Pulmonary Function Testing
Exam Solutions
Course Introduction
Pulmonary Function Testing is a comprehensive course designed to provide students with an in-depth understanding of the principles, techniques, and clinical applications of tests used to assess respiratory function. The course covers the physiological basis of pulmonary function tests such as spirometry, lung volumes, diffusion capacity, and airway resistance, as well as the standardized protocols for conducting and interpreting these assessments. Students will explore the indications, contraindications, and limitations of each test, and gain practical experience with equipment and data analysis. Emphasis is placed on the role of pulmonary function testing in diagnosing and managing various respiratory diseases, ensuring students are prepared for clinical and laboratory settings.
Recommended Textbook
Basic Clinical Lab Competencies for Respiratory Care An Integrated Approach 5th Edition by Gary
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Chapter 1: Basics of Asepsis
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Sample Questions
Q1) When performing tracheostomy care,which piece of personal protective equipment should be used to protect the health care provider from being splashed in the eyes with contaminated secretions?
A) Mask
B) Goggles
C) HEPA mask
D) Cover gown
Answer: B
Q2) What is the most important way to minimize indirect contact transmission?
A) Isolation
B) Disposable equipment
C) Handwashing
D) Antibiotics
Answer: C
Q3) 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
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Chapter 2: Basic Patient Assessment: Vital Signs and Breath Sounds
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Sample Questions
Q1) What determines the loudness (intensity)of a sound?
A) Duration
B) Frequency
C) Amplitude
D) Pitch
Answer: C
Q2) Which of the following environmental conditions should be considered when auscultating a patient's chest?
I.Close the door before initiating the examination
II.The temperature should be comfortable,especially not too cold
III.Turn off noise producing appliances in the room
A) III only
B) II and III
C) I and II
D) I, II, and III
Answer: D
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Chapter 3: Advanced Patient Assessment: Inspection,
Palpation, and Percussion
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Q1) What is a congenital deformity of the sternum characterized by a depression in the sternum at the level of the lower body and xyphoid process?
A) Lordosis
B) Pectus excavatum
C) Kyphoscoliosis
D) Pectus carinatum
Answer: B
Q2) What is defined as the presence of air beneath the skin in the subcutaneous tissues?
A) Tension pneumothorax
B) Subcutaneous emphysema
C) Pleural effusion
D) Fibrosis
Answer: B
Q3) What is an increase in the depth of respirations to greater than normal?
A) Hyperventilation
B) Hypopnea
C) Hyperpnea
D) Hypercapnia
Answer: C
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Chapter 4: Radiologic Assessment
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Q1) Which view is utilized to identify and quantify the extent of pleural effusion?
A) Lateral
B) Lateral decubitus
C) Apical lordotic
D) Portable
Q2) How can the practitioner tell if the chest radiograph is overpenetrated (overexposed)with x-ray energy?
A) The spinal processes will just barely be distinguishable from one another
B) The lung fields will appear white
C) The carina will be distinguishable
D) Dark lines will clearly separate the spinal processes
Q3) By comparing which views of the chest can a three-dimensional image be created?
A) Posterior-anterior film, lateral film
B) Lordotic film, anterior-posterior film
C) Anterior-posterior film, posterior-anterior film
D) Lordotic film, lateral film
Q4) What can be evaluated on a chest radiograph besides the heart and lungs?
Q5) A patient with a bilateral hyperresonant percussion note has a chest x-ray taken.What would you expect to find on the chest x-ray?
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Chapter 5: Pulmonary Function Testing
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Q1) What device moves at different speeds to allow the measurement of slow and forced maneuvers?
A) Kymograph
B) Peak flowmeter
C) Respirometer
D) Spirometer
Q2) When comparing the 2 largest FVCs,what should their value be to ensure that there is reproducibility in the spirometry results?
A) Within 200 ml of each other
B) 20% before and after bronchodilator
C) At least 3.0 L
D) Within 21.432 ml of each other
Q3) Which gas law or calculation is used in the body plethysmograph to measure lung volumes?
A) Nitrogen Washout Law
B) Boyles' Law
C) C1V1 = C2V2
D) Gas Dilution Technique
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Chapter 6: Electrocardiography
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Q1) Which lead(s)is (are)placed at the fourth intercostal space adjacent to the sternum?
A) V1
B) V2
C) V3
D) V1 and V2
Q2) When the heart is stimulated and contracts,this is termed _____________.
A) depolarization.
B) repolarization.
C) pacing.
D) voltage.
Q3) Leads I,II,and III and the augmented leads are _______ containing both a positive and negative electrode whereas the precordial leads are _________ and are helpful in the diagnosis of a myocardial infarction.
A) bipolar; unipolar
B) unipolar; bipolar
C) tripolar; bipolar
D) synchronized; asynchronized
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Chapter 7: Phlebotomy
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Q1) 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
Q2) If a blood spill occurs,what is the first thing you should do?
A) Notify environmental service to clean up the spill
B) Clean it up thoroughly with proper materials
C) Contain the spill by blocking off the area
D) Notify the supervisor to find the location of the environmental control procedure
Q3) Which of the following transporting methods is LEAST reliable?
A) The drawing therapist carrying the blood to the lab him- or herself
B) The lab picks up the blood samples at some collection point
C) Sending the blood specimen through the pneumatic tube system
D) Having another therapist carry the blood sample to the lab
Q4) A tourniquet can be used to enhance vein distension to ease the location of a good vein for a venous draw.What would happen if the tourniquet were left on too long?
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Chapter 8: Arterial Blood Gas Sampling
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Q1) How should the practitioner ensure that the arterial line's measured blood pressure is accurate?
Q2) If the modified Allen's test is negative on one hand what should the practitioner do at this time?
A) Hold the patient's hand above the level of the heart for 30 to 60 seconds.
B) Release the pressure on the radial artery and determine if circulation returns.
C) Perform the modified Allen's test on the other hand.
D) Perform the arterial stick anyway because of the poor perfusion.
Q3) Pressure should be held after arterial blood gas sampling for a minimum of _____________.
A) 5 minutes.
B) 1 minute.
C) 20 to 30 minutes.
D) 15 minutes.
Q4) Hyperventilation may lower the patient's ___________
A) PaCO .
B) anxiety.
C) pH.
D) PaO .
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Chapter 9: Hemodynamic Monitoring
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Sample Questions
Q1) Increased pulmonary artery pressure can be caused by: I.Hypervolemia
II.Left ventricular failure
III.Mitral stenosis
A) I only
B) II and III only
C) I and II only
D) I, II, and III
Q2) When interpreting a fall in the CVP,how should the fluid volume be correlated to confirm the relevance of the value?
A) The CVP should be correlated with the systolic blood pressure.
B) The CVP should be correlated with the diastolic blood pressure.
C) The CVP should be correlated with the fluid intake and output.
D) The CVP should be correlated with the PCWP.
Q3) PEEP _________________________________
A) increases the PCWP reading.
B) Increases the CVP reading.
C) increases cardiac output.
D) increases the CVP and PCWP reading.
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11
Chapter 10: Noninvasive Monitoring
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Q1) Skin burns are hazards of ______________
A) pulse oximetry.
B) transcutaneous monitoring.
C) end-tidal C02 monitoring.
D) a and b
Q2) What principle does the pulse oximeter use to measure the oxygen saturation of a capillary bed?
A) Photospectrometry
B) Heated spectrometry
C) Sidestream sampling
D) Blood gas sampling
Q3) What electrode does the transcutaneous O monitor incorporate into its design?
A) Clark electrode
B) Severinghaus electrode
C) Sanz electrode
D) Reference electrode
Q4) A practitioner is monitoring an intubated patient on a mechanical ventilator with a capnograph.The reading on the capnograph suddenly drops to zero from 35 mmHg.How would the practitioner determine the cause of the reading?
Q5) How does the pulse oximeter measure O saturation in the capillary bed?
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Chapter 11: Documentation and Goals Assessment
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Sample Questions
Q1) How are entries entered into the medical record?
A) In chronological order
B) In random order
C) In order of department
D) Alphabetical order
Q2) Which of the following are recorded in the patient's record?
I.Tests
II.Treatments
III.Procedures
IV.Assessments
A) I and II only
B) II and III only
C) I, III, and IV
D) I, II, III, and IV
Q3) Vital signs,breath sounds,jugular venous distention,heart tones,SpO ,and bowel sounds are all examples of _________________.
A) objective data.
B) subjective data.
C) clinical goals.
D) graphic records.
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Chapter 12: Oxygen Supply Systems
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Sample Questions
Q1) What happens to a cylinder if it fails hydrostatic testing?
A) The vessel is filled with water to 5/3 of the service pressure.
B) It is filled with another gas.
C) It is destroyed.
D) It is retested.
Q2) Medical gas supply systems include all of the following EXCEPT ______________
A) medical gas cylinders.
B) liquid systems.
C) oxygen concentrators.
D) oxygen regulators.
Q3) The most common service pressure indicated on an oxygen cylinder that is followed by a (+)sign is ___________.
A) 50 psi
B) 2200 psi
C) 2015 psi
D) 2 psi
Q4) You are going to transport a patient to the MRI department for a MRI scan.The patient is on a non-rebreathing mask at 15 LPM.The procedure will last approximately 60 minutes.What equipment should the practitioner gather for the transport?
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Chapter 13: Oxygen Administration
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Sample Questions
Q1) A patient has been on a non-rebreathing mask for 36 hours.What signs should the practitioner watch for and why?
Q2) How is the liter flow determined on a partial rebreathing and a non-rebreathing mask?
A) The FIO should be estimated by measuring the patient's minute volume.
B) The flow should be adjusted so that the bag is not allowed to collapse completely on inspiration
C) When the patient states that his/her shortness of breath is relieved.
D) By measuring the patient's SpO and increasing the FIO until the hypoxia is corrected.
Q3) A respiratory care practitioner sets up an oxygen device on a patient.How should the practitioner document the oxygen?
A) The flowrate or FI0<sub>2</sub>
B) The oxygen device
C) Date and time of set-up
D) All of these
Q4) During oxygen rounds,a patient on a nasal cannula has an oxygen saturation of 89%.No flow is felt coming from the device.What could be the problem?
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Chapter 14: Introduction to Respiratory Care Pharmacology
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Sample Questions
Q1) Corticosteroids:
A) cause brondilation directly.
B) reduce inflammation.
C) stabilize Mast cells.
D) should always be administered with a bronchodilator.
Q2) A patient is ready to be discharged to her home.At home the patient has a compressor and a small volume nebulizer.Which of the following corticosteroids is in solution and is intended to be administered via a small volume nebulizer?
A) Prednisone
B) Dexamethasone
C) Budesonide
D) Triamcinolone
Q3) Stimulation of the beta 2 receptors causes ___________________
A) peripheral vasoconstriction and mild bronchoconstriction in the lungs.
B) tachycardia, an increased potential for arrhythmias, and an increased cardiac output.
C) bronchodilation.
D) peripheral vasodilation, bradycardia, and decreased cardiac output.
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Chapter 15: Humidity and Aerosol Therapy
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Sample Questions
Q1) What is the purpose of a baffle in a large volume nebulizer?
A) Entrains air into the nebulizer to achieve various FIO .
B) Serves to stabilize particle size.
C) Regulates total gas flow to ensure a high-flow device.
D) It controls the output of the aerosol.
Q2) Which of the following statements is true concerning a heat and moisture exchanger (HME)humidifier?
A) The patient should be carefully monitored for increases in airway resistance and increased work of breathing.
B) It absorbs water vapor from the inhaled gas and delivers it to the patient.
C) The relative humidity of these devices is 100% at temperatures of 30 to 31°C.
D) They are indicated for patients that have a minute volume of greater than 15 LPM
Q3) Which of the following situations would be a contraindication for Heat-Moisture Exchanger (HME)use to provide humidification to a mechanically ventilated patient?
A) Body temperature of 34°C
B) Inspired Vt 600ml, expired Vt 400 ml
C) Spontaneous minute volume of 8 LPM
D) a and b
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Chapter 16: Bronchial Hygiene Therapy
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Sample Questions
Q1) A patient has severe hypoxemia despite high levels of oxygen.To help alleviate the hypoxemia the patient is positioned with the good lung down.How does this work?
Q2) What bronchial hygiene technique is indicated for a patient who has poor oxygenation associated with a unilateral lung disease?
A) Turning
B) Postural drainage
C) External manipulation of the thorax
D) Suctioning
Q3) 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.
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Chapter 17: Hyperinflation Therapy
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Sample Questions
Q1) While administering IPPB with a inspiratory pressure of 25 cmH O,a patient develops sudden shortness of breath.When assessing the patient it is noted that breaths are absent on the right side.Percussion of the right side yields a hyperresonant percussion note.No chest tube has been placed yet.Which way would the patient's trachea shift?
A) Toward the right
B) Cephalid
C) Toward the left
D) It will remain midline
Q2) What is defined as a combination of high-frequency phased pulse gas delivery and the administration of a dense aerosol?
A) Incentive spirometry (IS)
B) Intermittent positive pressure breathing (IPPB) therapy
C) Intrapulmonary percussive ventilation (IPV) therapy
D) High frequency chest wall oscillation (HFCWO) therapy
Q3) Which of the following is an absolute contraindication of IPPB therapy?
A) Tension pneumothorax
B) Radiographic evidence of blebs
C) Pneumothorax with a functioning chest tube
D) a and c
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Page 19
Chapter 18: Bronchoscopy Assisting
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Q1) Wheezing may be precipitated by the irritation of the patient's airway by the bronchoscope.This stimulation can result in bronchospasm,causing wheezing.How can this bronchospasm be prevented?
A) Mixing a bronchodilator with the lidocaine administered before the bronchoscopy
B) Administering a sedative to prevent anxiety and anxiety-induced bronchospasm
C) Hyperoxygenating the patient before the bronchoscopy
D) Blocking the sympathetic nervous system
Q2) Which of the following are indications of fiberoptic bronchoscopies?
I.The need to reevaluate persistent pulmonary infiltrates
II.The need for aid in difficult intubations
III.The need to obtain upper respiratory tract secretions
IV.Negative sputum cytology results with diagnosed cancer elsewhere in the body
A) III and IV
B) II only
C) I and II
D) I, II, III, and IV
Q3) A patient has just had a bronchoscopy procedure performed.What precautions and instructions should you give the patient following the procedure?
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Chapter 19: Equipment Processing and Surveillance
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Q1) What is the application of chemical agents to a surface to inhibit microbial growth and reproduction?
A) Antisepsis
B) Sterilization
C) Disinfection
D) Pasteurization
Q2) How should equipment flow through an equipment processing facility?
A) Flow through the facility is only one directional
B) Flow should in and out through the same door
C) Flow of equipment should be from the storage side to the cleaning side of the facility
D) Flow should go from a room on a lower level to a room on a higher level
Q3) What is done to provide data on the effectiveness of disinfection and sterilization methods?
A) Gram staining
B) Aliquot Culturing
C) Bacteriological surveillance
D) Alkylation
Q4) What types of vaccines should a health care worker undergo routinely?
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Chapter 20: Emergency Airway Management
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Q1) Where is the Miller laryngoscope blade placed during endotracheal intubation?
A) Under the epiglottis
B) In the vallecula
C) In the trachea
D) In the esophagus
Q2) After an emergency intubation,the respiratory care practitioner auscultates the chest and the abdomen.Breath sounds are absent over the chest but heard over the abdomen.What is the cause?
A) Endotracheal tube in the esophagus
B) Endotracheal tube in the trachea
C) Trauma has occurred to the upper airway
D) Left mainstem intubation
Q3) All of the following are conditions requiring management of the airway EXCEPT
A) secretions in the airway.
B) respiratory failure.
C) airway compromise.
D) the need to protect the airway.
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Chapter 21: Artificial Airway Care
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Q1) If a patient is expected to be on a ventilator for more than _________,a heated humidifier should be used if the patient has an artificial airway in place.
A) 24 hours
B) 48 hours
C) 72 hours
D) 96 hours
Q2) A patient has just been nasotracheally suctioned by the respiratory care practitioner.What improvements in the patient should occur after the procedure to indicate that the nasotracheal suctioning procedure was effective?
I.Improved breath sounds
II.Removal of secretions
III.Improved blood gas data or pulse oximetry
IV.Decreased work of breathing
A) I and II
B) III and IV
C) I only
D) I, II, III, IV
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Chapter 22: Chest Tubes
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Q1) 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?
Q2) Chest tubes are indicated to remove which of the following from a patient's thoracic cavity?
I.Pus
II.Air
III.Blood
IV.Fluid
A) I and II
B) III and IV
C) II only
D) I, II, III, IV
Q3) What is "tidaling"?
A) Gentle continuous bubbling observed in the suction control chamber
B) Vigorous bubbling observed in the suction control chamber
C) Fluid collection in the collection chamber
D) The normal rise and fall of the fluid level with the patient's breathing pattern
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Chapter 23: Insertion and Maintenance of Intravenous Lines
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Q1) What is the purpose of a tourniquet when attempting to start an IV on a patient?
A) It will stop the flow of fluids so that there will be no waste of fluids during the insertion of the IV
B) It stops the flow of the blood through the patient's arteries so there will be no blood loss during insertion of the IV
C) It causes the veins of the arm to distend and become engorged with blood
D) It causes the patient to not feel any irritation or pain during the insertion of the IV
Q2) What is another name for 0.9% sodium chloride in water?
A) Normal or physiologic saline
B) Lactated Ringer's solution
C) D5W
D) Plasma
Q3) When applying a tourniquet to help with the insertion of an IV on a patient,where should the tourniquet be placed?
A) Proximal to the intended insertion site
B) Distal to the intended insertion site
C) Over the insertion site
D) A tourniquet should never be used except when inserting an arterial line
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25
Chapter 24: Noninvasive Positive-Pressure Ventilation
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Q1) A patient complains of eye irritation and dryness.Which of the following would the practitioner NOT use to correct this problem?
A) Increase the delivered pressure
B) Use of spacers
C) Proper mask fit,
D) Correct adjustment of the headgear
Q2) A physician orders a patient to be placed on NPPV.The physician wants the patient to breathe spontaneously with assistance,but since the patient has frequent apneic episodes,she also wants the patient to have a back-up rate.Which mode should the practitioner recommend to the physician?
A) Spontaneous mode
B) Spontaneous/timed mode
C) Timed mode
D) CPAP mode
Q3) A patient on a full face mask on noninvasive positive-pressure ventilation (NPPV)is swallowing air and having trouble exhaling due to a leak around the naso-gastric (NG)tube.What can be done?
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Chapter 25: Continuous Mechanical Ventilation
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Q1) The purpose of a patient ventilator system check (vent check)is all of the following EXCEPT ___________________
A) to assess patient response to mechanical ventilation.
B) to verify the correct operation of the ventilation.
C) to assure use for billing purposes.
D) to verify patient settings and alarms are correct.
Q2) Myasthenia gravis,amyotrophic lateral sclerosis,Gullain-Barre syndrome,spinal cord injuries,and multiple sclerosis may all lead to respiratory failure due to
A) interference with the neurotransmission to the ventilatory muscles.
B) failure of the respiratory pump.
C) loss of nervous signals to contract for ventilation.
D) all of the above.
Q3) A practitioner is assigned to a patient on a ventilator.Which of the following is the most appropriate time to do a patient-ventilator system check?
A) After obtaining an arterial blood gas sample.
B) After obtaining a cardiac output measurement.
C) After making changes in the ventilator settings.
D) Prior to changing from PEEP level.
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Page 27
Chapter 26: Advanced Modes of Mechanical Ventilation
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Q1) How does a respiratory care practitioner assess the patient's work of breathing?
Q2) What is proportional assist ventilation?
Q3) Which of the following statements are true regarding RSBI?
I.Less than 105 indicates increasing work of breathing.
II.Respiratory rate divided by tidal volume in liters
III.Increasing RSBI indicates a patient may become fatigued.
A) I, II and III
B) I and II
C) II and III
D) II only
Q4) Intermittent Mandatory Ventilation is _______________________
A) spontaneous breathing between machine breaths.
B) periodic pressure breathing in between volume breaths.
C) the same as control ventilation.
D) used to improve arterial oxygenation.
Q5) Time cycled breath control _______________
A) identifies periods of apnea.
B) is adjusted in increments of 1-3 mm Hg.
C) adjusts the end of inspiration after a specified time.
D) increases pressure to a set value.
28
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Chapter 27: Wave Form Analysis
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Q1) Which of the following wave forms would be most useful in detecting changes in airway resistance especially after delivery of a bronchodilator?
A) Pressure versus volume
B) Pressure versus time
C) Flow versus volume
D) Volume versus time
Q2) The respiratory care practitioner is assessing a pressure versus volume loop and notices that it starts at zero and moves upward and to the left in a clockwise direction.Which of the following statement is true?
A) This is normal for a positive pressure breath
B) This is normal for a spontaneous breath
C) This is abnormal. The therapist should manually ventilate the patient
D) This occurs when there is a leak in the endotracheal tube cuff
Q3) A breath that rises and then remains at a specific cmH O pressure for varying lengths of inspiratory is which type of breath?
A) Spontaneous
B) Volume control
C) Pressure support
D) Pressure control
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Chapter 28: Weaning and Discontinuance of Mechanical Ventilation
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30 Verified Questions
30 Flashcards
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Sample Questions
Q1) A closed loop ventilator system ____________________
A) Eliminates the need for nurses and respiratory care practitioners.
B) can be used in the absence of a protocol.
C) continually adjusts the ventilator based on measured patient parameters.
D) is a rebreathing system of ventilator care
Q2) According to the AARC Clinical Practice Guidelines,which of the following identifies success or tolerance in the spontaneous breathing trial?
A) PaO less than 50 mmHg
B) Increase in PaCO of less than 10 mmHg
C) pH less than 7.32
D) Systolic blood pressure greater than 200 mmHg
Q3) How do cardiovascular problems result in ventilator dependence?
Q4) Which of the following is true of the method of ventilator weaning called spontaneous breathing trials (SBT)?
A) Mechanical ventilation can be discontinued if patient cannot tolerate as little as 30 minutes off
B) SBT is the same as SIMV mode of ventilation
C) Measurements of cardiac output and SvO are essential
D) Sedation can be given if a patient begins to have difficulty with breathing
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Chapter 29: Neonatal Mechanical Ventilation
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34 Verified Questions
34 Flashcards
Source URL: https://quizplus.com/quiz/40363
Sample Questions
Q1) Which of the following is a complication due to high PaO levels?
A) Barotrauma
B) Retinopathy of prematurity
C) Reduced intracranial pressure
D) Subcutaneous emphysema
Q2) According to the AARC Clinical Practice Guidelines for application of CPAP to neonates,which of the following is a contraindication for its use?
A) ROP
B) Need for intubation
C) Stable respiratory drive without apneas
D) Prematurity
Q3) Which of the following indicates poor ventilatory status?
A) PaO less than 50 mmHg
B) SpO below 60%
C) PaCO greater than 55 mmHg
D) pH greater than 7.35
Q4) Describe the 5 characteristics of the Apgar scoring system.
Q5) Describe how the initial newborn ventilator alarm setting are determined.
Q6) Describe how the initial newborn ventilator setting are determined for mode,rate and flow rate.
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