Cardiopulmonary Diagnostics
Final Exam Questions
Course Introduction
Cardiopulmonary Diagnostics explores the principles, procedures, and interpretation of diagnostic tests used to evaluate the function and pathology of the heart and lungs. This course covers a range of non-invasive and invasive diagnostic modalities, including electrocardiography (ECG), echocardiography, pulmonary function testing, arterial blood gas analysis, and exercise stress testing. Students will learn the indications, contraindications, and clinical applications of each diagnostic tool, as well as develop skills in performing and analyzing test results to assist in the diagnosis and management of cardiovascular and respiratory disorders. Emphasis is placed on patient safety, quality assurance, and effective communication of findings within the healthcare team.
Recommended Textbook
Basic Clinical Lab Competencies for Respiratory Care An Integrated Approach 5th Edition by Gary
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Chapter 1: Basics of Asepsis
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Q1) Which of the following statements is FALSO concerning the removal of a gown aseptically?
A)Begin by untying the waist tie,and then wash the hands because the area from the waist down is considered dirty.
B)Untie the neck tie and shrug the shoulders forward so that the gown slips off the body down the arms.
C)Allow the gown to slip down so that it can be grasped inside at the neck of the gown.Fold the gown inside out and dispose of it appropriately.
D)Remove the gown by pulling it off from the sleeves before washing your hands.
Answer: D
Q2) What is the most common cause of hospital acquired infections?
A)Direct contact transmission
B)Indirect contact transmission
C)Airborne transmission
D)Vehicle transmission
Answer: B
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Chapter 2: Basic Patient Assessment: Vital Signs and Breath
Sounds
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Q1) A patient is brought to the emergency department after being involved in a motor vehicle accident.She has had massive blood loss and hypotension.What should the practitioner expect the heart rate to be?
A)Tachycardic
B)Bradycardic
C)High pulse pressure
D)Absent
Answer: A
Q2) What is the correct term to describe a patient with a body temperature of 101 degrees F?
A)Hypertension
B)Hyperthermia
C)Hypotension
D)Hypothermia
Answer: B
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Chapter 3: Advanced Patient Assessment: Inspection, Palpation, and Percussion
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Q1) 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
Q2) Which of the following CANNOT be determined with detailed inspection of the chest?
A)The patient's breathing pattern
B)Assess the patient's work of breathing
C)Determination of the type of lung disease
D)Identification of skeletal abnormalities
Answer: C
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Chapter 4: Radiologic Assessment
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Q1) 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
Q2) Which of the following chest x-ray views is the most common for a standard chest x-ray to evaluate a patient's lung tissue?
A)Posterior-anterior (PA)view
B)Anterior-posterior (AP)view
C)Lateral view
D)Apical lordotic view
Q3) The most radiodense material viewed on a chest x-ray will _______________.
A)appear black.
B)not show up on a standard chest x-ray.
C)appear as gray shadows.
D)appear white.
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?
Q5) What can be evaluated on a chest radiograph besides the heart and lungs?
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Chapter 5: Pulmonary Function Testing
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Q1) What volume or flow of a PFT does the following two statements describe? The measurement can provide an indication of obstruction.However,the test validity depends on the effort and cooperation of the patient.
A)Peak expiratory flow (PEF)
B)Timed forced expiratory volume (FEVt)
C)Forced vital capacity (FVC)
D)Maximum inspiratory pressure (MIP)
Q2) 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
Q3) What device moves at different speeds to allow the measurement of slow and forced maneuvers?
A)Kymograph
B)Peak flowmeter
C)Respirometer
D)Spirometer
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Chapter 6: Electrocardiography
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Q1) What lead is placed 5th intercostal space,mid-axillary line?
A)V6
B)V5
C)V4
D)V3
Q2) Which of the following is the heart's pacemaker?
A)Right and left bundle branches
B)Vagus nerve
C)AV node
D)SA node
Q3) When a stimulus only causes a small portion of the atria to contract in an unorganized pattern,then ____________ occurs.
A)atrial fibrillation
B)ventricular fibrillation
C)a normal sinus rhythm
D)a sinus tachycardia
Q4) The patient wants an exercise EKG.To ensure the electrodes stay remain in the proper position,what precautions should be taken?
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Chapter 7: Phlebotomy
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Q1) If the patient is taking blood thinning medication,what should the phlebotomist do?
A)Hold pressure on the blood draw site longer
B)Inform the patient the stick may hurt worse than normal
C)Notify the supervisor for special vacuum collection tubes
D)Contact the physician for special instructions
Q2) How can the phlebotomist enhance sites to draw blood from a patient?
Q3) If the vacuum tube is pushed in too soon or attached to the needle too soon,what would happen?
A)Unnecessary contamination will occur at the draw site.
B)The angle of the needle stick should be increased.
C)A larger needle needs to be used.
D)The negative pressure stored in the tube will be lost.
Q4) How does the phlebotomist gain the confidence of the patient for a blood draw?
Q5) What is defined as the invasive puncturing of a vein for the purpose of collecting blood?
A)Venous blood gas sampling
B)Phlebotomy
C)Arterial blood gas sampling
D)Transcutaneous blood sampling
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Chapter 8: Arterial Blood Gas Sampling
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Q1) When an air bubble is present in a blood gas sample that was drawn on room air,what will happen to the PCO of the blood gas sample?
A)The PCO will remain the same.
B)The PCO will increase.
C)The PCO will decrease.
Q2) Which artery is used to collect arterial blood during a cardiopulmonary arrest?
A)Radial artery
B)Brachial artery
C)Femoral artery
D)Ulnar artery
Q3) A delay of more than 30 minutes in analyzing an arterial blood gas sample,even if it is iced,would have what effect on the blood gas values?
A)Higher PO ,higher PC02,lower pH
B)Lower PO ,lower PC02,higher pH
C)Lower PO ,higher PCO ,higher pH
D)Lower PO ,higher PCO ,lower pH
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) Normal mean pulmonary artery pressure is _________________.
A)6-12 mmHg
B)10-22 mmHg
C)0-6 mmHg
D)80-120 mmHg
Q2) A patient has a CVP reading of 12 mmHg.What does this indicate?
A)Hypervolemia
B)Hypovolemia
C)Decreased right ventricular preload
D)Increased left atrial preload
Q3) What happens if the right ventricular preload is increased too much?
A)The cardiac output is optimized.
B)The myocardium loses efficiency.
C)Oxygen consumption decreases.
D)Deadspace ventilation increases.
Q4) The proximal lumen of the pulmonary artery catheter measures the
A)central venous pressure.
B)pulmonary capillary wedge pressure.
C)cardiac output.
D)left ventricular end-diastolic pressure.
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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) All of the following are limitations of end-tidal CO monitoring EXCEPT ______________.
A)pulmonary emboli.
B)tubing obstructions.
C)vasopressive drugs.
D)shunt producing pulmonary disease.
Q3) Pressure sores are a potential hazard of __________________.
A)pulse oximetry monitoring.
B)transcutaneous CO monitoring.
C)transcutaneous O monitoring.
D)end-tidal CO monitoring.
Q4) How does the pulse oximeter measure O saturation in the capillary bed?
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Chapter 11: Documentation and Goals Assessment
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Q1) How are entries entered into the medical record?
A)In chronological order
B)In random order
C)In order of department
D)Alphabetical order
Q2) What is the method of charting that usually employs fill-in-the-blank forms where only data that change are documented?
A)Clinical goal charting
B)Charting by exception
C)Objective data charting
D)Progress notes
Q3) Information provided to the physician by the patient is
A)contained in the progress notes.
B)always confidential.
C)objective data.
D)subjective data
Q4) A patient was given a respiratory treatment by a practitioner who did not chart the treatment immediately on the patient's chart due to an excessive workload.Ultimately,the treatment was not charted on the medical record.What problem is associated with the therapist's judgement?
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Chapter 12: Oxygen Supply Systems
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Q1) Hydrostatic testing is required for all cylinders every _____________
A)year.
B)5 to 10 years.
C)10 to 15 years.
D)15 to 20 years.
Q2) A half-full 'E' cylinder will last how long running at 3 L/min?
A)About 180 minutes
B)About 30 minutes
C)About 4 hours,13 minutes
D)About 1 hour,43 minutes
Q3) The ____________ has developed a color code for the different gases and gas mixtures.
A)U.S.Department of Transportation (DOT)
B)Compressed Gas Association (CGA)
C)Pin Index Safety System (PISS)
D)National Fire Protection Association (NFPA)
Q4) You attach a pressure reducing valve to a 'M' sized gas cylinder.When you open the cylinder valve you hear gas leaking from of near the valve-cylinder connection.What should you do?
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Chapter 13: Oxygen Administration
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Q1) Which of the following arterial blood gas or oximetry values would be an indication for oxygen in the hospital setting?
I.PaO - 50 mmHg
II.SaO - 91%
III.PaO - 89 mmHg
IV.SaO - 60%
A)I and IV
B)II and III
C)IV only
D)I,II,and III
Q2) During laser bronchoscopy,minimal levels of supplemental oxygen should be used to ___________.
A)prevent oxygen toxicity.
B)decrease the risk of bronchospasm.
C)avoid intratracheal ignition.
D)decrease the chance of bacterial contamination.
Q3) 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) What is the name of the receptor sites that are located in the peripheral vasculature,the heart,bronchial muscle,and bronchial blood vessels?
A)Beta 2 receptors
B)Gamma receptors
C)Alpha receptors
D)Beta 1 receptors
Q2) Salmeterol and Fluticasone are combined into a DPI preparation.What is the purpose of these two drugs combined?
A)Maintenance bronchodilation and Mast cell stabilization
B)Mucolysis and anti-inflammation
C)Bronchodilation by stimulating the sympathetic nervous system and inhibiting the parasympathetic nervous system
D)Maintenance bronchodilation and anti-inflammation
Q3) What immunoglobulin antibody sensitizes the mast cell?
A)Leukotrienes
B)IgE
C)Histamine
D)Prostaglandins
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Chapter 15: Humidity and Aerosol Therapy
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Q1) What controls the particle size generated by an ultrasonic nebulizer?
A)Amplitude
B)Frequency
C)Piezoelectric crystal
D)Couplant
Q2) Which of the following defines body humidity?
A)37°C,100 mmHg partial press [H O],and 47% saturation
B)37°C,44 mmHg partial press [H O],and 100% saturation
C)37°C,47 mmHg partial press [H O],and 100% saturation
D)47°C,37 mmHg partial press [H O],and 100% saturation
Q3) The presence of which one or more of the following may be an indication for administration of a water,isotonic,or hypotonic saline aerosol?
A)Stridor
B)Diagnosis of laryngotracheobronchitis
C)Clinical history suggesting upper airway irritation and increased work of breathing,such as smoke inhalation
D)a,b,and c
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Page 17
Chapter 16: Bronchial Hygiene Therapy
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Q1) During bronchial hygiene therapy in the Trendelenburg position,the patient's heart rhythm exhibits bigeminy PVCs.What intervention would be the most correct for the Respiratory Care Practitioner to take at this time?
A)Stop therapy,return patient to original resting position,administer or increase oxygen delivery while contacting physician.Administer physician-ordered bronchodilators.
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,return patient to previous resting position,allow patient to rest,continue therapy with patient in the modified position,document heart rhythm in the patient's chart.
D)Stop therapy,return patient to previous resting position,administer or increase oxygen delivery while contacting physician.
Q2) What is the only absolute contraindication to a directed cough?
A)Increased intracranial pressure
B)Increased potential for aspiration
C)Untreated pneumothorax
D)There are no absolute contraindications.
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Chapter 17: Hyperinflation Therapy
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Q1) During IPV (intrapulmonary percussive ventilation)therapy,how is the frequency of percussion to the airway controlled?
A)Operational pressure
B)Flow rate
C)Expiratory timer
D)By the Phasitron
Q2) What is defined as a combination of high-frequency phased pulse gas delivery and the administration of a dense aerosol?
A)Incentive spirometry (IS)
B)Intermittent positive pressure breathing (IPPB)therapy
C)Intrapulmonary percussive ventilation (IPV)therapy
D)High frequency chest wall oscillation (HFCWO)therapy
Q3) A surgeon orders lung expansion therapy for an obtunded 68-year-old,170-lb (77.3 kg,IBW)man who has developed atelectasis after thoracic surgery.On baseline assessment,the patient cannot perform an IC or VC maneuver,but has no evidence of retained secretions.Which type of hyperinflation therapy would you recommend?
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Chapter 18: Bronchoscopy Assisting
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Q1) Patient monitoring should be done before,during,and after bronchoscopic procedures.Which of the following is important to monitor?
A)Patient's level of consciousness
B)Patient vital signs,including heart rhythm
C)Patient's subjective response to the procedure
D)a,b,and c
Q2) A pulmonologist performs a fiberoptic bronchoscopy on an outpatient with recurrent bouts of pneumonia.During post-procedure instruction,the patient should be informed to contact the physician if which of the following occurs?
A)Dyspnea,wheezing or hemoptysis
B)Fever or chest pain
C)Ringing in the ears or constipation
D)a and b
Q3) What instructions would you give a patient who is to have a bronchoscopy procedure?
Q4) The practitioner being oriented on the pediatric unit finds that one of the duties she will be performing will be helping with bronchoscopy procedures.Why would bronchoscopies be performed on pediatric patients?
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Chapter 19: Equipment Processing and Surveillance
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Q1) Which of the following is NOT a main area of an equipment processing facility?
A)Decontamination
B)Processing
C)Storage
D)Manufacture
Q2) Hospital acquired infections are also called _______________
A)spores.
B)Bacillus.
C)nosocomial infections.
D)Clostridium.
Q3) When ethylene oxide combines with water it forms ______________
A)hydrogen peroxide.
B)ethylene glycol.
C)ethyl alcohol.
D)carbonic anhydrase.
Q4) Which of the following bacteria is NOT gram negative?
A)Streptococcus
B)Serratia
C)Klebsiella
D)Legionella
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Chapter 20: Emergency Airway Management
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Q1) Which of the following is NOT a contraindication for resuscitation of a patient?
A)Resuscitation has been determined to be futile because of the patient's underlying condition or disease
B)A patient that has had a diagnosis of lung cancer with metastasis to another part of the body
C)The patient's desire not to be resuscitated has been clearly expressed and documented in the patient's medical record
D)a and c
Q2) A patient is unconscious and has blood is his mouth upon being admitted to the emergency department.Breath sounds are diminished bilaterally.What would you recommend to maintain the patient's airway and why?
Q3) 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
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22
Chapter 21: Artificial Airway Care
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Q1) A patient has just been nasotracheally suctioned by the respiratory care practitioner.What improvements in the patient should occur after the procedure to indicate that the nasotracheal suctioning procedure was effective?
I.Improved breath sounds
II.Removal of secretions
III.Improved blood gas data or pulse oximetry
IV.Decreased work of breathing
A)I and II
B)III and IV
C)I only
D)I,II,III,IV
Q2) 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.
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23
Chapter 22: Chest Tubes
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Q1) What is "tidaling"?
A)Gentle continuous bubbling observed in the suction control chamber
B)Vigorous bubbling observed in the suction control chamber
C)Fluid collection in the collection chamber
D)The normal rise and fall of the fluid level with the patient's breathing pattern
Q2) Once the chest tube has been sutured in place,the practitioner should help the physician by doing what to the dressing site?
A)Applying a sterile petrolatum dressing around the chest tube site
B)Applying a sterile airtight dressing at the chest tube site
C)Applying providone-iodine to the insertion site
D)a and b
Q3) Which part/chamber of the chest tube acts as a one-way valve,allowing air to escape from the pleural or mediastinal space but not allowing it to enter those spaces from the atmosphere?
A)Collection chamber
B)Water seal chamber
C)Chest tube tubing
D)Suction control chamber
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Chapter 23: Insertion and Maintenance of Intravenous Lines
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Q1) What is inflammation of the vein called?
A)Phlebitis
B)Cellulitis
C)Thrombosis
D)Arteriosclerosis
Q2) A patient with an IV complains of pain and tenderness at the IV site.The practitioner notes swelling at the IV site.Why should these findings be investigated thoroughly?
A)The IV has infiltrated
B)Cellulitis is developing in the surrounding tissue
C)The possibility of thrombus formation
D)Inflammation of the vein
Q3) What happens to the small air bubbles that pass through the IV tubing and enter into the patient?
Q4) What is another name for 0.9% sodium chloride in water?
A)Normal or physiologic saline
B)Lactated Ringer's solution
C)D5W
D)Plasma
Q5) What is the purpose of transparent dressings on a IV?
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Chapter 24: Noninvasive Positive-Pressure Ventilation
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Q1) A patient is admitted to the emergency department in respiratory distress.The respiratory care practitioner utilizes a full face mask to administer NPPV.After 20 minutes of NPPV the patient exhibits signs of gastric distention.The physician is concerned about the patient vomiting and aspirating.What should the practitioner recommend to decrease the gastric distention and decrease the possibility of aspiration?
A)The patient should be placed on his side to lessen the possibility of air swallowing. B)The practitioner should place a little force on the mask harness to maintain a good seal.
C)Reduce the pressure on the face mask and allow the positive-pressure to seal the mask.
D)A nasogastric tube should be placed to decompress the stomach and reduce the risk of aspiration.
Q2) Noninvasive positive-pressure ventilation has been applied the most to patients with what diagnosis?
A)Acute hypoxemic respiratory failure
B)Severe acute asthma
C)Acute exacerbation of chronic obstructive pulmonary disease
D)Acute cardiogenic pulmonary edema
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26
Chapter 25: Continuous Mechanical Ventilation
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Q1) When considering types of ventilation,which of the following is NOT an advantage of invasive positive-pressure ventilation?
A)Better regulation of minute ventilation especially in volume modes
B)Improved delivery of oxygen therapy
C)Better accuracy in monitoring parameters
D)Enhanced ability to communicate
Q2) A family does not want to have their parent with congestive heart failure intubated,but the patient is in need of mechanical ventilation,the therapist should recommend _____________
A)IPPB therapy for 20 minutes every hour.
B)CPAP therapy via nasal mask with 50% oxygen.
C)noninvasive ventilation using IPAP and EPAP pressures.
D)disregarding the wishes of the family and intubate and mechanically ventilate the patient.
Q3) How does a practitioner perform a system leak test?
Q4) How is tubing compliance determined?
Q5) What is the difference in calculating dynamic compliance vs static compliance?
Q6) How does a practitioner measure airway resistance on a ventilator?
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Chapter 26: Advanced Modes of Mechanical Ventilation
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Q1) Mandatory minute volume is described by which of the following?
A)It is a totally assist mode used to wean a patient from the ventilator.
B)If patient does not breathe target minute volume ventilator will make up difference.
C)It is a control mode that requires the patient to breathe a target minute volume.
D)It uses set mandatory breaths with spontaneous tidal volume breaths.
Q2) A respiratory care practitioner identifies that a patient is having breathing difficulties because the endotracheal tube is one size smaller than optimal.The practitioner should consider which of the follow modes to overcome the airway resistance from a small tube?
A)Mandatory Minute Ventilation
B)Proportional Assist Ventilation
C)Automatic tube compensation
D)Automode
Q3) What is proportional assist ventilation?
Q4) How does a respiratory care practitioner assess the patient's work of breathing?
Q5) What are three problems that mandatory minute ventilation cannot prevent?
Q6) What is the auto-set-point control?
Q7) What are the purposes of ventilator alarms and backup modes?
Page 28
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Chapter 27: Wave Form Analysis
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Q1) Which of the following wave forms would be most useful in detecting changes in airway resistance especially after delivery of a bronchodilator?
A)Pressure versus volume
B)Pressure versus time
C)Flow versus volume
D)Volume versus time
Q2) Which graphic displays can indicate adequacy of inspiratory flow during a ventilator inspiration and how are they used?
Q3) A mechanical breath that rises and then remains at the same cmH O pressure for the same length of time is which type of mechanical breath?
A)SIMV
B)Volume control
C)Pressure support
D)Pressure control
Q4) You are concerned that the ventilator patient you are assessing may have autoPEEP.How would you use ventilator graphics to identify whether or not this problem exists?
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Chapter 28: Weaning and Discontinuance of Mechanical Ventilation
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Q1) How do neurological problems result in ventilator dependence?
Q2) How do respiratory conditions result in ventilator dependence?
Q3) According to the AARC Clinical Practice Guidelines which of the following identifies failure or intolerance in the spontaneous breathing trial?
A)Increasing or worsening of discomfort
B)Thorcoabdominal paradox
C)Use of accessory respiratory muscles
D)All of the above
Q4) According to the AARC Clinical Practice Guidelines,which of the following identifies success or tolerance in the spontaneous breathing trial?
A)PaO less than 50 mmHg
B)Increase in PaCO of less than 10 mmHg
C)pH less than 7.32
D)Systolic blood pressure greater than 200 mmHg
Q5) What should the respiratory therapist do if the patient does not pass the SBT?
Q6) What four general questions should the respiratory care practitioner assess prior to weaning from mechanical ventilation?
Q7) How do cardiovascular problems result in ventilator dependence?
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Chapter 29: Neonatal Mechanical Ventilation
Available Study Resources on Quizplus for this Chatper
35 Verified Questions
35 Flashcards
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Sample Questions
Q1) What is the significance of urine output in neonatal ventilation?
A)Identifies the adequacy of oxygenation
B)Identifies metabolic function
C)Indicates function of vital organs
D)Decrease can indicate renal impairment due to ventilating pressures
Q2) The respiratory care practitioner wants to reduce or overcome the work of breathing due to the endotracheal tube and ventilator tubing.Which mode can be used for that purpose?
A)Volume me Support
B)Synchronized Intermittent Mandatory Ventilation
C)Pressure Regulated Volume Control
D)Pressure Support
Q3) Describe how the initial newborn ventilator setting are determined for tidal volume,oxygen percent and PEEP/CPAP
Q4) Describe the 5 characteristics of the Apgar scoring system.
Q5) Describe how the initial newborn ventilator setting are determined for mode,rate and flow rate.
Q6) Describe the point system used when determining an Apgar score.
Q7) Describe how the initial newborn ventilator alarm setting are determined.
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