Clinical Laboratory Techniques for Respiratory Care
Final Test Solutions
Course Introduction
This course provides students with a comprehensive understanding of laboratory techniques frequently utilized in the diagnosis and management of respiratory disorders. Emphasizing practical skills, the curriculum covers specimen collection, blood gas analysis, pulmonary function testing, and microbiological assessments relevant to respiratory care. Students will learn proper handling and processing of specimens, principles of quality control, and interpretation of laboratory data to support clinical decision-making. Through hands-on laboratory sessions and case-based discussions, students will develop competence in safely performing and analyzing tests critical to patient care in respiratory therapy settings.
Recommended Textbook
Basic Clinical Lab Competencies for Respiratory Care An Integrated Approach 5th Edition by Gary
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29 Chapters
852 Verified Questions
852 Flashcards
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Chapter 1: Basics of Asepsis
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Sample Questions
Q1) Which of the following statements is FALSO concerning the removal of a gown aseptically?
A)Begin by untying the waist tie,and then wash the hands because the area from the waist down is considered dirty.
B)Untie the neck tie and shrug the shoulders forward so that the gown slips off the body down the arms.
C)Allow the gown to slip down so that it can be grasped inside at the neck of the gown.Fold the gown inside out and dispose of it appropriately.
D)Remove the gown by pulling it off from the sleeves before washing your hands.
Answer: D
Q2) What is the most frequent cause of needle sticks?
A)Attempting to recap a needle
B)Removing discarded needles or syringes from sharps containers
C)Attempting to force a needle into an already full container
D)Using puncture-proof containers
Answer: A
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3
Chapter 2: Basic Patient Assessment: Vital Signs and Breath
Sounds
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Q1) What is described as having a rapid upstroke and a rapid downstroke tracing,with a maximum point of intensity between the peak and the base of the pulse pressure?
A)Bounding pulse
B)Hypertension
C)Plateau pulse
D)Blood volume loss
Answer: A
Q2) Which of the following is not an optimal position the patient should be in for chest expansion?
A)The patient sitting in a Fowler's position
B)The patient lying supine while performing deep breathing
C)The patient dangling on the side of the bed
D)The patient sitting in a chair at the bedside
Answer: B
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Chapter 3: Advanced Patient Assessment: Inspection,
Palpation, and Percussion
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Q1) What breathing pattern is periodic in nature,with a gradual increase in depth and respiratory rate followed by a tapering of rate and depth with periods of apnea or as a waxing and waning of respirations?
A)Kussmaul's respirations
B)Cheyne-Stokes respirations
C)Biot's respirations
D)Paradoxical breathing
Answer: B
Q2) Resonance is the sound heard in percussing normal lung tissue.Which of the following best describes this percussion note?
A)It is a low-pitched sound of long duration.
B)It is a loud,low-pitched sound of long duration.
C)It is a sound of medium intensity and pitch with a short duration.
D)It is a sound of low amplitude and pitch.
Answer: A
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5
Chapter 4: Radiologic Assessment
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Q1) By comparing which views of the chest can a three-dimensional image be created?
A)Posterior-anterior film,lateral film
B)Lordotic film,anterior-posterior film
C)Anterior-posterior film,posterior-anterior film
D)Lordotic film,lateral film
Q2) What is the presence of air in the soft tissues in an extrathoracic location called?
A)Pneumothorax
B)Hyperinflation
C)Subcutaneous emphysema
D)Atelectasis
Q3) When the practitioner needs to focus attention on the upper lobes of the lungs,which x-ray view should be utilized?
A)Posterior-anterior (PA)view
B)Anterior-posterior (AP)view
C)Lateral view
D)Apical lordotic view
Q4) Air appears dark on the chest radiograph.What type(s)of pathology would appear dark 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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Q1) What is defined as the amount of air moved into or out of a resting patient's lungs with each normal breath?
A)Inspiratory reserve volume (IRV)
B)Expiratory reserve volume (ERV)
C)Tidal volume (Vt)
D)Minute volume
Q2) Why are three pulmonary function test trials performed for simple spirometry and flow volume loops and how should the results be reported?
Q3) What gas in the single breath diffusion test because it only trace amounts are found in the atmosphere and it has a greater affinity for hemoglobin than oxygen?
A)Carbon Dioxide
B)Nitrogen
C)Carbon Monoxide
D)Nitric Oxide
Q4) Patient cooperation must be elicited for the best pulmonary function test results.How would the technician elicit the best cooperation and test results from the patient?
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Chapter 6: Electrocardiography
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Q1) Which of the following waves in an ECG tracing represents atrial depolarization?
A)'P' wave
B)'QRS'complex
C)'T' wave
D)'U' wave
Q2) Which lead(s)is (are)placed at the fourth intercostal space adjacent to the sternum?
A)V1
B)V2
C)V3
D)V1 and V2
Q3) What lead(s)is (are)placed at the fifth intercostal space,mid-clavicular line?
A)V1 and V2
B)V3
C)V3.
D)V4
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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Q1) What is defined as the invasive puncturing of a vein for the purpose of collecting blood?
A)Venous blood gas sampling
B)Phlebotomy
C)Arterial blood gas sampling
D)Transcutaneous blood sampling
Q2) Place the following steps of the venipuncture procedure in the correct order.
I.Identify yourself to the patient and explain the procedure
II.Check the blood drawing order and patient identification
III.Dress the site
IV.Prepare the skin for venipuncture
A)II,I,IV,III
B)I,II,III,IV
C)II,IV,I,III
D)I,II,IV,III
Q3) How can the phlebotomist enhance sites to draw blood from a patient?
Q4) How does the phlebotomist gain the confidence of the patient for a blood draw?
Q5) A tourniquet can be used to enhance vein distension to ease the location of a good vein for a venous draw.What would happen if the tourniquet were left on too long?
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Chapter 8: Arterial Blood Gas Sampling
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Q1) If the modified Allen's test is negative on one hand what should the practitioner do at this time?
A)Hold the patient's hand above the level of the heart for 30 to 60 seconds.
B)Release the pressure on the radial artery and determine if circulation returns.
C)Perform the modified Allen's test on the other hand.
D)Perform the arterial stick anyway because of the poor perfusion.
Q2) Which artery is used to collect arterial blood during a cardiopulmonary arrest?
A)Radial artery
B)Brachial artery
C)Femoral artery
D)Ulnar artery
Q3) Which artery is located on the medial side of the antecubital fossa near the insertion of the biceps muscle at the radial tuberosity?
A)Radial artery
B)Brachial artery
C)Femoral artery
D)Dorsalis pedis
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 are the 2 main concepts in Pascal's law?
I.Cardiac output = stroke volume X rate.
II.The pressure of a fluid in a closed container is equal at all points within the container.
III.The pressure acts perpendicularly against the walls of the container.
IV.The pressure of the systemic vessels is proportional to the viscosity of the fluid.
A)II and IV
B)I and III
C)I and IV
D)II and III
Q2) A patient has a CVP catheter inserted.The patient is then placed on CPAP to maintain oxygenation.What will happen to the patient's CVP reading?
A)It will decrease.
B)It will not change.
C)It will increase.
D)It will either increase or decrease.
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Chapter 10: Noninvasive Monitoring
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Q1) All of the following are limitations of end-tidal CO monitoring EXCEPT ______________.
A)pulmonary emboli.
B)tubing obstructions.
C)vasopressive drugs.
D)shunt producing pulmonary disease.
Q2) Skin burns are hazards of ______________
A)pulse oximetry.
B)transcutaneous monitoring.
C)end-tidal C02 monitoring.
D)a and b
Q3) What is the standard by which noninvasive monitors are compared?
A)Capnography
B)Pulmonary artery pressure monitoring
C)Transcutaneous P02 monitoring
D)Blood gas analysis
Q4) How does the pulse oximeter measure O saturation in the capillary bed?
Q5) 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?
Page 12
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Chapter 11: Documentation and Goals Assessment
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Sample Questions
Q1) When attempting to achieve ventilation goals the respiratory care practitioner should assess the ________________.
A)PaO .
B)SaO .
C)PaCO .
D)HCO .
Q2) Which of the following is NOT found in the laboratory reports?
A)Computerized tomography reports
B)Arterial blood gas reports
C)Hematology reports
D)Endocrinology reports
Q3) Why are the medical record is used by third-party payers?
A)For patient information for future care
B)To assist physician's diagnose patients
C)For purposes of reimbursement
D)To provide patient's a copy of their chart
Q4) Upon entering a severe asthmatic's room to deliver bronchodilator therapy,the patient expresses displeasure with his physician and the hospital.What should the practitioner do at this time?
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Chapter 12: Oxygen Supply Systems
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Sample Questions
Q1) What is the color code for an air cylinder?
A)Yellow
B)White
C)Gray
D)Red
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) What is a device called that provides a precise oxygen concentration between 21% and 100% by mixing air and oxygen?
A)Riser
B)Concentrator
C)Blender
D)Multi-stage regulator
Q4) A patient needs to be transported from the emergency department to the ICU on a 50% Venturi mask.What oxygen equipment is needed for you to accomplish the transport?
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Chapter 13: Oxygen Administration
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Sample Questions
Q1) The respiratory care practitioner receives an order for a simple oxygen mask at 3 LPM.How should the practitioner proceed?
A)Set up the simple mask as ordered and return to check on the patient in 10 minutes
B)Call the physician to clarify the order and explain the flowrate would allow the patient's CO to build-up in the mask
C)Set up a nasal cannula at 3 LPM instead of the original order
D)Assess the patient's oxygenation before setting up the oxygen and determine if that much oxygen is needed
Q2) An air entrainment device is set to deliver 30% oxygen.If back pressure is applied by water accumulating in the device distal to the entrainment port,what will happen to the FIO delivered to the patient?
A)It would decrease.
B)It would increase.
C)It would remain unchanged.
D)It would increase initially,then decrease.
Q3) A patient has been on a non-rebreathing mask for 36 hours.What signs should the practitioner watch for and why?
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Page 15
Chapter 14: Introduction to Respiratory Care Pharmacology
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Q1) 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
Q2) Place the following intracellular events of the Beta 2 receptor stimulation in order.
I.Phosphodiesterase breaks down cyclic 3',5'-AMP into 5'-AMP
II.Adenylate cyclase combines with magnesium and ATP to form cyclic 3',5'-AMP
III.Cyclic 3',5'-AMP results in bronchial smooth muscle relaxation
IV.Beta-2 stimulation causes the formation of adenylate cyclase
A)I,II,III,IV
B)III,IV,I,II
C)IV,II,III,I
D)IV,III,II,I
Q3) An aerosol drug is ordered on a patient in MDI form.The propellant causes a reflex bronchospasm in the patient.What can be done?
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Chapter 15: Humidity and Aerosol Therapy
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Q1) What is defined as is water in gaseous form,or vapor?
A)Humidity
B)Aerosol
C)Humidity deficit
D)Barometric pressure
Q2) The presence of which one or more of the following may be an indication for administration of a water,isotonic,or hypotonic saline aerosol?
A)Stridor
B)Diagnosis of laryngotracheobronchitis
C)Clinical history suggesting upper airway irritation and increased work of breathing,such as smoke inhalation
D)a,b,and c
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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Chapter 16: Bronchial Hygiene Therapy
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Q1) The respiratory therapy practitioner asks the patient how she feels during postural drainage therapy.The patient complains of feelings of pain,shortness of breath,and nausea.What should be done at this time?
A)Stop the therapy,allow the patient to rest,and continue the therapy.
B)The patient should be suctioned and then the therapy should be continued.
C)The patient should be comforted and the therapy should be shortened slightly.
D)A decision should be made to modify or stop therapy.
Q2) The left lung has ____ lobes and the right lung has ______ lobes.There are ____ bronchopulmonary segments total in both lungs.
A)three,two,twelve
B)two,three,eighteen
C)two,three,twelve
D)three,three,eighteen
Q3) A patient has severe hypoxemia despite high levels of oxygen.To help alleviate the hypoxemia the patient is positioned with the good lung down.How does this work?
Q4) A patient who is receiving postural drainage and percussion desaturates during therapy,complains of dizziness,and states he cannot tolerate the treatment any longer.What should the practitioner do?
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Page 18
Chapter 17: Hyperinflation Therapy
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Sample Questions
Q1) Which of the following volumes would indicate that a 55-kg,post-operative male patient needs IPPB?
A)Vital capacity of 0.75 L
B)Inspiratory capacity of 1/2 of predicted
C)Vital capacity of 450 ml
D)Inspiratory capacity 1.2 L,predicted inspiratory capacity of 2.9 L
Q2) 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
Q3) When using flow measuring incentive spirometer,two balls are suspended for 4 seconds.One ball indicates 800 ml/second,two balls indicates 1000 ml/second,and three balls indicates 1200 ml/second.What is the volume the patient achieved?
A)3200 ml
B)4000 ml
C)4800 ml
D)1000 ml
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Page 19
Chapter 18: Bronchoscopy Assisting
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Q1) ______________ is performed to obtain lower respiratory tract secretions or tissue samples for cytological,histological,or microbiological study.
A)Therapeutic bronchoscopy
B)Diagnostic bronchoscopy
C)Bronchoalveolar lavage
D)Rigid bronchoscopy
Q2) A patient is being prepared to undergo a diagnostic bronchoscopic procedure.During the preparation of the patient,a small volume nebulizer is used to aerosolize 2% lidocaine to the airway.Which of the following is NOT a hazard of the medication?
A)Vertigo
B)Dizziness
C)Respiratory depression
D)Difficulty focusing the eyes
Q3) A patient has just had a bronchoscopy procedure performed.What precautions and instructions should you give the patient following the procedure?
Q4) What instructions would you give a patient who is to have a bronchoscopy procedure?
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Chapter 19: Equipment Processing and Surveillance
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Q1) A disinfection process that involves heating liquid to destroy vegetative organisms is called ___________
A)chemical disinfection.
B)antisepsis.
C)pasteurization.
D)steam autoclaving.
Q2) If Staphylococcus epidermidis or other nonpathogenic members of the normal flora are cultured on clean or in-use equipment,what is the most likely contamination source?
A)The person conducting the culturing.
B)Contaminated liquid in an aerosol device.
C)The sterilization gas used in the processing of the equipment.
D)Gamma irradiation of the equipment.
Q3) Which of the following is NOT a bacterial shape?
A)Rod-shaped
B)Spiral
C)Round
D)Flat
Q4) What types of vaccines should a health care worker undergo routinely?
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21
Chapter 20: Emergency Airway Management
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Sample Questions
Q1) A patient is unconscious and has blood is his mouth upon being admitted to the emergency department.Breath sounds are diminished bilaterally.What would you recommend to maintain the patient's airway and why?
Q2) What should be evaluated once an airway is established on a patient?
A)Ventilation
B)Central nervous system function
C)Retractions
D)Stridor
Q3) As a person loses consciousness,what happens to the reflexes that protect the airway?
A)They remain intact
B)They are lost in ascending order
C)They are lost in descending order
D)The cough reflexes are lost but the others remain intact
Q4) Where is the Miller laryngoscope blade placed during endotracheal intubation?
A)Under the epiglottis
B)In the vallecula
C)In the trachea
D)In the esophagus
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Chapter 21: Artificial Airway Care
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Q1) The patient has been decannulated.The chest radiograph indicates atelectasis in the right lower lobe caused by retained secretions.The patient's cough is weak and non-productive.Since the patient needs to be suctioned periodically,which of the following would be best to facilitate suctioning without reinserting the tracheostomy tube?
A)Use of a Bivona tube
B)Use of IPPB
C)Use a tracheostomy button
D)Use of a Silver Holinger tube
Q2) 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
Q3) 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) 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
Q2) While troubleshooting a chest tube leak,the respiratory care practitioner clamps the tubing where it enters the chamber and the leak stops.Where is the leak in the system?
A)In the tubing
B)In the patient's chest
C)At the vacuum regulator
D)In the drainage system
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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Chapter 23: Insertion and Maintenance of Intravenous Lines
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Q1) A 0.225% NaCl solution is classified as which type of solution?
A)Hypotonic solution
B)Hypertonic solution
C)Isotonic solution
D)Lactated Ringer's solution
Q2) If a blood pressure cuff is used as a tourniquet,how should the cuff be inflated?
A)To the maximum pressure of the cuff.
B)It is inflated to a pressure 20 to 30-mm Hg below the systolic pressure.
C)The same as the patient's diastolic pressure.
D)To 20 to 30 mmHg.
Q3) 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
Q4) What is the purpose of transparent dressings on a IV?
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25
Chapter 24: Noninvasive Positive-Pressure Ventilation
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Q1) A patient on a full face mask on noninvasive positive-pressure ventilation (NPPV)is swallowing air and having trouble exhaling due to a leak around the naso-gastric (NG)tube.What can be done?
Q2) In acute respiratory failure,NPPV tends to cause which of the following beneficial effects for the patient?
I.Increase the PaO
II.Decrease the pH
III.Increase the PaCO
IV.Decrease HCO
A)I only
B)I,II,III
C)III and IV
D)I and II
Q3) The respiratory care practitioner sets up NPPV on a patient with central sleep apnea.Which of the following modes would be the most dangerous for the patient during NPPV?
A)Spontaneous/timed mode
B)Timed mode
C)Spontaneous mode
D)Assist/control
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Chapter 25: Continuous Mechanical Ventilation
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Q1) In the early stages of an acute asthmatic attack the practitioner will note which of the following?
A)Type I respiratory failure (normal or low PaCO with low PaO )
B)Type II respiratory failure(high PaCO with a low PaO
C)Respiratory failure with PaCO greater than 50 and PaO less than 50
D)Near normal arterial PCO and PO
Q2) Use of high pressure,large volume and increased oxygen tension can result in
A)VAP (ventilator associated pneumonia).
B)VILI (ventilator induced lung injury).
C)RSBI (rapid shallow breathing index).
D)MOV (maximum occluding volume).
Q3) Myasthenia gravis,amyotrophic lateral sclerosis,Gullain-Barre syndrome,spinal cord injuries,and multiple sclerosis may all lead to respiratory failure due to
A)interference with the neurotransmission to the ventilatory muscles.
B)failure of the respiratory pump.
C)loss of nervous signals to contract for ventilation.
D)all of the above.
Q4) How does a practitioner measure airway resistance on a ventilator?
Page 27
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Chapter 26: Advanced Modes of Mechanical Ventilation
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Q1) BiLevel with the Nellcor Puritan Bennett 840 allows adjustment of High PEEP,Low PEEP,Time High and Time Low.These controls are also seen in _________________
A)SIMV
B)PRVC
C)APRV
D)VSV
Q2) Which of the following is true of THIGH with APRV?
A)It is the same as IPAP in BiPAP.
B)It keeps the alveoli recruited and inflated.
C)Time on Thigh is short than TLOW.
D)It is the same as plateau pressure in volume ventilation.
Q3) The Nellcor Puritan Bennett 840 recommends an operational check of the BDU,sensors,resistance and compliance of the circuit prior to use.This is called
A)tubing compliance.
B)The short self test.
C)the power on self test
D)the user verification test
Q4) How does a respiratory care practitioner assess the patient's work of breathing?
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Chapter 27: Wave Form Analysis
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Q1) As the respiratory care practitioner assigned to a ventilator patient,how would you use ventilator graphics to identify patient effort?
Q2) Which of the following are true regarding ventilator air trapping"
I.It is also called AutoMode.
II.It is detected when expiratory flow does not return to baseline prior to next inspiration. III.It can be reduced by allowing more expiratory time.
A)I,II and III
B)I and II
C)II and III
D)II only
Q3) The respiratory care practitioner is unable to determine by watching the chest if a patient has spontaneous breath efforts.On the graphic display,the practitioner can note that ___________________
A)mandatory breaths are often smaller and inconsistent.
B)spontaneous breaths have square wave pressure curves.
C)spontaneous breaths are more variable and have smaller pressures.
D)mandatory breaths have an oscillating wave form.
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Chapter 28: Weaning and Discontinuance of Mechanical Ventilation
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30 Verified Questions
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Sample Questions
Q1) Which of the following is the best predictor of successfully weaning a patient from a ventilator?
A)f/Vt ratio of less than 105
B)PaO /FIO ratio greater than 150-200
C)VD/VT ratio less than 0.55-0.60
D)MIP less than -20 to -30 cm H O
Q2) What four general questions should the respiratory care practitioner assess prior to weaning from mechanical ventilation?
Q3) According to the AARC Clinical Practice Guidelines,which of the following identifies success or tolerance in the spontaneous breathing trial?
A)PaO less than 50 mmHg
B)Increase in PaCO of less than 10 mmHg
C)pH less than 7.32
D)Systolic blood pressure greater than 200 mmHg
Q4) What should the respiratory therapist do if the patient does not pass the SBT?
Q5) How do cardiovascular problems result in ventilator dependence?
Q6) How do neurological problems result in ventilator dependence?
Q7) How do respiratory conditions result in ventilator dependence?
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Chapter 29: Neonatal Mechanical Ventilation
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Sample Questions
Q1) According to the retired AARC Clinical Practice Guidelines,which of the following is a hazard associated with use of time-triggered,pressure-limited,time-cycled neonatal ventilation?
A)Overinflation and/or barotrauma causing air leak syndrome
B)Failure to thrive syndrome
C)Cystic fibrosis
D)Apnea
Q2) The respiratory care practitioner wants to use a spontaneous mode of ventilation that will provide a continuous flow of oxygenated gas at a pressure slightly above ambient pressure on both inspiration and expiration.The practitioner wants to use
A)CPAP.
B)SIMV.
C)PRVC.
D)PS.
Q3) Describe the point system used when determining an Apgar score.
Q4) Describe how the initial newborn ventilator alarm setting are determined.
Q5) Describe how the initial newborn ventilator setting are determined for tidal volume,oxygen percent and PEEP/CPAP
Page 31
Q6) Describe the 5 characteristics of the Apgar scoring system.
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