Physical Therapy in Acute Care
Chapter Exam Questions
Course Introduction
This course explores the principles and practices of physical therapy within acute care settings, emphasizing the assessment, intervention, and management of patients with complex medical and surgical conditions. Students learn to collaborate with multidisciplinary healthcare teams, understand the distinct challenges of acute care environments such as hospitals and intensive care units, and develop skills in patient mobility, rehabilitation, and discharge planning. The course also addresses safety considerations, documentation standards, and evidence-based practices for optimizing patient outcomes in the acute phase of illness or injury.
Recommended Textbook
Cardiovascular and Pulmonary Physical Therapy Evidence to Practice 5th Edition by Donna Frownfelter
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Chapter 1: Epidemiology As a Basis for Informing Contemporary
Physical Therapy Practice
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Sample Questions
Q1) As with ischemic heart disease,risk factors for high blood pressure consist of nonmodifiable and modifiable risk factors.Modifiable risk factors include:
A) alcohol consumption and reduced physical activity.
B) alcohol consumption and age.
C) obesity and age.
D) obesity and race.
Answer: A
Q2) Failure of traditional models of health education in reducing the prevalence of lifestyle-related conditions and their risk factors has been thought to be attributable to:
A) the personal, bidirectional model of delivery.
B) establishing rapport, trust, commitment, and follow-up.
C) understanding beliefs, timing, readiness to change, and barriers.
D) a unidirectional model of information delivery.
Answer: D
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3
Chapter 2: Oxygen Transport: the Basis of Cardiovascular and Pulmonary Physical Therapy
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Q1) The effects of recumbency (bed rest)on patients have been described as detrimental and leading to a state of general deconditioning.This negative condition can be affected through the interventions of physical therapy by simply:
A) providing progressive resistive exercise to patients.
B) providing instruction in the most appropriate form of diaphragmatic breathing.
C) restoration of upright positioning.
D) providing supplemental oxygenation during activities.
Answer: C
Q2) What is the minimum intracellular oxygen pressure needed to support metabolism?
A) 5 mm Hg
B) 3 mm Hg
C) 23 mm Hg
D) 15 mm Hg
Answer: B
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4
Chapter 3: Cardiovascular and Pulmonary Anatomy
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Q1) During the active contraction of this muscle,the thoracic volume is increased vertically and transversely,thus creating a forward push of the internal organs.What muscle is this?
A) Rectus abdominis
B) Diaphragm
C) Transversus abdominis
D) Obliquus externus abdominis
Answer: B
Q2) The bifurcation of the trachea into the right and left mainstem bronchi occurs near what anatomic landmark?
A) Angle of Louis
B) Sternal notch
C) Articulation of the sternum and manubrium
D) Articulation of the sternum and xiphoid process
Answer: A
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5
Chapter 4: Cardiovascular and Pulmonary Physiology
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Q1) If the pneumotaxic center is compromised,the resulting breathing pattern would be known as:
A) pneumotaxic respiration.
B) apneustic breathing.
C) pneumotaxic breathing.
D) apneustic respiration.
Q2) Considering the oxyhemoglobin dissociation curve,a shift in the curve to the left results in decreased oxygen affinity and a greater dissociation of oxygen and hemoglobin.What condition might have this effect on the curve?
A) Working skeletal muscle
B) Emphysema
C) Polycythemia
D) None of the above
Q3) The period of time in the cardiac cycle when the ventricles fill with blood is known as:
A) ventricular systole.
B) ventricular isovolumic.
C) ventricular diastole.
D) ventricular ejection.
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Chapter 5: Cardiovascular and Pulmonary Pathophysiology
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Q1) A patient who survives a complicate myocardial infarction is at a direct risk of developing:
A) type II diabetes mellitus.
B) heart failure.
C) sarcoidosis.
D) athletic heart syndrome.
Q2) Which of the following conditions or diseases is NOT considered to be a restrictive lung disorder (RLD)?
A) Pregnancy
B) Bronchiectasis
C) Lung cancer
D) Idiopathic pulmonary fibrosis
Q3) The known causes of pulmonary fibrosis are either environmental or occupational.All of the following are known causes EXCEPT:
A) inhaled fungi spores.
B) toxic gases.
C) drugs or poisons.
D) inorganic dust.
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Chapter 6: Cardiovascular and Pulmonary Manifestations of Systemic Conditions
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Q1) A physical therapist completes an examination for a patient with quadriplegia.As part of the plan of care,the therapist should likely address which of the following?
A) Impaired cough
B) Sitting posture
C) Upper body strengthening
D) Cardiovascular endurance
Q2) What substance is responsible for stimulating the synthesis of surfactant,which assists in holding the alveolar sac open for oxygenation to occur?
A) Thyroid hormone
B) Antidiuretic hormone
C) Corticotrophin hormone
D) Lipolytic hormone
Q3) Lymphatic vessels are located in the pleurae and not the alveolar capillary spaces of the pulmonary system.These vessels drain fluid into the .
A) interlobular septae
B) hilar vessels
C) subpleural spaces
D) lung parenchyma
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Chapter 7: Measurement and Documentation
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Q1) Which of the following is true?
A) When deciding whether a measurement is a ratio or interval, the attribute that is being measured is irrelevant.
B) Interval measurements can only have negative values and cannot be subjected to some arithmetic operations.
C) For a measurement to be of value to a therapist, the measure should be both reliable (reproducible) and valid (meaningful).
D) Categorical measurements are considered ordinal if being assigned to multiple categories.
Q2) Which principle is not a consideration regarding performing tests and measures?
A) Care must be taken to use procedures that can be replicated for future comparisons.
B) Measures should be made with a subjective and open mind.
C) Documenting the conditions in which a measure was made is also important.
D) In clinics where more than one therapist is likely to evaluate or treat a patient, written procedures for performing measurements are needed.
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Chapter 8: History
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Q1) Which is not a neurologic abnormality resulting in dyspnea?
A) Spinal cord injury
B) Fibrotic lung disease
C) Ascending polyneuritis
D) Amyotrophic lateral sclerosis
Q2) Which best describes platypnea?
A) Onset of dyspnea when the patient assumes the sitting position from the supine position
B) Onset of dyspnea when the patient assumes the prone position from the supine position
C) Onset of dyspnea when the patient assumes the sitting position from the standing position
D) Onset of dyspnea when the patient assumes the standing position from the prone position
Q3) Which is not a basic cause of dyspnea?
A) An abnormality in the ventilatory system itself
B) An increase in the work of breathing
C) A decrease in the work of breathing
D) An increased awareness of normal breathing
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Page 10
Chapter 9: Pulmonary Function Tests
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Q1) Which is not true regarding total lung capacity (TLC)?
A) TLC is the amount of gas the lung contains at the end of a maximum inspiration.
B) A decrease in TLC may be seen in restrictive lung disease, such as pulmonary brosis.
C) It is made up of inspiration capacity (IC) and functional residual capacity (FRC).
D) An increase in TLC may be seen in atelectasis, neoplasms, pleural effusions, and hemothorax.
Q2) Which best describes an obstructive condition of the lungs?
A) A condition that limits the amount of volume coming into the lungs
B) A condition that increases air volume coming into the lungs
C) A condition that increases the volume in exhalation
D) A condition that relates to problems in exhalation airflow
Q3) Which best describes the anatomical dead space in the lungs?
A) The volume of air from the trachea to the terminal bronchi
B) The volume of air in the alveoli, trachea, and mouth
C) The volume of air from the bronchial tree, including the alveoli
D) The volume of air in the trachea to the terminal bronchi proportionate to half a person's body weight
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11
Chapter 10: Arterial Blood Gases
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Q1) What is the purpose of hemoglobin?
A) It is crucial for oxygen transport.
B) It is crucial for carbon dioxide transport.
C) It is crucial for H CO transport.
D) It is unable to cross the capillary membrane.
Q2) How should physical therapists use arterial blood gas measurements?
A) Use the measurement with oximeter readings to get an overall status of the patient's condition
B) To prescribe external oxygen
C) To titrate oxygen levels
D) To determine when to remove external oxygen
Q3) What is arterial blood gas used for?
A) To measure the number of respirations
B) To obtain an accurate blood pressure
C) To measure the count of white blood cells
D) A physiological assessment tool that measures a patient's acid-base balance, alveolar ventilation, and oxygenation status
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12
Chapter 11: Imaging of the Chest
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Q1) Which imaging technique shows the function of the organs?
A) PET scan
B) CT scan
C) MRI
D) Ultrasonography
Q2) What general anatomy should be identified in a chest radiograph?
A) Spine, sternum, and pelvis
B) Mediastinum and great vessels
C) Heart and esophagus
D) Main bronchi and femoral artery
Q3) Which of the following is not an initial step when evaluating a radiograph?
A) Check that the information identifying the patient has been properly provided on the image and that the image is indeed of the patient in question.
B) Check that the part of the body in question is the part that was imaged.
C) Check that there are three images, one for each plane of movement.
D) Check the overall exposure of the film.
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13
Chapter 12: Electrocardiogram Identification
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Q1) What is the 10th electrode on a standard 12 lead ECG is used for?
A) To monitor the frontal plane
B) To monitor the transverse plane
C) To monitor the sagittal plane
D) To stabilize the baseline
Q2) Ventricular tachycardia and ventricular fibrillation may present the same with the exception of which of the following?
A) All complexes are ventricular in origin.
B) The patient may be asymptomatic.
C) Effective circulation is not preserved.
D) There may be an immediate loss of consciousness.
Q3) Where do supraventricular dysrhythmias occur?
A) At the level of the SA node
B) Above the level of the atria
C) Above the level of the ventricles
D) At the level of the AV node
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14
Chapter 13: Multisystem Assessment and Laboratory Investigations
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Q1) Which hormone produced by the pancreas regulates carbohydrate metabolism and is responsible for maintaining a constant level of blood glucose?
A) Adrenaline
B) Insulin
C) Testosterone
D) Cortisol
Q2) Which of the following is not a test of peripheral vascular function?
A) Peripheral pulses
B) Capillary filling time
C) Ankle systolic pressures
D) Fibrin clotting time
Q3) Which organ produces bile and is responsible for detoxification of the blood?
A) Pancreas
B) Spleen
C) Liver
D) Kidney
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Chapter 14: Special Tests
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Q1) Which testing provides direct measurements of heart chamber pressures,blood flow,and oxygen saturation?
A) Cardiac ventriculography
B) Echocardiography
C) Computed tomography
D) Cardiac catheterization
Q2) What is the strongest radionuclide predictor of patient outcome?
A) Exercise LVEF
B) First-pass study
C) Pharmacologic stress study
D) Gated equilibrium scan
Q3) Which of the following may be used as a diagnostic tool or as a form of treatment?
A) Ventilation-perfusion lung scan
B) PET
C) MRI
D) Bronchoscopy
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Chapter 15: Clinical Evaluation and Assessment of the Cardiovascular
and Pulmonary
Systems
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Q1) Which adventitious breath sounds are described as discontinuous,low-pitched sounds?
A) Crackles
B) Rhonchi
C) Wheezes
D) Whistles
Q2) Which tone derived from mediate percussion describes a high-pitched,medium-duration tone heard over hollow structures such as the stomach?
A) Tympanic
B) Flat
C) Dull
D) Resonant
Q3) Which breathing pattern exists when respiration is slowed to less than 12 breaths/min?
A) Tachypnea
B) Bradypnea
C) Eupnea
D) Kussmaul breathing
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Chapter 16: Monitoring Systems, catheters, and Devices in the Intensive Care Unit
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Q1) What is the normal range for pulmonary artery pressure (PAP)?
A) 7 to 12 mm Hg
B) 15 to 20 mm Hg
C) 20 to 30 mm Hg
D) 30 to 35 mm Hg
Q2) Which of the following is most likely symptomatic of fluid excess?
A) Jugular vein distention
B) Blood pressure decrease
C) Decreased skin turgor
D) All of the above
Q3) What percentage of intravascular fluid deficit must develop before blood pressure drops significantly?
A) 5% to10%
B) 10% to15%
C) 15% to 25%
D) 25% to 35%
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18
Chapter 17: Maximizing Outcomes: Relating Interventions to an
Individuals Needs
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Q1) The goals of treatment fall into three categories:
A) preventive, long term, and short term.
B) primary, secondary, and tertiary.
C) cognitive, psychosocial, and nutritional.
D) restricted mobility, intrinsic factors, and extrinsic factors.
Q2) The American Physical Therapy Association's Guide To Physical Therapist Practice (2001)reflects a broad scope of practice.The guide describes:
A) diagnosis, treatment, extrinsic factors, and intrinsic factors.
B) long-term goals, short-term goals, primary goals, secondary goals.
C) examination, evaluation, diagnosis, prognosis, intervention.
D) extrinsic factors, intrinsic factors, prognosis, intervention.
Q3) The physical therapist has a major role in preventing infections of all types but:
A) respiratory infections.
B) renal infections.
C) cardiopulmonary infections.
D) blood infections.
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Chapter 18: Mobilization and Exercise: Physiological Basis for Assessment,
evaluation, and Training
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Q1) What pathophysiological factor that contributes to increased metabolic demand and oxygen consumption?
A) Healing or repairing
B) Fever
C) Combating infection
D) All of the above
Q2) Physical therapists exploit the effects of exercise in most patients and adapt the prescription based on the patient's:
A) clinical presentation and needs.
B) ability to pay or insurance coverage.
C) age and gender.
D) past exercise training.
Q3) Return to work is often related to oxygen transport capacity in terms of:
A) aerobic and muscle power.
B) mobilization and exercise.
C) stress level and social contact.
D) capacity for activity and participation.
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Page 20
Chapter 19: Mobilization and Exercise: Testing and Training
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Q1) The prone position,which is underused clinically,can have such a significant powerful effect on:
A) oxygen transport.
B) high blood pressure.
C) diabetes.
D) alveolar volume.
Q2) Extreme body position changes simulate,but do not replace,the:
A) physiological stir-up and perturbations that occur with normal mobility and being left side-lying.
B) physiological stir-up and perturbations that occur with normal mobility and being recumbent.
C) physiological stir-up and perturbations that occur with normal mobility and being prone.
D) physiological stir-up and perturbations that occur with normal mobility and being upright.
Q3) The practice of routinely turning patients every 2 hours continues to be an:
A) unrealistic goal for the caregiver.
B) underused standard of care.
C) unaccepted standard of care.
D) accepted standard of care.
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Chapter 20: Body Positioning
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Q1) Ventilation of the alveoli is an important step in:
A) oxygen diffusion.
B) physiologic respiration.
C) airway ventilation.
D) oxygen transport chain.
Q2) The application of positive expiratory pressure involves:
A) an adjustable level of expiratory resistance.
B) an adjustable level of inspiration resistance.
C) a fixed level of expiratory resistance.
D) a fixed level of inspiratory resistance.
Q3) All of the following refer to bronchial hygiene techniques EXCEPT:
A) chest physical therapy.
B) tracheal tapping.
C) bronchial drainage.
D) chest physiotherapy.
Q4) Contraindications to external manipulation of the thorax are:
A) lung contusion and osteoporosis.
B) lung contusion, osteoporosis, and coagulopathy.
C) osteoporosis and coagulopathy.
D) lung contusion and coagulopathy.
Page 22
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Chapter 21: Airway Clearance Techniques
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Q1) The techniques of ________ and _______ are at opposite ends of a spectrum
A) vibration, clapping
B) clapping, shaking
C) vibration, gentle high-frequency force
D) vibration, shaking
Q2) The three-phased repeated active cycle of breathing technique (ACBT)includes all of the following EXCEPT:
A) active percussive reflex.
B) the forced expiratory technique.
C) breathing control.
D) thoracic expansion.
Q3) Complications that occur as a result of a technique or precautions associated with a particular method should guide a patient or caregiver to:
A) find an alternate technique.
B) seek additional training.
C) find a new therapist.
D) contact the vendor.
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Chapter 22: Facilitating Airway Clearance With Coughing Techniques
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Q1) Populations commonly in need of evaluation of swallowing are:
A) patients with pulmonary disorders.
B) patients with cardiovascular disorders.
C) patients with musculoskeletal disorders.
D) patients with neurologic disorders.
Q2) One of the two assisted cough techniques is:
A) intrathoracic assisted.
B) self-assisted.
C) manually assisted.
D) intraabdominal assisted.
Q3) Speech and language pathologists work with patients who have swallowing dysfunction (dysphagia)by:
A) helping them to learn techniques and procedures for safe swallowing.
B) helping them to learn proper breathing techniques to aid in swallowing.
C) helping them to learn proper airway clearing techniques to aid in swallowing.
D) working in conjunction with a physical therapist on a treatment plan.
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24
Chapter 23: Facilitating Ventilation Patterns and Breathing Strategies
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Q1) The following are all goals of teaching controlled-breathing techniques EXCEPT:
A) to decrease the rate of respiration.
B) to decrease the work of breathing.
C) to assist in relaxation.
D) to improve airway clearance by improving cough.
Q2) Sniffing is a simple and effective way of teaching:
A) controlled breathing.
B) diaphragmatic breathing.
C) hyperventilation.
D) Biot respiration.
Q3) Normal breathing,repeated rhythmic inspiratory-expiratory cycles,is known as: A) eupnea.
B) hyperpnea.
C) apnea.
D) Cheyne-Stokes respiration
Q4) Time spent in a horizontal position can be used as an opportunity in:
A) retention of lung secretions.
B) active drainage.
C) passive drainage.
D) postural orthostatics.
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Chapter 24: Exercise Testing and Training: Primary
Cardiopulmonary Dysfunction
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Q1) Chronic heart failure is usually hallmarked by:
A) right ventricular dysfunction.
B) left ventricular dysfunction.
C) upper ventricular dysfunction.
D) lower ventricular dysfunction.
Q2) Type 2 diabetes mellitus is a strong risk factor for:
A) sudden cardiac death.
B) coronary artery disease.
C) neither a nor b.
D) both a and b.
Q3) Noninvasive cardiac and pulmonary rehabilitation is more cost effective than medical and surgical treatments.All of the following are considered noninvasive EXCEPT:
A) smoking cessation.
B) angioplasty.
C) nutrition and weight control.
D) self-management training.
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26
Chapter 25: Exercise Testing and Training: Secondary
Cardiopulmonary Dysfunction
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Q1) Compared with the general population,what two things are more common in persons with Down syndrome?
A) Cardiac defects and sleep apnea
B) Cardiac defects and diabetes
C) Pulmonary dysfunction and sleep apnea
D) Pulmonary dysfunction and anemia
Q2) Manifestations of oxygen transport limitations or one or more risk factors include individuals with systemic conditions.Goals for these individuals would include all but which of the following?
A) Optimize central adaptation to exercise.
B) Reduce hemodynamic responses.
C) Optimize peripheral adaptation to exercise.
D) Reduce biomechanical stress.
Q3) Immunodeficiency has been implicated in:
A) renal conditions.
B) irritable bowel syndrome.
C) endocrine conditions.
D) chronic fatigue syndrome.
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Chapter 26: Respiratory Muscle Training
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Q1) Inspiratory muscles are mainly involved in:
A) repetitive contractions with high-intensity training strategies.
B) repetitive contractions with low-intensity training strategies.
C) repetitive contractions with high intensity and endurance.
D) repetitive contractions with low intensity and endurance.
Q2) About 75% to 80% of patients who are mechanically ventilated can be:
A) expected to have respiratory muscle dysfunction.
B) weaned to breath spontaneously without difficulty.
C) expected to have poorer prognoses.
D) weaned to breath spontaneously but with much difficulty.
Q3) Abnormal respiratory muscle function plays an important role in people with chronic heart failure (CHF)in:
A) extended exercise sessions.
B) extended periods of rest.
C) premature exercise termination.
D) exertional dyspnea.
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28
Chapter 27: Complementary Therapies As
Cardiopulmonary Physical Therapy Interventions
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Q1) Rosen method body work is a:
A) manual therapy that uses light touch to balance energy flow, partly by balancing the flow of cerebral spinal fluid during its circulation around the meninges of the cranium and down the spinal column
B) manipulation of tissue through the skin with the intention of bringing about a change in the present condition of the mind/body
C) belief that illness and disease result from vertebral misalignment and regular Manipulation can maintain energy flow to organs and the body/mind
D) form of hands-on therapy with the goal being to enhance relaxation and emotional awareness
Q2) T'ai chi practice has been recommended as a:
A) way of lessening anxiety
B) therapeutic intervention in balance disorders and fall prevention in the elderly
C) to lower episodes of myocardial ischemia
D) way to lower the incidents of Type A behavior patterns
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Chapter 28: Patient Education
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Q1) Physical therapists believe that:
A) patient-clinician rapport is the most important education objective.
B) meditation should always be included in patient education.
C) patient education is an important part of patient care.
D) relaxation and emotional awareness should be a main focus in patient education.
Q2) The learning needs assessment encompasses the following five major areas:
A) perceptual, motor, affective, cognitive, and environmental.
B) seeing, hearing, smelling, touching, and tasting.
C) reading, testing, group discussion, role playing, and individual instruction.
D) lecture, video, audiotape, computer programs, and directed activities.
Q3) The most important aspect of planning for patient education is:
A) assessing the physical therapist.
B) assessing the clinic where the patient will be treated.
C) assessing the behavior-modification approach.
D) assessing the learner.
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Chapter 29: Individuals With Acute Medical Conditions
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Q1) Which of the following is LEAST appropriate for a patient with hypertension?
A) Smoking cessation
B) Nutritional counseling
C) Aerobic exercise
D) Resistance training
Q2) All of the following are true with regard to chronic bronchitis EXCEPT:
A) chronic bronchitis is common in smokers.
B) chronic bronchitis can be diagnosed after 1 year.
C) chronic bronchitis occurs in the presence of decreased functional cilia.
D) chronic bronchitis is characterized by tenacious, purulent sputum.
Q3) Interstitial pulmonary fibrosis is:
A) most often seen in health care workers.
B) strongly associated with smoking.
C) sometimes associated with pulmonary hypertension.
D) not responsive to pharmacologic management.
Q4) Pneumonia:
A) rarely results in morbidity and mortality in hospitalized patients.
B) decreased in the presence of artificial airways.
C) transmitted through contact.
D) often preceded by atelectasis.
Page 31
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Chapter 30: Individuals With Acute Surgical Conditions
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Q1) Which of the following is TRUE regarding the typical pattern of breathing after surgery?
A) Spontaneous deep breaths are normal.
B) Tachypnea and tachycardia are rare.
C) Breath sounds are decreased and lung bases.
D) Mucus is not heard typically on auscultation.
Q2) Anesthesia results in:
A) decreased atelectasis.
B) depression of breathing.
C) increased functional residual capacity.
D) increased residual volume.
Q3) You are consulted on a patient after resection of the right lung for treatment of lung cancer.The patient has had no postoperative precautions,but you wish to implement treatment plans that will sustain alveolar inflation and functional residual capacity.According to the textbook,_______________________ is/are the most appropriate course of action to achieve these goals.
A) placing the patient in a recumbent position
B) maximal inspiratory maneuvers alone
C) mobilization and position changes
D) forced coughing
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Chapter 31: Individuals With Chronic Primary
Cardiovascular and Pulmonary Dysfunction
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Sample Questions
Q1) Angina is caused by:
A) valve dysfunction.
B) electrical dysfunction.
C) atherosclerosis.
D) bacterial infection.
Q2) The goal of physical therapy with a patient with valve dysfunction is to:
A) optimize oxygen transport.
B) decrease quality of life.
C) increase work of the heart.
D) provide long doses of exercise.
Q3) Valve dysfunction is:
A) congenital or acquired.
B) a consequence of rheumatic fever.
C) caused by calcification of the valves.
D) all of the above.
Q4) Which of the following is FALSE about coronary artery disease (CAD)?
A) CAD is associated with depression.
B) CAD is worsened by mental stress.
C) CAD is typically seen in people with type B personalities.
D) CAD is associated with increased morbidity.
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Chapter 32: Individuals With Chronic Secondary
Cardiovascular and Pulmonary Dysfunction
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Q1) Which of the following is TRUE regarding quadriplegia and cough?
A) Patients with quadriplegia do not need to cough.
B) Quadriplegia results in ineffective cough.
C) Postural drainage can improve cough.
D) The diaphragm will replace the intercostals in cough.
Q2) Which of the following contributes to pulmonary compromise in a patient with Parkinson disease?
A) Spasticity
B) Chest wall rigidity
C) Hypotonicity
D) Hypervigilance
Q3) All of the following are examples of musculoskeletal thoracic deformities that can affect breathing or coughing EXCEPT:
A) scoliosis.
B) rib fractures.
C) spondylolisthesis.
D) ankylosing spondylitis.
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Page 34
Chapter 33: Comprehensive Management of Individuals in the Intensive Care Unit
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Q1) In addition to age and comorbidity,what risk factors might indicate a suboptimal clinical outcome for an ICU patient?
A) Acute renal failure
B) Cardiac arrest
C) Peritoneal dialysis
D) All of the above
Q2) What is the primary intervention choice to maximize oxygen transport?
A) Acute mobilization and upright positioning
B) Ventilation and mobilization
C) Acute mobilization only
D) Positioning with restricted mobility
Q3) Which of the following medications might help a patient cooperate and tolerate a physical therapy treatment session better?
A) Beta-blocker
B) Bronchodilator
C) Vasopressor agent
D) Narcotics
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Page 35
Chapter 34: Intensive Care Management of Individuals
With Primary Cardiovascular and Pulmonary Dysfunction
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Q1) Which of these is not a classical sign and symptom of a severe asthma attack that may progress to status asthmaticus?
A) Audible wheezing
B) Tachypnea
C) Cyanosis
D) Bradycardia
Q2) Which of the following interventions would have the greatest effect on oxygen transport for a patient in ICU?
A) Active movement of large muscle groups
B) Active assisted movements
C) Passive motion
D) Sitting in a chair at the bedside
Q3) What body position has been shown to have the greatest benefit for the patient with acute respiratory failure?
A) Sitting upright in a chair at the bedside
B) Scheduled four point turning
C) Randomized positioning
D) High Fowler position
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Chapter 35: Intensive Care Management of Individuals
With Secondary Cardiovascular and Pulmonary Dysfunction
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Q1) Which of the following is not a goal of treatment for a patient with burns?
A) Improving arterial saturation
B) Prevent infection
C) Maintain fluid balance
D) All of the above
Q2) What should not be included during treatment and management of a patient with central nervous system trauma?
A) Occasional turning regimen of the patient
B) Judicious tracheal suctioning
C) Lung hyperventilation with manual breathing bag in nonventilated patient
D) Deep breathing or sighs in ventilated patients
Q3) While working with a patient,the patient begins to experience deterioration in level of consciousness,pupillary reflexes,ocular reflexes,pattern of respiration,and exaggerated muscle tone and posture.What do you suspect is occurring with this patient?
A) Fatigue from therapy session
B) Cerebral edema with increased intracranial pressure
C) Myocardial infarction
D) Hemorrhage
Page 37
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Chapter 36: Intensive Care Management of Medical and Surgical Complications
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Q1) Which of the following methods would not reduce the risk of infection with use of a mechanical ventilator?
A) Drain condensation from the hose toward the ventilator.
B) Use a mask and gloves when connecting the patient to the ventilator.
C) Do not directly handle ventilator attachments that communicate with air flow channels.
D) Avoid draining condensation from the hose toward the patient.
Q2) Which of the following would not be a treatment choice for a patient presenting with a thromboembolism?
A) Pneumatic pressure over the lower legs
B) Bed exercises of the lower legs
C) Compression stockings
D) Bed rest
Q3) What mineral losses are most commonly associated with severe alkalemia?
A) Sodium and potassium
B) Sodium and chloride
C) Potassium and chloride
D) Potassium and calcium
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Chapter 37: Infants and Children With Cardiovascular and Pulmonary Concerns
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Q1) Which of the following features may not be a potential source of upper airway obstruction in children?
A) Lymphatic tissues
B) Tonsils
C) Rib angulation
D) Adenoids
Q2) How does chest physical therapy differ in neonates and infants compared with children ages 2 years and older in terms of primary goals?
A) CPT in neonates includes improving airway clearance and emphasizes muscles of respiration.
B) CPT in children includes improving airway clearance and improving ventilation and the efficiency of breathing.
C) There are no differences.
D) CPT in children should only include airway clearance.
Q3) What does the foramen ovale allow to occur during fetal circulation?
A) Passage of oxygenated blood
B) Left-to-right blood flow through the atria
C) Right-to-left blood flow through the atria
D) Passage of deoxygenated blood
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Chapter 38: The Aging Patient
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Q1) Although the improvements in increasing VO max in elderly people are not clear,which of one the following is consistent?
A) Improvement in thoracic mobility leading to better O saturation with lung expansion
B) Greater extraction of oxygen caused by wider arteriovenous oxygen content
C) Decreases in O demands in the peripheral muscles
D) An increase in maximum heart rate
Q2) Diastolic changes to the heart that occur with aging include which of the following?
A) Prolonged myocardial relaxation
B) Decreases in filling pressures of older men with increased age
C) Increases in peak left ventricular diastolic filling rate in older men
D) Decreases in ventricular stiffness.
Q3) The limited data available in aging populations may not provide an accurate description of the entire population in this age group because which of the following?
A) The studies are limited to people younger than the age of 65 years.
B) The studies are limited to mainly one sex.
C) The studies are limited to individuals who are healthy.
D) The studies are limited to those who exercise regularly.
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Chapter 39: Multisystem Clinical Implications of Impaired
Breathing Mechanics and Postural Control
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Q1) The soda can model of respiratory and postural control outlines the needs for which of the following organ systems?
A) Skeletal supports for a weakened muscular system
B) Muscular support for poor development of organ systems
C) Muscular support for an incapable skeletal frame
D) Skeletal support for an incapable respiratory system
Q2) If a patient is to work on strengthening muscles to help with expansion of the anterior abdominal wall,how should the therapist position the patient?
A) Prone
B) Supine
C) Side-lying
D) Sitting
Q3) Which of the following is not a function of the diaphragm?
A) Respiration
B) Creation of pressure in the thoracic and abdominal cavities
C) Trunk stabilization
D) Works in an isolated role to provide respiration and postural support
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Page 41
Chapter 40: The Transplant Patient
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Q1) Which of the following is not a risk factor for idiopathic pulmonary fibrosis?
A) Respiratory failure
B) Pulmonary function results
C) Lung pathology
D) Development of COPD
Q2) Psychological issues associated with transplant patients before surgery are limited to which of the following?
A) Stress from unknown waiting time and employment disruption
B) Moving from home to a new location
C) Staying hopeful and realization of terminal disease
D) Stresses are unlimited because each patient's case is different
Q3) What is the primary need of heart transplant in children younger than the age of 1 year?
A) Coronary artery disease
B) Acute myocardial infarction
C) Mitral valve prolapse
D) Congenital abnormalities
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Chapter 41: The Patient in the Community
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Q1) With regard to Medicare guidelines considering O saturation during exercise or recovery,which of the following is considered to be the minimal SpO requirement to be placed on O ?
A) 80%
B) 85%
C) 88%
D) 90%
Q2) Which of the following is a priority among impairments found during the recovery of an episode of cardiac or pulmonary issues according to the text?
A) Ineffective sleep
B) Nonemergent breathing problems
C) Nutritional concerns
D) Pain
Q3) Vital signs and oximetry should be performed during the evaluation in which position first?
A) Standing
B) Sitting
C) Walking
D) Supine
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Page 43
Chapter 42: Body Mechanics: Positioning and Moving Patients
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Q1) How do upright postures create a challenge to breathing?
A) By adding the component of balance
B) By increasing the effect of gravity on rib expansion
C) By narrowing airways
D) By decreasing heart rate
Q2) Which explains the relationship between a person's center of gravity and his or her body stability?
A) The higher a person's center of gravity, the greater his or her body stability.
B) The lower a person's center of gravity, the lesser his or her body stability.
C) The farther anterior a person's center of gravity, the greater his or her body stability.
D) The lower a person's center of gravity, the greater his or her body stability.
Q3) Which of the following is an appropriate lifting tip?
A) Lift with your legs.
B) Do not attempt to lift solely with your arms and back.
C) Avoid rotation of the spine when lifting.
D) All of the above
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Chapter 43: Respiratory Care Practice Review
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Q1) Which aspect of a patient is especially important to evaluate when a nasal cannula is used?
A) Skin integrity
B) Blood pressure
C) Thirst and appetite
D) Sleeping patterns
Q2) Which of the following is most cost effective and strictly used to deliver medication?
A) SVN
B) MDI
C) COPD
D) FEV
Q3) Which device has become more popular over the past 20 years for supporting patients with Duchenne muscular dystrophy and cystic fibrosis?
A) IPPB
B) MDI
C) NMIV
D) CPAP
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Chapter
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Q1) Before suctioning an artificial airway,how many hyperoxygenating breaths with a manual resuscitation bag should be provided?
A) 1 to 2
B) 3 to 5
C) 10 to 15
D) 30 to 40
Q2) Which complication from tracheal suctioning can be minimized by performing preoxygenation?
A) Infection
B) Bronchospasm
C) Hypoxemia
D) All of the above
Q3) Which is needed to reinsert a dislodged outer cannula?
A) Tracheal hook
B) Trousseau dilator
C) Satisfactory tissue retraction
D) All of the above
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46
Chapter 45: Respiratory and Cardiovascular Drug Actions
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Q1) Which is an advantage of using a nebulizer instead of a metered-dose inhaler (MDI)?
A) Does not require hand-breathing coordination
B) More portable
C) Less expensive
D) All of the above
Q2) Which is an expectorant that acts by increasing the production of respiratory secretions?
A) Guaifenesin
B) Acetylcysteine
C) Zileuton
D) Cromolyn sodium
Q3) Which class of drugs has been used as insecticides and is beneficial in problems related to the eye,intestine,and the skeletal neuromuscular junction?
A) Cholinergic drugs
B) Anticholinesterase drugs
C) Sympatholytic drugs
D) -Adrenergic blocking drugs
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