Patient Assessment in Respiratory Care Exam Bank
Course Introduction
Patient Assessment in Respiratory Care provides students with the essential knowledge and skills to evaluate individuals with respiratory disorders accurately. The course covers comprehensive patient history taking, physical examination techniques, assessment of vital signs, interpretation of respiratory diagnostics such as spirometry and arterial blood gases, and the use of assessment tools specific to respiratory function. Emphasis is placed on integrating clinical findings with patient symptoms to develop effective care plans, promoting critical thinking and decision-making in the management of respiratory patients. Students are prepared to perform systematic assessments in a variety of healthcare settings, ensuring safe, evidence-based, and patient-centered respiratory care.
Recommended Textbook
Egans Fundamentals of Respiratory Care 9th Edition by Robert M. Kacmarek
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51 Chapters
3410 Verified Questions
3410 Flashcards
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Page 2
Chapter 1: History of Respiratory Care
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28 Verified Questions
28 Flashcards
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Sample Questions
Q1) Today, respiratory care educational programs in the United States are accredited by what organization?
A)National Board for Respiratory Care (NBRC)
B)American Association for Respiratory Care (AARC)
C)Committee on Accreditation for Respiratory Care (CoARC)
D)Joint Review Committee for Respiratory Therapy Education (JRCRTE)
Answer: C
Q2) When was the first Ventimask introduced that allows the precise delivery of 24%, 28%, 35%, and 40% oxygen?
A)1945
B)1954
C)1960
D)1972
Answer: C
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Chapter 2: Quality and Evidence-Based Respiratory Care
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29 Verified Questions
29 Flashcards
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Sample Questions
Q1) Current JCAHO standards for accreditation emphasize which of the following?
A)continual quality improvement
B)therapist-driven protocols
C)license and registration of health care providers
D)health, welfare, and safety of patients using respiratory care equipment
E)development of continuing education programs for health care providers
Answer: A
Q2) Quality in the practice of respiratory care encompasses which of the following?
A)personnel performing care
B)equipment used
C)method or manner in which care is provided
D)level of experience of respiratory care providers
E)all of the above
Answer: E
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4
Chapter 3: Patient Safety, Communication, and Record Keeping
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52 Flashcards
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Sample Questions
Q1) To confirm a physician's prescription for a drug that you need to give to a patient, you would go to which section of the medical record?
A)history and physical exam
B)laboratory sheet
C)physician's orders
D)medication record
Answer: C
Q2) Which of the following factors are most critical in determining when a patient can be ambulated?
I.willingness of patient
II.stability of vital signs
III.absence of severe pain
A)II and III
B)I and II
C)I, II, and III
D)I and III
Answer: A
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Chapter 4: Principles of Infection Control
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Sample Questions
Q1) What is the recommended dilution level of bleach according to the CDC for cleaning up blood spills?
A)1:1
B)1:5
C)1:10
D)1:20
Q2) Which of the following statements is NOT true regarding the use of alcohol disinfectants?
A)Their activity drops when diluted below 50% concentration.
B)Alcohols are good for surface cleaning of stethoscope bells and diaphragms.
C)They can damage rubber tubing.
D)They are considered sporicidal.
Q3) Which of the following statements is NOT true regarding the use of glutaraldehyde?
A)It is a true sterilizing agent when used properly.
B)It can retain activity up to 90 days once activated.
C)It is not used for disinfection on surfaces due to cost.
D)It can cause significant tissue inflammation in workers who use it.
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Chapter 5: Ethical and Legal Implications of Practice
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36 Flashcards
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Sample Questions
Q1) What is the term for a civil wrong committed against an individual or property, for which a court provides a remedy in the form of damages?
A)tort
B)misdemeanor
C)felony
D)litigation
Q2) What ethical issue has recently become a significant concern for respiratory therapists and all health care providers due to a congressional act?
A)patient's right to privacy
B)patient's right to care
C)patient's right to consultation
D)patient's right to refuse treatment
Q3) The debate over prolongation of life versus relief of suffering in elderly patients mainly involves differing opinions regarding what ethical principle?
A)autonomy
B)beneficence
C)role fidelity
D)justice
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7
Chapter 6: Physical Principles of Respiratory Care
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Sample Questions
Q1) Which of the following represents a direct measure of the kinetic activity of water vapor molecules?
A)absolute humidity
B)water vapor pressure
C)percent body humidity
D)relative humidity
Q2) One atmosphere (1 atm) of pressure is equivalent to which of the following?
I.29.9 inches Hg
II.14.7 lb/in<sup>2</sup>
III.1034.0 g/cm<sup>2</sup>
IV.760.0 mm Hg
A)I, II, and III
B)II and IV
C)I and III
D)I, II, III, and IV
Q3) What occurs when the temperature of a saturated gas drops down to its dew point?
A)Excess water vapor will condense as visible droplets.
B)The temperature of the surrounding air decreases.
C)Any liquid water present will quickly evaporate.
D)The relative humidity of the gas begins to decrease.
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Chapter 7: Computer Applications in Respiratory Care
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Sample Questions
Q1) You are conducting a research project and you need a software program to analyze the data collected. Which of the following would be most useful?
A)ADDC
B)SPSS
C)SOS
D)DADD
Q2) Hotmail, Yahoo, and Microsoft Outlook are examples of software for what purpose?
A)e-mailing
B)word processing
C)spread sheets
D)database management
Q3) What system is capable of point-of-care patient charting using a hand-held computer?
A)CliniVision MPC
B)Microsoft Flow
C)IBM Ready Now
D)Word Perfect
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Chapter 8: The Respiratory System
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Sample Questions
Q1) What is a primary function of the larynx?
A)cover the glottic opening during forced expiration
B)house Waldeyer's ring of tonsilar material for airway defense
C)protect airway during eating or drinking
D)provide a common passageway for food and gas
Q2) The pulmonary arterial circulation does which of the following?
I.delivers oxygenated blood back to the heart
II.delivers unoxygenated blood to the lungs
III.originates on the left side of the heart
IV.originates on the right side of the heart
A)I and IV
B)II and IV
C)I and III
D)II and III
Q3) Where does the sternal angle lie?
A)at the depression in the body of the sternum to which the clavicles attach
B)at the join between the manubrium and sternal body
C)at the superior edge of the sternum
D)where the xiphoid process connects to the sternum
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Page 10
Chapter 9: The Cardiovascular System
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Sample Questions
Q1) What is a normal cardiac ejection fraction?
A) \(1 / 4\)
B) \(1 / 3\)
C) \(1 / 2\)
D) \(2 / 3\)
Q2) Most of the muscle mass of the heart is located in which chamber?
A)left atrium (LA)
B)left ventricle (LV)
C)right atrium (RA)
D)right ventricle (RV)
Q3) What are the major effects of peripheral chemoreceptor stimulation?
A)decreased drive to breathe
B)decreased production of erythropoietin
C)vasoconstriction and increased heart rate
D)vasodilation and increased stroke volume
Q4) What is the affect on the cardiovascular medullary centers when the cerebral carbon dioxide is low?
A)excitatory
B)inhibitory
C)no affect
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Chapter 10: Ventilation
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Sample Questions
Q1) Which of the following lung units would empty and fill most slowly?
A)a unit with high resistance and high compliance
B)a unit with high resistance and low compliance
C)a unit with low resistance and high compliance
D)a unit with low resistance and low compliance
Q2) On inspecting a volume-pressure curve of the lungs and thorax, an increase in the mechanical work of breathing above normal would always be indicated by which of the following?
A)decrease in the area of the volume-pressure curve
B)decrease in the slope of the volume-pressure curve
C)increase in the area of the volume-pressure curve
D)Increase in the slope of the volume-pressure curve
Q3) During normal inspiration, which of the following occurs?
A)Alveoli at the apexes expand less than those at the bases.
B)Alveoli at the apexes expand more than those at the bases.
C)Alveoli at the bases expand less than those at the apexes.
D)Central alveoli expand more than those at the periphery.
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Chapter 11: Gas Exchange and Transport
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Sample Questions
Q1) What can you assume about a patient who has a \(\dot { V }\) / \(\dot { Q }\) imbalance and exhibits hypercapnia (PCO<sub>2</sub> greater than 45 mm Hg)?
A)The central nervous system is not responding to the increased PCO<sub>2</sub>.
B)The patient cannot sustain the high \(\dot { V }\) <sub>E</sub> to overcome the high V<sub>D</sub>.
C)The patient is compensating for an acute metabolic alkalosis.
D)The patient is compensating for a chronic metabolic acidosis.
Q2) What occurs in the bases of the upright lung?
A)The PAO<sub>2</sub> is higher than normal.
B)The respiratory exchange ratio is elevated.
C)There is significant deadspace under normal conditions
D)The \(\dot { V }\) / \(\dot { Q }\) is lower than the average.
Q3) Given the following blood parameters, compute the total oxygen content (dissolved + HbO<sub>2</sub>) of the blood in ml/dl: Hb = 16; PO<sub>2</sub> = 625 Hg; SO<sub>2</sub> = 100%.
A)17.8 ml/dl
B)19.4 ml/dl
C)21.4 ml/dl
D)23.3 ml/dl
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Page 13
Chapter 12: Solutions, Body Fluids, and Electrolytes
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Sample Questions
Q1) What is the most prominent anion in the body?
A)Cl<sup>-</sup>
B)HCO<sub>3</sub><sup>-</sup>
C)phosphate
D)sulfate
Q2) Which answer best describes the relationship between K<sup>+</sup> movement and acid-base balance?
A)Excess extracellular H<sup>+</sup> ions are exchanged for intracellular K<sup>+</sup>.
B)Extracellular acidosis results in serum hypokalemia.
C)Low-K<sup>+ </sup>diets are required following nasogastric suctioning.
D)When the extracellular pH rises, K<sup>+</sup> moves out of the cells.
Q3) What type of solution could have 1 gEq of solute per L of solution?
A)molal
B)molar
C)normal
D)weight/volume
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Chapter 13: Acid-Base Balance
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Sample Questions
Q1) According to the Henderson-Hasselbalch equation, the pH of the blood will be normal as long as the ratio of HCO<sub>3</sub><sup>-</sup> to dissolved CO<sub>2</sub> is which of the following?
A)10:1
B)20:1
C)24:1
D)30:1
Q2) Fixed acids are produced primarily from the catabolism of which of the following?
A)carbohydrates
B)fats
C)proteins
D)simple sugars
Q3) Which of the following is NOT a cause of hyperchloremic metabolic acidosis?
A)hyperalimentation
B)methanol intoxication
C)severe diarrhea
D)NH<sub>4</sub>Cl administration
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Chapter 14: Regulation of Breathing
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Sample Questions
Q1) When given high concentrations of oxygen, a patient with chronic hypercapnia may develop a more serious respiratory acidosis. Which of the following might be contributing to the patient's increased PCO<sub>2</sub>?
I.worsening ventilation-perfusion ( \(\dot { V }\) / \(\dot { Q }\) ) balance
II.desensitization of the carotid bodies
III.removal of the hypoxic stimulus
A)I and II
B)I only
C)I and III
D)I, II, and III
Q2) In patients with closed-head injuries, what may happen if the patient has hypercapnia?
A)High CO<sub>2</sub> increases the risk of psychotic events.
B)High CO<sub>2</sub> levels cause cerebral vasodilation and improved oxygenation.
C)Severe cerebral vasoconstriction results in anoxia and stroke.
D)Vasodilation causes increased intracranial pressure and possibly stops blood flow.
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16
Chapter 15: Bedside Assessment of the Patient
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Sample Questions
Q1) Which of the following conditions would tend to shift the point of maximal impulse (PMI) farther to the left?
I.pulmonary emphysema
II.collapse of the left lower lobe
III.collapse of the right lower lobe
IV.right-sided tension pneumothorax
A)I, II, and III
B)II and IV
C)II, III, and IV
D)I, II, III, and IV
Q2) In which of the following patient categories would the intensity of the point of maximal impulse (PMI) be most difficult to palpate?
A)chronic pulmonary hyperinflation
B)mitral (bicuspid) stenosis
C)left ventricular hypertrophy
D)right ventricular hypertrophy
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Chapter 16: Interpretation of Clinical Laboratory Data
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Sample Questions
Q1) The sweat chloride level is used to diagnose which of the following disorders?
A)asthma
B)cystic fibrosis
C)hyperthyroidism
D)hepatitis
Q2) What is indicated by an elevation of the anion gap?
A)respiratory failure
B)metabolic alkalosis
C)metabolic acidosis
D)renal failure
Q3) The mean cell hemoglobin concentration of your patient is reduced. What type of anemia is this?
A)microcytic
B)macrocytic
C)hypochromic
D)hypotrophic
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18
Chapter 17: Interpreting the Electrocardiogram
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Sample Questions
Q1) Which of the following is NOT a common characteristic of a premature ventricular complex (PVC)?
A)no P wave prior to the QRS complex
B)widened QRS complex
C)bizarre QRS complex
D)narrow QRS
Q2) What is the normal maximum length of the P wave?
A)1 mm
B)3 mm
C)5 mm
D)7 mm
Q3) Which of the following clinical conditions is not associated with tachycardia?
A)anxiety
B)hypoxemia
C)pain
D)hypothermia
Q4) An occasional premature ventricular complex (PVC) is not of major concern.
A)True
B)False
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Chapter 18: Analysis and Monitoring of Gas Exchange
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Sample Questions
Q1) What is the quality control procedure of analysis and reporting on externally provided control media with unknown values?
A)automated calibration
B)performance validation
C)proficiency testing
D)preventive maintenance
Q2) A patient being monitored by capnography exhibits a sudden rise in end-tidal CO<sub>2</sub> levels. All of the following are possible causes of this change except:
A)sudden release of a tourniquet
B)massive pulmonary embolism
C)sudden increase in cardiac output
D)injection of NaHCO<sub>3</sub>
Q3) What is the greatest hazard of pulse oximetry?
A)false results leading to incorrect decisions
B)pressure sores at the measuring site
C)skin burns due to using incompatible probes
D)electrical shock at the measuring site
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20
Chapter 19: Pulmonary Function Testing
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Sample Questions
Q1) Which of the following statements is FALSE regarding measurement of the patient's forced vital capacity (FVC)?
A)The patient can be sitting or standing.
B)Nose clips are not required.
C)It is an effort-dependent test.
D)Accurate results can be obtained without patient cooperation.
Q2) What is the most common measurement of pulmonary mechanics during pulmonary function testing?
A)tidal volume
B)forced vital capacity
C)residual volume
D)inspiratory reserve volume
Q3) A patient has an expired minute ventilation of 14.2 L and a ventilatory rate of 25/min. What is the average V<sub>T</sub>?
A)568 ml
B)635 ml
C)725 ml
D)410 ml
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Chapter 20: A Review of Thoracic Imaging
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Sample Questions
Q1) Radiographically, into how many compartments is the mediastinum divided?
A)two
B)three
C)four
D)five
Q2) Which of the following diseases is NOT typically evaluated using high-resolution CT?
A)emphysema
B)asthma
C)bronchiectasis
D)interstitial lung disease
Q3) Which of the following is NOT true regarding the visualization of air bronchograms on the chest film?
A)They indicate fluid in the pleura.
B)They are caused by air-filled airways surrounded by consolidation.
C)They are the hallmark of alveolar consolidation.
D)They signify air space disease.
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Chapter 21: Nutrition Assessment
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Sample Questions
Q1) What tube feeding method must be used when the food substance is delivered beyond the pylorus?
A)bolus
B)intermittent
C)continuous drip
D)pressurized
Q2) Which of the following blood tests is most useful for day to day monitoring of long-term trends in the nutrition status of the patient?
A)albumin levels
B)total white blood cell count
C)hematocrit
D)serum potassium levels
Q3) Your male patient has a creatinine excretion level of 8 mg/kg body weight/day. What does this indicate?
A)It is normal.
B)There is mild muscle wasting.
C)There is moderate muscle wasting.
D)There is severe muscle wasting.
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23
Chapter 22: Pulmonary Infections
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Sample Questions
Q1) What timeline has been established to initiate antibiotic treatment in patients with pneumonia who are admitted to the hospital that will result in improved survival?
A)2 hours or less
B)4 hours or less
C)6 hours or less
D)8 hours or less
Q2) A 45-year-old patient diagnosed with pneumonia has received appropriate antibiotic therapy. Radiographic resolution is most often seen within what time period?
A)1 week
B)1 month
C)6 months
D)1 year
Q3) What is the drug of choice for the patient with Pneumocystis jiroveci pneumonia?
A)ampicillin
B)doxycycline
C)erythromycin
D)trimethoprim-sulfamethoxazole
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Page 24
Chapter 23: Obstructive Lung Disease: Copd, Asthma, and Related Diseases
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Sample Questions
Q1) What causes the degranulation of mast cells in asthma patients?
A)antigens attaching to IgE molecules on the mast cell surface
B)antigens attaching to proteins receptors on mast cell surface
C)irritant receptors on the mast cells are stimulated by antigens
D)infectious particles attacking the mast cells
Q2) Which of the following signs associated with COPD is considered a late manifestation?
A)accessory muscle usage
B)frequent coughing
C)shortness of breath
D)wheezing
Q3) Which airways are most susceptible to airway obstruction in patients with COPD?
A)large
B)medium
C)small
Q4) Which of the following is NOT typically found in a patient with COPD?
A)airway inflammation
B)at least partially reversible airway obstruction
C)progressive airway obstruction
D)restrictive disease
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Chapter 24: Interstitial Lung Disease
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Sample Questions
Q1) Which of the following medications has been shown to be useful in the treatment of almost all interstitial lung diseases?
A)acetaminophen
B)aspirin
C)oxytocin
D)oxygen
Q2) It is determined that a patient has silicosis. What profession is he most likely to have worked at?
A)foundry worker
B)talc manufacturer employee
C)carpenter
D)miller
Q3) The first line of treatment for patients with hypersensitivity pneumonitis is to avoid the offending agent.
A)True
B)False
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Chapter 25: Pleural Diseases
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Sample Questions
Q1) What is the most common cause of pleural effusion in the clinical setting?
A)acute renal failure
B)congestive heart failure
C)liver disease
D)lung cancer
Q2) In what age group is a primary spontaneous pneumothorax most commonly seen?
A)under 15 years
B)18 to 25 years
C)35 to 45 years
D)over 60 years
Q3) For which type of pneumothorax is pleurodesis most commonly indicated?
A)iatrogenic
B)bronchopleural fistula
C)spontaneous
D)traumatic
Q4) Most pleural effusions are transudative.
A)True
B)False
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Chapter 26: Pulmonary Vascular Disease
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Sample Questions
Q1) Which of the following is true regarding the use of CT with contrast for diagnosing pulmonary embolism (PE)?
A)limited due to availability of CT equipment
B)most sensitive of the diagnostic techniques
C)can only identify the medium to large PE
D)high risk of mortality limits its use
Q2) Death from massive pulmonary embolism is the result of cardiovascular collapse rather than respiratory failure.
A)True B)False
Q3) The presence of previous chronic obstructive pulmonary disease (COPD) reduces the diagnostic usefulness of \(\dot { V } / \dot { Q }\) scans in acute pulmonary embolism.
A)True B)False
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Page 28
Chapter 27: Acute Lung Injury, Pulmonary Edema, and Multiple System Organ
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Sample Questions
Q1) Which of the following systems is the primary operant to rid the body of fluid accumulation in nonpathologic conditions?
A)respiratory
B)cardiac
C)lymphatic
D)renal
Q2) Which of the following clinical features is often common to both ARDS and congestive heart failure (CHF)?
A)PCWP >18 mm Hg
B)diffuse alveolar and interstitial infiltrates in chest radiograph
C)pleural effusions on chest radiograph
D)recent history of trauma
Q3) Which of the following assessment tools is most useful in distinguishing ARDS from CHF?
A)chest radiograph
B)arterial blood gas
C)Swan-Ganz catheter
D)pulmonary function testing
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Chapter 28: Lung Cancer
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Sample Questions
Q1) Which of the following organs is not commonly compromised in metastatic lung cancer?
A)brain
B)liver
C)bone
D)stomach
Q2) What type of histopathologic cells is associated with large-cell carcinoma?
A)pleomorphic cells
B)glandular structures
C)stratified epithelial cells
D)pulmonary stem cells
Q3) What composition of adenocarcinoma best describes its histopathology?
A)stratified epithelial cells
B)pleomorphic cells
C)polygonal cells
D)glandular structures
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Chapter 29: Neuromuscular and Other Diseases of the Chest Wall
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Sample Questions
Q1) What percentage of amyotrophic lateral sclerosis patients die within 5 years of diagnosis?
A)10%
B)25%
C)50%
D)80%
Q2) What is the mortality rate for Guillain-Barré syndrome?
A)0%
B)low, less than 10%
C)moderate, 40% to 60 %
D)high, greater than 80%
Q3) Patients with poor inspiratory muscle function might show significant orthopnea and prefer to sleep in a prone position.
A)True
B)False
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Page 31
Chapter 30: Disorders of Sleep
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Sample Questions
Q1) Central sleep apnea occurs more often than obstructive sleep apnea.
A)True
B)False
Q2) Oral devices may prove useful for cases of mild OSA.
A)True
B)False
Q3) What is considered to be the major problem with the use of CPAP in patients with obstructive sleep apnea?
A)patient compliance
B)frequent pneumothorax
C)cardiovascular complications
D)expense
Q4) Which of the following medical therapies is considered first-line treatment for obstructive sleep apnea (OSA)?
A)continuous positive airway pressure (CPAP)
B)surgery
C)oxygen therapy
D)antibiotics
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Chapter 31: Neonatal and Pediatric Respiratory Disorders
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Q1) In which of the following defects is heart transplantation an accepted option for treatment?
A)interrupted aortic arch
B)coarctation of the aorta
C)hypoplastic left heart syndrome
D)none of the above
Q2) Which of the following infant characteristics is associated with an increased risk of SIDS?
A)female gender
B)preterm birth
C)high APGAR score
D)full-term birth
Q3) Which of the following treatments is least likely to be needed in the treatment of the child with croup?
A)oxygen
B)mechanical ventilation
C)aerosolized racemic epinephrine
D)budesonide
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33
Chapter 32: Airway Pharmacology
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Q1) What is the available formulation strength for flunisolide (AeroBid) by metered-dose inhaler?
A)42 \(\mu\)g/puff
B)84 \(\mu\)g/puff
C)100 \(\mu\)g/puff
D)250 \(\mu\)g/puff
Q2) What is the duration of action for the formulation of ipratropium bromide plus albuterol sulfate (DuoNeb)?
A)4 to 6 hours
B)6 to 8 hours
C)8 to 10 hours
D)12 hours
Q3) Long-acting adrenergic bronchodilators such as salmeterol (Serevent) are not well suited for relief of acute airflow obstruction because it takes about how long for their peak effect to occur.
A)1 to 3 hours
B)3 to 5 hours
C)5 to 7 hours
D)longer than 12 hours
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Chapter 33: Airway Management
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Q1) What is the primary indication for tracheostomy?
A)when a patient loses pharyngeal or laryngeal reflexes
B)when a patient has a long-term need for an artificial airway
C)when a patient has been orally intubated for more than 24 hours
D)when a patient has upper airway obstruction due to secretions
Q2) Which of the following techniques may be used to diagnose injury associated with artificial airways?
I.laryngoscopy or bronchoscopy
II.physical examination
III.air tomography
IV.pulmonary function studies
A)I and II
B)I and III
C)II, III, and IV
D)I, II, III, and IV
Q3) What is the most common complication of suctioning?
A)hypoxemia
B)hypotension
C)arrhythmias
D)infection
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Chapter 34: Emergency Cardiovascular Life Support
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Q1) Which of the following drugs can be administered through an endotracheal tube during emergency life support?
I.lidocaine HCl
II.atropine sulfate
III.epinephrine HCl
IV.dopamine HCl
A)II and IV
B)I, III, and IV
C)I, II, and III
D)II and III
Q2) A patient with suspected spinal trauma is admitted to the emergency department and subsequently goes into respiratory arrest. Which of the following would be the appropriate action to initially secure an open airway in this patient?
A)Insert an esophageal obturator airway.
B)Apply the jaw thrust maneuver.
C)Apply the head-tilt and chin-lift method.
D)Employ the log-roll technique.
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Chapter 35: Humidity and Bland Aerosol Therapy
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Q1) A heated humidifier should trigger both auditory and visual alarms and interrupt power to the heater when the delivered temperature exceeds which of the following?
A)25° C
B)30° C
C)35° C
D)40° C
Q2) Which type of humidifier "traps" the patient's body heat and expired water vapor to raise the humidity of inspired gas?
A)membrane
B)bubble
C)heat-moisture exchanger
D)passover
Q3) What is the most common device used to generate bland aerosols?
A)small-volume jet nebulizer
B)ultrasonic nebulizer
C)large-volume jet nebulizer
D)spinning disk nebulizer
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Chapter 36: Aerosol Drug Therapy
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Q1) Which of the following would be correct instructions for a patient being taught proper use of a dry power inhaler?
I. Place mouthpiece 4 cm from mouth.
II. Exhale slowly to FRC.
III. Inhale slowly (less than 30 L/min).
IV. Repeat until dose is used up.
A)II and IV
B)III and IV
C)I, II, and III
D)I, II, III, and IV
Q2) A physician wants to deliver a therapeutic aerosol to the lung parenchyma (alveolar region). To help ensure maximum deposition in this area, you would select an aerosol generator with an MMAD in what range?
A)5 to 20 \(\mu\)m
B)2 to 5 \(\mu\)m
C)1 to 3 \(\mu\)m
D)less than 1 \(\mu\)m
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Chapter 37: Storage and Delivery of Medical Gases
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Q1) Which of the following is/are considered therapeutic gases?
I.O<sub>2</sub>
II.O<sub>2</sub>-NO mixture
III.O<sub>2</sub>-He mixture
IV.N<sub>2</sub>O
A)I and II
B)II and IV
C)III and IV
D)I, II, and III
Q2) What is the PISS index hole position for O<sub>2</sub>?
A)1 and 5
B)2 and 5
C)1 and 6
D)4 and 6
Q3) Which of the following statements about CO<sub>2</sub> is FALSE?
A)It does not support animal life.
B)It is a flammable gas.
C)It is odorless and colorless.
D)It is heavier than air.
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Chapter 38: Medical Gas Therapy
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Q1) Specific clinical objectives of oxygen (O<sub>2</sub>) therapy include which of the following?
I.decrease the symptoms caused by chronic hypoxemia
II.decrease the workload hypoxemia imposes on the heart and lungs
III.correct documented arterial hypoxemia
A)I and II
B)II and III
C)I and III
D)I, II, and III
Q2) What is the problem with input flows greater than 10 to 15 L/min in an infant Oxy-Hood?
A)production of harmful noise levels
B)difficulty in maintaining adequate humidification
C)difficulty in maintaining stable high FIO<sub>2</sub> values
D)increased likelihood of cold stress
Q3) Which of the following is TRUE about reservoir cannulas?
A)They reduce O<sub>2</sub> use as much as 200%.
B)During exercise, they do not reduce O<sub>2</sub> use.
C)Humidification is absolutely necessary.
D)Nasal anatomy and breathing pattern can affect performance of the device.
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Chapter 39: Lung Expansion Therapy
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Q1) Which of the following clinical findings indicate the development of atelectasis?
I.opacified areas on the chest x-ray film
II.inspiratory and expiratory wheezing
III.tachypnea
IV.diminished or bronchial breath sounds
A)I, III, and IV
B)I, II, III, and V
C)I and IV
D)II, III, and IV
Q2) In order to eliminate leaks in an alert patient receiving intermittent positive-pressure breathing therapy, which of the following adjuncts would you first try?
A)flanged mouthpiece
B)form-fitting mask
C)nasopharyngeal airway
D)nose clips
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Chapter 40: Bronchial Hygiene Therapy
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Sample Questions
Q1) Which of the following is true about exercise and airway clearance?
I. Exercise can enhance mucus clearance.
II. Exercise can improve pulmonary function.
III. Exercise can improve \(\dot { V } / \dot { Q }\) matching.
IV.Exercise can cause desaturation in some patients.
A)I, III, and IV
B)I, II, and III
C)I, II, III, and IV
D)II, III, and IV
Q2) The airway clearance technique that uses a pneumatic device to deliver compressed gas minibursts to the airway at rates above 100/min best describes which of the following?
A)intrapulmonary percussive ventilation
B)active cycle of breathing
C)high-frequency external chest wall compression
D)intermittent positive-pressure breathing
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42
Chapter 41: Respiratory Failure and the Need for Ventilatory Support
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Q1) When is respiratory muscle fatigue likely to occur?
A)when V<sub>E</sub> exceeds 20% of the maximum voluntary ventilation (MVV)
B)when V<sub>E</sub> exceeds 40% of the MVV
C)when V<sub>E</sub> exceeds 60% of the MVV
D)when V<sub>E</sub> exceeds 80% of the MVV
Q2) What is the normal range of maximum inspiratory pressure, or MIP (also called negative inspiratory force, or NIF), generated by adults?
A)-80 to -100 cm H<sub>2</sub>O
B)-50 to -80 cm H<sub>2</sub>O
C)-30 to -50 cm H<sub>2</sub>O
D)-20 to -30 cm H<sub>2</sub>O
Q3) A need for some form of ventilatory support is usually indicated when an adult's rate of breathing rises above what level?
A)35/min
B)30/min
C)25/min
D)20/min
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Page 43
Chapter 42: Mechanical Ventilators
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Q1) Which of the following ventilators is the simplest example of a true flow controller?
A)Newport Wave
B)Bear 1
C)Emerson 3-PV
D)Sechrist
Q2) A time-cycled constant flow generator is set up with a flow of 35 L/min and an inspiratory time of 1.7 seconds. What is the approximate V<sub>T</sub>?
A)750 ml (0.75 L)
B)1000 ml (1.00 L)
C)1900 ml (1.90 L)
D)1200 ml (1.20 L)
Q3) What is the primary use of pressure support ventilation at low pressure levels?
A)decrease the ventilator circuit-imposed respiratory muscle work
B)increase the functional residual capacity
C)decrease the V<sub>D</sub>/V<sub>T</sub>
D)restore tone to atrophied respiratory muscles
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Chapter 43: Physiology of Ventilatory Support
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Q1) Which of the following variables determine the level of support achieved with adaptive support ventilation?
I.patient effort
II.flow
III.time constant
A)I and III
B)II
C)I
D)I, II, and III
Q2) Which of the following parameters are set when volume-supported ventilation (VSV) is used?
I.tidal volume
II.maximum peak pressure
III.positive end-expiratory pressure (PEEP)IV.flow
A)I and III
B)II
C)I, II, III, and IV
D)I, II, and III
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45
Chapter 44: Initiating and Adjusting Ventilatory Support
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Q1) Which of the following statements is NOT true regarding the use of intermittent mandatory ventilation (IMV) or synchronized intermittent mandatory ventilation (SIMV)?
A)The machine breath is typically time cycled to inspiration.
B)The patient can breathe spontaneously between machine breaths.
C)SIMV is easy to apply.
D)SIMV may help maintain ventilatory muscle strength.
Q2) All the following are hazards associated with mechanical ventilation except:
A)reduced cardiac output
B)liver failure
C)increased work of breathing
D)acute lung injury
Q3) How long may the clinical benefit of inverse ratio ventilation take to be seen?
A)10 to 20 minutes
B)30 to 45 minutes
C)1 hour
D)several hours
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Chapter 45: Noninvasive Positive Pressure Ventilation
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Q1) What physiologic effect will raising the expiratory positive airway pressure have in the patient receiving noninvasive positive-pressure ventilation?
A)increase the functional residual capacity
B)increase the tidal volume
C)decrease the PCO<sub>2</sub>
D)lower the mean airway pressure
Q2) How does noninvasive positive-pressure ventilation (NPPV) benefit the patient with restrictive thoracic disease?
I.rests the respiratory muscles
II.lowers the PaCO<sub>2</sub>
III.improves lung compliance
IV.improves pulmonary function testing
A)I, II, and III
B)II and IV
C)I, II, and IV
D)I, III, and IV
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Chapter 46: Monitoring and Management of the Patient in the
Intensive Care
Unit
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Q1) What is the normal range for P(A-a)O<sub>2</sub> in a healthy 30-year-old person breathing room air?
A)0 to 10 mm Hg
B)5 to 15 mm Hg
C)10 to 20 mm Hg
D)cannot predict
Q2) Above what value for V<sub>DS</sub>/V<sub>T</sub> is weaning NOT likely?
A)0.10
B)0.30
C)0.50
D)0.60
Q3) Which of the following factors is not associated with an increased risk for auto-PEEP?
A)mechanical ventilation of a patient with obstructive lung disease
B)high minute volume during mechanical ventilation
C)acute respiratory distress syndrome (ARDS) patients
D)pulmonary fibrosis
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Chapter 47: Discontinuing Ventilatory Support
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Q1) Successful weaning is less likely when a patient's work of breathing exceeds what level?
A)4 J/min
B)8 J/min
C)12 J/min
D)16 J/min
Q2) Which of the following ventilator modes can ensure delivery of a preset V<sub>T</sub> during spontaneous breathing?
I. volume support or VERSUS (Siemens Servo Ventilator 300)
II. volume-assured pressure support or VAPS (Bird 8400ST)
III. augmented minute ventilation or MMV (Bear 1000)
A)II and III
B)I and II
C)I and III
D)I, II, and III
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Chapter 48: Neonatal and Pediatric Respiratory Care
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Q1) Which of the following is considered a limitation of the high-flow nasal cannula?
A)It does not meet patient's flow needs.
B)The amount of airway positive pressure cannot be measured.
C)It does not provide for appropriate CO<sub>2</sub> clearance.
D)It does not reduce the use of noninvasive positive-pressure ventilation.
Q2) Which of the following mean airway pressures is considered potentially deleterious when applying positive airway pressure?
A)2 cm H<sub>2</sub>O
B)5 cm H<sub>2</sub>O
C)10 cm H<sub>2</sub>O
D)15 cm H<sub>2</sub>O
Q3) You notice in drawing (retractions) of chest-wall muscle and tissue between the ribs, and above and below the sternum, all occurring during inspiration. Which of the following conclusions is most consistent with this observation?
A)airway resistance (Raw) is decreased.
B)lung compliance (C<sub>L</sub>) is decreased.
C)work of breathing is decreased.
D)chest-wall compliance is decreased.
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Chapter 49: Patient Education and Health Promotion
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Q1) Which of the following is the goal of tertiary prevention?
A)to prevent acceleration of the disease process once it has occurred
B)to cure the disease
C)to prevent related diseases
D)to stop recurrent episodes
Q2) Teaching physical skills to patients is learning in what domain?
A)cognitive
B)affective
C)psychomotor
D)analytical
Q3) Which of the following is used to evaluate cognitive objectives?
A)verbal exam
B)demonstration
C)written exam
D)performance checklist
Q4) Teaching facts to patients involves learning in what domain?
A)cognitive
B)affective
C)psychomotor
D)analytical
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Chapter 50: Cardiopulmonary Rehabilitation
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Q1) Specific patient objectives for a pulmonary rehabilitation program could include all of the following except:
A)proper use of medications, O<sub>2</sub>, and breathing equipment
B)reconditioning of both skeletal and respiratory muscles
C)adherence to proper hygiene and good nutrition
D)improvement in the results of pulmonary function tests
Q2) A patient is being considered for participation in a pulmonary rehabilitation program. Which of the following pulmonary function tests would you recommend be performed as a component of the preliminary evaluation?
I.lung volumes, including functional residual capacity (FRC)II.diffusing capacity (DLCO)III.pre- and post-bronchodilator flows
IV.lung and thoracic compliance
A)II and IV
B)I, II, and III
C)I, II, III, and IV
D)I, II, and IV
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Chapter 51: Respiratory Care in Alternative Settings
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Q1) Which of the following is an additional goal of home care of the terminally ill patient near the end of life?
A)prolong life
B)maximize comfort and well-being
C)maximize equipment use
D)minimize medication use
Q2) Which O<sub>2</sub> delivery system would you recommend for an active home care patient with low FIO<sub>2</sub> needs who desires increased mobility?
A)traditional low-flow nasal cannula supplied by O<sub>2</sub> concentrator
B)compressor-driven humidifier with supplemental O<sub>2</sub> through a concentrator
C)conserving device used in conjunction with a portable liquid O<sub>2</sub> system
D)air entrainment mask driven by a large (H/K) compressed gas cylinder
Q3) Which of the following is NOT normally part of the respiratory home care team?
A)respiratory care
B)durable medical equipment supplier
C)pulmonary function
D)nursing
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