Clinical Practice in Respiratory Therapy Mock
Exam
Course Introduction
Clinical Practice in Respiratory Therapy offers students hands-on experience in the assessment, diagnosis, and management of patients with respiratory disorders. Through supervised clinical placements, students apply foundational knowledge of respiratory care techniques and medical equipment in real-world settings, including hospitals and outpatient clinics. Emphasis is placed on developing professional communication, critical thinking, and patient-centered care skills as students observe and participate in procedures such as bronchodilator therapy, mechanical ventilation management, and airway clearance techniques. This course bridges classroom learning with practical application, preparing students to excel in diverse respiratory therapy clinical environments.
Recommended Textbook
Egans Fundamentals of Respiratory Care 9th Edition by Robert M. Kacmarek
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51 Chapters
3410 Verified Questions
3410 Flashcards
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Page 2
Chapter 1: History of Respiratory Care
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Sample Questions
Q1) Who introduced the first laryngoscope, in 1913?
A)Thomas Allen
B)Chevalier Jackson
C)Jack Emerson
D)Forrest Bird
Answer: B
Q2) When were aerosolized glucocorticoids for the maintenance of patients with moderate to severe asthma first introduced?
A)in the 1950s
B)in the 1960s
C)in the 1970s
D)in the 1980s
Answer: C
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Chapter 2: Quality and Evidence-Based Respiratory Care
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Sample Questions
Q1) Responsibility for the technical direction of a respiratory care department lies with whom?
A)medical director
B)department manager
C)hospital administrator
D)shift supervisor
E)hospital biomedical engineering department
Answer: B
Q2) For the CRT credential, what does the letter "T" stand for?
A)therapist
B)technician
C)trainee
D)teacher
E)none of the above
Answer: A
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Page 4
Chapter 3: Patient Safety, Communication, and Record Keeping
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Sample Questions
Q1) Which of the following conditions must be met for a fire to occur?
I.temperature high enough for combustion
II.presence of oxygen
III.presence of flammable material
A)I and II
B)II and III
C)I and III
D)I, II, and III
Answer: D
Q2) In the standard approach to hospital fires, the RACE plan has been suggested. What does the letter "C" stand for in this approach?
A)capture
B)contain
C)call for help
D)collapse
Answer: B
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Chapter 4: Principles of Infection Control
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Sample Questions
Q1) Approximately what percent of patients receiving mechanical ventilation develop pneumonia as a complication?
A)1%
B)10%
C)15%
D)25%
Q2) Which of the following is NOT a category under Expanded Precautions?
A)Contact precautions
B)Droplet precautions
C)Standard precautions
D)Airborne Infection Isolation
Q3) Which of the following characteristics is true for iodophors as disinfectants?
A)water soluble
B)nonstaining
C)less irritating to tissue
D)all the above
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Chapter 5: Ethical and Legal Implications of Practice
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Sample Questions
Q1) A health professional who withholds the truth from a patient, saying it is for her own good, is engaged in what practice?
A)fraud
B)infidelity
C)benevolent deception
D)nonmaleficence
Q2) Which ethical principle obliges a respiratory therapist to uphold a patient's right to refuse a treatment?
A)autonomy
B)veracity
C)role fidelity
D)beneficence
Q3) When a practitioner performs a procedure that involves physical contact without the patient's consent, it can result in what charge?
A)assault
B)negligence
C)battery
D)slander
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Chapter 6: Physical Principles of Respiratory Care
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Sample Questions
Q1) Which of the following is a FALSE statement about oxygen?
A)No pressure can keep it in a liquid state above -118.8°C.
B)Below its boiling point, it remains liquid at ambient pressure.
C)Its critical temperature is above normal room temperature.
D)It cannot be turned into a liquid at room temperature.
Q2) What is the phenomenon whereby a liquid in a small tube tends to move upward against the force of gravity?
A)capillary action
B)shear stress
C)surface tension
D)buoyancy
Q3) A gas at 50° C with a relative humidity of 100% is cooled to 37°C. Which of the following will occur?
I.condensation on surfaces
II.visible droplet formation
III.warming of the adjacent air
A)I, II, and III
B)I and II
C)I and III
D)II and III
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Chapter 7: Computer Applications in Respiratory Care
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Sample Questions
Q1) Computers are often used to interpret which of the following tests in respiratory care patients?
A)chest radiograph
B)CBC and electrolytes
C)pulmonary function testing
D)EEG testing
Q2) Clinical decision support systems perform all the following tasks except:
A)match individual patients with proper drug doses
B)provide standing patient care orders
C)remind patients of when to reorder meds
D)provide directions to the best local pharmacy
Q3) What software program is useful for preparing slides for a professional presentation?
A)Microsoft Word
B)Microsoft PowerPoint
C)Microsoft Excel
D)Microsoft Access
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Chapter 8: The Respiratory System
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Sample Questions
Q1) Running vertically down each hemithorax anteriorly is an imaginary line that is used as an anatomical landmark. What is that line called?
A)anterior axillary line
B)midaxillary line
C)midclavicular line
D)midsternal line
Q2) As ventilatory muscles, the sternomastoids do which of the following?
A)elevate the upper chest, increasing chest anteroposterior diameter
B)elevate the ribs and decrease chest anteroposterior diameter
C)increase lateral chest movement during inspiration
D)lower the sternum, thus increasing chest anteroposterior diameter
Q3) Compared with the systemic circulation, pressure in the normal pulmonary circulation is:
A)higher
B)lower
C)the same
Q4) Infants are more susceptible to profound hypoxemia than are adults.
A)true
B)false
C)unable to determine
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Chapter 9: The Cardiovascular System
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Sample Questions
Q1) What is the loose membranous sac that encloses the heart?
A)endocardium
B)mesothelium
C)myocardium
D)pericardium
Q2) What is a normal cardiac ejection fraction?
A) \(1 / 4\)
B) \(1 / 3\)
C) \(1 / 2\)
D) \(2 / 3\)
Q3) Where are the central centers responsible for regulating the cardiovascular system located?
A)aortic bodies
B)brainstem
C)carotid arteries
D)cerebral hemispheres
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11
Chapter 10: Ventilation
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Sample Questions
Q1) A patient in the pulmonary lab has the following test results: compliance of the lung (C<sub>L</sub>) = 0.20 L/cm H<sub>2</sub>O; compliance of the lung and thorax = 0.04 L/cm H<sub>2</sub>O. What is the patient's chest wall compliance?
A)0.05 L/cm H<sub>2</sub>O
B)0.08 L/cm H<sub>2</sub>O
C)0.24 L/cm H<sub>2</sub>O
D)0.70 L/cm H<sub>2</sub>O
Q2) Most of the drop in pressure due to frictional resistance to gas flow occurs in what region?
A)nose, mouth, and large airways
B)respiratory bronchioles
C)terminal bronchioles
D)terminal respiratory unit
Q3) What will happen if the rate of breathing increases without any change in total minute ventilation ( \(\dot { V }\) <sub>E</sub>constant)?
A)The dead space ventilation per minute will decrease.
B)The \(\dot { V }\) <sub>A</sub> per minute will decrease.
C)The \(\dot { V }\) <sub>A</sub> per minute will increase.
D)The \(\dot { V }\) <sub>A</sub> per minute will remain constant.
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Page 12
Chapter 11: Gas Exchange and Transport
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Sample Questions
Q1) What is the normal range of PAO<sub>2</sub> - PaO<sub>2</sub> for healthy young adults breathing room air?
A)5 to 10 mm Hg
B)10 to 20 mm Hg
C)20 to 30 mm Hg
D)50 to 60 mm Hg
Q2) Which of the following best represents the partial pressures of all gases in the normally ventilated and perfused alveolus when breathing room air at sea level?
A)PO<sub>2</sub> = 40 mm Hg; PCO<sub>2</sub> = 100 mm Hg; PN<sub>2</sub> = 573 mm Hg; PH<sub>2</sub>O = 47 mm Hg
B)PO<sub>2</sub> = 100 mm Hg; PCO<sub>2</sub> = 40 mm Hg; PN<sub>2</sub> = 573 mm Hg; PH<sub>2</sub>O = 47 mm Hg
C)PO<sub>2</sub> = 100 mm Hg; PCO<sub>2</sub> = 40 mm Hg; PN<sub>2</sub> = 713 mm Hg; PH<sub>2</sub>O = 47 mm Hg
D)PO<sub>2</sub> = 149 mm Hg; PCO<sub>2</sub> = 40 mm Hg; PN<sub>2</sub> = 573 mm Hg; PH<sub>2</sub>O = 47 mm Hg
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Page 13
Chapter 12: Solutions, Body Fluids, and Electrolytes
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Sample Questions
Q1) Which of the following drugs can be used to temporarily lower K<sup>+</sup> in severe hyperkalemia?
A)corticosteroids
B)insulin
C)K-sparing diuretics
D)nonsteroidal antiinflammatory drugs
Q2) Clinical symptoms of hyponatremia would NOT include which of the following?
A)headache
B)bradycardia
C)lassitude
D)weakness
Q3) Which of the following describe roles played by HCO<sub>3</sub><sup>-</sup>?
I.HCO<sub>3</sub><sup>-</sup>levels vary directly with Cl<sup>-</sup> levels.
II.It is the primary vehicle for blood carbon dioxide transport.
III.It plays a key role in acid-base homeostasis.
A)I, II, and III
B)I and III
C)II only
D)II and III
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Page 14
Chapter 13: Acid-Base Balance
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Sample Questions
Q1) The majority of the acid the body produces in a day is excreted through the lungs as CO<sub>2</sub>. What happens to the H<sup>+</sup> ions?
A)They are bound to Hb.
B)They bind to phosphate.
C)They form carbamino compounds.
D)They bind to an OH-forming H<sub>2</sub>O.
Q2) In acute respiratory acidosis, what would you expect the BE range to be?
A)-4 to -6 mEq/L
B)+2 to -2 mEq/L
C)+4 to +6 mEq/L
D)+22 to +26 mEq/L
Q3) Which of the following are potential causes of respiratory alkalosis?
I.anxiety
II.central nervous system depression
III.hypoxemia
IV.pain
A)I, II, and III
B)I, III, and IV
C)I and IV
D)I, II, III, and IV
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Chapter 14: Regulation of Breathing
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Sample Questions
Q1) Causes of central neurogenic hyperventilation include which of the following?
I.head trauma
II.inadequate brain blood flow
III.severe brain hypoxia
A)II and III
B)I and II
C)I and III
D)I, II, and III
Q2) Which of the following is NOT an effect of J receptor stimulation?
A)deep breathing
B)dyspnea
C)glottic narrowing
D)rapid breathing
Q3) Adjustment of respiratory muscle contractions to accommodate varying loads is regulated by which of the following?
A)medullary respiratory centers
B)muscle spindle fiber feedback
C)pontine apneustic center
D)pontine pneumotaxic center
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Chapter 15: Bedside Assessment of the Patient
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Sample Questions
Q1) Right ventricular hypertrophy often produces a systolic thrust that can be felt and seen near which of the following?
A)lower left border of the sternum
B)upper right border of the sternum
C)left fifth intercostal space, midclavicular line
D)lower right border of the sternum
Q2) In auscultating the precordium of a patient, you hear a high-pitched "whooshing" noise occurring simultaneously with S<sub>1</sub>. This finding is most consistent with which of the following?
A)incompetent mitral valve
B)stenotic tricuspid valve
C)incompetent pulmonic valve
D)stenotic mitral valve
Q3) Which of the following is the least likely cause of lymphadenopathy in the neck?
A)lymphoma
B)pulmonary infection
C)congestive heart failure
D)lung cancer
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Chapter 16: Interpretation of Clinical Laboratory Data
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Sample Questions
Q1) What term is used to describe a red blood cell (RBC) count that is below normal values?
A)leukocytosis
B)leukopenia
C)anemia
D)polycythemia
Q2) What type of white blood cell increases in response to allergic reactions?
A)neutrophils
B)eosinophils
C)lymphocytes
D)monocytes
Q3) What term is used to describe a white blood cell (WBC) count that is below normal values?
A)anemia
B)thrombocytopenia
C)leukopenia
D)hyponatremia
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18
Chapter 17: Interpreting the Electrocardiogram
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Sample Questions
Q1) The ECG you are looking at has one P wave for every QRS complex and the PR interval is 0.30 second. What is your interpretation?
A)first-degree heart block
B)right-axis deviation
C)third-degree heart block
D)atrial hypertrophy
Q2) For which of the following arrhythmias would an electronic pacemaker be indicated?
A)first-degree block
B)sinus tachycardia
C)third-degree block
D)ventricular fibrillation
Q3) Why is the electrical impulse temporarily delayed at the atrioventricular (AV) node?
A)to allow complete emptying of the ventricles
B)to allow more sodium buildup in the myocardial cells
C)to allow better filling of the ventricles
D)to allow complete filling of the atria
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19
Chapter 18: Analysis and Monitoring of Gas Exchange
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Sample Questions
Q1) All of the following can help avoid the problem of arterial blood sample contamination with air except:
A)discarding frothy samples
B)fully expelling any bubbles
C)mixing before expelling air
D)capping syringe quickly
Q2) All of the following are common sites for transcutaneous blood gas electrode placement except the:
A)chest
B)abdomen
C)lower back
D)thigh
Q3) All of the following are indications for capnography except:
A)evaluating the response to therapies affecting ventilation/perfusion ratio ( \(\dot { V } / \dot { Q }\) ) relationships
B)determining the position of an artificial airway (trachea versus esophagus)
C)assessing a patient's readiness for weaning from ventilatory support
D)monitoring the integrity of the ventilatory circuit and artificial airway
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Chapter 19: Pulmonary Function Testing
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Sample Questions
Q1) When evaluating a forced vital capacity maneuver post bronchodilator use to determine the reversibility of any airway obstruction, what percent increase in FEV<sub>1</sub> is needed to be able to say the treatment was effective?
A)5%
B)10%
C)15%
D)20%
Q2) To what does the range or limit of a device's measuring ability refer?
A)capacity
B)accuracy
C)error
D)precision
Q3) Which of the following statements is TRUE when comparing the pulmonary function test results of men versus women?
A)Males and females have the same predicted values when corrected for height.
B)Males and females have the same predicted values when corrected for weight.
C)Males and females have the same predicted values when corrected for age.
D)Males have larger predicted volumes when corrected for height.
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Chapter 20: A Review of Thoracic Imaging
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Sample Questions
Q1) What is the earliest sign of a left-sided pleural effusion on an upright chest radiograph?
A)an increased distance between the inferior margin of the left lung and the stomach gas bubble
B)inability to see small pulmonary blood vessels over the left lower lung
C)a widened mediastinum
D)elevation of the right hemidiaphragm
Q2) What type of imaging is most useful for diagnosing idiopathic pulmonary fibrosis?
A)conventional chest radiography
B)CT angiography
C)HRCT
D)MRI
Q3) Which of the following statements best describe the typical findings on a chest radiograph for a patient with interstitial lung disease?
A)unilateral upper lobe infiltrates
B)diffuse bilateral infiltrates
C)diffuse pulmonary hyperinflation
D)diffuse pleural inflammation
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22
Chapter 21: Nutrition Assessment
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Sample Questions
Q1) Magnesium deficiencies are associated with all the following except:
A)reduced diaphragm strength
B)neurologic abnormalities
C)cardiac abnormalities
D)liver enlargement
Q2) Which of the following illnesses is NOT associated with acute catabolic disease?
A)trauma
B)sepsis
C)burns
D)pulmonary embolism
Q3) Which of the following is NOT considered part of the anthropometric assessment?
A)body mass index
B)activity level
C)history of weight loss
D)triceps skinfold
Q4) What tube feeding method is associated with an increased risk of aspiration?
A)bolus
B)intermittent
C)continuous drip
D)pressurized
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Chapter 22: Pulmonary Infections
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Sample Questions
Q1) What would be important to perform in order to obtain a good sputum sample that is to be used to detect the pathogen causing community-acquired pneumonia?
A)Ensure that antibiotic treatment was instituted at least 24 hours earlier.
B)Have patient sit in the semirecumbent position to obtain sample.
C)Have patient spit into sample container.
D)Patient should rinse mouth prior to sample collection.
Q2) Which of the following would interfere with the collection of a good sputum sample for Gram stain?
I.contamination of the sample with oral secretions
II.lack of productive cough
III.prior antibiotic therapy
IV.rinsing with mouthwash prior to sputum collection
A)I, II, and III
B)II and IV
C)III only
D)I, II, III, and IV
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Chapter 23: Obstructive Lung Disease: Copd, Asthma, and Related Diseases
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Q1) What is the critical \(\alpha\)<sub>1</sub>-antitrypsin level below which lung elastin is attacked and broken down?
A)60 mg/dl
B)80 mg/dl
C)100 mg/dl
D)150 mg/dl
Q2) Which of the following problems is associated with intravenous augmentation of synthetic \(\alpha\)<sub>1</sub>-antitrypsin for the patient with genetic emphysema?
A)bronchospasm
B)expense
C)headache
D)nausea
Q3) Which of the following symptoms is NOT a classic symptom of asthma?
A)cough
B)shortness of breath
C)chest tightness
D)chest pain
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Page 25
Chapter 24: Interstitial Lung Disease
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Sample Questions
Q1) In smokers with idiopathic pulmonary fibrosis, normal spirometry and lung volumes with a reduced diffusion capacity suggest emphysema.
A)True
B)False
Q2) Your patient with interstitial lung disease (ILD) has hypoxemia during exertion and at rest. This implies the ILD may be in its early stages.
A)True
B)False
Q3) Which group of disorders is categorized together because of similarities in their clinical presentations, plain chest radiographic appearance, and physiologic features?
A)congestive heart failure
B)infant respiratory distress syndrome
C)interstitial lung diseases
D)sudden acute respiratory syndrome
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Chapter 25: Pleural Diseases
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Q1) The administration of oxygen to a patient with a pneumothorax will speed the rate at which resolution occurs once the leak has stopped.
A)True B)False
Q2) What is the most common cause of pleural effusion that occurs due to lymphatic obstruction within the mediastinum?
A)cancer that has metastasized to the mediastinum
B)hepatic hydrothorax
C)malignant pleural effusion
D)tuberculous pleurisy
Q3) Chest pain occurs in only a small percentage of patients with a pneumothorax.
A)True B)False
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Chapter 26: Pulmonary Vascular Disease
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Q1) What is the most frequent symptom found in patients with confirmed pulmonary emboli?
A)cough
B)dyspnea
C)leg swelling
D)pleuritic chest pain
Q2) In patients suspected of having pulmonary emboli in whom noninvasive studies do not give a definite diagnosis, what diagnostic procedure is the test of choice?
A)CT
B)MRI
C)pulmonary angiography
D) \(\dot { V } / \dot { Q }\)
Q3) What is the critical value for mean pulmonary arterial pressure, above which the right ventricle fails and death may ensue?
A)30 mm Hg
B)40 mm Hg
C)50 mm Hg
D)60 mm Hg
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Chapter 27: Acute Lung Injury, Pulmonary Edema, and Multiple System Organ
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Q1) Which of the following organs plays a major role in induction and modulation of the systemic inflammatory response?
A)heart
B)brain
C)kidneys
D)liver
Q2) Which of the following systems is the primary operant to rid the body of fluid accumulation in nonpathologic conditions?
A)respiratory
B)cardiac
C)lymphatic
D)renal
Q3) What mode of mechanical ventilation is designed to optimize ventilation by reducing alveolar collapse while using small tidal volumes in patients with ARDS?
A)inverse-ratio ventilation
B)high-frequency ventilation (HFV)
C)intermittent mandatory ventilation
D)airway pressure-release ventilation
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Chapter 28: Lung Cancer
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Sample Questions
Q1) What age group has been targeted by tobacco companies as a primary source of new customers?
A)teenagers
B)women aged 21 to 35 years
C)men aged 21 to 35 years
D)men and women over 50 years of age
Q2) Which of the following is not associated with the clinical features of lung cancer?
A)local growth of tumor
B)metastasis extrathoracic or intrathoracic
C)associated pain or discomfort
D)paraneoplastic syndrome
Q3) Which bronchogenic carcinoma is staged as limited or extensive?
A)large cell
B)adenocarcinoma
C)squamous cell
D)small cell
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Chapter 29: Neuromuscular and Other Diseases of the Chest Wall
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Sample Questions
Q1) What is the approximate mean age of onset for amyotrophic lateral sclerosis?
A)26 years
B)36 years
C)46 years
D)56 years
Q2) In what group of patients is myasthenia gravis most common?
A)older males
B)younger males
C)younger females
D)older females
Q3) Which of the following is NOT a pulmonary complication frequently associated with flail chest?
A)pneumothorax
B)hemothorax
C)pulmonary contusion
D)aspiration pneumonia
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Chapter 30: Disorders of Sleep
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Q1) Which of the following is NOT a parameter used to confirm the metabolic syndrome associated with obstructive sleep apnea?
A)low triglycerides
B)insulin resistance
C)hypertension
D)impaired glucose intolerance
Q2) Uvulopalatopharyngoplasty has a success rate of less than 50%.
A)True
B)False
Q3) The definition of sleep apnea uses what criteria for defining an episode of apnea?
A)5 seconds
B)10 seconds
C)15 seconds
D)20 seconds
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Chapter 31: Neonatal and Pediatric Respiratory Disorders
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Q1) Which of the following ventilatory modalities has been associated with a lesser rate of air leak in MAS?
I.IMV II.SIMV
III.HFV
IV.CPAP
A)I only
B)I and II
C)II and III
D)I, II, and III
Q2) How soon after birth does the ductus typically close?
A)1 to 2 days
B)3 to 4 days
C)5 to 7 days
D)10 days
Q3) The mortality rate for infants with congenital diaphragmatic hernia is usually low.
A)True
B)False
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Page 33
Chapter 32: Airway Pharmacology
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Sample Questions
Q1) What is the name of the enzyme responsible for the short duration of action of catecholamine bronchodilators?
A)catechol O-methyltransferase (COMT)
B)epinephrine dismutase
C)EDTA
D)hyaluronidase
Q2) Which of the following are indications for the use of acetylcysteine (Mucomyst)?
I.treatment of acetaminophen overdose
II.treatment of excessive, viscous mucus secretions
III.treatment of aspirin overdose
IV.treatment of purulent mucus secretions by breaking up DNA
A)I and II only
B)II and IV only
C)I, II, and III
D)I, II, III, and IV
Q3) When stimulated, which of the following receptors cause bronchoconstriction?
A)M<sub>3</sub>
B)M<sub>2</sub>
C)\(\alpha\)<sub>1</sub>
D)\(\beta\)<sub>2</sub>
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Chapter 33: Airway Management
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Q1) What is the average distance from the tip of a properly positioned oral endotracheal tube to the incisors of an adult man?
A)16 to 18 cm
B)19 to 21 cm
C)21 to 23 cm
D)24 to 26 cm
Q2) What size endotracheal tube would you select to intubate an adult female?
A)6 mm
B)7 mm
C)8 mm
D)9 mm
Q3) When checking for proper placement of an endotracheal tube or a tracheostomy tube on a chest radiograph, how far above the carina should the distal tip of the tube be positioned?
A)1 to 2 cm
B)2 to 4 cm
C)4 to 6 cm
D)6 to 8 cm
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Chapter 34: Emergency Cardiovascular Life Support
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Q1) Which of the following statements are true about adult external cardiac compression?
A)Compressions should displace the sternum at least 3 to 4 inches.
B)Compressions should occur at a rate of 60 to 80 per minute.
C)Compression time should at least equal the upstroke phase.
D)Compressions can be safely interrupted for up to 50 seconds.
Q2) After confirming respiratory arrest and securing the airway in a 1-year-old infant, at which of the following rates would you provide rescue breathing?
A)12 to 20 breaths/min
B)20 to 30 breaths/min
C)30 to 40 breaths/min
D)40 to 60 breaths/min
Q3) What is the proper rate of external chest compressions for children up to puberty?
A)80/min
B)100/min
C)120/min
D)140/min
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Chapter 35: Humidity and Bland Aerosol Therapy
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Q1) All of the following reduce the risk of nosocomial infection when using heated humidification systems except:
A)use of wick or membrane humidifiers
B)use of heated-wire delivery circuits
C)high humidifier reservoir temperatures
D)frequent changing of delivery circuits
Q2) A patient receiving ventilatory support is being provided with humidification using a heat-moisture exchanger (HME). A physician orders a bronchodilator drug administered through a metered-dose inhaler (MDI) via the ventilator circuit. Which of the following must be performed to ensure delivery of the drug to the patient?
A)The inspiratory flow setting of the ventilator should be increased.
B)The HME must be removed from the circuit during MDI use.
C)The V<sub>T</sub> setting of the ventilator should be decreased.
D)A heated humidifier should replace the HME when using the MDI.
Q3) Which of the following measures can help to ensure a good sputum sample?
A)using an ultrasonic nebulizer instead of a jet nebulizer
B)using a 5% saline solution instead of a 3% concentration
C)having the patient rinse the mouth or blow the nose before induction
D)using the lowest possible aerosol density (high flow and low output)
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Page 37
Chapter 36: Aerosol Drug Therapy
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Q1) What is a potential limitation of flow-triggered metered-dose inhaler devices?
A)increased pharyngeal impaction
B)less effective lung deposition
C)high flows necessary for actuation
D)requires accessory equipment
Q2) Advantages of the dry power inhaler (DPI) drug delivery systems include all of the following except:
A)low relative cost
B)no propellants required
C)no hand-breath coordination necessary
D)unaffected by humidity
Q3) To assess the effectiveness of a particular aerosol delivery device selection, what would you evaluate?
I.patient's technique in using the device
II.patient's response to and compliance with procedure
III.objective measures of improvement (e.g., peak flow)
A)I and II
B)II and III
C)I and III
D)I, II, and III
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Chapter 37: Storage and Delivery of Medical Gases
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Q1) Which of the following devices would you select if the goal was to accurately meter the flow through a jet nebulizer?
A)Bourdon gauge
B)flow restrictor
C)uncompensated Thorpe tube
D)compensated Thorpe tube
Q2) Which of the following mechanisms do all compressed gas cylinders use to avoid excessively high buildup of cylinder pressure?
A)internal convection cooling mechanism
B)pressure-relief mechanism on the valve stem
C)automatic cylinder breech mechanism
D)pressure-relief mechanism on the cylinder body
Q3) One cu/ft of liquid O<sub>2 </sub>is the equivalent of about how many cu/ft of gaseous O<sub>2</sub>?
A)28
B)244
C)360
D)860
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Chapter 38: Medical Gas Therapy
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Q1) Which of the following is FALSE about the simple O<sub>2</sub> mask?
A)It has no valving system or reservoir bag.
B)It can easily deliver high FIO<sub>2</sub> values (greater than 0.6 to 0.7)
C)It requires a minimal input flow of 5 L/min.
D)It functions as a variable-performance system.
Q2) When determining a need for O<sub>2</sub> therapy, the respiratory therapist should assess which of the following?
I.neurologic status
II.pulmonary status
III.cardiac status
A)I and II
B)II and III
C)I and III
D)I, II, and III
Q3) Which of the following is considered an advantage of the transtracheal catheter?
A)It does not provide any economic benefit compared with the nasal cannula.
B)It decreases the anatomic reservoir.
C)It requires 40% to 60% less O<sub>2</sub> flow than the nasal cannula.
D)It requires higher flows than the nasal cannula.
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Page 40
Chapter 39: Lung Expansion Therapy
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Sample Questions
Q1) In order to eliminate leaks in an alert patient receiving intermittent positive-pressure breathing therapy, which of the following adjuncts would you first try?
A)flanged mouthpiece
B)form-fitting mask
C)nasopharyngeal airway
D)nose clips
Q2) Which of the following statements is not true about intermittent positive-pressure breathing (IPPB)?
A)IPPB could cause lung overinflation.
B)IPPB could cause no expansion of regions affected by secretions.
C)Bronchial hygiene must be used in conjunction with IPPB to adequately manage secretions.
D)IPPB should be the single treatment modality for resorption atelectasis.
Q3) What is the most common complication associated with intermittent positive-pressure breathing (IPPB)?
A)air-trapping
B)oral bleeding
C)respiratory alkalosis
D)gastric distention
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Chapter 40: Bronchial Hygiene Therapy
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Sample Questions
Q1) Which of the following is/are necessary for normal airway clearance?
I.patent airway
II.functional mucociliary escalator
III.effective cough
A)I and II
B)I, II, III
C)II and III
D)II
Q2) Which if the following is the only absolute contraindication to turning?
A)when the patient cannot or will not change body position
B)when poor oxygenation is associated with unilateral lung disease
C)when the patient has or is at high risk for atelectasis
D)when the patient has unstable spinal cord injuries
Q3) All of the following are considered bronchial hygiene therapies except:
A)postural drainage and percussion
B)incentive spirometry
C)positive airway pressure
D)percussion, vibration, and oscillation
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42
Chapter 41: Respiratory Failure and the Need for Ventilatory Support
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Q1) Which of the following best describes the difference between \(\dot { V } / \dot { Q }\) mismatch and shunt when supplemental oxygen is administered?
A.Both will respond equally well.
B. \(\dot { V } / \dot { Q }\) mismatch will respond well but shunt will not.
C. \(\dot { V } / \dot { Q }\) mismatch will not respond but shunt will respond well.
D.Neither will respond to the administration of supplemental oxygen.
Q2) In patients suffering from acute respiratory acidosis, below what pH level are intubation and ventilatory support generally considered?
A)7.2
B)7.3
C)7.1
D)7.0
Q3) Inadequate respiratory muscle strength is likely when a patient's MVV is which of the following?
A)<2 times the resting V<sub>E</sub>
B)>3 times the resting V<sub>E</sub>
C)<200 L/min
D)>120 L/min
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Chapter 42: Mechanical Ventilators
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Sample Questions
Q1) A volume-cycled ventilator has a rate knob for setting the controlled frequency of breathing. If this control is set to 12/min, which of the following other settings will determine the inspiratory and expiratory times?
I.FIO<sub>2</sub>
II.flow
III.volume
A)I and II
B)I and III
C)II and III
D)I, II, and III
Q2) A patient is receiving continuous mandatory ventilation in the control mode at a rate of 15/min. The inspiratory time is 0.8 second. What is the expiratory time?
A)3.2 seconds
B)2.8 seconds
C)2.4 seconds
D)4.2 seconds
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Chapter 43: Physiology of Ventilatory Support
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Sample Questions
Q1) Which of the following groups of patients are primarily affected by ventilator-associated pneumonia?
I.infants
II.adults older than 65 years
III.immunosuppressed
IV.thoracoabdominal surgery
V.depressed sensorium
A)I, II, III and V
B)I, II, III, IV, and V
C)III and V
D)I and IV
Q2) During volume-assured pressure-supported ventilation, if the desired V<sub>T</sub> is not reached or exceeded at the preset pressure support level, what happens?
A)Flow continues at a constant rate until the desired volume is achieved.
B)The breath terminates when a predetermined low flow is achieved.
C)Flow decreases exponentially until the desired volume is achieved.
D)Flow increases linearly until the desired volume is achieved.
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Chapter 44: Initiating and Adjusting Ventilatory Support
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Q1) When using a pressure-volume curve to identify optimal PEEP levels, what does the upper inflection point represent?
A)point of lung recruitment
B)point of lung over distension
C)optimal PEEP level
D)optimal compliance level
Q2) In which of the following clinical situations is the incidence of auto-PEEP the greatest?
I.patients with high respiratory rates
II.intubated patients with obstructive lung disease
III.patients with low minute volumes
A)I and II
B)I and III
C)II and III
D)I, II, and III
Q3) All the following are hazards associated with mechanical ventilation except:
A)reduced cardiac output
B)liver failure
C)increased work of breathing
D)acute lung injury
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Chapter 45: Noninvasive Positive Pressure Ventilation
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Q1) What patient population is the only group currently accepted for the use of noninvasive positive-pressure ventilation (NPPV) in the hospital ward?
A)chronic obstructive pulmonary disease (COPD) patients with near normal pH
B)postoperative patients without pneumonia
C)no-code patients
D)asthma patients with normal SpO<sub>2</sub>
Q2) Which of the following is a potential risk of overtightening the straps of the mask?
A)absence of an air leak
B)tissue necrosis
C)eye irritation
D)claustrophobia
Q3) Which of the following is required for noninvasive ventilators to work properly?
A)exhalation valve
B)pressure alarm
C)leak
D)blender
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Chapter 46: Monitoring and Management of the Patient in the
Intensive
Care Unit
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Q1) What parameter is considered to be the most accurate and reliable measure of oxygenation efficiency?
A)PaO<sub>2</sub>/FIO<sub>2</sub> ratio
B)P(A - a)O<sub>2</sub>/PaO<sub>2</sub> ratio
C) \(\dot { \mathrm { Q } } _ { s } / \dot { \mathrm { Q } } _ { t }\)
D)PaO<sub>2</sub>/SaO<sub>2</sub> ratio
Q2) What is considered normal for the PaO<sub>2</sub>/FIO<sub>2</sub> ratio?
A)greater than 50
B)greater than 150
C)greater than 250
D)greater than 400
Q3) What is the Glasgow Coma Scale (GCS) score that requires intracranial pressure monitoring?
A)less than 8
B)less than 9
C)less than 10
D)less than 11
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Page 48
Chapter 47: Discontinuing Ventilatory Support
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Sample Questions
Q1) What is the best way to decrease the work of breathing imposed by an artificial airway on a patient receiving ventilatory support?
A)Provide pressure support.
B)Decrease inspiratory flow.
C)Lower the minute ventilation.
D)Use low rates of breathing.
Q2) Which of the following patients exhibits an acceptable ventilatory demand?
\(\begin{array}{ll}&\mathrm{V}_{\mathrm{E}}&\mathrm{PaCO}_{2}\\
A.&14 \mathrm{~L} / \mathrm{min} & 40 \mathrm{~mm} \mathrm{Hg} \\
B.&12 \mathrm{~L} / \mathrm{min} & 48 \mathrm{~mm} \mathrm{Hg} \\
C.&8 \mathrm{~L} / \mathrm{min} & 36 \mathrm{~mm} \mathrm{Hg} \\
D.&15 \mathrm{~L} / \mathrm{min} & 35 \mathrm{~mm} \mathrm{Hg} \end{array}\)
Q3) All of the following indicate that an adult patient is ready to be weaned from ventilatory support except:
A)PAO<sub>2</sub> - PaO<sub>2</sub> = 430 on 100% O<sub>2</sub>
B)V<sub>D</sub>/V<sub>T</sub> = 0.55
C)MIP = -33 cm H<sub>2</sub>O
D)PO<sub>2</sub> = 76 mm Hg on 40% O<sub>2</sub>
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Page 49
Chapter 48: Neonatal and Pediatric Respiratory Care
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Q1) Which of the following methods is useful in determining gestational age of the newborn?
A)Dubowitz
B)Adams
C)Apgar
D)Perkinson
Q2) Venoarterial is the preferred method for use of ECMO when cardiovascular support is not required.
A)True
B)False
Q3) What positive end-expiratory pressure level is commonly used in pediatric patients during mechanical ventilation?
A)1 to 3 cm H<sub>2</sub>O
B)3 to 5 cm H<sub>2</sub>O
C)5 to 8 cm H<sub>2</sub>O
D)10 to 12 cm H<sub>2</sub>O
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Chapter 49: Patient Education and Health Promotion
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Q1) Which of the following is used to evaluate the affective and psychomotor domains?
A)verbal exam
B)demonstration
C)written exam
D)performance checklist
Q2) Which of the following is NOT among the top common causes of death in the United States?
A)heart disease
B)cerebrovascular disease
C)chronic obstructive lung disease
D)cystic fibrosis
Q3) The objective that states "Verbalize willingness to use oxygen properly and safely" falls in which domain?
A)cognitive
B)affective
C)psychomotor
D)analytical
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Chapter 50: Cardiopulmonary Rehabilitation
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Q1) What is the ideal class size for pulmonary rehabilitation programs?
A)5 to 15
B)10 to 20
C)20 to 30
D)3 to 10
Q2) In preparing an outpatient for a cardiopulmonary stress test to be conducted the next day, which of the following instructions would you provide?
I .The patient should fast for at least 8 hours before testing.
II.The patient should wear loose-fitting clothing and sneakers.
III.The patient should stop all medications at once.
IV.The patient should review the drugs with the physician.
A)I, II, and III
B)II and IV
C)I, II, III, and IV
D)I, II, and IV
Q3) Where are most cardiac rehabilitation programs conducted?
A)private practice offices
B)clinics
C)hospital facilities
D)homes
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Chapter 51: Respiratory Care in Alternative Settings
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Q1) When the flow-metering device of a home liquid O<sub>2</sub> system is turned on, O<sub>2</sub> leaves the container through a vaporizing coil, where it is heated by exposure to which of the following?
A)hot water
B)ambient air
C)electrical energy
D)ultrasound
Q2) An ambulatory home O<sub>2</sub> therapy patient complains that the portable liquid (at 3 L/min) does not last long enough for a visit with the grandchildren. What might you recommend to overcome this limitation?
A)Decrease the flow to 2 L/min.
B)Put a couple of E cylinders in her car.
C)Use an O<sub>2</sub>-conserving device.
D)Put the large liquid unit in the car.
Q3) Which of the following is FALSE about home O<sub>2</sub> therapy?
A)A PRN (as needed) prescription for O<sub>2</sub> is acceptable.
B)Hypoxemia can be confirmed by arterial blood gas (ABG) or oximetry.
C)A PaO<sub>2</sub> at or below 55 mm Hg documents need.
D)An SaO<sub>2</sub> below 88% is clinical evidence of need.
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Page 53