Introduction to Respiratory Therapy Pre-Test Questions
Course Introduction
Introduction to Respiratory Therapy provides an overview of the fundamental concepts and practices in the field of respiratory care. This course introduces students to the anatomy and physiology of the respiratory system, common respiratory diseases and disorders, and the principles of assessment and therapeutic interventions. Emphasis is placed on understanding the roles and responsibilities of respiratory therapists in various healthcare settings, patient communication, and the use of essential equipment such as ventilators, oxygen delivery systems, and pulmonary function testing devices. Through lectures and hands-on learning, students gain a foundational understanding necessary for advanced study and clinical practice in respiratory therapy.
Recommended Textbook Egans Fundamentals of Respiratory Care 11th Edition by Robert M. Kacmarek
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Chapter 1: History of Respiratory Care
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Q1) What was the name of the first professional organization for the field of respiratory care?
A) American Association for Inhalation Therapy
B) National Organization for Inhalation Therapy
C) Inhalation Therapy Association
D) Better Breathers Organization
Answer: C
Q2) 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
Q3) Where are the majority of respiratory therapists employed?
A) Skilled nursing facilities
B) Diagnostic laboratories
C) Hospitals or acute care settings
D) Outpatient physician offices
Answer: C
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Chapter 2: Delivering Evidence-Based Respiratory Care
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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-based health care.
Answer: A
Q2) 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
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Chapter 3: Quality, Patient Safety, and Communication, and Recordkeeping
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Q1) Which of the following strategies for conflict resolution represents a middle-ground strategy that combines assertiveness and cooperation?
A) Avoiding
B) Competing
C) Compromising
D) Accommodating
Answer: C
Q2) What is the role of the RT during a disaster situation?
A) Transporting the critically ill patients to safety first
B) Shutting off the main O<sub>2</sub> supply in the hospital
C) Getting themselves to safety
D) Going to look for a backup generator
Answer: A
Q3) Which of the following terms describes the power potential behind electrical energy?
A) Voltage
B) Current
C) Ohms
D) Resistance
Answer: A
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Chapter 4: Principles of Infection Prevention and Control
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Q1) Which of the following statements is NOT true regarding the use of soaps to clean equipment?
A) Soaps act by lowering the surface tension.
B) Soaps work poorly in hard water.
C) Soaps have good bactericidal activity.
D) Soaps can help remove organic material.
Q2) If you are caring for a patient who is suspected of having SARS, at what distance from the patient is it recommended to wear an effective filtration mask?
A) 6 ft
B) 10 ft
C) 12 ft
D) 15 ft
Q3) Which of the following characteristics is false for iodophors as disinfectants?
A) Water soluble
B) Nonstaining
C) Less irritating to tissue
D) Bacteriostatic
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Chapter 5: Ethical and Legal Implications of Practice
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Q1) When a practitioner performs a procedure that involves physical contact without the patient's consent, it can result in what charge?
A) Assault
B) Negligence
C) Battery
D) Slander
Q2) In tort law, what is "proximate causation"?
A) It turns on foreseeability to decide whether it is fair to impose damages on a defendant.
B) It helps keep record of all Medicare patients.
C) The collection of any needed evidence before filing charges.
D) It finds legal aid for those in need
Q3) A clinician who justifies support for withdrawing life support from a patient because "in the end, it would be best for all involved" 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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Q1) What is the change in state of a substance from liquid to gaseous form occurring below its boiling point?
A) Evaporation
B) Sublimation
C) Boiling
D) Vaporization
Q2) Which of the following occurs when the temperature of a gas rises?
1) The kinetic activity of the gas increases.
2) The rate of molecular collisions increases.
3) The pressure exerted by the gas rises.
A)1, 2, and 3
B)1 and 2 only
C)2 and 3 only
D)3 only
Q3) The peak pressure on a ventilator reads 40 cm H<sub>2</sub>O. What is the equivalent pressure in mm Hg?
A) 37.0 mm Hg
B) 29.6 mm Hg
C) 68.3 mm Hg
D) 4.9 mm Hg
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Chapter 7: E-Medicine in Respiratory Care
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Q1) Which of the following are ways health care workers and facilities conform to HIPPA regulations concerning securing patient confidentiality within electronic medical records?
1) Refraining from sharing passwords
2) Accessing electronic personal health information on a need-to-know basis
3) Utilizing thumbprint protected security
4) Allowing only close family members to view personal health information in the hospital computer
A)1 and 2 only
B)1, 3, and 4 only
C)1, 2, and 3 only
D)1, 2, 3, and 4
Q2) Therapists-driven protocols are used to:
A) extend the length of stay.
B) allocate and titrate respiratory care services.
C) resist automation of treatment based on patient data.
D) avoid confrontation with nurses regarding patient care.
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Chapter 8: Fundamentals of Respiratory Care Research
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Q1) 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
Q2) What search engine looks for scholarly publications in a wide range of fields and includes peer-reviewed manuscripts, abstracts, theses, and books from academic publishers, professional societies, and university libraries?
A) Medline.org
B) Google Scholar
C) Minimed.org
D) Cochrane.org
Q3) What are the three basic missions of academic medicine?
A) To research, to discover, and to publish
B) To research, to discover, and to cure disease
C) To heal, to teach, and to discover
D) To teach, to research, and to cure
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Chapter 9: The Respiratory System
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Sample Questions
Q1) Which of the following statements is false regarding the pulmonary circulation?
A) Pulmonary blood flow is highly dependent on gravity.
B) The pulmonary circulation is a low-pressure system.
C) Toward the top of the upright lung, blood flow is high.
D) Toward the top of the upright lung, blood flow is low.
Q2) Identify functions of airway mucus in the normal lung.
1) Increased mucus production decreases bronchospasm.
2) Protect the airways from excessive water loss.
3) Shield the airway from toxic particles.
4) Trap inhaled contaminants.
A)1, 2, and 3 only
B)2, 3, and 4 only
C)1 and 4 only
D)3 and 4 only
Q3) What is the function of the very small amount of pleural fluid that is found in the pleural space?
A) Composes part of anatomic shunt.
B) Liquid barrier for pathogens.
C) Part of pulmonary blood flow.
D) Reduces friction.
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Chapter 10: The Cardiovascular System
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Q1) An abnormal amount of fluid can accumulate between the layers of the pericardium resulting in which of the following?
A) Pericardial effusion
B) Pulmonary embolism
C) Atrial fibrillation
D) Premature ventricular contractions
Q2) The first heart sound is associated with what mechanical event of the cardiac cycle?
A) Atrioventricular valve closure
B) Atrioventricular valve opening
C) Semilunar valve closure
D) Semilunar valve opening
Q3) Which of the following statements is true?
A) Pulmonary vascular resistance (PVR) is equal to systemic resistance.
B) Pulmonary vasculature is a high-pressure, high-resistance circulation.
C) Systemic vascular resistance (SVR) is less than PVR.
D) SVR is normally approximately 10 times higher than PVR.
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Chapter 11: Ventilation
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Sample Questions
Q1) A normal 150-lb man is breathing at a rate of 17 with a tidal volume of 450 ml. By estimation, what is his approximate alveolar ventilation?
A) 7.65 L/min
B) 5.10 L/min
C) 3.85 L/min
D) 2.60 L/min
Q2) Total lung-thorax compliance in normal subjects is about what level?
A) 0.1 L/cm H<sub>2</sub>O
B) 0.2 L/cm H<sub>2</sub>O
C) 1.0 L/cm H<sub>2</sub>O
D) 2.0 L/cm H<sub>2</sub>O
Q3) Normal lung compliance is approximately which of the following?
A) 0.01 L/cm H<sub>2</sub>O
B) 0.20 L/cm H<sub>2</sub>O
C) 2.00 L/cm H<sub>2</sub>O
D) 10.00 L/cm H<sub>2</sub>O
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
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Chapter 12: Gas Exchange and Transport
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Q1) The time available for diffusion in the lung is mainly a function of which of the following?
A) Functional residual capacity (FRC)
B) Inspired O<sub>2</sub> concentration
C) Level of V<sub>A</sub>
D) Rate of pulmonary blood flow
Q2) At a PaO<sub>2</sub> of 65 mm Hg, what is the approximate saturation of Hb with O<sub>2</sub>?
A) 73%
B) 80%
C) 90%
D) 97%
Q3) What is the minimum amount of time that blood must take for pulmonary capillary transit for equilibration of O<sub>2</sub> to occur across the alveolar-capillary membrane?
A) 0.15 sec
B) 0.25 sec
C) 0.35 sec
D) 0.45 sec
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Chapter 13: Solutions, Body Fluids, and Electrolytes
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Q1) Which of the following is true regarding osmotic pressure?
A) Osmotic pressure depends on the number of particles in solution.
B) Osmotic pressure varies inversely with temperature.
C) Osmotic pressure is highest in dilute solutions.
D) Osmotic pressure varies inversely with tonicity.
Q2) What are the main intracellular electrolytes?
1) K<sup>+</sup>
2) Na<sup>+</sup>
3) Phosphate
4) Sulfate
A)1, 3, and 4 only
B)2, 3, and 4 only
C)1 and 2 only
D)1, 2, 3, and 4
Q3) What is the normal serum calcium concentration?
A) 4.5 to 5.3 mg/dl
B) 8.7 to 10.4 mg/dl
C) 98.0 to 105.0 mg/dl
D) 137 to 147 mg/dl
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Chapter 14: Acid-Base Balance
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Q1) Which of the following is/are cause(s) of hyperchloremic metabolic acidosis?
1) Hyperalimentation
2) Methanol intoxication
3) Severe diarrhea
4) NH<sub>4</sub>Cl administration
A)2 only
B)1 and 4 only
C)1, 3, and 4 only
D)1, 2, 3, and 4
Q2) A patient has a blood gas result of: pH 7.29, PaCO<sub>2</sub> of 60 mm Hg, and a HCO<sub>3</sub> of 18 mEq/L. What is the blood gas indicating?
1) It is indicating a combined acidosis.
2) Patient has a primary respiratory and a primary metabolic disorder.
3) Compensation is not possible.
A)3 only
B)1 and 2 only
C)2 and 3 only
D)1, 2, and 3
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Chapter 15: Regulation of Breathing
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Q1) Which statement(s) describe aspects of the Hering-Breuer reflex?
1) It affects the rate and depth of breathing during exercise.
2) It is only activated at large tidal volumes in normal adults.
3) Its impulses travel via the vagus nerve to the dorsal respiratory groups (DRGs).
4) Its receptors are located in the large and small airways.
A)1 only
B)1 and 2 only
C)2, 3, and 4 only
D)1, 2, 3, and 4
Q2) How should O<sub>2</sub> therapy be administered to chronically hypercapnic patients?
A) Avoid giving any supplemental O<sub>2</sub>.
B) Give as much O<sub>2</sub> as possible (60% to 100%).
C) Withhold O<sub>2</sub> until the patient is intubated.
D) Give as much O<sub>2</sub> as required to maintain adequate oxygenation.
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Chapter 16: Bedside Assessment of the Patient
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Q1) What disease is associated with a barrel chest?
A) Emphysema
B) Heart failure
C) Pneumonia
D) Pleural effusions
Q2) Which of the following factors has minimal or no impact on the effectiveness of the patient's cough?
A) Lung recoil
B) Airways resistance
C) Lung volume
D) Pulmonary vascular resistance
Q3) A patient with asthma would tend to exhibit which of the following?
A) Prolonged inhalation
B) Slow and shallow breathing
C) Prolonged exhalation
D) Deep and fast breathing
Q4) 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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Chapter 17: Interpreting Clinical and Laboratory Data
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Q1) What should be done in response to a sputum sample that has many epithelial cells in it?
A) Repeat Gram stain.
B) Sputum culture.
C) Sputum sensitivity.
D) Obtain new sputum sample.
Q2) What test is useful for evaluating the blood-clotting ability of your patient?
A) Red blood cell count
B) Platelet count
C) Neutrophil count
D) Hematocrit
Q3) Which of the following values represents a normal serum lactate level?
A) 0.7 to 2.1 mEq/L
B) 1.2 to 2.3 mEq/L
C) 1.7 to 2.1 mEq/L
D) 3.5 to 5.0 mEq/L
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Chapter 18: Interpreting the Electrocardiogram
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Q1) What medication is most useful for the treatment of premature ventricular contractions?
A) Digoxin
B) Atropine
C) Lidocaine
D) Digitalis
Q2) Which of the following waves represents depolarization of the ventricles?
A) P wave
B) QRS wave
C) T wave
D) U wave
Q3) What structure serves as the backup pacemaker for the heart?
A) Atrioventricular (AV) node
B) Sinoatrial (SA) node
C) Bundle of His
D) Purkinje fibers
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Chapter 19: Analysis and Monitoring of Gas Exchange
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Q1) The shape of the expired CO<sub>2</sub> tracing of a patient is normal but instead of being zero, the baseline is elevated to approximately 12 mm Hg. Which of the following is the most likely problem?
A) Patient disconnected from the system
B) Obstruction of the sampling tube
C) Rebreathing
D) Presence of N<sub>2</sub>O
Q2) Under ideal conditions, pulse oximeter readings patients usually fall in what range of those obtained with invasive hemoximetry?
A) 1% to 2%
B) 2% to 3%
C) 3% to 5%
D) 5% to 7%
Q3) Which of the following is not a common tissue injury to be on guard for at the site of transcutaneous blood gas electrode placement?
A) Erythema
B) Hematomas
C) Burns or blisters
D) Skin tears
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Chapter 20: Pulmonary Function Testing
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Q1) Which of the following adverse reactions is not typically seen with pulmonary function testing?
A) Syncope
B) Cough
C) Hemoptysis
D) Chest pain
Q2) Which of the following techniques are used to measure residual volume?
1) Helium dilution
2) Body plethysmography
3) Nitrogen washout
4) Flow-volume loops
A)2 and 4 only
B)1, 2, and 3 only
C)1, 2, 3, and 4
D)1, 3, and 4 only
Q3) What is the most common lung volume measured during spirometry?
A) Tidal volume
B) Vital capacity
C) Total lung capacity
D) Expiratory reserve volume
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Chapter 21: Review of Thoracic Imaging
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Q1) Which of the following statements is false regarding the use of the chest x-ray to detect a pneumothorax?
A) An expiratory film may be best for a small pneumothorax.
B) The standard chest film is of limited use in detecting a pneumothorax.
C) The film will show a lack of vascular markings in the affected region.
D) The lung margin is often visible with a pneumothorax.
Q2) Which of the following is not a typical cause of atelectasis?
A) Abdominal surgery
B) Rib fracture
C) Hepatomegaly
D) Pleurisy
Q3) What is the optimal position of the endotracheal tube following intubation as seen on the chest radiograph?
A) 1 to 2 cm above the carina
B) 3 to 4 cm above the carina
C) 5 to 7 cm above the carina
D) In the upper third of the carina
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Chapter 22: Flexible Bronchoscopy and the Respiratory Therapist
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Q1) What is the most difficult parameter to monitor during FB?
A) Depth of sedation
B) Airway pressure
C) Chest movement
D) Pulse oximetry
Q2) To obtain lavage fluid, the bronchoscope is wedged at which of the following locations?
A) The level of the carina
B) The level of second or third generation bronchus
C) The level of fourth or fifth generation bronchus
D) At least at the level of the sixth generation bronchus
Q3) Where should a bronchoalveolar lavage be obtained?
A) The nondependent part of the lung
B) The dependent part of the lung
C) The largest lobe of the lung affected
D) The smallest lobe of the lung affected
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Chapter 23: Nutrition Assessment
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Q1) What is the recommended measurement for nitrogen balance?
A) Blood urea nitrogen
B) Serum urea nitrogen
C) Urinary nitrogen
D) Urinary urea nitrogen
Q2) 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
Q3) What is the normal BMI for adults?
A) 15.5 to 20.6 kg/m<sup>2</sup>
B) 18.5 to 24.9 kg/m<sup>2</sup>
C) 20.6 to 25.9 kg/m<sup>2</sup>
D) 22.5 to 26.0 kg/m<sup>2</sup>
Q4) Which of the following is not associated with zinc deficiencies?
A) Poor blood clotting
B) Impaired wound healing
C) Bronchospasm
D) Reduced immunity
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Chapter 24: Pulmonary Infections
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Q1) What is an often-neglected but very important component of preventing transmission of pathogens between patients, particularly those who are ventilated?
A) Adequate antibiotic therapy
B) Brushing of teeth
C) Handwashing
D) Use of negative-pressure rooms
Q2) A 26 year-old seasonal worker from South America came to the ER with a history of a dry, hacking blood-tinged cough, fever, chills, and loss of appetite. The chest x-ray showed cavitary lesion in the right upper lobe. After a week in the hospital, the sputum culture shows the present of acid-fast stained organisms. Which of the following medications would you recommend for this patient at this time?
1) Ceftizoxime
2) Isoniazid
3) Rifampin
4) Ethambutol
A)1 only
B)2 and 4 only
C)1, 2, and 3 only
D)2, 3, and 4 only
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Chapter 25: Obstructive Lung Disease: Chronic Obstructive
Pulmonary Disease Copd, Asthma, and Related Diseases
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Q1) During an acute exacerbation of COPD, what is the role of IV methylprednisolone?
A) It accelerates recovery as noted in FEV<sub>1</sub>.
B) It causes pulmonary edema due to retention of water.
C) It causes severe immunosuppression and worsens outcomes.
D) It has been shown to have no effect.
Q2) A patient is experiencing an exacerbation of COPD. He is 65 years old, slim, and in notable distress with tachypnea, tachycardia, and an arterial blood pH of 7.29. Which of the following therapies would be most indicated?
A) Intrapulmonary percussive ventilation
B) Intubation and mechanical ventilation
C) Nasal CPAP
D) Noninvasive ventilation
Q3) What lung disease is the most common current indication for lung transplantation?
A) Adult respiratory distress syndrome
B) COPD
C) Pneumoconiosis
D) Pulmonary fibrosis
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Page 27
Chapter 26: Interstitial Lung Disease
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Q1) It is determined that a patient has silicosis. What profession is he most likely to have worked at?
A) Foundry worker
B) Talc manufacturer employee
C) Carpenter
D) Miller
Q2) What radiographic technique has the ability to better define the specific parenchymal characteristics associated with specific types of interstitial lung disease?
A) Bronchograms
B) High-resolution CT
C) MRI
D) Scans
Q3) What is the most common treatment for patients with idiopathic pulmonary fibrosis (IPF)?
A) Hyperbaric oxygen treatments
B) Lung transplantation
C) Penicillin
D) Prednisone
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28
Chapter 27: Pleural Diseases
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Q1) Describe a secondary spontaneous pneumothorax.
A) Pneumothorax that occurs secondary to cardiac complications
B) Pneumothorax that occurs without trauma or any underlying disease
C) Pneumothorax that results from nonpenetrating chest trauma
D) Pneumothorax that results from underlying lung disease
Q2) If accurate sizing on a pneumothorax is desired, what diagnostic technique would be most appropriate?
A) Chest radiography
B) Computed tomography
C) PET scan
D) Ultrasonography
Q3) Which of the following conditions is most closely associated with exudative pleural effusion?
A) Cirrhosis of the liver
B) Congestive heart failure
C) Nephrotic syndrome
D) Tuberculosis
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Chapter 28: Pulmonary Vascular Disease
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Q1) Which of the following arterial blood gas findings is seen in most patients with pulmonary embolism?
A) Hypercapnia
B) Hypoxemia
C) Low pH
D) Normal SaO<sub>2</sub>
Q2) Why is the use of oxygen to maintain oxygen saturations greater than 90% particularly important in the management of idiopathic pulmonary artery hypertension?
A) These patients have a low cardiopulmonary reserve.
B) Low alveolar oxygen causes vasoconstriction.
C) Many patients have central cyanosis.
D) These patients are especially susceptible to tissue hypoxia.
Q3) What is the fastest way to achieve therapeutic levels of heparin in the treatment of acute deep venous thrombi?
A) Continuous drip system
B) Follow established nomogram
C) Large bolus at 10 µg/kg
D) IV injections while tracking blood levels
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Chapter 29: Acute Respiratory Distress Syndrome
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Sample Questions
Q1) 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>
Q2) Which of the following risk factors for ARDS is classified as a nonpulmonary cause?
A) Toxic inhalation
B) Gastric aspiration
C) Near drowning
D) Sepsis
Q3) What is the name of the period that follows the exudative phase in ARDS?
A) Fibroproliferative
B) Transudative
C) Proliferative
D) Intraalveolar
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Chapter 30: Trauma, Burns and Near Drowning
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Sample Questions
Q1) Your patient is brought in by EMS after being pulled from a house fire. She is complaining of difficulty breathing, has burnt nasal hairs, soot in the oral pharynx, and stridor. The physician asks for a treatment suggestion regarding her respiratory needs. What would you suggest?
A) Racemic epinephrine
B) Hyperbaric oxygen therapy
C) Nonrebreathing mask at 15 L/min
D) Intubations and mechanical ventilation
Q2) Survival in burn patients is associated with which of the following?
A) Pharmacological treatment to improve hemodynamic stability
B) Conservative surgical treatments
C) Development of multidisciplinary teams
D) Delayed fluid resuscitation
Q3) How should tidal volume be determined for an obese patient?
A) Based on actual body weight
B) Based on predicted body weight
C) Based on chest rise
D) Based on arterial blood gas results
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Chapter 31: Lung Cancer
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Sample Questions
Q1) Approximately what percentage of all lung cancer is linked to smoking?
A) 50% to 55%
B) 70% to 75%
C) 85% to 90%
D) 100%
Q2) What is the treatment of choice for limited-stage small-cell lung cancer?
A) Surgical resection
B) Chemoradiotherapy
C) Radiation therapy only
D) Chemotherapy only
Q3) What is the number one cause of cancer-related death in the United States?
A) Leukemia
B) Lung cancer
C) Breast cancer
D) Brain cancer
Q4) Squamous cell carcinoma is composed of which of the following?
A) Glandular structures from lung scars
B) Common pulmonary stem cells
C) Flattened stratified epithelial cells
D) Multicentric stratified cells
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Chapter 32: Neuromuscular and Other Diseases of the
Chest Wall
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Sample Questions
Q1) Which of the following is often preceded by a history of upper respiratory or flulike symptoms?
A) Myotonic dystrophy
B) Polymyositis
C) Guillain-Barré syndrome
D) Amyotrophic lateral sclerosis
Q2) Which of the following is a clinical condition that typically does not precipitate rapid respiratory failure in patients with significant neuromuscular weakness?
A) Pulmonary edema
B) Pneumonia
C) Mucous plugging
D) Lung cancer
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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Page 34
Chapter 33: Disorders of Sleep
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Sample Questions
Q1) 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
Q2) Which of the following complaints is frequently seen in a patient with obstructive sleep apnea?
A) Dizziness
B) Chest pain
C) Shortness of breath with exertion
D) Excessive daytime sleepiness
Q3) What value for the apnea-hypopnea index (AHI) is consistent with moderate obstructive sleep apnea?
A) 5 to 15
B) 15 to 30
C) Above 30
D) Below 5
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Chapter 34: Neonatal and Pediatric Respiratory Disorders
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Sample Questions
Q1) Clinical findings associated with congenital diaphragmatic hernia include which of the following?
1) Severe cyanosis
2) Decreased breath sounds
3) Displaced heart sounds
4) Hepatomegaly
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 findings are typical for infants with bronchiolitis?
1) Stridor
2) Wheezing
3) Dyspnea
4) Tachypnea
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 35: Airway Pharmacology
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Sample Questions
Q1) Pentamidine is indicated for the treatment of which of the following diseases?
A) Pneumocystis jiroveci
B) Tuberculosis
C) HIV infection
D) Pneumococcal pneumonia
Q2) Which of the following anticholinergics is poorly ionized?
A) Atropine
B) Ipratropium bromide
C) Tiotropium bromide
D) Aclidinium bromide
Q3) Which of the following FEV<sub>1</sub> values indicates severe compromise of expiratory airflow that may contraindicate the use of mucoactive therapy?
A) Less than 65%
B) Less than 55%
C) Less than 35%
D) Less than 25%
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Chapter 36: Airway Management
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Sample Questions
Q1) An alert patient with a long-term need for a tracheostomy tube (because of recurrent aspiration) is having difficulty communicating with the intensive care unit staff.
Which of the following would you recommend to help this patient communicate better?
1) Use a letter, phrase, or picture board.
2) Consider switching to a fenestrated tracheostomy tube.
3) Consider a "talking" tracheostomy tube.
A)1 and 2 only
B)1 and 3 only
C)2 and 3 only
D)1, 2, and 3
Q2) What is the standard size for endotracheal or tracheostomy tube adapters?
A) 22-mm external diameter
B) 15-mm external diameter
C) 15-mm internal diameter
D) 22-mm internal diameter
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Chapter 37: Emergency Cardiovascular Life Support
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Sample Questions
Q1) What is the best way to increase CPR survival rates in the field?
A) Provide early defibrillation.
B) Start intravenous access immediately.
C) Get the patient to a hospital.
D) Immediately intubate the patient.
Q2) When are nasopharyngeal airways contraindicated?
1) When foreign body obstruction already exists
2) In neonatal/pediatric patients
3) In cases of trauma to the nasal region
4) When the jaws of a patient cannot be separated
A)2 and 4 only
B)2 and 3 only
C)2, 3, and 4 only
D)1, 2, and 3 only
Q3) How long will the apneic patient take to die without intervention?
A) 1 min
B) 3 to 5 min
C) 4 to 6 min
D) 10 to 20 min
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Chapter 38: Humidity and Bland Aerosol Therapy
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Sample Questions
Q1) Which of the following automatic feed systems are used to regulate water levels when using a humidifier with a continuous feed system?
1) Leveling reservoirs
2) Flotation controls
3) Optical sensors
A)2 and 3 only
B)1 and 2 only
C)1, 2, and 3
D)1 and 3 only
Q2) All mist tents prevent CO<sub>2</sub> build-up by what process?
A) Recirculating the gas
B) Providing high gas flows
C) Using CO<sub>2</sub> absorbers
D) Cooling the gas
Q3) What is the simplest way to increase the humidity output of a humidifier?
A) Increase the time that the gas and the water are in contact.
B) Increase the surface area between the water and the gas.
C) Decrease the water vapor pressure of the gas.
D) Increase the temperature of either the water or the gas.
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Page 40
Chapter 39: Aerosol Drug Therapy
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Sample Questions
Q1) Which of the following source gas characteristics affect the performance of small-volume jet nebulizers?
1) Humidity
2) Flow
3) Pressure
4) Viscosity
A)1 and 3 only
B)1, 2, and 3 only
C)3 and 4 only
D)2, 3, and 4 only
Q2) With which of the following devices are therapeutic aerosols generated?
1) Atomizers
2) Nebulizers
3) Humidifiers
4) Soft mist inhalers
A)1, 2, and 4 only
B)1 and 4 only
C)2 and 3 only
D)1, 2, 3, and 4
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Page 41
Chapter 40: Storage and Delivery of Medical Gases
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Sample Questions
Q1) Which of the following components are common to a standard compressed gas cylinder manifold system?
1) Automatic switch-over control
2) Pressure-reducing valves
3) Primary and reserve bank
4) Alarm system
A)1, 2, and 3 only
B)2 and 4 only
C)3 and 4 only
D)1, 2, 3, and 4
Q2) Which of the following statements regarding O<sub>2</sub> are true?
1) It is only slightly soluble in water.
2) It is odorless and transparent.
3) It is flammable.
4) It is heavier than air.
A)1 and 3 only
B)1, 2, and 4 only
C)3 and 4 only
D)1, 2, 3 only
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Chapter 41: Medical Gas Therapy
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Sample Questions
Q1) Which of the following is consistent with the radiographic appearance after prolonged exposure to O<sub>2</sub>?
A) Air bronchograms
B) Pulmonary abscess
C) Patchy infiltrates
D) Pneumothorax
Q2) A 52-year-old man is admitted to the hospital emergency department with a primary complaint of severe radiating chest pain and signs of central cyanosis. The attending asks for your advice on selecting a device that provides a moderate FiO<sub>2</sub> for this patient. Which of the following would you recommend?
A) Simple O<sub>2</sub> mask at 8 L/min
B) Air-entrainment mask at 40% O<sub>2</sub>
C) Nasal cannula at 5 L/min
D) Nonrebreathing mask at 10 L/min
Q3) What is the upper limit of O<sub>2</sub> concentrations available through tents?
A) 60% to 70%
B) 50% to 60%
C) 40% to 50%
D) 30% to 40%
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Page 43
Chapter 42: Lung Expansion Therapy
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Sample Questions
Q1) Which of the following modes of lung expansion therapy is physiologically most normal?
A) Continuous positive airway pressure
B) Incentive spirometry
C) Positive end expiratory pressure
D) Intermittent positive-pressure breathing therapy
Q2) Persistent breathing at small tidal volumes typically results in which of the following?
A) Reabsorption atelectasis
B) Spontaneous pneumothorax
C) Compression atelectasis
D) Respiratory alkalosis
Q3) In observing a postoperative woman conduct incentive spirometry, you note repetitive performance of the sustained maximal inspiration maneuver at a rate of approximately 10 to 12/min. Which of the following would you recommend to her?
A) Decrease the treatment frequency to 4 times/day.
B) Increase her breathing rate to 12 to 15/min.
C) Take a 30-sec rest period between breaths.
D) Repeat the treatment every 30 min.
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Chapter 43: Airway Clearance Therapy Act
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Sample Questions
Q1) If a patient's chest radiograph shows infiltrates in the posterior basal segments of the lower lobes, what postural drainage position would you recommend?
A) Head down, patient supine with a pillow under knees
B) Patient prone with a pillow under head, bed flat
C) Patient supine with a pillow under knees, bed flat
D) Head down, patient prone with a pillow under abdomen
Q2) Which of the following are true of postural drainage?
1) It is most effective in disorders causing excessive sputum.
2) It is most effective in head-down positions greater than 25 degrees.
3) It requires adequate systemic hydration to be effective.
4) It improves mucociliary clearance in normal subjects.
A)2 and 4 only
B)1, 2, and 3 only
C)3 and 4 only
D)1, 2, and 4 only
Q3) 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
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Chapter 44: Respiratory Failure and the Need for
Ventilatory
Support
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Sample Questions
Q1) Mr. Adam is in the ICU on an FiO<sub>2</sub> of 100%. An arterial blood gas reveals the following information: pH of 7.18, PaCO<sub>2</sub> of 59 mm Hg, PaO<sub>2</sub> of 65 mm Hg, HCO<sub>3</sub> of 24 mEq/L What action would you recommend?
A) Provide ventilatory support.
B) Put patient on steroids.
C) Give patient chest PT.
D) Put patient on CPAP.
Q2) What is respiratory failure due to inadequate ventilation?
A) Hypoxemic
B) Hypercapnic
C) Compensated
D) Chronic
Q3) Which of the following MIP measures taken on an adult patient indicates inadequate respiratory muscle strength?
A) -90 cm H<sub>2</sub>O
B) -70 cm H<sub>2</sub>O
C) -40 cm H<sub>2</sub>O
D) -15 cm H<sub>2</sub>O
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Chapter 45: Mechanical Ventilators
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Sample Questions
Q1) To describe what happens during the expiratory phase of mechanical ventilation, you must know the value of which variable?
A) Limit
B) Cycle
C) Trigger
D) Baseline
Q2) Flow serves as a limit variable whenever a ventilator controls what?
A) Pressure
B) Flow
C) Time
D) Volume
Q3) A ventilator can derive its input power from which of the following sources?
1) Alternating current (AC) electricity
2) Battery
3) Pneumatic
A)1 and 2 only
B)1 and 3 only
C)2 and 3 only
D)1, 2, and 3
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Page 47
Chapter 46: Physiology of Ventilatory Support
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Sample Questions
Q1) During pressure-targeted modes of ventilatory support, the volume delivered depends on which of the following?
1) Set pressure limit
2) Patient lung mechanics
3) Patient effort
A)1 and 2 only
B)1 and 3 only
C)2 and 3 only
D)1, 2, and 3
Q2) In which of the following types of ventilation can pleural pressure become positive during inspiration?
1) Positive-pressure ventilation
2) Spontaneous ventilation
3) Negative-pressure ventilation
A)2 and 3 only
B)1 and 2 only
C)1, 2, and 3
D)1 only
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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) Which of the following is considered a patient-related cause of poor patient-ventilator interaction?
A) Abnormal respiratory drive
B) Asynchrony
C) Inadequate ventilatory support
D) Inadequate FiO<sub>2</sub>
Q3) Your patient's clinical status abruptly changed and the alarms on the ventilator are sounding. What is/are the first step(s) you should take?
A) Silence the alarms and adjust the alarm parameters.
B) Perform a rapid physical examination.
C) Remove the patient from the ventilator and manually ventilate.
D) Check the patency of the airway.
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Chapter 48: Initiating and Adjusting Invasive Ventilatory Support
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Sample Questions
Q1) Beneficial effects of using high inspiratory flows in patients with chronic airflow obstruction receiving flow-limited mechanical ventilation include which of the following?
1) Decreased work of breathing
2) Improved gas exchange
3) Decreased auto-PEEP
A)1 and 2 only
B)1 and 3 only
C)2 and 3 only
D)1, 2, and 3
Q2) Which of the following statements are true regarding the use of controlled ventilation?
1) May allow the muscles of breathing to rest.
2) Can use larger 1:E ratio and may improve oxygenation.
3) Requires use of paralytic agents in spontaneously breathing patients.
4) Therapist has little control of needed inspiratory flow and pressure.
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 49: Noninvasive Ventilation
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Sample Questions
Q1) 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
Q2) Which of the following are potential benefits of using noninvasive ventilation (NIV) during weaning?
1) Reduced length of intensive care unit (ICU) stay
2) Reduced incidence of nosocomial pneumonia
3) Reduced mortality rate
4) Reduced incidence of pulmonary embolism
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 50: Extracorporeal Life Support Ecls
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Sample Questions
Q1) Your patient is receiving ECMO and requires frequent medications. IV access is limited. The physician asks for your recommendations on ways to improve the ease of medication delivery. What would you suggest?
A) Establish intraosseous (IO) access.
B) Deliver the medications down the endotracheal tube.
C) Utilize the infusion ports along the tubing.
D) Aerosolize the medications.
Q2) What is a major advantage of ECMO?
A) Mortality rate is much lower than conventional ventilation.
B) The need for hemodynamic monitoring is reduced.
C) It can be used on premature infants less than 28 weeks.
D) The potential of ventilator induced lung injury is reduced.
Q3) Why is anticoagulation required during ECMO?
A) Patients are at risk for DVTs due to immobility.
B) The body tends to activate coagulation when exposed to the nonbiologic surfaces of the cannulas and circuit.
C) Coagulation is suppressed during ECMO.
D) Mechanical ventilation during ECMO causes thrombocytopenia.
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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 associated with an increase in central venous pressure?
1) Right heart failure
2) Pulmonary valvular stenosis
3) Pulmonary embolism
4) Dehydration
A)1 and 3 only
B)1, 2, and 3 only
C)2 and 4 only
D)1, 2, 3, and 4
Q2) Which of the following physical findings is not consistent with starvation?
A) Temporal muscle wasting
B) Sunken supraclavicular fossae
C) Decreased adipose stores
D) Less than 50 ml/day
Q3) What is the average total work of breathing for healthy persons?
A) 0.31 to 0.2 J/L
B) 0.3 to 0.5 J/L
C) 0.5 to 0.8 J/L
D) 0.8 to 1.5 J/L
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Chapter 52: Discontinuing Ventilatory Support
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Sample Questions
Q1) In considering a patient for extubation, which of the following would you recommend to minimize the risk of postextubation aspiration?
A)Perform and confirm a positive cuff leak test.
B)Discontinue (DC) tube feeding 4 to 6 hr before extubation.
C)Perform deep endotracheal suctioning before extubation.
D)Keep the cuff inflated when removing the tube.
Q2) The physician has requested that the respiratory therapist determine a patient's rapid shallow breathing index (RSBI) before placing the patient on PSV. The patient has a respiratory rate of 32/min and VT of 300 ml. What is the patient's RSBI?
A) 107
B) 110
C) 112
D) 114
Q3) Above what pressure-time index (PTI) will most patients be unable to sustain spontaneous breathing?
A) 0.03
B) 0.05
C) 0.10
D) 0.15
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Page 54
Chapter 53: Neonatal and Pediatric Respiratory Care
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Sample Questions
Q1) In high-frequency ventilation (HFV), CO<sub>2</sub> elimination depends mainly on which of the following?
A) Pressure amplitude
B) Mean airway pressure
C) High-frequency rate
D) Sinusoidal waveform
Q2) What is the recommended dose of inhaled NO?
A) 10 ppm
B) 20 ppm
C) 30 ppm
D) 40 ppm
Q3) What V<sub>T</sub> range should be used for mechanical ventilation of a neonate?
A) 5 to 7 ml/kg
B) 6 to 8 ml/kg
C) 8 to 10 ml/kg
D) 10 to 12 ml/kg
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Chapter 54: Patient Education and Health Promotion
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Sample Questions
Q1) What concept will be most emphasized in teaching new skills to patients?
A) Handouts and illustrations
B) Repetition
C) Proper evaluation
D) Use of a pretest
Q2) Teaching physical skills to patients is learning in what domain?
A) Cognitive
B) Affective
C) Psychomotor
D) Analytical
Q3) Which of the following examples of health care represents tertiary prevention?
A) Pulmonary rehabilitation
B) Mammogram
C) Immunization
D) Bronchial provocation testing
Q4) Which of the following is used to evaluate cognitive objectives?
A) Verbal exam
B) Demonstration
C) Written exam
D) Performance checklist
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Chapter 55: Cardiopulmonary Rehabilitation
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Sample Questions
Q1) Which of the following are differences between cardiac and pulmonary rehabilitation?
1) Cardiac patients are typically younger.
2) Most cardiac patients are not able to walk for 1 hr.
3) Reimbursement is easier to obtain with cardiac rehabilitation.
4) Breathing exercises are not essential to cardiac patients.
A)1 and 2 only
B)2 and 3 only
C)1, 3, and 4 only
D)1, 2, and 3 only
Q2) Absolute contraindications for conducting a cardiopulmonary exercise evaluation include which of the following?
1) Diastolic blood pressure greater than 110 mm Hg
2) Serious cardiac arrhythmias
3) Unstable angina
4) Recent myocardial infarction
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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Page 57
Chapter 56: Respiratory Care in Alternative Settings
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Sample Questions
Q1) Which of the following are first-line aerosol drug delivery systems for home care patients?
1) Small volume nebulizer
2) Dry powder inhaler
3) Metered dose inhaler
A)1 and 2 only
B)2 and 3 only
C)1 and 3 only
D)1, 2, and 3
Q2) What is the purpose of the small refillable liquid O<sub>2</sub> tank that comes with many stationary home liquid O<sub>2</sub> reservoirs?
A) To provide O<sub>2</sub> to ambulatory patients outside the home
B) To serve as a backup should the primary reservoir fail
C) To collect and save gas vented by the primary reservoir
D) To provide higher flows for patients requiring high FiO<sub>2</sub> values
Q3) What is the most common respiratory home care modality?
A) Aerosol therapy
B) Mechanical ventilation
C) O<sub>2</sub> therapy
D) Nasal continuous positive airway pressure (CPAP)
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