Advanced Assessment in Respiratory Care
Textbook Exam Questions
Course Introduction
Advanced Assessment in Respiratory Care provides an in-depth exploration of the techniques, tools, and interpretation skills necessary for evaluating patients with complex respiratory conditions. Emphasizing advanced patient assessment, this course covers comprehensive physical examination skills, diagnostic testing, interpretation of laboratory and imaging results, and clinical decision-making strategies. Students will learn to utilize advanced assessment tools such as pulmonary function testing, arterial blood gas analysis, and patient monitoring systems while integrating evidence-based practices into care planning. The course prepares respiratory care professionals to perform thorough, accurate assessments and contribute to multidisciplinary healthcare teams for optimal patient outcomes.
Recommended Textbook
Clinical Manifestations and Assessment of Respiratory Disease 7th Edition by Terry
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44 Chapters
673 Verified Questions
673 Flashcards
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Page 2
Des Jardins
Chapter 1: The Patient Interview
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Sample Questions
Q1) The respiratory therapist should be aware of a patient's culture and religious beliefs for which of the following reasons?
A) To be able to engage in a meaningful conversation
B) To change any misguided notions the patient has that may impact his or her health
C) To explain to the patient how these beliefs will lead to discrimination and stereotyping
D) To better understand how the patient's beliefs may impact how the patient thinks and behaves
Answer: D
Q2) The physical setting for the interview should provide for all of the following EXCEPT:
A) minimize or prevent interruptions.
B) ensure privacy during discussions.
C) interviewer is the same sex as the patient to prevent bias.
D) be comfortable for the patient and interviewer.
Answer: C
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3
Chapter 2: The Physical Examination and Its Basis in Physiology
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Sample Questions
Q1) The respiratory therapist is monitoring the blood pressure of a patient in the emergency department and notes that the blood pressure is 15 mm Hg less on inspiration than on expiration. Which of the following would most likely result in this finding?
A) The patient is hypovolemic.
B) The patient has a pulmonary embolism.
C) The patient is having a myocardial infarction.
D) The patient is having a severe exacerbation of asthma.
Answer: D
Q2) Coarse crackles are associated with:
1) inspiration typically.
2) air passing through an airway intermittently occluded by mucus.
3) bronchial asthma.
4) expiration typically.
A) 2, 4
B) 3, 4
C) 2, 3, 4
D) 1, 2, 3
Answer: A
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Chapter 3: Pulmonary Function Study Assessments
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Sample Questions
Q1) All of the following are true of the peak expiratory flow rate test EXCEPT it:
A) is effort dependent.
B) is taken from the FVC test results.
C) is taken from the MVV test results.
D) assesses large upper airways.
Answer: C
Q2) The respiratory therapist is performing a pulmonary function study on a patient who has periodic symptoms of asthma. The pulmonary function results are within normal limits. What further testing can the therapist recommend to aid in either confirming or negating the possible diagnosis?
A) Inhaled methacholine challenge testing
B) Body plethysmography
C) Inhaled digitalis
D) Warm, humid air challenge
Answer: A
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Chapter 4: Arterial Blood Gas Assessments
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Sample Questions
Q1) A patient has had chronic ventilatory failure for several years. What is the primary factor that determines her breathing pattern?
A) Muscle efficiency
B) Ventilatory efficiency
C) Heart function
D) Work efficiency
Q2) Which of the following would be a normal person's arterial carbon dioxide pressure (PaCO<sub>2</sub>)?
A) 25 to 35 mm Hg
B) 35 to 45 mm Hg
C) 45 to 60 mm Hg
D) 60 to 80 mm Hg
Q3) Common causes of metabolic acidosis include all of the following EXCEPT:
A) diabetic ketoacidosis.
B) shallow breathing from a sedative overdose.
C) lactic acidosis.
D) renal (kidney) failure.
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Chapter 5: Oxygenation Assessments
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Sample Questions
Q1) A patient has been exposed to carbon monoxide during a house fire. An ABG result shows a normal PaO<sub>2</sub>. How should the patient's PaO<sub>2</sub> value be interpreted?
A) The PaO<sub>2</sub> is being falsely elevated by the carbon monoxide.
B) The PaO<sub>2</sub> is being falsely decreased by the carbon monoxide.
C) The PaO<sub>2</sub> is accurate.
D) The PaO<sub>2</sub> is a false measurement because the presence of carbon monoxide makes the analyzer unable to determine the PaO<sub>2</sub>.
Q2) Oxygen consumption:
1) increases with exercise.
2) is the amount of oxygen used by the body.
3) is inversely related to carbon dioxide production.
4) is about 250 mL/min in the resting adult.
A) 1, 2
B) 3, 4
C) 2, 4
D) 1, 2, 4
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Chapter 6: Cardiovascular System Assessments
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Sample Questions
Q1) Which of the following is found when a patient has sinus arrhythmia?
1) Rate decreases during expiration.
2) Rate decreases during inspiration.
3) Rate varies by more than 10% from beat to beat.
4) Rate increases during inspiration.
A) 3
B) 2, 3
C) 1, 4
D) 1, 3, 4
Q2) Which of the following will be found in a patient with asystole?
1) Increased ventricular activity
2) Absence of electrical activity
3) No blood pressure
4) Highly variable heart rate
A) 2
B) 1, 4
C) 2, 3
D) 1, 3, 4
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8
Chapter 7: Radiologic Examination of the Chest
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Sample Questions
Q1) Which of the following would be normal findings of the heart and its surrounding area?
1) The left hilum is about 2 cm higher than the right hilum.
2) Most of the heart shadow is to the right of the sternum.
3) Calcified lymph nodes indicate an adult patient.
4) The cardiothoracic ratio is less than 1:2.
A) 1, 4
B) 2, 3
C) 1, 2, 4
D) 1, 2, 3, 4
Q2) The respiratory therapist is called to evaluate a patient with a suspected pulmonary embolus. The respiratory therapist would MOST likely recommend which of the following diagnostic procedures to help determine if the patient has a pulmonary embolus?
A) CTPA
B) Fluoroscopy
C) PET scan
D) MRI scan
E) CT scan
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9
Chapter 8: Other Important Tests and Procedures
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Sample Questions
Q1) The respiratory therapist is called to evaluate a patient for arterial line placement needed for accessibility and repeated ABG sampling. In evaluating the risk of bleeding, the therapist should establish that the patient has a platelet count of at least ____/mm³ before recommending placement of the arterial line.
A) 1,000
B) 10,000
C) 20,000
D) 50,000
E) 100,000
Q2) The respiratory therapist is caring for a patient who is receiving diuretic therapy as part of the medication regimen for her congestive heart failure. Which of the following would the therapist MOST likely monitor in watching for common side effects associated with diuretic therapy?
A) Hypokalemia
B) Hyperchloremia
C) Hyperbilirubinemia
D) Hyponatremia
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Chapter 9: The Therapist-Driven Protocol Program and the
Role of the Respiratory Therapist
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Sample Questions
Q1) Which of the following protocols would be indicated when a patient with increased alveolar-capillary membrane thickening has increased opacity on the chest radiograph, bronchial breath sounds, and a dull percussion note?
A) Aerosolized medication protocol
B) Lung expansion protocol
C) Oxygen therapy protocol
D) Bronchopulmonary hygiene protocol
Q2) Which of the following would be associated with the distal airway and alveolar weakening clinical scenario?
1) Depressed diaphragm on chest radiograph
2) Use of accessory muscles of inspiration
3) Rhonchi and wheezing
4) Increased PEFR
A) 1, 2
B) 1, 3
C) 1, 2, 3
D) 1, 3, 4
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11
Chapter 10: Respiratory Failure and the Mechanical
Ventilation Protocol
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Sample Questions
Q1) All of the following are causes of hypercapnic respiratory failure EXCEPT:
A) impending ventilatory failure.
B) apnea.
C) severe refractory hypoxemia.
D) acute ventilatory failure.
Q2) Which of the following are clinical indicators of Type I respiratory failure?
1) Decreased PaO<sub>2</sub>
2) Increased P(A-a)O<sub>2</sub>
3) Decreased PaO<sub>2</sub>/FIO<sub>2</sub>
4) Decreased ÓS/ÓT
A) 1, 2
B) 2, 4
C) 1, 2, 3
D) 1, 2, 3, 4
Q3) What effect would a pulmonary embolism have on the VD/VT and the /Ó ratio?
A) The VD/VT would increase and the /Ó would decrease.
B) The VD/VT would decrease and the /Ó would increase.
C) The VD/VT and the /Ó ratios would both increase.
D) The VD/VT and the /Ó ratios would both decrease.
Page 12
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Chapter 11: Recording Skills: The Basis for Data Collection,
Organization, Assessment Skill
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Sample Questions
Q1) Computer-based records are commonly used for which of the following?
1) Retrieving pulmonary function studies
2) Storing treatment information
3) Storing admission data
4) Ordering patient supplies
A) 3, 4
B) 1, 2
C) 1, 2, 3
D) 1, 2, 3, 4
Q2) When reviewing a SOAPIER progress note, the R stands for:
A) revisions made in the original plan.
B) reimbursement by the insurance carrier.
C) respiratory care notes.
D) resuscitation status of the patient.
Q3) When reviewing a SOAPIER progress note, all of the following would be found in the O area EXCEPT:
A) hemodynamic data.
B) patient's admission complaint.
C) blood pressure.
D) sputum production.
Page 13
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Chapter 12: Chronic Obstructive Pulmonary Disease (COPD),
Chronic Bronchitis, and Emphysema
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Sample Questions
Q1) Which of the following are used to confirm the diagnosis of COPD?
1) Presence of a chronic cough
2) Chronic exposure to environmental smoke
3) FEV<sub>1</sub>/FVC ratio greater than 0.70
4) FEV<sub>1</sub> <80%
A) 1, 2
B) 3, 4
C) 1, 2, 3
D) 1, 3, 4
Q2) A genetically linked cause of panlobular emphysema is:
A) bronchiectasis.
B) a1-antitrypsin deficiency.
C) cystic fibrosis.
D) bronchial asthma.
Q3) According to the GOLD report, which of the following is the greatest worldwide risk factor for COPD?
A) Exposure to fungal spores in the soil
B) Genetic predisposition
C) Exposure to influenza viruses
D) Exposure to environmental tobacco smoke
Page 14
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Chapter 13: Asthma
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Sample Questions
Q1) Which of the following factors are associated with intrinsic asthma?
1. Emotional stress
2) Cockroach allergen
3) GERD
4) Dust mites
A) 2, 4
B) 1, 3
C) 2, 3, 4
D) 1, 2, 3, 4
Q2) A sputum sample from a patient has been sent to the laboratory for analysis. Which of the following findings could help confirm the diagnosis of extrinsic asthma?
A) Increased IgE level
B) Increased erythrocyte count
C) Colonization of P. aeruginosa
D) Decreased IgE level
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Chapter 14: Bronchiectasis
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Sample Questions
Q1) Which of the following is the hallmark of bronchiectasis?
A) Chronic cough with production of large quantities of foul-smelling sputum
B) Bronchospasm
C) Decreased DLCO with normal to decreased expiratory flow rates on pulmonary function
D) Dyspnea on exertion
Q2) Which of the following should a patient with bronchiectasis do to reduce the risk of the condition worsening?
1) Avoid air pollution.
2) Get an influenza vaccination.
3) Take an antibiotic every day.
4) Avoid smoking.
A) 3, 4
B) 1, 2, 4
C) 2, 3, 4
D) 1, 2, 3, 4
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Chapter 15: Cystic Fibrosis
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Sample Questions
Q1) What complicating pulmonary problem is likely to happen to a patient with cystic fibrosis?
A) Pulmonary edema
B) Pleural effusion
C) Spontaneous pneumothorax
D) Cardiac tamponade
Q2) A common nonrespiratory clinical manifestation of cystic fibrosis is:
A) sinusitis.
B) hyperpigmentation.
C) rheumatoid arthritis.
D) glaucoma.
Q3) How can the genetic mutation found with cystic fibrosis (CF) be characterized?
1) There are many variations in the mutation.
2) CF is the most common fatal childhood inherited disorder.
3) The mutation is a dominant trait.
4) The mutation stops ciliary function.
A) 1, 2
B) 3, 4
C) 1, 3
D) 2, 3, 4
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Chapter 16: Pneumonia
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Sample Questions
Q1) A patient has bilateral pneumonia. What findings can be expected on the CT scan?
1) Depressed diaphragms
2) Elongated heart
3) Air bronchograms
4) Consolidation
A) 3, 4
B) 1, 2
C) 2, 3, 4
D) 1, 2, 3, 4
Q2) Overall, most cases of pneumonia are caused by:
A) viruses.
B) gram-negative bacteria.
C) protozoa.
D) fungi.
Q3) Which of the following pulmonary infections is most commonly seen in patients with AIDS?
A) Anaerobic
B) Pneumocystis jiroveci
C) Streptococcus pneumoniae (Diplococcus pneumoniae)
D) Legionella pneumophila
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Chapter 17: Lung Abscess
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Sample Questions
Q1) Which of the following are predisposing factors to aspiration of oropharyngeal secretions and/or gastric contents into the lower respiratory tract?
1) General anesthesia
2) Head trauma
3) Seizure disorder
4) Alcohol abuse
A) 1, 2
B) 1, 3, 4
C) 1, 2, 3
D) 1, 2, 3, 4
Q2) The respiratory therapist heard a pleural friction rub while performing a chest assessment on a patient with a lung abscess. What does this likely indicate?
A) The lungs are hyperinflated.
B) Hemoptysis has developed.
C) The abscess is located near the pleural surface.
D) A pneumothorax has developed.
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Chapter 18: Tuberculosis
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Sample Questions
Q1) Mycobacterium tuberculosis is most readily transmitted through:
A) drinking milk from or the milking of infected cows.
B) shaking hands and then rubbing your eye.
C) coughing.
D) accidental direct inoculation.
Q2) In which of the following ways is tuberculosis generally NOT spread?
A) Inhaling droplets of aerosol from an infected person
B) Drinking unpasteurized milk from cattle infected with the pathogen
C) Laceration with contact of infected secretions during postmortem autopsy
D) Sharing utensils and glassware with an infected person
Q3) The respiratory therapist is educating a patient just diagnosed with tuberculosis. Which of the following statements should the therapist tell the patient regarding tuberculosis?
A) Take the medication with a glass of water 1/2 hour before meals.
B) If you skip a dose of medication, double up at the next dose.
C) Don't take the medication if you have a fever or flulike symptoms.
D) Make sure to take the full prescribed course of therapy.
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Page 20
Chapter 19: Fungal Diseases of the Lung
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Sample Questions
Q1) In the Midwestern part of the United States, what is the most common fungal infection of the lungs?
A) Cryptococcosis
B) Histoplasmosis
C) Blastomycosis
D) Coccidioidomycosis
Q2) Fungal infection of the lungs is closest in similarity to:
A) pleural disease.
B) interstitial lung disease.
C) tuberculosis.
D) bronchiectasis.
Q3) What is considered to be the gold standard for the diagnosis of histoplasmosis?
A) Fungal stain
B) Blood serum antigen levels
C) Chest x-ray
D) Fungal culture
E) Skin test
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21
Chapter 20: Pulmonary Edema
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Sample Questions
Q1) What is the normal hydrostatic pressure in the pulmonary capillaries?
A) 0 to 5 mm Hg
B) 5 to 10 mm Hg
C) 10 to 15 mm Hg
D) 15 to 20 mm Hg
Q2) A patient has noncardiogenic pulmonary edema. What chest radiograph findings would be expected?
1) "Bat's wings" pattern fluffy infiltrates
2) Normal cardiac silhouette
3) Fluffy densities near the hilum
4) Pleural effusion
A) 1
B) 2, 3
C) 3, 4
D) 1, 2, 4
Q3) All of the following are causes of cardiogenic pulmonary edema EXCEPT:
A) myocardial infarction.
B) mitral valve disease.
C) allergic reaction to drugs.
D) congenital heart defects.
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Chapter 21: Pulmonary Vascular Disease: Pulmonary
Embolism and Pulmonary Hypertension
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Q1) All of the following medications may be used to prevent pulmonary emboli EXCEPT:
A) enoxaparin.
B) dalteparin.
C) tinzaparin.
D) reteplase.
Q2) All of the following are preventive measures taken with patients at high risk for thromboembolic disease EXCEPT:
A) Drink lots of water.
B) Dangle your legs over the edge of the bed before getting up.
C) Walk frequently.
D) Wear compression stockings.
Q3) All of the following are associated with the formation of a deep vein thrombosis (DVT) EXCEPT:
A) blood vessel injury.
B) age greater than 40 years.
C) hypercoagulability.
D) venous stasis.
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Page 23
Chapter 22: Flail Chest
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Sample Questions
Q1) What is the term for abnormal gas movement from one lung to the other?
A) Paradoxical movement
B) Pendelluft
C) Palindromic breathing
D) Pneumatic shift
Q2) Which of the following accurately describes a flail chest?
A) Double fractures of 2 adjacent ribs
B) Double fractures of 3 adjacent ribs
C) Single fracture of 3 adjacent ribs
D) Triple fractures of 2 adjacent ribs
Q3) Which of the following are pathologic changes associated with a flail chest?
1) Pneumothorax
2) Secondary pneumonia
3) Pleural effusion
4) Elevated diaphragms
A) 1, 2
B) 3, 4
C) 1, 3, 4
D) 1, 2, 3, 4
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Page 24
Chapter 23: Pneumothorax
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Sample Questions
Q1) A patient had a penetrating knife wound to her chest wall that resulted in a valvular pneumothorax. What is another term for this condition?
A) Spontaneous pneumothorax
B) Tension pneumothorax
C) Iatrogenic pneumothorax
D) Benign pneumothorax
Q2) A 6-foot-tall, 140-pound, 28-year-old female patient has come to the emergency department with a complaint of a sudden sharp pain in the right upper chest followed by shortness of breath. The pain originated while she participated in deep breathing exercises in a yoga class. The physician has determined that she has a 15% pneumothorax. How should the pneumothorax be classified?
A) Open
B) Exercise related
C) Spontaneous
D) Traumatic
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Chapter 24: Pleural Effusion and Empyema
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Q1) Treatment of an empyema usually includes:
A) pleurodesis.
B) thoracostomy tube insertion.
C) lobectomy.
D) pneumonectomy.
Q2) While reviewing an upright chest radiograph of a patient with a pleural effusion, the respiratory therapist observes a fluid density in the right lung area that extends upward around the anterior, lateral, and posterior thoracic walls. What is this characteristic sign called?
A) Meniscus sign
B) Scarf sign
C) Transudate sign
D) Kerley B lines
Q3) A patient has a pleural effusion from an unknown cause. A fluid sample has been taken for analysis. To help identify the cause of the effusion, all of the following tests should be performed EXCEPT:
A) specific gravity.
B) biochemical makeup.
C) cytologic examination.
D) bacterial culture.
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Chapter 25: Kyphoscoliosis
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Q1) In a case of severe kyphoscoliosis, which of the following chest radiograph findings would be expected?
1) Enlarged heart
2) Areas of atelectasis
3) Increased lung opacity
4) Thoracic deformity
A) 1, 4
B) 2, 3
C) 2, 3, 4
D) 1, 2, 3, 4
Q2) Posterior curvature of the spine best describes:
A) kyphoscoliosis.
B) spina bifida.
C) scoliosis.
D) kyphosis.
Q3) Which age group is most likely to develop idiopathic scoliosis?
A) Infants
B) Juveniles
C) Adolescents
D) Adults
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Chapter 26: Interstitial Lung Diseases
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Q1) All of the following are associated with lymphangioleiomyomatosis (LAM) EXCEPT:
A) recurrent chylothoraces and recurrent pneumothoraces.
B) increased airway obstruction.
C) postmenopausal women are primarily affected.
D) airway smooth muscle is affected.
Q2) All of the following are anatomic alterations of the lungs that may be found with the chronic stage of interstitial lung disease (ILD) EXCEPT:
A) honeycombing.
B) edema.
C) interstitial thickening.
D) granulomas.
Q3) What category of medications is commonly prescribed to manage interstitial lung disease?
A) Antibiotics
B) Mucolytics
C) Corticosteroids
D) Diuretics
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28
Chapter 27: Cancer of the Lung
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Q1) Staging of a lung cancer is based on which of these criteria?
1) L, for location of the tumor
2) M, for extent of metastasis
3) N, for lymph node involvement
4) T, for extent of the primary tumor
A) 1, 4
B) 2, 3
C) 2, 3, 4
D) 1, 2, 3, 4
Q2) What is the preferred surgical treatment for a large, single tumor located in the right lower lobe?
A) Lobectomy
B) Wedge resection
C) Segmentectomy
D) Pneumonectomy
Q3) Which form of lung cancer has the poorest prognosis?
A) Large cell carcinoma
B) Adenocarcinoma
C) Small cell carcinoma
D) Squamous cell carcinoma
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Chapter 28: Acute Respiratory Distress Syndrome
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Q1) ARDS can result from the inhalation of all of the following EXCEPT:
A) FIO<sub>2</sub> >0.60 for prolonged exposure.
B) nitrogen dioxide.
C) very dry air.
D) chlorine gas.
Q2) What initial tidal volume setting on the ventilator would be recommended for a 70-kg adult male with ARDS?
A) 350 mL
B) 420 mL
C) 560 mL
D) 700 mL
Q3) Which of the following are causes of ARDS?
1) Liver failure
2) Heroin abuse
3) Septicemia
4) Goodpasture's syndrome
A) 1, 4
B) 2, 3
C) 2, 3, 4
D) 1, 2, 3, 4
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Chapter 29: Guillain-Barré Syndrome
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Q1) Clinical indications that a patient has impending acute ventilatory failure include:
1) pH <7.35.
2) vital capacity (VC) <20 mL/kg.
3) PaCO<sub>2 </sub>>45 mm Hg.
4) Negative inspiratory force (NIF) <25 cm H<sub>2</sub>O.
A) 1, 3
B) 1, 2, 3
C) 2, 4
D) 1, 2, 3, 4
Q2) Common noncardiopulmonary manifestations associated with Guillain-Barré is (are):
1) difficulty swallowing.
2) leg pain.
3) distal paresthesia.
4) absent deep tendon reflexes.
A) 1
B) 2, 3
C) 1, 2, 4
D) 1, 2, 3, 4
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Chapter 30: Myasthenia Gravis
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Q1) The major pathologic or structural changes of the lungs associated with myasthenic crisis include:
1) alveolar consolidation.
2) airway obstruction.
3) mucus accumulation.
4) atelectasis.
A) 1, 4
B) 2, 3
C) 2, 3, 4
D) 1, 2, 3, 4
Q2) Which demographic group(s) is/are most likely to develop myasthenia gravis?
1) African-American females >40 years of age
2) White males <40 years of age
3) Females 15 to 35 years of age
4) Males 40 to 70 years of age
A) 1
B) 4
C) 2, 3
D) 3, 4
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Chapter 31: Sleep Apnea
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Q1) Which of the following may be used in the management of a patient with central sleep apnea?
1) Acetazolamide
2) Oxygen therapy
3) Inhaled bronchodilator medications
4) Adaptive servo-ventilation (VPAP)
A) 1, 3
B) 2, 4
C) 1, 2, 4
D) 1, 2, 3, 4
Q2) Clinical disorders associated with central sleep apnea include:
1) Pickwickian syndrome.
2) depression.
3) encephalitis.
4) brain stem infarction.
A) 1, 2
B) 3, 4
C) 1, 2, 3
D) 2, 3, 4
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Chapter 32: Clinical Manifestations Common with Newborn and
Early Childhood Respiratory Dis
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Q1) Early clinical manifestations of an infant with respiratory distress include: 1) cyanosis.
2) substernal retractions.
3) expiratory grunting.
4) apnea.
A) 1, 3
B) 2, 4
C) 2, 3, 4
D) 1, 2, 3
Q2) PPHN usually appears:
A) in utero during the last trimester.
B) within 1 hour of birth.
C) within the first 12 hours of birth.
D) between the 1st and 6th days of life.
Q3) Apneic episodes in a premature neonate can be caused by all of the following EXCEPT:
A) epiglottitis.
B) immature central nervous system.
C) immature airway receptors.
D) immature chemoreceptors.
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Chapter 33: Meconium Aspiration Syndrome
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Q1) A common finding in a neonate with MAS is a respiratory rate that is:
A) under 40/min.
B) between 40 and 60/min.
C) well over 60/min.
D) cyclical with faster and then slower breaths.
Q2) Hyperinflation is noted on the chest radiograph of a patient with MAS. What sudden development(s) must be watched for?
1) PPHN
2) Pneumothorax
3) Cardiomegaly
4) Pneumomediastinum
A) 2
B) 2, 4
C) 1, 2, 3
D) 2, 3, 4
Q3) How may a fetus respond when he or she becomes hypoxemic?
A) The fetus stops making breathing efforts.
B) The fetus makes rapid, shallow chest movements.
C) The fetus makes very deep, gasping inspiratory movements.
D) The fetus shows Kussmaul respirations.
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Chapter 34: Transient Tachypnea of the Newborn
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Q1) All of the following radiologic findings would be expected in a 12-hour-old neonate with TTN EXCEPT:
A) air bronchograms.
B) fluid in the interlobular fissures.
C) elevated diaphragms.
D) prominent perihilar streaking.
Q2) How soon will TTN begin to resolve after birth?
A) 4 to 6 hours after birth
B) 12 to 24 hours after birth
C) 48 to 72 hours after birth
D) 72 to 96 hours after birth
Q3) Initially, TTN will have a clinical presentation similar to:
A) the early stage of respiratory distress syndrome (RDS).
B) the late stage of respiratory distress syndrome (RDS).
C) bronchial pneumonia.
D) meconium aspiration syndrome (MAS).
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Chapter 35: Respiratory Distress Syndrome
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Q1) A patient with RDS has alveolar hypoxia and pulmonary vasoconstriction. How will this affect his blood flow?
1) Blood shunts through the foramen ovale
2) Increased systemic blood flow
3) Blood shunts through the ductus arteriosus
4) Decreased blood flow to the gut
A) 2, 4
B) 1, 3
C) 1, 2, 3
D) 1, 2, 3, 4
Q2) Management of a neonate with RDS may include: 1) CPAP.
2) instilling surfactant into the lungs.
3) mechanical ventilation.
4) supplemental oxygen.
A) 2
B) 1, 3
C) 2, 3, 4
D) 1, 2, 3, 4
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Chapter 36: Pulmonary Air Leak Syndromes
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Q1) During the physical exam of a neonate with early pulmonary air leak syndromes, what respiratory rate would be expected?
A) <20 breaths/min
B) 20 to 30 breaths/min
C) 40 to 60 breaths/min
D) >60 breaths/min
Q2) Which of the following medications would be recommended for the treatment of SIAHD?
A) Beta2-agonists
B) NSAIDs
C) Diuretics
D) Corticosteroids
Q3) A neonate on mechanical ventilation developed pulmonary air leak syndrome. What change should the respiratory therapist now recommend?
A) Initiate the bronchopulmonary hygiene therapy protocol.
B) Decrease the oxygen percentage.
C) Initiate high-frequency ventilation.
D) Insert bilateral pleural chest tubes.
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Chapter 37: Respiratory Syncytial Virus (Bronchiolitis or Pneumonitis)
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Q1) Anatomic alterations related to an RSV infection can lead to all of the following EXCEPT:
A) pneumomediastinum.
B) partial airway obstruction.
C) decreased airway lumen.
D) complete airway obstruction.
Q2) Which of the following are major pathologic or structural changes associated with RSV?
1) Dilation and distortion of the airways
2) Inflammation of the peripheral airways
3) Alveolar hyperinflation
4) Pulmonary edema
A) 1, 4
B) 2, 3
C) 2, 3, 4
D) 1, 2, 3, 4
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Chapter 38: Bronchopulmonary Dysplasia
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Q1) Which of the following can increase an infant's likelihood of developing BPD?
A) Birth weight >3000 g
B) Overfeeding
C) Use of beta2-agonists
D) Bacterial sepsis
Q2) If a patient has an advanced stage of BPD, what cardiac problem may be identified on the chest radiograph?
A) Pneumomediastinum
B) Cardiac tamponade
C) Change in point of maximum impulse
D) Cor pulmonale
Q3) What would contribute to the development of "new" bronchopulmonary dysplasia (BPD) in an infant delivered at 25 weeks' gestation?
A) Interruption of the canalicular stage of lung development
B) Transient tachypnea of the newborn (TTN)
C) Low Apgar scores
D) Laryngotracheobronchitis
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Chapter 39: Congenital Diaphragmatic Hernia
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Q1) The prognosis of an infant with a diaphragmatic hernia depends on which of the following factors?
1) Success of the surgical diaphragmatic closure
2) Size of the diaphragmatic defect
3) Condition of the lung on the unaffected side
4) Degree of hypoplasia
A) 1
B) 1, 2
C) 1, 3, 4
D) 1, 2, 3, 4
Q2) What additional procedures or treatments might be required for a patient with a CDH and significant pulmonary hypoplasia?
A) Plasmapheresis
B) ECMO
C) Cardiac pacemaker
D) Bronchoscopy
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Chapter 40: Congenital Heart Diseases
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Q1) What is the most common form of TGA?
A) a-TGA
B) b-TGA
C) c-TGA
D) d-TGA
Q2) According to the NHLBI, what is the most common type of birth defect?
A) Cerebral palsy
B) Congenital heart defects
C) Congenital diaphragmatic hernia
D) Cleft palate
Q3) All of the following are associated with tetralogy of Fallot EXCEPT:
A) pulmonary artery stenosis.
B) dextroposition of the aorta.
C) right ventricular hypertrophy.
D) atrial septal defect.
Q4) What is the most common type of VSD?
A) Inlet ventricular septal defect
B) Perimembranous ventricular septal defect
C) Muscular ventricular septal defect
D) Conoventricular ventricular septal defect
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Chapter 41: Croup Syndrome: Laryngotracheobronchitis and
Acute Epiglottitis
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Q1) A patient has epiglottitis. This condition will affect which of the following?
1) Pharynx
2) Aryepiglottic folds
3) False vocal cords
4) Trachea
A) 1, 2
B) 2, 3
C) 1, 2, 3
D) 2, 3, 4
Q2) The barking sound heard in a patient with LTB is caused by which of the following?
A) Partial lower airway obstruction
B) Partial upper airway obstruction
C) Expiration against a partially closed glottis
D) Pharyngeal edema
Q3) The diagnosis of LTB is made by all of the following EXCEPT the child:
A) has inspiratory stridor and barking cough.
B) has a normal temperature or low fever.
C) has a significant fever.
D) can drink without difficulty.
Page 43
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Chapter 42: Near Drowning/Wet Drowning
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Q1) A near-drowning victim in cardiac arrest has been placed in an ambulance. During transport, the goals of the paramedics should be to:
1) contact the victim's insurance carrier.
2) perform high-quality CPR.
3) conserve the victim's body heat.
4) administer FIO<sub>2 </sub>1.0.
A) 2
B) 2, 3
C) 2, 3, 4
D) 1, 2, 3, 4
Q2) Which of the following breath sounds would be expected during auscultation of a wet-drowning victim?
1) Bronchovesicular
2) Vesicular
3) Crackles
4) Friction rub
A) 1
B) 3
C) 2, 4
D) 1, 2, 3
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Chapter 43: Smoke Inhalation, Thermal Injuries, and Carbon
Monoxide Intoxication
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Q1) A patient with carbon monoxide poisoning has a COHb level of 20%. If the patient is given 100% oxygen, what will the approximate COHb level be in 1 hour?
A) 15%
B) 10%
C) 5%
D) 2.5%
Q2) What COHb level is associated with a throbbing headache, nausea, vomiting, and impaired judgment?
A) 1% to 10%
B) 10% to 20%
C) 20% to 30%
D) 30% to 50%
Q3) The long-term effects of a smoke inhalation injury are:
A) obstructive lung disorders.
B) restrictive lung disorders.
C) obstructive and restrictive lung disorders.
D) neither obstructive nor restrictive lung disorders, since there is normally complete recovery.
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Chapter 44: Atelectasis
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Q1) Examples of the types of surgical procedures that often result in atelectasis include all of the following EXCEPT:
A) open heart surgery.
B) craniotomy.
C) gallbladder removal.
D) splenectomy.
Q2) After surgery, a patient must lie supine in bed. Because of this, atelectasis is thought to have developed. What chest radiograph finding would confirm this?
A) Depression of the hemidiaphragms
B) Pulmonary interstitial emphysema (PIE)
C) Increased density in both upper lobe areas
D) Increased density in both posterior lower lobe areas
Q3) Which of the following patients should be placed on short-term mechanical ventilation because of the high risk of postoperative atelectasis?
A) Appendectomy
B) Tracheostomy
C) Bronchoscopy for tumor biopsy
D) Cardiac surgery
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