51. A patient has a minute volume of 7.50 L/min and is breathing at a rate of 16 breaths/min. What is his average tidal volume?
A. 120 mL
B. 215 mL
C. 350 mL
D. 470 mL
52. To minimize the risk of aspiration of glottic secretions or cord damage during the removal of an oral endotracheal tube, you should:
A. Have the patient cough while you quickly pull the tube
B. Provide 100% oxygen for 1-2 minute before extubation
C. Keep the tube cuff pressure below 25-30 cm H20
D. Fully occlude the ET tube while you quickly pull it out
53. Which of the following is false regarding switching from an esophageal-tracheal Combitube® (ETC) to an oral endotracheal tube?
A. The equipment needed is the same as for endotracheal intubation
B. The patient’s stomach contents should be aspirate through the #2 tube
C. The body of the tube normally must be positioned in the trachea
D. The large #1 pharyngeal cuff must be deflated before laryngoscopy
54. All of the following are common causes of fluid overload (overhydration) in patients EXCEPT:
A. Congestive heart failure
B. Hemorrhage
C. Renal failure
D. Overinfusion of fluids
55. At rest, the normal tidal movement of the diaphragm is approximately:
A. 6-10 cm
B. 1-2 cm
C. 30-40 cm
D. 6-10 in
56. A physician has requested your assistance in extubating an orally intubated patient. Which of the following should be done BEFORE the tube itself is removed? 1. suction the pharynx 2. preoxygenate the patient 3. confirm cuff inflation 4. suction the ET tube
A. 2 and 4 only
B. 1, 2 and 4 only
C. 3 and 4 only
D. 1, 2, 3 and 4
57. A patient suddenly loses consciousness. Which of the following is the first procedure you should perform to maintain an open airway in this patient?
A. Inserting a laryngeal mask airway
B. Applying the “jaw thrust” maneuver
C. Inserting an oropharyngeal airway
D. Applying the “head-tilt/chin-lift” maneuver
58. When open to the atmosphere, a manometer calibrated in cm H2O units should read:
A. 0 cm H2O
B. 1 atmosphere
C. 760 cm H2O
D. 1034 cm H2O
59. A patient has a pH of 7.58 and a PaCO2 of 25 torr. Based on these data, what is the primary acid-base disturbance?
A. Respiratory alkalosis
B. Metabolic acidosis
C. Respiratory acidosis
D. Metabolic alkalosis
60. The methylene blue test is used to confirm:
A. Tracheal granuloma
B. “leakage” type aspiration
C. Infection with pneumococcus
D. Artificial airway obstruction
61. Bronchial breath sounds heard over the periphery indicate
A. Normal lungs
B. Lung consolidation
C. Small airways obstruction
D. Acute bronchospasm
62. Which of the following endotracheal tube malfunctions could require extubation and reintubation with a new tube to allow effective positive pressure ventilation of the patient? 1. a large leak in the cuff of the tube 2, obstruction of the tube that is unrelieved by suctioning 3. separation of the pilot tube from the endotracheal tube cuff
A. 1 and 2 only
B. 1 and 3 only
C. 2 and 3 only
D. 1, 2 and 3
63. While assessing the endotracheal tube cuff pressure in an intubated patient, you confirm a leak at 18 cm H20 throughout most of inspiration. You should:
A. Add air to the cuff until a minimal leak is heard
B. Reassess the cuff pressure during expiration
C. Replace the endotracheal tube with a larger size
D. Inflate cuff until the leak ceases at < 25-30 cm H20
64. A patient has a minute volume of 7.50 L/min and is breathing at a rate of 16 breaths/min. What is his average tidal volume?
A. 120 mL
B. 215 mL
C. 350 mL
D. 470 mL
65. In most blood gas analyzers, what media is used to calibrate the pH electrode?
A. Tonometered whole blood samples
B. Commercial calibration control media
C. Precision gas mixtures (02/002)
D. Standardized buffer solutions
66. Which of the following is the approximate total output flow delivered from a 40% air-entrainment mask operating at 12 L/min?
A. 12 L/min
B. 48 L/min
C. 52 L/min
D. 72 L/min
67. Which of the following parameters is affected when the air-mix control is changed to 100% oxygen on a pneumatically-powered IPPB device?
A. Pressure
B. Sensitivity
C. Peak flow
D. Nebulization
68. The proper positioning of an endotracheal tube in an adult is confirmed by which of the following?
A. 21-23 cm marks at teeth
B. Adequate airway seal
C. Chest X-ray
D. Neutral head position
69. When inspecting the x-ray of a patient in ICU, you note a large area of radiolucency between the left lung border and chest wall and increased density of left lung. Which of the following is the most likely problem?
A. Pleural effusion
B. Pneumomediastinum
C. Pneumothorax
D. Interstitial infiltration
70. Which of the following would deliver the most particulate water to a patient’s airway?
A. A bubble humidifier
B. A wick humidifier
C. An ultrasonic nebulizer
D. A jet nebulizer
71. On a pneumatically-powered IPPB device, switching the air-mix control to 100% oxygen will have which of the following effects on flow?
A. Make the flow dependent on patient effort
B. Decrease the flow to a lower level
C. Increase the flow to a higher level
D. The change will have no effect on flow
72. Rule-based procedures designed to help detect, respond to and correct blood gas analyzer or hemoximeter errors over time best describe:
A. Statistical quality control
B. Machine calibration
C. Preventive maintenance
D. Control media verification
73. To avoid preanalytic errors associated with air contamination of a blood gas sample, all of the following are appropriate EXCEPT:
A. Fully expel any bubbles
B. Mix only after bubbles expelled
C. Cap the syringe quickly
D. Place sample in ice slush
