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Online Exam Practice

Clinical Simulations

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There are currently 78 RRT Clinical Simulations available. Please scroll down to view the complete listing and descriptions of our simulations.

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RRT Clinical Simulations

The content and feel of each of our simulations is designed to recreate the same experience found on the actual exam. As you become more comfortable with the computer testing format, you will be able to focus more on what is best for the patient and less on how the computer works.
Separate scoring for Information Gathering and Decision Making is provided at the end of each simulation.
An analysis of your positive and negative choices is also produced. A complete post-test review of the entire simulation using color-coded options will allow you to quickly see your correct and incorrect selections.
A detailed review of each section will explain what was the best course of action and how you can improve your test-taking.
Each simulation requires 1 token to play. Once you complete a simulation, you may repeat that simulation for a period of two weeks without using another token.

Having technical problems with a simulation? There is often an easy solution! Please see the Online Exam Practice: Problems/Solutions section of our FAQs (Frequently Asked Questions) page for the most common problems and solutions.

	Simulations marked with an asterisk (*) involve pathologies that are specific to the current exam matrix.
	All remaining (unmarked) simulations involve patient-care content that is critical for your test-taking skills.

Select from the following categories or scroll down to select a simulation:

Cardiac

General Medical / Surgical

Cardiac

Cardiac - 1 *

You are the critical care specialist assigned to the Intensive Care Unit of a 544 bed medical center. As you arrive in the unit at 07:00 you are requested to come to the bedside of the patient in room 1119. The medical resident informs you that the patient was admitted last night and had a quadruple-lumen, balloon tipped, flow directed, pulmonary artery catheter inserted soon after admission. The resident asks you to confirm that the catheter and monitoring system is functioning properly. She also asks you to assist her in interpreting the values currently being measured by the catheter.

Cardiac - 2 *

You are the respiratory therapist assigned to the Intensive Care Unit of a 200 bed hospital. As you arrive in the unit to begin your shift you are requested to come to the bedside of the patient in room 7. The physician present informs you that the patient was admitted this morning complaining of severe chest pain and nausea. The patient was diagnosed with acute coronary artery disease and was taken to surgery. The patient had a pulmonary artery catheter inserted soon after returning to the ICU. The physician would like you to assist in the care of the patient.

Cardiac - 3 *

You are a respiratory therapist working at a small community hospital. You have been called to the emergency department to assist in the care of a patient. The patient is a 68 year-old retired corporate executive. Earlier today he started to experience some breathlessness and chest pain. His wife brought him to the emergency department to be checked. The ED physician has asked you to assess the patient and report your findings to him.

Cardiac - 4 *

You are a respiratory therapist working at a 180 bed community hospital. You have been called to the coronary care unit to assist in the care of a patient. The patient is a 65 year-old stock broker. Earlier today he started to experience some breathlessness and chest pain while working. EMS brought him to the emergency department to be evaluated. He has a history of peripheral vascular disease. He arrived with his ECG exhibiting elevated "ST" segments. His physician has asked you to follow the patient and report any unusual findings to him. You proceed to the patient's room.

Cardiac - 5 *

You are the day shift supervisor in a 605-bed medical center. You are finishing morning rounds when you are paged to the intensive care unit to await the arrival of a post-cardiac surgery patient. Upon arrival in the ICU the head nurse hands you the patient's chart and informs you that the patient is a 52-year-old female who has undergone double bypass surgery. She is 177.5 cm. (5'11") tall, and weighs 82 kg. (180 lb.) She has a history of cor pulmonale.

Cardiac - 6 *

You are the night shift supervisor in a 550-bed medical center. You are finishing first rounds when you are called to the intensive care unit to evaluate a post-cardiac surgery patient. Upon arrival in the Cardiovascular Surgical ICU the nurse informs you that the patient, a 72-year-old female, is a post-op aortic valve replacement. Her height is 5'10" (179 cm) and she weighs 170 lbs (77 kg). You confirm the order and proceed to the patient's room.

General Medical / Surgical

General Medical - 1 *

You are a 24 year old registered respiratory therapist. You are single, love to travel and work for a company called Mobile Medical Corps. It is winter and you are fulfilling a six-month temporary work contract at a major medical center in south Florida on the Atlantic coast. There has been a deep-sea diving accident and some of the victims are being brought to the hospital's Emergency Department. You have been called in to assist.

General Medical - 2 *

You are a respiratory therapist working at a major medical center in Honolulu, Hawaii. There has been an accident involving a cruise ship. A large number of victims have been brought to the hospital's Emergency Department. The Medical Director of the ED asks you to evaluate the cardiopulmonary status of the middle-aged woman who fell 12' from a deck who has been triaged to the waiting room. You now proceed to the waiting room.

General Medical - 3 *

You are the day shift supervisor in a 600-bed medical center. You receive a call at 0900 to come to the intensive care unit. As you enter the unit a patient arrives from surgery. The patient is a 39 year old female who was admitted for a routine Hodgkin's workup. During a liver biopsy she developed disseminated intravascular coagulation (DIC). The attending physician would like you to assist in the care of this patient.

General Medical - 4 *

You are the evening shift therapist in a 500-bed medical center. You receive a call at 2100 to come to the intensive care unit. As you enter the unit, the patient arrives from surgery. The patient is a 42 year old female who was admitted for abdominal swelling and tenderness. Exploratory surgery was performed to identify possible causes. A central line was inserted at the bedside in the right subclavian vein following the surgery. The attending physician would like you to assist in the care of the patient.

General Medical - 5 *

You are a staff respiratory care practitioner at a 125 bed regional hospital in a small Midwestern city. As part of your day shift assignment you are to initiate Q4h incentive spirometry treatments on a female patient, age 24, who was admitted last evening through the Emergency Department with a complaint of severe pain in her left calf.

General Medical - 6 *

You are a staff respiratory care practitioner at a 225 bed regional hospital in a small city. As part of your day shift assignment you are assigned to Medical Intensive Care Unit. You are asked to evaluate a female patient, age 64, who was admitted 4 days ago with a closed head injury after an accidental fall. A craniotomy was performed to evacuate a subdural hematoma.

General Medical - 7 *

You are a respiratory therapist working the day shift at a 150-bed suburban hospital. You are paged by the emergency room physician who asks you to come to the ER and assist him with the assessment of a patient who was found shivering in a stairwell by the police.

General Medical - 8 *

You are a respiratory therapist working the night shift at a 175-bed suburban hospital. You are called by the nursing supervisor for a rapid response to a patient's room to assess the patient.

General Medical - 9 *

You are the day shift therapist in a 800-bed medical center. You receive a call at 1100 to come to the surgical intensive care unit. The patient is a 53 year old female who was admitted 24 hours ago for a acute abdominal pain. She had an exploratory laporotomy performed with no internal injuries found. She has a history of diabetes. Her height is 170 cm (5'7") and she weighs 60 kg (132 lbs). The attending physician would like you to perform an assessment of the patient and assist in her care.

General Medical 10 *

You are a respiratory therapist working the 7 am - 7 pm shift in the surgical intensive care unit at a large urban medical center. Your first patient today is a 69-year old male, 5' 10" tall, who was brought to the unit 3 hours ago after a right lower lobectomy for a new onset carcinoma. You receive report and proceed to the patient’s room.

Neonatal

Neonate - 1 *

You are working at one of your part-time jobs. You are currently one of only two respiratory care practitioners working the night shift of a 210 bed community hospital when you are called STAT to the delivery room.

Neonate - 2 *

A preterm, extremely low birthweight baby (0.8 Kg), was delivered three weeks ago by emergency caesarian section at 27 weeks gestational age. The baby girl quickly developed IRDS with cyanosis and was placed on mechanically ventilated.

Neonate - 3

You are a neonatal intensive care respiratory therapist working at a 200 bed children's medical center. You are called to the newborn nursery to evaluate a baby girl with respiratory distress.

Neonate - 4

You are a neonatal intensive care respiratory therapist working at a large urban medical center. You are called to the delivery room to assist in the delivery of a baby estimated to be at 42 weeks gestation.

Neonate - 5

You are a respiratory therapist working at a 300 bed children's hospital. You are called by the NICU supervisor to assist in the ventilatory management of a male infant born six hours ago. The infant is 28 weeks gestation and weighs 1300 grams. Apgar scores were 3 at 1 minute and 6 at 10 minutes. The pulmonary condition of the infant has deteriorated despite the administration of surfactant therapy. He is currently receiving ventilatory support via high frequency oscillatory ventilation, FIO2 0.70, f 15 Hz, I Time %33, amplitude 25. The baby is afebrile, his body is pink, and he has no spontaneous respiratory effort. The supervisor asks you to evaluate the infant and recommend changes in management to the attending physican

Neonate - 6

You are the respiratory therapist at a 400 bed urban hospital working the night shift. At midnight you are called to the newborn nursery to assist in the management of a baby in respiratory distress.

Neonate - 7

You are the respiratory therapist at a large metropolitan hospital working the night shift. At 2:00 AM you are called to the delivery room to assist in the care of a newborn infant.

Neonate - 8

You are the respiratory therapist working the day shift at a 500 bed medical center. At 5:00 PM you are called to the delivery room to assist in the care of a full-term infant (3000 gm) who is experiencing distress. Apgar scores at 1 minute were reported as 4 and at 5 minutes as 5. As you enter the delivery room, the baby is being intubated with a 3.0 mm endotracheal tube. You note a normally developed male infant with tachypnea. Breath sounds are heard bilaterally but are more distinct on the right. You take over ventilation and note bilateral chest movement. Suddenly the resuscitation bag becomes very difficult to squeeze and requires a peak pressure of 45 mmHg.

Neonate - 9

You are a respiratory therapist working at a 150 bed children’s hospital. You are assigned to care for a baby girl who was born in your institution 4 weeks ago at 30 weeks gestation. She now weighs 1675 grams and is on a traditional nasal cannula with a SpO2 of 93%. She has been feeding without problems via a nasogastric tube. You are asked to determine if she can be weaned from oxygen.

Neonate - 10 *

You are a respiratory therapist working at a 300 bed children’s medical center. You have been called to assist in the care of a newborn baby girl who was transported from an outlying hospital to the NICU in your institution. She was born at 31 weeks gestation and weighs 1200 gr. She is noted to have a Silverman-Anderson score of 6, retractions and diminished breath sounds. Vitals: HR 100 bpm, RR 72 bpm with irregular periods of apnea, BP 50/30, temperature 36.2^oC (97.2^oF). An umbilical arterial line has been established and arterial blood gas results on FIO2 of 0.50 are pH 7.26, PCO2 63 torr, PO2 41 torr, HCO3^-23 mEq/L. The baby has just been intubated.

Neuromuscular

Neurological - 1 *

A 77 year-old women has been admitted to the medical/surgical unit of the 130 bed community hospital at which you are a staff therapist. She arrived yesterday from the long-term care facility down the street. She has been ordered to receive Incentive Spirometry Q2h because she seems unable to take deep breaths on her own.

Neurological - 2 *

You are a respiratory therapist working on the medical unit of a 300 bed hospital. You have been assigned to a patient who was admitted two days ago for generalized weakness and difficulty breathing. She was diagnosed with muscular dystrophy four years ago. She is 45 years old, 5'5" tall and weighs 52 kg (114 lbs.). She was intubated and placed on mechanical ventilation last night when she went into ventilatory failure. Her current ventilator setting are: VC/AC, Vt 400 ml, f 12/min., FIO2 0.40, PEEP 4 cmH20. Current arterial blood gasses are pH 7.39, PaCO2 41 mmHg PaO2 96 mmHg, SaO2 97%. You now proceed to the patient's bedside.

Neurological - 3 *

You are a staff respiratory therapist working the night shift at a 350 bed metropolitan hospital. At 10:00 p.m. you are called to the Emergency Department (ED) to assist in the admission of a patient suspected of a drug overdose.You proceed to the ED.

Neurological - 4 *

You are a respiratory therapist working at a 300 bed urban hospital. A 91 year old man with a history of atrial fibrillation and multiple strokes has been brought to the emergency room by his family for treatment. He collapsed at home and is suspected of suffering from septic shock. He is conscious and alert but complaining of severe dyspnea and abdominal pain. He is receiving oxygen via partial-rebreathing mask at 10 LPM. His current vitals are heart rate 135/min., respiratory rate 23/min., temperature 39^oC (102.2^oF), blood pressure 92/55 mmHg, SpO2 90%. He has a do-not-intubate order in his chart. The physician orders that the patient be transported to the intensive care unit (ICU) and placed on non-invasive positive pressure ventilation. You are assigned to go with the patient and set-up the NIPPV therapy. You proceed to the ICU with the patient.

Neurological - 5 *

You are a staff therapist in a large metropolitan hospital. You have one last assessment to do before the end of your shift. As you approach the nursing station the nurse calls you into your patient's room stat!

Neurological - 6 *

You are a staff therapist in a small community hospital. You have been called to the medical unit to assist in the care of a 76 year old female who was admitted 4 days ago with a viral pneumonia. She is complaining of general weakness and is unable to stand or walk. Her current vital signs are heart rate 92/min., respiratory rate 22/min., temperature 38^oC (100.4^oF), blood pressure 138/87 mmHg, SpO2 94%.The patient is receiving oxygen via nasal cannula at 3 LPM. The physician suspects that a neuromuscular disorder is developing and asked you to assess the patient and report your findings to him. You proceed to the patient's room.

Neurological - 7 *

You are a staff respiratory therapist working at a 150 bed community hospital. You have been called to the medical ICU to assist in the care of a patient who was admitted two days ago for a hand injury and a fractured femur he suffered while working on a construction site. After having his wound treated and surgery to set his leg, he developed painful muscle spasms and stiffness in his neck and jaw. He was diagnosed with tetanus. He has received a tetanus antitoxin injection, antibiotics, pain medication and diazepam for the muscle spasms. He is currently receiving ventilatory support with NPPV. IPAP is 10 cmH2O, EPAP is 4 cmH20. Current vitals are heart rate 88/min., respiratory rate 22/min., temperature 38^oC (100.4^oF), blood pressure 132/91 mmHg, SpO2 88%. The patient is alert and oriented but appears restless. His color is pale. You are asked to assess the patient's current status and report your findings to the physician.

Neurological - 8 *

You are a staff therapist in a 200 bed community hospital. You are assigned to assist in the care of a female patient who was admitted 10 days ago with an acute flare up of her Multiple Sclerosis. She developed ventilatory failure shortly after admission, was orally intubated and placed on continuous mechanical ventilation. The patient is 48 years old, 5' 9" tall, and weighs 65 kg (143 lbs.). After reviewing her chart you proceed to her bedside.

Neurological - 9 *

You are a respiratory therapist working in a 300 bed hospital. You have been called to the medical floor to assist in the care of a 37 year old female who was admitted yesterday for generalized weakness and dyspnea. This morning the patient is complaining of increased shortness of breath and blurred vision. You have been asked to evaluate her condition and assist in her management.

Pediatric

Pediatric - 1 *

You are a respiratory therapist working the day shift at a 250 bed community hospital. You are assigned to assist in the care of a two year old boy who was brought to the emergency department three days ago after ingesting gasoline. The boy was admitted to the pediatric intensive care unit when he aspirated and developed a bacterial infection. You have been called to the bedside to quickly assess the boy who appears to be in respiratory distress. He is currently receiving 30% oxygen and antibiotic therapy. His respiratory rate and heart rate are increased. He appears pale and lethargic. His breath sounds are bilateral rales and expiratory wheezes. An arterial blood gas is drawn and results are: pH 7.29, PaCO2 68 torr, PaO2 51 torr, HCO3^- 22 mEq/L., SaO2 83%. You report your findings to the physician who asks for your recommendation.

Pediatric - 2 *

You are a staff therapist at a 250 bed community hospital in the southwest region of the United States. You are called to the Emergency Department (ED) to assist in the care of a 4 year old boy.

Pediatric - 3 *

It is a cold December day in a Milwaukee suburb and you are the respiratory care practitioner assigned to the Emergency Department of a 500 bed hospital. You are asked to evaluate the patient in room C.

Pediatric - 4 *

You are assigned to the pediatric intensive care unit (PICU)of a 500 bed hospital. You are asked to evaluate a 8 year-old male who is being admitted via transport from a rural hospital.

Pediatric - 5 *

You are the respiratory therapist assigned to the out-patient area of a 350 bed hospital in a small city. You receive a request to come to the Ambulatory Care Center (ACC).

Pediatric - 6 *

You are the respiratory therapist assigned to the Emergency Department (ED) of a 350 bed pediatric hospital in the southeast region of the United States.

Pediatric - 7 *

You are the only respiratory care practitioner on the day shift of a 50 bed community hospital. You are called STAT to the Emergency Department. Upon your arrival the ED physician is busy with another patient. He asks you to conduct the initial cardiopulmonary evaluation on a 12 year old boy who has a history of asthma. The paramedics report that the patient began to have difficulty breathing while he was playing with the school soccer team.

Pediatric - 8 *

You are one of two respiratory care practitioners on the night shift of a 90 bed community hospital. You have just arrived to begin your shift when you are called to the Emergency Department to relieve the therapist who is working with a patient. Upon arrival, you find the therapist administering albuterol to a 14 year old girl. She is 5' 0" tall and weights 50 kg (110 lbs). Her parents brought her to the hospital when she started to have difficulty breathing. She has a history of moderate persistent asthma. She monitors her peak flow daily and takes medium dose inhaled corticosteroids (fluticasone) BID. She is now completing her third treatment with albuterol and has been in the ED for an hour. She has improved a little after each treatment but her current peak flow is only 60% of her personal best. She is receiving oxygen via nasal cannula at 6 L/min. Arterial blood gases have been drawn and the results show pH 7.44, PaCO2 32 torr, HCO3^- 24 mEq/L, PaO2 94 torr, SaO2 97%. The physician asks you to administer another treatment with albuterol via small volume nebulizer. He also asks for your recommendation for additional therapy.

Pediatric - 9 *

You are a respiratory therapist working the day shift at a 300 bed metropolitan hospital. A 23 month old male patient has been admitted to the hospital by a private physician. The child was seen in the physician's office for a fever and increased work of breathing. The physician asks you to evaluate the patient's condition and report your findings. You proceed to the bedside to assess the child.

Pediatric - 10 *

You are a staff therapist at a 150 bed community hospital in the southwest region of the United States. While conducting your morning round of treatments in the general medical unit you are asked by a staff RN and the medical resident to look in on the patient in room 232 who was admitted last evening.

Pediatric - 11 *

You are the respiratory therapist at a 300 bed county hospital. You have just started your shift when your supervisor asks you to go to the emergency department to assess a new admit. When you arrive, the physician asks you to evaluate a 10 year old boy with difficulty breathing and assist in his management.

Pediatric - 12 *

You are the respiratory therapist working at a 500 bed urban medical center. You have been called to the emergency department to assist with a new admission. When you arrive, the ED physician asks you to assess the condition of and assist in the management of a 9 year old boy in respiratory distress who was just brought in by his parents. You proceed to the patient's bedside.

Pediatric - 13

You are a respiratory therapist working the 7 am to 7 pm shift at a 400 bed suburban hospital. A senior respiratory student has been assisting you today. You have been treating a 12 year-old girl in the emergency department for a severe exacerbation of her asthma for the last 2 hours. The supervisor has sent someone to relieve you and the student for a lunch break. At lunch, your student asks you what parameters you would use to indicate the need for mechanical ventilation when dealing with an asthma patient.

Pulmonary

Pulmonary - 1 *

You are a staff therapist at a 240 bed community hospital. Your assignment for today's 7-3 shift includes the third floor and ICU relief. One of your patients, a female who is in room 306, was admitted through the ER last evening and the night shift describes her as a "severe COPD patient." She has been receiving 2.5 mg Albuterol and 0.5 mg Ipratropium diluted in 3.0 ml of normal saline Q4h (Q2h PRN) via small volume nebulizer. She received her last treatment at 0530. It is now 0730 and your phone alerts you that her nurse is calling for the patient to have a treatment STAT.

Pulmonary - 2 *

You are a respiratory therapist working at a 200 bed community hospital. A female patient with severe COPD has been receiving home care for the past six months. She is now back in the hospital in what her physician describes as an "end-stage" condition. She is also unable to adequately clear her secretions. You have been called to the bedside to assist the physician in assessing the patient's current condition and recommending appropriate care.

Pulmonary - 3

You are a day shift respiratory care practitioner at a major public hospital in an large east coast city. It is Tuesday morning and you have been called to the outpatient drug rehabilitation clinic to administer 2.5 mg Albuterol with 3.0 ml normal saline via aerosol to a patient.

Pulmonary - 4

You are a day shift respiratory care practitioner at a 400 bed metropolitan hospital. You receive a letter from the hospital's Employee Health Office asking you to report to that office as soon as possible.

Pulmonary - 5 *

You are the respiratory therapist in charge of the pulmonary outpatient clinic of a 800 bed medical center. Dr. Marsh, a family practitioner, calls you about a 65 year old, retired coal miner who has just moved into a retirement community in this area. Dr. Marsh is sending him to your clinic and asks you to evaluate his pulmonary status.

Pulmonary - 6 *

You are the respiratory therapist working for a home care company in a small rural community. You have been assigned to work with a patient diagnosed with COPD. The patient is a 68 year old man who was recently discharged from the local hospital after suffering an acute bacterial pulmonary infection. He is currently receiving 2 LPM oxygen via nasal cannula PRN and Albuterol via MDI, PRN. You arrive at his home, introduce yourself, and perform a physical exam. His vitals are normal but his breath sounds are diminished with bilateral wheezing. The patient is alert and oriented but complains of difficulty breathing when he dresses himself in the morning and when he cooks or tries to do chores around the house. He tells you that his wife died two years ago and that his son's family lives a few miles away on the next farm. He states that he has tried to use the inhaler when he gets short of breath but it doesn't seem to help much and is difficult for him to use. You tell him that you will call his physician and see what can be done to help him.

Pulmonary - 7 *

You are a respiratory therapist working at a 200 bed community hospital. You are called to the medical/surgical unit on the 3rd floor to assess the respiratory therapy needs of a new admission. You proceed to the nursing unit to assess the patient's condition. As you arrive in the unit, the head nurse meets you and tells you that the patient is a 52 year old male in room 320. She also tells you that the patient is slightly dyspneic.

Pulmonary - 8

You are the respiratory therapy assessor for a 400 bed hospital. A physician has requested that you assess one of his patients. You have gone to the patient's unit to confirm the order and review the patient's chart. The chart reveals that the patient is a 57 year old male recently diagnosed with COPD. He has a 110 pack year smoking history and an industrial exposure to radon. The chest radiograph shows consolidation of the right lower lobe, normal heart shadow, normal vascular markings, and a mediastinal shift to the right. You now proceed to the patient's room.

Pulmonary - 9 *

You are a respiratory therapist working at a 120 bed community hospital. You have been called to the emergency room to see a patient who has come to the ER complaining of shortness of breath and hacking cough. The patient is a 67 year old retired printer. The ER physician has asked you to evaluate the patient's condition and assist in his management.

Pulmonary - 10 *

You are a respiratory therapist working in the PFT lab of a small community hospital. One of the primary care physicians has ordered basic pulmonary function testing on one of his patient's that he suspects has COPD. He asks you to select the specific testing and call him with the results.

Pulmonary - 11 *

You are the respiratory therapist working in the pulmonary rehabilitation department at a large urban hospital. The patient's primary care physician asks you to initiate chest physical therapy for a 45 year old woman who has been diagnosed with non-CF bronchiectasis. The physician tells you that the chest radiograph shows consolidation in the lower lobes and has ordered postural drainage and chest percussion to be performed on the posterior basal segments. The physician asks how you would position the patient to achieve the best results.

Pulmonary - 12 *

You are the respiratory therapist assigned to the 2nd floor of a 120 bed community hospital. You have been paged by the unit secretary to assess the new admission in room 211. The unit secretary advises you that the patient's physician will be in shortly to discuss the status of the patient.

Pulmonary - 13 *

You are the respiratory therapist working in the outpatient clinic at a 200 bed community hospital. You have just started your shift when the clinic supervisor asks you to go over to the emergency department to assess a new admission. When you arrive at the patient's examination room, the physician assistant asks you to evaluate the patient and to assist in his management. The patient is a 40 year old man with difficulty breathing.

Pulmonary - 14 *

You are the respiratory therapist working in the outpatient department of a large city hospital. The physician in charge asks you to evaluate and assist in the management of a new patient in room 12. You proceed to the examination room, confirm the patient's ID and introduce yourself. The patient is a 52 year old woman who appears to be in respiratory distress. She agrees to being examined and you proceed to assess her.

Pulmonary - 15 *

You are the respiratory therapist working in an outpatient clinic. You have been treating a 49 year old male patient with an acute exacerbation of asthma with oxygen via high flow nasal cannula and continuous albuterol via small volume nebulizer. One hour of therapy has passed and you are asked to assess the patient's current status and report your findings to the clinical supervisor.

Pulmonary - 16

You are the Respiratory Therapist assigned to cover the Emergency Department (ED) of a 450 bed urban Medical Center. A sales representative was delivering a lecture in the hospital auditorium when she developed increasing shortness of breath, coughing, wheezing and chest tightness. The patient is a 45 year old female with a history of asthma. She is 165 cm (5 ft 5 in) tall and weighs 57 kg (125 lbs). She took 2 puffs of her Albuterol inhaler in the auditorium without improvement. She has been transferred to the ED and placed on a nasal cannula at 3 L/min. She is alert, agitated and talks in single words.

Pulmonary - 17

You are the Respiratory Therapist working in the Emergency Room (ER) of a 150 bed community hospital. You have been treating a female patient for an acute exacerbation of asthma for two hours. She has received continuous SABA via small volume nebulizer and systemic corticosteroids via IV. The ER physician has asked you to asses her current condition and report your findings.

Pulmonary - 18 *

You are a respiratory therapist working the 7pm to 7am shift at a 200 bed hospital. As you start of your shift, you are receiving report on one of your patients. She is 57 years old, 5' 5" tall and weights 60 kg (132 lbs.). She is receiving non-invasive ventilation for an acute exacerbation of COPD. Following the report you proceed to the patient’s room.

Pulmonary - 19 *

You are a respiratory therapist working the 7 am to 7 pm shift at a small community hospital. You have been called to the emergency department to help manage a female patient in room #4. The patient was brought to the ED by her husband. She is 5 feet, 5 inches tall and weighs 92 kg (202 lbs.). Upon arrival in the ED you are asked by the physician to assess the patient and report your findings. You now proceed to room #4.

Pulmonary - 20 *

You are a respiratory therapist working at a large urban medical center. You are assigned to a 62-year-old male patient who was admitted for acute abdominal pain. The patient required an exploratory laparotomy that was performed this morning. The patient is 5', 6" tall and weights 80 kg (176 lbs). He was weaned successfully from mechanical ventilation following surgery without difficulty and has now been transferred to the surgical floor. The physician assistant assigned to care for this patient has asked you to assess the patient and report your findings. You proceed to the patient's room.

Trauma

Trauma - 1 *

You are a respiratory therapist in a 200 bed community hospital. You have been called to the Emergency Department to assist in admitting a new patient. The patient is a 28 year old Italian dock worker who presents to the ED. The paramedic states that the patient was unloading gas canisters when one exploded, igniting paper and packaging materials. Witnesses state that the patient was in a small enclosed room surrounded by fire for about 3 minutes before he was pulled to safety. He was conscious and breathing when rescue personnel arrived. The patient is 5'10" tall and weights 68 kg (150 lbs).

Trauma - 2 *

You are a respiratory therapist working at a 300 bed urban hospital. You been called to the medical/surgical unit to assist in the care of a patient who was involved in an automobile accident three days ago. The patient received blunt chest trauma when the airbag was deployed and is reported to be in respiratory distress. The patient is male, 34 years old, 6'0" tall and weighs 85 kg (187 lbs). You confirm the order to assess the patient and proceed to the bedside.

Trauma - 3 *

You are a respiratory therapist in a 750 bed metropolitan hospital working the day shift. You are charting at a nurses’ station when the respiratory therapy day shift supervisor informs you that a burn victim is coming into the emergency room via ambulance. He states that the victim was working in a shed when the kerosene heater that he was using to heat the shed exploded and caught the shed on fire. The patient has 25% total body burns, he is conscious and talking. The paramedics have taken vitals which show pulse 110 b/min., respiratory rate 22 breaths/min., B/P 140/96, breath sounds are audible with mild wheezing. The patient weighs approximately 70 kg. (155 lbs.) and is 5' 9" tall. Time of arrival is 5 minutes. The supervisor would like you to go to the emergency room to assist in the assessment and management of this patient.

Trauma - 4 *

You are a respiratory therapist in a 500 bed metropolitan hospital working the day shift. You are called to the medical intensive care unit to assist in the management of a patient who was admitted 24 hours ago following a motor vehicle accident. His car went through a guard rail and dropped 60 feet down a ravine. He was not wearing a seat belt and the airbag did not deploy. His chest impacted against the steering wheel causing double fractures of four (4) ribs on his left side. He was intubated, sedated, paralyzed and placed on mechanical ventilation. Current ventilator settings are VC/SIMV, Vt 500 ml, f 10/min., FIO2 0.60, PEEP 5 cmH2O. You arrive at the unit, confirm the order to assess the patient and then report your findings to the hospitalist in charge of the patient.

Trauma - 5 *

You are a respiratory therapist assigned to the 15 bed intensive care unit of a 450 bed medical center. The medical director of the unit, Dr. Gort, has just informed you that he believes the patient in bed 6 has developed an early phase of ARDS. Dr. Gort would like you to evaluate the patient and recommend treatment.

Trauma - 6 *

You are a respiratory therapist assigned to the intensive care unit of a 200 bed hospital. You have just returned to work after a two week vacation. You arrive at the ICU and receive report from the night shift. The medical director of the unit has just ordered the patient in room 5 to be assessed by respiratory for possible ventilator changes. The patient was admitted 8 days ago following a motorcycle accident where she sustained blunt chest trauma. She developed a hemothorax and was treated with closed chest drainage. Three days ago she developed respiratory failure, was orally intubated and placed on volume control ventilation. She is 33 years old, 5' 5" tall, and weights 60kg (132 lbs.) Her current ventilator settings are: VC/SIMV, FIO2 0.60, mandatory rate 12 b/min., tidal volume 400 ml, PEEP 6 cmH2O, inspiratory flow 45 L/min. She is receiving midazolam (Versed). The medical director would like you to evaluate the patient and call him right away with your recommendations.

Trauma - 7 *

You are the respiratory therapist assigned to the Critical Care Areas of a 150 bed community hospital. The hospital is located in northern Wisconsin and it is mid-January. The town is in the middle of celebrating its annual "Winter Carnival." As you are conducting ventilator rounds in the ICU, you receive a STAT call to proceed to the Emergency Department (ED). Upon arrival in the ED, you learn that someone has made a phone call to the hospital from their ice boat. This "Good Samaritan" has just pulled a 50 year-old adult male member of the Polar Bear Club from a five foot diameter hole cut through the ice. Apparently the victim had been diving into the water and failed to emerge.

Trauma - 8 *

You are the respiratory therapist assigned to the Critical Care Area of a 350 bed community hospital. As you are conducting ventilator rounds, you receive a STAT call to proceed to the ICU. Upon arrival, you learn that a multiple trauma case that was admitted to the hospital 4 days ago is in distress. The patient is 55 year-old adult male. He was involved in a head on collision and pulled from a frozen pond near the scene. Upon arrival to the ED, he was noted to have a slight flail chest on the right side.

Trauma - 9 *

You are the lead therapist for the critical care units of a 900 bed major metropolitan medical center. During morning rounds with the critical care team in the surgical intensive care unit (SICU), you learn that the patient, a motorcycle accident victim, seems to be having some increased respiratory difficulty.

Trauma - 10 *

You are the respiratory therapist for the trauma critical care unit of a 1100 bed major metropolitan medical center. You enter the room of a 33 year old male patient admitted 24 hours ago after suffering major trauma. The patient was involved in a sky diving accident. His parachute failed during the last 100 feet of his jump. The patient sustained multiple injuries, was taken to surgery, and is now in the surgical intensive care unit.