1. A patient’s sputum specimen is purulent
0L
green in appearance, has separated into
layers, and has a foul odor. Which of the
following is most likely causing the patient
to produce this type of sputum?
a. Aspiration
b. Tuberculosis
c. Emphysema
d. Bronchiectasis
2. A patient in the ICU complains of
light-headedness, nausea, and chest pains.
The patient is diaphoretic and has a blood
pressure of 90/60 mmHg. A respiratory
therapist observes the following ECG
pattern:
a. Lidocaine HCl
b. Cardioversion
c. Defibrillation
d. Epinephrine
3. A patient with Guillain-Barre syndrome has
a vital capacity of 625 mL. A respiratory
therapist should recommend which of the
following be performed FIRST?
a. MIP evaluation
b. Edrophonium chloride (Tensilon)
test
c. MVV test
d. EMG and nerve conduction study
4. Which of the following bedside pulmonary
function testing results for a patient with
multiple sclerosis most strongly indicates
the need for ventilatory assistance?
a. 5% decrease in peak expiratory flow
b. FEV1/FVC of 85%
c. MIP of -23 cmH2O
d. Vital capacity of 5 mL/kg
5. The following patient pulmonary function
results were obtained:
Vital capacity 3.6L
FRC 6.0L
ERV 1.
a. 6.0
b. 7.0
c. 8.6
d. 9.6
6. A 62-year old patient with a history of COPD
becomes hypotensive following a drug
overdose. Following intubation, VC, AC
ventilation should be initiated with which of
the following oxygen concentrations?
a. 0.21
b. 0.50
c. 0.70
d. 1.0
7. A patient has been receiving VC ventilation
for 24 hours. A respiratory therapy is called
to the bedside because high pressure alarm
is sounding with each breath. Which of the
following should the therapist do FIRST?
a. Change to PC ventilation
b. Withdraw the endotracheal tube 4
cm
c. Manually ventilate the patient
d. Increase the high pressure alarm
limit
8. Just prior to removing the endotracheal
tube, a respiratory therapist should
a. decrease the oxygen concentration
b. deflate the cuff
c. cut the pilot tube
d. ask the patient to breath-hold
9. While preparing to assist with a chest tube
insertion, a respiratory therapist learns that
pleurodesis will follow. Which of the
following additional equipment should the
therapist provide?
a. Pressure manometer and hemostat
b. 3-way stopcock and hypertonic
saline
c. Hemostat and 3-way stopcock
d. Hypertonic saline and pressure
manometer
10. Dynamic compliance is obtained by dividing
VT by:
a.
 b.
c.
d.
11. A 52-year-old patient with newly diagnosed
OSA undergoes a CPAP titration study. With
a CPAP of 12 cm H20, the AHI is 3 and the
lowest observed oxygen saturation is 90%.
The patient continues to snore. A
respiratory therapist should
a. maintain the current settings.
b. increase the CPAP level.
c. add supplemental oxygen.
d. switch to bilevel PAP.
12. What is the target FiO2 range of a nasal
cannula in a patient with normal minute
ventilation?
a. 0.85 – 1.0
b. 0.64 – 0.80
c. 0.45 – 0.60
d. 0.24 – 0.40
13. A respiratory therapist is called to the ED to
assist with the intubation of an alert,
agitated patient in respiratory failure. Two
intubation attempts were unsuccessful. In
addition to a neuromuscular blockade,
which of the following drugs will best
facilitate intubation?
a. propranolol HCI (Inderal)
b. midazolam HCI (Versed)
c. amlodipine (Norvasc)
d. nitroprusside sodium (Nipride)
14. A 14-year-old male who is 163 cm (5 ft 4 in)
tall and weighs 51 kg (112 lb) is brought to
the ED for a suspected drug overdose. He is
intubated and receiving VC, A/C ventilation.
The following data are available:
Mandatory rate 14
Tidal volume 300 mL
Inspiratory flow 20 L/min
Pressure limit 50 cmH2O
A physician notices the I:E display indicates
1:1.2 and asks a respiratory therapist to
make an adjustment so the I:E will be 1:3.
The therapist should increase the
a. tidal volume.
b. inspiratory flow.
c. mandatory rate.
d. sensitivity.
15. A 180-cm (5-ft 11-in), 75-kg (165-Ib) male
had a cardiac arrest and is admitted to the
ICU. The patient is apneic, is receiving 100%
02 by a bag-valve-mask resuscitator, and
has an Sp02 of 94%. Which of the following
are the most appropriate ventilator
settings?
a. 4
b. 1
c. 2
d. 3
16. While instructing a 9-year-old child with
pneumonia in use of a PEP therapy device,
a respiratory therapist observes that the
child is consistently unable to keep a seal
around the mouthpiece. Which of the
following should the therapist recommend?
a. Discontinue therapy
b. Use nose clips in addition to the
mouthpiece
c. Select a mask rather than a
mouthpiece
d. Increase the pressure level by 4
cmH2O
17. A 23-year-old patient is in moderate
respiratory distress while receiving oxygen.
Blood gas analysis results are:
A respiratory therapist should interpret
these results as:
a. Compensated metabolic alkalosis
with mild hypoxemia
 b. Chronic respiratory alkalosis with
severe hypoxemia
c. Chronic hypercapnia with severe
hypoxemia
d. Acute respiratory alkalosis with
moderate hypoxemia
18. Which of the following can be used to
confirm correct endotracheal tube position?
a. Tube marking at incisor
b. Pulse oximeter
c. Colorimetric CO2 detector
d. Chest radiograph
19. Lung fields will appear whiter on a chest
radiograph when the imagine technique is
a. Overexposed
b. A lateral view
c. Rotated
d. Underexposed
20. A 71-year-old male who has a femur
fracture had a chest CT angiogram due to
increased shortness of breath. A respiratory
therapist observes multiple pulmonary
arterial thrombi. SpO2 is 94% while
receiving oxygen at 2 L/min by nasal
cannula. Which of the following should the
therapist recommend?
a. intravenous heparin
b. sublingual nitroglycerin
c. intravenous epoprostenol
(Prostacyclin)
d. nitric oxide inhalation
21. A 49-year-old female with polyneuropathy
has received mechanical ventilation for 74
days. For the past week, the patient has
been receiving an Fi02 of 0.28 by
tracheostomy collar for progressively longer
periods of time. Data collected for a daily
3-hour weaning trial are below:
A respiratory therapist should recommend
performing the weaning trial the next day
for:
a. 30 minutes
b. 2 hours
c. 4 hours
d. 3 hours
22. VC, A/C ventilation has been initiated for a
38-year-old male patient with ARDS who is
180 cm (5 ft 11 in) tall and weighs 85 kg (187
lb). The patient's cardiovascular status is
stable. Ventilator settings and ABG analysis
results after 30 minutes are as follows:
The therapist should recommend
a. Increasing the FiO2 to 1.0
b. Increasing to 10 cmH2O PEEP
c. Administering sodium bicarbonate
IV
d. Setting the mandatory rate at 12
23. To determine the etiology of a pleural
effusion, a respiratory therapist should
recommend a
a. Lung biopsy
b. Chest CT scan
c. Bronchoscopy
d. Thoracentesis
24. A patient receiving a nebulizer treatment
with 3% saline complains of shortness of
breath. A respiratory therapist should
a. Decrease the nebulizer output
b. Add oxygen to the inspired gas
c. Discontinue therapy
d. Add a bronchodilator to the
nebulizer
25. A respiratory therapist is asked to perform
an apnea test on a patient for whom brain
death is clinically suspected. Which of the
following should be confirmed prior to
performing the test?
a. body temperature greater than 36°
C (96.8° F)
 b. family's consent
c. PaCO2 of at least 32 mm Hg
d. DR status
26. A respiratory therapist arrives to perform
vibratory PEP on a patient with cystic
fibrosis. The patient confides he has begun
coughing up blood, but does not want
anyone to know. Which of the following
should the therapist do NEXT?
a. Perform therapy as ordered and
respect the patient's wishes.
b. Hold therapy and inform the
physician about the hemoptysis.
c. Perform therapy as ordered and
observe for hemoptysis.
d. Hold therapy and instruct the nurse
to observe for hemoptysis.
27. A chest radiograph for a 21-year-old patient
shows multilobar infiltrates in the right
lung. SpO2 is 85% while receiving 80%
oxygen by HHFNC at 50 L/min. To improve
oxygenation, a respiratory therapist should
place the patient in which of the following
positions?
a. left lateral decubitus
b. prone
c. supine
d. right lateral decubitus
28. A sedated 152-cm (5-ft), 42-kg (93-Ib)
patient with pneumonia has been receiving
VC, A/C ventilation for 3 days and has a
worsening chest radiograph. The following
information is available:
A respiratory therapist should change the
a. VT to 500 mL.
b. mode to PC, AIC.
c. mandatory rate to 36.
d. PEEP to 10 cm H20.
29. A respiratory therapist returns to the room
of a 63-year-old female patient and finds
her less responsive. The patient has an HR
of 154/min, an RR of 8/min, and a weak
pulse. She is currently receiving oxygen at 2
L/min by a nasal cannula.
The therapist should FIRST
a. contact the physician for evaluation
of the patient.
b. activate the medical emergency
team.
c. recommend obtaining a chest
radiograph to evaluate pulmonary
status.
d. increase the nasal cannula to 4
L/min and monitor with pulse
oximetry.
30. When assessing the airway of a patient
prior to intubation, a Mallampati score of 4
is observed. Which of the following should a
respiratory therapist recommend to
facilitate intubation?
a. nasopharyngeal airway
b. video laryngoscopy
c. neck hyperextension
d. cricoid pressure
31. An adult patient who weighs 62 kg (136 lb)
requires a minute ventilation of 15 L/min to
maintain a PaCO2 of 36 mm Hg while
receiving mechanical ventilation. Which of
the following could explain these ventilatory
requirements?
1. excessive caloric intake
2. increased dead space ventilation
3. febrile patient
4. increased intrapulmonary shunt
a. 1,2, and 3 only
b. 1, 2, and 4 only
c. 1, 3, and 4 only
d. 2, 3, and 4 only
32. While performing bedside spirometry on a
patient, the following FEV1 values (L) are
obtained from three maneuvers:
3.13
3.75
2.85
Which of the following should a respiratory
therapist conclude about these results?
a. A value of 3.24 L should be reported.
 b. A value of 3.75 L should be reported.
c. These are normal values.
d. The effort was inconsistent.
33. A respiratory therapist is assisting a
physician with a needle biopsy of a lung
mass during fiberoptic bronchoscopy. The
biopsy site begins to hemorrhage. Which of
the following should the therapist have
ready for instillation?
a. vitamin K
b. iced saline
c. lidocaine HCI
d. sterile water
34. An adult patient with a tracheostomy tube
is receiving a heated aerosol with an FiO2 of
0.30 by T-piece. A respiratory therapist
observes the T-piece often becomes
disconnected from the tracheostomy tube.
The therapist should
a. tape the T-piece to
tracheostomy tube.
b. exchange the T-piece for a
tracheostomy collar.
c. replace the inner cannula of the
tracheostomy tube.
d. add a reservoir to the T-piece.
35. A respiratory therapist will assist a physician
perform cardioversion for a spontaneously
breathing patient with supraventricular
tachycardia. The patient is alert and awake.
Which of the following steps should be
performed in preparation for this
procedure?
a. 2
b. 3
c. 1
d. 4
36. A tracheostomy stoma site should be
cleaned with
a. normal saline
b. chlorhexidine
c. Cilpovidone-iodine
d. acetic acid
37. Which of the following devices can provide
100% humidity at body temperature?
a. pneumatic nebulizer
b. bubble humidifier
c. spinning-disc humidifier
d. heated-wick humidifier
38. While examining a chest radiograph from
an adult patient, a respiratory therapist
notes the presence of air bronchograms.
Which of the following is the most likely
cause?
a. pneumothorax
b. pleural effusion
c. bronchiectasis
d. pneumonia
39. A patient who is 188 cm (6 ft 2 in) tall is
intubated with an 8.0-mm ID endotracheal
the tube that is secured with an 18-cm mark
adjacent to the incisor. A respiratory
therapist hears a gurgling sound with each
inhalation and observes the exhaled VT is
300 mL less than the inhaled VT. The
therapist increases the cuff pressure from
16 cm H20 to 24 cm H20.
There is no change in the sound or the exhaled
VT. The therapist should
a. change to a 10.0-mm ID
endotracheal tube.
b. increase the cuff pressure to 30 cm
H20.
c. recommend performance of
tracheostomy.
d. deflate the cuff before advancing
the tube 4 cm.
40. According to ATS Standards, a patient's
FEV1 must increase by a minimum of what
percent to demonstrate significant
postbronchodilator improvement?
a. 15
b. 8
c. 12
d. 20
41. A patient with dyspnea, tachypnea, and
expiratory wheezing is unresponsive to
 bronchodilator therapy. The following chest
radiograph is obtained:

His skin tone is normal. A respiratory

therapist should recommend FIRST
obtaining
a. a carboxyhemoglobin level
b. an echocardiogram.
c. serial cardiac enzymes.
d. a sputum culture and sensitivity.
45. An adult patient receiving PC, A/C
ventilation has a blood pressure of 64/42
mm Hg. The patient is currently on a
continuous norepinephrine infusion and
a. Emphysema
the SpO2 monitor does not consistently
b. Tuberculosis
display a waveform or saturation value.
c. A hemothorax
Which of the following should a respiratory
d. Pulmonary edema
therapist do FIRST?
42. A 132-kg (291-Ib), 168-cm (5-ft 6-in) female
a. Discontinue pulse oximetry.
who underwent a tracheotomy 2 weeks ago
b. Initiate transcutaneous 02
remains in the ICU receiving VC ventilation.
monitoring.
After the patient is repositioned in the bed,
c. Perform serial blood gas analyses.
the ventilator high pressure alarm sounds
d. Change to a forehead sensor.
with each breath. The suction catheter can
46. A respiratory therapist notes a prolonged
be passed only 10 cm into the
inspiratory time and variable cycling to
tracheostomy tube and no secretions are
exhalation for a patient receiving PS
evident. Sp02 is 80%. Which of the following
ventilation. The circuit is verified to be
should a respiratory therapist do FIRST?
intact. The therapist should NEXT
a. Recommend a chest radiograph.
a. check for right mainstem intubation.
b. Initiate bag-mask ventilation.
b. evaluate for auto-PEEP.
c. Remove the tracheostomy tube.
c. check the integrity of the
d. Evaluate cuff pressure.
endotracheal tube cuff.
43. A patient is being evaluated for blunt chest
d. evaluate for mucus plugging.
trauma. A respiratory therapist palpates
47. Results of a sleep study reveal a patient has
crepitus near the patient's right clavicle.
OSA with marked oxygen desaturation.
This most likely indicates
Which of the following therapies should be
a. bronchospasm.
recommended for the patient during sleep?
b. tactile fremitus.
a. oropharyngeal airway
c. secretions in the airway.
b. oxygen at 2 L/min by nasal cannula
d. subcutaneous emphysema
c. bed elevation to 45 degrees
44. A 24-year-old male is admitted to the ED
d. nasal CPAP
after he was pulled from a burning building.
48. Five minutes after starting a 2.5 mg
The patient has second-degree burns on his
albuterol nebulizer administration, a patient
face and chest. The following vital signs are
complains of palpitations, headache, and
observed while the patient receives oxygen
by nonrebreathing mask:
 tremors. Which of the following should the
respiratory therapist do?
a. Terminate the treatment.
b. Continue the treatment.
c. Obtain peak flow rates.
d. Alert the medical emergency team.
49. A suction canister from the bronchoscopy
suite was used for a patient with hepatitis B.
How should the canister be disposed?
a. Double-bag it in plastic.
b. Send with regular waste.
c. Place it in a biohazard waste bag.
d. Wipe it with isopropyl alcohol and
incinerate.
50. A patient with cystic fibrosis, who usually
expectorates white sputum, complains of
increased cough and dark yellow sputum
production over the past week. She is
febrile, and a chest radiograph reveals a
right middle lobe infiltrate.
These clinical findings suggest
a. acute bronchitis.
b. pulmonary edema.
c. pneumonia.
d. hemoptysis.
51. A patient is receiving PC, A/C ventilation. A
respiratory therapist is assisting with an
uncomplicated thoracentesis during which
1200 mL of fluid is drained from the
patient's pleural space. Which of the
following changes should the therapist
expect to observe?
a. decreased peak inspiratory pressure
b. increased plateau pressure
c. decreased compliance
d. increased tidal volume
52. A 58-year-old male who is 175 cm (5 ft 9 in)
tall and weighs 85 kg (187 lb) is receiving VC,
SIMV with the following settings:
A physician asks a respiratory therapist to
change settings to reduce a patient's PCO2.
The physician prefers to keep the
mandatory rate at 8. Which of the following
options should the therapist offer?
a. Increase pressure support.
b. Decrease FIO2.
c. Decrease PEEP.
d. Increase VT.
53. Which of the following pulmonary function
tests measures FRC, RV, and TLC?
a. DLCO
b. spirometry
c. MVV
d. body plethysmography
54. According to the ACLS guidelines, the
correct placement for the needle during
decompression of a tension pneumothorax
is
a. under the second rib in the anterior
axillary line.
b. under the third rib in the
mid-clavicular line.
c. over the third rib in the
mid-clavicular line.
d. over the second rib in the anterior
axillary line.
55. Four hours post-CABG, a patient is receiving
supplemental oxygen through a nasal
cannula at 2 L/min. Which of the following is
the most appropriate method for a
respiratory therapist to evaluate the
patient's response to the oxygen therapy?
a. Evaluate the patient for respiratory
distress.
b. Perform ABG analysis.
c. Observe the patient for cyanosis.
d. Measure the SpO2.
56. A respiratory therapist is performing
postural drainage and percussion to the
lateral basal segment of the right lower lobe
for a patient with chronic bronchitis. The
patient complains of shortness of breath
after being positioned for 10 minutes.
Which of the following modifications should
the therapist make to the procedure?
a. Use a mechanical percussor.
 b. Modify the postural drainage
position to supine.
c. Perform nasotracheal suctioning.
d. Decrease the time the patient is
positioned.
57. Trendelenburg position for postural
drainage is CONTRAINDICATED after a
patient has had
a. a pneumonectomy.
b. hip surgery.
c. intracranial surgery.
d. cardiovascular surgery.
58. A manometer is being used to monitor a
continuous-flow mask CPAP device set at 10
cm H20. Each time the patient ales, the
pressure decreases to 2 cm H20, then
returns to 10 cm H20 on exhalation. Which
of the following is the ost likely cause?
a. The CPAP pressure valve is too
small for the patient.
b. There is a leak in the patient
system.
c. The mask size is too large for this
patient.
d. The flow of gas to the patient
system is insufficient.
59. Immediately following an arterial puncture
to a patient's radial artery, a respiratory
therapist should
a. label the sample.
b. perform an Allen's test.
c. compress the site.
d. place the sample on ice.
60. A 30-year-old female with a PBW of 50 kg
(110 lb) is admitted to the ED for a drug
overdose. Upon arrival, she is hypotensive
and nonresponsive, and subsequently
vomits and aspirates. VC, A/C ventilation is
initiated. Two days later, a chest radiograph
shows bilateral infiltrates. The following
ventilator data is observed:
An ABG analysis shows:
Which of the following ventilator settings
should a respiratory therapist recommend?
a. 1
b. 2
c. 3
d. 4
61. A 22-year-old female patient is being
considered for possible extubation after
being treated for status asthmaticus over
the last 48 hours. Breath sounds are clear,
and no current distress is
noted. While receiving an FiO2 of 0.40, PS
of 10 cmH2O, and 5 cmH2O PEEP, her vital
signs are:
After breathing through a T-piece for 30
minutes with an FiO2 of 0.40, vital signs
reveal:
A respiratory therapist should conclude the
a. Patient is ready for extubation
b. Patient has failed the SBT
c. Trial should be continued
d. Patient requires VC, A/C ventilation
62. A 1400-g, 28-week gestational age infant
was delivered after a precipitous vaginal
delivery. The infant is receiving nasal CPAP
with an FiO2 of 0.50 in the delivery room
and has an SpO2 of 85%. Which of the
following is the most appropriate NEXT
course of treatment?
 a. Initiate HFOV
b. Administer surfactant
c. Increase the FiO2
d. Add nitric oxide
63. When performing MVV maneuvers, a
patient repeatedly terminates the test
between 8 to 10 seconds. A respiratory
therapist should
a. Report the average of the values
b. Report the lowest and highest
values
c. Reschedule testing a later time
d. Administer oxygen and repeat the
maneuvers
64. A 68-year-old male with a history of COPD is
admitted to the hospital for increasing
shortness of breath and a nonproductive
cough. Chest auscultation reveals
expiratory wheezes. Which of the following
is most appropriate to improve the patient's
clinical condition?
a. Beclomethasone dipropionate
(QVAR)
b. Ipratropium (Atrovent)
c. Amoxicillin/clavulanate (Augmentin)
d. Mometasone furoate (Asmanex)
65. Which of the following is the best
instruction for a patient receiving
small-volume nebulizer bronchodilator
therapy?
a. Breathe in and out normally
b. Blow out hard, then breath in fast
and deep
c. Breathe in deep and fast, then
exhale forcefully
d. Breathe normally with an occasional
deep inspiratory hold
66. Which of the following is the simplest
method of preventing postoperative
atelectasis in a patient with no preoperative
pulmonary problems?
a. PEP therapy
b. Cough and deep breathing
c. Incentive spirometry
d. IPPB therapy
67. Which of the following are potential
complications associated with obtaining a
blood sample through an indwelling radial
arterial catheter?
a. 2
b. 3
c. 1
d. 4
68. What is the amount of air that can be
forcibly exhaled from the lungs after taking
the deepest breath possible?
a. FRC
b. IRV
c. ERV
d. FVC
69. An 18-year-old with muscular dystrophy is
receiving treatment for recurrent
pneumonia and atelectasis. Which of the
following should a respiratory therapist
recommend in addition to HFCWO?
a. Vibratory PEP
b. Incentive spirometry
c. Mechanical insufflation/exsufflation
d. Manual chest physical therapy
70. A respiratory therapist is checking a jet
nebulizer with an entrainment setting of
35%. A properly calibrated oxygen analyzer
measures the concentration at 45%. Which
of the following best explains this finding?
a. Inadequate flow through the jet
b. Obstructed jet orifice
c. Water in the tubing
d. Excessive flow from the flowmeter
71. In which of the following patient discharge
situations should a respiratory therapist
recommend apnea monitoring for home
use?
a. Preterm neonate who has been
treated with caffeine
b. Neonate who was diagnosed with
cystic fibrosis
 c. 3-year-old child following surgery for
an intestinal obstruction
d. Term infant who exhibits
intermittent acrocyanosis
72. While reading a chart, a respiratory
therapist notes that an 18-month-old child
with a history of asthma was admitted with
severe respiratory distress. Wheezing is
auscultated over the right lung only. These
findings are most consistent with
a. Acute bronchiolitis
b. An acute asthma exacerbation
c. Croup
d. Foreign body aspiration
73. The following graphic is displayed for a
patient receiving mechanical ventilation in
the SIMV mode:
Which of the following types of breath does
the graph represent?
a. Patient-triggered mandatory
b. Spontaneous
c. Pressure supported
d. Pressure controlled
74. A right heart catheterization is scheduled to
assess vaso-responsiveness in a 45-year-old
patient with pulmonary hypertension. A
respiratory therapist should expect to
titrate inhaled
a. Heliox
b. Oxygen
c. Nitric oxide
d. Carbon dioxide
75. A 188-cm (6-ft 2-in) male who weighs 100 kg
(220 lb) is receiving SIMV with the following
settings:
Which of the following should the
respiratory therapist increase?
a. PEEP
b. Tidal volume
c. Mechanical dead space
d. Pressure support
76. A 56-year-old female with a diagnosis of
bilateral basilar pneumonia is in the ICU
and receiving VC, A/C ventilation. A
respiratory therapist observes that her
SpO2 has dropped from 95% to 84%. Her
current FiO2 is 0.50 with 12 cmH2O PEEP.
Her PaCO2 values have remained within
normal range. Which of the following
should the therapist do FIRST?
a. Increase PEEP
b. Increase the FiO2
c. Initiate SIMV
d. Sedate the patient
77. A patient requires frequent nasotracheal
suctioning. The patient begins to cough
violently after a respiratory therapist places
a nasopharyngeal airway. Which of the
following actions should the therapist
recommend?
a. Wait 10 minutes for the patient to
adapt to the airway
b. Wait until the patient falls asleep to
insert an airway
c. Insert a nasal airway that is wider
d. Insert a nasal airway that has a
shorter length
78. Common emotional manifestations of
chronic pulmonary disability include
a. Anger, hostility, and euphoria
b. Hostility, euphoria, depression
c. Depression, anger, and hostility
d. Euphoria, depression, and anger
79. A 71 year old with COPD is admitted to the
ED with shortness of breath, tachypnea,
 and confusion. Oxygen is initiated at 2
L/min by nasal cannula and an ABG analysis
reveals:
Which of the following should a respiratory
therapist recommend?
a. Switch to 6 L/min by simple mask
b. Increase to 4 L/min by nasal cannula
c. Change to a 40% air-entrainment
mask
d. Initiate bilevel ventilation
80. A 41-year-old female who is 168 cm (5 ft 6
in) and weighs 70 kg (154 lb) is receiving PS
ventilation with the following settings:
Following a 45-minute SBT, the following
information is obtained:
A respiratory therapist should recommend
a. Extubating the patient
b. Returning to the previous settings
c. Extending the SBT
d. Increasing the PEEP
81. Recent ABG analysis results for an
intubated patient reveal:
A respiratory therapist should interpret
these results as
a. Respiratory acidosis
b. Respiratory alkalosis
c. Metabolic acidosis
d. Hypoxemia
82. A respiratory therapist is performing quality
control on a blood gas analyzer. To be
accepted, results must occur within how
many standard deviations of established
limits?
a. 3
b. 2
c. 4
d. 1
83. A patient is receiving VC ventilation. A
respiratory therapist notes the patient's
peak pressure has increased from 20 to 30
cm H2O after 6 hours. Which of the
following can explain this change?
a. 3
b. 1
c. 2
d. 4
84. A respiratory therapist reviews the following
ABG analysis results for a patient who is
receiving an FiO2 of 0.30:
These results most likely indicate
a. Anemic hypoxemia
b. Laboratory error
c. Oxygen toxicity
d. Normal oxygenation
85. Which of the following will lower mean
airway pressure in a patient receiving VC
ventilation?
a. Decrease the inspiratory time
b. Increase the tidal volume
c. Increase the PEEP
d. Decrease the trigger sensitivity
86. A 183-cm (6-ft), 80-kg (176-lb) male was
receiving PSV with an FiO2 of 0.35 before
surgery. After the patient returns from
surgery, the following data are obtained
while the patient is receiving VC, A/C
ventilation:
 a. Increasing the FiO2 to 0.30
b. Decreasing to EPAP 4 cmH2O
c. Administering flumazenil
(Romazicon)
d. Administering naloxone HCl
(Narcan)
89. In a healthy adult, which of the following
pulmonary measurements is the largest?
a. Vital capacity
b. Inspiratory capacity
A respiratory therapist should recommend c. Functional residual capacity
a. Decreasing FiO2 d. Expiratory reserve volume
b. An auto-PEEP measurement 90. During a spontaneous breathing trial, an
c. Increasing tidal volume adult patient who is 157 cm (5 ft 2 in) and
d. A lung recruitment maneuver 50 kg (110 lb) has a respiratory rate of
87. A 32-year-old, 168-cm (5-ft 6-in), 60-kg 12/min and an exhaled tidal volume of 300
(132-lb) female with Guillain-Barré mL. The patient is awake and following
syndrome is receiving intravenous commands. Which of the following should
immunoglobulin (IVIg) and an FiO2 of 0.24 the respiratory therapist recommend?
by air-entrainment mask. The following a. PC ventilation
data are obtained: b. VC ventilation
c. Extubation
d. PS ventilation
Which of the following should a respiratory 91. A patient with a tracheostomy tube has
therapist do? transitioned from an HME to a heated
a. Initiate bilevel NPPV aerosol. Acute dyspnea has developed.
b. Maintain current care Which of the following is the most likely
c. Perform nasotracheal suctioning explanation?
d. Recommend tracheostomy a. Oxygen molecules were displaced by
88. One day following a cholecystectomy, a aerosol particles
25-year-old male with muscular dystrophy b. Secretions expanded as they
is returned to his home settings for NPPV in became hydrated
spontaneous mode. He is receiving c. Terminal airways became occluded
intravenous hydromorphone (Dilaudid) for by aerosol particles
pain management. The following data are d. Crystals formed as aerosol
available: evaporated
92. A patient is receiving mechanical ventilation
at home. Which of the following devices
should be available to provide temporary
support in the event of a power failure?
a. Bag-valve resuscitator
b. CPAP device with nasal mask
c. Pneumatic demand-valve
resuscitator
d. Face shield for mouth-to-mouth
ventilation
A respiratory therapist should recommend
93. Which of the following provides the best compromise should receive priority for
indication of the adequacy of alveolar mechanical ventilation?
ventilation? a. A 14 year old with an open skull
a. Vital capacity fracture and a GCS of 5
b. ABG analysis b. A 56 year old who is receiving CPR
c. VT for cardiac arrest
d. MVV c. A 28 year old with flail chest with
94. A patient has been receiving invasive multiple pulmonary contusions
mechanical ventilation with heated d. A 75 year old with third-degree
humidification for 4 days. When burns over 25% of body surface area
suctioning, a respiratory therapist notices 97. Which of the following values should be
that the secretions are becoming tenacious. observed while performing the low-end
The therapist should calibration of an oxygen analyzer?
a. Instill 5 mL of normal saline into the a. 100%
endotracheal tube prior to b. 21%
suctioning c. 70%
b. Ensure proximal airway temperature d. 40%
is at least 35 C (95.0 F) 98. Which of the following should be used to
c. Switch to a heat moisture exchanger administer 80/20 He/O2 to a 9-year-old
d. Recommend administration of boy?
ipratropium (Atrovent) a. Nasal cannula
95. A patient presents with fever and left lower b. Air-entrainment mask
lobe necrotizing pneumonia. The following c. Simple face mask
ABG values are obtained while the patient d. Nonrebreathing mask
breaths air: 99. Which of the following positions is the best
for drainage of the anterior segments of the
upper lobes in a patient who is able to
tolerate position changes?
a. Supine with pillow under knees
b. Prone with feet elevated 12 inches
c. Seated and hunched over pillow on
Broad-spectrum antibiotic therapy is knees
started. Which of the following additional d. Prone with a pillow under hips
therapies is most appropriate? 100. A 56-year-old female is admitted to the ED
a. Postural drainage therapy to the left following a motor vehicle crash. A
lower lobe respiratory therapist notes that the
b. Intrapulmonary percussive patient's HR is 130/min and spontaneous
ventilation RR is 33/min. ABG analysis reveals:
c. Titrate oxygen to maintain SpO2
greater than 92%
d. NPPV to maintain PCO2 at 35 mmHg
or less
96. A respiratory therapist is assisting with
triage following a bus crash. Which of the The therapist should anticipate orders for
following patients with respiratory a. Bronchoscopy
b. A serum D-dimer
 c. A chest radiograph The therapist should recommend
d. An MRI a. Changing to 5 cmH2O CPAP
101. Which of the following particle sizes b. Increasing the mandatory rate
should a nebulizer produce to allow proper c. Increasing the tidal volume
deposition of albuterol? d. Changing to PC, SIMV
a. 20 to 22 micrometers 104. The primary reason to administer
b. 13 to 15 micrometers aerosolized corticosteroids rather than oral
c. 8 to 10 micrometers corticosteroids is to
d. 3 to 5 micrometers a. Decrease bronchial irritation
102. A 29-year-old male presents to the ED b. Reduce the systemic side effects
with complaints of frequent vomiting. ABG c. Reverse bronchospasm
analysis results while the patient is d. Decrease secretions
breathing air reveal: 105. During a volume check on a
microprocessor ventilator, a respiratory
therapist notes the digital display shows an
expired volume of 500 mL. At the same
time, a respirometer attached to the
expiratory circuit reads 490 mL. Which of
Which of the following electrolyte levels the following is the most appropriate action
most likely corresponds with these ABG for the therapist to take?
values? a. Continue using the ventilator
b. Recalibrate the pneumotachometer
c. Check the pneumotachometer for
condensation
d. Queue the ventilator for a biomed
check
a. 3 106. PEEP has been increased from 5 to 10
b. 2 cm H2O for a female patient with ARDS who
c. 1 is receiving VC, A/C ventilation. With each
d. 4 breath, the high pressure alarm sounds. A
103. A respiratory therapist is assessing a respiratory therapist evaluates the patient
178-cm (5-ft 10-in), 75-kg (165-lb) male who and determines her to be stable. Which of
is receiving VC, SIMV with the following the following should the therapist do NEXT?
settings: a. Decrease the PEEP to 5 cmH2O
b. Suction the patient
c. Evaluate the alarm settings
d. Check the ventilator circuits for leaks
107. A respiratory therapist is evaluating a
33-year-old male patient for
implementation of an assess-and-treat
The following ABG values are observed:
respiratory care protocol. The following
information is obtained while the patient is
breathing air:
 Breath sounds are decreased bilaterally in
the bases, and there is decreased
resonance to percussion bilaterally in
bases. The patient has a strong, dry cough
and a chest radiograph indicates atelectasis
in both bases. The therapist should initiate
a. Postural drainage and percussion
b. PEP therapy
c. Albuterol by nebulizer
d. Cool aerosol by mask
108. A patient with pulmonary emphysema
has been receiving 24% oxygen for 30
minutes. PaCO2 has risen from 45 to 48
mm Hg, and PaO2 has risen from 45 to 60
mm Hg. Which of the following should a
respiratory therapist do NEXT?
a. Increase the O2 concentration
b. Discontinue the O2 administration
c. Continue current O2 therapy
d. Initiate mechanical ventilation
109. A 45-year-old female is receiving oxygen
therapy by a HHFNC set to an FiO2 of 0.90
at a flow of 50 L/min. Vital signs are:
ABG analysis results are:
respiratory therapist recommend FIRST?
A respiratory therapist should
a. Reduce FiO2 to 0.80
b. Reduce flow to 40 L/min
c. Change to a nonrebreathing mask
d. Maintain current therapy
110. A patient is receiving continuous
mechanical ventilation. To monitor and
assess lung compliance and airway
resistance, the following data are collected:
Which of the following should a respiratory
therapist do NEXT?
a. Decrease the PEEP setting
b. Request a chest radiograph
c. Perform bronchoalveolar lavage
d. Increase the inspiratory flow setting
111. Which of the following serum sodium
values (mEq/L) is typical for a healthy adult?
a. 141
b. 131
c. 121
d. 111
112. A 72-year-old female in the ICU is
receiving VC, A/C ventilation. She is agitated
and has deteriorating vital signs. The
following chest radiograph is obtained:
SpO2 is 79%. Which of the following should a
a. Switch to PC, A/C ventilation
b. Perform needle decompression
c. Obtain an ABG analysis
d. Administer 2 mg midazolam HCl
(Versed)
113. Which of the following is suggestive of
dehydration?
a. Pedal edema
b. Bradycardia
c. Poor skin turgor
d. Jugular venous distension
114. Following a cholecystectomy, a 43 year
old with a BMI of 45 kg/m2 experiences
increasing shortness of breath and a rapid,
shallow breathing pattern. The patient is
 receiving O2 by an air-entrainment mask
with an FiO2 of 0.40. ABG analysis reveals:
To correct the patient’s hypoxemia, a
respiratory therapist should recommend
a. NPPV
b. Invasive mechanical ventilation
c. A nonrebreathing mask
d. PEP therapy
115. A patient is receiving VC, SIMV following
surgery. The patient's vital signs are stable.
Which of the following should a respiratory
therapist recommend as the patient
awakens?
a. Initiate weaning
b. Sedate the patient
c. Switch to A/C mode
d. Increase the SIMV rate
116. When palpating the anterior chest of a
patient receiving continuous ventilatory
support, a respiratory therapist observes a
reduction in chest expansion on the left
side. The therapist should FIRST
a. Recommend immediate infusion of
furosemide (Lasix)
b. Compare breath sounds between
each side of the chest
c. Palpate for subcutaneous
emphysema along the lateral left
chest wall
d. Prepare a needle decompression kit
and sterilize the anterior left chest
117. A patient is admitted to the ED for
asthma. A respiratory therapist auscultates
loud wheezing. Following two aerosolized
bronchodilator treatments, breath sounds
and wheezing are markedly diminished.
The therapist should conclude the patient's
bronchospasm has
a. Worsened
b. Improved
c. Resolved
d. Not changed
118. Heated humidification should be used
with
a. An endotracheal tube
b. A 50% air-entrainment
c. A 4-L/min nasal cannula
d. A nonrebreathing mask
119. PEP therapy will be performed at home
by a 6 year old who has been diagnosed
with cystic fibrosis. Which of the following
should a respiratory therapist do when
instructing the child and caregiver?
a. Encourage the child to focus on
reaching the prescribed pressure
level on inspiration
b. Remind the child that it is her
responsibility to take the therapy for
the prescribed duration
c. Assess the caregivers’
understanding of how the child
should perform the therapy
d. Recommend that the therapy be
conducted before breakfast and
immediately after dinner
120. To ensure the safety of a patient's home
environment prior to discharge with an
oxygen concentrator, a respiratory therapist
should assess the
a. Heating fuel source
b. Electrical system
c. Domestic water supply
d. Type of bed
121. A previously healthy 35-year-old male
patient has been admitted for unknown
neuromuscular weakness. The patient is
178 cm (5 ft 10 in) tall and weighs 77 kg (170
lb). The following data have been obtained
over the past 4 hours:
The patient is having difficulty clearing oral
secretions. A respiratory therapist should
initiate
a. Mask CPAP
 b. Invasive mechanical ventilation
c. Nasotracheal suctioning prn
d. PEP therapy
122. While a patient is receiving VC
ventilation, the ventilator suddenly begins
to pressure limit with every breath. The
patient's vital signs are deteriorating, and
the SpO2 is dropping. On physical
examination, it is noted that the patient's
trachea has shifted to the right and breath
sounds are absent on the left side of the
thorax. Which of the following should be
done FIRST?
a. Obtain a chest radiograph
b. Obtain an ABG analysis
c. Perform needle decompression
d. Reposition the patient’s
endotracheal tube
123. A bronchodilator by MDI is ordered for a
patient receiving mechanical ventilation.
Which of the following is the most
appropriate way to administer the
medication?
a. Discharge the MDI directly into the
endotracheal tube
b. Place the MDI adapter in the
inspiratory limb, close to the Y
c. Increase the mandatory rate during
the MDI actuation
d. Insert the MDI adaptor in the
expiratory limb of the ventilator
124. The following flow-time graph is
observed for a patient with COPD who is
receiving VC, A/C ventilation
A respiratory therapist should recommend
adjusting the ventilator settings to
a. Decrease PEEP
b. Increase expiratory time
c. Decrease inspiratory flow
d. Increase the tidal volume
125. Which of the following can increase
methemoglobin?
a. 2
b. 1
c. 4
d. 3
126. HFOC is initiated for a 25-week
gestational age neonate with severe RDS.
Ventilator settings are:
The neonate has an HR of 160/min and a BP
of 64/40 mmHg. A blood gas analysis
obtained 20 minutes after intubation
shows:
A respiratory therapist should recommend
a. Initiating conventional ventilation
b. Increasing the oscillatory amplitude
c. Decreasing the frequency
d. Changing the FiO2
127. Which of the following agents should be
used to disinfect the surface of a
stethoscope?
a. Glutaraldehyde
b. Hydrogen peroxide
c. Acetic acid
d. Isopropyl alcohol
128. A colorimetric CO2 detection device
verifies endotracheal tube placement by
indicating
a.
b. PaCO2
c. %CO2
 d. PetCO2 c. Premature ventricular complexes
129. After an oxygen concentrator has been d. Ventricular bigeminy
used in a patient's home, a respiratory 133. Tracheal suctioning should be
therapist must complete which of the terminated immediately with the
following maintenance procedures? occurrence of
a. Change the filters a. Diaphoresis
b. Lubricate oxygen tubing connections b. Coughing
c. Check pressure in the oxygen c. Bradycardia
reservoir d. Patient discomfort
d. Check the electrical system monthly 134. A 50 year old is intubated and receiving
130. The following CBG results are obtained VC, A/C ventilation. Over the last 3 hours,
for a 34-week gestational age infant PetCO2 has increased from 35 mm Hg to 50
receiving 35% oxygen by nasal cannula at mm Hg. Which of the following is the most
0.5 L/min: likely cause?
a. Increased cardiac output
b. Decreased alveolar ventilation
c. Pulmonary embolism
d. Mainstem intubation
135. A 55 year old who is obese is referred to
SpO2 is 95%. A respiratory therapist should a pulmonary rehabilitation program. The
recommend patient was recently diagnosed with chronic
a. Increasing the flow bronchitis and smokes two packs of
b. Maintaining the FiO2 cigarettes per day. Patient assessment
c. Initiating nasal CPAP reveals dyspnea on exertion, daily sputum
d. Decreasing the FiO2 production, and wheezing. Which of the
131. A 71 year old with a history of COPD is following are realistic goals for the first
brought to the ED due to respiratory week of the rehabilitation program?
distress. The patient is receiving oxygen by
nasal cannula at 3 L/min. A respiratory
therapist notes the patient has shallow
breathing and has become progressively
more difficult to arouse. To evaluate the
patient's ventilatory status, the therapist a. 4
should b. 1
a. Initiate pulse oximetry c. 3
b. Request a chest radiograph d. 2
c. Perform bedside spirometry 136. A respiratory therapist has received
d. Obtain an ABG analysis orders to deliver 1.25 mg of 0.5% albuterol
132. The following ECG tracing is observed: to a patient with a small-volume nebulizer.
How many mL of albuterol should the
therapist administer?
a. 0.125
b. 0.50
c. 0.25
a. Mobitz type II atrioventricular block d. 0.625
b. Paced ventricular beats
 137. An end-expiratory PA chest radiograph
is most often useful in the detection of a
a. Pneumonia
b. Tuberculosis
c. Small pneumothorax
d. Small pleural effusion
138. In a healthy adult, the difference
between pulmonary artery diastolic
pressure and pulmonary capillary wedge
pressure is approximately
a. 3 mmHg
b. 21 mmHg
c. 15 mmHg
d. 9 mmHg
139. Transcutaneous monitoring of a 3 week
old in the NICU with an SpO2 of 97% reveals
a PtcCO2 of 42 mm Hg. Concurrent CBG
analysis results are:

Which of the following is the most likely

cause of the discrepancy in this patient’s
values?
a. The sample site was the lateral
aspect of the heel
b. The sample size was 100 microliters
c. The sample site was warmed to 36º
C (96.8º F).
d. The sample site was cleaned with
alcohol
140. During sleep, which of the following is
characterized by cessation of airflow for 10
seconds associated with paradoxical
movement of the chest and abdomen?
a. Hypopnea
b. Central apnea
c. Mixed apnea
d. Obstructive apnea

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