Respiratory Care Anatomy and Physiology Practice
Questions
Course Introduction
This course provides a comprehensive overview of the anatomical structures and physiological functions of the respiratory system, with an emphasis on clinical relevance for respiratory care practitioners. Topics include the structure and function of the airways, lungs, and thoracic cavity; mechanisms of breathing; gas exchange and transport; and the regulatory processes involved in respiration. Students will explore the integration of respiratory anatomy and physiology with other body systems to understand normal and altered respiratory functions, laying the foundation for assessment and intervention in respiratory care.
Recommended Textbook
Respiratory Care Anatomy and Physiology Foundations for Clinical Practice 3rd Edition by Will Beachey
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Chapter 1: The Airways and Alveoli
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Sample Questions
Q1) If the delicate balance between mucus water content and airway humidity is affected, which of the following will occur to the mucus sheet?
I.It may become dehydrated.
II.It may become thick.
III.It may become immobile.
IV.It may become infected.
A) II, IV
B) I, II, III
C) II, III
D) I, II, III, IV
Answer: C
Q2) Which of the following is the term that describes a volume of gas that is approximately 150 mL in the average adult and does not participate in gas exchange?
A) Tidal volume
B) Residual volume
C) Anatomical dead space
D) Shunt
Answer: C
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Chapter 2: The Lungs and Chest Wall
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Sample Questions
Q1) Which of the following are explanations for the left hemidiaphragmatic surface being slightly lower than the right?
I.The heart rests on the left half of the diaphragm, pushing it downward.
II.The presence of air in the stomach acts as a vacuum, pulling the diaphragm downward.
III.The liver, directly below the right half of the diaphragm, props up this area.
A) I, II
B) III
C) I, II, III
D) I, III
Answer: D
Q2) What is the term that describes the presence of fluid in the pleural space as a result of inflammation?
A) Pleural effusion
B) Thoracentesis
C) Pleural rub
D) Pneumothorax
Answer: A
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Chapter 3: Mechanics of Ventilation
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Sample Questions
Q1) The respiratory system equation of motion is the theoretical basis for what kind of mechanical ventilation?
A) Inverse ratio ventilation
B) Proportional assist ventilation
C) High-frequency ventilation
D) Negative pressure ventilation
Answer: B
Q2) With normal values for total compliance (0.1 L/cm H<sub>2</sub>O) and Raw (1.0 cm H<sub>2</sub>O/L/sec), one TC should be approximately:
A) 0.1 sec
B)0.2 sec
C)0.3 sec
D)0.4 sec
Answer: A
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Chapter 4: Ventilation
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Sample Questions
Q1) What is the approximate amount of anatomical dead space in normal adults?
A) 1 mL/pound IBW
B) 2 mL/pound IBW
C) 3 mL/pound IBW
D) 4 mL/pound IBW
Q2) Which of the following terms defines the conducting airways from the mouth and nose down to and including terminal bronchioles?
A) Physiological dead space
B) Anatomical dead space
C) Anatomical tidal volume
D) Gas exchange units
Q3) Which technique allows a more precise measurement of V<sub>Danat</sub>?
A) Dubowitz
B) Ballard's
C) Boyle's
D) Fowler
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Chapter 5: Pulmonary Function Measurements
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Sample Questions
Q1) Which of the following values indicates significant airway obstruction?
A) FEV<sub>1</sub>/FVC < 85%
B) FEV<sub>1</sub>/FVC < 80%
C) FEV<sub>1</sub>/FVC < 75%
D) FEV<sub>1</sub>/FVC < 65%
Q2) Which of the following mechanisms primarily explains the increased WOB in restrictive diseases?
A) Loss of elastance
B) Increased airway resistance
C) Loss of compliance
D) Increased airflow
Q3) Which of the following tests is considered the most sensitive for early detection of abnormal small airways resistance?
A) FEF<sub>25-75%</sub>
B) Frequency dependence of compliance
C) Closing volume
D) Low-density gas spirometry
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Chapter 6: Pulmonary Blood Flow
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Sample Questions
Q1) In which of the following conditions is the HPV response often diminished?
I.Smoke inhalation
II.ARDS
III.Emphysema
IV.Sepsis
A) I, III, IV
B) II, III, IV
C) I, II, IV
D) I, II, III, IV
Q2) Which of the following is the most important chemical factor causing pulmonary vasoconstriction?
A) Alveolar hypoxia
B) Tissular hypoxia
C) Acidosis
D) Hypercapnia
Q3) What would happen to PCWP in a patient with a stenotic mitral valve?
A) Increase
B) Decrease
C) Remain unchanged
D) Decrease only during cardiac systole
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Chapter 7: Gas Diffusion
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Sample Questions
Q1) Diffusion of which of the following gases will be limited by a defective alveolar capillary membrane?
A) O<sub>2</sub>
B) CO<sub>2</sub>
C) NO<sub>2</sub>
D) N<sub>2</sub>O
Q2) The D<sub>L</sub>CO<sub>sb</sub> is useful in differentiating emphysema from what other obstructive disease?
A) Asthma
B) Pneumonia
C) ARDS
D) Bronchiectasis
Q3) When are patients with thickened alveolar capillary membranes most likely to show evidence of oxygen diffusion impairment?
A) In supine position
B) In prone position
C) During exercise
D) In any position at rest
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9
Chapter 8: Oxygen Equilibrium and Transport
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Sample Questions
Q1) Which of the following conditions is an example of hypoxemia with cyanosis?
A) CO inhalation
B) Severe anemia
C) Polycythemia
D) Elevated carboxyhemoglobin
Q2) Under resting conditions, what percentage of the arterial oxygen content is extracted by the tissues?
A) 25%
B) 50%
C) 75%
D) 100%
Q3) How many times the body tissues' resting requirement is oxygen delivery?
A) Two times
B) Three times
C) Four times
D) Five times
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Chapter 9: Carbon Dioxide Equilibrium and Transport
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Sample Questions
Q1) Which of the following statements are true of CO<sub>2</sub>?
I.Most CO<sub>2</sub> diffusing into the blood from tissue cells enters the erythrocyte.
II.The rate of reaction between CO<sub>2</sub> and H<sub>2</sub>O in the RBC is quite slow.
III.The amount of CO<sub>2</sub> carried as H<sub>2</sub>CO<sub>3</sub> in the RBC is quite small.
IV.The rate of reaction between CO<sub>2</sub> and H<sub>2</sub>O in the RBC is quite fast.
A) II, III, IV
B) I, II, III, IV
C) I, IV
D) I, II, III
Q2) The affinity of hemoglobin for CO<sub>2</sub> is greater when it is not combined with oxygen.What is the name of this phenomenon?
A) Bohr effect
B) Haldane effect
C) Fick effect
D) Reynold effect
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Chapter 10: Acid-Base Regulation
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Sample Questions
Q1) What is the function of buffers?
A) They force H<sup>+</sup> to go inside the cell.
B) They readily combine with HCO<sub>3</sub><sup>-</sup>, removing H<sup>+</sup> from solution.
C) They readily combine with H<sup>+ </sup>ions, removing them from solution.
D) They increase the HCO<sub>3</sub><sup>-</sup> concentration in plasma.
Q2) What is the pH of a chemically neutral solution?
A) 6.5
B) 7.0
C) 7.5
D) 8.0
Q3) Which of the following nonbicarbonate buffers is the most important?
A) Hb
B) HCO<sub>3</sub><sup>-</sup>
C) Organic phosphates
D) Plasma proteins
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Chapter 11: Control of Ventilation
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Sample Questions
Q1) Which of the following describes Biot's breathing?
A) Tidal volume gradually increases and then gradually decreases to complete apnea without changes in respiratory rate. Then the tidal volume gradually increases again.
B) The respiratory rate and tidal volume gradually increase and then gradually decrease to complete apnea. Then the tidal volume and breathing frequency gradually increase again.
C) The respiratory rate gradually increases and then gradually decreases to complete apnea but tidal volume has essentially the same depth. Then the breathing frequency gradually increases again.
D) Tidal volume gradually decreases to complete apnea. Then the tidal volume gradually increases again, repeating the cycle.
Q2) Which of the following conditions produces the strongest stimulation of the J-receptors?
A) Pneumonia
B) Pneumothorax
C) Pleural effusion
D) Lung cancer
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Chapter 12: Ventilation-Perfusion Relationships
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Sample Questions
Q1) Which of the following is the definition of absolute shunt?
A) When ventilation gradually decreases to zero with no change in blood flow
B) When ventilation gradually increases with no change in blood flow
C) When ventilation gradually increases with a corresponding change in blood flow
D) When ventilation gradually decreases to zero with an associated decrease in blood flow
Q2) What are the major characteristics of increased alveolar dead space?
I.Pulmonary embolism
II.Increased work of breathing
III.Retractions
IV. \( \dot{v} \)<sub>E</sub> out of proportion with the PaCO<sub>2</sub>
A) I, II
B) II, IV
C) I, II, III, IV
D) II, III
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14
Chapter 13: Clinical Assessment of Acid-Base and Oxygenation Status
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Sample Questions
Q1) What is the interpretation of a blood gas that shows a low PaCO<sub>2</sub>, a low [HCO<sub>3</sub><sup>-</sup>], and an alkaline pH?
A) Uncompensated respiratory acidosis
B) Partially compensated respiratory alkalosis
C) Uncompensated metabolic alkalosis
D) Partially compensated metabolic alkalosis
Q2) What will be the expected pH if the PaCO<sub>2</sub> is 50 mm Hg in the presence of a normal metabolic status?
A)7.0
B)7.24
C)7.30
D)7.34
Q3) What is the most common clinical condition associated with respiratory acidosis?
A) Pneumonia
B) ARDS
C) Asthma
D) COPD
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Page 15
Chapter 14: Physiological Basis for Oxygenation and Lung Protection Strategies
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Sample Questions
Q1) What is the level of PaO<sub>2</sub> set as a goal for oxygen therapy in the healthy adult?
A) At least 50 mm Hg
B) At least 60 mm Hg
C) At least 70 mm Hg
D) At least 80 mm Hg
Q2) Which of the following are characteristics of ALI?
I.PaO<sub>2</sub>/FIO<sub>2</sub> < 200 mm Hg
II.Alveolar-capillary membrane injury
III.Widespread atelectasis
IV.Low compliance
A) I, II, III
B) II, III, IV
C) I, II, III, IV
D) II, III
Q3) What is the major difference between CPAP and PEEP?
A) Airway pressure does not rise during inspiration with CPAP.
B) Airway pressure does not rise during inspiration with PEEP.
C) Airway pressure does not rise during expiration with CPAP.
Page 16
D) Airway pressure does not rise during expiration with PEEP.
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Chapter 15: Physiology of Sleep Disordered Breathing
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Sample Questions
Q1) Which of the following risk factors are associated with worsening of OSA?
I.BMI 25
II.Alcohol ingestion before bedtime
III.Smoking
IV.Diabetes
A) I, II, IV
B) I, II, III
C) I, II, III, IV
D) II, III, IV
Q2) EEG tracings during REM typically reflect the level of brain activity seen in which state?
A) Stage 1 NREM
B) REM
C) Stage 2 NREM
D) Awake
Q3) Which of the following is the most vulnerable position for the patient with OSA?
A) Prone
B) Supine
C) Side
D) Fowler's
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Chapter 16: Fetal and Newborn Cardiopulmonary Physiology
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Sample Questions
Q1) Which of the following conditions decreases an infant's ability to generate heat?
I.Hyperglycemia
II.Hypoxia
III.Acidosis
IV.Hypoglycemia
A) I, II, III
B) II, III, IV
C) I, II, III, IV
D) II, IV
Q2) A premature baby is potentially capable of breathing and may survive with intensive medical care at how many weeks of gestation?
A) 18 weeks
B) 20 weeks
C) 24 weeks
D) 32 weeks
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Page 18
Chapter 17: Functional Anatomy of the Cardiovascular System
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Sample Questions
Q1) Which of the following are consistent with the definition of hypertension?
I.Diastolic pressure of approximately 90 mm Hg
II.Diastolic pressure of 80 mm Hg and systolic pressure of 130 mm Hg
III.Mean arterial pressure greater than 110 mm Hg at rest
IV.Systolic pressure of approximately 135 to 140 mm Hg
A) III, IV
B) I, III, IV
C) I, II, IV
D) I, II, III, IV
Q2) What is the explanation for using two times the diastolic pressure to calculate the MAP?
A) The diastolic pressure is half the systolic pressure.
B) The diastolic pressure is twice the mean systolic pressure.
C) The heart spends two-thirds of the cardiac cycle in diastole.
D) The diastolic pressure is less than half the systolic pressure
Q3) Which of the following is the main type of adrenergic receptor in the heart?
A)
B) <sub>1</sub>
C) <sub>2</sub>
D) Nicotinic
Page 19
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Chapter 18: Cardiac Electrophysiology
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Sample Questions
Q1) In which of the following clinical conditions are calcium channel blockers indicated?
A) Coronary artery disease
B) Hypotension
C) Asthma
D) Congestive heart failure
Q2) Which of the following are known effects of catecholamines?
I.They increase the influx of Ca<sup>++</sup> into the myocardial cell during the plateau phase of the action potential.
II.They activate beta receptors in the cardiac cell membrane.
III.They raise intracellular levels of cyclic AMP.
IV.They raise intracellular levels of cyclic GMP.
A) I, II
B) III, IV
C) I, II, III, IV
D) I, II, III
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20
Chapter 19: The Electrocardiogram and Cardiac Arrhythmias In Adults
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Sample Questions
Q1) Which of the following limb leads are unipolar?
I.Leads aVR, aVL, aVF
II.Leads V<sub>1</sub>, V<sub>2</sub>, V<sub>3</sub>
III.Leads V<sub>4</sub>, V<sub>5</sub>, V<sub>6</sub>
IV.Leads I, II, III
A) I
B) II, III
C) IV
D) I, IV
Q2) Atrial depolarization is represented by which of the following waves in the ECG?
A) P
B) QRS
C) T
D) U
Q3) What is considered the hallmark of atrial fibrillation?
A) Regular ventricular rhythm accompanied by f waves
B) Totally irregular ventricular rhythm accompanied by flutter waves
C) Totally irregular auricular rhythm accompanied by normal QRS waves
D) Totally irregular ventricular rhythm accompanied by f waves
Page 21
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Chapter 20: Control of Cardiac Output and Hemodynamic
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Sample Questions
Q1) When the balloon-tipped catheter wedges in a small pulmonary arteriole, the blood pressure measured through the distal lumen is approximately the same as which of the following?
A) Right atrium
B) Right ventricle
C) Left atrium
D) Left ventricle
Q2) What is considered the hallmark of cardiac contractility?
A) Preload pressure
B) Afterload pressure
C) Mean arterial blood pressure
D) Conduction rate
Q3) A PCWP > 18 mm Hg and a CI < 2.2 L/min/m² is consistent with which of the following conditions?
A) Left ventricular failure
B) Blood volume loss
C) Pulmonary edema
D) Peripheral hypoperfusion
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22
Chapter 21: Filtration, Urine Formation, and Fluid Regulation
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Q1) Which of the following substances, when excessive, does the nephron clear from the plasma?
I.Sodium
II.Potassium
III.Chloride
IV.Calcium
A) I, II, III
B) III, IV
C) I, II, III, IV
D) II, III, IV
Q2) Which of the following substances is secreted at the juxtaglomerular apparatus when systemic blood pressure decreases?
A) Renin
B) Angiotensin
C) Aldosterone
D) Vasopressin
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23
Chapter 22: Electrolyte and Acid-Base Regulation
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Q1) Which of the following parts of the nephron does not actively secrete H<sup>+</sup>?
A) Proximal tubule
B) Distal tubule
C) Thick segment of the loop of Henle
D) Thin segment of the loop of Henle
Q2) Primary active transport accounts for what percentage of sodium reabsorption?
A) 50%
B) 60%
C) 70%
D) 80%
Q3) What is the normal range for creatinine?
A)0.6 to 1.2 mg/Dl
B)1.2 to 2.4 mg/dL
C)2.4 to 3.6 mg/dL
D)3.6 to 4.8 mg/dL
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Chapter 23: Cardiopulmonary Response to Exercise in
Health and Disease
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Sample Questions
Q1) Which of the following is the major ventilatory limiting factor in severely obstructed individuals?
A) Inability to eliminate carbon dioxide
B) Inability to make oxygen available to the tissues
C) Inability to reach ventilation limits
D) Inability to increase HbO<sub>2</sub>
Q2) Which of the following are the major energy sources for ATP synthesis?
I.Carbohydrates
II.Fats
III.Amino acids
IV.Proteins
A) I, II, IV
B) III, IV
C) I, II, III, IV
D) II, III
Q3) The VD/VT falls to approximately what level during exercise?
A)0.3 to 0.4
B)0.2 to 0.3
C)0.15 to 0.2
D)0.05 to 0.1
25
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Chapter 24: Aging and the Cardiopulmonary System
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Q1) Which of the following is the best explanation for the reduction in heart rate with aging?
A) Decrease in valvular function
B) Decline in ventricular filling
C) Decline in atrial filling
D) Reduction of sinus node pacemaker cells
Q2) Which of the following are the major age-related impairments seen in the cardiovascular system?
I.Increased vascular resistance
II.Reduced response to beta-adrenergic stimulation
III.Hampered ventricular relaxation
IV.Decreased vascular resistance
A) I, II, III
B) II, III, IV
C) I, III
D) I, IV
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