Medical-Surgical Physical Therapy
Solved Exam Questions
Course Introduction
Medical-Surgical Physical Therapy is a specialized field that focuses on the management and rehabilitation of patients before and after surgical procedures, as well as those with acute or chronic medical conditions. This course covers the principles of assessment, planning, and implementation of evidence-based physical therapy interventions for a variety of medical and surgical cases. Students will learn about wound care, pain management, mobility training, respiratory care, and functional restoration, while also exploring strategies to prevent post-surgical complications and enhance patient outcomes. Integration of multidisciplinary approaches and patient-centered care are emphasized, preparing students to work effectively within healthcare teams in hospital and outpatient settings.
Recommended Textbook
Cardiovascular and Pulmonary Physical Therapy Evidence to Practice 5th Edition by Donna Frownfelter
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861 Verified Questions
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Chapter 1: Epidemiology As a Basis for Informing
Contemporary Physical Therapy Practice
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Sample Questions
Q1) The leading cause and contributor to chronic conditions and premature death in the United States is:
A) smoking, with poor diet and sedentary lifestyle anticipated soon to overtake smoking.
B) diabetes, with smoking and ischemic heart disease as second.
C) ischemic heart disease and cancer.
D) smoking, with cancer and stroke anticipated soon to overtake smoking.
Answer: A
Q2) One of the concepts of the health belief model is self-efficacy,which is defined as:
A) confidence in one's ability to take action.
B) one's belief in the seriousness of a condition.
C) strategies to activate "readiness."
D) one's belief of the chances of getting a condition.
Answer: A
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Chapter 2: Oxygen Transport: the Basis of Cardiovascular and Pulmonary Physical Therapy
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Q1) The effects of recumbency (bed rest)on patients have been described as detrimental and leading to a state of general deconditioning.This negative condition can be affected through the interventions of physical therapy by simply:
A) providing progressive resistive exercise to patients.
B) providing instruction in the most appropriate form of diaphragmatic breathing.
C) restoration of upright positioning.
D) providing supplemental oxygenation during activities.
Answer: C
Q2) Basal metabolic rate (BMR)is a measure of an individual's resting metabolic rate; this rate is said to be constant among individuals under similar circumstances.The BMR takes into account the resting function of all but which of the following?
A) Breathing
B) Brain function
C) Thermoregulation
D) Digestion
Answer: D
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4
Chapter 3: Cardiovascular and Pulmonary Anatomy
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Q1) What structure in the circulatory system is said to have a higher proportion of connective tissue?
A) Capillaries
B) Arterioles
C) Medium-size blood vessels
D) Large blood vessels
Answer: D
Q2) Identify the structures that carry deoxygenated blood away from the heart to the lungs.
A) Pulmonary arteries
B) Systemic arteries
C) Pulmonary veins
D) Systemic veins
Answer: A
Q3) The palatine tonsils can be found in which area of the upper airways?
A) Larynx
B) Pharynx
C) Oropharynx
D) Laryngopharynx
Answer: C
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Chapter 4: Cardiovascular and Pulmonary Physiology
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Sample Questions
Q1) 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.
Q2) 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.
Q3) When preparing to position a patient for a planned intervention,the physical therapist should consider to prevent a stressful respiratory event for the patient.
A) Ventilation and perfusion matching
B) Respiratory mechanics
C) Oxyhemoglobin dissociation
D) Peripheral circulation
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6
Chapter 5: Cardiovascular and Pulmonary Pathophysiology
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Q1) Which of the following conditions or diseases is NOT considered to be a restrictive lung disorder (RLD)?
A) Pregnancy
B) Bronchiectasis
C) Lung cancer
D) Idiopathic pulmonary fibrosis
Q2) Stable angina pectoris is responsive to:
A) nitrates.
B) calcium channel blockers.
C) beta-blockers.
D) ACE inhibitors.
Q3) What condition results in hemodynamic maladaptations,stiff central arteries,cardiac hypertrophy,and blood pressure variability?
A) Athletic heart syndrome
B) Systemic hypertension
C) Obstructive lung disease
D) Pulmonary hypertension
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Page 7
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) The heart and lungs should be seen as a continuous system in as much as changes in one will ultimately affect the other.If the right side of the heart falters in operation,it could result in increased pressure and create a condition known as:
A) right heart failure.
B) pulmonary failure.
C) left heart failure.
D) pulmonary hypertension.
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Chapter 7: Measurement and Documentation
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Q1) Which best describes specificity?
A) A false-negative result has a negative test result even though the disease or characteristic is absent.
B) A high number of false-negative results would produce a high specificity.
C) Specificity is the ability of a measurement to identify individuals who have negative results or who do not have the characteristic.
D) Specificity is the ability of a measurement to identify individuals who have positive results or who have the characteristic that is being measured,
Q2) What is the best example of an interval measurement?
A) A classification of heart failure
B) Grade 1 angina
C) 0° Celsius
D) 0° Kelvin
Q3) Which of the following is not a type or level of measurement?
A) Nominal
B) Ordinal
C) Ratio
D) Segmental
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9
Chapter 8: History
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Q1) Which is not true regarding pleural chest pain?
A) Chest pain originates from the parietal pleura or endothoracic fascia.
B) Chest pain originates from the parietal pleura or visceral pleura.
C) Pleuritic chest pain worsens sharply with inspiration.
D) Deep breathing, coughing, and laughing are extremely painful.
Q2) Which is not a basic cause of dyspnea?
A) An abnormality in the ventilatory system itself
B) An increase in the work of breathing
C) A decrease in the work of breathing
D) An increased awareness of normal breathing
Q3) In regards to pulmonary hypertension,which of the following is not true?
A) Sitting up and leaning forward or lying on the right side often relieves the pain.
B) Chest pain related to pulmonary hypertension may mimic angina pectoris.
C) It is usually found in patients with mitral stenosis.
D) It is believed to result from dilation of the pulmonary artery or from right ventricular ischemia.
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Chapter 9: Pulmonary Function Tests
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Q1) Which best describes an obstructive condition of the lungs?
A) A condition that limits the amount of volume coming into the lungs
B) A condition that increases air volume coming into the lungs
C) A condition that increases the volume in exhalation
D) A condition that relates to problems in exhalation airflow
Q2) Which best describes the work of breathing?
A) The tidal volume (TV) divided by the respiratory rate (RR)
B) The expiratory reserve volume (ERV) times the respiratory rate (RR)
C) The expiratory reserve volume (ERV) divided by the respiratory rate (RR)
D) The tidal volume (TV) times the respiratory rate (RR)
Q3) In regards to vital capacity (VC),which is true?
A) It contains the IRV, TV, and TLC.
B) An increase in VC can occur as a result of absolute reduction in distensible lung tissue.
C) A decrease in VC may also be seen only with primary lung disease or airway obstruction.
D) VC is the maximum amount of gas that can be expelled from the lungs by forceful effort after a maximum inspiration.
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Chapter 10: Arterial Blood Gases
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Sample Questions
Q1) What are the normal arterial pH values?
A) 7.80 to 9.0
B) 2.5 to 5.0
C) 6.35 to 7.2
D) 7.35 to 7.45
Q2) How should physical therapists use arterial blood gas measurements?
A) Use the measurement with oximeter readings to get an overall status of the patient's condition
B) To prescribe external oxygen
C) To titrate oxygen levels
D) To determine when to remove external oxygen
Q3) How is respiratory failure defined?
A) The failure of the digestive system to meet the metabolic demands of the body
B) The failure of the nervous system to meet the metabolic demands of the body
C) The failure of the pulmonary system to meet the metabolic demands of the body
D) The failure of the integumentary system to meet the metabolic demands of the body
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12
Chapter 11: Imaging of the Chest
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Q1) Which is true regarding the position of the diaphragm?
A) The costophrenic angles are where the diaphragm meets the pelvis.
B) The L diaphragm is usually lower than the R diaphragm.
C) The R diaphragm is usually lower than the L diaphragm.
D) The costophrenic angles at the apex of the chest cavity are where fluid can accumulate.
Q2) How might chronic obstructive pulmonary disease appear on chest imaging?
A) A barrel-shaped chest
B) A narrow chest in all planes
C) A peaked diaphragm in the transverse plane
D) Decreased density of the pulmonary markings
Q3) Which of the following is not an initial step when evaluating a radiograph?
A) Check that the information identifying the patient has been properly provided on the image and that the image is indeed of the patient in question.
B) Check that the part of the body in question is the part that was imaged.
C) Check that there are three images, one for each plane of movement.
D) Check the overall exposure of the film.
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Chapter 12: Electrocardiogram Identification
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Sample Questions
Q1) 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
Q2) A premature ventricular contraction (PVC)may occur at regular intervals in an established pattern.Which of the following is the result of this occurring every other beat?
A) Bigeminy
B) Trigeminy
C) Quadrigeminy
D) Couplet
Q3) What is the 10th electrode on a standard 12 lead ECG is used for?
A) To monitor the frontal plane
B) To monitor the transverse plane
C) To monitor the sagittal plane
D) To stabilize the baseline
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14
Chapter 13: Multisystem Assessment and Laboratory Investigations
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Q1) Which test is used to diagnose and monitor the treatment of acute pancreatitis?
A) CBC
B) Amylase test
C) Electrolyte levels
D) Creatinine test
Q2) Which of the following is not a test of peripheral vascular function?
A) Peripheral pulses
B) Capillary filling time
C) Ankle systolic pressures
D) Fibrin clotting time
Q3) 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
Q4) Which of the following is not a key endocrine gland?
A) Pancreas
B) Adrenal glands
C) Appendix
D) Thyroid gland
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Chapter 14: Special Tests
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Q1) Which technology uses nuclear magnetic resonance to build tissue images?
A) CT
B) PET
C) MRI
D) Radiography
Q2) Which is not an advantage of using technetium radionuclides versus thallium radionuclides?
A) Higher count rates
B) Higher energy
C) It redistributes readily
D) None of the above
Q3) 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
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Chapter 15: Clinical Evaluation and Assessment of the
Cardiovascular and Pulmonary Systems
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Q1) Which of the following may be present if crepitus is palpated over the chest wall?
A) An air leak from a chest-tube site
B) Pleural rub
C) Friction rub
D) All of the above
Q2) Which of the following may cause tracheal deviation?
A) A pneumothorax
B) Atelectasis
C) A tumor
D) All of the above
Q3) What will likely be observed during inspection of a patient's skin when oxygen saturation is less than 80%?
A) Cyanosis
B) Ecchymosis
C) Edema
D) Unusually prominent bony landmarks
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17
Chapter 16: Monitoring Systems, catheters, and Devices in the Intensive Care Unit
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Q1) Which of the following cardiac dysrhythmias are life threatening or require immediate recognition and treatment?
A) Subjunctional tachycardias
B) Ventricular tachycardia
C) Ventricular fibrillation
D) All of the above
Q2) Which assessment of arousal and brain activity includes a review of motor,sensory,pain,arousal,and cognitive status?
A) Richmond Agitation-Sedation Scale
B) Glasgow Coma Scale
C) Electroencephalogram
D) FACES scale
Q3) Which of the following is an example of upper motor neuron involvement?
A) Progressive muscle weakness
B) The Babinski sign
C) Hyperreflexia
D) All of the above
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Page 18
Chapter 17: Maximizing Outcomes: Relating Interventions to an Individuals Needs
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Q1) The goals of treatment fall into three categories:
A) preventive, long term, and short term.
B) primary, secondary, and tertiary.
C) cognitive, psychosocial, and nutritional.
D) restricted mobility, intrinsic factors, and extrinsic factors.
Q2) Physical therapists have an active role on wellness and its promotion in the form of: A) structured programs.
B) one-on-one care.
C) evidence-based planning.
D) a and
Q3) Health has been defined by the World Health Organization as:
A) the absence of pathology.
B) a person's capacity to live a life consistent with his or her needs and wants.
C) emotional, spiritual, intellectual, and physical well-being.
D) a and
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Chapter 18: Mobilization and Exercise: Physiological Basis for Assessment,
evaluation, and Training
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Q1) An intervention-related factor that contributes to increased metabolic demand and oxygen consumption is:
A) fever.
B) noise.
C) anxiety.
D) range of motion exercises.
Q2) Hospitalized patients whose oxygen transport capacity is reduced or threatened tend to be:
A) hypermetabolic
B) hypometabolic
C) catabolic
D) dehydrated
Q3) Three outcomes related to improving abilities and participation includes:
A) mobilization, exercise, and oxygen transport.
B) optimal physiological reserve, participation, and mobilization.
C) self-care, home management, and return to work.
D) patient's needs, mobilization, and home management.
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Page 20
Chapter 19: Mobilization and Exercise: Testing and Training
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Q1) Frequent body position changes are used by physical therapists to stimulate:
A) circulation and increase blood flow to the extremities.
B) the patient and increase arousal to a more alert and wakeful state.
C) the patient's awareness of their therapy session.
D) the patient's hand-eye coordination.
Q2) Side-lying increases end-diastolic ventricular pressure on the dependent side secondary to compression of the viscera beneath the diaphragm and to:
A) atelectasis formation.
B) central pneumothorax lesion.
C) increased lung compliance on that side.
D) reduced lung compliance on that side.
Q3) There is mounting physiological and scientific justification for use of the prone position to enhance arterial oxygenation and reduce the work of:
A) patients with congenital cardiovascular conditions.
B) breathing in patients with musculoskeletal dysfunction.
C) breathing in patients with cardiopulmonary dysfunction.
D) breathing in patients with neurogenic dysfunction.
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21
Chapter 20: Body Positioning
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Q1) ACT is the acronym for:
A) advanced cardiac treatment.
B) avascular coronary treatment.
C) airway clearance techniques.
D) always clear trachea.
Q2) Exercise has many positive effects on the body; in a study by Oldenberg,exercise was shown to increase:
A) alveolar filling time.
B) mucociliary transport in patients with chronic bronchitis.
C) completion of the oxygen transport chain.
D) mucociliary dysfunction in patients with chronic bronchitis.
Q3) Contraindications to external manipulation of the thorax are:
A) lung contusion and osteoporosis.
B) lung contusion, osteoporosis, and coagulopathy.
C) osteoporosis and coagulopathy.
D) lung contusion and coagulopathy.
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22
Chapter 21: Airway Clearance Techniques
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Q1) Airway clearance must take place on a daily basis.For this reason,many patients and caregivers need to consider modifications to the:
A) equipment schedule.
B) caregiver's schedule.
C) patient's schedule.
D) therapist's schedule.
Q2) All of the following are reasons for using manual hyperinflation on a patient EXCEPT:
A) the patient has an artificial airway.
B) the patient is mechanically ventilated.
C) the patient has a tracheostomy.
D) the patient has a productive cough.
Q3) Light percussion,_______ and ________ are used in conjunction with postural drainage positioning:
A) vibration, clapping
B) clapping, shaking
C) vibration, shaking
D) soft clapping, shaking
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Chapter 22: Facilitating Airway Clearance With Coughing Techniques
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Sample Questions
Q1) What functions to clear secretions and inhaled particular matter?
A) Throat clearing
B) Mucociliary escalator
C) Cough
D) Sneeze
Q2) 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.
Q3) Three manually assisted techniques are:
A) anterior chest compression, long sitting, and hands-and-knees rocking.
B) anterior chest compression, counterrotation, and prone on elbows head flection.
C) costophrenic, anterior chest compression, and long sitting.
D) costophrenic, anterior chest compression, and counterrotation.
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Chapter 23: Facilitating Ventilation Patterns and Breathing Strategies
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Q1) Patients with either primary pulmonary dysfunction or secondary pulmonary dysfunction can benefit from:
A) chest mobilization.
B) pectoralis facilitation.
C) scalene facilitation.
D) spinal mobilization.
Q2) All of the following are all considered daily dynamic activities that improve ventilation EXCEPT:
A) coming up to sitting.
B) coming up to standing.
C) dancing.
D) rolling.
Q3) Normal breathing,repeated rhythmic inspiratory-expiratory cycles,is known as:
A) eupnea.
B) hyperpnea.
C) apnea.
D) Cheyne-Stokes respiration
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Page 25
Chapter 24: Exercise Testing and Training: Primary
Cardiopulmonary Dysfunction
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Q1) Chronic heart failure is usually hallmarked by:
A) right ventricular dysfunction.
B) left ventricular dysfunction.
C) upper ventricular dysfunction.
D) lower ventricular dysfunction.
Q2) 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.
Q3) Of the multiple facets of a cardiac rehabilitation programs,different components may have different effects on:
A) diagnosis.
B) motivation.
C) physiology.
D) individual heart health.
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Chapter 25: Exercise Testing and Training: Secondary
Cardiopulmonary Dysfunction
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Q1) Besides altered hemodynamic responses to exercise,individuals with spinal cord injury also are affected by:
A) temperature stress.
B) fluid stress.
C) pulmonary stress.
D) positional stress.
Q2) Management of patients with systemic atherosclerosis and circulatory dysfunction is similar to management of patients with which of the following pathologies?
A) Stroke
B) Heart and lung failure
C) End-stage renal disease
D) Hypertension
Q3) Limitation of mitochondrial oxidative capacity has been ruled out as a limiter of exercise capacity in patients with which of the following conditions?
A) Connective tissue disorders
B) Chronic renal failure
C) Rheumatoid arthritis
D) Hepatopulmonary
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Chapter 26: Respiratory Muscle Training
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Q1) The capacity of the respiratory muscle pump is vital for the movement of air to the level of gas exchange in the respiratory system.Failure could result in all but which of the following?
A) Gas exchange
B) Ventilation
C) Tissue repair
D) Diaphragmatic movement
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) To prevent chest wall and lung recoil pressures from contributing to the pressure generated by the inspiratory muscles,measurements are recorded for:
A) residual capacity (RC).
B) total lung capacity (TLC).
C) inspiratory reserve (IR).
D) functional residual capacity (FRC).
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28
Chapter 27: Complementary Therapies As
Cardiopulmonary Physical Therapy Interventions
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Q1) Complementary therapies are often viewed as:
A) holistic therapies
B) mind/body therapies
C) energy-based therapies
D) all of the above
Q2) 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
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Chapter 28: Patient Education
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Q1) The behavior-modification approach:
A) can help a patient to attain a certain level of performance.
B) consists of techniques that manipulate environmental rewards and punishments in relationship to a specified behavior.
C) can help to affect a durable cognitive improvement.
D) can help to enhance patient-clinician rapport.
Q2) As a physical therapist sets intervention goals for a patient,he or she should include:
A) the patient's physical limitations.
B) the patient's age and gender.
C) the patient's educational goals.
D) the patient's highest degree in education.
Q3) Determining the effectiveness of patient education efforts involves evaluating not only what the patient learned but also:
A) how smart the patient is.
B) how the teacher taught.
C) the age of the patient being treated.
D) how well the treatment was documented.
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Chapter 29: Individuals With Acute Medical Conditions
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Q1) Patients with tuberculosis present with:
A) dry, nonproductive cough.
B) weight gain.
C) fever.
D) increased appetite.
Q2) You have been consulted to evaluate and treat a patient in the cardiac step-down unit.The patient is 2 days post acute myocardial infarction.Upon meeting the patient,you assess the vital signs and objectively get the following measures: blood pressure (BP),134/65 mm Hg; heart rate (HR),99 beats/min; and pulse oximeter reading,98%.Which of the following treatment decisions would be MOST appropriate?
A) Ten minutes of ambulation in the hallway with a HR of 119 beats/min
B) Ten minutes of biking with a HR of 135 beats/min
C) Ten minutes of running on treadmill with a HR of 165 beats/min
D) All of the above are contraindicated
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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Page 31
Chapter 30: Individuals With Acute Surgical Conditions
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Q1) Which of the following would promote postoperative complications after thoracic or cardiovascular surgery?
A) Deep breathing
B) Ambulation
C) Reduced arousal
D) Huffing
Q2) All of the following are true about the immediate postoperative period EXCEPT:
A) rest is as important as activity.
B) patients may be using patient-controlled analgesia (PCA).
C) therapists should determine the benefits of nonpharmacologic interventions.
D) oversedation results in an increased respiratory rate.
Q3) Which of the following statements is TRUE about thoracic and cardiovascular surgery?
A) Patients are at increased risk of aspiration postoperatively.
B) Irritation or compression of the phrenic nerve is not possible during surgery.
C) Artificial airways decrease the risk of postoperative complications.
D) Blood gasses do not indicate the need for mechanical ventilation.
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Chapter 31: Individuals With Chronic Primary
Cardiovascular and Pulmonary
Dysfunction
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Sample Questions
Q1) Smoking contributes to:
A) decreased mucus production in the small airways.
B) increased elastic recoil of the lung.
C) decreased airway reactivity.
D) increased vascular changes in the lungs.
Q2) In which of the following lung diseases do increased pulmonary artery pressure and increased pulmonary vascular resistance lead to increased right ventricular work and hypertrophy?
A) Asthma
B) Upper respiratory infection
C) Interstitial lung disease
D) Bronchiectasis
Q3) 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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Page 33
Chapter 32: Individuals With Chronic Secondary
Cardiovascular and Pulmonary Dysfunction
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Sample Questions
Q1) Cardiovascular and pulmonary manifestations of systemic lupus erythematous (SLE)are:
A) Atelectasis
B) Barrel chest and overcompliance
C) Pleuritis
D) Pulmonary hypertension
Q2) You are treating a patient with multiple sclerosis (MS).Your patient presents with poor airway management and increased secretions.Which of the following would be the MOST appropriate treatment intervention to consider?
A) Body positioning and postural drainage
B) Maximal aerobic exercise in a warm environment
C) Regimented intensity and duration of strengthening exercises
D) Incentive spirometry
Q3) All of the following are examples of musculoskeletal thoracic deformities that can affect breathing or coughing EXCEPT:
A) scoliosis.
B) rib fractures.
C) spondylolisthesis.
D) ankylosing spondylitis.
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Chapter 33: Comprehensive Management of Individuals in the Intensive Care Unit
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Q1) Which of the following is a contraindication for manual techniques performed in the head-down position?
A) Hemorrhage
B) Acute chest trauma
C) Myocardial infarction
D) Gastric reflux
Q2) What type of foods might be limited for the patient in ICU?
A) Carbohydrates
B) Proteins
C) Fats
D) Dairy
Q3) What is the purpose of a Swan-Ganz catheter?
A) Gives an indication of fluid loading
B) Measures the ability of the right side of the heart to cope with changes in circulating body fluids
C) Gives pressures for pulmonary artery pressure and wedge pressure
D) Measures pulmonary sufficiency
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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 may contribute to generally low incidences of complications and mortality after open heart surgery?
A) Emphasis on patient education
B) Early weight bearing
C) Extubating the patient quickly after surgery
D) Foot and ankle exercises
Q2) Which of these is not a classical sign and symptom of a severe asthma attack that may progress to status asthmaticus?
A) Audible wheezing
B) Tachypnea
C) Cyanosis
D) Bradycardia
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) What should not be included during treatment and management of a patient with central nervous system trauma?
A) Occasional turning regimen of the patient
B) Judicious tracheal suctioning
C) Lung hyperventilation with manual breathing bag in nonventilated patient
D) Deep breathing or sighs in ventilated patients
Q2) What is a major pathophysiological mechanism of significantly impaired cardiovascular and pulmonary function in a very heavy (obese)individual?
A) Decreased pulmonary vascular resistance
B) Decreased right ventricular work
C) Myocardial hypertrophy
D) Alveolar hyperventilation
Q3) You have just finished positioning your obese patient upright in a chair at bedside when you notice the patient slumping.What action should you take?
A) None. The slumping caused by weak postural muscles.
B) Put the patient back to bed because of increased fatigue.
C) Correct the patient position and recheck it frequently.
D) Proceed to standing and walking.
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 are common signs of fluid retention with prolonged mechanical ventilation?
A) Systemic edema, weight gain, increased pulmonary compliance, and reduced oxygen transport
B) Pulmonary edema, weight gain, increased pulmonary compliance, and reduced oxygen transport
C) Pulmonary edema, weight gain, decreased pulmonary compliance, and reduced oxygen transport
D) Systemic edema, weight loss, decreased pulmonary compliance, and reduced oxygen transport
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) What is the cause of pulmonary edema that is cardiogenic in nature?
A) Accumulation of vascular fluid in interstitial spaces
B) Left ventricular failure
C) Right ventricular failure
D) Movement of water into alveolar spaces
Page 38
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Chapter 37: Infants and Children With Cardiovascular and Pulmonary Concerns
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Q1) Which of the following describe the defects associated with tetralogy of Fallot (TOF)?
A) Ventricular septal defect, right ventricular outflow obstruction, left ventricular hypertrophy, and aortic override
B) Atrial septal defect, right ventricular outflow obstruction, right ventricular hypertrophy, and aortic override
C) Ventricular septal defect, right ventricular outflow obstruction, right ventricular hypertrophy, and aortic override
D) Ventricular septal defect, left ventricular outflow obstruction, left ventricular hypertrophy, and aortic override
Q2) What activities should be included as you design an exercise program for a child with CF?
A) Activities to elongate tight muscles
B) Strengthen muscles for functional activities
C) Strengthen weak muscles
D) Avoid endurance activities
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Chapter 38: The Aging Patient
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Q1) Although the improvements in increasing VO max in elderly people are not clear,which of one the following is consistent?
A) Improvement in thoracic mobility leading to better O saturation with lung expansion
B) Greater extraction of oxygen caused by wider arteriovenous oxygen content
C) Decreases in O demands in the peripheral muscles
D) An increase in maximum heart rate
Q2) Which of the following is not a suspected mechanism of VO max reduction?
A) Decrease in maximum heart rate
B) Decrease in cardiac output
C) Decrease in blood pressure
D) Decrease in stroke volume
Q3) Postural hypotension occurs in elder patients when positions are quickly changed.This complaint of dizziness is important to physical therapists because of which of the following?
A) There is a potential for risk of falls.
B) There is less likelihood of stroke with decreases in blood pressure.
C) There is better response to exercise with lower blood pressure.
D) This is a poor indicator in the patient's willingness to participate in therapy.
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Chapter 39: Multisystem Clinical Implications of Impaired
Breathing Mechanics and Postural Control
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Q1) 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
Q2) Paradoxical breathing type I has the end result of upper chest wall collapse because of which of the following muscular functions?
A) Lack of stabilizing contractions of the intercostal
B) The diaphragm fails to descend into the abdomen
C) The abdominal muscle contract decreasing the diaphragms descent into the abdomen
D) The upper respiratory muscles are unopposed in their pull of the chest wall superiorly
Q3) A child with pronounced muscle imbalance from lying in the recumbent position does not have which of the following?
A) Triangular-shaped thorax or chest wall
B) Ability to meet ventilation needs
C) Anteriorly flared lower ribs
D) Posteriorly flared ribs
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Chapter 40: The Transplant Patient
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Q1) What is the score the International Society for Heart and Lung Transplantation (ISHLT)guidelines requires for transplant?
A) 2 to 5
B) 5 to 8
C) 7 to 10
D) 10 to 13
Q2) What is the most common diagnosis referred for lung transplant?
A) Idiopathic pulmonary fibrosis
B) COPD
C) Cystic fibrosis
D) Pulmonary arterial hypertension
Q3) Compensatory mechanisms of heart failure include which of the following?
A) Increased sympathetic nervous system activity and increased blood pressure
B) Increased fatigue and orthopnea
C) Appearance of third heart sound and jugular venous distention
D) Peripheral edema and hepatomegaly
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Chapter 41: The Patient in the Community
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Q1) When considering patient education about returning home,the therapist should gain understanding of which of the following?
A) The caregiver and patient's ability to interpret the medication schedule
B) The therapist's ability to monitor the patient's signs and symptoms in response to activity
C) The validity and reliability of the therapist's assessments
D) The patient's ability to determine the need for emergency services
Q2) Which of the following is a priority among impairments found during the recovery of an episode of cardiac or pulmonary issues according to the text?
A) Ineffective sleep
B) Nonemergent breathing problems
C) Nutritional concerns
D) Pain
Q3) How can a patient best carry out an effective plan?
A) The patient is taught to identify problems and manage them.
B) The patient is given a list of exercises to complete each day.
C) The patient is placed in a skilled nursing facility to begin rehabilitation.
D) The caregivers request the patient be place at home because of the previous independent status at home.
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Page 43
Chapter 42: Body Mechanics: Positioning and Moving Patients
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Q1) In a patient with right lower lung pneumonia or atelectasis,which position is recommended to improve oxygenation?
A) Supine
B) Right side-lying
C) Left side-lying
D) Prone
Q2) To what level should a patient's bed be adjusted to facilitate a lift by a practitioner?
A) The lifter's mid-thigh level
B) The lifter's hip level
C) The lifter's thoracic level
D) The lifter's elbow level
Q3) Which positioning maneuver for the upright patient may reduce the kyphotic curve in the thoracic spine,improve upper extremity ROM,and improve ventilation?
A) Anterior tilting of the pelvis
B) Posterior tilting of the pelvis
C) Extension of bilateral knees
D) Lowering seat height
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Chapter 43: Respiratory Care Practice Review
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Q1) Which of the following is most cost effective and strictly used to deliver medication?
A) SVN
B) MDI
C) COPD
D) FEV
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 device has become more popular over the past 20 years for supporting patients with Duchenne muscular dystrophy and cystic fibrosis?
A) IPPB
B) MDI
C) NMIV
D) CPAP
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Sample Questions
Q1) 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
Q2) Which is a potential complication from tracheal suctioning?
A) Hypoxemia
B) Cardiac dysrhythmia
C) Bronchospasm
D) All of the above
Q3) How is the size of the suctioning catheter determined?
A) Doubling the size of the tracheostomy tube
B) Tripling the size of the tracheostomy tube
C) Doubling the size of the tracheostomy tube and adding 2
D) Adding 2 to the size of the tracheostomy tube
Q4) Which is needed to reinsert a dislodged outer cannula?
A) Tracheal hook
B) Trousseau dilator
C) Satisfactory tissue retraction
D) All of the above
46
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Chapter 45: Respiratory and Cardiovascular Drug Actions
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Q1) Which adrenergic drug causes the release of norepinephrine and has potent central nervous system activity?
A) Phenylephrine
B) Metaraminol
C) Ephedrine
D) Amphetamine
Q2) Which class of drugs has been used as insecticides and is beneficial in problems related to the eye,intestine,and the skeletal neuromuscular junction?
A) Cholinergic drugs
B) Anticholinesterase drugs
C) Sympatholytic drugs
D) -Adrenergic blocking drugs
Q3) Which is true of receptors in the sympathetic system?
A) Found in arterioles, heart, and bronchioles; stimulation lowers blood pressure
B) Found in arterioles, heart, and bronchioles; stimulation increases blood pressure
C) Found only in arterioles; stimulation lowers blood pressure
D) Found only in arterioles; stimulation increases blood pressure
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