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Pulmonary Function Testing is a comprehensive course that explores the principles, techniques, and clinical significance of assessing respiratory system function. Students will learn about various pulmonary function tests, including spirometry, lung volume measurement, diffusion capacity, and arterial blood gas analysis. The course covers the physiological basis of these tests, indications, contraindications, interpretation of results, and the role of testing in diagnosing and managing respiratory diseases such as asthma, COPD, and restrictive lung disorders. Emphasis is placed on hands-on practice, quality control, and understanding sources of error to ensure accurate and meaningful results in clinical practice.
Recommended Textbook
Egans Fundamentals of Respiratory Care 11th Edition by Robert M. Kacmarek
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56 Chapters
3426 Verified Questions
3426 Flashcards
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Sample Questions
Q1) When was synchronized intermittent mandatory ventilation (SIMV) first introduced?
A) 1975
B) 1985
C) 1995
D) 2005
Answer: A
Q2) Which of the following was one of the first positive-pressure ventilators developed?
A) MA-1
B) Bird Mark 7
C) Dräger Pulmotor
D) Engstrom
Answer: C
Q3) What was the primary duty of the first inhalation therapists?
A) Provide airway care.
B) Support O<sub>2</sub> therapy.
C) Aerosol therapy to patients.
D) Maintain patients on mechanical ventilation.
Answer: B
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Q1) How are competencies being used to monitor the quality of respiratory care?
A) They focus on cost saving strategies.
B) They are used to check the skill and knowledge of respiratory through the use of clinical simulations.
C) They are used to educate therapist on new treatments and procedures.
D) They are used to review protocols.
Answer: B
Q2) Quality in the practice of respiratory care encompasses which of the following?
1) Personnel performing care
2) Equipment used
3) Method or manner in which care is provided
4) Level of experience of respiratory care providers
A)1 and 2 only
B)3 only
C)1, 3, and 4 only
D)1, 2, 3, and 4
Answer: D
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Q1) An RT is instructing a patient on a particular piece of equipment and should use which scenario on educating the patient?
A) Call Back
B) Read Back
C) Teach Back
D) A short quiz
Answer: C
Q2) Which of the following currents passing through the chest can cause ventricular fibrillation, diaphragm dysfunction (due to severe, persistent contraction), and death?
A) 100 mA
B) 100 A
C) 100 µA
D) 10 µA
Answer: A
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Sample Questions
Q1) Approximately what percent of hospitalized patients develop a health care-associated infection?
A) 1%
B) 4%
C) 10%
D) 25%
Q2) Which of the following diseases is transmitted through direct contact?
A) HIV
B) Pertussis
C) Hepatitis B
D) Hepatitis C
Q3) Which of the following steps for disinfection of a bronchoscope is false?
A) The first step is cleaning the scope.
B) Disinfection is done by immersion in a liquid disinfectant.
C) The device is stored lying flat to promote drying.
D) Drying techniques can include forced air.
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Q1) The AARC Code of Ethics holds professionals to which of following principles?
1) Actively maintaining and improving one's competence
2) Following sound scientific procedures and ethical principles in research
3) Promoting disease prevention and wellness
4) Respecting and protecting the rights of patients they treat
A)1, 2, 3, and 4
B)2 and 4 only
C)1, 2, and 3 only
D)4 only
Q2) The moral basis for rationing health care services falls under what ethical principle?
A) Compensatory justice
B) Harm
C) Distributive justice
D) Role duty
Q3) Which of the following is not a common element in a professional practice act?
A) Scope of professional practice
B) Requirements and qualifications for licensure
C) Penalties and sanctions for unauthorized practice
D) Professional code of ethics
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Sample Questions
Q1) What is the most common application of Bernoulli's principle in respiratory care equipment?
A) Fluidic ventilator
B) Pneumotachygraph
C) Air injector
D) U-tube manometer
Q2) What is the temperature at which the vapor pressure of a liquid equals the pressure exerted on the liquid by the surrounding atmosphere?
A) Boiling point
B) Dew point
C) Triple point
D) Melting point
Q3) What is the change in state of a substance from liquid to gaseous form occurring below its boiling point?
A) Evaporation
B) Sublimation
C) Boiling
D) Vaporization
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Q1) Computerized reminders increase:
1) The proportion of indicated influenza vaccinations
2) Adherence to medications
3) Necessary hospital admissions for appropriately diagnosed cardiac ischemia
A)2 only
B)3 only
C)2 and 3 only
D)1, 2, and 3
Q2) Which of the following is/are step(s) to help prevent computer infiltration by malicious software?
1) Users should never share or use their password on public unsecured devices.
2) Users should install a virus scanning program and regularly update it.
3) Users should refrain from updating their computers with security patches.
4) Users should be careful when opening e-mail file attachments and refrain from downloading applications from unknown sources.
A)1 only
B)1 and 2 only
C)1, 2, and 4 only
D)1, 2, 3, and 4
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Q1) What is the name of the search engine sponsored by the National Library of Medicine for information on health care?
A) PubMed
B) HotMed
C) Up-to-date-Med
D) NationalMedline
Q2) In what section of a paper are you likely to find exactly what was done to answer the research question?
A) Introduction
B) Discussion
C) Methods
D) Results
Q3) 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
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Sample Questions
Q1) What pulmonary disorder could lead to acute flattening of the diaphragm?
A) Adult respiratory distress syndrome
B) Asthma
C) Atelectasis
D) Pneumonia
Q2) What is the major source of respiratory tract secretions in the normal lung?
A) Bronchial glands
B) Clara cells
C) Goblet cells
D) Mast cells
Q3) The pulmonary arterial circulation does which of the following?
1) Delivers oxygenated blood back to the heart.
2) Delivers deoxygenated blood to the lungs.
3) Originates on the left side of the heart.
4) Originates on the right side of the heart.
A)1 and 4 only
B)2 and 4 only
C)1 and 3 only
D)2 and 3 only
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Sample Questions
Q1) The heart's ability to vary stroke volume based solely on changes in end-diastolic volume is based on what mechanism?
A) Automaticity
B) Autoregulation
C) Bohr equation
D) Frank-Starling's law
Q2) What are the major branches of the left coronary artery?
1) Anterior descending
2) Circumflex
3) Coronary sinus
4) Posterior descending
A)1, 2, and 3 only
B)2 and 4 only
C)1 and 2 only
D)2 and 3 only
Q3) 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)
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Sample Questions
Q1) Which of the following diseases or disorders is most likely to result in an increased V<sub>D</sub>/V<sub>T</sub> ratio?
A) Atelectasis
B) Pneumonia
C) Pulmonary embolus
D) Pulmonary fibrosis
Q2) Which of the following pressures vary throughout the normal breathing cycle?
1) Alveolar pressure (P<sub>alv</sub>)
2) Body surface pressure (P<sub>bs</sub>)
3) Mouth pressure (P<sub>ao</sub>)
4) Pleural pressure (P<sub>pl</sub>)
A)1, 2, 3, and 4
B)2, 3, and 4 only
C)2 and 4 only
D)1 and 4 only
Q3) A fibrotic lung would exhibit which of the following characteristics?
A) Decreased airway resistance
B) Decreased lung compliance
C) Decreased PVR
D) Decreased surface tension
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Sample Questions
Q1) Which of these statements applies to the following reaction: Prot-NH<sub>2</sub> + CO<sub>2</sub> Prot-NHCOO<sup>-</sup> + H<sup>+</sup>?
A) Approximately 20% of the total blood carbon dioxide is carried in this form.
B) It is second in importance to only the bicarbonate buffer system.
C) It represents the formation of blood carbamino compounds.
D) The resulting H<sup>+</sup> ions are buffered by reduced HCO<sub>3.</sub>
Q2) Hypoxia is best defined as a condition in which what occurs?
A) Blood Hb levels are less than normal (15 g/dl).
B) The arterial PCO<sub>2</sub> is greater than normal (45 mm Hg).
C) The arterial PO<sub>2</sub> is greater than normal (100 mm Hg).
D) Tissue O<sub>2</sub> delivery is inadequate to meet cellular needs.
Q3) The conversion of HbO<sub>2</sub> to deoxygenated Hb does which of the following?
1) Decreases blood carbon dioxide content.
2) Enhances carbon dioxide loading on Hb.
3) Helps buffer H<sup>+</sup> ions.
A)2 and 3 only
B)1 and 2 only
C)3 only
D)1, 2, and 3
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Sample Questions
Q1) You prepare a solution by combining 5 g of glucose with 95 g of water. What type of solution are you making?
A) Normal
B) Percent
C) Ratio
D) Weight/volume
Q2) You prepare a solution by dissolving 5 g of glucose in 100 ml of solution. What type of solution are you making?
A) Normal
B) Percent
C) Ratio
D) Weight/volume
Q3) The combination of red blood cells in plasma is a good example of what?
A) Colloid
B) Mixture
C) Solution
D) Suspension
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Q1) Why is a buffer system such as phosphate considered a closed system?
A) All the components remain in the system.
B) It has limited utility in buffering acids.
C) Its ability to buffer volatile acids is incomplete.
D) Once its buffer level is established, it will never change.
Q2) The primary goal of acid-base homeostasis is to maintain which of the following?
A) Normal HCO<sub>3</sub><sup>-</sup>
B) Normal PCO<sub>2</sub>
C) Normal pH
D) Normal PO<sub>2</sub>
Q3) What is the primary buffer system for fixed acids?
A) Cl<sup>-</sup>
B) HCO<sub>3</sub><sup>-</sup>
C) Phosphate
D) Plasma proteins
Q4) What is the primary chemical event in respiratory acidosis?
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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Sample Questions
Q1) Which of the following can be stimulated by pulmonary J receptors?
1) Edema
2) Inflammatory processes
3) Pulmonary vascular congestion
A)1 and 2 only
B)1 only
C)1 and 3 only
D)1, 2, and 3
Q2) Why does it take approximately 24 hr for a full ventilatory response to develop to acute hypoxemia?
A) Initial cerebrospinal fluid alkalemia blunts the hypoxic ventilatory stimulus.
B) Peripheral chemoreceptors are slow to respond to decreased blood O<sub>2</sub> levels.
C) Renal compensation for respiratory alkalosis increases chemoreceptor sensitivity.
D) A full ventilatory response is not possible until after the muscles become fatigued.
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Q1) In which of the following disorders is digital clubbing a common physical sign?
1) Congenital heart disease
2) Lung cancer
3) Chronic obstructive pulmonary disease
4) Pancreatic cancer
A)3 only
B)1, 3 and 4 only
C)1, 2, and 4 only
D)1, 2, and 3 only
Q2) What change in the patient's respiratory breathing pattern is commonly seen with significant fever?
A) Slower rate
B) More rapid rate
C) More prolonged expiratory time
D) More prolonged inspiratory time
Q3) What is the area of the anterior chest wall overlying the heart called?
A) Epigastrium
B) Precordium
C) Pericardium
D) Axillary
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Sample Questions
Q1) 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
Q2) What is indicated by an elevation of the anion gap?
A) Respiratory failure
B) Metabolic alkalosis
C) Metabolic acidosis
D) Renal failure
Q3) Which of the following are causes of leukopenia?
1) Chemotherapy
2) Bone marrow disease
3) Radiation therapy
4) Antibiotics
A)1 and 4 only
B)1, 2, and 3 only
C)2 and 3 only
D)1, 2, and 4 only
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Sample Questions
Q1) What medication is most useful for the treatment of premature ventricular contractions?
A) Digoxin
B) Atropine
C) Lidocaine
D) Digitalis
Q2) A patient who has been diagnosed with myocardial infarction is getting an ECG. The ECG trace shows a series of nonconducted P waves followed by a P wave that is conducted to the ventricles. The ratio of nonconducted to conducted P waves is fixed at 4:1. What plan for treatment should this patient receive?
1) Rapid defibrillation
2) Atropine
3) Cardioversion
4) Pacemaker
A)1, 2, and 3 only
B)2 and 4 only
C)3 only
D)1, 2, 3, and 4
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Q1) Which of the following factors contributing to imprecision (random) errors during blood gas analysis?
A) Sample contamination
B) Contaminated buffers
C) Statistical probability
D) Sample mishandling
Q2) What is the most common source of error and false alarms with pulse oximetry?
A) Presence of HbCO
B) Patient motion artifact
C) Presence of vascular dyes
D) Ambient light detection
Q3) Why is the radial artery the preferred site for arterial blood sampling?
1) It is near the surface and easy to palpate and stabilize.
2) The ulnar artery normally provides good collateral circulation.
3) The radial artery is not near any large veins.
4) It is the largest artery located in the upper extremities.
A)1 and 4 only
B)3 only
C)2 and 4 only
D)1, 2, and 3 only
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Sample Questions
Q1) To what should all spirometric values obtained under ambient conditions be converted?
A) Ambient temperature and pressure, saturated (ATPS)
B) Standard temperature and pressure, dry (STPD)
C) Body temperature, ambient pressure, saturated (BTPS)
D) Ambient temperature and pressure, dry (ATPD)
Q2) What is a normal single-breath diffusing capacity for carbon monoxide for a young, healthy man of average size?
A) 10 ml/min/mm Hg
B) 20 ml/min/mm Hg
C) 30 ml/min/mm Hg
D) 40 ml/min/mm Hg
Q3) What is the normal predicted vital capacity (VC) measurement in the adult patient?
A) 3600 ml
B) 4800 ml
C) 5400 ml
D) 6000 ml
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Q1) Which of the following is not a typical cause of atelectasis?
A) Abdominal surgery
B) Rib fracture
C) Hepatomegaly
D) Pleurisy
Q2) Which of the following is a major limitation of magnetic resonance imaging (MRI) of the chest?
A) Cannot visualize large vessels.
B) Cannot be used in patients with pacemakers.
C) Cannot be used to examine hilar structures.
D) Interpretation is difficult.
Q3) What is the optimal position of the endotracheal tube following intubation as seen on the chest radiograph?
A) 1 to 2 cm above the carina
B) 3 to 4 cm above the carina
C) 5 to 7 cm above the carina
D) In the upper third of the carina
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Sample Questions
Q1) The assessment of the upper airway prior to a flexible bronchoscopy procedure to help identify patients in whom it may be difficult to secure an airway is referred to as:
A) the Glasgow Coma Scale.
B) the Mallampati classification.
C) the APACHE scale.
D) the Borg scale.
Q2) During bronchoscopy of an intubated patient receiving mechanical ventilation, what should the RT be aware of?
A) Risks are minimal since the patient already has a secured airway.
B) The resistance imposed by the bronchoscope may cause tracheal pressures to increase noticeably.
C) Albuterol should be available to address and airway resistance changes.
D) Inspiratory and expiratory effort (measured by tracheal pressure) appears minimally affected in most patients.
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Q1) Your male patient has a creatinine excretion level of 8 mg/kg body weight/day. What does this indicate?
A) It is normal.
B) There is mild muscle wasting.
C) There is moderate muscle wasting.
D) There is severe muscle wasting.
Q2) What probably represents the most significant problem while performing calorimetry on a patient being mechanically ventilated?
A) Compensating for mechanical dead space
B) Leaks in the circuit
C) Volume compression during inspiration
D) High PEEP levels
Q3) Which of the following is associated with primary protein-energy malnutrition (PEM)?
A) Poor diet due to living in a developing country
B) Anorexia
C) Malabsorption
D) Severe infection
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Sample Questions
Q1) Which of the following organisms have been found to colonize the oropharynx of healthy individuals?
A) Coccidioides immitis
B) Haemophilus influenzae
C) Histoplasma capsulatum
D) Mycobacterium
Q2) If an HIV-infected patient has an adverse reaction to the treatment of choice for Pneumocystis jiroveci pneumonia, what treatment should be instituted?
A) Amphotericin B
B) Pentamidine
C) Trimethoprim-sulfamethoxazole
D) Vancomycin
Q3) What type of lung infection is most commonly associated with cavitating lesions on the chest radiograph?
A) Community-acquired pneumonia
B) Reactivation tuberculosis
C) Staphylococcus aureus
D) Viral pneumonias
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Q1) What beta-2 agonist is associated with 12 to 24 hr of bronchodilation?
A) Albuterol
B) Metaproterenol
C) Salmeterol
D) Aclinidium
Q2) Which of the following symptoms is not a typical symptom of asthma?
A) Cough
B) Shortness of breath
C) Chest tightness
D) Chest pain
Q3) It is not clear whether your patient has COPD or asthma. Which of the following characteristics is most closely associated with the diagnosis of asthma?
A) Daily phlegm production
B) Diminished vascularity on the chest radiograph
C) Low diffusion capacity
D) Reversal of the FEV<sub>1</sub> after use of a bronchodilator
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Q1) 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
Q2) What is the most common radiographic finding in the chest film of a patient with sarcoidosis?
A) Bibasilar parenchymal opacities
B) Bilateral hilar lymphadenopathy
C) Pleural plaque with calcification
D) Upper-lobe distribution of fibrotic cysts
Q3) What disease process is associated with much higher risk of tuberculosis?
A) Asbestosis
B) Coal worker's pneumoconiosis
C) Sarcoidosis
D) Silicosis
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Q1) Which of the following pathologies is the most common cause of pleural effusions in clinical practice?
A) Hepatic disease
B) Acute renal failure
C) Congestive heart failure
D) Cor pulmonale
Q2) What method of chest tube removal has been associated with the lowest level of pneumothorax recurrence?
A) Clamp the chest tube for 4 hr; if chest radiograph is good, remove the tube.
B) Clamp chest tube for 24 hr; if clinically stable, remove the tube.
C) Remove the chest tube as soon as the air leak resolves.
D) Remove the chest tube 48 hr after the air leak resolves.
Q3) A patient with nephritic syndrome is noted to have a large right-sided pleural effusion and a small to medium-sized left-sided pleural effusion. What would explain this finding?
A) The nephrosis is complicated by CHF.
B) The nephrosis is complicated by pulmonary emboli.
C) This is a common finding in patients with nephrosis.
D) This just a complicated case of nephrosis.
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Q1) Where in the lung is pulmonary embolism most frequently observed?
A) Right lower lobe
B) Lingula
C) Left lower lobe
D) Right middle lobe
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) Which of the following medications would be standard therapy to treat acute deep venous thrombi?
A) Acetylcholine esterase
B) Heparin
C) Streptokinase
D) Warfarin
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Q1) Which of the following clinical features is often common to both ARDS and congestive heart failure (CHF)?
A) BALF is proteinaceous and inflammatory.
B) Diffuse alveolar and interstitial infiltrates in chest radiograph.
C) Pleural effusions on chest radiograph.
D) Recent history of trauma.
Q2) What mode of mechanical ventilation is designed to optimize ventilation by reducing alveolar collapse while using small tidal volumes in patients with ARDS?
A) Inverse ratio ventilation
B) High-frequency ventilation (HFV)
C) Intermittent mandatory ventilation
D) Airway pressure-release ventilation
Q3) Which of the following complications has been associated with the use of PEEP in patients with ARDS?
A) Lung infection
B) Reduced cardiac output
C) Hepatic failure
D) Myocardial infarction
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Q1) 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
Q2) 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
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Q1) Which of the following is typically not associated with local tumor growth in the central airways?
A) Large airway obstruction
B) Cough
C) Hemoptysis
D) Fine crackles
Q2) What treatment is the best initial modality for patients with non-small-cell lung cancer because it offers the best prospect of long-term survival?
A) Chemotherapy
B) Surgical resection
C) Radiation therapy
D) Endobronchial laser therapy
Q3) Which of the following is the most common type of lung cancer?
A) Large cell
B) Adenocarcinoma
C) Squamous cell
D) Small cell
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Q1) What treatment strategies have improved the outcome in Guillain-Barré syndrome?
A) Plasmapheresis
B) Corticosteroids
C) Radiation therapy
D) Antibiotics
Q2) What alteration in respiration is typically associated with stroke involving the cerebral cortex?
A) Severe hypoxemia
B) Respiratory acidosis
C) Mild hyperventilation
D) Sleep apnea
Q3) Disorders of the neuromuscular junction include which of the following?
1) Lambert-Eaton syndrome
2) Myasthenia gravis
3) Dermatomyositis
4) Tetanus, botulism
A)1 and 3 only
B)1, 2, and 4 only
C)3 and 4 only
D)2, 3, and 4 only
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Q1) Which of the following physical exam findings are associated with obstructive sleep apnea?
1) Large tonsils
2) Microcephaly
3) Macroglossia
4) Deviated nasal septum
A)1 and 3 only
B)1, 2, and 3 only
C)3 and 4 only
D)2, 3, and 4 only
Q2) Which of the following behavioral interventions is least useful for the treatment of sleep apnea?
A) Weight loss
B) Avoidance of alcohol
C) Avoidance of sedatives
D) Avoidance of daytime naps
Q3) Central sleep apnea occurs more often than obstructive sleep apnea.
A)True
B)False
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Q1) Treatment of the infant with persistent pulmonary hypertension may include which of the following?
1) ECMO
2) High-frequency ventilation
3) Nitric oxide
4) Caffeine citrate
A)1 and 3 only
B)1, 2, and 3 only
C)3 and 4 only
D)2, 3, and 4 only
Q2) Which of the following therapies has little effect on long-term outcome such as mortality and duration of oxygen therapy in infants with BPD?
A) Diuretics
B) Steroids
C) Antibiotics
D) Bronchodilators
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Q1) Which of the following is the generic name for Arcapta Neohaler?
A) Indacaterol
B) Olodaterol
C) Formoterol
D) Umeclidinium bromide
Q2) Which of the following nebulizers is used to nebulize iloprost?
A) Hudson
B) Pari
C) I-neb
D) Respirgard
Q3) 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
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Q1) What is the standard size for endotracheal or tracheostomy tube adapters?
A) 22-mm external diameter
B) 15-mm external diameter
C) 15-mm internal diameter
D) 22-mm internal diameter
Q2) To minimize the problems associated with pharyngeal aspiration in intubated patients, which of the following could you recommend?
1) Position patients in semi-recumbent position.
2) Insert the feeding tube into the duodenum.
3) Suction above the tracheal tube cuff.
4) Provide continuous aspiration of subglottic secretions.
A)1 only
B)1 and 2 only
C)1, 2, 3, and 4
D)2, 3, and 4 only
Q3) How often should patients be suctioned?
A) At least once every 2 to 3 hr
B) Whenever they are moved or ambulated
C) When physical findings support the need
D) Whenever the charge nurse requests it
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Q1) What is the primary indication for dopamine in advanced cardiac life support?
A) Ventricular tachycardia
B) Ventricular fibrillation
C) Hypotension with signs and symptoms of shock
D) Cardiogenic shock with CHF
Q2) What is the proper ratio of external chest compressions to ventilation for a newborn?
A) 5:1
B) 3:1
C) 15:2
D) 30:5
Q3) What is the proper rate of external chest compressions for children up to puberty?
A) 80/min
B) 100/min
C) 120/min
D) 140/min
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Q1) Clinical indications for delivering cool humidified gas include which of the following?
1) Postextubation edema
2) Upper airway inflammation
3) Croup (laryngotracheal bronchitis)
4) Epiglottitis
A)2, 3, and 4 only
B)1, 2, and 3 only
C)1, 2, 3, and 4
D)2 and 3 only
Q2) When using nebulizers, where should you place them to minimize risk of contamination?
A) In the inspiratory limb only, at a high point in the circuit
B) In both the expiratory and inspiratory limbs, at high points in the circuit
C) In the expiratory limb only, at a low point in the circuit
D) In both the expiratory and inspiratory limbs, at low points in the circuit
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Q1) Which of the following is false about the optimal technique for using a small-volume jet nebulizer (SVN) for aerosol drug delivery?
A) SVNs are less technique- and device-dependent.
B) Slow inspiration improves SVN aerosol deposition.
C) Deep breathing or breath-holding improves SVN deposition.
D) Use of a mouthpiece or mask provides similar results.
Q2) Which of the following would you recommend as initial therapy for a patient admitted to the emergency department with acute airway obstruction (wheezing, cough, dyspnea, peak expiratory flow rate [PEFR] <60% predicted)?
1) Assess dose-response of metered dose inhaler (MDI) albuterol (up to 12 puffs).
2) Provide up to three small-volume jet nebulizer (SVN) treatments with albuterol every 20 min.
3) Immediately begin continuous albuterol therapy at 15 mg/hr.
A)1 or 2 only
B)1 or 3 only
C)2 or 3 only
D)1, 2, and 3
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Q1) You must connect a large-volume nebulizer to a bedside compressed-air outlet through a flowmeter. You have only standard O<sub>2</sub> flowmeters available.
Which of the following actions is appropriate?
A) Connect the O<sub>2</sub> flowmeter to the air outlet with piping tape.
B) Use an O<sub>2</sub>-to-air DISS adapter to join the flowmeter and outlet.
C) Connect the O<sub>2</sub> flowmeter to the air outlet with a petroleum jelly seal.
D) Try to cross-thread an O<sub>2</sub> flowmeter directly on the air outlet.
Q2) The NFPA standard for bulk liquid O<sub>2</sub> systems requires that the reserve supply be which of the following?
A) Fixed cylinder bank of 75 H cylinders
B) At least one large liquid O<sub>2</sub> cylinder
C) Equal to the average gas use of 1 day
D) At least 3000 cu/ft of gaseous O<sub>2</sub>
Q3) Which of the following is false about a compensated Thorpe tube?
A) Variable-orifice, constant-pressure flowmeter device
B) Calibrated in liters per minute at atmospheric pressure
C) Flow-control needle valve placed distal to the flow tube
D) Accuracy unaffected by changes in downstream resistance
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Q1) Features of an ideal delivery system for NO for use with mechanical ventilation include which of the following?
1) Provides precise and stable NO dose delivery.
2) Premixes NO and O<sub>2</sub> in a holding reservoir.
3) Provides accurate NO and NO<sub>2</sub> monitoring.
4) Maintains proper ventilator function.
A)1 and 3 only
B)1, 3, and 4 only
C)2 and 4 only
D)1, 2, 3, and 4
Q2) Which of the following is consistent with the radiographic appearance after prolonged exposure to O<sub>2</sub>?
A) Air bronchograms
B) Pulmonary abscess
C) Patchy infiltrates
D) Pneumothorax
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Q1) 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
Q2) Which of the following possesses the most significant risk for hypoventilation?
A) IPPB
B) IS
C) IPAP/EPAP
D) CPAP
Q3) How do all modes of lung expansion therapy aid lung expansion?
A) Increasing the transpulmonary pressure gradient
B) Decreasing the transthoracic pressure gradient
C) Increasing the pressure in the pleural space
D) Decreasing the pressure in the alveoli
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Q1) 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
Q2) If a patient's chest radiograph shows infiltrates in the posterior basal segments of the lower lobes, what postural drainage position would you recommend?
A) Head down, patient supine with a pillow under knees
B) Patient prone with a pillow under head, bed flat
C) Patient supine with a pillow under knees, bed flat
D) Head down, patient prone with a pillow under abdomen
Q3) The application of gravity to achieve specific clinical objectives in respiratory care best describes which of the following?
A) Breathing exercises
B) Postural drainage therapy
C) Hyperinflation therapy
D) Directed coughing
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Sample Questions
Q1) Which of the following is a feature of Guillain-Barré?
A)Ascending muscle weakness
B)Descending muscle weakness
C)Limited to lower extremities
D)Limited to trunk
Q2) A diagnosis of respiratory failure can be made if which of the following are present?
1) PaO<sub>2</sub> 55 mm Hg, FiO<sub>2</sub> 0.21, P<sub>B</sub> 760 mm Hg
2) PaCO<sub>2</sub> 57 mm Hg, FiO<sub>2</sub> 0.21, P<sub>B</sub> 760 mm Hg
3) P(A-a)O<sub>2</sub> 45 mm Hg, FiO<sub>2</sub> 1.0, P<sub>B</sub> 760 mm Hg
4) PaO<sub>2</sub>/FiO<sub>2</sub> 400, P<sub>B</sub> 750 mm Hg
A)1 and 2 only
B)1, 3, and 4 only
C)3 and 4 only
D)2, 3, and 4 only
Q3) What happens to the P(A-a)O<sub>2</sub> with mismatch and shunt?
A) It increases withmismatch and decreases with shunt.
B) It decreases with bothmismatch and shunt.
C) It increases with bothmismatch and shunt.
D) It does not change.

Page 46
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Q1) During volume-targeted ventilation, which of the following settings determine the machine-delivered minute volume?
1) Volume
2) Flow
3) Rate
A)1 and 2 only
B)1 and 3 only
C)2 and 3 only
D)1, 2, and 3
Q2) In which of the following situations is pressure-controlled ventilation sometimes used?
1) When a precise PaCO<sub>2</sub> has to be maintained (some closed-head injuries)
2) When more even distribution of ventilation is required
3) When ventilating patients with severe, refractory hypoxemia
4) When tidal volume in unstable due to leaks
A)1 and 2 only
B)3 and 4 only
C)1, 2, and 3 only
D)1, 3, and 4 only
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Q1) Which of the following strategies are useful in the management of shunt?
1) Positive end expiratory pressure
2) Permissive hypercapnia
3) Control of membrane permeability
A)2 and 3 only
B)1 and 3 only
C)1, 2, and 3
D)1 only
Q2) Which of the following conditions is associated with a lack of response to increased FiO<sub>2</sub> in patients receiving positive-pressure ventilation?
A) Dead space
B) Shunt
C) Hypoxemia
D) Hypoventilation
Q3) What is traumatic injury to lung tissue caused by excessive pressure called?
A) Pulmonary barotrauma
B) Pulmonary hemorrhage
C) Pulmonary infarction
D) Pulmonary embolism
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Sample Questions
Q1) In which mode does flow asynchrony most commonly occur?
A) Volume ventilation.
B) Pressure ventilation.
C) CPAP.
D) No mode is more susceptible.
Q2) Which of the following can cause trigger delay?
1) Auto-PEEP
2) Poor sensitivity setting
3) Water in the circuit
4) Ventilator malfunction
A)3 only
B)1, 2, and 4 only
C)2 and 3 only
D)1, 2, 3, and 4
Q3) In severe cases of pneumothorax, the mediastinum and trachea:
A) remain midline.
B) sink posteriorly into the chest cavity.
C) are shifted toward from the side with the pneumothorax.
D) are shifted away from the side with the pneumothorax.
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Q1) Beneficial effects of using high inspiratory flows in patients with chronic airflow obstruction receiving flow-limited mechanical ventilation include which of the following?
1) Decreased work of breathing
2) Improved gas exchange
3) Decreased auto-PEEP
A)1 and 2 only
B)1 and 3 only
C)2 and 3 only
D)1, 2, and 3
Q2) When titrating the FiO<sub>2</sub> down from 50% to 21%, in what increments should it be reduced?
A) All at once is acceptable.
B) No more than 5%.
C) 5% to 10%.
D) 10% to 20%.
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Q1) Which of the following is/are the minimum performing characteristics of most noninvasive ventilators?
1) Mandatory rate of 50 breaths/min or less
2) Inspiratory pressure of 30 cm H<sub>2</sub>O or less
3) PEEP of 15 cm H<sub>2</sub>O or less
4) Inspiratory flow of 180 L/min or less at 20 cm H<sub>2</sub>O
A)1 only
B)1, 2, and 3 only
C)1, 2, 3, and 4
D)2, 3, and 4 only
Q2) What strategy should be used when the patient complains of nasal congestion during the use of a nasal mask for noninvasive ventilation (NIV)?
A) Switch to an oral mask.
B) Switch to a face mask.
C) Add a heated humidifier.
D) Reduce the inspiratory flow.
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Q1) Which of the following are absolute contraindications for the use of ECMO?
1) Lethal congenital anomalies
2) Grade III or higher intracranial hemorrhage
3) Mechanical ventilation with 100% O<sub>2</sub> for greater than 13 days
4) Gestational age less than 34 weeks
A)1 and 2 only
B)1, 2, and 3 only
C)2 and 4 only
D)1, 2, 3, and 4
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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Q1) Which of the following parameters are used in calculating the Murray lung injury score of a patient with acute lung injury?
1) Results of chest radiograph
2) PEEP setting
3) Lung compliance
4) Cardiac output
A)1 and 3 only
B)1, 2, and 3 only
C)3 and 4 only
D)2, 3, and 4 only
Q2) In low-perfusion patients, what site would be best for monitoring SpO<sub>2</sub>?
A) Finger
B) Earlobe
C) Nose
D) Forehead
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Q1) A physician orders a T tube trial for a patient receiving ventilatory support in the assist-control mode with an FiO<sub>2</sub> of 0.4. What FiO<sub>2</sub> would you recommend for this patient during the spontaneous breathing period?
A) 0.3
B) 0.4
C) 0.5
D) 0.6
Q2) Which of the following signs observed on a mechanically ventilated patient indicate that successful weaning is unlikely?
1) Palpable scalene muscle use during inspiration
2) Palpable abdominal tensing during expiration
3) Presence of an irregular breathing pattern
4) Patient unable to alter breathing pattern on command
A)2 and 4 only
B)1, 2, and 3 only
C)3 and 4 only
D)1, 2, 3, and 4
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Q1) In which of the following conditions may bronchial hygiene therapy be considered for infants or children?
1) Hyaline membrane disease
2) Foreign body aspiration
3) Cystic fibrosis
4) Bronchopulmonary dysplasia (BPD)
A)2 and 4 only
B)1, 3, and 4 only
C)2, 3, and 4 only
D)1, 2, 3, and 4
Q2) What is the normal arterial PO<sub>2</sub> in healthy infants?
A) Greater than 50 mm Hg
B) Greater than 60 mm Hg
C) Greater than 70 mm Hg
D) Greater than 80 mm Hg
Q3) The most probable explanation for the flip-flop phenomenon in the newborn is:
A) oxygen (O<sub>2</sub>) toxicity.
B) right-to-left shunting.
C) cardiac disease.
D) reactive pulmonary vasoconstriction.
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Q1) Teaching facts to patients involves learning in what domain?
A) Cognitive
B) Affective
C) Psychomotor
D) Analytical
Q2) Which of the following is used to evaluate cognitive objectives?
A) Verbal exam
B) Demonstration
C) Written exam
D) Performance checklist
Q3) 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
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Q1) Which of the following exercises are useful for reconditioning the upper extremities of patients undergoing pulmonary rehabilitation?
1) Using a rowing machine
2) Using an arm ergometer
3) Pedaling a stationary bicycle
4) Using free hand weights
A)1, 2, 3, and 4
B)1 and 3 only
C)1, 2, and 4 only
D)2 and 4 only
Q2) Below what level of the predicted FEV<sub>1</sub>/FVC are patients with irreversible airway obstruction considered good candidates for pulmonary rehabilitation?
A) 75%
B) 80%
C) 60%
D) 70%
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Q1) A home care patient on transtracheal O<sub>2</sub> therapy at 0.5 L/min frantically calls you, unable to reinsert the catheter after cleaning. What would you recommend?
A) Use a clean, pointed instrument to guide catheter reinsertion.
B) Put on a nasal cannula at 1 L/min and call the physician.
C) Insert the catheter into the nasal cavity approximately 3 to 4 in.
D) Insert the catheter into the oral cavity.
Q2) In which of the following situations would you recommend that more than one ventilator be provided for a home care patient?
1) If the patient cannot maintain spontaneous ventilation for at least 1 hr
2) If the patient's care plan requires mechanical ventilation during mobility
3) If a replacement ventilator cannot be secured within 2 hr
A)1 and 2 only
B)2 and 3 only
C)1 and 3 only
D)1, 2, and 3
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