Pulmonary Diagnostics
Test Questions
Course Introduction
Pulmonary Diagnostics is a comprehensive course that explores the principles and practices of assessing respiratory system function. Students will gain an in-depth understanding of various diagnostic techniques, including spirometry, lung volume measurements, diffusion studies, and arterial blood gas analysis. The course also covers patient preparation, the operation and calibration of diagnostic equipment, quality assurance, and the interpretation of results in relation to normal and pathological conditions. Emphasis is placed on the application of these diagnostic procedures in the management and monitoring of respiratory diseases, enabling students to effectively support patient care in both clinical and laboratory settings.
Recommended Textbook
Egans Fundamentals of Respiratory Care 11th Edition by Robert M. Kacmarek
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Chapter 1: History of Respiratory Care
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Q1) Which of the following is an expected role of a respiratory therapist?
1) Promoting lung health and wellness
2) Providing patient education
3) Assessing the patient's cardiopulmonary health status
4) Selling oxygen (O<sub>2</sub>) therapy devices to patients
A)1 only
B)1 and 4 only
C)1, 2, and 3 only
D)1, 2, 3, and 4
Answer: C
Q2) In 1662, a chemist published a book that described the relationship between gas, volume, and pressure. What was the chemist's name?
A) Sir Isaac Newton
B) Robert Boyle
C) Anthony van Leeuwenhoek
D) Nicolaus Copernicus
Answer: B
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Chapter 2: Delivering Evidence-Based Respiratory Care
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Q1) Respiratory care education programs are reviewed by which committee to ensure quality?
A) Committee on Accreditation for Respiratory Care
B) American Association for Respiratory Care Education
C) Joint Review Committee Respiratory Care Education
D) Respiratory Care Education Committee
Answer: A
Q2) What is the chief reason that respiratory care protocols were developed and are currently being used in hospitals throughout North America?
A) Enhance proper allocation of respiratory care services.
B) Decrease patient care costs to hospitals and insurance companies.
C) Expand patient care skills among respiratory care providers.
D) Enhance efficiency of respiratory care personnel in providing patient care.
Answer: A
Q3) What are the key outcomes that are looked at in different types of studies?
A) Patient survival
B) Discharge from ICU
C) Organ system failure
D) All of the above
Answer: D
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Chapter 3: Quality, Patient Safety, and Communication, and Recordkeeping
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Q1) What is a time-based record of measurement during a specialized procedure such as mechanical ventilation?
A) Consultation sheet
B) Specialized flowsheet
C) Progress notes
D) Graphic sheet
Answer: B
Q2) What is the role of the RT during a disaster situation?
A) Transporting the critically ill patients to safety first
B) Shutting off the main O<sub>2</sub> supply in the hospital
C) Getting themselves to safety
D) Going to look for a backup generator
Answer: A
Q3) What is the primary purpose of grounding all electrical equipment used in the hospital setting?
A) To prevent the dangerous buildup of voltage in the equipment
B) To make the equipment more secure and less likely to break down
C) To avoid excessive energy costs
D) To convert electrical power from DC to AC
Answer: A
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Chapter 4: Principles of Infection Prevention and Control
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Q1) Which of the following statements is false regarding the use of ETO for sterilization?
A) It is harmless to rubber and plastics.
B) It will penetrate prewrapping.
C) Acute exposure is of little consequence.
D) It is useful for equipment that cannot be autoclaved.
Q2) If you are caring for a patient who is suspected of having SARS, at what distance from the patient is it recommended to wear an effective filtration mask?
A) 6 ft
B) 10 ft
C) 12 ft
D) 15 ft
Q3) Small volume nebulizers produce bacterial aerosols that have been commonly associated with which of the following diseases?
A) Pseudomonas aeruginosa
B) Measles
C) Small pox
D) Nosocomial pneumonia
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Chapter 5: Ethical and Legal Implications of Practice
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Q1) In a case of professional negligence, all of the following are required to support a claim of res ipsa loquitur except:
A) evidence must exist to show that the defendant acted with malfeasance or intent.
B) the action responsible for the injury was under the control of the defendant.
C) the harm was such that it would not normally occur without someone's negligence.
D) negligence or voluntary risk-taking by the plaintiff did not contribute to the injury.
Q2) HIPAA is primarily referred to as the Privacy Rule and is concerned with PHI. What do the letters PHI stand for?
A) Patient health information
B) Protected health information
C) Past health information
D) Protected health insurance
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Chapter 6: Physical Principles of Respiratory Care
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Q1) Which of the following are true about molecular water vapor?
1) Water vapor exhibits kinetic activity.
2) Molecular water vapor can be seen.
3) Water vapor exerts pressure.
A)1 and 2 only
B)2 and 3 only
C)1, 2, and 3
D)1 and 3 only
Q2) Assuming a constant flow, what will happen to a fluid if the cross-sectional area of the tube in which its flows decrease?
A) Its velocity will increase.
B) Its velocity will decrease.
C) Its density will decrease.
D) Its viscosity will decrease.
Q3) What is the motion referred to when solid molecules travel until they collide?
A) Jiggle
B) Jingle
C) Surface tension
D) Boiling point
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Chapter 7: E-Medicine in Respiratory Care
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Q1) Computers are often used to interpret which of the following tests in respiratory care patients?
A) Chest radiograph
B) Complete blood count
C) Pulmonary function testing
D) EEG testing
Q2) In what area are computers used to apply quality assurance measures in respiratory care departments?
A) Arterial blood gas analyzers
B) O<sub>2</sub> delivery systems
C) Interpreting ECGs
D) Equipment cleaning and sterilization
Q3) Which of the following is considered an emerging application of information technology that may improve national health care issues in the future?
A) Clinical simulation for training
B) A nationally available electronic health record
C) Medical ID bracelets
D) The national database for organ donors
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Chapter 8: Fundamentals of Respiratory Care Research
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Q1) What are the three basic missions of academic medicine?
A) To research, to discover, and to publish
B) To research, to discover, and to cure disease
C) To heal, to teach, and to discover
D) To teach, to research, and to cure
Q2) What search engine looks for scholarly publications in a wide range of fields and includes peer-reviewed manuscripts, abstracts, theses, and books from academic publishers, professional societies, and university libraries?
A) Medline.org
B) Google Scholar
C) Minimed.org
D) Cochrane.org
Q3) What entity is responsible for approving experimental procedures prior to collecting data?
A) AARC
B) IRB
C) NBRC
D) NIH
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Chapter 9: The Respiratory System
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Q1) What is meant by "internal respiration"?
A) Any gas exchange that occurs inside the body
B) Consumption of O<sub>2</sub> in the mitochondria
C) Continuous absorption of O<sub>2</sub> and excretion of carbon dioxide
D) Exchange of gases between the blood and the tissue
Q2) To what does the term "faster-weaker" refer when discussing the alveolar-capillary membrane?
A) Portion of the alveolar-capillary membrane that is average in thickness
B) Shortest airways in the acinus, which allow fast gas exchange
C) Thinnest portion of the alveolar-capillary membrane
D) Thickest portion of the alveolar-capillary membrane
Q3) What is the name of the upper portion of the sternum?
A) Angle of Louis
B) Manubrium
C) Vertebral process
D) Xiphoid process
Q4) Infants are more susceptible to profound hypoxemia than are adults.
A)True
B)False
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Chapter 10: The Cardiovascular System
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Q1) Most of the muscle mass of the heart is located in which chamber?
A) Left atrium (LA)
B) Left ventricle (LV)
C) Right atrium (RA)
D) Right ventricle (RV)
Q2) Toward the end of systole, as repolarization starts (indicated by the T wave), the ventricles begin to relax. Which of the following will occur next?
A) Rapid rise in ventricular pressures.
B) Arterial pressures exceed ventricular pressures.
C) Closure of the atrioventricular valves.
D) Opening of semilunar valves.
Q3) Which of the following are true of the force against which the left ventricle must pump?
1) Referred to as left ventricular afterload.
2) Equivalent to systemic vascular resistance.
3) Helps to determine left ventricular stroke volume.
A)1 and 3 only
B)1 and 2 only
C)1, 2, and 3
D)2 and 3 only
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Chapter 11: Ventilation
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Q1) What occurs at a lung volume equivalent to the functional residual capacity (FRC)?
1) The forces of the chest wall and lungs are in balance.
2) Chest wall expansion is offset by lung contraction.
3) Opposing chest wall-lung forces generate negative P<sub>pl</sub>.
A)1, 2, and 3
B)1 and 2 only
C)1 and 3 only
D)2 and 3 only
Q2) In healthy individuals, what may lead to airway collapse?
A) Increased lung recoil
B) Significantly decreased surfactant
C) Maximal inspiration to TLC
D) Forced exhalation to RV
Q3) Which of the following pressures normally remains negative (relative to atmospheric pressure) during quiet breathing?
A) P<sub>alv</sub>
B) P<sub>pl</sub>
C) P<sub>ao</sub>
D) P<sub>bs</sub>
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Chapter 12: Gas Exchange and Transport
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Q1) What is the approximate normal level of carbon dioxide production (CO<sub>2</sub>) for an adult?
A) 200 ml/min
B) 250 ml/min
C) 4200 ml/min
D) 6000 ml/min
Q2) In which of the following conditions will erythrocyte concentration of 2,3-DPG be decreased?
A) Anemia
B) Banked blood
C) High pH
D) Hypoxemia
Q3) What is the most common cause of hypoxemia in patients with lung disease?
A) Diffusion defect
B) Hypoventilation
C) Right-to-left shunt
D) mismatch
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Chapter 13: Solutions, Body Fluids, and Electrolytes
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Q1) What is a normal range for serum sodium?
A) 3.5 to 4.8 mEq/L
B) 67.0 to 75.0 mEq/L
C) 98.0 to 105.0 mEq/L
D) 136.0 to 145.0 mEq/L
Q2) What is a common cause for pulmonary edema due to increased hydrostatic pressure?
A) Alveolar-capillary damage
B) Chronic liver disease
C) Failing left ventricle
D) Failing right ventricle
Q3) Which of the following describes an aspect of pH?
A) Any solution with a pH of 7.0 is neutral.
B) A pH of 7.0 describes an acidotic solution.
C) A pH change from 7.0 to 8.0 equals a two-fold increase in H<sup>+</sup> ion concentration.
D) The pH is the log of the OH<sup>-</sup> ion concentration.
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Chapter 14: Acid-Base Balance
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Q1) According to the Henderson-Hasselbalch equation, the pH of the blood will be normal as long as the ratio of HCO<sub>3</sub><sup>-</sup> to dissolved CO<sub>2</sub> is which of the following?
A) 10:1
B) 20:1
C) 24:1
D) 30:1
Q2) Of the nonbicarbonate buffer systems, which one is the most important?
A) Hemoglobin
B) Inorganic phosphates
C) Organic phosphates
D) Plasma proteins
Q3) What is the primary chemical event in metabolic alkalosis?
A) Decrease in blood CO<sub>2</sub> levels
B) Decrease in blood HCO<sub>3</sub><sup>-</sup> levels
C) Increase in blood CO<sub>2</sub> levels
D) Increase in blood HCO<sub>3</sub><sup>-</sup> levels
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Chapter 15: Regulation of Breathing
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Q1) Both anemia and carbon monoxide (CO) poisoning can cause severe hypoxia, yet neither condition results in a major stimulation of breathing. Why is this so?
A) The peripheral chemoreceptors do not respond to low O<sub>2</sub> content.
B) Anemia and CO poisoning depresses the peripheral chemoreceptors.
C) Anemia and CO poisoning depresses the central chemoreceptors.
D) Anemia and CO cause stagnant hypoxia, not hypoxemia.
Q2) Which of the following can cause Cheyne-Stokes breathing?
1) Brain injuries
2) Congestive heart failure
3) Metabolic acidosis
A)1 and 2 only
B)2 and 3 only
C)1 and 3 only
D)1, 2, and 3
Q3) Where are the inspiratory and expiratory centers in the brain found?
A) Broca's area
B) Neurons in the cerebellum
C) Pons
D) No such centers exist
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Chapter 16: Bedside Assessment of the Patient
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Q1) Splitting of the second heart sound (S<sub>2</sub>) is normally most pronounced during which of the following?
A) Exhalation
B) Breath holding
C) Inhalation
D) Forced exhalation
Q2) Which of the following represent proper chest auscultation technique?
1) The practitioner should begin auscultation at the lung bases.
2) The patient should be instructed to breathe through an open mouth.
3) The patient should be placed in a comfortable upright position.
4) The patient should avoid deeply inhaling because it can mask certain lung sounds.
A)1 and 4 only
B)1, 2, and 3 only
C)3 only
D)1, 2, and 4 only
Q3) What is the normal range for pulse pressure?
A) 20 to 35 mm Hg
B) 30 to 60 mm Hg
C) 30 to 40 mm Hg
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Chapter 17: Interpreting Clinical and Laboratory Data
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Q1) What abnormality in the complete blood count is often seen in a patient with significant hypoxemia caused by chronic lung disease?
A) Leukocytosis
B) Anemia
C) Polycythemia
D) Leukopenia
Q2) Which of the following tests is used to evaluate renal function?
A) Creatinine
B) Protein level
C) Serum enzymes
D) Sweat chloride
Q3) What term is used to describe a sodium concentration that is below normal in the blood serum?
A) Hypokalemia
B) Hyponatremia
C) Hypocalcemia
D) Hypochloremia
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Chapter 18: Interpreting the Electrocardiogram
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Q1) What is the width of the normal QRS complex?
A) Not wider than 1 mm
B) Not wider than 3 mm
C) Not wider than 5 mm
D) Not wider than 7 mm
Q2) Which of the following waves represents repolarization of the ventricles?
A) P wave
B) QRS wave
C) T wave
D) U wave
Q3) Which of the following are common causes of ventricular tachycardia?
1) Myocardial infarction
2) Coronary artery disease
3) Hypertensive heart disease
4) Pericarditis
A)2 and 3 only
B)1, 2, and 4 only
C)1 and 4 only
D)1, 2, and 3 only
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Chapter 19: Analysis and Monitoring of Gas Exchange
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Q1) Clinical indications for arterial blood analysis include which of the following?
1) Sudden, unexplained dyspnea
2) Cardiopulmonary resuscitation
3) Changes in ventilator settings
4) Chest pain
A)1 and 3 only
B)2 and 4 only
C)1, 2, and 4 only
D)1, 2, and 3 only
Q2) Which of the following will result in falsely low HbO<sub>2</sub> readings with a pulse oximeter?
A) Presence of HbCO
B) Vascular dyes
C) Dark skin pigmentation
D) Presence of fetal hemoglobin
Q3) The transcutaneous blood gas electrode should not be placed on the:
A) chest.
B) abdomen.
C) lower back.
D) thigh.
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Chapter 20: Pulmonary Function Testing
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Q1) During a helium dilution test for functional residual capacity, you notice that it takes 19 min for equilibration between the gas concentrations in the spirometer and the patient's lungs. Based on this information, what can you conclude?
A) The patient has restrictive lung disease.
B) The spirometer is leaking helium.
C) The patient has obstructive lung disease.
D) Insufficient oxygen was added to the system.
Q2) Toward the end of a nitrogen washout test for functional residual capacity, the expired concentration of N<sub>2</sub> begins rising. What does this probably indicate?
A) The patient is trying too hard.
B) There is a leak in the system.
C) The test is nearing completion.
D) N<sub>2</sub> is being trapped in the lungs.
Q3) In which of the following conditions will you see an increase in the DLCO?
A) Pulmonary emphysema
B) Secondary polycythemia
C) Severe anemia
D) Pulmonary fibrosis
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Chapter 21: Review of Thoracic Imaging
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Q1) What is the most common cause of pulmonary fibrosis?
A) A virus
B) Inhaled dusts
C) Drug reaction
D) Unknown
Q2) Which of the following is not a typical cause of atelectasis?
A) Abdominal surgery
B) Rib fracture
C) Hepatomegaly
D) Pleurisy
Q3) A 49-year-old COPD patient arrives to the ER complaining of shortness of breath (SOB) and difficulty breathing. The physical examination reveals bilateral coarse crackles throughout the lung fields, pedal edema, and hepatomegaly. The chest x-ray shows bilateral fluffy infiltrates with a "bat's wing" configuration. What clinical condition you may suspect on this patient?
A) Acute coronary syndrome
B) COPD exacerbation
C) Hypertensive crisis
D) Left heart failure
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Chapter 22: Flexible Bronchoscopy and the Respiratory Therapist
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Q1) What portion of the airway are bronchial washings generally obtained?
A) The large airways
B) Either of the upper lobes
C) Either of the lower lobes
D) The lowest portion of the airways possible
Q2) What is the major challenge of ultrathin bronchoscopy?
A) Bronchoscopy kinking during procedure
B) The equipment is expensive
C) Issues with CT guidance equipment
D) Maintaining proper anatomical orientation in the peripheral airways
Q3) Which of the following are divisions of imaging systems used during flexible bronchoscopy?
1) Fiberoptic
2) Video
3) Hybrid
4) Fusion
A)1 and 3 only
B)1, 2, and 3 only
C)3 and 4 only
D)2, 3, and 4 only
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Chapter 23: Nutrition Assessment
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Q1) Morbid obesity is defined as a BMI over what value?
A) 20 kg/m<sup>2</sup>
B) 25 kg/m<sup>2</sup>
C) 30 kg/m<sup>2</sup>
D) 35 kg/m<sup>2</sup>
Q2) What is the classic measure of energy expenditure?
A) Basal oxygen consumption
B) Basal metabolic rate (BMR)
C) Resting caloric uptake
D) Resting carbon dioxide production
Q3) What effect does high carbohydrate intake have on metabolism?
A) Increases CO<sub>2</sub> production.
B) Reduces oxygen consumption.
C) Increases caloric needs.
D) Reduces protein catabolism.
Q4) Which of the following is not associated with zinc deficiencies?
A) Poor blood clotting
B) Impaired wound healing
C) Bronchospasm
D) Reduced immunity
25
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Chapter 24: Pulmonary Infections
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Q1) Which of the following types of pneumonia suggests that the patient acquired it through inhalation of infectious particles?
A) Cytomegalovirus
B) Haemophilus influenzae
C) Histoplasmosis
D) Staphylococcus
Q2) Which of the following types of pneumonia suggests that the patient acquired it because of the reactivation of a latent infection, often in the setting of immunosuppression?
A) Cytomegalovirus
B) Haemophilus influenzae
C) Histoplasmosis
D) Staphylococcus
Q3) The chest radiograph is often of little help in the diagnosis of nosocomial pneumonia in mechanically ventilated patients in the ICU because these individuals often have other reasons for radiographic abnormalities.
A)True
B)False
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Chapter 25: Obstructive Lung Disease: Chronic Obstructive
Pulmonary Disease Copd, Asthma, and Related Diseases
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Q1) Which of the following pulmonary function improvements have been associated with lung volume-reduction surgery (LVRS) in patients with emphysema?
1) Improved exercise endurance
2) Improved FEV<sub>1</sub>
3) Improved quality-of-life
4) Improved survival
A)1, 3, and 4 only
B)2 and 4 only
C)3 only
D)2, 3, and 4 only
Q2) What is the critical alpha<sub>1</sub>-antitrypsin level below which lung elastin is attacked and broken down?
A) 57 mg/dl
B) 84 mg/dl
C) 100 mg/dl
D) 150 mg/dl
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Chapter 26: Interstitial Lung Disease
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Q1) Which of the interstitial lung diseases will in one-third of patients cause a chylothorax?
A) Alveolar proteinosis
B) Idiopathic pulmonary fibrosis
C) Lymphangioleiomyomatosis
D) Nonspecific interstitial pneumonitis
Q2) Which of the interstitial lung diseases is directly tied to exposure to first- and secondhand tobacco smoke?
A) Alveolar proteinosis
B) Idiopathic pulmonary fibrosis
C) Nonspecific interstitial pneumonitis
D) Pulmonary Langerhans cell histiocytosis (PLCH)
Q3) A patient is exposed a second time to an antigen and subsequently seeks medical attention with sudden shortness of breath, chest pain, fever, chills, malaise, and a cough that may be productive of purulent sputum. What is the most likely cause of this pathology?
A) Acute anaphylactic shock
B) Acute hypersensitivity pneumonitis
C) Allergic congestive heart failure
D) Bronchial asthma
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Chapter 27: Pleural Diseases
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Q1) How much pleural fluid does a normal healthy adult have in each hemithorax?
A) 5 ml
B) 8 ml
C) 12 ml
D) 16 ml
Q2) Which of the following procedures would you recommend to assess her situation at this time?
A) Chest x-ray
B) Auto-PEEP maneuver
C) Measure her compliance manually
D) CT scan of the chest
Q3) What underlying lung disease is most often present in a patient with secondary spontaneous pneumothorax?
A) Asthma
B) Chronic obstructive pulmonary disease (COPD)
C) Interstitial pulmonary fibrosis
D) Pneumonia
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Chapter 28: Pulmonary Vascular Disease
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Q1) Where do most pulmonary emboli originate?
A) Deep veins of the arms
B) Deep veins of the legs
C) Thrombi from the right side of the heart
D) Veins of the thorax
Q2) Why are calcium-channel blockers not used in all patients with idiopathic pulmonary artery hypertension?
A) It causes severe side effects.
B) Many of these patients have systemic hypotension.
C) Only a small percentage of IPAH patients respond.
D) There is a high incidence of anaphylaxis.
Q3) What is the most important factor contributing to the onset of pulmonary hypertension in the patient with COPD?
A) Alveolar hypoxia
B) Compression of pulmonary vasculature
C) Left ventricular failure
D) Loss of vascular surface
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Chapter 29: Acute Respiratory Distress Syndrome
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Q1) In most ARDS patients, PEEP levels below __________ are generally preferred.
A) 10 cm H<sub>2</sub>O
B) 15 cm H<sub>2</sub>O
C) 20 cm H<sub>2</sub>O
D) 25 cm H<sub>2</sub>O
Q2) Which of the following parameters are important in the management of patients with ARDS?
1) Keep systolic blood pressure below 90 mm Hg.
2) Keep hemoglobin saturation above 90%.
3) Ensure adequate urine output.
4) Keep mean arterial pressure above 60 mm Hg.
A)1 and 2 only
B)1 and 4 only
C)2, 3, and 4 only
D)1, 3, and 4 only
Q3) What time does the fibroproliferative phase of ARDS typically present?
A) Between days 1 and 7
B) After 3 days to weeks
C) After 3 weeks
D) After 1 month
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Chapter 30: Trauma, Burns and Near Drowning
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21 Flashcards
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Sample Questions
Q1) You are taking care of a trauma patient in the ICU. Following placement of a chest tube, there is a large amount of air that continues to exit the chest tube in a synchronized pattern with positive pressure ventilation. What do you suspect?
A) Inappropriate ventilator settings
B) Bronchial injury
C) Correct placement of the chest tube
D) Endotracheal tube cuff leak
Q2) Your patient is brought in by EMS after being pulled from a house fire. She is complaining of difficulty breathing, has burnt nasal hairs, soot in the oral pharynx, and stridor. The physician asks for a treatment suggestion regarding her respiratory needs. What would you suggest?
A) Racemic epinephrine
B) Hyperbaric oxygen therapy
C) Nonrebreathing mask at 15 L/min
D) Intubations and mechanical ventilation
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Chapter 31: Lung Cancer
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Sample Questions
Q1) What is the number one cause of cancer-related death in the United States?
A) Leukemia
B) Lung cancer
C) Breast cancer
D) Brain cancer
Q2) In what age group has smoking increased recently?
A) 18 to 24 years
B) 25 to 40 years
C) 45 to 60 years
D) Older than 70 years
Q3) Squamous cell carcinoma is composed of which of the following?
A) Glandular structures from lung scars
B) Common pulmonary stem cells
C) Flattened stratified epithelial cells
D) Multicentric stratified cells
Q4) Apical growth may be associated with which of the following syndromes?
A) Good pasture
B) Pancoast
C) Miller
D) Granulomatosis
Page 33
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Chapter 32: Neuromuscular and Other Diseases of the Chest
Wall
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Sample Questions
Q1) In what group of patients is myasthenia gravis most common?
A) Older males
B) Younger males
C) Younger females
D) Older females
Q2) Which of the following is not a clinical condition that precipitates respiratory failure rapidly in patients with significant neuromuscular weakness?
A) Pulmonary edema
B) Pneumonia
C) Mucus plugging
D) Pulmonary fibrosis
Q3) What is the most common peripheral neuropathy causing respiratory insufficiency?
A) Lambert-Eaton syndrome
B) Amyotrophic lateral sclerosis
C) Guillain-Barré syndrome
D) Myasthenia gravis
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Chapter 33: Disorders of Sleep
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30 Flashcards
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Sample Questions
Q1) Which of the following are true about obstructive sleep apnea (OSA)?
1) It is overdiagnosed in the United States.
2) It has an equivalent prevalence to asthma in the general population.
3) It has an equivalent prevalence to diabetes in the general population.
4) The spectrum of the disease includes sleep disruption related to increased airway resistance.
A)1 and 2 only
B)2 and 3 only
C)1, 2, and 4 only
D)2, 3, and 4 only
Q2) Which of the following conditions are associated with central apnea?
1) Congestive heart failure
2) Primary central nervous system lesions
3) High-altitude hypoxemia
4) Obesity
A)1 and 4 only
B)2 and 3 only
C)1, 2, and 3 only
D)1, 2, 3, and 4
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Chapter 34: Neonatal and Pediatric Respiratory Disorders
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Sample Questions
Q1) What is the maximum PIP that should be used with mechanical ventilation of larger premature infants to prevent volutrauma?
A) 25 cm H<sub>2</sub>O
B) 30 cm H<sub>2</sub>O
C) 40 cm H<sub>2</sub>O
D) 50 cm H<sub>2</sub>O
Q2) Which test is commonly used to confirm the diagnosis of cystic fibrosis?
A) Sweat chloride
B) Chest radiograph
C) Lung diffusion capacity
D) Serum enzyme levels
Q3) Which of the following statements are true about croup?
1) Caused by viral organism
2) Most common form of airway obstruction in children aged 6 months to 6 years
3) Causes subglottic swelling and obstruction
4) Most often caused by parainfluenza virus
A)1 and 3 only
B)2, 3, and 4 only
C)3 and 4 only
D)1, 2, 3, and 4
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Chapter 35: Airway Pharmacology
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Sample Questions
Q1) Which of the following is NOT considered part of the assessment of severity of symptoms recommended by the NAEPP and GOLD guidelines to modify level or dosage of corticosteroids?
A) Number of exacerbations
B) Missed work or school days
C) Pulmonary function
D) Use of anticholinergics
Q2) Which of the following are advantages for the treatment of the respiratory tract with inhaled aerosols?
1) Doses are usually smaller.
2) Onset of drug action is rapid.
3) Delivered dose is consistent with each administration.
4) Systemic side effects are often fewer and less severe.
A)1 and 3 only
B)1, 2, and 4 only
C)4 only
D)2 and 4 only
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Chapter 36: Airway Management
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Sample Questions
Q1) What is the purpose of the pilot balloon on an endotracheal or a tracheostomy tube?
A) To help ascertain proper tube position
B) To minimize mucosal trauma during insertion
C) To monitor cuff status and pressure
D) To protect the airway against aspiration
Q2) A patient is being evaluated for tracheal damage sustained while having undergone prolonged tracheostomy intubation approximately 3 months earlier. The flow-volume loop demonstrates a fixed obstructive pattern. What is the most likely cause of the problem?
A) Tracheomalacia
B) Laryngeal web
C) Cord paralysis
D) Tracheal stenosis
Q3) A patient exhibits persistent stridor after a fiberoptic bronchoscopy procedure. Which of the following would you recommend?
A) Aerosol therapy with albuterol (Proventil)
B) Administration of a benzodiazepine (e.g., Valium)
C) Aerosol therapy with racemic epinephrine
D) Administration of a narcotic antagonist (e.g., Narcan)
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Page 38
Chapter 37: Emergency Cardiovascular Life Support
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Sample Questions
Q1) On inspection of an electrocardiographic rhythm strip, you note the following occurring in sustained "bursts" over 2 to 3 min: a rate of 195; regular rhythm; P waves and PR intervals not easily discernible; normal QRS complexes (a few are widened). What is most likely the problem?
A) Ventricular tachycardia
B) Premature ventricular contractions
C) Atrial fibrillation
D) Supraventricular tachycardia (SVT)
Q2) You enter an adult woman's room and find her collapsed on the floor near the bed. When you shake her shoulder and shout, "Are you OK?" there is no response. What should your next, immediate step be?
A) Open her airway.
B) Call for help (call a code).
C) Begin chest compressions.
D) Determine pulselessness.
Q3) Which of the following arteries should be palpated in pulseless infants?
A) Brachial
B) Radial
C) Carotid
D) Femoral
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Chapter 38: Humidity and Bland Aerosol Therapy
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Sample Questions
Q1) The risk of overhydration with continuous delivery of bland water aerosols is greatest among which patient group?
1) Patients with fluid or electrolyte imbalances
2) Patients with fever and infection
3) Infants and small children
A)1, 2, and 3
B)1 and 2 only
C)2 and 3 only
D)1 and 3 only
Q2) Which of the following factors cause the isothermic saturation boundary (ISB) to shift farther down into the airways?
1) Decreased ambient temperature
2) Increased tidal volume (V<sub>T</sub>)
3) Endotracheal intubation
A)1 and 2 only
B)2 and 3 only
C)1 and 3 only
D)1, 2, and 3
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Chapter 39: Aerosol Drug Therapy
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Sample Questions
Q1) When assessing a patient's response to bronchodilator therapy, you notice a decrease in wheezing accompanied by an overall decrease in the intensity of breath sounds. Which of the following is most likely?
A) Increasing airway obstruction
B) Improving ventilation/perfusion ratio (V/Q)
C) Decreasing airway obstruction
D) Deteriorating oxygenation
Q2) Which of the following agents has been associated with increased intraocular pressure?
A) Anticholinergics
B) Epinephrine
C) Beta-2 agonists
D) Antibiotics
Q3) Normally, when using a 50-psi flowmeter to drive a small-volume jet nebulizer, to what should you set the flow?
A) 2 to 4 L/min
B) 4 to 6 L/min
C) 6 to 10 L/min
D) 8 to 10 L/min
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Chapter 40: Storage and Delivery of Medical Gases
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Sample Questions
Q1) What is the key difference between small compressed gas cylinders (sizes AA to E) and their larger counterparts (sizes F to K)?
A) Small gas cylinders do not undergo regular DOT testing.
B) Small gas cylinders are always filled to lower pressures.
C) Small gas cylinders cannot be used for anesthetic gases.
D) Small gas cylinders use a yoke (not threaded) connector.
Q2) What is the indexed safety system for threaded high-pressure connections between large compressed gas cylinders and their attachments?
A) Pin-Indexed Safety System (PISS)
B) Diameter-Index Safety System (DISS)
C) American Standard Safety System (ASSS)
D) CGA System
Q3) What is the primary purpose of indexed connector systems?
A) To prevent inadvertent misconnections between equipment
B) To speed making connections between equipment
C) To allow U.S. equipment to "mate" with foreign equipment
D) To provide universal connections among all equipment
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Chapter 41: Medical Gas Therapy
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Sample Questions
Q1) What is the maximum FiO<sub>2</sub> expected to be delivered by most air-entrainment masks?
A) 30%
B) 40%
C) 50%
D) 60%
Q2) A 27-year-old woman received from the emergency department is on a nasal cannula at 5 L/min. Approximately what FiO<sub>2</sub> is this patient receiving?
A) 28%
B) 32%
C) 35%
D) 40%
Q3) You set up an Oxy-Hood with an FiO<sub>2</sub> of 0.5 for a newborn infant. What is the maximum time that should pass before assessing this patient's PaO<sub>2</sub> or SaO<sub>2</sub>?
A) 1 hr
B) 2 hr
C) 8 hr
D) 12 hr
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Page 43
Chapter 42: Lung Expansion Therapy
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Sample Questions
Q1) The short-term application of inspiratory positive pressure to a spontaneously breathing patient best defines which of the following?
A) Sustained maximal inspiration
B) Intermittent positive-pressure breathing
C) Continuous positive airway pressure
D) Positive end-expiration pressure
Q2) Which of the following are contraindications for continuous positive airway pressure (CPAP) therapy?
1) Hemodynamic instability
2) Hypoventilation
3) Facial trauma
4) Low intracranial pressures
A)1 and 3 only
B)2 and 3 only
C)1, 2, and 3 only
D)2, 3, and 4 only
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Chapter 43: Airway Clearance Therapy Act
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Sample Questions
Q1) Which of the following should be charted after completing a postural drainage treatment?
1) Amount and consistency of sputum produced
2) Patient tolerance of procedure
3) Position(s) used (including time)
4) Any untoward effects observed
A)1, 2, and 3 only
B)2 and 4 only
C)1, 2, 3, and 4
D)3 and 4 only
Q2) A physician orders postural drainage for a patient with aspiration pneumonia in the superior segments of the left lower lobe. Which of the following positions would you recommend for this patient?
A) Patient prone with a pillow under abdomen, bed flat
B) Head down, patient prone with a pillow under abdomen
C) Head down, patient supine with a pillow under knees
D) Patient supine with a pillow under knees, bed flat
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Chapter 44: Respiratory Failure and the Need for
Ventilatory
Support
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Sample Questions
Q1) Which of the following clinical signs suggest more severe hypoxemia?
A) Tachycardia
B) Cyanosis with polycythemia
C) Central nervous system dysfunction
D) Use of accessory muscles
Q2) A patient with an opiate drug overdose is unconscious and exhibits the following blood gas results breathing room air: pH = 7.19; PCO<sub>2</sub> = 89; HCO<sub>3</sub><sup>-</sup> = 27; PO<sub>2</sub> = 48. Which of the following best describes this patient's condition?
A) Chronic hypoxemic respiratory failure
B) Chronic hypercapnic respiratory failure
C) Acute hypoxemic respiratory failure
D) Acute hypercapnic respiratory failure
Q3) Hypercapnic (type II) respiratory failure is a synonym for which one of the following terms?
A) Mismatching
B) Shunt
C) Diffusion impairment
D) Ventilatory failure
Page 46
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Chapter 45: Mechanical Ventilators
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Sample Questions
Q1) If a ventilator, not the patient, initiates a breath, what is the trigger variable?
A) Time
B) Pressure
C) Flow
D) Volume
Q2) A time-cycled constant flow generator is set up with a flow of 35 L/min and an inspiratory time of 1.7 sec. What is the approximate V<sub>T</sub>?
A) 750 ml (0.75 L)
B) 1000 ml (1.00 L)
C) 1900 ml (1.90 L)
D) 1200 ml (1.20 L)
Q3) A patient is receiving continuous mandatory ventilation in the control mode at a rate of 12/min. The inspiratory time control is set at 33%. What is the expiratory time?
A) 1.65 sec
B) 2.45 sec
C) 3.35 sec
D) 3.85 sec
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Chapter 46: Physiology of Ventilatory Support
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Sample Questions
Q1) What is traumatic injury to lung tissue caused by excessive pressure called?
A) Pulmonary barotrauma
B) Pulmonary hemorrhage
C) Pulmonary infarction
D) Pulmonary embolism
Q2) Patients receiving mechanical ventilation are usually turned every 2 hr to prevent which of the following?
1) Atelectasis
2) Secretion retention
3) Pressure sores
4) Hyperoxemia
A)1 and 2 only
B)2 and 3 only
C)1, 2 and 3 only
D)1, 2, 3, and 4
Q3) Which of the following is the consequence of decreased resistance or compliance?
A) It takes more time to fill the alveoli.
B) It takes more time to empty the alveoli.
C) It takes less time to fill and more time to empty the alveoli.
D) It takes less time to fill and empty the alveoli.
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Chapter 47: Patient Ventilator Interaction
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Sample Questions
Q1) In which mode does double triggering most commonly occur?
A) Volume ventilation.
B) Pressure ventilation.
C) CPAP.
D) No mode is more susceptible.
Q2) Possible ways to correct flow asynchrony in volume ventilation include which of the following?
1) Change to decelerating flow.
2) Increase peak flow to be greater than 60 L/min.
3) Match ventilator's inspiratory time to the patient's inspiratory time.
4) Decrease peak flow to be less than 60 L/min.
A)1 and 3 only
B)1, 2, and 3 only
C)3 and 4 only
D)1, 3, and 4 only
Q3) The most important variable affecting trigger asynchrony is:
A) the mode of mechanical ventilation being used.
B) the tidal volume being delivered.
C) the presence of auto-PEEP.
D) the patient's underlying disease process requiring mechanical ventilation.
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Chapter 48: Initiating and Adjusting Invasive Ventilatory Support
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Sample Questions
Q1) During initial mechanical ventilation of the chronic obstructive pulmonary disease (COPD) patient with chronic hypercapnia, what PaCO<sub>2</sub> is most likely used as a target value?
A) 30 mm Hg
B) 40 mm Hg
C) 55 mm Hg
D) 75 mm Hg
Q2) Which of the following represents a clinical situation where partial ventilatory support is commonly used?
A) Patient with head trauma
B) During weaning from continuous mandatory ventilation
C) While ventilating an asthmatic
D) In a drug overdose case
Q3) What flow pattern is least optimal for ventilating a patient with cardiovascular instability?
A) Accelerating flow pattern
B) Square flow pattern
C) Decelerating flow pattern
D) Constant flow pattern
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Chapter 49: Noninvasive Ventilation
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Sample Questions
Q1) Which of the following define successful application of noninvasive ventilation (NIV)?
1) Overall improvement of patient's blood gas
2) Normal blood gas
3) PaO<sub>2</sub> increased
4) PaCO<sub>2</sub> decreased
A)1 only
B)1, 2, and 3 only
C)1, 2, 3, and 4
D)1, 3, and 4 only
Q2) The respiratory therapist has placed a patient on noninvasive ventilation. After 2 hr the patient showing significant improvement in her work of breathing but is experiencing nasal and oral dryness. Which of the following corrective action should be performed?
A) Add heated humidifier.
B) Add ultrasonic nebulizer.
C) Immediately discontinue NIV.
D) Intubate the patient.
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Chapter 50: Extracorporeal Life Support Ecls
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Sample Questions
Q1) Which of the following situations could cause an excessive negative pressure on the right atrium during ECMO?
1) Hypovolemia
2) Insufficient height of the patient
3) A kink in the cannula or circuit tubing
4) Hypervolemia
A)1 and 3 only
B)1, 2, and 3 only
C)3 and 4 only
D)2, 3, and 4 only
Q2) Common complications of ECMO include which of the following?
1) Seizures
2) Bleeding
3) Arrhythmias
4) Neurologic complications
A)1 and 3 only
B)1, 2, and 3 only
C)2 and 4 only
D)1, 2, 3, and 4
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Chapter 51: Monitoring the Patient in the Intensive Care Unit
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Sample Questions
Q1) Which parameter is considered to be the most accurate and reliable measure of oxygenation efficiency?
A) PaO<sub>2</sub>/FiO<sub>2</sub> ratio
B) P(A-a)O<sub>2</sub>/PaO<sub>2</sub> ratio
C) Q<sub>s</sub>/Q<sub>t</sub>
D) PaO<sub>2</sub>/SaO<sub>2</sub> ratio
Q2) What is the best measure of the efficiency of gas exchange in the lung?
A) PaCO<sub>2</sub>
B) V<sub>DS</sub>/V<sub>T</sub>
C) End-tidal PCO<sub>2</sub>
D) PaCO<sub>2</sub>/PETCO<sub>2</sub>
Q3) Which of the following are causes of increased airway resistance?
1) Small endotracheal tube
2) High gas flow
3) Increased secretions
4) Frequent suctioning
A)1 and 3 only
B)1, 2, and 3 only
C)3 and 4 only
D)2, 3, and 4 only
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Chapter 52: Discontinuing Ventilatory Support
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Sample Questions
Q1) What patients are at high risk for postextubation upper airway obstruction?
1) Those with neuromuscular disorders
2) Those who have had major neck surgery
3) Those with infectious masses or abscesses
A)2 and 3 only
B)1 and 2 only
C)1 and 3 only
D)1, 2, and 3
Q2) The physician has requested that the respiratory therapist determine a patient's rapid shallow breathing index (RSBI) before placing the patient on PSV. The patient has a respiratory rate of 32/min and VT of 300 ml. What is the patient's RSBI?
A) 107
B) 110
C) 112
D) 114
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54
Chapter 53: Neonatal and Pediatric Respiratory Care
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Sample Questions
Q1) Which of the following is considered a limitation of the high-flow nasal cannula?
A) It does not meet patient's flow needs.
B) The amount of airway positive pressure cannot be measured.
C) It does not provide for appropriate CO<sub>2</sub> clearance.
D) It does not reduce the use of noninvasive positive-pressure ventilation.
Q2) You notice in the chart of an infant receiving neonatal intensive care the designation "preterm, AGA." Based on this information, what can you correctly conclude?
A) This is an infant whose weight falls between the tenth and ninetieth percentiles.
B) This is an infant whose weight falls between the tenth and fiftieth percentiles.
C) This is an infant whose weight falls between the fiftieth and ninetieth percentiles.
D) This is an infant whose weight falls between the tenth and twentieth percentiles.
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Chapter 54: Patient Education and Health Promotion
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Sample Questions
Q1) What concept will be most emphasized in teaching new skills to patients?
A) Handouts and illustrations
B) Repetition
C) Proper evaluation
D) Use of a pretest
Q2) Which of the following are acceptable phrases for writing an educational objective?
1) "At the end of the lesson, the patient will be able to list "
2) "At the end of the lesson, the patient will be able to understand "
3) "At the end of the lesson, the patient will be able to describe "
4) "At the end of the lesson, the patient will be able to demonstrate "
A)1 and 3 only
B)1, 2, and 3 only
C)2 and 4 only
D)1, 3, and 4 only
Q3) Teaching physical skills to patients is learning in what domain?
A) Cognitive
B) Affective
C) Psychomotor
D) Analytical
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56
Chapter 55: Cardiopulmonary Rehabilitation
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Sample Questions
Q1) Which of the following are differences between cardiac and pulmonary rehabilitation?
1) Cardiac patients are typically younger.
2) Most cardiac patients are not able to walk for 1 hr.
3) Reimbursement is easier to obtain with cardiac rehabilitation.
4) Breathing exercises are not essential to cardiac patients.
A)1 and 2 only
B)2 and 3 only
C)1, 3, and 4 only
D)1, 2, and 3 only
Q2) Which of the following clinicians are commonly involved in the cardiac rehabilitation programs?
1) Nurse specialist
2) Cardiologist
3) Dietitian
A)1 and 2 only
B)2 and 3 only
C)1 and 3 only
D)1, 2, and 3
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Chapter 56: Respiratory Care in Alternative Settings
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Sample Questions
Q1) Conditions in which patient need for home mechanical ventilation is generally limited to daytime or nocturnal support include which of the following?
1) Kyphoscoliosis
2) High spinal cord injuries
3) Amyotrophic lateral sclerosis
4) Myasthenia gravis
A)1 and 3 only
B)1, 3, and 4 only
C)2 and 4 only
D)2, 3, and 4 only
Q2) Which of the following can benefit most from intermittent use of noninvasive ventilation?
A) A patient with muscular dystrophy
B) A patient with pulmonary edema
C) A high cervical spine injury patient
D) A chronic obstructive pulmonary disease patient in respiratory failure
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58