RRT RRT Patient Assessment 1 — Questions and Answers
Question 1: Which respiratory rate would be classified as tachypnea in an adult patient?
- 12 breaths/min
- 16 breaths/min
- 24 breaths/min (Correct answer)
- 10 breaths/min
Correct answer: 24 breaths/min
Tachypnea is defined as a respiratory rate exceeding 20 breaths per minute in adults, making 24 breaths/min the correct answer.
Question 2: Pulsus paradoxus during patient assessment is best described as:
- An increase in blood pressure during inspiration
- A decrease in systolic BP >10 mmHg during normal inspiration (Correct answer)
- An irregular pulse alternating between strong and weak beats
- A consistently elevated diastolic pressure
Correct answer: A decrease in systolic BP >10 mmHg during normal inspiration
Pulsus paradoxus is an exaggerated decrease in systolic blood pressure greater than 10 mmHg during normal inspiration, commonly seen in cardiac tamponade and severe asthma.
Question 3: Which finding during inspection is the most classic sign of accessory muscle recruitment in a distressed patient?
- Intercostal retractions during inspiration
- Pursed-lip breathing on exhalation
- Sternocleidomastoid muscle use during inspiration (Correct answer)
- Abdominal paradox during expiration
Correct answer: Sternocleidomastoid muscle use during inspiration
Active use of the sternocleidomastoid muscles during inspiration is a hallmark sign of accessory muscle recruitment, indicating significantly increased work of breathing.
Question 4: A patient produces rusty-colored sputum during assessment. This finding is most classically associated with which condition?
- Pulmonary edema
- Pneumococcal pneumonia (Correct answer)
- Bronchiectasis
- Lung abscess
Correct answer: Pneumococcal pneumonia
Rusty or prune-juice–colored sputum is a classic hallmark of pneumococcal (Streptococcus pneumoniae) pneumonia, caused by red blood cell breakdown products in the consolidated tissue.
Question 5: Which breathing pattern is characterized by cyclic, gradually increasing and then decreasing tidal volumes separated by periods of apnea?
- Kussmaul breathing
- Biot's breathing
- Cheyne-Stokes breathing (Correct answer)
- Apneustic breathing
Correct answer: Cheyne-Stokes breathing
Cheyne-Stokes breathing features a waxing and waning tidal volume with intervening apneic periods, often seen in severe heart failure or neurological injury.
Question 6: A barrel chest deformity observed during patient inspection is best characterized by:
- Increased AP-to-transverse diameter ratio approaching or exceeding 1:1 (Correct answer)
- Kyphosis with markedly decreased lung volumes
- Pectus excavatum with decreased chest wall compliance
- Flail chest with paradoxical chest wall movement
Correct answer: Increased AP-to-transverse diameter ratio approaching or exceeding 1:1
Barrel chest results from chronic air trapping (e.g., emphysema), causing the anteroposterior diameter to increase until it approaches or equals the transverse diameter.
Question 7: During patient assessment, digital clubbing is most commonly associated with which underlying condition?
- Acute asthma exacerbation
- Chronic hypoxemia from pulmonary fibrosis or cystic fibrosis (Correct answer)
- Hyperventilation syndrome
- Obesity hypoventilation syndrome
Correct answer: Chronic hypoxemia from pulmonary fibrosis or cystic fibrosis
Digital clubbing is associated with chronic hypoxemia and chronic lung diseases such as pulmonary fibrosis, cystic fibrosis, bronchiectasis, and lung cancer.
RRT RRT Patient Assessment 1
Which respiratory rate would be classified as tachypnea in an adult patient?