RRT RRT Ultimate 4

Question 1

A patient with myasthenia gravis is in respiratory failure. Which measurement BEST indicates the need for intubation?

Accepted Answer

Vital capacity < 15 mL/kg

Answer

The 20-30-40 rule in neuromuscular disease: VC < 20 mL/kg, MIP weaker than -30 cmH2O, or MEP < 40 cmH2O indicate impending failure.

Question 2

Which FEV1/FVC ratio is most consistent with obstructive lung disease?

Accepted Answer

0.65

Answer

An FEV1/FVC ratio below 0.70 (or the LLN) is the diagnostic criterion for airflow obstruction per GOLD guidelines.

Question 3

Which inhaled medication is classified as a long-acting muscarinic antagonist (LAMA) used in COPD management?

Accepted Answer

Tiotropium

Answer

Tiotropium is a once-daily LAMA that blocks M3 muscarinic receptors, reducing bronchoconstriction in COPD.

Question 4

What is the MOST common complication of endotracheal suctioning?

Accepted Answer

Hypoxemia

Answer

Suctioning removes oxygen along with secretions, making hypoxemia the most frequent complication, especially if pre-oxygenation is omitted.

Question 5

A patient receiving heated high-flow nasal cannula (HFNC) at 40 L/min and FiO2 0.60 still has SpO2 of 86%. What is the BEST next step?

Accepted Answer

Transition to non-invasive positive pressure ventilation (NIV) or intubation

Answer

Failure to maintain adequate oxygenation on maximal HFNC settings is an indication to escalate to NIV or invasive mechanical ventilation.

RRT Exam Practice Test