Fundamentals of Respiratory Therapy
Mock Exam
Course Introduction
Fundamentals of Respiratory Therapy introduces students to the essential principles and practices involved in the care and management of individuals with cardiopulmonary disorders. This course covers basic respiratory anatomy and physiology, the pathophysiology of common respiratory illnesses, and the roles and responsibilities of the respiratory therapist within the healthcare team. Students will learn about therapeutic modalities such as oxygen therapy, aerosol therapy, airway management, mechanical ventilation, and pulmonary function testing. Emphasis is placed on patient assessment, ethical considerations, and evidence-based practices to ensure safe and effective respiratory care in clinical settings.
Recommended Textbook
Egans Fundamentals of Respiratory Care 9th Edition by Robert M. Kacmarek
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3410 Verified Questions
3410 Flashcards
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Chapter 1: History of Respiratory Care
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Sample Questions
Q1) When was synchronized intermittent mandatory ventilation (SIMV) first introduced?
A)1975
B)1985
C)1995
D)2005
Answer: A
Q2) The majority of respiratory care education programs in the United States offer what degree?
A)associate's degree
B)bachelor's degree
C)master's degree
D)none of the above
Answer: A
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3
Chapter 2: Quality and Evidence-Based Respiratory Care
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Sample Questions
Q1) What is the chief reason that respiratory care protocols were developed and are currently being used in hospitals throughout North America?
A)enhance proper allocation of respiratory care services
B)decrease patient care costs to hospitals and insurance companies
C)expand patient care skills among respiratory care providers
D)enhance efficiency of respiratory care personnel in providing patient care
E)justify reasons for increasing patient care costs
Answer: A
Q2) Which of the following is an essential element of a comprehensive protocol program?
A)carefully structured assessment tool and care plan form
B)active quality monitoring
C)comprehensive delineation of boundaries between respiratory care, nursing, and physician personnel
D)both B and C
E)none of the above
Answer: A
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Chapter 3: Patient Safety, Communication, and Record Keeping
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Sample Questions
Q1) Key barriers to effective interpersonal communication include all of the following except:
A)use of symbols or words with different meanings
B)value systems that are different or not accepted
C)similar perceptions of the problem
D)feelings of personal insecurity by one or both parties
Answer: C
Q2) When a small, usually imperceptible current (usually less than 1 mA) is allowed to bypass the skin and follow a direct, low resistance pathway into the body, which of the following conditions exists?
A)macroshock hazard
B)grounding hazard
C)isolation hazard
D)microshock hazard
Answer: D
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Page 5
Chapter 4: Principles of Infection Control
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Sample Questions
Q1) Exposure to which of the following organisms calls for postexposure chemoprophylaxis?
A) N. meningitides
B) B. pertussis
C) B. anthracis
D) all the above
Q2) Which of the following is an example of indirect contact transmission involving fomites?
A)use of a sterile needle on a pneumonia patient
B)use of a dirty nebulizer on another patient
C)drinking tap water
D)inhaling tuberculosis pathogens in the emergency department
Q3) Which of the following statements is NOT true regarding the use of ETO for sterilization?
A)It is harmless to rubber and plastics.
B)Will penetrate prewrapping.
C)Acute exposure is of little consequence.
D)It is useful for equipment that cannot be autoclaved.
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6
Chapter 5: Ethical and Legal Implications of Practice
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Sample Questions
Q1) HIPAA primarily is 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
Q2) The debate over prolongation of life versus relief of suffering in elderly patients mainly involves differing opinions regarding what ethical principle?
A)autonomy
B)beneficence
C)role fidelity
D)justice
Q3) Which of the following has played a major 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) Which of the following design components of an air injector would result in entraining the greatest amount of air?
I.small orifice jet
II.large entrainment ports
III.low-velocity gas flow
A)I, II, and III
B)I and II
C)I and III
D)III
Q2) What is the temperature at which the vapor pressure of a liquid equals the pressure exerted on the liquid by the surrounding atmosphere?
A)boiling point
B)dew point
C)triple point
D)melting point
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8
Chapter 7: Computer Applications in Respiratory Care
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Sample Questions
Q1) What software program is useful for preparing slides for a professional presentation?
A)Microsoft Word
B)Microsoft PowerPoint
C)Microsoft Excel
D)Microsoft Access
Q2) How often does the performance capacity of computers double?
A)every 6 months
B)every year
C)every 18 months
D)every 2 years
Q3) Which of the following patients would benefit the most from a disease management program?
A)patient with pneumonia
B)patient with a sinus infection
C)patient with hay fever
D)patient with COPD
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Chapter 8: The Respiratory System
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Sample Questions
Q1) What is the name of the reflex associated with the sensory stimulation of the pulmonary stretch receptors that stimulates a deeper breath upon inspiration?
A)carotid sinus
B)Head's paradoxical
C)Hering-Breuer
D)vagovagal
Q2) What are the three bony projections that arise from the lateral walls of the nasal cavity that enhance filtration and humidification?
A)alar nasi
B)frontal sinuses
C)palatine tonsils
D)turbinates
Q3) What is meant by "internal respiration"?
A)any gas exchange that occurs inside the body
B)consumption of oxygen in the mitochondria
C)continuous absorption of oxygen and excretion of carbon dioxide
D)exchange of gases between the blood and the tissue
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10
Chapter 9: The Cardiovascular System
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Sample Questions
Q1) What is the ability of myocardial tissue to propagate electrical impulses?
A)automaticity
B)conductivity
C)contractility
D)excitability
Q2) The second heart sound is associated with what mechanical event of the cardiac cycle?
A)atrioventricular valve closure
B)atrioventricular valve opening
C)semilunar valve closure
D)semilunar valve opening
Q3) The semilunar (pulmonary and aortic) valves do which of the following?
A)cause almost the entire afterload for the ventricles
B)consist of two half-moon or crescent-shaped cusps
C)prevent arterial backflow during ventricular relaxation
D)separate the ventricles from their arterial outflow tracts
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11
Chapter 10: Ventilation
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Sample Questions
Q1) What term is used to note the difference between inspiratory lung volume and expiratory lung volume at any given pressure?
A)alveolar aphasia
B)hysteresis
C)pleural pressure variance
D)transpulmonary pressures
Q2) Which of the following statements about the equal pressure point (EPP) is true?
A)As gas travels from the EPP to the mouth, greater expiratory effort increases flow.
B)At the EPP, pressure inside the airway exceeds P<sub>pl</sub>.
C)The EPP normally occurs at volumes greatly below the FRC.
D)Upstream from the EPP (toward the alveoli), P<sub>pl</sub> exceeds pressure in the airway.
Q3) What is the term for the impedance to ventilation caused by the movement of gas through the conducting system of the lungs?
A)airway resistance
B)lung compliance
C)surface tension
D)tissue elastance
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Chapter 11: Gas Exchange and Transport
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Sample Questions
Q1) Compared to normal levels, a shift in the HbO<sub>2</sub> curve to the right has which of the following effects?
I .The affinity of Hb for oxygen decreases.
II.The Hb saturation for a given PO<sub>2</sub> falls.
III.The Hb saturation for a given PO<sub>2</sub> rises.
A)I only
B)I and II
C)II and III
D)I, II, and III
Q2) When oxygen uptake by the tissues is abnormally low, as occurs in certain forms of dysoxia, what would you expect to find?
A)decreased CaO<sub>2</sub>
B)decreased CvO<sub>2</sub>
C)decreased PaO<sub>2</sub>
D)increased CvO<sub>2</sub>
Q3) How is the vast majority of oxygen carried in the blood?
A)as bicarbonate ion (HCO<sub>3</sub>)
B)as carbamino compounds
C)chemically combined with Hb
D)in physical solution
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Chapter 12: Solutions, Body Fluids, and Electrolytes
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Sample Questions
Q1) Which of the following describes serum Ca<sup>2+</sup>?
A)About 30% of the serum Ca<sup>2+</sup> is ionized and combined with plasma anions.
B)Acidemia decreases the serum levels of ionized Ca<sup>2+</sup>.
C)More than half of the serum Ca<sup>2+</sup> is nonionized and bound to plasma albumin.
D)Serum Ca<sup>2+</sup> is present in three forms: ionized, protein bound, and complex.
Q2) Which of the following is FALSE about phosphate?
A)Organic phosphate is the primary extracellular cation.
B)Inorganic phosphate plays a primary role in energy metabolism.
C)Phosphate is the main urinary buffer for titratable acid excretion.
D)Serum phosphate levels range from 1.2 to 2.3 mEq/L.
Q3) An adult's insensible water through the lungs averages what level?
A)100 ml/day
B)200 ml/day
C)300 ml/day
D)400 ml/day
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14
Chapter 13: Acid-Base Balance
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Sample Questions
Q1) Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 7.62, PCO<sub>2</sub> = 41 mm Hg, HCO<sub>3</sub><sup>-</sup> = 40.9 mEq/L
A)acute (uncompensated) metabolic alkalosis
B)acute (uncompensated) respiratory alkalosis
C)fully compensated metabolic alkalosis
D)partially compensated metabolic alkalosis
Q2) When a strong acid is added to the bicarbonate buffer system, what is the result?
A)strong base and neutral salt
B)strong acid and neutral salt
C)weak acid and neutral salt
D)weak acid and basic salt
Q3) Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 6.89, PCO<sub>2</sub> = 24 mm Hg, HCO<sub>3</sub><sup>-</sup> = 4.7 mEq/L
A)acute (uncompensated) metabolic acidosis
B)acute (uncompensated) respiratory acidosis
C)partially compensated metabolic acidosis
D)partially compensated respiratory acidosis
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Chapter 14: Regulation of Breathing
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Sample Questions
Q1) Coexisting arterial hypoxemia, acidemia, and high PaCO<sub>2</sub> (i.e., asphyxia) will have what affect on the peripheral chemoreceptors?
A)There is a decreased drive to breathe.
B)There is a maximal increased drive to breathe.
C)There is insufficient information to make a determination.
D)There is virtually no response.
Q2) What happens in chronic hypercapnia?
I.The central chemoreceptive response to CO<sub>2</sub> is decreased.
II.The cerebrospinal fluid pH is restored to normal.
III.Responsiveness to increased CO<sub>2</sub> is decreased.
A)I
B)I and II
C)II and III
D)I, II, and II
Q3) Which respond more rapidly to high levels of CO<sub>2</sub>?
A)aortic chemoreceptors
B)carotid chemoreceptors
C)central chemoreceptors
D)ventral respiratory centers
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Page 16
Chapter 15: Bedside Assessment of the Patient
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Sample Questions
Q1) A creaking or grating sound that increases in intensity with deep breathing and is similar to coarse crackles, but is not affected by coughing, best describes which of the following?
A)rhonchi
B)friction rub
C)rales
D)wheezing
Q2) While observing a patient's breathing, you note that the depth and rate first increase, then decrease, followed by a period of apnea. Which of the following are potential causes of this abnormality?
I.central nervous system disorder
II.congestive heart failure
III.metabolic acidosis
A)I and II
B)II and III
C)I and III
D)I, II, and III
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Chapter 16: Interpretation of Clinical Laboratory Data
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Sample Questions
Q1) What is the name used for immature neutrophils?
A)segs
B)bands
C)polys
D)monos
Q2) Which of the following tests is used to evaluate renal function?
A)creatinine
B)protein level
C)serum enzymes
D)sweat chloride
Q3) The sweat chloride level is used to diagnose which of the following disorders?
A)asthma
B)cystic fibrosis
C)hyperthyroidism
D)hepatitis
Q4) Which of the following is NOT a cause of leukopenia?
A)chemotherapy
B)bone marrow disease
C)radiation therapy
D)antibiotics
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Chapter 17: Interpreting the Electrocardiogram
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Sample Questions
Q1) The QRS of an ECG falls on a dark vertical line of the ECG paper. Subsequent QRS complexes fall on every other dark line (10 mm apart). What is the ventricular rate?
A)300/min
B)200/min
C)150/min
D)100/min
Q2) What structure serves as the backup pacemaker for the heart?
A)atrioventricular (AV) node
B)sinoatrial node
C)bundle of His
D)Purkinje fibers
Q3) On inspection of an ECG rhythm strip from an adult patient, you notice the following: regular sawtooth-like waves occurring at a rate of 280/min and a regular ventricular rhythm occurring at a rate of about 140/min. What is the most likely interpretation?
A)atrial fibrillation
B)atrial flutter
C)ventricular tachycardia
D)ventricular fibrillation
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Chapter 18: Analysis and Monitoring of Gas Exchange
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Sample Questions
Q1) What is the best site for capillary puncture in an infant?
A)lateral aspect of the heel's plantar surface
B)anterior curvature of the heel
C)medial aspect of the heel's plantar surface
D)posterior curvature of the heel
Q2) Before performing puncture or cannulation of the radial artery, what should you do?
A)Fix and tighten a tourniquet above the antecubital fossa.
B)Perform the Allen test to ensure collateral circulation.
C)Inject heparin into the adjoining subcutaneous tissues.
D)Apply firm pressure to the arterial site for 5 minutes.
Q3) For continuous monitoring of adults and children, you should set a pulse oximeter's low alarm in what range?
A)80% to 85%
B)85% to 88%
C)88% to 92%
D)93% to 97%
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Chapter 19: Pulmonary Function Testing
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Sample Questions
Q1) What is the normal predicted total lung capacity (TLC) for adults?
A)about 6 L
B)about 7 L
C)about 8 L
D)about 9 L
Q2) During a helium dilution test for functional residual capacity, you notice that it takes 19 minutes for equilibration between the gas concentrations in the spirometer and the patient's lungs. Based on this information, what can you conclude?
A)The patient has restrictive lung disease.
B)The spirometer is leaking helium.
C)The patient has obstructive lung disease.
D)Insufficient oxygen was added to the system.
Q3) What is the normal average inspiratory capacity (IC)?
A)1200 ml
B)2400 ml
C)3600 ml
D)4800 ml
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Chapter 20: A Review of Thoracic Imaging
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Sample Questions
Q1) How many solitary pulmonary nodules (SPNs) would be encountered for every 1000 routine chest radiographs?
A)1 or 2
B)10 to 15
C)30 to 40
D)80 to 100
Q2) Which of the following is NOT a common radiographic finding seen in patients with volume loss due to atelectasis?
A)elevation of the hemidiaphragm
B)narrowing of the space between the ribs
C)increase in the retrosternal airspace
D)shift of the mediastinum
Q3) In what pulmonary condition does the chest radiograph often "lag behind" the clinical status of the patient?
A)pulmonary embolism
B)emphysema
C)pneumonia
D)congestive heart failure
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Chapter 21: Nutrition Assessment
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Sample Questions
Q1) What tube feeding method is associated with an increased risk of aspiration?
A)bolus
B)intermittent
C)continuous drip
D)pressurized
Q2) Magnesium deficiencies are associated with all the following except:
A)reduced diaphragm strength
B)neurologic abnormalities
C)cardiac abnormalities
D)liver enlargement
Q3) Which of the following illnesses is NOT associated with acute catabolic disease?
A)trauma
B)sepsis
C)burns
D)pulmonary embolism
Q4) Which of the following statements is NOT true regarding kwashiorkor?
A)occurs with a long-term loss of protein
B)often causes facial and limb edema
C)child often has a pot belly
D)may occur in combination with marasmus
Page 23
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Chapter 22: Pulmonary Infections
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Sample Questions
Q1) Which of the following would be the more common route for nosocomial pathogens to be transmitted?
A)directly patient to patient
B)fecal-oral route
C)aerosol route
D)via the health care worker
Q2) What is the drug of choice for the patient with Pneumocystis jiroveci pneumonia?
A)ampicillin
B)doxycycline
C)erythromycin
D)trimethoprim-sulfamethoxazole
Q3) What antibiotic is the drug of choice for the patient with nonresistant S. pneumoniae?
A)ampicillin
B)azithromycin
C)penicillin
D)vancomycin
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24
Chapter 23: Obstructive Lung Disease: Copd, Asthma, and Related Diseases
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Q1) What does the National Asthma Education Project (NAEP) recommend be measured at home in patients with moderate to severe asthma?
A)arterial blood gases
B)degree of pulmonary shunt
C)DLCO
D)peak expiratory flow
Q2) Which airways are most susceptible to airway obstruction in patients with COPD?
A)large
B)medium
C)small
Q3) Which of the following signs and symptoms is most closely associated with respiratory failure in a COPD patient?
A)bilateral wheezing
B)changes in mental status
C)dyspnea on exertion
D)excessive sputum production
Q4) Which form of COPD is most common?
A)chronic bronchitis
B)emphysema
Chapter 24: Interstitial Lung Disease
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Q1) What auscultatory finding is most consistent with the diagnosis of interstitial lung disease (ILD)?
A)coarse inspiratory and expiratory crackles
B)fine bilateral inspiratory crackles
C)monophonic expiratory wheezes
D)polyphonic expiratory wheezes
Q2) Which of the interstitial lung diseases is directly tied to exposure to first- and second-hand tobacco smoke?
A)alveolar proteinosis
B)idiopathic pulmonary fibrosis
C)nonspecific interstitial pneumonitis
D)pulmonary Langerhans cell histiocytosis (PLCH)
Q3) A patient is exposed a second time to an antigen and subsequently seeks medical attention with sudden shortness of breath, chest pain, fever, chills, malaise, and a cough that may be productive of purulent sputum. What is the most likely cause of this pathology?
A)acute anaphylactic shock
B)acute hypersensitivity pneumonitis
C)allergic congestive heart failure
D)bronchial asthma
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Chapter 25: Pleural Diseases
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Q1) What type of pleural problem is most likely to develop from rupture of the thoracic duct?
A)chylothorax
B)hemothorax
C)hydrothorax
D)pneumothorax
Q2) Chest pain occurs in only a small percentage of patients with a pneumothorax.
A)True
B)False
Q3) What is the primary risk factor associated with spontaneous pneumothoraces?
A)cigarette smoking
B)heavy exercise
C)obesity
D)urban living
Q4) Iatrogenic pneumothorax is the most common type of traumatic pneumothorax.
A)True
B)False
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Chapter 26: Pulmonary Vascular Disease
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Q1) Unless there are contraindications, what treatment is given universally to all patients with idiopathic pulmonary artery hypertension (IPAH)?
A)oral anticoagulation
B)oxygen
C)steroids
D)vasodilators
Q2) Pulmonary artery hypertension (PAH) is NOT associated with which of the following conditions?
A)amyotrophic lateral sclerosis
B)cirrhosis of the liver
C)congenital heart disease
D)human immunodeficiency virus infection
Q3) Which of the diagnostic tests for pulmonary embolism is probably the safest and the most consistently accurate?
A)impedance plethysmography
B)MRI
C)pulmonary angiogram
D)spiral CT
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Chapter 27: Acute Lung Injury, Pulmonary Edema, and Multiple System Organ
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Q1) Which of the following terms describes programmed cell death?
A)osmosis
B)apoptosis
C)mitosis
D)necrosis
Q2) Which of the following parameters is important in determining the optimal level of positive end-expiratory pressure (PEEP) in a patient with ARDS?
A)PaO<sub>2</sub>
B)SaO<sub>2</sub>
C)DO<sub>2</sub>
D)CaO<sub>2</sub>
Q3) What is recommended in terms of fluid management of patients with ARDS?
A)conservative
B)aggressive volume replacement
C)increased dieresis
D)only administer colloids
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29
Chapter 28: Lung Cancer
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Q1) Which of the following is NOT a therapeutic option for patients with lung cancer?
A)surgical resection
B)radiotherapy
C)laser
D)chemotherapy
Q2) What minimum size does a lesion in the lung need to be in order to be called a nodule?
A)1 cm
B)2 cm
C)3 cm
D)4 cm
Q3) Which of the following is NOT a major histopathologic type of lung cancer?
A)adenocarcinoma
B)squamous cell carcinoma
C)small-cell carcinoma
D)ciliated cell carcinoma
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Chapter 29: Neuromuscular and Other Diseases of the Chest Wall
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Sample Questions
Q1) Patients with respiratory muscle weakness due to neuromuscular disease may initially report with the following symptoms except:
A)exertional dyspnea
B)fatigue
C)oliguria
D)orthopnea
Q2) What is the approximate mean age of onset for amyotrophic lateral sclerosis?
A)26 years
B)36 years
C)46 years
D)56 years
Q3) In myasthenia gravis, which two pulmonary function values are the most sensitive in detecting respiratory muscle weakness?
A)TLC and VC
B)PI<sub>max</sub> and PE<sub>max</sub>
C)VC and expired volume per unit time (V<sub>E</sub>)
D)VC and tidal volume (V<sub>T</sub>)
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Page 31
Chapter 30: Disorders of Sleep
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Sample Questions
Q1) Which of the following conditions are associated with central apnea?
I.congestive heart failure
II.primary central nervous system lesions
III.high-altitude hypoxemia
IV.obesity
A)I and IV
B)II and III
C)I, II, and III
D)I, II, III, and IV
Q2) Oral devices may prove useful for cases of mild OSA.
A)True
B)False
Q3) What is the primary cause of obstructive sleep apnea?
A)small or unstable pharyngeal airway
B)deviated septum
C)unstable larynx
D)large tongue
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Chapter 31: Neonatal and Pediatric Respiratory Disorders
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Sample Questions
Q1) The current standard of care is delivery surfactant replacement to all infants with RDS.
A)True
B)False
Q2) Which of the following clinical findings is NOT typically seen in patients with epiglottitis?
A)high fever
B)stridor
C)croupy barking cough
D)drooling
Q3) Which of the following findings on the chest radiograph is not typical for RDS?
A)hyperinflation
B)air bronchograms
C)diffuse hazy infiltrates
D)bilateral reticulogranular densities
Q4) Most infants with transient tachypnea are born premature.
A)True
B)False
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Chapter 32: Airway Pharmacology
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Sample Questions
Q1) Which phase describes the time course and disposition of a drug in the body based on its absorption, distribution, metabolism, and elimination?
A)pharmaceutical
B)pharmacognosy
C)pharmacokinetic
D)pharmacodynamic
Q2) Which of the following are considered nonsteroidal antiasthma drugs?
I.cromolyn-like agents
II.leukotriene modifiers
III.anti-IgE agents
IV.anti-IgA agents
A)I and III
B)I, II, and III
C)II, III, and IV
D)I, II, III, and IV
Q3) Which of the following inhaled corticosteroids is a prodrug?
A)ciclesonide
B)flunisolide
C)budesonide
D)triamcinolone
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Chapter 33: Airway Management
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Sample Questions
Q1) Before beginning an intubation procedure, the practitioner should check and confirm the operation of which of the following?
I.laryngoscope light source
II.endotracheal tube cuff
III.suction equipment
IV.cardiac defibrillator
A)I, II, and III
B)II and IV
C)III and IV
D)I, III, and IV
Q2) What is the purpose of a tracheostomy tube obturator?
A)minimize trauma to the tracheal mucosal during insertion
B)provide a patent airway should the tube become obstructed
C)help ascertain the proper tube position by radiograph
D)provide a means to inflate and deflate the tube cuff
Q3) Complications of tracheal suctioning include all of the following except:
A)bronchospasm
B)hyperinflation
C)mucosal trauma
D)elevated intracranial pressure
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Chapter 34: Emergency Cardiovascular Life Support
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Sample Questions
Q1) What is the major complication associated with manual removal of foreign material from the airway?
A)forcing the object deeper into the airway
B)lacerating upper airway structures
C)causing gagging and reflex bradycardia
D)increasing the possibility of infection
Q2) During properly performed external chest compression on children under 8 years old or on large toddlers, how much should the sternum be compressed?
A)0.5 to 1.0 inch
B)1.0 to 1.5 inches
C)1.5 to 2.0 inches
D)2.0 to 2.5 inches
Q3) What is the proper ratio of external chest compressions to ventilation for neonates?
A)5:1
B)3:1
C)15:2
D)30:5
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Chapter 35: Humidity and Bland Aerosol Therapy
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Sample Questions
Q1) The typical pressure pop-off incorporated into most simple bubble humidifiers releases pressure above which of the following?
A)760 mm Hg
B)10 cm H<sub>2</sub>O
C)250 kPa
D)2 psig
Q2) Which of the following methods are used to heat the gas delivered by a heated humidifier system?
I.using a wraparound heater (yoke or collar)II.placing a heating element in-line with gas flow
III.using a reservoir immersion heater
IV.placing a "hot plate" at humidifier base
A)II and IV
B)I, II, and III
C)III and IV
D)I, II, III, and IV
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Chapter 36: Aerosol Drug Therapy
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Sample Questions
Q1) 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
Q2) Which of the following is the effect of aerosol particles entrained into a warm and fully saturated gas stream?
A)no effect
B)increase in size
C)decrease in size
D)increase in number
Q3) Which of the following is false about the optimal technique for using a small-volume jet nebulizer (SVN) for aerosol drug delivery?
A)SVNs are less technique and device dependent.
B)Slow inspiration improves SVN aerosol deposition.
C)Deep breathing or breath-holding improves SVN deposition.
D)Use of a mouthpiece or mask provides similar results.
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Chapter 37: Storage and Delivery of Medical Gases
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Sample Questions
Q1) When used to control the flow of medical gases to a patient, how is a Bourdon gauge classified?
A)fixed-orifice, variable-pressure flowmeter device
B)fixed-orifice, constant-pressure flowmeter device
C)variable-orifice, variable-pressure flowmeter device
D)variable-orifice, constant-pressure flowmeter device
Q2) If you have to deliver O<sub>2</sub> to a patient directly from a bedside outlet station, which of the following devices would you select?
A)Thorpe tube flowmeter
B)Bourdon type gauge
C)pressure-reducing valve
D)medical gas regulator
Q3) What is the usual method of monitoring the remaining contents in a gas-filled cylinder?
A)Weigh the cylinder.
B)Read the pressure gauge.
C)Compute the gas density.
D)Read the cylinder label.
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Chapter 38: Medical Gas Therapy
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Sample Questions
Q1) What is/are the primary organ system(s) affected by O<sub>2</sub> toxicity?
I.central nervous system (CNS)II.lungs
III.kidneys
A)I
B)I and III
C)I and II
D)I, II, and III
Q2) Directing a cool O<sub>2</sub> mixture to an infant in an Oxy-Hood can result in which of the following?
I.increased O<sub>2 </sub>consumption
II.increased convective heat loss
III.apnea (cessation of breathing)
A)I and II
B)II and III
C)I and III
D)I, II, and III
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Chapter 39: Lung Expansion Therapy
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Sample Questions
Q1) Which of the following should be charted in the patient's medical record after completion of an intermittent positive-pressure breathing treatment?
I.results of pre- and posttreatment assessment
II.any side effects
III.duration of therapeutic session
A)II and III
B)I and III
C)I and II
D)I, II, and III
Q2) Which of the following are potential desirable outcomes of intermittent positive-pressure breathing (IPPB) therapy?
I.improved oxygenation
II.increased cough and secretion clearance
III.improved breath sounds
IV.reduced dyspnea
A)II and IV
B)I, II, and III
C)III and IV
D)I, II, III, and IV
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Chapter 40: Bronchial Hygiene Therapy
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Sample Questions
Q1) A patient with a tracheostomy tube is having difficulty developing an effective cough. Which of the following phases of the cough reflex are primarily affected in this patient?
A)irritation
B)inspiration
C)compression
D)expulsion
Q2) Whether using traditional methods or the FET, a period of diaphragmatic breathing and relaxation should always follow attempts at coughing. What is the purpose of this approach?
A)restore the patient's SO<sub>2</sub>
B)restore lung volume and minimize fatigue
C)allow the patient time to ask questions
D)decrease the likelihood of acute air-trapping
Q3) All of the following would indicate a successful outcome for postural drainage therapy except:
A)decreased sputum production
B)normalization in ABGs
C)improved breath sounds
D)improvement in chest radiograph
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Chapter 41: Respiratory Failure and the Need for Ventilatory Support
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Q1) Because an elevated PaCO<sub>2 </sub>increases ventilatory drive in normal subjects, the clinical presence of hypercapnia indicates which of the following?
I.inability of the stimulus to get to the muscles
II.weak or missing central nervous system response to the elevated PCO<sub>2</sub>
III.pulmonary muscle fatigue
A)I and II
B)I and III
C)II and III
D)I, II, and III
Q2) In intubated patients, what do sources of increased imposed work of breathing include?
I.endotracheal tube
II.ventilator circuit
III.auto-PEEP
A)I and II
B)I and III
C)II and III
D)I, II, and III
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Chapter 42: Mechanical Ventilators
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Sample Questions
Q1) While observing a patient receiving ventilatory support, you notice that some delivered breaths are begun or ended by the machine, whereas others are begun and ended by the patient. Which of the following modes of ventilatory support is in force?
A)intermittent mandatory ventilation (IMV)
B)pressure support ventilation
C)continuous mandatory ventilation (CMV)
D)airway pressure release ventilation
Q2) A patient is receiving continuous mandatory ventilation in the control mode at a rate of 12/min. The inspiratory time control is set at 33%. What is the expiratory time?
A)1.65 seconds
B)2.45 seconds
C)3.35 seconds
D)3.85 seconds
Q3) Mean airway pressure is highest with what waveform?
A)rectangular flow
B)rectangular pressure
C)ascending ramp flow
D)sinusoidal flow
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Chapter 43: Physiology of Ventilatory Support
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Sample Questions
Q1) Which of the following are potential effects of positive-pressure ventilation on the cardiovascular system?
I.decreased venous return
II.decreased cranial perfusion pressures
III.increased pulmonary blood flow
IV.decreased ventricular stroke volume
A)II and IV
B)I and IV
C)III and IV
D)I, II, III, and IV
Q2) What are some primary uses for pressure-supported ventilation (PSV)?
I.recruiting collapsed alveoli and improving oxygenation
II.augmenting patient's spontaneous V<sub>T</sub>
III.overcoming the imposed work of breathing
A)I and II
B)I and III
C)II and III
D)I, II, and III
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Chapter 44: Initiating and Adjusting Ventilatory Support
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Sample Questions
Q1) Which of the following statements is NOT true regarding the use of an inspiratory pause during mechanical ventilation?
A)It may be useful in ARDS patients.
B)It may be useful when obtaining a chest radiograph.
C)It has been shown to increase effectiveness of bronchodilator therapy.
D)It will increase mean airway pressure.
Q2) Immediately after cardiac arrest and resuscitation, a patient is placed on a ventilator in the continuous mandatory ventilation assist-control mode. What initial FIO<sub>2</sub> would you recommend?
A)1.0
B)0.8
C)0.6
D)0.4
Q3) What mode of ventilation may be most useful for ventilating a patient with a bronchopulmonary fistula?
A)high-frequency jet ventilation
B)pressure-supported ventilation
C)high-frequency percussive ventilation
D)pressure-controlled ventilation
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Chapter 45: Noninvasive Positive Pressure Ventilation
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Sample Questions
Q1) Which of the following is the current recommendation for adding humidity while using noninvasive positive-pressure ventilation (NPPV)?
A)It is never recommended.
B)It is recommended for short-term application (less than 1 day).
C)It is recommended for long-term application (longer than 1 day).
D)It is always recommended.
Q2) Which of the following modes is NOT commonly seen on noninvasive ventilators?
A)continuous positive airway pressure (CPAP)
B)spontaneous (pressure assist)
C)pressure assist
D)volume control
Q3) Which of the following is NOT a goal of noninvasive positive-pressure ventilation (NPPV) in the acute care setting?
A)avoid intubation
B)decrease incidence of ventilation-associated pneumonia
C)decrease length of stay
D)improve mobility
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Chapter 46: Monitoring and Management of the Patient in the
Intensive Care
Unit
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Sample Questions
Q1) Which of the following breathing patterns suggests respiratory muscle decompensation?
A)rapid and deep breaths
B)rapid and shallow breaths
C)slow and shallow breaths
D)slow and deep breaths
Q2) What method(s) is/are used to measure oxygen consumption?
I.Fick method
II.analysis of inspired and expired gases
III. \(\dot { V } / \dot { Q }\) scans
A)I only
B)I and II
C)I and III
D)I, II, and III
Q3) In which of the following disorders would an increased V<sub>DS</sub>/V<sub>T</sub> ratio not be likely?
A)congestive heart failure
B)pulmonary embolism
C)acute lung injury
D)hypothalamus tumor
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Chapter 47: Discontinuing Ventilatory Support
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Sample Questions
Q1) Which of the following is false about the P<sub>0.1</sub> measure?
A)P<sub>0.1</sub> correlates well with central respiratory drive.
B)P<sub>0.1</sub> is the airway pressure measured 100 ms after occlusion.
C)P<sub>0.1 </sub>is an effort-dependent measure of respiratory drive.
D)Chronic obstructive pulmonary disease (COPD) patients with a P<sub>0.1</sub> greater than 6 cm H<sub>2</sub>O are difficult to wean.
Q2) Which of the following ventilator strategies would you consider as a good alternative to T-tube trials when using a rapid weaning protocol?
I. continuous positive airway pressure (CPAP) with flow-by (flow triggering)
II. low-level pressure-supported ventilation (PSV)
III. intermittent mandatory ventilation
A)II and III
B)I and II
C)I, II, and III
D)I and III
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Chapter 48: Neonatal and Pediatric Respiratory Care
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Sample Questions
Q1) At 1 minute after birth, a newborn infant exhibits the following: heart rate of 65/min, a slow and irregular respiratory rate, some muscle flexion, a grimace when nasally suctioned, and a pink body with blue extremities. What is the infant's 1-minute Apgar score?
A)3
B)4
C)5
D)6
Q2) Which of the following is not a common indication for ECMO?
A)persistent pulmonary hypertension of the newborn (PPHN)
B)respiratory distress syndrome (RDS)
C)meconium aspiration syndrome (MAS)
D)congenital diaphragmatic hernia (CDH)
Q3) The most probable explanation for the flip-flop phenomenon in the newborn is:
A)oxygen toxicity
B)right-to-left shunting
C)cardiac disease
D)reactive pulmonary vasoconstriction
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Chapter 49: Patient Education and Health Promotion
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Q1) The objective that states "Verbalize willingness to use oxygen properly and safely" falls in which domain?
A)cognitive
B)affective
C)psychomotor
D)analytical
Q2) Which of the following is used to evaluate cognitive objectives?
A)verbal exam
B)demonstration
C)written exam
D)performance checklist
Q3) Which of the following may be necessary with children before learning can take place?
A)television shows
B)patience
C)games
D)reward system
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Chapter 50: Cardiopulmonary Rehabilitation
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Sample Questions
Q1) Which of the following clinicians are commonly involved in the cardiac rehabilitation programs?
I.nurse specialist
II.cardiologist
III.dietitian
A)I and II
B)II and III
C)I and III
D)I, II, and III
Q2) Which of the following is NOT a factor affecting the cost of a pulmonary rehabilitation program?
A)space and utility expenses
B)equipment and supplies
C)patient health insurance
D)program promotion costs
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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Sample Questions
Q1) The gauge reading of a 50-lb home liquid O<sub>2</sub> system indicates that the cylinder is a third full. What is the approximate duration of flow of this system at 2 L/min?
A)24 hours
B)48 hours
C)72 hours
D)95 hours
Q2) Routine in-home monthly maintenance of an O<sub>2</sub> concentrator should include which of the following?
I.flushing the system for 20 minutes with an inert gas
II.confirming the FIO<sub>2</sub> with a calibrated O<sub>2</sub> analyzer
III.cleaning and replacing the internal and external filters
A)I and II
B)II and III
C)I and III
D)I, II, and III
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