Cardiopulmonary Pathophysiology
Final Exam
Course Introduction
Cardiopulmonary Pathophysiology focuses on the study of the functional alterations and mechanisms underlying diseases affecting the heart, lungs, and their interactions. The course explores the causes, progression, and clinical manifestations of common and complex cardiopulmonary conditions such as heart failure, myocardial infarction, chronic obstructive pulmonary disease (COPD), and pulmonary embolism. By understanding how normal physiological processes are disrupted in disease states, students gain insight into diagnostic approaches, therapeutic interventions, and the impact of these disorders on overall health. Emphasis is placed on integrating physiological concepts with clinical applications to prepare students for advanced study and practice in healthcare fields.
Recommended Textbook
Wilkins Clinical Assessment in Respiratory Care 7th Edition by Al Heuer PhD
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21 Chapters
773 Verified Questions
773 Flashcards
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Chapter 1: Preparing for the Patient Encounter
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35 Flashcards
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Sample Questions
Q1) While interviewing a patient in a room with another patient and that patient's family present, the appropriate course of action for an RT would be to:
A)Introduce himself or herself to the patient from a distance of about 5 to 7 feet and proceed with the interview.
B)Introduce himself or herself to the patient from a distance of about 5 to 7 feet, move to within 2 to 3 feet of the patient, and proceed with the interview.
C)Introduce himself or herself to the patient from a distance of about 5 to 7 feet, move to within 2 to 3 feet of the patient, draw the privacy curtain around the bed, and proceed with the interview.
D)Introduce himself or herself to the patient from a distance of about 5 to 7 feet, draw the privacy curtain around the bed, sit on the bed about 1 foot from the patient, and proceed with the interview.
Answer: C
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Chapter 2: The Medical History and the Interview
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Sample Questions
Q1) A pertinent negative is defined as:
A)Any negative response made by the patient during the interview.
B)Refusal by the patient to answer questions about a certain topic.
C)Any negative response by the patient to an important question about possible symptoms.
D)A negative response by a patient to a therapist who asks whether the patient needs a breathing treatment.
Answer: C
Q2) In which section of the patient record should the following entry appear? "Day 4 of hospitalization.Patient febrile (39 C).Rales in both lung bases; sputum moderate, thick, green, tinged with blood.Plan: Continue ordered antibiotic therapy.Bronchoscopy tomorrow in AM."
A)Admission note
B)Physician orders
C)Progress notes
D)Discharge plan
Answer: C
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Chapter 3: Cardiopulmonary Symptoms
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Sample Questions
Q1) Cough syncope is associated most often with which of the following types of patients?
A)Middle-aged men with underlying COPD
B)Pregnant women
C)Children with asthma
D)Older obese men with diabetes
Answer: A
Q2) Which of the following is the best definition of sputum?
A)Secretions
B)Thick tenacious secretions
C)Secretions from the lungs and lower airways
D)Secretions from the nose, mouth, and tracheobronchial tree
Answer: D
Q3) Which of the following mechanisms does not explain why patients with chronic obstructive pulmonary disease (COPD) have a poor cough?
A)Weak muscles of breathing
B)Increased elastic recoil
C)Airway obstruction
D)Glottis function failure
Answer: B
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Chapter 4: Vital Signs
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Sample Questions
Q1) A well-written description of an RT's initial observations is beneficial to other healthcare providers because it:
A)shows that the RT has established rapport with the patient.
B)helps them know how to plan care and relate to the patient's needs.
C)decreases the length of hospitalization of the patient and keeps costs down.
D)allows them to read the information quickly without confusion and misunderstandings.
Q2) A patient's general clinical presentation indicates to the respiratory therapist (RT) that the patient is in distress.The RT's first step should be to:
A)call a code and stand by to assist with cardiopulmonary resuscitation (CPR).
B)do a complete physical examination to determine the precise cause of the distress.
C)evaluate the problem quickly and intervene or locate someone to assist the patient.
D)follow the procedure learned in class to introduce himself or herself to the patient and ask the patient what is wrong.
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Chapter 5: Fundamentals of Physical Examination
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Sample Questions
Q1) Which of the following terms is used to describe the normal breath sounds heard around the sternum on the anterior chest and between the scapulae on the posterior chest?
A)Tubular
B)Vesicular
C)Bronchial
D)Bronchovesicular
Q2) The length of normal capillary refill is less than _____ second(s).
A)1
B)3
C)5
D)10
Q3) At what point on the posterior chest wall can the inferior border of the lung normally be found?
A)Between T4 and T6
B)Between T6 and T8
C)Between T9 and T12
D)None of the above
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Chapter 6: Neurologic Assessment
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Sample Questions
Q1) The brain death determination test involving disconnecting a patient from the ventilator, providing 100% oxygen, and monitoring closely for spontaneous breathing is the __________________.
A)apnea test.
B)metabolic test.
C)tendon reflex test.
D)deep pain test.
Q2) The main goal of assessing mental status is to determine which of the following?
A)Consciousness
B)Awareness
C)Thinking
D)CNS dysfunction
Q3) Which of the following is the most critical parameter to keep in mind when managing a patient with intracranial hypertension?
A)Mean arterial pressure
B)Cerebral perfusion pressure
C)Intracranial pressure
D)Pulse pressure
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8
Chapter 7: Clinical Laboratory Studies
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56 Flashcards
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Sample Questions
Q1) What procedure is performed by a pulmonologist to obtain organisms that may be present deep in the lung in patients with pneumonia?
A)Sputum induction with hypotonic nebulized solution
B)Bronchoalveolar lavage (BAL)
C)Tracheal intubation with lavage
D)All of the above
Q2) Which of the following disorders is associated with hyperglycemia?
A)Hepatitis
B)Diabetes
C)Renal failure
D)Myocardial infarction
Q3) What percentage of circulating white blood cells is made up of neutrophils?
A)10% to 30%
B)25% to 50%
C)40% to 75%
D)60% to 85%
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9
Chapter 8: Interpretation of Blood Gases
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Sample Questions
Q1) A shift to the right in the oxyhemoglobin dissociation curve has what effect on the affinity of hemoglobin for oxygen?
A)Increased
B)Decreased
C)No change
D)Cannot predict the change
Q2) Which of the following is a true statement regarding the term hypoxemia?
A)It occurs when the patient's PaO is lower than predicted.
B)It indicates a condition in which tissue oxygenation is inadequate.
C)It is always considered a severe disorder.
D)It is independent of the age of the patient.
Q3) Given the following ABG results, interpret the acid-base status: pH 7.44, PaCO 25 mm Hg, HCO - 17 mEq/L, base excess -6 mEq/L
A)Compensated metabolic acidosis
B)Uncompensated respiratory alkalosis
C)Uncompensated respiratory acidosis
D)Compensated respiratory alkalosis
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Chapter 9: Pulmonary Function Testing
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Sample Questions
Q1) The MVV reflects all of the following except:
A)airway resistance.
B)condition of respiratory muscles.
C)condition of lung tissue.
D)compliance of the lungs and thorax.
Q2) Obstructive lung disorders are characterized by a reduction in:
A)Lung capacities.
B)Lung volumes.
C)Expiratory flows.
D)Inspiratory flows.
Q3) Which of the following medications is used most commonly during bronchoprovocation testing?
A)Methacholine
B)Isoproterenol
C)Methylene blue
D)Metaproterenol
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Chapter 10: Chest Imaging
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Sample Questions
Q1) Which of the following tissues represent the four distinct densities recognized in the x-ray (from higher to lower density)?
A)Bone, water, air, fat
B)Fat, bone, water, air
C)Bone, water, fat, air
D)Air, fat, water, bone
Q2) The casting of a white shadow on a film is consistent with which of the following situations?
A)Less exposed film
B)More exposed film
C)More radiolucent film
D)More penetrated film
Q3) To minimize the magnification associated with portable films, how far should the patient and the film be from the source of the x-rays in a conventional chest x-ray?
A)6 feet
B)8 feet
C)10 feet
D)12 feet
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Chapter 11: Interpretation of Electrocardiogram Tracings
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Sample Questions
Q1) Why is an ECG tracing so useful?
A)It reflects the heart's pumping ability.
B)It can identify structural abnormalities in the heart.
C)It can be used to diagnose malfunctioning valves.
D)It can aid in the diagnosis of cardiac tissue ischemia.
Q2) Which of the following symptoms is least suggestive of the need for an ECG?
A)Fever
B)Orthopnea
C)Chest pain
D)Fainting spells
Q3) In the terminology for three of the limb leads-aVR, aVL, and aVF-what does the letter "A" stand for?
A)Atrial
B)Assisted
C)Ambient
D)Augmented
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13
Chapter 12: Neonatal and Pediatric Assessment
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Sample Questions
Q1) Which of the following is part of the biophysical evaluation of a fetus performed by ultrasound?
A)Reactive heart rate
B)Fetal brain development
C)Fetal gastrointestinal function
D)Body size
Q2) Which lung volumes can be measured easily in newborns?
1)Thoracic gas volume
2)Residual volume
3)Functional residual capacity
4)Crying vital capacity
A)1, 3, 4
B)2, 44
C)1, 3
D)1, 2, 3, 4
Q3) What is the significance of "grunting" in an infant?
A)A low functional residual capacity (FRC)
B)Increased airway resistance
C)Significant secretion retention
D)High compliance
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Chapter 13: Older Patient Assessment
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Sample Questions
Q1) Which of the following pulmonary function measurements decreases with age?
A)Tidal volume
B)Residual volume
C)Total lung capacity
D)Diffusing capacity
Q2) The normal resting respiratory rate in elderly patients is in what range?
A)10 to 18 breaths/min
B)12 to 21 breaths/min
C)14 to 23 breaths/min
D)16 to 25 breaths/min
Q3) Which of the following laboratory values decreases with age?
A)Albumin
B)Hemoglobin
C)Serum glucose
D)Serum cholesterol
Q4) Ageism in the healthcare setting can lead to:
A)practitioners spending more time with older patients.
B)practitioners listening to older patients less carefully.
C)practitioners treating older patients with compassion.
D)better communication with elderly patients.
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Chapter 14: Respiratory Monitoring in Critical Care
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Sample Questions
Q1) Ventilatory measurements routinely monitored at the bedside include all of the following except:
A)airway pressures.
B)lung volumes and flows.
C)fractional gas concentrations.
D)oxygen consumption and carbon dioxide production.
Q2) Volutrauma is most likely to develop in:
A)the larger airways.
B)dependent lung regions.
C)nondependent lung regions.
D)small airways.
Q3) The "stacking" of breaths, which often is seen in mechanically ventilated patients with severe airway obstruction, can be caused by:
A)ventilator malfunction.
B)a low-measured tidal volume.
C)insufficient expiratory time.
D)a respiratory rate that is too low.
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16
Chapter 15: Vascular Pressure Monitoring
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Sample Questions
Q1) All of the following cause an increase in the CVP except:
A)volume overload.
B)tension pneumothorax.
C)spontaneous inspiration.
D)increased intrathoracic pressure.
Q2) In left ventricular failure, the pulmonary capillary wedge pressure is expected to:
A)fall to zero.
B)remain in the normal range.
C)increase to above the normal range.
D)decrease to below the normal range.
Q3) Complications of direct arterial monitoring include all the following except:
A)infection.
B)ischemia.
C)hemorrhage.
D)hypotension.
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Chapter 16: Cardiac Output Measurement
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Sample Questions
Q1) Why has use of the pulmonary artery catheter diminished in many ICUs?
A)It is expensive.
B)It is difficult to place.
C)Patients complain about the discomfort.
D)Some experts believe it increases death rates.
Q2) The periodic, noninvasive measurement of cardiac performance that requires only the use of a sphygmomanometer is called:
A)echocardiography.
B)electrical bioimpedance.
C)pulse contour cardiac output monitoring.
D)pulse pressure.
Q3) The strength of contraction of the myocardial muscle fibers is related directly to the amount of stretch on the fiber before contraction is a definition of:
A)preload.
B)Starling law.
C)cardiac contractility.
D)ventricular compliance.
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Chapter 17: Bronchoscopy
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Sample Questions
Q1) What is the primary purpose of bronchoscopy in a patient with pneumonia?
A)To obtain biopsy specimens
B)To identify the causative organism
C)To control hemoptysis
D)To remove secretions
Q2) What complication associated with bronchoscopy is most common?
A)A complication associated with medications used in the procedure
B)Pneumothorax
C)Secondary infection
D)Excessive bleeding
Q3) What is the most common sign of xylocaine overdose during bronchoscopy?
A)Tachycardia
B)Bradycardia
C)Seizures
D)Apnea
Q4) For what condition is the rigid bronchoscope most likely to be used?
A)Pneumonia
B)Massive hemoptysis
C)Tumor
D)Interstitial lung disease
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Chapter 18: Nutrition Assessment
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Sample Questions
Q1) Which of the following is an indicator of the energy requirements of the patient?
A)PaO to PaO ratio
B)Minute ventilation
C)Oxygen uptake per minute
D)Vital capacity
Q2) Which of the following is a pulmonary effect of starvation?
A)Increased diffusing capacity of the lung for carbon monoxide (DLCO)
B)Increased forced expiratory volume in 1 second (FEV1)
C)Increased risk of pneumonia
D)Increased functional residual capacity (FRC)
Q3) What dietary adjustment might be best for patients with more severe chronic obstructive pulmonary disease (COPD)?
A)Increased carbohydrates
B)Increased fats
C)Increased proteins
D)Increased salt intake
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Chapter 19: Sleep and Breathing Assessment
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Sample Questions
Q1) What is the first sign of SDB?
A)Snoring
B)Excessive daytime sleepiness (EDS)
C)Hypercarbia
D)Cyanosis
Q2) A reduction in air flow of between 4% and 50% of baseline air flow for at least 10 seconds during sleep defines which of the following?
A)Apnea
B)Respiratory effort-related arousal (RERA)
C)Arousal
D)Hypopnea
Q3) A patient has an apnea-hypopnea index (AHI) of 15.What would this be considered?
A)Normal
B)Mild sleep apnea
C)Moderate sleep apnea
D)Severe sleep apnea
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21
Chapter 20: Home Care Patient Assessment
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Sample Questions
Q1) A visit by a home care RT is required for a patient who is using any of the following types of equipment except:
A)An oximeter.
B)A bland aerosol therapy equipment.
C)A pneumatic nebulizer.
D)Oxygen therapy equipment.
Q2) For which of the following conditions (which is the third most common cause of death in the United States) are both mortality rates and prevalence rates increasing?
A)Chronic obstructive pulmonary disease (COPD)
B)Asthma
C)Pneumonia
D)Heart failure
Q3) What is the most common respiratory care modality applied in the home care setting?
A)Intermittent positive pressure breathing (IPPB)
B)Oxygen therapy
C)Nebulizer therapy
D)Continuous positive airway pressure (CPAP)
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22
Chapter 21: Documentation
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Sample Questions
Q1) All of the following are examples of "objective" data, except:
A)laboratory results.
B)observation of a patient's sleep apnea.
C)the patient's report of the amount of sputum that he or she produces daily.
D)the physician's interpretation of the patient's electrocardiogram (ECG).
Q2) The patient's medical record is a/an:
A)financial document.
B)legal document.
C)educational tool.
D)all of the above.
Q3) Which of the following organizations influences what needs to be documented in a patient's medical record?
A)The Joint Commission
B)Center for Medicare and Medicaid Services (CMS)
C)Financial intermediaries
D)All of the above
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