Breadth of Knowledge: Patient Data (25 of 160 items)

RT · 47 questions

• A ventilated 70-year-old shows three-day positive fluid balance of 4 L, rising central venous pressure, new peripheral edema, RSBI rising from 68 to 118, vital capacity falling, and intracranial pressure 22 mm Hg with coughing. Which conclusion about ventilator liberation readiness best integrates fluid balance, hemodynamics, and pulmonary mechanics trends?
• A 60-year-old on volume control ventilation shows peak pressure 38 cm H2O, plateau 28 cm H2O, PEEP 8 cm H2O, with prolonged exhalation and missed trigger efforts. The circuit is unkinked and secretions are minimal. Which measurement sequence should the therapist perform to assess compliance, resistance, plateau pressure and auto-PEEP?
• In pulmonary clinic a 55-year-old with chronic dyspnea and wheezing has normal chest radiograph and pulse oximetry 96% on room air, and the physician asks respiratory therapy what diagnostic testing to order next. History suggests variable airflow limitation. Which diagnostic recommendation best evaluates airflow limitation and gas exchange for this stable outpatient?
• A 68-year-old in septic shock has blood pressure 90/60 mm Hg, heart rate 112, central venous pressure 14 mm Hg, and cool mottled extremities despite fluids and norepinephrine. The team asks whether perfusion pressure is adequate. Which hemodynamic evaluation should the therapist provide using cardiopulmonary calculations?
• A 65-year-old with COPD exacerbation has a chart noting sulfa allergy with rash, home warfarin and albuterol, a new order for trimethoprim-sulfamethoxazole, a signed DNR order, and no documented influenza vaccination. Which medication reconciliation and order conflict should the therapist clarify first before treatment?
• A 60-year-old with sudden dyspnea after central line placement has diminished right breath sounds, tachypnea and SpO2 90%. The therapist is asked to perform focused palpation before imaging. Which palpation finding for pulse, asymmetry, crepitus, fremitus and tracheal deviation best clarifies this presentation?
• A 64-year-old with acute dyspnea and COPD has labs showing WBC 14,200 with neutrophilia, potassium 2.9 mEq/L, INR 2.8 on warfarin, and troponin mildly elevated with tachycardia and accessory muscle use. Which laboratory interpretation best informs respiratory relevance and immediate priorities?
• A 62-year-old with unexplained dyspnea, snoring with daytime sleepiness, and a small unilateral pleural effusion has basic spirometry that is inconclusive, and the team asks for advanced diagnostic guidance. Which diagnostic recommendation best matches exhaled gas, hemodynamic, sleep, and pleural evaluation needs for this patient?
• A 64-year-old intubated for pneumonia is on pressure support 5 cm H2O with PEEP 5 cm H2O for 30 minutes, with RSBI 78, SpO2 95%, hemodynamically stable, strong cough, and minimal secretions. Arterial blood gas is near baseline. Which spontaneous breathing trial interpretation should the therapist document to recognize pass/fail criteria?
• A 65-year-old with fever, productive cough and right-sided chest pain has decreased right base breath sounds with crackles and tachycardia with systolic murmur. The student must link sounds to disease. Which auscultation interpretation relating breath and heart sounds to pathology best explains these findings?
• A 62-year-old is on day 3 of ventilation for pneumonia in a 12-bed ICU, now on pressure support 5 with PEEP 5 and FiO2 0.40 for 30 minutes. Rate 22, tidal volume 480 mL, RSBI 46, SpO2 94%, hemodynamically stable, and continuous apnea monitoring shows no central apnea alarms. Which SBT outcome interpretation best integrates apnea monitoring and apnea test readiness?
• A 68-year-old ventilated patient in the ICU has stable SpO2 93-94% on FiO2 0.40, cuff pressure 24 cmH2O, flat capnography at 39 mmHg, but transcutaneous CO2 rising from 52 to 69 mmHg over 3 hours with increasing sedation and small tidal volumes. Which transcutaneous monitoring interpretation best confirms worsening hypoventilation?
• In the ICU a comatose patient after catastrophic brain injury has absent brainstem reflexes, is normothermic and normotensive, and is preoxygenated on 100% oxygen with baseline ABG documented before testing for brain death. Which apnea test procedure best gathers valid clinical information for brain death determination?
• A 58-year-old mechanically ventilated patient develops fever, leukocytosis and increased purulent secretions. Portable AP chest radiograph shows dense left lower lobe opacity with visible air bronchograms, sharp costophrenic angles, no visceral pleural line, and endotracheal tube tip 4 cm above the carina. Which radiographic interpretation should the therapist document for this consolidation finding?
• A respiratory therapist assesses a 72-year-old patient with community-acquired pneumonia on a medical-surgical unit. The patient sits upright leaning forward, alert but anxious, reports pleuritic chest pain 6/10 and dyspnea 6/10, has a frequent strong cough with greenish sputum, and shows intercostal retractions with nasal flaring. Which assessment summary best documents general appearance, mental status, pain, dyspnea, cough, sputum, and work of breathing?
• A 64-year-old with ventilator-associated pneumonia has sputum Gram stain showing many gram-negative rods with few epithelial cells, culture growing Pseudomonas aeruginosa, and sensitivities showing resistance to ceftriaxone but susceptibility to cefepime. Which interpretation of Gram stain, culture, and sensitivity best guides respiratory antibiotic therapy?
• A newly admitted older adult with pneumonia has a chart showing penicillin allergy, home metoprolol and apixaban, a new order for ceftriaxone, a signed DNR bracelet note, and missing influenza and pneumococcal vaccine records. Which record evaluation best reconciles history, orders, medications, code status, and vaccines?
• A 49-year-old tracheostomized patient in a long-term unit produces scant saliva-like secretions from suction, has a cuff pressure of 12 cm H2O with audible air leak, and new low-grade fever with questionable infiltrate. Which evaluation of sputum sample characteristics and cuff status best guides next action?
• A 68-year-old with COPD on 2 L/min by nasal cannula has resting SpO2 93%, heart rate 88/min, and no chest pain. The physician orders a 6-minute walk test with exercise oxygen titration to evaluate exertional desaturation. The corridor is 30 meters, turnaround cones are placed, and continuous pulse oximetry is available. Which exercise oxygen titration procedure should the therapist follow during the 6-minute walk test?
• A 31-year-old barista with six weeks of dry cough, wheeze, and chest tightness reports daily menthol vaping, weekend hookah, candle-making at home with fragrances, and evening shifts in a dusty roasting room without a mask. Symptoms ease on vacation. Which exposure history best identifies vaping, smoking, occupational, and environmental contributors?
• A 55-year-old admitted with fever, productive cough, tachypnea, and pleuritic chest pain has WBC 18,000 with neutrophilia and left shift, hemoglobin 9.1 g/dL, potassium 3.0 mEq/L, INR 1.1, D-dimer mildly elevated, and troponin mildly elevated with tachycardia and hypotension. Which integrated CBC, electrolyte, coagulation, and cardiac biomarker interpretation best explains the respiratory relevance?
• A 64-year-old on telemetry after COPD exacerbation develops sudden palpitations, blood pressure 118/74 mm Hg, and shortness of breath. The bedside rhythm strip shows a narrow-complex tachycardia at 172/min with no visible P waves and regular R-R intervals. Which ECG interpretation should the respiratory therapist report to guide immediate management?
• A 42-year-old with headache, confusion, and cherry-red appearance after garage exposure has ABG pH 7.40, PaCO2 40 mmHg, PaO2 92 mmHg on room air with co-oximetry showing carboxyhemoglobin 28% and oxyhemoglobin 68%. Which interpretation best explains the arterial blood gas and co-oximetry findings in suspected carbon monoxide exposure?
• A 66-year-old with pulmonary fibrosis on 2 L/min nasal cannula reports dyspnea climbing stairs, resting SpO2 94%, exercise SpO2 84% after 320 meters on a 6-minute walk, and rapid recovery to 92% with rest. Which interpretation of oxygen titration and walk results should the therapist document?
• A ventilated adult with new fever, purulent secretions, and left-lobe infiltrate has sputum Gram stain showing many neutrophils with gram-negative rods and pending culture, plus a respiratory pathogen panel detecting rhinovirus. Which interpretation best guides respiratory isolation and secretion management?
• A 5-year-old with status asthmaticus is on continuous albuterol, tachypneic with prolonged expiration, SpO2 93% on 2 L cannula, and an attached capnography cannula shows a shark-fin waveform with a sloping alveolar plateau and rising ETCO2 to 48 mm Hg. Blood pressure and perfusion are normal. Which noninvasive monitoring interpretation should guide the next respiratory action?
• A 58-year-old former smoker with progressive dyspnea completes pulmonary function testing showing reduced FEV1/FVC ratio, increased total lung capacity and residual volume, and markedly reduced DLCO with normal hemoglobin. Which pattern interpretation should the therapist document for obstructive disease with diffusion impairment?
• A 46-year-old with six months of dyspnea on exertion has spirometry showing FVC 62% predicted with normal FEV1/FVC ratio, no bronchodilator response, and normal oximetry at rest. The physician suspects respiratory muscle weakness versus interstitial disease and orders complete pulmonary function and muscle strength assessment. Which pulmonary function testing sequence should the therapist perform to distinguish muscle weakness from parenchymal restriction?
• A 48-year-old with stridor and a neck mass is evaluated for urgent intubation, with muffled voice, limited mouth opening, Mallampati class IV view, and trachea deviated rightward on palpation and chest film. Oxygenation is borderline on room air. Which airway patency assessment best guides safe management of Mallampati class and tracheal shift?
• A 52-year-old with severe OSA is on in-lab CPAP titration at 10 cm H2O. Snoring resolved but the tracing shows persistent hypopneas, REM-related desaturation to 84%, and residual AHI 18/hour with mouth leak noted. Pressure tolerance is good and central events are rare. Which titration adjustment best addresses residual obstruction on this sleep study?
• A 34-year-old rescued from a house fire is confused with headache, SpO2 94% by pulse oximeter, ABG pH 7.40, PaCO2 38, PaO2 96 on room air, calculated SaO2 97%, and CO-oximetry showing COHb 29%, MetHb 0.8%, O2Hb 68%. Carboxyhemoglobin is markedly high while PaO2 appears normal. Which interpretation best explains these arterial blood gas and CO-oximetry findings?
• A 48-year-old intubated for 5 days is triggering the ventilator and the team requests spontaneous ventilation parameters to assess weaning readiness. The patient is alert, afebrile, hemodynamically stable and on minimal pressure support. Which measurement technique should the therapist use to obtain a reliable maximum inspiratory pressure for weaning assessment?
• An intubated adult needs cuff pressure verification and a febrile ventilated neighbor needs diagnostic mini-BAL for suspected pneumonia, while a ward patient with weak cough needs sputum induction for tuberculosis testing. Which procedure selection and technique best gathers clinical information safely?
• A term newborn at 1 minute has heart rate 95, slow irregular respirations, some flexion of extremities, grimace to suction, and blue extremities with pink trunk. At 5 minutes tone and color improve with routine care. Which clinical assessment correctly interprets APGAR, gestational age, and cardiopulmonary status?
• A 54-year-old with sudden pleuritic chest pain and dyspnea after knee surgery has tachycardia, clear lungs, SpO2 90% on room air, and a chest radiograph without infiltrate, plus a high-probability V/Q scan showing mismatched perfusion defects with normal ventilation. ECG shows sinus tachycardia without ST elevation. Which imaging and ECG interpretation best guides immediate respiratory management for suspected embolism?
• A 26-year-old nursing student with prior BCG vaccination had close classroom exposure to active pulmonary tuberculosis, has no cough, fever, or weight loss, and has a normal chest radiograph. Which TB test should the therapist recommend to screen for latent infection in this BCG-vaccinated contact?
• A 72-year-old with prolonged BiPAP use, nasogastric tube, and recent tracheostomy develops redness under the mask bridge, ear groove pressure from oxygen tubing, sacral moisture redness from supine positioning, and peristomal irritation. Which assessment best evaluates skin integrity related to devices, positioning, and stomas?
• A 52-year-old with loud snoring, witnessed apneas and daytime sleepiness undergoes split-night titration with baseline SpO2 88% and transcutaneous CO2 52 mm Hg, with residual events and mask leak on CPAP 8 cm H2O. Which overnight titration and monitoring strategy best optimizes CPAP/NPPV and gas exchange?
• A 36-week infant is delivered after maternal fever and prolonged rupture of membranes, the L/S ratio is 1.4 with absent phosphatidylglycerol, 1-minute APGAR is 5 for tone, color, and reflexes, and gestational age suggests borderline lung maturity. Which perinatal history interpretation best guides immediate neonatal respiratory assessment?
• A 62-year-old former smoker completes outpatient pulmonary function testing for progressive dyspnea. Results show reduced FEV1, reduced FEV1/FVC ratio, increased residual volume and total lung capacity, and reduced DLCO corrected for hemoglobin. Which PFT pattern interpretation best fits these spirometry, lung volume, and DLCO findings?
• A 62-year-old with COPD exacerbation needs a radial arterial blood gas to guide ventilation. The therapist performs Allen testing, cleans with chlorhexidine, uses a preheparinized syringe, and notes a small air bubble after a brisk arterial puncture. The sample must travel 10 minutes to the lab on ice. Which sampling technique for arterial blood gas collection best avoids pre-analytic error?
• A 55-year-old with ARDS is on FiO2 0.60 with PaO2 90 mm Hg, PaCO2 45 mm Hg, SpO2 93% and PEEP 10 cm H2O. The team needs a standardized oxygenation metric to track severity and ventilator response over the next day. Which calculation of P/F ratio, oxygenation index or related index best quantifies oxygenation impairment?
• A 28-year-old single parent with asthma has two ED visits in three months, missed refills, night-shift work, limited bus access, low health literacy, and shared housing with indoor smoking. Inhaler technique is rushed and teach-back is incomplete. Which evaluation of learning needs and social determinants best guides discharge planning?
• A 58-year-old woman has acute pleuritic chest pain, tachycardia, and hypoxemia after knee surgery. Chest radiograph shows a wedge-shaped peripheral opacity, ECG shows sinus tachycardia with nonspecific T-wave changes, and CT angiography is delayed. Which imaging interpretation best explains her presentation while awaiting definitive CT?
• A 52-year-old with loud snoring and daytime sleepiness has a sleep study showing apnea-hypopnea index 22 events per hour with nadir SpO2 84% and fragmented sleep. The record notes no central events. Which sleep study interpretation of apnea-hypopnea index best guides therapy planning?
• A 45-year-old former smoker with exertional dyspnea completes pulmonary function testing showing FEV1 68% predicted, FEV1/FVC 0.62, TLC 108% predicted, and DLCO 58% predicted without anemia, with repeatable efforts and reference values matched for age, height, and sex. Peak flow diary shows 15% diurnal variability. Which interpretation best evaluates these peak flow, spirometry, and DLCO results?
• A 63-year-old with prolonged fever, productive cough and right upper lobe cavitation has three negative sputum smears, persistent infiltrate after antibiotics and new neutropenia limiting expectoration in a medical ICU. CT shows bronchiectasis with mucus plugging. Which diagnostic recommendation best obtains lower airway samples for this nonresolving pneumonia?