Patient Assessment for Respiratory Therapists
Midterm Exam
Course Introduction
This course provides respiratory therapy students with foundational knowledge and practical skills in patient assessment, focusing on the evaluation of cardiopulmonary function and health status. Students will learn systematic approaches to obtaining medical histories, conducting physical examinations, and interpreting diagnostic tests such as arterial blood gases, chest radiographs, and pulmonary function studies. Emphasis is placed on recognizing normal and abnormal findings, using evidence-based assessment tools, and developing clinical decision-making skills to guide respiratory care interventions. Through case studies and hands-on simulation, learners will refine their ability to gather and communicate assessment data, ensuring safe and effective patient management across diverse healthcare settings.
Recommended Textbook
Wilkins Clinical Assessment in Respiratory Care 7th Edition by Al Heuer PhD
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Chapter 1: Preparing for the Patient Encounter
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Sample Questions
Q1) What is the goal of the introductory phase?
A)Assess the patient's apparent age.
B)Identify the patient's family history.
C)Determine the patient's diagnosis.
D)Establish a rapport with the patient.
Answer: D
Q2) What is the appropriate distance for the social space from the patient?
A)3 to 5 feet
B)4 to 12 feet
C)6 to 18 feet
D)8 to 20 feet
Answer: B
Q3) In 1996, Congress passed the HIPAA.What does the letter "P" stand for?
A)Patient
B)Payment
C)Portability
D)Personal
Answer: C
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3
Chapter 2: The Medical History and the Interview
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Sample Questions
Q1) A pertinent negative is defined as:
A)Any negative response made by the patient during the interview.
B)Refusal by the patient to answer questions about a certain topic.
C)Any negative response by the patient to an important question about possible symptoms.
D)A negative response by a patient to a therapist who asks whether the patient needs a breathing treatment.
Answer: C
Q2) In the physical examination, objective data gathered are referred to as:
A)Measurements.
B)Symptoms.
C)Variables.
D)Signs.
Answer: D
Q3) Which of the following would not be found in the past medical history?
A)Injuries and accidents
B)Surgeries and hospitalizations
C)Associated symptoms and aggravating factors
D)Over-the-counter medications, vitamins, and "home remedies"
Answer: C
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Chapter 3: Cardiopulmonary Symptoms
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Sample Questions
Q1) Snoring is caused by all of the following except:
A)Excessive daytime sleepiness.
B)Obesity.
C)Excessive alcohol consumption.
D)Use of sleeping medications.
Answer: A
Q2) All of the following conditions are associated with acute dyspnea in children except:
A)Asthma.
B)Cystic fibrosis.
C)Bronchiolitis.
D)Croup.
Answer: B
Q3) Which of the following is the best definition of sputum?
A)Secretions
B)Thick tenacious secretions
C)Secretions from the lungs and lower airways
D)Secretions from the nose, mouth, and tracheobronchial tree
Answer: D
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5
Chapter 4: Vital Signs
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Sample Questions
Q1) Which of the following reasons has been listed as the number one concern regarding use of the tympanic site for body temperature measurement?
A)Speed
B)Safety
C)Accuracy
D)Cost
Q2) Which of the following organs is not at risk for disease in the presence of systemic hypertension?
A)Heart
B)Kidneys
C)Blood vessels
D)Pancreas
Q3) Which of the following arteries is most appropriate for measuring the pulse of a patient with very low blood pressure?
A)Radial artery
B)Popliteal artery
C)Brachial artery
D)Femoral artery
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6
Chapter 5: Fundamentals of Physical Examination
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Sample Questions
Q1) Which of the following terms has had a confusing history with regard to its use and has been replaced with the term crackles?
A)Rales
B)Wheezes
C)Rhonchi
D)Crepitations
Q2) All of the following are characteristics of breath sounds that should be evaluated whenever chest auscultation is performed except:
A)the breath rate.
B)the pitch (vibration frequency).
C)the amplitude or intensity (loudness).
D)the duration of inspiration versus expiration.
Q3) Which of the following terms best describes continuous types of adventitious lung sounds?
A)Rhonchi
B)Stridor
C)Wheezes
D)Sibilant rales
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7
Chapter 6: Neurologic Assessment
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Sample Questions
Q1) Which of the following is the most important part of the neurologic examination?
A)Sensory examination
B)Motor examination
C)Level of consciousness
D)Gait examination
Q2) Which of the following diseases is characterized by abnormal deep tendon reflexes due to abnormalities of the neuromuscular junction?
A)Syphilis
B)Myasthenia gravis
C)Cerebritis
D)Multiple sclerosis
Q3) Injury to the cervical spine roots C3 to C5 is associated with which of the following abnormalities?
A)Absence of deep tendon reflexes
B)Babinski sign
C)Paralysis of the diaphragm
D)Doll's-eye maneuver
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Chapter 7: Clinical Laboratory Studies
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Sample Questions
Q1) Which of the following terms describes an increase in white blood cell count associated with a shift of cells from the marginated pool to the circulating pool?
A)Pseudoneutrophilia
B)Pseudoneutropenia
C)Neutropenia
D)Lymphocytosis
Q2) In which of the following conditions would spurious polycythemia most likely be seen?
A)Lung cancer
B)Dehydration
C)Fever
D)Hypertension
Q3) Which of the following terms describes an abnormal increase in the proportion of circulating immature neutrophils?
A)Neutrophilia
B)Left shift
C)Leukopenia
D)Leukocytosis
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9
Chapter 8: Interpretation of Blood Gases
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Sample Questions
Q1) The acid-base status is classified as which of the following?
A)Uncompensated metabolic alkalosis
B)Partially compensated metabolic alkalosis
C)Uncompensated respiratory acidosis
D)Partially compensated respiratory acidosis
Q2) Which of the following is the best indicator of metabolic acid-base status?
A)Plasma HCO -
B)Base excess
C)Standard HCO -
D)T40 HCO -
Q3) What is a decrease in tissue oxygenation called?
A)Hypoxia
B)Hypoxemia
C)Hypercapnia
D)Acidosis
Q4) Which of the following is true regarding respiratory alkalosis?
A)The PaCO is less than 35 mm Hg.
B)An increase in HCO - compensates for respiratory alkalosis.
C)It is called completely compensated if the pH is 7.52.
D)It is called partially compensated if the pH is in the normal range.
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Chapter 9: Pulmonary Function Testing
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Sample Questions
Q1) Which of the following conditions is not a determinant of gas exchange across the membrane?
A)Amount of oxygen in the blood
B)Thickness of the alveolar-capillary membrane
C)Diffusion coefficient of carbon monoxide in the lungs
D)Surface area of the membrane
Q2) Obstructive lung disorders are characterized by a reduction in:
A)Lung capacities.
B)Lung volumes.
C)Expiratory flows.
D)Inspiratory flows.
Q3) The maximal voluntary ventilation (MVV) test usually is performed over a period of:
A)5 to 10 breaths.
B)12 to 15 seconds.
C)1 to 2 minutes.
D)5 to 10 minutes.
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11
Chapter 10: Chest Imaging
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Sample Questions
Q1) Which of the following views is most helpful in identifying a pneumothorax?
A)Expiratory view
B)AP view
C)Left lateral view
D)Lateral decubitus view
Q2) Which of the following tissues represent the four distinct densities recognized in the x-ray (from higher to lower density)?
A)Bone, water, air, fat
B)Fat, bone, water, air
C)Bone, water, fat, air
D)Air, fat, water, bone
Q3) Which of the following views provides less cardiac magnification and a sharper view of the left lower lobe?
A)PA view
B)AP view
C)Left lateral view
D)Lateral decubitus view
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Chapter 11: Interpretation of Electrocardiogram Tracings
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Sample Questions
Q1) Which of the following physiologic effects is associated with myocardial infarction?
A)Arterial hypertension
B)Increased cardiac output
C)Good blood flow to the brain
D)Backup of blood into the lungs
Q2) What is the normal range for the PR interval?
A)0.05 to 0.1 second
B)0.12 to 0.2 second
C)0.2 to 0.35 second
D)0.25 to 0.5 second
Q3) What is the upper limit in height of the normal P wave?
A)1 mm
B)2.5 mm
C)3.5 mm
D)5 mm
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13
Chapter 12: Neonatal and Pediatric Assessment
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Sample Questions
Q1) What do the L/S ratio and phosphatidylinositol (PI) and phosphatidylglycerol (PG) levels assess?
A)Cardiovascular maturation
B)Lung maturation
C)Renal system maturation
D)Overall level of fetal maturation
Q2) What is the significance of "grunting" in an infant?
A)A low functional residual capacity (FRC)
B)Increased airway resistance
C)Significant secretion retention
D)High compliance
Q3) Why is it so important to quickly identify a low blood glucose level in a newborn?
A)Because of worry about impaired pulmonary function
B)Because it is detrimental to brain development
C)Because it results in rapid renal deterioration
D)Because it can result in blindness through retinal detachment
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14
Chapter 13: Older Patient Assessment
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Sample Questions
Q1) At approximately what age do respiratory muscles begin to weaken?
A)55 years
B)65 years
C)70 years
D)75 years
Q2) How much does the incidence of congestive heart failure (CHF) increase with each decade of life between 45 and 75 years?
A)Doubles
B)Triples
C)Quadruples
D)Quintuples
Q3) In healthy elderly men, what is the expected supine resting heart rate?
A)50 to 60 beats/min
B)60 to 100 beats/min
C)90 to 110 beats/min
D)>110 beats/min
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Chapter 14: Respiratory Monitoring in Critical Care
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Sample Questions
Q1) Ventilatory measurements routinely monitored at the bedside include all of the following except:
A)airway pressures.
B)lung volumes and flows.
C)fractional gas concentrations.
D)oxygen consumption and carbon dioxide production.
Q2) Which of the following ventilator changes will have to be made if the problem of "breath stacking" is to be resolved?
A)Increase in tidal volume
B)Increase in respiratory rate
C)Increase in inspiratory flow
D)Increase in both respiratory rate and inspiratory flow
Q3) Volutrauma is most likely to develop in:
A)the larger airways.
B)dependent lung regions.
C)nondependent lung regions.
D)small airways.
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16
Chapter 15: Vascular Pressure Monitoring
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Sample Questions
Q1) Pulmonary artery catheter monitoring is likely to be considered for patients with any of the following conditions except:
A)ARDS.
B)pulmonary embolus.
C)cardiogenic pulmonary edema.
D)septic shock.
Q2) Circulation to the vital organs (kidneys, coronary arteries) may be compromised if the MAP falls to below _____ mm Hg.
A)60
B)80
C)100
D)120
Q3) When the pulmonary artery catheter is inserted, the balloon is inflated in the right atrium before it is inserted further.This is done to:
A)allow the catheter to float.
B)decrease the risk of premature ventricular contractions.
C)allow the catheter to enter the right ventricle more easily.
D)all of the above.
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17
Chapter 16: Cardiac Output Measurement
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Sample Questions
Q1) To standardize the measurement of cardiac output in individuals of different sizes, the value for cardiac output is divided by the person's body surface area.The result is known as:
A)cardiac work.
B)the cardiac index.
C)the standardized cardiac output.
D)the cardiac end-systolic volume.
Q2) What method of measuring cardiac output is most popular in intensive care units (ICUs) around the country?
A)Thermodilution
B)Fick method
C)Pulse contour method
D)Intravascular ultrasound
Q3) The greatest determinant of peripheral resistance to blood flow is:
A)the radius of the vessels.
B)the viscosity of the blood.
C)the compliance of the vessels.
D)the distance of the vessels from the heart.
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18
Chapter 17: Bronchoscopy
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Sample Questions
Q1) The respiratory therapist (RT) who is assisting the pulmonologist during bronchoscopy should have medication cups of xylocaine, normal saline, and ________ ready before beginning the procedure.
A)acetylcysteine (Mucomyst)
B)epinephrine
C)sterile water
D)midazolam (Versed)
Q2) For what purpose are lasers used during bronchoscopy?
A)To obliterate obstructing tumors
B)To stop excessive bleeding
C)To open mucus-plugged airways
D)To improve visualization of smaller airways
Q3) For what condition is the rigid bronchoscope most likely to be used?
A)Pneumonia
B)Massive hemoptysis
C)Tumor
D)Interstitial lung disease
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Chapter 18: Nutrition Assessment
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Sample Questions
Q1) Which of the following are associated with increased metabolism?
1)Severe burns
2)Severe infection
3)Multiple traumas
4)Hyperthyroidism
A)1, 2, 3
B)1, 3
C)2, 4
D)1, 2, 3, 4
Q2) Which of the following might indicate poor nutritional status?
A)Low BMI
B)Positive nitrogen balance
C)Positive response to skin antigen testing
D)High serum albumin level
Q3) What is nitrogen balance useful in determining?
A)The adequacy of protein intake
B)The adequacy of carbohydrate intake
C)The need for vitamin supplementation
D)Fluid and electrolyte balance
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Page 20
Chapter 19: Sleep and Breathing Assessment
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Sample Questions
Q1) With what pattern of SDB is SIDS thought to be associated?
A)CSA
B)OSA
C)MSA
D)RERA
Q2) Cheyne-Stokes breathing is associated most closely with which type of SDB?
A)CSA
B)OSA
C)Mixed sleep apnea (MSA)
D)Sudden infant death syndrome (SIDS)
Q3) How would you diagnose central sleep apnea (CSA)?
A)Obesity
B)Patient complains of EDS
C)Excessive snoring
D)10-second apnea without respiratory effort during sleep
Q4) What test is used to diagnose sleep disorders?
A)Overnight oximetry
B)Polysomnography
C)Electroencephalogram (EEG)
D)Leg twitch study
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Chapter 20: Home Care Patient Assessment
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Sample Questions
Q1) For which of the following conditions (which is the third most common cause of death in the United States) are both mortality rates and prevalence rates increasing?
A)Chronic obstructive pulmonary disease (COPD)
B)Asthma
C)Pneumonia
D)Heart failure
Q2) What is the most common respiratory care modality applied in the home care setting?
A)Intermittent positive pressure breathing (IPPB)
B)Oxygen therapy
C)Nebulizer therapy
D)Continuous positive airway pressure (CPAP)
Q3) If the home care patient is suffering from a poor appetite, what could be the cause?
A)Depression
B)Dyspnea
C)Infection
D)All of the above
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Chapter 21: Documentation
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Sample Questions
Q1) What does the letter I stand for in the APIE method of documentation?
A)Implementation
B)Impact
C)Inconsistencies
D)Initiative
Q2) Which of the following sections of the patient assessment or procedures should be charted immediately?
A)Date and time of test or treatment
B)Vital signs
C)Result of or response to treatment, including adverse reactions
D)Drugs and their dosages
Q3) Which of the following definitions is consistent with negligence?
A)Failure to document a procedure performed on a patient
B)Failure to explain to a patient the purpose of a therapy
C)Failure to obtain a license to practice despite good clinical performance
D)Failure to use a reasonable amount of care that results in injury or damage to another
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