Pharm Review Mashup

In a cord blood gas analysis, a pH of 7.30, pCO2 of 55 mmHg, and a pO2 of 70 mmHg are observed with an FiO2 of 0.6. What should be the appropriate FiO2 adjustment for the respiratory therapist to improve oxygenation while considering the patient's condition?

• Increase FiO2 to 0.7
• Decrease FiO2 to 0.4
• Increase FiO2 to 0.8
• Decrease FiO2 to 0.5

A 62-year-old male, 6 feet 2 inches tall and weighing 232 lbs, underwent a tracheotomy two weeks ago. He remains in the ICU receiving volume-controlled mechanical ventilation. After repositioning the patient in bed, the high-pressure alarm activates with each breath. The suction catheter can only advance 8 cm into the trachea without encountering secretions. The patient's SpO2 is currently 78%. What should a respiratory therapist prioritize as the initial action?

• Increase FiO2 to 1.0
• Administer bronchodilator medication
• Adjust PEEP level
• Remove the trach tube

A 25-year-old patient diagnosed with a neuromuscular disorder is experiencing increased difficulty in managing secretions, leading to recurrent respiratory infections. The current treatment plan involves chest physiotherapy and suctioning as needed. Lately, the patient has been reporting increased respiratory distress and coughing due to excessive secretions throughout the day. What adjustment to the current treatment plan should the respiratory therapist prioritize to address the heightened secretion management?

• Increase the frequency of chest physiotherapy sessions
• Increase the duration of chest physiotherapy sessions
• Increase the suctioning frequency
• Add insufflation-exsufflation device to the treatment plan

A 55-year-old patient without a history of chronic lung disease demonstrates an elevated minute ventilation while maintaining a normal arterial partial pressure of carbon dioxide (PaCO2) level. The PaCO2 remains within the normal range (35-45 mmHg) despite the increased minute ventilation. Which of the following potential factors or compensatory mechanisms might account for this scenario?

• Decreased deadspace ventilation
• Increased alveolar ventilation
• Decreased respiratory rate
• Increased deadspace ventilation

A patient is on volume-controlled mechanical ventilation with the following settings: tidal volume of 500 mL, respiratory rate of 12 breaths per minute, FiO2 of 0.5, and PEEP of 5 cmH2O. The patient's arterial blood gas analysis shows a pH of 7.48, pCO2 of 30 mmHg, and pO2 of 80 mmHg. What adjustment to the ventilator settings should the respiratory therapist consider?

• Increase tidal volume
• Decrease FiO2
• Decrease PEEP
• Decrease respiratory rate

A patient with known obstructive sleep apnea presents to the sleep clinic with excessive daytime sleepiness. A polysomnography is performed, which shows an apnea-hypopnea index (AHI) of 25 events per hour. What should the respiratory therapist recommend as the initial treatment for this patient?

• Continuous positive airway pressure (CPAP)
• Mandibular advancement device (MAD)
• Supplemental oxygen therapy
• Uvulopalatopharyngoplasty (UPPP)

A 40-year-old patient with a history of chronic obstructive pulmonary disease (COPD) is admitted to the hospital with worsening dyspnea and increased sputum production. The patient is currently receiving home oxygen therapy at a flow rate of 2 L/min. On physical examination, the patient has decreased breath sounds and increased resonance to percussion over the left lung. What complication should the respiratory therapist suspect?

• Pneumothorax
• Bronchospasm

• Pulmonary embolism
• Pleural effusion

A patient presents to the emergency department with acute shortness of breath. On physical examination, the patient has decreased breath sounds and hyperresonance to percussion over the affected lung. The patient's chest X-ray shows a collapsed lung. What is the appropriate intervention for this patient?

• Needle aspiration
• Chest tube insertion
• Antibiotic therapy
• Bronchodilator medication

A 60-year-old patient with a history of chronic bronchitis and emphysema presents to the clinic with worsening dyspnea and increased cough. The patient's arterial blood gas analysis shows a pH of 7.35, pCO2 of 55 mmHg, and pO2 of 60 mmHg. What is the appropriate classification of the patient's respiratory status?

• Compensated Respiratory acidosis with hypoxemia

• Partially Compensated Respiratory alkalosis with hypoxemia

• Partially Compensated Respiratory acidosis with hyperoxemia

• Compensated Respiratory alkalosis with hyperoxemia

A patient with acute respiratory distress syndrome (ARDS) is receiving mechanical ventilation with a tidal volume of 6 mL/kg of predicted body weight. What is the appropriate range for the plateau pressure in this patient?

• 55-60cmH2O

• 20-25 cmH2O
• 30-35 cmH2O
• 40-45 cmH2O