RRT RRT Ultimate 3 — Questions and Answers
Question 1: A neonate born at 28 weeks gestation develops grunting, nasal flaring, and intercostal retractions within 2 hours of birth. What is the most likely diagnosis?
- Transient tachypnea of the newborn
- Meconium aspiration syndrome
- Respiratory distress syndrome (RDS) (Correct answer)
- Congenital diaphragmatic hernia
Correct answer: Respiratory distress syndrome (RDS)
Premature neonates lack surfactant, leading to RDS with classic signs of increased work of breathing shortly after birth.
Question 2: Which flow-volume loop pattern is characteristic of a fixed upper airway obstruction?
- Reduced expiratory flow with normal inspiratory flow
- Flattened inspiratory loop only
- Flattened both inspiratory and expiratory loops (Correct answer)
- Reduced total lung capacity with normal flows
Correct answer: Flattened both inspiratory and expiratory loops
A fixed obstruction (e.g., tracheal stenosis) causes equal flattening of both the inspiratory and expiratory limbs of the loop.
Question 3: Which parameter best reflects the adequacy of alveolar ventilation?
- SpO2
- PaO2
- PaCO2 (Correct answer)
- End-tidal CO2 (EtCO2)
Correct answer: PaCO2
PaCO2 is the gold standard for assessing alveolar ventilation; elevated PaCO2 indicates hypoventilation.
Question 4: A patient is receiving aerosolized albuterol. The therapist notes the patient's HR increases from 78 to 118 bpm. What is the BEST course of action?
- Continue the treatment; tachycardia is always expected
- Discontinue the treatment and notify the physician (Correct answer)
- Double the dose to enhance bronchodilation
- Switch to ipratropium and continue the same dose
Correct answer: Discontinue the treatment and notify the physician
A HR > 20% above baseline or exceeding 110–120 bpm is a criterion to stop albuterol therapy and report to the physician.
Question 5: What is the normal range for airway resistance (Raw) in a healthy adult?
- 0.5–1.0 cmH2O/L/s
- 0.6–2.4 cmH2O/L/s (Correct answer)
- 5–10 cmH2O/L/s
- 10–20 cmH2O/L/s
Correct answer: 0.6–2.4 cmH2O/L/s
Normal airway resistance in adults is approximately 0.6–2.4 cmH2O/L/s, measured via body plethysmography.
Question 6: Which ventilator mode delivers a set tidal volume but allows the patient to breathe spontaneously between mandatory breaths?
- Assist-Control (AC)
- Synchronized Intermittent Mandatory Ventilation (SIMV) (Correct answer)
- Pressure Support Ventilation (PSV)
- Continuous Positive Airway Pressure (CPAP)
Correct answer: Synchronized Intermittent Mandatory Ventilation (SIMV)
SIMV delivers a set number of mandatory breaths synchronized to patient effort and allows unassisted spontaneous breaths in between.
Question 7: What is the primary purpose of adding PEEP during mechanical ventilation?
- Reduce PaCO2
- Prevent alveolar collapse at end-expiration (Correct answer)
- Increase tidal volume delivery
- Eliminate air trapping
Correct answer: Prevent alveolar collapse at end-expiration
PEEP maintains positive pressure at end-expiration to prevent alveolar derecruitment and improve oxygenation.
RRT RRT Ultimate 3
A neonate born at 28 weeks gestation develops grunting, nasal flaring, and intercostal retractions within 2 hours of birth.
What is the most likely diagnosis?