RRT RRT Clinical Concepts 5

Question 1

Which maneuver is used to assess intrinsic PEEP (auto-PEEP) in a mechanically ventilated patient?

Accepted Answer

End-expiratory hold

Answer

An end-expiratory hold occludes the expiratory valve at end-exhalation, allowing trapped pressure to equilibrate and be measured as auto-PEEP.

Question 2

A patient on CPAP for OSA is mouth breathing and complaining of dry mouth. The MOST appropriate intervention is:

Accepted Answer

Apply a chin strap and add a humidifier

Answer

A chin strap reduces mouth opening while a heated humidifier adds moisture to prevent mucosal drying from mouth breathing on CPAP.

Question 3

Which radiographic finding is most characteristic of pulmonary embolism on a plain chest X-ray?

Accepted Answer

Westermark sign (oligemia)

Answer

The Westermark sign is a focal area of oligemia (decreased vascular markings) distal to a pulmonary embolus, though it is an uncommon finding.

Question 4

A spontaneously breathing patient with neuromuscular disease has MIP of -18 cmH2O. This indicates:

Accepted Answer

Severely weakened inspiratory muscles

Answer

Normal MIP is more negative than -80 cmH2O; an MIP of only -18 cmH2O indicates severely compromised inspiratory muscle strength.

Question 5

Which statement about nitric oxide (NO) therapy in neonatal hypoxic respiratory failure is correct?

Accepted Answer

It selectively dilates pulmonary vasculature in ventilated lung units

Answer

Inhaled NO selectively reaches ventilated alveoli, dilating adjacent pulmonary vessels and improving V/Q matching without systemic vasodilation.

RRT Exam Practice Test