Respiratory Care Fundamentals
Textbook Exam Questions
Course Introduction
Respiratory Care Fundamentals introduces students to the essential principles and practices involved in the field of respiratory therapy. The course covers the anatomy and physiology of the respiratory system, the basics of pulmonary function, and common respiratory diseases and disorders. Students learn about the assessment and monitoring of patients with respiratory issues, including the use of medical equipment such as oxygen delivery systems, ventilators, and airway management devices. The course also emphasizes infection control, patient safety, and the foundational skills necessary for effective patient care in clinical and non-clinical settings, preparing students for further study and hands-on experience in respiratory care.
Recommended Textbook
Egans Fundamentals of Respiratory Care 9th Edition by Robert M. Kacmarek
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Chapter 1: History of Respiratory Care
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Sample Questions
Q1) Who was the first scientist in 1865 to suggest that many diseases were caused by microorganisms?
A)Thomas Young
B)Louis Pasteur
C)Henry Graham
D)Robert Koch
Answer: B
Q2) When was the first Ventimask introduced that allows the precise delivery of 24%, 28%, 35%, and 40% oxygen?
A)1945
B)1954
C)1960
D)1972
Answer: C
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Chapter 2: Quality and Evidence-Based Respiratory Care
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Sample Questions
Q1) Which of the following factors is important in determining the quality of care delivered by a respiratory therapist?
A)education
B)experience
C)training
D)all the above
E)none of the above
Answer: D
Q2) Respiratory care plans may be monitored by which of the following?
A)experienced care plan auditors
B)computerized case study exercises
C)patient scenarios
D)comparison of therapist's patient assessment with the department's "gold standard" assessment
E)all the above
Answer: E
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Chapter 3: Patient Safety, Communication, and Record Keeping
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Sample Questions
Q1) Which of the following parameters should be monitored during ambulation?
A)skin color
B)breathing rate and effort
C)level of consciousness
D)all the above
Answer: D
Q2) All of the following techniques can be used to improve one's effectiveness as a sender of messages except:
A)share information rather than telling
B)emphasize agreement over disagreement
C)eliminate threatening behavior
D)use effective nonverbal communication
Answer: B
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Page 5
Chapter 4: Principles of Infection Control
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Sample Questions
Q1) What techniques are used by most hospitals to reduce host susceptibility to infection?
A)immunization
B)chemoprophylaxis
C)surveillance
D)both A and B
Q2) Exposure to which of the following organisms calls for postexposure chemoprophylaxis?
A) N. meningitides
B) B. pertussis
C) B. anthracis
D) all the above
Q3) Which of the following diseases is transmitted primarily by airborne transmission?
A)tuberculosis
B)measles
C)smallpox
D)all the above
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6
Chapter 5: Ethical and Legal Implications of Practice
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Sample Questions
Q1) All of the following sanctions can apply when one breaks a law except:
A)reparations or fines
B)incarceration
C)licensure suspension
D)professional censure
Q2) A respiratory therapist who engages in a questionable business practice is committing what type of malpractice?
A)civil
B)statutory
C)criminal
D)ethical
Q3) What conditions are necessary to incur liability under the doctrine of respondeat superior?
I.The injury caused must be the result of an act of negligence.
II.The act must occur within the subordinate's scope of employment.
III.The act must involve willful intent on the part of the subordinate.
A)I and II
B)II and III
C)I, II, and III
D)I and III
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Chapter 6: Physical Principles of Respiratory Care
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Sample Questions
Q1) Which of the following factors determine how much of a given gas can dissolve in a liquid?
I.solubility coefficient of the gas
II.temperature of the liquid
III.gas pressure above the liquid
A)II and III
B)I and II
C)I and III
D)I, II, and III
Q2) Under conditions of turbulent flow, what is the driving pressure?
A)proportional to the square of the flow
B)inversely proportional to the flow
C)linearly proportional to the flow
D)inversely proportional to the density
Q3) What is the internal force that opposes the flow of fluids (equivalent to friction between solid substances)?
A)conductivity
B)kinetic energy
C)viscosity
D)density
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Chapter 7: Computer Applications in Respiratory Care
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Sample Questions
Q1) Which of the following patients would benefit the most from a disease management program?
A)patient with pneumonia
B)patient with a sinus infection
C)patient with hay fever
D)patient with COPD
Q2) 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
Q3) In what area are computers used to apply quality assurance measures in respiratory care departments?
A)arterial blood gas analyzers
B)oxygen delivery systems
C)interpreting ECGs
D)equipment cleaning and sterilization
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9
Chapter 8: The Respiratory System
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Sample Questions
Q1) What is the primary purpose of the respiratory system?
A)continuous absorption of oxygen and excretion of carbon dioxide
B)filtering to prevent allergens and microbes from reaching the lungs
C)transport oxygenated blood to the tissues
D)warm and humidify inspired gas
Q2) Developmental morphogenesis of the human respiratory system can be categorized into:
A)three periods
B)five stages
C)6 weeks
D)40 weeks
Q3) What factor contributes to increased likelihood of an upper airway obstruction in an infant compared to an adult?
A)higher percentage of body fat
B)higher volumes of sinus discharge
C)relatively smaller head size
D)tongue that is proportionally larger
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10
Chapter 9: The Cardiovascular System
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Sample Questions
Q1) Tissue layers making up the heart wall include which of the following?
I.endocardium
II.epicardium
III.myocardium
A)I, II, and III
B)II and III
C)II only
D)I and III
Q2) What makes it impossible for myocardium to go into tetany?
A)absolute refractory period
B)automaticity
C)cardiac myofibrils
D)intercalated discs
Q3) During blood loss due to hemorrhage, perfusing pressures can be kept near normal until the volume loss overwhelms the system. Why is this so?
A)Arteries constrict, increasing vascular resistance.
B)Arterioles dilate, decreasing vascular capacity.
C)Muscle vessels dilate, increasing vascular capacity.
D)Venules constrict, decreasing vascular capacity.
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Page 11
Chapter 10: Ventilation
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Sample Questions
Q1) How can the body effectively compensate for an increased V<sub>Dphy</sub>?
A)decreased drive to breath
B)decreased respiratory rate
C)increased respiratory rate
D)increased tidal volume
Q2) Normal Raw is approximately which of the following?
A)0.1 to 0.2 cm H<sub>2</sub>O/L/sec
B)0.5 to 2.5 cm H<sub>2</sub>O/L/sec
C)15.0 to 20.0 cm H<sub>2</sub>O/L/sec
D)20.0 to 25.0 cm H<sub>2</sub>O/L/sec
Q3) In patients with small-airway disease breathing at higher than normal frequencies, what will NOT happen?
A)Dynamic compliance drops.
B)Oxygen consumption decreases.
C)The distribution of ventilation worsens.
D)The work of breathing increases.
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Page 12
Chapter 11: Gas Exchange and Transport
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Sample Questions
Q1) What is the primary factor that maintains the pressure gradient that drives oxygen from the capillaries into the interstitial spaces and into the cells?
A)Bohr effect on the RBC
B)cellular consumption of oxygen
C)Haldane effect on the RBC
D)increased carbon dioxide in blood decreases Hb affinity for oxygen
Q2) What is the highest PAO<sub>2</sub> one could expect to observe in an individual breathing room air at sea level?
A)90 to 100 mm Hg
B)110 to 120 mm Hg
C)640 to 670 mm Hg
D)710 to 760 mm Hg
Q3) What role does the Bohr effect play in oxygen transport?
A)describes the affect of varying enzyme levels on Hb and oxygen affinity
B)diminishes tissue oxygenation due to electrolyte imbalances
C)enhances oxygen delivery to tissues and oxygen pickup at lungs
D)explains the affect that oxygen levels have on carbon dioxide transport
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Chapter 12: Solutions, Body Fluids, and Electrolytes
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Sample Questions
Q1) Where does ammonia play its most important role as a base buffer?
A)kidney
B)liver
C)lung
D)vasculature
Q2) Clinical symptoms of hyponatremia would NOT include which of the following?
A)headache
B)bradycardia
C)lassitude
D)weakness
Q3) What is the most prominent anion in the body?
A)Cl<sup>-</sup>
B)HCO<sub>3</sub><sup>-</sup>
C)phosphate
D)sulfate
Q4) What is the normal serum calcium concentration?
A)4.5 to 5.3 mg/dl.
B)8.7 to 10.4 mg/dl
C)98.0 to 105.0 mg/dl
D)137 to 147 mg/dl
14
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Chapter 13: Acid-Base Balance
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Sample Questions
Q1) Which of the following acts as the "first-line" or immediate defense against the accumulation of H<sup>+</sup> ions?
A)blood buffer systems
B)GI tract
C)renal system
D)respiratory system
Q2) Correction of acute respiratory acidosis is accomplished by which of the following?
A)increasing HCO<sub>3</sub><sup>-</sup>reabsorption
B)increasing alveolar ventilation
C)decreasing HCO<sub>3</sub><sup>-</sup>reabsorption
D)decreasing alveolar ventilation
Q3) An ABG result shows pH of 7.35, PaCO<sub>2</sub> of 30 mm Hg, and HCO<sub>3</sub><sup>-</sup>of 18 mEq/L. Which of the following is the patient's most likely primary disorder?
A)metabolic acidosis
B)metabolic alkalosis
C)respiratory acidosis
D)respiratory alkalosis
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Page 15
Chapter 14: Regulation of Breathing
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Sample Questions
Q1) Biot's respiration is most frequently observed in patients with which of the following?
A)congestive heart failure
B)increased intracranial pressure
C)metabolic acidosis
D)peripheral nerve disorders
Q2) The medulla oblongata contains which of the following areas?
I.apneustic center
II.dorsal respiratory group neurons (DRGs)III.pneumotaxic center
IV.ventral respiratory group neurons (VRGs)
A)I, II, and III
B)II and IV
C)III only
D)I, II, III, and IV
Q3) What receptors are associated with causing coughing, sneezing, and tachypnea when stimulated?
A)irritant receptors
B)J receptors
C)muscle spindles
D)peripheral proprioceptor
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Page 16
Chapter 15: Bedside Assessment of the Patient
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Sample Questions
Q1) Which of the following is the least likely cause of lymphadenopathy in the neck?
A)lymphoma
B)pulmonary infection
C)congestive heart failure
D)lung cancer
Q2) While observing a patient's breathing, you note that the depth and rate first increase, then decrease, followed by a period of apnea. Which of the following are potential causes of this abnormality?
I.central nervous system disorder
II.congestive heart failure
III.metabolic acidosis
A)I and II
B)II and III
C)I and III
D)I, II, and III
Q3) What is indicated by the presence of central cyanosis?
A)respiratory failure
B)circulatory failure
C)anemia
D)hypotension
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Chapter 16: Interpretation of Clinical Laboratory Data
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Sample Questions
Q1) What term is used to describe a white blood cell (WBC) count that is above normal values?
A)leukocytosis
B)leukopenia
C)neutropenia
D)polycythemia
Q2) Which of the following is NOT one of the formed elements in the blood?
A)leukocytes
B)erythrocytes
C)thrombocytes
D)electrolytes
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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18
Chapter 17: Interpreting the Electrocardiogram
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Sample Questions
Q1) At what part of the cardiac conduction system does the electrical impulse travel most rapidly?
A)bundle of His
B)bundle branches
C)intraatrial pathways
D)Purkinje fibers
Q2) What is the normal maximum length of the P wave?
A)1 mm
B)3 mm
C)5 mm
D)7 mm
Q3) Which of the following criteria applies to third-degree block?
A)There is no relationship between the P waves and the QRS complexes.
B)The PR interval becomes progressively longer.
C)The ventricular rate is twice that of the atrial rate.
D)The QRS complex is inverted compared to the P wave.
Q4) An occasional premature ventricular complex (PVC) is not of major concern.
A)True
B)False
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Chapter 18: Analysis and Monitoring of Gas Exchange
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Sample Questions
Q1) Statistically derived limits for internal quality control of blood gas samples are usually set at what appropriate level?
A)1 standard deviation from the mean
B)2 standard deviations from the mean
C)3 standard deviations from the mean
D)5 standard deviations from the mean
Q2) Which blood gas analyzer electrode uses a separate reference electrode?
A)O<sub>2</sub>
B)pH
C)Clark
D)HCO<sub>3</sub><sup>-</sup>
Q3) How does the Clark polarographic O<sub>2</sub> electrode function?
A)measures the magnetic properties of O<sub>2</sub> versus N<sub>2</sub>
B)measures the electrical potential across a Wheatstone bridge
C)uses O<sub>2</sub> to produce a reduction-oxidation reaction
D)measures the comparative cooling effect on a heated wire
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Chapter 19: Pulmonary Function Testing
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Sample Questions
Q1) How often should a spirometer in continual use undergo volumetric calibration?
A)every 4 hours
B)every shift
C)at least daily
D)weekly
Q2) While checking the accuracy of a portable spirometer for volumetric measures with a calibrated super syringe, you obtain a mean measured value of 2.7 L. What is the percent error of this instrument?
A)1%
B)10%
C)30%
D)90%
Q3) What pulmonary function test presents the highest risk for fainting?
A)slow vital capacity
B)tidal volume per minute
C)maximum voluntary ventilation
D)total lung capacity
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Chapter 20: A Review of Thoracic Imaging
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Q1) Which of the following is NOT true regarding the visualization of air bronchograms on the chest film?
A)They indicate fluid in the pleura.
B)They are caused by air-filled airways surrounded by consolidation.
C)They are the hallmark of alveolar consolidation.
D)They signify air space disease.
Q2) What is the most common cause of cephalization as seen on the upright chest film?
A)renal failure
B)left heart failure
C)hypoxemia
D)empyema
Q3) Which of the following is NOT a common radiographic finding seen in patients with volume loss due to atelectasis?
A)elevation of the hemidiaphragm
B)narrowing of the space between the ribs
C)increase in the retrosternal airspace
D)shift of the mediastinum
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22
Chapter 21: Nutrition Assessment
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Sample Questions
Q1) 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
Q2) Which of the following illnesses is NOT associated with acute catabolic disease?
A)trauma
B)sepsis
C)burns
D)pulmonary embolism
Q3) 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.
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Chapter 22: Pulmonary Infections
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Sample Questions
Q1) Rapidly spreading multilobar consolidation is typical for what type of pneumonia?
A)Klebsiella
B)Legionella
C)Pneumocystis jiroveci
D)Viral
Q2) Which of the following clinical conditions are often associated with a normal chest radiograph in the patient with pneumonia?
I.dehydration
II.early infection
III.Klebsiella pneumonia
IV.Pneumocystis jiroveci infection
A)I, II, and IV
B)II and III
C)I only
D)I, II, III, and IV
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24
Chapter 23: Obstructive Lung Disease: Copd, Asthma, and Related Diseases
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Sample Questions
Q1) What is the benefit of pulmonary rehabilitation in patients with moderate to severe COPD?
A)improves exercise tolerance
B)improves FEV<sub>1</sub>
C)improves lung function
D)improves survival
Q2) Which of the following medications is indicated for REGULAR use in patients with stable COPD?
A)antibiotics
B)\(\beta\)<sub>2</sub>-agonists
C)corticosteroids
D)methylxanthines
Q3) Which of the following signs associated with COPD is considered a late manifestation?
A)accessory muscle usage
B)frequent coughing
C)shortness of breath
D)wheezing
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Chapter 24: Interstitial Lung Disease
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Q1) The prognosis is much better for nonspecific interstitial pneumonitis (NSIP) than idiopathic pulmonary fibrosis (IPF).
A)True B)False
Q2) The disease seen in interstitial lung disease is primarily a/an _____ process.
A)airway constrictive
B)obstructive
C)restrictive
D)supralaryngeal
Q3) Your patient with interstitial lung disease (ILD) has hypoxemia during exertion and at rest. This implies the ILD may be in its early stages.
A)True B)False
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26
Chapter 25: 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) For which type of pneumothorax is pleurodesis most commonly indicated?
A)iatrogenic
B)bronchopleural fistula
C)spontaneous
D)traumatic
Q3) What agent has proved to be the most successful in pleurodesis?
A)mixture of saline and Mucomyst
B)acetaminophen in suspension
C)saline solution mixed with heparin
D)talc suspended in saline
Q4) Which of the following is NOT a typical complication of thoracentesis?
A)infection
B)intercostal artery laceration
C)rib fracture
D)pneumothorax
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Chapter 26: Pulmonary Vascular Disease
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Q1) What IV infusion has been found to improve exercise capacity, hemodynamic variables, and survival in patients with severe IPAH?
A)Bosentan
B)Epoprostenol
C)Methylprednisolone
D)Sildenafil
Q2) What are the two most common findings on the electrocardiogram (ECG) in the patient with pulmonary embolism?
A)bradycardia and elevated ST segment
B)inverted T waves and depressed ST segment
C)large P waves and inverted T waves
D)tachycardia and depressed ST segment
Q3) On average, how long does the diagnosis of idiopathic pulmonary artery hypertension (IPAH) follow the onset of the disease?
A)6 months
B)1 year
C)18 months
D)2 years
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28
Chapter 27: Acute Lung Injury, Pulmonary Edema, and Multiple System Organ
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Q1) Which of the following statements is true about prone-positioning of patients with ARDS?
A)It produces a transient improvement in gas exchange.
B)It dramatically reduces the mortality of patients with ARDS.
C)It does not require experienced staff.
D)It does not improve gas exchange at all.
Q2) Which of the following tests provides useful information in making the diagnosis of ARDS for patients with inconclusive results on traditional tests?
A)examination of bronchoalveolar lavage fluid (BALF)
B)measurement of mixed venous oxygen level
C)measurement of total white blood-cell count
D)ventilation/perfusion ratio ( \(\dot { V } / \dot { Q }\) ) scanning
Q3) What is the maximal inspiratory pressure that should be targeted when using pressure control ventilation in patients with ARDS?
A)20 to 25 cm H<sub>2</sub>O
B)25 to 30 cm H<sub>2</sub>O
C)30 to 35 cm H<sub>2</sub>O
D)35 to 40 cm H<sub>2</sub>O
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Chapter 28: Lung Cancer
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Q1) Which of the following is NOT a therapeutic option for patients with lung cancer?
A)surgical resection
B)radiotherapy
C)laser
D)chemotherapy
Q2) What is the treatment of choice for limited-stage small-cell lung cancer?
A)surgical resection
B)chemoradiotherapy
C)radiation therapy only
D)chemotherapy only
Q3) Apical growth may be associated with which of the following syndromes?
A)Goodpasture
B)Pancoast
C)Miller
D)granulomatosis
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30
Chapter 29: Neuromuscular and Other Diseases of the Chest Wall
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Q1) Which of the following would not be considered a common pulmonary consequence of neuromuscular disease?
A)sleep apnea
B)aspiration
C)cor pulmonale
D)pneumothorax
Q2) In what group of patients is myasthenia gravis most common?
A)older males
B)younger males
C)younger females
D)older females
Q3) What finding is associated with Duchenne's muscular dystrophy?
A)Lordosis
B)Drooping eyelids
C)Pedal edema
D)Hepatomegaly
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Chapter 30: Disorders of Sleep
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Q1) Patients with more severe levels of OSA usually need higher levels of CPAP to eliminate the apnea episodes.
A)True
B)False
Q2) Which of the following parameters is NOT typically monitored with a polysomnogram?
A)SaO<sub>2</sub>
B)electroencephalogram (EEG)
C)breathing effort
D)exhaled PCO<sub>2</sub>
Q3) Central sleep apnea occurs more often than obstructive sleep apnea.
A)True
B)False
Q4) Uvulopalatopharyngoplasty has a success rate of less than 50%.
A)True B)False
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Chapter 31: Neonatal and Pediatric Respiratory Disorders
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Q1) Which of the following should be done early in the treatment of the non-vigorous infant with meconium aspiration syndrome?
A)suctioning
B)mask CPAP
C)antibiotics
D)vasopressors
Q2) Mothers of infants with transient tachypnea tend to have longer labor intervals and a higher incidence of failure to progress in labor.
A)True
B)False
Q3) Which of the following blood gas alteration is usually seen in meconium aspiration syndrome?
A)hypoxemia and respiratory acidosis
B)hypoxemia and mixed respiratory and metabolic alkalosis
C)hypoxemia and normal acid-base balance
D)hypoxemia and mixed respiratory and metabolic acidosis
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Chapter 32: Airway Pharmacology
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Q1) Which of the following are TRUE regarding glucocorticoids?
I.They work through activation of intracellular receptors.
II.Relief is immediate.
III.Daily compliance is essential to controlling inflammation in asthma.
IV.They work in a similar fashion to adrenergic bronchodilators.
A)I and III
B)I, III, and IV
C)II, III, and IV
D)I, II, III, and IV
Q2) Which of the following is NOT an advantage for the treatment of the respiratory tract with inhaled aerosols?
A)Doses are usually smaller.
B)Onset of drug action is rapid.
C)Delivered dose is consistent with each administration.
D)Systemic side effects are often fewer and less severe.
Q3) Zileuton belongs to which of the following categories?
A)cromolyn-like agents
B)leukotriene modifiers
C)anti-IgE agents
D)anti-IgA agents
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Chapter 33: Airway Management
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Q1) A patient with a tracheostomy tube is receiving positive-pressure ventilation through a volume ventilator. Over the past 5 minutes, the peak inspiratory pressure has risen, and the pressure limit alarm is now sounding. On quick examination, you notice a generalized decreased in breath sounds. Which of the following problems is most likely?
A)partial obstruction of the tracheostomy tube
B)complete obstruction of the tracheostomy tube
C)development of a left-sided pneumothorax
D)obstruction of the left bronchus by a mucus plug
Q2) Therapeutic indications for fiberoptic bronchoscopy include which of the following?
I.inspect the airways
II.retrieve foreign bodies
III.obtain specimens for analysis
IV.aid endotracheal intubation
A)II and IV
B)III and IV
C)I, II, and III
D)I, II, III, and IV
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Chapter 34: Emergency Cardiovascular Life Support
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Q1) A patient is having frequent premature ventricular contractions and runs of ventricular tachycardia. Which of the following drugs would be considered for this patient?
I.procainamide
II.epinephrine HCl
III.isoproterenol HCl
IV.amiodarone
A)I, II, and III
B)II and IV
C)I and IV
D)I, II, III, and IV
Q2) Two prior attempts at defibrillation of an adult patient in ventricular fibrillation have been unsuccessful. At this time, what would you recommend?
A)Switch to synchronous countershock (cardioversion).
B)Apply subsequent shocks at 200 J.
C)Immediately deliver three to five precordial thumps.
D)Get larger paddles and apply more electrolyte gel.
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Chapter 35: Humidity and Bland Aerosol Therapy
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Q1) Clinical indications for delivering cool humidified gas include which of the following?
I.postextubation edema
II.upper airway inflammation
III.croup (laryngotracheal bronchitis)IV.epiglottitis
A)II, III, and IV
B)I, II, and III
C)I, II, III, and IV
D)II and III
Q2) What is the primary goal of humidity therapy?
A)decrease airway reactivity to cold
B)maintain normal physiologic conditions
C)deliver drugs to the airway
D)reduce upper airway inflammation
Q3) The greater the temperature of the gas, the:
A)more water vapor it can hold
B)less water vapor it can hold
C)less efficient the humidifier is
D)more water vapor is lost
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Chapter 36: Aerosol Drug Therapy
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Q1) To assess the effectiveness of a particular aerosol delivery device selection, what would you evaluate?
I.patient's technique in using the device
II.patient's response to and compliance with procedure
III.objective measures of improvement (e.g., peak flow)
A)I and II
B)II and III
C)I and III
D)I, II, and III
Q2) This problem of ribavirin (Virazole) aerosol precipitation causing malfunction of ventilator circuits can be overcome by which of the following?
I.Placing a one-way valve between the small-particle aerosol generator (SPAG) and the circuit
II.Placing a HEPA filter proximal to the exhalation valve
III.Decreasing the SPAG's total flow to below 10 L/min
A)I and II
B)I and III
C)II and III
D)I, II, and III
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Page 38
Chapter 37: Storage and Delivery of Medical Gases
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Q1) Why are zone valves incorporated into a hospital's central gas piping systems?
I.to terminate O<sub>2 </sub>delivery to an area in case of fire
II.to allow selective maintenance without shutting the system down III.to allow variable pressure reduction throughout the system
A)I and II
B)I and III
C)II and III
D)I, II, and III
Q2) You are preparing to conduct a complex transport of a patient receiving O<sub>2</sub>, and you expect to have to alter O<sub>2</sub> flows during the transport. Which of the following devices would best meet your needs?
A)uncompensated Thorpe tube
B)flow restrictor
C)compensated Thorpe tube
D)Bourdon gauge
Q3) Which of the following statements about He is false?
A)It is an inert gas.
B)It is odorless.
C)It is nonflammable.
D)It is heavier than air.
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Chapter 38: Medical Gas Therapy
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Q1) To prevent an adverse rebound effect when withdrawing NO therapy, what should you do?
I. Reduce the NO to the lowest effective dose (ideally, less than 5 ppm).
II. Hyperoxygenate the patient just before discontinuing NO.
III. Ensure that the patient is hemodynamically stable.
A)I and II
B)II and III
C)I and III
D)I, II, and III
Q2) Which of the following is FALSE about the simple O<sub>2</sub> mask?
A)It has no valving system or reservoir bag.
B)It can easily deliver high FIO<sub>2</sub> values (greater than 0.6 to 0.7)
C)It requires a minimal input flow of 5 L/min.
D)It functions as a variable-performance system.
Q3) What is the minimum flow setting for a simple mask applied to an adult?
A)3 L/min
B)5 L/min
C)8 L/min
D)10 L/min
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Chapter 39: Lung Expansion Therapy
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Q1) Incentive spirometry devices can generally be categorized as which of the following?
I.pressure-oriented
II.flow-oriented
III.volume-oriented
A)III
B)I and II
C)I, II, and III
D)II and III
Q2) Which of the following are appropriate initial settings for intermittent positive-pressure breathing given to a new patient?
A)sensitivity -2 cm H<sub>2</sub>O; pressure 20 to 25 cm H<sub>2</sub>O; high flow
B)sensitivity -3 to -4 cm H<sub>2</sub>O; pressure 5 to 10 cm H<sub>2</sub>O; moderate flow
C)sensitivity -1 to -2 cm H<sub>2</sub>O; pressure 10 to 15 cm H<sub>2</sub>O; moderate flow
D)sensitivity -8 cm H<sub>2</sub>O; pressure 15 cm H<sub>2</sub>O; moderate flow
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Chapter 40: Bronchial Hygiene Therapy
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Q1) Properly performed chest vibration is applied at what point?
A)throughout inspiration
B)at the end of expiration
C)at the start of inspiration
D)throughout expiration
Q2) Key considerations in initial and ongoing patient assessment for chest physical therapy include which of the following?
I.posture and muscle tone
II.breathing pattern and ability to cough
III.sputum production
IV.cardiovascular stability
A)I, II, and III
B)II and IV
C)I, II, III, and IV
D)III and IV
Q3) What does phase 1 of autogenic drainage involve?
A)breathing at low to mid-lung volumes
B)an inspiratory capacity maneuver, followed by breathing at low lung volumes
C)vigorous coughing using the FET
D)progressive breaths at higher and higher lung volumes
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Chapter 41: Respiratory Failure and the Need for Ventilatory Support
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Q1) A patient with interstitial lung disease who presents with hypoxemia due to diffusion defect would have which of the following clinical signs?
I.fine bibasilar crackles
II.clubbing of the finger nail beds
III.jugular venous distention
IV.increased P2
A)I and II
B)I, III, and IV
C)III and IV
D)I, II, III, and IV
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
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Chapter 42: Mechanical Ventilators
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Q1) Which of the following is true of the relationship between flow and volume?
I. Volume is the integral of flow.
II. Volume is the derivative of flow.
III. Flow is the derivative of volume.
A)I and II
B)I and III
C)II and III
D)I, II, and III
Q2) For which of the following uses might you consider the use of a purely pneumatically powered ventilator?
I.as a backup to electrically powered ventilators
II.when electrical device cannot be used (e.g., magnetic resonance imaging)III.during certain types of patient transport
A)I and II
B)I and III
C)II and III
D)I, II, and III
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Chapter 43: Physiology of Ventilatory Support
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Q1) Beneficial physiological effects of positive end-expiratory pressure (PEEP) include which of the following?
I.increased PaO<sub>2</sub> for given FIO<sub>2</sub>
II.increased lung compliance (C<sub>L</sub>)III.decreased shunt fraction
IV.increased functional residual capacity
A)I, II, III, and IV
B)III and IV
C)II, III, and IV
D)II and IV
Q2) In which of the following modes of ventilatory support would the patient's work of breathing be least?
A)continuous positive airway pressure (CPAP)
B)pressure-supported ventilation (PSV)
C)intermittent mandatory ventilation (IMV)
D)continuous mandatory ventilation (CMV)
Q3) Which of the following is considered a normal spontaneous tidal volume?
A)3 to 5 ml/kg
B)5 to 7 ml/kg
C)7 to 9 ml/kg
D)10 to 12 ml/kg
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Chapter 44: Initiating and Adjusting Ventilatory Support
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Q1) When adjusting a patient's oxygenation during mechanical ventilatory support, what should your goal be?
A)SaO<sub>2</sub> of 80% to 90%
B)PaO<sub>2</sub> of 100 to 150 mm Hg
C)SaO<sub>2 </sub>of 95% to 100%
D)PaO<sub>2 </sub>of 60 to 100 mm Hg
Q2) A patient suffering from postoperative complications has been receiving mechanical ventilation for 6 days with a volume ventilator. A heat-moisture exchanger (HME) is providing control over humidification and airway temperature. Over the past 24 hours, the patient's secretions have decreased in quantity but are thicker and more purulent. Which of the following actions would you suggest at this time?
A)Replace the HME.
B)Switch over to a heated wick humidifier.
C)Administer acetylcysteine every 2 hours via the nebulizer.
D)Increase the frequency of suctioning.
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Chapter 45: Noninvasive Positive Pressure Ventilation
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Q1) What is the best option for the patient in respiratory failure who continues to deteriorate 30 minutes after the initiation of noninvasive positive-pressure ventilation?
A)Wait another 30 minutes and monitor the patient.
B)Begin continuous positive airway pressure.
C)Intubate and begin mechanical ventilation.
D)Ventilate the patient using a bag-valve-mask.
Q2) Your patient is being ventilated with a nasal mask to relieve dyspnea. He has a long history of chronic obstructive pulmonary disease and hypercarbia. What is the goal of noninvasive positive-pressure ventilation in this setting with regard to the ABGs?
A)Return the PaCO<sub>2</sub> to 40 to 45 mm Hg.
B)Return the pH to near normal.
C)Return the PaCO<sub>2</sub> to less than 60 mm Hg.
D)Return the bicarbonate level to near normal.
Q3) Which of the following is required for noninvasive ventilators to work properly?
A)exhalation valve
B)pressure alarm
C)leak
D)blender
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Chapter 46: Monitoring and Management of the Patient in the
Intensive Care
Unit
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Q1) Which of the following does NOT lead to an increased end-tidal PCO<sub>2</sub>?
A)decreased effective ventilation
B)increased metabolic rate
C)decreased minute ventilation
D)exercise
Q2) Which of the following is NOT a global monitoring index?
A)APACHE
B)APS
C)TISS
D)ATS
Q3) What is the normal range for the percent of oxygen consumption consumed by the respiratory muscles?
A)2% to 5%
B)5% to 10%
C)10% to 15%
D)20% to 25%
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Chapter 47: Discontinuing Ventilatory Support
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Q1) Which of the following weaning methods provides the best respiratory muscle strength conditioning?
A)pressure-supported ventilation
B)T-tube
C)intermittent mandatory ventilation
D)volume-assured pressure support (VAPS)
Q2) With most ventilators that provide mandatory minute ventilation, what happens if the patient's minute ventilation falls below the preset level?
A)The frequency of mandatory breaths increases.
B)The level of pressure support increases.
C)The frequency of mandatory breaths decreases.
D)The machine delivers a series of sigh breaths.
Q3) What is the least reliable weaning index?
A)vital capacity (VC)
B)maximum inspiratory capacity (MIP)
C)minute ventilation (V<sub>E</sub>)
D)rapid-shallow breathing index (f/V<sub>T</sub>)
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Chapter 48: Neonatal and Pediatric Respiratory Care
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Q1) Which of the following mean airway pressures is considered potentially deleterious when applying positive airway pressure?
A)2 cm H<sub>2</sub>O
B)5 cm H<sub>2</sub>O
C)10 cm H<sub>2</sub>O
D)15 cm H<sub>2</sub>O
Q2) Temporary drops in the fetal heart rate during uterine contractions are known as: A)fetal stress
B)decelerations
C)primary apnea
D)secondary bradycardia
Q3) Which of the following is not an inclusion criterion for neonatal ECMO?
A)reversible lung disease
B)gestational age less than 35 weeks
C)pulmonary barotrauma
D)persistent acidosis
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Chapter 49: Patient Education and Health Promotion
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Q1) What type of information is associated with teaching in the affective domain?
A)motivation and attitude
B)tasks and skills
C)knowledge and facts
D)organization and definitions
Q2) Which of the following is used to evaluate the affective and psychomotor domains?
A)verbal exam
B)demonstration
C)written exam
D)performance checklist
Q3) Which of the following may be necessary with children before learning can take place?
A)television shows
B)patience
C)games
D)reward system
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Chapter 50: Cardiopulmonary Rehabilitation
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Q1) Which of the following elements should be considered in most pulmonary rehabilitation programs?
I.individual needs
II.patient's education
III.patient's personality
IV.patient's aptitudes
A)I, II, and III
B)II and IV
C)I, II, III, and IV
D)III and IV
Q2) The \(\dot { V }\) O<sub>2max</sub> at termination of exercise (as a percentage of the predicted) for five patients appears below. Which of these patients is the best candidate for pulmonary rehabilitation?
\(\begin{array}{ll}
\dot{V}&\mathrm{O}_{2 \max } \text { (predicted) }\\
\text { A. } & 65 \% \\
\text { B. } & 80 \% \\
\text { C. } & 90 \% \\
\text { D. } & 95 \%
\end{array}\)
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Page 52
Chapter 51: Respiratory Care in Alternative Settings
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Q1) What equipment function should lay caregivers of home mechanical ventilation assess regularly?
I.cleanliness and function of bag-valve-mask
II.internal and external battery power levels
III.cleanliness of filters and alarm functions
IV.accuracy of ventilator tidal volume (V<sub>T</sub>) output
A)I, II, and III
B)II and IV
C)I, II, III, and IV
D)III and IV
Q2) Emergency situations that home mechanical ventilation caregivers must be trained to recognize and manage include all of the following except:
A)ventilator or power failure
B)tension pneumothorax
C)artificial airway obstruction
D)ventilator circuit problems
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