Cardiopulmonary Diagnostics Exam
Review
Course Introduction
Cardiopulmonary Diagnostics explores the principles and techniques used to assess the function of the heart and lungs. The course covers topics such as pulmonary function testing, electrocardiography (ECG), arterial blood gas analysis, stress testing, and imaging modalities like echocardiography and chest radiography. Students learn to interpret data from diagnostic procedures, understand indications and contraindications, and apply clinical reasoning in the evaluation of common cardiopulmonary disorders. Practical laboratory sessions reinforce skills in conducting and analyzing diagnostic tests, preparing students for roles in clinical and laboratory settings.
Recommended Textbook
Egans Fundamentals of Respiratory Care 9th Edition by Robert M. Kacmarek
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Chapter 1: History of Respiratory Care
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Sample Questions
Q1) Who introduced the use of soft rubber endotracheal tubes around 1930?
A)Davidson
B)McGill
C)Haight
D)Murphy
Answer: B
Q2) Which of the following is NOT predicted to be a growing trend in respiratory care for the future?
A)greater use of respiratory therapy protocols
B)increased need for patient assessment skills
C)increased involvement in smoking cessation programs
D)increased use of intravascular lines for patient monitoring
Answer: D
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Chapter 2: Quality and Evidence-Based Respiratory Care
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Sample Questions
Q1) For the CRT credential, what does the letter "T" stand for?
A)therapist
B)technician
C)trainee
D)teacher
E)none of the above
Answer: A
Q2) What is the most essential aspect of providing quality respiratory care?
A. Care being provided is indicated.B. Care is delivered competently and appropriately.C. Patient is appropriately evaluated by physician before care is initiated.D. A and B.E. A, B, and C.
A)Care being provided is indicated.
B)Care is delivered competently and appropriately.
C)Patient is appropriately evaluated by physician before care is initiated.
D)A and B
E)A,B and C
Answer: D
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Chapter 3: Patient Safety, Communication, and Record Keeping
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Sample Questions
Q1) Which of the following is used to report electrical current?
A)Ohms
B)voltage
C)amps
D)cycles
Answer: C
Q2) To determine any recent trends in a patient's pulse, respiration, or blood pressure, you would go to which section of the medical record?
A)progress sheet
B)nurses' notes
C)anesthesia record
D)vital signs sheet
Answer: D
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Page 5
Chapter 4: Principles of Infection Control
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Sample Questions
Q1) What is the most common, efficient, and easiest sterilization method?
A)ETO
B)flash sterilization
C)steam sterilization
D)use of hydrochlorofluorcarbon
Q2) Which of the following statements is NOT true regarding the use of alcohol disinfectants?
A)Their activity drops when diluted below 50% concentration.
B)Alcohols are good for surface cleaning of stethoscope bells and diaphragms.
C)They can damage rubber tubing.
D)They are considered sporicidal.
Q3) What is the minimum recommended time for handwashing in the health care environment?
A)5 seconds
B)15 seconds
C)30 seconds
D)60 seconds
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Chapter 5: Ethical and Legal Implications of Practice
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Sample Questions
Q1) Contemporary ethical principles have evolved from all of the following sources except:
A)natural law (Aristotle and Aquinas)
B)psychoanalysis (Freud)
C)Jewish and Christian morality
D)universal duties (Kant)
Q2) The moral basis for rationing health care services falls under what ethical principle?
A)compensatory justice
B)harm
C)distributive justice
D)role duty
Q3) All of the following are common elements in a professional practice act except:
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) Which of the following methods would increase the rate of evaporation of a container of water?
I.Increase the temperature of the surrounding air.
II.Decrease the pressure of the surrounding air.
III.Increase the temperature of the water.
A)I and II
B)II and III
C)I and III
D)I, II, and III
Q2) According to Bernoulli's principle, as a fluid flows through a narrow passage or stricture, which of the following will occur?
I.Fluid velocity will decrease.
II.Lateral pressure will fall.
III.Total energy will increase.
A)II and III
B)I and II
C)I and III
D)II
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Chapter 7: Computer Applications in Respiratory Care
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Sample Questions
Q1) What is the name of the database management system for documenting and reporting clinical educational activities for nursing and the allied health professions?
A)DataARC
B)DataFILE
C)DataBASE
D)DataNOW
Q2) What software program is useful for creating spreadsheets, creating data files, and performing calculations on the data?
A)Microsoft Word
B)Microsoft PowerPoint
C)Microsoft Excel
D)Microsoft Access
Q3) What is the name of the database often purchased and used by hospitals and university libraries to provide key research information on a large variety of medical topics?
A)SPAN
B)OVID
C)CINUP
D)MITO
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Page 9
Chapter 8: The Respiratory System
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Sample Questions
Q1) What is your primary concern if you discover that a patient does not have a gag reflex?
A)fear of aspiration of bacteria or food
B)that their tonsilar tissues are grossly swollen
C)that they will not be able to breathe adequately
D)tracheal collapse
Q2) How short could the trachea of small preterm infant to be?
A)2 cm
B)4 cm
C)6 cm
D)8 cm
Q3) What could the "effort closure" of the larynx facilitate?
A)crying
B)talking
C)whispering
D)yelling
Q4) Infants are more susceptible to profound hypoxemia than are adults.
A)true
B)false
C)unable to determine
Page 10
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Chapter 9: The Cardiovascular System
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Sample Questions
Q1) What is the primary function of local or intrinsic cardiovascular control mechanisms?
A)alter local blood flow according to tissue needs
B)alter the rate of cardiac contractions
C)maintain a basal level of systemic vascular tone
D)control the capacity of the venous reservoir
Q2) The underlying goal of the body's cardiovascular control mechanisms is to ensure that all tissues receive which of the following?
A)blood flow according to their mass
B)blood flow according to their size
C)equivalent amounts of blood flow
D)perfusion according to their metabolic needs
Q3) What is the affect on the cardiovascular medullary centers when the cerebral carbon dioxide is low?
A)excitatory
B)inhibitory
C)no affect
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11
Chapter 10: Ventilation
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Sample Questions
Q1) A fibrotic lung would exhibit which of the following characteristics?
A)decreased airway resistance
B)decreased lung compliance
C)decreased PVR
D)decreased surface tension
Q2) Normal Raw is approximately which of the following?
A)0.1 to 0.2 cm H<sub>2</sub>O/L/sec
B)0.5 to 2.5 cm H<sub>2</sub>O/L/sec
C)15.0 to 20.0 cm H<sub>2</sub>O/L/sec
D)20.0 to 25.0 cm H<sub>2</sub>O/L/sec
Q3) How is airway resistance (Raw) computed?
A)change in pressure/change in volume
B)change in pressure/flow
C)change in volume / change in pressure
D)change in volume/change in pressure
Q4) How is compliance computed?
A)change in pressure/change in flow
B)change in pressure/change in volume
C)change in volume/change in flow
D)change in volume/change in pressure
Page 12
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Chapter 11: Gas Exchange and Transport
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Sample Questions
Q1) Given the following blood parameters, compute the total oxygen content (dissolved + HbO<sub>2</sub>) of the blood in ml/dl: Hb = 16; PO<sub>2</sub> = 625 Hg; SO<sub>2</sub> = 100%.
A)17.8 ml/dl
B)19.4 ml/dl
C)21.4 ml/dl
D)23.3 ml/dl
Q2) According to the Bohr effect, when the pH drops (blood becomes more acidic), what happens?
I .The affinity of Hb for oxygen decreases.
II.The Hb saturation for a given PO<sub>2</sub> falls.
III.The Hb saturation for a given PO<sub>2</sub> rises.
A)I and II
B)II only
C)II and III
D)I, II, and III
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Chapter 12: Solutions, Body Fluids, and Electrolytes
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Sample Questions
Q1) What is the normal range for serum phosphate?
A)1.2 to 2.3 mEq/L.
B)3.5 to 5.8 mEq/L
C)9.0 to 10.5 mEq/L
D)98.0 to 106.0 mEq/L
Q2) Which of the following describe roles played by HCO<sub>3</sub><sup>-</sup>?
I.HCO<sub>3</sub><sup>-</sup>levels vary directly with Cl<sup>-</sup> levels.
II.It is the primary vehicle for blood carbon dioxide transport.
III.It plays a key role in acid-base homeostasis.
A)I, II, and III
B)I and III
C)II only
D)II and III
Q3) What are normal values for serum Mg<sup>2+</sup>?
A)1.3 to 2.1 mEq/L.
B)3.5 to 4.8 mEq/L
C)9.0 to 10.5 mEq/L
D)98.0 to 105.0 mEq/L
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Chapter 13: Acid-Base Balance
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Sample Questions
Q1) What is the role of carbonic anhydrase in the kidneys?
A)It drives the recovery of HCO<sub>3</sub><sup>-</sup> and excretion of H<sup>+</sup>.
B)It is the catalyst for the hamburger phenomenon.
C)It promotes the excretion of CO<sub>2</sub> in the urine.
D)It promotes the loss of fluids in congestive heart failure.
Q2) Metabolic acidosis may be caused by:
I.an increase in fixed (nonvolatile) acids
II.an increase in blood carbon dioxide (CO<sub>2</sub>)
III.excessive loss of bicarbonate (HCO<sub>3</sub><sup>-</sup>)
A)I
B)I and II
C)I, II, and III
D)I and III
Q3) What condition or treatment could cause iatrogenic respiratory alkalosis?
A)central nervous system stimulation
B)mechanical hyperventilation
C)severe hypoxemia
D)vagal stimulation
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Page 15
Chapter 14: Regulation of Breathing
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Sample Questions
Q1) Which of the following centers respond more strongly to high levels of CO<sub>2</sub>?
A)aortic chemoreceptors
B)carotid chemoreceptors
C)central chemoreceptors
D)ventral respiratory centers
Q2) Which statements describe aspects of the Hering-Breuer reflex?
I.It affects the rate and depth of breathing during exercise.
II.It is only activated at large tidal volumes in normal adults.
III.Its impulses travel via the vagus nerve to the dorsal respiratory groups (DRGs).
IV.Its receptors are located in the large and small airways.
A)I
B)I and II
C)II, III, and IV
D)I, II, III, and IV
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Chapter 15: Bedside Assessment of the Patient
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Sample Questions
Q1) Which of the following are true of early inspiratory crackles?
I.They most often occur in COPD patients.
II.They generally indicate severe airway obstruction
III.They are not affected by coughing or positional change.
IV.They are usually scant (few in number).
A)II and IV
B)I, II, and III
C)I, III, and IV
D)I, II, III, and IV
Q2) What is the normal range for diastolic blood pressure in the adult patient?
A)40 to 80 mm Hg
B)60 to 90 mm Hg
C)80 to 110 mm Hg
D)60 to 110 mm Hg
Q3) Which of the following is associated with tripodding?
A)severe pulmonary hyperinflation
B)congestive heart disease
C)pneumonia
D)pulmonary fibrosis
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Page 17
Chapter 16: Interpretation of Clinical Laboratory Data
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Sample Questions
Q1) What test is useful for evaluating the blood-clotting ability of your patient?
A)red blood cell count
B)platelet count
C)neutrophil count
D)hematocrit
Q2) Which of the following is NOT one of the formed elements in the blood?
A)leukocytes
B)erythrocytes
C)thrombocytes
D)electrolytes
Q3) What is the name used for immature neutrophils?
A)segs
B)bands
C)polys
D)monos
Q4) What is the normal anion gap?
A)5 to 10 mEq/L
B)8 to 16 mEq/L
C)25 to 32 mEq/L
D)35 to 45 mEq/L
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Chapter 17: Interpreting the Electrocardiogram
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Sample Questions
Q1) Which of the following clinical conditions is not associated with tachycardia?
A)anxiety
B)hypoxemia
C)pain
D)hypothermia
Q2) Sources for the electrical impulse that triggers cardiac contraction that lie outside the sinoatrial node are referred to as ectopic foci.
A)True
B)False
Q3) What is a possible serious complication associated with atrial fibrillation?
A)pulmonary edema
B)atrial thrombi
C)cardiac tamponade
D)cardiac standstill
Q4) An occasional premature ventricular complex (PVC) is not of major concern.
A)True
B)False
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Chapter 18: Analysis and Monitoring of Gas Exchange
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Sample Questions
Q1) Components of a laboratory blood gas analyzer include which of the following?
I.three-electrode measuring chamber
II.reagent containers
III.calibrating gas tanks
IV.waste container
A)I, II, and IV
B)II and III
C)II and IV
D)I, II, III, and IV
Q2) A patient being monitored by capnography exhibits a sudden rise in end-tidal CO<sub>2</sub> levels. All of the following are possible causes of this change except:
A)sudden release of a tourniquet
B)massive pulmonary embolism
C)sudden increase in cardiac output
D)injection of NaHCO<sub>3</sub>
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Chapter 19: Pulmonary Function Testing
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Sample Questions
Q1) What is a normal single-breath diffusing capacity for carbon monoxide for a young, healthy man of average size?
A)10 ml/min/mm Hg
B)20 ml/min/mm Hg
C)30 ml/min/mm Hg
D)40 ml/min/mm Hg
Q2) Under which of the following conditions would you postpone a diffusing capacity test?
I. Just before the test, the patient smoked two cigarettes.
II. Just before the test, the patient had an episode of severe coughing.
III. Just before the test, the patient had a long wait at a busy bus stop.
A)I
B)I and III
C)II and III
D)I, II, and III
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Chapter 20: A Review of Thoracic Imaging
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Sample Questions
Q1) Which of the following structures will result in the most radiopaque shadow on the chest radiograph?
A)aorta
B)heart
C)lungs
D)ribs
Q2) What is the most common cause of lobar atelectasis?
A)bronchial obstruction
B)loss of surfactant
C)viral pneumonia
D)pleurisy
Q3) What is indicated by rounding of the costophrenic angles seen on the posteroanterior or lateral chest film?
A)emphysema
B)excess pleural fluid
C)obesity
D)rib fractures
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Chapter 21: Nutrition Assessment
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Sample Questions
Q1) Which of the following metabolism issues is NOT associated with systemic inflammatory response syndrome (SIRS)?
A)hypoglycemia
B)protein catabolism
C)increased macronutrient requirement
D)triglyceride intolerance
Q2) What effect does high carbohydrate intake have on metabolism?
A)increases CO<sub>2</sub> production
B)reduces oxygen consumption
C)increases caloric needs
D)reduces protein catabolism
Q3) What procedure is used to overcome the limitations associated with estimating resting energy expenditures?
A)measuring blood glucose before and after exercise
B)monitoring body temperature during heavy exercise
C)indirect calorimetry
D)the Douglas procedure
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Chapter 22: Pulmonary Infections
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Sample Questions
Q1) ATS guidelines suggest using which of the following antibiotics if methicillin-resistant S. aureus is a concern?
A)cefazolin
B)doxycycline
C)penicillin
D)vancomycin
Q2) What antibiotic is the drug of choice for the patient with nonresistant S. pneumoniae?
A)ampicillin
B)azithromycin
C)penicillin
D)vancomycin
Q3) Which of the following organisms that cause pneumonia is most likely to result in a positive blood culture?
A)Chlamydia pneumoniae
B)Haemophilus influenzae
C)Mycoplasma pneumoniae
D)Pneumocystis jiroveci
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24
Chapter 23: Obstructive Lung Disease: Copd, Asthma, and Related Diseases
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Sample Questions
Q1) Which bronchodilator is commonly used in the hospital management of acute asthma exacerbation but is not the first-line bronchodilator?
A)albuterol
B)ipratropium bromide
C)salmeterol
D)terbutaline
Q2) Which of the following signs associated with COPD is considered a late manifestation?
A)accessory muscle usage
B)frequent coughing
C)shortness of breath
D)wheezing
Q3) What causes the degranulation of mast cells in asthma patients?
A)antigens attaching to IgE molecules on the mast cell surface
B)antigens attaching to proteins receptors on mast cell surface
C)irritant receptors on the mast cells are stimulated by antigens
D)infectious particles attacking the mast cells
Q4) Which form of COPD is most common?
A)chronic bronchitis
B)emphysema
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Chapter 24: Interstitial Lung Disease
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Sample Questions
Q1) The first line of treatment for patients with hypersensitivity pneumonitis is to avoid the offending agent.
A)True
B)False
Q2) A patient is exposed a second time to an antigen and subsequently seeks medical attention with sudden shortness of breath, chest pain, fever, chills, malaise, and a cough that may be productive of purulent sputum. What is the most likely cause of this pathology?
A)acute anaphylactic shock
B)acute hypersensitivity pneumonitis
C)allergic congestive heart failure
D)bronchial asthma
Q3) Indicate the typical chest radiographic findings of a patient with silicosis.
A)apical nodules
B)bibasilar reticulogranular appearance
C)lymphadenopathy
D)pleural plaque
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Chapter 25: Pleural Diseases
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Sample Questions
Q1) Which of the following findings on a radiologic report would indicate the presence of a tension pneumothorax?
A)bilateral inversion of diaphragm, long narrow heart, flattened ribs
B)blunting of costophrenic angles, marked interstitial infiltrates, apical free air
C)contralateral mediastinal shift, diaphragmatic depression, flattening of ribs
D)ipsilateral mediastinal shift, sail-shape noted right hemithorax, marked interstitial infiltrates right sided
Q2) When using a small-bore catheter with a one-way valve such as a Heimlich valve, how can you determine definitively that there is or is not a small air leak?
A)Connect to an underwater seal.
B)Increase the FIO<sub>2</sub> and note clinical changes.
C)Listen for air movement.
D)Watch the valve to see if it moves.
Q3) Pleural effusion is a complication of ascites in less than 10% of the cases.
A)True
B)False
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Chapter 26: Pulmonary Vascular Disease
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Sample Questions
Q1) Approximately what percentage of patients with pulmonary embolism have a normal ECG?
A)10% to 15%
B)25% to 30%
C)40% to 60%
D)70% to 75%
Q2) Which of the following treatments is least useful in the treatment of the patient with idiopathic pulmonary artery hypertension?
A)oxygen
B)steroids
C)vasodilators
D)warfarin
Q3) At rest, what level does the mean pulmonary artery pressure need to reach before it is considered pulmonary hypertension?
A)>10 mm Hg
B)>15 mm Hg
C)>20 mm Hg
D)>25 mm Hg
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28
Chapter 27: Acute Lung Injury, Pulmonary Edema, and Multiple System Organ
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Sample Questions
Q1) Which of the following terms describes programmed cell death?
A)osmosis
B)apoptosis
C)mitosis
D)necrosis
Q2) According to the Starling's equation, which forces influence the movement of fluid from the bloodstream to the interstitium?
I.microvascular hydrostatic pressure
II.interstitial osmotic pressure
III.microvascular osmotic pressure
IV.interstitial hydrostatic pressure
A)I only
B)I and II
C)III and IV
D)I and IV
Q3) What time does the exudative phase of ARDS typically presents?
A)between days 1 and 3
B)between days 4 and 7
C)after 1 week
D)after 1 month
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Chapter 28: Lung Cancer
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Q1) Which of the following organs is not commonly compromised in metastatic lung cancer?
A)brain
B)liver
C)bone
D)stomach
Q2) Which of the following is NOT associated with local tumor growth in the central airways?
A)large airway obstruction
B)cough
C)hemoptysis
D)fine crackles
Q3) What percentage of all cancer deaths are related to lung cancer?
A)less than 10%
B)about 30%
C)about 50%
D)more than 60%
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Page 30
Chapter 29: Neuromuscular and Other Diseases of the Chest Wall
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Q1) Which of the following would not be considered a common pulmonary consequence of neuromuscular disease?
A)sleep apnea
B)aspiration
C)cor pulmonale
D)pneumothorax
Q2) What is the most common peripheral neuropathy causing respiratory insufficiency?
A)Lambert-Eaton syndrome
B)amyotrophic lateral sclerosis
C)Guillain-Barré syndrome
D)myasthenia gravis
Q3) What is the approximate mean age of onset for amyotrophic lateral sclerosis?
A)26 years
B)36 years
C)46 years
D)56 years
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Chapter 30: Disorders of Sleep
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Sample Questions
Q1) Available evidence has shown that bilevel pressure is associated with better patient compliance than the conventional CPAP.
A)True
B)False
Q2) Which of the following conditions is not associated with untreated obstructive sleep apnea?
A)systemic hypotension
B)pulmonary hypertension
C)heart failure
D)myocardial infarction
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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Chapter 31: Neonatal and Pediatric Respiratory Disorders
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Sample Questions
Q1) Which of the following treatments is the least useful for the treatment of RDS?
A)CPAP
B)surfactant replacement therapy
C)high-frequency ventilation
D)bronchial hygiene techniques
Q2) Which of the following infant characteristics is associated with an increased risk of SIDS?
A)female gender
B)preterm birth
C)high APGAR score
D)full-term birth
Q3) What is believed to be the cause of transient tachypnea of the newborn (TTN)?
A)persistent hypoxemia
B)immature surfactant
C)delayed clearance of fetal lung fluid
D)persistent fetal circulation
Q4) Most infants with transient tachypnea are born premature.
A)True
B)False
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Chapter 32: Airway Pharmacology
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Sample Questions
Q1) Which of the following is the only inhaled human insulin available at this time?
A)Humulin
B)Exubera
C)Glucomax
D)No inhaled insulin has yet been approved.
Q2) Zileuton belongs to which of the following categories?
A)cromolyn-like agents
B)leukotriene modifiers
C)anti-IgE agents
D)anti-IgA agents
Q3) Which of the following is NOT considered an aerosolized antiinfective agent?
A)pentamidine
B)ribavirin
C)tobramycin
D)amikacin
Q4) What is the dosage for ipratropium bromide (Atrovent)?
A)2 puffs four times daily
B)2 puffs three times daily
C)2 puffs twice daily
D)2 puffs every 12 hours
34
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Chapter 33: Airway Management
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Q1) Which of the following tracheal tube cuff designs are used as alternatives to cuff pressure measurement?
I.Kamen-Wilkinson foam cuff
II.low-residual-volume cuff
III.Lanz pressure-regulated cuff
A)I and II
B)I and III
C)II and III
D)I, II, and III
Q2) For which of the following purposes is a tracheal button appropriate?
I.facilitate secretion removal
II.protect the airways from aspiration
III.relieve airway obstruction
IV.aid in positive-pressure ventilation
A)I and III
B)II and IV
C)III and IV
D)I, II, III and IV
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Chapter 34: Emergency Cardiovascular Life Support
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Sample Questions
Q1) When properly performed, mouth-to-mouth (expired air) ventilation provides about how much oxygen?
A)20%
B)16%
C)12%
D)30%
Q2) Most sudden deaths of cardiac origin are due to which of the following?
A)cardiac tamponade
B)ventricular aneurysm
C)mitral stenosis
D)cardiac arrhythmias
Q3) What is the most common cause of airway obstruction in unconscious patients?
A)foreign body lodged in the upper airway
B)oral or nasal secretions blocking the pharynx
C)tongue falling back into the pharynx
D)severe spasm of the laryngeal musculature
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Chapter 35: Humidity and Bland Aerosol Therapy
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Q1) What is the typical water vapor output of an unheated bubble humidifier?
A)5 to 10 mg/L
B)10 to 15 mg/L
C)15 to 20 mg/L
D)20 to 25 mg/L
Q2) Which of the following inspired conditions should be maintained when delivering medical gases to the nose or mouth?
A)50% relative humidity (RH) at 20° to 22° C
B)100% RH at 20° to 22° C
C)80% RH at 28° to 32° C
D)100% RH at 32° to 35° C
Q3) For which of the following patients might you recommend bland aerosol therapy administration?
I.patient with upper airway edema
II.patient with a bypassed upper airway
III.patient who must provide a sputum specimen
A)I, II, and III
B)II and III
C)I and II
D)I and III
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Chapter 36: Aerosol Drug Therapy
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Q1) Which of the following is false about the optimal technique for using a small-volume jet nebulizer (SVN) for aerosol drug delivery?
A)SVNs are less technique and device dependent.
B)Slow inspiration improves SVN aerosol deposition.
C)Deep breathing or breath-holding improves SVN deposition.
D)Use of a mouthpiece or mask provides similar results.
Q2) Advantages of the dry power inhaler (DPI) drug delivery systems include all of the following except:
A)low relative cost
B)no propellants required
C)no hand-breath coordination necessary
D)unaffected by humidity
Q3) When assessing a patient's response to bronchodilator therapy, you notice a decrease in wheezing accompanied by an overall increase in the intensity of breath sounds. Which of the following is most likely?
A)increasing airway obstruction
B)improving \(\dot { V } / \dot { Q }\)
C)decreasing airway obstruction
D)deteriorating oxygenation
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Page 38
Chapter 37: Storage and Delivery of Medical Gases
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Q1) In clinical practice, how is a positive identification made of the contents of a medical gas cylinder?
A)noting the color of the cylinder
B)inspecting the cylinder threads
C)reading the cylinder label
D)collecting and analyzing a gas sample
Q2) One cu/ft of liquid O<sub>2 </sub>is the equivalent of about how many cu/ft of gaseous O<sub>2</sub>?
A)28
B)244
C)360
D)860
Q3) 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>
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Chapter 38: Medical Gas Therapy
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Q1) Potential adverse effects associated with NO therapy include all of the following except:
A)poor or paradoxical response
B)increased blood clotting
C)increased left ventricular filling pressures
D)rebound hypoxemia or pulmonary hypertension
Q2) What is the minimum criterion for how often an O<sub>2</sub> delivery system should be checked according to the clinical practice guidelines from the AARC?
A)every 4 hours
B)every 8 hours
C)every 24 hours
D)every 48 hours
Q3) What is the minimum flow setting for a simple mask applied to an adult?
A)3 L/min
B)5 L/min
C)8 L/min
D)10 L/min
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Chapter 39: Lung Expansion Therapy
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Sample Questions
Q1) Lung expansion methods that increase the transpulmonary pressure gradients by increasing alveolar pressure include which of the following?
I.incentive spirometry (IS)II.positive end-expiration pressure therapy
III.intermittent positive-pressure breathing (IPPB)IV.expiratory positive airway pressure (EPAP)
A)I and II
B)II, III, and IV
C)I and III
D)I, II, III, and IV
Q2) What is the optimal breathing pattern for intermittent positive-pressure breathing (IPPB) treatment of atelectasis?
A)slow, deep breaths held at end-inspiration
B)rapid, deep breaths held at end-inspiration
C)slow, shallow breaths held at end-inspiration
D)rapid, shallow breaths held at end-inspiration
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Chapter 40: Bronchial Hygiene Therapy
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Q1) Which of the following should be charted after completing a postural drainage treatment?
I.amount and consistency of sputum produced
II.patient tolerance of procedure
III.position(s) used (including time)IV.any untoward effects observed
A)I, II, and III
B)II and IV
C)I, II, III, and IV
D)III and IV
Q2) Maintaining an open glottis during coughing (as with the FET) can help to minimize increases in pleural pressure and lessen the likelihood of bronchiolar collapse. Which of the following techniques can aid the practitioner in teaching the patient this maneuver?
A)having the patient inhale slowly through the nose
B)having the patient phonate or "huff" during expiration
C)having the patient "tense" the neck muscles while coughing
D)telling the patient to exert effort, as in straining at stool
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Chapter 41: Respiratory Failure and the Need for Ventilatory Support
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Q1) A patient develops acute hypercapnic respiratory failure due to muscle fatigue. Which of the following modes of ventilatory support would you consider for this patient?
I.assist-control ventilation with adequate backup
II.continuous positive airway pressure
III.synchronized intermittent mandatory ventilation with adequate backup rate
IV.bilevel pressure support by mask
A)II and IV
B)III and IV
C)I, II, and III
D)I, III, and IV
Q2) What is the normal range of maximum inspiratory pressure, or MIP (also called negative inspiratory force, or NIF), generated by adults?
A)-80 to -100 cm H<sub>2</sub>O
B)-50 to -80 cm H<sub>2</sub>O
C)-30 to -50 cm H<sub>2</sub>O
D)-20 to -30 cm H<sub>2</sub>O
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Chapter 42: Mechanical Ventilators
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Sample Questions
Q1) Which of the closed-loop controllers is used by all ventilators?
A)setpoint
B)auto setpoint
C)adaptive
D)servo
Q2) Types of output control valves used in modern ventilators include all of the following except:
A)pneumatic diaphragm valve
B)proportional valve
C)electromagnetic poppet or plunger
D)linear screw valve
Q3) During volume-targeted ventilation, which of the following settings determine the inspiratory time?
I.volume
II.flow
III.rate
A)I and II
B)I and III
C)II and III
D)I, II, and III
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Chapter 43: Physiology of Ventilatory Support
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Q1) In which of the following patients is positive end-expiratory pressure (PEEP) most indicated?
\(\begin{array}{ll}&\underline{\mathrm{FIO}_{2}}&\underline{\mathrm{PaO}_{2}}\ \
A.&0.70 & 185 \mathrm{~mm} \mathrm{Hg} \\
B.&0.40 & 65 \mathrm{~mm} \mathrm{Hg} \\
C.&0.55 & 48 \mathrm{~mm} \mathrm{Hg} \\
D.&0.21 & 45 \mathrm{~mm} \mathrm{Hg} \end{array}\)
Q2) Bilevel positive airway pressure (BiPAP) is used for all of the following purposes except:
A)nocturnal ventilatory support of chronic disease patients
B)preventing intubation of patients with acute exacerbations of chronic obstructive pulmonary disease (COPD)
C)treatment of obstructive sleep apnea (OSA) in the home
D)providing ventilatory support for patients with status asthmaticus
Q3) Which of the following lung units would be most prone to air-trapping?
A)one with high resistance and low compliance
B)one with low resistance and low compliance
C)one with normal resistance and low compliance
D)one with high resistance and high compliance
Page 45
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Chapter 44: Initiating and Adjusting Ventilatory Support
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Q1) Indications for delivering sigh breaths during mechanical ventilation include all of the following except which of the following?
A)before and after suctioning
B)during chest physical therapy
C)in patients with stiff lungs
D)when small V<sub>T</sub> values are used
Q2) What phrase is used to describe the situation where the patient with acute lung injury is ventilated with a smaller tidal volume and the PaCO<sub>2</sub> is allowed to increase above normal range to avoid additional lung injury?
A)physiologic ventilation
B)permissive hypercapnia
C)adjusted ventilation
D)dialed acidosis
Q3) Which of the following statements is NOT true regarding the use of an inspiratory pause during mechanical ventilation?
A)It may be useful in ARDS patients.
B)It may be useful when obtaining a chest radiograph.
C)It has been shown to increase effectiveness of bronchodilator therapy.
D)It will increase mean airway pressure.
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Page 46
Chapter 45: Noninvasive Positive Pressure Ventilation
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Sample Questions
Q1) Which of the following interfaces that improve ventilation appears to be more tolerated?
A)nasal pillows
B)full face mask
C)nasal mask
D)oral mask
Q2) Which of the following is a potential risk of overtightening the straps of the mask?
A)absence of an air leak
B)tissue necrosis
C)eye irritation
D)claustrophobia
Q3) Which of the following statements is NOT true about the use of home care ventilators for delivering noninvasive positive-pressure ventilation (NPPV)?
A)They operate only with pressure triggering.
B)They can operate on AC or DC power sources.
C)They can have a single-limb ventilator circuit.
D)Flow delivery pattern can be adjusted.
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Chapter 46: Monitoring and Management of the Patient in the
Intensive Care
Unit
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Q1) What is the value of determining the lower inflection point during measurement of the pressure-volume curve?
A)best tidal volume
B)best PEEP level
C)to determine best airway size
D)to determine type of ventilator inspiratory flow pattern
Q2) Which of the following is NOT associated with a decreased end-tidal PCO<sub>2</sub>?
A)decreased metabolic rate
B)increase in lung perfusion
C)rapid and very shallow breathing
D)decreased CO<sub>2</sub> production
Q3) Above what value for V<sub>DS</sub>/V<sub>T</sub> is weaning NOT likely?
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Page 48
Chapter 47: Discontinuing Ventilatory Support
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Q1) What is the most important prerequisite for weaning a patient from ventilatory support?
A)improvement in the original problem requiring mechanical ventilation
B)assurance that the patient's ventilatory demand exceeds the patient's capacity
C)objective evidence indicating good respiratory muscle endurance
D)ability to maintain adequate oxygenation with an FIO<sub>2</sub> less than 0.4
Q2) Which of the following ventilator modes can ensure delivery of a preset V<sub>T</sub> during spontaneous breathing?
I. volume support or VERSUS (Siemens Servo Ventilator 300)
II. volume-assured pressure support or VAPS (Bird 8400ST)
III. augmented minute ventilation or MMV (Bear 1000)
A)II and III
B)I and II
C)I and III
D)I, II, and III
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Chapter 48: Neonatal and Pediatric Respiratory Care
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Q1) Which of the following is not a common indication for ECMO?
A)persistent pulmonary hypertension of the newborn (PPHN)
B)respiratory distress syndrome (RDS)
C)meconium aspiration syndrome (MAS)
D)congenital diaphragmatic hernia (CDH)
Q2) The most probable explanation for the flip-flop phenomenon in the newborn is:
A)oxygen toxicity
B)right-to-left shunting
C)cardiac disease
D)reactive pulmonary vasoconstriction
Q3) Which of the following aerosol devices would you recommend to administer a bronchodilator to a 15-day-old baby who is spontaneously breathing?
A)SVN
B)MDI
C)DPI
D)MDI with spacer
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Chapter 49: Patient Education and Health Promotion
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Q1) Which of the following is NOT a learning domain?
A)cognitive
B)affective
C)psychomotor
D)analytical
Q2) What percentage of smokers has been reported to want to stop the smoking habit?
A)10%
B)25%
C)50%
D)70%
Q3) The objective that states "Verbalize willingness to use oxygen properly and safely" falls in which domain?
A)cognitive
B)affective
C)psychomotor
D)analytical
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Chapter 50: Cardiopulmonary Rehabilitation
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Q1) Reconditioning the inspiratory muscles of patients undergoing pulmonary rehabilitation is accomplished through which of the following methods?
A)walking aerobically for a specified time
B)using a rowing machine for a specified time
C)pedaling a stationary bicycle for a specified distance
D)performing inspiratory resistive breathing exercises
Q2) Under which of the following conditions would you recommend ending a cardiopulmonary exercise evaluation?
I.electrocardiogram indicating supraventricular tachycardia
II.10% fall from baseline oxyhemoglobin (HbO<sub>2</sub>) saturation
III.fall in systolic blood pressure of more than 20 mm Hg
IV.request from the patient to terminate the test
A)II, III, and IV
B)I, II, and III
C)I, II, III, and IV
D)I, II, and IV
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Chapter 51: Respiratory Care in Alternative Settings
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Q1) A home care patient using a reservoir cannula for long-term low-flow O<sub>2 </sub>therapy objects to the cosmetic appearance of the device. Which of the following alternatives would you recommend to this patient's physician as capable of addressing the patient's concerns?
I.transtracheal catheter
II.entrainment mask
III.pendant reservoir
A)I
B)II and III
C)I and II
D)I, II, and III
Q2) Which of the following is FALSE about home O<sub>2</sub> therapy?
A)A PRN (as needed) prescription for O<sub>2</sub> is acceptable.
B)Hypoxemia can be confirmed by arterial blood gas (ABG) or oximetry.
C)A PaO<sub>2</sub> at or below 55 mm Hg documents need.
D)An SaO<sub>2</sub> below 88% is clinical evidence of need.
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