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Quizzes > Health & Medicine

Free RRT Exam Practice Questions: Respiratory Therapy Quiz

Quick, free RRT practice exam. Instant results.

Editorial: Review CompletedCreated By: Ryan BrooksUpdated Aug 27, 2025
Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art illustration showing quiz theme with lungs xray film ventilator icons on golden yellow background.

This quiz helps you check your RRT exam knowledge on PEP therapy, chest x-ray interpretation, and ventilator modes. Use it to spot weak areas and build confidence before test day. For deeper practice, try NCLEX respiratory practice, refresh skills with the rn respiratory practice quiz, or broaden your base in the med surg respiratory quiz.

What does PEP in PEP therapy stand for?
Positive Endoscopic Pressure
Positive Expiratory Pressure
Peak End Pressure
Passive Expiratory Piping
PEP stands for Positive Expiratory Pressure, which is generated during exhalation against a resistor to keep airways open and enhance lung volume. PEP therapy uses this principle to improve alveolar ventilation and mobilize secretions. It is commonly used in patients with mucus retention and atelectasis.
Which condition is a primary indication for PEP therapy?
Cystic fibrosis
Acute respiratory distress syndrome
Asthma
Pulmonary embolism
PEP therapy is indicated in conditions with excessive mucus production and difficulty clearing secretions, such as cystic fibrosis. By generating backpressure, PEP prevents small airway collapse and promotes mucus mobilization. It is less useful in purely bronchoconstrictive or vascular conditions.
On a standard chest X-ray, which view is preferred for assessing the cardiac silhouette size?
Lateral decubitus view
Lordotic view
Anteroposterior (AP) view
Posteroanterior (PA) view
The PA view is preferred for evaluating the cardiac silhouette because the heart is closer to the detector, reducing magnification. In the AP view, the heart is farther from the detector, leading to apparent enlargement. Proper positioning is critical for accurate cardiothoracic ratio assessment.
What indicates correct endotracheal tube placement on a chest X-ray?
Tip 2 - 3 cm above the carina
Tip below the carina
Tip at the level of the vocal cords
Tip 5 cm above the medial clavicles
The endotracheal tube should rest 2 - 3 cm above the carina on chest X-ray to avoid mainstem bronchus intubation while ensuring the airway is secured. Placement too high risks extubation, and too low risks unilateral ventilation. Radiographic confirmation is standard practice.
In Assist-Control (AC) ventilation mode, what happens when a patient initiates a spontaneous breath?
They receive only pressure support
They receive a reduced tidal volume
They receive the full preset tidal volume
They only trigger PEEP
In AC mode, every patient-initiated breath is delivered at the full preset tidal volume, ensuring predictable minute ventilation. The ventilator supports spontaneous efforts to meet set volume targets. This differs from pressure support, where volume varies.
What does blunting of the costophrenic angle on a chest X-ray suggest?
COPD
Pneumothorax
Pulmonary embolism
Pleural effusion
Blunting of the costophrenic angle is a classic sign of pleural effusion, as fluid accumulates in the pleural space and obscures the sharp angle. Pneumothorax shows a clear space without lung markings. Accurate identification guides thoracentesis decisions.
In pressure-controlled ventilation, which parameter does the clinician directly set?
Peak inspiratory pressure
Inspiratory flow
Tidal volume
Minute ventilation
Pressure-controlled ventilation allows the clinician to set the peak inspiratory pressure, while the delivered tidal volume varies based on lung compliance and resistance. This contrasts with volume control, where tidal volume is fixed. Pressure control helps limit barotrauma.
A large difference between peak inspiratory pressure and plateau pressure indicates what?
Intrinsic PEEP
Increased airway resistance
Increased chest wall stiffness
Reduced lung compliance
The difference between PIP and plateau pressure reflects airway resistance; a greater difference signals elevated resistance from secretions, bronchospasm, or tubing issues. Plateau pressure approximates alveolar pressure and reflects compliance. Monitoring both helps optimize ventilation.
Which disadvantage is associated with an AP chest X-ray view compared to a PA view?
Better visualization of lung apices
Reduced radiation dose
Magnification of the cardiac silhouette
More accurate diaphragm position
AP views, often performed supine, place the heart farther from the detector, leading to magnification and overestimation of cardiac size. PA views reduce this effect. Choice of view impacts interpretation of cardiothoracic ratio.
Which ventilation mode delivers mandatory breaths at set intervals but allows spontaneous breaths between them without assistance?
PSV (Pressure Support Ventilation)
AC (Assist-Control)
PCV (Pressure-Controlled Ventilation)
SIMV (Synchronized Intermittent Mandatory Ventilation)
SIMV provides a set number of mandatory breaths synchronized with the patient while permitting unassisted spontaneous breaths between. AC delivers full support for every breath, and PSV supports only spontaneous efforts. SIMV aids in weaning.
According to the ARDSnet PEEP/FiO? table, what PEEP is recommended for a patient requiring FiO? of 0.60?
5 cm H?O
18 cm H?O
12 cm H?O
8 cm H?O
The ARDSnet low PEEP/FiO? table recommends 12 cm H?O of PEEP for an FiO? of 0.60 to optimize oxygenation while minimizing volutrauma. Adjustments are made based on oxygenation response. This strategy is evidence-based for ARDS management.
Which radiographic feature helps differentiate ARDS from cardiogenic pulmonary edema on chest X-ray?
Normal cardiac size
Prominent Kerley B lines
Cephalization of pulmonary vessels
Bilateral pleural effusions
In ARDS, the cardiac silhouette is typically normal because the edema is non-cardiogenic. Cardiogenic pulmonary edema often shows cardiomegaly, Kerley B lines, and vessel redistribution. Recognizing this distinction guides appropriate therapy.
Which ventilation mode provides support only for patient-triggered breaths up to a preset pressure and delivers no mandatory breaths?
Pressure Support Ventilation (PSV)
CPAP
AC
SIMV
In PSV, the ventilator supports only patient-initiated breaths to a preset inspiratory pressure without delivering mandatory breaths. It assists spontaneous ventilation and is often used during weaning trials. Unlike CPAP, PSV augments inspiratory effort.
Which PEP device uses an oscillating mechanism created by a steel ball in a conical chamber to enhance secretion clearance?
Flutter valve
Acapella device
Ultrasonic nebulizer
Incentive spirometer
The Flutter valve uses a steel ball in a conical chamber to generate oscillating PEP during exhalation, which helps mobilize secretions. The Acapella uses magnets for oscillation, and incentive spirometers encourage deep inhalation. Device choice depends on patient ability.
In inverse ratio ventilation, how is the inspiratory-to-expiratory (I:E) ratio typically adjusted to improve oxygenation?
I:E maintained at 1:2
I:E less than 1:3
I:E equal to 1:1 only
I:E greater than 1:1
Inverse ratio ventilation prolongs inspiratory time so that the I:E ratio exceeds 1:1, improving mean airway pressure and alveolar recruitment. This technique can enhance oxygenation in severe hypoxemia but requires sedation and careful monitoring to avoid air trapping.
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Study Outcomes

  1. Understand PEP Therapy Principles -

    Learn the physiological mechanisms and clinical applications of positive expiratory pressure (PEP) therapy to improve airway clearance and patient outcomes.

  2. Analyze X-Ray Imaging Findings -

    Interpret key radiographic differences between normal and pathological chest images to support accurate respiratory assessments.

  3. Differentiate Ventilation Modes -

    Compare and contrast common mechanical ventilation strategies, including volume-controlled and pressure-controlled modes, to optimize ventilator settings.

  4. Apply Critical Thinking to RRT Exam Questions -

    Use targeted practice scenarios to sharpen problem-solving skills and adapt clinical reasoning under timed quiz conditions.

  5. Evaluate Intervention Strategies -

    Assess the effectiveness of various respiratory therapies and make evidence-based decisions for patient management.

  6. Identify Study Gaps and Growth Areas -

    Review quiz feedback to pinpoint knowledge weaknesses and develop a focused plan for continued exam preparation.

Cheat Sheet

  1. PEP Therapy Mechanics -

    Positive Expiratory Pressure (PEP) therapy applies 10 - 20 cm H₂O of back pressure during exhalation to stent open small airways and mobilize secretions (AARC 2021). Remember "BEEP" (Back pressure, Exhale, Expand, Postural drainage) as a mnemonic to recall key steps. Testing settings in your free RRT practice quiz can help you master device resistance adjustment and patient coaching.

  2. Chest X-Ray View Differentiation -

    Recognizing PA versus AP projection hinges on marker position, heart magnification, and scapular overlap (Radiopaedia 2023). Use the "RAPE" mnemonic - Right marker, Alignment of mediastinum, Pulmonary markings, Elevation of diaphragm - to systematically evaluate images. Practicing sample RRT exam questions on imaging improves speed and accuracy when interpreting ventilated patient films.

  3. Fundamental Ventilation Modes -

    Volume-Controlled (VC) versus Pressure-Controlled (PC) ventilation differ in target variable: tidal volume or peak pressure, respectively, while PRVC combines both (ATS 2022). Compare AC, SIMV, and PSV using a chart, then internalize with "VIP": Volume, Inspiratory pressure, Patient-triggered support. Simulating these scenarios in a free RRT exam practice questions quiz cements your understanding of mode selection and alarms.

  4. Alveolar Gas Equation Application -

    The alveolar gas equation (PAO₂ = FiO₂ × [Patm - PH₂O] - PaCO₂/R) predicts oxygen pressure in alveoli and assesses V/Q mismatch (West's Respiratory Physiology). Plug in sea”level values (Patm 760 mmHg, PH₂O 47 mmHg, R ≈ 0.8) to calculate PAO₂ on quiz questions. This formula is a staple on free RRT exam practice questions and helps you pinpoint diffusion defects.

  5. Systematic ABG Interpretation -

    A structured approach uses the ROME mnemonic: Respiratory Opposite (pH vs PaCO₂) for respiratory disorders, Metabolic Equal (pH vs HCO₃❻) for metabolic issues (BMJ 2020). Verify compensation and calculate the anion gap (Na❺ - [Cl❻ + HCO₃❻]) to refine your diagnosis. Regular practice with RRT exam sample questions on ABG interpretation builds speed and confidence in critical care settings.

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