Cardiopulmonary Rehabilitation Chapter Exam
Questions
Course
Introduction
Cardiopulmonary Rehabilitation is a specialized course that introduces students to the principles and practices involved in the assessment and management of patients with cardiovascular and pulmonary diseases. The course covers the physiological basis of cardiopulmonary conditions, patient evaluation techniques, exercise prescription, risk factor modification, and the development of comprehensive rehabilitation programs. Emphasis is placed on multidisciplinary approaches, patient education, and long-term management strategies to improve functional capacity, quality of life, and overall outcomes for individuals recovering from heart and lung conditions.
Recommended Textbook
Cardiovascular and Pulmonary Physical Therapy Evidence to Practice 5th Edition by Donna Frownfelter
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Chapter 1: Epidemiology As a Basis for Informing
Contemporary Physical Therapy Practice
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Q1) One of the concepts of the health belief model is self-efficacy,which is defined as:
A) confidence in one's ability to take action.
B) one's belief in the seriousness of a condition.
C) strategies to activate "readiness."
D) one's belief of the chances of getting a condition.
Answer: A
Q2) Modifiable risk factors for ischemic heart disease include increased cholesterol,increased homocysteine,smoking,inactivity,high blood pressure,weight,and:
A) diabetes and stress.
B) diabetes and osteoarthritis.
C) age and family history.
D) sex and past medical history.
Answer: A
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Chapter 2: Oxygen Transport: the Basis of Cardiovascular and Pulmonary Physical Therapy
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Q1) Cellular ATP and creatine phosphate are used first for energy as the patient or client initiates exercise activities; food substances are necessary to maintain energy stores.The process by which energy is created within the body is:
A) an anaerobic process.
B) an aerobic process.
C) a glycolysis process.
D) a glycolytic process.
Answer: C
Q2) What is the normal hematocrit value for men?
A) 38%
B) 40%
C) 42%
D) 44%
Answer: C
Q3) What is the minimum intracellular oxygen pressure needed to support metabolism?
A) 5 mm Hg
B) 3 mm Hg
C) 23 mm Hg
D) 15 mm Hg
Answer: B
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Chapter 3: Cardiovascular and Pulmonary Anatomy
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Q1) The accessory action of the trapezius muscles is said to be:
A) inspiration.
B) expiration.
C) both inspiration and expiration.
D) neither inspiration nor expiration.
Answer: D
Q2) The phrenic nerve passes through the diaphragm along with the inferior vena cava.Both of these structures pierce the diaphragm and create which opening?
A) Vena caval opening
B) Esophageal opening
C) Aortic opening
D) Lymphatic opening
Answer: A
Q3) Movement of the lower ribs during inspiration is described as:
A) caliper movement.
B) pump-handle movement.
C) bucket-handle movement.
D) pivot movement.
Answer: C
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Chapter 4: Cardiovascular and Pulmonary Physiology
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Q1) The period of time in the cardiac cycle when the ventricles fill with blood is known as:
A) ventricular systole.
B) ventricular isovolumic.
C) ventricular diastole.
D) ventricular ejection.
Q2) It is known that red blood cells contain hemoglobin and that hemoglobin has an affinity for oxygen.It is also know that oxygen dissolves into the bloodstream.What factor describes why the oxygen saturation in arterial oxygenated blood not 100%?
A) The oxygen saturation curve
B) High arterial pressure
C) Coronary and pulmonary circulation
D) The brain takes oxygen first
Q3) All of the following factors can affect ventilation and perfusion matching in the cardiovascular and pulmonary system except:
A) smoking history.
B) posture.
C) body position.
D) disease.
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Chapter 5: Cardiovascular and Pulmonary Pathophysiology
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Q1) Angina is an ischemic cardiac event.Most often individuals experiencing angina are prescribed pharmacologic agent.Which anginal event most often is treated with a calcium channel blocker?
A) Angina pectoris
B) Variant angina
C) Stable angina
D) Unstable angina
Q2) Hypercholesterolemia can lead to other cardiovascular diagnoses because:
A) it is always associated with atherosclerotic disease.
B) it increases the blood coagulation rate and increases the risk of blood clot formation.
C) it changes the structure and function of endothelial tissue.
D) it changes the heart rate.
Q3) Which of the following conditions or diseases is NOT considered to be a restrictive lung disorder (RLD)?
A) Pregnancy
B) Bronchiectasis
C) Lung cancer
D) Idiopathic pulmonary fibrosis
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Chapter 6: Cardiovascular and Pulmonary Manifestations of Systemic Conditions
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Q1) For patients diagnosed with sickle cell anemia,all of the following are characteristics of the condition EXCEPT:
A) vitamin K deficiency.
B) pleuritic chest pain.
C) abnormal pulmonary function test results.
D) erythrocyte rigidity.
Q2) The heart and lungs should be seen as a continuous system in as much as changes in one will ultimately affect the other.If the right side of the heart falters in operation,it could result in increased pressure and create a condition known as:
A) right heart failure.
B) pulmonary failure.
C) left heart failure.
D) pulmonary hypertension.
Q3) A patient with left-sided heart failure would likely have changes in which of the following systems?
A) Integumentary system
B) Endocrine system
C) Metabolic system
D) Lymphatic system
8
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Chapter 7: Measurement and Documentation
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Q1) When performing an examination,which of the following is the most accurate?
A) Initial data collection from referral information or the medical record regarding the patient's current medical stability and functional status will limit the examination strategy.
B) The client's goals for physical therapy should be disregarded.
C) The examination begins with and is centered on the client's self-identified problems that may reflect specific impairments; limitations in activity; or restrictions in client-identified roles at home, work, and the community.
D) It is not necessary to examine other body systems other than those stated in the diagnosis.
Q2) Which best describes reliability?
A) A measurement that is ordered or ranked
B) The consistency or reproducibility of a measurement
C) Measurements that provide meaningful information and accurately reflect the characteristic for which the measure is intended
D) A measurement that has a high level of relative error
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Chapter 8: History
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Q1) Which of the following would cause an abnormality in the ventilator pump?
A) Kyphoscoliosis
B) Large pleural effusions
C) Phrenic nerve injuries
D) All of the above
Q2) Which best defines dyspnea?
A) Shortness of breath when the patient assumes the sitting position from the supine position
B) Shortness of breath in one lateral position but not the other
C) Chest pain that originates from the parietal pleura
D) The sensation of difficulty in breathing
Q3) Which is not a cause of coughing?
A) Congestive heart failure
B) Aortic aneurysms decreasing pressure on the bronchi
C) A large left atrium displacing the left mainstem bronchus upward
D) Acute left-side heart failure
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Chapter 9: Pulmonary Function Tests
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Q1) Which of the following would not contribute to preoperative complications with pulmonary function tests?
A) Smoking
B) Younger age
C) Chronic obstructive pulmonary disease
D) Obesity
Q2) Which is not true regarding total lung capacity (TLC)?
A) TLC is the amount of gas the lung contains at the end of a maximum inspiration.
B) A decrease in TLC may be seen in restrictive lung disease, such as pulmonary brosis.
C) It is made up of inspiration capacity (IC) and functional residual capacity (FRC).
D) An increase in TLC may be seen in atelectasis, neoplasms, pleural effusions, and hemothorax.
Q3) Which best describes the work of breathing?
A) The tidal volume (TV) divided by the respiratory rate (RR)
B) The expiratory reserve volume (ERV) times the respiratory rate (RR)
C) The expiratory reserve volume (ERV) divided by the respiratory rate (RR)
D) The tidal volume (TV) times the respiratory rate (RR)
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Chapter 10: Arterial Blood Gases
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Q1) Which best describes cyanosis?
A) An abnormal acid-base balance in which the acids dominate
B) The presence of a bluish color to the skin, mucous membranes, and nail beds
C) An abnormal acid-base balance in which the bases dominate
D) An inability of the kidneys to excrete the normal metabolic acids
Q2) What is the main route for the body to expel normal metabolic acids?
A) The skin
B) The lungs
C) The kidneys
D) The gastrointestinal tract
Q3) Which best describes Dalton's law?
A) In a mixture of gases, the partial pressure is equal to the sum of the total pressures of the separate gases.
B) In a mixture of gases, the total pressure is unequal to the sum of the partial pressures of the separate gases.
C) In a solitary gas, the total pressure is equal to the sum of the partial pressures of the separate gases.
D) In a mixture of gases, the total pressure is equal to the sum of the partial pressures of the separate gases.
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Chapter 11: Imaging of the Chest
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Q1) When assessing the skeleton on a chest radiograph,what should you look for?
A) Facet joint alignment
B) Sacroiliac alignment
C) Stenosis
D) Fractures
Q2) On a radiograph,what does the white area represent?
A) Pockets of air within the body
B) Fatty areas within the body
C) Muscle and other soft tissues
D) Bones within the body
Q3) Which best describes a pneumothorax?
A) It is an area that appears white because of increased tissue density.
B) It does not appear in chest imaging.
C) It causes part of the lung to collapse, creating a less dense empty space in the chest cavity that is devoid of any pulmonary or vascular markings.
D) It fills the chest cavity with fluid that is denser than normal lung tissue.
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Chapter 12: Electrocardiogram Identification
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Q1) With regard to a patient's readiness for activity or participation in a cardiac rehabilitation program,which of the following does not need to be able to be answered by the rehabilitation professional?
A) Recognition of heart rhythms and their associated variations
B) Implications of a rhythms systemic and hemodynamic effects
C) Benign heart rhythms
D) All of the above
Q2) How can a ventricular dysrhythmia be differentiated from a supraventricular dysrhythmia?
A) Taking the patient's heart rate.
B) The length of the QRS segment
C) The presence of an ectopic focus in the atria
D) The absence of QRS complex
Q3) What is the definition of a narrow-complex tachycardia?
A) Supraventricular in origin and has a QRS complex <0.12 sec
B) Ventricular in origin and ha a QRS complex <0.12 sec
C) Supraventricular in origin and has a QRS complex >0.12 sec
D) Ventricular in origin and has a QRS complex > 0.12 sec
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Chapter 13: Multisystem Assessment and Laboratory Investigations
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Q1) Why is knowledge of multisystem function within the body necessary for cardiovascular and pulmonary physical therapists?
A) The cardiovascular and pulmonary systems are affected by virtually all other body systems.
B) It is helpful to confirm a patient's diagnosis.
C) It is helpful to predict a patient's response to treatment as well as his or her prognosis.
D) All of the above
Q2) Which test is used to assess bleeding capacity?
A) Thrombin time
B) Capillary filling time
C) CBC
D) BUN
Q3) Which product of the adrenal glands inhibits the action of insulin and thus the uptake of glucose by cells?
A) Dopamine
B) Cortisol
C) Epinephrine
D) Norepinephrine
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Chapter 14: Special Tests
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Q1) Which of the following may be used as a diagnostic tool or as a form of treatment?
A) Ventilation-perfusion lung scan
B) PET
C) MRI
D) Bronchoscopy
Q2) What type of imaging is valuable in delineating myocardial areas with reversible and irreversible injury and uses short scanning times of 5" to 35"?
A) SPECT
B) PET
C) Planar
D) TEE
Q3) What is the purpose of a ventilation-perfusion lung scan?
A) To diagnose pulmonary embolism
B) To monitor the response to radiotherapy
C) To predict whether someone can tolerate a pneumonectomy
D) All of the above
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Chapter 15: Clinical Evaluation and Assessment of the
Cardiovascular and Pulmonary
Systems
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Q1) Which adventitious breath sounds are described as discontinuous,low-pitched sounds?
A) Crackles
B) Rhonchi
C) Wheezes
D) Whistles
Q2) Which kind of question is likely to give the most valuable information?
A) A yes/no question directed toward a patient
B) An open-ended question directed toward a patient
C) A yes/no question directed toward a patient's family
D) An open-ended question directed toward a patient's family
Q3) Which structural chest deformity describes a depressed lower sternum that usually causes restriction only when it is severe?
A) Flail chest
B) Pigeon chest
C) Pectus carinatum
D) Pectus excavatum
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Page 17
Chapter 16: Monitoring Systems, catheters, and Devices in the Intensive Care Unit
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Q1) Which assessment of arousal and brain activity includes a review of motor,sensory,pain,arousal,and cognitive status?
A) Richmond Agitation-Sedation Scale
B) Glasgow Coma Scale
C) Electroencephalogram
D) FACES scale
Q2) What percentage of intravascular fluid deficit must develop before blood pressure drops significantly?
A) 5% to10%
B) 10% to15%
C) 15% to 25%
D) 25% to 35%
Q3) Which of the following factors contribute to an individual's overall stress,leading to possible complication in the form of acute distress disorder?
A) Pain management
B) Length of ICU stay
C) ICU experience
D) All of the above
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Chapter 17: Maximizing Outcomes: Relating Interventions to an
Individuals Needs
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Q1) The prescription must be reviewed at each treatment session and: A) changed whether or not improvement has been made.
B) changed only if the patient requests.
C) kept the same as the previous week for a 4-week period.
D) modified accordingly.
Q2) Physical therapists often require the results of invasive tests such as: A) bronchoscopy.
B) blood work.
C) invasive hemodynamic monitoring.
D) b and
Q3) Health has been defined by the World Health Organization as:
A) the absence of pathology.
B) a person's capacity to live a life consistent with his or her needs and wants.
C) emotional, spiritual, intellectual, and physical well-being.
D) a and
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Chapter 18: Mobilization and Exercise: Physiological Basis for Assessment,
evaluation, and Training
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Q1) An intervention-related factor that contributes to increased metabolic demand and oxygen consumption is:
A) fever.
B) noise.
C) anxiety.
D) range of motion exercises.
Q2) The goals of mobilization and exercise are directed at:
A) correcting impairments and enhancing the patient's capacity for activity and participation.
B) estimating the limits of a patient's physiological tolerance for mobilization.
C) identifying the specific effects of exercise required and define the optimal therapeutic stimulus.
D) adapting the prescription based on the patient's needs.
Q3) Hospitalized patients whose oxygen transport capacity is reduced or threatened tend to be:
A) hypermetabolic
B) hypometabolic
C) catabolic
D) dehydrated
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Chapter 19: Mobilization and Exercise: Testing and Training
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Q1) The practice of routinely turning patients every 2 hours continues to be an:
A) unrealistic goal for the caregiver.
B) underused standard of care.
C) unaccepted standard of care.
D) accepted standard of care.
Q2) In the mid-1800s,the use of immobilization to heal bones and injuries was extended to the:
A) management of other conditions.
B) treatment of hypotension.
C) treatment of hypertension.
D) kidney stones.
Q3) Side-lying increases end-diastolic ventricular pressure on the dependent side secondary to compression of the viscera beneath the diaphragm and to:
A) atelectasis formation.
B) central pneumothorax lesion.
C) increased lung compliance on that side.
D) reduced lung compliance on that side.
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21
Chapter 20: Body Positioning
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Q1) Exercise has many positive effects on the body; in a study by Oldenberg,exercise was shown to increase:
A) alveolar filling time.
B) mucociliary transport in patients with chronic bronchitis.
C) completion of the oxygen transport chain.
D) mucociliary dysfunction in patients with chronic bronchitis.
Q2) Vibration is applied throughout exhalation concurrent with:
A) slight compression to the chest wall.
B) mild compression to the chest wall.
C) significant compression to the chest wall.
D) maximal compression to the chest wall.
Q3) It has been suggested that exercise can replace:
A) all or part of the stored fats with muscle.
B) the need for physical therapists after cardiovascular insult.
C) the need for pulmonary inhalers.
D) all or part of a conventional chest physiotherapy routine in some patients.
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22
Chapter 21: Airway Clearance Techniques
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Q1) The aim of loosening retained secretions by the use of percussion is so that:
A) they can be sent to the laboratory for culturing.
B) they may be removed by suctioning or expectoration.
C) they can be picked up and removed by the lymphatic system.
D) they may be redirected through collateral circulation.
Q2) Which therapeutic pulmonary modality simultaneously delivers intrathoracic percussion and aerosolized solution for bronchodilation?
A) Extrapulmonary oscillation ventilator (EOV)
B) Intrapulmonary oscillation ventilator (IOV)
C) Extrapulmonary percussive ventilator (EPV)
D) Intrapulmonary percussive ventilator (IPV)
Q3) Inhalation of prescribed bronchodilator medications should take placed before:
A) administration of supplemental oxygen to improve alveolar respiration.
B) airway clearance maneuvers to improve secretion removal by opening the airways.
C) determining the patients resting vital signs.
D) after airway clearance maneuvers to maintain open airways.
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Chapter 22: Facilitating Airway Clearance With Coughing Techniques
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Q1) The anterior chest compression technique is more effective than the costophrenic assist for patients with a very weak:
A) chest wall muscle.
B) immune system.
C) pectoral muscle.
D) abdominal muscle.
Q2) Speech and language pathologists work with patients who have swallowing dysfunction (dysphagia)by:
A) helping them to learn techniques and procedures for safe swallowing.
B) helping them to learn proper breathing techniques to aid in swallowing.
C) helping them to learn proper airway clearing techniques to aid in swallowing.
D) working in conjunction with a physical therapist on a treatment plan.
Q3) A complete lack of glottal closure will not produce any cough or sound because:
A) pulmonary function has been compromised.
B) the vocal folds are not approximating (adducting).
C) respiratory function has been compromised.
D) the focal folds are not separating (abducting).
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Page 24
Chapter 23: Facilitating Ventilation Patterns and Breathing Strategies
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Q1) Normal breathing,repeated rhythmic inspiratory-expiratory cycles,is known as: A) eupnea.
B) hyperpnea.
C) apnea.
D) Cheyne-Stokes respiration
Q2) Time spent in a horizontal position can be used as an opportunity in: A) retention of lung secretions.
B) active drainage.
C) passive drainage.
D) postural orthostatics.
Q3) Patients with either primary pulmonary dysfunction or secondary pulmonary dysfunction can benefit from:
A) chest mobilization.
B) pectoralis facilitation.
C) scalene facilitation.
D) spinal mobilization.
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25
Chapter 24: Exercise Testing and Training: Primary
Cardiopulmonary Dysfunction
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Q1) There is an interaction between circadian rhythms and the pathogenesis of heart rate and blood pressure variability.The rhythms are under the influence of all except the following:
A) renal influence.
B) adrenal influence.
C) autonomic influence.
D) pituitary influence.
Q2) Over the past 20 years,heart transplant had become an accepted therapy for:
A) end-stage heart failure.
B) multivalve failure.
C) conduction blocks.
D) increasing ejection fractions.
Q3) Intermittent claudication is the symptom of exercise-induced muscle ischemia of: A) peripheral venous disease.
B) peripheral arterial disease.
C) central venous disease.
D) central arterial disease.
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Page 26
Chapter 25: Exercise Testing and Training: Secondary
Cardiopulmonary Dysfunction
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Q1) Management of patients with systemic atherosclerosis and circulatory dysfunction is similar to management of patients with which of the following pathologies?
A) Stroke
B) Heart and lung failure
C) End-stage renal disease
D) Hypertension
Q2) Manifestations of oxygen transport limitations or one or more risk factors include individuals with systemic conditions.Goals for these individuals would include all but which of the following?
A) Optimize central adaptation to exercise.
B) Reduce hemodynamic responses.
C) Optimize peripheral adaptation to exercise.
D) Reduce biomechanical stress.
Q3) Individuals with rheumatoid arthritis have a higher incidence of:
A) musculoskeletal disease.
B) neuromuscular disease.
C) pulmonary disease.
D) cardiovascular disease.
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Chapter 26: Respiratory Muscle Training
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Q1) Abnormal respiratory muscle function plays an important role in people with chronic heart failure (CHF)in:
A) extended exercise sessions.
B) extended periods of rest.
C) premature exercise termination.
D) exertional dyspnea.
Q2) Respiratory muscle weakness increase:
A) the movement of the diaphragm.
B) alveolar inflation.
C) the relative load for breathing.
D) collateral circulation.
Q3) Respiratory muscle weakness is not frequently observed in patients with:
A) asthma.
B) chronic bronchitis.
C) acute respiratory failure.
D) chronic obstructive pulmonary disease (COPD).
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Chapter 27: Complementary Therapies As
Cardiopulmonary Physical Therapy Interventions
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Q1) Psychosocial management has been identified as a:
A) mind/body technique that that includes cognitive behavioral interventions
B) pathophysiological basis for applying CAM therapies to cardiovascular conditions
C) specific intervention that addresses psychological stress and hypertension
D) core component of cardiac rehabilitation/secondary prevention programs
Q2) _______ is one of the most well-studied mind/body therapies
A) T'ai chi
B) Meditation
C) Chi
D) Yoga
Q3) Chinese medicine focuses on:
A) enhancing the flow of chi along body pathways or meridians
B) movement awareness techniques
C) acupressure
D) acupuncture
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29
Chapter 28: Patient Education
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Q1) The overall objective of patient education is to develop a:
A) reasonable plan for patient education.
B) durable cognitive improvement that results in a positive change in an individual's or group's health behavior.
C) strong health care contract.
D) make patient education unique when compared with other types of teaching.
Q2) The primary mode of transmission of culture is:
A) friendship.
B) spirituality.
C) education.
D) language.
Q3) The specific content of patient education materials and programs should be determined by:
A) the individual or the group being taught.
B) how quickly the patient can catch on to the education materials.
C) the age of the patient.
D) how long the treatment will continue.
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Chapter 29: Individuals With Acute Medical Conditions
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Q1) Atelectasis is associated with:
A) increased lung compliance.
B) mechanical ventilation.
C) highly mobile patients.
D) total collapse of the lung parenchyma.
Q2) Which of the following pharmacologic approaches is MOST common to address hypertension?
A) Beta-blockers
B) Antihistamines
C) Inotropic agents
D) Digoxin
Q3) Pneumonia:
A) rarely results in morbidity and mortality in hospitalized patients.
B) decreased in the presence of artificial airways.
C) transmitted through contact.
D) often preceded by atelectasis.
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Chapter 30: Individuals With Acute Surgical Conditions
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Q1) Anesthesia results in:
A) decreased atelectasis.
B) depression of breathing.
C) increased functional residual capacity.
D) increased residual volume.
Q2) You have been consulted to evaluate and treat a patient after coronary artery bypass graft via sternotomy.All of the following would be appropriate treatment interventions EXCEPT:
A) postural drainage with percussion.
B) splinted coughing.
C) incentive spirometry.
D) ambulation.
Q3) Which of the following is TRUE regarding the typical pattern of breathing after surgery?
A) Spontaneous deep breaths are normal.
B) Tachypnea and tachycardia are rare.
C) Breath sounds are decreased and lung bases.
D) Mucus is not heard typically on auscultation.
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Chapter 31: Individuals With Chronic Primary
Cardiovascular and Pulmonary
Dysfunction
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Q1) The hallmark sign of peripheral arterial disease is:
A) claudication.
B) angina.
C) confusion.
D) back pain.
Q2) Which of the following should be monitored when working with a patient with valve disease?
A) Rate pressure product
B) Rate of perceived exertion
C) Blood pressure
D) All of the above
Q3) All of the following diagnoses typically fall under the umbrella of chronic airflow limitation EXCEPT:
A) asthma.
B) bronchiectasis.
C) chronic bronchitis.
D) emphysema.
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Page 33
Chapter 32: Individuals With Chronic Secondary
Cardiovascular and Pulmonary Dysfunction
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Q1) Patients with scleroderma may present with esophageal involvement.All of the following would be precautions to take with these patients EXCEPT:
A) avoid recumbency.
B) do not have patients exercise immediately after a meal.
C) educate patient to have well-spaced larger meals.
D) all of the above are precautions.
Q2) Cardiovascular and pulmonary manifestations of systemic lupus erythematous (SLE)are:
A) Atelectasis
B) Barrel chest and overcompliance
C) Pleuritis
D) Pulmonary hypertension
Q3) In the case of cerebral palsy (CP),which of the following would be the MOST appropriate education to provide parents?
A) The importance of assisting with changes in position
B) The necessity of ambulation at all cost
C) The possibly risks and signs of aspiration
D) a and c
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Chapter 33: Comprehensive Management of Individuals in the Intensive Care Unit
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Q1) What change in an ICU patient is associated with reduced cardiac output,reduced blood pressure,hypoxemia,hypercapnia,and increased cranial pressure?
A) Impairment of neuromuscular status
B) Length of stay
C) Maximized oxygen transport
D) Mechanical ventilation will be necessary
Q2) What is the purpose of a Swan-Ganz catheter?
A) Gives an indication of fluid loading
B) Measures the ability of the right side of the heart to cope with changes in circulating body fluids
C) Gives pressures for pulmonary artery pressure and wedge pressure
D) Measures pulmonary sufficiency
Q3) Which of the following is not a relative contraindication of manual airway clearance interventions?
A) Hemorrhage
B) Acute chest trauma
C) Gastric reflux
D) All of these are relative contraindications
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Chapter 34: Intensive Care Management of Individuals
With Primary Cardiovascular and Pulmonary Dysfunction
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Q1) Which of the following may contribute to generally low incidences of complications and mortality after open heart surgery?
A) Emphasis on patient education
B) Early weight bearing
C) Extubating the patient quickly after surgery
D) Foot and ankle exercises
Q2) What pathophysiological deficits are present with advanced chronic airflow limitation caused by acute respiratory failure?
A) Decreased compliance of alveolar tissue
B) Increased diffusing capacity
C) Hyperinflated chest wall
D) Rounded hemidiaphragms
Q3) Which of the following is true regarding positive end-expiratory pressure (PEEP)?
A) Promotes venous return
B) Maintains airway patency during spontaneous ventilation
C) Improves myocardial perfusion
D) Promotes greater opportunity for gas exchange
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Page 36
Chapter 35: Intensive Care Management of Individuals
With Secondary Cardiovascular and Pulmonary Dysfunction
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Q1) What signs and symptoms would you expect to see with a patient with advancing cerebral edema?
A) Deterioration in level of consciousness
B) Exaggerated muscle tone and posture
C) Deterioration in pupillary reflexes
D) All are signs or symptoms of advancing cerebral edema
Q2) Which of the following findings would you not expect with a patient with a flail chest segment?
A) Increased elevation of chest segment during inspiration
B) Instability of the chest wall
C) Chest depression over segment during inspiration
D) Asynchronous movement of the chest wall
Q3) How should you position the bed to reduce intracranial pressure in a patient with a head injury?
A) Head of the bed elevated to 30 to 40 degrees
B) Head of the bed elevated to 50 to 60 degrees
C) Head of the bed declined to 30 to 40 degrees
D) Head of the bed declined to 50 to 60 degrees
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Chapter 36: Intensive Care Management of Medical and Surgical Complications
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Q1) A patient with acute lung injury presents with atelectasis and loss of lung compliance because of the impairment of the production of surfactant and pulmonary fluid that covers the alveolar epithelium.Which type(s)of alveolar cell is/are damaged?
A) Type I
B) Type II
C) Types I and II
D) Type III
Q2) Which of the following is a risk factor of a critical illness neuropathy or myopathy?
A) ICU stays of less than 7 days
B) Patients with hypoglycemia
C) The use of beta-blockers
D) Patients who have had organ transplants
Q3) Which of the following is a complication from surgery that may arise with a patient in intensive care?
A) Pulmonary dysfunction
B) Cardiac dysrhythmias
C) Metabolic dysfunction
D) Deep vein thrombosis
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Chapter 37: Infants and Children With Cardiovascular and Pulmonary Concerns
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Q1) Which of the following is not a common trigger for asthma symptoms and exacerbations?
A) Weight loss
B) Allergens
C) Tobacco smoke
D) Extreme temperatures
Q2) Which of the following conditions is associated with Arnold-Chiari type II malformation?
A) Cerebral palsy
B) Myelomeningocele
C) Down syndrome
D) Muscular dystrophy
Q3) You are creating an exercise program for a 5-year-old patient with cystic fibrosis (CF).What components should be included in your pre-exercise examination and evaluation?
A) Complete chest evaluation
B) Evaluation of ADL tolerance and limitations
C) Evaluation of ROM, strength and posture
D) All of these should be assessed
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Chapter 38: The Aging Patient
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Q1) Increases in functional capacity are seen in young elderly patients who demonstrated which of the following variables?
A) Were younger in age
B) Had a shorter length of training
C) Started with a lower VO max before training
D) Had a shorter duration of training sessions
Q2) Diastolic changes to the heart that occur with aging include which of the following?
A) Prolonged myocardial relaxation
B) Decreases in filling pressures of older men with increased age
C) Increases in peak left ventricular diastolic filling rate in older men
D) Decreases in ventricular stiffness.
Q3) Although the improvements in increasing VO max in elderly people are not clear,which of one the following is consistent?
A) Improvement in thoracic mobility leading to better O saturation with lung expansion
B) Greater extraction of oxygen caused by wider arteriovenous oxygen content
C) Decreases in O demands in the peripheral muscles
D) An increase in maximum heart rate
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Chapter 39: Multisystem Clinical Implications of Impaired
Breathing Mechanics and Postural Control
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Q1) Patients with which form(s)of compensatory breathing patterns need assistance from a ventilator?
A) Type I paradoxical
B) Paradoxical Type II paradoxical
C) Asymmetrical
D) Lateral or gravity eliminated
Q2) Which of the following strategies may be used to optimize thoracic development?
A) Frequent changes in position
B) Facilitation of the weakened chest wall muscles
C) Promotion of optimal breathing patterns
D) All of the above
Q3) If a patient is to work on strengthening muscles to help with expansion of the anterior abdominal wall,how should the therapist position the patient?
A) Prone
B) Supine
C) Side-lying
D) Sitting
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Chapter 40: The Transplant Patient
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Q1) One of the major limitations of organ transplantation comes from which of the following?
A) The risk of disease that is inherent in all tissue
B) The increasing demand with limited supply
C) Lack of organization
D) All of the above
Q2) What change was made in 2005 to determine the priority of patients needing lung transplants?
A) Those on the waiting list the longest were considered first.
B) Those with greater medical emergency were considered first.
C) Those with the least possibility of rejection were considered first.
D) Those with the greatest number of comorbidities were considered first.
Q3) What time frame is provided for weaning of patients from mechanical ventilation after heart transplant surgery?
A) 12 to 24 hours
B) 24 to 36 hours
C) 12 to 36 hours
D) 24 to 48 hours
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Chapter 41: The Patient in the Community
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Q1) Positive self-management involves the combination of which of the following?
A) Positive emotional outlook
B) Active involvement in decision making
C) Maintenance of a lifestyle that is as optimal as possible
D) All of the above
Q2) The goal of helping a patient accomplish what he or she wants day with regard to return to function excludes which of the following?
A) Knowledge of symptoms
B) Reliance on a support system
C) Return to prior level of function immediately
D) Goal setting that allows easy achievement
Q3) Which interaction will provide the patient with the optimal outcome when setting up a plan of care?
A) Strategies to help the patient stay motivated
B) Information about living with a chronic condition
C) Review of current pathology
D) Helping the patient to take charge of his or her care
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Chapter 42: Body Mechanics: Positioning and Moving Patients
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Q1) Which patient position limits the effect of gravity on anterior expansion of the lungs?
A) Supine
B) Side-lying
C) Hook-lying
D) Prone
Q2) Which position is generally best for a patient with acute respiratory distress syndrome (ARDS)?
A) Supine
B) Side-lying
C) Hook-lying
D) Prone
Q3) To what level should a patient's bed be adjusted to facilitate a lift by a practitioner?
A) The lifter's mid-thigh level
B) The lifter's hip level
C) The lifter's thoracic level
D) The lifter's elbow level
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Chapter 43: Respiratory Care Practice Review
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Q1) Which is a serious concern when portable oxygen is prescribed?
A) Cooking with a gas stove
B) Smoking or having others smoke nearby
C) The patient's understanding about his or her prescribed level of oxygen
D) All of the above
Q2) Which is an appropriate purpose of oxygen therapy?
A) Treat and prevent hypoxemia.
B) Treat and prevent excessive work of breathing.
C) Treat and prevent excessive myocardial work.
D) All of the above
Q3) Which term describes the speed at which a ventilator breath is delivered?
A) Frequency
B) Flow rate
C) Spontaneous breath
D) Trigger
Q4) Which of the following is used to ensure mandatory minute ventilation?
A) Pressure support ventilation
B) Triggers
C) Incentive spirometry
D) None of the above
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Chapter
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Q1) Which vacuum settings should be used while suctioning?
A) The lowest possible settings (<120 mm Hg)
B) The highest possible settings
C) Between 120 and 200 mm Hg
D) None of the above
Q2) Which is a potential complication from tracheal suctioning?
A) Hypoxemia
B) Cardiac dysrhythmia
C) Bronchospasm
D) All of the above
Q3) In which position should nasotracheal and pharyngeal suctioning be done?
A) Fully supine position
B) Fowler position
C) Trendelenburg position
D) Side-lying position
Q4) Which term refers to the removal of an artificial airway?
A) Decannulation
B) Intubation
C) Excision
D) Tracheostomy
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Chapter 45: Respiratory and Cardiovascular Drug Actions
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Q1) Long-term use of which of the following often leads to Cushing syndrome?
A) Adrenergic drugs
B) Propranolol
C) Anticholinergics
D) Corticosteroids
Q2) Which is an advantage of using a nebulizer instead of a metered-dose inhaler (MDI)?
A) Does not require hand-breathing coordination
B) More portable
C) Less expensive
D) All of the above
Q3) Which is an expectorant that acts by increasing the production of respiratory secretions?
A) Guaifenesin
B) Acetylcysteine
C) Zileuton
D) Cromolyn sodium
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