Critical Care Respiratory Therapy
Test Questions
Course Introduction
Critical Care Respiratory Therapy is an advanced course designed to equip students with in-depth knowledge and practical skills necessary for managing patients with life-threatening respiratory conditions in intensive care settings. The course covers the pathophysiology of acute respiratory disorders, principles of mechanical ventilation, advanced airway management, monitoring techniques, and evidence-based interventions for critically ill patients. Emphasis is placed on rapid assessment, decision-making, and interdisciplinary collaboration to optimize patient outcomes. Through case studies and simulation exercises, students gain hands-on experience in handling complex respiratory emergencies and supporting patients with advanced therapeutic modalities.
Recommended Textbook
Egans Fundamentals of Respiratory Care 11th Edition by Robert M. Kacmarek
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Page 2
Chapter 1: History of Respiratory Care
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Sample Questions
Q1) Who discovered O<sub>2</sub> in 1774 and described it as "dephlogisticated air"?
A) Robert Boyle
B) Jacque Charles
C) Thomas Beddoes
D) Joseph Priestley
Answer: D
Q2) Due to the aging of the majority of the population, which of the following will be the focus of the Respiratory Therapist of the future?
1) Verifying insurance information
2) Disease management and rehabilitation
3) Patient and family education
4) Tobacco education and smoking cessation
A)1 and 3 only
B)1, 2, and 3 only
C)2, 3, and 4 only
D)1, 2, 3, and 4
Answer: C
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Chapter 2: Delivering Evidence-Based Respiratory Care
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Sample Questions
Q1) The word "credentialing" in general refers to what?
A) Recognition of an individual in the profession
B) Licensure by a state or national organization
C) Successful completion of entry-level board examination
D) Voluntary certification by state agency
Answer: A
Q2) Current Joint Commission standards for accreditation emphasize which of the following?
A) Continual quality improvement
B) Therapist-driven protocols
C) License and registration of health care providers
D) Health, welfare, and safety of patients using respiratory care equipment
Answer: A
Q3) What is a cohort study?
A) Comparing the clinical outcomes from two different groups
B) Single patient study
C) A literature-based review
D) Collection of patients with similar clinical situations
Answer: A
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Page 4
Chapter 3: Quality, Patient Safety, and Communication, and Recordkeeping
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Sample Questions
Q1) Maintaining eye contact, leaning toward the patient, and nodding your head are all good examples of what communication technique?
A) Clarifying
B) Empathizing
C) Attending
D) Reflecting
Answer: C
Q2) Improper storage or handling of medical gas cylinders can result in which of the following?
1) Increased risk of fire
2) Explosive releases of high-pressure gas
3) Toxic effects of some gases
4) A contained environment
A)1, 2 and 4 only
B)1 and 2 only
C)1 and 4 only
D)1, 2, and 3 only
Answer: D
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Chapter 4: Principles of Infection Prevention and Control
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Sample Questions
Q1) Which of the following statements is false regarding the use of ETO for sterilization?
A) It is harmless to rubber and plastics.
B) It will penetrate prewrapping.
C) Acute exposure is of little consequence.
D) It is useful for equipment that cannot be autoclaved.
Q2) Which of the following diseases is transmitted through direct contact?
A) HIV
B) Pertussis
C) Hepatitis B
D) Hepatitis C
Q3) The unit residence asked you to reduce the risk of contamination caused by condensation in the circuit of a mechanically ventilated patient. Which of the following would help to reduce or eliminate condensation in this patient's circuit?
A) Using a heat and moisture exchange (HME)
B) By draining the circuit on a daily basis
C) By not using any form of heater at all
D) By lowering the temperature in the heater
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Chapter 5: Ethical and Legal Implications of Practice
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Sample Questions
Q1) What legal doctrine holds superiors responsible for the actions of their workers?
A) Res ipsa loquitur
B) Respondent superior
C) Caveat emptor
D) Promissory estoppel
Q2) HIPAA is primarily referred to as the Privacy Rule and is concerned with PHI. What do the letters PHI stand for?
A) Patient health information
B) Protected health information
C) Past health information
D) Protected health insurance
Q3) Which of the following has played a minor role in increasing the cost of health care?
A) Beneficence
B) Compensatory justice
C) Distributive justice
D) Role fidelity
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Chapter 6: Physical Principles of Respiratory Care
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Sample Questions
Q1) According to Poiseuille's law, the pressure needed to drive a fluid through a tube will increase under which of the following conditions?
1) Increased fluid viscosity
2) Decreased tube length
3) Decreased rate of flow
4) Decreased tube radius
A)1 and 2
B)2, 3, and 4
C)1 and 4
D)1, 3, and 4
Q2) Which of the following is a false statement about O<sub>2</sub>?
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.
Q3) Under conditions of turbulent flow, what is the driving pressure?
A) Proportional to the square of the flow
B) Inversely proportional to the flow
C) Linearly proportional to the flow
D) Inversely proportional to the density
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Chapter 7: E-Medicine in Respiratory Care
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Q1) For which of the following is there the most interest in using eHealth applications to improve health outcomes in a cost-effective manner?
A) Lung cancer
B) Pediatric heart disease
C) Chronic diseases
D) Heart attack victims
Q2) Clinical decision support systems perform which of the following tasks?
1) Match individual patients with proper drug doses.
2) Provide standing patient care orders.
3) Remind patients of when to reorder meds.
4) Provide directions to the best local pharmacy.
A)2 and 4 only
B)3 and 4 only
C)1, 2, and 3 only
D)1, 2, 3, and 4
Q3) Therapists-driven protocols are used to:
A) extend the length of stay.
B) allocate and titrate respiratory care services.
C) resist automation of treatment based on patient data.
D) avoid confrontation with nurses regarding patient care.
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Chapter 8: Fundamentals of Respiratory Care Research
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Sample Questions
Q1) What search engine looks for scholarly publications in a wide range of fields and includes peer-reviewed manuscripts, abstracts, theses, and books from academic publishers, professional societies, and university libraries?
A) Medline.org
B) Google Scholar
C) Minimed.org
D) Cochrane.org
Q2) What Web site is known for well-respected rigorously conducted systematic evidence-based reviews and provides free access to abstracts and summaries pertaining to relevant clinical questions?
A) Cochrane.org
B) Medsearch.org
C) Wikepedia.com
D) Systemview.org
Q3) What are the three basic missions of academic medicine?
A) To research, to discover, and to publish
B) To research, to discover, and to cure disease
C) To heal, to teach, and to discover
D) To teach, to research, and to cure
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10
Chapter 9: The Respiratory System
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Sample Questions
Q1) What is the only complete circular cartilage of the larynx?
A) Arytenoid
B) Corniculate
C) Cricoid
D) Thyroid
Q2) What is the name of the negative feedback reflex associated with the termination of inspiration?
A) Carotid sinus
B) Head's paradoxical
C) Hering-Breuer
D) Vagovagal
Q3) By which of the following routes does blood flow through the umbilical cord between the placenta and the fetus?
A) One umbilical vein and one umbilical artery
B) One umbilical vein and two umbilical arteries
C) Two umbilical veins and one umbilical artery
D) Two umbilical veins and two umbilical arteries
Q4) Infants are more susceptible to profound hypoxemia than are adults.
A)True
B)False
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Chapter 10: The Cardiovascular System
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Sample Questions
Q1) Vascular low-pressure baroreceptors have their greatest impact on which system?
A) Central chemoreceptors
B) Endocrine
C) Exocrine
D) Renin-angiotensin
Q2) Mixing of venous blood with arterial blood (a right-to-left shunt) occurs normally because of which of the following?
1) Congenital cardiac defects
2) Bronchial venous drainage
3) Thebesian venous drainage in the heart
A)1, 2, and 3
B)2 and 3 only
C)1 only
D)2 only
Q3) What circulatory system is referred to as a low-pressure, low-resistance system?
A) Left heart
B) Pulmonary vascular bed
C) Right heart
D) Systemic vascular bed
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Page 12
Chapter 11: Ventilation
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Sample Questions
Q1) Which of the following lung units would empty and fill most slowly?
A) A unit with high resistance and high compliance
B) A unit with high resistance and low compliance
C) A unit with low resistance and high compliance
D) A unit with low resistance and low compliance
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) Which of the following causes gas to flow into and out of the alveoli during breathing?
A) Transrespiratory system pressure (P<sub>TR</sub>)
B) Intrapleural pressure (P<sub>pl</sub>)
C) Transpulmonary pressure (P<sub>TP</sub>)
D) Transmural pressure (P<sub>tm</sub>)
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Chapter 12: Gas Exchange and Transport
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Sample Questions
Q1) Under normal physiologic circumstances, how many milliliters of O<sub>2</sub> are capable of combining with 1 g of Hb?
A) 0.003 ml
B) 0.450 ml
C) 0.820 ml
D) 1.340 ml
Q2) What does / mismatch have the biggest impact on?
A)Carbon dioxide elimination
B)Dissolved HCO<sub>3</sub><sup>-</sup>
C)Oxygenation
D)pH
Q3) What occurs in the bases of the lung when a person is standing upright?
A) The PAO<sub>2</sub> is higher than normal.
B) The respiratory exchange ratio is elevated.
C) There is significant dead space under normal conditions.
D) Theis lower than the average.
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14
Chapter 13: Solutions, Body Fluids, and Electrolytes
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Sample Questions
Q1) Patients with what condition are prone to evaporative water loss through the lungs?
1) Artificial airways
2) Hypothermia
3) Increased ventilation
A)1 and 2 only
B)1 and 3 only
C)2 and 3 only
D)1, 2, and 3
Q2) What type of solution could have 1 mol of solute per liter of solution?
A) Molal
B) Molar
C) Normal
D) Weight/volume
Q3) In which of the following types of solutions is the relationship of solute to solvent expressed as a proportion?
A) Normal
B) Percent
C) Ratio
D) Weight/volume
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Page 15
Chapter 14: Acid-Base Balance
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Sample Questions
Q1) An ABG result shows the pH to be 7.56 and the HCO<sub>3</sub><sup>-</sup> to be 23 mEq/L. Which of the following is the most likely disorder?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Q2) Approximately how much CO<sub>2 </sub>is removed daily by the lungs?
A) ~24,000 mmol/L of CO<sub>2</sub>
B) ~14,000 mmol/L of CO<sub>2</sub>
C) ~34,000 mmol/L of CO<sub>2</sub>
D) ~4,000 mmol/L of CO<sub>2</sub>
Q3) Correction of metabolic alkalosis may involve which of the following?
1) Restoring normal fluid volume
2) Administering acidifying agents
3) Restoring normal K<sup>+</sup> and Cl<sup>-</sup> levels
A)3 only
B)1 and 2 only
C)2 and 3 only
D)1, 2, and 3
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Page 16
Chapter 15: Regulation of Breathing
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Sample Questions
Q1) What receptors cause a rapid shallow breathing pattern when stimulated by pulmonary disease?
A) Irritant receptors
B) J receptors
C) Muscle spindles
D) Peripheral proprioceptors
Q2) Biot's respiration is most frequently observed in patients with which of the following?
A) Congestive heart failure
B) Increased intracranial pressure
C) Metabolic acidosis
D) Peripheral nerve disorders
Q3) What is the response of a patient with chronic hypercapnia to a sudden acute rise in carbon dioxide?
A) In almost all of these patients, there will be no response.
B) The patient's drive to breathe will be increased.
C) This will further depress his or her respiratory centers.
D) This will induce apnea and sudden death.
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Chapter 16: Bedside Assessment of the Patient
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Sample Questions
Q1) In which of the following disorders is digital clubbing a common physical sign?
1) Congenital heart disease
2) Lung cancer
3) Chronic obstructive pulmonary disease
4) Pancreatic cancer
A)3 only
B)1, 3 and 4 only
C)1, 2, and 4 only
D)1, 2, and 3 only
Q2) To minimize bony interference with percussion on the posterior chest wall, the practitioner should have the patient do which of the following?
A) Lean forward at a 45-degree angle.
B) Keep his or her arms at the sides of the body.
C) Raise his or her arms above the shoulders.
D) Place his or her hands on the hips.
Q3) What is the normal range for systolic blood pressure in the adult patient?
A) 90 to 140 mm Hg
B) 80 to 100 mm Hg
C) 75 to 100 mm Hg
D) 60 to 100 mm Hg
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Chapter 17: Interpreting Clinical and Laboratory Data
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Sample Questions
Q1) An RT receives a doctor's order to perform an ABG on a 71-year-old woman. Upon reviewing the patient's chart, the RT notices that the patient has a platelet count of 110 \(\times\) 10<sup>3</sup> mcl. What should the RT do?
1) Perform ABG as normal.
2) Refuse to perform the ABG.
3) After ABG is performed, compress the puncture site for a longer time.
4) Recommend that an ABG should be performed on the patient only when it is absolutely necessary.
A)2 and 4 only
B)1 only
C)3 and 4 only
D)2 only
Q2) What is the upper limit of normal for the fasting blood glucose level?
A) 50 mg/dl
B) 85 mg/dl
C) 120 mg/dl
D) 140 mg/dl
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19
Chapter 18: Interpreting the Electrocardiogram
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Sample Questions
Q1) At what part of the cardiac conduction system does the electrical impulse travel most rapidly?
A) Bundle of His
B) Bundle branches
C) Intraatrial pathways
D) Purkinje fibers
Q2) Which of the following is NOT a common characteristic of a premature ventricular complex (PVC)?
A) No P wave prior to the QRS complex
B) Widened QRS complex
C) Bizarre QRS complex
D) Narrow QRS complex
Q3) What is the normal maximum length of the P wave?
A) 1 mm
B) 3 mm
C) 5 mm
D) 7 mm
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Chapter 19: Analysis and Monitoring of Gas Exchange
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Sample Questions
Q1) What is the appropriate interval for changing the site for a transcutaneous blood gas monitor sensor?
A) 1 to 2 hr
B) 2 to 6 hr
C) 6 to 8 hr
D) 8 to 12 hr
Q2) What is the process of testing a new blood gas analyzer to confirm a manufacturer's claims?
A) Automated calibration
B) Performance validation
C) Proficiency testing
D) Preventive maintenance
Q3) Which blood gas analyzer electrode uses a separate reference electrode?
A) O<sub>2</sub>
B) pH
C) Clark
D) HCO<sub>3</sub><sup>-</sup>
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21
Chapter 20: Pulmonary Function Testing
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Sample Questions
Q1) What would you use to determine the accuracy of a water-sealed spirometer in measuring lung volumes?
A) Calibrated high-flow flowmeter
B) Computer-generated flow patterns
C) Calibrated 3-L syringe
D) Standard subject with known volumes
Q2) What is the minimum objective standard for the volume exhaled during the final 1 sec of an acceptable forced vital capacity effort?
A) 0.10 L
B) 0.05 L
C) 0.025 L
D) 0.001 L
Q3) To what does the range or limit of a device's measuring ability refer?
A) Capacity
B) Accuracy
C) Error
D) Precision
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22
Chapter 21: Review of Thoracic Imaging
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Q1) Which of the following statements is false regarding the use of ultrasound to image the chest?
A) It is useful to image the heart.
B) It is useful to image pleural abnormalities.
C) It is useful to image lung tissue.
D) It uses sound waves that echo back to the sensor.
Q2) An air-fluid level in the pleural space typically indicates:
A) tension pneumothorax.
B) hydropneumothorax.
C) pleural effusion.
D) an aerobic infection.
Q3) 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
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Chapter 22: Flexible Bronchoscopy and the Respiratory Therapist
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Sample Questions
Q1) Which of the following are indications for self-expanding metallic stent placement?
1) Extrinsic compression of central airways
2) Stabilizing airway patency after endoscopic removal of an intrinsic tumor
3) Sealing fistula between the lung and the gastrointestinal tract
4) Managing benign central airway obstruction
A)1 and 3 only
B)1, 2, and 3 only
C)3 and 4 only
D)1, 2, 3, and 4
Q2) What two directions can the distal tip of a flexible bronchoscope be flexed?
A) Up to 90 degree in ante-flexion and up to 30 degree in retro-flexion positions
B) Up to 270 degree in ante-flexion and up to 220 degree in retro-flexion positions
C) Up to 180 degree in ante-flexion and up to 90 degree in retro-flexion positions
D) Up to 180 degree in ante-flexion and up to 130 degree in retro-flexion positions
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24
Chapter 23: Nutrition Assessment
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Sample Questions
Q1) Which of the following statements is true regarding kwashiorkor?
1) Occurs with a long-term loss of protein.
2) Often causes facial and limb edema.
3) Child often has a pot belly.
4) May occur in combination with marasmus.
A)1, 2, and 3 only
B)2 and 3 only
C)2, 3, and 4 only
D)1 and 4 only
Q2) Which of the following metabolism issues is not associated with systemic inflammatory response syndrome (SIRS)?
A) Hypoglycemia
B) Protein catabolism
C) Increased macronutrient requirement
D) Triglyceride intolerance
Q3) Which of the following statements is false regarding energy needs?
A) They vary with state of health.
B) They vary with activity level.
C) They are increased with obese patients.
D) They increase with sepsis.
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Chapter 24: Pulmonary Infections
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Q1) What might be indicated by failure of the patient's temperature to normalize 4 or 5 days after the start of antibiotic therapy?
1) A closed-space infection
2) Drug fever
3) A missed pathogen
A)1 and 2 only
B)2 and 3 only
C)1 only
D)1, 2, and 3
Q2) In what type of pneumonia is diarrhea a common symptom?
A) Cytomegalovirus
B) Klebsiella
C) Pneumococcal
D) Staphylococcal
Q3) Which of the following mechanisms is an uncommon route for the spread of pneumonia?
A) Aspiration of infectious particles
B) Inhalation of infectious particles
C) Through the bloodstream
D) Direct contact
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Chapter 25: Obstructive Lung Disease: Chronic Obstructive
Pulmonary Disease Copd, Asthma, and Related Diseases
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Q1) Identify the drug whose regular use in the treatment of asthma may worsen control or even increase the risk of death by asthma.
A) Anticholinergic
B) Antiinflammatory
C) Beta-2 agonists
D) Corticosteroid
Q2) Approximately how many Americans are affected by COPD?
A) 8 million
B) 16 million
C) 24 million
D) 32 million
Q3) During an acute exacerbation of COPD, what is the role of IV methylprednisolone?
A) It accelerates recovery as noted in FEV<sub>1</sub>.
B) It causes pulmonary edema due to retention of water.
C) It causes severe immunosuppression and worsens outcomes.
D) It has been shown to have no effect.
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Chapter 26: Interstitial Lung Disease
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Q1) Scleroderma, rheumatoid arthritis, and systemic lupus erythematosus are all examples of what type of disease group?
A) Asbestos-associated illnesses
B) Connective tissue diseases
C) Hypersensitivity pneumonitis
D) Pneumoconiosis
Q2) In interstitial lung disease, which of the following mechanisms contributes to impaired gas exchange?
1) Depression of respiratory drive
2) Diffusion defect
3) Shunt
4) Ventilation/perfusion mismatch
A)1 and 4 only
B)2 and 3 only
C)2, 3, and 4 only
D)1, 2, and 4
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Chapter 27: Pleural Diseases
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Q1) What is a common complication of pleurodynia?
A) Atelectasis
B) Insomnia
C) Pneumonia
D) Pneumothorax
Q2) What method of chest tube removal has been associated with the lowest level of pneumothorax recurrence?
A) Clamp the chest tube for 4 hr; if chest radiograph is good, remove the tube.
B) Clamp chest tube for 24 hr; if clinically stable, remove the tube.
C) Remove the chest tube as soon as the air leak resolves.
D) Remove the chest tube 48 hr after the air leak resolves.
Q3) Pleural fluid with a total protein concentration of less than ____________ of the serum total protein level is one of the indications of transudative pleural effusion.
A) 20%
B) 30%
C) 40%
D) 50%
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29
Chapter 28: Pulmonary Vascular Disease
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Q1) Which of the following findings on a chest radiograph are consistent with pulmonary embolism?
1) Diffuse hyperinflation
2) Elevation of the diaphragm
3) Enlargement of the heart shadow
4) Pleural effusion
A)2, 3, and 4 only
B)1 and 2 only
C)3 and 4 only
D)1, 2, and 3 only
Q2) Where in the lung is pulmonary embolism most frequently observed?
A) Right lower lobe
B) Lingula
C) Left lower lobe
D) Right middle lobe
Q3) The presence of previous chronic obstructive pulmonary disease (COPD) reduces the diagnostic usefulness of scans in acute pulmonary embolism.
A)True
B)False
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Page 30
Chapter 29: Acute Respiratory Distress Syndrome
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Q1) What ventilatory strategy has been found to be useful for avoiding barotrauma in the treatment of patients with ARDS?
A) Prolonged expiratory time
B) Permissive hypercapnia
C) Inverse ratio ventilation
D) Intermittent mandatory ventilation
Q2) Which of the following explains the basis for permissive hypercapnia as a ventilator strategy for ARDS?
A) Introduction of CO<sub>2</sub> into the breathing circuit to stimulate spontaneous breaths.
B) Use of lower tidal volumes and accepting a gradual rise in PCO<sub>2</sub> to avoid associated hazards of high P<sub>aw</sub>.
C) Allow patients with ARDS to breathe spontaneously to build their respiratory muscular endurance.
D) To use exhaled CO<sub>2</sub> to increase residual volume and improve gas exchange.
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Chapter 30: Trauma, Burns and Near Drowning
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Sample Questions
Q1) While discussing the care of a morbidly obese patient with hemodynamic instability, the physician expresses concern regarding aggressive IV fluid therapy. Which patient pathologies associated with obesity could be an explanation?
1) Decreased preload
2) Myocardial hypertrophy
3) Decreased heart-wall compliance
4) Reduces heart chamber volumes
A)1 and 3 only
B)1, 2, and 3 only
C)3 and 4 only
D)2, 3, and 4 only
Q2) Your patient is brought in by EMS after being pulled from a house fire. She is complaining of difficulty breathing, has burnt nasal hairs, soot in the oral pharynx, and stridor. The physician asks for a treatment suggestion regarding her respiratory needs. What would you suggest?
A) Racemic epinephrine
B) Hyperbaric oxygen therapy
C) Nonrebreathing mask at 15 L/min
D) Intubations and mechanical ventilation
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Chapter 31: Lung Cancer
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28 Flashcards
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Sample Questions
Q1) Approximately what percentage of all lung cancer is linked to smoking?
A) 50% to 55%
B) 70% to 75%
C) 85% to 90%
D) 100%
Q2) Which of the following are being targeted as a primary source of new customers by tobacco companies?
A) Young people and developing countries
B) Women aged 21 to 35 years
C) Men aged 21 to 35 years
D) Men and women over 50 years of age
Q3) Which of the following comments regarding lung cancer is true?
A) The incidence has risen over the past few decades.
B) It is the third leading cause of cancer deaths in the United States.
C) The peak incidence occurred in the mid-1970s.
D) Incidence has increased in women 40 to 58 years of age.
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Chapter 32: Neuromuscular and Other Diseases of the Chest
Wall
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Sample Questions
Q1) By what age do most patients with Duchenne muscular dystrophy die?
A) 10 years
B) 20 years
C) 35 years
D) 50 years
Q2) What percentage of amyotrophic lateral sclerosis patients die within 5 years of diagnosis?
A) 10%
B) 25%
C) 50%
D) 80%
Q3) Nerve conduction studies are most helpful in the clinical diagnosis of which of the following?
A) Myasthenia gravis
B) Lambert-Eaton syndrome
C) Myotonic dystrophy
D) Amyotrophic lateral sclerosis
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Page 34
Chapter 33: Disorders of Sleep
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30 Flashcards
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Sample Questions
Q1) Which of the following physical exam findings are associated with obstructive sleep apnea?
1) Large tonsils
2) Microcephaly
3) Macroglossia
4) Deviated nasal septum
A)1 and 3 only
B)1, 2, and 3 only
C)3 and 4 only
D)2, 3, and 4 only
Q2) What value for the apnea-hypopnea index (AHI) is consistent with moderate obstructive sleep apnea?
A) 5 to 15
B) 15 to 30
C) Above 30
D) Below 5
Q3) Available evidence has shown that bilevel pressure is associated with better patient compliance than the conventional CPAP.
A)True
B)False
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Chapter 34: Neonatal and Pediatric Respiratory Disorders
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Sample Questions
Q1) What treatment usually causes improvement in the initial treatment of transient tachypnea of the newborn?
A) Mechanical ventilation with PEEP
B) Oxygen with low FiO<sub>2</sub>
C) Bronchodilators
D) Mucolytics
Q2) Which of the following is false regarding ventricular septal defects in infants?
A) Are quite common.
B) Usually cause right-to-left shunting.
C) May cause congestive heart failure.
D) Usually do not appear immediately after birth.
Q3) Which of the following statements are true about croup?
1) Caused by viral organism
2) Most common form of airway obstruction in children aged 6 months to 6 years
3) Causes subglottic swelling and obstruction
4) Most often caused by parainfluenza virus
A)1 and 3 only
B)2, 3, and 4 only
C)3 and 4 only
D)1, 2, 3, and 4
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Chapter 35: Airway Pharmacology
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Sample Questions
Q1) Which of the following are considered nonsteroidal antiasthma drugs?
1) Cromolyn-like agents
2) Leukotriene modifiers
3) Anti-IgE agents
4) Anti-IgA agents
A)1 and 3 only
B)1, 2, and 3 only
C)2, 3, and 4 only
D)1, 2, 3, and 4
Q2) Which of the following is the usual neurotransmitter in the sympathetic system?
A) Atropine
B) Acetylcholine
C) Norepinephrine
D) Dopamine
Q3) A metered dose inhaler of salmeterol delivers which of the following?
A) 131 mcg/puff
B) 90 mcg/puff
C) 65 mcg/puff
D) 25 mcg/puff
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Page 37
Chapter 36: Airway Management
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Sample Questions
Q1) To make oral intubation easier, how should the patient's head and neck be positioned?
A) Neck extended over the edge of the bed, with head dangling down
B) Neck extended, with head supported by towel and flexed forward
C) Both the neck and head fully extended, with neck supported by towel
D) Neck flexed, with head supported by towel and tilted back
Q2) During fiberoptic bronchoscopy, a patient receiving intravenous fentanyl exhibits signs of respiratory depression. Which of the following would you recommend?
A) Increase the oxygen flow rate and continue monitoring.
B) Immediately administer naloxone (Narcan).
C) Decrease the oxygen flow rate and continue monitoring.
D) Immediately administer neostigmine or prostigmine.
Q3) What is the normal range of negative pressure to use when suctioning children?
A) -60 to -80 mm Hg
B) -80 to -100 mm Hg
C) -100 to -120 mm Hg
D) -120 to -150 mm Hg
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Page 38
Chapter 37: Emergency Cardiovascular Life Support
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Sample Questions
Q1) A patient is having frequent premature ventricular contractions and runs of ventricular tachycardia. Which of the following drugs would be considered for this patient?
1) Procainamide
2) Epinephrine HCl
3) Atropine
4) Amiodarone
A)1 and 3 only
B)2 only
C)1 and 4 only
D)2, 3, and 4 only
Q2) When are oropharyngeal airways contraindicated?
1) When foreign body obstruction already exists
2) In patients who are unconscious or comatose
3) In cases of oromaxillary or mandibular trauma
A)1, 2, and 3
B)1 and 3 only
C)3 only
D)1 and 2 only
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Page 39
Chapter 38: Humidity and Bland Aerosol Therapy
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Sample Questions
Q1) How often would you recommend that a home care patient disinfect a home ultrasonic room humidifier?
A) Per manufacturer's specifications or at least every day
B) Per manufacturer's specifications or at least every 3 days
C) Per manufacturer's specifications or at least every 6 days
D) Per manufacturer's specifications or at least every 2 weeks
Q2) Which of the following are features of an ideal heat and moisture exchanger (HME)?
1) High compliance
2) Minimal dead space
3) 70% or higher efficiency
4) Minimal flow resistance
A)1 and 3 only
B)2, 3, and 4 only
C)2 and 4 only
D)1, 2, 3, and 4
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Chapter 39: Aerosol Drug Therapy
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116 Flashcards
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Sample Questions
Q1) Which of the following aerosols would have the highest rate of deposition by diffusion?
A) MMAD of 0.1 µm
B) MMAD of 3.0 µm
C) MMAD of 10.0 µm
D) MMAD of 50.0 µm
Q2) What measure is used to identify the particle diameter, which corresponds to the most typical settling behavior of an aerosol?
A) Mean mass velocity coefficient (MMVC)
B) Logarithmic standard diameter (LSD)
C) Mean mass aerodynamic diameter (MMAD)
D) Geometric standard deviation (GSD)
Q3) What is the preferred method for delivering bronchodilators to spontaneously breathing and intubated, ventilated patients?
A) Dry powder inhaler
B) Small-volume jet nebulizer
C) Metered dose inhaler
D) Hand-bulb atomizer
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Chapter 40: Storage and Delivery of Medical Gases
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Sample Questions
Q1) Where do respiratory therapists typically find DISS connections?
1) At the outlets of pressure-reducing valves attached to cylinders
2) At the nurse station
3) At the station outlets of central piping systems
4) At the inlets of blenders, flowmeters, ventilators, and other pneumatic equipments
A)1 and 2 only
B)1, 2, and 3 only
C)1, 3, and 4 only
D)3 and 4 only
Q2) When minimal fluctuations in pressure and flow are critical factors, which of the following pressure-reducing valves would be the best choice?
A) Single-stage preset pressure-reducing valve
B) Multiple-stage pressure-reducing valve
C) Uncompensated Thorpe tube flowmeter
D) Bourdon adjustable pressure regulator
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42
Chapter 41: Medical Gas Therapy
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Sample Questions
Q1) In giving O<sub>2</sub> to an infant through a hood, which of the following are correct?
1) A neutral thermal environment should be maintained.
2) Gases should be directed away from the infant's face.
3) High input flow (>10 to 15 L/min) should be avoided.
4) A minimum flow of 7 L/min must be maintained.
A)1, 2, and 3 only
B)2 and 4 only
C)2, 3, and 4 only
D)1, 2, 3, and 4
Q2) A physician orders 40% O<sub>2</sub> through an air-entrainment nebulizer for a patient with a minute volume of 12 L/min. What is the minimum nebulizer input flow required to ensure the prescribed FiO<sub>2</sub>?
A) 8 L/min
B) 10 L/min
C) 12 L/min
D) 14 L/min
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Chapter 42: Lung Expansion Therapy
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Sample Questions
Q1) Which of the following are true about gastric distention with intermittent positive-pressure breathing (IPPB)?
1) Gastric distention is uncommon in alert and cooperative patients.
2) Gastric distention is most likely at high airway pressures.
3) Gastric distention is a significant risk in obtunded patients.
4) Gastric distention is a relatively harmless effect of IPPB.
A)1 and 3 only
B)1, 2, and 3 only
C)2 and 4 only
D)1, 2, 3, and 4
Q2) Incentive spirometry devices can generally be categorized as which of the following?
1) Pressure-oriented
2) Flow-oriented
3) Volume-oriented
A)3 only
B)1 and 2 only
C)1, 2, and 3
D)2 and 3 only
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44
Chapter 43: Airway Clearance Therapy Act
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Sample Questions
Q1) Which of the following are goals of airway clearance therapy?
1) Help reverse the underlying disease process.
2) Help mobilize retained secretion.
3) Improve pulmonary gas exchange.
4) Reduce the work of breathing.
A)1 and 3 only
B)1, 2, and 3 only
C)3 and 4 only
D)2, 3, and 4 only
Q2) A physician orders postural drainage for a patient with aspiration pneumonia in the anterior segments of the upper lobes. Which of the following positions would you recommend for this patient?
A) Head down, patient prone with a pillow under abdomen
B) Patient supine with a pillow under knees, bed flat
C) Head down, patient supine with a pillow under knees
D) Patient prone with a pillow under abdomen, bed flat
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Chapter 44: Respiratory Failure and the Need for
Ventilatory
Support
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Sample Questions
Q1) Which of the following is the normal alveolar-to-arterial difference for a 56-year-old female in the emergency department?
A) 12 mm Hg
B) 14 mm Hg
C) 16 mm Hg
D) 18 mm Hg
Q2) Ventilatory support may be indicated when the VC falls below what level?
A) 45 ml/kg
B) 65 ml/kg
C) 10 ml/kg
D) 30 ml/kg
Q3) What is the optimal treatment of intrapulmonary shunt?
A) Increase the FiO<sub>2</sub>.
B) Decrease the FiO<sub>2</sub>.
C) Surgery.
D) Alveolar recruitment.
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Chapter 45: Mechanical Ventilators
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Sample Questions
Q1) During volume-targeted ventilation, which of the following settings determine I:E ratio?
1) Volume
2) Flow
3) Rate
A)1 and 2 only
B)1 and 3 only
C)2 and 3 only
D)1, 2, and 3
Q2) A time-cycled constant flow generator is set up with a flow of 35 L/min and an inspiratory time of 1.7 sec. What is the approximate V<sub>T</sub>?
A) 750 ml (0.75 L)
B) 1000 ml (1.00 L)
C) 1900 ml (1.90 L)
D) 1200 ml (1.20 L)
Q3) During mechanical ventilation, a spontaneous breath is defined as one that:
A) initiated and terminated by the machine.
B) begun by the patient and ended by the machine.
C) initiated and terminated by the patient.
D) begun by the machine and ended by the patient.
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Chapter 46: Physiology of Ventilatory Support
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Sample Questions
Q1) During pressure-controlled continuous mandatory ventilation, when the patient's lung compliance increases, which of the following will occur?
A) The tidal volume will increase.
B) The FRC will increase.
C) The peak airway pressure will increase.
D) The inspiratory time will decrease.
Q2) What factors contribute to the development of auto-positive end expiratory pressure (PEEP)?
1) High expiratory Raw
2) High inspiratory flows
3) Inadequate expiratory time
A)1 and 2 only
B)1 and 3 only
C)2 and 3 only
D)1, 2, and 3
Q3) What is traumatic injury to lung tissue caused by excessive pressure called?
A) Pulmonary barotrauma
B) Pulmonary hemorrhage
C) Pulmonary infarction
D) Pulmonary embolism
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Chapter 47: Patient Ventilator Interaction
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Sample Questions
Q1) Which of the following modes of mechanical ventilation are least likely to cause asynchrony?
1) Proportional assist ventilation
2) Pressure support ventilation
3) Neurally adjusted ventilator assist
4) Volume control/assist ventilation
A)1 and 3 only
B)2, 3, and 4 only
C)2 and 3 only
D)1 and 4 only
Q2) The most important variable affecting trigger asynchrony is:
A) the mode of mechanical ventilation being used.
B) the tidal volume being delivered.
C) the presence of auto-PEEP.
D) the patient's underlying disease process requiring mechanical ventilation.
Q3) In which mode does double triggering most commonly occur?
A) Volume ventilation.
B) Pressure ventilation.
C) CPAP.
D) No mode is more susceptible.
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Chapter 48: Initiating and Adjusting Invasive Ventilatory Support
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Sample Questions
Q1) In which of the following clinical situations is the incidence of auto-PEEP the greatest?
1) Patients with high respiratory rates
2) Intubated patients with obstructive lung disease
3) Patients with low minute volumes
A)1 and 2 only
B)1 and 3 only
C)2 and 3 only
D)1, 2, and 3
Q2) After placing a patient on a volume-cycled ventilator in the continuous mandatory ventilation assist-control mode, you note that 55 cm H<sub>2</sub>O pressure is required to deliver the preset V<sub>T</sub> of 950 ml. What high-pressure limit would you now set for this patient?
A) 60 cm H<sub>2</sub>O
B) 70 cm H<sub>2</sub>O
C) 80 cm H<sub>2</sub>O
D) 90 cm H<sub>2</sub>O
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Chapter 49: Noninvasive Ventilation
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Sample Questions
Q1) The use of noninvasive ventilation (NIV) in the long-term care of patients with chronic obstructive pulmonary disease (COPD) will benefit the patient in which the following ways except:
1) better gas exchange.
2) improved sleep quality.
3) resetting the respiratory center to better respond to hypoxemia.
4) unloading the respiratory muscles.
A)1 and 3 only
B)1, 2, and 4 only
C)2 and 4 only
D)2, 3, and 4 only
Q2) What mode of ventilation is most often used for noninvasive ventilation (NIV) when a critical care ventilator is in use?
A) Pressure support ventilation (PSV)
B) Continuous positive airway pressure
C) Intermittent mandatory ventilation
D) Control
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Chapter 50: Extracorporeal Life Support Ecls
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Sample Questions
Q1) What can cause a decrease in pump flow?
A) Both an increase in preload and an increase in afterload
B) Both a decrease in preload and a decrease in afterload
C) An increase in preload or decrease in afterload
D) A decrease in preload or increase in afterload
Q2) Which of the following is the typical ratio of sweep flow to pump flow?
A) 1:1
B) 3:1
C) 6:1
D) 9:1
Q3) Why is anticoagulation required during ECMO?
A) Patients are at risk for DVTs due to immobility.
B) The body tends to activate coagulation when exposed to the nonbiologic surfaces of the cannulas and circuit.
C) Coagulation is suppressed during ECMO.
D) Mechanical ventilation during ECMO causes thrombocytopenia.
Q4) Venoarterial is the preferred method for use of ECMO when cardiovascular support is not required.
A)True
B)False
Page 52
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Chapter 51: Monitoring the Patient in the Intensive Care Unit
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Sample Questions
Q1) Which of the following parameters are major factors in determining tissue oxygenation?
1) Arterial oxygenation
2) Tissue perfusion
3) Oxygen (O<sub>2</sub>) uptake
4) P/F ratio
A)1 and 3 only
B)1, 2, and 3 only
C)3 and 4 only
D)2, 3, and 4 only
Q2) Which of the following should be considered first if medical and mechanical problems have been excluded and the patient continues to fight the ventilator or exhibit high levels of agitation or distress?
A) Paralytics
B) Sedatives
C) Narcotics
D) Anesthetics
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Chapter 52: Discontinuing Ventilatory Support
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Sample Questions
Q1) A physician is using a pressure support protocol to wean a patient off ventilatory support. The patient is now at a 5 cm H<sub>2</sub>O pressure level and has a spontaneous respiratory rate of 21/min. Other cardiovascular and respiratory signs indicate that the patient remains stable. Which of the following actions would you recommend at this point?
A) Switch the patient to 5 cm H<sub>2</sub>O continuous positive airway pressure (CPAP) through the endotracheal tube.
B) Extubate the patient and provide supplemental O<sub>2</sub>.
C) Switch the patient to intermittent mandatory ventilation at a rate of 2/min.
D) Decrease the pressure support level to 3 cm H<sub>2</sub>O.
Q2) Which of the following is false about noninvasive positive-pressure ventilation (NIV)?
A) NIV can support ventilation without a tracheal airway.
B) NIV should not be used with patients at risk for aspiration.
C) Patients likely to fail weaning are good candidates for NIV.
D) NIV can be used to prevent reintubation when weaning fails.
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Chapter 53: Neonatal and Pediatric Respiratory Care
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Sample Questions
Q1) You are called to the NICU to assess the blood pressure of a neonate who weighs 750 g. You determine that the pressure is normal. Which of the following pressure did you obtain?
A) 40/25
B) 45/35
C) 55/40
D) 55/25
Q2) Late decelerations are consistent with which of the following conditions?
1) Uteroplacental insufficiency
2) Umbilical cord compression
3) Normal contraction
4) Maternal bradycardia
A)1 and 2 only
B)2 and 3 only
C)3 and 4 only
D)1, 2, 3, and 4
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55
Chapter 54: Patient Education and Health Promotion
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Sample Questions
Q1) Which of the following may be necessary with children before learning can take place?
A) Television shows
B) Patience
C) Games
D) Reward system
Q2) What concept will be most emphasized in teaching new skills to patients?
A) Handouts and illustrations
B) Repetition
C) Proper evaluation
D) Use of a pretest
Q3) Which of the following is used to evaluate cognitive objectives?
A) Verbal exam
B) Demonstration
C) Written exam
D) Performance checklist
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Chapter 55: Cardiopulmonary Rehabilitation
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Sample Questions
Q1) Which of the following clinicians are commonly involved in the cardiac rehabilitation programs?
1) Nurse specialist
2) Cardiologist
3) Dietitian
A)1 and 2 only
B)2 and 3 only
C)1 and 3 only
D)1, 2, and 3
Q2) Which of the following elements should be considered in most pulmonary rehabilitation programs?
1) Individual needs
2) Patient's education
3) Patient's personality
4) Patient's aptitudes
A)1, 2, and 3 only
B)2 and 4 only
C)1, 2, 3, and 4
D)3 and 4 only
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Chapter 56: Respiratory Care in Alternative Settings
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Sample Questions
Q1) What equipment function should lay caregivers of home mechanical ventilation assess regularly?
1) Cleanliness and function of bag-valve-mask
2) Internal and external battery power levels
3) Cleanliness of filters and alarm functions
4) Accuracy of ventilator tidal volume (V<sub>T</sub>) output
A)1, 2, and 3 only
B)2 and 4 only
C)1, 2, 3, and 4
D)3 and 4 only
Q2) Which of the following strategies would you recommend for a hemodynamically unstable patient with an intact upper airway who requires home ventilatory support?
A) Invasive positive pressure ventilation
B) Noninvasive positive pressure ventilation
C) Abdominal displacement ventilation
D) Negative pressure ventilation
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