Introduction to Respiratory Therapy Final
Exam
Course Introduction
Introduction to Respiratory Therapy provides students with a foundational understanding of the field of respiratory care, emphasizing the essential roles and responsibilities of respiratory therapists in various healthcare settings. The course covers the anatomy and physiology of the respiratory system, fundamental principles of ventilation and gas exchange, and common respiratory diseases and disorders. Students will also explore basic patient assessment techniques, an overview of diagnostic and therapeutic procedures, infection control practices, and the ethical and professional standards guiding respiratory therapy practice. Through interactive lectures and practical demonstrations, this course prepares students for further study and hands-on training in respiratory care.
Recommended Textbook
Egans Fundamentals of Respiratory Care 11th Edition by Robert M. Kacmarek
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56 Chapters
3426 Verified Questions
3426 Flashcards
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Chapter 1: History of Respiratory Care
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Sample Questions
Q1) When was the first Venti-mask introduced that allows the precise delivery of 24%, 28%, 35%, and 40% O<sub>2</sub>?
A) 1945
B) 1954
C) 1960
D) 1972
Answer: C
Q2) Who is credited with first describing the law of partial pressures for a gas mixture?
A) John Dalton
B) Joseph Prestley
C) Jacque Charles
D) Thomas Young
Answer: A
Q3) Who introduced the first laryngoscope, in 1913?
A) Thomas Allen
B) Chevalier Jackson
C) Jack Emerson
D) Forrest Bird
Answer: B
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Page 3
Chapter 2: Delivering Evidence-Based Respiratory Care
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Sample Questions
Q1) Which of the following are characteristics of a respiratory care professional?
1) Participates in continuing education activities.
2) Obtains professional credentials.
3) Adheres to a code of ethics.
4) Completes an accredited education program.
A)1, 2 and 3 only
B)2, 3, and 4 only
C)1, 2, and 4 only
D)1, 2, 3, and 4
Answer: D
Q2) What term is used to describe the work done by a researcher who reviews numerous studies on a single topic and gives more weight to the more rigorous ones before making recommendations?
A) White paper
B) Meta-analysis
C) Alpha review
D) Apical review
Answer: B
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Chapter 3: Quality, Patient Safety, and Communication, and Recordkeeping
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Sample Questions
Q1) An RT is instructing a patient on a particular piece of equipment and should use which scenario on educating the patient?
A) Call Back
B) Read Back
C) Teach Back
D) A short quiz
Answer: C
Q2) Which of the following statements are true regarding the use of O<sub>2</sub>?
1) O<sub>2</sub> is flammable.
2) O<sub>2</sub> accelerates the rate of combustion.
3) Increased O<sub>2</sub> concentration accelerates the rate of combustion.
A)1 and 2 only
B)2 and 3 only
C)1 and 3 only
D)1, 2, and 3
Answer: B
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Chapter 4: Principles of Infection Prevention and Control
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Sample Questions
Q1) Which of the following statements is false regarding the use of glutaraldehyde?
A) It is a true sterilizing agent when used properly.
B) It can retain activity up to 90 days once activated.
C) It is used for disinfection on surfaces due to cost.
D) It can cause significant tissue inflammation in workers who use it.
Q2) Which of the following diseases are transmitted primarily by airborne transmission?
1) Tuberculosis
2) Measles
3) Smallpox
4) Viral hemorrhagic fever
A)1, 2, and 3 only
B)1 and 4 only
C)2, 3, and 4 only
D)1, 2, 3, and 4
Q3) What is the first step in equipment processing for reuse on another patient?
A) Drying the equipment
B) Cleaning the equipment
C) Disinfecting the equipment
D) Sterilizing the equipment
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6
Chapter 5: Ethical and Legal Implications of Practice
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Sample Questions
Q1) Under what conditions can the principle of confidentiality be breached?
A) When the welfare of the community or a vulnerable individual is at stake
B) When the health professional believes that the information is not vital
C) When a patient tells the health professional that there are no secrets
D) When a lawyer tells the health professional that the information must be revealed
Q2) The moral basis for rationing health care services falls under what ethical principle?
A) Compensatory justice
B) Harm
C) Distributive justice
D) Role duty
Q3) When a respiratory therapist defers a patient's questions about a condition to the attending physician, what ethical principle is being practiced?
A) Autonomy
B) Beneficence
C) Role fidelity
D) Harm principle
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Chapter 6: Physical Principles of Respiratory Care
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Sample Questions
Q1) What is the term for the actual content or weight of water present in a given volume of air?
A) Percent body humidity
B) Water vapor pressure
C) Absolute humidity
D) Relative humidity
Q2) What is the water vapor pressure of saturated gas at normal body temperature (37° C)?
A) 47.0 mm Hg
B) 43.8 mm Hg
C) 37.0 mm Hg
D) 98.6 mm Hg
Q3) What temperature is necessary to liquefy O<sub>2</sub> at 1 atm pressure?
A) -118.8° C
B) -181.1° F
C) -463.3° F
D) -183.0° C
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8
Chapter 7: E-Medicine in Respiratory Care
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Sample Questions
Q1) Which of the following is/are advantage(s) of a wireless hand-held computer for charting patient care?
1) Documentation is more legible.
2) Documentation is available to others more quickly.
3) It is less expensive.
4) There is improved fulfillment of physicians' orders.
A)1 only
B)1 and 2 only
C)2, 3 and 4 only
D)1, 2, and 4 only
Q2) Microprocessors can benefit mechanical ventilation by doing which of the following?
1) Equilibrate measured values with target values on a breath-by-breath basis.
2) Control ventilator alarms.
3) Archive the history of set and measured values.
4) Change clinician set parameters as needed.
A)1 and 3 only
B)1 and 4 only
C)1, 2, and 3 only
D)1, 3, and 4 only
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Chapter 8: Fundamentals of Respiratory Care Research
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Sample Questions
Q1) What is the name of the search engine sponsored by the National Library of Medicine for information on health care?
A) PubMed
B) HotMed
C) Up-to-date-Med
D) NationalMedline
Q2) What Web site is known for well-respected rigorously conducted systematic evidence-based reviews and provides free access to abstracts and summaries pertaining to relevant clinical questions?
A) Cochrane.org
B) Medsearch.org
C) Wikepedia.com
D) Systemview.org
Q3) Which of the following describes a database that is a structured collection of facts?
A) Synthesized databases
B) Portal databases
C) Electronic journal databases
D) Bibliographic databases
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Chapter 9: The Respiratory System
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Sample Questions
Q1) What position is used to open the airway in an unconscious patient?
A) Neck extension
B) Neck flexion
C) Recovery position
D) Sniff position
Q2) In the fetal heart, the foramen ovale allows blood to flow between which two structures?
A) Bypass the liver and enter the inferior vena cava.
B) Pulmonary artery to aortic arch.
C) Right atrium to left atrium.
D) Right atrium to left ventricle.
Q3) Which of the following would NOT promote transition from fetal circulation to a normal extrauterine circulatory pattern?
A) Closure of the foramen ovale
B) Constriction of the ductus arteriosus
C) Decreased pulmonary vascular resistance
D) Decreased systemic vascular resistance
Q4) Infants are more susceptible to profound hypoxemia than are adults.
A)True
B)False
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Chapter 10: The Cardiovascular System
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Sample Questions
Q1) What is the affect on the cardiovascular medullary centers when the cerebral carbon dioxide is low?
A) Excitatory
B) Inhibitory
C) No affect
D) Increased vascular tone
Q2) Narrowing of the mitral valve (mitral stenosis) results in which of the following?
A) Increased afterload on left ventricle
B) Increased preload on right ventricle
C) Increased pulmonary congestion
D) Systemic hypertension
Q3) Vascular low-pressure baroreceptors have their greatest impact on which system?
A) Central chemoreceptors
B) Endocrine
C) Exocrine
D) Renin-angiotensin
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12
Chapter 11: Ventilation
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Sample Questions
Q1) How is compliance calculated?
A) Change in pressure/change in flow
B) Change in pressure/change in volume
C) Change in volume/change in flow
D) Change in volume/change in pressure
Q2) What is ventilation that is insufficient to meet metabolic needs called?
A) Hypoventilation
B) Hyperventilation
C) Hyperpnea
D) Hypopnea
Q3) Which is the correct formula to calculate the alveolar minute ventilation of a spontaneously breathing subject?
A) f \(\times\)V<sub>DS</sub>/V<sub>T</sub>
B) f \(\times\) V<sub>T</sub>
C) f \(\times\) (V<sub>T</sub> - V<sub>DSphys</sub>)
D) f \(\times\) (V<sub>T</sub> + V<sub>DSphys</sub>)
Q4) How is airway resistance (R<sub>aw</sub>) computed?
A) Change in pressure/change in volume
B) Change in pressure/flow
C) Change in volume/change in pressure
Page 13
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Chapter 12: Gas Exchange and Transport
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Sample Questions
Q1) Which of the following equations best describes O<sub>2</sub> delivery to the tissues?
A) Arterial O<sub>2</sub> content ÷ cardiac output
B) Arterial O<sub>2</sub> content . cardiac output
C) Cardiac output + arterial O<sub>2</sub> content
D) Cardiac output . vascular resistance
Q2) What does / mismatch have the biggest impact on?
A)Carbon dioxide elimination
B)Dissolved HCO<sub>3</sub><sup>-</sup>
C)Oxygenation
D)pH
Q3) During normal inspiration, which of the following occurs?
A) Alveoli at the apexes expand less than those at the bases.
B) Alveoli at the apexes expand more than those at the bases.
C) Alveoli at the bases and apexes expand almost equally.
D) Alveoli at the bases expand less than those at the apexes.
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Chapter 13: Solutions, Body Fluids, and Electrolytes
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Sample Questions
Q1) Which of the following correctly describes a facet of chloride?
A) A loss of Cl<sup>-</sup> is equivalent to a gain in acid.
B) Cl<sup>-</sup> is usually excreted with H<sup>+</sup> as HCl.
C) Cl<sup>-</sup> levels vary inversely with HCO<sub>3</sub><sup>-</sup> levels.
D) Cl<sup>-</sup> plays a key role in acid-base buffering.
Q2) Positive ions are referred to as:
A) anions.
B) cations.
C) covalents.
D) electrolytes.
Q3) What is the most common cause of hyperkalemia?
A) Cardiac arrest
B) Metabolic alkalosis
C) Renal failure
D) Respiratory acidosis
Q4) Where does ammonia play its most important role as a base buffer?
A) Kidney
B) Liver
C) Lung
D) Vasculature
Page 15
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Chapter 14: Acid-Base Balance
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Sample Questions
Q1) Which organ system actually excretes H<sup>+</sup> from the body?
A) Kidneys
B) Liver
C) Lungs
D) Spleen
Q2) A 21-year-old woman in the emergency room is displaying rapid and deep, labored breathing. Her room ABG reveals a pH of 7.25, PaCO<sub>2</sub> of 28, HCO<sub>3</sub><sup>-</sup> of 14 mEq/L, and a base excess of -14 mEq/L. How would the respiratory therapist assess her acid-base condition?
1) Severe hyperventilation
2) Partially compensated metabolic acidosis
3) Compensatory response to the metabolic acidosis
4) Severe hypoventilation
A)1, 2, and 3 only
B)1 and 3 only
C)3 only
D)2, 3, and 4 only
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Page 16
Chapter 15: Regulation of Breathing
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Sample Questions
Q1) When given high concentrations of O<sub>2</sub>, a patient with chronic hypercapnia may develop a more serious respiratory acidosis. Which of the following might be contributing to the patient's increased PCO<sub>2</sub>?
1) Worsening ventilation-perfusion (VV/QQ) balance
2) Desensitization of the carotid bodies
3) Removal of the hypoxic stimulus
A)1 and 2 only
B)1 only
C)1 and 3 only
D)1, 2, and 3
Q2) What centers are located in the pons of the brainstem?
1) Apneustic center
2) Dorsal respiratory neurons
3) Pneumotaxic center
A)1, 2, and 3
B)2 and 3 only
C)1 and 3 only
D)1 and 2 only
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Chapter 16: Bedside Assessment of the Patient
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Sample Questions
Q1) Which of the following are elements of a patient's social and environmental history?
1) Occupation and employment history
2) Drugs and medications
3) Recent travel
4) Living arrangements
A)1, 3, and 4 only
B)1 and 4 only
C)1, 2, and 3 only
D)1, 2, 3, and 4
Q2) Why should the respiratory therapist perform a blood pressure assessment fairly quickly?
A) The procedure is expensive.
B) The procedure cuts off blood flow to the forearm temporarily.
C) The respiratory therapist has other procedures to do.
D) The procedure is billed by the time involved.
Q3) What is the normal range for pulse pressure?
A) 20 to 35 mm Hg
B) 30 to 60 mm Hg
C) 30 to 40 mm Hg
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Page 18
Chapter 17: Interpreting Clinical and Laboratory Data
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Sample Questions
Q1) An RT receives a doctor's order to perform an ABG on a 71-year-old woman. Upon reviewing the patient's chart, the RT notices that the patient has a platelet count of 110 \(\times\) 10<sup>3</sup> mcl. What should the RT do?
1) Perform ABG as normal.
2) Refuse to perform the ABG.
3) After ABG is performed, compress the puncture site for a longer time.
4) Recommend that an ABG should be performed on the patient only when it is absolutely necessary.
A)2 and 4 only
B)1 only
C)3 and 4 only
D)2 only
Q2) What term is used to describe a white blood cell (WBC) count that is below normal values?
A) Anemia
B) Thrombocytopenia
C) Leukopenia
D) Hypoleukemia
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19
Chapter 18: Interpreting the Electrocardiogram
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Sample Questions
Q1) What is implied by an abnormally prolonged PR interval?
A) Atrioventricular block
B) Bundle-branch block
C) Myocardial infarction
D) Valvular detachment
Q2) A run of three or more PVCs should be called:
A) ventricular tachycardia.
B) ventricular fibrillation.
C) atrial tachycardia.
D) supra ventricular tachycardia.
Q3) What term is used to define the ability of certain cardiac cells to depolarize without stimulation?
A) Automaticity
B) Polarization
C) Contraction
D) Autopolarization
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20
Chapter 19: Analysis and Monitoring of Gas Exchange
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Sample Questions
Q1) Pulse oximeter readings are generally unreliable at saturations below what level?
A) 70%
B) 80%
C) 90%
D) 95%
Q2) After obtaining an arterial blood sample through percutaneous puncture using a syringe that does not have a capping safety device, what should you do?
A) Remove the needle with a Kelly clamp, then plug the syringe.
B) "Scoop" the needle cap up with one hand, then plug the syringe.
C) Force the needle into a rubber cork or plastic stopper.
D) Manually remove and bend the needle, then plug the syringe.
Q3) Which of the following patient parameters does not need to be assessed as part of arterial blood sampling?
A) Blood pressure
B) Temperature
C) Position or activity level
D) Clinical appearance
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21
Chapter 20: Pulmonary Function Testing
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Sample Questions
Q1) Normal healthy people can exhale what percentage of the forced vital capacity in 1 sec?
A) 50%
B) 60%
C) 70%
D) 80%
Q2) You perform a series of pulmonary function tests on a patient with a potentially infectious disease carried via the airborne route. Which of the following infection-control procedures should you implement?
1) Wear a respirator or close-fitting surgical mask.
2) Dispose of, sterilize, or disinfect the tubing circuit after testing.
3) Clean the interior surface of the spirometer before the next test.
A)1 only
B)1 and 2 only
C)2 and 3 only
D)1, 2, and 3
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22
Chapter 21: Review of Thoracic Imaging
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Sample Questions
Q1) Which of the following is not a typical cause of atelectasis?
A) Abdominal surgery
B) Rib fracture
C) Hepatomegaly
D) Pleurisy
Q2) Which of the following statements is false regarding the use of ultrasound to image the chest?
A) It is useful to image the heart.
B) It is useful to image pleural abnormalities.
C) It is useful to image lung tissue.
D) It uses sound waves that echo back to the sensor.
Q3) What is the earliest sign of a left-sided pleural effusion on an upright chest radiograph?
A) An increased distance between the inferior margin of the left lung and the stomach gas bubble
B) Inability to see small pulmonary blood vessels over the left lower lung
C) A widened mediastinum
D) Elevation of the right hemidiaphragm
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Chapter 22: Flexible Bronchoscopy and the Respiratory Therapist
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Sample Questions
Q1) What is the major challenge of ultrathin bronchoscopy?
A) Bronchoscopy kinking during procedure
B) The equipment is expensive
C) Issues with CT guidance equipment
D) Maintaining proper anatomical orientation in the peripheral airways
Q2) What are the two major complications of transbronchial biopsy?
A) Uncontrollable coughing and bleeding
B) Pneumothorax and bleeding
C) Pneumothorax and coughing
D) Cardiac arrest and pneumothorax
Q3) For patient safety, to help avoid methemoglobinemia, the total dose of lidocaine should not exceed:
A) 2 mg/kg.
B) 5 mg/kg.
C) 7 mg/kg.
D) 10 mg/kg.
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24
Chapter 23: Nutrition Assessment
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Sample Questions
Q1) Which of the following is not a nutritional goal for the management of a cystic fibrosis patient?
A) Maximize nutritional intake.
B) Meet clinical and psychological needs.
C) Avoid caloric dense foods.
D) Encourage mineral and vitamin supplementation.
Q2) Which of the following has an RQ of 1.0?
A) Fat
B) Carbohydrates
C) Protein
D) Soy
Q3) Which of the following is associated with acute cardiac muscle weakness and potential cardiopulmonary failure?
A) Hyperkalemia
B) Hypophosphatemia
C) Hypernatremia
D) Low folic acid levels
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Chapter 24: Pulmonary Infections
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Q1) What would be important to perform in order to obtain a good sputum sample that is to be used to detect the pathogen causing community-acquired pneumonia?
A) Ensure that antibiotic treatment was instituted at least 24 hr earlier.
B) Have patient sit in the semirecumbent position to obtain sample.
C) Have patient spit into sample container.
D) Patient should rinse mouth prior to sample collection.
Q2) What type of severe lung infection may result in the development of small lung cavities called pneumatoceles?
A) Community-acquired pneumonia
B) Legionella pneumoniae
C) Staphylococcus aureus
D) Viral pneumonia
Q3) Which of the following organisms that cause pneumonia is most likely to result in a positive blood culture?
A) Chlamydia pneumoniae
B) Haemophilus influenzae
C) Mycoplasma pneumoniae
D) Pneumocystis jiroveci
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Chapter 25: Obstructive Lung Disease: Chronic Obstructive
Pulmonary Disease Copd, Asthma, and Related Diseases
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Q1) Which of the following are typically found in a patient with COPD?
1) Airway inflammation
2) Partially reversible airway obstruction
3) Progressive airway obstruction
4) Restrictive disease
A)2 and 3 only
B)1 and 4 only
C)1, 2, and 3 only
D)2, 3, and 4 only
Q2) It is not clear whether your patient has COPD or asthma. Which of the following characteristics is most closely associated with the diagnosis of asthma?
A) Daily phlegm production
B) Diminished vascularity on the chest radiograph
C) Low diffusion capacity
D) Reversal of the FEV<sub>1</sub> after use of a bronchodilator
Q3) What beta-2 agonist is associated with 12 to 24 hr of bronchodilation?
A) Albuterol
B) Metaproterenol
C) Salmeterol
D) Aclinidium
Page 27
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Chapter 26: Interstitial Lung Disease
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Q1) What use, other than prognostic value, can serial pulmonary function tests provide for the management of interstitial lung disease patients?
A) Determine the degree of refractory hypoxemia.
B) Establish the need for lung transplantation.
C) Guide the type of oxygen therapy delivered.
D) Guide the type of medication therapy delivered.
Q2) Which of the following medications has been shown to be useful in the treatment of almost all interstitial lung diseases?
A) Acetaminophen
B) Aspirin
C) Oxytocin
D) Oxygen
Q3) Scleroderma, rheumatoid arthritis, and systemic lupus erythematosus are all examples of what type of disease group?
A) Asbestos-associated illnesses
B) Connective tissue diseases
C) Hypersensitivity pneumonitis
D) Pneumoconiosis
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Chapter 27: Pleural Diseases
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Q1) Which of the following medications is known to cause drug-induced pleural disease?
1) Bleomycin
2) Amiodarone
3) Advair
4) Vilanterol
A)1 and 2 only
B)2 and 4 only
C)4 only
D)1, 2, and 3 only
Q2) The most common symptom of pneumothorax that occurs in nearly every patient is:
A) shortness of breath.
B) chest pain.
C) dizziness.
D) syncope.
Q3) In what age group is a primary spontaneous pneumothorax most commonly seen?
A) Under 15 years
B) 18 to 25 years
C) 35 to 45 years
D) Over 60 years
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Page 29
Chapter 28: Pulmonary Vascular Disease
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Sample Questions
Q1) Which of the following physical examination findings are found in patients with primary pulmonary hypertension?
1) Cyanosis
2) Diastolic heart murmur
3) Digital clubbing
4) Loud second heart sound (P<sub>2</sub>)
A)2 and 4 only
B)1 and 3 only
C)1, 2, and 4 only
D)2, 3, and 4 only
Q2) Why is the D-dimer test not routinely performed on hospital inpatients suspected of having pulmonary emboli?
A) A high D-dimer only suggests the presence of comorbidities.
B) A low D-dimer is associated with immunodepression.
C) It loses sensitivity if numerous blood tests have been performed.
D) The cost is prohibitive.
Q3) Most hospitalized patients who are immobile need prophylaxis for venous thromboembolism.
A)True
B)False
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Chapter 29: Acute Respiratory Distress Syndrome
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Q1) What ventilatory strategy has been found to be useful for avoiding barotrauma in the treatment of patients with ARDS?
A) Prolonged expiratory time
B) Permissive hypercapnia
C) Inverse ratio ventilation
D) Intermittent mandatory ventilation
Q2) Which of the following mechanisms ultimately leads to ARDS regardless of the etiology?
A) Disruption of the endothelial and epithelial barriers
B) Alveolar flooding
C) Interstitial damage
D) Increased oncotic pressure
Q3) What range is now recommended for tidal volumes (V<sub>T</sub>) in a patient with ARDS who is being mechanically ventilated?
A) 4 to 6 ml/kg
B) 6 to 10 ml/kg
C) 6 to 8 ml/kg
D) 10 to 12 ml/kg
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Chapter 30: Trauma, Burns and Near Drowning
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Sample Questions
Q1) Which of the following is a true statement?
A) It has not been demonstrated that recruitment maneuvers in obese, mechanically ventilated patients are effective at improving respiratory system compliance and oxygenation without affecting hemodynamics.
B) It is not advisable to perform a recruitment maneuver whenever PEEP is increased or after temporary PEEP discontinuation.
C) It has been shown that the elevation of the head of bed is effective at improving respiratory system compliance, oxygenation, reducing expiratory flow limitation, and reducing PEEP requirements for optimal ventilation in obese patients.
D) PEEP should be weaned before FiO<sub>2</sub> and pressure support level is decreased.
Q2) Which of the following precautions should be immediately taken in a patient with blunt trauma?
A) Securing the airway with an endotracheal tube
B) Immobilization of the cervical spine
C) IV placement and aggressive fluid replacement therapy
D) CT scanning to determine occult internal bleeding
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Chapter 31: Lung Cancer
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Sample Questions
Q1) Which of the following is not associated with the clinical features of lung cancer?
A) Local growth of tumor
B) Metastasis extrathoracic or intrathoracic
C) Associated pain or discomfort
D) Paraneoplastic syndrome
Q2) Other causes of lung cancer include:
1) asbestos.
2) arsenic.
3) chromium.
4) microwave radiation.
A)2, 3, and 4 only
B)2 and 3 only
C)1 and 4 only
D)1, 2, and 3 only
Q3) Which of the following comments regarding lung cancer is true?
A) The incidence has risen over the past few decades.
B) It is the third leading cause of cancer deaths in the United States.
C) The peak incidence occurred in the mid-1970s.
D) Incidence has increased in women 40 to 58 years of age.
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Page 33
Chapter 32: Neuromuscular and Other Diseases of the Chest
Wall
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Sample Questions
Q1) A decrease in forced expiratory volume in 1 second (FEV<sub>1</sub>) and vital capacity (VC) of greater than 20% when a patient moves from the seated to the supine position is suggestive of which of the following?
A) Diaphragmatic muscle weakness
B) Scalene muscle weakness
C) Brainstem injury
D) Internal intercostal weakness
Q2) What percentage of amyotrophic lateral sclerosis patients die within 5 years of diagnosis?
A) 10%
B) 25%
C) 50%
D) 80%
Q3) By what age do most patients with Duchenne muscular dystrophy die?
A) 10 years
B) 20 years
C) 35 years
D) 50 years
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Chapter 33: Disorders of Sleep
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Sample Questions
Q1) Which of the following physical exam findings are associated with obstructive sleep apnea?
1) Large tonsils
2) Microcephaly
3) Macroglossia
4) Deviated nasal septum
A)1 and 3 only
B)1, 2, and 3 only
C)3 and 4 only
D)2, 3, and 4 only
Q2) Which of the following factors has been shown to positively correlate with obstructive sleep apnea?
A) Age
B) Height
C) Obesity of the upper body
D) Blood pressure at rest
Q3) Central sleep apnea occurs more often than obstructive sleep apnea.
A)True
B)False
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Page 35
Chapter 34: Neonatal and Pediatric Respiratory Disorders
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Q1) Which of the following ventilatory modalities have been associated with a lesser rate of air leak in meconium aspiration syndrome?
1) IMV
2) HFV
3) CPAP
A)1 only
B)1 and 2 only
C)2 and 3 only
D)3 only
Q2) What therapy has been shown to reduce the rate of loss of lung function in patients with cystic fibrosis?
A) High doses of ibuprofen
B) Continuous oxygen therapy
C) Corticosteroids
D) Inhaled DNase
Q3) What radiographic finding is common in infants with transient tachypnea?
A) Low lung volumes
B) Bilateral perihilar lymphadenopathy
C) Hyperinflation
D) Mucus plugging
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Chapter 35: Airway Pharmacology
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Sample Questions
Q1) Which of the following is the usual neurotransmitter in the sympathetic system?
A) Atropine
B) Acetylcholine
C) Norepinephrine
D) Dopamine
Q2) Which of the following are considered nonsteroidal antiasthma drugs?
1) Cromolyn-like agents
2) Leukotriene modifiers
3) Anti-IgE agents
4) Anti-IgA agents
A)1 and 3 only
B)1, 2, and 3 only
C)2, 3, and 4 only
D)1, 2, 3, and 4
Q3) Short-acting adrenergic bronchodilators are considered what type of agent according to the National Asthma Education and Prevention Program?
A) Antiinflammatory
B) Rescue
C) Controller
D) Mucolytic
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Chapter 36: Airway Management
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Sample Questions
Q1) What is the most common problem with fenestrated tracheostomy tubes?
A) Relative frequency of accidental extubation
B) Increased likelihood of tracheomalacia
C) Poor positioning of the tube fenestration
D) Inability to provide mechanical ventilation
Q2) What general condition requires airway management?
1) Airway compromise
2) Respiratory failure
3) Need to protect the airway
A)1 and 2 only
B)1 and 3 only
C)2 and 3 only
D)1, 2, and 3
Q3) After an intubation attempt, an expired capnogram indicates a CO<sub>2</sub> level near zero. What does this finding probably indicate?
A) Abnormally high ventilation/perfusion ratio ()
B) Placement of the endotracheal tube in the esophagus
C) Placement of the endotracheal tube in the trachea
D) Failure of the cuff to properly seal the airway
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Page 38
Chapter 37: Emergency Cardiovascular Life Support
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Sample Questions
Q1) When used as an airway adjunct for CPR, an ideal mask should have which of the following characteristics?
1) Constructed of opaque material
2) Include an inlet for supplemental O<sub>2</sub>
3) Capable of a tight seal against the face
4) Standard 15/22 mm connection
A)2 and 4 only
B)1 and 3 only
C)2, 3, and 4 only
D)1, 3, and 4 only
Q2) A patient with supraventricular tachycardia (SVT) at a rate of 195/min is developing symptoms of shock and unconsciousness. At this time, what would you recommend?
A) Vagal stimulation through carotid sinus massage
B) Administration of a strong beta-adrenergic agent
C) Synchronous electrical shock (cardioversion)
D) Administration of a bolus of intravenous lidocaine
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Chapter 38: Humidity and Bland Aerosol Therapy
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Sample Questions
Q1) Which of the following are clinical signs and symptoms of inadequate airway humidification?
1) Atelectasis
2) Dry cough
3) Increased airway resistance
4) Increased incidence of infection
5) Increased work of breathing
A)2, 3, and 4 only
B)1, 2, and 3 only
C)3, 4, and 5 only
D)1, 2, 3, 4, and 5
Q2) Which of the following is false about a simple heated humidifier (one that does not incorporate a servo-control mechanism)?
A) The controller regulates the heating element's electric power.
B) The controller monitors the temperature of the heating element.
C) The controller varies current to achieve a set airway temperature.
D) The patient's airway does affect the controller.
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Chapter 39: Aerosol Drug Therapy
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Sample Questions
Q1) What is the major problem with using large volume nebulizers for continuous aerosol drug therapy?
A) Decreased pulmonary deposition
B) Drug reconcentration and toxicity
C) Frequent interruption of therapy
D) Greater waste of drug
Q2) Factors associated with reduced pulmonary deposition of aerosolized drugs include which of the following?
1) Mechanical ventilation
2) Artificial airways
3) Poor patient technique
4) Mouth breathing
A)1 and 3 only
B)1, 2, and 3 only
C)3 and 4 only
D)2, 3, and 4 only
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Chapter 40: Storage and Delivery of Medical Gases
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Sample Questions
Q1) Which of the following devices would you select if the goal was to accurately meter the flow through a jet nebulizer?
A) Bourdon gauge
B) Flow restrictor
C) Uncompensated Thorpe tube
D) Compensated Thorpe tube
Q2) The gauge on an H cylinder of O<sub>2</sub> reads 2000 psig. Approximately how long would the contents of this cylinder last, until completely empty, at a flow of 6 L/min?
A) 1 hr 30 min
B) 17 hr 30 min
C) 18 hr 10 min
D) 21 hr 50 min
Q3) What key property of He makes it useful as a therapeutic gas?
A) Low solubility
B) Chemical inertness
C) Low cost
D) Low density
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42
Chapter 41: Medical Gas Therapy
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Sample Questions
Q1) Which of the following typically occurs first when monitoring the earliest physiologic response to breathing 100% O<sub>2</sub>?
A) Substernal chest pain
B) Decreased using capacity (DLCO)
C) Decreased lung compliance (C<sub>L</sub>)
D) Decreased vital capacity (VC)
Q2) A true high-flow O<sub>2</sub> delivery system should provide at least what flow?
A) 60 L/min
B) 50 L/min
C) 40 L/min
D) 30 L/min
Q3) You start a chronic obstructive pulmonary disease (COPD) patient on a nasal O<sub>2</sub> cannula at 2 L/min. What is the maximum time that should pass before assessing this patient's PaO<sub>2</sub> or SaO<sub>2</sub>?
A) 2 hr
B) 8 hr
C) 12 hr
D) 72 hr
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43
Chapter 42: Lung Expansion Therapy
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Sample Questions
Q1) Which of the following are potential hazards of intermittent positive-pressure breathing (IPPB)?
1) Air trapping, auto-PEEP
2) Hyperventilation
3) Nosocomial infection
4) Increased airway resistance
A)1, 2, 3, and 4
B)2 and 4 only
C)2, 3, and 4 only
D)3 and 4 only
Q2) How do all modes of lung expansion therapy aid lung expansion?
A) Increasing the transpulmonary pressure gradient
B) Decreasing the transthoracic pressure gradient
C) Increasing the pressure in the pleural space
D) Decreasing the pressure in the alveoli
Q3) Successful application of incentive spirometry depends on:
A) the use of a true volume-oriented incentive spirometry system.
B) the type of surgery previously performed.
C) the effectiveness of patient teaching.
D) setting an easily achieved initial goal.
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Chapter 43: Airway Clearance Therapy Act
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Sample Questions
Q1) What is the ideal patient position for directed coughing?
A) Sitting with one shoulder rotated inward, the head and spine slightly flexed
B) Supine, with knees slightly flexed and feet braced
C) Prone, with the head and spine slightly flexed
D) Supine, with forearms relaxed and feet supported
Q2) Which of the following are true about the FET?
1) It causes less bronchiolar collapse than traditional coughing.
2) It occurs from mid to low lung volume without glottis closure.
3) It has a period of diaphragmatic breathing and relaxation.
4) It occurs from mid to high lung volume without glottis closure.
A)1 and 3 only
B)1, 2, and 3 only
C)3 and 4 only
D)2, 3, and 4 only
Q3) Why is strenuous patient coughing during postural drainage in a head-down position contraindicated?
A) It can impair the mucociliary clearance mechanism.
B) It can increase expiratory airway resistance (Raw).
C) It can cause air trapping and pulmonary distension.
D) It can markedly increase intracranial pressure (ICP).
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Chapter 44: Respiratory Failure and the Need for
Ventilatory
Support
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Sample Questions
Q1) Which of the following indicate severely impaired oxygenation requiring high FiO<sub>2</sub>s and positive end expiratory pressure?
1) PaO<sub>2</sub>-PaO<sub>2</sub> greater than 350 mm Hg on 100% O<sub>2</sub>
2) VC less than 10 ml/kg
3) PaO<sub>2</sub>/FiO<sub>2</sub> less than 200
4) PaCO<sub>2</sub> greater than 45 mm Hg
A)1 and 4 only
B)1 and 3 only
C)2 and 3 only
D)1, 2, and 4 only
Q2) A patient with an opiate drug overdose is unconscious and exhibits the following blood gas results breathing room air: pH = 7.19; PCO<sub>2</sub> = 89; HCO<sub>3</sub><sup>-</sup> = 27; PO<sub>2</sub> = 48. Which of the following best describes this patient's condition?
A) Chronic hypoxemic respiratory failure
B) Chronic hypercapnic respiratory failure
C) Acute hypoxemic respiratory failure
D) Acute hypercapnic respiratory failure
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Chapter 45: 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) What parameter serves as the baseline variable on all modern ventilators?
A) Pressure
B) Flow
C) Time
D) Volume
Q3) A physician requests that you switch from pressure-triggering a patient to flow-triggering. Which of the following new settings would be appropriate?
A) Base flow = 0 L/min; trigger at 2 L/min
B) Base flow = 10 L/min; trigger at -2 cm H<sub>2</sub>O
C) Base flow = 10 L/min; trigger at 2 L/min
D) Base flow = 0 L/min; trigger at 10 cm H<sub>2</sub>O
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Chapter 46: Physiology of Ventilatory Support
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Sample Questions
Q1) Ventricular dysfunction occurs in patients receiving positive-pressure ventilation for which of the following reasons?
1) Hypovolemia
2) Excessive tidal volume
3) Receiving more than optimal positive end expiratory pressure (PEEP)
4) Hypervolemia
A)1 and 3 only
B)1, 2, and 3 only
C)3 and 4 only
D)2, 3, and 4 only
Q2) Patients receiving mechanical ventilation are usually turned every 2 hr to prevent which of the following?
1) Atelectasis
2) Secretion retention
3) Pressure sores
4) Hyperoxemia
A)1 and 2 only
B)2 and 3 only
C)1, 2 and 3 only
D)1, 2, 3, and 4
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Page 48
Chapter 47: Patient Ventilator Interaction
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Sample Questions
Q1) Your patient has relatively normal lungs and is receiving mechanical ventilation following surgery. You observe double triggering. What is the most likely cause?
A) The termination criteria is set too low.
B) The flow rate is too slow.
C) Auto-PEEP.
D) The inspiratory time is too short.
Q2) The most important variable affecting trigger asynchrony is:
A) the mode of mechanical ventilation being used.
B) the tidal volume being delivered.
C) the presence of auto-PEEP.
D) the patient's underlying disease process requiring mechanical ventilation.
Q3) How are the effects of auto-PEEP on missed triggering improved in the presence of dynamic airway obstruction?
A) Adjustment of the sensitivity setting
B) The application of PEEP
C) Mode change
D) Administration of a bronchodilator
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Chapter 48: Initiating and Adjusting Invasive Ventilatory Support
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Sample Questions
Q1) On a ventilator that has separate rate and minute ventilation (V<sub>E</sub>) controls, the rate is set at 13/min and the V<sub>E</sub> at 11 L/min. Approximately what V<sub>T</sub> is the patient receiving?
A) 700 ml
B) 850 ml
C) 1000 ml
D) 1200 ml
Q2) Which of the following trigger levels is appropriate when setting a ventilator for flow triggering?
A) 9 to 11 L/min below baseline flow
B) 7 to 9 L/min below baseline flow
C) 4 to 6 L/min below baseline flow
D) 1 to 2 L/min below baseline flow
Q3) When titrating the FiO<sub>2</sub> down from 50% to 21%, in what increments should it be reduced?
A) All at once is acceptable.
B) No more than 5%.
C) 5% to 10%.
D) 10% to 20%.
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Chapter 49: Noninvasive Ventilation
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Sample Questions
Q1) What is the recommended initial setting for ventilating pressure when delivering noninvasive ventilation in the pressure triggered timed mode?
A) 2 to 5 cm H<sub>2</sub>O
B) 5 to 8 cm H<sub>2</sub>O
C) 8 to 12 cm H<sub>2</sub>O
D) 12 to 20 cm H<sub>2</sub>O
Q2) Which of the following define successful application of noninvasive ventilation (NIV)?
1) Overall improvement of patient's blood gas
2) Normal blood gas
3) PaO<sub>2</sub> increased
4) PaCO<sub>2</sub> decreased
A)1 only
B)1, 2, and 3 only
C)1, 2, 3, and 4
D)1, 3, and 4 only
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Chapter 50: Extracorporeal Life Support Ecls
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Sample Questions
Q1) Which of the following factors affect ACTs level of a patient receiving ECMO?
1) Hypothermia
2) Thrombocytopenia
3) Anemia
4) Hypofibrinogenemia
A)1 and 3 only
B)1, 2, and 3 only
C)2 and 4 only
D)1, 2, 3, and 4
Q2) Common complications of ECMO include which of the following?
1) Seizures
2) Bleeding
3) Arrhythmias
4) Neurologic complications
A)1 and 3 only
B)1, 2, and 3 only
C)2 and 4 only
D)1, 2, 3, and 4
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Chapter 51: Monitoring the Patient in the Intensive Care Unit
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Sample Questions
Q1) Which of the following are global monitoring indexes?
1) APACHE
2) APS
3) TISS
4) ATS
A)1 and 3 only
B)1, 2, and 3 only
C)2 and 4 only
D)1, 2, 3, and 4
Q2) At what level of intracranial pressure will venous drainage be impeded and cerebral edema develop in uninjured tissue?
A) 10 to 15 mm Hg
B) 20 to 30 mm Hg
C) 30 to 35 mm Hg
D) 40 to 45 mm Hg
Q3) What is the best measure of the efficiency of gas exchange in the lung?
A) PaCO<sub>2</sub>
B) V<sub>DS</sub>/V<sub>T</sub>
C) End-tidal PCO<sub>2</sub>
D) PaCO<sub>2</sub>/PETCO<sub>2</sub>
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Chapter 52: Discontinuing Ventilatory Support
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Sample Questions
Q1) Which of the following indicate that an adult patient is ready to be weaned from ventilatory support?
1) VC = 1.9 L
2) Spontaneous rate of 32/min
3) Q<sub>s</sub>/Q<sub>t</sub> = 8%
4) MIP = -45 cm H<sub>2</sub>O
A)2 and 4 only
B)1, 2, and 3 only
C)3 and 4 only
D)1, 3, and 4 only
Q2) Which factors lead to the development of computer-based weaning protocols?
1) Respiratory therapists are unable to successfully wean most patients using protocols.
2) Computer-based weaning protocols are relatively easy to develop.
3) Weaning is time-consuming.
4) Weaning is a labor-intensive process.
A)3 only
B)1, 2, and 3 only
C)2, 3, and 4 only
D)1, 2, 3, and 4
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Chapter 53: Neonatal and Pediatric Respiratory Care
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Sample Questions
Q1) What is the recommended dose of inhaled NO?
A) 10 ppm
B) 20 ppm
C) 30 ppm
D) 40 ppm
Q2) Which of the following O<sub>2</sub> modalities would you recommend for a toddler needing a low FiO<sub>2</sub>?
A) Mist tent
B) Cannula
C) Oxy-Hood
D) Mask
Q3) Which of the following techniques would you recommend to assess the state of pulmonary maturity before birth?
A) Blood gas analysis
B) Ultrasonography
C) Maternal history
D) Amniocentesis
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Chapter 54: Patient Education and Health Promotion
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Sample Questions
Q1) Teaching facts to patients involves learning in what domain?
A) Cognitive
B) Affective
C) Psychomotor
D) Analytical
Q2) Which of the following is the goal of tertiary prevention?
A) To prevent acceleration of the disease process once it has occurred
B) To cure the disease
C) To prevent related diseases
D) To stop recurrent episodes
Q3) Which of the following factors are linked to one of the major causes of death in the United States?
1) Use of tobacco
2) High-fat diet
3) Excessive alcohol use
4) High-sodium diet
A)1 and 3 only
B)1, 2, and 3 only
C)3 and 4 only
D)2, 3, and 4 only
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Chapter 55: Cardiopulmonary Rehabilitation
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Sample Questions
Q1) Which of the following exercises are useful for reconditioning the upper extremities of patients undergoing pulmonary rehabilitation?
1) Using a rowing machine
2) Using an arm ergometer
3) Pedaling a stationary bicycle
4) Using free hand weights
A)1, 2, 3, and 4
B)1 and 3 only
C)1, 2, and 4 only
D)2 and 4 only
Q2) A cardiopulmonary exercise evaluation is conducted on a patient before participation in pulmonary rehabilitation for what purposes?
1) To quantify the patient's baseline exercise capacity
2) To develop an exercise prescription (including target heart rate)
3) To determine how much desaturation occurs with exercise
A)2 and 3 only
B)1, 2, and 3
C)1 and 2 only
D)1 and 3 only
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Chapter 56: Respiratory Care in Alternative Settings
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Sample Questions
Q1) Durable medical equipment (DME) companies usually provide which of the following respiratory home care services?
1) Third-party insurance processing
2) Most respiratory care modalities
3) 24-hr/7-days-a-week service
4) Home instruction and follow-up
A)2 and 4 only
B)1, 2, and 3 only
C)3 and 4 only
D)1, 2, 3, and 4
Q2) After making a home care visit, to whom should you forward copies of your written report?
1) Patient's physician
2) Patient's family
3) Home care agency
A)2 and 3 only
B)1 and 2 only
C)1, 2, and 3
D)1 and 3 only
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