Patient Assessment in Respiratory Care Question Bank
Course Introduction
This course provides a comprehensive overview of patient assessment skills essential for respiratory care professionals. Students will learn techniques for obtaining and evaluating medical histories, performing physical examinations focusing on the respiratory system, and interpreting vital signs. Emphasis is placed on differentiating normal and abnormal breath sounds, assessing oxygenation and ventilation status, and recognizing clinical manifestations of common pulmonary diseases. The course also covers the use of diagnostic tools such as pulse oximetry, arterial blood gas analysis, and pulmonary function testing. Through case studies and practical exercises, students develop critical thinking and clinical decision-making skills required for effective patient evaluation in diverse healthcare settings.
Recommended Textbook
Clinical Manifestations and Assessment of Respiratory Disease 7th Edition by Terry
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44 Chapters
673 Verified Questions
673 Flashcards
Source URL: https://quizplus.com/study-set/248
Page 2
Des Jardins
Chapter 1: The Patient Interview
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13 Verified Questions
13 Flashcards
Source URL: https://quizplus.com/quiz/3919
Sample Questions
Q1) During the interview the patient states, "Every time I climb the stairs I have to stop to catch my breath." Hearing this, the respiratory therapist replies, "So, it sounds like you get short of breath climbing stairs." This interviewing technique is called:
A) clarification.
B) modeling.
C) empathy.
D) reflection.
Answer: D
Q2) For there to be a successful interview, the respiratory therapist must:
A) provide leading questions to guide the patient.
B) be an active listener.
C) reassure the patient.
D) use medical terminology to show knowledge of the subject matter.
Answer: B
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3
Chapter 2: The Physical Examination and Its Basis in Physiology
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13 Verified Questions
13 Flashcards
Source URL: https://quizplus.com/quiz/3920
Sample Questions
Q1) A patient comes into the emergency department with a complaint of centrally located, constant chest pain. What is his most likely problem?
A) Pleurisy
B) Myocardial ischemia
C) Pneumothorax
D) Fractured rib
Answer: B
Q2) A patient with bronchiectasis has a productive cough. Which of the following should the respiratory therapist be evaluating about the patient's sputum?
1) Color
2) Odor
3) Amount
4) Consistency
A) 3
B) 3, 4
C) 1, 2
D) 1, 2, 3, 4
Answer: D
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Chapter 3: Pulmonary Function Study Assessments
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13 Verified Questions
13 Flashcards
Source URL: https://quizplus.com/quiz/3921
Sample Questions
Q1) The respiratory therapist is called to the neurologic care unit to assess the muscle strength of a patient diagnosed with myasthenia gravis. Which of the following tests should the therapist recommend to assess respiratory muscle strength?
A) Maximum inspiratory pressure (MIP)
B) Maximum inspiratory flow rate (MIFR)
C) Maximum expiratory flow rate (MEFR)
D) Vital capacity (VC)
Answer: A
Q2) Overall characteristics of pulmonary function testing results on a patient with obstructive lung disease include that the FEV<sub>1</sub>:
A) is reduced and FEV1% is normal.
B) and FEV<sub>1</sub>% are both increased.
C) and FEV<sub>1</sub>% are both reduced.
D) is increased and FEV1% is decreased.
Answer: C
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Chapter 4: Arterial Blood Gas Assessments
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13 Verified Questions
13 Flashcards
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Sample Questions
Q1) The respiratory therapist is assessing a patient with end-stage COPD who was admitted to the medical ward for an exacerbation of COPD due to increasing sputum purulence. The therapist notes the following ABG results in the patient's electronic medical record: pH 7.52, PaCO<sub>2</sub> 51; HCO<sub>2</sub> 40; PaO<sub>2</sub>
46. Which of the following is the best interpretation of these ABG results?
A) Chronic ventilatory failure with hypoxemia
B) Acute ventilatory failure with hypoxemia
C) Partially compensated metabolic alkalosis with hypoxemia
D) Partially compensated respiratory acidosis with hypoxemia
E) Acute alveolar hyperventilation superimposed on chronic ventilatory failure
Q2) A patient has had chronic ventilatory failure for several years. What is the primary factor that determines her breathing pattern?
A) Muscle efficiency
B) Ventilatory efficiency
C) Heart function
D) Work efficiency
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6
Chapter 5: Oxygenation Assessments
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13 Verified Questions
13 Flashcards
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Sample Questions
Q1) A condition that will cause anemic hypoxia is:
A) cyanide poisoning.
B) decreased cardiac output or heart failure.
C) polycythemia.
D) carbon monoxide poisoning.
Q2) Oxygen consumption:
1) increases with exercise.
2) is the amount of oxygen used by the body.
3) is inversely related to carbon dioxide production.
4) is about 250 mL/min in the resting adult.
A) 1, 2
B) 3, 4
C) 2, 4
D) 1, 2, 4
Q3) A patient has a chronic respiratory disorder and vasoconstriction of her pulmonary vascular system. What is the chief control over this vasoconstriction?
A) Low PAO<sub>2</sub>
B) Low PaO<sub>2</sub>
C) High PaCO<sub>2</sub>
D) High pH
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Chapter 6: Cardiovascular System Assessments
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13 Verified Questions
13 Flashcards
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Sample Questions
Q1) Which of the following is found when a patient has sinus arrhythmia?
1) Rate decreases during expiration.
2) Rate decreases during inspiration.
3) Rate varies by more than 10% from beat to beat.
4) Rate increases during inspiration.
A) 3
B) 2, 3
C) 1, 4
D) 1, 3, 4
Q2) When reviewing a cardiac rhythm strip, the respiratory therapist notices that there are three large boxes between two QRS complexes. Approximately what is this patient's heart rate?
A) 60
B) 75
C) 100
D) 150
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Chapter 7: Radiologic Examination of the Chest
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13 Verified Questions
13 Flashcards
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Sample Questions
Q1) The respiratory therapist is called to evaluate a patient with a suspected pulmonary embolus. The respiratory therapist would MOST likely recommend which of the following diagnostic procedures to help determine if the patient has a pulmonary embolus?
A) CTPA
B) Fluoroscopy
C) PET scan
D) MRI scan
E) CT scan
Q2) Which of the following is true of a chest radiograph?
A) Lateral films are shot through one side of an upright patient.
B) AP films are typically taken in the x-ray department.
C) PA films artificially increase the size of the heart shadow.
D) Lateral decubitus films are shot with the patient lying supine.
Q3) A patient has had a ventilation-perfusion scan. What would be identified from the ventilation scan?
A) Location of a lung abscess
B) Alveolar consolidation
C) Location of a pulmonary embolism
D) Location of an airway obstruction
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Page 9
Chapter 8: Other Important Tests and Procedures
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13 Flashcards
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Sample Questions
Q1) In response to a viral infection, which of the following can be expected to be seen in the white blood cell count?
A) Increased lymphocytes
B) Decreased monocytes
C) Increased basophils
D) Decreased platelets
Q2) The respiratory therapist is caring for a patient who is receiving diuretic therapy as part of the medication regimen for her congestive heart failure. Which of the following would the therapist MOST likely monitor in watching for common side effects associated with diuretic therapy?
A) Hypokalemia
B) Hyperchloremia
C) Hyperbilirubinemia
D) Hyponatremia
Q3) Therapeutic bronchoscopy is used for all of the following EXCEPT:
A) to remove a foreign body.
B) in selective lavage.
C) in bronchiectasis evaluation.
D) to manage life-threatening hemoptysis.
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Chapter 9: The Therapist-Driven Protocol Program and the
Role of the Respiratory Therapist
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11 Verified Questions
11 Flashcards
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Sample Questions
Q1) Which of the following is (are) associated with the bronchospasm clinical scenario?
1) Increased airway resistance
2) Decreased FRC
3) Bronchial breath sounds
4) Hyperresonant percussion note
A) 3
B) 1, 4
C) 2, 3
D) 1, 3, 4
Q2) Postural drainage, percussion, and vibration are part of what TDP?
A) Lung expansion protocol
B) Bronchopulmonary hygiene therapy protocol
C) Aerosolized medication therapy protocol
D) Oxygen therapy protocol
Q3) A TDP can be started after:
A) the nurse finishes his or her assessment.
B) the treatment option is selected.
C) a physician's order for the TDP is received.
D) authorization is received from the patient's insurance carrier.
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Chapter 10: Respiratory Failure and the Mechanical
Ventilation Protocol
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6 Verified Questions
6 Flashcards
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Sample Questions
Q1) All of the following are contraindications for noninvasive ventilation (NIV) EXCEPT:
A) facial and head trauma.
B) community-acquired pneumonia.
C) copious, viscous sputum.
D) severe upper GI bleeding.
Q2) What is the primary pathophysiologic mechanism in alveolar hypoventilation?
A) Decreased minute ventilation
B) Increased ventilation/perfusion ratio
C) Decreased venous admixture
D) Decreased inspired oxygen pressure
Q3) All of the following are causes of hypercapnic respiratory failure EXCEPT:
A) impending ventilatory failure.
B) apnea.
C) severe refractory hypoxemia.
D) acute ventilatory failure.
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12
Chapter 11: Recording Skills: The Basis for Data
Organization, Assessment Skill
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10 Verified Questions
10 Flashcards
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Sample Questions
Q1) When the respiratory therapist is entering a SOAPIER progress note in a patient's chart, the A stands for:
A) application of the data.
B) acceptance of the treatment options by the patient.
C) affect of the patient.
D) assessment of the data by the respiratory therapist.
Q2) All of the following statements are true regarding a patient's chart EXCEPT:
A) the patient's chart is a legal record and can be used in court.
B) accreditation agencies may access a patient's chart to assess appropriateness of care.
C) the patient's insurance company may review the patient's chart before providing reimbursement.
D) the patient's spouse may access the patient's chart without authorization by the patient.
Q3) When reviewing a SOAPIER progress note, the R stands for:
A) revisions made in the original plan.
B) reimbursement by the insurance carrier.
C) respiratory care notes.
D) resuscitation status of the patient.
Page 13
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Chapter 12: Chronic Obstructive Pulmonary Disease (COPD),
Chronic Bronchitis, and Emphysema
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17 Verified Questions
17 Flashcards
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Sample Questions
Q1) Which of the following clinical manifestations are associated with late-stage chronic bronchitis?
1) Rhonchi
2) Cor pulmonale
3) Digital clubbing
4) Stocky, overweight build
A) 1, 2
B) 2, 3
C) 1, 3, 4
D) 1, 2, 3, 4
Q2) Which of the following are pathologic alterations found with emphysema?
1) Air trapping and hyperinflation
2) Mucus plugs
3) Decreased surface area for gas exchange
4) Weakened respiratory bronchioles
A) 1, 2
B) 2, 4
C) 1, 3, 4
D) 1, 2, 3, 4
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Chapter 13: Asthma
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15 Verified Questions
15 Flashcards
Source URL: https://quizplus.com/quiz/3931
Sample Questions
Q1) If a beta?-agonist agent and an anticholinergic agent were administered concurrently to a patient during an acute asthma episode, what result would be expected?
A) Bronchial smooth muscle contraction will occur.
B) Airway edema will increase.
C) The medications oppose each other, resulting in no airway changes.
D) Bronchial smooth muscle relaxation will occur.
Q2) Which of the following would be expected when a chest assessment is performed on a patient during an asthmatic episode?
1) Inverse I:E ratio
2) Decreased vocal fremitus
3) Increased vesicular breath sounds
4) Hyperresonant percussion note
A) 1, 4
B) 2, 4
C) 2, 3, 4
D) 1, 2, 3, 4
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Chapter 14: Bronchiectasis
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18 Verified Questions
18 Flashcards
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Sample Questions
Q1) For religious reasons, a young couple has not given their 4-year-old daughter the usual childhood immunizations. She has been repeatedly hospitalized with pulmonary infections. What should the respiratory therapist caring for the child tell the parents that the child is at risk of developing?
A) Chronic bronchitis
B) Asthma
C) Bronchiectasis
D) Left ventricular hypertrophy
Q2) Which of the following should a patient with bronchiectasis do to reduce the risk of the condition worsening?
1) Avoid air pollution.
2) Get an influenza vaccination.
3) Take an antibiotic every day.
4) Avoid smoking.
A) 3, 4
B) 1, 2, 4
C) 2, 3, 4
D) 1, 2, 3, 4
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Page 16
Chapter 15: Cystic Fibrosis
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19 Verified Questions
19 Flashcards
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Sample Questions
Q1) If both the mother and the father are carriers for the cystic fibrosis gene, what are the chances that their child will be a cystic fibrosis carrier?
A) 0%
B) 25%
C) 50%
D) 75%
Q2) All of the following pulmonary function findings would be expected in a patient with moderate to severe cystic fibrosis EXCEPT:
A) increased FVC.
B) increased RV.
C) decreased PEFR.
D) decreased FEF50%.
Q3) Which ethnic group has the greatest number of people with cystic fibrosis?
A) African-Americans
B) Asians
C) Hispanics
D) Caucasians
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Chapter 16: Pneumonia
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12 Verified Questions
12 Flashcards
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Sample Questions
Q1) A 28-year-old patient who has dogs, parakeets, and cats as pets has been admitted with pneumonia. It is suspected that she acquired the infection from one of her pets. What organism is likely to be found in her sputum?
A) Bacteroides melaninogenicus
B) Staphylococcus aureus
C) Chlamydia psittaci
D) Haemophilus influenzae
Q2) When a patient has pneumonia, which of the following would be found in the alveolar effusion fluids?
1) Mucus
2) Serum fluid
3) Saliva
4) Red blood cells
A) 1, 3
B) 2, 4
C) 2, 3
D) 1, 2, 3, 4
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Page 18
Chapter 17: Lung Abscess
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Sample Questions
Q1) Which of the following can occur when tissue necrosis occurs in a lung abscess?
1) Fluid can rupture into a bronchus.
2) Broncholithiasis can occur.
3) Bronchospasm can close off the affected bronchi.
4) Fluid can rupture into the intrapleural space.
A) 1, 2
B) 1, 4
C) 3, 4
D) 1, 2, 3
Q2) What is the recommended treatment for a lung abscess caused by methicillin-resistant Staphylococcus aureus (MRSA)?
A) Neomycin
B) Linezolid
C) Penicillin
D) Clindamycin
Q3) In the early stages of a lung abscess, a patient would most likely have a:
A) nonproductive, hacking cough.
B) productive cough with foul-smelling, grey sputum.
C) productive cough with hemoptysis.
D) productive cough with copious white sputum.
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Chapter 18: Tuberculosis
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Sample Questions
Q1) A patient who has an uncontrolled tuberculosis infection will show all of the following signs EXCEPT:
A) weight loss.
B) high fever.
C) bloody sputum.
D) night sweats.
Q2) Pulmonary function testing results on a patient with an advanced case of TB will display all of the following EXCEPT:
A) increased RV.
B) decreased IRV.
C) decreased VC.
D) decreased TLC.
Q3) A first-line agent used to treat a TB infection is:
A) gentamycin.
B) penicillin.
C) streptomycin.
D) isoniazid.
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Page 20
Chapter 19: Fungal Diseases of the Lung
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18 Flashcards
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Sample Questions
Q1) Fungal lung infections are usually spread by:
A) inhaling spores.
B) blood.
C) contact with infected sputum.
D) inhaling infected droplets.
Q2) A patient lives in Chicago and has HIV and a weakened immune system. What fungal infection is the patient at risk of developing?
A) Mycoplasma infection
B) Blastomycosis
C) Streptococcal infection
D) Disseminated histoplasmosis
Q3) What parts of the lungs are most commonly affected by a fungal infection?
A) Mainstem bronchi
B) Lingula
C) Lower lobes
D) Upper lobes
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Chapter 20: Pulmonary Edema
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Sample Questions
Q1) The respiratory therapist is asked to recommend a medication to reduce afterload for a patient with cardiogenic pulmonary edema. The therapist could recommend all of the following EXCEPT:
A) captopril.
B) norepinephrine (Levophed).
C) enalapril (Vasotec).
D) nitroprusside (Nitropress).
Q2) Which of the following is/are considered noncardiogenic cause(s) of increased capillary permeability?
1) Therapeutic lung radiation
2) Cigarette smoke
3) Acute respiratory distress syndrome (ARDS)
4) Inhaled phosgene
A) 1
B) 2, 3
C) 1, 3, 4
D) 1, 2, 3, 4
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Chapter 21: Pulmonary Vascular Disease: Pulmonary
Embolism and Pulmonary Hypertension
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Sample Questions
Q1) All of the following are preventive measures taken with patients at high risk for thromboembolic disease EXCEPT:
A) Drink lots of water.
B) Dangle your legs over the edge of the bed before getting up.
C) Walk frequently.
D) Wear compression stockings.
Q2) All of the following are associated with the formation of a deep vein thrombosis (DVT) EXCEPT:
A) blood vessel injury.
B) age greater than 40 years.
C) hypercoagulability.
D) venous stasis.
Q3) In order to prevent pulmonary emboli, a filter may be placed into which of the following vessels to prevent clots from being carried into the pulmonary circulation?
A) Subclavian vein
B) Pulmonary artery
C) Thoracic duct
D) Inferior vena cava
E) Femoral artery
Page 23
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Chapter 22: Flail Chest
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Sample Questions
Q1) Which of the following would be recommended for the management of an adult with a severe flail chest?
1) Continuous positive airway pressure (CPAP)
2) Pain management
3) Mechanical ventilation
4) Positive end-expiratory pressure (PEEP)
A) 1, 2
B) 2, 3
C) 2, 3, 4
D) 1, 2, 3, 4
Q2) When a patient has a flail chest, what happens during the ventilatory cycle?
A) The I:E ratio becomes inverse.
B) Air leaks out through the flail area.
C) Air leaks in through the flail area.
D) Air is shunted from one lung to the other.
Q3) Which of the following accurately describes a flail chest?
A) Double fractures of 2 adjacent ribs
B) Double fractures of 3 adjacent ribs
C) Single fracture of 3 adjacent ribs
D) Triple fractures of 2 adjacent ribs
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Chapter 23: Pneumothorax
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Sample Questions
Q1) An iatrogenic pneumothorax may be caused by all of the following EXCEPT:
A) positive-pressure mechanical ventilation.
B) pleural biopsy.
C) subclavian vein cannulation.
D) endotracheal intubation.
Q2) What is the primary cause of hypotension in a patient with a large pneumothorax?
A) Pain
B) Decreased venous return to the heart
C) Tracheal compression
D) Atelectasis
Q3) A 40-year-old patient requires placement of a thoracostomy chest tube. All of the following are recommended for the procedure EXCEPT:
A) application of -5-cm H<sub>2</sub>O pressure to the chest tube.
B) use of a No. 28 to 36 French gauge tube.
C) placement of the tube at the apex of the lung.
D) clamping and removing the tube within 24 hours of insertion.
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Chapter 24: Pleural Effusion and Empyema
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Sample Questions
Q1) While reviewing an upright chest radiograph of a patient with a pleural effusion, the respiratory therapist observes a fluid density in the right lung area that extends upward around the anterior, lateral, and posterior thoracic walls. What is this characteristic sign called?
A) Meniscus sign
B) Scarf sign
C) Transudate sign
D) Kerley B lines
Q2) The major pathologic and structural changes associated with a significant pleural effusion include all of the following EXCEPT:
A) diaphragm elevation.
B) atelectasis.
C) compression of the great vessels.
D) lung compression.
Q3) What is the most common cause of a chylothorax?
A) Thoracic duct trauma
B) Abdominal tumor
C) GERD
D) Pyloric stenosis
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Chapter 25: Kyphoscoliosis
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Sample Questions
Q1) What is the name for the degree of lateral spinal curvature calculated from a radiograph?
A) Carr angle
B) Sheumann angle
C) Cobb angle
D) Sands angle
Q2) All of the following are orthotic braces used in the management of scoliosis EXCEPT _____ brace.
A) Boston
B) Milwaukee
C) Chicago
D) Charleston bending
Q3) For best results, how many hours per day should a SpineCor brace be worn?
A) 8
B) 10
C) 16
D) 20
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Page 27
Chapter 26: Interstitial Lung Diseases
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Sample Questions
Q1) The diffusing capacity of a patient with coal worker's pneumoconiosis or silicosis would be expected to be:
A) normal.
B) increased.
C) decreased.
D) variable based on the age of the patient.
Q2) Which of the following are associated with an increased DLCO?
A) Goodpasture's syndrome and idiopathic pulmonary hemosiderosis
B) Goodpasture's syndrome and Churg-Strauss syndrome
C) Churg-Strauss syndrome and LAM
D) Idiopathic pulmonary hemosiderosis and COP
Q3) What major pathologic and structural changes are associated with asbestosis?
1) Fibrocalcific pleural plaques
2) Excessive bronchial secretions
3) Bronchospasm
4) Mediastinal shift
A) 1, 3
B) 2, 4
C) 1, 2, 3
D) 1, 2, 3, 4
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Chapter 27: Cancer of the Lung
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Sample Questions
Q1) What is the preferred surgical treatment for a large, single tumor located in the right lower lobe?
A) Lobectomy
B) Wedge resection
C) Segmentectomy
D) Pneumonectomy
Q2) The most common cause of lung cancer is:
A) cigarette smoking.
B) air pollution.
C) exposure to asbestos.
D) exposure to radon gas.
Q3) When a patient develops drooping eyelid and small pupil in the same eye, which of the following syndromes is present?
A) Superior vena cava syndrome
B) Paraneoplastic syndrome
C) Horner's syndrome
D) Cushing's syndrome
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Chapter 28: Acute Respiratory Distress Syndrome
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Sample Questions
Q1) Which of the following are causes of ARDS?
1) Liver failure
2) Heroin abuse
3) Septicemia
4) Goodpasture's syndrome
A) 1, 4
B) 2, 3
C) 2, 3, 4
D) 1, 2, 3, 4
Q2) Which of the following are current ventilatory strategies in the treatment of ARDS?
1) Large tidal volume
2) Small tidal volume
3) Rapid respiratory rates
4) Slow respiratory rates
A) 2
B) 3
C) 1, 4
D) 2, 3
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Chapter 29: Guillain-Barré Syndrome
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Sample Questions
Q1) The diagnosis of Guillain-Barré syndrome is based on all of the following EXCEPT:
A) urinalysis shows elevated blood urea nitrogen.
B) abnormal electromyography results.
C) cerebrospinal fluid shows elevated protein level.
D) clinical history.
Q2) A Guillain-Barré syndrome patient has autonomic nervous system dysfunction which can result in all of the following EXCEPT:
A) tachycardia.
B) hypotension.
C) urinary retention.
D) fever.
Q3) A 75-kg, 50-year-old male patient has Guillain-Barré syndrome. His most recent assessment indicates his VC is 900 mL and NIF is -16 cm H<sub>2</sub>O. What plan should the respiratory therapist recommend?
A) Initiate EMG monitoring.
B) Initiate continuous positive airway pressure (CPAP).
C) Initiate mechanical ventilation.
D) Reassess the patient each hour.
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Chapter 30: Myasthenia Gravis
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Sample Questions
Q1) Which of the following values would be associated with impending ventilatory failure in a patient with myasthenia gravis?
1) NIF -15cm H<sub>2</sub>O
2) VC 10 mL/kg
3) PaCO<sub>2</sub>43 mm Hg
4) pH 7.36
A) 1
B) 1, 2
C) 2, 4
D) 1, 2, 3
Q2) During a myasthenia crisis, a patient was placed on mechanical ventilation but is now stable. What will the chest radiograph most likely show?
A) Normal lungs
B) Mediastinal shift
C) Pericardial tamponade
D) Ground glass appearance
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Chapter 31: Sleep Apnea
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Sample Questions
Q1) Sleep apnea is associated with:
1) increased SVR.
2) decreased SVR.
3) increased PVR.
4) decreased PVR.
A) 1, 3
B) 2, 3
C) 1, 3, 4
D) 1, 2, 3, 4
Q2) All of the following may be an advantage of in-home portable sleep testing EXCEPT:
A) convenience.
B) patient acceptance.
C) can be easily performed over multiple nights.
D) decreased cost.
E) published standards for scoring or interpretation.
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33
Chapter 32: Clinical Manifestations Common with Newborn and
Early Childhood Respiratory Dis
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Q1) PPHN usually appears:
A) in utero during the last trimester.
B) within 1 hour of birth.
C) within the first 12 hours of birth.
D) between the 1st and 6th days of life.
Q2) Early clinical manifestations of an infant with respiratory distress include: 1) cyanosis.
2) substernal retractions.
3) expiratory grunting.
4) apnea.
A) 1, 3
B) 2, 4
C) 2, 3, 4
D) 1, 2, 3
Q3) A neonatal patient is found to have grunting on expiration. What physiologic effect does this produce?
A) Increased vital capacity
B) Increased PAO<sub>2</sub>
C) Decreased PaCO<sub>2</sub>
D) Closes the ductus arteriosus
34
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Chapter 33: Meconium Aspiration Syndrome
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Q1) The major pathologic or structural changes associated with the physical presence of meconium in MAS include all of the following EXCEPT:
A) partially obstructed airways, air trapping, and alveolar hyperinflation.
B) pulmonary air leak syndromes (pneumomediastinum or pneumothorax).
C) totally obstructed airways and absorption atelectasis.
D) pulmonary edema and alveolar flooding.
Q2) Infants who are older than 42 weeks' gestation are at greater risk for MAS because they have:
1) a full bowel.
2) strong peristalsis.
3) amniotic fluid in their stomach.
4) sphincter tone.
A) 1, 3
B) 2, 4
C) 2, 3, 4
D) 1, 2, 4
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Chapter 34: Transient Tachypnea of the Newborn
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Q1) What respiratory rate would be expected during the physical exam of a patient with TTN?
A) 80 to 120 breaths/min
B) 30 to 40 breaths/min
C) 20 to 30 breaths/min
D) Less than 20 breaths/min
Q2) What are the radiologic findings anticipated on a chest radiograph taken 2 hours after delivery in a newborn suspected of having TTN?
A) Normal lung fields
B) Hyperlucency
C) Flattened diaphragms
D) Bulging intercostal spaces
Q3) Initially, TTN will have a clinical presentation similar to:
A) the early stage of respiratory distress syndrome (RDS).
B) the late stage of respiratory distress syndrome (RDS).
C) bronchial pneumonia.
D) meconium aspiration syndrome (MAS).
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Chapter 35: Respiratory Distress Syndrome
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Q1) The hyaline membrane seen in the alveoli of a neonate with RDS is similar to the anatomic alteration found in what other pulmonary disease?
A) Bacterial pneumonia
B) Pulmonary fibrosis
C) Acute respiratory distress syndrome (ARDS)
D) Meconium aspiration syndrome (MAS)
Q2) Management of a neonate with RDS may include:
1) CPAP.
2) instilling surfactant into the lungs.
3) mechanical ventilation.
4) supplemental oxygen.
A) 2
B) 1, 3
C) 2, 3, 4
D) 1, 2, 3, 4
Q3) Respiratory distress syndrome (RDS) primarily affects infants who are:
A) preterm with insufficient surfactant.
B) full-term.
C) postterm with too much surfactant.
D) preterm with too much surfactant.
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Chapter 36: Pulmonary Air Leak Syndromes
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Q1) During mechanical ventilation of a preterm neonate, which of the following are considered to be important etiologic factors for the development of pulmonary air leak syndromes?
1) High levels of PEEP
2) High oxygen concentration
3) Prolonged inspiratory time
4) High PIP
A) 2, 3
B) 3, 4
C) 1, 3, 4
D) 1, 2, 3, 4
Q2) All of the following are associated with a pneumopericardium EXCEPT:
A) systemic hypotension.
B) reduced cardiac output.
C) decreased stroke volume.
D) increased cardiac index.
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Chapter 37: Respiratory Syncytial Virus (Bronchiolitis or Pneumonitis)
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Q1) Which of the following is no longer recommended in the management of a patient with RSV infection?
A) Palivizumab (Synagis)
B) Bulb suctioning of the nares
C) Nebulized hypertonic saline
D) Ribavirin (Virazole)
Q2) Several small children who attend the same day care facility have become sick with RSV. The owner of the day care can expect them to recover within:
A) 4 to 6 days.
B) 3 to 8 days.
C) 1 to 2 weeks.
D) greater than 3 weeks.
Q3) A chest radiograph was taken of a patient with RSV. What finding can be expected?
A) Elevated diaphragms
B) "Steeple point" sign
C) Lobar atelectasis
D) Pneumothorax
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Page 39
Chapter 38: Bronchopulmonary Dysplasia
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Sample Questions
Q1) Which of the following clinical manifestations are associated with BPD?
1) Expiratory grunting
2) Wheezes and crackles
3) Flaring nostrils
4) Intercostal retractions
A) 1, 3
B) 1, 3, 4
C) 1, 2, 4
D) 1, 2, 3, 4
Q2) What agent can be administered to a preterm infant to help reduce lung inflammation and the incidence of BPD?
A) Vitamin D
B) Bronchodilators
C) Ribavirin (VirazoleÒ)
D) Corticosteroids
Q3) What is the most common chronic lung disease of premature infants?
A) BPD
B) Asthma
C) Cystic fibrosis
D) TTN
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Chapter 39: Congenital Diaphragmatic Hernia
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Sample Questions
Q1) What pulmonary change is associated with a Bochdalek hernia?
A) Pulmonary hypoplasia
B) Respiratory distress syndrome (RDS)
C) Pulmonary edema
D) Meconium aspiration
Q2) When does respiratory distress normally develop in a newborn with a CDH?
A) Shortly after delivery
B) 6 to 12 hours after delivery
C) 12 to 24 hours after delivery
D) 24 to 48 hours after delivery
Q3) What happens as an infant with a CDH creates an increased negative inspiratory pressure in order to breathe?
A) Meconium is drawn deeper into the airways.
B) Lung compliance is improved.
C) More of the gastrointestinal structures are sucked into the thorax.
D) Lungs fill and expand to full capacity.
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Chapter 40: Congenital Heart Diseases
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Sample Questions
Q1) What is the most common form of TGA?
A) a-TGA
B) b-TGA
C) c-TGA
D) d-TGA
Q2) Which cardiac anomaly is associated with coeur-en-sabot on a chest radiograph?
A) TOF
B) ASD
C) VSD
D) PDA
Q3) Which of the following is used to confirm the diagnosis of ASD?
A) Electromyogram
B) Electrocardiogram
C) Echocardiogram
D) Electrophoresis
Q4) According to the NHLBI, what is the most common type of birth defect?
A) Cerebral palsy
B) Congenital heart defects
C) Congenital diaphragmatic hernia
D) Cleft palate
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Chapter 41: Croup Syndrome: Laryngotracheobronchitis and
Acute Epiglottitis
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Q1) What is the main clinical risk facing a patient with epiglottitis?
A) Secretions will block the trachea.
B) The epiglottis will bleed.
C) The laryngeal inlet may become covered by the epiglottis.
D) The vocal cords will spasm and close the laryngeal inlet.
Q2) The medication racemic epinephrine (Micronefrin, Vaponefrin) is given to a patient with LTB because it:
A) is an effective bronchodilator.
B) causes mucosal vasoconstriction.
C) causes bradycardia.
D) has an appealing taste and smell.
Q3) Most cases of LTB occur during which season(s) of the year?
1) Spring
2) Summer
3) Fall
4) Winter
A) 1
B) 4
C) 3, 4
D) 1, 2, 3
Page 43
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Chapter 42: Near Drowning/Wet Drowning
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Q1) A 10-year-old girl was rescued from a school swimming pool, where she was found unconscious, and transported to a nearby hospital, where her lungs were discovered to be dry. What could cause dry lungs in this near drowning?
A) Her glottis spasmed and prevented pool water from entering her lungs.
B) Chlorinated pool water is quickly absorbed across the alveolar-capillary membrane.
C) Her young age and the cool pool water prevented serious pulmonary injury.
D) She swallowed the water.
Q2) What is the upper time limit that a cold-water near-drowning victim can be submerged and survive?
A) 10 minutes
B) 20 minutes
C) 40 minutes
D) 60 minutes
Q3) In the United States, what percentage of pediatric drowning victims are male?
A) 20%
B) 40%
C) 60%
D) 80%
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Chapter 43: Smoke Inhalation, Thermal Injuries, and Carbon
Monoxide Intoxication
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Q1) What level of carbon monoxide toxicity is associated with coma, convulsions, and Cheyne-Stokes respiration?
A) 10% to 20% COHb
B) 20% to 30% COHb
C) 30% to 50% COHb
D) 50% to 60% COHb
Q2) According to the Parkland Formula, what is the recommended volume of fluid that should be infused over a 24-hour period for each percent of body surface burned?
A) 1 mL/kg of body weight
B) 4 mL/kg of body weight
C) 6 mL/kg of body weight
D) 10 mL/kg of body weight
Q3) In an industrial accident, an adult incurred burns over his head and neck, both arms, and his anterior trunk. What percent of his BSA was burned?
A) 27%
B) 36%
C) 45%
D) 54%
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Chapter 44: Atelectasis
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Sample Questions
Q1) Common chest assessment findings in a patient with atelectasis include:
1) increased tactile fremitus.
2) dull percussion note.
3) crackles.
4) bronchial breath sounds.
A) 4
B) 1, 2
C) 3, 4
D) 1, 2, 3, 4
Q2) A patient has a tumor blocking the left mainstem bronchus. What additional factor would favor the development of atelectasis?
A) Breathing a nitric oxide mix (iNO)
B) Breathing a helium/oxygen mix (heliox)
C) Breathing a high percentage of oxygen
D) Breathing a low percentage of oxygen
Q3) All of the following would be found in a patient with atelectasis EXCEPT:
A) normal shunt fraction.
B) whispered pectoriloquy.
C) chest radiograph shows increased density in areas of atelectasis.
D) diminished breath sounds.
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