Skip to content
Past Exams

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

Use CRTE Nursing Diagnosis Practice Exam With Answers to study past exams, giving you the chance to practice with realistic test questions.

Preview 13 of 40 pages

See the first 13 pages exactly as they appear in the document.

  1. Page 1
    Read page 1 as text

    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

  2. Page 2
  3. Page 3
    Read page 3 as text

    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.

  4. Page 4
    Read page 4 as text

    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

  5. Page 5
    Read page 5 as text

    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.

  6. Page 6
    Read page 6 as text

    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

  7. Page 7
    Read page 7 as text

    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

  8. Page 8
    Read page 8 as text

    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.

  9. Page 9
    Read page 9 as text

    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

  10. Page 10
    Read page 10 as text

    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

  11. Page 11
    Read page 11 as text

    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

  12. Page 12
    Read page 12 as text

    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).

  13. Page 13
    Read page 13 as text

    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.

27 more pages in the full document

Unlock it once and it stays in your library, ready to chat with or turn into flashcards.

Unlock the full document

More Nursing study materials

See all

Study this document with CramX

Once it is in your library, every tool can work from it.