Introduction to Respiratory Therapy
Exam Answer Key
Course Introduction
Introduction to Respiratory Therapy offers students a comprehensive overview of the principles and practices involved in the care and management of patients with respiratory disorders. The course covers the anatomy and physiology of the respiratory system, fundamentals of gas exchange, and the common diseases affecting lung function. It introduces the roles and responsibilities of respiratory therapists within the healthcare team, emphasizing patient assessment, equipment usage, and the application of therapeutic modalities such as oxygen therapy, aerosol therapy, and mechanical ventilation. Additionally, students develop foundational knowledge in infection control, communication skills, and ethical considerations relevant to respiratory care practice.
Recommended Textbook
Egans Fundamentals of Respiratory Care 9th Edition by Robert M. Kacmarek
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51 Chapters
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3410 Flashcards
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Chapter 1: History of Respiratory Care
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Sample Questions
Q1) What was the primary duty of the first inhalation therapists?
A)provide airway care
B)support oxygen therapy
C)aerosol therapy to patients
D)maintain patients on mechanical ventilation
Answer: B
Q2) Who was the first to develop the large-scale production of oxygen in 1907?
A)Robert Dalton
B)David Boyle
C)Thomas Anderson
D)Karl von Linde
Answer: D
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3
Chapter 2: Quality and Evidence-Based Respiratory Care
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Sample Questions
Q1) Treatment based on careful review of available literature is known as:
A)evidence-based medicine
B)protocol-based medicine
C)review-based medicine
D)team health care
Answer: A
Q2) The responsibilities of a respiratory care department manager include all of the following except:
A)check that medical devices function at an appropriate and safe level
B)develop respiratory care protocols and procedures
C)regulate medications delivered by respiratory care staff
D)maintain knowledge of changes in medications and delivery devices
E)evaluate new devices and methods for effectiveness commensurate with cost
Answer: C
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Chapter 3: Patient Safety, Communication, and Record Keeping
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Sample Questions
Q1) If you make a mistake when charting a patient treatment, what should you do?
A)Make a new entry (called "correction") just below the mistake.
B)Erase the mistake and have your supervisor countersign it.
C)Draw a line through the mistake and write "error" above it.
D)Have your supervisor make the chart correction later.
Answer: C
Q2) A therapist who says "You seem to be anxious about your surgery" to a patient just admitted for bypass surgery is using what interpersonal communication technique?
A)clarifying
B)paraphrasing
C)perception checking
D)reflecting feelings
Answer: D
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Chapter 4: Principles of Infection Control
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Sample Questions
Q1) What should be used to wipe down the surface of devices that cannot be immersed in water?
A)70% ethyl alcohol
B)warm soapy water
C)strong detergent
D)bleach
Q2) Approximately what percent of patients receiving mechanical ventilation develop pneumonia as a complication?
A)1%
B)10%
C)15%
D)25%
Q3) What solution should be used to disinfect the surfaces of the room of a patient who was infected with C. difficile?
A)70% ethyl alcohol
B)5.25% sodium hypochlorite
C)1% sodium benzoate
D)5% iodine solution
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Chapter 5: Ethical and Legal Implications of Practice
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Sample Questions
Q1) Primary guiding principles in contemporary ethical decision-making include which of the following?
I.nonmaleficence
II.autonomy
III.justice
IV.role fidelity
A)II, III, and IV
B)I, II, III, and IV
C)III and IV
D)II and III
Q2) A clinician who justifies not billing a poor patient for services rendered because "that's what a professional should do" is applying what ethical viewpoint?
A)relativism
B)formalism
C)consequentialism
D)virtue ethics
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Chapter 6: Physical Principles of Respiratory Care
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Sample Questions
Q1) What is the term for the ratio of the actual water vapor present in a gas compared with the capacity of that gas to hold the vapor at a given temperature?
A)relative humidity
B)absolute humidity
C)water vapor pressure
D)percent body humidity
Q2) Which of the following is a good clinical example of using the principle of convection to transfer heat?
A)humidifiers with immersion heaters
B)heated, enclosed infant incubators
C)wire-heated pneumotachometers
D)heated ventilator exhalation valves
Q3) If the absolute humidity in a medical gas being delivered to a patient is 14 mg/L, then what is the body humidity (BH)?
A)7%
B)16%
C)24%
D)32%
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8
Chapter 7: Computer Applications in Respiratory Care
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Sample Questions
Q1) Hotmail, Yahoo, and Microsoft Outlook are examples of software for what purpose?
A)e-mailing
B)word processing
C)spread sheets
D)database management
Q2) What respiratory care equipment uses microprocessors for monitoring and control of complex data?
A)oxygen flowmeters
B)pulse oximeters
C)mechanical ventilators
D)water sealed spirometers
Q3) Who is credited with starting the Internet?
A)two geeks in Seattle
B)the U.S. Department of Defense
C)Microsoft
D)IBM
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Chapter 8: The Respiratory System
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Sample Questions
Q1) The fetus is potentially viable if born at the end of which stage of development?
A)alveolar
B)canalicular
C)pseudoglandular
D)saccular
Q2) Compared to a normal diaphragm, contraction of a diaphragm that is low and flat may result in which of the following?
A)compression of the thoracic cavity
B)enhanced venous return and thus cardiac output
C)greater diaphragmatic efficiency
D)larger than normal change in thoracic volume
Q3) What type of alveolar cells cover over 90% of the surface area of the alveolar-capillary membrane?
A)alveolar macrophages
B)granular pneumocytes
C)type I cells
D)type II cells
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Chapter 9: The Cardiovascular System
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Sample Questions
Q1) During the later stages of ventricular relaxation, the pressures in their chambers drop below those in the atria. This results in which of the following?
I.rapid drop in atrial pressures
II.opening of the atrioventricular valves
III.rapid ventricular filling
IV.V pressure wave
A)II and III
B)I and II
C)I, II, III, and IV
D)II, III, and IV
Q2) In order to function effectively, the central cardiovascular control center must receive signals regarding changes in blood volume or pressure. From where do these signals come?
A)central chemoreceptors
B)hypothalamus
C)peripheral baroreceptors
D)skeletal muscles
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11
Chapter 10: Ventilation
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Sample Questions
Q1) On inspecting a volume-pressure curve of the lungs and thorax, an increase in the mechanical work of breathing above normal would always be indicated by which of the following?
A)decrease in the area of the volume-pressure curve
B)decrease in the slope of the volume-pressure curve
C)increase in the area of the volume-pressure curve
D)Increase in the slope of the volume-pressure curve
Q2) A lung that loses elastic fibers (as in emphysema) would exhibit which of the following characteristics?
A)decreased airways resistance
B)decreased pulmonary vascular resistance
C)increased airway resistance
D)increased pulmonary compliance
Q3) Which of the following diseases or disorders is most likely to result in an increased V<sub>D</sub>/V<sub>T</sub> ratio?
A)atelectasis
B)pneumonia
C)pulmonary embolus
D)pulmonary fibrosis
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Page 12
Chapter 11: Gas Exchange and Transport
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Sample Questions
Q1) The conversion of HbO<sub>2</sub> to deoxygenated Hb does which of the following?
I.decreases blood carbon dioxide content
II.enhances carbon dioxide loading on Hb
III.helps buffer H<sup>+</sup> ions
A)II and III
B)I and II
C)III only
D)I, II, and III
Q2) The affinity of Hb for carbon monoxide (CO) is approximately how many times greater than its affinity for oxygen?
A)10 to 50 times greater
B)50 to 90 times greater
C)100 to 190 times greater
D)200 or greater
Q3) What does \(\dot { V }\) / \(\dot { Q }\) mismatch have the biggest impact on?
A)carbon dioxide elimination
B)dissolved HCO<sub>3</sub><sup>-</sup>
C)oxygenation
D)pH
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Chapter 12: Solutions, Body Fluids, and Electrolytes
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Sample Questions
Q1) Which of the following would NOT cause an abnormal loss of Na<sup>+</sup> (hyponatremia)?
A)ascites
B)excessive sweating or fever
C)use of certain diuretics
D)steroid therapy
Q2) What is a uniform distribution of large molecules that attract and hold water?
A)colloid
B)mixture
C)solution
D)suspension
Q3) What is the role of kidneys when a patient experiences acute respiratory alkalosis?
A)Cl<sup>-</sup> shift enhances the body's compensatory mechanisms.
B)HCO<sub>3</sub><sup>-</sup> is eliminated in the urine.
C)It dumps Cl<sup>-</sup> so as to retain HCO<sub>3</sub><sup>-</sup>.
D)The Hamburger phenomenon occurs.
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Chapter 13: Acid-Base Balance
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Sample Questions
Q1) Which of the following is FALSE about the relationship between chloride (Cl<sup>-</sup>) and bicarbonate HCO<sub>3</sub><sup>-</sup><sup> </sup>in acid-base balance?
A)For each Cl ion excreted into the urine, the blood gains an HCO<sub>3</sub> ion.
B)Blood Cl<sup>-</sup> and HCO<sub>3</sub><sup>-</sup> ion levels are reciprocally related.
C)People with chronically high CO<sub>2</sub> tend to have low blood Cl<sup>-</sup> levels.
D)Activation of the NH<sub>3</sub> buffer system enhances Cl<sup>-</sup> gain and HCO<sub>3</sub> loss.
Q2) What affect does hyperventilation have on HCO<sub>3</sub><sup>-</sup> recovery in the kidneys?
A)less H<sup>+</sup> excretion, greater HCO<sub>3</sub><sup>-</sup> loss
B)no affect as these involve two independent systems
C)vicious cycle of worsening alkalemia as hyperventilation stimulates increased HCO<sub>3</sub><sup>-</sup>retention
D)escalating retention of other buffer bases along with HCO<sub>3</sub><sup>-</sup>
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Chapter 14: Regulation of Breathing
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Sample Questions
Q1) To which anatomic structures do the ventral respiratory centers send motor signals during inspiration?
I.diaphragm
II.larnyx
III.pharynx
IV.sternocleidomastoids
A)I, II, and III
B)II and IV
C)I only
D)I, II, III, and IV
Q2) Causes of central neurogenic hyperventilation include which of the following?
I.head trauma
II.inadequate brain blood flow
III.severe brain hypoxia
A)II and III
B)I and II
C)I and III
D)I, II, and III
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Page 16
Chapter 15: Bedside Assessment of the Patient
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Sample Questions
Q1) Which of the following are potential causes of cardiac murmurs?
I.backflow of blood through an incompetent valve
II.forward flow through a stenotic valve
III.rapid flow through a normal valve
A)II and III
B)I and II
C)I, II, and III
D)I and III
Q2) During posterior thoracic palpation of an adult, you notice little or no movement on the right side during a full, deep breath. Which of the following conditions could explain this finding?
I.bilateral phrenic nerve paralysis
II.right-sided pleural effusion
III.atelectasis of the right lower lobe
IV.right lobar consolidation
A)I, II, and III
B)II and III
C)II, III, and IV
D)I, II, III, and IV
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17
Chapter 16: Interpretation of Clinical Laboratory Data
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Sample Questions
Q1) The sweat chloride level is used to diagnose which of the following disorders?
A)asthma
B)cystic fibrosis
C)hyperthyroidism
D)hepatitis
Q2) What is the upper limit of normal for the fasting blood glucose level?
A)50 mg/dl
B)85 mg/dl
C)105 mg/dl
D)140 mg/dl
Q3) What abnormality in the complete blood count is often seen in a patient with chronic lung disease that causes significant hypoxemia?
A)leukocytosis
B)anemia
C)polycythemia
D)leukopenia
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Page 18
Chapter 17: Interpreting the Electrocardiogram
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Sample Questions
Q1) For which of the following arrhythmias would an electronic pacemaker be indicated?
A)first-degree block
B)sinus tachycardia
C)third-degree block
D)ventricular fibrillation
Q2) An occasional premature ventricular complex (PVC) is not of major concern.
A)True
B)False
Q3) The electrocardiogram (ECG) is primarily used to evaluate the patient with symptoms suggestive of acute myocardial disease.
A)True
B)False
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19
Chapter 18: Analysis and Monitoring of Gas Exchange
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Sample Questions
Q1) Statistically derived limits for internal quality control of blood gas samples are usually set at what appropriate level?
A)1 standard deviation from the mean
B)2 standard deviations from the mean
C)3 standard deviations from the mean
D)5 standard deviations from the mean
Q2) A PaO<sub>2</sub> below what value would be considered severe hypoxemia?
A)60 mm Hg
B)50 mm Hg
C)40 mm Hg
D)depends on the FIO<sub>2</sub>
Q3) In which of the following patients would transcutaneous blood gas monitoring most likely provide inaccurate or erroneous results?
A)newborn infant with respiratory distress syndrome (RDS)
B)patient with hypoxemia
C)patient with a hyperpyrexia
D)patient in hypovolemic shock
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20
Chapter 19: Pulmonary Function Testing
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Sample Questions
Q1) Which of the following statements is TRUE when comparing the pulmonary function test results of men versus women?
A)Males and females have the same predicted values when corrected for height.
B)Males and females have the same predicted values when corrected for weight.
C)Males and females have the same predicted values when corrected for age.
D)Males have larger predicted volumes when corrected for height.
Q2) What is the most common measurement of pulmonary mechanics during pulmonary function testing?
A)tidal volume
B)forced vital capacity
C)residual volume
D)inspiratory reserve volume
Q3) What is the normal predicted vital capacity (VC) measurement in the adult patient?
A)3600 ml
B)4800 ml
C)5400 ml
D)6000 ml
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21
Chapter 20: A Review of Thoracic Imaging
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Q1) Which of the following statements best describe the typical findings on a chest radiograph for a patient with interstitial lung disease?
A)unilateral upper lobe infiltrates
B)diffuse bilateral infiltrates
C)diffuse pulmonary hyperinflation
D)diffuse pleural inflammation
Q2) What imaging technique would be most useful to determine which patients with emphysema may benefit from lung volume reduction surgery?
A)chest HRCT
B)CT angiography
C)MRI
D)ultrasound
Q3) Which of the following is a major limitation of magnetic resonance imaging (MRI) of the chest?
A)cannot visualize large vessels
B)cannot be used in patients with pacemakers
C)cannot be used to examine hilar structures
D)interpretation difficult
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22
Chapter 21: Nutrition Assessment
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Sample Questions
Q1) Which of the following blood tests is most useful for day to day monitoring of long-term trends in the nutrition status of the patient?
A)albumin levels
B)total white blood cell count
C)hematocrit
D)serum potassium levels
Q2) When is the basal metabolic rate (BMR) best obtained?
A)after 10 hours of fasting
B)while walking on a treadmill
C)on rising in the morning
D)1 hour after lunch
Q3) What is the classic measure of energy expenditure?
A)basal oxygen consumption
B)basal metabolic rate (BMR)
C)resting caloric uptake
D)resting carbon dioxide production
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Chapter 22: Pulmonary Infections
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Sample Questions
Q1) Which of the following is true concerning pneumonia?
A)Patients with community-acquired pneumonia most often require hospitalization.
B)Community-acquired pneumonias are most often antibiotic-resistant strains.
C)Pneumonia is the number one cause of death in the United States.
D)Pneumonia is the sixth leading cause of death in the United States.
Q2) What organism is associated with the highest mortality rate for patients with pneumonia?
A)Klebsiella
B)Legionella
C)Pseudomonas aeruginosa
D)Staphylococcus aureus
Q3) In the patient suspected of having tuberculosis, what finding on Gram stain would result in the initiation of antituberculosis medications?
A)acid-fast bacilli
B)gram-negative rods
C)pleomorphic cocci
D)presence of gram-negative cocci
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Chapter 23: Obstructive Lung Disease: Copd, Asthma, and Related Diseases
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Sample Questions
Q1) Which bronchodilator is commonly used in the hospital management of acute asthma exacerbation but is not the first-line bronchodilator?
A)albuterol
B)ipratropium bromide
C)salmeterol
D)terbutaline
Q2) Which of the following is NOT typically found in a patient with COPD?
A)airway inflammation
B)at least partially reversible airway obstruction
C)progressive airway obstruction
D)restrictive disease
Q3) Your patient has bronchiectasis. Which of the following therapies is most needed?
A)antibiotics
B)bronchodilators
C)incentive spirometry
D)oxygen
Q4) Which form of COPD is most common?
A)chronic bronchitis
B)emphysema
Chapter 24: Interstitial Lung Disease
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Q1) Which of the following pulmonary function tests is most likely to be normal in the patient with interstitial pulmonary fibrosis?
A)diffusing capacity of the lungs (DLCO)
B)FEV<sub>1</sub> (forced expiratory volume in 1 second)
C)FEV<sub>1</sub>/FVC
D)FVC (forced vital capacity)
Q2) What is the most common radiographic finding in the chest film of a patient with sarcoidosis?
A)bibasilar parenchymal opacities
B)bilateral hilar lymphadenopathy
C)pleural plaque with calcification
D)upper-lobe distribution of fibrotic cysts
Q3) What treatment is most useful in preventing subsequent right-sided heart failure in a patient with interstitial lung disease?
A)bronchodilator
B)digoxin
C)oxygen
D)turbutaline
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Chapter 25: Pleural Diseases
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Q1) What is the primary tool used to diagnosis a pneumothorax?
A)chest radiography
B)computed tomography
C)PET scan
D)ultrasonography
Q2) Which of the following findings on a radiologic report would indicate the presence of a tension pneumothorax?
A)bilateral inversion of diaphragm, long narrow heart, flattened ribs
B)blunting of costophrenic angles, marked interstitial infiltrates, apical free air
C)contralateral mediastinal shift, diaphragmatic depression, flattening of ribs
D)ipsilateral mediastinal shift, sail-shape noted right hemithorax, marked interstitial infiltrates right sided
Q3) Primary spontaneous pneumothorax occurs in a patient with no previous underlying lung disease.
A)True
B)False
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Chapter 26: Pulmonary Vascular Disease
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Q1) Which of the following medications should be used for in hospital prophylactic deep venous thrombosis therapy?
A)acetylcholine esterase
B)albuterol
C)aspirin
D)heparin
Q2) Approximately what percentage of patients with pulmonary embolism have a normal ECG?
A)10% to 15%
B)25% to 30%
C)40% to 60%
D)70% to 75%
Q3) What is the 5-year survival rate for patients with untreated idiopathic pulmonary artery hypertension (IPAH)?
A)33%
B)44%
C)55%
D)66%
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28
Chapter 27: Acute Lung Injury, Pulmonary Edema, and Multiple System Organ
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Q1) Which of the following tests provides useful information in making the diagnosis of ARDS for patients with inconclusive results on traditional tests?
A)examination of bronchoalveolar lavage fluid (BALF)
B)measurement of mixed venous oxygen level
C)measurement of total white blood-cell count
D)ventilation/perfusion ratio ( \(\dot { V } / \dot { Q }\) ) scanning
Q2) Which of the following white blood cells is most commonly implicated in the inflammatory process of ARDS?
A)eosinophils
B)monocytes
C)neutrophils
D)lymphocytes
Q3) 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>
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Chapter 28: Lung Cancer
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Q1) Which of the following pulmonary function tests are frequently used to determine tolerance to resectional surgery?
I.FEV<sub>1</sub>
II.FEF<sub>25-75</sub>
III.FVC
IV.DLCO
A)I only
B)I and IV
C)II and IV
D)I, II, III, and IV
Q2) What is the most effective way to prevent lung cancer?
A)vitamin E
B)beta-carotene
C)smoking prevention
D)avoidance of atmospheric pollution
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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Q1) What respiratory dysfunction is commonly seen in myotonic dystrophy?
A)sleep-related disorders
B)pulmonary fibrosis
C)obstructive pulmonary disease
D)pulmonary edema
Q2) What percentage of amyotrophic lateral sclerosis patients die within 5 years of diagnosis?
A)10%
B)25%
C)50%
D)80%
Q3) Which of the following is NOT a pulmonary complication frequently associated with flail chest?
A)pneumothorax
B)hemothorax
C)pulmonary contusion
D)aspiration pneumonia
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Page 31
Chapter 30: Disorders of Sleep
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Q1) Which of the following characteristics is not typically associated with sleep apnea?
A)male patient
B)over the age of 40 years
C)hypotensive
D)loud snoring during sleep
Q2) What is the amount of CPAP that is typically required to abolish upper airway obstruction in patients with OSA?
A)3 to 5 cm H<sub>2</sub>O
B)10 to 20 cm H<sub>2</sub>O
C)2.5 to 7.5 cm H<sub>2</sub>O
D)7.5 to 12.5 cm H<sub>2</sub>O
Q3) What term is used to describe CPAP units that use a computer to adjust CPAP levels as needed by the patient during sleep?
A)min-CPAP
B)max-CPAP
C)retro-CPAP
D)auto-CPAP
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Chapter 31: Neonatal and Pediatric Respiratory Disorders
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Q1) Meconium-stained amniotic fluid is common among infants of less than 37 weeks' gestational age.
A)True
B)False
Q2) Which of the following treatments is the least useful for the treatment of RDS?
A)CPAP
B)surfactant replacement therapy
C)high-frequency ventilation
D)bronchial hygiene techniques
Q3) Which of the following is the most common defect of the abdominal wall?
A)inguinal hernia
B)omphalocele
C)gastroschisis
D)agenesis of abdominal muscles
Q4) What is the best strategy in the management of BPD?
A)adequate fluid management
B)prevention
C)aggressive mechanical ventilation
D)PEEP
Page 33
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Chapter 32: Airway Pharmacology
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Q1) Which of the following inhaled corticosteroids is a prodrug?
A)ciclesonide
B)flunisolide
C)budesonide
D)triamcinolone
Q2) Which of the following mucus-controlling agents is NOT currently approved for inhalation in the United States?
A)tryptase
B)dornase alfa
C)acetylcysteine
D)Mucomyst
Q3) Long-acting adrenergic bronchodilators such as salmeterol (Serevent) are not well suited for relief of acute airflow obstruction because it takes about how long for their peak effect to occur.
A)1 to 3 hours
B)3 to 5 hours
C)5 to 7 hours
D)longer than 12 hours
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34
Chapter 33: Airway Management
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Sample Questions
Q1) A patient exhibits persistent mild hypoxemia after a fiberoptic bronchoscopy procedure. Which of the following would you recommend?
A)Continue oxygen therapy and reassess in 4 hours.
B)Administer a benzodiazepine (e.g., Valium or Versed).
C)Administer a racemic epinephrine aerosol treatment.
D)Have the patient refrain from eating or drinking.
Q2) During oral intubation of an adult, the endotracheal tube should be advanced into the trachea about how far?
A)until its cuff has passed the cords
B)just far enough so that the tube cuff is no longer visible
C)until its cuff has passed the cords by 2 to 3 inches
D)until its tip has passed the cords by 2 to 3 cm
Q3) During fiberoptic bronchoscopy, a patient receiving intravenous fentanyl exhibits signs of respiratory depression. Which of the following would you recommend?
A)Increase the oxygen flow rate and continue monitoring.
B)Immediately administer naloxone (Narcan).
C)Decrease the oxygen flow rate and continue monitoring.
D)Immediately administer neostigmine or prostigmine.
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35
Chapter 34: Emergency Cardiovascular Life Support
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Q1) After two attempts at securing the airway and ventilating an infant in respiratory arrest, you still cannot confirm adequate air movement. At this point, what should you do?
A)Provide external cardiac compressions.
B)Apply 6 to 10 strong abdominal thrusts.
C)Apply back blows, followed by chest thrusts.
D)Try to ventilate again with smaller puffs.
Q2) How would you estimate the appropriate length for a nasopharyngeal airway?
A)Subtract twice the diameter of the tube from its length.
B)Measure the distance from the earlobe to the Adam's apple.
C)Apply the estimating formula: length (cm) = 15 + (age ÷ 2).
D)Measure the distance from the earlobe to the tip of the nose.
Q3) What is the proper rate of external chest compressions for infants?
A)80/min
B)100/min
C)120/min
D)140/min
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Chapter 35: Humidity and Bland Aerosol Therapy
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Q1) Increasing the flow through an unheated bubble humidifier has which of the following effects?
A)decreasing the water vapor content
B)decreasing the relative humidity
C)increasing the water vapor content
D)increasing the relative humidity
Q2) Indications for warming inspired gases include all of the following except:
A)treating a patient whose airways are reactive to cold
B)providing humidification when the upper airway is bypassed
C)treating a patient with a low body temperature (hypothermia)
D)reducing upper airway inflammation or swelling
Q3) Causes of inadequate mist production with pneumatically powered jet nebulizers include all of the following except:
A)inadequate input flow
B)siphon tube obstruction
C)jet orifice misalignment
D)tripped circuit breaker
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Chapter 36: Aerosol Drug Therapy
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Q1) A semiconscious patient with inadequate spontaneous ventilation requires aerosol drug administration. Which of the following approaches would you recommend?
A)large-volume continuous nebulizer
B)small-volume jet nebulizer (SVN)
C)SVN with delivery by intermittent positive-pressure breathing
D)metered-dose inhaler and holding chamber
Q2) Where do most aerosol particles in the 1- to 5-\(\mu\)m range deposit?
A)alveoli
B)bronchioles
C)central airways
D)upper airways
Q3) Exhalation into which device can result in loss of drug delivery?
A)small-volume jet nebulizers
B)metered-dose inhaler
C)dry power inhaler
D)ultrasonic nebulizer
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Chapter 37: Storage and Delivery of Medical Gases
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Sample Questions
Q1) You must connect a large-volume nebulizer to a bedside compressed-air outlet through a flowmeter. You have only standard O<sub>2</sub> flowmeters available. Which of the following actions is appropriate?
A)Connect the O<sub>2</sub> flowmeter to the air outlet with piping tape.
B)Use an O<sub>2</sub>-to-air DISS adapter to join the flowmeter and outlet.
C)Connect the O<sub>2</sub> flowmeter to the air outlet with a petroleum jelly seal.
D)Try to cross-thread an O<sub>2</sub> flowmeter directly on the air outlet.
Q2) You are preparing to conduct a complex transport of a patient receiving O<sub>2</sub>, and you expect to have to alter O<sub>2</sub> flows during the transport. Which of the following devices would best meet your needs?
A)uncompensated Thorpe tube
B)flow restrictor
C)compensated Thorpe tube
D)Bourdon gauge
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Chapter 38: Medical Gas Therapy
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Sample Questions
Q1) A physician requests you provide a patient with exactly 45% O<sub>2 </sub>at a flow of 60 L/min. Lacking a blender, you must manually mix air and O<sub>2</sub> to achieve the desired mixture at the prescribed flow. Which of the following air and O<sub>2 </sub>flows would you select?
\(\begin{array}{ll}&\underline{\operatorname{Air}(\mathrm{L} / \mathrm{min})}&\underline{\mathrm{O}_{2}(\mathrm{~L} / \mathrm{min})}\\
\text { A. } &42 & 18 \\
\text { B. } &35 & 25 \\
\text { C. } &48 & 12 \\
\text { D. } &30 & 30 \end{array}\)
Q2) What is the level of SpO<sub>2</sub> typically associated with discontinuation of O<sub>2</sub> therapy?
A)88%
B)90%
C)92%
D)94%
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Page 40
Chapter 39: Lung Expansion Therapy
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Sample Questions
Q1) Which of the following is false about gastric distention with intermittent positive-pressure breathing (IPPB)?
A)Gastric distention is uncommon in alert and cooperative patients.
B)Gastric distention is most likely at high airway pressures.
C)Gastric distention is a significant risk in obtunded patients.
D)Gastric distention is a relatively harmless effect of IPPB.
Q2) Which of the following patient groups should be considered for lung expansion therapy using intermittent positive-pressure breathing (IPPB)?
I.patients with clinically diagnosed atelectasis who are not responsive to other therapies
II.patients at high risk for atelectasis who cannot cooperate with other methods
III.all obese patients who have undergone abdominal surgery
A)I and II
B)II and III
C)I and III
D)I, II, and III
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Chapter 40: Bronchial Hygiene Therapy
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Sample Questions
Q1) Directed coughing is useful in helping to maintain bronchial hygiene in all of the following cases except:
A)bronchiectasis
B)acute asthma
C)cystic fibrosis
D)spinal cord injury
Q2) Conditions that can lead to bronchiectasis include all of the following except:
A)chronic airway infection
B)muscular dystrophy
C)foreign body aspiration
D)obliterative bronchiolitis
Q3) What are the best documented preventive uses of bronchial hygiene therapy?
I.prevent retained secretions in the acutely ill
II.maintain lung function in cystic fibrosis
III.prevent postoperative pulmonary complications
A)I, II, and III
B)I and II
C)I and III
D)II and III
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Page 42
Chapter 41: Respiratory Failure and the Need for Ventilatory Support
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Q1) Which of the following are associated with hypercapnic respiratory failure due to decreased ventilatory drive?
I.brainstem lesions
II.encephalitis
III.hypothyroidism
IV.asthma
A)I, II, and III
B)II and IV
C)III and IV
D)I, II, III, and IV
Q2) A reversible impairment in the response of an overloaded muscle to neural stimulation best describes which of the following?
A)central respiratory muscle fatigue
B)transmission respiratory muscle fatigue
C)contractile respiratory muscle fatigue
D)chronic respiratory muscle fatigue
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Chapter 42: Mechanical Ventilators
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Q1) A patient is receiving continuous mandatory ventilation in the control mode at a rate of 15/min. The expiratory time is 2.9 seconds. What is the inspiratory time?
A)1.1 seconds
B)1.3 seconds
C)1.5 seconds
D)1.7 seconds
Q2) Which of the closed-loop controllers is used by all ventilators?
A)setpoint
B)auto setpoint
C)adaptive
D)servo
Q3) If a ventilator, not the patient, initiates a breath, what is the trigger variable?
A)time
B)pressure
C)flow
D)volume
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Chapter 43: Physiology of Ventilatory Support
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Q1) Which of the following is the recommended tidal volume for mechanical ventilation in acute respiratory failure?
A)4 to 8 ml/kg
B)3 to 5 ml/kg
C)6 to 10 ml/kg
D)10 to 12 ml/kg
Q2) The increased work of breathing associated with auto-positive end-expiratory pressure (PEEP) during mechanical ventilation is due to:
I.hyperinflation or impaired contractility of the diaphragm
II.large alveolar pressure drops required to trigger breaths
III.increased volume of the intrathoracic airways
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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Q1) A patient receiving continuous mandatory ventilation in the assist-control mode develops auto-PEEP. Which of the following general approaches would you consider to minimize the effects of auto-PEEP in this patient?
I.increasing expiratory time
II.applying PEEP
III.switching ventilating mode to synchronized intermittent mandatory ventilation
A)I and II
B)I and III
C)II and III
D)I, II, and III
Q2) Which of the following is FALSE about flow-triggered ventilatory support?
A)The work of breathing with flow-triggering is less than with pressure triggering.
B)Flow-triggered systems respond to changes in flow rather than pressure.
C)Pressure-triggering on new ventilators may be as sensitive as flow-triggering.
D)Flow-triggering will decrease the work of breathing in patients with small endotracheal tubes and auto-PEEP.
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Chapter 45: Noninvasive Positive Pressure Ventilation
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Sample Questions
Q1) Which of the following is a potential risk of overtightening the straps of the mask?
A)absence of an air leak
B)tissue necrosis
C)eye irritation
D)claustrophobia
Q2) Which of the following interfaces appear to be more efficient to improve ventilation?
I.nasal pillows
II.full face mask
III.nasal mask
IV.oral mask
A)I only
B)I and II
C)I, II, III, and IV
D)I and IV
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Chapter 46: Monitoring and Management of the Patient in the Intensive Care Unit
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Sample Questions
Q1) Above what value for V<sub>DS</sub>/V<sub>T</sub> is weaning NOT likely?
A)0.10
B)0.30
C)0.50
D)0.60
Q2) What parameter is considered to be the most accurate and reliable measure of oxygenation efficiency?
A)PaO<sub>2</sub>/FIO<sub>2</sub> ratio
B)P(A - a)O<sub>2</sub>/PaO<sub>2</sub> ratio
C) \(\dot { \mathrm { Q } } _ { s } / \dot { \mathrm { Q } } _ { t }\)
D)PaO<sub>2</sub>/SaO<sub>2</sub> ratio
Q3) Which of the following is NOT associated with an increase in central venous pressure?
A)right heart failure
B)pulmonary valvular stenosis
C)pulmonary embolism
D)dehydration
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Page 48
Chapter 47: Discontinuing Ventilatory Support
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Sample Questions
Q1) All of the following are advantages of using pressure-supported ventilation for weaning except:
A)guaranteed V<sub>T</sub>
B)reduced work of breathing
C)respiratory muscle fatigue prevented
D)better patient comfort and synchrony
Q2) Ventilatory capacity is determined by all of the following except:
A)central nervous system (CNS) drive
B)trigger level
C)muscle strength
D)muscle endurance
Q3) Who should make the decisions related to terminal weaning?
A)patient
B)patient's family and patient's physician
C)nurse
D)respiratory therapist
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Chapter 48: Neonatal and Pediatric Respiratory Care
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Q1) What FIO<sub>2</sub> should be used in neonates prior to endotracheal suctioning?
A)same FIO<sub>2</sub> on the ventilator
B)always 100%
C)FIO<sub>2</sub> 10% to 15% higher than FIO<sub>2</sub> set in the ventilator
D)low FIO<sub>2</sub> to prevent retinopathy of prematurity
Q2) What is the normal arterial PO<sub>2</sub> in healthy infants?
A)>50 mm Hg
B)>60 mm Hg
C)>70 mm Hg
D)>80 mm Hg
Q3) Which of the following is considered a limitation of the high-flow nasal cannula?
A)It does not meet patient's flow needs.
B)The amount of airway positive pressure cannot be measured.
C)It does not provide for appropriate CO<sub>2</sub> clearance.
D)It does not reduce the use of noninvasive positive-pressure ventilation.
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Chapter 49: Patient Education and Health Promotion
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Q1) Which of the following is NOT among the top common causes of death in the United States?
A)heart disease
B)cerebrovascular disease
C)chronic obstructive lung disease
D)cystic fibrosis
Q2) Which of the following is NOT a learning domain?
A)cognitive
B)affective
C)psychomotor
D)analytical
Q3) Which of the following is used to evaluate the affective and psychomotor domains?
A)verbal exam
B)demonstration
C)written exam
D)performance checklist
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Chapter 50: Cardiopulmonary Rehabilitation
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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) Patients with chronic cardiopulmonary disorders all share an inability to do what?
A)understand the disease process
B)regain functional use of atrophied muscles
C)improve tolerance for physical activity
D)cope effectively with their disease process
Q3) Where are most cardiac rehabilitation programs conducted?
A)private practice offices
B)clinics
C)hospital facilities
D)homes
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Page 52
Chapter 51: Respiratory Care in Alternative Settings
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Sample Questions
Q1) To avoid product failure, transtracheal catheters and their tubing should be replaced every how often?
A)every week
B)every 3 months
C)every month
D)every 6 months
Q2) Disadvantages of using compressed O<sub>2</sub> cylinders in the home include all of the following except:
A)high-pressure hazards
B)limited volume of O<sub>2</sub>
C)gas waste when not used
D)need for frequent deliveries
Q3) When visiting a home care patient receiving nasal O<sub>2</sub> at 2 L/min through an O<sub>2</sub> concentrator, you measure the FIO<sub>2 </sub>of the outlet gas as 0.63. Which of the following best explains this finding?
A)This FIO<sub>2</sub> is normal at this flow.
B)The sieve pellets are exhausted.
C)The gas inlet filter must be clogged.
D)Electrical power is inadequate.
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Page 53