Pulmonary Assessment
Exam Questions
Course Introduction
Pulmonary Assessment is a course designed to provide students with the theoretical knowledge and practical skills necessary to evaluate respiratory function and diagnose pulmonary conditions. The course covers the techniques and interpretation of physical examination, patient history taking, and the use of diagnostic tools such as spirometry, pulse oximetry, peak flow measurement, and arterial blood gas analysis. Emphasizing both normal and pathological findings, students will learn to assess and monitor lung function, recognize signs and symptoms of common respiratory diseases, and apply evidence-based approaches to clinical decision-making in diverse healthcare settings.
Recommended Textbook
Clinical Manifestations Assessment of Respiratory Disease 6th Edition by Terry Des Jardins
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Chapter 1: The Patient Interview
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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) To have the most productive interviewing session, the respiratory therapist must avoid all of the following types of verbal messages EXCEPT: A) confrontation.
B)giving advice.
C)using avoidance language.
D)distancing.
Answer: A
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Chapter 2: The Physical Examination and Its Basis in Physiology
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Q1) Benefits of pursed-lip breathing include that it:
1) stabilizes airways.
2) offsets air trapping on exhalation.
3) generates a better gas mixing breathing pattern.
4) slows the respiratory rate.
A)1
B)2, 3
C)1, 2, 3
D)1, 2, 3, 4
Answer: D
Q2) Your patient has come into the emergency department with a complaint of centrally located constant pain. What is his most likely problem?
A) Pleurisy
B)Myocardial ischemia
C)Pneumothorax
D)Fractured rib
Answer: B
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Chapter 3: Pulmonary Function Study Assessments
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Q1) Total lung capacity is composed of all of the following EXCEPT:
A) IRV.
B)IC.
C)ERV.
D)RV.
Answer: A
Q2) Which of the following forced vital capacity test times should be interpreted as normal?
A) Less than 4 seconds
B)4 to 6 seconds
C)6 to 8 seconds
D)8 to 10 seconds
Answer: B
Q3) All of the following are true of the peak expiratory flow rate test EXCEPT:
A) it is effort dependent.
B)it is taken from the FVC test results.
C)it is taken from the MVV test results.
D)it assesses large upper airways.
Answer: C
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Page 5
Chapter 4: Arterial Blood Gas Assessments
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Q1) What causes stimulation of the peripheral chemoreceptors to increase the ventilator rate?
A) Pain or anxiety
B)PaCO<sub>2</sub> of about 40 mm Hg
C)PaO<sub>2</sub> of about 60 mm Hg
D)Venous pH of 7.30 to 7.40
Q2) An anion gap of 15 would indicate:
A) metabolic acidosis.
B)respiratory alkalosis.
C)respiratory acidosis.
D)metabolic alkalosis.
Q3) Which of the following would be a normal person's venous oxygen pressure (PaO<sub>2</sub>)?
A) 35 to 45 mm Hg
B)45 to 80 mm Hg
C)80 to 100 mm Hg
D)100 to 120 mm Hg
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6
Chapter 5: Oxygenation Assessments
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Q1) 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
Q2) A condition that will cause anemic hypoxia is:
A) cyanide poisoning.
B)decreased cardiac output or heart failure.
C)polycythemia.
D)carbon monoxide poisoning.
Q3) Your 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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Q1) When reviewing a cardiac rhythm strip, you notice 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
Q2) Which of the following will be found in a patient with asystole?
1) Increased ventricular activity
2) Absence of electrical activity
3) No blood pressure
4) Highly variable heart rate
A)2
B)1, 4
C)2, 3
D)1, 3, 4
Q3) The "T" wave represents:
A) depolarization of the ventricles.
B)repolarization of the ventricles.
C)depolarization of the atria.
D)repolarization of the atria.
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Chapter 7: Radiologic Examination of the Chest
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Q1) Your patient has a long smoking history and has recently coughed up blood. The physician suspects that there may be lung cancer but no lesions can be seen on a standard chest radiograph. A CT scan offers all of the following advantages EXCEPT:
A) bronchial tumors can be seen.
B)lung tumors as small as 0.4 cm can be seen.
C)a tumor's metabolism can be identified.
D)a mediastinal mass can be seen.
Q2) Which of the following would be normal findings of the heart and surrounding area?
1) The left hilum is about 2 cm higher than the right hilum.
2) Most of the heart shadow is to the right of the sternum.
3) Calcified lymph nodes indicate an adult patient.
4) The cardiothoracic ratio is less than 1:2.
A)1, 4
B)2, 3
C)1, 2, 4
D)1, 2, 3, 4
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Chapter 8: Other Important Tests and Procedures
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Q1) In a normal differential white blood cell (WBC) count, which of the following would have the highest number?
A) Neutrophils
B)Basophils
C)Eosinophils
D)Lymphocytes
Q2) In response to a viral infection, 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
Q3) For blood urea nitrogen (BUN) and creatinine values:
A) serum creatinine is a protein produced in the kidneys.
B)BUN and serum creatinine values that are higher than the normal range indicate renal failure.
C)urea is a waste product of carbohydrate metabolism in the intestines.
D)BUN values that are below normal indicate renal failure.
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10
Chapter 9: The Therapist-Driven Protocol Program and the
Role of the Respiratory Care Practitioner
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Q1) Your patient required mechanical ventilation for apnea after an accidental drug overdose. She is now awake. According to the mechanical ventilation protocol, what should be done to initially assess her readiness to be weaned from the ventilator?
A) 1-Minute spontaneous breathing trial
B)30-Minute spontaneous breathing trial
C)Assessment on CPAP
D)Consultation with the physician
Q2) When performing a therapist-driven protocol (TDP), the severity assessment refers to:
A) the frequency of performing a treatment modality.
B)how sick the patient is.
C)the Department of Homeland Security's threat level.
D)how urgently the physician wants the patient treated.
Q3) Postural drainage, percussion, and vibration are part of what TDP?
A) Hyperinflation therapy
B)Bronchopulmonary hygiene therapy
C)Mechanical ventilation
D)Oxygen therapy
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Chapter 10: Recording Skills:
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Sample Questions
Q1) Computer-based records are commonly used for which of the following?
1) Retrieving pulmonary function studies
2) Storing treatment information
3) Storing admission data
4) Playing back recorded patient interviews
A)3, 4
B)1, 2
C)1, 2, 3
D)1, 2, 3, 4
Q2) According to the chapter text, which of the following are basic methods to record assessment data?
1) Computer documentation
2) Charting by exception
3) Source-oriented record
4) Problem-oriented medical record
A)1, 2
B)2, 3
C)1, 3, 4
D)1, 2, 3, 4
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Chapter 11: Chronic Obstructive Pulmonary Disease Copd:
Chronic Bronchitis, and Emphysema
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Q1) The genetic reference to a person with a normal level of \(\alpha\)<sub>1</sub>-antitrypsin is:
A) Z phenotype.
B)MZ.
C)MM.
D)ZZ.
Q2) Emphysema is probably caused by all of the following EXCEPT:
A) inhaling asbestos fibers.
B)(\(\alpha\)<sub>1</sub>)-antitrypsin deficiency.
C)second-hand cigarette smoke.
D)air pollution.
Q3) Which of the following are associated with chronic bronchitis?
1) Cyanosis
2) Purulent sputum
3) Right heart failure
4) Elevated CO<sub>2</sub> level
A)1, 2
B)3, 4
C)1, 3
D)1, 2, 3, 4
Page 13
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Chapter 12: Asthma
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Q1) A patient has been admitted to the hospital with a suspected asthma attack. What radiographic findings would confirm this diagnosis?
1) Depressed diaphragm
2) Increased anterior-posterior diameter
3) Asymmetrical lung inflation
4) Translucent lung fields
A)1, 2
B)3, 4
C)1, 2, 4
D)1, 2, 3, 4
Q2) Pulsus paradoxus would be manifested as:
A) a greater than 40 mm Hg difference between systolic and diastolic blood pressures.
B)inspiratory systolic blood pressure >10 mm Hg less than during expiration.
C)inspiratory diastolic blood pressure >10 mm Hg less than during expiration.
D)systolic and diastolic blood pressure reading being reversed.
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14
Chapter 13: Bronchiectasis
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Q1) Which of the following pulmonary function testing values would be found in a patient with severe, obstructive bronchiectasis?
A) Decreased RV/TLC ratio
B)Increased PEFR
C)Increased FEF<sub>25%-75%</sub>
D)Decreased FEF<sub>25%-75%</sub>
Q2) Rigid and dilated bronchi are the key anatomic alterations found in which type of bronchiectasis?
A) Varicose
B)Cystic
C)Emphysematous
D)Cylindrical
Q3) Which form of bronchiectasis causes the greatest amount of damage to the tracheobronchial tree?
A) Triphasic
B)Varicose
C)Cystic
D)Fusiform
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15
Chapter 14: Cystic Fibrosis
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Q1) Which of the following is/are commonly used in the treatment of cystic fibrosis?
1) Pancreatic enzymes and vitamins
2) Antibiotics
3) Postural drainage
4) Expectorants
A)1, 4
B)2, 3
C)1, 2, 3
D)1, 2, 3, 4
Q2) Which ethnic group has the greatest number of people with cystic fibrosis?
A) African Americans
B)Asians
C)Hispanics
D)whites
Q3) All of the following can be used in the diagnosis of cystic fibrosis EXCEPT:
A) an elevated potassium level in the sweat.
B)an elevated chloride level in the sweat.
C)genetic testing of the patient and/or parents.
D)chronic lung infections from an early age.
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Page 16
Chapter 15: Pneumonia
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Q1) Your patient has bilateral pneumonia. What findings can be expected on the CT scan?
1) Depressed diaphragms
2) Elongated heart
3) Air bronchograms
4) Consolidation
A)3, 4
B)1, 2
C)2, 3, 4
D)1, 2, 3, 4
Q2) Ventilator-acquired pneumonia (VAP) is defined as pneumonia that develops:
A) between 24 and 48 hours after endotracheal intubation.
B)more than 48 to 72 hours after endotracheal intubation.
C)less than 24 hours after mechanical ventilation is started.
D)more than 48 to 72 hours after mechanical ventilation is started.
Q3) Overall, most cases of pneumonia are caused by: A) viruses.
B)Gram-negative bacteria.
C)protozoa.
D)fungi.
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Chapter 16: Lung Abscess
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Q1) A lung abscess may be caused by which of the following?
1) Penetrating chest wound
2) Septic embolism
3) Aspirated foreign body
4) Bronchogenic cyst
A)1, 2
B)3, 4
C)1, 2, 4
D)1, 2, 3, 4
Q2) While performing an assessment of your female patient, a pleural friction rub is heard. What does this indicate?
A) Her secretions are becoming thinner.
B)She has atelectasis.
C)An abscess is near the pleural surface.
D)She has a pneumothorax.
Q3) Your patient has aspirated. This can result in all of the following EXCEPT:
A) fungal pneumonia.
B)anaerobic bacterial pneumonia.
C)chemical pneumonitis.
D)Both B and C
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Chapter 17: Tuberculosis
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Q1) A patient with an advanced case of TB may have the following radiologic findings:
1) Bronchial tumors
2) Hyperlucent lung fields
3) Retraction of lung segments
4) Right-sided heart enlargement
A)2
B)2, 3
C)3, 4
D)1, 3, 4
Q2) Mycobacterium tuberculosis is particularly damaging to the lungs because of:
A) the healing of a tubercle.
B)micropulmonary emboli.
C)the increased mucus production.
D)the irreversible bronchospasm that it causes.
Q3) The most effective medication used to treat a TB infection is:
A) rifampin.
B)penicillin.
C)streptomycin.
D)isoniazid.
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Page 19
Chapter 18: Fungal Diseases of the Lung
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Q1) In the midwestern part of the United States, what is the most common fungal infection of the lungs?
A) Cryptococcosis
B)Histoplasmosis
C)Blastomycosis
D)Coccidioidomycosis
Q2) A skin test is available to confirm which of the following fungal infections?
A) Coccidioidomycosis
B)Blastomycosis
C)Tuberculosis
D)Pseudomonal infection
Q3) Which type of fungal lung infection frequently results in productive cough with purulent sputum?
A) Staphylococcal infection
B)Blastomycosis
C)Klebsiella infection
D)Histoplasmosis
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Chapter 19: Pulmonary Edema
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Q1) Your patient has a decreased oncotic pressure. What can be done to increase it?
A) High-salt diet
B)Mannitol
C)Albumin withheld
D)Morphine sulfate
Q2) What is the normal hydrostatic pressure in the pulmonary capillaries?
A) 0 to 5 mm Hg
B)5 to 10 mm Hg
C)10 to 15 mm Hg
D)15 to 20 mm Hg
Q3) Pulmonary edema manifests itself clinically as a/an:
A) restrictive pulmonary disorder.
B)obstructive pulmonary disorder.
C)equally restrictive and obstructive disorder.
D)restrictive cardiac disorder.
Q4) All of the following are causes of cardiogenic pulmonary edema EXCEPT:
A) myocardial infarction.
B)mitral valve disease.
C)allergic reaction to drugs.
D)congenital heart defects.
Page 21
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Chapter 20: Pulmonary Embolism
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Q1) The death of lung tissue that may result from an obstruction of the pulmonary artery is called a:
A) pulmonary embolism.
B)pleural effusion.
C)pulmonary infarction.
D)pulmonary empyema.
Q2) Which of the following fibrinolytic agents is/are used to treat a pulmonary embolism?
1) Urokinase
2) Vitamin K
3) Heparin
4) Streptokinase
A)1, 4
B)2, 3
C)1, 3, 4
D)1, 2, 3, 4
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22
Chapter 21: Flail Chest
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Q1) What chest radiograph findings would be expected on a patient with a flail chest?
1) Decreased opacity
2) Rib fractures
3) Increased opacity
4) Tracheal narrowing or deviation
A)2
B)1, 4
C)2, 3
D)2, 3, 4
Q2) A flail chest is defined as:
1) one fractured rib or two adjacent fractured ribs.
2) three or more adjacent fractured ribs.
3) single rib fractures.
4) double rib fractures.
A)2
B)2, 3
C)1, 3
D)2, 4
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Page 23
Chapter 22: Pneumothorax
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Q1) After the patient has had repeated pneumothoraces of her right lung, the physician has recommended that the patient have the problem permanently eliminated. What should be done?
A) Pleurodesis
B)Right pneumonectomy
C)Permanent right sided chest tube
D)Right upper lobectomy
Q2) Your patient with a large pneumothorax has tachycardia and a low blood pressure. What could cause this?
A) Shock
B)Decreased venous return to the heart
C)Tracheal compression
D)Compression of the abdominal aorta
Q3) Which of the following chest assessment findings would be expected in a patient with a tension pneumothorax?
A) Tracheal shift toward the pneumothorax
B)Dull percussion note
C)Tracheal shift away from the pneumothorax
D)Hyperresonant breath sounds
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Chapter 23: Effusion and Empyema
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Q1) Your patient with pneumonia of the left lung and related empyema has a distinctive breath sound heard over the affected area. What is the name of this characteristic breath sound?
A) Bronchial breath sound
B)Pleural friction rub
C)Empyema rhonchi
D)Pleural crackles
Q2) Your patient has a large pleural effusion. It will act as a/an:
A) restrictive lung disorder.
B)obstructive lung disorder.
C)obstructive > restrictive lung disorder.
D)restrictive > obstructive lung disorder.
Q3) While reviewing the upright chest radiograph of your patient, you see a fluid density in the right lung area that extends upward around the anterior, lateral, and posterior thoracic walls. What is this sign of a pleural effusion called?
A) Meniscus sign
B)Scarf sign
C)Transudate sign
D)Kerley B lines
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Page 25
Chapter 24: Kyphoscoliosis
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Q1) General conditions associated with kyphoscoliosis include all of the following EXCEPT:
A) age-based scoliosis.
B)neuromuscular scoliosis.
C)congenital scoliosis.
D)idiopathic scoliosis.
Q2) In a case of severe kyphoscoliosis, which of the following chest radiograph findings would be expected?
1) Enlarged heart
2) Atelectasis
3) Increased lung opacity
4) Thoracic deformity
A)1, 4
B)2, 3
C)2, 3, 4
D)1, 2, 3, 4
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26
Chapter 25: Interstitial Lung Diseases
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Q1) Your patient has been diagnosed with Wegener's granulomatosis. Her long-term prognosis is:
A) excellent, with full recovery expected.
B)fair, with recovery expected after proper treatment.
C)guarded, recovery is possible after proper treatment.
D)poor, recovery is not expected.
Q2) Cryptogenic organizing pneumonia (COP) (also known as bronchiolitis obliterans with organizing pneumonia [BOOP]) has been associated with which of the following?
A) COPD
B)Heart failure
C)Infection
D)Asthma
Q3) Which of the following classes of drugs has the largest group of agents that can cause interstitial lung disease?
A) Anticancer
B)Cardiovascular
C)Antibiotics
D)Antiinflammatory
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Chapter 26: Cancer of the Lung
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Q1) During bronchoscopy, a tumor was found in the right mainstem bronchus. What is the best way to manage the problem?
A) Prophylactic cranial irradiation
B)Brachytherapy
C)Cryotherapy
D)Laser bronchoscopy
Q2) The most common cause of lung cancer is:
A) smoking tobacco.
B)smoking marijuana.
C)inhaling asbestos.
D)inhaling radon gas.
Q3) Malignant tumors:
1) invade surrounding tissues.
2) grow slowly.
3) cause necrosis.
4) push aside surrounding tissue.
A)1
B)4
C)2, 3
D)1, 3
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Chapter 27: Acute Respiratory Distress Syndrome
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Q1) A chest radiograph finding indicative of ARDS is:
A) "ground-glass" appearance.
B)pleural effusion.
C)lung hyperinflation.
D)tracheal deviation.
Q2) The ventilation strategy used with most patients with ARDS includes:
1) large tidal volume.
2) small tidal volume.
3) high respiratory rate.
4) low respiratory rate.
A)2
B)3
C)1, 4
D)2, 3
Q3) The anatomic alterations found in the alveoli of a patient with ARDS are closest to those found with what other disease?
A) Bacterial pneumonia
B)Hyaline membrane disease
C)Congestive heart failure
D)Emphysema
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Chapter 28: Guillain-Barré Syndrome
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Q1) Your patient with Guillain-Barré syndrome is developing atelectasis. His chest radiograph findings would show:
A) "ground-glass" appearance.
B)crackles.
C)increased opacity.
D)blunted costophrenic angles.
Q2) The diagnosis of Guillain-Barré syndrome is based on all of the following, EXCEPT:
A) urinalysis shows elevate blood urea nitrogen.
B)abnormal electromyography results.
C)cerebrospinal fluid shows elevated protein level.
D)clinical history.
Q3) Guillain-Barré syndrome is most likely to be found in which demographic group?
A) African-American female 20-30 years of age
B)Hispanic male <45 years of age
C)Asian female 20-40 years of age
D)White male = 45 years of age
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Chapter 29: Myasthenia Gravis
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Q1) Treatment and care of the myasthenia gravis patient include:
1) pyridostigmine (Mestinon).
2) plasmapheresis.
3) thymectomy.
4) mechanical ventilation.
A)1, 3
B)2, 4
C)1, 2, 4
D)1, 2, 3, 4
Q2) Because of respiratory failure, your patient with myasthenia gravis was placed on mechanical ventilation and is now stable. What will the chest radiograph most likely show?
A) Normal lungs
B)Mediastinal shift
C)Pericardial tamponade
D)Pneumonia
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Chapter 30: Sleep Apnea
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Q1) Which of the following cardiac arrhythmias is life threatening?
A) Atrioventricular block
B)Sinus bradycardia
C)Ventricular tachycardia
D)Premature ventricular contraction
Q2) All of the following are evaluated during a polysomnographic sleep study, EXCEPT:
A) breath sounds.
B)chest and/or abdominal movement.
C)electro-oculogram (EOG).
D)nasal and oral air flow.
Q3) A CPAP titration polysomnogram is performed to:
A) find the maximum CPAP level for the functional residual capacity.
B)determine the lowest possible CPAP level.
C)find the CPAP level to maintain an open airway.
D)determine the pressure needed for negative-pressure ventilation.
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Chapter 31: Newborn and Early Childhood Respiratory Disorders
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Q1) A premature neonate must generate a higher negative intrapleural pressure during inspiration than a term neonate. This will result in all of the following, EXCEPT:
A) cyanosis of dependent thoracic areas.
B)"seesaw" breathing pattern.
C)alveolar hyperinflation.
D)intercostal retractions.
Q2) A neonate in respiratory distress will often dilate his/her nostrils to:
A) facilitate inspiration.
B)nurse more easily.
C)sneeze out amniotic fluid.
D)raise its intrapleural pressure.
Q3) A newborn's 5-minute Apgar score is 7. How should this be interpreted?
A) Normal adjustment to being born
B)Moderate distress; intubate the airway and suction the lungs
C)Moderate distress; administer supplemental oxygen
D)Severe distress; begin bag-mask resuscitation
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Chapter 32: Meconium Aspiration Syndrome
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Q1) Risk factors for the development of MAS include:
1) being post-term.
2) a mother who is hypertensive.
3) a mother who is toxemic.
4) being the first twin born.
A)1, 4
B)2, 3
C)2, 3, 4
D)1, 2, 3
Q2) A common finding in a neonate with MAS is a respiratory rate that is:
A) under 40/min.
B)between 40 and 60/min.
C)well over 60/min.
D)cyclical with faster and then slower breaths.
Q3) What is the consequence of meconium aspiration if there is a "ball-valve" effect in the small airways?
A) Air trapping on exhalation
B)Apnea of prematurity
C)Air trapping on inhalation
D)Bronchiectasis
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Chapter 33: Transient Tachypnea of the Newborn
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Q1) The causes of TTN include:
1) the mother having cystic fibrosis.
2) infant's hypoxemia.
3) mother's hypoxemia.
4) inadequate inspiratory effort.
A)1, 3
B)2, 4
C)2, 3, 4
D)1, 2, 3
Q2) Your infant patient has TTN. What clinical manifestations are associated with the more negative intrapleural pressures needed during inspiration?
1) Thick, tenacious secretions
2) Intercostals retractions
3) Nasal flaring
4) Mediastinal shift
A)1, 3
B)2, 3
C)2, 3, 4
D)1, 2, 3, 4
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Chapter 34: Respiratory Distress Syndrome
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Q1) It is likely that a neonate with RDS will have the following chest radiograph finding:
A) airway dilation and distortion.
B)fluffy infiltrates in the bases of the lungs.
C)ground-glass appearance.
D)cardiomegaly.
Q2) Which of the following are usually seen in the lungs of a neonate with RDS?
A) Alveolar collapse (atelectasis)
B)Segmental atelectasis
C)Lobar atelectasis
D)Pulmonary fibrosis
Q3) A mother is about to deliver a 25 weeks' gestation infant. As the respiratory therapist in the delivery room, what therapeutic intervention should you be prepared to give to minimize the risk of RDS?
A) Mask CPAP
B)Airway suctioning
C)Exogenous surfactant
D)Mechanical ventilation
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36
Chapter 35: Pulmonary Air Leak Syndromes
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Q1) What pulmonary condition can be identified by a change in the point of maximum impulse (PMI)?
A) Pneumothorax
B)PIE
C)Pneumomediastinum
D)Meconium aspiration syndrome (MAS)
Q2) Your patient has PIE and a pneumomediastinum. What clinical manifestations are associated with the more negative intrapleural pressures needed during an inspiration by your patient?
1) Lower thoracic areas are cyanotic
2) Substernal retractions
3) Flaring nostrils
4) Inspiratory stridor
A)1, 4
B)2, 3
C)1, 2, 3
D)1, 2, 3, 4
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Chapter 36: Respiratory Syncytial Virus Infection
Bronchiolitis or Pneumonitis
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Q1) An infant with RSV will show what clinical manifestations associated with the more negative intrapleural pressures needed during inspiration?
1) See-saw breathing movement
2) Breath sounds reveal pleural friction rub
3) Inspiratory stridor
4) Cyanosis of the dependent abdominal areas
A)2, 4
B)1, 4
C)1, 3, 4
D)1, 2, 3, 4
Q2) Which of the following are major pathologic or structural changes associated with RSV?
1) Dilation and distortion of the airways
2) Inflammation of the peripheral airways
3) Alveolar hyperinflation
4) Pulmonary edema
A)1, 4
B)2, 3
C)2, 3, 4
D)1, 2, 3, 4
38
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Chapter 37: Bronchopulmonary Dysplasia
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Q1) A very preterm infant has just been born. What would contribute to its development of the "new" bronchopulmonary dysplasia (BPD)?
A) Interruption of the canalicular stage of lung development
B)Transient tachypnea of the newborn (TTN)
C)Low Apgar scores
D)Laryngotracheobronchitis
Q2) Your patient is beginning to develop BPD. What can be given to promote pulmonary vasodilation?
A) Furosemide (Lasix)
B)Inhaled nitric oxide (iNO)
C)Inhaled albuterol
D)> 50% oxygen
Q3) What essential nutrient maintains the epithelial cells of the tracheobronchial tree?
A) Vitamin A
B)Vitamin C
C)Carbohydrates
D)Proteins
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Chapter 38: Congenital Diaphragmatic Hernia
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Q1) An infant with a CDH also has pulmonary hypertension. What can be given to help correct this problem?
A) Inhaled nitric oxide (iNO)
B)Inhaled parasympatholytic agent
C)100% oxygen
D)Corticosteroids
Q2) All of the following chest radiograph findings would be found in a patient with a CDH, EXCEPT:
A) steeple point sign.
B)complete lung collapse.
C)lungs do not meet the chest wall.
D)heart is shifted to the unaffected side.
Q3) If a newborn is born with a CDH, when does respiratory distress develop?
A) During labor
B)Soon after birth
C)Within the first 4 to 6 hours of birth
D)Within the first 48 hours of birth
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Chapter 39: Croup Syndrome: Laryngotracheobronchitis and
Acute Epiglottitis
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Q1) All of the following would be expected during the assessment of a young child with LTB, EXCEPT:
A) decreased respiratory rate.
B)diminished breath sounds.
C)use of accessory muscles.
D)hypoxemia.
Q2) All of the following anatomic alterations may be found in a patient with LTB, EXCEPT:
A) increased secretions.
B)ineffective cilia.
C)narrowed airway lumen.
D)excessive surfactant production.
Q3) The diagnosis of LTB is made by all of the following, EXCEPT:
A) child has inspiratory stridor and barking cough.
B)child has a normal temperature or low fever.
C)child has a significant fever.
D)child can drink without difficulty.
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Chapter 40: Near Drowning
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Q1) The initial chest radiograph appearance of a near drowning victim may include: 1) normal lung fields.
2) atelectasis.
3) pulmonary edema.
4) pencil point sign.
A)1, 3
B)2, 4
C)1, 2, 3
D)1, 2, 3, 4
Q2) Favorable prognostic factors in cold-water near-drowning include: 1) greater effort to reach the surface.
2) alcohol in the victim.
3) colder water.
4) younger age.
A)1, 2
B)3, 4
C)2, 3, 4
D)1, 2, 3, 4
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42
Chapter 41: Smoke Inhalation and Thermal Injuries
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Q1) Your patient with carbon monoxide poisoning has a COHb level of 20%. If he is given 100% oxygen, what will be the approximate COHb level be at 1 hour?
A) 15%
B)10%
C)5%
D)2.5%
Q2) Clinical signs that a patient has a thermal injury to the upper airway include:
1) wheezing.
2) inspiratory stridor.
3) pulmonary edema.
4) painful swallowing.
A)1, 3
B)2, 4
C)2, 3, 4
D)1, 2, 3, 4
Q3) The long term effects of a smoke inhalation injury are:
A) obstructive lung disease.
B)restrictive lung disease.
C)obstructive and restrictive lung disease.
D)neither, there is normally complete healing.
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Chapter 42: Postoperative Atelectasis
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Q1) Which of the following is the least commonly found type of postoperative atelectasis?
A) Primary lobule
B)Lung segment
C)Lung lobe
D)Entire lung
Q2) What definition of atelectasis would best fit that of a premature newborn with respiratory distress syndrome (RDS)?
A) Partial or total collapse of previously expanded lung regions
B)Free pleural air compressed the lungs
C)Enlarged heart causes compression of the lungs
D)The lungs remain unexpanded since birth
Q3) After surgery, your patient must lie supine in bed. Because of this, atelectasis is thought to have developed. What chest radiograph finding would confirm this?
A) Depression of the hemidiaphragms
B)Pulmonary interstitial emphysema (PIE)
C)Increased density in both upper lobe areas
D)Increased density in both posterior lower lobe areas
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