RRT Respiratory Therapy 2 — Questions and Answers
Question 1: A patient's ABG reveals pH 7.28, PaCO2 58 mmHg, HCO3 26 mEq/L. What is the primary acid-base disorder?
- Metabolic acidosis
- Respiratory acidosis uncompensated (Correct answer)
- Respiratory alkalosis
- Mixed metabolic and respiratory acidosis
Correct answer: Respiratory acidosis uncompensated
pH below 7.35 with elevated PaCO2 and near-normal HCO3 indicates uncompensated respiratory acidosis.
Question 2: Which lung volume cannot be measured by spirometry alone?
- Tidal volume
- Inspiratory reserve volume
- Functional residual capacity (Correct answer)
- Expiratory reserve volume
Correct answer: Functional residual capacity
FRC contains the residual volume, which cannot be measured by spirometry and requires body plethysmography or gas dilution.
Question 3: A patient on mechanical ventilation develops sudden hypotension and absent breath sounds on the left. The most likely diagnosis is:
- Pulmonary embolism
- Right mainstem intubation
- Left tension pneumothorax (Correct answer)
- ARDS exacerbation
Correct answer: Left tension pneumothorax
Absent breath sounds on one side plus sudden hypotension in a ventilated patient indicates tension pneumothorax requiring immediate needle decompression.
Question 4: The P/F ratio (PaO2/FiO2) threshold for classifying severe ARDS is:
- < 300 mmHg
- < 200 mmHg
- < 100 mmHg (Correct answer)
- < 150 mmHg
Correct answer: < 100 mmHg
Per the Berlin Definition, severe ARDS is defined by a P/F ratio less than 100 mmHg on PEEP ≥ 5 cmH2O.
Question 5: Which inhaled medication is classified as a long-acting muscarinic antagonist (LAMA)?
- Ipratropium bromide
- Tiotropium (Correct answer)
- Albuterol
- Salmeterol
Correct answer: Tiotropium
Tiotropium (Spiriva) is a once-daily LAMA used for COPD maintenance, providing bronchodilation lasting 24 hours.
Question 6: During a 6-minute walk test, which finding would prompt the RT to immediately stop the test?
- SpO2 drops from 98% to 93%
- Patient reports mild dyspnea at 3 minutes
- SpO2 drops to 85% with chest pain (Correct answer)
- Heart rate increases by 20 bpm
Correct answer: SpO2 drops to 85% with chest pain
SpO2 below 88% or the presence of chest pain are absolute indications to stop a 6-minute walk test.
Question 7: A non-rebreather mask at 15 L/min delivers approximately what FiO2?
- 0.40–0.50
- 0.55–0.65
- 0.60–0.80 (Correct answer)
- 0.90–1.00
Correct answer: 0.60–0.80
A properly fitted non-rebreather mask at 15 L/min delivers an FiO2 of approximately 0.60–0.80 depending on patient's inspiratory flow.
RRT Respiratory Therapy 2
A patient's ABG reveals pH 7.28, PaCO2 58 mmHg, HCO3 26 mEq/L.
What is the primary acid-base disorder?