Clinical Competencies in Respiratory Care
Final Exam Questions
Course Introduction
Clinical Competencies in Respiratory Care is designed to equip students with essential practical skills and assessment techniques required for effective respiratory therapy. The course covers core competencies such as patient assessment, airway management, oxygen therapy, mechanical ventilation, and infection control within clinical settings. Through hands-on laboratories and supervised clinical experiences, students gain proficiency in using respiratory equipment, interpreting patient data, and delivering therapeutic interventions. Emphasis is placed on ethical practice, patient safety, and evidence-based approaches, preparing students to confidently manage respiratory care across diverse patient populations.
Recommended Textbook
Basic Clinical Lab Competencies for Respiratory Care An Integrated Approach 5th Edition by Gary
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Chapter 1: Basics of Asepsis
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Sample Questions
Q1) Which of the following are precautions that should be taken with sharps?
1)Do not attempt to force a needle or sharp instrument into an already full container.
2)Do not attempt to remove discarded needles or syringes from sharps containers.
3)Do not ever attempt to recap a needle.
A)2 and 3
B)1,2,3
C)1 only
D)3 only
Answer: B
Q2) Respiratory care equipment is usually _______ because it is too difficult and costly to keep it _______.
A)disinfected;aseptic
B)in standard precaution states;isolated
C)aseptic;sterile
D)isolated;aseptic
Answer: C
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Chapter 2: Basic Patient Assessment: Vital Signs and Breath Sounds
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Q1) What breath sound is described as a loud,higher pitched breath sound with the expiratory phase longer than the inspiratory phase,with a short pause between phases?
A)Vesicular
B)Tracheal
C)Bronchial
D)Bronchovesicular
Answer: C
Q2) Which of the following environmental conditions should be considered when auscultating a patient's chest?
I.Close the door before initiating the examination
II.The temperature should be comfortable,especially not too cold
III.Turn off noise producing appliances in the room
A)III only
B)II and III
C)I and II
D)I,II,and III
Answer: D
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Chapter 3: Advanced Patient Assessment: Inspection, Palpation, and Percussion
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Sample Questions
Q1) In diabetic acidosis,a condition termed metabolic acidosis is produced.What type of breathing pattern is produced to compensate for this condition?
A)Kussmaul's respiration
B)Cheyne-Stokes respiration
C)Biot's respiration
D)Paradoxical breathing
Answer: A
Q2) What is defined as the presence of air beneath the skin in the subcutaneous tissues?
A)Tension pneumothorax
B)Subcutaneous emphysema
C)Pleural effusion
D)Fibrosis
Answer: B
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Chapter 4: Radiologic Assessment
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Q1) When the bronchus is seen surrounded by fluid-filled structures it creates a distinct separation between the regions of differing densities (air versus fluid).What is this called?
A)Air bronchograms
B)Subcutaneous emphysema
C)Consolidation
D)Hyperinflation
Q2) What is described by a consolidated lung region that demonstrates an increased radiodensity that appears lighter than the surrounding lung fields?
A)Atelectasis
B)Consolidation
C)Pneumothorax
D)Hyperinflation
Q3) Air appears dark on the chest radiograph.What type(s)of pathology would appear dark on the chest x-ray?
Q4) A patient with a bilateral hyperresonant percussion note has a chest x-ray taken.What would you expect to find on the chest x-ray?
Q5) What can be evaluated on a chest radiograph besides the heart and lungs?
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Chapter 5: Pulmonary Function Testing
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Sample Questions
Q1) Which of the following pulmonary function values CANNOT be measured directly by a bedside pulmonary function test?
I.Tidal volume (Vt)
II.Functional residual capacity (FRC)
III.Residual volume (RV)
IV.Minute volume
A)I and IV
B)II and III
C)II,III,and IV
D)I only
Q2) Which of the following measurements can not be monitored at the patient's bedside?
I.Minute volume
II.Peak flow
III.Tidal volume
IV.Negative inspiratory force
A)I and II
B)III and IV
C)I,II,III,IV
D)I,III,and IV
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Page 7
Chapter 6: Electrocardiography
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Q1) What happens to the heart's atria when the ventricles contract?
A)They pump blood to the ventricles
B)They contract
C)They depolarize
D)They repolarize
Q2) When a stimulus only causes a small portion of the atria to contract in an unorganized pattern,then ____________ occurs.
A)atrial fibrillation
B)ventricular fibrillation
C)a normal sinus rhythm
D)a sinus tachycardia
Q3) What is located by palpating the patient's sternal angle?
A)Fourth intercostal space
B)The xiphoid process
C)Second intercostal space
D)Mid clavicular line
Q4) The patient wants an exercise EKG.To ensure the electrodes stay remain in the proper position,what precautions should be taken?
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Chapter 7: Phlebotomy
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Sample Questions
Q1) When will the therapist's blood test be repeated following the initial testing after an accidental needle stick?
A)Blood will be tested again at 1,3,6,and 12 months after the accidental needle stick.
B)Blood will be tested again at 6 and 12 years after the accidental needle stick.
C)Blood will be drawn after antibiotics are started.
D)There will be no need to draw any more blood.
Q2) What is the first obligation of the therapist related to the performance of phlebotomy?
A)To the lab
B)To themselves
C)To the patient
D)To the hospital
Q3) How long should the area be scrubbed with antimicrobial soap after an accidental needle stick?
A)30 seconds
B)2 minutes
C)30 minutes
D)The area should not be scrubbed
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9
Chapter 8: Arterial Blood Gas Sampling
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Q1) Which of the following patient considerations for arterial blood gas sampling is NOT correct?
A)It is important to assess if the patient is receiving the proper oxygen therapy before doing the puncture
B)Check the circulation proximal to the puncture site and for any bleeding at the site 20 to 30 minutes after the procedure.
C)It is important to check the patient's chart for a physician's order for anticoagulant therapy before arterial sampling.
D)A physician's order is required before performing this procedure.
Q2) A patient has an elevated leukocyte count.What precautions should be done for the sample?
A)The sample needs to be properly anticoagulated.
B)No special precautions need to be taken with the sample.
C)Air bubbles need to be introduced into the sample.
D)The sample needs to by immediately chilled and analyzed.
Q3) Possible complications of arterial puncture at any site are vessel trauma and occlusion,embolization,infection,and vessel spasm.How could these be prevented?
Q4) What should the practitioner teach the patient concerning an arterial line?
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Page 10
Chapter 9: Hemodynamic Monitoring
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Sample Questions
Q1) What is defined as a device that converts one form of energy to another?
A)Transducer
B)Thermister
C)Phlebostatic axis
D)Catheter
Q2) What are the most commonly used veins or arteries for the insertion of a central venous catheter?
I.Antecubital fossa
II.Basilic vein
III.Internal jugular vein
IV.Subclavian vein
A)I,II,III,and IV
B)III and IV
C)I and II
D)I,III,and IV
Q3) Normal mean pulmonary artery pressure is _________________.
A)6-12 mmHg
B)10-22 mmHg
C)0-6 mmHg
D)80-120 mmHg
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Chapter 10: Noninvasive Monitoring
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Q1) How do end-tidal CO monitors measure the PetCO ?
A)Heat
B)Oximetry
C)Infrared light absorption
D)Red light absorption
Q2) What is defined as ongoing assessment of the patient's condition without entry into the body (through body orifices or via puncture of the skin or vessels)?
A)Transcutaneous monitoring
B)Noninvasive monitoring
C)Oximetry monitoring
D)End-tidal monitoring
Q3) Which of the following is a hazard of end-tidal CO monitoring?
A)Airway blistering
B)Airway occlusion
C)Airway burns
D)Airway pressure
Q4) A practitioner is monitoring an intubated patient on a mechanical ventilator with a capnograph.The reading on the capnograph suddenly drops to zero from 35 mmHg.How would the practitioner determine the cause of the reading?
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Chapter 11: Documentation and Goals Assessment
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Q1) What is the method of charting that usually employs fill-in-the-blank forms where only data that change are documented?
A)Clinical goal charting
B)Charting by exception
C)Objective data charting
D)Progress notes
Q2) Which of the following are recorded in the patient's record?
I.Tests
II.Treatments
III.Procedures
IV.Assessments
A)I and II only
B)II and III only
C)I,III,and IV
D)I,II,III,and IV
Q3) Which of the following is NOT true concerning documentation?
A)Document things in anticipation of doing it
B)The date and time of interaction
C)Accuracy,timeliness,and truthfulness all are important
D)Document only what has been performed
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Chapter 12: Oxygen Supply Systems
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Sample Questions
Q1) Because large medical gas cylinders (larger than 'E' sized)may contain a variety of gases besides oxygen,a safety system was designed by the CGA to prevent the interchange of cylinders containing dissimilar gases.What is the name of this system?
A)Frangible Disk
B)Diameter-indexed Safety System
C)Pin Index Safety System
D)American Standard Safety System
Q2) How many cubic feet of oxygen are in an 'E' sized cylinder?
A)244 cu.ft.
B)22 cu.ft.
C)28.3 cu.ft.
D)2200 cu.ft.
Q3) The connection for attaching equipment for patient use is termed a station outlet.These outlets have what kind of fittings?
A)Quick-connect fittings
B)Diameter-index safety system fittings
C)Reducing valve fittings
D)Either a or b
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Chapter 13: Oxygen Administration
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Sample Questions
Q1) A patient is admitted to the emergency department.The patient's minute volume is steady and an exact FIO is not required.Which oxygen delivery device would be best to administer approximately 30% oxygen?
A)40% Venturi
B)Nasal cannula at 2.5 LPM
C)Simple oxygen mask at 7 LPM
D)Non rebreathing mask at 15 LPM
Q2) All of the following statements are true concerning the indications for long-term oxygen therapy (LTOT)in the home or alternate site health care facility EXCEPT
A)For the treatment of documented hypoxemia.
B)LTOT has been shown to reduce Hospitalizations and lengths of stay.
C)LTOT has been indicated to improve the effectiveness of prophylactic bronchodilator therapy.
D)LTOT has been shown to significantly Improve survival in hypoxemic patients with chronic obstructive pulmonary disease (COPD).
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Page 15
Chapter 14: Introduction to Respiratory Care Pharmacology
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Sample Questions
Q1) Montelukast,Zarfirlukast,and Zileuton are all used as maintenance therapy for asthma.How do they work?
A)They stabilize the Mast cells.
B)The cause bronchodilation.
C)They are mucolytics.
D)They are leukotriene inhibitors.
Q2) Which of the following is a frequently nebulized antibiotic for patients with cystic fibrosis?
A)Pentamidine
B)Ribvirin
C)Sodium bicarbonate
D)Tobramycin
Q3) MDI spacer devices are used in conjunction with MDIs to:
A)serve as a baffle,removing smaller particles from suspension.
B)enhance the effectiveness of aerosol deposition and improve medication delivery.
C)act as a reservoir that helps to decrease the evaporation of the MDI propellant.
D)a,b,and c
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16
Chapter 15: Humidity and Aerosol Therapy
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Sample Questions
Q1) Connection of a large-volume nebulizer to the correct type flowmeter is ensured because the connection incorporates a:
A)PISS fitting at the top of the unit.
B)ASSS fitting at the top of the unit.
C)DISS fitting at the top of the unit.
D)15 mmID fitting at the top of the unit
Q2) With the administration of water,hypotonic,or isotonic saline,an improved outcome is indicated by the presence of which of the following?
A)Heart rate increasing with more PVCs
B)Decreased work of breathing
C)Increasing PaCO with decreasing pH
D)Increased audible stridor
Q3) If a gas is fully saturated with water vapor (100% saturated),what can be stated about the gas?
A)It is at body humidity.
B)It is at maximum humidity.
C)The relative humidity is 50%.
D)The temperature of the gas is 37°C.
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17
Chapter 16: Bronchial Hygiene Therapy
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Sample Questions
Q1) How does the Respironics Coughassist MI-E simulate a cough to help the patient?
A)The device chatters during exhalation
B)Increases the FRC following a larger than normal tidal breath
C)This rapid shift from positive to negative pressure
D)It provides the patient a breath hold and decreases intrathoracic pressure
Q2) Trendelenburg position is contraindicated for ___________________.
I.Intracranial pressure (ICP)of 30-mm Hg
II.Uncontrolled airway at risk for aspiration
III.Distended abdomen
IV.Recent gross hemoptysis associated with radiation therapy
A)I and II
B)III and IV
C)I,II,III,and IV
D)I,III,and IV
Q3) What is the only absolute contraindication to a directed cough?
A)Increased intracranial pressure
B)Increased potential for aspiration
C)Untreated pneumothorax
D)There are no absolute contraindications.
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Page 18
Chapter 17: Hyperinflation Therapy
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Sample Questions
Q1) Which modality utilizes the patient's own muscular effort to accomplish hyperinflation of the lungs?
A)Incentive spirometry
B)Intermittent positive pressure breathing
C)Intermittent percussive ventilation
D)Positive airway pressure therapy
Q2) After inhalation during IPPB therapy,exhalation should _________________
A)take place quickly to maintain an I:E ratio of 1:1.
B)be performed against resistance to prolong exhalation.
C)take place forcefully.
D)take place passively.
Q3) Which of the following is NOT an indication for incentive spirometry?
A)Presence of pulmonary atelectasis
B)Inability to clear secretions adequately because of pathology that severely limits the ability to cough effectively
C)Presence of a restrictive lung defect associated with quadriplegic and/or dysfunctional diaphragm
D)Presence of conditions predisposing to the development of pulmonary atelectasis
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Chapter 18: Bronchoscopy Assisting
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Q1) A patient has just had a bronchoscopy procedure performed.What precautions and instructions should you give the patient following the procedure?
Q2) __________________ is performed to remove excessive pulmonary secretions or foreign material suspected of causing lobar or segmental atelectasis.
A)Therapeutic bronchcoscopy
B)Diagnostic bronchoscopy
C)Bronchoalveolar lavage
D)Rigid bronchoscopy
Q3) Which of the following Personal Protective Equipment should be used during a bronchoscopic procedure?
I.Mask with face shield
II.Gloves
III.Gown
IV.Shoe covers
A)I,II,and III
B)I and II
C)III and IV
D)IV only
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Chapter 19: Equipment Processing and Surveillance
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Q1) Which of the following is NOT a main area of an equipment processing facility?
A)Decontamination
B)Processing
C)Storage
D)Manufacture
Q2) When ethylene oxide combines with water it forms ______________
A)hydrogen peroxide.
B)ethylene glycol.
C)ethyl alcohol.
D)carbonic anhydrase.
Q3) Some bacteria secrete a slimy or gummy material on the surface of the cell wall.When this material forms a closely compacted structure,it is termed a/an\ ________________:
A)endospore.
B)capsule.
C)endotoxin.
D)prokaryotic.
Q4) The practitioner has just performed a bedside pulmonary function test on a patient who tests positive for tuberculosis.This is detected only 1 hour before the next test is to be performed.What should be done?
21
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Chapter 20: Emergency Airway Management
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Sample Questions
Q1) After an emergency intubation,the respiratory care practitioner auscultates the chest and the abdomen.Breath sounds are absent over the chest but heard over the abdomen.What is the cause?
A)Endotracheal tube in the esophagus
B)Endotracheal tube in the trachea
C)Trauma has occurred to the upper airway
D)Left mainstem intubation
Q2) A physician asks the practitioner for Magill forceps.What type of airway is the physician going to place in the patient's airway?
A)Nasotracheal tube
B)Orotracheal tube
C)Laryngeal mask airway (LMA)
D)Combitube airway
Q3) Partial upper airway obstruction is characterized by ________________ A)bronchospasm.
B)asymmetrical chest movement.
C)noisy inspiratory efforts.
D)no sound of air movement.
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22
Chapter 21: Artificial Airway Care
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Q1) You cannot pass the suction catheter down the endotracheal tube on an intubated patient.What should you do and how would you correct the problems?
Q2) If a patient is expected to be on a ventilator for more than _________,a heated humidifier should be used if the patient has an artificial airway in place.
A)24 hours
B)48 hours
C)72 hours
D)96 hours
Q3) What should be done to the patient's tracheostomy tube when a Passy-Muir is placed on the tube?
A)The cuff must be inflated to a pressure between 20-25 cmH20
B)The tracheostomy must be suctioned until it is clear
C)The tracheostomy cuff must be deflated
D)The tracheostomy tube should be replaced by a button
Q4) Why is the nasopharyngeal airway placed for frequent nasotracheal suctioning?
A)To minimize trauma to the patient's nose and nasopharynx
B)To allow the patient to be able to speak during the procedure
C)To prevent aspiration of abdominal contents
D)To prevent hypoxemia during the procedure
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Chapter 22: Chest Tubes
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Q1) How should the vacuum regulator be adjusted after the set-up of a chest tube system?
A)Adjust until gentle continuous bubbling is observed in the suction control chamber
B)Adjust until vigorous continuous bubbling is observed in the suction control chamber
C)Adjust the vacuum regulator to full vacuum
D)The chest tube should not be connected to wall vacuum
Q2) A patient is admitted to the emergency department after a motor vehicle accident.A chest radiograph reveals a pneumothorax on the left side.What percussion note could the respiratory care practitioner expect to hear over the right chest?
A)Resonant
B)Flat
C)Hyperresonant
D)Dull
Q3) A patient with a chest tube in place suddenly develops chest pain and severe respiratory distress.What could be causing this?
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24
Chapter 23: Insertion and Maintenance of Intravenous Lines
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Q1) The patient complains of tenderness at the IV site in his lower arm.The practitioner notes swelling and redness at the IV site.The site feels very warm but the IV is still running.What is the most likely cause of these findings?
A)Infiltration of the IV
B)A thrombus in the vessel
C)Cellulitis of the tissues
D)An air embolism has developed
Q2) After starting an IV,the practitioner is concerned about preventing an air embolism.Which of the following will best prevent an air embolism in the patient?
A)Maintaining the IV bag in an upright position at all times
B)Ensuring that all air is removed before the tubing is connected to the catheter
C)Running the intravenous infusion at a normal rate.
D)a and b
Q3) You are asked to start an IV on a 94 year-old,115 lb (52.3 kg)patient.What precautions,if any,should you take with this geriatric patient?
Q4) What is the purpose of transparent dressings on a IV?
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Page 25
Chapter 24: Noninvasive Positive-Pressure Ventilation
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Q1) Which of the following is NOT a sign of increased ventilatory work?
A)Accessory muscle usage
B)Respiratory rate of 18/min
C)Retractions
D)Pursed lip breathing
Q2) In the spontaneous mode of NPPV,how long is the EPAP pressure maintained during the expiratory phase?
A)Until the ventilator senses the next spontaneous breath
B)After a set amount of time
C)Until the % EPAP time has expired
D)Until a specific volume is delivered to the patient
Q3) A patient on NPPV has an increase in lung compliance.If the set pressure remains the same what will happen to the delivered Vt?
A)It will remain the same.
B)It will increase.
C)It will decrease.
D)It will remain the same if the RAW decreases at the same time.
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Chapter 25: Continuous Mechanical Ventilation
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Q1) Recommend tidal volume for initial ventilator setting is
A)400 mL for women and 500 ml for men.
B)4-9 mL/Kg of ideal body weight.
C)10-15 mL/kg of ideal body weight.
D)800 mL for both males and females.
Q2) What equipment procedure should be done prior to using a mechanical ventilator on a patient?
A)Perform a ventilator operational verification procedure
B)Identify patient insurance coverage
C)Perform a static compliance measurement
D)Determine alveolar ventilation
Q3) Which of the following is an advantage of using noninvasive ventilation?
I.The reimbursement rate is higher than for mechanical ventilation
II.Intubation can be avoided
III.There is a decreased risk of acquiring a pulmonary infection
IV.Patient maintains ability to communicate
A)I,II,III and IV
B)I,II and III
C)II,III and IV
D)II and IV
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Chapter 26: Advanced Modes of Mechanical Ventilation
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Q1) What are the purposes of ventilator alarms and backup modes?
Q2) Proportional assist ventilation will do which of the following?
A)Provide better ventilator synchrony and application of pressure
B)Adjust pressure support with changes in the patient's efforts
C)Proportionally assist a patient's spontaneous ventilation
D)All of the above
Q3) A respiratory care practitioner identifies that a patient is having breathing difficulties because the endotracheal tube is one size smaller than optimal.The practitioner should consider which of the follow modes to overcome the airway resistance from a small tube?
A)Mandatory Minute Ventilation
B)Proportional Assist Ventilation
C)Automatic tube compensation
D)Automode
Q4) APRV is which of the following?
A)Airway Pressure Release Ventilation
B)Continuous Positive Airway Pressure with two pressure levels
C)Time triggered,pressure limited,time cycled with spontaneous breathing
D)All of the above
Q5) What are three problems that mandatory minute ventilation cannot prevent?
Page 28
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Chapter 27: Wave Form Analysis
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Q1) Which graphic displays can indicate adequacy of inspiratory flow during a ventilator inspiration and how are they used?
Q2) Static pressure is determined by which of the following methods?
A)Adding an inspiratory pause and stopping air flow
B)Adding an expiratory pause and waiting for slight rise in baseline pressure
C)Assessing pressure generated in tubing at 100-200 mL volume
D)Dividing rate by tidal volume
Q3) A mechanical breath that rises and then remains at the same cmH O pressure for the same length of time is which type of mechanical breath?
A)SIMV
B)Volume control
C)Pressure support
D)Pressure control
Q4) A steeper slope of the pressure versus volume loop indicates
A)overdistention.
B)increased compliance.
C)increased resistance.
D)increased work of breathing.
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Chapter 28: Weaning and Discontinuance of Mechanical Ventilation
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Q1) How do respiratory conditions result in ventilator dependence?
Q2) To assess for the presences of an endotracheal tube cuff leak ,the RCP should do which of the following?
A)Listen at the patient's mouth for air escaping with each ventilator breath
B)Place a stethoscope on the patient's neck and listen for air on inspiratory breath
C)Check ventilator delivered Vt and measured exhaled Vt
D)All of the above
Q3) According to the AARC Clinical Practice Guidelines on Weaning and Discontinuation on Ventilatory Support other objective criteria for weaning is measured by
I.Patient is arousable and not on sedation
II.Hemoglobin level greater than 8-10 g/dL
III.No fever present
IV.No respiratory acidosis
A)I,II,III and IV
B)I,II and III
C)I,II and IV
D)II,III and IV
Q4) How do neurological problems result in ventilator dependence?
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Chapter 29: Neonatal Mechanical Ventilation
Available Study Resources on Quizplus for this Chatper
35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/44622
Sample Questions
Q1) According to the AARC Clinical Practice Guidelines for application of CPAP to neonates which of the following are true?
I.CPAP maintains inspiratory and expiratory pressure above ambient
II.CPAP improves static lung compliance
III.CPAP can decrease airway resistance
IV CPAP increases mean airway pressure
A)I,II,III and IV
B)I,II and III
C)II and III
D)I and III
Q2) When using time-cycled,pressure-limited,IMV,the respiratory care practitioner will set the length of inspiratory time and pressure.What will happen if the pressure is reached before inspiratory time ends?
A)Pressure limiting will end inspiration
B)Pressure limiting will result in loss of tidal volume
C)The ventilator pressure alarm will sound
D)Pressure limiting will result in inspiratory plateau
Q3) Describe the 5 characteristics of the Apgar scoring system.
Q4) Describe how the initial newborn ventilator alarm setting are determined.
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