The National Board for Respiratory Care, Inc. Therapist Multiple-Choice SAE (Form 2020 B) INDIVIDUAL FEEDBACK REPORT

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Finish date: 9/12/2019 6:35 PM Central Daylight Time Points: 102 of 140 Percent: 73% √ 1. A patient with a PBW of 55 kg (121 lb) is receiving VC, A/C ventilation. Ventilator settings and blood ga... s analysis results are: FIO2 0.70 Mandatory rate 14 VT 350 mL PEEP 5 cm H2O pH 7.35 PaCO2 35 mm Hg PaO2 40 mm Hg - HCO3 19 mEq/L BE -6 mEq/L SO2 (calc) 74% A respiratory therapist should recommend A. changing to SIMV mode. increasing to 10 cm H2O PEEP. C. changing to 5 cm H2O CPAP. D. increasing to 400 mL VT. EXPLANATIONS (h) A. Changing to SIMV will not treat the hypoxemia. It may also cause a decrease in minute ventilation and adverse changes in the acid-base status. (c) B. The increase in PEEP will increase FRC, decrease the intrapulmonary shunt, and address the hypoxemia. (h) C. Changing to CPAP may decrease minute ventilation causing adverse changes in the acid-base status. (u) D. Increasing the tidal volume will further decrease the PaCO2. It will not significantly improve oxygenation. √ 2. When instructing a patient on the administration of umeclidinium/vilanterol (Anoro Ellipta), which of the following is most important to emphasize? A. Gargle immediately after use. B. Inhale slowly with a breath hold. C. √ Breathe in fast and deep. D. Shake medication vigorously before use. EXPLANATIONS: (u) A. Umeclidinium/vilanterol (Anoro Ellipta) is not an inhaled steroid and, thus, does not require gargling after use. (u) B. Umeclidinium/vilanterol (Anoro Ellipta) is a DPI that requires rapid inhalation. (c) C. Breathing in fast and deep is the proper method of administration for umeclidinium/vilanterol (Anoro Ellipta). (u) D. Umeclidinium/vilanterol (Anoro Ellipta) is a DPI and does not require shaking before use. √ 3. Following placement of a tracheostomy tube for long-term mechanical ventilation, which of the following patient positions best prevents ventilator-associated pneumonia? A. prone B. Trendelenburg C. supine D. √ semi-Fowler EXPLANATIONS: (h) A. Prone positioning is contraindicated following tracheostomy placement. (h) B. Use of Trendelenburg positioning may increase the risk of aspiration. (u) C. A decreased incidence of ventilator-associated pneumonia has been observed with an elevated head of bed as compared to supine. (c) D. Routine use of semi-Fowler positioning with the head of the bed elevated at an angle of 30-45 degrees has been shown to decrease rates of ventilator-associated pneumonia. √ 4. Which of the following is used to monitor the partial pressure of transcutaneous carbon dioxide? A. red-light absorption sensor [Show More]

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