Clinical Assessment in Respiratory Therapy Exam Solutions
Course Introduction
Clinical Assessment in Respiratory Therapy is a comprehensive course designed to equip students with the knowledge and skills necessary for evaluating patients with respiratory disorders. The course emphasizes systematic assessment techniques, including patient history taking, physical examination, and the interpretation of diagnostic tests such as arterial blood gases, pulmonary function tests, and imaging studies. Students will learn to recognize clinical signs and symptoms, assess the severity of respiratory impairment, and integrate assessment findings into effective care plans. Through a combination of lectures, demonstrations, and hands-on practice, the course prepares students for competent clinical decision-making and application of evidence-based assessment strategies in various healthcare settings.
Recommended Textbook
Clinical Manifestations and Assessment of Respiratory Disease 7th Edition by Terry Des Jardins
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44 Chapters
673 Verified Questions
673 Flashcards
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Page 2
Chapter 1: The Patient Interview
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Sample Questions
Q1) During the interview the patient states, "Every time I climb the stairs I have to stop to catch my breath." Hearing this, the respiratory therapist replies, "So, it sounds like you get short of breath climbing stairs." This interviewing technique is called:
A) clarification.
B) modeling.
C) empathy.
D) reflection.
Answer: D
Q2) The respiratory therapist is conducting a patient interview. The therapist chooses to use open-ended questions. Open-ended questions allow the therapist to do all of the following EXCEPT:
A) gather information when a patient introduces a new topic.
B) introduce a new subject area.
C) begin the interview process.
D) gather specific information.
Answer: D
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Chapter 2: The Physical Examination and Its Basis in Physiology
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Sample Questions
Q1) A 50-year-old patient has a heart rate by palpation of 120 bpm. How should this be interpreted?
A) Within the normal range for an adult
B) An error since a stethoscope was not used
C) Bradycardia
D) Tachycardia
Answer: D
Q2) Tachypnea may be the result of:
1) hypoxemia.
2) hypothermia.
3) fever.
4) sedation.
A) 2, 4
B) 1, 3
C) 2, 3, 4
D) 1, 2, 3, 4
Answer: B
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Page 4
Chapter 3: Pulmonary Function Study Assessments
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Sample Questions
Q1) Which of the following forced vital capacity test times should be interpreted as normal?
A) Less than 4 seconds
B) 4 to 6 seconds
C) 6 to 8 seconds
D) 8 to 10 seconds
Answer: B
Q2) The FEF<sub>25%-75%</sub> is used to evaluate:
A) flow in large airways.
B) restrictive lung disease.
C) maximum breathing effort.
D) flow in medium-size to small airways.
Answer: D
Q3) A special indirect measurement procedure must be done to find which of the following?
A) Inspiratory reserve volume
B) Residual volume
C) Expiratory reserve volume
D) Inspiratory capacity
Answer: B
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Chapter 4: Arterial Blood Gas Assessments
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Sample Questions
Q1) An anion gap of 15 would indicate:
A) metabolic acidosis.
B) respiratory alkalosis.
C) respiratory acidosis.
D) metabolic alkalosis.
Q2) Common causes of metabolic acidosis include all of the following EXCEPT:
A) diabetic ketoacidosis.
B) shallow breathing from a sedative overdose.
C) lactic acidosis.
D) renal (kidney) failure.
Q3) Which of the following would be a normal person's arterial carbon dioxide pressure (PaCO<sub>2</sub>)?
A) 25 to 35 mm Hg
B) 35 to 45 mm Hg
C) 45 to 60 mm Hg
D) 60 to 80 mm Hg
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Chapter 5: Oxygenation Assessments
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Sample Questions
Q1) A sample of blood has been taken from a patient's pulmonary artery. What mixed venous oxygen saturation value (SvO<sub>2</sub>) would indicate that the patient is normal?
A) 40 mm Hg
B) 95 mm Hg
C) 75%
D) 97%
Q2) Oxygen consumption:
1) increases with exercise.
2) is the amount of oxygen used by the body.
3) is inversely related to carbon dioxide production.
4) is about 250 mL/min in the resting adult.
A) 1, 2
B) 3, 4
C) 2, 4
D) 1, 2, 4
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Chapter 6: Cardiovascular System Assessments
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Sample Questions
Q1) A pulmonary artery (Swan-Ganz) catheter can be used for all of the following EXCEPT:
A) measuring cardiac output.
B) arterial blood sampling.
C) measuring left atrial pressure.
D) measuring pulmonary artery pressure.
Q2) Which of the following hemodynamic changes are commonly seen in a patient with cardiogenic pulmonary edema?
1) Increased pulmonary capillary wedge pressure (PCWP)
2) Increased pulmonary vascular resistance (PVR)
3) Decreased mean pulmonary artery pressure (PA)
4) Decreased cardiac output (CO)
A) 1, 4
B) 2, 3
C) 1, 2, 3
D) 1, 2, 3, 4
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8
Chapter 7: Radiologic Examination of the Chest
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Sample Questions
Q1) The chest radiograph shows blunting of the patient's costophrenic angles. What does this suggest?
A) The patient did not take a deep enough breath.
B) Lung cancer
C) Pleural fluid
D) Underpenetrated exposure on the film
Q2) Which of the following are evaluated on a chest radiograph?
1) The bony structures
2) Exposure quality
3) The heart shadow
4) The tracheobronchial tree
A) 4
B) 1, 4
C) 1, 2, 4
D) 1, 2, 3, 4
Q3) For most chest x-ray studies, what is usually done?
A) There is a full exhalation.
B) There is a full inspiration.
C) Separate inspiratory and expiratory films are taken.
D) The patient is told to pant to provide a middle lung volume.
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Chapter 8: Other Important Tests and Procedures
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Sample Questions
Q1) For blood urea nitrogen (BUN) and creatinine values:
A) serum creatinine is a protein produced in the kidneys.
B) BUN and serum creatinine values that are higher than the normal range indicate renal failure.
C) urea is a waste product of carbohydrate metabolism in the intestines.
D) BUN values that are below normal indicate renal failure.
Q2) The respiratory therapist is caring for a patient who is receiving diuretic therapy as part of the medication regimen for her congestive heart failure. Which of the following would the therapist MOST likely monitor in watching for common side effects associated with diuretic therapy?
A) Hypokalemia
B) Hyperchloremia
C) Hyperbilirubinemia
D) Hyponatremia
Q3) Therapeutic bronchoscopy is used for all of the following EXCEPT:
A) to remove a foreign body.
B) in selective lavage.
C) in bronchiectasis evaluation.
D) to manage life-threatening hemoptysis.
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Page 10
Chapter 9: The Therapist-Driven Protocol Program and the
Role of the Respiratory Therapist
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Sample Questions
Q1) When a patient has acute MI, which of the following protocols should the respiratory therapist initiate?
A) Hyperinflation therapy protocol
B) Oxygen therapy protocol
C) Bronchopulmonary hygiene therapy protocol
D) Aerosolized medication therapy protocol
Q2) When performing a therapist-driven protocol (TDP), the severity assessment determines:
A) the frequency of performing a treatment modality.
B) the baseline dyspnea index.
C) the number of hospital days covered by the insurance carrier.
D) how urgently the physician wants the patient treated.
Q3) A TDP can be started after:
A) the nurse finishes his or her assessment.
B) the treatment option is selected.
C) a physician's order for the TDP is received.
D) authorization is received from the patient's insurance carrier.
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Page 11
Chapter 10: Respiratory Failure and the Mechanical
Ventilation Protocol
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Sample Questions
Q1) All of the following are causes of hypercapnic respiratory failure EXCEPT: A) impending ventilatory failure.
B) apnea.
C) severe refractory hypoxemia.
D) acute ventilatory failure.
Q2) All of the following are contraindications for noninvasive ventilation (NIV) EXCEPT: A) facial and head trauma.
B) community-acquired pneumonia.
C) copious, viscous sputum.
D) severe upper GI bleeding.
Q3) Which of the following are clinical indicators of Type I respiratory failure?
1) Decreased PaO<sub>2</sub>
2) Increased P(A-a)O<sub>2</sub>
3) Decreased PaO<sub>2</sub>/FIO<sub>2</sub>
4) Decreased ÓS/ÓT
A) 1, 2
B) 2, 4
C) 1, 2, 3
D) 1, 2, 3, 4
Page 12
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Chapter 11: Recording Skills: The Basis for Data Collection,
Organization, Assessment Skill
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Sample Questions
Q1) Which agency should be notified if violations of HIPAA regulations have occurred?
A) HHS
B) FDA
C) CDC
D) Joint Commission
Q2) When reviewing a SOAPIER progress note, all of the following would be found in the O area EXCEPT:
A) hemodynamic data.
B) patient's admission complaint.
C) blood pressure.
D) sputum production.
Q3) When reviewing a SOAPIER progress note, the R stands for:
A) revisions made in the original plan.
B) reimbursement by the insurance carrier.
C) respiratory care notes.
D) resuscitation status of the patient.
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Chapter 12: Chronic Obstructive Pulmonary Disease (COPD),
Chronic Bronchitis, and Emphysema
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Sample Questions
Q1) In the United States, the primary factor leading to the development of COPD is:
A) a1-antitrypsin deficiency.
B) recurrent respiratory infections.
C) socioeconomic status.
D) tobacco smoking.
Q2) Which of the following are clinical findings associated with chronic bronchitis?
1) Cyanosis
2) Purulent sputum
3) Right heart failure
4) Elevated CO<sub>2</sub> level
A) 1, 2
B) 3, 4
C) 1, 3
D) 1, 2, 3, 4
Q3) What is the term for the inward movement of the lateral chest wall during inspiration?
A) Truman's sign
B) Burton's sign
C) Carr's sign
D) Hoover's sign
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Chapter 13: Asthma
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Sample Questions
Q1) What term is used to describe the situation when an initial asthmatic response occurs within 1 hour of exposure to an allergen followed by a delayed asthmatic response hours later?
A)Deferred dyspneic response
B)Asynchronous activation response
C)Biphasic response
D)Bipolar response
Q2) Which of the following ABG values would be consistent with ventilatory failure with hypoxemia in a patient with severe status asthmaticus?
1) Increased PaCO<sub>2</sub>
2) Decreased SaO<sub>2</sub>
3) Increased pH
4) Decreased pH
A) 1, 2
B) 2, 3
C) 1, 2, 4
D) 1, 3, 4
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Chapter 14: Bronchiectasis
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Sample Questions
Q1) Which of the following should a patient with bronchiectasis do to reduce the risk of the condition worsening?
1) Avoid air pollution.
2) Get an influenza vaccination.
3) Take an antibiotic every day.
4) Avoid smoking.
A) 3, 4
B) 1, 2, 4
C) 2, 3, 4
D) 1, 2, 3, 4
Q2) A patient with severe bronchiectasis may show all of the following signs EXCEPT:
A) distended neck veins.
B) pitting edema.
C) enlarged and tender liver.
D) S<sub>3</sub> heart sound.
Q3) The preferred radiographic method to evaluate a patient's bronchiectasis is:
A) posterior-anterior radiograph (x-ray).
B) anterior-posterior radiograph (x-ray).
C) computed tomography (CT).
D) bronchogram.
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Chapter 15: Cystic Fibrosis
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Sample Questions
Q1) During the advanced stages of cystic fibrosis, the anatomic alterations cause the patient to have:
A) a primarily restrictive lung disease.
B) a primarily obstructive lung disease.
C) equal parts restrictive and obstructive lung disease.
D) normal airways with emphysema.
Q2) What complicating pulmonary problem is likely to happen to a patient with cystic fibrosis?
A) Pulmonary edema
B) Pleural effusion
C) Spontaneous pneumothorax
D) Cardiac tamponade
Q3) Which ethnic group has the greatest number of people with cystic fibrosis?
A) African-Americans
B) Asians
C) Hispanics
D) Caucasians
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Chapter 16: Pneumonia
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Sample Questions
Q1) Which of the following pulmonary infections is most commonly seen in patients with AIDS?
A) Anaerobic
B) Pneumocystis jiroveci
C) Streptococcus pneumoniae (Diplococcus pneumoniae)
D) Legionella pneumophila
Q2) A patient has a pleural effusion related to her pneumonia. Which of the following should the respiratory therapist recommend to treat the pleural effusion?
A) Hyperinflation therapy
B) Supplemental oxygen
C) Thoracentesis
D) Percussion and postural drainage
Q3) All of the following are considered to be normal causative agents for community-acquired pneumonia (CAP) EXCEPT:
A) staphylococcal pneumonia.
B) Haemophilus influenza.
C) Legionella pneumophila.
D) Candida albicans.
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18
Chapter 17: Lung Abscess
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Sample Questions
Q1) A patient with an abscess has produced a large volume of brown-colored, putrid sputum. What type of microorganism would most likely result in brown, putrid sputum production?
A) Fungi
B) Viruses
C) Aerobic bacteria
D) Anaerobic bacteria
Q2) An unconscious patient aspirated gastric contents. Which of the following anaerobic microorganisms would likely now be found in her lower respiratory tract?
1) Legionella pneumophila
2) Pseudomonas aeruginosa
3) Peptococci
4) Bacteroides fragilis
A) 1, 3
B) 3, 4
C) 1, 3, 4
D) 1, 2, 3, 4
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Chapter 18: Tuberculosis
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Sample Questions
Q1) What medication is used to treat a person who has converted to a positive TB skin test but does not have active disease?
A) Virazole
B) Isoniazid
C) Rifampin
D) Tetracycline
Q2) The preferred stain that is used to identify the TB organism is called:
A) Gram stain.
B) fluorescent acid-fast stain.
C) Ziehl-Neelsen.
D) gentian violet.
Q3) Mycobacterium tuberculosis is particularly damaging to the lungs because of the:
A) healing of a tubercle.
B) formation of micropulmonary emboli.
C) increased mucus production.
D) irreversible bronchospasm that it causes.
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Chapter 19: Fungal Diseases of the Lung
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Sample Questions
Q1) A patient has an Aspergillus niger infection. What should be used to treat it?
A) Fluconazole (Diflucan)
B) Ribavirin (Virazole)
C) Metronidazole (Flagyl)
D) Ketoconazole (Nizoral)
Q2) A skin test is available to confirm which of the following fungal infections?
A) Coccidioidomycosis
B) Blastomycosis
C) Tuberculosis
D) Pseudomonal infection
Q3) Fungal lung infections are usually spread by:
A) inhaling spores.
B) blood.
C) contact with infected sputum.
D) inhaling infected droplets.
Q4) Fungal diseases cause which type of pulmonary disorder?
A) An acute restrictive disorder
B) A chronic restrictive disorder
C) An acute obstructive disorder
D) A chronic obstructive disorder
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Chapter 20: Pulmonary Edema
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Sample Questions
Q1) A patient has a decreased oncotic pressure. What can be done to increase it?
A) High-salt diet
B) Mannitol
C) Albumin withheld
D) Morphine sulfate
Q2) The respiratory therapist is asked to evaluate a patient with suspected congestive heart failure. Which of the following laboratory tests should the respiratory therapist recommend to evaluate the patient for possible congestive heart failure?
A) Brain natriuretic peptide (BNP)
B) Lactic dehydrogenase (LDH)
C) Aspartate aminotransferase (AST)
D) Alanine aminotransferase (ALT)
Q3) All of the following may be causes of cardiogenic pulmonary edema EXCEPT:
A) dysrhythmias.
B) systemic hypertension.
C) congenital heart defects.
D) excessive fluid administration.
E) pulmonary embolism.
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Chapter 21: Pulmonary Vascular Disease: Pulmonary
Embolism and Pulmonary Hypertension
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Sample Questions
Q1) Bronchospasm may happen after a pulmonary embolism. Which of the following can lead to this bronchospasm?
1) Localized hypoxemia
2) Localized hypercapnia
3) Localized hypocapnia
4) Release of cellular mediators from platelets
A) 1, 2
B) 2, 4
C) 1, 3
D) 1, 3, 4
Q2) A pulmonary angiogram is usually ordered:
A) as the first test to identify a pulmonary embolism.
B) when other tests for a pulmonary embolism are inconclusive.
C) in conjunction with a magnetic resonance image to identify a pulmonary embolism.
D) in conjunction with an extremity venogram to identify a pulmonary embolism.
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Chapter 22: Flail Chest
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Sample Questions
Q1) What is the term for abnormal gas movement from one lung to the other?
A) Paradoxical movement
B) Pendelluft
C) Palindromic breathing
D) Pneumatic shift
Q2) How many days of ventilatory support are anticipated for a patient with a flail chest to allow sufficient time for bone healing?
A) 3 to 5 days
B) 5 to 10 days
C) 12 to 15 days
D) 18 to 21 days
Q3) What is the most common finding at the site of the flail portion of a flail chest?
A) Pulmonary contusion
B) Pulmonary abscess
C) Pulmonary edema
D) Pulmonary fibrosis
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Chapter 23: Pneumothorax
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Sample Questions
Q1) A 40-year-old patient requires placement of a thoracostomy chest tube. All of the following are recommended for the procedure EXCEPT:
A) application of -5-cm H<sub>2</sub>O pressure to the chest tube.
B) use of a No. 28 to 36 French gauge tube.
C) placement of the tube at the apex of the lung.
D) clamping and removing the tube within 24 hours of insertion.
Q2) After a patient experienced four pneumothoraces of her right lung over a 24-month period, the physician recommended a procedure to reduce the occurrence of future pneumothoraces. Which procedure would the physician have recommended?
A) Pleurodesis
B) Right pneumonectomy
C) Permanent right-sided thoracostomy tube
D) Right upper lobectomy
Q3) Which type of untreated pneumothorax is considered to be the most serious?
A) Spontaneous
B) Tension
C) Malignant
D) Iatrogenic
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25
Chapter 24: Pleural Effusion and Empyema
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Sample Questions
Q1) What is the most common cause of a chylothorax?
A) Thoracic duct trauma
B) Abdominal tumor
C) GERD
D) Pyloric stenosis
Q2) The major pathologic and structural changes associated with a significant pleural effusion include all of the following EXCEPT:
A) diaphragm elevation.
B) atelectasis.
C) compression of the great vessels.
D) lung compression.
Q3) What percentage of patients with bacterial pneumonia are likely to develop pleural effusion?
A) Up to 10%
B) Up to 20%
C) Up to 30%
D) Up to 40%
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26
Chapter 25: Kyphoscoliosis
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Sample Questions
Q1) Which of the following chest assessment findings are associated with kyphoscoliosis?
1) Crackles or wheezing
2) Hyperresonant percussion note
3) Whispered pectoriloquy
4) Tracheal shift
A) 1, 2
B) 3, 4
C) 1, 3, 4
D) 1, 2, 3, 4
Q2) The Charleston bending brace is preferred over other braces because it:
1) is worn only 23 hours a day.
2) is worn for 8 to 10 hours at night.
3) is worn at night, when human growth hormone level is highest.
4) corrects any associated upper airway obstruction.
A) 1
B) 2
C) 2, 3
D) 1, 3, 4
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Chapter 26: Interstitial Lung Diseases
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Sample Questions
Q1) What is another name for rheumatoid pneumoconiosis?
A) Goodpasture's syndrome
B) Caplan's syndrome
C) Churg-Strauss syndrome
D) Sjögren's syndrome
Q2) The diffusing capacity of a patient with coal worker's pneumoconiosis or silicosis would be expected to be:
A) normal.
B) increased.
C) decreased.
D) variable based on the age of the patient.
Q3) What major pathologic and structural changes are associated with asbestosis?
1) Fibrocalcific pleural plaques
2) Excessive bronchial secretions
3) Bronchospasm
4) Mediastinal shift
A) 1, 3
B) 2, 4
C) 1, 2, 3
D) 1, 2, 3, 4
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Chapter 27: Cancer of the Lung
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Q1) The most common cause of lung cancer is:
A) cigarette smoking.
B) air pollution.
C) exposure to asbestos.
D) exposure to radon gas.
Q2) Chest radiograph findings associated with lung cancer include all of the following EXCEPT a(n):
A) large irregular mass.
B) enlarged heart.
C) coin lesion.
D) pleural effusion.
Q3) During bronchoscopy, a tumor was found in the right mainstem bronchus. What is the recommended treatment?
A) Pneumonectomy
B) Brachytherapy
C) Cryotherapy
D) Photodynamic therapy
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Chapter 28: Acute Respiratory Distress Syndrome
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Q1) Which of the following pulmonary changes are associated with ARDS?
1) Abnormal surfactant
2) Interstitial edema
3) Decreased shunt
4) Narrowing of the alveolar-capillary membrane
A) 1, 2
B) 3, 4
C) 1, 3
D) 1, 2, 3
Q2) A patient has a prolonged case of ARDS. What changes would be expected in the patient's alveolar cells?
A) Multiplication of the type I cells
B) Influx of macrophages
C) Hyperplasia and swelling of the type II cells
D) Development of emphysema
Q3) ARDS can result from the inhalation of all of the following EXCEPT:
A) FIO<sub>2</sub> >0.60 for prolonged exposure.
B) nitrogen dioxide.
C) very dry air.
D) chlorine gas.
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Chapter 29: Guillain-Barré Syndrome
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Q1) Which of following has been shown to shorten the course of a severe case of Guillain-Barré syndrome?
A) Renal dialysis
B) Plasmapheresis
C) Blood transfusion
D) NSAIDs
Q2) The diagnosis of Guillain-Barré syndrome is based on all of the following EXCEPT:
A) urinalysis shows elevated blood urea nitrogen.
B) abnormal electromyography results.
C) cerebrospinal fluid shows elevated protein level.
D) clinical history.
Q3) Approximately what percentage of patients with GBS develop respiratory muscle paralysis?
A) <5%
B) 6% to 9%
C) 10% to 30%
D) 31% to 50%
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Chapter 30: Myasthenia Gravis
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Sample Questions
Q1) The major pathologic or structural changes of the lungs associated with myasthenic crisis include:
1) alveolar consolidation.
2) airway obstruction.
3) mucus accumulation.
4) atelectasis.
A) 1, 4
B) 2, 3
C) 2, 3, 4
D) 1, 2, 3, 4
Q2) What clinical change would be expected following a rest period for a patient with myasthenia gravis?
A) There is no clinical change.
B) Strength decreases.
C) Muscle strength improves.
D) Ascending paralysis descends.
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Chapter 31: Sleep Apnea
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Sample Questions
Q1) Signs and symptoms associated with obstructive sleep apnea include:
1) insomnia.
2) excessive daytime sleepiness.
3) hypothyroidism.
4) metabolic alkalosis.
A) 1, 2
B) 3, 4
C) 1, 2, 4
D) 1, 2, 3, 4
Q2) During a pulmonary function study, it was found that a patient has a sawtooth pattern on his flow-volume loop. What is this finding associated with?
A) Central sleep apnea
B) COPD
C) Obstructive sleep apnea
D) Laryngeal edema (epiglottitis)
Q3) Which of the following cardiac dysrhythmias is life threatening?
A) Atrioventricular block
B) Sinus bradycardia
C) Ventricular tachycardia
D) Premature ventricular contraction
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Chapter 32: Clinical Manifestations Common with Newborn and
Early Childhood Respiratory Dis
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Sample Questions
Q1) Which of the following can trigger apnea in the premature infant?
1) Micrognathia
2) Intracranial hemorrhage
3) REM sleep
4) Hypothermia
A) 2
B) 3, 4
C) 1, 2, 3
D) 1, 2, 3, 4
Q2) Apnea of prematurity can be defined as:
1) respiratory pause causing bradycardia.
2) cycles of short breathing pauses followed by faster breathing.
3) no breathing for >20 seconds.
4) sudden apnea and death (crib death).
A) 4
B) 2
C) 1, 3
D) 3, 4
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Chapter 33: Meconium Aspiration Syndrome
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Sample Questions
Q1) An infant with MAS will show what clinical manifestations associated with the more negative intrapleural pressures needed during inspiration?
1) Seesaw breathing movement
2) Breath sounds reveal rhonchi and crackles
3) Expiratory grunting
4) Cyanosis of the dependent thoracic areas
A) 1, 4
B) 2, 3
C) 2, 3, 4
D) 1, 2, 3, 4
Q2) How may a fetus respond when he or she becomes hypoxemic?
A) The fetus stops making breathing efforts.
B) The fetus makes rapid, shallow chest movements.
C) The fetus makes very deep, gasping inspiratory movements.
D) The fetus shows Kussmaul respirations.
Q3) A common finding in a neonate with MAS is a respiratory rate that is:
A) under 40/min.
B) between 40 and 60/min.
C) well over 60/min.
D) cyclical with faster and then slower breaths.
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Chapter 34: Transient Tachypnea of the Newborn
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Sample Questions
Q1) Which of the following breathing patterns are associated with TTN?
1) Normal rate
2) Rapid rate
3) Higher than normal tidal volume
4) Shallow tidal volume
A) 1, 3
B) 2, 3
C) 1, 4
D) 2, 4
Q2) What respiratory rate would be expected during the physical exam of a patient with TTN?
A) 80 to 120 breaths/min
B) 30 to 40 breaths/min
C) 20 to 30 breaths/min
D) Less than 20 breaths/min
Q3) At what gestational age is TTN most common?
A) 26 to 28 weeks' gestational age
B) 28 to 30 weeks' gestational age
C) 34 to 36 weeks' gestational age
D) 38 to 40 weeks' gestational age
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Chapter 35: Respiratory Distress Syndrome
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Sample Questions
Q1) A patient with RDS has alveolar hypoxia and pulmonary vasoconstriction. How will this affect his blood flow?
1) Blood shunts through the foramen ovale
2) Increased systemic blood flow
3) Blood shunts through the ductus arteriosus
4) Decreased blood flow to the gut
A) 2, 4
B) 1, 3
C) 1, 2, 3
D) 1, 2, 3, 4
Q2) A mother is about to deliver a 25-weeks' gestation infant. What therapeutic intervention should the respiratory therapist be prepared to give to minimize the risk of RDS?
A) Mask CPAP
B) Airway suctioning
C) Exogenous surfactant
D) Mechanical ventilation
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Chapter 36: Pulmonary Air Leak Syndromes
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Sample Questions
Q1) What clinical manifestations are associated with the more negative intrapleural pressures generated during inspiration by a patient with pulmonary air leak syndrome?
1) Cyanosis of dependent thorax and abdomen
2) Intercostal and substernal retractions
3) Flaring nostrils
4) Inspiratory stridor
A) 1, 3
B) 2, 3
C) 1, 2, 3
D) 1, 2, 3, 4
Q2) All of the following are associated with a pneumopericardium EXCEPT: A) systemic hypotension.
B) reduced cardiac output.
C) decreased stroke volume.
D) increased cardiac index.
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Chapter 37: Respiratory Syncytial Virus (Bronchiolitis or Pneumonitis)
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Sample Questions
Q1) Outbreaks of RSV are usually found in all of the following seasons of the year EXCEPT: A) spring.
B) summer.
C) fall.
D) winter.
Q2) A respiratory syncytial virus (RSV) infection will cause which of the following anatomic alterations of the lungs?
1) Chemical pneumonitis of the small airways
2) Peribronchiolar mononuclear infiltration
3) Small airway epithelial necrosis
4) Edema of the epiglottis and upper airway
A) 1, 4
B) 2, 3
C) 1, 2, 3
D) 2, 3, 4
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Chapter 38: Bronchopulmonary Dysplasia
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Sample Questions
Q1) What is the most significant treatment of the neonate for the prevention of BPD?
A) Corticosteroids
B) Diuretic therapy
C) Vitamin E therapy
D) Exogenous surfactant
Q2) A patient with classic Stage 1 BPD will have which of the following chest radiograph findings?
A) Ground-glass granular pattern
B) Emphysematous bullae
C) Honeycomb appearance
D) Mediastinal shift
Q3) Which of the following clinical manifestations are associated with BPD?
1) Expiratory grunting
2) Wheezes and crackles
3) Flaring nostrils
4) Intercostal retractions
A) 1, 3
B) 1, 3, 4
C) 1, 2, 4
D) 1, 2, 3, 4
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Chapter 39: Congenital Diaphragmatic Hernia
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Sample Questions
Q1) All of the following anatomic alterations may be found in a patient with a congenital diaphragmatic hernia EXCEPT:
A) lungs are compressed.
B) atelectasis.
C) hyperinflation.
D) complete lung collapse.
Q2) What effect would a substantial left-sided CDH have on pulmonary function test findings?
A) A restrictive pulmonary disorder
B) An obstructive pulmonary disorder
C) An equally restrictive and obstructive disorder
D) A restrictive disorder with increased DLCO
Q3) When does respiratory distress normally develop in a newborn with a CDH?
A) Shortly after delivery
B) 6 to 12 hours after delivery
C) 12 to 24 hours after delivery
D) 24 to 48 hours after delivery
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Chapter 40: Congenital Heart Diseases
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Q1) Which of the following are considered to be noncyanotic defects?
1) PDA
2) ASD
3) TOF
4) VSD
A) 1, 2
B) 2, 3
C) 1, 2, 4
D) 1, 2, 3, 4
Q2) What is the most common congenital heart disorder?
A) ASD
B) VSD
C) TGA
D) TOF
Q3) Which cardiac anomaly is associated with coeur-en-sabot on a chest radiograph?
A) TOF
B) ASD
C) VSD
D) PDA
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Page 42
Chapter 41: Croup Syndrome: Laryngotracheobronchitis and
Acute Epiglottitis
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Sample Questions
Q1) A patient has been diagnosed with bacterial epiglottitis. Which of the following antibiotics should the respiratory therapist most likely recommend?
A) Amikacin (Amikin)
B) Tobramycin (Nebcin)
C) Cefalexin (Keflex)
D) Ampicillin/sulbactam (Unasyn)
Q2) What is the main clinical risk facing a patient with epiglottitis?
A) Secretions will block the trachea.
B) The epiglottis will bleed.
C) The laryngeal inlet may become covered by the epiglottis.
D) The vocal cords will spasm and close the laryngeal inlet.
Q3) The treatment of epiglottitis includes:
1) antibiotics specific to the virus causing the illness.
2) antibiotics specific to the bacteria causing the illness.
3) supplemental oxygen by face mask.
4) endotracheal intubation.
A) 1
B) 4
C) 2, 4
D) 1, 3
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Chapter 42: Near Drowning/Wet Drowning
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Sample Questions
Q1) In the United States, what percentage of pediatric drowning victims are male?
A) 20%
B) 40%
C) 60%
D) 80%
Q2) A 10-year-old girl was rescued from a school swimming pool, where she was found unconscious, and transported to a nearby hospital, where her lungs were discovered to be dry. What could cause dry lungs in this near drowning?
A) Her glottis spasmed and prevented pool water from entering her lungs.
B) Chlorinated pool water is quickly absorbed across the alveolar-capillary membrane.
C) Her young age and the cool pool water prevented serious pulmonary injury.
D) She swallowed the water.
Q3) Warming techniques for a cold-water near-drowning victim include all of the following EXCEPT:
A) cooling the extremities and warming the body core.
B) warming the inspired oxygen.
C) heated intravenous solutions.
D) heated lavage of the pericardial space.
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44
Chapter 43: Smoke Inhalation, Thermal Injuries, and Carbon
Monoxide Intoxication
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Q1) A patient has been brought to the emergency department after inhaling superheated steam. Pulmonary injuries unique to this situation include:
1) atelectasis.
2) pulmonary edema.
3) thick secretions.
4) pharyngeal edema.
A) 3
B) 1, 2
C) 2, 3, 4
D) 1, 2, 3
Q2) What COHb level is associated with a throbbing headache, nausea, vomiting, and impaired judgment?
A) 1% to 10%
B) 10% to 20%
C) 20% to 30%
D) 30% to 50%
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Chapter 44: Atelectasis
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Sample Questions
Q1) A 40-year-old patient was in a motor vehicle accident. Among his injuries and related problems are three broken ribs on the right side, pleural fluid in the right pleural space, and atelectasis of both lungs. What should be done to help with the atelectasis problem?
1) Adequate pain management
2) Mechanical ventilation to stabilize the broken ribs
3) Remove the pleural fluid
4) Selective intubation of the right mainstem bronchus
A) 1, 3
B) 2, 4
C) 1, 2, 3
D) 1, 2, 3, 4
Q2) After gastric bypass surgery, a patient is showing tachypnea. What is the best explanation for this?
A) Diaphragmatic apraxia
B) Postoperative pain
C) Low-grade fever
D) Anesthetic sedation
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