Medical Screening for Physical Therapists
Textbook Exam Questions
Course Introduction
Medical Screening for Physical Therapists is designed to equip students with the knowledge and skills necessary to identify signs and symptoms that may indicate underlying medical conditions beyond the scope of physical therapy. The course covers the principles and processes of differential diagnosis, red and yellow flag identification, and decision making for appropriate referral to other healthcare professionals. Emphasis is placed on systematic patient evaluation, interpretation of clinical findings, and the use of evidence-based guidelines to ensure patient safety, optimize outcomes, and contribute effectively as part of an interdisciplinary healthcare team.
Recommended Textbook
Cardiovascular and Pulmonary Physical Therapy Evidence to Practice 5th Edition by Donna Frownfelter
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2
Chapter 1: Epidemiology As a Basis for Informing Contemporary
Physical Therapy Practice
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Sample Questions
Q1) Major modifiable risk factors of cardiovascular and peripheral vascular disease include smoking,physical inactivity,obesity,high blood pressure,and:
A) sick sinus syndrome.
B) elevated glucose levels.
C) genetic cardiac markers.
D) dietary calcium levels.
Answer: B
Q2) Failure of traditional models of health education in reducing the prevalence of lifestyle-related conditions and their risk factors has been thought to be attributable to:
A) the personal, bidirectional model of delivery.
B) establishing rapport, trust, commitment, and follow-up.
C) understanding beliefs, timing, readiness to change, and barriers.
D) a unidirectional model of information delivery.
Answer: D
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3
Chapter 2: Oxygen Transport: the Basis of Cardiovascular and Pulmonary Physical Therapy
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Q1) Concerning the process of oxygen transport,all of the following are essential to the process except:
A) cellular uptake of oxygen.
B) utilization of oxygen in the tissue.
C) delivery of fully oxygenated blood to the peripheral tissue.
D) return of oxygenated blood to the lungs for exchange.
Answer: D
Q2) Plasma is an extracellular fluid found in the bloodstream.This fluid is composed of protein and fibrinogen.How much protein is in plasma?
A) 17% albumin
B) 7% albumin
C) 10% albumin
D) 35% albumin
Answer: C
Q3) What is the normal hematocrit value for women?
A) 38%
B) 40%
C) 42%
D) 44%
Answer: A
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Chapter 3: Cardiovascular and Pulmonary Anatomy
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Q1) While dining with friends,a young lady begins to choke and eventually becomes unconscious.Given the anatomy of the tracheobronchial tree,you would determine the foreign object was most likely in the portion of the lung.
A) trachea
B) right mainstem bronchus
C) left mainstem bronchus
D) esophagus
Answer: B
Q2) The accessory action of the trapezius muscles is said to be:
A) inspiration.
B) expiration.
C) both inspiration and expiration.
D) neither inspiration nor expiration.
Answer: D
Q3) The accessory action of the internal intercostal muscles is said to be:
A) inspiration.
B) expiration.
C) both inspiration and expiration.
D) neither inspiration nor expiration.
Answer: C
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Chapter 4: Cardiovascular and Pulmonary Physiology
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Q1) It is known that red blood cells contain hemoglobin and that hemoglobin has an affinity for oxygen.It is also know that oxygen dissolves into the bloodstream.What factor describes why the oxygen saturation in arterial oxygenated blood not 100%?
A) The oxygen saturation curve
B) High arterial pressure
C) Coronary and pulmonary circulation
D) The brain takes oxygen first
Q2) All of the following factors can affect ventilation and perfusion matching in the cardiovascular and pulmonary system except:
A) smoking history.
B) posture.
C) body position.
D) disease.
Q3) If the pneumotaxic center is compromised,the resulting breathing pattern would be known as:
A) pneumotaxic respiration.
B) apneustic breathing.
C) pneumotaxic breathing.
D) apneustic respiration.
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Page 6
Chapter 5: Cardiovascular and Pulmonary Pathophysiology
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Q1) Bullae present in the lungs of patients with chronic obstructive pulmonary disease (COPD)because of:
A) increased elasticity and compliance in the lung
B) decreased elasticity and alveolar hyperinflation
C) increased elasticity and alveolar hypoinflation
D) decreased elasticity and compliance in the lung
Q2) Patients seen after having a myocardial infraction (MI)recover at various rates depending on the complicated versus uncomplicated nature of the MI.What is the most important factor for determining the prognosis of a patient for a physical therapist planning a rehabilitation program for that patient after MI?
A) Persistence of angina
B) Extent of ventricular damage
C) Use of nitrates versus antiarrhythmic agents
D) Pre-insult exercise intensity
Q3) Systemic hypertension presents with:
A) stiff peripheral arteries and dilated arterioles.
B) stiff central arteries and dilated arterioles.
C) normal peripheral arteries and constricted arterioles.
D) stiff central arteries and stiff peripheral arteries.
Page 7
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Chapter 6: Cardiovascular and Pulmonary Manifestations of Systemic Conditions
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Q1) A physical therapist is conducting a systems review of a potential patient with a history of alcohol abuse.During the conversation,the patient reveals the onset of increasing difficulty getting cuts and nosebleeds to clot.What should the therapist do?
A) Instruct the patient to take more iron.
B) Question the patient about his or her medications.
C) Advise the patient to stop taking aspirin.
D) Consider liver dysfunction and consult with the physician.
Q2) Reduced lung compliance resulting from an increased fibrotic event of the lung parenchyma would be related to changes of what origin?
A) Musculoskeletal conditions
B) Neurologic conditions
C) Gastrointestinal conditions
D) Connective tissue conditions
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8
Chapter 7: Measurement and Documentation
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Q1) Which best describes ratio measurements?
A) Measurements that have units on a scale with equal distance between consecutive measurements and an arbitrary zero point
B) Measurements that have scales with units that are equal in size and have a zero point that indicates absence of the attribute being measured
C) Measurements that are categorized or ranked
D) Measurements that have no rank or order
Q2) Which best describes validity?
A) A measurement that is ordered or ranked
B) The consistency or reproducibility of a measurement
C) Measurements that provide meaningful information and accurately reflect the characteristic for which the measure is intended
D) A measurement that has a high level of relative error
Q3) Which is the best example of a ratio measurement?
A) 0° Celsius
B) A classification of heart failure
C) 0° Kelvin
D) Grade 1 angina
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9
Chapter 8: History
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Q1) Which is true regarding wheezing?
A) Wheezing in cardiac patients is a manifestation of widened airways and thickened bronchial walls as a result of pulmonary edema.
B) Is commonly caused by laryngotracheal narrowing from a tracheostomy scar, trauma of intubation, laryngeal paralysis, epiglottitis, or tumors.
C) It's de ned as shortness of breath at rest but not during exertion.
D) If rst reported in patients older than the age of 40 years, is often related to heart failure.
Q2) Which is true regarding paroxysmal nocturnal dyspnea (PND)?
A) The patient usually falls asleep in the sitting position and 1 or 2 hours later, awakens from sleep with acute shortness of breath.
B) The mechanism of PND is the transfer of fluid from intravascular tissues into the bloodstream (or extravascularly) during sleep.
C) Classic PND is resolved by elevating the lower extremities in the supine position.
D) This symptom has strong predictive value as a sign of CHF.
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10
Chapter 9: Pulmonary Function Tests
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Q1) Which is not true regarding total lung capacity (TLC)?
A) TLC is the amount of gas the lung contains at the end of a maximum inspiration.
B) A decrease in TLC may be seen in restrictive lung disease, such as pulmonary brosis.
C) It is made up of inspiration capacity (IC) and functional residual capacity (FRC).
D) An increase in TLC may be seen in atelectasis, neoplasms, pleural effusions, and hemothorax.
Q2) Which best describes a restrictive condition of the lungs?
A) A condition that relates to restrictions in exhalation airflow
B) A condition that limits the amount of volume coming into the lungs
C) A condition that increases air volume coming into the lungs
D) A condition that increases the volume in exhalation
Q3) What can occur when the dead space of the lungs increases?
A) A larger percentage of the tidal volume is ventilating the dead space, leaving a smaller percentage for alveolar ventilation.
B) The patient does not have to work as hard to fill the alveoli.
C) There is better lung perfusion.
D) Patient fatigue lessens.
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11
Chapter 10: Arterial Blood Gases
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Q1) What is the purpose of hemoglobin?
A) It is crucial for oxygen transport.
B) It is crucial for carbon dioxide transport.
C) It is crucial for H CO transport.
D) It is unable to cross the capillary membrane.
Q2) What is the main route for the body to expel normal metabolic acids?
A) The skin
B) The lungs
C) The kidneys
D) The gastrointestinal tract
Q3) Which of the following is true regarding the partial pressure of carbon dioxide (Pco )?
A) If the Pco is above 45 mm Hg, the patient is hyperventilating.
B) If the Pco is below 35 mm Hg, the patient is said to be hypoventilating.
C) If the Pco is below 35 mm Hg, the patient is said to be hyperventilating.
D) Normal Pco values are 55 to 65 mm Hg.
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12
Chapter 11: Imaging of the Chest
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Q1) When assessing the skeleton on a chest radiograph,what should you look for?
A) Facet joint alignment
B) Sacroiliac alignment
C) Stenosis
D) Fractures
Q2) On a radiograph,what does the white area represent?
A) Pockets of air within the body
B) Fatty areas within the body
C) Muscle and other soft tissues
D) Bones within the body
Q3) Which is not true regarding inspiratory effort and radiograph imaging?
A) Patients are asked to take a deep breath at the time of the radiograph.
B) Deep inspiration should make it possible to visualize 10 to 12 ribs within the thoracic cavity.
C) A radiograph is taken during inspiration will show the ribs appearing very close together.
D) It can give you a quick guide as to your patient's respiratory ability.
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13
Chapter 12: Electrocardiogram Identification
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Q1) A premature junctional complex (PJC)has which of the following characteristics?
A) An ectopic focus in the atria causing spontaneous depolarization
B) A run of P waves preceded by a QRS complex
C) A later and later appearance of the R wave
D) No associated P wave or one that is inverted followed or preceded by a QRS complex
Q2) What is the normal spontaneous depolarization of the SA node?
A) 60 to 100 beats/min
B) 80 to 100 beats/min
C) 60 to 120 beats/min
D) 80 to 120 beats/min
Q3) Which of the following causes the absolute refractory period during depolarization?
A) An influx of Ca² ions
B) An influx of Na ions
C) The lack of an ion gradient for potential discharge
D) The increased ion gradient
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Chapter 13: Multisystem Assessment and Laboratory Investigations
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Q1) Which of the following is likely to result from an increase in thyroid hormones?
A) Decrease in the rate and depth of breathing
B) Increased appetite and food intake
C) Decreased gastrointestinal motility
D) None of the above
Q2) Which test is used to assess bleeding capacity?
A) Thrombin time
B) Capillary filling time
C) CBC
D) BUN
Q3) Which test is used to diagnose and monitor the treatment of acute pancreatitis?
A) CBC
B) Amylase test
C) Electrolyte levels
D) Creatinine test
Q4) What is a normal hemoglobin value for a man?
A) 10 g/dL
B) 15 g/dL
C) 20 g/dL
D) 25 g/dL
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Chapter 14: Special Tests
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Q1) Which type of contractile dysfunction delineated by myocardial perfusion imaging is the result of prolonged ischemia?
A) Myocardial stunning
B) Congestive heart failure
C) Hibernating myocardium
D) All of the above
Q2) Which testing is performed with FDG isotopes as a diagnostic tool for pulmonary nodules and mass lesions?
A) PET
B) Gallium scintigraphy
C) Ventilation-perfusion lung scan
D) Angiography
Q3) Which of the following-the modality of choice for pericardium evaluation-also allows the measurement of right and left ventricular volumes,ejection fraction,and cardiac output?
A) CT
B) MRI
C) Radiography
D) Echocardiography
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Page 16
Chapter 15: Clinical Evaluation and Assessment of the
Cardiovascular and Pulmonary
Systems
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Q1) What is the normal respiratory rate for newborns?
A) 14 to 20 breaths/min
B) 15 to 25 breaths/min
C) 20 to 40 breaths/min
D) 30 to 60 breaths/min
Q2) Which breath sounds are described as high pitched and are distinguished by a pause that exists between the inspiratory and expiratory phases that are heard?
A) Bronchial
B) Bronchovesicular
C) Vesicular
D) Adventitious
Q3) Which voice sound phenomenon distorts the "e" sound so that an "aaa" sound is heard over the peripheral lung area?
A) Bronchophony
B) Egophony
C) Whispered pectoriloquy
D) Wheezing
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Page 17
Chapter
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Q1) What is the normal value of mixed venous oxygen saturation (SvO )?
A) Less than 60%
B) 65%
C) 75%
D) Above 80%
Q2) What is the normal range for PaO in young adults in the upright seated position?
A) 70 to 85 mm Hg
B) 85 to 95 mm Hg
C) 90 to 100 mm Hg
D) 100 to 110 mm Hg
Q3) What is the normal range for pulmonary artery pressure (PAP)?
A) 7 to 12 mm Hg
B) 15 to 20 mm Hg
C) 20 to 30 mm Hg
D) 30 to 35 mm Hg
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18
Chapter 17: Maximizing Outcomes: Relating Interventions to an Individuals Needs
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Q1) Clinical reasoning is the process of critically analyzing the patient's status with respect to the individual's:
A) environmental context.
B) psychological context.
C) cultural context.
D) all of the above.
Q2) Three modalities that enhance the prescribed interventions over the short and long term are:
A) bronchodilators, antihypertensives, and mucolytics.
B) mobilization, body positioning, and manual techniques.
C) breathing, coughing, and suctioning.
D) weights, pulleys, and incentive spirometry.
Q3) The three primary levels of analysis are:
A) structure and function, ability, and participation in life.
B) physical barriers, assessment, and activities.
C) limitations, deficits, and patient symptoms.
D) occupation, activities, and facilitating factors.
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Page 19
Chapter 18: Mobilization and Exercise: Physiological Basis for Assessment,
evaluation, and Training
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Q1) It is essential that the physical therapist be able to:
A) estimate the limits of a patient's physiological tolerance for mobilization.
B) adapt the prescription based on the patient's needs.
C) identify the specific effects of exercise required and define the optimal therapeutic stimulus.
D) manage patients who are acutely ill.
Q2) Exercise refers it's prescription in the management of:
A) musculoskeletal and pulmonary dysfunction.
B) neurologic and pulmonary dysfunction.
C) subacute and chronic cardiovascular or pulmonary dysfunction.
D) subacute and chronic musculoskeletal or neurological dysfunction.
Q3) Whenever possible,mobilization is performed in the:
A) supine position.
B) prone position.
C) upright position.
D) recumbent position.
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Chapter 19: Mobilization and Exercise: Testing and Training
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Q1) Because of the marked changes that can be expected with body positioning and body positioning changes,the physical therapist has a narrow window of opportunity to assess and:
A) treat the patient before, during, and after position changes.
B) treat the patient after position changes.
C) treat the patient before and during position changes.
D) treat the patient before position changes.
Q2) Positioning patients between treatments can contribute as much to the overall treatment response as the treatment itself because:
A) the patient spends more time in the before-treatment positions than in the within-treatment positions.
B) the patient spends the same amount of time in the between-treatment positions as in the within-treatment positions.
C) the patient spends more time in the within-treatment positions than in the between-treatment positions
D) the patient spends more time in the between-treatment positions than in the within-treatment positions.
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Chapter 20: Body Positioning
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Q1) The oscillation of the intrapulmonary percussive ventilation device is delivered:
A) internally through a valve.
B) externally through a valve.
C) internally through a mouthpiece.
D) externally through a mouthpiece.
Q2) Another name for percussion,which is a traditional approach to secretion mobilization,is:
A) rhythmic stabilization.
B) mechanical tapping.
C) chest therapy.
D) chest clapping.
Q3) All of the following refer to bronchial hygiene techniques EXCEPT:
A) chest physical therapy.
B) tracheal tapping.
C) bronchial drainage.
D) chest physiotherapy.
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Chapter 21: Airway Clearance Techniques
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Q1) Positive expiratory pressure creates a backpressure to stent the airways open during:
A) diaphragmatic respiration.
B) inhalation.
C) collateral ventilation.
D) exhalation.
Q2) The process of prescribing an appropriate technique for secretion mobilization should be ongoing,with periodic:
A) increased frequency.
B) equipment checks.
C) reevaluation of the method.
D) patient/caregiver education.
Q3) The aim of loosening retained secretions by the use of percussion is so that:
A) they can be sent to the laboratory for culturing.
B) they may be removed by suctioning or expectoration.
C) they can be picked up and removed by the lymphatic system.
D) they may be redirected through collateral circulation.
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Chapter 22: Facilitating Airway Clearance With Coughing Techniques
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Q1) A complete lack of glottal closure will not produce any cough or sound because:
A) pulmonary function has been compromised.
B) the vocal folds are not approximating (adducting).
C) respiratory function has been compromised.
D) the focal folds are not separating (abducting).
Q2) Patients with asthma and emphysema tend to go into an expiratory wheeze when they:
A) overexert themselves.
B) are in a prone position for too long.
C) force and prolong exhalation.
D) force and prolong inhalation.
Q3) A clinician may pick a modified sitting position for a patient with:
A) a neurologic disorder.
B) generalized weakness.
C) musculoskeletal dysfunction.
D) generalized numbness of the extremities.
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24
Chapter 23: Facilitating Ventilation Patterns and Breathing Strategies
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Q1) The trapezius muscle assists in superior expansion of the: A) chest.
B) throat.
C) diaphragm.
D) trachea.
Q2) Normal breathing,repeated rhythmic inspiratory-expiratory cycles,is known as: A) eupnea.
B) hyperpnea.
C) apnea.
D) Cheyne-Stokes respiration
Q3) Positioning the patient for respiratory success is important before beginning the patient's therapy or daily-living activities.All of the following positions are associated with the respiratory pattern EXCEPT:
A) trunk flexion.
B) trunk extension.
C) shoulder adduction, internal rotation.
D) shoulder abduction, external rotation.
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Chapter 24: Exercise Testing and Training: Primary
Cardiopulmonary Dysfunction
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Q1) In individuals with severe disease,exercise intolerance may reflect limited _____________ and oxygen extraction caused by the disproportionate demand on the respiratory muscles.
A) peripheral circulation
B) central circulation
C) peripheral profusion
D) central profusion
Q2) Prevention and rehabilitation programs are aimed at reducing an individual's cardiac risk factors.All of the following are factors that can change from participation EXCEPT:
A) age.
B) smoking.
C) blood pressure.
D) cholesterol level.
Q3) Type 2 diabetes mellitus is a strong risk factor for:
A) sudden cardiac death.
B) coronary artery disease.
C) neither a nor b.
D) both a and b.
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Chapter 25: Exercise Testing and Training: Secondary
Cardiopulmonary Dysfunction
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Q1) Secondary cardiopulmonary dysfunction refers to dysfunction of the cardiopulmonary system that is a consequence of pathology other than primary chronic heart and lung disease.All of the following are examples EXCEPT:
A) endocrine.
B) hematologic.
C) connective tissue.
D) cardiomegaly.
Q2) The exercise limitations of individuals with connective tissue conditions result in part from the restrictive component associated with which of the following body systems?
A) Pulmonary
B) Circulatory
C) Muscular
D) Neurologic
Q3) Individuals with rheumatoid arthritis have a higher incidence of:
A) musculoskeletal disease.
B) neuromuscular disease.
C) pulmonary disease.
D) cardiovascular disease.
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Chapter 26: Respiratory Muscle Training
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Q1) Diaphragm fatigue can occur during:
A) intermittent low-intensity exercise.
B) intermittent high-intensity exercise.
C) sustained high-intensity exercise.
D) sustained low-intensity exercise.
Q2) Respiratory muscle weakness is often observed in patients with:
A) asthma.
B) chronic bronchitis.
C) acute respiratory failure.
D) chronic obstructive pulmonary disease (COPD).
Q3) Inspiratory muscles are mainly involved in:
A) repetitive contractions with high-intensity training strategies.
B) repetitive contractions with low-intensity training strategies.
C) repetitive contractions with high intensity and endurance.
D) repetitive contractions with low intensity and endurance.
Q4) Inspiratory and expiratory training enhances the:
A) respiratory muscle in patients with Parkinson disease.
B) neuromuscular junction in patients with neuromuscular disease (NMD).
C) respiratory muscle performance in patients with chronic heart failure (CAD).
D) respiratory muscle performance in patients with neuromuscular disease (NMD).
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Chapter 27: Complementary Therapies As
Cardiopulmonary Physical Therapy Interventions
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Q1) Rolfing is an approach that uses a:
A) light touch to balance energy flow, partly by balancing the flow of cerebral spinal fluid during its circulation around the meninges of the cranium and down the spinal column
B) deep connective tissue massage to loosen fascial restrictions and line up the structure of bones, muscles and organs so the body has a more vertical relation to gravity
C) form of hands-on therapy with the goal being to enhance relaxation and emotional awareness
D) manipulation of tissue through the skin with the intention of bringing about a change in the present condition of the mind/body
Q2) Complementary and alternative medical (CAM)therapies alter the mechanics of the:
A) musculoskeletal pump of the thorax
B) cardiopulmonary system
C) nervous system
D) spinal cord
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Chapter 28: Patient Education
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Q1) The specific content of patient education materials and programs should be determined by:
A) the individual or the group being taught.
B) how quickly the patient can catch on to the education materials.
C) the age of the patient.
D) how long the treatment will continue.
Q2) The graduate physical therapist is required to be able to:
A) determine the effectiveness of patient education.
B) formulate and prioritize goals.
C) effectively educate others using culturally appropriate teaching methods that are commensurate with the needs of the learner.
D) determine what concepts are pertinent to patient education.
Q3) When a clinician uses the learning needs assessment survey,it allows for:
A) mistakes to be easily caught.
B) facilitation of optimal learning in a given patient or group.
C) less of a chance for the patient to reinjure themselves.
D) a quicker rehabilitation time.
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30
Chapter 29: Individuals With Acute Medical Conditions
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Q1) Which of the following strategies will help a patient during an asthma attack?
A) Attempt to have the patient increase his or her ventilatory rate.
B) Attempt use of a CO rebreathing bag.
C) Increase the patient's activity.
D) Provide environmental stimulation.
Q2) All of the following examination findings are typical of patients with bronchiolitis EXCEPT:
A) productive cough.
B) rhonchi on auscultation.
C) diminished breath sounds.
D) pain or difficulty with inhalation.
Q3) Interstitial pulmonary fibrosis is:
A) most often seen in health care workers.
B) strongly associated with smoking.
C) sometimes associated with pulmonary hypertension.
D) not responsive to pharmacologic management.
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Chapter 30: Individuals With Acute Surgical Conditions
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Q1) Which of the following is TRUE regarding the typical pattern of breathing after surgery?
A) Spontaneous deep breaths are normal.
B) Tachypnea and tachycardia are rare.
C) Breath sounds are decreased and lung bases.
D) Mucus is not heard typically on auscultation.
Q2) You are consulted on a patient after resection of the right lung for treatment of lung cancer.The patient has had no postoperative precautions,but you wish to implement treatment plans that will sustain alveolar inflation and functional residual capacity.According to the textbook,_______________________ is/are the most appropriate course of action to achieve these goals.
A) placing the patient in a recumbent position
B) maximal inspiratory maneuvers alone
C) mobilization and position changes
D) forced coughing
Q3) Incentive spirometry is:
A) more effective at removing secretions than huffing.
B) considered more effective than deep breathing for noncompliant patients.
C) detrimental to postoperative oxygenation.
D) used only when the patient is recumbent.
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Chapter 31: Individuals With Chronic Primary
Cardiovascular and Pulmonary Dysfunction
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Q1) Angina is caused by:
A) valve dysfunction.
B) electrical dysfunction.
C) atherosclerosis.
D) bacterial infection.
Q2) The goal of physical therapy with a patient with valve dysfunction is to:
A) optimize oxygen transport.
B) decrease quality of life.
C) increase work of the heart.
D) provide long doses of exercise.
Q3) The hallmark sign of peripheral arterial disease is:
A) claudication.
B) angina.
C) confusion.
D) back pain.
Q4) Which of the following is FALSE about coronary artery disease (CAD)?
A) CAD is associated with depression.
B) CAD is worsened by mental stress.
C) CAD is typically seen in people with type B personalities.
D) CAD is associated with increased morbidity.
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Chapter 32: Individuals With Chronic Secondary
Cardiovascular and Pulmonary Dysfunction
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Q1) Which of the following exercises at target heart rate would be MOST appropriate for aerobic conditioning with a patient with osteoporosis?
A) Weighted plyometrics
B) Biking
C) Swimming
D) Pilates
Q2) All of the following would be considered diseases causing secondary cardiovascular and pulmonary dysfunction EXCEPT:
A) coronary artery disease.
B) chronic renal failure.
C) systemic lupus erythematous.
D) thoracic kyphosis.
Q3) Ankylosis spondylitis result in decreases in all of the following EXCEPT:
A) vital capacity.
B) total lung capacity.
C) inspiratory muscle function.
D) ventilatory capacity.
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Page 34
Chapter 33: Comprehensive Management of Individuals in the Intensive Care Unit
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Q1) In addition to movement and body position,what benefits are provided for a patient when using breathing and coughing maneuvers?
A) Increase minute ventilation
B) Increase respiratory rate
C) Increase tidal volume
D) Improve venous blood gases
Q2) What is the main purpose of supplemental oxygen?
A) Prevent desaturation with exercise
B) For use before and after suctioning
C) Maintain PaO within an optimal range
D) Minimize the effects of acidemia
Q3) In addition to age and comorbidity,what risk factors might indicate a suboptimal clinical outcome for an ICU patient?
A) Acute renal failure
B) Cardiac arrest
C) Peritoneal dialysis
D) All of the above
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Page 35
Chapter 34: Intensive Care Management of Individuals
With Primary Cardiovascular and Pulmonary Dysfunction
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Q1) Which of the following would you expect to see for a patient with end-stage respiratory failure?
A) Decrease in airway resistance
B) Carbon monoxide production
C) Work of breathing
D) Alveolar hyperventilation
Q2) Which of these interventions would not achieve the goal of trying to minimize oxygen demand on the patient?
A) Body positioning
B) Relaxation techniques
C) Coordinating treatment with other interventions
D) Coordinating treatment before medications take effect
Q3) While treating a patient with obstructive lung disease,what complicating factor(s)might you expect to find?
A) Rigid barrel-shaped chest wall
B) Decreased oxygen consumption
C) Decreased work of the heart
D) Effective cough mechanism
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Chapter 35: Intensive Care Management of Individuals
With Secondary Cardiovascular and Pulmonary Dysfunction
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Q1) Which of the following body positions will reduce respiratory distress to the greatest extent in a patient with neuromuscular dysfunction?
A) Supine in bed with the feet elevated
B) Sitting in bed with the head of the bed elevated to 30 degrees
C) Upright and leaning forward
D) Sitting in a chair at the bedside
Q2) How should you position the bed to reduce intracranial pressure in a patient with a head injury?
A) Head of the bed elevated to 30 to 40 degrees
B) Head of the bed elevated to 50 to 60 degrees
C) Head of the bed declined to 30 to 40 degrees
D) Head of the bed declined to 50 to 60 degrees
Q3) Which of the following findings would you not expect with a patient with a flail chest segment?
A) Increased elevation of chest segment during inspiration
B) Instability of the chest wall
C) Chest depression over segment during inspiration
D) Asynchronous movement of the chest wall
Page 37
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Chapter 36: Intensive Care Management of Medical and Surgical Complications
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Q1) Which of the following would not be a treatment choice for a patient presenting with a thromboembolism?
A) Pneumatic pressure over the lower legs
B) Bed exercises of the lower legs
C) Compression stockings
D) Bed rest
Q2) What are the clinical features of sepsis?
A) Fever and bradycardia
B) Bradycardia and tachypnea
C) Respiratory alkalemia and fever
D) Bradycardia and respiratory alkalemia
Q3) Which of the following is a risk factor of a critical illness neuropathy or myopathy?
A) ICU stays of less than 7 days
B) Patients with hypoglycemia
C) The use of beta-blockers
D) Patients who have had organ transplants
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Chapter 37: Infants and Children With Cardiovascular and Pulmonary Concerns
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Q1) Which of the following features may not be a potential source of upper airway obstruction in children?
A) Lymphatic tissues
B) Tonsils
C) Rib angulation
D) Adenoids
Q2) What does the foramen ovale allow to occur during fetal circulation?
A) Passage of oxygenated blood
B) Left-to-right blood flow through the atria
C) Right-to-left blood flow through the atria
D) Passage of deoxygenated blood
Q3) How is the diaphragm of a newborn different than that of an adult?
A) The diaphragm of a newborn has fewer type II muscle fibers.
B) The diaphragm of a newborn has fewer type I muscle fibers.
C) The diaphragm of a newborn has more type I muscle fibers.
D) The diaphragm of a newborn has more type III muscle fibers.
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Chapter 38: The Aging Patient
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Q1) Increases in functional capacity are seen in young elderly patients who demonstrated which of the following variables?
A) Were younger in age
B) Had a shorter length of training
C) Started with a lower VO max before training
D) Had a shorter duration of training sessions
Q2) Cardiac output is the product what two factors?
A) Heart rate and blood pressure
B) Stroke volume and O blood gas extraction
C) Gas exchange rate and blood pressure
D) Heart rate and stroke volume
Q3) Diastolic changes to the heart that occur with aging include which of the following?
A) Prolonged myocardial relaxation
B) Decreases in filling pressures of older men with increased age
C) Increases in peak left ventricular diastolic filling rate in older men
D) Decreases in ventricular stiffness.
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Chapter 39: Multisystem Clinical Implications of Impaired
Breathing Mechanics and Postural Control
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Q1) Patients with which form(s)of compensatory breathing patterns need assistance from a ventilator?
A) Type I paradoxical
B) Paradoxical Type II paradoxical
C) Asymmetrical
D) Lateral or gravity eliminated
Q2) Which of the following is not the cause of symmetrical breathing patterns?
A) Stroke
B) Scoliosis
C) Unilateral spinal or nerve root injuries
D) Bilateral spinal cord injuries
Q3) The primary muscles involved in the soda can model of respiratory and postural control include which group?
A) Pectorals, upper trapezius, abdominals and gluteals
B) Intercostals, scalenes, lower abdominals, and back extensors
C) Diaphragm, scalenes, pectorals, and lower abdominals
D) Back extensors, abdominals, diaphragm, and intercostals
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Chapter 40: The Transplant Patient
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Q1) What change was made in 2005 to determine the priority of patients needing lung transplants?
A) Those on the waiting list the longest were considered first.
B) Those with greater medical emergency were considered first.
C) Those with the least possibility of rejection were considered first.
D) Those with the greatest number of comorbidities were considered first.
Q2) What is important to know about heart rate transplant patients when sitting up these patient for the first time?
A) An overcompensation of the orthostatic hypertension response
B) No orthostatic hypotension response
C) Slower changes in heat rate and stroke volume
D) Faster changes in heart rate and stroke volume
Q3) What time frame is provided for weaning of patients from mechanical ventilation after heart transplant surgery?
A) 12 to 24 hours
B) 24 to 36 hours
C) 12 to 36 hours
D) 24 to 48 hours
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Chapter 41: The Patient in the Community
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Q1) After a patient has settled into his or her home or new place of residence after an acute illness,he or she may benefit from which of the following?
A) Additional therapy despite repeated plateaus in improvement
B) Support groups in the form of peer and family encouragement
C) Abstaining from viewing information on the Internet
D) Maintaining current levels of function because of comfort
Q2) What is the definition of optimal health or function?
A) How the patient's health and function is related to his or her personal circumstances
B) Completion of a rehabilitation program
C) Limitations of third-party payers
D) Decisions made by the health care team supporting the patient to discontinue treatment
Q3) Positive self-management involves the combination of which of the following?
A) Positive emotional outlook
B) Active involvement in decision making
C) Maintenance of a lifestyle that is as optimal as possible
D) All of the above
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43
Chapter 42: Body Mechanics: Positioning and Moving Patients
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Q1) How do upright postures create a challenge to breathing?
A) By adding the component of balance
B) By increasing the effect of gravity on rib expansion
C) By narrowing airways
D) By decreasing heart rate
Q2) When standing,where is the body's approximate center of gravity?
A) Near 35% of the body's total height from the ground
B) Near 55% of the body's total height from the ground
C) Near the heart
D) Near the diaphragm
Q3) Which action will facilitate the breathing of a patient in supine?
A) Adding a pillow beneath the patient's head
B) Adding a pillow beneath the patient's low back
C) Adding towel rolls beneath the patient's shoulders
D) Removing pillows from beneath the patient's head
Q4) Which of the following is an appropriate lifting tip?
A) Lift with your legs.
B) Do not attempt to lift solely with your arms and back.
C) Avoid rotation of the spine when lifting.
D) All of the above
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Chapter 43: Respiratory Care Practice Review
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Q1) Which device is often used to deliver low-flow oxygen?
A) Oximeter
B) Nasal cannula
C) Arterial line
D) Venturi mask
Q2) Which term describes the speed at which a ventilator breath is delivered?
A) Frequency
B) Flow rate
C) Spontaneous breath
D) Trigger
Q3) Which cost-intensive oxygen delivery method has been shown to improve exercise tolerance in patients with asthma and COPD?
A) CPAP
B) Liquid oxygen
C) Partial rebreathing mask
D) Heliox
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Q1) Which should be performed after suctioning a patient's artificial airway?
A) Check the patient's breath sounds.
B) Monitor the patient for dysrhythmias.
C) Use pulse oximetry to monitor desaturation.
D) All of the above
Q2) How long should each suctioning procedure last?
A) 5 to 10 seconds
B) 15 to 20 seconds
C) 25 to 30 seconds
D) 35 to 40 seconds
Q3) Which is uncommon after extubation?
A) Skin edges are taped together with butterfly strips.
B) Air may escape through the wound.
C) Noise from the partially closed trachea is normal.
D) Dressings over the wound are discouraged.
Q4) Which term refers to the removal of an artificial airway?
A) Decannulation
B) Intubation
C) Excision
D) Tracheostomy
46
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Chapter 45: Respiratory and Cardiovascular Drug Actions
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Q1) Which is an advantage of using a nebulizer instead of a metered-dose inhaler (MDI)?
A) Does not require hand-breathing coordination
B) More portable
C) Less expensive
D) All of the above
Q2) Which is a cholinergic blocking drug that is useful as an antiulcer and antispasmodic agent?
A) Donepezil
B) Acetylcholine
C) Atropine
D) Clonidine
Q3) How many patients are estimated to use metered-dose inhalers correctly?
A) 25%
B) 50%
C) 75%
D) 100%
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