Breadth of Knowledge: Management of Devices and Patient Safety Procedures (25 of 160 items)

RT · 47 questions

A 68-year-old postoperative patient on a general floor wears a simple oxygen mask at 6 L/min but SpO2 stays 88%, respiratory rate is 26/min, the mask sits loosely with open side gaps, and the tubing is unkinked with audible flow. Which troubleshooting action best restores effective oxygen mask gas delivery?
In pulmonary clinic, a 9-year-old with persistent asthma uses a dry-powder inhaler for maintenance but reports poor control. The caregiver notes the child exhales into the mouthpiece, inhales slowly and gently, stores the device in a steamy bathroom and never checks the dose counter. Technique review shows no breath-hold. Which troubleshooting correction for the DPI technique restores drug delivery?
In a busy pulmonary function lab, reusable mouthpieces, spacers and nebulizer cups from stable outpatients must be reprocessed between uses. Staff are debating rinse-only versus full disinfection. Which disinfection policy for reusable respiratory equipment should the therapist apply to ensure safety?
An adult with ARDS on volume ventilation starts inhaled nitric oxide from a cylinder system with scavenging, but the therapist notes a low-delivery alarm, fluctuating ppm readings, and rising nitrogen dioxide on the monitor. Cylinders, power, and ventilator function appear intact. Which troubleshooting action should the therapist perform first to restore safe nitric oxide delivery?
A 55-year-old with a cuffed tracheostomy has a persistent low-pressure alarm, audible peritubal leak, and cuff manometer reading falling from 25 to 12 cm H2O after inflation. Tubing and pilot balloon connections appear intact but the pilot valve feels loose. Which troubleshooting step best addresses suspected cuff and manometer system leak?
In a 20-bed medical ICU ventilator-associated events have increased, oral care and head-of-bed elevation are inconsistent, and sedation vacations are often missed on night shift. The quality committee asks respiratory therapy to lead prevention. Which ventilator-associated event prevention protocol should the therapist initiate first to reduce harm?
A night-shift therapist must dispose of suction canisters with bloody secretions, used suction catheters and a leaking specimen bag on a medical unit with limited housekeeping. Which safe handling of biohazardous materials should the therapist perform to protect staff and patients?
A pulmonary function lab reports inconsistent FVC results on a portable spirometer, with failed daily calibration checks using a 3-L syringe, variable room temperatures, and recent transport between clinics. Patients show good effort and coaching. Which troubleshooting step should the therapist perform to restore accurate spirometry?
A respiratory therapist obtains an arterial sample with visible air bubbles, excess liquid heparin, delayed icing, and a result that conflicts with pulse oximetry and clinical status on high FiO2. Which troubleshooting action best resolves suspected preanalytic blood gas and CO-oximetry analyzer error?
A 72-year-old on home oxygen reports increased dyspnea, the concentrator shows low-output alarm, the flowmeter ball bounces, tubing is 50 feet long and coiled under furniture, and the inlet filter looks gray with dust. Which troubleshooting step best restores concentrator and flowmeter delivery?
In the ED a term newborn is apneic with poor tone, and the team uses a T-piece resuscitator with a tight mask seal. The manometer shows no pressure rise, the chest does not move, and the gas supply and flowmeter are on with audible flow. Which T-piece resuscitator troubleshooting step should be completed first to restore effective ventilation?
In the emergency department an adult with pneumonia wears a Venturi mask prescribed at 28% with the manufacturer-matched flowmeter setting, but SpO2 is 84%, the jet nozzle is cracked, the diluter window is misaligned, and room air hisses loudly around loose connections. The prescription must stay at 28%. Which troubleshooting action should the therapist take first to restore accurate gas delivery?
A postoperative patient in a four-bed step-down unit has a chest tube to water-seal drainage with tidaling absent, continuous bubbling in the water-seal chamber, and a pulse oximeter showing intermittent low signal with poor waveform during shivering. Which troubleshooting sequence best addresses chest drainage and noninvasive monitor function?
A skilled nursing facility reports several concentrators alarming low purity, one liquid oxygen base venting vapor, and flowmeters that drift between settings on a busy evening with limited backup cylinders. You are asked to troubleshoot the bulk gas supply chain. Which troubleshooting sequence best restores safe concentrators, liquid, flowmeters, and analyzers?
A home-care teenage patient reports the high-frequency chest wall vest runs but chest vibration feels weak, therapy takes longer to raise sputum, with new hissing at the hose connectors and a looser vest after weight loss. Which troubleshooting sequence should the therapist perform first to restore hyperinflation and secretion clearance?
A heated high-flow nasal cannula at 50 L/min alarms for low airway temperature with heavy condensate in the circuit and cool aerosol. The reservoir has low water, the probe is dislodged, and the circuit sags below the bed. Which troubleshooting sequence best restores heated high-flow humidifier performance?
Your ICU blood gas analyzer, end-tidal CO2 monitor, bedside spirometer, ventilator, and pulse oximeter all drifted after a power outage before morning rounds. Which quality control process best verifies analyzers, pulmonary function equipment, ventilators, and monitors are safe to use?
In the ICU a volume-controlled ventilated patient suddenly has a high-pressure alarm, decreased exhaled volume, tachycardia, and asymmetric breath sounds after repositioning with intact power and oxygen supply. Which ventilator, alarm, and circuit troubleshooting action best restores safe ventilation?
A 68-year-old in the emergency department is on bilevel NPPV with an oronasal mask for cardiogenic edema, with persistent high unintentional leak, eye irritation, and falling tidal volumes despite adequate pressure settings and an awake cooperative patient. Which mask interface correction should the therapist prioritize to control unintentional leak during NPPV?
An adult with pneumonia is on heated high-flow nasal cannula at 60 L/min, FiO2 0.60, set temp 37C, in a cool step-down room. The circuit has dependent-loop rainout, the chamber water is full, and the display shows low airway temperature with cool mist. Which troubleshooting action best restores heated high-flow humidification performance?
A 68-year-old patient is intubated in the medical ICU on day 2 for pneumonia, stable on assist-control ventilation with continuous sedation and a standard endotracheal tube without subglottic port. The head of bed is flat for a procedure and oral secretions are pooling. Which VAE prevention protocol should the respiratory therapist initiate first to reduce aspiration risk?
An adult with pulmonary hypertension on inhaled nitric oxide via the ventilator injector module develops a sudden low delivery alarm, FiO2 drift upward, and NO2 rising after a circuit change for transport, with systemic pressure dropping. Backup cylinder and battery power are available. Which device troubleshooting action best restores safe inhaled nitric oxide delivery?
During bronchoscopy in a 54-year-old with hemoptysis, the image suddenly darkens, suction is weak, and the arterial pressure waveform on the bedside monitor is damped with loss of dicrotic notch after line flushing. Which troubleshooting action should the therapist prioritize for the devices involved?
In the emergency department a 45-year-old requires urgent intubation for airway protection. The video laryngoscope powers on but the screen image is dim, flickering, and intermittently blank, while the conventional direct laryngoscope and backup airway equipment are at bedside. The blade appears seated, the room lights are bright, and no trauma to the device is reported. Which troubleshooting action should the respiratory therapist take first to restore video laryngoscope function?
In a busy outpatient PFT lab, a portable spirometer reports FVC 18% below the patient's recent lab value, flow-volume loops show jagged expiratory limbs, and the 3-L calibration syringe check fails low on two trials at different flows. No new symptoms are reported. Which troubleshooting action best restores portable spirometer and PFT lab accuracy?
A hospitalized adult with cardiogenic pulmonary edema is on bilevel NPPV with high unintentional leak, dry eyes, falling tidal volumes, and persistent SpO2 87% despite intact headgear and a full-face mask fitted yesterday. Which troubleshooting sequence best resolves CPAP/NPPV leak and interface failure?
A 26-year-old with suspected tuberculosis needs sputum induction in a negative-pressure room, requiring gown, gloves, N95 respirator and face shield for droplet and airborne risks. Which donning and doffing sequence best applies Standard Precautions with isolation?
A 12-year-old with asthma uses a metered-dose inhaler with valved holding chamber but continues coughing, has poor symptom control, white residue on the tongue, and actuates multiple puffs in rapid succession without inhaling slowly. Which inhaler technique correction should the therapist teach to improve drug delivery from a pressurized inhaler and chamber?
A 70-year-old with pneumonia on a nonrebreather mask at 15 L/min remains at SpO2 86% with the reservoir bag fully collapsing on inspiration, mask loosely fitting, and tachypnea at 32/min. Blood pressure is stable and the flowmeter is confirmed open. Which troubleshooting step best restores effective oxygen delivery?
An ICU nurse reports a water-seal chest drainage system shows continuous vigorous bubbling in the water-seal chamber, tidaling absent, and a portable SpO2 monitor reads 78% with good waveform while the patient is alert and pink with no distress. Suction is set at -20 cm H2O. Which troubleshooting sequence best resolves chest drain and pulse oximeter dysfunction?
A mechanically ventilated adult has gurgling around the cuff, tidal volume loss on exhaled measurement, low-pressure cuff alarm, and weak suction with collapsed tubing during inline suctioning. Cuff pressure reads 14 cm H2O and pilot balloon stays flat after inflation attempts. Which device troubleshooting sequence best resolves artificial airway and suction failure?
An outpatient pulmonary clinic reuses mouthpieces, spacers, and resuscitation masks between patients and currently wipes all items with a damp cloth at day's end. The manager asks how to correct reprocessing. Which disinfection policy should the therapist recommend for these reusable respiratory items?
A home-care patient reports a 5-L stationary oxygen concentrator alarming with low output and the flowmeter ball bouncing at 2 L despite a 2-L prescription. Tubing is 25 feet, humidifier bottle is attached and power is on. Which troubleshooting sequence should the therapist perform first for this concentrator and flow delivery system?
In an ICU a self-inflating resuscitator compressed for an intubated adult fails to re-expand, the oxygen reservoir remains attached, the PEEP valve is in place, the air intake is covered by a blanket, and exhaled air leaks around the bag valves. Which troubleshooting action best restores resuscitator function during assembly?
A 24-year-old with asthma uses an albuterol metered-dose inhaler with a valved holding chamber but reports poor relief. Observation shows rapid multiple actuations into the chamber, immediate exhalation without a breath-hold, and failure to check priming or the dose counter. Which troubleshooting correction best restores effective metered-dose inhaler delivery through the spacer?
A respiratory therapist obtains PaO2 210 mm Hg on FiO2 0.40 with normal SpO2 96%, plus erratic CO-oximetry carboxyhemoglobin readings and point-of-care analyzer QC failures on repeated samples with air bubbles and delayed iced analysis. Which analyzer troubleshooting approach best ensures reliable blood gas results?
In a medical ICU a therapist assembles a fiberoptic bronchoscope with weak suction and an arterial line monitor showing a damped waveform after flushing, with the transducer leveled at the phlebostatic axis and zeroed to air and all stopcocks closed to air. Bedside check finds no kinked tubing and a small air bubble near the transducer dome. Which troubleshooting sequence best corrects the bronchoscope and arterial catheter monitor performance?
An adult with pneumonia is on heated high-flow nasal cannula at 50 L/min, FiO2 0.60 with target 37 C. The circuit shows heavy rainout, chamber is overfilled, temperature reads 31 C and the low-temperature alarm sounds. Tubing drapes below the bed with condensate draining toward the patient. Which troubleshooting step for heated high-flow humidification best restores warm humidification?
In a busy emergency department a sputum trap from a tuberculosis isolation patient cracks and leaks purulent secretions onto the bedside table, and the nurse asks for help while two intubated patients wait nearby. The spill kit, red bags, disinfectant and puncture-proof sharps box are stocked. Which biohazard containment action best handles leaking respiratory secretions safely?
In the emergency department a 3-kg neonate remains apneic and bradycardic. The team assembles a T-piece resuscitator set to 20/5 cm H2O with 10 L/min gas flow, but the manometer shows no PEEP, the chest does not rise, and the mask seal appears tight. Which resuscitator troubleshooting action best restores T-piece function?
An adult volume-controlled ventilated patient in the ICU suddenly triggers a high peak pressure alarm with low exhaled tidal volume. The circuit is newly assembled, the patient is biting the tube, and secretions are present. Which ventilator circuit troubleshooting step best resolves this high-pressure low-volume alarm?
A 60-year-old man on volume-controlled ventilation suddenly triggers repeated high-pressure alarms at 45 cm H2O with delivered volume falling from 450 to 210 mL. The circuit shows dependent water pooling, the patient is biting the tube, and suction yields thick plugs. Which ventilator-circuit troubleshooting sequence best resolves these high-pressure alarms?
A pulmonary lab performs morning quality control on a portable spirometer using a 3-L calibration syringe, with repeated volumes reading 2.68 L despite correct technique, proper connections, and stable room temperature. Patients are scheduled for pre-operative testing. Which quality-control action should the therapist take for the spirometer before patient use?
In the ICU an adult with stridor and morbid obesity requires urgent intubation for a difficult airway. The therapist assembles a video laryngoscope with detachable monitor and tests it at bedside. The monitor powers on, the blade light is bright, the battery shows full charge, but the screen shows no airway image. Which troubleshooting step for video laryngoscope signal connection should the therapist perform first?
A 30-year-old patient with cystic fibrosis using a positive expiratory pressure mask and oscillatory vest at home reports poor sputum clearance, prolonged treatment time, and intermittent low-pressure alarms on the vest, with thick yellow secretions and SpO2 92%. Equipment appears assembled but filters look damp and hoses have visible condensation. Which device troubleshooting action best restores hyperinflation and secretion clearance?
In an emergency department a therapist must enter the room of an adult with suspected tuberculosis with cough and fever to administer a breathing treatment, with an N95 respirator, gown, gloves, and eye protection available at the doorway and hand hygiene stations nearby. The unit requires airborne plus Standard Precautions and safe disposal. Which sequence best applies Standard Precautions, isolation, and donning and doffing for this encounter?
A 58-year-old with OSA on nasal CPAP at 10 cm H2O reports morning dry eyes, mouth leaks, machine shows leak 45 L/min, residual AHI 12, and red marks from overtight straps. The cushion is 2 years old, the wrong size, and the humidifier is empty. Which CPAP interface troubleshooting step to control leaks best restores effective therapy?