Respiratory Disease Management
Exam Answer Key
Course Introduction
Respiratory Disease Management provides students with an in-depth understanding of the assessment, diagnosis, and evidence-based treatment of acute and chronic respiratory conditions such as asthma, chronic obstructive pulmonary disease (COPD), pneumonia, and interstitial lung diseases. The course emphasizes patient-centered care approaches, pharmacologic and non-pharmacologic interventions, and the integration of pulmonary rehabilitation, patient education, and preventive strategies. Students will learn to evaluate clinical data, interpret diagnostic tests, and develop individualized management plans while considering comorbidities and the latest clinical guidelines.
Recommended Textbook
Clinical Manifestations Assessment of Respiratory Disease 6th Edition by Terry Des Jardins
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Chapter 1: The Patient Interview
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Q1) During the interview, the patient states, "Every time I climb the stairs I have to stop to catch my breath." Hearing this, the respiratory therapist replies, "So, it sounds like you get short of breath climbing stairs." This interviewing technique is called:
A) clarification.
B)modeling.
C)empathy.
D)reflection.
Answer: D
Q2) The interviewing technique called silence is used:
A) to prompt the patient to ask a question.
B)after a direct question.
C)after an open-ended question.
D)to allow the patient to review his/her history.
Answer: C
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Chapter 2: The Physical Examination and Its Basis in Physiology
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Q1) While assessing an unconscious patient, you observe that her breathing becomes progressively faster and deeper and then progressively becomes slower and more shallow. After that, there is a period of apnea before the cycle begins again. This breathing pattern would be identified as:
A) Cheyne-Stokes.
B)tachypnea.
C)Kussmaul.
D)hyperventilation.
Answer: A
Q2) A dull percussion note would be heard in all of the following situations EXCEPT: A) atelectasis.
B)pleural thickening.
C)chronic obstructive pulmonary disease (COPD).
D)consolidation.
Answer: C
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Chapter 3: Pulmonary Function Study Assessments
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Q1) Your patient has obstructive lung disease. In response to this, which of the following are typically found?
1) Decreased lung compliance
2) Increased ventilatory rate
3) Increased tidal volume
4) Decreased ventilator rate
A)3, 4
B)2, 3
C)1, 2
D)1, 3, 4
Answer: A
Q2) Pulmonary function studies are done for all of the following measurements EXCEPT:
A) the patient's carbon monoxide level.
B)lung volumes and capacities.
C)pulmonary diffusion capacity.
D)forced expiratory flow rates.
Answer: A
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Chapter 4: Arterial Blood Gas Assessments
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Q1) Common causes of metabolic alkalosis include:
1) diuretic therapy.
2) vomiting.
3) excessive sodium bicarbonate administration.
4) gastric suctioning.
A)1, 3
B)2, 4
C)2, 3, 4
D)1, 2, 3, 4
Q2) Which of the following would be a normal person's venous oxygen pressure (PaO<sub>2</sub>)?
A) 35 to 45 mm Hg
B)45 to 80 mm Hg
C)80 to 100 mm Hg
D)100 to 120 mm Hg
Q3) Common causes of metabolic acidosis include all of the following EXCEPT:
A) diabetic ketoacidosis.
B)shallow breathing from a sedative overdose.
C)lactic acidosis.
D)renal (kidney) failure.
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Chapter 5: Oxygenation Assessments
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Q1) A sample of blood has been taken from a patient's pulmonary artery. What mixed venous oxygen saturation value (SvO<sub>2</sub>) would indicate that the patient is normal?
A) 40 mm Hg
B)95 mm Hg
C)75%
D)97%
Q2) When a sample of arterial blood is analyzed for the pressure of oxygen (PaO<sub>2</sub>) and carbon dioxide (PaCO<sub>2</sub>) the value comes from the:
A) blood plasma.
B)leukocytes.
C)hemoglobin.
D)erythrocytes.
Q3) A condition that will cause anemic hypoxia is:
A) cyanide poisoning.
B)decreased cardiac output or heart failure.
C)polycythemia.
D)carbon monoxide poisoning.
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Chapter 6: Cardiovascular System Assessments
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Q1) Which of the following hemodynamic changes are commonly seen in a patient with pulmonary edema?
1) Increased pulmonary capillary wedge pressure (PCWP)
2) Increased pulmonary vascular resistance (PVR)
3) Decreased mean pulmonary artery pressure (PA)
4) Decreased cardiac output (CO)
A)1, 4
B)2, 3
C)1, 2, 3
D)1, 2, 3, 4
Q2) In which of the following is the atrial rate faster than the ventricular rate?
1) Atrial fibrillation
2) Sinus bradycardia
3) Atrial flutter
4) Ventricular flutter
A)1, 3
B)2, 4
C)3, 4
D)1, 2, 3
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Chapter 7: Radiologic Examination of the Chest
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Q1) Your patient has had a ventilation-perfusion scan. What would be identified from the ventilation scan?
A) Location of a lung abscess
B)Alveolar consolidation
C)Location of a pulmonary embolism
D)Location of an airway obstruction
Q2) The heart shadow on a chest radiograph will show up larger than normal on:
A) an AP film.
B)a PA film.
C)a left lateral film.
D)a computed tomography (CT) scan.
Q3) Which of the following is true of a chest radiograph?
A) Lateral films are shot through one side of an upright patient.
B)AP films are typically taken in the x-ray department.
C)PA films artificially increase the size of the heart shadow.
D)Lateral decubitus films are shot with the patient lying supine.
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Chapter 8: Other Important Tests and Procedures
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Q1) Therapeutic bronchoscopy is used for all of the following EXCEPT:
A) to remove a foreign body.
B)in selective lavage.
C)in bronchiectasis evaluation.
D)to manage life-threatening hemoptysis.
Q2) After a thoracentesis procedure, it is important to monitor the patient for:
A) bronchospasm.
B)hemoptysis.
C)increased blood urea nitrogen (BUN).
D)pneumothorax.
Q3) For blood urea nitrogen (BUN) and creatinine values:
A) serum creatinine is a protein produced in the kidneys.
B)BUN and serum creatinine values that are higher than the normal range indicate renal failure.
C)urea is a waste product of carbohydrate metabolism in the intestines.
D)BUN values that are below normal indicate renal failure.
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Chapter 9: The Therapist-Driven Protocol Program and the
Role of the Respiratory Care Practitioner
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Q1) According to the oxygen therapy protocol, what should be done with a patient who has severe trauma when hypoxemia is suspected?
A) Begin hyperinflation therapy.
B)Initiate supplemental oxygen.
C)Begin mechanical ventilation.
D)Notify the physician.
Q2) According to the aerosolized medication protocol, a patient with COPD could be treated with all of the following medications EXCEPT:
A) antiinflammatory agents.
B)sympathomimetic agents.
C)parasympatholytic agents.
D)antibiotics.
Q3) Postural drainage, percussion, and vibration are part of what TDP?
A) Hyperinflation therapy
B)Bronchopulmonary hygiene therapy
C)Mechanical ventilation
D)Oxygen therapy
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Sample Questions
Q1) A patient who had pneumonia, and her family, are suing the hospital, physician, and respiratory therapist. How can the patient's medical care and treatment be proved?
A) Care is documented in the chart.
B)The patient's testimony
C)The physician's testimony
D)The respiratory therapist's testimony
Q2) When reviewing a SOAPIER progress note, all of the following would be found in the O area EXCEPT:
A) hemodynamic data.
B)patient's admission complaint.
C)blood pressure.
D)sputum production.
Q3) Which of the following is a Health Insurance Portability and Accountability Act (HIPAA) rule?
A) A bank can check for a preexisting condition.
B)The patient controls access to his/her medical records.
C)Psychotherapy and medical records are treated equally.
D)An employer can check for a preexisting condition.
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Chapter 11: Chronic Obstructive Pulmonary Disease Copd:
Chronic Bronchitis, and Emphysema
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Q1) Which of the following are anatomic alterations found with chronic bronchitis?
1) Increased size of submucosal bronchial glands
2) Destruction of pulmonary capillaries
3) Chronic bronchial wall inflammation
4) Bronchospasm
A)2, 3
B)3, 4
C)1, 2, 3
D)1, 3, 4
Q2) Which of the following is true of the diffusing capacity test (DLCO) findings in a patient with COPD?
A) Normal in all cases
B)Decreased in emphysema
C)Decreased in chronic bronchitis
D)Increased in all cases
Q3) Emphysema is probably caused by all of the following EXCEPT:
A) inhaling asbestos fibers.
B)(\(\alpha\)<sub>1</sub>)-antitrypsin deficiency.
C)second-hand cigarette smoke.
D)air pollution.
Page 13
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Chapter 12: Asthma
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Sample Questions
Q1) As a respiratory therapist, you are performing a chest assessment. What findings would be common in a patient during an asthma attack?
1) Inverse I:E ratio
2) Decreased vocal fremitus
3) Increased vesicular breath sounds
4) Hyperresonant percussion note
A)1, 4
B)2, 4
C)2, 3, 4
D)1, 2, 3, 4
Q2) A patient with a severe asthma attack has many mucus plugs. What structural changes can be expected because of this?
A) Atelectasis
B)Fibrosis
C)Alveolar hyperinflation
D)Pulmonary edema
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Chapter 13: Bronchiectasis
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Sample Questions
Q1) Congenital causes of bronchiectasis include:
1) Influenza
2) Cystic fibrosis
3) COPD
4) Kartagener's syndrome
A)2, 4
B)1, 3
C)1, 2, 3
D)2, 3, 4
Q2) Mechanical ventilation would be justified in the management of a patient with bronchiectasis under the following circumstances:
A) Patient has a reversible lung problem
B)To prevent atelectasis
C)To provide supplemental oxygen
D)To help to mobilize secretions
Q3) Severe bronchiectasis is associated with all of the following EXCEPT:
A) vesicular breath sounds.
B)cor pulmonale.
C)distended neck veins.
D)polycythemia.
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Chapter 14: Cystic Fibrosis
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Sample Questions
Q1) total airway obstruction leading to atelectasis.
A) 1, 2
B)3, 4
C)1, 3, 4
D)1, 2, 3, 4
Q2) All of the following can be used in the diagnosis of cystic fibrosis EXCEPT:
A) an elevated potassium level in the sweat.
B)an elevated chloride level in the sweat.
C)genetic testing of the patient and/or parents.
D)chronic lung infections from an early age.
Q3) Cystic fibrosis patients can have all of the following EXCEPT:
A) malnutrition.
B)meconium ileus (bowel obstruction).
C)excessive, viscous pulmonary secretions.
D)tendency for status asthmaticus.
Q4) Which ethnic group has the greatest number of people with cystic fibrosis?
A) African Americans
B)Asians
C)Hispanics
D)whites
Page 16
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Chapter 15: Pneumonia
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Q1) The most commonly prescribed class of antibiotic used against Gram-positive bacterial organisms is:
A) penicillin (Amoxicillin).
B)isoniazid (INH).
C)cephalosporins (Cefotaxime).
D)ketoconazole (Nizoral).
Q2) Your patient has bilateral pneumonia. What findings can be expected on the CT scan?
1) Depressed diaphragms
2) Elongated heart
3) Air bronchograms
4) Consolidation
A)3, 4
B)1, 2
C)2, 3, 4
D)1, 2, 3, 4
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Chapter 16: Lung Abscess
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Q1) In severe cases of tissue necrosis related to an abscess, what can occur?
1) Fluid ruptures into a bronchus.
2) Broncholithiasis occurs.
3) Bronchospasm will close off the affected bronchi.
4) Fluid ruptures into the intrapleural space.
A)1, 2
B)1, 4
C)3, 4
D)1, 2, 3
Q2) Your intubated, unconscious patient has accidentally had the cuff deflated. This has resulted in the aspiration of oral secretions. What microorganisms are likely to be found in her tracheal secretions now?
1) Legionella pneumophila
2) Pseudomonas aeruginosa
3) Peptococci
4) Bacteroides fragilis
A)1, 3
B)3, 4
C)1, 2
D)1, 2, 4
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Chapter 17: Tuberculosis
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Q1) Mycobacterium tuberculosis is most readily transmitted through:
A) drinking milk from or the milking of infected cows.
B)shaking hands and then rubbing your eye.
C)coughing.
D)accidental direct inoculation.
Q2) Your patient has been found to have tuberculosis (TB) in several organs of the body. What term is used to describe this situation?
A) Primary TB
B)Postprimary TB
C)Disseminated TB
D)Multiorgan TB
Q3) Nontuberculous mycobacteria such as Mycobacterium avium and Mycobacterium kansasii are associated with which of the following diseases?
A) COPD
B)Bronchiectasis
C)Status asthmaticus
D)Cystic fibrosis
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Chapter 18: Fungal Diseases of the Lung
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Q1) What parts of the lungs are most commonly affected by a fungal infection?
A) Mainstem bronchi
B)Lingula
C)Lower lobes
D)Upper lobes
Q2) Your patient with an advanced pulmonary fungal infection has cor pulmonale. How will this manifest itself?
A) Distended neck veins
B)Poor skin turgor
C)Wheezy breath sounds
D)Asymmetrical chest movement when breathing
Q3) Pulmonary function testing results on a patient with advanced fungal pneumonia will display all of the following EXCEPT:
A) increased ERV.
B)decreased IRV.
C)decreased IC.
D)decreased TLC.
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Chapter 19: Pulmonary Edema
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Q1) All of the following are positive risk factors for coronary heart disease (CHD) EXCEPT:
A) elevated homocysteine level.
B)elevated vitamin E level.
C)hypertension.
D)diabetes mellitus.
Q2) Management of cardiogenic pulmonary edema includes the following:
1) giving the patient a low salt intake diet.
2) giving the patient a medication to lower blood pressure.
3) giving the patient a diuretic drug.
4) performing balloon angioplasty on the patient.
A)1, 4
B)2, 3
C)3, 4
D)1, 2, 3
Q3) Pulmonary edema manifests itself clinically as a/an:
A) restrictive pulmonary disorder.
B)obstructive pulmonary disorder.
C)equally restrictive and obstructive disorder.
D)restrictive cardiac disorder.
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Chapter 20: Pulmonary Embolism
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Q1) All of the following are associated with the formation of a deep vein thrombosis (DVT) EXCEPT:
A) blood vessel injury.
B)age greater than 40 years.
C)hypercoagulability.
D)venous stasis.
Q2) The duplex venous ultrasonography test is used to:
A) diagnose a blood clot below the knee.
B)identify a saddle embolism.
C)diagnose a blood clot behind the knee or thigh.
D)identify a pulmonary infarction.
Q3) The death of lung tissue that may result from an obstruction of the pulmonary artery is called a:
A) pulmonary embolism.
B)pleural effusion.
C)pulmonary infarction.
D)pulmonary empyema.
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Chapter 21: Flail Chest
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Q1) Your patient with a flail chest is experiencing pendelluft. What are its effects?
1) Hypoventilation
2) Hypertension
3) Cyclical deeper and then more shallow breathing
4) Rebreathing dead-space gas
A)1, 4
B)1, 3
C)2, 3, 4
D)1, 2, 3, 4
Q2) Your patient with a flail chest has paradoxical chest movement. What would be seen with this?
A) With an inspiration, the fractured ribs move outward.
B)The trachea deviates away from the flail side of the chest.
C)During inspiration, the fractured ribs move inward.
D)During exhalation, the flail area moves inward.
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Chapter 22: Pneumothorax
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Q1) Which of the following chest assessment findings would be expected in a patient with a tension pneumothorax?
A) Tracheal shift toward the pneumothorax
B)Dull percussion note
C)Tracheal shift away from the pneumothorax
D)Hyperresonant breath sounds
Q2) After the patient has had repeated pneumothoraces of her right lung, the physician has recommended that the patient have the problem permanently eliminated. What should be done?
A) Pleurodesis
B)Right pneumonectomy
C)Permanent right sided chest tube
D)Right upper lobectomy
Q3) An iatrogenic pneumothorax may be caused by all of the following EXCEPT:
A) positive-pressure mechanical ventilation.
B)pleural biopsy.
C)subclavian vein cannulation.
D)endotracheal intubation.
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Chapter 23: Effusion and Empyema
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Q1) Your patient with pneumonia of the left lung and related empyema has a distinctive breath sound heard over the affected area. What is the name of this characteristic breath sound?
A) Bronchial breath sound
B)Pleural friction rub
C)Empyema rhonchi
D)Pleural crackles
Q2) While reviewing the upright chest radiograph of your patient, you see a fluid density in the right lung area that extends upward around the anterior, lateral, and posterior thoracic walls. What is this sign of a pleural effusion called?
A) Meniscus sign
B)Scarf sign
C)Transudate sign
D)Kerley B lines
Q3) The anatomic alteration caused by a pleural effusion is:
A) pulmonary fibrosis.
B)separation of the visceral and parietal pleura.
C)adhesion of the visceral and parietal pleura.
D)pulmonary edema.
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Page 25
Chapter 24: Kyphoscoliosis
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Q1) Which of the following chest assessment findings are associated with kyphoscoliosis?
1) Crackles or rhonchi breath sounds
2) Hyperresonant percussion note
3) Whispered pectoriloquy
4) Tracheal shift
A)1, 2
B)3, 4
C)1, 3, 4
D)1, 2, 3, 4
Q2) Which of the following pulmonary function values are likely to be found in a patient with kyphoscoliosis?
1) Normal or decreased Vt
2) Normal or increased PEFR
3) Decreased VC
4) Decreased FVC
A)1, 2
B)2, 4
C)1, 3, 4
D)1, 2, 3, 4
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Page 26
Chapter 25: Interstitial Lung Diseases
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Q1) In a patient with coal worker's pneumoconiosis or silicosis, the diffusing capacity would be:
A) unaffected.
B)increased.
C)decreased.
D)variable based on the age of the patient.
Q2) All of the following are anatomic alterations of the lungs that may be found with the chronic stage of interstitial lung disease (ILD) EXCEPT:
A) honeycombing.
B)edema.
C)interstitial thickening.
D)granulomas.
Q3) Which of the following classes of drugs has the largest group of agents that can cause interstitial lung disease?
A) Anticancer
B)Cardiovascular
C)Antibiotics
D)Antiinflammatory
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Chapter 26: Cancer of the Lung
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Q1) Malignant tumors:
1) invade surrounding tissues.
2) grow slowly.
3) cause necrosis.
4) push aside surrounding tissue.
A)1
B)4
C)2, 3
D)1, 3
Q2) Your patient with a lung tumor in his right lower lobe is going to need surgery. He is otherwise healthy and has good respiratory reserve. What is the preferred surgical method?
A) lobectomy
B)wedge resection
C)segmentectomy
D)pneumonectomy
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Chapter 27: Acute Respiratory Distress Syndrome
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Q1) Your adult male patient weighs 68 kg (150 pounds). Because he has developed ARDS, the physician wants to adjust the mechanical ventilator to minimize further lung injury. What tidal volume should be set for the patient?
A) 150 ml
B)400 ml
C)680 ml
D)800 ml
Q2) Your patient has a prolonged case of ARDS. What will happen to his alveolar cells?
A) Multiplication of the type I cells
B)Influx of macrophages
C)Hyperplasia and swelling of the type II cells
D)Development of emphysema
Q3) A chest radiograph finding indicative of ARDS is:
A) "ground-glass" appearance.
B)pleural effusion.
C)lung hyperinflation.
D)tracheal deviation.
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Chapter 28: Guillain-Barré Syndrome
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Q1) Clinical indications that your patient has acute ventilatory failure include:
1) pH < 7.35.
2) vital capacity (VC) < 20 ml/kg.
3) PaCO<sub>2</sub> > 45 mm Hg.
4) negative inspiratory force (NIF) < -25 cm H<sub>2</sub>O.
A)3
B)1, 3
C)2, 4
D)1, 2, 3, 4
Q2) Your patient with Guillain-Barré syndrome is developing atelectasis. His chest radiograph findings would show:
A) "ground-glass" appearance.
B)crackles.
C)increased opacity.
D)blunted costophrenic angles.
Q3) Guillain-Barré syndrome is most likely to be found in which demographic group?
A) African-American female 20-30 years of age
B)Hispanic male <45 years of age
C)Asian female 20-40 years of age
D)White male = 45 years of age
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Chapter 29: Myasthenia Gravis
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Q1) Myasthenia gravis:
1) interferes with acetylcholine transmission.
2) causes weakness of voluntary muscles.
3) is an ascending paralysis starting in the legs.
4) is usually preceded by a viral infection.
A)1, 2
B)3, 4
C)2, 3, 4
D)1, 2, 3
Q2) A 50-kg (110-lb) 30-year-old female patient has myasthenia gravis. Bedside spirometry has found her VC to be 700 ml and NIF -14 cm H<sub>2</sub>O. Vital signs show a respiratory rate of 38, heart rate of 140/minute, and blood pressure of 130/90 mm
Hg. What would you recommend be done?
A) Check the vital signs every hour.
B)Begin intermittent positive pressure breathing (IPPB) treatments.
C)Administer supplemental oxygen.
D)Begin mechanical ventilation.
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Chapter 30: Sleep Apnea
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Q1) Which of the following may be used in the management of a patient with central sleep apnea?
1) Carbonic anhydrase inhibitor drugs
2) Oxygen therapy
3) Inhaled bronchodilator medications
4) Negative-pressure ventilation
A)1, 3
B)2, 4
C)1, 2, 4
D)1, 2, 3, 4
Q2) A CPAP titration polysomnogram is performed to:
A) find the maximum CPAP level for the functional residual capacity.
B)determine the lowest possible CPAP level.
C)find the CPAP level to maintain an open airway.
D)determine the pressure needed for negative-pressure ventilation.
Q3) Long-term management of central sleep apnea includes:
A) CPAP.
B)adaptive servo-ventilation (VPAP).
C)mechanical ventilation.
D)palatopharyngoplasty.
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Chapter 31: Newborn and Early Childhood Respiratory Disorders
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Q1) A premature neonate must generate a higher negative intrapleural pressure during inspiration than a term neonate. This will result in all of the following, EXCEPT:
A) cyanosis of dependent thoracic areas.
B)"seesaw" breathing pattern.
C)alveolar hyperinflation.
D)intercostal retractions.
Q2) Your neonatal patient is having expiratory grunting. What physiologic effect does this produce?
A) Increased vital capacity.
B)Increased PAO<sub>2</sub>.
C)Decreased PaCO<sub>2</sub>.
D)Closes the ductus arteriosus.
Q3) Apneic episodes in a premature neonate can be caused by all of the following, EXCEPT:
A) epiglottitis.
B)immature central nervous system.
C)immature airway receptors.
D)immature chemoreceptors.
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Chapter 32: Meconium Aspiration Syndrome
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Q1) If mechanical ventilation is needed to support a neonate with MAS, which of the following settings is especially important?
A) High positive end-expiratory pressure (PEEP) level
B)Long exhalation time
C)High humidity level
D)Give no more than 50% oxygen
Q2) Your patient with MAS has had a chest radiograph taken. What findings can be expected?
A) Elevated diaphragms
B)Mediastinal shift
C)Irregular densities throughout the lungs
D)Air bronchograms
Q3) A common finding in a neonate with MAS is a respiratory rate that is:
A) under 40/min.
B)between 40 and 60/min.
C)well over 60/min.
D)cyclical with faster and then slower breaths.
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Chapter 33: Transient Tachypnea of the Newborn
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Q1) During the physical exam of a patient with TTN, what respiratory rate is usually found?
A) 80 to 120/min
B)60 to 80/min
C)30 to 60/min
D)Less than 30/min
Q2) Initially, TTN will have a clinical presentation similar to:
A) the early stage of respiratory distress syndrome (RDS).
B)the late stage of respiratory distress syndrome (RDS).
C)bronchial pneumonia.
D)meconium aspiration syndrome (MAS).
Q3) A newborn is suspected of having TTN. If this is true, what will the initial chest radiograph show?
A) Normal lung fields
B)Hyperlucency
C)Flattened diaphragms
D)Bulging intercostal spaces
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35
Chapter 34: Respiratory Distress Syndrome
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Q1) The respiratory pattern of a neonate with RDS will have these characteristics:
1) Respiratory rate of about 50/min
2) Respiratory rate of >60/min
3) Cyclical breathing pattern
4) Hard and deep breaths
A)1
B)2, 3
C)1, 4
D)2, 4
Q2) All of the following amniotic fluid lab findings would indicate mature fetal lungs, EXCEPT:
A) S:A ratio is >55
B)PG is present
C)L:S ratio is 2:1
D)L:S ratio is 1:2
Q3) Which of the following are usually seen in the lungs of a neonate with RDS?
A) Alveolar collapse (atelectasis)
B)Segmental atelectasis
C)Lobar atelectasis
D)Pulmonary fibrosis
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Chapter 35: Pulmonary Air Leak Syndromes
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Q1) What pulmonary condition can be identified by a change in the point of maximum impulse (PMI)?
A) Pneumothorax
B)PIE
C)Pneumomediastinum
D)Meconium aspiration syndrome (MAS)
Q2) Your patient has PIE and a pneumomediastinum. What clinical manifestations are associated with the more negative intrapleural pressures needed during an inspiration by your patient?
1) Lower thoracic areas are cyanotic
2) Substernal retractions
3) Flaring nostrils
4) Inspiratory stridor
A)1, 4
B)2, 3
C)1, 2, 3
D)1, 2, 3, 4
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Chapter 36: Respiratory Syncytial Virus Infection
Bronchiolitis or Pneumonitis
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Q1) Which of the following are major pathologic or structural changes associated with RSV?
1) Dilation and distortion of the airways
2) Inflammation of the peripheral airways
3) Alveolar hyperinflation
4) Pulmonary edema
A)1, 4
B)2, 3
C)2, 3, 4
D)1, 2, 3, 4
Q2) During the early stages of RSV in a young child, what respiratory rate is commonly found?
A) Under 30/min
B)Between 30 and 60/min
C)well over 60/min
D)rapid, then up to a 10-second period of apnea
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38
Chapter 37: Bronchopulmonary Dysplasia
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Q1) What can be given to a preterm infant to help reduce lung inflammation and the incidence of BPD?
A) Vitamin D
B)Exogenous surfactant
C)Ribavirin (Virazole)
D)Corticosteroids
Q2) A patient with Stage 1 BPD would have which of the following chest radiograph findings?
A) Ground-glass granular pattern
B)Emphysematous bullae
C)Honeycomb appearance
D)Mediastinal shift
Q3) Your patient requires mechanical ventilation. All of the following ventilator parameters have been linked to the development of BPD, EXCEPT:
A) high peak inspiratory pressure.
B)lung overdistention.
C)low oxygen percentage.
D)high mean airway pressure.
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Chapter 38: Congenital Diaphragmatic Hernia
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Q1) Which of the following auscultation findings would be found in a patient with a CDH?
1) Bilateral bruits
2) Apical heart beat heard over the unaffected side
3) Absent breath sounds over the affected area
4) Bowel sounds over the affected area
A)1, 2
B)3, 4
C)2, 3, 4
D)1, 2, 3, 4
Q2) All of the following anatomic alterations may be found in a patient with a congenital diaphragmatic hernia (CDH), EXCEPT:
A) lungs are compressed.
B)atelectasis.
C)hyperinflation.
D)complete lung collapse.
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Chapter 39: Croup Syndrome: Laryngotracheobronchitis and
Acute Epiglottitis
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Q1) Most cases of LTB occur during which season(s) of the year?
1) Spring
2) Summer
3) Fall
4) Winter
A)1
B)4
C)3, 4
D)1, 2, 3
Q2) The medication racemic epinephrine (Micro-Nefrin, Vaponefrin) is given to a patient with LTB because it:
A) is an effective bronchodilator.
B)causes mucosal vasoconstriction.
C)causes bradycardia.
D)has an appealing taste and smell.
Q3) The diagnosis of LTB is made by all of the following, EXCEPT:
A) child has inspiratory stridor and barking cough.
B)child has a normal temperature or low fever.
C)child has a significant fever.
D)child can drink without difficulty.
Page 41
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Chapter 40: Near Drowning
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Q1) What water temperature has been shown to be a favorable prognostic factor in near drowning?
A) Higher than 104° F
B)98.6° F
C)Between 98° F and 70° F
D)Less than 70° F
Q2) The initial chest radiograph appearance of a near drowning victim may include: 1) normal lung fields.
2) atelectasis.
3) pulmonary edema.
4) pencil point sign.
A)1, 3
B)2, 4
C)1, 2, 3
D)1, 2, 3, 4
Q3) A wet drowning victim will have the following pulmonary function test finding:
A) increased Vt.
B)increased DLCO.
C)decreased VC.
D)increased TLC.
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Chapter 41: Smoke Inhalation and Thermal Injuries
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Q1) All of the following classes of medications are commonly used in the care of patients with a smoke inhalation injury, EXCEPT:
A) parasympatholytics.
B)mucolytics.
C)sympathomimetics.
D)xanthines.
Q2) Your patient with carbon monoxide poisoning has a COHb level of 20%. If he is given 100% oxygen, what will be the approximate COHb level be at 1 hour?
A) 15%
B)10%
C)5%
D)2.5%
Q3) A 10-year-old patient has inhaled hot gases and an inspection of her mouth shows edema and blisters. What should be done?
A) Perform a bronchoscopy to evaluate the trachea.
B)Perform endotracheal intubation.
C)Check her pulse oximeter value.
D)Give her a breathing treatment with racemic epinephrine.
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43
Chapter 42: Postoperative Atelectasis
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Q1) What definition of atelectasis would best fit that of a premature newborn with respiratory distress syndrome (RDS)?
A) Partial or total collapse of previously expanded lung regions
B)Free pleural air compressed the lungs
C)Enlarged heart causes compression of the lungs
D)The lungs remain unexpanded since birth
Q2) All of the following conditions can lead to atelectasis, EXCEPT:
A) Chronic obstructive pulmonary disease (COPD)
B)Acute respiratory distress syndrome (ARDS)
C)Pleural effusion
D)Pneumothorax
Q3) Your patient has a tumor blocking the left mainstem bronchus. What additional factor would favor the development of atelectasis?
A) Breathing a nitric oxide mix (iNO)
B)Breathing a helium/oxygen mix (heliox)
C)Breathing a high percentage of oxygen
D)Breathing a low percentage of oxygen
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