RRT RRT Clinical Concepts 3

Question 1

A patient with status asthmaticus is intubated. Dynamic hyperinflation is suspected. Which intervention directly addresses auto-PEEP?

Accepted Answer

Increase inspiratory flow rate to allow longer expiratory time

Answer

Increasing inspiratory flow rate shortens inspiratory time, thereby lengthening expiratory time and reducing air trapping and auto-PEEP.

Question 2

Which condition is characterized by a diffusion defect rather than a V/Q mismatch as the primary mechanism of hypoxemia?

Accepted Answer

Pulmonary fibrosis

Answer

Pulmonary fibrosis thickens the alveolar-capillary membrane, impairing oxygen diffusion across it.

Question 3

A COPD patient has chronic hypercapnia with pH 7.38, PaCO2 58 mmHg, HCO3 33 mEq/L. Administering high-flow oxygen may cause hypoventilation because:

Accepted Answer

The hypoxic drive is abolished

Answer

In some COPD patients chronically reliant on hypoxic drive, supplemental oxygen can blunt the stimulus to breathe, causing hypoventilation.

Question 4

Which hemodynamic finding is most consistent with cor pulmonale?

Accepted Answer

Elevated right ventricular pressure with normal PAWP

Answer

Cor pulmonale causes right heart strain from pulmonary hypertension, elevating RV pressure while the left heart and PAWP remain normal.

Question 5

A patient post-lobectomy develops subcutaneous emphysema and a persistent air leak from the chest tube. The most likely cause is:

Accepted Answer

Bronchopleural fistula

Answer

A bronchopleural fistula is an abnormal communication between the bronchial tree and the pleural space, causing persistent air leak.

RRT Exam Practice Test