Patient Assessment in Respiratory Therapy
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Course Introduction
Patient Assessment in Respiratory Therapy provides students with the foundational knowledge and practical skills needed to perform comprehensive evaluations of patients with respiratory disorders. The course covers techniques for collecting patient histories, conducting physical examinations, interpreting diagnostic tests such as spirometry and arterial blood gases, and assessing vital signs. Students learn to identify and interpret signs and symptoms related to respiratory and cardiopulmonary conditions, utilizing evidence-based assessment tools and protocols. Emphasis is placed on clinical decision-making, effective patient communication, and accurate documentation, preparing students to contribute to the diagnosis, treatment planning, and ongoing management of patients within respiratory therapy settings.
Recommended Textbook
Wilkins Clinical Assessment in Respiratory Care 7th Edition by Al Heuer PhD
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21 Chapters
773 Verified Questions
773 Flashcards
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Page 2
Chapter 1: Preparing for the Patient Encounter
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Sample Questions
Q1) Which of the following techniques for expressing genuine concern is the most difficult to use appropriately?
A)Touch
B)Posture
C)Eye contact
D)Proper introductions
Answer: A
Q2) You are riding in an elevator at the hospital where you are employed as an RT.The elevator is full, but standing next to you is Joe, the RT who is scheduled to relieve you.He turns to you and asks, "How is Mr.Copper doing?" Earlier in the day, Mr.Copper had a cardiac arrest, and he is now being mechanically ventilated.How should you respond to Joe?
A)"He took a turn for the worse."
B)"He is fine."
C)"Let's talk later in the report room."
D)"He is on a ventilator and will keep you very busy."
Answer: C
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Chapter 2: The Medical History and the Interview
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Sample Questions
Q1) Which of the following is not a reason for obtaining a family history?
A)To assess the current health status of the extended family
B)To learn about the health status of the patient's blood relatives
C)To determine whether the patient is adopted
D)To identify the presence in the family of diseases with a hereditary tendency
Answer: C
Q2) Which of the following cardiopulmonary conditions would not be found in the chief complaint list?
A)Asthma
B)Wheezing
C)Chest pain
D)Hemoptysis
Answer: A
Q3) Which of the following symptoms is often seen in patients with tight building syndrome?
A)Headache
B)Stuffy nose
C)Cough
D)All of the above
Answer: D
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Chapter 3: Cardiopulmonary Symptoms
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Sample Questions
Q1) What is the most common manifestation of infection in a patient with pulmonary disease?
A)Fever
B)Cough
C)Diaphoresis
D)Increased sputum production
Answer: A
Q2) Snoring is caused by all of the following except:
A)Excessive daytime sleepiness.
B)Obesity.
C)Excessive alcohol consumption.
D)Use of sleeping medications.
Answer: A
Q3) Chest pain is the cardinal symptom of which of the following diseases?
A)Heart disease
B)Pleural disease
C)Chest wall disease
D)Neuromuscular disease
Answer: A
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Page 5
Chapter 4: Vital Signs
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Sample Questions
Q1) Which of the following statements regarding vital signs is most accurate?
A)Vital signs are used only to establish a baseline.
B)Vital signs monitor only the response to therapy.
C)Trends in vital signs are far more important than a single measurement.
D)Vital signs at baseline should never be compared with those that were obtained 24 hours earlier.
Q2) Which of the following is the method of choice for measuring temperature in neonates?
A)Oral
B)Rectal
C)Axillary
D)Tympanic
Q3) Which of the following conditions causes hypothermia?
A)Damage to the hypothalamus
B)Excessive shivering and vasoconstriction
C)Exposure to high environmental temperatures
D)Invasion of the body by microorganisms that produce an infection
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Chapter 5: Fundamentals of Physical Examination
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Sample Questions
Q1) Which of the following statements is not true about vesicular or normal breath sounds?
A)They have a minimal expiratory sound.
B)They are produced somewhat regionally.
C)They are produced when air enters the alveoli.
D)They are used to help confirm proper placement of an endotracheal tube.
Q2) Which of the following terms describes the area of the chest wall that overlies the heart?
A)Periosteum
B)Precordium
C)Pericardium
D)None of the above
Q3) Which of the following terms is used to describe an abnormal collection of fluid in the peritoneal cavity?
A)Ascites
B)Pericarditis
C)Pancreatitis
D)Hepatomegaly
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7
Chapter 6: Neurologic Assessment
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Sample Questions
Q1) Injury to the cervical spine roots C3 to C5 is associated with which of the following abnormalities?
A)Absence of deep tendon reflexes
B)Babinski sign
C)Paralysis of the diaphragm
D)Doll's-eye maneuver
Q2) Which of the following is not part of the brain?
A)Cerebrum
B)Cranial nerves
C)Brainstem
D)Cerebellum
Q3) The brain death determination test involving disconnecting a patient from the ventilator, providing 100% oxygen, and monitoring closely for spontaneous breathing is the __________________.
A)apnea test.
B)metabolic test.
C)tendon reflex test.
D)deep pain test.
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8
Chapter 7: Clinical Laboratory Studies
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Sample Questions
Q1) Which of the following is a formed element found in circulating blood?
A)Sodium
B)Platelets
C)Potassium
D)Bicarbonate
Q2) What is believed to cause neutropenia in patients with viral infection?
A)Phagocytosis
B)Increased margination of neutrophils
C)Increased neutrophil lysis
D)Increased loss of neutrophils to gastrointestinal waste
Q3) Which of the following types of leukocytosis is typically seen in patients with viral infection?
A)Basophilia
B)Neutrophilia
C)Monocytosis
D)Lymphocytosis
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Page 9
Chapter 8: Interpretation of Blood Gases
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Sample Questions
Q1) What is a decrease in tissue oxygenation called?
A)Hypoxia
B)Hypoxemia
C)Hypercapnia
D)Acidosis
Q2) For the test of collateral circulation in an Allen's Test, "pinking up" of the hand is normal if it occurs within ____ seconds.
A)10 to 15
B)15 to 20
C)20 to 25
D)25 to 30
Q3) Which of the following statements is true regarding the accuracy of the reported results?
A)The oxygen is inaccurate.
B)The pH is reported considerably higher than it should be.
C)The blood gas results are all accurate.
D)The reported pH is considerably lower than the given PaCO and HCO - would indicate.
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Chapter 9: Pulmonary Function Testing
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Sample Questions
Q1) A restrictive defect is present when lung volumes are reduced to less than what percentage of predicted levels?
A)60%
B)70%
C)80%
D)90%
Q2) The closing-volume (CV) test is used for early diagnosis of obstruction of airways of which of the following sizes?
A)Large
B)Medium
C)Small
D)Large and medium
Q3) Which of the following is not a general purpose of performing pulmonary function tests (PFTs)?
A)The functional status of the lungs
B)The diffusion characteristics of the alveolar-capillary membrane
C)How much and how fast gas can be moved into and out of the lungs
D)The specific diagnosis of pulmonary disease
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11
Chapter 10: Chest Imaging
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Sample Questions
Q1) A portable film is ordered immediately after a central venous pressure (CVP) catheter is placed via the subclavian vein.Which of the following is the correct placement site for the catheter?
A)1 to 2 cm above the right atrium
B)Between the left and right ventricles
C)At the confluence of the superior vena cava and the right atrium
D)Anywhere in the superior vena cava
Q2) Which of the following views provides less cardiac magnification and a sharper view of the left lower lobe?
A)PA view
B)AP view
C)Left lateral view
D)Lateral decubitus view
Q3) A portable film is ordered immediately after a patient is intubated in the emergency department.Which of the following distances confirms proper placement of the endotracheal tube?
A)1 to 2 cm below the cricoid cartilage
B)5 to 7 cm above the carina
C)3 cm below the thyroid cartilage
D)3 to 5 cm above the carina
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Chapter 11: Interpretation of Electrocardiogram Tracings
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Sample Questions
Q1) What term describes the sudden loss of the negative charge inside the myocardial cells?
A)Repolarization
B)Depolarization
C)Automaticity
D)Conductivity
Q2) Which chamber is responsible for pumping blood into the pulmonary circulation?
A)Left atrium
B)Left ventricle
C)Right atrium
D)Right ventricle
Q3) What is the upper limit of normal for the width of a normal Q wave?
A)0.08 second
B)0.04 second
C)1.2 seconds
D)1.4 seconds
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13
Chapter 12: Neonatal and Pediatric Assessment
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Sample Questions
Q1) What range of gestational weeks is considered term?
A)32 to 36
B)34 to 40
C)37 to 42
D)38 to 44
Q2) What differentiates pneumonia from transient tachypnea of the newborn (TTNB) on chest radiograph?
A)Rapid resolution of TTNB
B)TTNB will have a ground-glass appearance
C)Silhouette sign
D)Diffuse streakiness and fluid in the major and minor fissures
Q3) A child presents at the emergency department with difficulty breathing and a harsh, barking cough.The history reveals a runny nose over the past few days.What is the most likely diagnosis?
A)Croup
B)Epiglottitis
C)Asthma
D)Bronchopulmonary dysplasia (BPD)
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14
Chapter 13: Older Patient Assessment
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Sample Questions
Q1) Which of the following disorders would be characterized by Cheyne-Stokes breathing?
A)COPD
B)Asthma
C)CHF
D)Raynaud phenomenon
Q2) How much does the incidence of congestive heart failure (CHF) increase with each decade of life between 45 and 75 years?
A)Doubles
B)Triples
C)Quadruples
D)Quintuples
Q3) Which of the following laboratory values decreases with age?
A)Albumin
B)Hemoglobin
C)Serum glucose
D)Serum cholesterol
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Chapter 14: Respiratory Monitoring in Critical Care
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Sample Questions
Q1) If intubated and mechanically ventilated patients are given shallow tidal volumes without sighs, which of the following is most likely to occur?
A)Coughing
B)Atelectasis
C)Respiratory arrest
D)Increase in secretion production
Q2) Under most clinical conditions, the PaO should be kept within the range of _____ mm Hg.
A)60 to 80
B)80 to 100
C)100 to 120
D)120 to 150
Q3) The ratio of respiratory frequency to tidal volume that is used to predict the likelihood of success in weaning the patient from mechanical ventilation is also known as:
A)a spontaneous breathing test.
B)the successful weaning test.
C)the spontaneous ventilation index.
D)the rapid-shallow breathing index.
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Page 16
Chapter 15: Vascular Pressure Monitoring
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Sample Questions
Q1) With a properly inserted and positioned pulmonary artery catheter, a systolic pressure reading in the pulmonary artery of 50 mm Hg could be due to:
A)pulmonary vasodilation.
B)tricuspid valve stenosis.
C)pulmonic valve stenosis.
D)chronic obstructive pulmonary disease (COPD).
Q2) What will the MAP be if the systolic blood pressure is 140 mm Hg and the diastolic blood pressure is 80 mm Hg?
A)60 mm Hg
B)100 mm Hg
C)110 mm Hg
D)120 mm Hg
Q3) Complications involving the use of CVP catheters include all of the following except: A)Bleeding.
B)Pneumothorax.
C)Infection.
D)Atrial septal puncture.
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Chapter 16: Cardiac Output Measurement
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Sample Questions
Q1) To obtain the coronary perfusion pressure, what two values are needed?
A)Afterload and preload
B)Ejection fraction and heart rate
C)Mean arterial pressure and afterload
D)Diastolic blood pressure and pulmonary capillary wedge pressure
Q2) A drug that increases the contractility of the heart is known as a positive:
A)inotrope.
B)dromotrope.
C)chromotrope.
D)vasoconstrictor.
Q3) The greatest determinant of peripheral resistance to blood flow is:
A)the radius of the vessels.
B)the viscosity of the blood.
C)the compliance of the vessels.
D)the distance of the vessels from the heart.
Q4) At rest, approximately 64% of the total blood volume is stored in the:
A)liver.
B)lungs.
C)extremities.
D)venous system.
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Chapter 17: Bronchoscopy
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Sample Questions
Q1) What is the advantage of using fluoroscopy during bronchoscopy for peripheral lesions?
A)Less contamination of samples
B)Increased diagnostic yield
C)Increased sample size
D)Less tissue destruction
Q2) What complication associated with bronchoscopy is most common?
A)A complication associated with medications used in the procedure
B)Pneumothorax
C)Secondary infection
D)Excessive bleeding
Q3) For what purpose are lasers used during bronchoscopy?
A)To obliterate obstructing tumors
B)To stop excessive bleeding
C)To open mucus-plugged airways
D)To improve visualization of smaller airways
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Chapter 18: Nutrition Assessment
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Sample Questions
Q1) What is the RQ value of a patient eating a pure carbohydrate diet?
A)0.60
B)0.70
C)0.85
D)1.00
Q2) How does the cachectic patient appear physically?
A)Central obesity only
B)Very thin and malnourished
C)Edematous around the face
D)Very short of breath
Q3) What dietary adjustment might be best for patients with more severe chronic obstructive pulmonary disease (COPD)?
A)Increased carbohydrates
B)Increased fats
C)Increased proteins
D)Increased salt intake
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Chapter 19: Sleep and Breathing Assessment
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Sample Questions
Q1) A reduction in air flow of between 4% and 50% of baseline air flow for at least 10 seconds during sleep defines which of the following?
A)Apnea
B)Respiratory effort-related arousal (RERA)
C)Arousal
D)Hypopnea
Q2) Which of the following will assist the RT in predicting sleep apnea?
A)Epworth Sleepiness Scale (ESS)
B)Berlin Questionnaire
C)Inspection of the chest
D)Electrocardiogram (ECG)
Q3) A patient comment regarding the lack of dreaming could mean that the patient is not spending a significant period of sleep in which stage?
A)Stage 1 NREM
B)Stage 2 NREM
C)Stage 3 NREM
D)REM
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Chapter 20: Home Care Patient Assessment
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Sample Questions
Q1) Which of the following should be done only with a physician's order?
A)Chest auscultation
B)Pulse oximetry
C)Check of blood pressure
D)Check of body temperature
Q2) What should the home care RT do if a patient cannot demonstrate proper use of his metered-dose inhaler (MDI)?
A)Contact the physician.
B)Switch the patient to a small-volume nebulizer.
C)Discontinue the use of the MDI.
D)Call the patient's nurse.
Q3) If the home care patient is suffering from a poor appetite, what could be the cause?
A)Depression
B)Dyspnea
C)Infection
D)All of the above
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Chapter 21: Documentation
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Sample Questions
Q1) The absence of information or the lack of documented recognition of specific problems could result in which one of the following situations?
A)Malpractice
B)Reduction in salary for an RT
C)Reduction in workload
D)Probation status for the clinician at fault
Q2) All of the following are advantages of the EMR except: A)lack of standardization among systems.
B)increased storage capacity.
C)information is concurrently available even at remote sites.
D)increased accuracy.
Q3) Which of the following charting methods has been promoted with implementation of rapid response teams (RRTs)?
A)PIP
B)SOAP
C)SBAR
D)APIE
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