The patient's lung has an air leak - Answer -You are called to the emergency department to help care for
a patient who was in a vehicle accident and has chest injuries including broken ribs. Crepitations are felt
while palpitating the patient's neck. What is most likely the cause of this?
Reversible airway obstruction - Answer -A forced expiratory measurement obtained after the
administration of a bronchodilator shows an increase in FEV1 from 60% to 80% of predicted. This
indicates a:
complete airway obstruction - Answer -During capnography monitoring of a mechanically ventilated
patient, you note that the end-tidal PCO2 (PetCO2) has dropped to 0 mm Hg. This finding may indicate:
inserting an esophageal-tracheal combitube - Answer -An unconscious apneic patient with a full
stomach cannot be orally intubated in the emergency room. Which of the following would your
recommend be?
patients size and clinical condition - Answer -While establishing initial ventilatory support settings for a
new patient, the most important consideration is the:
Fever (hyperthermia) - Answer -A male patient has a lower than normal mixed venous O2 content.
Which of the following is the most likely cause of this condition?
,apply 5-10 cm H20 pressure support - Answer -You are trying to wean an alert intubated patient off full
ventilatory support using the CPAP protocol with 40% O2. Early in the initial effort her respiratory rate
increases from 24 to 30/min and you start to observe some use of her accessory muscles while
breathing. Which of the following would be your first action at this time?
70 minutes - Answer -What is the approximate duration of flow of an oxygen E-cylinder at 1000 psi
running at 4 L/min?
increase the suction pressure to -120 mm Hg - Answer -While using a Yankauer device to suction an
adult patient, you are unable to remove thick secretions. The regulator attached to the oropharyngeal
suctioning device displays a reading of -70 mm Hg. Which of the following actions should you take at this
time?
a missing lead - Answer -While setting up a 12-lead EKG on a patient, you are unable obtain any
electrical signal. The batteries are fully charged and the device was able to power-on. The most likely
cause of this problem is which of the following?
angiography - Answer -Which of the following imaging procedures is used to evaluate the arteries for
abnormalities such as aneurysm, atherosclerosis, embolism, occlusion, stenosis, thrombosis, trauma, or
vasculitis?
has smoked within the prior 12-24 hours - Answer -You obtain an expired carbon monoxide (CO) reading
of 18 ppm on a COPD patient participating in a pulmonary rehabilitation program. Based on this finding,
you can conclude that the patient:
decrease in O2 saturation from 91% to 82% - Answer -While monitoring a patient during a spontaneous
breathing trial, which of the following observations would cause you to stop the trial and return the
patient to ventilatory support?
increased ventilation - Answer -Your patient is receiving volume control A/C ventilation. She has become
increasingly agitated and the end-tidal CO2 has decreased from 38 to 27 torr over the last 3 hours.
Which of the following is most likely the cause?
3500 mL - Answer -A normal vital capacity for a female patient who is five feet three inches tall and
weighs fifty kilograms would be approximately:
, the sensitivity - Answer -An asthmatic patient is struggling to initiate inspiration on a ventilator
operating in the assist-control mode. Which of the following ventilator settings would you first check in
order to resolve of this problem?
atrial fibrillation - Answer -On inspection of a patient's EKG strip, you note that there are no identifiable
P waves; rapid irregular undulations of the isoelectric line; and an irregular ventricular rhythm. In
addition, the precordial cardiac rate is greater than the peripheral pulse rate. What is the most likely
problem?
Vital Capacity (VC) - Answer -Which of the following is the best bedside measurement for assessing the
integrated function of the respiratory muscles and mechanical properties of the lungs and thorax?
Sinus Tachycardia - Answer -While inspecting an EKG rhythm strip from an adult patient, you note the
following: rate of 148; regular rhythm; normal P waves, P-R intervals, and QRS complexes. What is most
likely the problem?
whether the patient is stable on low FiO2s and PEEP - Answer -Which of the following is a prerequisite
for discharging a ventilator-dependent patient to the homecare setting?
a large volume (3 L) calibration syringe - Answer -You would need which of the following equipment in
order to calibrate a portable bedside spirometer?
Ventilator-associated pneumonia (VAP) - Answer -A physician orders a blind bronchoalveolar lavage
procedure for a patient in intensive care unit. What is the most likely potential diagnosis that the doctor
is trying to confirm with this procedure?
croup - Answer -An AP X-ray of a 4-year-old child with wheezing and stridor shows an area of prominent
subglottic edema, but the lateral neck X-ray appears normal. The most likely problem is?
sternocleidomastoid muscles used at rest - Answer -If noted on inspiration, which of the following
respiratory signs of an adult patient would be considered abnormal?
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