Patient Assessment in Respiratory Care Final Exam
Course Introduction
This course provides an in-depth exploration of patient assessment techniques specific to respiratory care. Students will learn to gather, interpret, and integrate data from patient histories, physical examinations, and bedside assessments to inform clinical decision-making. Emphasis is placed on identifying signs and symptoms of respiratory dysfunction, performing systematic auscultation, pulse oximetry, and arterial blood gas analysis, as well as utilizing diagnostic tools such as spirometry and imaging. Through case studies and practicum exercises, students develop the critical thinking and technical skills necessary to assess and monitor patients with diverse respiratory conditions in both acute and chronic care settings.
Recommended Textbook
Basic Clinical Lab Competencies for Respiratory Care An Integrated Approach 5th Edition by Gary
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Chapter 1: Basics of Asepsis
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Sample Questions
Q1) Tuberculosis is transmitted by ______________.
A) Vehicle transmission
B) Vectorborne transmission
C) Direct contact transmission
D) Airborne transmission
Answer: D
Q2) What precaution should be followed for all health care settings and with all patients regardless of diagnosis?
A) Standard precautions
B) Use of a cover gown
C) Use of a mask
D) Droplet precautions
Answer: A
Q3) What should be done after performing a procedure on a patient prior to touching other surfaces in the patient's room?
A) remove the gloves
B) apply a cover gown
C) wash your hands
D) A and C
Answer: D
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Chapter 2: Basic Patient Assessment: Vital Signs and Breath
Sounds
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Q1) The practitioner places a sphygmomanometer on the patient's upper arm.The brachial artery is palpated and the cuff is inflated until the pulse disappears at 110 mmHg.How should this be recorded in the patient's chart?
A) This is the systolic pressure
B) This is the diastolic pressure
C) This is the pulse pressure
D) This is the intrathoracic pressure
Answer: A
Q2) The practitioner records a carotid pulse of 45/minute.How should this be documented in the patient's chart?
A) Tachycardia
B) Bradycardia
C) Hypotension
D) Hypertension
Answer: B
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Chapter 3: Advanced Patient Assessment: Inspection,
Palpation, and Percussion
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Q1) What is (are)the bony prominence(s)on the posterior chest?
I.Vertebrae
II.Sternum
III.Scapulae
IV.Clavicles
A) I and III
B) II and IV
C) I only
D) II, III, IV
Answer: A
Q2) What is a congenital deformity of the sternum characterized by a depression in the sternum at the level of the lower body and xyphoid process?
A) Lordosis
B) Pectus excavatum
C) Kyphoscoliosis
D) Pectus carinatum
Answer: B
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Chapter 4: Radiologic Assessment
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Q1) Which view is utilized to identify and quantify the extent of pleural effusion?
A) Lateral
B) Lateral decubitus
C) Apical lordotic
D) Portable
Q2) When observing the chest x-ray of a patient,how can you tell if a patient is rotated?
A) The trachea should be at the level of the fourth thoracic vertebra
B) The spine should lie equal distance between each clavicle
C) The trachea should be about 4 to 6 cm in length
D) The clavicles should be connected to the sternum
Q3) The most radiodense material viewed on a chest x-ray will _______________.
A) appear black.
B) not show up on a standard chest x-ray.
C) appear as gray shadows.
D) appear white.
Q4) A patient with a bilateral hyperresonant percussion note has a chest x-ray taken.What would you expect to find on the chest x-ray?
Q5) Air appears dark on the chest radiograph.What type(s)of pathology would appear dark on the chest x-ray?
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Chapter 5: Pulmonary Function Testing
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Sample Questions
Q1) Anatomical dead space is approximately _____________.
A) 1 ml/kg.
B) 165 ml.
C) 10 ml/kg.
D) 1 ml/lb.
Q2) Which of the following would be used to measure a patient's tidal volume and minute volume?
A) Peak flowmeter
B) Manometer
C) Respirometer
D) Mini-Wright device
Q3) What gas in the single breath diffusion test because it only trace amounts are found in the atmosphere and it has a greater affinity for hemoglobin than oxygen?
A) Carbon Dioxide
B) Nitrogen
C) Carbon Monoxide
D) Nitric Oxide
Q4) Why are three pulmonary function test trials performed for simple spirometry and flow volume loops and how should the results be reported?
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Chapter 6: Electrocardiography
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Q1) When looking at the ECG graph paper,you notice the 'P-R' interval is exactly the same distance of one of the larger squares.What is this distance?
A) 1 millivolt
B) 1 second
C) 0.04 seconds
D) 0.20 seconds
Q2) When a stimulus only causes a small portion of the atria to contract in an unorganized pattern,then ____________ occurs.
A) atrial fibrillation
B) ventricular fibrillation
C) a normal sinus rhythm
D) a sinus tachycardia
Q3) Which of the following is the heart's pacemaker?
A) Right and left bundle branches
B) Vagus nerve
C) AV node
D) SA node
Q4) An extremely obese patient is to ordered to have an EKG.What problems could be encountered and how should they be approached?
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Chapter 7: Phlebotomy
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Q1) What is the key to maintaining a safe work environment?
A) Patient
B) Supervisor
C) Exposure control policy
D) Physician
Q2) An exposure control policy is meant to protect ________________.
A) health care providers.
B) patients.
C) support staff.
D) health care providers, patients, and support staff.
Q3) A tourniquet can be used to enhance vein distension to ease the location of a good vein for a venous draw.What would happen if the tourniquet were left on too long?
Q4) Which of the following would NOT make the patient's veins distend and make blood drawing easier?
A) Apply a tourniquet
B) Use the proper vacuum collection container
C) Place the patient's extremity in a dependent position
D) Have the patient clench his/her fist
Q5) How does the phlebotomist gain the confidence of the patient for a blood draw?
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Chapter 8: Arterial Blood Gas Sampling
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Q1) A delay of more than 30 minutes in analyzing an arterial blood gas sample,even if it is iced,would have what effect on the blood gas values?
A) Higher PO , higher PC0 , lower pH
B) Lower PO , lower PC0 , higher pH
C) Lower PO , higher PCO , higher pH
D) Lower PO , higher PCO , lower pH
Q2) Which artery is located on the medial side of the antecubital fossa near the insertion of the biceps muscle at the radial tuberosity?
A) Radial artery
B) Brachial artery
C) Femoral artery
D) Dorsalis pedis
Q3) Hyperventilation may lower the patient's ___________
A) PaCO .
B) anxiety.
C) pH.
D) PaO .
Q4) What should the practitioner teach the patient concerning an arterial line?
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Chapter 9: Hemodynamic Monitoring
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Q1) The hemodynamic data are recorded from a pulmonary artery catheter on a patient who is being mechanically ventilated.
\( \begin{array}{lc}\text { Cardiac Output } & 2.5 \mathrm{~L} / \mathrm{min} \\ \text { PAP } & 22 / 10 \mathrm{mmHg} \\ \text { PCWP } & 2 \mathrm{mmHg} \\ \text { CVP } & 1 \mathrm{mmHg} \\ \text { HR } & 125 / \mathrm{min}\end{array} \)
How should the practitioner interpret this data and what treatment should be recommended?
Q2) The hemodynamic data are recorded from a pulmonary artery catheter on a patient who is being mechanically ventilated.
\( \begin{array}{lc}\text { Cardiac Output } & 7.0 \mathrm{~L} / \mathrm{min} \\ \mathrm{PAP} & 50 / 30 \mathrm{mmHg} \\ \text { PCWP } & 12 \mathrm{mmHg} \\ \text { CVP } & 3 \mathrm{mmHg} \\ \text { HR } & 125 / \mathrm{min}\end{array} \)
How would the practitioner interpret this data and what should be recommended?
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Chapter 10: Noninvasive Monitoring
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Q1) What would be indicated for the monitoring the matching of ventilation to perfusion during independent lung ventilation for unilateral pulmonary contusion?
A) Pulse oximetry
B) Minute volume
C) Capnography
D) Transcutaneous oxygen monitoring
Q2) Transcutaneous monitoring's limitations can be minimized by all of the following EXCEPT _______________.
A) site changes.
B) calibrations.
C) frequent membrane changes.
D) temperature adjustments.
Q3) What noninvasive monitoring technique should be used to help confirm the ET tube is in the proper position?
A) Capnography
B) Transcutaneous C02 monitoring
C) Pulse oximetry
D) Transcutaneous 02 monitoring
Q4) How does the pulse oximeter measure O saturation in the capillary bed?
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Chapter 11: Documentation and Goals Assessment
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Q1) What are measurable,demonstrated outcomes that can be assessed following patient treatment or intervention?
A) Goals
B) Objectives
C) Assessments
D) Procedures
Q2) Which of the following are NOT included in imaging reports?
A) Ultrasound
B) Surgery
C) Chest radiographs
D) Magnetic resonance imaging scans
Q3) Vital signs,breath sounds,jugular venous distention,heart tones,SpO ,and bowel sounds are all examples of _________________.
A) objective data.
B) subjective data.
C) clinical goals.
D) graphic records.
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Chapter 12: Oxygen Supply Systems
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Q1) What is the color code for an air cylinder?
A) Yellow
B) White
C) Gray
D) Red
Q2) The ____________ has developed a color code for the different gases and gas mixtures.
A) U.S. Department of Transportation (DOT)
B) Compressed Gas Association (CGA)
C) Pin Index Safety System (PISS)
D) National Fire Protection Association (NFPA)
Q3) Certain substances,when exposed to oxygen,may ignite with great force without the addition of heat to initiate the process.This phenomenon is termed
A) the tank factor.
B) cracking a cylinder.
C) spontaneous combustion.
D) hydrostatic testing.
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Chapter 13: Oxygen Administration
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Q1) Which of the following is an absolute contraindication to oxygen therapy?
A) Oxygen toxicity
B) Paraquat poisoning
C) Bleomycin therapy
D) There are none
Q2) Which type of oxygen analyzer uses an oxidation-reduction reaction to measure the FO of an oxygen sample?
A) Galvanic oxygen analyzer
B) Polarographic oxygen analyzer
C) Electrical oxygen analyzer
D) a and b
Q3) Because low-flow devices provide only part of the inspiratory needs,the delivered fraction of inspired oxygen may vary depending on several factors.Which of the following is NOT one of those factors?
A) Decreased oxygen content in the blood
B) Flow of oxygen through the device
C) Patient's tidal volume
D) Patient's respiratory rate
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Chapter 14: Introduction to Respiratory Care Pharmacology
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Sample Questions
Q1) After delivery of an adrenergic bronchodilator with a small volume nebulizer,a patient complains of "shakiness" and feeling "nervous".He notes palpitations and his heart feels like it is racing.What is happening and how could these problems be corrected?
Q2) Which of the following drugs stabilize mast cells?
A) Ipratropium
B) Cromolyn sodium
C) Albuterol
D) Fluticasone
Q3) An aerosol drug is ordered on a patient in MDI form.The propellant causes a reflex bronchospasm in the patient.What can be done?
Q4) Stimulation of the beta 2 receptors causes ___________________
A) peripheral vasoconstriction and mild bronchoconstriction in the lungs.
B) tachycardia, an increased potential for arrhythmias, and an increased cardiac output.
C) bronchodilation.
D) peripheral vasodilation, bradycardia, and decreased cardiac output.
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Chapter 15: Humidity and Aerosol Therapy
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Q1) If a gas is fully saturated with water vapor (100% saturated),what can be stated about the gas?
A) It is at body humidity.
B) It is at maximum humidity.
C) The relative humidity is 50%.
D) The temperature of the gas is 37°C.
Q2) When monitoring the effectiveness of bronchodilator administration,which of the following pulmonary function tests would indicate the airway responsiveness the best?
A) Residual volume
B) Functional residual capacity
C) Tidal volume
D) Peak flow
Q3) With the administration of water,hypotonic,or isotonic saline,an improved outcome is indicated by the presence of which of the following?
A) Heart rate increasing with more PVCs
B) Decreased work of breathing
C) Increasing PaCO with decreasing pH
D) Increased audible stridor
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Chapter 16: Bronchial Hygiene Therapy
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Q1) Before initiating PEP therapy,the respiratory care practitioner verifies the physician's order for PEP therapy.Upon review of the patient's chart,it is noted that the patient has an acute sinusitis and a history of epistaxis.What should this tell the practitioner about the patient?
A) The patient may have cystic fibrosis also and the PEP therapy should be given with a mucolytic drug.
B) The patient should be set in the Fowler's position before the therapy is initiated.
C) A drug with alpha effects should be given before proceeding with the therapy.
D) The patient should be carefully evaluated before PEP therapy is initiated.
Q2) During bronchial hygiene therapy in the Trendelenburg position,the patient's SpO decreases from 92% on a 35% Venturi mask to 80% during the first 5 minutes of the therapy.What intervention would be the most correct for the Respiratory Care Practitioner to take at this time?
A) Administer 100% oxygen, stop therapy immediately, return the patient to original resting position, and consult the physician.
B) Administer 100% oxygen and consult the physician.
C) Administer 100% oxygen and continue the therapy with the patient flat in bed.
D) Stop therapy immediately and return patient to original resting position.
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Chapter 17: Hyperinflation Therapy
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Sample Questions
Q1) Which of the following are hazards of IS?
I.Exacerbation of bronchospasm
II.Hyperventilation
III.Barotrauma
IV.Oxygen induced hypoventilation
A) I and III
B) II and IV
C) I, II, III, and IV
D) I, II, and III
Q2) While administering IPPB with a inspiratory pressure of 25 cmH O,a patient develops sudden shortness of breath.When assessing the patient it is noted that breaths are absent on the right side.Percussion of the right side yields a hyperresonant percussion note.No chest tube has been placed yet.Which way would the patient's trachea shift?
A) Toward the right
B) Cephalid
C) Toward the left
D) It will remain midline
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Chapter 18: Bronchoscopy Assisting
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Q1) Which of the following are indications of fiberoptic bronchoscopies?
I.The need to reevaluate persistent pulmonary infiltrates
II.The need for aid in difficult intubations
III.The need to obtain upper respiratory tract secretions
IV.Negative sputum cytology results with diagnosed cancer elsewhere in the body
A) III and IV
B) II only
C) I and II
D) I, II, III, and IV
Q2) What procedure should follow a bronchoscopic procedure involving a transbronchial biopsy?
A) Microscopic sputum examination
B) Chest x-ray
C) Mechanical ventilation
D) Bronchoalveolar lavage
Q3) Bronchoscopy is commonly performed for two reasons:
A) identification and assessment.
B) bronchoscopic and radiographic.
C) therapeutic and diagnostic.
D) cytological and infection control.
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Chapter 19: Equipment Processing and Surveillance
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Q1) What is defined as the complete destruction of all forms of microorganisms,including spores?
A) Antisepsis
B) Sterilization
C) Disinfection
D) Pasteurization
Q2) What types of vaccines should a health care worker undergo routinely?
Q3) Which of the following is NOT a main area of an equipment processing facility?
A) Decontamination
B) Processing
C) Storage
D) Manufacture
Q4) Hospital acquired infections are also called _______________
A) spores.
B) Bacillus.
C) nosocomial infections.
D) Clostridium.
Q5) The practitioner has just performed a bedside pulmonary function test on a patient who tests positive for tuberculosis.This is detected only 1 hour before the next test is to be performed.What should be done?
21
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Chapter 20: Emergency Airway Management
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Q1) Which of the following reflexes of the upper airway are cough reflexes?
I.Carinal reflex
II.Tracheal reflex
III.Laryngeal reflex
IV.Gag reflex
V.Swallow reflex
A) I and II
B) III and V
C) II only
D) I, III, IV, V
Q2) Which of the following is NOT a contraindication for resuscitation of a patient?
A) Resuscitation has been determined to be futile because of the patient's underlying condition or disease
B) A patient that has had a diagnosis of lung cancer with metastasis to another part of the body
C) The patient's desire not to be resuscitated has been clearly expressed and documented in the patient's medical record
D) a and c
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Chapter 21: Artificial Airway Care
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Q1) When evaluating sputum suctioned from a patient that is being mechanically ventilated,which of the following characteristics should be evaluated?
I.Color
II.Consistency
III.Odor
IV.Amount
A) I and III
B) II and IV
C) I, II, III, IV
D) I, II, IV
Q2) A patient requires nasotracheal suctioning as evidenced by coarse breath sounds.How should the patient be positioned for the procedure?
A) Semi-Fowler's position
B) Sniffing position
C) Prone position
D) Either a or b
Q3) You cannot pass the suction catheter down the endotracheal tube on an intubated patient.What should you do and how would you correct the problems?
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Chapter 22: Chest Tubes
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Q1) A patient with a chest tube in place develops swelling of the tissue surrounding the chest tube with crackling sensations also noted in the same area.What could be causing this and how is it treated?
Q2) Which of the following drugs would you suggest to the physician as a local anesthetic to use at the point of insertion of a chest tube?
A) 4% Lidocaine
B) Midazolam
C) Providone-iodine
D) Aspirin cream
Q3) A chest radiograph reveals a massive pleural effusion in the patient's left thorax.How should the chest tube be positioned to drain the effusion?
A) Anteriorly near the apex of the lung
B) Posteriorly along the base of the lung
C) Medially toward the mediastinum
D) Laterally toward the periphery of the lung
Q4) A patient with a chest tube in place suddenly develops chest pain and severe respiratory distress.What could be causing this?
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Chapter 23: Insertion and Maintenance of Intravenous Lines
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Q1) After starting an IV,the practitioner is concerned about preventing an air embolism.Which of the following will best prevent an air embolism in the patient?
A) Maintaining the IV bag in an upright position at all times
B) Ensuring that all air is removed before the tubing is connected to the catheter
C) Running the intravenous infusion at a normal rate.
D) a and b
Q2) A patient is admitted to the MICU with a closed head injury with cerebral edema.What type of IV solution will cause water to be drawn from inside the cell and into the vascular space and is desirable in cases of cerebral edema?
A) Hypotonic solution
B) Hypertonic solution
C) Isotonic solution
D) Lactated Ringer's solution
Q3) What happens to the small air bubbles that pass through the IV tubing and enter into the patient?
Q4) What is the purpose of transparent dressings on a IV?
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Chapter 24: Noninvasive Positive-Pressure Ventilation
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Q1) Noninvasive positive-pressure ventilation has been applied the most to patients with what diagnosis?
A) Acute hypoxemic respiratory failure
B) Severe acute asthma
C) Acute exacerbation of chronic obstructive pulmonary disease
D) Acute cardiogenic pulmonary edema
Q2) The respiratory care practitioner is called to the medical intensive care unit to evaluate a pneumonia patient for impending ventilatory failure.Arterial blood gases (ABGs)are drawn and the results are as follows: PaO 49 mmHg,PaCO 58 mmHg,pH
7.24,HCO 23 mEq/L,FIO 0.6.What do the patient's ABGs indicate?
A) The patient has impending ventilatory failure.
B) The patient has normal PaO status for an increased FIO .
C) The patient has chronic ventilatory failure.
D) The patient's RSBI needs to be measured to determine ventilatory status.
Q3) Which of the following is NOT a sign of increased ventilatory work?
A) Accessory muscle usage
B) Respiratory rate of 18/min
C) Retractions
D) Pursed lip breathing
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Chapter 25: Continuous Mechanical Ventilation
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Q1) Which of the following is true of CPAP?
I.It can be applied noninvasively by mask to the patient
II.It is pressure held in the lungs on inspiration and expiration
III.It is Continuous Primary Alveolar Pressure
IV.It can be delivered by endotracheal or tracheostomy tube
A) I, II, III and IV
B) I, II and III
C) II, III and IV
D) I, II and IV
Q2) How is tubing compliance determined?
Q3) A practitioner needs to ventilate a patient with airway resistance and lung compliance that will be changing.Which of the following will give a stable tidal volume and minute volume despite this change.
A) Pressure ventilator
B) Bird Mark 7
C) Volume control ventilator (VCV)
D) Pressure control ventilation
Q4) How does a practitioner perform a system leak test?
Q5) How does a practitioner measure airway resistance on a ventilator?
Q6) What is the difference in calculating dynamic compliance vs static compliance?
Page 27
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Chapter 26: Advanced Modes of Mechanical Ventilation
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Q1) The Nellcor Puritan Bennett 840 recommends an operational check of the BDU,sensors,resistance and compliance of the circuit prior to use.This is called
A) tubing compliance.
B) The short self test.
C) the power on self test
D) the user verification test
Q2) Which of the following will occur after 12 seconds in the VSV Automode?
A) The ventilator will flash a visible apnea alarm.
B) The ventilator will switch to pressure support.
C) The ventilator will switch to PRVC.
D) The ventilator will volume assist ventilation.
Q3) A respiratory care practitioner may use which of the following to eliminate the airway resistance caused by an artificial airway?
A) APRV
B) Automatic tube compensation
C) Inverse ratio ventilation
D) Automode
Q4) What is proportional assist ventilation?
Q5) How does a respiratory care practitioner assess the patient's work of breathing?
Page 28
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Chapter 27: Wave Form Analysis
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Q1) The respiratory care practitioner wants to check the airway resistance with an asthmatic patient on a ventilator.She can check airway resistance by which of the following?
A) Checking the inspiratory pressure time display for peak pressure.
B) Evaluating the volume time tracing for evidence of unevenness of filling
C) Dividing frequency by tidal volume in liters
D) Observing the slope of the expiratory flow tracing
Q2) Which of the following wave forms would be most useful in detecting changes in airway resistance especially after delivery of a bronchodilator?
A) Pressure versus volume
B) Pressure versus time
C) Flow versus volume
D) Volume versus time
Q3) The respiratory care practitioner wants to use the graphic display to determine the ventilator's tidal volume.Which of the following should he do?
A) Read the Vt from the horizontal axis of the pressure time display
B) Read the Vt from the vertical axis of the volume time display
C) Read the Vt from the horizontal axis of the volume time display
D) Read the Vt from the vertical axis of the flow volume display
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Page 29
Chapter 28: Weaning and Discontinuance of Mechanical Ventilation
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Q1) What four general questions should the respiratory care practitioner assess prior to weaning from mechanical ventilation?
Q2) According to the AARC Clinical Practice Guidelines on Weaning and Discontinuation on Ventilatory Support,adequate patient oxygenation criteria for weaning is measured by
I.PaO greater than 60 mm Hg
II.FIO set less than 0.4
III.PEEP zero
IV.PO /FIO ratio greater than 150-300
A) I, II, III and IV
B) I, II and III
C) I, II and IV
D) II, III and IV
Q3) Which of the following is the best predictor of successfully weaning a patient from a ventilator?
A) f/Vt ratio of less than 105
B) PaO /FIO ratio greater than 150-200
C) VD/VT ratio less than 0.55-0.60
D) MIP less than -20 to -30 cm H2O
Q4) What should the respiratory therapist do if the patient does not pass the SBT?
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Chapter 29: Neonatal Mechanical Ventilation
Available Study Resources on Quizplus for this Chatper
34 Verified Questions
34 Flashcards
Source URL: https://quizplus.com/quiz/40363
Sample Questions
Q1) Which of the following are goals for mechanical ventilation?
I.Adequate alveolar gas exchange
II.Prevent ventilator induced lung injury
III.Reduce patient's work of breathing
A) I, II and III
B) II and III
C) I and III
D) I only
Q2) According to the retired AARC Clinical Practice Guidelines on time-triggered,pressure- limited,time-cycled neonatal ventilation,risk of ROP can be minimized by ___________________
A) keeping PaO less than 60 mmHg.
B) keeping SpO greater than 80%.
C) keeping PaO less than 80 mmHg.
D) maintaining pH greater than 7.35.
Q3) Describe how the initial newborn ventilator setting are determined for mode,rate and flow rate.
Q4) Describe how the initial newborn ventilator alarm setting are determined.
Q5) Describe how the initial newborn ventilator setting are determined for tidal volume,oxygen percent and PEEP/CPAP
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