Cardiopulmonary Anatomy and Physiology
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Course Introduction
Cardiopulmonary Anatomy and Physiology is an essential course that explores the structure and function of the heart and lungs, as well as their roles in maintaining homeostasis within the human body. Students will examine the detailed anatomy of the cardiovascular and respiratory systems, including the heart chambers, blood vessels, airways, and alveoli, and gain an understanding of physiological processes such as gas exchange, oxygen transport, and regulation of blood pressure. Emphasis is placed on the integration between these two systems to support metabolic demands, as well as common pathophysiological conditions that impact cardiopulmonary health. This foundational knowledge is crucial for pursuing advanced studies in health sciences and clinical practice.
Recommended Textbook
Basic Clinical Lab Competencies for Respiratory Care An Integrated Approach 5th Edition by Gary
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Page 2
Chapter 1: Basics of Asepsis
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Q1) When microorganisms that are present in everyday environments cause infection when the body's defense mechanisms are impaired are called_______________.
A) Virulence
B) Cross contamination
C) Opportunistic infections
D) Hospital acquired infections
Answer: C
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) Abnormal breath sounds are often referred to as ___________________.
A) vesicular breath sounds.
B) bronchial breath sounds.
C) tracheal breath sounds.
D) adventitious breath sounds.
Answer: D
Q3) What is the pressure called that is measured at the time the ventricles are at rest?
A) Tachycardia pressure
B) Diastolic pressure
C) Systolic pressure
D) Bradycardia pressure
Answer: B
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Chapter 3: Advanced Patient Assessment: Inspection,
Palpation, and Percussion
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Q1) Where is (are)the midscapulae line(s)located?
A) They are imaginary lines on the posterior chest bisecting the shoulder blades and descending vertically.
B) They are vertical lines on the anterior chest bisecting the clavicles. Each of these lines pass just medial to the nipples.
C) It is an imaginary line on the lateral chest extending downward from the center of the armpit.
D) It is an imaginary line on the posterior chest descending along the vertebral column.
Answer: A
Q2) A patient had a respiratory rate of 16/minute with an I:E ratio of 1:2.How would you record this in the patient's chart?
A) Normocapnia
B) Eupnea
C) Hyperpnea
D) Normopnea
Answer: B
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5
Chapter 4: Radiologic Assessment
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Q1) The respiratory care practitioner evaluates the patient's chest x-ray to determine any abnormalities.The practitioner evaluates the lung field and the diaphragms.Which hemidiaphragm should be higher than the other?
A) The right hemidiaphragm
B) The left hemidiaphragm
C) They both should be at the same level
D) The hemidiaphragm over the stomach
Q2) Which of the following is the most radiodense?
A) Air
B) Water
C) Fat
D) Bone
Q3) By comparing which views of the chest can a three-dimensional image be created?
A) Posterior-anterior film, lateral film
B) Lordotic film, anterior-posterior film
C) Anterior-posterior film, posterior-anterior film
D) Lordotic film, lateral film
Q4) A patient with a bilateral hyperresonant percussion note has a chest x-ray taken.What would you expect to find on the chest x-ray?
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Chapter 5: Pulmonary Function Testing
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Q1) Which of the following measurements can not be monitored at the patient's bedside?
I.Minute volume
II.Peak flow
III.Tidal volume
IV.Negative inspiratory force
A) I and II
B) III and IV
C) I, II, III, IV
D) I, III, and IV
Q2) Patient cooperation must be elicited for the best pulmonary function test results.How would the technician elicit the best cooperation and test results from the patient?
Q3) What is defined as the amount of air moved into or out of a resting patient's lungs with each normal breath?
A) Inspiratory reserve volume (IRV)
B) Expiratory reserve volume (ERV)
C) Tidal volume (Vt)
D) Minute volume
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Chapter 6: Electrocardiography
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Q1) Which of the following waves in an ECG tracing represents ventricular depolarization?
A) 'P' wave
B) 'QRS' complex
C) 'T' wave
D) 'U' wave
Q2) The patient must always be placed _________ for an ECG.
A) in semi-fowler's position
B) in a chair
C) prone
D) supine
Q3) What lead is placed at the 5th intercostal space,anterior axillary line?
A) V3
B) V4
C) V5
D) V6
Q4) A female patient comes to the emergency department complaining of chest pain.She is from a very conservative culture and objects to a male performing her EKG.How should the male practitioner approach this problem since no female is available to do the EKG?
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Chapter 7: Phlebotomy
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Q1) Place the following steps of the venipuncture procedure in the correct order.
I.Identify yourself to the patient and explain the procedure
II.Check the blood drawing order and patient identification
III.Dress the site
IV.Prepare the skin for venipuncture
A) II, I, IV, III
B) I, II, III, IV
C) II, IV, I, III
D) I, II, IV, III
Q2) 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
Q3) A tourniquet can be used to enhance vein distension to ease the location of a good vein for a venous draw.What would happen if the tourniquet were left on too long?
Q4) How can the phlebotomist enhance sites to draw blood from a patient?
Q5) How does the phlebotomist gain the confidence of the patient for a blood draw?
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Chapter 8: Arterial Blood Gas Sampling
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Q1) What are capillary blood gas values that most closely correlate with arterial blood gas values in the newborn patient?
A) PaCO
B) pH
C) PaO
D) a and b
Q2) What is the maximum amount of time that a blood gas sample should be stored at room temperature in a plastic syringe when storing an arterial blood gas for a shunt study?
A) 5 minutes
B) 30 minutes
C) 30 seconds
D) 10 minutes
Q3) Possible complications of arterial puncture at any site are vessel trauma and occlusion,embolization,infection,and vessel spasm.How could these be prevented?
Q4) What should the practitioner teach the patient concerning an arterial line?
Q5) How should the practitioner ensure that the arterial line's measured blood pressure is accurate?
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Chapter 9: Hemodynamic Monitoring
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Q1) Common causes of increased pulmonary artery pressures include _________________.
A) left atrial failure.
B) left ventricular failure.
C) hypovolemia.
D) reduced venous return.
Q2) The hemodynamic data are recorded from a pulmonary artery catheter on a patient who is being mechanically ventilated.
\( \begin{array}{lc}\text { Cardiac Output } & 6.0 \mathrm{~L} / \mathrm{min} \\ \mathrm{PAP} & 44 / 22 \mathrm{mmHg} \\ \text { PCWP } & 18 \mathrm{mmHg} \\ \text { CVP } & 7 \mathrm{mmHg} \\ \mathrm{HR} & 105 / \mathrm{min}\end{array} \)
How would the practitioner interpret this data and what treatment should be recommended?
Q3) PEEP _________________________________
A) increases the PCWP reading.
B) Increases the CVP reading.
C) increases cardiac output.
D) increases the CVP and PCWP reading.
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Page 11
Chapter 10: Noninvasive Monitoring
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Q1) What would be indicated for the monitoring the matching of ventilation to perfusion during independent lung ventilation for unilateral pulmonary contusion?
A) Pulse oximetry
B) Minute volume
C) Capnography
D) Transcutaneous oxygen monitoring
Q2) What is the standard by which noninvasive monitors are compared?
A) Capnography
B) Pulmonary artery pressure monitoring
C) Transcutaneous P02 monitoring
D) Blood gas analysis
Q3) Which of the following are limiting factors of pulse oximeters?
I.Vascular dyes
II.Motion
III.Ambient light
IV.Nail polish
A) I and II only
B) III and IV only
C) IV only
D) I, II, III, and IV
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Chapter 11: Documentation and Goals Assessment
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Q1) 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
Q2) How are entries entered into the medical record?
A) In chronological order
B) In random order
C) In order of department
D) Alphabetical order
Q3) When attempting to achieve ventilation goals the respiratory care practitioner should assess the ________________.
A) PaO .
B) SaO .
C) PaCO .
D) HCO .
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Chapter 12: Oxygen Supply Systems
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Q1) Because of the high pressure contained in a medical gas cylinder,a device is needed to contain the gas and to provide a point of attachment for equipment.What is this called?
A) Outlet
B) Stem
C) Pin valve
D) Cylinder valve
Q2) What is the purpose of 'cracking' a cylinder before use?
A) This primes the system with oxygen so there is no air mixed in with the oxygen with the first part of the gas delivered to the patient.
B) This removes any dust, or particulate matter, from the outlet of the cylinder valve.
C) It causes the regulator to become pressurized precisely to 50 psi before gas is delivered to the patient.
D) It pressurizes the cylinder to make sure it will not leak and compensate for the cylinder until the cylinder is hydrostatically tested.
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14
Chapter 13: Oxygen Administration
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Q1) Ventilatory depression may occur in spontaneously breathing patients with elevated PaCO .The PaO should be kept around what level to prevent this complication?
A) 60%
B) 90 mmHg
C) 40 mmHg
D) 60 mmHg
Q2) A respiratory care practitioner sets up an oxygen device on a patient.How should the practitioner document the oxygen?
A) The flowrate or FI0<sub>2</sub>
B) The oxygen device
C) Date and time of set-up
D) All of these
Q3) During oxygen rounds,a patient on a nasal cannula has an oxygen saturation of 89%.No flow is felt coming from the device.What could be the problem?
Q4) A patient has an oxygen saturation of 95% on room air.The patient's vital signs reveal a heart rate of 120/minute with occasional PVCs,a respiratory rate of 38/minute,and mild cyanosis of the patient's mucous membranes.What should be done?
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Chapter 14: Introduction to Respiratory Care Pharmacology
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Q1) An aerosol drug is ordered on a patient in MDI form.The propellant causes a reflex bronchospasm in the patient.What can be done?
Q2) Stimulation of the beta 2 receptors causes ___________________
A) peripheral vasoconstriction and mild bronchoconstriction in the lungs.
B) tachycardia, an increased potential for arrhythmias, and an increased cardiac output.
C) bronchodilation.
D) peripheral vasodilation, bradycardia, and decreased cardiac output.
Q3) Inhibition of the sympathetic nervous system would cause _________________
A) bronchoconstriction.
B) stridor.
C) bronchodilation.
D) relaxation of the bronchial smooth muscle.
Q4) Which of the following is a frequently nebulized antibiotic for patients with cystic fibrosis?
A) Pentamidine
B) Ribvirin
C) Sodium bicarbonate
D) Tobramycin
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Page 16
Chapter 15: Humidity and Aerosol Therapy
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Q1) Connection of a large-volume nebulizer to the correct type flowmeter is ensured because the connection incorporates a:
A) PISS fitting at the top of the unit.
B) ASSS fitting at the top of the unit.
C) DISS fitting at the top of the unit.
D) 15 mmID fitting at the top of the unit
Q2) Back pressure exerted downstream from the nebulizer will cause
A) the aerosol output to increase.
B) the total flow output of the unit to increase.
C) the delivered FIO to increase.
D) the amount of air entrained through the entrainment ports to increase.
Q3) If a gas is fully saturated with water vapor (100% saturated),what can be stated about the gas?
A) It is at body humidity.
B) It is at maximum humidity.
C) The relative humidity is 50%.
D) The temperature of the gas is 37°C.
Q4) 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 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?
Q2) During bronchial hygiene therapy in the Trendelenburg position,the patient vomits and aspirates.What intervention would be the most correct for the Respiratory Care Practitioner to take at this time?
A) Administer 100% oxygen, stop therapy immediately, return patient to original resting position, and consult physician.
B) Stop therapy, clear airway and suction as needed, administer oxygen, maintain airway, return patient to previous resting position, and contact physician immediately.
C) Stop therapy, administer oxygen, maintain airway, and return the patient to previous resting position.
D) Administer oxygen, maintain airway, and contact physician immediately.
Q3) Which of the following is NOT a hazard or complication of a directed cough?
A) Increased cerebral perfusion
B) Chest pain
C) Fatigue
D) Headaches
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18
Chapter 17: Hyperinflation Therapy
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Q1) Which of the following is NOT an indication for incentive spirometry?
A) Presence of pulmonary atelectasis
B) Inability to clear secretions adequately because of pathology that severely limits the ability to cough effectively
C) Presence of a restrictive lung defect associated with quadriplegic and/or dysfunctional diaphragm
D) Presence of conditions predisposing to the development of pulmonary atelectasis
Q2) Which of the following volumes would indicate that a 55-kg,post-operative male patient needs IPPB?
A) Vital capacity of 0.75 L
B) Inspiratory capacity of 1/2 of predicted
C) Vital capacity of 450 ml
D) Inspiratory capacity 1.2 L, predicted inspiratory capacity of 2.9 L
Q3) After inhalation during IPPB therapy,exhalation should _________________
A) take place quickly to maintain an I:E ratio of 1:1.
B) be performed against resistance to prolong exhalation.
C) take place forcefully.
D) take place passively.
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19
Chapter 18: Bronchoscopy Assisting
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Q1) Which type of testing and analysis performed on bronchoscopic sample would be performed to detect cancerous cells?
A) Cytologic testing
B) Microbiologic testing
C) Histological testing
D) Protozoal testing
Q2) A rigid bronchoscope cannot remove large foreign body in the tracheobronchial tree in the airways lower than the _________________
A) trachea.
B) mainstem bronchi.
C) segmental bronchi.
D) terminal bronchioles.
Q3) Which type of sample obtained by bronchoscopic analysis should be fixated in a formalin solution?
A) Sample for cytological analysis
B) Sample for histological analysis
C) Sample for microbiological analysis
D) Sample for fungal analysis
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Chapter 19: Equipment Processing and Surveillance
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Q1) If Staphylococcus epidermidis or other nonpathogenic members of the normal flora are cultured on clean or in-use equipment,what is the most likely contamination source?
A) The person conducting the culturing.
B) Contaminated liquid in an aerosol device.
C) The sterilization gas used in the processing of the equipment.
D) Gamma irradiation of the equipment.
Q2) Which of the following bacteria is NOT gram negative?
A) Streptococcus
B) Serratia
C) Klebsiella
D) Legionella
Q3) Which of the following is NOT a main area of an equipment processing facility?
A) Decontamination
B) Processing
C) Storage
D) Manufacture
Q4) What types of vaccines should a health care worker undergo routinely?
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Chapter 20: Emergency Airway Management
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Q1) All of the following are conditions requiring management of the airway EXCEPT
A) secretions in the airway.
B) respiratory failure.
C) airway compromise.
D) the need to protect the airway.
Q2) Which resuscitation bag would be the best to assess a patient's compliance of the lungs and thorax?
A) Self-inflating resuscitator
B) Flow-inflating resuscitator
C) Gas-powered resuscitator
D) Manual resuscitator
Q3) A patient needs to placed on mechanical ventilation.For intubation,the practitioner selects a Macintosh laryngoscope blade.Where in the airway should the tip of the blade be placed?
A) The tip directly lifts the epiglottis.
B) The distal tip is placed in the vallecula.
C) The tip is placed on the left side of the tongue and positioned until the trachea is visualized.
D) The tip is inserted posteriorly to the trachea to ensure tracheal intubation.
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Chapter 21: Artificial Airway Care
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Q1) A patient has been placed on mechanical ventilation.The respiratory care practitioner needs to know the absolute contraindication to suctioning a patient through an endotracheal tube that is on mechanical ventilation is:
A) a bronchospasm.
B) coagulopathy.
C) an irritable airway.
D) none of these.
Q2) A patient on mechanical ventilation has been suctioned and a large amount of thick secretions are obtained.Which of the following clinical signs would you expect after suctioning?
A) More pressure limiting delivering the tidal volume
B) Deterioration of the patient's arterial blood gases
C) Increased PIP/plateau pressure difference
D) Decreased PIP/plateau pressure difference
Q3) Which of the following would help the patient with a tracheostomy talk?
A) Single cuff tracheostomy tube
B) Passy-Muir valve
C) Minimal occluding volume
D) Minimal leak technique
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Page 23
Chapter 22: Chest Tubes
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Q1) A pneumothorax develops while a patient is being mechanically ventilated.A chest tube is placed and the lung fails to seal.There is a large amount of air bubbling through the water seal chamber.What could be causing this?
Q2) Which of the following drugs would you suggest to the physician as an analgesic to help relax the patient before the insertion of a chest tube?
A) 4% Lidocaine
B) Midazolam
C) Providone-iodine
D) Aspirin
Q3) Which part/chamber of the chest tube would collect blood from a patient who has suffered chest trauma?
A) Collection chamber
B) Water seal chamber
C) Chest tube tubing
D) Suction control chamber
Q4) A patient with a chest tube in place suddenly develops chest pain and severe respiratory distress.What could be causing this?
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24
Chapter 23: Insertion and Maintenance of Intravenous Lines
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Q1) Which of the following is an example of a hypertonic solution?
A) 0.9% NaCl
B) Plasma
C) Mannitol
D) 0.225% NaCl
Q2) What is inflammation of the vein called?
A) Phlebitis
B) Cellulitis
C) Thrombosis
D) Arteriosclerosis
Q3) A 0.225% NaCl solution is classified as which type of solution?
A) Hypotonic solution
B) Hypertonic solution
C) Isotonic solution
D) Lactated Ringer's solution
Q4) What is the preferred IV site on an adult patient?
A) The smallest artery that can be accessed
B) In the radial artery of the non-dominant hand
C) The temporal vein
D) A vein on the non-dominant hand or arm of the patient
25
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Chapter 24: Noninvasive Positive-Pressure Ventilation
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Q1) The respiratory care practitioner is called to the medical intensive care unit to evaluate a pneumonia patient for impending ventilatory failure.Arterial blood gases (ABGs)are drawn and the results are as follows: PaO 49 mmHg,PaCO 58 mmHg,pH 7.24,HCO 23 mEq/L,FIO 0.6.What do the patient's ABGs indicate?
A) The patient has impending ventilatory failure.
B) The patient has normal PaO status for an increased FIO .
C) The patient has chronic ventilatory failure.
D) The patient's RSBI needs to be measured to determine ventilatory status.
Q2) A patient is set up on NPPV without humidification.Which of the following should the practitioner tell the nurse are potential hazards of inadequate humidification?
A) Drying of the respiratory mucosa
B) Mucous plugging
C) Gastric insufflation
D) a and b
Q3) A COPD patient is being ventilated on a noninvasive positive-pressure ventilation (NPPV)in the spontaneous/timed mode of ventilation.The ventilator is not triggering each time the patient attempts to initiate a breath.What can be done?
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26
Chapter 25: Continuous Mechanical Ventilation
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Q1) In the face of changing airway resistance or thoracic compliance,which of the following will occur in volume ventilation?
A) Pressure is selected as the controlled variable
B) Volume will change while pressure will stay the same
C) Pressure will vary but the tidal volume will remain unchanged
D) Pressure will stay the same but FIO will vary with back pressure
Q2) 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
Q3) The high pressure limit alarm is used to ____________________
A) prevent ventilator disconnect from the patient.
B) protect the lungs from over distention and injury.
C) identify when unauthorized individuals decrease the volume setting.
D) adjust the pressure limit in PCV.
Q4) How does a practitioner measure airway resistance on a ventilator?
Q5) How is tubing compliance determined?
Q6) What is the difference in calculating dynamic compliance vs static compliance?
Page 27
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Chapter 26: Advanced Modes of Mechanical Ventilation
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Q1) Inverse ratio ventilation is __________________
A) where the expiratory phase is longer than inspiration.
B) best described a expiratory retard.
C) when inspiration is longer than expiration.
D) is an I:E of 1:1.1
Q2) Rapid shallow breathing index is used _______________________
A) to measure effectiveness of oxygenation.
B) to identify the settings used in high frequency ventilation.
C) in assessment of neonates and infants.
D) to quantify the relationship between tidal volume and respiratory rate.
Q3) Tidal volume delivery during APRV is __________________
A) affected by lung compliance.
B) affected by airway resistance.
C) affected by Phigh and Plow.
D) all of the above.
Q4) The goal of inverse ratio ventilation is to ____________________
A) decrease carbon dioxide by over inflation of the alveoli.
B) increase mean airway pressure to improve oxygenation in ARDS.
C) hyperextend alveoli to increase pulmonary vascular resistance.
D) increase air trapping by lengthening inspiration
Page 28
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Chapter 27: Wave Form Analysis
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Q1) With the pressure versus volume loop,which of the following are true?
I.Volume is displayed on the vertical axis.
II.Positive pressure is on the right of the vertical axis
III.With ventilator inspiration,the graph moves from zero upward and to the right
A) I, II and III
B) I and II
C) II and III
D) I and III
Q2) Which graphic displays can indicate adequacy of inspiratory flow during a ventilator inspiration and how are they used?
Q3) 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.
Q4) As the respiratory care practitioner assigned to a ventilator patient,how would you use ventilator graphics to identify patient effort?
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Page 29
Chapter 28: Weaning and Discontinuance of Mechanical Ventilation
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30 Flashcards
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Sample Questions
Q1) According to the AARC Clinical Practice Guidelines on Weaning and Discontinuation on Ventilatory Support,adequate patient oxygenation criteria for weaning is measured by
I.PaO greater than 60 mm Hg
II.FIO set less than 0.4
III.PEEP zero
IV.PO /FIO ratio greater than 150-300
A) I, II, III and IV
B) I, II and III
C) I, II and IV
D) II, III and IV
Q2) Prior to weaning or discontinuing ventilatory support the first step a respiratory therapist should take is to ______________
A) identify the hospital critical care census.
B) assess the amount and level of sedation.
C) determine if the patient has ventilator associated pneumonia.
D) determine if the cause of ventilator failure has been resolved.
Q3) How do respiratory conditions result in ventilator dependence?
Q4) How do cardiovascular problems 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
Available Study Resources on Quizplus for this Chatper
34 Verified Questions
34 Flashcards
Source URL: https://quizplus.com/quiz/40363
Sample Questions
Q1) When using time-cycled,pressure-limited,IMV,the respiratory care practitioner will set the length of inspiratory time and pressure.What will happen if the pressure is reached before inspiratory time ends?
A) Pressure limiting will end inspiration
B) Pressure limiting will result in loss of tidal volume
C) The ventilator pressure alarm will sound
D) Pressure limiting will result in inspiratory plateau
Q2) The respiratory care practitioner wants to use a spontaneous mode of ventilation that will provide a continuous flow of oxygenated gas at a pressure slightly above ambient pressure on both inspiration and expiration.The practitioner wants to use
A) CPAP.
B) SIMV.
C) PRVC.
D) PS.
Q3) Describe how the initial newborn ventilator setting are determined for mode,rate and flow rate.
Q4) Describe the 5 characteristics of the Apgar scoring system.
Q5) Describe how the initial newborn ventilator alarm setting are determined.
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