A patient with a neuromuscular disorder is evaluated in the ED after reporting increasing shortness of breath and difficulty in clearing secretions. The patient was admitted to monitor any progression of symptoms or decline in respiratory function. Which of the following will be the best method to assess the adequacy of the patient’s respiratory muscle strength?

A patient has recently had a chest tube placed anteriorly in the third intercostal space and is connected to an underwater seal drainage system with suction. You observed that one of the side holes of the chest tube is outside the chest wall. Correct statements about the situation include which of the following:I. the RT should remove the chest tubeII. the tube should be clamped immediatelyIII. the chest tube should be placed in 2 cm of sterile waterIV. a tension pneumothorax will developV. a new chest tube will need to be placed

A patient who was intubated with a history of COPD who exacerbated due to RML and RLL pneumonia has been in the MICU for the past two days with little improvement of the underlying condition. At 0700 you document the following parameters, PIP 26, Pplat 14 and then two hours later you note the following, PIP 27, Pplat 23. What is the underlying problem that has resulted in these changes?

Which of the following symptoms IS NOT associated with myasthenia gravis?

Which of the following is LEAST likely to be found during the inspection and palpation of a patient with flail chest?I. paradoxical chest movementII. chest wall abrasionsIII. equal chest excursionIV. splinting during inspirationV. increased tactile fremitus

What is the actual I:E ratio of a newborn just placed on mechanical ventilation on the following settings? VC-A/C, tidal volume = 15 mL, f = 30 bpm, FiO2 = 50%, flow = 8 L/min, Ti = 0.35 seconds, PEEP = 5 cmH2O and you wanted to maintain and I:E ratio of 1:2?

A patient has been scheduled for a outpatient cardioversion for atrial fibrillation and the physician has asked you to set the cardioverter to a proper initial shock strength. Which of the following would be recommended?

BONUS: In which of the following situations would hyperinflation therpay be appropriate to recommend to the physician in the presence of atelectasis?

A patient’s P(A-a)O2 is calculated to be 132 mmHg, what is the most likely cause?

Mr. Narco Lepsey was evaluated by neurologist after complaining of weakness and lethargy. The neurologist tells the patient that he has a neuromuscular disorder caused by inflammation and destruction of the myelin sheath around the peripheral nerves. Which disorder matches this description?