Pulmonary Diagnostics Laboratory Test
Questions
Course Introduction
This course provides an in-depth exploration of diagnostic techniques and procedures used to assess pulmonary function and respiratory health. Students will develop hands-on skills in operating and interpreting diagnostic equipment such as spirometers, plethysmographs, and gas analyzers, and will learn the theoretical foundations behind pulmonary function tests, arterial blood gas analysis, and sleep studies. Emphasis is placed on understanding the clinical significance of test results for various respiratory conditions, ensuring patient safety during diagnostic procedures, and adhering to quality control protocols in a laboratory setting.
Recommended Textbook
Basic Clinical Lab Competencies for Respiratory Care An Integrated Approach 5th Edition by Gary
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2
Chapter 1: Basics of Asepsis
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Sample Questions
Q1) What is the most frequent cause of needle sticks?
A) Attempting to recap a needle
B) Removing discarded needles or syringes from sharps containers
C) Attempting to force a needle into an already full container
D) Using puncture-proof containers
Answer: A
Q2) What is defined as an infection a patient develops while in the hospital and did not have before hospital admission?
A) Pathogenic infection
B) Virulent infection
C) Hospital-acquired infection
D) Microorganism
Answer: C
Q3) What is defined as the complete destruction of all forms of microorganisms?
A) Isolation
B) Standard precautions
C) Asepsis
D) Sterility
Answer: D
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Page 3
Chapter 2: Basic Patient Assessment: Vital Signs and Breath
Sounds
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Q1) The practitioner places a sphygmomanometer on the patient's upper arm.The brachial artery is palpated and the cuff is inflated until the pulse disappears at 110 mmHg.How should this be recorded in the patient's chart?
A) This is the systolic pressure
B) This is the diastolic pressure
C) This is the pulse pressure
D) This is the intrathoracic pressure
Answer: A
Q2) What are continuous abnormal breath sounds described low-pitched and thought to be produced by fluid or secretions vibrating in the airways?
A) Tracheal
B) Wheezes
C) Crackles
D) Rhonchi
Answer: D
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4
Chapter 3: Advanced Patient Assessment: Inspection,
Palpation, and Percussion
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Q1) Where is (are)the midscapulae line(s)located?
A) They are imaginary lines on the posterior chest bisecting the shoulder blades and descending vertically.
B) They are vertical lines on the anterior chest bisecting the clavicles. Each of these lines pass just medial to the nipples.
C) It is an imaginary line on the lateral chest extending downward from the center of the armpit.
D) It is an imaginary line on the posterior chest descending along the vertebral column.
Answer: A
Q2) What is normal I:E ratio?
A) 1:2
B) 1:4
C) 1:6
D) 1:8
Answer: A
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Chapter 4: Radiologic Assessment
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Q1) Which of the following chest x-ray views is the most common for a standard chest x-ray to evaluate a patient's lung tissue?
A) Posterior-anterior (PA) view
B) Anterior-posterior (AP) view
C) Lateral view
D) Apical lordotic view
Q2) When the practitioner needs to focus attention on the upper lobes of the lungs,which x-ray view should be utilized?
A) Posterior-anterior (PA) view
B) Anterior-posterior (AP) view
C) Lateral view
D) Apical lordotic view
Q3) A 2 year-old patient is admitted to the emergency department with a suspicion of epiglottitis.Which of the following would you recommend to confirm the diagnosis?
A) Lateral neck
B) Lateral chest
C) Apical lordotic
D) Left or right anterior oblique
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Chapter 5: Pulmonary Function Testing
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Q1) What is defined as the maximum volume of air that can be exhaled after a maximal inspiration?
A) Inspiratory reserve volume (IRV)
B) Expiratory reserve volume (ERV)
C) Inspiratory capacity (IC)
D) Vital capacity (VC)
Q2) The patient's tidal volume can be calculated by ________________
A) MVV divided by the respiratory rate.
B) Vt multiplied by the respiratory rate.
C) Vt divided by the respiratory rate.
D) Vt divided by the MVV.
Q3) Which of the following would be used to measure a patient's tidal volume and minute volume?
A) Peak flowmeter
B) Manometer
C) Respirometer
D) Mini-Wright device
Q4) A patient comes to the PFT lab to get an annual pulmonary function test.What factors would cause changes in the results from year to year?
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Chapter 6: Electrocardiography
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Q1) Which of the following is NOT normally a cause of ECG artifact?
A) Patient motion artifact
B) Wandering baseline
C) 60 Hz artifact
D) Cell phone interference
Q2) Cleaning the patient's skin with isopropyl alcohol,using more electrode cream,or cleaning the electrode contacts and connections can help with which of the following?
A) Wandering baseline
B) Determining the area of myocardial infarction
C) Determining the presence of a 'P' wave
D) Differentiation between right or left axis deviation
Q3) Which of the following waves in an ECG tracing represents ventricular repolarization?
A) 'P' wave
B) 'QRS' complex
C) 'T' wave
D) 'U' wave
Q4) The patient wants an exercise EKG.To ensure the electrodes stay remain in the proper position,what precautions should be taken?
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Chapter 7: Phlebotomy
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Q1) If the blood clots in the tube or needle,what should the phlebotomist do?
A) Replace the vacuum collection tube.
B) Remove the tube from the needle and releasing the tourniquet while leaving the needle in the vein.
C) Advance the needle.
D) Start over.
Q2) What is defined as the invasive puncturing of a vein for the purpose of collecting blood?
A) Venous blood gas sampling
B) Phlebotomy
C) Arterial blood gas sampling
D) Transcutaneous blood sampling
Q3) If the vacuum tube is pushed in too soon or attached to the needle too soon,what would happen?
A) Unnecessary contamination will occur at the draw site.
B) The angle of the needle stick should be increased.
C) A larger needle needs to be used.
D) The negative pressure stored in the tube will be lost.
Q4) How can the phlebotomist enhance sites to draw blood from a patient?
Q5) How does the phlebotomist gain the confidence of the patient for a blood draw?
Page 9
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Chapter 8: Arterial Blood Gas Sampling
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Q1) If a blood gas sample cannot be analyzed immediately and the sample is not iced,how much time can elapse before blood gas samples will start to change due to further metabolism of the blood dramatically?
A) 5 minutes
B) 15 minutes
C) 25 minutes
D) 35 minutes
Q2) Possible complications of arterial puncture at any site are vessel trauma and occlusion,embolization,infection,and vessel spasm.How could these be prevented?
Q3) How should the practitioner ensure that the arterial line's measured blood pressure is accurate?
Q4) When an air bubble is present in a blood gas sample that was drawn on room air,what will happen to the PO of the blood gas sample?
A) The PO will increase.
B) The PO will decrease.
C) The PO will not change.
Q5) What should the practitioner teach the patient concerning an arterial line?
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Page 10
Chapter 9: Hemodynamic Monitoring
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Q1) Common causes of increased pulmonary artery pressures include _________________.
A) left atrial failure.
B) left ventricular failure.
C) hypovolemia.
D) reduced venous return.
Q2) A patient has a CVP reading of 12 mmHg.What does this indicate?
A) Hypervolemia
B) Hypovolemia
C) Decreased right ventricular preload
D) Increased left atrial preload
Q3) The proximal lumen of the pulmonary artery catheter measures the ______________.
A) central venous pressure.
B) pulmonary capillary wedge pressure.
C) cardiac output.
D) left ventricular end-diastolic pressure.
Q4) What is defined as a device that converts one form of energy to another?
A) Transducer
B) Thermister
C) Phlebostatic axis
D) Catheter
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Chapter 10: Noninvasive Monitoring
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Q1) What is the standard by which noninvasive monitors are compared?
A) Capnography
B) Pulmonary artery pressure monitoring
C) Transcutaneous P02 monitoring
D) Blood gas analysis
Q2) What electrode does the transcutaneous O monitor incorporate into its design?
A) Clark electrode
B) Severinghaus electrode
C) Sanz electrode
D) Reference electrode
Q3) A patient being monitored by pulse oximetry has a reading of 82%.The patient's color is good,the respiratory rate is 16/minute,and the heart rate is 88/minute.Routine daily arterial blood gases (ABG)are drawn and analyzed which reveal; PaO 90 mmHg,PaCO 37 mmHg,pH 7.38.An CO-oximeter is also used for analyzation and reveals; SaO 95%,Hb 13.5 g/dl,metHb 0.3%,HbCO 0.5%.Explain the difference between the two readings.
Q4) How does the pulse oximeter measure O saturation in the capillary bed?
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Page 12
Chapter 11: Documentation and Goals Assessment
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Q1) Where are the consents for surgery contained in the patient's chart?
A) Operative data
B) Progress notes
C) Physician orders
D) Multidisciplinary records
Q2) Which of the following is NOT found in the laboratory reports?
A) Computerized tomography reports
B) Arterial blood gas reports
C) Hematology reports
D) Endocrinology reports
Q3) Which of the following represents falsification of the medical record?
I.Concealment of an incident
II.Making up ventilator settings
III.Charting an arterial blood gas that wasn't done
A) II only
B) I and II
C) III only
D) I, II, and III
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Chapter 12: Oxygen Supply Systems
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Q1) Because large medical gas cylinders (larger than 'E' sized)may contain a variety of gases besides oxygen,a safety system was designed by the CGA to prevent the interchange of cylinders containing dissimilar gases.What is the name of this system?
A) Frangible Disk
B) Diameter-indexed Safety System
C) Pin Index Safety System
D) American Standard Safety System
Q2) How should the contents of a cylinder be identified?
A) Verify the color code of the cylinder
B) Match the label to the color code
C) By the size of the cylinder
D) a and b
Q3) A half-full 'E' cylinder will last how long running at 3 L/min?
A) About 180 minutes
B) About 30 minutes
C) About 4 hours, 13 minutes
D) About 1 hour, 43 minutes
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14
Chapter 13: Oxygen Administration
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Q1) If an air entrainment device is set to deliver an FIO of 60% with the flowmeter set at 15 LPM,what would be the total flow delivered by the device?
A) 40.5 LPM
B) 60 LPM
C) 15 LPM
D) 30 LPM
Q2) A nasal cannula is set up on an adult patient at 3 LPM.What is the approximate FIO delivered to the patient?
A) 24%
B) 28%
C) 32%
D) 36%
Q3) Which type of oxygen analyzer uses an oxidation-reduction reaction to measure the FO of an oxygen sample?
A) Galvanic oxygen analyzer
B) Polarographic oxygen analyzer
C) Electrical oxygen analyzer
D) a and b
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Chapter 14: Introduction to Respiratory Care Pharmacology
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Q1) Which of the following would NOT cause a bronchospasm or bronchoconstriction?
A) Leukotrienes
B) Beta 1 receptors
C) Histamine
D) Prostaglandins
Q2) Stimulation of the sympathetic nervous system causes _________________
A) vascular permeability.
B) decreased blood pressure.
C) bronchodilation.
D) bronchoconstriction.
Q3) Which of the following is a frequently nebulized antibiotic for patients with cystic fibrosis?
A) Pentamidine
B) Ribvirin
C) Sodium bicarbonate
D) Tobramycin
Q4) A small volume nebulizer is ordered for a patient on a mechanical ventilator.To prevent condensation and secretions from draining into the nebulizer and contaminating it,what could be done?
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Chapter 15: Humidity and Aerosol Therapy
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Q1) When utilizing a Brigg's adaptor to connect the aerosol unit to a tracheostomy tube,a 6 inch piece of wide-bore tubing should be attached to the adaptor opposite the aerosol tubing coming from the nebulizer.What is the purpose of this tubing?
A) To maintain a constant FIO
B) To collect expectorated secretions from the patient
C) To act as a reservoir for the couplant
D) To decrease the risk of contamination from aerosolized droplets
Q2) What controls the particle size generated by an ultrasonic nebulizer?
A) Amplitude
B) Frequency
C) Piezoelectric crystal
D) Couplant
Q3) When monitoring the effectiveness of bronchodilator administration,which of the following pulmonary function tests would indicate the airway responsiveness the best?
A) Residual volume
B) Functional residual capacity
C) Tidal volume
D) Peak flow
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Chapter 16: Bronchial Hygiene Therapy
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Q1) During bronchial hygiene therapy in the Trendelenburg position,the patient's SpO decreases from 92% on a 35% Venturi mask to 80% during the first 5 minutes of the therapy.What intervention would be the most correct for the Respiratory Care Practitioner to take at this time?
A) Administer 100% oxygen, stop therapy immediately, return the patient to original resting position, and consult the physician.
B) Administer 100% oxygen and consult the physician.
C) Administer 100% oxygen and continue the therapy with the patient flat in bed.
D) Stop therapy immediately and return patient to original resting position.
Q2) Which of the following is NOT a hazard or complication of a directed cough?
A) Increased cerebral perfusion
B) Chest pain
C) Fatigue
D) Headaches
Q3) A patient positioned on their back is placed in which position?
A) Trendelenburg.
B) Lateral.
C) Supine.
D) Prone.
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Page 18
Chapter 17: Hyperinflation Therapy
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Q1) The effectiveness of any hyperinflation therapy is dependent on _____________
A) patient effort.
B) patient cooperation.
C) the patient's diagnosis.
D) a and b
Q2) A 35 year-old patient is admitted for gall bladder surgery.The patient has a 40 pack/year smoking history,and has a past history of minor health problems.Breath sounds reveal expiratory wheezing and coarse crackles bilaterally.The patient is 5'6" and weighs 250 lbs.What risk factors does this patient have for post-operative atelectasis and what should be done?
Q3) Which control on a pressure ventilator should be used if the patient is having trouble triggering the ventilator into inspiration?
A) Flow rate
B) Sensitivity
C) Expiratory timer
D) Air mix
Q4) The respiratory care department puts you in charge of the hyperinflation monitoring committee.What should be monitored to determine the type and the effectiveness of the hyperinflation therapy?
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Chapter 18: Bronchoscopy Assisting
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Q1) Which type of testing and analysis performed on bronchoscopic sample would be performed to detect cancerous cells?
A) Cytologic testing
B) Microbiologic testing
C) Histological testing
D) Protozoal testing
Q2) A patient has just had a bronchoscopy procedure performed.What precautions and instructions should you give the patient following the procedure?
Q3) Patient monitoring should be done before,during,and after bronchoscopic procedures.Which of the following is important to monitor?
A) Patient's level of consciousness
B) Patient vital signs, including heart rhythm
C) Patient's subjective response to the procedure
D) a, b, and c
Q4) What instructions would you give a patient who is to have a bronchoscopy procedure?
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Chapter 19: Equipment Processing and Surveillance
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Q1) Ethylene oxide _________________
A) Is not sporicidal but is a sterilization process that uses moisture and heat.
B) Is a toxic gas that is combined with moisture and heat to sterilize equipment.
C) It uses only water so that employee exposure to chemicals does not occur and no residue is left on the equipment.
D) It is a chemical that is used to cold-sterilize or disinfect equipment by immersion.
Q2) If Staphylococcus epidermidis or other nonpathogenic members of the normal flora are cultured on clean or in-use equipment,what is the most likely contamination source?
A) The person conducting the culturing.
B) Contaminated liquid in an aerosol device.
C) The sterilization gas used in the processing of the equipment.
D) Gamma irradiation of the equipment.
Q3) When ethylene oxide combines with water it forms ______________
A) hydrogen peroxide.
B) ethylene glycol.
C) ethyl alcohol.
D) carbonic anhydrase.
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Page 21
Chapter 20: Emergency Airway Management
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Q1) An endotracheal tube is placed in a patient followed by the attachment of a capnograph.The reading reads zero.What could cause this problem and how could it be corrected?
Q2) If vomiting and aspiration is a concern with a patient who needs an airway in place,which of the following airways would best protect the patient's airway?
A) Nosopharyngeal airway
B) Oropharyngeal airway
C) Laryngeal mask airway
D) a and b
Q3) What is the most common cause of upper airway obstruction?
A) Spasm of the larynx
B) Dried secretions occluding the airway
C) The tongue falling back against the posterior pharynx
D) Food or other foreign material obstructing the airway
Q4) What should be evaluated once an airway is established on a patient?
A) Ventilation
B) Central nervous system function
C) Retractions
D) Stridor
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Chapter 21: Artificial Airway Care
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Q1) Why is the nasopharyngeal airway placed for frequent nasotracheal suctioning?
A) To minimize trauma to the patient's nose and nasopharynx
B) To allow the patient to be able to speak during the procedure
C) To prevent aspiration of abdominal contents
D) To prevent hypoxemia during the procedure
Q2) What should be done to the patient's tracheostomy tube when a Passy-Muir is placed on the tube?
A) The cuff must be inflated to a pressure between 20-25 cmH20
B) The tracheostomy must be suctioned until it is clear
C) The tracheostomy cuff must be deflated
D) The tracheostomy tube should be replaced by a button
Q3) What is defined as the removal of a tracheostomy tube?
A) Decannulation
B) Leak technique
C) Invagination
D) Wash-out volume
Q4) You are suctioning a patient with a metal (silver)tracheostomy with an inner cannula that has a one-way valve.You insert the catheter through the one-way valve to suction the patient but are unable to remove the catheter because the valve closes on the catheter.What should you do now?
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Chapter 22: Chest Tubes
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Q1) Which of the following drugs would you suggest to the physician as an analgesic to help relax the patient before the insertion of a chest tube?
A) 4% Lidocaine
B) Midazolam
C) Providone-iodine
D) Aspirin
Q2) If the chest tube drainage system needs to be changed,when should it be done?
A) During inhalation
B) During expiration
C) During spontaneous breathing
D) During positive-pressure ventilation
Q3) A pneumothorax develops while a patient is being mechanically ventilated.A chest tube is placed and the lung fails to seal.There is a large amount of air bubbling through the water seal chamber.What could be causing this?
Q4) A patient with a chest tube in place develops swelling of the tissue surrounding the chest tube with crackling sensations also noted in the same area.What could be causing this and how is it treated?
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Chapter 23: Insertion and Maintenance of Intravenous Lines
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Q1) A patient has been brought to the emergency department suffering from heat exhaustion and dehydration.Which of the following fluids would enhance the function of cells that are hampered owing to the absence of necessary intracellular fluid?
A) Hypotonic solution
B) Hypertonic solution
C) Isotonic solution
D) Lactated Ringer's solution
Q2) What is inflammation of the vein called?
A) Phlebitis
B) Cellulitis
C) Thrombosis
D) Arteriosclerosis
Q3) If 1 liter of lactated ringers needs to be administered to the patient in 4 hours by an infusion set that delivers 10 drops/ml,how many drops/min need to be delivered to the patient?
A) 84 gtt/min
B) 42 gtt/min
C) 20 gtt/min
D) 100 gtt/min
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25
Chapter 24: Noninvasive Positive-Pressure Ventilation
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Q1) Which of the following is NOT an advantage of a nasal mask for NPPV?
A) Improved verbal communication
B) Decreased risk of aspiration
C) Ability to eat and drink
D) Improved humidification
Q2) In acute respiratory failure,NPPV tends to cause which of the following beneficial effects for the patient?
I.Increase the PaO
II.Decrease the pH
III.Increase the PaCO
IV.Decrease HCO
A) I only
B) I, II, III
C) III and IV
D) I and II
Q3) A patient is placed on noninvasive positive-pressure ventilation (NPPV).The patient is on a nasal mask and is having trouble keeping his mouth closed due to tachypnea and dyspnea.Breath sounds are diminished bilaterally.The patient is also complaining of nasal dryness.What should be done to help the patient?
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Chapter 25: Continuous Mechanical Ventilation
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Q1) Which of the following is true of CPAP?
I.It can be applied noninvasively by mask to the patient
II.It is pressure held in the lungs on inspiration and expiration
III.It is Continuous Primary Alveolar Pressure
IV.It can be delivered by endotracheal or tracheostomy tube
A) I, II, III and IV
B) I, II and III
C) II, III and IV
D) I, II and IV
Q2) How does a practitioner measure airway resistance on a ventilator?
Q3) Which of the following are contraindications for sending a patient home on a mechanical ventilator?
I.PEEP greater that 10 cm H O
II.Inadequate utilities to operate medical devices
III.Oxygen setting above 40%
IV.Presence of elementary age children in the home
A) I, II, III and IV
B) I, II and III
C) II, III and IV
D) I and III
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Chapter 26: Advanced Modes of Mechanical Ventilation
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Q1) A practitioner wants to use volume support but is concerned that the patient might have periods of apnea.What should be used to ensure that the patient will have a backup ventilation mode?
A) Automode
B) Automatic tube compensation
C) Mandatory minute ventilation
D) Proportional assist ventilation
Q2) A practitioner decreases the oxygenation setting on the mechanical ventilator,which results in an increase in heart rate.This is _____________________
A) a first sign of hypoxemia.
B) an expected cardiovascular change.
C) typical with normal healthy patients.
D) an indication that the patient needs suctioning.
Q3) A respiratory care practitioner may use which of the following to eliminate the airway resistance caused by an artificial airway?
A) APRV
B) Automatic tube compensation
C) Inverse ratio ventilation
D) Automode
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Chapter 27: Wave Form Analysis
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Q1) Wave form graphically displays which of the following?
I.Arterial blood gas values
II.Gas flowrates
III.Inspiratory and expiratory volumes
IV.Airway pressures
A) I, II, III and IV
B) I, II and III
C) II, III and IV
D) II and III
Q2) The respiratory care practitioner determines that a patient has increased airway resistance.How was this identified?
A) On the flow-volume loop by evaluating the shape of the curve
B) On the flow-volume loop by identifying the maximum delivered volume
C) On the pressure-volume loop by the amount of beaking
D) On the pressure-volume loop by the amount of bowing
Q3) You have just place a patient with early ARDS onto a mechanical ventilator.Using ventilator graphics how will you monitor the patient's changing lung compliance?
Q4) Which graphic displays can indicate adequacy of inspiratory flow during a ventilator inspiration and how are they used?
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Chapter 28: Weaning and Discontinuance of Mechanical Ventilation
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Q1) Besides meeting the criteria of previous assessments done by the respiratory care practitioner to determine readiness for extubation,the patient must also be able to
A) speak and sit up.
B) protect the upper airway and cough effectively.
C) tolerate SIMV of 4 breaths per minute.
D) maintain PaO 70 mmHg or more on FIO 0.4
Q2) Which of the following should the practitioner use as a rationale to disqualify a patient from a weaning trial?
A) Heart rate less than 140 beats per minute but still above 80 bpm
B) Mentation clearing
C) Lack of spontaneous respiratory drive
D) PaO / FiO ratio of 220
Q3) Once the patient successfully tolerates SBT,the respiratory care practitioner should
A) recommend insertion of tracheostomy tube.
B) switch to a smaller endotracheal tube.
C) assess the potential for endotracheal tube extubation.
D) reduce the ventilator setting to minimum levels.
Q4) How do cardiovascular problems result in ventilator dependence?
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Chapter 29: Neonatal Mechanical Ventilation
Available Study Resources on Quizplus for this Chatper
34 Verified Questions
34 Flashcards
Source URL: https://quizplus.com/quiz/40363
Sample Questions
Q1) Describe how the initial newborn ventilator setting are determined for mode,rate and flow rate.
Q2) According to the retired AARC Clinical Practice Guidelines the indication for time-triggered,pressure-limited,time-cycled neonatal ventilation is which of the following?
I.On CPAP and FIO of 0.6 or more
II.pH greater than 7.45
III.PaO less than 50 mmHg
IV.Apnea
A) I, II, III and IV
B) I, II and III
C) II, III and IV
D) I, III and IV
Q3) According to the retired AARC Clinical Practice Guidelines on time-triggered,pressure- limited,time-cycled neonatal ventilation,risk of ROP can be minimized by ___________________
A) keeping PaO less than 60 mmHg.
B) keeping SpO greater than 80%.
C) keeping PaO less than 80 mmHg.
D) maintaining pH greater than 7.35.
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