Allied Health Sciences: Respiratory Assessment
Final Exam
Course Introduction
This course provides an in-depth exploration of respiratory assessment techniques within the field of allied health sciences. Students will develop foundational knowledge of the anatomy and physiology of the respiratory system, learn to identify normal and abnormal respiratory patterns, and acquire skills in performing physical examinations such as inspection, palpation, percussion, and auscultation. Emphasis is placed on interpreting clinical findings, utilizing assessment tools, understanding case scenarios, and integrating results into care planning for patients with a variety of respiratory conditions. The course combines theoretical concepts with practical application, preparing students for interprofessional clinical environments.
Recommended Textbook
Clinical Manifestations Assessment of Respiratory Disease 6th Edition by Terry Des Jardins
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580 Flashcards
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Chapter 1: The Patient Interview
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Sample Questions
Q1) The main purpose of a patient interview is to:
A) review data with the patient.
B)gather subjective data from the patient.
C)gather objective data from the respiratory therapist.
D)fill out the history form or checklist.
Answer: B
Q2) The direct question interview format is used to:
1) speed up the interview.
2) let the patient fully explain his/her situation.
3) help the respiratory therapist show empathy.
4) gather specific information.
A)1, 4
B)2, 3
C)3, 4
D)1, 2, 3, 4
Answer: A
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3
Chapter 2: The Physical Examination and Its Basis in Physiology
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Sample Questions
Q1) Tachypnea may be the result of:
1) hypoxemia.
2) hypothermia.
3) fever.
4) sedation.
A)2, 4
B)1, 3
C)2, 3, 4
D)1, 2, 3, 4
Answer: B
Q2) Your 50-year-old patient has a heart rate by palpation of 120 bpm. How should this be interpreted?
A) Within the normal range for an adult
B)An error since a stethoscope was not used
C)Bradycardia
D)Tachycardia
Answer: D
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Page 4
Chapter 3: Pulmonary Function Study Assessments
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Sample Questions
Q1) Overall characteristics of pulmonary function testing results on a patient with obstructive lung disease include that:
A) FEV<sub>1</sub> is reduced and FEV<sub>1</sub>% is normal.
B)FEV<sub>1</sub> and FEV<sub>1</sub>% are both increased.
C)FEV<sub>1</sub> and FEV<sub>1</sub>% are both reduced.
D)FEV<sub>1</sub> is increased and FEV<sub>1</sub>% is decreased.
Answer: C
Q2) A special indirect measurement procedure must be done to find the following:
A) Inspiratory reserve volume
B)Residual volume
C)Expiratory reserve volume
D)Inspiratory capacity
Answer: B
Q3) 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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Page 5
Chapter 4: Arterial Blood Gas Assessments
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Sample Questions
Q1) Your patient has had chronic ventilatory failure for several years. What is the primary factor that determines her breathing pattern?
A) Muscle efficiency
B)Ventilatory efficiency
C)Heart function
D)Work efficiency
Q2) 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.
Q3) All of the following will be seen in the arterial blood gas values of a patient with acute ventilatory failure EXCEPT:
A) an acidic pH.
B)a near-normal bicarbonate level.
C)an alkaline pH.
D)a high carbon dioxide level.
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6
Chapter 5: Oxygenation Assessments
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Sample Questions
Q1) A condition that will cause hypoxic hypoxia is:
A) cyanosis.
B)decreased cardiac output or heart failure.
C)hypoventilation from an overdose of a sedative medication.
D)carbon monoxide poisoning.
Q2) Your patient has a chronic respiratory disorder and vasoconstriction of her pulmonary vascular system. What is the chief control over this vasoconstriction?
A) Low PAO<sub>2</sub>
B)Low PaO<sub>2</sub>
C)High PaCO<sub>2</sub>
D)High pH
Q3) A person's C(a-v)O<sub>2</sub> increases in all of the following situations EXCEPT: A) seizures.
B)peripheral shunting.
C)hyperthermia.
D)exercise.
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Chapter 6: Cardiovascular System Assessments
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Sample Questions
Q1) 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
Q2) When reviewing a cardiac rhythm strip, you notice that there are three large boxes between two QRS complexes. Approximately what is this patient's heart rate?
A) 60
B)75
C)100
D)150
Q3) The "T" wave represents:
A) depolarization of the ventricles.
B)repolarization of the ventricles.
C)depolarization of the atria.
D)repolarization of the atria.
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Chapter 7: Radiologic Examination of the Chest
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Q1) Which of the following are steps used in the evaluation of a chest radiograph?
1) Evaluation of the bony structures
2) Evaluation of exposure quality
3) Evaluation of the heart shadow
4) Evaluation of the tracheobronchial tree
A)4
B)1, 4
C)1, 2, 4
D)1, 2, 3, 4
Q2) Which of the following would be normal findings of the heart and surrounding area?
1) The left hilum is about 2 cm higher than the right hilum.
2) Most of the heart shadow is to the right of the sternum.
3) Calcified lymph nodes indicate an adult patient.
4) The cardiothoracic ratio is less than 1:2.
A)1, 4
B)2, 3
C)1, 2, 4
D)1, 2, 3, 4
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9
Chapter 8: Other Important Tests and Procedures
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Sample Questions
Q1) Diagnostic thoracentesis can be used to:
A) withdraw a secretion sample from the lung for a sputum smear.
B)withdraw a secretion sample from the lung for a Gram stain.
C)determine the etiology of a pleural effusion.
D)remove air from the pleural space.
Q2) 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.
Q3) After a thoracentesis procedure, it is important to monitor the patient for:
A) bronchospasm.
B)hemoptysis.
C)increased blood urea nitrogen (BUN).
D)pneumothorax.
Q4) Culture and sensitivity tests:
A) stain a microorganism as Gram-positive or Gram-negative.
B)determine the shape of the organisms present.
C)identify the DNA of organisms present in the sputum.
D)determine the antibiotic(s) best suited for combating an infection.
10
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Chapter 9: The Therapist-Driven Protocol Program and the
Role of the Respiratory Care Practitioner
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Sample Questions
Q1) An obese patient had upper abdominal surgery 2 days earlier. He has a weak nonproductive cough and a pulse oximeter (SpO<sub>2</sub>) reading of 84% on room air. What therapist-driven protocol(s) should be implemented?
1) mechanical ventilation
2) hyperinflation therapy
3) oxygen therapy
4) aerosolized medication
A)1
B)3, 4
C)2, 3
D)1, 3, 4
Q2) When performing a therapist-driven protocol (TDP), the severity assessment refers to:
A) the frequency of performing a treatment modality.
B)how sick the patient is.
C)the Department of Homeland Security's threat level.
D)how urgently the physician wants the patient treated.
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Q1) When reviewing a SOAPIER progress note, the R stands for:
A) revisions made in the original plan.
B)refusal of care by the patient.
C)rejection by the physician.
D)resuscitate the patient.
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) Many respiratory therapists now use portable devices for bedside computer charting. These units are referred to as:
A) point-of-care systems.
B)laptop computers.
C)i-pods.
D)MP3 players.
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Page 12
Chapter 11: Chronic Obstructive Pulmonary Disease Copd:
Chronic Bronchitis, and Emphysema
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Sample Questions
Q1) Which of the following would indicate a diagnosis of advanced COPD?
1) Arterial blood gases show low O<sub>2</sub> and high CO<sub>2</sub>.
2) Arterial blood gases show high O<sub>2</sub> and low CO<sub>2</sub>.
3) Pulmonary function tests show low flow of air on expiration.
4) Pulmonary function tests show low flow of air on inspiration.
A)1, 3
B)2, 4
C)1, 4
D)2, 3
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) An asthmatic patient has been complaining of increased difficulty breathing. The physician has ordered pulmonary function testing to be performed. Which of the following findings would confirm how the patient feels?
1) Decreased tidal volume
2) Decreased FRC
3) Increased RV
4) Decreased VC
A)2
B)1, 3
C)1, 2
D)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) Management of the patient with bronchiectasis may include:
1) Expectorants
2) Early childhood immunizations
3) Lung resection
4) Lung transplant
A)1, 3
B)3, 4
C)1, 2, 3
D)1, 2, 3, 4
Q2) Irregularly dilated and constricted bronchi are the key anatomic alterations found in which type of bronchiectasis?
A) Cystic
B)Varicose
C)Tubular
D)Saccular
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) How can the genetic mutation found with cystic fibrosis (CF) be characterized?
1) There are many variations in the mutation.
2) CF is the most common childhood inherited disorder.
3) The mutation is a dominant trait.
4) The mutation stops cilia function.
A)1, 2
B)3, 4
C)1, 3
D)2, 3, 4
Q2) Which ethnic group has the greatest number of people with cystic fibrosis?
A) African Americans
B)Asians
C)Hispanics
D)whites
Q3) During the advanced stages of cystic fibrosis, the anatomic alterations cause the patient to have:
A) a primarily restrictive lung disease.
B)a primarily obstructive lung disease.
C)equal parts restrictive and obstructive lung disease.
D)normal airways with emphysema.
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Chapter 15: Pneumonia
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Sample Questions
Q1) A patient has a pleural effusion related to her pneumonia. What can be used to help treat it?
A) Hyperinflation therapy
B)Supplemental oxygen
C)Thoracentesis
D)Percussion and postural drainage
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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17
Chapter 16: Lung Abscess
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Sample Questions
Q1) In response to the patient having a lung infection, how does the body respond?
A) Polymorphonuclear leukocytes go to the area.
B)Erythrocytes go to the area.
C)Surface goblet cells increase mucus production.
D)Metabolism is decreased.
Q2) 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
Q3) Your patient has aspirated. This can result in all of the following EXCEPT:
A) fungal pneumonia.
B)anaerobic bacterial pneumonia.
C)chemical pneumonitis.
D)Both B and C
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Page 18
Chapter 17: Tuberculosis
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Sample Questions
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) A patient with an advanced case of TB may have the following radiologic findings:
1) Bronchial tumors
2) Hyperlucent lung fields
3) Retraction of lung segments
4) Right-sided heart enlargement
A)2
B)2, 3
C)3, 4
D)1, 3, 4
Q3) Risk factors predisposing a person to TB include all of the following EXCEPT:
A) having HIV/AIDS.
B)being immunosuppressed.
C)African American or Hispanic heritage.
D)malnutrition.
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Page 19
Chapter 18: Fungal Diseases of the Lung
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Q1) In the midwestern part of the United States, what is the most common fungal infection of the lungs?
A) Cryptococcosis
B)Histoplasmosis
C)Blastomycosis
D)Coccidioidomycosis
Q2) The drug of choice for the treatment of fungal lung diseases is:
A) penicillin (Penicillin G).
B)tetracycline.
C)amphotericin B (Fungizone).
D)ketoconazole (Nizoral).
Q3) 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
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Chapter 19: Pulmonary Edema
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Sample Questions
Q1) 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
Q2) Your patient has noncardiogenic pulmonary edema. What chest radiograph findings would be expected?
1) "Bat's wings" pattern fluffy infiltrates
2) Normal cardiac silhouette
3) Fluffy densities near the hilum
4) Pleural effusion
A)1
B)2, 3
C)3, 4
D)1, 2, 4
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Chapter 20: Pulmonary Embolism
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Sample Questions
Q1) The sudden onset of which of the following signs and symptoms indicate a pulmonary embolism:
1) wheezing.
2) coughing out blood-streaked sputum.
3) cyanosis.
4) sudden shortness of breath.
A)3, 4
B)1, 2
C)2, 3, 4
D)1, 2, 3, 4
Q2) Bronchospasm may happen after a pulmonary embolism. Which of the following can lead to this bronchospasm?
1) Localized hypoxemia
2) Localized hypercapnia
3) Localized hypocapnia
4) Release of cellular mediators from platelets
A)1, 2
B)2, 4
C)1, 3
D)1, 3, 4
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Page 22
Chapter 21: Flail Chest
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Sample Questions
Q1) A flail chest is defined as:
1) one fractured rib or two adjacent fractured ribs.
2) three or more adjacent fractured ribs.
3) single rib fractures.
4) double rib fractures.
A)2
B)2, 3
C)1, 3
D)2, 4
Q2) In severe cases of flail chest, all of the following will usually be needed:
1) Continuous positive airway pressure (CPAP)
2) Pain management
3) Mechanical ventilation
4) Positive end-expiratory pressure (PEEP)
A)1, 2
B)2, 4
C)2, 3, 4
D)1, 2, 3, 4
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Chapter 22: Pneumothorax
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Sample Questions
Q1) What are the anatomic alterations that occur when a person has a pneumothorax?
1. The lung on the affected side collapses.
2. The visceral and parietal pleura separate.
3. The visceral pleura adheres to the parietal pleura.
4. The chest wall moves outward.
A) 1, 3
B) 3, 4
C) 2, 4
D) 1, 2, 4
Q2) Your 40-year-old patient is having a chest tube placed to remove the air from her pleural space. All of the following are necessary aspects of this process EXCEPT:
A) apply about -5 cm H<sub>2</sub>O pressure to the chest tube.
B)a No. 28 to 36 French gauge tube will be used.
C)place the tube at the apex of the lung.
D)place the tube at the base of the lung.
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Chapter 23: Effusion and Empyema
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Q1) 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.
Q2) Treatment of an empyema usually includes:
1) antibiotics for bacterial infection.
2) thoracentesis.
3) lung removal (pneumonectomy).
4) lung transplant.
A)1
B)2
C)2, 3
D)1, 2
Q3) Your patient has a large pleural effusion. It will act as a/an:
A) restrictive lung disorder.
B)obstructive lung disorder.
C)obstructive > restrictive lung disorder.
D)restrictive > obstructive lung disorder.
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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) The major pathologic and structural changes of the lungs found with kyphoscoliosis include:
1) mediastinal shift.
2) elevated diaphragms.
3) lung compression.
4) mucus accumulation.
A)1, 2
B)3, 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) Your patient with mild to moderate ILD has hypoxemia and will be given oxygen therapy. All of the following are possible causes of hypoxemia EXCEPT:
A) hypoventilation.
B)capillary shunting.
C)alveolar thickening.
D)fibrosis.
Q2) Your patient has systemic lupus erythematosus (SLE) of the lungs. What is the most commonly found pulmonary complication of SLE?
A) Bronchospasm
B)Pleurisy
C)Atelectasis
D)Diaphragmatic dysfunction
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) The major pathologic and structural changes associated with bronchogenic carcinoma include all of the following, EXCEPT:
A) bronchospasm.
B)airway obstruction.
C)destruction of airways and alveoli.
D)atelectasis.
Q2) The most common cause of lung cancer is:
A) smoking tobacco.
B)smoking marijuana.
C)inhaling asbestos.
D)inhaling radon gas.
Q3) A patient has gone to see her physician after recently developing hoarseness and difficulty swallowing. What does this indicate?
A) Mediastinal cancer
B)Gastroesophageal reflux
C)Stomach cancer
D)Salivary gland cancer
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28
Chapter 27: Acute Respiratory Distress Syndrome
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Q1) A patient with massive blood transfusion or disseminated intravascular coagulation (DIC) is at risk for developing ARDS because of:
A) shock (hypovolemia).
B)receiving the wrong blood type.
C)fat emboli.
D)blockages in pulmonary blood vessels.
Q2) Clinical manifestations of ARDS include:
1) low or normal pulmonary capillary wedge pressure (PCWP).
2) tachycardia.
3) intercostal retractions.
4) cyanosis.
A)1, 2
B)3, 4
C)2, 3, 4
D)1, 2, 3, 4
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) Your 75-kg (165-lb) 50-year-old male patient has Guillain-Barré syndrome. His most recent vital signs show a heart rate of 130/min, blood pressure of 125/85 mm Hg, and respiratory rate of 40/min. As the respiratory therapist, you have checked his breathing and found his VC is 1100 ml and NIF is -16 cm H<sub>2</sub>O. What would you recommend?
A) Begin electrocardiogram monitoring.
B)Begin continuous positive airway pressure (CPAP).
C)Begin mechanical ventilation.
D)Assess the patient each hour.
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) The physician is recommending a thymectomy in a patient. The benefit of this procedure is to:
A) remove the source of anti-ACh receptor antibodies.
B)block the antigen-antibody reactions.
C)remove the source of cholinesterase.
D)prevent the development of myasthenia gravis.
Q2) Which of the following is/are signs and symptoms associated with myasthenia gravis?
1) Double vision
2) Weakness of neck muscles
3) Drooping of eyelids
4) Difficulty speaking
A)2
B)1, 3
C)2, 3, 4
D)1, 2, 3, 4
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Chapter 30: Sleep Apnea
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Q1) 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.
Q2) During sleep, there is loss of muscle tone in the upper airway. What could this cause?
A) Airway obstruction
B)Vocal cords stay dilated
C)Vocal cords stay closed
D)Aspiration or oral secretions
Q3) Continuous positive airway pressure (CPAP) is useful in the management of the patient with obstructive sleep apnea because it:
A) pushes air into and out of the lungs like a mechanical ventilator.
B)prevents airway collapse.
C)stretches the J receptors in the chest wall to stimulate breathing.
D)delivers a tidal volume breath to the patient.
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Chapter 31: Newborn and Early Childhood Respiratory Disorders
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Q1) A newborn's 5-minute Apgar score is 7. How should this be interpreted?
A) Normal adjustment to being born
B)Moderate distress; intubate the airway and suction the lungs
C)Moderate distress; administer supplemental oxygen
D)Severe distress; begin bag-mask resuscitation
Q2) When a neonate has PPHN, what structure(s) does the blood flow through to bypass the lungs?
1) Ductus venosus
2) Foramen ovale
3) Hypogastric arteries
4) Ductus arteriosus
A)2
B)1, 3
C)2, 4
D)1, 2, 4
Q3) A neonate in respiratory distress will often dilate his/her nostrils to:
A) facilitate inspiration.
B)nurse more easily.
C)sneeze out amniotic fluid.
D)raise its intrapleural pressure.
Page 33
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Chapter 32: Meconium Aspiration Syndrome
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Q1) 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
Q2) An infant with MAS will show what clinical manifestations associated with the more negative intrapleural pressures needed during inspiration?
1) Seesaw breathing movement
2) Breath sounds reveal rhonchi and crackles
3) Expiratory grunting
4) Cyanosis of the dependent thoracic areas
A)1, 4
B)2, 3
C)2, 3, 4
D)1, 2, 3, 4
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Chapter 33: Transient Tachypnea of the Newborn
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Q1) 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).
Q2) The breathing pattern seen in a patient with TTN includes:
1) normal rate.
2) rapid rate.
3) higher than normal tidal volume.
4) shallow tidal volume.
A)1, 3
B)2, 3
C)2, 4
D)1, 4
Q3) 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
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Chapter 34: Respiratory Distress Syndrome
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Q1) The neonate with RDS would have a phosphatidylglycerol (PG) level that is A) present.
B)absent.
C)above normal.
D)below normal.
Q2) What vascular anatomic alteration could occur as a consequence of hypoxia in your RDS patient?
A) Closure of the ductus arteriosus
B)Transient pulmonary hypertension
C)Increased flow through the ductus venosus
D)Airway mucosal edema
Q3) 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
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36
Chapter 35: Pulmonary Air Leak Syndromes
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Sample Questions
Q1) When trapped gas causes alveolar overdistention and rupture, does where the gas initially go?
1) Both pleural spaces
2) Tissue sheaths surrounding airways and capillaries
3) Interlobular septa containing pulmonary veins
4) Pericardial sac
A)2, 3
B)1, 4
C)1, 2, 3
D)2, 3, 4
Q2) Your patient with pulmonary interstitial emphysema has developed a pneumothorax. It will manifest itself clinically as:
A) equally restrictive and obstructive disorder.
B)an obstructive pulmonary disorder.
C)a restrictive pulmonary disorder.
D)a restrictive cardiac disorder.
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Chapter 36: Respiratory Syncytial Virus Infection
Bronchiolitis or Pneumonitis
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Q1) Outbreaks of RSV are usually found in all of the following seasons of the year, EXCEPT: A) spring.
B)summer.
C)fall.
D)winter.
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
Q3) Anatomic alterations related to an RSV infection can lead to all of the following, EXCEPT:
A) pneumomediastinum.
B)partial airway obstruction.
C)decreased airway lumen.
D)complete airway obstruction.
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Page 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) All of the following methods or goals with mechanical ventilation have been used to help prevent the development of BPD, EXCEPT:
A) keep the PaCO<sub>2</sub> above 55 mm Hg.
B)low tidal volumes.
C)prevent the infant from triggering the ventilator.
D)high ventilator respiratory rate.
Q3) Your patient is beginning to develop BPD. What can be given to promote pulmonary vasodilation?
A) Furosemide (Lasix)
B)Inhaled nitric oxide (iNO)
C)Inhaled albuterol
D)> 50% oxygen
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Chapter 38: Congenital Diaphragmatic Hernia
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Q1) Your patient has a left-sided CDH. How would this manifest itself clinically?
A) A restrictive pulmonary disorder
B)An obstructive pulmonary disorder
C)Equally restrictive and obstructive disorder
D)A restrictive cardiac disorder
Q2) If a newborn is born with a CDH, when does respiratory distress develop?
A) During labor
B)Soon after birth
C)Within the first 4 to 6 hours of birth
D)Within the first 48 hours of birth
Q3) An infant with a CDH has lungs that are immature and hypoplastic. What can be done to help correct this situation?
A) Suction out excessive lung fluid.
B)Administer intermittent positive end-expiratory pressure (PEEP).
C)Nebulized sympathomimetic agent
D)Give pulmonary surfactant.
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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) Your patient has epiglottitis. This condition will affect which of the following:
1) Pharynx
2) Aryepiglottic folds
3) False vocal cords
4) Trachea
A)1, 2
B)2, 3
C)1, 2, 3
D)2, 3, 4
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Chapter 40: Near Drowning
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Q1) Favorable prognostic factors in cold-water near-drowning include:
1) greater effort to reach the surface.
2) alcohol in the victim.
3) colder water.
4) younger age.
A)1, 2
B)3, 4
C)2, 3, 4
D)1, 2, 3, 4
Q2) If a person should near drown in unclean, swampy water what are the possible pulmonary complications?
1) Pneumonia
2) Acute respiratory distress syndrome (ARDS)
3) Pulmonary fibrosis
4) Pulmonary hypertension
A)1
B)3, 4
C)1, 2
D)1, 2, 3
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Page 42
Chapter 41: Smoke Inhalation and Thermal Injuries
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Q1) Late stage complications of extensive body surface burns include:
1) sepsis.
2) cyanide poisoning.
3) pneumonia.
4) pulmonary embolism.
A)1, 2
B)3, 4
C)2, 3
D)1, 3, 4
Q2) After the correction of any hypoxemia, the next pulmonary complication seen in the fire victim with extensive body and facial burns is:
A) acute respiratory distress syndrome (ARDS).
B)upper airway obstruction.
C)pneumonia.
D)pulmonary embolism.
Q3) The long term effects of a smoke inhalation injury are:
A) obstructive lung disease.
B)restrictive lung disease.
C)obstructive and restrictive lung disease.
D)neither, there is normally complete healing.
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Chapter 42: Postoperative Atelectasis
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Q1) After gastric bypass surgery, your patient is showing tachypnea. What is the best explanation for this?
A) Diaphragmatic apraxia
B)Postoperative pain
C)Low-grade fever
D)Anesthetic sedation
Q2) Which of the following patients should be placed on short-term mechanical ventilation because of the high risk of postoperative atelectasis?
A) Appendectomy
B)Tracheostomy
C)Bronchoscopy for tumor biopsy
D)Cardiac surgery
Q3) 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
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