Critical Care Respiratory Therapy
Textbook Exam Questions
Course Introduction
Critical Care Respiratory Therapy is an advanced course designed to equip students with the knowledge and clinical skills required to manage and support patients with life-threatening respiratory conditions in critical care settings. The course covers the principles and application of mechanical ventilation, advanced airway management, monitoring techniques, pharmacological interventions, and the interpretation of diagnostic tests relevant to respiratory failure and critical illness. Emphasis is placed on evidence-based practices, interdisciplinary collaboration, and patient safety to prepare students for the dynamic and high-stakes environment of critical care units.
Recommended Textbook
Clinical Manifestations Assessment of Respiratory Disease 6th Edition by Terry Des Jardins
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Chapter 1: The Patient Interview
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Q1) During the interview, the patient states, "Every time I climb the stairs I have to stop to catch my breath." Hearing this, the respiratory therapist replies, "So, it sounds like you get short of breath climbing stairs." This interviewing technique is called:
A) clarification.
B)modeling.
C)empathy.
D)reflection.
Answer: D
Q2) The main purpose of a patient interview is to:
A) review data with the patient.
B)gather subjective data from the patient.
C)gather objective data from the respiratory therapist.
D)fill out the history form or checklist.
Answer: B
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Chapter 2: The Physical Examination and Its Basis in Physiology
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Q1) When would induced hypothermia be indicated?
A) During brain surgery
B)During bowel surgery
C)To break a fever
D)To treat carbon monoxide poisoning
Answer: A
Q2) Rhonchi are associated with:
1) inspiration typically.
2) airway secretions.
3) bronchial asthma.
4) expiration typically.
A)2, 4
B)3, 4
C)2, 3, 4
D)1, 2, 3
Answer: A
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Page 4
Chapter 3: Pulmonary Function Study Assessments
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Q1) All of the following are true of the peak expiratory flow rate test EXCEPT:
A) it is effort dependent.
B)it is taken from the FVC test results.
C)it is taken from the MVV test results.
D)it assesses large upper airways.
Answer: C
Q2) The pulmonary diffusion capacity of carbon monoxide test is used to:
A) assess the patient's blood carbon monoxide level.
B)remove carbon monoxide from the patient's blood.
C)measure the residual volume.
D)assess the alveolar-capillary membrane.
Answer: D
Q3) Total lung capacity is composed of all of the following EXCEPT:
A) IRV.
B)IC.
C)ERV.
D)RV.
Answer: A
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5
Chapter 4: Arterial Blood Gas Assessments
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Q1) Which of the following would be found in a stable patient with longstanding obstructive lung disease?
A) Low bicarbonate level and low carbon dioxide level
B)Low bicarbonate level and high carbon dioxide level
C)High bicarbonate level and low carbon dioxide level
D)High bicarbonate level and high carbon dioxide level
Q2) Common causes of metabolic acidosis include all of the following EXCEPT:
A) diabetic ketoacidosis.
B)shallow breathing from a sedative overdose.
C)lactic acidosis.
D)renal (kidney) failure.
Q3) Your patient has had chronic ventilatory failure for several years. What is the primary factor that determines her breathing pattern?
A) Muscle efficiency
B)Ventilatory efficiency
C)Heart function
D)Work efficiency
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Chapter 5: Oxygenation Assessments
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Q1) Your patient has been exposed to carbon monoxide during a house fire. How should the patient's PaO<sub>2</sub> value be interpreted?
A) Accurate oxygenation reading
B)Higher than actual oxygenation reading
C)False normal oxygenation reading
D)It should match the CO<sub>2</sub> value.
Q2) An increased cardiac output causes the:
1) C(a-v)O<sub>2</sub> to decrease.
2) SvO<sub>2</sub> to increase.
3) Total O<sub>2</sub> delivery to decrease.
4) O<sub>2</sub>ER to increase.
A)1
B)2, 3
C)3, 4
D)1, 2
Q3) A condition that will cause anemic hypoxia is:
A) cyanide poisoning.
B)decreased cardiac output or heart failure.
C)polycythemia.
D)carbon monoxide poisoning.
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Chapter 6: Cardiovascular System Assessments
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Q1) Which of the following are found when a patient has sinus arrhythmia?
1) Rate decreases during expiration
2) Rate decreases during inspiration
3) Rate varies by more than 10% from beat to beat
4) Rate increases during inspiration
A)3
B)2, 3
C)1, 4
D)1, 3, 4
Q2) A central venous pressure (CVP) catheter is used to:
A) measure left atrial pressure.
B)measure right ventricular work.
C)monitor right ventricular function.
D)monitor left ventricular function.
Q3) When reviewing a cardiac rhythm strip, you notice that there are three large boxes between two QRS complexes. Approximately what is this patient's heart rate?
A) 60
B)75
C)100
D)150
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Chapter 7: Radiologic Examination of the Chest
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Q1) Your patient has had a ventilation-perfusion scan. What would be identified from the ventilation scan?
A) Location of a lung abscess
B)Alveolar consolidation
C)Location of a pulmonary embolism
D)Location of an airway obstruction
Q2) Which of the following are steps used in the evaluation of a chest radiograph?
1) Evaluation of the bony structures
2) Evaluation of exposure quality
3) Evaluation of the heart shadow
4) Evaluation of the tracheobronchial tree
A)4
B)1, 4
C)1, 2, 4
D)1, 2, 3, 4
Q3) Which of the following is true of a chest radiograph?
A) Lateral films are shot through one side of an upright patient.
B)AP films are typically taken in the x-ray department.
C)PA films artificially increase the size of the heart shadow.
D)Lateral decubitus films are shot with the patient lying supine.
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Chapter 8: Other Important Tests and Procedures
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Q1) In a normal differential white blood cell (WBC) count, which of the following would have the highest number?
A) Neutrophils
B)Basophils
C)Eosinophils
D)Lymphocytes
Q2) After a thoracentesis procedure, it is important to monitor the patient for:
A) bronchospasm.
B)hemoptysis.
C)increased blood urea nitrogen (BUN).
D)pneumothorax.
Q3) Culture and sensitivity tests:
A) stain a microorganism as Gram-positive or Gram-negative.
B)determine the shape of the organisms present.
C)identify the DNA of organisms present in the sputum.
D)determine the antibiotic(s) best suited for combating an infection.
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10
Chapter 9: The Therapist-Driven Protocol Program and the
Role of the Respiratory Care Practitioner
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Q1) When performing a therapist-driven protocol (TDP), the severity assessment refers to:
A) the frequency of performing a treatment modality.
B)how sick the patient is.
C)the Department of Homeland Security's threat level.
D)how urgently the physician wants the patient treated.
Q2) A TDP can be started after:
A) the nurse finishes his/her assessment.
B)the treatment is selected.
C)a physician's order for the TDP is received.
D)the patient's insurance carrier is contacted.
Q3) According to the aerosolized medication protocol, a patient with COPD could be treated with all of the following medications EXCEPT:
A) antiinflammatory agents.
B)sympathomimetic agents.
C)parasympatholytic agents.
D)antibiotics.
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Q1) All of the following blocks of information will be found in a patient's source-oriented record EXCEPT:
A) laboratory reports.
B)history.
C)police record.
D)admission information.
Q2) When reviewing a SOAPIER progress note, the R stands for:
A) revisions made in the original plan.
B)refusal of care by the patient.
C)rejection by the physician.
D)resuscitate the patient.
Q3) When reviewing a SOAPIER progress note, the A stands for:
A) application of the data.
B)assessment of the data by the patient.
C)affect of the patient.
D)assessment of the data by the health-care worker.
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Chapter 11: Chronic Obstructive Pulmonary Disease Copd:
Chronic Bronchitis, and Emphysema
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Q1) Emphysema is probably caused by all of the following EXCEPT:
A) inhaling asbestos fibers.
B)(\(\alpha\)<sub>1</sub>)-antitrypsin deficiency.
C)second-hand cigarette smoke.
D)air pollution.
Q2) According to the GOLD report, which of the following is the greatest worldwide risk factor for COPD?
A) AIDS
B)Genetic predisposition
C)Marijuana smoke
D)Tobacco smoke
Q3) The management of chronic obstructive pulmonary disease (COPD) includes:
1) annual influenza immunization.
2) bronchopulmonary hygiene procedures.
3) lung volume-reduction surgery.
4) smoking cessation.
A)1, 2
B)2, 3
C)2, 3, 4
D)1, 2, 3, 4
Page 13
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Chapter 12: Asthma
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Q1) Which of the following are associated with so-called intrinsic asthma?
1) Emotional stress
2) Cockroach allergen
3) GERD
4) Obesity
A)2, 4
B)1, 3
C)2, 3, 4
D)1, 2, 3, 4
Q2) Pulsus paradoxus would be manifested as:
A) a greater than 40 mm Hg difference between systolic and diastolic blood pressures.
B)inspiratory systolic blood pressure >10 mm Hg less than during expiration.
C)inspiratory diastolic blood pressure >10 mm Hg less than during expiration.
D)systolic and diastolic blood pressure reading being reversed.
Q3) Mechanical ventilation may be required during which of the following situations?
A) Status asthmaticus
B)Intrinsic asthma
C)Early asthmatic response
D)Nonatopic asthma
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Chapter 13: Bronchiectasis
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Q1) Mechanical ventilation would be justified in the management of a patient with bronchiectasis under the following circumstances:
A) Patient has a reversible lung problem
B)To prevent atelectasis
C)To provide supplemental oxygen
D)To help to mobilize secretions
Q2) Congenital causes of bronchiectasis include:
1) Influenza
2) Cystic fibrosis
3) COPD
4) Kartagener's syndrome
A)2, 4
B)1, 3
C)1, 2, 3
D)2, 3, 4
Q3) Severe bronchiectasis is associated with all of the following EXCEPT:
A) vesicular breath sounds.
B)cor pulmonale.
C)distended neck veins.
D)polycythemia.
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Chapter 14: Cystic Fibrosis
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Q1) Which ethnic group has the greatest number of people with cystic fibrosis?
A) African Americans
B)Asians
C)Hispanics
D)whites
Q2) If a cystic fibrosis patient is in generally good condition, what might be done to permanently fix the lung problem?
A) Cryosurgery
B)Total DNA replacement
C)Diaphragmatic pacemaker
D)Lung transplant
Q3) What complicating pulmonary problem is likely to happen to a patient with cystic fibrosis?
A) Pulmonary edema
B)Pleural effusion
C)Spontaneous pneumothorax
D)Cardiac tamponade
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Chapter 15: Pneumonia
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Q1) Which of the following is the most important in determining the cause of the patient's pneumonia?
A) Radiograph
B)Sputum examination
C)History
D)Breath sounds
Q2) Which of the following can cause pneumonia?
1) Bacteria
2) Viruses
3) Prions
4) Fungi
A)1,2
B)2, 3
C)1, 2, 4
D)1, 2, 3, 4
Q3) Overall, most cases of pneumonia are caused by:
A) viruses.
B)Gram-negative bacteria.
C)protozoa.
D)fungi.
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Chapter 16: Lung Abscess
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Q1) During the early stages of a lung abscess, the pathological process is the same as that of:
A) pulmonary edema.
B)bronchopulmonary dysplasia.
C)pneumonia.
D)pulmonary fibrosis.
Q2) A patient who had a stroke is lying supine in bed when he vomits and aspirates. He is most likely to develop a lung abscess in the:
1) posterior segments of the upper lobes.
2) lingular segments.
3) superior segments of the lower lobes.
4) all segments of both lower lobes.
A)4
B)1, 3
C)2, 3
D)1, 2, 4
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Chapter 17: Tuberculosis
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Q1) Your patient has been found to have tuberculosis (TB) in several organs of the body. What term is used to describe this situation?
A) Primary TB
B)Postprimary TB
C)Disseminated TB
D)Multiorgan TB
Q2) A patient with an advanced case of TB may have the following radiologic findings:
1) Bronchial tumors
2) Hyperlucent lung fields
3) Retraction of lung segments
4) Right-sided heart enlargement
A)2
B)2, 3
C)3, 4
D)1, 3, 4
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19
Chapter 18: Fungal Diseases of the Lung
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Q1) After cleaning out his chicken coop, a farmer has developed a fungal lung infection. What type of infection is it most likely to be?
A) Coccidioidomycosis
B)Blastomycosis
C)Histoplasmosis
D)Cryptococcal infection
Q2) Pulmonary function testing results on a patient with advanced fungal pneumonia will display all of the following EXCEPT:
A) increased ERV.
B)decreased IRV.
C)decreased IC.
D)decreased TLC.
Q3) Your patient with an advanced pulmonary fungal infection has cor pulmonale. How will this manifest itself?
A) Distended neck veins
B)Poor skin turgor
C)Wheezy breath sounds
D)Asymmetrical chest movement when breathing
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20
Chapter 19: Pulmonary Edema
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Q1) Lymphatic insufficiency could be caused by:
1) lung transplantation.
2) lymphangitic carcinomatosis.
3) removal of pleural fluid.
4) decreased oncotic pressure.
A)1, 2
B)3, 4
C)1, 2, 4
D)1, 2, 3, 4
Q2) Your patient has a decreased oncotic pressure. What can be done to increase it?
A) High-salt diet
B)Mannitol
C)Albumin withheld
D)Morphine sulfate
Q3) What is the normal hydrostatic pressure in the pulmonary capillaries?
A) 0 to 5 mm Hg
B)5 to 10 mm Hg
C)10 to 15 mm Hg
D)15 to 20 mm Hg
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Chapter 20: Pulmonary Embolism
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Q1) All of the following are preventative measures taken with patients at high risk for thromboembolic disease EXCEPT:
A) to drink lots of water.
B)to dangle your legs over the edge of the bed before getting up.
C)to walk frequently.
D)to wear compression stockings.
Q2) A pulmonary angiogram is usually ordered:
A) as the first test to identify a pulmonary embolism.
B)when other tests for a pulmonary embolism are inconclusive.
C)in conjunction with a magnetic resonance image to identify a pulmonary embolism.
D)in conjunction with an extremity venogram to identify a pulmonary embolism.
Q3) Your patient's D-dimer blood test results show a value of 250 ng/mL. How should these results be interpreted?
A) The patient does not have a pulmonary embolism.
B)The patient's anticoagulant level is acceptable.
C)The patient has a pulmonary embolism.
D)The patient has a deep vein thrombosis.
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Chapter 21: Flail Chest
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Q1) If mechanical ventilation is required, how long will it be needed to allow sufficient time for bone healing?
A) up to 5 days
B)5 to 10 days
C)10 to15 days
D)greater than 15 days for full bone healing
Q2) When a patient has a flail chest, what happens during the ventilatory cycle?
A) The I:E ratio becomes inverse.
B)Air leaks out through the flail area.
C)Air leaks in through the flail area.
D)Air is shunted from one lung to the other.
Q3) Major pathologic and structural changes associated with a flail chest include:
1) pneumothorax.
2) secondary pneumonia.
3) pleural effusion.
4) elevated diaphragms.
A)1, 2
B)3, 4
C)1, 3, 4
D)1, 2, 3, 4
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Chapter 22: Pneumothorax
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Q1) After the patient has had repeated pneumothoraces of her right lung, the physician has recommended that the patient have the problem permanently eliminated. What should be done?
A) Pleurodesis
B)Right pneumonectomy
C)Permanent right sided chest tube
D)Right upper lobectomy
Q2) What are the anatomic alterations that occur when a person has a pneumothorax?
1. The lung on the affected side collapses.
2. The visceral and parietal pleura separate.
3. The visceral pleura adheres to the parietal pleura.
4. The chest wall moves outward.
A) 1, 3
B) 3, 4
C) 2, 4
D) 1, 2, 4
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24
Chapter 23: Effusion and Empyema
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Q1) The anatomic alteration caused by a pleural effusion is:
A) pulmonary fibrosis.
B)separation of the visceral and parietal pleura.
C)adhesion of the visceral and parietal pleura.
D)pulmonary edema.
Q2) Which of the following are major causes of an exudative pleural effusion?
1) Empyema
2) Chylothorax
3) Pancreatitis
4) Peritoneal dialysis
A)1, 4
B)2, 3
C)1, 2, 3
D)1, 2, 3, 4
Q3) The major pathologic and structural changes associated with a significant pleural effusion include all of the following EXCEPT:
A) diaphragm elevation.
B)atelectasis.
C)compression of the great vessels.
D)lung compression.
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Chapter 24: Kyphoscoliosis
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Q1) Braces are most effective with which group of kyphoscoliosis patients?
A) Adolescents with idiopathic scoliosis
B)Patients with congenital scoliosis
C)Patients with neuromuscular scoliosis
D)Infants with idiopathic scoliosis
Q2) The Charleston Bending Brace is preferred over other braces because:
1) it is only worn 23 hours a day.
2) it is worn for 8 to 10 hours at night.
3) it is used when the patient's Human Growth Hormone level is highest.
4) it corrects any associated upper airway obstruction.
A)2, 3
B)1, 4
C)2, 4
D)2, 3, 4
Q3) A patient with severe kyphoscoliosis and chronic ventilatory failure with hypoxemia will have all of the following laboratory findings, EXCEPT:
A) increased PaCO<sub>2</sub>.
B)increased hematocrit.
C)normal pH.
D)increased pH.
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Chapter 25: Interstitial Lung Diseases
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Q1) Generally, a patient with ILD will have a lung compliance that is:
A) higher than normal.
B)normal.
C)less than normal.
D)variable based on the etiology.
Q2) What group of people are the most likely to get sarcoidosis?
1) African-American women
2) White men
3) 20- to 30-year age bracket
4) >50-year age bracket
A)2
B)1, 3
C)1, 4
D)2, 3
Q3) All of the following are anatomic alterations of the lungs that may be found with the chronic stage of interstitial lung disease (ILD) EXCEPT:
A) honeycombing.
B)edema.
C)interstitial thickening.
D)granulomas.
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Chapter 26: Cancer of the Lung
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Q1) Your patient with advanced lung cancer with metastasis to several organs has chosen palliative care. What does this mean?
A) Aggressive chemotherapy
B)Chemotherapy and radiation therapy
C)Surgery, chemotherapy, and radiation therapy
D)Treating his symptoms
Q2) During bronchoscopy, a tumor was found in the right mainstem bronchus. What is the best way to manage the problem?
A) Prophylactic cranial irradiation
B)Brachytherapy
C)Cryotherapy
D)Laser bronchoscopy
Q3) Chest radiograph findings indicating lung cancer include all of the following, EXCEPT:
A) a large irregular mass.
B)an enlarged heart.
C)a coin lesion.
D)a pleural effusion.
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28
Chapter 27: Acute Respiratory Distress Syndrome
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Q1) Inhalation of all of the following can lead to ARDS, EXCEPT:
A) greater than 60% oxygen for a long period.
B)nitrogen dioxide.
C)very dry air.
D)chlorine gas.
Q2) The anatomic alterations found in the alveoli of a patient with ARDS are closest to those found with what other disease?
A) Bacterial pneumonia
B)Hyaline membrane disease
C)Congestive heart failure
D)Emphysema
Q3) Your patient has a prolonged case of ARDS. What will happen to his alveolar cells?
A) Multiplication of the type I cells
B)Influx of macrophages
C)Hyperplasia and swelling of the type II cells
D)Development of emphysema
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29
Chapter 28: Guillain-Barré Syndrome
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Q1) Guillain-Barré syndrome is most likely to be found in which demographic group?
A) African-American female 20-30 years of age
B)Hispanic male <45 years of age
C)Asian female 20-40 years of age
D)White male = 45 years of age
Q2) Your Guillain-Barré syndrome patient has autonomic nervous system dysfunction and should be monitored for all of the following:
1) tachycardia.
2) hypotension.
3) bradycardia.
4) fever.
A)2, 4
B)1, 3
C)2, 3, 4
D)1, 2, 3
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Chapter 29: Myasthenia Gravis
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Q1) What test is usually performed to confirm the diagnosis of myasthenia gravis?
A) Electromyography
B)Pulmonary function testing
C)Complete blood count
D)Electroencephalogram (EEG)
Q2) Clinical indications that a patient with myasthenia gravis has acute ventilatory failure include:
1) NIF < -25 cm H<sub>2</sub>O
2) VC < 20 ml/kg
3) PaCO<sub>2</sub> > 45 mm Hg
4) pH < 7.35
A)1
B)2, 3
C)1, 4
D)1, 2, 3, 4
Q3) In a myasthenia gravis patient, what happens after a rest period?
A) There is no clinical change.
B)Strength decreases.
C)Muscle strength improves.
D)Ascending paralysis descends.
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Chapter 30: Sleep Apnea
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Q1) Sleep apnea in an adult:
1) may be caused by upper airway obstruction.
2) may be due to an abnormal respiratory center.
3) is characterized by periods of apnea during non-REM and REM sleep.
4) lowers a person's oxygen level.
A)1, 4
B)2, 3
C)1, 2, 3
D)1, 2, 3, 4
Q2) A CPAP titration polysomnogram is performed to:
A) find the maximum CPAP level for the functional residual capacity.
B)determine the lowest possible CPAP level.
C)find the CPAP level to maintain an open airway.
D)determine the pressure needed for negative-pressure ventilation.
Q3) All of the following are found during rapid eye movement sleep, EXCEPT:
A) the diaphragm functions normally.
B)the person is easy to awaken.
C)dreaming occurs.
D)skeletal muscles are paralyzed.
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Page 32
Chapter 31: Newborn and Early Childhood Respiratory Disorders
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Q1) A premature neonate must generate a higher negative intrapleural pressure during inspiration than a term neonate. This will result in all of the following, EXCEPT:
A) cyanosis of dependent thoracic areas.
B)"seesaw" breathing pattern.
C)alveolar hyperinflation.
D)intercostal retractions.
Q2) The most recent arterial blood gas results on your premature neonatal patient show that the PaO<sub>2</sub> is low. All of the following are possible causes of this, EXCEPT: A) fatigue.
B)PPHN.
C)hyperventilation.
D)pulmonary shunting.
Q3) Your neonatal patient is having expiratory grunting. What physiologic effect does this produce?
A) Increased vital capacity.
B)Increased PAO<sub>2</sub>.
C)Decreased PaCO<sub>2</sub>.
D)Closes the ductus arteriosus.
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Chapter 32: Meconium Aspiration Syndrome
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Q1) Indications that a newborn has aspirated meconium include all of the following, EXCEPT:
A) high Apgar score.
B)meconium in amniotic fluid.
C)newborn is not actively breathing.
D)meconium staining on skin.
Q2) If mechanical ventilation is needed to support a neonate with MAS, which of the following settings is especially important?
A) High positive end-expiratory pressure (PEEP) level
B)Long exhalation time
C)High humidity level
D)Give no more than 50% oxygen
Q3) Your patient with MAS has had a chest radiograph taken. What findings can be expected?
A) Elevated diaphragms
B)Mediastinal shift
C)Irregular densities throughout the lungs
D)Air bronchograms
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Chapter 33: Transient Tachypnea of the Newborn
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Q1) All of the following are usually performed in the general management of a patient with TTN, EXCEPT:
A) close monitoring.
B)give a diuretic medication.
C)proper stabilization.
D)rule out of other serious conditions.
Q2) Usually TTN will begin to resolve within what time period?
A) 4 to 6 hours
B)12 to 24 hours
C)About 48 hours
D)Greater than 72 hours
Q3) Which of the following is the most likely to be utilized in the management of a patient with TTN?
A) Lung expansion therapy
B)Oxygen therapy
C)Mechanical ventilation
D)Bronchopulmonary hygiene therapy
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35
Chapter 34: Respiratory Distress Syndrome
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Q1) The neonate with RDS would have a phosphatidylglycerol (PG) level that is
A) present.
B)absent.
C)above normal.
D)below normal.
Q2) Management of a neonate with RDS may include:
1) CPAP
2) Instilling surfactant into the lungs
3) Mechanical ventilation
4) Supplemental oxygen
A)2
B)1, 3
C)2, 3, 4
D)1, 2, 3, 4
Q3) Respiratory distress syndrome (RDS) primarily affects infants who are:
A) pre-term with insufficient surfactant.
B)full-term.
C)post-term with too much surfactant.
D)pre-term with too much surfactant.
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Page 36
Chapter 35: Pulmonary Air Leak Syndromes
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Q1) When trapped gas causes alveolar overdistention and rupture, does where the gas initially go?
1) Both pleural spaces
2) Tissue sheaths surrounding airways and capillaries
3) Interlobular septa containing pulmonary veins
4) Pericardial sac
A)2, 3
B)1, 4
C)1, 2, 3
D)2, 3, 4
Q2) During the physical exam of a patient with PIE and a pneumoperitoneum, what respiratory rate is usually found?
A) 80 to 120/min
B)>60/min
C)30 to 60/min
D)Less than 30/min
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Chapter 36: Respiratory Syncytial Virus Infection
Bronchiolitis or Pneumonitis
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Q1) Your patient with RSV is hypoxemic. What could cause this?
1) Atelectasis
2) Excessive airway fluid
3) Persistent pulmonary hypertension of the newborn (PPHN)
4) Consolidation
A)1, 2
B)3, 4
C)1, 2, 4
D)1, 2, 3, 4
Q2) Which of the following are major pathologic or structural changes associated with RSV?
1) Dilation and distortion of the airways
2) Inflammation of the peripheral airways
3) Alveolar hyperinflation
4) Pulmonary edema
A)1, 4
B)2, 3
C)2, 3, 4
D)1, 2, 3, 4
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Chapter 37: Bronchopulmonary Dysplasia
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Q1) If your mechanically ventilated patient develops stress fractures of the capillary endothelium and adjacent tissues, what can happen?
A) Fluid leakage into alveolar spaces
B)Mucosal edema
C)Pulmonary embolism
D)Respiratory distress syndrome (RDS)
Q2) Which of the following can increase an infant's likelihood of developing BPD?
A) Use of inhaled parasympatholytic agents
B)Patent ductus arteriosus (PDA)
C)High Apgar scores
D)Meconium aspiration syndrome (MAS)
Q3) A patient with Stage 1 BPD would have which of the following chest radiograph findings?
A) Ground-glass granular pattern
B)Emphysematous bullae
C)Honeycomb appearance
D)Mediastinal shift
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Chapter 38: Congenital Diaphragmatic Hernia
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Q1) All of the following chest radiograph findings would be found in a patient with a CDH, EXCEPT:
A) steeple point sign.
B)complete lung collapse.
C)lungs do not meet the chest wall.
D)heart is shifted to the unaffected side.
Q2) An infant with a CDH also has pulmonary hypertension. What can be given to help correct this problem?
A) Inhaled nitric oxide (iNO)
B)Inhaled parasympatholytic agent
C)100% oxygen
D)Corticosteroids
Q3) All of the following anatomic alterations may be found in a patient with a congenital diaphragmatic hernia (CDH), EXCEPT:
A) lungs are compressed.
B)atelectasis.
C)hyperinflation.
D)complete lung collapse.
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Chapter 39: Croup Syndrome: Laryngotracheobronchitis and
Acute Epiglottitis
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Q1) In evaluating a 16- month-old boy you find him to be in mild respiratory distress, without a fever, but with a barking-type cough. A lateral neck x-ray taken in the Emergency Department shows a "steeple point" narrowing of the trachea. Based on this information, what do you think is the boy's probable diagnosis?
A) Acute bronchitis
B)Epiglottitis
C)Bronchiolitis
D)LTB
Q2) All of the following anatomic alterations may be found in a patient with LTB, EXCEPT: A) increased secretions.
B)ineffective cilia.
C)narrowed airway lumen.
D)excessive surfactant production.
Q3) The diagnosis of LTB is made by all of the following, EXCEPT:
A) child has inspiratory stridor and barking cough.
B)child has a normal temperature or low fever.
C)child has a significant fever.
D)child can drink without difficulty.
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Chapter 40: Near Drowning
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Q1) Many adult drowning victims have been shown to have:
A) used alcohol.
B)had a stroke.
C)eaten just before swimming.
D)had a heart attack.
Q2) Hospital management of near drowning victims includes all of the following, EXCEPT:
A) measurement of arterial blood gas values.
B)rewarming if the patient is hypothermic.
C)measurement of venous blood gas values.
D)chest radiography.
Q3) The pulmonary effects of a near-drowning victim inhaling water include:
1) alveolar consolidation.
2) bronchospasm.
3) production of frothy, white secretions.
4) pleural effusion.
A)2, 3
B)1, 2, 3
C)2, 3, 4
D)1, 2, 3, 4
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Page 42
Chapter 41: Smoke Inhalation and Thermal Injuries
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Q1) Your patient with carbon monoxide poisoning has a COHb level of 20%. If he is given 100% oxygen, what will be the approximate COHb level be at 1 hour?
A) 15%
B)10%
C)5%
D)2.5%
Q2) All of the following classes of medications are commonly used in the care of patients with a smoke inhalation injury, EXCEPT:
A) parasympatholytics.
B)mucolytics.
C)sympathomimetics.
D)xanthines.
Q3) A 65-year-old patient has third-degree skin burns over 30% of his body and a smoke inhalation injury. How does the combination of skin burns and smoke inhalation affect his prognosis?
A) It quadruples the mortality rate.
B)It more than triples the mortality rate.
C)It almost doubles the mortality rate.
D)There is no mortality change between having one or two problems.
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Page 43
Chapter 42: Postoperative Atelectasis
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Q1) Your patient has a tumor blocking the left mainstem bronchus. What additional factor would favor the development of atelectasis?
A) Breathing a nitric oxide mix (iNO)
B)Breathing a helium/oxygen mix (heliox)
C)Breathing a high percentage of oxygen
D)Breathing a low percentage of oxygen
Q2) Examples of the types of surgical procedures that often result in atelectasis include all of the following, EXCEPT:
A) Open heart surgery
B)Craniotomy
C)Gallbladder removal
D)Splenectomy
Q3) What definition of atelectasis would best fit that of a premature newborn with respiratory distress syndrome (RDS)?
A) Partial or total collapse of previously expanded lung regions
B)Free pleural air compressed the lungs
C)Enlarged heart causes compression of the lungs
D)The lungs remain unexpanded since birth
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