Respiratory Care Techniques
Exam Materials
Course Introduction
Respiratory Care Techniques covers the fundamental principles and practical skills essential for assessing, managing, and treating patients with respiratory disorders. The course explores airway management, oxygen therapy, aerosol and humidity therapy, chest physiotherapy, and the operation of various respiratory equipment such as ventilators and nebulizers. Students gain hands-on experience in patient assessment, infection control, arterial blood gas analysis, and emergency interventions. Emphasis is placed on critical thinking, ethical considerations, and interdisciplinary collaboration to optimize respiratory care for diverse patient populations.
Recommended Textbook
Basic Clinical Lab Competencies for Respiratory Care An Integrated Approach 5th Edition by Gary
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851 Verified Questions
851 Flashcards
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2
Chapter 1: Basics of Asepsis
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Sample Questions
Q1) The soap and water scrub lasting _______________ is the most common hand washing protocol used in the hospital setting,but a scrub that lasts ___________ is performed prior to surgery and before entry into specialized areas such as the newborn ICU or burn unit.
A) 15 second; 5 minute
B) 5 minute; 10 minute
C) 5 second; 15 minute
D) 15 second;15 second
Answer: A
Q2) What is defined as a microorganism capable of causing disease in humans?
A) Pathogenic microorganism
B) Hospital-acquired infection
C) Virulent microorganism
D) Cross-contamination
Answer: A
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Chapter 2: Basic Patient Assessment: Vital Signs and Breath Sounds
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Sample Questions
Q1) What breath sound is described as a loud,higher pitched breath sound with the expiratory phase longer than the inspiratory phase,with a short pause between phases?
A) Vesicular
B) Tracheal
C) Bronchial
D) Bronchovesicular
Answer: C
Q2) Abnormal breath sounds are often referred to as ___________________.
A) vesicular breath sounds.
B) bronchial breath sounds.
C) tracheal breath sounds.
D) adventitious breath sounds.
Answer: D
Q3) What determines the loudness (intensity)of a sound?
A) Duration
B) Frequency
C) Amplitude
D) Pitch
Answer: C
Page 4
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Chapter 3: Advanced Patient Assessment: Inspection, Palpation, and Percussion
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Sample Questions
Q1) What is defined as vibration felt on the palpation of the chest during phonation,or speech?
A) Pectus carinatum
B) Subcutaneous emphysema
C) Tactile fremitus
D) Hyperresonance
Answer: C
Q2) Upon reviewing a patient's admission notes,the history states the patient has a long-standing history of emphysema.What type of percussion note would you expect over the patient's chest?
A) Resonance
B) Dullness
C) Flatness
D) Hyperresonance
Answer: D
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Chapter 4: Radiologic Assessment
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Sample Questions
Q1) What on a chest radiograph can be observed as a dark (black)shadow along the pleural space?
A) Atelectasis
B) Pneumothorax
C) Subcutaneous emphysema
D) Hyperinflation
Q2) By comparing which views of the chest can a three-dimensional image be created?
A) Posterior-anterior film, lateral film
B) Lordotic film, anterior-posterior film
C) Anterior-posterior film, posterior-anterior film
D) Lordotic film, lateral film
Q3) Where on the chest radiograph should the pulmonary artery catheter be located?
A) Superior vena cava
B) Cardiac silhouette
C) Right side of the heart
D) Pulmonary artery
Q4) What can be evaluated on a chest radiograph besides the heart and lungs?
Q5) A patient with a bilateral hyperresonant percussion note has a chest x-ray taken.What would you expect to find on the chest x-ray?
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Chapter 5: Pulmonary Function Testing
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Sample Questions
Q1) 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?
Q2) 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?
Q3) Anatomical dead space is approximately _____________.
A) 1 ml/kg.
B) 165 ml.
C) 10 ml/kg.
D) 1 ml/lb.
Q4) Which of the following conditions could affect the reliability of spirometry measurements?
A) Emphysema
B) Pneumothorax
C) Asthma
D) COPD
Q5) Why are three pulmonary function test trials performed for simple spirometry and flow volume loops and how should the results be reported?
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Chapter 6: Electrocardiography
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Sample Questions
Q1) When a stimulus only causes a small portion of the atria to contract in an unorganized pattern,then ____________ occurs.
A) atrial fibrillation
B) ventricular fibrillation
C) a normal sinus rhythm
D) a sinus tachycardia
Q2) The patient must always be placed _________ for an ECG.
A) in semi-fowler's position
B) in a chair
C) prone
D) supine
Q3) What is located by palpating the patient's sternal angle?
A) Fourth intercostal space
B) The xiphoid process
C) Second intercostal space
D) Mid clavicular line
Q4) An extremely obese patient is to ordered to have an EKG.What problems could be encountered and how should they be approached?
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Chapter 7: Phlebotomy
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Sample Questions
Q1) Which of the following techniques will reduce the probability of infection with a blood draw?
A) Proper cover over the site
B) Good aseptic technique before venipuncture
C) Reviewing the chart for infections
D) Both a and b
Q2) Following the post needle stick scrub,what should be done to the wound?
A) Apply an ointment such as polymixin-bacitracin to the area
B) It should be lanced by a physician
C) The area should be squeezed to increase perfusion to the area
D) Nothing
Q3) If the patient refuses a blood draw after a needle stick what is the procedure?
A) The patient is informed the blood will be drawn anyway
B) The patient's previous blood sample is tested
C) Due to patient confidentiality, nothing can be done
D) The therapist's blood will be drawn and tested immediately
Q4) How does the phlebotomist gain the confidence of the patient for a blood draw?
Q5) 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) Which artery is used to collect arterial blood during a cardiopulmonary arrest?
A) Radial artery
B) Brachial artery
C) Femoral artery
D) Ulnar artery
Q2) A patient has an elevated leukocyte count.What precautions should be done for the sample?
A) The sample needs to be properly anticoagulated.
B) No special precautions need to be taken with the sample.
C) Air bubbles need to be introduced into the sample.
D) The sample needs to by immediately chilled and analyzed.
Q3) What should the practitioner teach the patient concerning an arterial line?
Q4) If the brachial artery is damaged and circulation is stopped through the brachial artery,what could possibly happen to the patient?
A) Damage to the median nerve
B) Collateral circulation could continue through the ulnar artery.
C) Loss of the arm
D) The vein could support circulation through the arm.
Q5) How should the practitioner ensure that the arterial line's measured blood pressure is accurate?
Page 10
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Chapter 9: Hemodynamic Monitoring
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Sample Questions
Q1) Normal pulmonary artery wedge pressure is ______________.
A) 6-12 mmHg
B) 10-22 mmHg
C) 0-6 mmHg
D) 80-120 mmHg
Q2) A patient has a CVP reading of 12 mmHg.What does this indicate?
A) Hypervolemia
B) Hypovolemia
C) Decreased right ventricular preload
D) Increased left atrial preload
Q3) What happens if the right ventricular preload is increased too much?
A) The cardiac output is optimized.
B) The myocardium loses efficiency.
C) Oxygen consumption decreases.
D) Deadspace ventilation increases.
Q4) The proximal lumen of the pulmonary artery catheter measures the
A) central venous pressure.
B) pulmonary capillary wedge pressure.
C) cardiac output.
D) left ventricular end-diastolic pressure.
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Chapter 10: Noninvasive Monitoring
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Sample Questions
Q1) Which electrode does the transcutaneous CO monitor incorporate into its design?
A) Clark electrode
B) Severinghaus electrode
C) Sanz electrode
D) Reference electrode
Q2) How do end-tidal CO monitors measure the PetCO ?
A) Heat
B) Oximetry
C) Infrared light absorption
D) Red light absorption
Q3) Which of the following is a hazard of end-tidal CO monitoring?
A) Airway blistering
B) Airway occlusion
C) Airway burns
D) Airway pressure
Q4) What electrode does the transcutaneous O monitor incorporate into its design?
A) Clark electrode
B) Severinghaus electrode
C) Sanz electrode
D) Reference electrode
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Chapter 11: Documentation and Goals Assessment
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Sample Questions
Q1) How are entries entered into the medical record?
A) In chronological order
B) In random order
C) In order of department
D) Alphabetical order
Q2) Which of the following represents falsification of the medical record?
I.Concealment of an incident
II.Making up ventilator settings
III.Charting an arterial blood gas that wasn't done
A) II only
B) I and II
C) III only
D) I, II, and III
Q3) How is the history of the patient obtained by the physician?
A) From the patient
B) From the physical examination
C) From the patient's family
D) a and c
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13
Chapter 12: Oxygen Supply Systems
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Sample Questions
Q1) What happens to a cylinder if it fails hydrostatic testing?
A) The vessel is filled with water to 5/3 of the service pressure.
B) It is filled with another gas.
C) It is destroyed.
D) It is retested.
Q2) Each floor of a building is divided into several zones.Each zone has a safety shutoff valve called a _______________
A) zone valve.
B) riser.
C) reserve valve.
D) reducing valve.
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
Q4) You attach a pressure reducing valve to a 'M' sized gas cylinder.When you open the cylinder valve you hear gas leaking from of near the valve-cylinder connection.What should you do?
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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) The practitioner notes that a patient has been on a partial rebreathing mask for 4 days.The chest x-ray indicates bilateral atelectasis in both bases.What would be the most likely reason for this finding?
A) Oxygen tolerance
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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Chapter 14: Introduction to Respiratory Care Pharmacology
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Sample Questions
Q1) Place the following intracellular events of the Beta 2 receptor stimulation in order.
I.Phosphodiesterase breaks down cyclic 3',5'-AMP into 5'-AMP
II.Adenylate cyclase combines with magnesium and ATP to form cyclic 3',5'-AMP
III.Cyclic 3',5'-AMP results in bronchial smooth muscle relaxation
IV.Beta-2 stimulation causes the formation of adenylate cyclase
A) I, II, III, IV
B) III, IV, I, II
C) IV, II, III, I
D) IV, III, II, I
Q2) MDI spacer devices are used in conjunction with MDIs to:
A) serve as a baffle, removing smaller particles from suspension.
B) enhance the effectiveness of aerosol deposition and improve medication delivery. C) act as a reservoir that helps to decrease the evaporation of the MDI propellant.
D) a, b, and c.
Q3) An aerosol drug is ordered on a patient in MDI form.The propellant causes a reflex bronchospasm in the patient.What can be done?
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16
Chapter 15: Humidity and Aerosol Therapy
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Sample Questions
Q1) The Centers for Disease Control and Prevention (CDC)recommends addressing exposure control issues when delivering an aerosol to the lung parenchyma by (1)administrative policy,(2)engineering controls,and (3)personal protective equipment,in that order.Which of the following is NOT a CDC recommendation for engineering controls?
A) Booths or stalls for sputum induction and aerosolized medication administration in areas in which multiple patients are treated.
B) Frequent air exchanges to dilute concentration of aerosol in room to eliminate 99% of aerosol before the next patient enters and receives treatment in the area.
C) Filters or filtered scavenger systems to remove aerosols that cannot be contained.
D) Rinsing filters, nebulizers, and other contaminated components of the aerosol delivery system used with suspect agents as hazardous waste after each use.
Q2) Back pressure exerted downstream from the nebulizer will cause
A) the aerosol output to increase.
B) the total flow output of the unit to increase.
C) the delivered FIO to increase.
D) the amount of air entrained through the entrainment ports to increase.
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17
Chapter 16: Bronchial Hygiene Therapy
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Sample Questions
Q1) 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.
Q2) Abnormal chest x-ray consistent with atelectasis and mucus plugging,rhonchi suggesting secretions in the airways,and excessive sputum production would establish the need for:
A) positioning.
B) postural drainage therapy.
C) chest clapping.
D) bronchodilator therapy.
Q3) A patient who is receiving postural drainage and percussion desaturates during therapy,complains of dizziness,and states he cannot tolerate the treatment any longer.What should the practitioner do?
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Page 18
Chapter 17: Hyperinflation Therapy
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Sample Questions
Q1) 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.
Q2) How does expiration take place after a positive-pressure breath during an IPPB treatment?
A) The elastic recoil of the lungs and thorax allows the patient to exhale
B) The sensitivity is set to allow the ventilator to be 'sensitive' to the patient when exhalation is started
C) The expiratory timer is set to limit the amount of time inspiration takes place
D) The flow rate through the Venturi is cut off cycling the ventilator into expiration
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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Page 19
Chapter 18: Bronchoscopy Assisting
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Sample Questions
Q1) Which of the following is NOT an absolute contraindication for a flexible bronchoscopy?
A) The need to evaluate problems associated with endotracheal or tracheostomy tubes (tracheal damage, airway obstruction, or tube placement) in an end-stage COPD patient
B) Absence of consent from the patient or his/her representative unless a medical emergency exists and patient is not competent to give permission
C) Absence of an experienced bronchoscopist to perform or closely and directly supervise the procedure
D) Lack of adequate facilities and personnel to care for such emergencies such as cardiopulmonary arrest, pneumothorax, or bleeding
Q2) Which type of brush/needle/mechanical device are is/are used to sample areas of interest by "biting" off small chunks of tissue?
A) Unsheathed cytology brush
B) Sheathed cytology brush
C) Forceps
D) Wang needle
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Page 20
Chapter 19: Equipment Processing and Surveillance
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Q1) What should be the first step in any sterilization method?
A) Making sure the equipment is wrapped in cloth or paper.
B) Making sure that the equipment to be sterilized is exposed to the sterilization solution.
C) Cold sterilize the equipment to ensure that the equipment is properly processed.
D) The first step is to disassemble the equipment, remove the foreign material on it,and washing it.
Q2) What is the application of chemical agents to a surface to inhibit microbial growth and reproduction?
A) Antisepsis
B) Sterilization
C) Disinfection
D) Pasteurization
Q3) Which of the following bacteria is NOT gram negative?
A) Streptococcus
B) Serratia
C) Klebsiella
D) Legionella
Q4) What types of vaccines should a health care worker undergo routinely?
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21
Chapter 20: Emergency Airway Management
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Sample Questions
Q1) What should be evaluated once an airway is established on a patient?
A) Ventilation
B) Central nervous system function
C) Retractions
D) Stridor
Q2) A 6'5",300-lb male patient is admitted to ICU for mechanical ventilation via an endotracheal tube.A 7.5 mm-ID tube is in place.What problems could be present with this patient and how could they be treated?
Q3) 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
Q4) What is the most common cause of upper airway obstruction?
A) Spasm of the larynx
B) Dried secretions occluding the airway
C) The tongue falling back against the posterior pharynx
D) Food or other foreign material obstructing the airway
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Chapter 21: Artificial Airway Care
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Q1) Why should the patient's chest be auscultated before tracheostomy care is performed?
A) To determine if the patient's lungs are clear of secretions.
B) To confirm if tracheostomy care needs to be done
C) To determine whether suctioning is required prior to performing tracheostomy care.
D) a and c
Q2) PEEP therapy through a mechanical ventilator may increase the patient's susceptibility to significant hypoxemia.Which suction catheter will maintain the PEEP level in a ventilated patient?
A) Whistle tip suction catheter
B) Coude suction catheter
C) Closed suction system catheter
D) Fenestrated suction catheter
Q3) You cannot pass the suction catheter down the endotracheal tube on an intubated patient.What should you do and how would you correct the problems?
Q4) Before suctioning a patient,you notice that no suction pressure is being generated at the end of the suction catheter when you attempt to suction sterile water through the catheter.What could be causing the problem?
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Page 23
Chapter 22: Chest Tubes
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Q1) What is "tidaling"?
A) Gentle continuous bubbling observed in the suction control chamber
B) Vigorous bubbling observed in the suction control chamber
C) Fluid collection in the collection chamber
D) The normal rise and fall of the fluid level with the patient's breathing pattern
Q2) While troubleshooting a chest tube leak,the respiratory care practitioner clamps the tubing where it enters the chamber and the leak stops.Where is the leak in the system?
A) In the tubing
B) In the patient's chest
C) At the vacuum regulator
D) In the drainage system
Q3) Once the chest tube has been sutured in place,the practitioner should help the physician by doing what to the dressing site?
A) Applying a sterile petrolatum dressing around the chest tube site
B) Applying a sterile airtight dressing at the chest tube site
C) Applying providone-iodine to the insertion site
D) a and b
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24
Chapter 23: Insertion and Maintenance of Intravenous Lines
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Q1) What is an IV solution called that has the same tonicity as measured by solute concentration?
A) Hypotonic solution
B) Lactated Ringer's solution
C) Hypertonic solution
D) Isotonic solution
Q2) When applying a tourniquet to help with the insertion of an IV on a patient,where should the tourniquet be placed?
A) Proximal to the intended insertion site
B) Distal to the intended insertion site
C) Over the insertion site
D) A tourniquet should never be used except when inserting an arterial line
Q3) Which of the following does NOT need to be monitored once an IV infusion is established?
A) How the tourniquet is being used
B) The rate of infusion of the IV fluids
C) The IV site be monitored
D) The fluid level in the IV bag
Q4) What happens to the small air bubbles that pass through the IV tubing and enter into the patient?
25
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Chapter 24: Noninvasive Positive-Pressure Ventilation
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Q1) The respiratory care practitioner sets up a patient on NPPV in the spontaneous/timed mode due to frequent apneic episodes.To ensure that the patient receives continuous ventilation,which of the following should be set on the ventilator?
A) EPAP pressure
B) Low pressure alarm
C) %IPAP time
D) Set rate
Q2) In the spontaneous mode of NPPV,how long is the EPAP pressure maintained during the expiratory phase?
A) Until the ventilator senses the next spontaneous breath
B) After a set amount of time
C) Until the % EPAP time has expired
D) Until a specific volume is delivered to the patient
Q3) A COPD patient is being ventilated on a noninvasive positive-pressure ventilation (NPPV)in the spontaneous/timed mode of ventilation.The ventilator is not triggering each time the patient attempts to initiate a breath.What can be done?
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Chapter 25: Continuous Mechanical Ventilation
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Q1) A practitioner should not use the assist ventilation mode in which of the following conditions?
A) Asthmatic patient prior to extubation
B) Congestive heart failure after delivery of diuretics
C) Resolving pneumonia
D) Post-operative abdominal surgery with sedation
Q2) Type I respiratory failure is which of the following?
A) PaCO greater than 50 mmHg and PaO within normal levels
B) PaCO greater than 50 mmHg and PaO less than 50 mmHg with pH below 7.35
C) High PaCO with a low PO but a normal pH
D) PaO of less than 59 mmHg with a normal PaCO
Q3) The purpose of auscultation includes all of the following EXCEPT
A) the need for suction.
B) distribution of ventilation.
C) changes in breath sounds.
D) as required by procedure.
Q4) How is tubing compliance determined?
Q5) How does a practitioner measure airway resistance on a ventilator?
Q6) What is the difference in calculating dynamic compliance vs static compliance?
27
Q7) How does a practitioner perform a system leak test?
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Chapter 26: Advanced Modes of Mechanical Ventilation
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Q1) How does a respiratory care practitioner assess the patient's work of breathing?
Q2) The Nellcor Puritan Bennett 840 recommends an operational check of the BDU,sensors,resistance and compliance of the circuit prior to use.This is called
A) tubing compliance.
B) The short self test.
C) the power on self test
D) the user verification test
Q3) Which of the following statements are true regarding RSBI?
I.Less than 105 indicates increasing work of breathing.
II.Respiratory rate divided by tidal volume in liters
III.Increasing RSBI indicates a patient may become fatigued.
A) I, II and III
B) I and II
C) II and III
D) II only
Q4) What are three problems that mandatory minute ventilation cannot prevent?
Q5) What is proportional assist ventilation?
Q6) What is the auto-set-point control?
Q7) What are the purposes of ventilator alarms and backup modes?
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Chapter 27: Wave Form Analysis
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Q1) Which of the following is true of the flow-volume loop?
I.Flow is plotted on the vertical axis.
II.It is commonly used in PF spirometry evaluation.
III.It is done only after bronchodilator administration.
A) I, II and III
B) I and II
C) I and III
D) II and III
Q2) Two scalar wave forms are combined to ___________________
A) identify presence of PEEP.
B) eliminate autoPEEP.
C) create a loop graphic.
D) demonstrate ventilation mode.
Q3) A steeper slope of the pressure versus volume loop indicates ________________
A) overdistention.
B) increased compliance.
C) increased resistance.
D) increased work of breathing.
Q4) Which graphic displays can indicate adequacy of inspiratory flow during a ventilator inspiration and how are they used?
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Chapter 28: Weaning and Discontinuance of Mechanical Ventilation
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30 Verified Questions
30 Flashcards
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Sample Questions
Q1) 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) Which of the following should the practitioner use as a rationale to disqualify a patient from a weaning trial?
A) Heart rate less than 140 beats per minute but still above 80 bpm
B) Mentation clearing
C) Lack of spontaneous respiratory drive
D) PaO / FiO ratio of 220
Q3) What four general questions should the respiratory care practitioner assess prior to weaning from mechanical ventilation?
Q4) How do neurological problems result in ventilator dependence?
Q5) What should the respiratory therapist do if the patient does not pass the SBT?
Q6) How do cardiovascular problems result in ventilator dependence?
Q7) How do respiratory conditions result in ventilator dependence?
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Chapter 29: Neonatal Mechanical Ventilation
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34 Verified Questions
34 Flashcards
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Sample Questions
Q1) According to the retired AARC Clinical Practice Guidelines on time-triggered,pressure- limited,time-cycled neonatal ventilation,risk of ROP can be minimized by ___________________
A) keeping PaO less than 60 mmHg.
B) keeping SpO greater than 80%.
C) keeping PaO less than 80 mmHg.
D) maintaining pH greater than 7.35.
Q2) The respiratory care practitioner is placing a Drager Babylog 8000 plus on a patient.What mode can she use to insure a steady tidal volume?
A) Pressure Control
B) SIMV
C) CPAP
D) Volume guarantee
Q3) Transillumination is which of the following?
A) Used to reduce bilirubin
B) A technique to detect a pneumothorax in newborns
C) The light reflecting from the ventilator
D) Used to identify pulmonary secretions
Q4) Describe the 5 characteristics of the Apgar scoring system.
Q5) Describe how the initial newborn ventilator alarm setting are determined.
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