarily only performed on burn victims.

134.

Which of the following is an advantage of using a dry powder inhaler (DPI) over a pressurized metered-dose inhaler (pMDI)?

  • It does not require hand-breath coordination

  • It does not require the patient to generate a high inspiratory flow

  • It can be administered to patients using mechanical ventilation

  • It provides a more reliable dose

Correct answer: It does not require hand-breath coordination

A dry powder inhaler (DPI) does not require hand-breath coordination like a pressurized metered-dose inhaler (pMDI) does. 

A DPI does require that a patient be able to generate a high inspiratory flow to aerosolize the medication while a pMDI does not. A pMDI can be administered to ventilated patients while a DPI cannot. DPIs and pMDIs provide equally reliable doses.

135.

The respiratory therapist is attending to a 71-year-old male who is being weaned from the ventilator. After 10 minutes of T-piece weaning, the patient complains of mild shortness of breath. An ECG is performed and shows inverted T waves and acute elevation of the ST segment. 

Which of the following BEST explains these EKG changes?

  • The patient is experiencing hypoxia caused by the stress of weaning

  • The patient is experiencing an acute myocardial infarction that was caused by weaning

  • These are normal EKG changes that are expected during weaning

  • The patient likely has electrolyte imbalances caused by physiological changes that can occur during weaning

Correct answer: The patient is experiencing hypoxia caused by the stress of weaning

Inverted T waves and an acute elevation of the ST segment that coincide with attempted weaning likely indicate myocardial hypoxia caused by the stress of weaning. 

Weaning is unlikely to trigger a myocardial infarction in which blood supply to the heart is obstructed; more likely, the myocardium is not receiving adequate oxygen. Weaning is unlikely to cause electrolyte changes that will affect conduction in the heart. These EKG changes are not normal.

136.

Use the following scenario to answer this question.

Which of the following vital signs are likely to be impacted by this patient's condition? 

(SELECT AS MANY as you consider indicated.)

  • Blood pressure

  • Oxygen saturation

  • Respiratory rate

  • Temperature

  • Heart rate

The patient likely has obstructive sleep apnea (OSA). OSA can lead to chronic hypertension. During the night it causes periods of apnea that may affect respiratory rate and oxygen staturation. 

OSA is not likely to affect temperature or heart rate in any meaningful way.

137.

The physician asks the respiratory therapist for their recommendations for VT settings for a patient who is being placed on a mechanical ventilator. The patient is an 82-year-old female  with ARDS who weighs 50kg (110lb), and is 5'1". 

What settings should the respiratory therapist recommend?

  • 200-300 mL

  • 300-400 mL

  • 250-350 mL

  • 400-500 mL

Correct answer: 200-300 mL

To determine the tidal volume (VT) that should be used, the respiratory therapist will have to determine the patient's ideal body weight (IBW). For females, the IBW is determined by using 105 lbs for the first 60 inches, then adding 5 lbs for every additional inch.

For this patient, IBW = 105 + (5*(61-60)) = 105 + 5 = 110 lbs. 

VT is normally set at 6-8 mL/kg, but for patients with ARDS it is set lower at 4-6 mL/kg. 110 lb / 2.2 lb/kg = 50 kg. This provides a range of about 200-300 mL.

138.

When drawing a capillary blood gas specimen, which of the following interventions is INCORRECT?

  • Squeezing a sample from the capillaries once the first drop of blood has been wiped away

  • Warming the site to 42° C

  • Confirming steady state conditions

  • Either chilling the sample after drawing or analyzing it immediately

Correct answer: Squeezing a sample from the capillaries once the first drop of blood has been wiped away

A sample should be acquired after the first drop of blood has been wiped away; however, the site should not be squeezed, as this can contaminate the sample with intracellular or lymphatic fluids. 

The site should be warmed to 42° C before accessing and steady-state conditions should be confirmed. The sample should be chilled or analyzed immediately.

139.

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.

140.

Use the following scenario to answer this question.

Which of the following tests are LIKELY to be performed during a polysomnogram to monitor sleep stage? 

(SELECT AS MANY as you consider indicated.)

  • Electroencephalogram (EEG)

  • Electroculogram (EOG)

  • Chin electromyogram (EMG)

  • Electrocardiogram (ECG)

  • Electroconvulsive therapy (ECT)

During a polysomnogram, an electroencephalogram (EEG), electroculogram (EOG), and chin electromyogram (EMG) are all used to monitor sleep stage. 

An ECG may be performed; however, it is not used to monitor sleep stage. Electroconvulsive therapy (ECT) is not ever used during a polysomnogram.

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