Internal Medicine for Physician Assistants
Practice Exam
Course Introduction
This course provides Physician Assistant students with a comprehensive overview of adult internal medicine, focusing on the prevention, diagnosis, and management of common acute and chronic diseases across various organ systems. Emphasis is placed on clinical reasoning, evidence-based decision-making, and patient-centered care, integrating knowledge of pathophysiology, pharmacology, and current clinical guidelines. Through lectures, case studies, and practical exercises, students develop essential skills to evaluate, diagnose, and manage diverse patient presentations in outpatient and inpatient settings as part of a multidisciplinary healthcare team.
Recommended Textbook
Clinical Manifestations and Assessment of Respiratory Disease 7th Edition by Terry Des Jardins
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44 Chapters
673 Verified Questions
673 Flashcards
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Chapter 1: The Patient Interview
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13 Verified Questions
13 Flashcards
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Sample Questions
Q1) The respiratory therapist is conducting a patient interview. The main purpose of this interview is to:
A) review data with the patient.
B) gather subjective data from the patient.
C) gather objective data from the patient.
D) fill out the history form or checklist.
Answer: B
Q2) To have the most productive interviewing session, the respiratory therapist must avoid all of the following types of verbal messages EXCEPT:
A) confrontation.
B) giving advice.
C) using avoidance language.
D) distancing.
Answer: A
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Page 3
Chapter 2: The Physical Examination and Its Basis in Physiology
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Sample Questions
Q1) While assessing an unconscious patient, the respiratory therapist observes that the patient's breathing becomes progressively faster and deeper and then progressively becomes slower and shallower. After that, there is a period of apnea before the cycle begins again. This breathing pattern would be identified as:
A) Cheyne-Stokes.
B) tachypnea.
C) Kussmaul.
D) hyperventilation.
Answer: A
Q2) Tachypnea may be the result of:
1) hypoxemia.
2) hypothermia.
3) fever.
4) sedation.
A) 2, 4
B) 1, 3
C) 2, 3, 4
D) 1, 2, 3, 4
Answer: B
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Chapter 3: Pulmonary Function Study Assessments
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13 Verified Questions
13 Flashcards
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Sample Questions
Q1) A special indirect measurement procedure must be done to find which of the following?
A) Inspiratory reserve volume
B) Residual volume
C) Expiratory reserve volume
D) Inspiratory capacity
Answer: B
Q2) Overall characteristics of pulmonary function testing results on a patient with obstructive lung disease include that the FEV<sub>1</sub>:
A) is reduced and FEV1% is normal.
B) and FEV<sub>1</sub>% are both increased.
C) and FEV<sub>1</sub>% are both reduced.
D) is increased and FEV1% is decreased.
Answer: C
Q3) The FEF<sub>25%-75%</sub> is used to evaluate:
A) flow in large airways.
B) restrictive lung disease.
C) maximum breathing effort.
D) flow in medium-size to small airways.
Answer: D
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Chapter 4: Arterial Blood Gas Assessments
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Sample Questions
Q1) Which of the following would be a normal person's venous oxygen pressure (PaO<sub>2</sub>)?
A) 35 to 45 mm Hg
B) 45 to 80 mm Hg
C) 80 to 100 mm Hg
D) 100 to 120 mm Hg
Q2) An anion gap of 15 would indicate:
A) metabolic acidosis.
B) respiratory alkalosis.
C) respiratory acidosis.
D) metabolic alkalosis.
Q3) A respiratory therapist is questioning the accuracy of the ABG results obtained on a patient in the ICU. The results show a pH and PaO<sub>2</sub> that seem unreasonably high, while the PaCO<sub>2</sub> seems unreasonably low. Which of the following would most likely cause these erroneous results?
A) A venous sample was obtained.
B) There was excessive heparin in the blood gas syringe.
C) The sample was excessively delayed in analysis.
D) There was an air bubble in the sample.
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Page 6
Chapter 5: Oxygenation Assessments
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Sample Questions
Q1) When a sample of arterial blood is analyzed for the pressure of oxygen (PaO<sub>2</sub>), the value comes from the:
A) blood plasma.
B) leukocytes.
C) hemoglobin.
D) erythrocytes.
Q2) Polycythemia is:
1) a condition of too many red blood cells.
2) a condition of too few red blood cells.
3) caused by lack of iron in the diet.
4) the body's response to chronic hypoxemia.
A) 1, 2
B) 2, 3
C) 1, 4
D) 2, 4
Q3) A condition that will cause hypoxic hypoxia is:
A) cyanosis.
B) decreased cardiac output or heart failure.
C) hypoventilation from an overdose of a sedative medication.
D) carbon monoxide poisoning.
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Chapter 6: Cardiovascular System Assessments
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Sample Questions
Q1) Which of the following will be found in a patient with asystole?
1) Increased ventricular activity
2) Absence of electrical activity
3) No blood pressure
4) Highly variable heart rate
A) 2
B) 1, 4
C) 2, 3
D) 1, 3, 4
Q2) Which of the following is 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
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Chapter 7: Radiologic Examination of the Chest
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Sample Questions
Q1) For most chest x-ray studies, what is usually done?
A) There is a full exhalation.
B) There is a full inspiration.
C) Separate inspiratory and expiratory films are taken.
D) The patient is told to pant to provide a middle lung volume.
Q2) The respiratory therapist is called to evaluate a patient with a suspected pleural effusion. The respiratory therapist would MOST likely recommend which of the following chest radiographic views to help determine if the patient has a pleural effusion?
A) An AP film
B) A PA film
C) A left lateral film
D) A lordotic film
E) A lateral decubitus film
Q3) A 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
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Page 9
Chapter 8: Other Important Tests and Procedures
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Sample Questions
Q1) The respiratory therapist is called to evaluate a patient for arterial line placement needed for accessibility and repeated ABG sampling. In evaluating the risk of bleeding, the therapist should establish that the patient has a platelet count of at least ____/mm³ before recommending placement of the arterial line.
A) 1,000
B) 10,000
C) 20,000
D) 50,000
E) 100,000
Q2) In response to a viral infection, which of the following can be expected to be seen in the white blood cell count?
A) Increased lymphocytes
B) Decreased monocytes
C) Increased basophils
D) Decreased platelets
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10
Chapter 9: The Therapist-Driven Protocol Program and the
Role of the Respiratory Therapist
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Sample Questions
Q1) Which of the following would be associated with the distal airway and alveolar weakening clinical scenario?
1) Depressed diaphragm on chest radiograph
2) Use of accessory muscles of inspiration
3) Rhonchi and wheezing
4) Increased PEFR
A) 1, 2
B) 1, 3
C) 1, 2, 3
D) 1, 3, 4
Q2) When performing a therapist-driven protocol (TDP), the severity assessment determines:
A) the frequency of performing a treatment modality.
B) the baseline dyspnea index.
C) the number of hospital days covered by the insurance carrier.
D) how urgently the physician wants the patient treated.
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Chapter 10: Respiratory Failure and the Mechanical
Ventilation Protocol
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6 Verified Questions
6 Flashcards
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Sample Questions
Q1) Which of the following are clinical indicators of Type I respiratory failure?
1) Decreased PaO<sub>2</sub>
2) Increased P(A-a)O<sub>2</sub>
3) Decreased PaO<sub>2</sub>/FIO<sub>2</sub>
4) Decreased ÓS/ÓT
A) 1, 2
B) 2, 4
C) 1, 2, 3
D) 1, 2, 3, 4
Q2) What is the primary pathophysiologic mechanism in alveolar hypoventilation?
A) Decreased minute ventilation
B) Increased ventilation/perfusion ratio
C) Decreased venous admixture
D) Decreased inspired oxygen pressure
Q3) All of the following are causes of hypercapnic respiratory failure EXCEPT:
A) impending ventilatory failure.
B) apnea.
C) severe refractory hypoxemia.
D) acute ventilatory failure.
Page 12
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Chapter 11: Recording Skills: The Basis for Data Collection,
Organization, Assessment Skill
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10 Flashcards
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Sample Questions
Q1) When reviewing a SOAPIER progress note, all of the following would be found in the O area EXCEPT:
A) hemodynamic data.
B) patient's admission complaint.
C) blood pressure.
D) sputum production.
Q2) Which of the following are basic methods to record assessment data?
1) Computer documentation
2) Block chart
3) Source-oriented record
4) Problem-oriented medical record
A) 1, 2
B) 2, 3
C) 1, 3, 4
D) 1, 2, 3, 4
Q3) When reviewing a SOAPIER progress note, the R stands for:
A) revisions made in the original plan.
B) reimbursement by the insurance carrier.
C) respiratory care notes.
D) resuscitation status of the patient.
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Chapter 12: Chronic Obstructive Pulmonary Disease
(COPD), Chronic Bronchitis, and Emphysema
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Sample Questions
Q1) A genetically linked cause of panlobular emphysema is:
A) bronchiectasis.
B) a1-antitrypsin deficiency.
C) cystic fibrosis.
D) bronchial asthma.
Q2) The management of COPD may include: 1) annual influenza immunization.
2) bronchopulmonary hygiene procedures.
3) bronchodilators.
4) smoking cessation.
A) 1, 2
B) 2, 3
C) 2, 3, 4
D) 1, 2, 3, 4
Q3) Emphysema may be caused by all of the following EXCEPT:
A) inhaling asbestos fibers.
B) a1-antitrypsin deficiency.
C) secondhand cigarette smoke.
D) air pollution.
14
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Chapter 13: Asthma
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Sample Questions
Q1) What findings on a chest radiograph would be expected during a prolonged asthma episode?
1) Depressed diaphragm
2) Increased anterior-posterior diameter
3) Asymmetrical lung inflation
4) Translucent lung fields
A) 1, 2
B) 3, 4
C) 1, 2, 4
D) 1, 2, 3, 4
Q2) What term is used to describe the situation when an initial asthmatic response occurs within 1 hour of exposure to an allergen followed by a delayed asthmatic response hours later?
A)Deferred dyspneic response
B)Asynchronous activation response
C)Biphasic response
D)Bipolar response
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Chapter 14: Bronchiectasis
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Sample Questions
Q1) Irregularly dilated and constricted bronchi are the key anatomic alterations found in which type of bronchiectasis?
A) Cystic
B) Varicose
C) Tubular
D) Saccular
Q2) Congenital causes of bronchiectasis include:
A) influenza.
B) cystic fibrosis.
C) COPD.
D) rheumatic disease.
Q3) In developed countries, the most common cause of acquired bronchiectasis is: A) emphysema.
B) lung abscess.
C) cystic fibrosis.
D) pulmonary fibrosis.
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Chapter 15: Cystic Fibrosis
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Sample Questions
Q1) 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
Q2) Which of the following are commonly used in the management of cystic fibrosis?
1) Pancreatic enzymes and vitamins
2) Antibiotics
3) Postural drainage
4) Expectorants
A) 1, 4
B) 2, 3
C) 1, 2, 3
D) 1, 2, 3, 4
Q3) A common nonrespiratory clinical manifestation of cystic fibrosis is:
A) sinusitis.
B) hyperpigmentation.
C) rheumatoid arthritis.
D) glaucoma.
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Chapter 16: Pneumonia
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Sample Questions
Q1) If a patient has pneumonia, which of the following can increase the risk of life-threatening illness or death?
1) Weakened immune system
2) COPD
3) Marfan's syndrome
4) Heart disease
A) 1, 3
B) 2, 4
C) 1, 2, 3
D) 1, 2, 4
Q2) A patient has bilateral pneumonia. What findings can be expected on the CT scan?
1) Depressed diaphragms
2) Elongated heart
3) Air bronchograms
4) Consolidation
A) 3, 4
B) 1, 2
C) 2, 3, 4
D) 1, 2, 3, 4
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Chapter 17: Lung Abscess
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Sample Questions
Q1) A patient with an abscess has produced a large volume of brown-colored, putrid sputum. What type of microorganism would most likely result in brown, putrid sputum production?
A) Fungi
B) Viruses
C) Aerobic bacteria
D) Anaerobic bacteria
Q2) Following a cerebrovascular accident, a patient lying in the supine position aspirated gastric contents. In what area(s) of the lungs would a lung abscess be most likely to develop?
1) Posterior segments of the upper lobes
2) Apical segments of the upper lobes
3) Superior segments of the lower lobes
4) Anterior segments of both lower lobes
A) 1
B) 1, 3
C) 1, 4
D) 1, 2, 3
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Chapter 18: Tuberculosis
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Sample Questions
Q1) A negative tuberculin test would be demonstrated by an induration (wheal) of what size?
A) 4 mm or less
B) 6 mm or less
C) 8 mm or greater
D) 10 mm or greater
Q2) The preferred stain that is used to identify the TB organism is called:
A) Gram stain.
B) fluorescent acid-fast stain.
C) Ziehl-Neelsen.
D) gentian violet.
Q3) Nontuberculous mycobacteria such as Mycobacterium avium and Mycobacterium kansasii are associated with which one of the following diseases?
A) COPD
B) Bronchiectasis
C) Status asthmaticus
D) Cystic fibrosis
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Chapter 19: Fungal Diseases of the Lung
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Sample Questions
Q1) The drug of choice for the treatment of fungal lung diseases is:
A) penicillin (penicillin G).
B) tetracycline.
C) amphotericin B (Fungizone).
D) ketoconazole (Nizoral).
Q2) Anatomic alterations found in the lungs of patients with a fungal infection include:
1) fibrosis of lung parenchyma.
2) alveolar-capillary destruction.
3) hyperinflation.
4) mucosal edema.
A) 1, 2
B) 2, 3
C) 3, 4
D) 1, 2, 4
Q3) Fungal infection of the lungs is closest in similarity to:
A) pleural disease.
B) interstitial lung disease.
C) tuberculosis.
D) bronchiectasis.
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Page 21
Chapter 20: Pulmonary Edema
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Sample Questions
Q1) Mask CPAP is used with pulmonary edema patients because it does all of the following EXCEPT:
A) decrease vascular congestion.
B) reduce work of breathing.
C) it is less expensive than mechanical ventilation.
D) improve lung compliance.
Q2) As pulmonary edema progressively worsens, the fluid moves in which of the following sequences?
A) Peribronchial interstitial spaces, bronchi, trachea
B) Alveoli , bronchioles, bronchi
C) Bronchioles, bronchi, trachea
D) Pulmonary capillaries, alveoli, bronchioles
Q3) All of the following may be causes of cardiogenic pulmonary edema EXCEPT:
A) dysrhythmias.
B) systemic hypertension.
C) congenital heart defects.
D) excessive fluid administration.
E) pulmonary embolism.
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22
Chapter 21: Pulmonary Vascular Disease: Pulmonary
Embolism and Pulmonary Hypertension
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Sample Questions
Q1) 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.
Q2) Which of the following fibrinolytic agents are used to treat a pulmonary embolism?
1) Urokinase
2) Vitamin K
3) Heparin
4) Streptokinase
A) 1, 4
B) 2, 3
C) 1, 3, 4
D) 1, 2, 3, 4
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Chapter 22: Flail Chest
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Sample Questions
Q1) How many days of ventilatory support are anticipated for a patient with a flail chest to allow sufficient time for bone healing?
A) 3 to 5 days
B) 5 to 10 days
C) 12 to 15 days
D) 18 to 21 days
Q2) What is the most common finding at the site of the flail portion of a flail chest?
A) Pulmonary contusion
B) Pulmonary abscess
C) Pulmonary edema
D) Pulmonary fibrosis
Q3) What is the term for abnormal gas movement from one lung to the other?
A) Paradoxical movement
B) Pendelluft
C) Palindromic breathing
D) Pneumatic shift
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Chapter 23: Pneumothorax
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Sample Questions
Q1) An iatrogenic pneumothorax may be caused by all of the following EXCEPT:
A) positive-pressure mechanical ventilation.
B) pleural biopsy.
C) subclavian vein cannulation.
D) endotracheal intubation.
Q2) Which type of pneumothorax would result from the rupture of bulla on the surface of a lung?
A) Spontaneous pneumothorax
B) Iatrogenic pneumothorax
C) Open pneumothorax
D) Visceral pneumothorax
Q3) A pneumothorax manifests itself clinically as a primary _____ disorder.
A) restrictive
B) obstructive
C) restrictive disorder with a secondary obstructive
D) obstructive disorder with secondary restrictive
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Chapter 24: Pleural Effusion and Empyema
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Sample Questions
Q1) A patient has malignant mesothelioma related to chronic asbestos exposure. What would his pleural effusion fluid likely show on laboratory analysis?
1) Erythrocytes
2) Lymphocytes
3) Normal mesothelial cells
4) Malignant mesothelial cells
A) 1, 4
B) 2, 3
C) 2, 3, 4
D) 1, 2, 3, 4
Q2) Treatment of an empyema usually includes:
A) pleurodesis.
B) thoracostomy tube insertion.
C) lobectomy.
D) pneumonectomy.
Q3) 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.
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Chapter 25: Kyphoscoliosis
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Sample Questions
Q1) A patient has a 45-degree curvature of her spine. The physician is most likely to recommend which of the following treatments?
A) Surgical intervention
B) Observation checkup in about 3 months
C) Milwaukee brace
D) Boston brace
Q2) The Charleston bending brace is preferred over other braces because it:
1) is worn only 23 hours a day.
2) is worn for 8 to 10 hours at night.
3) is worn at night, when human growth hormone level is highest.
4) corrects any associated upper airway obstruction.
A) 1
B) 2
C) 2, 3
D) 1, 3, 4
Q3) Posterior curvature of the spine best describes:
A) kyphoscoliosis.
B) spina bifida.
C) scoliosis.
D) kyphosis.
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Chapter 26: Interstitial Lung Diseases
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Sample Questions
Q1) A patient has just been diagnosed with Wegener's granulomatosis. Her long-term prognosis is:
A) excellent, with full recovery expected.
B) fair, with recovery expected after proper treatment.
C) guarded; recovery is possible after proper treatment.
D) poor; it is considered a fatal disease.
Q2) What major pathologic and structural changes are associated with asbestosis?
1) Fibrocalcific pleural plaques
2) Excessive bronchial secretions
3) Bronchospasm
4) Mediastinal shift
A) 1, 3
B) 2, 4
C) 1, 2, 3
D) 1, 2, 3, 4
Q3) Which of the following Americans would be the most likely to get sarcoidosis?
A) A 27-year-old African-American female
B) A 60-year-old African-American male
C) A 45-year-old Caucasian female
D) A 60-year-old Hispanic male
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Chapter 27: Cancer of the Lung
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Sample Questions
Q1) Chest radiograph findings associated with lung cancer include all of the following EXCEPT a(n):
A) large irregular mass.
B) enlarged heart.
C) coin lesion.
D) pleural effusion.
Q2) Which of the following is (are) non-small cell lung cancer(s)?
1) Large cell carcinoma
2) Squamous carcinoma
3) Adenocarcinoma
4) Oat cell carcinoma
A) 1
B) 4
C) 1, 2, 3
D) 2, 3, 4
Q3) The most common cause of lung cancer is:
A) cigarette smoking.
B) air pollution.
C) exposure to asbestos.
D) exposure to radon gas.
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Chapter 28: Acute Respiratory Distress Syndrome
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Sample Questions
Q1) All of the following would be low-tidal volume ventilation goals in a patient with ARDS, EXCEPT:
A) decrease barotrauma.
B) maintain plateau pressure >30 cm H<sub>2</sub>O.
C) decrease high transpulmonary pressures.
D) reduce overdistention of the lungs.
Q2) Which of the following are causes of ARDS?
1) Liver failure
2) Heroin abuse
3) Septicemia
4) Goodpasture's syndrome
A) 1, 4
B) 2, 3
C) 2, 3, 4
D) 1, 2, 3, 4
Q3) The chest radiograph finding indicative of severe ARDS is:
A) "ground-glass" appearance of the lungs.
B) pleural effusion.
C) bilateral hyperinflation of the lungs.
D) tracheal deviation.
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Chapter 29: Guillain-Barré Syndrome
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Sample Questions
Q1) Approximately what percentage of patients with GBS develop respiratory muscle paralysis?
A) <5%
B) 6% to 9%
C) 10% to 30%
D) 31% to 50%
Q2) Which of following has been shown to shorten the course of a severe case of Guillain-Barré syndrome?
A) Renal dialysis
B) Plasmapheresis
C) Blood transfusion
D) NSAIDs
Q3) When a person has Guillain-Barré syndrome, how are peripheral nerves affected?
A) They hypertrophy.
B) They fail to reproduce.
C) The myelin sheath is removed.
D) Schwann cells attack the peripheral nerves.
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31
Chapter 30: Myasthenia Gravis
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Sample Questions
Q1) A physician recommended a thymectomy for a patient with generalized myasthenia gravis. The primary benefit of this procedure is to:
A) eliminate the source of AChR antibodies.
B) block the antigen-antibody reactions.
C) remove the source of cholinesterase.
D) cure the ocular myasthenia gravis.
Q2) Which of the following are associated with myasthenia gravis?
1) It interferes with acetylcholine transmission.
2) It causes weakness of voluntary muscles.
3) It is usually an ascending paralysis starting in the legs.
4) It is usually preceded by a viral infection.
A) 1, 2
B) 3, 4
C) 2, 3, 4
D) 1, 2, 3
Q3) What test is usually performed to confirm the diagnosis of myasthenia gravis?
A) RNS
B) PFT
C) CBC
D) EEG
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Chapter 31: Sleep Apnea
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Sample Questions
Q1) During a pulmonary function study, it was found that a patient has a sawtooth pattern on his flow-volume loop. What is this finding associated with?
A) Central sleep apnea
B) COPD
C) Obstructive sleep apnea
D) Laryngeal edema (epiglottitis)
Q2) Which of the following cardiac dysrhythmias is life threatening?
A) Atrioventricular block
B) Sinus bradycardia
C) Ventricular tachycardia
D) Premature ventricular contraction
Q3) Sleep apnea would be diagnosed in a patient who has which of these findings?
1) More than 15 apnea episodes per hour of sleep
2) More than 5 apnea episodes per hour over an 8-hour period
3) More than 75% of the apneas are obstructive.
4) More than 75% of the apneas and hypopneas are obstructive.
A) 1, 4
B) 2, 3
C) 2, 3, 4
D) 1, 3, 4
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Chapter 32: Clinical Manifestations Common with Newborn and
Early Childhood Respiratory Dis
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Sample Questions
Q1) A neonatal patient is found to have grunting on expiration. 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
Q2) A premature infant is suspected of having persistent pulmonary hypertension of the newborn. How is this diagnosis confirmed?
A) Arterial blood gas analysis
B) Chest radiography
C) Pulmonary angiography
D) Echocardiography
E) Cardiac catheterization
Q3) A newborn is flaccid and apneic, has a cyanotic body and a heart rate of 85/min, and shows no reaction to stimulation. Her Apgar score would be:
A) 8.
B) 5.
C) 2.
D) 1.
34
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Chapter 33: Meconium Aspiration Syndrome
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Sample Questions
Q1) A neonate with MAS has hypoxemia. Which of the following can be a pulmonary effect of this?
A) Status asthmaticus
B) Persistent pulmonary hypertension of the newborn (PPHN)
C) Bronchopulmonary dysplasia (BPD)
D) Pulmonary fibrosis
Q2) What risk(s) is (are) there in positive-pressure ventilation before all meconium has been removed from the airways?
1) Forcing meconium into the lower airways
2) Pneumothorax
3) Triggering persistent pulmonary hypertension of the neonate (PPHN)
4) Triggering an asthma attack
A) 2
B) 3
C) 1, 2
D) 2, 3, 4
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Chapter 34: Transient Tachypnea of the Newborn
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Q1) What are the radiologic findings anticipated on a chest radiograph taken 2 hours after delivery in a newborn suspected of having TTN?
A) Normal lung fields
B) Hyperlucency
C) Flattened diaphragms
D) Bulging intercostal spaces
Q2) At what gestational age is TTN most common?
A) 26 to 28 weeks' gestational age
B) 28 to 30 weeks' gestational age
C) 34 to 36 weeks' gestational age
D) 38 to 40 weeks' gestational age
Q3) All of the following radiologic findings would be expected in a 12-hour-old neonate with TTN EXCEPT:
A) air bronchograms.
B) fluid in the interlobular fissures.
C) elevated diaphragms.
D) prominent perihilar streaking.
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Chapter 35: Respiratory Distress Syndrome
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Sample Questions
Q1) Respiratory distress syndrome (RDS) primarily affects infants who are:
A) preterm with insufficient surfactant.
B) full-term.
C) postterm with too much surfactant.
D) preterm with too much surfactant.
Q2) The neonate with RDS would have a phosphatidylglycerol (PG) level that is:
A) present.
B) absent.
C) above normal.
D) below normal.
Q3) 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
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Chapter 36: Pulmonary Air Leak Syndromes
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Q1) Which of the following chest radiograph findings would confirm the presence of PIE?
1) Mediastinal shift to the unaffected side
2) Air below the diaphragms
3) Lung hyperinflation
4) Fine, bubbly appearance of the lungs
A) 2, 3
B) 1, 4
C) 3, 4
D) 1, 3, 4
Q2) Prior to the introduction of exogenous surfactant, with which condition were preterm neonates most likely to develop pulmonary air leak syndrome?
A) Meconium aspiration syndrome (MAS)
B) Respiratory distress syndrome (RDS)
C) Transient tachypnea of the newborn (TTN)
D) Apnea of prematurity
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Chapter 37: Respiratory Syncytial Virus (Bronchiolitis or Pneumonitis)
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Sample Questions
Q1) A respiratory syncytial virus (RSV) infection will cause which of the following anatomic alterations of the lungs?
1) Chemical pneumonitis of the small airways
2) Peribronchiolar mononuclear infiltration
3) Small airway epithelial necrosis
4) Edema of the epiglottis and upper airway
A) 1, 4
B) 2, 3
C) 1, 2, 3
D) 2, 3, 4
Q2) Several small children who attend the same day care facility have become sick with RSV. The owner of the day care can expect them to recover within:
A) 4 to 6 days.
B) 3 to 8 days.
C) 1 to 2 weeks.
D) greater than 3 weeks.
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Chapter 38: Bronchopulmonary Dysplasia
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Sample Questions
Q1) What is the most common chronic lung disease of premature infants?
A) BPD
B) Asthma
C) Cystic fibrosis
D) TTN
Q2) Which of the following "new" BPD criteria would indicate a severe case of the condition?
1) Requires >30% oxygen upon discharge
2) Requires nasal CPAP at discharge
3) Requires room air upon discharge
4) Required supplemental oxygen for first 28 days of life
A) 1, 2
B) 2, 4
C) 1, 2, 4
D) 3, 4
Q3) What is the most significant treatment of the neonate for the prevention of BPD?
A) Corticosteroids
B) Diuretic therapy
C) Vitamin E therapy
D) Exogenous surfactant
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Chapter 39: Congenital Diaphragmatic Hernia
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Sample Questions
Q1) The prognosis of an infant with a diaphragmatic hernia depends on which of the following factors?
1) Success of the surgical diaphragmatic closure
2) Size of the diaphragmatic defect
3) Condition of the lung on the unaffected side
4) Degree of hypoplasia
A) 1
B) 1, 2
C) 1, 3, 4
D) 1, 2, 3, 4
Q2) What pulmonary change is associated with a Bochdalek hernia?
A) Pulmonary hypoplasia
B) Respiratory distress syndrome (RDS)
C) Pulmonary edema
D) Meconium aspiration
Q3) When does respiratory distress normally develop in a newborn with a CDH?
A) Shortly after delivery
B) 6 to 12 hours after delivery
C) 12 to 24 hours after delivery
D) 24 to 48 hours after delivery
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Chapter 40: Congenital Heart Diseases
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Sample Questions
Q1) What is the most common cyanotic congenital cardiac defect in neonates?
A) ASD
B) VSD
C) TGA
D) TOF
Q2) What is the most common form of TGA?
A) a-TGA
B) b-TGA
C) c-TGA
D) d-TGA
Q3) Which of the following is used to confirm the diagnosis of ASD?
A) Electromyogram
B) Electrocardiogram
C) Echocardiogram
D) Electrophoresis
Q4) According to the NHLBI, what is the most common type of birth defect?
A) Cerebral palsy
B) Congenital heart defects
C) Congenital diaphragmatic hernia
D) Cleft palate
Page 42
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Chapter 41: Croup Syndrome: Laryngotracheobronchitis and
Acute Epiglottitis
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Q1) The barking sound heard in a patient with LTB is caused by which of the following?
A) Partial lower airway obstruction
B) Partial upper airway obstruction
C) Expiration against a partially closed glottis
D) Pharyngeal edema
Q2) The treatment of epiglottitis includes:
1) antibiotics specific to the virus causing the illness.
2) antibiotics specific to the bacteria causing the illness.
3) supplemental oxygen by face mask.
4) endotracheal intubation.
A) 1
B) 4
C) 2, 4
D) 1, 3
Q3) What is the main clinical risk facing a patient with epiglottitis?
A) Secretions will block the trachea.
B) The epiglottis will bleed.
C) The laryngeal inlet may become covered by the epiglottis.
D) The vocal cords will spasm and close the laryngeal inlet.
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Chapter 42: Near Drowning/Wet Drowning
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Q1) 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.
Q2) Warming techniques for a cold-water near-drowning victim include all of the following EXCEPT:
A) cooling the extremities and warming the body core.
B) warming the inspired oxygen.
C) heated intravenous solutions.
D) heated lavage of the pericardial space.
Q3) After an extended time underwater, a near-drowning victim will most likely have:
A) tachypnea.
B) a normal respiratory rate.
C) bradypnea.
D) apnea.
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Chapter 43: Smoke Inhalation, Thermal Injuries, and Carbon
Monoxide Intoxication
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Sample Questions
Q1) A patient with carbon monoxide poisoning has a COHb level of 20%. If the patient is given 100% oxygen, what will the approximate COHb level be in 1 hour?
A) 15%
B) 10%
C) 5%
D) 2.5%
Q2) Which of the following conditions occurs in 20% to 30% of hospitalized fire victims with facial burns?
A) Acute respiratory distress syndrome (ARDS)
B) Upper airway obstruction
C) Pneumonia
D) Pulmonary embolism
Q3) All of the following classes of medications are commonly used in the care of patients with smoke inhalation injury EXCEPT:
A) parasympatholytics.
B) mucolytics.
C) sympathomimetics.
D) monoclonal antibody.
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Chapter 44: Atelectasis
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Sample Questions
Q1) The respiratory therapist is performing chest assessment on a post-op cholecystectomy patient who has developed cough, fever, and tachypnea. Which of the following would the therapist expect to find confirming the suspicion of post-op atelectasis in this patient?
A) Decreased tactile and vocal fremitus
B) Hyperresonant percussion note
C) Bronchial breath sounds
D) Wheezes
Q2) All of the following would be found in a patient with atelectasis EXCEPT:
A) normal shunt fraction.
B) whispered pectoriloquy.
C) chest radiograph shows increased density in areas of atelectasis.
D) diminished breath sounds.
Q3) Several pathophysiologic mechanisms operating simultaneously may lead to an increased ventilatory rate. These may include all of the following EXCEPT:
A) stimulation of central chemoreceptors.
B) decreased lung compliance-increased ventilatory rate relationship.
C) stimulation of J receptors.
D) pain.
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