Periodic weighing of a newborn's diaper is associated with
A. documenting weight loss
B. assessing response to breast feeding
C. IRDS in a premature neonate
D. measuring fluid output - ANS ✓The correct answer is : D
Explanation : It is not practical to insert a urinary catheter while caring for
the neonate. Weighing the diaper is the standard of care for measuring fluid
output.
A 38-week gestational age infant is to receive oxygen therapy by a blender
set at 100% with a heated large-volume nebulizer. To ensure the delivery
of the ordered FIO2, the respiratory therapist should properly set the
nebulizer FIO2 to
A. 21%
B. 0%
C. 100%
D. 50% - ANS ✓The correct answer is : C
Explanation : When using an air-oxygen blender, oxygen percentage is
predetermined prior to entering the large volume nebulizer device. When
TMC EXAM
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this happens, the large volume nebulizer should be set at 100% in order to
avoid entraining additional room air and lowering FIO2.
A patient has been receiving IPPB therapy after surgery to reduce
pulmonary complications. The respiratory therapist should use which
method to determine the effectiveness of the therapy?
A. Periodic chest radiograph
B. Airway resistance
C. Arterial blood gas analysis
D. SBN2 - ANS ✓The correct answer is : A
Explanation : Of the options offered, the purpose of an IPPB treatment is to
prevent post-operative complications, including consolidation of sputum in
the alveoli. Monitoring pre and post breath sounds and obtaining a periodic
chest x-ray is most helpful in assessing the effectiveness of the IPPB
therapy.
A respiratory therapist is asked to assist in the development of a teaching
plan for a 7-year-old asthmatic patient at home. The plan should avoid
instructions regarding
A. daily monitoring of peak-expiratory flow rates
B. improving the patient and family's understanding of infection control
C. the water-float technique to determine MDI canister content
D. the proper technique for the use of MDIs - ANS ✓The correct answer is : C
Explanation : Proper MDI technique, peak-flow monitoring, and improving
the understanding of infection control are all appropriate aspects of a
teaching plan for a pediatric patient. Determining MDI canister content by
floating the canister in water is never appropriate. The proper way to
assess content is by actuating the MDI and observing the output.
TMC EXAM
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Which of the following pre/post bronchodilator pulmonary function test
results is the most meaningful in suggesting that a bronchodilator is
indicated?
A. FEV1.0/FVC % increases by 10%.
B. FEV1 increases by 150 mL
C. FVC increases from 2.5 L to 2.6 L
D. FEF 200-1200 increases by 17% - ANS ✓The correct answer is : D
Explanation : The two primary considerations in pre-and post-
bronchodilator studies are (1) whether flows increased by at least 12% or
more and (2) whether the FEV1 increases by at least 200 mL. The FEF200-
1200, indicating the condition of the large airways, increases by well over
12%, and is therefore the correct choice.
A patient with known COPD has the following pre and post bronchodilator
studies. Based on this information, what bronchodilator should the
physician prescribe?
A. Albuterol 2.5 mg
B. Atrovent 0.5 mg
C. Combivent
D. None - ANS ✓The correct answer is : C
Explanation : Combivent is the best choice because improvement is seen
across the board. Vital capacity improves, FEV1 improves, and FEF 25-75
TMC EXAM
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improves significantly. Albuterol is helpful, but a greater impact is seen
with Combivent.
The resulting flow-volume loop of a patient with pulmonary obstruction
following a bronchodilator shows an inflection point on the positive side of
the graph that is 25% taller than the loop seen prior to the bronchodilator
trial. This would indicate that
A. patient may have taken a bronchodilator prior to the test
B. patient would benefit from bronchodilators
C. vital capacity increased by 25% with a bronchodilator
D. study should be repeated - ANS ✓The correct answer is : B
Explanation : An inflection point is a significant change in direction seen in
various types of graphic depictions. In this case the inflection point
represents the top or "peak" of the flow volume loop. This point is peak
flow. An increase in peak flow by 25% is well above the 12% threshold that
is considered significant, indicating bronchodilator therapy.
Which of the following may occur as a result of stimulation of the vagal
reflex during a suction procedure?
A. PVCs
B. decrease in blood pressure
C. first degree heart block
D. increase in heart rate - ANS ✓The correct answer is : B
Explanation : Suctioning can cause a decrease in heart rate and a decrease
in blood pressure. This natural, physiological response is associated with
stimulation of the vagal nerve during suctioning. This is also called the
vagal reflex.
TMC EXAM
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