CRTE Nursing Diagnosis Practice Exam With Answers (100 Solved Questions)

Name: CRTE Nursing Diagnosis Practice Exam With Answers (100 Solved Questions)
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CERTIFIED RESPIRATORY THERAPIST EXAM 3-8 100 QUESTIONS
AND ANSWERS RATED A+ WITH COMPLETE SOLUTIONS
Assessment of a 28-year-old trauma patient reveals diminished
breath sounds, asymmetrical chest expansion, severe chest pain,
and an SpO2 of 90%, despite receiving oxygen via cannula at 5
L/min. These findings are most consistent with what diagnosis? - B).
Pneumothorax
Both viral pneumonia and pleural effusion can be ruled out as
correct answers as they are related to trauma. Breath sounds,
though diminished, can be heard, and chest expansion, though
asymmetrical, is present; both of these are not consistent with a
complete airway obstruction. The physical assessment is consistent
with the correct answer, pneumothorax.
A 23-year-old firefighter is admitted with suspected smoke
inhalation. You place him on a nonrebreathing mask. What is the
most appropriate method of monitoring his oxygenation? - B). CO-
oximetry
In the case of smoke inhalation, carbon monoxide (CO) binds to the
hemoglobin molecule in place of oxygen. Neither ABGs, pulse
oximetry, or calculation of A-a gradient will indicate how much

oxygen is bound to hemoglobin. Any victim of suspected smoke
inhalation must be monitored with CO-oximetry.
The ratio of lecithin to sphingomyelin, or L/S ratio, is a test to
determine fetal lung maturity. Such a test may be done in the later
stages of pregnancy, and the values will initially be noted in the lab
results section of the mother's medical record. Approximately what
ratio is associated with the onset of mature surfactant production?
- A). 2:1
The lecithin to sphingpmyelin ratio, or L/S ratio, is used to
determine fetal lung maturity. Generally, this ratio reaches 2:1
(twice as much lecithin as sphingomyelin) near week 35 of
gestation, which corresponds to the onset of mature surfactant
production. The L/S ratio will generally be noted in the lab results
section of the mother's medical record.
Sputum culture and sensitivity would be indicated in the evaluation
of which of the following clinical conditions? - B). Bacterial
pneumonia
Sputum culture and sensitivity are used to identify microorganisms
and their most appropriate drug therapy. Bacterial pneumonia is the
obvious infectious process in the choice of answers.

You measure an oxygen concentration of 55% being delivered by an
air-entrainment mask set to deliver 31% oxygen. - C). Check the
entrainment ports.
Because air-entrainment masks mix air and oxygen at a constant
ratio, an alteration in the delivered oxygen concentration could
result only
from an alteration in the mixing ratio. Since jet size (for a given
adapter) is fixed, the problem must be with the entrainment ports.
Obstruction of the entrainment ports will decrease air entrainment
and raise the delivered oxygen concentration.
Which of the following is the approximate total output flow delivered
from a 35% air-entrainment mask operating at 8L/min? - B).
48L/min
To compute the total output flow delivered by an air-entrainment
device, multiply the sum of its ratio parts by the input flow. A 35%
air-entrainment mask mixes air and oxygen at a fixed 5:1 ratio; thus
(5+1) x 8 = 48 L/min
You observed that the reservoir bag on a patient receiving O2 at 10
L/min does not deflate at all when the patient inspires. What to do
first. - C). Check the mask for a snug fit.
If a nonrebreathing mask reservoir bag does not deflate at all when
the patient inspires, either the flow is higher than needed, there are

large inspiratory air leaks (around the mask or through the
exhalation valves), or the inspiratory valve is jammed. The most
common cause is large air leakage, which can easily be corrected by
making sure that the mask is fit comfortably tight to the patient,s
face.
Which of the following is the most probable cause of insufficient mist
in a croup tent)? - D). A clogged capillary tube in the nebulizer.
Since most croup tents use large-volume jet nebulizers to generate
mist, insufficient mist indicates malfunction of the nebulizer. The
most common cause of nebulizer malfunction is clogging of the
capillary tube that feeds liquid water to the jet.
A physician specifies in her respiratory orders the following
objective for a patient with an artificial airway: " to overcome the
patient's humidity deficit." Aerosol generator to be used for this
patient. - B). Large -reservoir heated jet nebulizer.
The large-reservoir air-entrainment jet nebulizer is the primary
gas-powered aerosol generator used to provide humidification to
the respiratory tract.
During CPR, the oxygen reservoir bag of a bag-valve manual
resuscitator collapses during the refill phase. You can correct this
problem by: - B). Increasing O2 flow to the bag.

Think of the reservoir bag of a bag-valve manual resuscitator as
equivalent to the bag on a reservoir mask. If the reservoir bag
collapses during the resuscitator's refill phase (equivalent to
patient inspiration), the flow is inadequate and should be increased
until the bag does not empty.
While a patient is being ventilated with a bag-valve resuscitator, the
bag fills rapidly and collapses on minimal pressure, although little
chest movement by the patient is noted. The cause may be. - A).
Absence of the inlet valve.
If a bag-valve resuscitator fills rapidly but collapses on minimal
pressure and delivers little volume, the likely problem is a missing,
torn or malpositioned inlet valve. In this case, when you squeeze the
bag, gas follows the path of least resistance and escapes out the
inlet port (instead of going to the patient). Can be avoided by
performing an operational check on the bag before applying it to the
patient.
An intubated adult patient with severe expiratory airway obstruction
requires ventilatory support. Which of the following factors is most
important in selecting a ventilator for this patient? - B). Variable
flow control and adjustable I:E ratios.
Of the functions listed, the most important capability when selecting
a ventilator for an intubated adult patient with severe expiratory
airway obstruction would be variable flow control and adjustable I:E

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ratios. This will allow clinicians to make sure the expiratory time is
sufficiently long to prevent air trapping / auto-PEEP
What type of breathing circuit would you use when assembling a
home-care ventilator. - B). Single-limb circuit with expiratory
balloon valve.
Most home-care ventilators use a single-limb circuit with expiratory
balloon valve. Single-limb circuits have a separate pneumatic line
running from the ventilator to the expiratory valve that pressurizes
the expiratory valve during inspiration in order to block gas outflow
during the application of positive pressure. An expiratory valve can
also be used to control or retard expiratory flow or provide
CPAP/PEEP.
To provide a low to moderate concentration of oxygen to a patient
receiving nasal BIPAP via a device that uses a turbine or blower to
generate pressure, you should: - C). Bleed supplemental O2 from a
flowmeter into the circuit.
Most NPPV ventilators and BIPAP devices use a simple air blower to
generate pressure. In order to provide supplemental oxygen with
devices, you place a small-bore tubing adapter at either the patient
interface or machine outlet. After connecting this adapter to a
flowmeter via O2 delivery tubing, you bleed O2 into the circuit until
he desired level is confirmed by O2 analysis. Note that high

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supplemental O2 flows can interfere with the proper triggering or
cycling of some NPPV ventilators.
What alarm conditions indicates a potential system leak when
delivering volume-oriented ventilatory support? - D). Low volume +
low pressure.
When delivering volume-oriented ventilatory support, potential
system leaks are indicated by a low-volume and low-pressure alarm
condition. Check for and correct any loose circuit connections.
A patient with a chronic neuromuscular condition requires nocturnal
positive pressure ventilation over the long term. What airway would
you recommend for this patient? - B). Fenestrated tracheostomy
tube.
A fenestrated tracheostomy tube is the best choice to support
patients needing intermittent (e.g. nocturnal) ventilatory support.
For positive pressure ventilation, the inner cannula is inserted to
close the fenestration and the cuff inflated to provide a seal. When
the patient is not on the ventilator, the inner cannula is removed (to
open the fenestration), the cuff is deflated, and the tube is plugged.
This allows normal use of the upper airway.
What would indicate an obstruction in the ET tube of a patient who is
being mechanically ventilated by a volume-cycled ventilator? - A). I.

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High pressure is required to deliver the volume. & III). A suction
catheter cannot be passed.
An obstruction in the ET tube of a patient who is being mechanically
ventilated increases flow resistance and thus the peak pressure
needed by a volume-cycled ventilator to deliver its preset volume. In
addition, you could detect the obstruction by trying to pass a suction
catheter through the ET tube. Failure to pass a suction catheter
through a tracheal airway indicates tube obstruction.
Prior to intubation in an emergency, injection of air into the pilot line
fails to inflate the cuff. You should: - C). Replace the endotracheal
tube.
A cuff that fails when injected with air has a large leak. The faulty ET
tube should be replaced and the new tube tested in the same
manner.
Resistance is encountered while suctioning through a size 6-mm ID
ET tube with a 14-Fr catheter. What is the most appropriate action to
take? - B). Use a 10-Fr catheter.
The catheter is too large for the ET tube. In general, the outside
diameter of a suction catheter should not be more than about 1/2 as
large as the inside diameter of the airway through which it passes.
To quickly estimate the correct catheter size in french units (Fr),
simply multiply the internal diameter (ID) of the tracheal tube (in

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mm) by 2 and select the next smallest catheter size.(e.g. 6.0-mm
tube, 2 x 6 = 12, next smallest catheter size = 10 Fr. 10Fr is the best
size to use for this patient.
What can cause suctioning stop suddenly during tracheobronchial
aspiration. - B). Clearence of secretions.
Conditions that could cause suctioning to stop suddenly during
tracheobronchial aspiration include: 1) disconnected tubing (leak:
loss of vacuum), 2). a full suction reservoir (ball-valve shutoff), and
3) plugging of the catheter (system obstruction).
About how many hours will an H-cylinder of oxygen last if it has 1100
psig and is emptying at a flow of 8L/min? - C). 7.2 hours
Duration of flow = (cylinder factor x psig)/flow. The factor for an H
cylinder is 3.14 Thus duration of flow = (3.14 x 1100)/ 8 = 432
minutes. 432/ 60 = 7.2 hours.
After attaching a yoke connector to an E-size cylinder and opening
the cylinder valve, you notice a leak at the gas outlet. What are the
possible causes of the leak? - C). The gas outlet bushing is missing &
The yoke hand screw is not tight enough.
Yoke connectors for cylinders A-E use a hand screw to hold the toke
on the valve stem. If not tightened properly, a leak could result. In
addition the small receiving nipple on the yoke is normally sealed to

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the gas outlet with a nylon bushing. A missing or damaged bushing
could also cause a leak.
While obtaining an arterial sample for analysis using a point-of-care
analyzer, you should do what? - B). Place the sample in an ice slush.
When obtaining an arterial sample for analysis using a point-of-care
analyzer, the equipment performed are essentially the same as
when preparing the sample for central lab analysis.
Exceptions = 1) sample to be analyzed within 3 minutes, & 2) sample
should not be placed in ice.
An alert 55-year-old patient who has two days earlier had abdominal
surgery has moderate basilar crackles on the left side, a
respiratory rate of 13 breaths/min, and an SpO2 of 96% on nasal
cannula at 2L/min. The surgeon is concerned that the patient may
be developing atelectasis, What approach can manage this patient? -
B). Incentive breathing therapy.
Incentive spirometry is the first choice for treating suspected or
confirmed atelectasis in an alert patient who does not have evidence
of bronchospasm or secretion clearance problems.
To apply vibrations to a patient when using an electrically powered
percussor during postural drainage, you should use the ______
available frequency and apply during _______ only. - A). Highest;
exhalation

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To provide vibration with a mechanical percussor, you should use
the higher available frequencies (20-30 Hz) and apply during
exhalation only.
After setting up a flow-resistor expiratory airway pressure (PEP)
device for a patient with postoperative atelectasis, you note that the
system does not generate any pressure during active patient
expiration. Your first action in this case should be to: - B). Recheck
and tighten all connections.
If a PEP device fails to generate pressure during patient expiration,
the most likely problem is a leak, either in the device itself or in the
connecting tubing (including any connection to a pressure
manometer,
You can use a fluid column pressure manometer for what? - D). To
measure rapid pressure changes.
Fluid pressure manometers are used to measure 1) atmospheric
pressure (barometer); 2) static or slowing changing pressures- e.g.
CVP; 3) systolic/diastolic blood pressures (occlusion method); and
also to calibrate other pressure measuring devices. They are not
suited for measuring rapidly changing pressures, thier accuracy
depends on position, and they can be messy or hazardous (if
mercury is used).

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You need to measure the forced vital capacity (FVC) of an adult
patient at the bedside. What device should be used to make this
measurement? - A). A computerized electronic spirometer with flow
sensor.
If you need to measure a patient's forced vital capacity or related
measures (e.g., peak flow, FEV1, FEV25-75%) at the bedside, you
should choose a portable electronic spirometer that incorporates a
flow sensor (pneumotachometer) and computer analysis module.
Mechanical turbine-type volumeters like the Wright respirometer
are used to measure tidal volume, minute volume, inspiratory
capacity, and slow vital capacity. Because the Wright respirometer
can be damaged by flows greater than 60 L/min, it should not be
used to measure forced inspiratory or expiratory volumes.
Upon inspection of a portable spirometer's FVC curve obtained on an
adult outpatient, you determine that the back extrapolated volume is
excessive. Prior to repeating the maneuver, what instruction should
you provide to the patient. - A). "Don't hesitate"
In adults, a back extrapolated volume greater than 150 ml, indicates
patient hesitation at the beginning of the breath, which will invalidate
the results.
After setting up a 12-lead ECG on a patient, you note a noisy and
unstable signal. What will help to resolve the problem. - C). Turning
off filtering of extraneous electrical activity.

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CRTE Nursing Diagnosis Practice Exam With Answers (100 Solved Questions)

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