Cardiopulmonary Anatomy and Physiology
Exam Answer Key
Course Introduction
Cardiopulmonary Anatomy and Physiology explores the structure and function of the heart, lungs, and associated vascular and respiratory systems. This course examines the anatomical features and physiological mechanisms that facilitate oxygen transport, gas exchange, and blood circulation. Topics include cardiopulmonary embryology, cardiac conduction, pulmonary ventilation, hemodynamics, and regulatory mechanisms maintaining homeostasis. Understanding these foundational concepts is critical for recognizing normal cardiopulmonary function as well as pathophysiological changes underlying common clinical conditions.
Recommended Textbook
Basic Clinical Lab Competencies for Respiratory Care An Integrated Approach 5th Edition by Gary
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Chapter 1: Basics of Asepsis
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Q1) What is defined as the complete destruction of all forms of microorganisms?
A)Isolation
B)Standard precautions
C)Asepsis
D)Sterility
Answer: D
Q2) Place in the proper sequence the donning of personal protective equipment aseptically.
I.Application of the mask
II.Application of the gown
III.Application of the gloves
A)I. ,II. ,III.
B)II. ,I. ,III.
C)III. ,II. ,I
D)I. ,III. ,II.
Answer: A
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Chapter 2: Basic Patient Assessment: Vital Signs and Breath Sounds
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Q1) Which type of breath sound would be described as low-pitched,soft sounds that have an inspiratory phase longer than the expiratory phase?
A)Tracheal
B)Broncho-vesicular
C)Bronchial
D)Vesicular
Answer: D
Q2) What breath sound is described as a loud,higher pitched breath sound with the expiratory phase longer than the inspiratory phase,with a short pause between phases?
A)Vesicular
B)Tracheal
C)Bronchial
D)Bronchovesicular
Answer: C
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Chapter 3: Advanced Patient Assessment: Inspection, Palpation, and Percussion
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Q1) What is a congenital deformity of the sternum characterized by a depression in the sternum at the level of the lower body and xyphoid process?
A)Lordosis
B)Pectus excavatum
C)Kyphoscoliosis
D)Pectus carinatum
Answer: B
Q2) What type of skeletal abnormality has an anterior-to-posterior curvature of the upper spine and a lateral curvature that causes the vertebrae in the affected area to rotate,flattening the rib cage anteriorly?
A)Kyphosis
B)Lordosis
C)Scoliosis
D)Kyphoscoliosis
Answer: D
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Chapter 4: Radiologic Assessment
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Q1) When observing the chest x-ray of a patient,how can you tell if a patient is rotated?
A)The trachea should be at the level of the fourth thoracic vertebra
B)The spine should lie equal distance between each clavicle
C)The trachea should be about 4 to 6 cm in length
D)The clavicles should be connected to the sternum
Q2) Which of the following chest x-ray views is the most common for a standard chest x-ray to evaluate a patient's lung tissue?
A)Posterior-anterior (PA)view
B)Anterior-posterior (AP)view
C)Lateral view
D)Apical lordotic view
Q3) During a normal full inspiration,the hemidiaphragms should be at about what level?
A)Tenth rib
B)Fourth rib
C)Clavicles
D)Sternal notch
Q4) What can be evaluated on a chest radiograph besides the heart and lungs?
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Chapter 5: Pulmonary Function Testing
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Q1) What gas in the single breath diffusion test because it only trace amounts are found in the atmosphere and it has a greater affinity for hemoglobin than oxygen?
A)Carbon Dioxide
B)Nitrogen
C)Carbon Monoxide
D)Nitric Oxide
Q2) What is defined as the maximum volume of air that can be exhaled after a maximal inspiration?
A)Inspiratory reserve volume (IRV)
B)Expiratory reserve volume (ERV)
C)Inspiratory capacity (IC)
D)Vital capacity (VC)
Q3) When comparing the 2 largest FVCs,what should their value be to ensure that there is reproducibility in the spirometry results?
A)Within 200 ml of each other
B)20% before and after bronchodilator
C)At least 3.0 L
D)Within 21.432 ml of each other
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Chapter 6: Electrocardiography
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Q1) What is located by palpating the patient's sternal angle?
A)Fourth intercostal space
B)The xiphoid process
C)Second intercostal space
D)Mid clavicular line
Q2) Which of the following waves in an ECG tracing represents atrial depolarization?
A)'P' wave
B)'QRS'complex
C)'T' wave
D)'U' wave
Q3) When looking at the ECG graph paper,you notice the 'P-R' interval is exactly the same distance of one of the larger squares.What is this distance?
A)1 millivolt
B)1 second
C)0.04 seconds
D)0.20 seconds
Q4) The patient wants an exercise EKG.To ensure the electrodes stay remain in the proper position,what precautions should be taken?
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Chapter 7: Phlebotomy
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Q1) There is an obligation for the respiratory therapist to protect himself from inadvertent exposure to blood specimens.How is this accomplished?
A)Knowledge
B)Preparation
C)Procedure
D)All of these
Q2) When drawing blood with a butterfly needle,how is the blood collected from the patient's vein?
A)Creating negative pressure with an attached syringe
B)By keeping the patient's extremity in the dependent position
C)"Milking' the site to start and allow the blood flow to continue
D)Adapting the vacuum collection container to fit the needle
Q3) Following the post needle stick scrub,what should be done to the wound?
A)Apply an ointment such as polymixin-bacitracin to the area
B)It should be lanced by a physician
C)The area should be squeezed to increase perfusion to the area
D)Nothing
Q4) How does the phlebotomist gain the confidence of the patient for a blood draw?
Q5) How can the phlebotomist enhance sites to draw blood from a patient?
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Chapter 8: Arterial Blood Gas Sampling
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Q1) Which artery is located on the medial side of the antecubital fossa near the insertion of the biceps muscle at the radial tuberosity?
A)Radial artery
B)Brachial artery
C)Femoral artery
D)Dorsalis pedis
Q2) The artery is surrounded by a layer of muscle.When an artery is punctured the artery may _________.
A)spasm.
B)form of an embolus.
C)become infected.
D)enhance circulation.
Q3) When performing the modified Allen's test,color should return in the hand within _____ seconds.
A)5 seconds
B)10 seconds
C)15 seconds
D)20 seconds
Q4) What should the practitioner teach the patient concerning an arterial line?
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Chapter 9: Hemodynamic Monitoring
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Q1) PEEP _________________________________
A)increases the PCWP reading.
B)Increases the CVP reading.
C)increases cardiac output.
D)increases the CVP and PCWP reading.
Q2) The pulmonary artery should always be measured _____________.
A)at end diastole.
B)during systole.
C)during a premature ventricular contraction.
D)at end exhalation.
Q3) The thermistor on the pulmonary artery catheter at the thermistor lumen is used to measure the __________________
A)central venous pressure.
B)dicrotic notch.
C)pulmonary capillary wedge pressure.
D)cardiac output.
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Chapter 10: Noninvasive Monitoring
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Q1) How does the pulse oximeter measure O saturation in the capillary bed?
Q2) When assessment of acid-base status and/or PaO is not required,what is used to assess a patient's oxygenation?
A)End-tidal CO
B)SPO
C)Vital capacity
D)Tidal volume
Q3) Which electrode does the transcutaneous CO monitor incorporate into its design?
A)Clark electrode
B)Severinghaus electrode
C)Sanz electrode
D)Reference electrode
Q4) What would allow the respiratory care practitioner to monitor in real time a patient's partial pressure of oxygen?
A)Capnography
B)Pulmonary artery pressure monitoring
C)Noninvasive monitoring
D)Arterial blood gases
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Chapter 11: Documentation and Goals Assessment
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Q1) When attempting to achieve ventilation goals the respiratory care practitioner should assess the ________________.
A)PaO .
B)SaO .
C)PaCO .
D)HCO .
Q2) Which part of the chart contains temperature,pulse,respiration,blood pressure,urine output,oral intake (fluids),and daily weights?
A)Physician's Orders
B)History and Physical Examination
C)Multidisciplinary Records
D)Graphic Record
Q3) Which part of the medical record states the date and time the patient was admitted to the acute care facility as well as the patient's medical diagnosis?
A)Physician's orders
B)Progress notes
C)Admission record
D)Medical history
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Chapter 12: Oxygen Supply Systems
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Q1) Medical gas supply systems include all of the following EXCEPT ______________
A)medical gas cylinders.
B)liquid systems.
C)oxygen concentrators.
D)oxygen regulators.
Q2) A device that reduces the pressure in the medical gas cylinder from 2200 psi to 50 psi is termed a ________________
A)riser.
B)flowmeter.
C)reducing valve.
D)station outlet.
Q3) If a cylinder valve is exposed to excessive temperature in a fire,which type of safety system is incorporated into the valve to release gas pressure?
A)Fusible plug
B)Frangible disk
C)Diameter-indexed Safety System (DISS)
D)Pin Index Safety System (PISS)
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Chapter 13: Oxygen Administration
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Q1) The oxygen percentage being delivered to a newborn by way of an oxygen hood needs to be analyzed.Where should the oxygen within the hood be analyzed?
A)At the oxygen source outlet
B)Any place where the analyzer probe can be placed
C)As close to the patient's airway as possible
D)At the highest point of the oxygen hood
Q2) If an oxygen delivery device mixes 10 LPM of air to 1 LPM of oxygen,approximately what FIO is delivered by this device?
A)24%
B)28%
C)30%
D)35%
Q3) What is defined as an oxygen delivery system that provides all of the total inspiratory flow required by the patient?
A)High-flow oxygen delivery system
B)Low-flow oxygen delivery system
C)Non-rebreathing oxygen delivery system
D)Reservoir oxygen delivery system
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Chapter 14: Introduction to Respiratory Care Pharmacology
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Q1) Salmeterol and Fluticasone are combined into a DPI preparation.What is the purpose of these two drugs combined?
A)Maintenance bronchodilation and Mast cell stabilization
B)Mucolysis and anti-inflammation
C)Bronchodilation by stimulating the sympathetic nervous system and inhibiting the parasympathetic nervous system
D)Maintenance bronchodilation and anti-inflammation
Q2) Release of acetylcholine will cause ___________________
A)bronchodilation.
B)Mast cell stabilization.
C)stimulation of cyclic 3'5' AMP.
D)bronchospasm.
Q3) A sympathomimetic drug would cause ________________
A)bronchodilation.
B)bronchoconstriction.
C)Histamine release.
D)Vagus nerve stimulation.
Q4) An aerosol drug is ordered on a patient in MDI form.The propellant causes a reflex bronchospasm in the patient.What can be done?
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Chapter 15: Humidity and Aerosol Therapy
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Q1) When administering a medication via a small volume nebulizer to a patient,instruct the patient to take slow,deep breaths with a slight pause before exhaling.What is the purpose of the pause before exhaling?
A)Allow deeper penetration of the medication into the lungs.
B)Decrease the risk of medication side effects.
C)Help the aerosol to deposit in the lungs.
D)Increase the delivered FI02 from the small volume nebulizer.
Q2) Which type of humidifier is described as a small hygroscopic device placed proximal to a patient's artificial airway,where it absorbs water vapor from the patient's exhaled gas.When the patient breathes or the mechanical ventilator delivers the next breath,moisture in the device evaporates,humidifying the airway?
A)Bubble humidifier
B)Conventional humidifier
C)Wick humidifier
D)Heat and moisture exchanger (HME)
Q3) Despite having the flowrate set on 15 LPM on a 30% aerosol to a T-piece,there is very little aerosol seen coming out of the aerosol tubing.What should the practitioner check?
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Chapter 16: Bronchial Hygiene Therapy
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Q1) A patient has severe hypoxemia despite high levels of oxygen.To help alleviate the hypoxemia the patient is positioned with the good lung down.How does this work?
Q2) You are called to assess a patient and recommend the appropriate therapy.Upon assessment the patient exhibits an abnormal chest radiograph consistent with infiltrates,sputum retention not responsive to directed coughing,and a deterioration in the patient's arterial blood gas values.What therapy should be recommended for this patient?
A)Postural drainage therapy
B)Forced expiratory technique
C)Positive expiratory pressure therapy
D)Positioning
Q3) A patient who is receiving postural drainage and percussion desaturates during therapy,complains of dizziness,and states he cannot tolerate the treatment any longer.What should the practitioner do?
Q4) A patient positioned on their back is placed in which position?
A)Trendelenburg.
B)Lateral.
C)Supine.
D)Prone.
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Chapter 17: Hyperinflation Therapy
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Q1) A 35 year-old patient is admitted for gall bladder surgery.The patient has a 40 pack/year smoking history,and has a past history of minor health problems.Breath sounds reveal expiratory wheezing and coarse crackles bilaterally.The patient is 5'6" and weighs 250 lbs.What risk factors does this patient have for post-operative atelectasis and what should be done?
Q2) During IPV how is the peak inspiratory pressure determined?
A)Measuring the heart rate
B)Measuring the respiratory rate
C)Observing the pressure manometer
D)Auscultate the breath sounds
Q3) How does expiration take place after a positive-pressure breath during an IPPB treatment?
A)The elastic recoil of the lungs and thorax allows the patient to exhale
B)The sensitivity is set to allow the ventilator to be 'sensitive' to the patient when exhalation is started
C)The expiratory timer is set to limit the amount of time inspiration takes place
D)The flow rate through the Venturi is cut off cycling the ventilator into expiration
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Chapter 18: Bronchoscopy Assisting
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Q1) Which type of brush/needle/mechanical device is/are used to sample an area of interest that lies on the opposite side of the bronchial wall from where the bronchoscope is located?
A)Sheathed cytology brush
B)Unsheathed cytology brush
C)Forceps
D)Wang needle
Q2) The need to retrieve a foreign object is done under most circumstances with
A)bronchoalveolar lavage.
B)a Wang needle.
C)a fiberoptic bronchoscope.
D)a rigid bronchoscope.
Q3) The practitioner being oriented on the pediatric unit finds that one of the duties she will be performing will be helping with bronchoscopy procedures.Why would bronchoscopies be performed on pediatric patients?
Q4) What instructions would you give a patient who is to have a bronchoscopy procedure?
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Chapter 19: Equipment Processing and Surveillance
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Q1) What technique would be used to sample fluids from an aerosol?
A)Gram Staining
B)Rodac Plate Sampling
C)Aliquot Culturing
D)Rinse Sampling
Q2) Equipment that is going to be sterilized by steam autoclaving should first be
A)thoroughly sprayed with an antiseptic spray.
B)cleaned in an alcohol solution and then pasteurized.
C)tightly wrapped in a special paper to make sure that the steam thoroughly penetrates around the equipment.
D)disassembled and washed in a detergent solution to remove gross particles and body secretions.
Q3) What is the application of chemical agents to a surface to inhibit microbial growth and reproduction?
A)Antisepsis
B)Sterilization
C)Disinfection
D)Pasteurization
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Chapter 20: Emergency Airway Management
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Q1) What is the proper position of a properly placed endotracheal tube in the patient's trachea?
A)1.5" or 5 cm above the vallecula
B)1.5" or 5 cm above the vocal cords
C)1.5" or 5 cm above the epiglottitis
D)1.5" or 5 cm above the carina
Q2) As a person loses consciousness,what happens to the reflexes that protect the airway?
A)They remain intact
B)They are lost in ascending order
C)They are lost in descending order
D)The cough reflexes are lost but the others remain intact
Q3) To help determine proper positioning of the endotracheal tube on a chest radiograph,which of the following is placed on the endotracheal tube?
A)Murphy eye
B)Radiopaque stripe
C)Polyvinyl chloride plastic
D)Pilot balloon
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Chapter 21: Artificial Airway Care
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Q1) What is the maximum amount of time that a suction procedure should last?
A)5 seconds
B)10 seconds
C)15 seconds
D)20 seconds
Q2) A patient has just been nasotracheally suctioned by the respiratory care practitioner.What improvements in the patient should occur after the procedure to indicate that the nasotracheal suctioning procedure was effective?
I.Improved breath sounds
II.Removal of secretions
III.Improved blood gas data or pulse oximetry
IV.Decreased work of breathing
A)I and II
B)III and IV
C)I only
D)I,II,III,IV
Q3) Before suctioning a patient,you notice that no suction pressure is being generated at the end of the suction catheter when you attempt to suction sterile water through the catheter.What could be causing the problem?
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Chapter 22: Chest Tubes
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Q1) Chest tubes are indicated to remove which of the following from a patient's thoracic cavity?
I.Pus
II.Air
III.Blood
IV.Fluid
A)I and II
B)III and IV
C)II only
D)I,II,III,IV
Q2) A patient is admitted to the emergency department after being involved in a motor vehicle accident.The patient has massive chest trauma and the physician is suspicious that he has a pneumothorax,though the patient has bilateral chest movement.Where on the chest radiograph would you look to find a smaller pneumothorax?
A)Base of the lung
B)Lateral periphery of the lung
C)Apex of the lung
D)Mediastinum
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Chapter 23: Insertion and Maintenance of Intravenous Lines
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Q1) A patient with an IV complains of pain and tenderness at the IV site.The practitioner notes swelling at the IV site.Why should these findings be investigated thoroughly?
A)The IV has infiltrated
B)Cellulitis is developing in the surrounding tissue
C)The possibility of thrombus formation
D)Inflammation of the vein
Q2) After starting an IV,the practitioner is concerned about preventing an air embolism.Which of the following will best prevent an air embolism in the patient?
A)Maintaining the IV bag in an upright position at all times
B)Ensuring that all air is removed before the tubing is connected to the catheter
C)Running the intravenous infusion at a normal rate.
D)a and b
Q3) What is the purpose of transparent dressings on a IV?
Q4) What happens to the small air bubbles that pass through the IV tubing and enter into the patient?
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Chapter 24: Noninvasive Positive-Pressure Ventilation
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Q1) A patient on a full face mask on noninvasive positive-pressure ventilation (NPPV)is swallowing air and having trouble exhaling due to a leak around the naso-gastric (NG)tube.What can be done?
Q2) The respiratory care practitioner sets up NPPV on a patient with central sleep apnea.Which of the following modes would be the most dangerous for the patient during NPPV?
A)Spontaneous/timed mode
B)Timed mode
C)Spontaneous mode
D)Assist/control
Q3) A patient complains of eye irritation and dryness.Which of the following would the practitioner NOT use to correct this problem?
A)Increase the delivered pressure
B)Use of spacers
C)Proper mask fit,
D)Correct adjustment of the headgear
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Chapter 25: Continuous Mechanical Ventilation
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Q1) Myasthenia gravis,amyotrophic lateral sclerosis,Gullain-Barre syndrome,spinal cord injuries,and multiple sclerosis may all lead to respiratory failure due to
A)interference with the neurotransmission to the ventilatory muscles.
B)failure of the respiratory pump.
C)loss of nervous signals to contract for ventilation.
D)all of the above.
Q2) What equipment procedure should be done prior to using a mechanical ventilator on a patient?
A)Perform a ventilator operational verification procedure
B)Identify patient insurance coverage
C)Perform a static compliance measurement
D)Determine alveolar ventilation
Q3) How is tubing compliance determined?
Q4) A practitioner should not use the assist ventilation mode in which of the following conditions?
A)Asthmatic patient prior to extubation
B)Congestive heart failure after delivery of diuretics
C)Resolving pneumonia
D)Post-operative abdominal surgery with sedation
Page 27
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Chapter 26: Advanced Modes of Mechanical Ventilation
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Q1) What are the purposes of ventilator alarms and backup modes?
Q2) Time cycled breath control _______________
A)identifies periods of apnea.
B)is adjusted in increments of 1-3 mm Hg.
C)adjusts the end of inspiration after a specified time.
D)increases pressure to a set value.
Q3) Which primary control variable will result in flow and pressure being variable in the presence of changing airway resistance or lung compliance?
A)Pressure
B)Volume
C)Flow
D)Time
Q4) The Nellcor Puritan Bennett 840 recommends an operational check of the BDU,sensors,resistance and compliance of the circuit prior to use.This is called
A)tubing compliance.
B)The short self test.
C)the power on self test
D)the user verification test
Q5) What are three problems that mandatory minute ventilation cannot prevent?
Page 28
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Chapter 27: Wave Form Analysis
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Q1) The practitioner states to the nurse that she is concerned about "beaking." The practitioner is referring to
A)a condition of cyanosis that changes the shape of the finger nail beds.
B)a hemodynamic problem caused by excessive PEEP.
C)overdistention of the lungs caused by excessive ventilation pressure.
D)a slight squeaking sound caused by a cuff leak.
Q2) Peak pressure is which of the following?
A)The highest point on the flow-time display
B)The highest point of the baseline pressure
C)The pressure recorded at the point of no airflow
D)The highest pressure reached during inspiration.
Q3) Combinations of ventilator wave forms can indicate __________________
A)Airway resistance
B)Air trapping
C)Increased work of breathing
D)All of the above
Q4) Which graphic displays can indicate adequacy of inspiratory flow during a ventilator inspiration and how are they used?
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Chapter 28: Weaning and Discontinuance of Mechanical Ventilation
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Q1) According to the AARC Clinical Practice Guidelines,which of the following identifies success or tolerance in the spontaneous breathing trial?
A)PaO less than 50 mmHg
B)Increase in PaCO of less than 10 mmHg
C)pH less than 7.32
D)Systolic blood pressure greater than 200 mmHg
Q2) According to the AARC Clinical Practice Guidelines on Weaning and Discontinuation on Ventilatory Support other objective criteria for weaning is measured by
I.Patient is arousable and not on sedation
II.Hemoglobin level greater than 8-10 g/dL
III.No fever present
IV.No respiratory acidosis
A)I,II,III and IV
B)I,II and III
C)I,II and IV
D)II,III and IV
Q3) How do neurological problems result in ventilator dependence?
Q4) How do respiratory conditions result in ventilator dependence?
Q5) What should the respiratory therapist do if the patient does not pass the SBT?
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Chapter 29: Neonatal Mechanical Ventilation
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Sample Questions
Q1) Describe how the initial newborn ventilator setting are determined for mode,rate and flow rate.
Q2) In neonatal time-cycled,pressure-limited ventilation,the respiratory care practitioner will set the inspiratory gas flow rate at ______________
A)40-60 L/min.
B)6-10 L/min.
C)20-30 L/min.
D)1-5 L/min.
Q3) Which of the following is true of I:E ratio?
A)Refers to inspiratory flow to expiratory flow
B)Inspiration is always longer than expiration
C)Long time constants need greater than 1:2 ratio
D)Higher I:E ratios are better tolerated with short time constants
Q4) Which of the following is a complication due to high PaO levels?
A)Barotrauma
B)Retinopathy of prematurity
C)Reduced intracranial pressure
D)Subcutaneous emphysema
Q5) Describe how the initial newborn ventilator alarm setting are determined.
Q6) Describe the point system used when determining an Apgar score.
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