Respiratory Therapy Lab Textbook Exam
Questions
Course Introduction
Respiratory Therapy Lab provides students with hands-on experience in the fundamental procedures and equipment used in respiratory care. Through guided laboratory sessions, students practice skills such as patient assessment, airway management, oxygen therapy, ventilator setup, and the administration of therapeutic modalities. The course emphasizes safety, infection control, and accurate documentation, preparing students to apply theoretical knowledge in clinical settings and work effectively as part of a healthcare team.
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) A patient with extensive burns requires oxygen therapy via face tent with a large volume nebulizer.What type of precautions should the respiratory care practitioner use in caring for the patient?
Answer: A large volume nebulizer with sterile water should be used for the cool aerosol to humidify the oxygen therapy.The face tent and the large bore tubing to deliver the oxygen must be aseptic and handled carefully.The therapist's stethoscope should be free of microorganisms.Personal protective equipment should be worn to protect the patient from being contaminated with microorganisms from the practitioner.Gloves should also be worn before contact with mucous membranes or broken or non-intact skin.A health care provider should wear a mask to protect the patient from being splashed or sprayed by contaminated body secretions.A cover gown or special scrubs prevent the spread of microorganisms to the patient via the contact transmission route.
Q2) What is the most frequent cause of needle sticks?
A)Attempting to recap a needle
B)Removing discarded needles or syringes from sharps containers
C)Attempting to force a needle into an already full container
D)Using puncture-proof containers
Answer: A
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Chapter 2: Basic Patient Assessment: Vital Signs and Breath Sounds
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Q1) The patient has a blood pressure of 150/100.Which of the following could cause this?
I.Renal failure/fluid retention
II.Hormonal imbalances
III.Shock
IV.Emotional stress
V.Depressant drugs
A)I,II,IV
B)III and V
C)I,II,III
D)IV and V
Answer: A
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
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Chapter 3: Advanced Patient Assessment: Inspection, Palpation, and Percussion
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Q1) In diabetic acidosis,a condition termed metabolic acidosis is produced.What type of breathing pattern is produced to compensate for this condition?
A)Kussmaul's respiration
B)Cheyne-Stokes respiration
C)Biot's respiration
D)Paradoxical breathing
Answer: A
Q2) Upon percussing the patient's chest,a dull percussion note is heard over the left lower lobe.What other findings would be expected to be found over the left lower lobe?
Answer: A dull percussion note is heard over areas containing a greater proportion of tissue or fluid than of air.This occurs in the lungs as a result of consolidation,atelectasis,or the presence of fluid in the pleural space.Breath sounds would be diminished in the area of the dull percussion note.There would be increased vocal fremitus.Chest movement would lag on the left side of the thoracic cavity due to diminished air entry.
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Chapter 4: Radiologic Assessment
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Q1) Which of the following views is also called a portable chest x-ray?
A)Posterior-anterior (PA)view
B)Lateral view
C)Lateral decubitus view
D)Anterior-posterior (AP)view
Q2) The respiratory care practitioner evaluates the patient's chest x-ray to determine any abnormalities.The practitioner evaluates the lung field and the diaphragms.Which hemidiaphragm should be higher than the other?
A)The right hemidiaphragm
B)The left hemidiaphragm
C)They both should be at the same level
D)The hemidiaphragm over the stomach
Q3) What is described by a consolidated lung region that demonstrates an increased radiodensity that appears lighter than the surrounding lung fields?
A)Atelectasis
B)Consolidation
C)Pneumothorax
D)Hyperinflation
Q4) What can be evaluated on a chest radiograph besides the heart and lungs?
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Chapter 5: Pulmonary Function Testing
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Q1) Which of the following is NOT an indication for spirometry?
A)Detect the presence or absence of lung dysfunction suggested by history or physical signs and symptoms
B)Quantify the severity of known lung disease
C)Assess the potential effects or response to environmental or occupational exposure
D)Hemoptysis of unknown origin
Q2) Vt + IRV = ?
A)Inspiratory capacity (IC)
B)Vital capacity (VC)
C)Total lung capacity (TLC)
D)Functional residual capacity (FRC)
Q3) Which gas law or calculation is used in the body plethysmograph to measure lung volumes?
A)Nitrogen Washout Law
B)Boyles' Law
C)C1V1 = C2V2
D)Gas Dilution Technique
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Chapter 6: Electrocardiography
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Q1) Which lead(s)is (are)placed at the fourth intercostal space adjacent to the sternum?
A)V1
B)V2
C)V3
D)V1 and V2
Q2) The patient wants an exercise EKG.To ensure the electrodes stay remain in the proper position,what precautions should be taken?
Q3) Which of the following waves in an ECG tracing represents ventricular repolarization?
A)'P' wave
B)'QRS' complex
C)'T' wave
D)'U' wave
Q4) Which of the following waves in an ECG tracing represents atrial depolarization?
A)'P' wave
B)'QRS'complex
C)'T' wave
D)'U' wave
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Chapter 7: Phlebotomy
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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) Which of the following needle sizes is the smallest size?
A)25 gauge
B)23 gauge
C)21 gauge
D)19 gauge
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?
Q5) How can the phlebotomist enhance sites to draw blood from a patient?
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Chapter 8: Arterial Blood Gas Sampling
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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 neonatal patient needs an arterial blood gas drawn to justify the need for oxygen,but arterial access is not available.What should done?
A)The patient's PaO should be estimated based on the patient's color.
B)A venous blood gas sample should be done and the PaO calculated.
C)A capillary blood gas sample should be drawn.
D)The patient's vital signs should be assessed to justify the need for O .
Q3) Which artery is located on the medial side of the antecubital fossa near the insertion of the biceps muscle at the radial tuberosity?
A)Radial artery
B)Brachial artery
C)Femoral artery
D)Dorsalis pedis
Q4) How should the practitioner ensure that the arterial line's measured blood pressure is accurate?
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Chapter 9: Hemodynamic Monitoring
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Q1) Normal mean pulmonary artery pressure is _________________.
A)6-12 mmHg
B)10-22 mmHg
C)0-6 mmHg
D)80-120 mmHg
Q2) PEEP _________________________________
A)increases the PCWP reading.
B)Increases the CVP reading.
C)increases cardiac output.
D)increases the CVP and PCWP reading.
Q3) Hemodynamic monitoring provides important clinical information regarding all of the following EXCEPT___________.
A)Cardiac preload and afterload
B)Blood pressure
C)Heart rate
D)Fluid volume
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Chapter 10: Noninvasive Monitoring
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Q1) What electrode does the transcutaneous O monitor incorporate into its design?
A)Clark electrode
B)Severinghaus electrode
C)Sanz electrode
D)Reference electrode
Q2) What is considered the standard of care during anesthesia?
A)Exhaled volume monitoring
B)Transcutaneous monitoring
C)Oximetry
D)Capnography
Q3) The pulse Masimo Rad-57 CO-Oximeter finger probe is placed on the patient's digit and can measure:
A)carbon monoxide.
B)methemoglobin.
C)fetal hemoglobin.
D)a and b
Q4) A practitioner is monitoring an intubated patient on a mechanical ventilator with a capnograph.The reading on the capnograph suddenly drops to zero from 35 mmHg.How would the practitioner determine the cause of the reading?
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Chapter 11: Documentation and Goals Assessment
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Q1) 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
Q2) A patient was given a respiratory treatment by a practitioner who did not chart the treatment immediately on the patient's chart due to an excessive workload.Ultimately,the treatment was not charted on the medical record.What problem is associated with the therapist's judgement?
Q3) Which of the following is NOT found in the laboratory reports?
A)Computerized tomography reports
B)Arterial blood gas reports
C)Hematology reports
D)Endocrinology reports
Q4) When attempting to achieve ventilation goals the respiratory care practitioner should assess the ________________.
A)PaO .
B)SaO .
C)PaCO .
D)HCO .
13
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Chapter 12: Oxygen Supply Systems
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Q1) The connection for attaching equipment for patient use is termed a station outlet.These outlets have what kind of fittings?
A)Quick-connect fittings
B)Diameter-index safety system fittings
C)Reducing valve fittings
D)Either a or b
Q2) A half-full 'E' cylinder will last how long running at 3 L/min?
A)About 180 minutes
B)About 30 minutes
C)About 4 hours,13 minutes
D)About 1 hour,43 minutes
Q3) How many cubic feet of oxygen are in an 'E' sized cylinder?
A)244 cu.ft.
B)22 cu.ft.
C)28.3 cu.ft.
D)2200 cu.ft.
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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Q1) What is defined as an oxygen delivery system that provides all of the total inspiratory flow required by the patient?
A)High-flow oxygen delivery system
B)Low-flow oxygen delivery system
C)Non-rebreathing oxygen delivery system
D)Reservoir oxygen delivery system
Q2) During laser bronchoscopy,minimal levels of supplemental oxygen should be used to ___________.
A)prevent oxygen toxicity.
B)decrease the risk of bronchospasm.
C)avoid intratracheal ignition.
D)decrease the chance of bacterial contamination.
Q3) Before analysis of oxygen percentage,the analyzer should be calibrated to which percentage?
A)21%
B)50%
C)100%
D)a and c
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Chapter 14: Introduction to Respiratory Care Pharmacology
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Q1) 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
Q2) What is the name of the receptor sites that are located in the peripheral vasculature,the heart,bronchial muscle,and bronchial blood vessels?
A)Beta 2 receptors
B)Gamma receptors
C)Alpha receptors
D)Beta 1 receptors
Q3) Stimulation of the beta 2 receptors causes ___________________
A)peripheral vasoconstriction and mild bronchoconstriction in the lungs.
B)tachycardia,an increased potential for arrhythmias,and an increased cardiac output.
C)bronchodilation.
D)peripheral vasodilation,bradycardia,and decreased cardiac output.
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Chapter 15: Humidity and Aerosol Therapy
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Q1) Which of the following is NOT an indication for bland aerosol administration?
A)The need for sputum specimens
B)The need to deliver bronchodilators
C)The presence of upper airway edema
D)The presence of a bypassed upper airway
Q2) A patient has an ultrasonic nebulizer ordered every 4 hours to help with secretion mobilization.After the treatment the patient complains of chest tightness and wheezing is heard upon auscultating the chest.What could be done to alleviate this problem?
Q3) Which of the following situations would be a contraindication for Heat-Moisture Exchanger (HME)use to provide humidification to a mechanically ventilated patient?
A)Body temperature of 34°C
B)Inspired Vt 600ml,expired Vt 400 ml
C)Spontaneous minute volume of 8 LPM
D)a and b
Q4) 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) During bronchial hygiene therapy in the Trendelenburg position,the patient's heart rhythm exhibits bigeminy PVCs.What intervention would be the most correct for the Respiratory Care Practitioner to take at this time?
A)Stop therapy,return patient to original resting position,administer or increase oxygen delivery while contacting physician.Administer physician-ordered bronchodilators.
B)Stop therapy,clear airway and suction as needed,administer oxygen,maintain airway,return patient to previous resting position,and contact physician immediately.
C)Stop therapy,return patient to previous resting position,allow patient to rest,continue therapy with patient in the modified position,document heart rhythm in the patient's chart.
D)Stop therapy,return patient to previous resting position,administer or increase oxygen delivery while contacting physician.
Q2) What is the only absolute contraindication to a directed cough?
A)Increased intracranial pressure
B)Increased potential for aspiration
C)Untreated pneumothorax
D)There are no absolute contraindications.
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Chapter 17: Hyperinflation Therapy
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Q1) What is defined as a combination of high-frequency phased pulse gas delivery and the administration of a dense aerosol?
A)Incentive spirometry (IS)
B)Intermittent positive pressure breathing (IPPB)therapy
C)Intrapulmonary percussive ventilation (IPV)therapy
D)High frequency chest wall oscillation (HFCWO)therapy
Q2) During IPV,what happens to the peak pressures during percussion when the source pressure is increased?
A)The peak pressures decrease
B)The peak pressures increase
C)Nothing,but the frequency of the percussion increases
D)The peak pressures remain the same as preset at the factory
Q3) The effectiveness of any hyperinflation therapy is dependent on _____________
A)patient effort.
B)patient cooperation.
C)the patient's diagnosis.
D)a and b
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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) Which type of brush/needle/mechanical device is/are used to sample an area of interest that lies on the opposite side of the bronchial wall from where the bronchoscope is located?
A)Sheathed cytology brush
B)Unsheathed cytology brush
C)Forceps
D)Wang needle
Q3) What instructions would you give a patient who is to have a bronchoscopy procedure?
Q4) A patient has just had a bronchoscopy procedure performed.What precautions and instructions should you give the patient following the procedure?
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Chapter 19: Equipment Processing and Surveillance
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Q1) Which of the following is NOT a bacterial shape?
A)Rod-shaped
B)Spiral
C)Round
D)Flat
Q2) Equipment that is going to be sterilized by steam autoclaving should first be
A)thoroughly sprayed with an antiseptic spray.
B)cleaned in an alcohol solution and then pasteurized.
C)tightly wrapped in a special paper to make sure that the steam thoroughly penetrates around the equipment.
D)disassembled and washed in a detergent solution to remove gross particles and body secretions.
Q3) Some bacteria secrete a slimy or gummy material on the surface of the cell wall.When this material forms a closely compacted structure,it is termed a/an\ ________________:
A)endospore.
B)capsule.
C)endotoxin.
D)prokaryotic.
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Chapter 20: Emergency Airway Management
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Q1) If vomiting and aspiration is a concern with a patient who needs an airway in place,which of the following airways would best protect the patient's airway?
A)Nosopharyngeal airway
B)Oropharyngeal airway
C)Laryngeal mask airway
D)a and b
Q2) What is the most important consideration in determining endotracheal tube position?
A)Depth of the endotracheal tube
B)Bilateral breath sounds
C)Symmetrical chest movement
D)Detection of esophageal intubation
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
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Chapter 21: Artificial Airway Care
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Q1) Why is the nasopharyngeal airway placed for frequent nasotracheal suctioning?
A)To minimize trauma to the patient's nose and nasopharynx
B)To allow the patient to be able to speak during the procedure
C)To prevent aspiration of abdominal contents
D)To prevent hypoxemia during the procedure
Q2) When using a fenestrated tracheostomy tube to facilitate weaning the patient from the tracheostomy tube,what procedure(s)should be performed?
A)The cuff should be deflated
B)The inner cannula should be removed
C)The minimum occluding volume should be done
D)a and b
Q3) What should be done to prevent a high-risk patient from aspiration of gastric contents?
A)Proper maintenance of cuff pressures
B)Use of humidification of secretions with a heated humidifier
C)Elevation of the patient's head 30-45 degrees
D)The use of subglottic secretion drainage
Q4) 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?
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Chapter 22: Chest Tubes
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Q1) If the chest tube drainage system needs to be changed,when should it be done?
A)During inhalation
B)During expiration
C)During spontaneous breathing
D)During positive-pressure ventilation
Q2) 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
Q3) Once the chest tube has been inserted,a large loop is inadvertently left in the chest tube tubing.What can happen because of the loop in the tubing?
A)Air evacuation can be enhanced by this
B)It can cause a leak in the system
C)It can collect fluid,stopping fluid flow from the chest
D)Nothing a large loop should always be made in a chest tube tubing
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Chapter 23: Insertion and Maintenance of Intravenous Lines
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Q1) The patient complains of tenderness at the IV site in his lower arm.The practitioner notes swelling and redness at the IV site.The site feels very warm but the IV is still running.What is the most likely cause of these findings?
A)Infiltration of the IV
B)A thrombus in the vessel
C)Cellulitis of the tissues
D)An air embolism has developed
Q2) 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
Q3) What does the medical abbreviation 'prn' mean after an order for administer a medication to a patient?
A)Immediately
B)Per nebulizer
C)As needed
D)Drop
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Chapter 24: Noninvasive Positive-Pressure Ventilation
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Q1) 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?
Q2) The post-operative patient is placed on NPPV to increase alveolar ventilation.After 4 hours the patient has arterial blood gases drawn that reveal hypoxemia and hypercarbia.Which of the following could be the cause of these arterial blood gas abnormality?
A)A proper size fitting face mask
B)A leak in the NPPV circuitry
C)A pressure sore on the patient's face
D)Too much pressure being delivered
Q3) A patient is placed on noninvasive positive-pressure ventilation (NPPV).The patient is on a nasal mask and is having trouble keeping his mouth closed due to tachypnea and dyspnea.Breath sounds are diminished bilaterally.The patient is also complaining of nasal dryness.What should be done to help the patient?
Q4) A patient on a full face mask on noninvasive positive-pressure ventilation (NPPV)is swallowing air and having trouble exhaling due to a leak around the naso-gastric (NG)tube.What can be done?
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Chapter 25: Continuous Mechanical Ventilation
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Q1) When considering types of ventilation,which of the following is NOT an advantage of invasive positive-pressure ventilation?
A)Better regulation of minute ventilation especially in volume modes
B)Improved delivery of oxygen therapy
C)Better accuracy in monitoring parameters
D)Enhanced ability to communicate
Q2) How does a practitioner measure airway resistance on a ventilator?
Q3) In the early stages of an acute asthmatic attack the practitioner will note which of the following?
A)Type I respiratory failure (normal or low PaCO with low PaO )
B)Type II respiratory failure(high PaCO with a low PaO
C)Respiratory failure with PaCO greater than 50 and PaO less than 50
D)Near normal arterial PCO and PO
Q4) In the face of changing airway resistance or thoracic compliance,which of the following will occur in volume ventilation?
A)Pressure is selected as the controlled variable
B)Volume will change while pressure will stay the same
C)Pressure will vary but the tidal volume will remain unchanged
D)Pressure will stay the same but FIO will vary with back pressure
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Chapter 26: Advanced Modes of Mechanical Ventilation
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Q1) What are the purposes of ventilator alarms and backup modes?
Q2) Which of the following will occur after 12 seconds in the VSV Automode?
A)The ventilator will flash a visible apnea alarm.
B)The ventilator will switch to pressure support.
C)The ventilator will switch to PRVC.
D)The ventilator will volume assist ventilation.
Q3) APRV is which of the following?
A)Airway Pressure Release Ventilation
B)Continuous Positive Airway Pressure with two pressure levels
C)Time triggered,pressure limited,time cycled with spontaneous breathing
D)All of the above
Q4) A respiratory care practitioner may use which of the following to eliminate the airway resistance caused by an artificial airway?
A)APRV
B)Automatic tube compensation
C)Inverse ratio ventilation
D)Automode
Q5) How does a respiratory care practitioner assess the patient's work of breathing?
Q6) What is the auto-set-point control?
Q7) What is proportional assist ventilation?
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Chapter 27: Wave Form Analysis
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Q1) If the volume wave form does not reach zero on exhalation,the practitioner can determine which of the following?
A)Air trapping is present
B)PEEP has been turned on
C)There are secretions in the airway that should be suctioned
D)Tidal volume control is set too low
Q2) 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
Q3) The wave form variables of flow,volume and pressure are most often plotted against
A)SPO .
B)mode.
C)time.
D)FIO .
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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) According to the AARC Clinical Practice Guidelines on Weaning and Discontinuation on Ventilatory Support,adequate patient oxygenation criteria for weaning is measured by
I.PaO greater than 60 mm Hg
II.FIO set less than 0.4
III.PEEP zero
IV.PO /FIO ratio greater than 150-300
A)I,II,III and IV
B)I,II and III
C)I,II and IV
D)II,III and IV
Q2) A closed loop ventilator system ____________________
A)Eliminates the need for nurses and respiratory care practitioners.
B)can be used in the absence of a protocol.
C)continually adjusts the ventilator based on measured patient parameters.
D)is a rebreathing system of ventilator care
Q3) How do respiratory conditions result in ventilator dependence?
Q4) What should the respiratory therapist do if the patient does not pass the SBT?
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Q5) What four general questions should the respiratory care practitioner assess prior to weaning from mechanical ventilation?
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Chapter 29: Neonatal Mechanical Ventilation
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35 Verified Questions
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Sample Questions
Q1) 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
Q2) Which of the following is true of I:E ratio?
A)Refers to inspiratory flow to expiratory flow
B)Inspiration is always longer than expiration
C)Long time constants need greater than 1:2 ratio
D)Higher I:E ratios are better tolerated with short time constants
Q3) Describe how the initial newborn ventilator setting are determined for mode,rate and flow rate.
Q4) Describe the 5 characteristics of the Apgar scoring system.
Q5) Describe how the initial newborn ventilator setting are determined for tidal volume,oxygen percent and PEEP/CPAP
Q6) Describe how the initial newborn ventilator alarm setting are determined.
Q7) Describe the point system used when determining an Apgar score.
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