Cardiopulmonary Physiology
Pre-Test Questions
Course Introduction
Cardiopulmonary Physiology explores the fundamental mechanisms governing the function of the heart and lungs and their intricate interactions in supporting life. This course covers the structure and function of the cardiovascular and respiratory systems, regulation of blood flow and gas exchange, neural and hormonal control mechanisms, and the physiological responses to exercise, disease, and environmental changes. Emphasis is placed on understanding how the heart and lungs work together to deliver oxygen and remove carbon dioxide, as well as how disturbances in one system can affect the other. The course is designed to provide students with a thorough foundation necessary for advanced studies in medicine, healthcare, and biomedical sciences.
Recommended Textbook Wilkins Clinical Assessment in Respiratory Care 7th Edition by Al Heuer PhD
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Page 2
Chapter 1: Preparing for the Patient Encounter
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Sample Questions
Q1) In 1996, Congress passed the HIPAA.What does the letter "P" stand for?
A)Patient
B)Payment
C)Portability
D)Personal Answer: C
Q2) The main objective of the I Speak Up initiative from the National Institute of Health (NIH) is:
A)Be sure that all billing for patient medical expenses occurs correctly.
B)Let caregivers know that the family wants to be informed at all times.
C)Let the hospital know when ancillary services such as food quality and parking are inadequate.
D)Help ensure that a patient's care is as safe and effective as possible. Answer: D
Q3) What is the main purpose of the initial assessment stage?
A)To identify any allergies to medications
B)To document the patient's smoking history
C)To personally get to know the patient better
D)To verify that the prescribed treatment is still needed and appropriate Answer: D
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Chapter 2: The Medical History and the Interview
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Sample Questions
Q1) Which of the following is not a reason for obtaining a family history?
A)To assess the current health status of the extended family
B)To learn about the health status of the patient's blood relatives
C)To determine whether the patient is adopted
D)To identify the presence in the family of diseases with a hereditary tendency
Answer: C
Q2) One disadvantage of using the pack-year method for calculating cigarette consumption is that:
A)The method is not used widely throughout the United States.
B)Advanced mathematical calculations are required to obtain the figure.
C)The method does not reveal how many packs per day were smoked over how many years.
D)The values are more meaningful to RTs and physicians than to other healthcare providers.
Answer: C
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4
Chapter 3: Cardiopulmonary Symptoms
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Sample Questions
Q1) Which of the following is not a complication of forceful coughing?
A)Rib fracture
B)Pneumothorax
C)Pleural effusion
D)Torn chest muscle
Answer: C
Q2) A sharp, "viselike" chest pain radiating usually down the left arm and possibly spreading to the shoulders, neck, and jaw is called:
A)Pleuritic pain.
B)Thoracic pain.
C)Angina.
D)Epigastric pain.
Answer: C
Q3) 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
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Page 5
Chapter 4: Vital Signs
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Sample Questions
Q1) What is the most common cause of fever above 102° F?
A)Aspiration pneumonitis
B)Infection
C)Blood transfusion reaction
D)Head injury
Q2) Which of the following is the method of choice for measuring temperature in neonates?
A)Oral
B)Rectal
C)Axillary
D)Tympanic
Q3) What is the most probable cause for the significant decrease in blood pressure that occurs during inhalation in some patients?
A)Hypovolemia
B)Variable systemic vascular resistance
C)Early left ventricular failure caused by coronary artery insufficiency
D)Negative intrathoracic pressure that diminishes blood flow out of the left ventricle
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6
Chapter 5: Fundamentals of Physical Examination
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Sample Questions
Q1) Which of the following clinical disorders will cause increased resonance to percussion?
A)Atelectasis
B)Pneumonia
C)Pneumothorax
D)Pleural effusion
Q2) Which of the following is not associated with dilated and unresponsive pupils?
A)Opiates
B)Atropine
C)Brain death
D)Catecholamines
Q3) A review of the patient's history of present illness and past clinical history prior to a physical examination is helpful in that it:
A)gives insight into the expected findings during the examination.
B)suggests examination techniques to emphasize.
C)helps establish a rapport with the patient.
D)all of the above.
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Chapter 6: Neurologic Assessment
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Sample Questions
Q1) A patient who is alert and oriented times three would know all of the following things correctly except?
A)First and last name
B)Today's date
C)City in which he or she lives
D)President or head of state's name
Q2) Which of the following anatomic areas is compromised when the patient has dysmetria?
A)Cerebrum
B)Pons
C)Cerebellum
D)Brainstem
Q3) Which of the following diseases may be suggested by the involvement of multiple nerve roots?
A)Myasthenia gravis
B)Guillain-Barré syndrome
C)Brain tumor
D)Intracranial hypertension
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8
Chapter 7: Clinical Laboratory Studies
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Sample Questions
Q1) Which of the following types of white blood cells is responsible for phagocytosis?
A)Basophil
B)Monocyte
C)Neutrophil
D)Lymphocyte
Q2) During evaluation of the enzymes, what disorder is associated with elevation of the CK-MB on electrophoresis?
A)Hepatitis
B)Renal failure
C)Metabolic acidosis
D)Myocardial infarction
Q3) Which of the following organisms is responsible for most cases of bacterial pneumonia?
A)Pseudomonas
B)Klebsiella pneumoniae
C)Staphylococcus aureus
D)Streptococcus pneumoniae
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Chapter 8: Interpretation of Blood Gases
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Sample Questions
Q1) An acute increase in PaCO of 10 to 15 mm Hg causes a corresponding increase in plasma HCO - of how many mEq/L?
A)1
B)2
C)3
D)4
Q2) What is the normal value for CaO ?
A)16-20 vol%
B)12-16 vol%
C)8-12 vol%
D)4-8 vol%
Q3) Which of the following is the most common site for arterial puncture?
A)Radial artery
B)Ulnar artery
C)Temporal artery
D)Jugular artery
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Chapter 9: Pulmonary Function Testing
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Sample Questions
Q1) The body plethysmograph uses which of the following gas laws?
A)Boyle's law
B)Charles' law
C)Gay-Lussac's law
D)Combined gas law
Q2) In a patient with an exacerbation of asthma, airway resistance will be:
A)normal.
B)increased.
C)decreased.
D)impossible to measure.
Q3) In which of the following diseases will the open-circuit nitrogen washout method tend to underestimate the total lung volume?
A)Asthma
B)Emphysema
C)Cystic fibrosis
D)Chronic bronchitis
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11
Chapter 10: Chest Imaging
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Sample Questions
Q1) Which of the following would suggest that a patient has congestive heart failure (CHF)?
A)Low and flat diaphragm
B)Increased cardiothoracic ratio
C)Tracheal deviation
D)Increased retrosternal air space on a lateral film
Q2) Which of the following tissues will look radiolucent on a chest radiograph?
A)Blood
B)Bone
C)Lungs
D)Liver
Q3) What is the significance of the silhouette sign?
A)It allows differentiation between alveolar and interstitial infiltrates.
B)It can aid in detection of pleural effusion.
C)It helps determine whether an infiltrate is in contact with a heart border.
D)It allows differentiation between alveolar and interstitial opacities.
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Chapter 11: Interpretation of Electrocardiogram Tracings
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Sample Questions
Q1) Which of the following is a hallmark of a premature ventricular contraction (PVC)?
A)The QRS complex is early but normal in appearance.
B)The QRS complex is wider than normal.
C)There is a P wave in front of the QRS complex.
D)The T wave moves in the same direction as the QRS complex.
Q2) What is the heart rate if the RR interval is five large boxes apart?
A)40 beats/min
B)60 beats/min
C)90 beats/min
D)120 beats/min
Q3) Which of the following is a characteristic of third-degree heart block?
A)There is a lengthening PR interval.
B)There is often a 2:1 ratio between P waves and QRS complexes.
C)The atrial rate is the same as the ventricular rate.
D)There is no relationship between the P waves and the QRS complexes.
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13
Chapter 12: Neonatal and Pediatric Assessment
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Sample Questions
Q1) Which of the following are typical causes of tachypnea in the newborn?
1)Hypothermia
2)Hypoxemia
3)Respiratory acidosis
4)Pain
A)2, 3, 4
B)2, 4
C)1, 3
D)1, 2, 3, 4
Q2) What does the Ballard examination of a newborn infant assess?
A)Lung maturation
B)Transition from fetal to extrauterine circulation
C)Gestational age
D)Cerebral function
Q3) What clinical problem is associated with low serum levels of calcium and phosphorus?
A)Acute hypoxia
B)Liver failure
C)Poor nutrition
D)Renal failure
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Chapter 13: Older Patient Assessment
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Sample Questions
Q1) Which of the following statements is true about the effects of aging on the pulmonary system?
1)Alveolar septa gradually deteriorate.
2)The number of alveoli gradually decreases.
3)Loss of alveolar walls reduces the surface area for gas exchange.
4)Smooth muscle fibers in the lungs are progressively replaced with fibrous connective tissue.
A)1, 2, 3
B)2, 4
C)1, 3
D)1, 3, 4
Q2) Which of the following PaO values would be normal for an 80-year-old individual who is breathing room air?
A)60 mm Hg
B)65 mm Hg
C)50 mm Hg
D)85 mm Hg
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15
Chapter 14: Respiratory Monitoring in Critical Care
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Sample Questions
Q1) 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.
Q2) Patients who are ventilated with excessively large tidal volumes are at risk for:
A)air trapping.
B)volutrauma.
C)emphysema.
D)hyperventilation.
Q3) On the oxygen dissociation curve (ODC), the P-50 refers to the:
A)partial pressure of oxygen when the hemoglobin is 50% saturated.
B)hemoglobin saturation when the fraction of inspired oxygen is 50%.
C)partial pressure of oxygen when the fraction of inspired oxygen is 50%.
D)hemoglobin saturation when the partial pressure of oxygen is 50 mm Hg.
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Chapter 15: Vascular Pressure Monitoring
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Sample Questions
Q1) When vasodilators such as sodium nitroprusside are administered, it is important to monitor the fall in blood pressure because low blood pressure can:
A)cause arterial spasm.
B)cause a stroke in obese adult patients.
C)decrease blood flow to the coronary arteries.
D)increase the likelihood that pulmonary edema may develop.
Q2) An exaggerated v wave would be found in which of the following conditions?
A)Atrial fibrillation
B)Tricuspid regurgitation
C)Ventricular diastole
D)All of the above
Q3) The normal range for pulmonary artery diastolic pressure is _____ mm Hg.
A)0 to 8
B)8 to 15
C)15 to 28
D)28 to 35
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17
Chapter 16: Cardiac Output Measurement
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Sample Questions
Q1) The greatest determinant of peripheral resistance to blood flow is:
A)the radius of the vessels.
B)the viscosity of the blood.
C)the compliance of the vessels.
D)the distance of the vessels from the heart.
Q2) The normal ejection fraction is approximately:
A)less than 50%.
B)55% to 60%.
C)65% to 70%.
D)75% to 80%.
Q3) At rest, approximately 64% of the total blood volume is stored in the: A)liver.
B)lungs.
C)extremities.
D)venous system.
Q4) According to the Fick equation, what could cause the C(a - v)O to decrease?
A)Exercise
B)High cardiac output
C)Cardiogenic shock
D)High fevers
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Chapter 17: Bronchoscopy
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Sample Questions
Q1) What is the most common sign of xylocaine overdose during bronchoscopy?
A)Tachycardia
B)Bradycardia
C)Seizures
D)Apnea
Q2) Which of the following criteria is least important before a patient is discharged after bronchoscopy?
A)Gag reflex is present
B)Stable vital signs
C)No bleeding is present
D)Ability to swallow without pain
Q3) The bronchoscopy technique that flushes 100 mL of normal saline through the scope's suction channel in four or five increments of 20 to 30 mL to distend the distal bronchioles and fill the alveoli, thereby washing out samples of any microorganisms, is which of the following?
A)Rigid bronchoscopy
B)Bronchoalveolar lavage
C)Bronchial fluoroscopy
D)Transbronchial biopsy
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Chapter 18: Nutrition Assessment
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Sample Questions
Q1) What test is most useful for screening a patient for protein malnutrition?
A)Serum albumin level
B)Triceps skinfold
C)Creatinine-height index
D)BMI
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) Of which of the following components should the majority of dietary intake be made up?
A)Fat
B)Carbohydrate
C)Protein
D)None of the above
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Chapter 19: Sleep and Breathing Assessment
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Sample Questions
Q1) Which of the following diagnostically defines the presence of moderate sleep apnea?
A)AHI of 3
B)AHI of 12
C)AHI of 32
D)AHI of 44
Q2) With what pattern of SDB is SIDS thought to be associated?
A)CSA
B)OSA
C)MSA
D)RERA
Q3) Which of the following will assist the RT in predicting sleep apnea?
A)Epworth Sleepiness Scale (ESS)
B)Berlin Questionnaire
C)Inspection of the chest
D)Electrocardiogram (ECG)
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Chapter 20: Home Care Patient Assessment
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Sample Questions
Q1) The home care RT notices that the patient is producing more sputum than usual.What is the most likely cause?
A)Improved vital capacity
B)An allergic reaction
C)A respiratory infection
D)Heart failure
Q2) Which of the following is a true statement related to reimbursement for RT services in the home care setting?
A)Only oxygen therapy orders allow the RT to be paid.
B)The HME cannot bill for RT hours.
C)All RT time spent in the home can be billed.
D)Only time spent setting up equipment can be reimbursed.
Q3) After teaching the patient to perform a specific skill for his or her home care, what should the RT do?
A)Document the demonstration.
B)Repeat the demonstration.
C)Ask for a return demonstration.
D)Ask the patient if he or she understands.
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Chapter 21: Documentation
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Sample Questions
Q1) The absence of information or the lack of documented recognition of specific problems could result in which one of the following situations?
A)Malpractice
B)Reduction in salary for an RT
C)Reduction in workload
D)Probation status for the clinician at fault
Q2) Which of the following outlines the professional standards for respiratory therapists (RTs)?
1)American Association for Respiratory Care (AARC) clinical practice guidelines
2)Respiratory care practice act and regulations
3)Place of employment
4)The Joint Commission
A)1, 2, and 4
B)1, 2, and 3
C)1, 2, 3, and 4
D)2 and 4
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