Respiratory Care Practicum
Midterm Exam
Course Introduction
The Respiratory Care Practicum is a hands-on, clinical course designed to provide students with supervised practical experience in a variety of healthcare settings. Through direct patient care, students will apply theoretical knowledge and technical skills learned in previous coursework to assess, treat, and monitor patients with cardiopulmonary disorders. Emphasis is placed on developing proficiency in therapeutic procedures such as oxygen therapy, mechanical ventilation, airway management, and patient evaluation. The practicum fosters professional growth, critical thinking, and effective communication while preparing students for entry-level roles as respiratory care practitioners.
Recommended Textbook
Basic Clinical Lab Competencies for Respiratory Care An Integrated Approach 5th Edition by Gary
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Chapter 1: Basics of Asepsis
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Q1) Respiratory care equipment is usually _______ because it is too difficult and costly to keep it _______.
A)disinfected;aseptic
B)in standard precaution states;isolated
C)aseptic;sterile
D)isolated;aseptic
Answer: C
Q2) What is defined as the complete destruction of all forms of microorganisms?
A)Isolation
B)Standard precautions
C)Asepsis
D)Sterility
Answer: D
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Chapter 2: Basic Patient Assessment: Vital Signs and Breath
Sounds
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Q1) The practitioner places a sphygmomanometer on the patient's upper arm.The brachial artery is palpated and the cuff is inflated until the pulse disappears at 110 mmHg.How should this be recorded in the patient's chart?
A)This is the systolic pressure
B)This is the diastolic pressure
C)This is the pulse pressure
D)This is the intrathoracic pressure
Answer: A
Q2) Which breath sounds are heard above the clavicular notch,are very harsh and quite high-pitched,and have the expiratory phase lasting a little longer than the inspiratory phase?
A)Tracheal
B)Bronchial
C)Bronchovesicular
D)Vesicular
Answer: A
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Chapter 3: Advanced Patient Assessment: Inspection,
Palpation, and Percussion
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Q1) Which of the following would cause a tracheal shift toward the affected side of the chest?
I.Pleural effusion
II.Atelectasis
III.Pulmonary fibrosis
IV.Tension pneumothorax
A)III and IV
B)II only
C)I only
D)II and III
Answer: D
Q2) What is a congenital deformity of the sternum characterized by a depression in the sternum at the level of the lower body and xyphoid process?
A)Lordosis
B)Pectus excavatum
C)Kyphoscoliosis
D)Pectus carinatum
Answer: B
Page 5
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Chapter 4: Radiologic Assessment
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Q1) If the density of an object being x-rayed is great,_____________________.
A)penetration is high.
B)penetration is low.
C)then the x-rays are being absorbed by the object.
D)the energy is not admitted by the tube.
Q2) When the bronchus is seen surrounded by fluid-filled structures it creates a distinct separation between the regions of differing densities (air versus fluid).What is this called?
A)Air bronchograms
B)Subcutaneous emphysema
C)Consolidation
D)Hyperinflation
Q3) Which of the following materials is the least radiodense?
A)Air
B)Water
C)Fat
D)Bone
Q4) A patient with a bilateral hyperresonant percussion note has a chest x-ray taken.What would you expect to find on the chest x-ray?
Q5) What can be evaluated on a chest radiograph besides the heart and lungs?
Page 6
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Chapter 5: Pulmonary Function Testing
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Sample Questions
Q1) Respirometers are designed to operate between flows of _______________.
A)5% to 10%
B)3 to 300 LPM
C)60 to 100 LPM
D)50 to 1000 LPM
Q2) Patient cooperation must be elicited for the best pulmonary function test results.How would the technician elicit the best cooperation and test results from the patient?
Q3) Which of the following would be used to measure a patient's tidal volume and minute volume?
A)Peak flowmeter
B)Manometer
C)Respirometer
D)Mini-Wright device
Q4) Why are three pulmonary function test trials performed for simple spirometry and flow volume loops and how should the results be reported?
Q5) A patient comes to the PFT lab to get an annual pulmonary function test.What factors would cause changes in the results from year to year?
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Chapter 6: Electrocardiography
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Q1) Which of the following waves in an ECG tracing represents ventricular repolarization?
A)'P' wave
B)'QRS' complex
C)'T' wave
D)'U' wave
Q2) When looking at the ECG graph paper,you notice the 'P-R' interval is exactly the same distance of one of the larger squares.What is this distance?
A)1 millivolt
B)1 second
C)0.04 seconds
D)0.20 seconds
Q3) An extremely obese patient is to ordered to have an EKG.What problems could be encountered and how should they be approached?
Q4) What lead is placed at the 5th intercostal space,anterior axillary line?
A)V3
B)V4
C)V5
D)V6
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Chapter 7: Phlebotomy
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Sample Questions
Q1) If a blood spill occurs,what is the first thing you should do?
A)Notify environmental service to clean up the spill
B)Clean it up thoroughly with proper materials
C)Contain the spill by blocking off the area
D)Notify the supervisor to find the location of the environmental control procedure
Q2) Which of the following would NOT make the patient's veins distend and make blood drawing easier?
A)Apply a tourniquet
B)Use the proper vacuum collection container
C)Place the patient's extremity in a dependent position
D)Have the patient clench his/her fist
Q3) Which of following is the best way to confirm the patient's identity?
A)Checking the order in the chart
B)Asking the nurse or other health care worker
C)Ask the patient
D)Check the patient's name band
Q4) A tourniquet can be used to enhance vein distension to ease the location of a good vein for a venous draw.What would happen if the tourniquet were left on too long?
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Chapter 8: Arterial Blood Gas Sampling
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Sample Questions
Q1) Hyperventilation may lower the patient's ___________
A)PaCO .
B)anxiety.
C)pH.
D)PaO .
Q2) A delay of more than 30 minutes in analyzing an arterial blood gas sample,even if it is iced,would have what effect on the blood gas values?
A)Higher PO ,higher PC02,lower pH
B)Lower PO ,lower PC02,higher pH
C)Lower PO ,higher PCO ,higher pH
D)Lower PO ,higher PCO ,lower pH
Q3) If a blood gas sample cannot be analyzed immediately and the sample is not iced,how much time can elapse before blood gas samples will start to change due to further metabolism of the blood dramatically?
A)5 minutes
B)15 minutes
C)25 minutes
D)35 minutes
Q4) What should the practitioner teach the patient concerning an arterial line?
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Chapter 9: Hemodynamic Monitoring
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Q1) What are the most commonly used veins or arteries for the insertion of a central venous catheter?
I.Antecubital fossa
II.Basilic vein
III.Internal jugular vein
IV.Subclavian vein
A)I,II,III,and IV
B)III and IV
C)I and II
D)I,III,and IV
Q2) Which catheter is a 'flow directed' catheter?
A)Central venous catheter
B)Pulmonary artery catheter
C)Radial artery catheter
D)a and b
Q3) When should the pulmonary artery pressure be measured?
A)Measured at end diastole
B)Measured during systole
C)Measured at end exhalation
D)Measured during a premature ventricular contraction
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Chapter 10: Noninvasive Monitoring
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Q1) Which of the following areas of the body can be used as probes sites for a pulse oximeter?
I.Ear
II.Finger
III.Toes
IV.Foot
A)I and II only
B)I,II,III,and IV
C)III and IV only
D)II,III,and IV only
Q2) Which of the following is a hazard of end-tidal CO monitoring?
A)Airway blistering
B)Airway occlusion
C)Airway burns
D)Airway pressure
Q3) How do the transcutaneous PO and PCO arterialize the sample site?
A)Oximetry
B)Red and infrared light
C)Photospectrometry
D)Heat
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Chapter 11: Documentation and Goals Assessment
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Q1) How are entries entered into the medical record?
A)In chronological order
B)In random order
C)In order of department
D)Alphabetical order
Q2) Vital signs,breath sounds,jugular venous distention,heart tones,SpO ,and bowel sounds are all examples of _________________.
A)objective data.
B)subjective data.
C)clinical goals.
D)graphic records.
Q3) Why are the medical record is used by third-party payers?
A)For patient information for future care
B)To assist physician's diagnose patients
C)For purposes of reimbursement
D)To provide patient's a copy of their chart
Q4) Upon entering a severe asthmatic's room to deliver bronchodilator therapy,the patient expresses displeasure with his physician and the hospital.What should the practitioner do at this time?
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Chapter 12: Oxygen Supply Systems
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Sample Questions
Q1) Because large medical gas cylinders (larger than 'E' sized)may contain a variety of gases besides oxygen,a safety system was designed by the CGA to prevent the interchange of cylinders containing dissimilar gases.What is the name of this system?
A)Frangible Disk
B)Diameter-indexed Safety System
C)Pin Index Safety System
D)American Standard Safety System
Q2) What is the color code for a helium and oxygen mixture?
A)White
B)Brown
C)Brown and green
D)Gray and green
Q3) How should the contents of a cylinder be identified?
A)Verify the color code of the cylinder
B)Match the label to the color code
C)By the size of the cylinder
D)a and b
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Chapter 13: Oxygen Administration
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Sample Questions
Q1) Because low-flow devices provide only part of the inspiratory needs,the delivered fraction of inspired oxygen may vary depending on several factors.Which of the following is NOT one of those factors?
A)Decreased oxygen content in the blood
B)Flow of oxygen through the device
C)Patient's tidal volume
D)Patient's respiratory rate
Q2) A newborn is admitted into the nursery and is started on an FIO of 35% through an isolette.The patient's arterial blood gas is drawn and his PaO measured to be 88 mmHg.What would be the associated risk for this patient?
A)Oxygen toxicity
B)Absorption atelectasis
C)Oxygen induced hypoventilation
D)Retinopathy of prematurity
Q3) What is the primary indication for oxygen therapy?
A)Severe trauma
B)Acute myocardial infarction
C)Hypoxemia
D)Short-term therapy
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Page 15
Chapter 14: Introduction to Respiratory Care Pharmacology
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Sample Questions
Q1) Stimulation of the sympathetic nervous system causes _________________
A)vascular permeability.
B)decreased blood pressure.
C)bronchodilation.
D)bronchoconstriction.
Q2) A pediatric patient is admitted to the emergency department from a physician's office with the suspected diagnosis of croup.An inspiratory stridor is heard.Which aerosolized sympathomimetic would you recommend to decrease the stridor?
A)Racemic epinephrine
B)Albuterol
C)Levalbuterol
D)Isoproterenol
Q3) A patient is ready to be discharged to her home.At home the patient has a compressor and a small volume nebulizer.Which of the following corticosteroids is in solution and is intended to be administered via a small volume nebulizer?
A)Prednisone
B)Dexamethasone
C)Budesonide
D)Triamcinolone
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Page 16
Chapter 15: Humidity and Aerosol Therapy
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Sample Questions
Q1) Which of the following hazards or complications can occur with bland aerosol administration?
A)Wheezing
B)Bronchodilation
C)Tachycardia
D)Tremors
Q2) Which of the following is NOT part of the preparation of a bubble humidifier for use on a patient?
A)Filling the reservoir with sterile,distilled water and testing to make sure there is no bacterial growth.
B)Testing can be accomplished by observing for bubbling and checking for flow at the outlet.
C)The outlet should also be occluded to test the safety popoff for function.
D)If the device is a prefilled disposable unit,make sure all seals have been appropriately broken on assembly.
Q3) Despite having the flowrate set on 15 LPM on a 30% aerosol to a T-piece,there is very little aerosol seen coming out of the aerosol tubing.What should the practitioner check?
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Chapter 16: Bronchial Hygiene Therapy
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Q1) Trendelenburg position is contraindicated for ___________________.
I.Intracranial pressure (ICP)of 30-mm Hg
II.Uncontrolled airway at risk for aspiration
III.Distended abdomen
IV.Recent gross hemoptysis associated with radiation therapy
A)I and II
B)III and IV
C)I,II,III,and IV
D)I,III,and IV
Q2) During bronchial hygiene therapy in the Trendelenburg position,the patient's SpO decreases from 92% on a 35% Venturi mask to 80% during the first 5 minutes of the therapy.What intervention would be the most correct for the Respiratory Care Practitioner to take at this time?
A)Administer 100% oxygen,stop therapy immediately,return the patient to original resting position,and consult the physician.
B)Administer 100% oxygen and consult the physician.
C)Administer 100% oxygen and continue the therapy with the patient flat in bed.
D)Stop therapy immediately and return patient to original resting position.
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Page 18
Chapter 17: Hyperinflation Therapy
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Sample Questions
Q1) Which of the following are hazards of IS?
I.Exacerbation of bronchospasm
II.Hyperventilation
III.Barotrauma
IV.Oxygen induced hypoventilation
A)I and III
B)II and IV
C)I,II,III,and IV
D)I,II,and III
Q2) After inhalation during IPPB therapy,exhalation should _________________
A)take place quickly to maintain an I:E ratio of 1:1.
B)be performed against resistance to prolong exhalation.
C)take place forcefully.
D)take place passively.
Q3) A surgeon orders lung expansion therapy for an obtunded 68-year-old,170-lb (77.3 kg,IBW)man who has developed atelectasis after thoracic surgery.On baseline assessment,the patient cannot perform an IC or VC maneuver,but has no evidence of retained secretions.Which type of hyperinflation therapy would you recommend?
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19
Chapter 18: Bronchoscopy Assisting
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Q1) Wheezing may be precipitated by the irritation of the patient's airway by the bronchoscope.This stimulation can result in bronchospasm,causing wheezing.How can this bronchospasm be prevented?
A)Mixing a bronchodilator with the lidocaine administered before the bronchoscopy
B)Administering a sedative to prevent anxiety and anxiety-induced bronchospasm
C)Hyperoxygenating the patient before the bronchoscopy
D)Blocking the sympathetic nervous system
Q2) A diagnostic bronchoscopy is ordered on a patient with a 5 mm lesion on a chest radiograph.The patient has excessive secretions in the airway inhibiting taking a sample of the lesion.Which medication should be recommended to help clear the dry the secretions in the airway to better visualize the area to be sampled?
A)Epinephrine
B)Diazepam
C)Lidocaine
D)Atropine
Q3) What instructions would you give a patient who is to have a bronchoscopy procedure?
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Page 20
Chapter 19: Equipment Processing and Surveillance
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Sample Questions
Q1) A serious H1N1 influenza outbreak takes place in a skilled care facility.Outline the isolation methods and treatments that should be implemented to help prevent the spread of the virus.
Q2) Which of the following processes are sterilizing methods?
I.Steam autoclaving
II.Pasteurization
III.Ethylene oxide
IV.Glutaraldehyde
V.Quaternary ammonium compounds
A)I,II,V
B)IV and V
C)I,III,IV
D)I only
Q3) If Staphylococcus epidermidis or other nonpathogenic members of the normal flora are cultured on clean or in-use equipment,what is the most likely contamination source?
A)The person conducting the culturing.
B)Contaminated liquid in an aerosol device.
C)The sterilization gas used in the processing of the equipment.
D)Gamma irradiation of the equipment.
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Page 21
Chapter 20: Emergency Airway Management
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Sample Questions
Q1) All of the following are conditions requiring management of the airway EXCEPT
A)secretions in the airway.
B)respiratory failure.
C)airway compromise.
D)the need to protect the airway.
Q2) To help determine proper positioning of the endotracheal tube on a chest radiograph,which of the following is placed on the endotracheal tube?
A)Murphy eye
B)Radiopaque stripe
C)Polyvinyl chloride plastic
D)Pilot balloon
Q3) A respiratory care practitioner is attempting to place an oral endotracheal tube in a patient.The attempt is unsuccessful.What should be done before attempted reintubation?
A)Reventilation
B)Reoxygenation
C)Suctioning the airway
D)a and b
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Page 22
Chapter 21: Artificial Airway Care
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Q1) What is the proper size of a suction catheter to be used through an endotracheal tube or tracheostomy tube?
A)The inside diameter of the catheter should not exceed one-half of the inside diameter of the artificial airway
B)The outside diameter of the catheter should not exceed one-third of the inside diameter of the artificial airway
C)The outside diameter of the catheter should not exceed one-half of the inside diameter of the artificial airway
D)A size 14-Fr suction catheter should be used for a 5-mm inside diameter of the artificial airway,otherwise a size 12-Fr catheter should be used.
Q2) Tissue trauma is a hazard of suctioning.All of the following will prevent tissue trauma
EXCEPT ____________________
A)hyperinflation of the patient's lungs before and after the procedure.
B)limiting the suction attempt to no more than 15-seconds.
C)vacuum pressures between -80 and -120 mmHg.
D)pressures should be set as low as possible while still permitting effective removal of secretions.
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Page 23
Chapter 22: Chest Tubes
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Sample Questions
Q1) Which of the following drugs would you suggest to the physician as a local anesthetic to use at the point of insertion of a chest tube?
A)4% Lidocaine
B)Midazolam
C)Providone-iodine
D)Aspirin cream
Q2) A pneumothorax develops while a patient is being mechanically ventilated.A chest tube is placed and the lung fails to seal.There is a large amount of air bubbling through the water seal chamber.What could be causing this?
Q3) When preparing a chest tube drainage system for use on a patient,what should the respiratory care practitioner do to the water seal chamber of the drainage system?
A)Fill the chamber with water to the 20 cm H O line
B)Fill the chamber with water to the 2 cm H O line
C)Attach the tubing that goes to the chest tube to the water seal chamber
D)Adjust the suction pressure at the wall outlet to full vacuum
Q4) A patient with a chest tube in place develops swelling of the tissue surrounding the chest tube with crackling sensations also noted in the same area.What could be causing this and how is it treated?
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Page 24
Chapter 23: Insertion and Maintenance of Intravenous Lines
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Q1) What abbreviation/term refers to the rate of IV fluid administration just fast enough to keep the infusion running and to prevent a clot from forming in the catheter?
A)TKO
B)KVO
C)NPO
D)a or b
Q2) A patient with an IV complains of pain and tenderness at the IV site.The practitioner notes swelling at the IV site.Why should these findings be investigated thoroughly?
A)The IV has infiltrated
B)Cellulitis is developing in the surrounding tissue
C)The possibility of thrombus formation
D)Inflammation of the vein
Q3) What is another name for 0.9% sodium chloride in water?
A)Normal or physiologic saline
B)Lactated Ringer's solution
C)D5W
D)Plasma
Q4) What is the purpose of transparent dressings on a IV?
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Chapter 24: Noninvasive Positive-Pressure Ventilation
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Q1) What should be monitored to determine whether NPPV is meeting the patient's oxygenation requirements?
A)Blood pressure
B)Cardiac arrhythmias
C)Oxygen percentage
D)Oximetry of arterial blood gases
Q2) The respiratory care practitioner sets up NPPV on a patient with central sleep apnea.Which of the following modes would be the most dangerous for the patient during NPPV?
A)Spontaneous/timed mode
B)Timed mode
C)Spontaneous mode
D)Assist/control
Q3) In the spontaneous mode of ventilation,how is the breath from the ventilator initiated?
A)Set time
B)Patient inspiratory flow
C)Inspiratory volume
D)Manually
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Chapter 25: Continuous Mechanical Ventilation
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Q1) The practitioner should consider noninvasive ventilation in which of the following conditions?
I.Pulmonary edema
II.Exacerbation of chronic obstructive pulmonary disease
III.Neuromuscular disease
IV.Hyperventilation syndrome
A)I,II,III and IV
B)I,II and III
C)II,III and IV
D)I and III
Q2) A family does not want to have their parent with congestive heart failure intubated,but the patient is in need of mechanical ventilation,the therapist should recommend _____________
A)IPPB therapy for 20 minutes every hour.
B)CPAP therapy via nasal mask with 50% oxygen.
C)noninvasive ventilation using IPAP and EPAP pressures.
D)disregarding the wishes of the family and intubate and mechanically ventilate the patient.
Q3) What is the difference in calculating dynamic compliance vs static compliance?
Q4) How does a practitioner measure airway resistance on a ventilator?
Page 27
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Chapter 26: Advanced Modes of Mechanical Ventilation
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Q1) Rapid shallow breathing index is used _______________________
A)to measure effectiveness of oxygenation.
B)to identify the settings used in high frequency ventilation.
C)in assessment of neonates and infants.
D)to quantify the relationship between tidal volume and respiratory rate.
Q2) Which of the following statements are true regarding RSBI?
I.Less than 105 indicates increasing work of breathing.
II.Respiratory rate divided by tidal volume in liters
III.Increasing RSBI indicates a patient may become fatigued.
A)I,II and III
B)I and II
C)II and III
D)II only
Q3) Inverse ratio ventilation is __________________
A)where the expiratory phase is longer than inspiration.
B)best described a expiratory retard.
C)when inspiration is longer than expiration.
D)is an I:E of 1:1.1
Q4) What are three problems that mandatory minute ventilation cannot prevent?
Q5) How does a respiratory care practitioner assess the patient's work of breathing?
Page 28
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Chapter 27: Wave Form Analysis
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Q1) The wave form variables of flow,volume and pressure are most often plotted against
A)SPO .
B)mode.
C)time.
D)FIO .
Q2) Combinations of ventilator wave forms can indicate __________________
A)Airway resistance
B)Air trapping
C)Increased work of breathing
D)All of the above
Q3) Wave form graphically displays which of the following?
I.Arterial blood gas values
II.Gas flowrates
III.Inspiratory and expiratory volumes
IV.Airway pressures
A)I,II,III and IV
B)I,II and III
C)II,III and IV
D)II and III
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Chapter 28: Weaning and Discontinuance of Mechanical Ventilation
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Q1) The respiratory therapist notices the mechanically ventilated patient's work of breathing is increased due to the resistance caused by the artificial airway.This problem can be reduced using _______________
A)BiPAP.
B)ATC.
C)PRVC.
D)PEEP.
Q2) How do cardiovascular problems result in ventilator dependence?
Q3) Evidence of decompensation during an SBT include which of the following?
I.Cardiac dysrhythmias
II.Increased anxiety
III.Diaphoresis
IV.Digital clubbing
A)I,II,III and IV
B)I,II and III
C)II,III and IV
D)I and III
Q4) What should the respiratory therapist do if the patient does not pass the SBT?
Q5) How do respiratory conditions result in ventilator dependence?
Q6) How do neurological problems result in ventilator dependence? Page 30
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Chapter 29: Neonatal Mechanical Ventilation
Available Study Resources on Quizplus for this Chatper
35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/44622
Sample Questions
Q1) The respiratory care practitioner has a patient that has a good respiratory effort but he wants to control the inspiratory pressure while maintaining the patient's tidal volume and minute volume.The RCP should consider which of the following modes?
A)Pressure support
B)Pressure assist control
C)Volume support
D)Time cycled,pressure limited ventilation
Q2) The practitioner notes that an infant is not ventilating sufficiently with the spontaneous breaths during SIMV with PEEP since there are periods of apnea.It is evident the infant should be changed to a different mode.Which mode should the therapist use?
A)VS
B)A/C
C)PS
D)CPAP
Q3) Describe the point system used when determining an Apgar score.
Q4) Describe the 5 characteristics of the Apgar scoring system.
Q5) Describe how the initial newborn ventilator setting are determined for mode,rate and flow rate.
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