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Quiz Session - Attempts With Random Questions

NBRC RRT Exam Questions

Page 9 of 30

161.

The respiratory therapist is preparing to document a patient's dyspnea using the Modified Borg Dyspnea Scale (MBS). Which of the following data is needed to document this?

  • The patient's subjective description of their dyspnea

  • The patient's heart rate

  • The patient's respiratory rate

  • The respiratory therapist's assessment of the patient's accessory muscle use

Correct answer: The patient's subjective description of their dyspnea

The Modified Borg Dyspnea Scale (MBS) rates the patient's dyspnea on a scale of 0-10 based on their subjective impression of their dyspnea. 

The patient's heart rate and respiratory rate are not needed for use of this tool. The respiratory therapist does not need to assess the patient's accessory muscle use to use this tool.

162.

Which of the following is NOT necessary when applying a Passy-Muir Speaking Valve to a tracheostomy tube?

  • If the patient is on a ventilator, the FiO2 should be increased

  • The tracheostomy tube must be suctioned before applying

  • The cuff on the tracheostomy tube must be deflated

  • If the patient is on a ventilator, the tidal volume should be increased

Correct answer: If the patient is on a ventilator, the FiO2 should be increased

Passy-Muir Speaking Valves can be used while on a ventilator, but the FiO2 does not need to be adjusted. The tidal volume should be increased, however, to compensate for gas loss through the upper airway. 

The tracheostomy tube must be suctioned before applying the Passy-Muir Speaking Valve so that secretions that have pooled above the cuff will not be aspirated into the airway. The cuff on the tracheostomy tube absolutely must be deflated as expired air will no longer be able to escape through the tracheostomy tube.

163.

The respiratory therapist is treating a patient with an air-entrainment mask delivering 60% O2. The patient has the following ABG values after starting the air-entrainment mask:

  • pH 7.41
  • PaCO2 38 mm Hg
  • PaO2 51 mm Hg
  • HCO3- 25 mEq/l
  • BE -0.9

Which of the following interventions is BEST for this patient?

  • Start CPAP

  • Increase to 70% O2

  • Intubate and begin mechanical ventilation

  • No intervention is needed for this patient

Correct answer: Start CPAP

The patient has a normal acid-base status, normal ventilation, and a normal metabolic status. The patient does, however, have moderate hypoxemia. As the patient is already on 60% O2, providing positive pressure using continuous positive airway pressure (CPAP) will be the most effective intervention for this patient. 

Increasing the O2 is unlikely to be more effective than providing positive pressure. Intubation may be necessary, but CPAP should be attempted first.

164.

Which of the following is the CORRECT description of proficiency testing?

  • Outside samples with an unknown value are analyzed and reported

  • The analyzer automatically adjusts output signals based on exposure to media with a known value

  • A respiratory therapist runs a certain number of samples under supervision and is signed off as being proficient in the skill

  • Statistical, rule-based procedures are used to identify and correct instrument errors

Correct answer: Outside samples with an unknown value are analyzed and reported

Proficiency testing involves having outside samples with unknown values analyzed and then compared to the actual sample values. Proficiency testing is typically done three times per year with five samples. 

Automated calibration describes the process through which an analyzer automatically adjusts output signals based on exposure to media with a known value. Internal Statistical Quality Control refers to the process through which statistical, rule-based procedures are used to identify and correct instrument errors. The process through which a clinician's skills are verified can be called many things, depending on the facility, but is different from proficiency testing.

165.

A 35-year-old female has a maximum inspiratory pressure of 140 cm H2O. Given the patient's age and gender, how does this reading compare to the expected value?

  • It is high

  • It is normal

  • It is low

  • It is dangerously low

Correct answer: It is high

A female who is 19 to 50 years old should have a maximum inspiratory pressure PIMAX of 91 with a standard deviation of 25. A PIMAX of 140 would be higher than would be expected for this patient given their age and gender.

166.

A chilled ABG sample has not been analyzed yet and was drawn 51 minutes ago. What action should the respiratory therapist take?

  • Run the specimen as normal

  • Discard this specimen and draw a new one

  • Run the specimen, but note that the results could be variable

  • Run the specimen, but realized that only the pH results will be valid

Correct answer: Run the specimen as normal

A chilled ABG specimen can be run as long as it was drawn less than 60 minutes ago. 

It is not necessary to discard the specimen and draw a new one or to make any additional notation in the documentation. The specimen should yield correct results for all data points, not just the pH.

167.

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.

168.

Which of the following is TURE regarding providing chest physical therapy (CPT) to a patient who has recently had esophageal surgery?

  • CPT may be performed, but the patient should not be placed in the Trendelenburg position

  • CPT may be performed without any limitations

  • CPT is contraindicated in this patient

  • CPT can only be performed if the patient is intubated

Correct answer: CPT may be performed, but the patient should not be placed in the Trendelenburg position

CPT can be performed in patients who have recently had esophageal surgery, but due to the risk of aspiration, these patients should not be placed in a Trendelenburg position. 

CPT is not absolutely contraindicated but cannot be performed without limitations. Intubation is not necessary to perform CPT on this patient.

169.

Which of the following dead spaces is NOT a significant factor that should be considered when ventilating an adult patient using PCV mode?

  • Mechanical dead space

  • Anatomic dead space

  • Alveolar dead space 

  • Physiologic dead space

Correct answer: Mechanical dead space

Mechanical dead space is dead space created by respiratory equipment and is not a significant consideration unless the patient has very low tidal volumes or unless they are ventilated using volume control ventilation (VCV). 

Anatomic dead space is dead space in conducting airways. Alveolar dead space is dead space in non-perfused alveoli. Physiologic dead space is the sum of anatomic dead space and alveolar dead space.

170.

Use the following scenario to answer this question.

Which of the following medications are MOST likely to be used in treating the patient's tracheal stenosis?

(SELECT AS MANY as you consider indicated.)

  • Bronchodilators

  • Aerosolized steroids

  • Mucolytics

  • Aerosolized antimicrobials

  • Pulmonary vasodialotors

Bronchodilators and aerosolized steroids will both decrease inflammation and increase the diameter of the tracheal lumen, potentially improving symptoms of tracheal stenosis. 

Mucolytics, aerosolized antimicrobials, and pulmonary vasodilators are unlikely to have any meaningful effect in treating tracheal stenosis. Mucolytics may assist in airway clearance in some situations, but will not actually have a direct effect on tracheal stenosis.

171.

The respiratory therapist suspects that a patient's pulse oximeter is not reading correctly. Which of the following is NOT a correct intervention to fix this problem?

  • Check the patient's hemoglobin levels

  • Try another pulse oximeter

  • Check that there is no excessive ambient light

  • Try the probe on another site

Correct answer: Check the patient's hemoglobin levels 

A pulse oximeter measures the percentage of hemoglobin that is carrying oxygen. The concentration of hemoglobin in the patient's blood will not affect this value. 

Trying another pulse oximeter, checking that there is no excessive ambient light, and trying the probe on another site are all interventions that could fix a pulse oximeter that is not reading correctly.

172.

Which of the following can be adverse consequences of obstructive sleep apnea (OSA)?

  1. Nocturnal arrhythmias
  2. Stroke
  3. Excessive daytime sleepiness
  4. Insulin resistance
  5. Personality changes

  • 1, 2, 3, 4, & 5

  • Only 3

  • 1, 3, & 5

  • 3, 4, & 5

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

OSA can lead to many potential adverse consequences. These may include nocturnal arrhythmias, stroke, excessive daytime sleepiness, insulin resistance, and adverse personality changes.

173.

Which of the following conditions would a methacholine challenge test be used for?

  • Exercised-induced asthma

  • Pulmonary fibrosis

  • Pneumonia

  • Bronchiectasis

Correct answer: Exercised-induced asthma 

A methacholine challenge test uses methacholine, a bronchoconstrictor, to evaluate the reactivity of airways. Exercised-induced asthma is an example of a condition that this test would be used to evaluate. 

Pulmonary fibrosis, pneumonia, and bronchiectasis would not normally be evaluated using a methacholine challenge test.

174.

The respiratory therapist is caring for a patient who has been ordered an anticholinergic medication. Which of the following describes the action of an anticholinergic drug?

  • It blocks a receptor for acetylcholine

  • It stimulates a receptor for acetylcholine

  • It blocks a receptor for norepinephrine or epinephrine

  • It stimulates a receptor for norepinephrine or epinephrine

Correct answer: It blocks a receptor for acetylcholine 

Anticholinergic drugs block acetylcholine receptors. 

Drugs that stimulate receptors for acetylcholine are called cholinergic drugs. Drugs that block receptors for norepinephrine or epinephrine are called antiadrenergic drugs, while drugs that stimulate these receptors are called adrenergic drugs.

175.

Use the following scenario to answer this question.

Which of the following should be inferred from the patient's X-ray?

(CHOOSE ONLY ONE.)

  • The patient may have tuberculosis; however, the chest X-ray is insufficient to make a diagnosis

  • The patient does not likely have tuberculosis, as no pleural effusion is present

  • The patient does not likely have tuberculosis, as no infiltrates are present

  • The patient almost certainly has tuberculosis

Correct answer: The patient may have tuberculosis; however, the chest X-ray is insufficient to make a diagnosis

Hilar lymphadenopathy is present in 65% of patients with tuberculosis. The patient may have tuberculosis; however, the chest X-ray is insufficient to make a diagnosis. 

Pleural effusions and infiltrates are seen on chest X-rays of patients with tuberculosis, but not in the majority of cases.

176.

When reviewing the chart of a patient with COPD, the respiratory therapist notes that the patient's CODP stage is documented as GOLD 3. Which of the following can be inferred from this?

  1. The patient's FEV1/FVC is less than 50% but equal to or greater than 30%
  2. The patient's FEV1/FVC is less than 70%
  3. The patient's FEV1/FVC is less than 50%
  4. The patient's FEV1 is less than 50% but equal to or greater than 30% predicted
  5. The patient's FEV1 is less than 29% predicted

  • 2 & 4 only

  • 3 & 5 only

  • 1, 3, & 5 only

  • 1 only

Correct answer: 2 & 4 only

The GOLD standard is used to stage COPD and is based on the FEV1 (forced expiratory volume over 1 second) for patients who have an FEV1/FVC that is less than 70%. The range for GOLD 3 is an FEV1 less than 50% but equal to or greater than 30% predicted.

177.

Which of the following is NOT a side effect that is likely to be caused by an inhaled corticosteroid?

  • Airway edema

  • Oropharyngeal fungal infections

  • Hoarseness

  • Bronchoconstriction

Correct answer: Airway edema

Inhaled corticosteroids will suppress inflammation in the airways. This will have the effect of reducing airway edema, not causing it. 

Oropharyngeal fungal infections can be caused by the localized immunosuppression that inhaled corticosteroids cause in the oral cavity. Hoarseness and bronchoconstriction can be side effects of inhaled corticosteroid due to the irritation they can cause.

178.

The respiratory therapist is called to evaluate a patient who has just been brought into the Emergency Department after being involved in a motor vehicle accident (MVA). Which of the following considerations is TRUE?

  • The role of the respiratory therapist includes tailoring the support of respiratory function

  • Trauma only requires respiratory support if it involves the airway

  • The presentation of trauma is normally homogenous

  • If the patient has a GCS less than 11, they are likely to have poorer post-injury quality of life

Correct answer: The role of the respiratory therapist includes tailoring the support of respiratory function

The role of the respiratory therapist in treating acute trauma includes identifying life-threatening problems and tailoring the support of respiratory function. 

Respiratory support during trauma is complex and may include many other components beyond managing a patient's airway. The presentation of trauma is normally heterogeneous, not homogenous. Patients with traumatic brain injury and a Glasgow Coma Score (GCS) less than 8 who require endotracheal intubation are likely to have poorer post-injury quality of life, but a GCS of less than 11 by itself is not an indicator.

179.

When suctioning a typical adult patient, what is the maximum time that suction time should be limited to?

  • 15 seconds

  • 10 seconds

  • 12 seconds

  • 20 seconds

Correct answer: 15 seconds

Suctioning should be restricted to 15 seconds or less in a typical adult patient. Suctioning may need to be restricted to shorter timeframes for more compromised patients, but should never exceed 15 seconds.

180.

Use the following scenario to answer this question.

Which of the following MOST likely increased the patient's risk of pulmonary infection?

(CHOOSE ONLY ONE.)

  • The recent bronchoscopy

  • Medications used to treat tracheal stenosis

  • Recent hospitalization

  • The patient's past medical history

Correct answer: The recent bronchoscopy

A bronchoscopy increases the risk of pulmonary infections by increasing the risk of introducing pathogens into the respiratory tract. 

Medications used to treat tracheal stenosis may include steroids that could increase the risk of pulmonary infection; however, the recent bronchoscopy is much more likely to increase this risk. Recent hospitalization is also a risk factor, but is not as important a risk factor as a recent bronchoscopy. The patient's past medical history does not significantly increase the risk of pulmonary infection.

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