Cardiopulmonary Anatomy and Physiology
Exam Answer Key
Course Introduction
This course provides an in-depth exploration of the structure and function of the cardiovascular and respiratory systems. Students will examine the anatomy of the heart, lungs, and associated vasculature, as well as the physiological principles that govern cardiac output, blood flow, gas exchange, and respiratory mechanics. Emphasis is placed on the integration of cardiopulmonary systems in maintaining homeostasis, the responses to physiological stress, and the implications for clinical assessment and intervention. The course prepares students for advanced study in health sciences and clinical practice by fostering a comprehensive understanding of normal and altered cardiopulmonary function.
Recommended Textbook
Egans Fundamentals of Respiratory Care 11th Edition by Robert M. Kacmarek
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3426 Flashcards
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Chapter 1: History of Respiratory Care
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Sample Questions
Q1) How is competency to practice Respiratory Care determined?
A) Achievement of good grades in school and graduating from an approved program.
B) Applying for a state license.
C) Only by graduating from a CoARC approved program.
D) Obtaining a passing grade on a credentialing examination administered by the NBRC after graduation from a CoARC approved program.
Answer: D
Q2) Who discovered the x-ray and opened the door for the modern field of radiology?
A) John Dalton
B) William Smith
C) William Roentgen
D) Thomas Young
Answer: C
Q3) Who discovered O<sub>2</sub> in 1774 and described it as "dephlogisticated air"?
A) Robert Boyle
B) Jacque Charles
C) Thomas Beddoes
D) Joseph Priestley
Answer: D
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Page 3
Chapter 2: Delivering Evidence-Based Respiratory Care
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Sample Questions
Q1) HIPAA was established in 1996 to set standards related to sharing confidential health history information about patients. What does the letter "P" stand for?
A) Privacy
B) Portability
C) Patient
D) Protection
Answer: B
Q2) Which of the following factors is important in determining the quality of care delivered by a respiratory therapist?
A) Education
B) Experience
C) Training
D) All of the above
Answer: D
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Chapter 3: Quality, Patient Safety, and Communication, and Recordkeeping
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Sample Questions
Q1) In the standard approach to hospital fires, the RACE plan has been suggested. What does the letter "C" stand for in this approach?
A) Capture
B) Contain
C) Call for help
D) Collapse
Answer: B
Q2) An RT is instructing a patient on a particular piece of equipment and should use which scenario on educating the patient?
A) Call Back
B) Read Back
C) Teach Back
D) A short quiz
Answer: C
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Page 5
Chapter 4: Principles of Infection Prevention and Control
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Sample Questions
Q1) Which of the following steps for disinfection of a bronchoscope is false?
A) The first step is cleaning the scope.
B) Disinfection is done by immersion in a liquid disinfectant.
C) The device is stored lying flat to promote drying.
D) Drying techniques can include forced air.
Q2) What is the minimum recommended time for handwashing in the health care environment?
A) 5 sec
B) 15 sec
C) 30 sec
D) 60 sec
Q3) Which of the following are categories under Expanded Precautions?
1) Contact Precautions
2) Droplet Precautions
3) Standard Precautions
4) Airborne Infection Isolation
A)1 and 2 only
B)1, 2, and 4 only
C)2, 3, and 4 only
D)1, 2, 3, and 4
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Chapter 5: Ethical and Legal Implications of Practice
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Sample Questions
Q1) What can be effective tools in preventing malpractice litigations?
1) Active risk management practices
2) Appropriate guest relations policies
3) Continuing education and certifications for facility maintenance staff
4) Having supervisors on every shift
A)1, 2 and 3 only
B)1 and 3 only
C)1, 2, and 4 only
D)1 and 2 only
Q2) A respiratory therapist who engages in a questionable business practice is committing what type of malpractice?
A) Civil
B) Statutory
C) Criminal
D) Ethical
Q3) Which of the following is not a common element in a professional practice act?
A) Scope of professional practice
B) Requirements and qualifications for licensure
C) Penalties and sanctions for unauthorized practice
D) Professional code of ethics
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Chapter 6: Physical Principles of Respiratory Care
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Sample Questions
Q1) A gas at 50° C with a relative humidity of 100% is cooled to 37° C. Which of the following will occur?
1) Condensation on surfaces
2) Visible droplet formation
3) Warming of the adjacent air
A)1, 2, and 3
B)1 and 2 only
C)1 and 3 only
D)2 and 3 only
Q2) After placing a liquid into a small-diameter glass tube, you observe the formation of a convex (upwardly curved) meniscus. What conclusion is correct?
A) The liquid must have a very low surface tension.
B) Strong adhesive forces exist between the liquid and glass.
C) The liquid must have an extremely high viscosity.
D) Strong cohesive forces exist among the liquid molecules.
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8
Chapter 7: E-Medicine in Respiratory Care
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Sample Questions
Q1) When coupled with electronic health records, clinical decision support is particularly useful in:
A) disease management.
B) influenza care.
C) respiratory therapy.
D) post-trauma care.
Q2) Microprocessors can benefit mechanical ventilation by doing which of the following?
1) Equilibrate measured values with target values on a breath-by-breath basis.
2) Control ventilator alarms.
3) Archive the history of set and measured values.
4) Change clinician set parameters as needed.
A)1 and 3 only
B)1 and 4 only
C)1, 2, and 3 only
D)1, 3, and 4 only
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Chapter 8: Fundamentals of Respiratory Care Research
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Sample Questions
Q1) What is the name of the search engine sponsored by the National Library of Medicine for information on health care?
A) PubMed
B) HotMed
C) Up-to-date-Med
D) NationalMedline
Q2) What Web site is known for well-respected rigorously conducted systematic evidence-based reviews and provides free access to abstracts and summaries pertaining to relevant clinical questions?
A) Cochrane.org
B) Medsearch.org
C) Wikepedia.com
D) Systemview.org
Q3) What are the three basic missions of academic medicine?
A) To research, to discover, and to publish
B) To research, to discover, and to cure disease
C) To heal, to teach, and to discover
D) To teach, to research, and to cure
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10
Chapter 9: The Respiratory System
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Sample Questions
Q1) Into what structure do the eustachian tubes drain?
A) Larynx
B) Nasopharynx
C) Oropharynx
D) Vestibule
Q2) What are the three bony projections that arise from the lateral walls of the nasal cavity that enhance filtration and humidification?
A) Alar nasi
B) Frontal sinuses
C) Palatine tonsils
D) Turbinates
Q3) What are the vascularized lymphoidal tissues that have a particularly active immunological role in children?
A) Lingual tonsils
B) Palatine tonsils
C) Pharyngeal tonsils
D) Superior turbinates
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11
Chapter 10: The Cardiovascular System
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Sample Questions
Q1) Opening of the semilunar valves occurs when which of the following occurs?
A) The pressures in the arteries exceed those in the ventricles.
B) The pressures in the atria exceed those in the ventricles.
C) The pressures in the ventricles exceed those in the aorta and pulmonary artery.
D) The pressures in the ventricles exceed those in the atria.
Q2) What is an approximate normal resting cardiac output for a healthy adult?
A) 75 ml/min
B) 500 ml/min
C) 2000 ml/min
D) 5000 ml/min
Q3) Vascular low-pressure baroreceptors have their greatest impact on which system?
A) Central chemoreceptors
B) Endocrine
C) Exocrine
D) Renin-angiotensin
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Chapter 11: Ventilation
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Sample Questions
Q1) For carbon dioxide levels to remain constant during exercise, which of the following factors must be elevated?
A) Alveolar ventilation
B) Dead space ventilation
C) Hemoglobin
D) Bicarbonate
Q2) Which of the following factors would tend to increase the frictional component of the work of breathing?
1) Decreased compliance of the lungs or thorax
2) High frequencies of breathing
3) Increased R<sub>aw</sub>
A)1 and 2 only
B)1, 2, and 3
C)1 and 3 only
D)2 and 3 only
Q3) How can the body effectively compensate for an increased V<sub>Dphy</sub>?
A) Decreased drive to breath
B) Decreased respiratory rate
C) Increased respiratory rate
D) Increased tidal volume
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Chapter 12: Gas Exchange and Transport
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Sample Questions
Q1) When using therapeutic agents that can cause methemoglobinemia (methHb), which of the following is important to prevent adverse effects?
A) Checking the frequency of ventilation
B) Frequent monitoring for methHb to weigh the risk against the benefit
C) Occasional monitoring for sickle cell anemia
D) Frequent monitoring for abnormal body temperature (high or low)
Q2) Which of the following equations best describes O<sub>2</sub> delivery to the tissues?
A) Arterial O<sub>2</sub> content ÷ cardiac output
B) Arterial O<sub>2</sub> content . cardiac output
C) Cardiac output + arterial O<sub>2</sub> content
D) Cardiac output . vascular resistance
Q3) A patient has a whole-body O<sub>2</sub> consumption of 320 ml/min and a measured CaO<sub>2</sub> - CO<sub>2 </sub>of 8 ml/dl. What is the cardiac output?
A) 3.2 L/min
B) 4.0 L/min
C) 5.0 L/min
D) 7.0 L/min
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Chapter 13: Solutions, Body Fluids, and Electrolytes
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Sample Questions
Q1) The most common causes of acute hyponatremia include:
1) postoperative iatrogenic causes.
2) not drinking enough water.
3) self-induced due to water intoxication.
4) not eating enough foods containing sodium.
A)1 and 3
B)2 and 3
C)1, 2, and 4
D)1, 2, 3, and 4
Q2) If a patient's pH were to drop from 7.40 to 7.10, the H<sup>+</sup> concentration will increase by how much?
A) 0.2
B) 0.3
C) 0.5
D) 0.10
Q3) What is the average urine output in a healthy adult?
A) 600 to 800 ml/day
B) 800 to 1000 ml/day
C) 1000 to 1200 ml/day
D) 1200 to 1400 ml/day
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Chapter 14: Acid-Base Balance
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Sample Questions
Q1) Which of the following acts as the "first-line" or immediate defense against the accumulation of H<sup>+</sup> ions?
A) Blood buffer system
B) GI tract
C) Renal system
D) Respiratory system
Q2) Why is the bicarbonate buffer system considered an open buffer system?
A) As the major blood and body buffer system, it is open by definition.
B) It operates only in the extracellular fluid, avoiding cell closure.
C) Its acid (carbonic acid) is converted to CO<sub>2</sub> and removed.
D) Its chemical reactions occur very quickly.
Q3) What is the primary chemical event in respiratory acidosis?
A) Decrease in blood CO<sub>2</sub> levels
B) Decrease in blood HCO<sub>3</sub><sup>-</sup> levels
C) Increase in blood CO<sub>2</sub> levels
D) Increase in blood HCO<sub>3</sub><sup>-</sup> levels
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Chapter 15: Regulation of Breathing
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Sample Questions
Q1) Sensory input to the dorsal respiratory neurons from the lungs, airways, and peripheral chemoreceptors is provided via which nerves?
1) Glossopharyngeal
2) Phrenic
3) Vagus
4) Trigeminal
A)1 and 2 only
B)1, 2, and 4 only
C)1 and 3 only
D)2 and 3 only
Q2) What has the primary responsibility for sensing and responding to changes in blood levels of CO<sub>2</sub>?
A) Apneustic centers
B) Central chemoreceptors
C) Peripheral chemoreceptors
D) Pneumotaxic center
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17
Chapter 16: Bedside Assessment of the Patient
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Sample Questions
Q1) What is indicated by the breathing pattern known as abdominal paradox?
A) Obstructive lung disease
B) Restrictive lung disease
C) Heart failure
D) Diaphragm fatigue
Q2) A 23-year-old patient enters the emergency room complaining of dyspnea. The RT places the patient on oxygen as per hospital protocol and begins to interview the patient about her symptoms. She states that she is having difficulty taking a breath with chest tightness. Patient has a respiratory rate of 28 breaths/min with a loose productive cough.
During auscultation, the RT hears bilateral wheezing in the lungs. What is the most likely cause of the patient's symptoms?
A) Asthma
B) Bronchitis
C) Congestive heart failure
D) Emphysema
Q3) Which of the following may cause the trachea to shift to the right?
A) Right-sided tension pneumothorax
B) Right-sided large pleural effusion
C) Right upper lobe atelectasis
D) Left lower lobe pneumonia
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Chapter 17: Interpreting Clinical and Laboratory Data
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Sample Questions
Q1) A patient is brought into the ER with chest pain. The physician is having difficulty confirming the patient's diagnosis through an ECG. Blood results show an elevated level of CPK-2. What can the physician suspect after reviewing the blood work?
A) Pulmonary embolism
B) Gastroesophageal reflux
C) Myocardial infarction
D) Valvular stenosis
Q2) Which of the following values represents a normal serum potassium level?
A) 137 to 147 mEq/L
B) 98 to 105 mEq/L
C) 7 to 20 mEq/L
D) 3.5 to 5.0 mEq/L
Q3) What term is used to describe a white blood cell (WBC) count that is below normal values?
A) Anemia
B) Thrombocytopenia
C) Leukopenia
D) Hypoleukemia
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Chapter 18: Interpreting the Electrocardiogram
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Sample Questions
Q1) Which of the following axis placements represents right-axis deviation?
A) +60
B) +90
C) +120
D) +190
Q2) What type of medications may lead to first-degree heart block?
A) Bronchodilators
B) Corticosteroids
C) Beta blockers
D) Xanthines
Q3) What is the normal period of time for the PR interval?
A) Not longer than 0.20 sec
B) Not longer than 0.30 sec
C) Not longer than 0.45 sec
D) Not longer than 0.50 sec
Q4) Which of the following waves represents depolarization of the ventricles?
A) P wave
B) QRS wave
C) T wave
D) U wave
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Chapter 19: Analysis and Monitoring of Gas Exchange
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Sample Questions
Q1) To assess gas exchange at the tissues, you would obtain a blood sample from which of the following?
A) Pulmonary artery (balloon-deflated)
B) Peripheral artery (radial, brachial)
C) Central vein (superior or inferior vena cava)
D) Pulmonary artery (balloon-inflated)
Q2) While monitoring an active infant through a transcutaneous blood gas system, you notice a rapid rise in P<sub>tc</sub>O<sub>2</sub> from 63 to 145 mm Hg. At that same time, the (P<sub>tc</sub>CO<sub>2</sub>) drops from 35 to 7 mm Hg. What is the most appropriate action in this case?
A) Perform a quick assessment of the infant's airway.
B) Stabilize the infant and call for emergency assistance.
C) Check the sensor for air leaks or dislodgment.
D) Remove the sensor and recalibrate the instrument.
Q3) Through which pulmonary artery catheter port would you obtain a mixed venous blood sample?
A) Proximal (right atrium) port
B) Catheter thermistor connector
C) Distal (catheter tip) port
D) Balloon inflation port
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Chapter 20: Pulmonary Function Testing
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Sample Questions
Q1) During a helium (He) dilution functional residual capacity (FRC) measurement, the technologist first bleeds in 500 ml of He (He Vol) and obtains an initial reading of 4.0% (FiHe). After equilibration, the second He reading is 3.2% (FfHe). What is the patient's FRC?
A) 4450 ml
B) 3125 ml
C) 2680 ml
D) 3670 ml
Q2) How often should a spirometer in continual use undergo volumetric calibration?
A) Every 4 hr
B) Every shift
C) At least daily
D) Weekly
Q3) What causes the residual volume (RV) and functional residual capacity (FRC) to increase?
A) Atelectasis
B) Chronic obstructive lung disease
C) Pneumonia
D) Pneumothorax
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22
Chapter 21: Review of Thoracic Imaging
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Sample Questions
Q1) How many solitary pulmonary nodules (SPNs) would be encountered for every 1000 routine chest radiographs?
A) 1 or 2
B) 10 to 15
C) 30 to 40
D) 80 to 100
Q2) Your patient just had an anteroposterior chest film taken. When you view the film, what may be a consideration?
A) The lungs may appear smaller than they really are.
B) The heart may appear less dense then it really is.
C) The ribs may appear more horizontal than normal.
D) The heart may appear larger than it really is.
Q3) Which of the following is the most common type of interstitial lung disease?
A) Asbestosis
B) Silicosis
C) Sarcoidosis
D) Scleroderma
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Chapter 22: Flexible Bronchoscopy and the Respiratory Therapist
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Sample Questions
Q1) For patient safety, to help avoid methemoglobinemia, the total dose of lidocaine should not exceed:
A) 2 mg/kg.
B) 5 mg/kg.
C) 7 mg/kg.
D) 10 mg/kg.
Q2) Your patient is being scheduled for a flexible bronchoscopy and is inquiring about when to stop taking her warfarin. After consulting the physician, what would you tell her?
A) 1 to 2 days prior to the procedure.
B) 3 to 5 days prior to the procedure.
C) 1 week prior to the procedure.
D) She does not need to discontinue her warfarin.
Q3) To obtain lavage fluid, the bronchoscope is wedged at which of the following locations?
A) The level of the carina
B) The level of second or third generation bronchus
C) The level of fourth or fifth generation bronchus
D) At least at the level of the sixth generation bronchus
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Chapter 23: Nutrition Assessment
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Sample Questions
Q1) Why raise the head of the bed during tube feedings?
A) It reduces the time needed.
B) It improves absorption.
C) It reduces the risk of aspiration.
D) It is easier for the caregiver.
Q2) Which of the following illnesses are associated with acute catabolic disease?
1) Trauma
2) Sepsis
3) Burns
4) Pulmonary embolism
A)3 only
B)1, 2, and 3 only
C)2, 3, and 4 only
D)3 and 4 only
Q3) Which of the following statements is false with regard to nutritional support of the patient with advanced chronic obstructive pulmonary disease?
A) Provide low-calorie options.
B) Provide high-protein nutrition.
C) Provide small, frequent meals.
D) Provide good patient education.
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Chapter 24: Pulmonary Infections
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Q1) In what percentage of patients with pneumonia has no microbial agent been isolated?
A) Up to 40%
B) Up to 50%
C) Up to 60%
D) Up to 70%
Q2) If an HIV-infected patient has an adverse reaction to the treatment of choice for Pneumocystis jiroveci pneumonia, what treatment should be instituted?
A) Amphotericin B
B) Pentamidine
C) Trimethoprim-sulfamethoxazole
D) Vancomycin
Q3) Which of the following mechanisms is an uncommon route for the spread of pneumonia?
A) Aspiration of infectious particles
B) Inhalation of infectious particles
C) Through the bloodstream
D) Direct contact
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Chapter 25: Obstructive Lung Disease: Chronic Obstructive
Pulmonary Disease Copd, Asthma, and Related Diseases
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Q1) According to the National Asthma Education Project guidelines, what should be considered if the patient with asthma requires more than 3 or 4 puffs of beta-2 agonists per day?
A) Add or increase the dose of anticholinergic.
B) Add or increase the dose of antiinflammatory.
C) Add or increase the dose of magnesium sulfite.
D) Increase dose of beta-2 agonists.
Q2) What beta-2 agonist is associated with 12 to 24 hr of bronchodilation?
A) Albuterol
B) Metaproterenol
C) Salmeterol
D) Aclinidium
Q3) Which of the following tests is recommended as part of the initial assessment of asthma?
A) Arterial blood gas
B) Chest radiograph
C) Spirometry
D) scan
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Chapter 26: Interstitial Lung Disease
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Q1) In simple coal worker's pneumoconiosis, a chest radiograph that is characterized by multiple small nodular opacities on the chest x-ray film is most likely to be associated with what clinical presentation?
A) Asymptomatic
B) Cough
C) Crackles
D) Shortness of breath
Q2) A 45 year-old patient with sarcoidosis complaints of being unable to perform his daily house chores due to shortness of breaths despite continued oxygen therapy of 2 L/min via a nasal cannula. You would recommend which of the following to the patient?
A) Increase O<sub>2</sub> to 5 L/min.
B) Nebulized budesonide BID.
C) Pulmonary rehabilitation.
D) Lung transplantation.
Q3) What is the most common cause of interstitial lung disease (ILD)?
A) Asbestosis
B) Berylliosis
C) Pulmonary fibrosis (IPF)
D) Sarcoidosis
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Page 28
Chapter 27: Pleural Diseases
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Q1) The chest radiograph showed the presence of a meniscus in the right chest together with a blunted right costophrenic angle. Which of the following procedures would you recommend at this point to treat Ms. Paul?
A) Anterior chest tube thoracostomy
B) Chest needle decompression
C) Video-assisted thoracoscopy (VAT)
D) Posterior chest tube thoracostomy
Q2) Pleural effusions that occur secondarily to _____ are most often treated with pleurodesis.
A) ascites
B) congestive heart failure
C) malignancy
D) nephrotic syndrome
Q3) What is a common clinical finding even with small pleural effusions?
A) Air bronchograms
B) Arrhythmias
C) Dyspnea
D) Tachycardia
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Chapter 28: Pulmonary Vascular Disease
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Q1) Most hospitalized patients who are immobile need prophylaxis for venous thromboembolism.
A)True
B)False
Q2) Which of the following medications would be standard therapy to treat acute deep venous thrombi?
A) Acetylcholine esterase
B) Heparin
C) Streptokinase
D) Warfarin
Q3) Why is the use of oxygen to maintain oxygen saturations greater than 90% particularly important in the management of idiopathic pulmonary artery hypertension?
A) These patients have a low cardiopulmonary reserve.
B) Low alveolar oxygen causes vasoconstriction.
C) Many patients have central cyanosis.
D) These patients are especially susceptible to tissue hypoxia.
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Chapter 29: Acute Respiratory Distress Syndrome
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Q1) Which of the following are common causes of volume overload in patients with hydrostatic pulmonary edema?
1) Renal failure
2) Hepatic failure
3) Hypoalbuminemia
4) Hyperkalemia
A)1 and 3 only
B)1, 2, and 3 only
C)3 and 4 only
D)2, 3, and 4 only
Q2) Which of the following is an indirect injury that can cause ARDS?
A) Pneumonia
B) Lung contusion
C) High concentrations of oxygen
D) Transfusions
Q3) What is the name of the period that follows the exudative phase in ARDS?
A) Fibroproliferative
B) Transudative
C) Proliferative
D) Intraalveolar
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Chapter 30: Trauma, Burns and Near Drowning
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21 Flashcards
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Sample Questions
Q1) Which of the following are respiratory and blood chemistry dysfunctions associated with the inhalation of freshwater?
1) Rapid depletion of alveolar surfactant
2) Direct damage to the alveolar-capillary membrane
3) Acute neurogenic pulmonary edema
4) Rapid loss of circulating volume into the alveolar space across the injured alveolar capillary membrane may cause hemoconcentration, hypernatremia, and hypoalbuminemia
A)1 and 3 only
B)1, 2, and 3 only
C)3 and 4 only
D)2, 3, and 4 only
Q2) You are taking care of a trauma patient in the ICU. Following placement of a chest tube, there is a large amount of air that continues to exit the chest tube in a synchronized pattern with positive pressure ventilation. What do you suspect?
A) Inappropriate ventilator settings
B) Bronchial injury
C) Correct placement of the chest tube
D) Endotracheal tube cuff leak
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Chapter 31: Lung Cancer
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28 Flashcards
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Sample Questions
Q1) Which of the following is not associated with the clinical features of lung cancer?
A) Local growth of tumor
B) Metastasis extrathoracic or intrathoracic
C) Associated pain or discomfort
D) Paraneoplastic syndrome
Q2) What does the acronym TNM mean?
A) Tumor, number, mass
B) Tumor, non-small, metastases
C) Tracheal, number, metastases
D) Tumor, lymph node, metastases
Q3) Approximately what percentage of all lung cancer is linked to smoking?
A) 50% to 55%
B) 70% to 75%
C) 85% to 90%
D) 100%
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33
Chapter 32: Neuromuscular and Other Diseases of the Chest
Wall
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29 Flashcards
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Sample Questions
Q1) To effectively document and assess the need for endotracheal intubation in a patient with neuromuscular disease, which of the following would be most appropriate?
A) Spirometry every 4 to 6 hr
B) Chest x-ray every shift
C) Polysomnograpy testing
D) Monitoring SpO<sub>2</sub> with pulse oximeter
Q2) Patients with respiratory muscle weakness due to neuromuscular disease may initially report with which of the following symptoms?
1) Exertional dyspnea
2) Fatigue
3) Oliguria
4) Orthopnea
A)1 and 3 only
B)1, 2, and 4 only
C)3 and 4 only
D)2 and 4 only
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Chapter 33: Disorders of Sleep
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30 Flashcards
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Sample Questions
Q1) What percent of the adult population is believed to have obstructive sleep apnea?
A) Less than 1%
B) 2% to 4%
C) 5% to 10%
D) Unknown
Q2) What is believed to be the cause of systemic hypertension in patients with sleep apnea?
A) Hypervolemia
B) Increased sympathetic tone
C) Elevated CO<sub>2</sub>
D) Tachycardia
Q3) What is the amount of CPAP that is typically required to abolish upper airway obstruction in patients with OSA?
A) 3 to 5 cm H<sub>2</sub>O
B) 10 to 20 cm H<sub>2</sub>O
C) 2.5 to 7.5 cm H<sub>2</sub>O
D) 7.5 to 12.5 cm H<sub>2</sub>O
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35
Chapter 34: Neonatal and Pediatric Respiratory Disorders
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Sample Questions
Q1) Which of the following therapies is considered controversial in the management of the infant with severe bronchiolitis?
A) Hydration
B) Oxygen
C) Bronchodilator therapy
D) CPAP
Q2) Which of the following is false regarding ventricular septal defects in infants?
A) Are quite common.
B) Usually cause right-to-left shunting.
C) May cause congestive heart failure.
D) Usually do not appear immediately after birth.
Q3) What are the major factors in the pathophysiology of RDS?
1) Qualitative surfactant deficiency
2) Increased alveolar surface area
3) Increased small airways compliance
4) Presence of the ductus arteriosus
A)1 and 2 only
B)1 and 3 only
C)1, 3, and 4 only
D)1, 2, 3, and 4
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Chapter 35: Airway Pharmacology
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67 Flashcards
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Sample Questions
Q1) Which of the following should be assessed during the administration of mucolytic agents?
1) Breathing pattern and rate
2) Monitoring peak flow changes
3) Patient's reaction to treatment
4) Monitoring for presence of hydrogen sulfide (a rotten egg odor), which means that the acetylcysteine (Mucomyst) is no longer active
A)1 and 3 only
B)1, 2, and 3 only
C)2, 3, and 4 only
D)1, 2, 3, and 4
Q2) Which of the following short-acting catecholamines is used for their strong alpha-1-vasoconstricting effects to reduce swelling in the nose and larynx and to control bleeding during bronchoscopic biopsy?
A) Levophed
B) Dopamine
C) Dobutamine
D) Racemic epinephrine
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Chapter 36: Airway Management
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Sample Questions
Q1) An alert patient with a long-term need for a tracheostomy tube (because of recurrent aspiration) is having difficulty communicating with the intensive care unit staff. Which of the following would you recommend to help this patient communicate better?
1) Use a letter, phrase, or picture board.
2) Consider switching to a fenestrated tracheostomy tube.
3) Consider a "talking" tracheostomy tube.
A)1 and 2 only
B)1 and 3 only
C)2 and 3 only
D)1, 2, and 3
Q2) Tracheal stenosis occurs in as many as 1 in 10 patients after prolonged tracheostomy. At what sites does this stenosis usually occur?
1) Cuff site
2) Tip of the tube
3) Stoma site
A)1 and 2 only
B)1 and 3 only
C)2 and 3 only
D)1, 2, and 3
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Chapter 37: Emergency Cardiovascular Life Support
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70 Flashcards
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Sample Questions
Q1) Which of the following are legitimate reasons for discontinuing basic life-support measures?
1) If spontaneous breathing and a palpable pulse return
2) If a physician pronounces the arrest victim dead
3) If advanced life-support measures become available
A)2 and 3 only
B)1 and 2 only
C)1, 2, and 3
D)1 and 3 only
Q2) When are oropharyngeal airways contraindicated?
1) When foreign body obstruction already exists
2) In patients who are unconscious or comatose
3) In cases of oromaxillary or mandibular trauma
A)1, 2, and 3
B)1 and 3 only
C)3 only
D)1 and 2 only
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Chapter 38: Humidity and Bland Aerosol Therapy
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109 Flashcards
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Sample Questions
Q1) For what should sputum collected by aerosol therapy induction be inspected?
1) Color
2) Volume
3) Odor
4) Consistency
A)2 and 4 only
B)1, 2, and 3 only
C)1 and 3 only
D)1, 2, 3, and 4
Q2) Why should you not heat the reservoirs of a bubble humidifier used with an oronasal O<sub>2</sub> delivery system?
A) Condensate will obstruct the delivery tubing.
B) Heating will melt the reservoir or cause a fire.
C) Heating will absorb the extra water vapor.
D) Heating will cause too much aerosol impaction.
Q3) What is the primary goal of humidity therapy?
A) Decrease airway reactivity to cold.
B) Maintain normal physiologic conditions.
C) Deliver drugs to the airway.
D) Reduce upper airway inflammation.
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Chapter 39: Aerosol Drug Therapy
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116 Flashcards
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Sample Questions
Q1) Which of the following device-related factors have a major effect on pressurized metered dose inhaler (MDI) delivery of aerosolized drugs during mechanical ventilation?
1) MDI propellant formula
2) Type of spacer or adapter used
3) Position of spacer in circuit
4) Timing of MDI actuation
A)1 and 3 only
B)1, 2, and 3 only
C)3 and 4 only
D)2, 3, and 4 only
Q2) Which of the following best defines an aerosol?
A) Suspension of liquid droplets in a gas
B) Suspension of particulate matter in a gas
C) Molecular water dispersed throughout a carrier gas
D) Suspension of liquid or solid particles in a gas
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Chapter 40: Storage and Delivery of Medical Gases
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Sample Questions
Q1) Which of the following is false about a compensated Thorpe tube?
A) Variable-orifice, constant-pressure flowmeter device
B) Calibrated in liters per minute at atmospheric pressure
C) Flow-control needle valve placed distal to the flow tube
D) Accuracy unaffected by changes in downstream resistance
Q2) According to the U.S. Department of Commerce, a gas cylinder that is color coded blue should contain which of the following?
A) Air
B) He
C) N<sub>2</sub>O
D) O<sub>2</sub>
Q3) The NFPA standard for bulk liquid O<sub>2</sub> systems requires that the reserve supply be which of the following?
A) Fixed cylinder bank of 75 H cylinders
B) At least one large liquid O<sub>2</sub> cylinder
C) Equal to the average gas use of 1 day
D) At least 3000 cu/ft of gaseous O<sub>2</sub>
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42
Chapter 41: Medical Gas Therapy
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Sample Questions
Q1) A patient receiving 3 L/min O<sub>2</sub> through a nasal cannula has a measured SpO<sub>2</sub> of 93% and no clinical signs of hypoxemia. At this point, what should you recommend?
A) Decreasing the flow to 2 L/min and rechecking the SpO<sub>2</sub>
B) Maintaining the therapy as is and rechecking the SpO<sub>2</sub> on the next shift
C) Increasing the flow to 4 L/min and rechecking the SpO<sub>2</sub>
D) Discontinuing the O<sub>2</sub> therapy
Q2) Which of the following factors determine the actual O<sub>2</sub> provided by an air-entrainment system?
1) O<sub>2</sub> input flow to the jet
2) Air-to-O<sub>2</sub> ratio of the device
3) Resistance downstream from the jet
A)2 and 3 only
B)1 and 2 only
C)1, 2, and 3
D)1 and 3 only
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43
Chapter 42: Lung Expansion Therapy
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63 Flashcards
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Sample Questions
Q1) Which of the following mechanisms probably contribute to the beneficial effects of continuous positive airway pressure (CPAP) in treating atelectasis?
1) Recruitment of collapsed alveoli
2) Decreased work of breathing
3) Improved distribution of ventilation
4) Increased efficiency of secretion removal
A)1, 2, and 4 only
B)2 and 3 only
C)1 and 4 only
D)1, 2, 3, and 4
Q2) Ideally, when should high-risk surgical patients be oriented to incentive spirometry?
A) Postoperatively, after full recovery from the anesthesia
B) Preoperatively, before undergoing the surgical procedure
C) Postoperatively, while they are still in the recovery room
D) Postoperatively, but no sooner than 24 hr after surgery
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Chapter 43: Airway Clearance Therapy Act
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90 Flashcards
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Sample Questions
Q1) Proper instructions for positive expiratory pressure include which of the following?
1) Take in a breath that is larger than normal, but do not fill lungs completely.
2) Exhale forcefully and maintain an expiratory pressure of 10 to 20 cm H<sub>2</sub>O.
3) After 10 to 20 breaths, take two or three "huff"' coughs, and rest as needed.
4) Repeat the cycle 8 to 10 times, not to exceed 30 min.
A)1 and 3 only
B)1, 2, and 3 only
C)3 and 4 only
D)2, 3, and 4 only
Q2) A physician orders postural drainage for a patient with aspiration pneumonia in the superior segments of the left lower lobe. Which of the following positions would you recommend for this patient?
A) Patient prone with a pillow under abdomen, bed flat
B) Head down, patient prone with a pillow under abdomen
C) Head down, patient supine with a pillow under knees
D) Patient supine with a pillow under knees, bed flat
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Chapter 44: Respiratory Failure and the Need for
Ventilatory Support
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Sample Questions
Q1) Which of the following is the normal alveolar-to-arterial difference for a 56-year-old female in the emergency department?
A) 12 mm Hg
B) 14 mm Hg
C) 16 mm Hg
D) 18 mm Hg
Q2) A patient with an opiate drug overdose is unconscious and exhibits the following blood gas results breathing room air: pH = 7.19; PCO<sub>2</sub> = 89; HCO<sub>3</sub><sup>-</sup> = 27; PO<sub>2</sub> = 48. Which of the following best describes this patient's condition?
A) Chronic hypoxemic respiratory failure
B) Chronic hypercapnic respiratory failure
C) Acute hypoxemic respiratory failure
D) Acute hypercapnic respiratory failure
Q3) What is the optimal treatment of intrapulmonary shunt?
A) Increase the FiO<sub>2</sub>.
B) Decrease the FiO<sub>2</sub>.
C) Surgery.
D) Alveolar recruitment.
Page 46
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Chapter 45: Mechanical Ventilators
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Sample Questions
Q1) During volume-targeted ventilation, which of the following settings determine the inspiratory time?
1) Volume
2) Flow
3) Rate
A)1 and 2 only
B)1 and 3 only
C)2 and 3 only
D)1, 2, and 3
Q2) Which of the following is false about the application of flow triggering on a mechanical ventilator?
A) The ventilator measures both input and output flow.
B) Between patient breaths, input flow exceeds output flow.
C) A relative drop in output flow triggers the machine to turn on.
D) Gas flows continuously through the ventilator circuit.
Q3) Which of the closed-loop controllers is used by all ventilators?
A) Set point
B) Auto set point
C) Adaptive
D) Servo
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Chapter 46: Physiology of Ventilatory Support
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Sample Questions
Q1) What are some physiological advantages of volume-assured pressure-supported ventilation?
1) Improved patient-ventilator synchrony
2) Increased pressure-time product
3) Decreased work of breathing
A)1 and 2 only
B)1 and 3 only
C)2 and 3 only
D)1, 2, and 3
Q2) Which of the following variables determine the level of support achieved with adaptive support ventilation?
1) Patient effort
2) Elastance
3) Resistance of the endotracheal tube
A)1 and 3 only
B)2 only
C)1 only
D)1, 2, and 3
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Chapter 47: Patient Ventilator Interaction
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Sample Questions
Q1) Which of the following is considered a patient-related cause of poor patient-ventilator interaction?
A) Abnormal respiratory drive
B) Asynchrony
C) Inadequate ventilatory support
D) Inadequate FiO<sub>2</sub>
Q2) You have determined your patient receiving volume ventilation has flow asynchrony. How can this be improved?
1) Increasing peak flow
2) Decreasing inspiratory time
3) Adjusting rise time
4) Adding an inspiratory pause
A)1 and 2 only
B)1, 2, and 3 only
C)3 and 4 only
D)1, 3, and 4 only
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Chapter 48: Initiating and Adjusting Invasive Ventilatory Support
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Sample Questions
Q1) Physiological goals of artificial ventilatory support include which of the following?
1) Support or manipulate gas exchange.
2) Reduce or manipulate the work of breathing.
3) Increase lung volume.
A)1 and 2 only
B)2 and 3 only
C)1 and 3 only
D)1, 2, and 3
Q2) Which of the following findings would you expect to see in a patient who has acute ventilatory failure with severe hypercapnia?
A) Jugular vein distension
B) Pale, dry skin
C) Bradycardia
D) Hyperresponsiveness and dilated pupils
Q3) In what scenario is pressure-controlled ventilation (PCV) most often used?
A) When limiting plateau pressure is needed
B) When a pneumothorax is present
C) When the patient has chronic obstructive pulmonary disease
D) When bilateral pneumonia is present
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Chapter 49: Noninvasive Ventilation
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Sample Questions
Q1) Initiating noninvasive ventilation (NIV) can be done in which of the following settings?
1) Emergency department
2) Intensive care unit
3) Hospital ward
4) Nursing home
A)1 and 3 only
B)1, 2, and 3 only
C)3 and 4 only
D)2, 3, and 4 only
Q2) Which of the following are benefits of continuous positive airway pressure (CPAP) in postoperative major abdominal surgery?
1) Lower mortality
2) Lower intubation rate
3) Lower incidence of pneumonia
4) Lower rate of sepsis
A)1 and 3 only
B)1, 2, and 3 only
C)3 and 4 only
D)2, 3, and 4 only
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Chapter 50: Extracorporeal Life Support Ecls
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Sample Questions
Q1) ECMO is typically only considered in conditions when conventional support: 1) has not been successful in delivering oxygen (O<sub>2</sub>).
2) is unable to effectively remove CO<sub>2.</sub>
3) cannot provide adequate cardiac function.
4) has been in use for more than 4 days.
A)1 only
B)1, 2, and 3 only
C)1, 2, and 4 only
D)1, 2, 3, and 4
Q2) ECMO is not an option as a bridge to transplant.
A)True
B)False
Q3) How is blood flow regulated during ECMO?
A) By dialing in a set RPM
B) By the amount of blood in the ECMO system
C) By administering Levaphed
D) By adjusting the blood temperature in the system
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Chapter 51: Monitoring the Patient in the Intensive Care Unit
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Sample Questions
Q1) Which of the following conditions is associated with an increased lung compliance measurement?
A) Atelectasis
B) Pneumonia
C) Emphysema
D) Bronchial intubation
Q2) What parameter is best used to assess left ventricular afterload?
A) CVP
B) PCWP
C) SVR
D) PVR
Q3) Which of the following are causes of increased airway resistance?
1) Small endotracheal tube
2) High gas flow
3) Increased secretions
4) Frequent suctioning
A)1 and 3 only
B)1, 2, and 3 only
C)3 and 4 only
D)2, 3, and 4 only
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Chapter 52: Discontinuing Ventilatory Support
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Sample Questions
Q1) Which of the following is false about noninvasive positive-pressure ventilation (NIV)?
A) NIV can support ventilation without a tracheal airway.
B) NIV should not be used with patients at risk for aspiration.
C) Patients likely to fail weaning are good candidates for NIV.
D) NIV can be used to prevent reintubation when weaning fails.
Q2) Which of the following metabolic factors can hinder weaning?
1) Excessive carbohydrate feeding
2) Amino acid-based parenteral nutrition
3) Calorie intake = 1.5 . resting energy expenditure (REE)
A)2 and 3 only
B)1 and 2 only
C)1, 2, and 3
D)1 and 3 only
Q3) Which of the following is false about the P<sub>0.1</sub> measure?
A) P<sub>0.1</sub> correlates well with central respiratory drive.
B) P<sub>0.1</sub> is the airway pressure measured 100 msec after occlusion.
C) P<sub>0.1 </sub>is an effort-dependent measure of respiratory drive.
D) Chronic obstructive pulmonary disease (COPD) patients with a P<sub>0.1</sub> greater than 6 cm H<sub>2</sub>O are difficult to wean.
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Page 54
Chapter 53: Neonatal and Pediatric Respiratory Care
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Sample Questions
Q1) What physiologic effect does inhaled nitric oxide have on the lung?
A) Pulmonary vasoconstriction
B) Pulmonary vasodilation
C) Smooth muscle dilation
D) Improved mucociliary clearance
Q2) What V<sub>T</sub> range should be used for mechanical ventilation of a neonate?
A) 5 to 7 ml/kg
B) 6 to 8 ml/kg
C) 8 to 10 ml/kg
D) 10 to 12 ml/kg
Q3) What positive end expiratory pressure level is commonly used in pediatric patients during mechanical ventilation?
A) 1 to 3 cm H<sub>2</sub>O
B) 3 to 5 cm H<sub>2</sub>O
C) 5 to 8 cm H<sub>2</sub>O
D) 10 to 12 cm H<sub>2</sub>O
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Chapter 54: Patient Education and Health Promotion
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Sample Questions
Q1) Which of the following are involved in work site wellness activities performed by respiratory therapists?
1) Performing pulmonary function and/or blood pressure screenings
2) Developing and implementing stress management or nicotine intervention programs
3) Consulting on policies related to smoking and occupational or environmental exposure to foreign dusts such as silica or asbestos or noxious fumes such as smog
4) Prescribing nicotine patches
A)1 and 3 only
B)1, 2, and 3 only
C)3 and 4 only
D)2, 3, and 4 only
Q2) Teaching facts to patients involves learning in what domain?
A) Cognitive
B) Affective
C) Psychomotor
D) Analytical
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Chapter 55: Cardiopulmonary Rehabilitation
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Sample Questions
Q1) By following the reimbursement guidelines for a comprehensive outpatient rehabilitative facility (CORF), Medicare will reimburse up to what percentage of the allowable charge for a rehabilitation program?
A) 60%
B) 80%
C) 20%
D) 40%
Q2) A small-group discussion format for pulmonary rehabilitation educational sessions is recommended in order to foster which of the following?
1) Group interaction
2) Peer support
3) Group identity
A)1 and 2 only
B)2 and 3 only
C)1 and 3 only
D)1, 2, and 3
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Chapter 56: Respiratory Care in Alternative Settings
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Sample Questions
Q1) Disadvantages of home liquid O<sub>2</sub> systems include which of the following?
1) Oxygen is lost when not used (because of venting).
2) The low temperature of liquid O<sub>2</sub> can be a hazard.
3) Liquid O<sub>2</sub> must be delivered when needed.
4) These systems cannot drive pneumatic equipment.
A)1, 2, and 3 only
B)2 and 4 only
C)1, 2, 3, and 4
D)3 and 4 only
Q2) Who can provide routine tracheostomy care for a home care patient?
1) Respiratory care practitioner
2) Trained family member
3) Visiting nurse
A)2 and 3 only
B)1 and 2 only
C)1, 2, and 3
D)1 and 3 only
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