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RCP 170 SJVC EXAM QUESTIONS AND CORRECT ANSWERS
100% VERIFIED NEWEST
The respiratory therapist has started iNO at 20 ppm for an infant in pulmonary hypertension. After 2 hours a blood gas shows a 10% improvement in SaO2. What does the therapist do? a. Continue iNO at 20 ppm and wait at least 2 hours before considering a change. b. Increase iNO to 30 ppm and continue with the same FiO2. c. Continue iNO at 20 ppm and wean the FiO2 by 10%. d. Increase iNO to 30 ppm with no changes in FiO2. - ANSWER a
An infant has been receiving iNO for the last 3 days. What is the significant level that should be monitored when ordering a co-oximetry? a. Methemoglobin b. Carboxyhemoglobin c. Reduced hemoglobin d. Oxyhemoglobin - ANSWER a
What is the inspiratory time percent setting for HFOV? a. 20% b. 25% c. 33% d. 50% - ANSWER c
The therapist is performing a ventilator check on a neonate and makes the following notations on the ventilator flow sheet: PEEP: 5 cm H2O
PIP : 25 cm H2O Mandatory rate : 15 breaths per minute FiO 2 : 0. On the basis of these observations, for which therapy should the therapist advocate on behalf of this neonate? a. Shunt study b. Weaning from mechanical ventilation c. Inhaled nitric oxide d. High frequency ventilation - ANSWER b
How is radiographic evaluation of neonatal lung volume completed? a. counting anterior ribs above diaphragm b. Counting posterior ribs above the diaphragm c. Counting the number of posterior ribs below the clavicle d. Counting the number of anterior ribs below the clavicle - ANSWER b
What is the primary physiologic effect of inhaled nitric oxide? a. Bronchodilation b. Pulmonary vasodilation c. Systemic vasodilation d. Cerebral vasodilation - ANSWER b
Which of the following Apgar score parameters is the most valuable initial reading? Question options: a. Heart rate b. Respiratory rate c. Skin color
b. 4.0 mm ID c. 4.5 mm ID d. 5.0 mm ID - ANSWER c
Which of the following statements describes the laryngeal mask airway (LMA)? Question options: a. The LMA should be used only with conscious patients. b. The potential for aspiration is lower than with translaryngeal intubation. c. The LMA is a good alternative as an emergency airway when positive-pressure ventilation is needed. d. The LMA is placed into the larynx immediately above the epiglottis. - ANSWER c
A 5-year-old child is brought to the emergency department in severe respiratory distress with a diagnosis of epiglottitis. What measures must be performed to secure the child's airway? Question options: a. The child should be immediately intubated orally in the emergency department. b. A tracheotomy should be done in the emergency department. c. This child must be taken immediately to the operating room for intubation. d. The child should be treated with nebulized 2.2% racemic epinephrine via face mask every 10 minutes. - ANSWER c
Which of the following is considered the best predictor of a readiness for extubation?
Question options: a. An oxygen saturation >95% b. A respiratory rate <35 breaths per minute c. A cuff leak <25 cm H2O d. Improvement in the disease process that initially mandated intubation - ANSWER d
Once preterm labor is diagnosed, which of the following medications should be considered as tocolytic? Question options: a. Magnesium sulfate b. Sodium bicarbonate c. Calcium carbonate d. Epinephrine - ANSWER a
A pregnant woman at 30 weeks of gestation with premature rupture of membranes has been admitted to the hospital with preterm labor. The physician has ordered betamethasone. When does the maximal benefit of antenatal corticosteroid occur to reduce RDS? Questions options: a. After 12 hours b. After 24 hours c. After 48 hours d. After premature membrane rupture - ANSWER c
Which of the following conditions is a significant problem in postterm pregnancy? Questions options: a. Infection b. Fetal anencephaly c. Meconium aspiration d. Obesity - ANSWER c
Which of the following procedures is performed after the 16th week of pregnancy and can be used to assess for chromosomal abnormalities? Question options:
c. consolidation d. pneumothorax - ANSWER b
How will well-expanded, air-filled lungs appear on a chest radiograph? Question options: a. White b. Black c. Gray d. Light colored - ANSWER b
A therapist is viewing a frontal chest radiograph of a neonate who has just been endotracheally intubated. The tip of the endotracheal tube is located between the inferior clavicular border and the carina. What should the therapist do at this time? Question options: a. Provide a morning respiratory assessment and care for the intubated patient at that time. b. Withdraw the endotracheal tube a few millimeters. c. Advance the endotracheal tube a few millimeters. d. Remove the endotracheal tube and reinsert it because it is in the esophagus. - ANSWER a
A therapist is examining the lateral view of a neck radiograph of an 18-month-old child. The epiglottis is enlarged, the aryepiglottic folds are thickened, and the hypopharynx is overdistended. Which condition is this child most likely to have? Questions options: a. Bronchopulmonary dysplasia b. Esophageal fistula c. Croup d. Epiglottitis ANSWER d
Why would rigid bronchoscopy be the preferred choice to remove a foreign body from the tracheobronchial tree of a pediatric patient compared with flexible bronchoscopy?
Options: a. It is the only method by which large foreign bodies can be safely passed through the subglottic area. b. It allows for superior ventilation of the patient during general anesthesia. c. A lower fraction of inspired oxygen is required with rigid bronchoscopy, reducing the risk of oxygen toxicity d. Less anesthesia is required for rigid bronchoscopy to be performed. - ANSWER b
What % lidocaine spray is used for neonatal flexible bronchoscopy?
Question options: a. < 1% lidocaine b. 1% to 2% lidocaine c. 3% to 4% lidocaine d. 5% to 6% lidocaine - ANSWER b
A pediatric patient is undergoing a bronchoscopy and the therapist observes a patient's SpO2 at 90%. Which of the following should be done by the therapist at this time?
Question options: a. Continue monitoring the patient as the procedure progresses. b. Provide supplemental oxygen to the patient until the SpO2 is 95% c. If the patient's SpO2 falls to 88%, administer oxygen to achieve an SpO2 of 90%. d. Stop the bronchoscopy procedure until the patient's SpO2 returns to its preprocedure level. - ANSWER b
The therapist is evaluating a mechanically ventilated infant and notices that the transcutaneous electrode temperature is set between 41 and 44°C. What, if any, action must the therapist take at this time? a. The range set is within the appropriate temperature range; thus, no action is required. b. The therapist should increase the temperature range to 46 to 48°C. c. The transcutaneous electrode temperature should be lowered to 36 to 38°C. d. The electrode should be repositioned and maintained at a consistent temperature. - ANS a
During a work session in the NICU, the therapist is providing care for a mechanically ventilated newborn whose PetCO2 is being monitored. The therapist notes the following capnogram. Which of the following interpretations should the therapist make of this capnogram? a. This is a normal capnogram b. This patient is receiving about 10cmh20 of positive end expiratory pressure. c. The patient is rebreathing his own exhaled gas d. The neonate is being hyperventilated. - ANSWER c
The following capnogram was obtained from a newborn infant receiving mechanical ventilation. How should the therapist evaluate this capnogram? they look like smooth mountains Question options: a. Airway obstruction b. Hypoventilation c. Hyperventilation d. Increased deadspace ventilation - ANSWER a
What clinical parameter is critically important to monitor when mechanical ventilation is administered? a. Blood pressure
b. Heart rate c. Temperature d. Respiratory rate - ANSWER a
A respiratory therapist has been ordered to obtain a blood gas sample from a nonintubated premature baby. After selecting the best site to obtain the sample, what should the RT suggest to ameliorate the pain associated with the procedure? a. Provide a small dose of fentanyl b. Provide lidocaine to the site of injection c. Offer a pacifier dipped in 24% sucrose d. Provide a lidocaine drip - ANSWER c
The neonatologist orders a heel stick to determine an infant's oxygenation status on an infant 12 hours of age who presents with respiratory distress. At this time, which action by the therapist is appropriate? Question options: a. Perform the heel stick as ordered. b. Instead of using the heel,the therapist should use a finger as the site c. Inform the physician that this procedure is inappropriate at this time. d. Increase the fio2 by 10% then draw the blood gas. - ANSWER c
True or false: A properly placed UAC on x-ray would be between thoracic vertebre T- and T-8. - ANSWER true
True or false: An umbilical artery catheter is indicated when frequent blood gasses will be required. - ANSWER true
True or false: ETCO2 can be monitored with an patient that is not intubated. - ANSWER true
True or false: In the RA most of the blood flow from the IVC crosses through the foramen ovale into the LA. The foramen ovale is a one-way valve. - ANS true
What purpose does Wharton's jelly serve inside the umbilical cord? a. It serves to provide nourishment for the fetus b. It serves to prevent the vessels inside the cord from kinking c. To help protect the fetus d. To regulate the temperature between the fetus and the mother - ANSWER b
Which of the following anatomic structures are fetal shunts? I. Foramen ovale II. Sinus venosus III. Ductus venosus IV. Ductus arteriosus - ANSWER I, III, and IV only
Which of the following paths correctly traces oxygenated blood from the placenta to the fetus? a. Umbilical arteries, ductus venosus, right atrium, left atrium, foramen ovale, aorta, umbilical vein b. Umbilical vein, ductus arteriosus, right atrium, umbilical arteries, foramen ovale, left atrium, aorta c. Aorta, umbilical arteries, umbilical vein, ductus venosus, right atrium, foramen ovale, left atrium d. Umbilical vein, ductus venosus, right atrium, foramen ovale, left atrium, aorta, umbilical arteries - ANSWER d
Which of the following microorganisms most commonly affect pregnancy outcome? a. Group B Streptococcus
b. Haemophilus influenzae c. Mycobacterium tuberculosis d. Hepatitis C virus - ANSWER a
A 30-week pregnant woman has been admitted to the hospital in preterm labor with premature rupture of membranes. The physician has ordered betamethasone. When does the maximal benefit of antenatal corticosteroid occur to reduce RDS? a. After 12 hours b. After 24 hours c. After 48 hours d. After 1 week - ANSWER c
Which of the following conditions is a significant problem in postterm pregnancy? a. Infection b. Fetal anencephaly c. Meconium aspiration d. Obesity - ANSWER c
A therapist is resuscitating a term newborn. The heart rate falls to 55 beats per minute. What is the best course of action? a. Intubate and provide positive airway pressure b. Administer IV or ET epinephrine c. Apply bag-mask ventilation d. Continue compressions until heart rate is greater than 60 - ANSWER b
A therapist is called to the labor and delivery room to assist in the resuscitation of a term newborn. If necessary, what FiO2 should be used to start positive pressure ventilation? a. 100% and wean as needed
and temperature. - ANSWER false
True or False: Nasal flaring, expiratory grunting, burping, tachypnea and retractions are signs of distress. Vesicular breath sounds are not usually associated with infants in distress - ANSWER false
True or false: The umbilical cord at birth is yellowish white, contains three blood vessels, and it is easy to see the two small and thick walled arteries and one large and thin walled vein at the end of a freshly cut cord. - ANSWER true
What are the therapist's actions to prevent heat loss and cold stress before resuscitation on a preterm neonate? I. Drying of skin of the infant II. Wrapping in pre-warmed blankets. III. Discard wet linens from around the infant. IV. Record the neonate's body temperature - ANSWER I, II, and III only
During the process of stabilizing a preterm neonate in advance of resuscitation, what is the appropriate action to prevent injury and atelectasis and prevent interfering with the infant's initial attempt to establish adequate ventilation? I. Suction a bulb syringe. II. Suction minimal clear fluid from the nasopharynx. III. Use a suction catheter clearing the mouth first and then the nose. IV. Suction using direct laryngoscopy. - ANSWER I, II, and III only
A 1-minute Apgar score has been performed by the therapist. The following assessments were noted: (1) The infant is pale. (2) The heart rate is 90 beats per minute. (3) The respiratory effort is irregular. (4) Some muscle tone is present. (5) No response to nasal suctioning is observed. On the basis of the previous findings, what Apgar score should this neonate be given? a. 1 b. 2 c. 3 d. 5 ANSWER c
Which of the following parameters of the Apgar score offers the best prognostic value? a. Heart rate b. Respiratory rate c. Skin color d. Muscle tone - ANSWER a
Why are chest retractions more pronounced in neonates compared with older children and adults? a. Because neonates create a greater subatmospheric intrapleural pressure b. Because newborns have relatively thin and weak musculature and a less rigid thorax c. Because neonates have a much higher respiratory rate d. Because airway resistance through the smaller caliber airways is higher - ANSWER b
Head bobbing, nasal flaring, and grunting are exhibiting signs of which of the following? a. Respiratory distress b. Hypoxemia c. Hypercapnia d. Acidemia - ANSWER a
While auscultating a young child's thorax, the therapist hears bilateral fine crackles. Which of the following conditions can produce these adventitious sounds? a. Pulmonary edema b. Bronchitis c. Croup d. Asthma - ANSWER a What is the primary factor that makes ECMO so successful in newborns? a. Newborns do not have as a high risk for bleeding as other age groups. b. Newborns require less ECMO flows.
d. Tetralogy of Fallot - ANSWER b
The therapist identifies the following signs in a pediatric client who has recently undergone a heart transplant:Decreased cardiac contractilityCongestive heart failureTachycardiaTachypneaMalaiseWhich of the following represents how the therapist should interpret these signs? a. These signs are normal and expected after heart transplantation. b. The patient has become hypovolemic. c. The patient requires cardioversion. d. The patient is in rejection. - ANSWER d
Months post-lung transplant, a patient with cystic fibrosis presents with the following findings: Dyspnea that is progressive Cough with sputa production Colonization with Pseudomonas species The patient also seems to be in respiratory failure. Which of the following is likely developing? a. Bronchiolitis obliterans b. Bronchorrhea c. Acute respiratory distress syndrome d. Pulmonary hypertension - ANSWER a At which stage of human lung development does a capillary network develop around airway passages? a. pseudoglandular b. saccular c. alveolar d. canalicular - ANSWER d
Which of the following mechanisms could explain the potential link between oligohydramnios and lung hypoplasia? I. Impaired carbohydrate metabolism II. Mechanical constraining of the chest wall
III. Interference with fetal breathing IV. Failure to produce fetal lung liquid - ANSWER 2, 3, 4
Which is the pathway through which the oxygenated blood leaves the placenta and reaches the fetus? a. Aortic artery b. Umbilical vein c. Umbilical artery d. Spiral artery - ANS b
What is the role of the substance produced by the type II pneumocyte? a. To enhance surface area for gas exchange b. To lower surface tension c. To maintain elasticity of lungs d. To maintain the volume of amniotic fluid - ANS b
true or false: Gas exchange surface area increases linearly with an increase in oxygen consumption. - ANSWER true
During what stage of human lung development does the lung become considered viable Question options: a. Embryonal b. Horizontal c. Canalicular d. Saccular - ANSWER c
true or false: With transition to extrauterine life Pulmonary Vascular Resistance(PVR) increases. - ANSWER false
