Kettering CSE Practice UPDATED
ACTUAL Questions and CORRECT
Answers
You are the respiratory therapist working in a 600-bed urban medical center and your
assignment includes providing care to patients on the general medical floor. You are asked to
assist in the care of a recently admitted 32-year-old male patient who is 180 cm (5'11") tall
and weighs 53 kg (117 lb). The patient is pale and complains of persistent cough and fever for
over a week. The hospitalist asks you to evaluate the patient and report your findings. You
arrive in the patient's room, introduce yourself, and explain the purpose of your visit. Which
of the following should you include in your assessment? - CORRECT ANSWER✔✔- Vital
Signs/ Pulse oximetry/ Breath sounds/ Respiratory pattern/ General appearance/ Past medical
history/ Diagnostic chest percussion/ History of present illness
You report your findings to the hospitalist, who asks for your recommendation. Based on
your assessment, which of the following would you recommend? - CORRECT
ANSWER✔✔- Administer oxygen by nasal cannula at 5 L/min
The hospitalist asks what additional testing may be indicated. You should recommend -
CORRECT ANSWER✔✔- Arterial blood gas/ Complete blood count/ chest radiograph/ 12-
lead ECG/ Sputum culture/ Sputum acid-fast stain/ drug toxicology/ serum electrolytes/
urinalysis/
An ELISA test confirms a diagnosis of HIV and a sputum acid fast stain is negative. Sputum
culture confirms the presence of Pneumocystis jiroveci. What additional therapy would you
recommend at this time? - CORRECT ANSWER✔✔- Pentamidine
Four hours later, arterial blood gas analysis on 40% oxygen reveals: pH 7.20, PaCO2 60 torr,
PaO2 64 torr, HCO3- 24 mEq/L, BE Zero, SaO2 (calc) 91%. Breath sounds are diminished
with bilateral wheezing. Which of the following would you recommend? - CORRECT
ANSWER✔✔- Initiate mechanical ventilation
The physician asks you to recommend initial ventilator settings. Which of the following
would you suggest? - CORRECT ANSWER✔✔- VC/SIMV, VT 450 mL, f 12/min, FIO2
0.50, PEEP 3 cm H2O
,You are the respiratory therapist working at a 330-bed suburban medical center. You are
called to Labor and Delivery to assist in the care of a 1500 g (3.3 lb) female neonate born at
30 weeks of gestation.The neonate has been dried and placed on a radiant warmer. Her heart
rate is 120/min, respiratory rate is 45/min, there is no activity or response to suctioning, and
she is cyanotic. You should now - CORRECT ANSWER✔✔- Administer oxygen
Two hours later you are called to the NICU to evaluate the neonate. She is currently receiving
50% oxygen via oxyhood. Vital signs are: temperature 36.3° C (97.3° F), pulse 166/min,
respirations 40/min, BP 75/59 mm Hg, SpO2 81%. Auscultation reveals diminished breath
sounds. Umbilical artery blood gas results are: pH 7.32, PaCO2 45 torr, PaO2 49 torr, HCO3-
23 mEq/L, BE -1, SaO2 (calc) 79%. Which of the following should you now recommend to
the neonatologist? - CORRECT ANSWER✔✔- Initiate nasal CPAP
An A-P chest radiograph reveals a ground glass appearance with diffuse bilateral
radiopacities. Which of the following would you recommend at this time? - CORRECT
ANSWER✔✔- Surfactant replacement therapy
Four hours later, you are asked to reassess the neonate. She is currently receiving 4 cm H2O
CPAP therapy via nasal prongs with 50% oxygen, Umbilical artery blood gas results are: pH
7.19, PaCO2 57 torr, PaO2 41 torr, HCO3- 22 mEq/L, BE -2, SaO2 (calc) 73%. You should
now recommend - CORRECT ANSWER✔✔- Initiate mechanical ventilation
The neonatologist asks for your recommendation for initial ventilator settings. You should
now recommend - CORRECT ANSWER✔✔- PC/SIMV, PIP 27 cm H2O, rate 29/min, FIO2
0.50, PEEP 4 cm H2O
You are the respiratory therapist working at a 350-bed suburban hospital. You receive a call
from the Emergency Department to assist in the care of a 53 year-old female patient who
drove herself to the ED after completing a high intensity exercise class. The patient presents
with shortness of breath, nausea, lightheadedness and an uncomfortable fullness in the center
of her chest. She is 163 cm (5' 4") tall and weighs 70 kg (154 lb). The ED physician asks you
to evaluate the patient and report your findings. - CORRECT ANSWER✔✔- Level of
consciousness/ Vital signs/ Electrolytes/ Pulse oximetry/ General appearance/ ECG monitor/
Breath sounds/ ABG results/ Diagnostic chest percussion/ CBC/ Troponin/ CXR
The ED physician asks for your recommendation. Which of the following would you
recommend? - CORRECT ANSWER✔✔- 40% O2 via air-entrainment mask/ Continuous
ECG monitor/ Aspirin therapy
, The patient has been transferred to the Cardiac Cath Lab where a percutaneous cardiac
catheterization has been performed. The result of the catheterization indicated two blocked
coronary vessels that have been stented. During the procedure, the patient experienced a
sudden decrease in heart rate, blood pressure and oxygen saturation. The patient was
successfully resuscitated and arrives in the Cardiac Care Unit intubated and being manually
ventilated. The intensivist asks you to recommend initial ventilator settings. Which of the
following should you suggest? - CORRECT ANSWER✔✔- VC/AC, VT 450 mL, f 12/min,
FIO2 0.50, PEEP 3 cm H2O/ or VC/SIMV, VT 500 mL, f 10/min, FIO2 0.50, PEEP 8
cmH2O
Thirty minutes later the patient has the following blood gas results. pH 7.50, PaCO2 30 torr,
PaO2 150 torr, HCO3- 24 mEq/L, BE Zero, SaO2 (calc) 99%. A chest radiograph reveals
small bilateral basilar infiltrates. You should now recommend - CORRECT ANSWER✔✔-
Decrease the set tidal volume/ or decrease the respiratory rate
One hour later, an arterial blood sample is obtained and the results are: pH 7.45, PaCO2 38
torr, PaO2 145 torr, HCO3- 26 mEq/L, BE +2, SaO2 (calc) 99%. Based on this information,
you should now recommend - CORRECT ANSWER✔✔- Decrease the FIO2
You are the respiratory therapist working at a suburban pulmonary clinic. You are asked to
assist in the care of a 70 year-old man who was brought to the clinic by his wife. The patient
complains of difficulty with his breathing and a persistent cough for the past few days. He
presents as conscious, alert, thin, pale, tachypneic, and has a barrel chest. The patient is 178
cm (5' 10") tall and weighs 60 kg (132 lb). - CORRECT ANSWER✔✔- General appearance/
Diagnostic chest percussion/ current medications/ vital signs/ hx of present illness/ pulse
oximetry/ chest auscultation/ respiratory pattern/ past medical hx/ sputum production/ current
home therapy
You report your findings to the clinic physician who asks for your recommendation. You
should recommend: - CORRECT ANSWER✔✔- Administer oxygen by nasal cannula at 2
L/min
The physician asks what further information would be appropriate at this time. Which of the
following should you evaluate? - CORRECT ANSWER✔✔- ABG/ CBC/ Chest radiograph/
12-lead ECG/ Slow vital capacity/ serum electrolytes/ FEV2/FVC%
