Cardiopulmonary Diagnostics
Practice Questions
Course Introduction
Cardiopulmonary Diagnostics is a course designed to introduce students to the fundamental principles and procedures used to assess and evaluate the function of the heart and lungs. The course covers a range of diagnostic modalities, including electrocardiography (ECG), echocardiography, pulmonary function testing, arterial blood gas analysis, and exercise stress testing. Students will explore the indications, techniques, and interpretation of these diagnostic tests, as well as their clinical applications in the diagnosis and management of cardiovascular and respiratory disorders. Emphasis is placed on patient preparation, infection control, quality assurance, and the integration of diagnostic data into patient care planning.
Recommended Textbook Egans Fundamentals of Respiratory Care 11th Edition by Robert M. Kacmarek
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Chapter 1: History of Respiratory Care
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Sample Questions
Q1) When were aerosolized glucocorticoids for the maintenance of patients with moderate to severe asthma first introduced?
A) In the 1950s
B) In the 1960s
C) In the 1970s
D) In the 1980s
Answer: C
Q2) The majority of respiratory care education programs in the United States offer what degree?
A) Associate's degree
B) Bachelor's degree
C) Master's degree
D) Certificate degree
Answer: A
Q3) Where are the majority of respiratory therapists employed?
A) Skilled nursing facilities
B) Diagnostic laboratories
C) Hospitals or acute care settings
D) Outpatient physician offices
Answer: C
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Chapter 2: Delivering Evidence-Based Respiratory Care
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Q1) Who is professionally responsible for the clinical function of the respiratory care department?
A) Shift supervisor
B) Department head
C) Medical director
D) Clinical supervisor
Answer: C
Q2) What term is used to describe the work done by a researcher who reviews numerous studies on a single topic and gives more weight to the more rigorous ones before making recommendations?
A) White paper
B) Meta-analysis
C) Alpha review
D) Apical review
Answer: B
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Page 4
Chapter 3: Quality, Patient Safety, and Communication, and Recordkeeping
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Sample Questions
Q1) When a small, usually imperceptible current (usually <1 mA) is allowed to bypass the skin and follow a direct, low resistance pathway into the body, which of the following conditions exists?
A) Macroshock hazard
B) Grounding hazard
C) Isolation hazard
D) Microshock hazard
Answer: D
Q2) Which of the following statements is false about patient ambulation?
A) Ambulation is necessary for normal body functioning.
B) Patients must be carefully monitored during ambulation.
C) Chairs or emergency supports must be available during ambulation.
D) Patients with intravenous (IV) lines should not be ambulated.
Answer: D
Q3) Which of the following is an acceptable practice in medical recordkeeping?
A) Leaving blank lines
B) Erasing incorrect entries
C) Using ditto marks
D) Using standard abbreviations
Answer: D
5
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Chapter 4: Principles of Infection Prevention and Control
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Sample Questions
Q1) What is the recommended dilution level of bleach according to the CDC for cleaning up blood spills?
A) 1:1
B) 1:5
C) 1:10
D) 1:20
Q2) What is the purpose of an inspiratory HEPA filter in a ventilator circuit?
A) The purpose is to serve as a heated thermistor that prevents condensation from forming in the circuits.
B) It prevents pathogens from being expelled into the surroundings.
C) When placed between the ventilator and the circuit, it can eliminate bacteria.
D) None of the above.
Q3) Which of the following organisms is NOT destroyed by a disinfection agent?
A) Gram-negative cocci
B) Bacterial spores
C) Gram-positive rods
D) Viruses
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Chapter 5: Ethical and Legal Implications of Practice
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Sample Questions
Q1) Which of the following has played a minor role in increasing the cost of health care?
A) Beneficence
B) Compensatory justice
C) Distributive justice
D) Role fidelity
Q2) Which of the following are legitimate defenses against an intentional tort?
1) Lack of intent to harm the patient
2) Performance of ordinary procedures
3) Informed consent given by patient
A)1 and 2 only
B)2 and 3 only
C)1, 2, and 3
D)1 and 3 only
Q3) What is the term for a civil wrong committed against an individual or property, for which a court provides a remedy in the form of damages?
A) Tort
B) Misdemeanor
C) Felony
D) Litigation
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Chapter 6: Physical Principles of Respiratory Care
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Sample Questions
Q1) Which of the following represents a direct measure of the kinetic activity of water vapor molecules?
A) Absolute humidity
B) Water vapor pressure
C) Percent body humidity
D) Relative humidity
Q2) Which of the following occur(s) when water vapor is added to a dry gas at a constant pressure?
1) The volume occupied by the gas mixture decreases.
2) The relative humidity of the mixture increases.
3) The partial pressure of the original gas is reduced.
A)1 and 2 only
B)1 and 3 only
C)1, 2 and 3
D)3 only
Q3) Which of the following would be the worst heat conductor?
A) Water
B) Glass
C) Air
D) Copper
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Chapter 7: E-Medicine in Respiratory Care
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Sample Questions
Q1) In what area are computers used to apply quality assurance measures in respiratory care departments?
A) Arterial blood gas analyzers
B) O<sub>2</sub> delivery systems
C) Interpreting ECGs
D) Equipment cleaning and sterilization
Q2) Which of the following is considered an emerging application of information technology that may improve national health care issues in the future?
A) Clinical simulation for training
B) A nationally available electronic health record
C) Medical ID bracelets
D) The national database for organ donors
Q3) Which of the following is included in the purposes of Telemedicine?
A) e-mailing test results to patients.
B) Support health care at a geographically different location from the patient to increase access to specialty care.
C) Allow access to patient's family members remotely.
D) Acquire patient assessment information in order to skip a patient home care visit.
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Chapter 8: Fundamentals of Respiratory Care Research
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Sample Questions
Q1) What search engine looks for scholarly publications in a wide range of fields and includes peer-reviewed manuscripts, abstracts, theses, and books from academic publishers, professional societies, and university libraries?
A) Medline.org
B) Google Scholar
C) Minimed.org
D) Cochrane.org
Q2) What is the name of the database often purchased and used by hospitals and university libraries to provide key research information on a large variety of medical topics?
A) SPAN
B) OVID
C) CINUP
D) MITO
Q3) What are the three basic missions of academic medicine?
A) To research, to discover, and to publish
B) To research, to discover, and to cure disease
C) To heal, to teach, and to discover
D) To teach, to research, and to cure
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Page 10
Chapter 9: The Respiratory System
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Sample Questions
Q1) Which phospholipid ratio would indicate a neonate with a low risk of developing respiratory distress syndrome (RDS)?
A) L/S ratio of 1
B) L/S ratio of 2 or more
C) L/S ratio of less than 1.5
D) L/S ratio of less than 1
Q2) The subdivisions of the pharynx include which of the following?
1) Nasopharynx
2) Oropharynx
3) Laryngopharynx
A)2 and 3 only
B)1 and 2 only
C)1 and 3 only
D)1, 2, and 3
Q3) Approximately how many alveoli are there in a 10-year-old's lung?
A) 50 million
B) 200 million
C) 350 million
D) 480 million
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Chapter 10: The Cardiovascular System
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Sample Questions
Q1) Which factor stimulates the carotid and aortic chemoreceptors?
A) High carbon dioxide levels
B) High oxygen (O<sub>2</sub>) levels
C) High pH levels
D) High 2,3-DPG levels
Q2) The cardiovascular system regulates perfusion mainly by altering which of the following?
A) Capacity and resistance of blood vessels
B) Rate of cardiac contractions
C) Strength of cardiac contractions
D) Volume of cardiac contractions
Q3) Central, or extrinsic, control of the cardiovascular system occurs through the action of which of the following?
1) Autonomic nervous system
2) Circulating humoral agents
3) Local metabolites
A)1, 2, and 3
B)2 and 3 only
C)3 only
D)1 and 2 only
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Chapter 11: Ventilation
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Sample Questions
Q1) On inspecting a volume-pressure curve of the lungs and thorax, an increase in the mechanical work of breathing above normal would always be indicated by which of the following?
A) Decrease in the area of the volume-pressure curve
B) Decrease in the slope of the volume-pressure curve
C) Increase in the area of the volume-pressure curve
D) Increase in the slope of the volume-pressure curve
Q2) Exhalation below the resting level requires active muscular effort in order to overcome what tendency?
A) The airways to collapse
B) The alveoli to expand
C) The chest wall to expand
D) The lungs to expand
Q3) In what portion of the lungs does alveolar dead space normally occur?
A) Apexes
B) Bases
C) Middle portions of the lungs
D) Terminal respiratory units
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13
Chapter 12: Gas Exchange and Transport
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Sample Questions
Q1) The PAO<sub>2</sub> depends on which of the following factors?
1) Ambient (atmospheric) pressure
2) Fractional concentration of inspired O<sub>2</sub>
3) Level of V<sub>A</sub>
4) Types of fuels burned (fat, protein, and carbohydrate)
A)1, 2, and 3 only
B)1 and 2 only
C)3 only
D)1, 2, 3, and 4
Q2) What role does the Bohr effect play in O<sub>2</sub> transport?
A) Describes the effect of varying enzyme levels on Hb and O<sub>2</sub> affinity.
B) Diminishes tissue oxygenation due to electrolyte imbalances.
C) Enhances O<sub>2</sub> delivery to tissues and O<sub>2</sub> pickup at lungs.
D) Explains the effect that O<sub>2</sub> levels have on carbon dioxide transport.
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Chapter 13: Solutions, Body Fluids, and Electrolytes
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Sample Questions
Q1) The most common causes of acute hyponatremia include:
1) postoperative iatrogenic causes.
2) not drinking enough water.
3) self-induced due to water intoxication.
4) not eating enough foods containing sodium.
A)1 and 3
B)2 and 3
C)1, 2, and 4
D)1, 2, 3, and 4
Q2) What is the net effect of the hydrostatic pressure gradient between the capillary and interstitial space?
A) It tends to push water into the capillaries.
B) It tends to push water into the interstitial spaces.
C) The pressure gradient is zero so fluid movement is due to osmosis.
D) It tends to push water into the cells.
Q3) What is the gEq weight of an acid?
A) Amount of the acid containing 1 mol of replaceable H<sup>+</sup> ions.
B) Amount of the acid containing 1 mol of replaceable OH<sup>-</sup> ions.
C) Gram atomic weight of the acid times its valence.
D) Milligrams of acid per deciliter (dl) of normal solution.
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Chapter 14: Acid-Base Balance
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Sample Questions
Q1) What are the major mechanisms responsible for maintaining a stable pH despite massive CO<sub>2</sub> production?
1) Isohydric buffering
2) Gastrointestinal secretion
3) Pulmonary ventilation
A)2 and 3 only
B)1 and 2 only
C)1, 2, and 3
D)1 and 3 only
Q2) What is the primary chemical event in metabolic alkalosis?
A) Decrease in blood CO<sub>2</sub> levels
B) Decrease in blood HCO<sub>3</sub><sup>-</sup> levels
C) Increase in blood CO<sub>2</sub> levels
D) Increase in blood HCO<sub>3</sub><sup>-</sup> levels
Q3) Which of the following acts as the "first-line" or immediate defense against the accumulation of H<sup>+</sup> ions?
A) Blood buffer system
B) GI tract
C) Renal system
D) Respiratory system
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Chapter 15: Regulation of Breathing
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Sample Questions
Q1) Failure to switch off the brainstem inspiratory neurons can result in which of the following?
A) Apnea
B) Apneustic breathing
C) Biot's breathing
D) Cheyne-Stokes breathing
Q2) In the face of chronically elevated levels of CO<sub>2</sub>, what happens to the response mediated by the central chemoreceptors?
A) It is accentuated or increased.
B) It is muted or decreased.
C) There is no change in the response.
D) There is no way to predict the body's response.
Q3) What has the primary responsibility for sensing and responding to changes in blood levels of CO<sub>2</sub>?
A) Apneustic centers
B) Central chemoreceptors
C) Peripheral chemoreceptors
D) Pneumotaxic center
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Chapter 16: Bedside Assessment of the Patient
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Sample Questions
Q1) Diastolic murmurs are generally associated with which of the following?
1) Stenotic semilunar valve
2) Incompetent atrioventricular (AV) valve
3) Incompetent semilunar valve
4) Stenotic atrioventricular valve
A)1, 2, and 3 only
B)2 and 4 only
C)3 and 4 only
D)1, 2, 3, and 4
Q2) Which of the following terms is used to describe coughing up blood-streaked sputum?
A) Hematemesis
B) Hemoptysis
C) Hemolysis
D) Hemostasis
Q3) Which of the following is the least likely cause of lymphadenopathy in the neck?
A) Lymphoma
B) Pulmonary infection
C) Congestive heart failure
D) Lung cancer
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Chapter 17: Interpreting Clinical and Laboratory Data
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Sample Questions
Q1) Your patient has an elevated aspartate aminotransferase (AST). What two organs are most likely diseased?
A) Heart and brain
B) Liver and kidney
C) Brain and kidney
D) Heart and liver
Q2) What term is used to describe a result significantly outside the reference range that may represent a pathophysiologic condition?
A) Reference range
B) Biological reference intervals
C) Expected value
D) Critical test value
Q3) What term is used to describe a white blood cell (WBC) count that is above normal values?
A) Leukocytosis
B) Leukopenia
C) Neutropenia
D) Polycythemia
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19
Chapter 18: Interpreting the Electrocardiogram
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Sample Questions
Q1) What type of medications may lead to first-degree heart block?
A) Bronchodilators
B) Corticosteroids
C) Beta blockers
D) Xanthines
Q2) A patient who has been diagnosed with myocardial infarction is getting an ECG. The ECG trace shows a series of nonconducted P waves followed by a P wave that is conducted to the ventricles. The ratio of nonconducted to conducted P waves is fixed at 4:1. What plan for treatment should this patient receive?
1) Rapid defibrillation
2) Atropine
3) Cardioversion
4) Pacemaker
A)1, 2, and 3 only
B)2 and 4 only
C)3 only
D)1, 2, 3, and 4
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Chapter 19: Analysis and Monitoring of Gas Exchange
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Sample Questions
Q1) At the very beginning of exhalation, the PETCO<sub>2</sub> normally should be at what level?
A) 0 mm Hg
B) 15 mm Hg
C) 25 mm Hg
D) 40 mm Hg
Q2) Under ideal conditions, pulse oximeter readings patients usually fall in what range of those obtained with invasive hemoximetry?
A) 1% to 2%
B) 2% to 3%
C) 3% to 5%
D) 5% to 7%
Q3) How is the accuracy of a blood gas analyzer determined?
A) Examining the repeatability of the analyzer's results
B) Comparing the analyzer's measurements to known values
C) Adjusting the offset (or balance) of the instrument
D) Adjusting the gain (or slope) of the instrument
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21
Chapter 20: Pulmonary Function Testing
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Sample Questions
Q1) What is the predicted normal tidal volume in the adult patient?
A) 300 to 450 ml
B) 400 to 500 ml
C) 500 to 700 ml
D) 450 to 750 ml
Q2) How reliable is the tidal volume measurement in predicting the type of lung disease present?
A) Very reliable
B) Somewhat reliable
C) Not reliable
D) Reliable but only in certain age groups
Q3) Under which of the following conditions would you postpone a diffusing capacity test?
1) Just before the test, the patient smoked two cigarettes.
2) Just before the test, the patient had an episode of severe coughing.
3) Just before the test, the patient had a long wait at a busy bus stop.
A)1 only
B)1 and 3 only
C)2 and 3 only
D)1, 2, and 3
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Chapter 21: Review of Thoracic Imaging
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Sample Questions
Q1) What imaging technique would be most useful to determine which patients with emphysema may benefit from lung volume reduction surgery?
A) Chest HRCT
B) CT angiography
C) MRI
D) Ultrasound
Q2) Blunting of the costophrenic angles seen on the posteroanterior or lateral chest film typically indicates:
A) emphysema.
B) excess pleural fluid.
C) obesity.
D) rib fractures.
Q3) Which of the following is a major limitation of magnetic resonance imaging (MRI) of the chest?
A) Cannot visualize large vessels.
B) Cannot be used in patients with pacemakers.
C) Cannot be used to examine hilar structures.
D) Interpretation is difficult.
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23
Chapter 22: Flexible Bronchoscopy and the Respiratory Therapist
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Sample Questions
Q1) Hypoxemia during FB on a mechanically ventilated patient is typically due to:
A) inappropriately set alarms.
B) equipment failure.
C) loss of lung volume.
D) bronchospasm.
Q2) What portion of the airway are bronchial washings generally obtained?
A) The large airways
B) Either of the upper lobes
C) Either of the lower lobes
D) The lowest portion of the airways possible
Q3) Which of the following are divisions of imaging systems used during flexible bronchoscopy?
1) Fiberoptic
2) Video
3) Hybrid
4) Fusion
A)1 and 3 only
B)1, 2, and 3 only
C)3 and 4 only
D)2, 3, and 4 only
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Chapter 23: Nutrition Assessment
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Q1) What tube feeding method is associated with an increased risk of aspiration?
A) Bolus
B) Intermittent
C) Continuous drip
D) Pressurized
Q2) Which of the following is not considered part of the anthropometric assessment?
A) Body mass index
B) Activity level
C) History of weight loss
D) Triceps skin fold
Q3) Which of the following pieces of equipment is not needed to perform indirect calorimetry?
A) Oxygen analyzer
B) Tissot spirometer
C) Douglas bag
D) Nitrogen analyzer
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25
Chapter 24: Pulmonary Infections
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Q1) Which of the following mechanisms is an uncommon route for the spread of pneumonia?
A) Aspiration of infectious particles
B) Inhalation of infectious particles
C) Through the bloodstream
D) Direct contact
Q2) Via what route is tuberculosis spread?
A) Direct contact
B) Fecal-oral route
C) Fomite
D) Inhaled particles
Q3) ATS guidelines suggest using which of the following antibiotics if methicillin-resistant
S. aureus is a concern?
A) Cefazolin
B) Doxycycline
C) Penicillin
D) Vancomycin
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Chapter 25: Obstructive Lung Disease: Chronic Obstructive
Pulmonary Disease Copd, Asthma, and Related Diseases
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Q1) Which of the following symptoms is not a typical symptom of asthma?
A) Cough
B) Shortness of breath
C) Chest tightness
D) Chest pain
Q2) What causes the degranulation of mast cells in asthma patients?
A) Antigens attaching to IgE molecules on the mast cell surface.
B) Antigens attaching to proteins receptors on mast cell surface.
C) Irritant receptors on the mast cells are stimulated by antigens.
D) Infectious particles attacking the mast cells.
Q3) Which of the following procedures would you recommend to further assess Mr. Jones' condition?
1) Pre-post PFT
2) Exercise testing
3) Chest x-ray
4) Room air ABG
A)1 and 4 only
B)1, 2, and 3 only
C)2, 3 and 4 only
D)1, 3, and 4 only
Page 27
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Chapter 26: Interstitial Lung Disease
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Q1) What disease process is the most common cause of interstitial lung disease (ILD) in the United States?
A) Asbestosis
B) Coal worker's pneumoconiosis
C) Idiopathic pulmonary fibrosis
D) Sarcoidosis
Q2) What treatment is recommended by the Centers for Disease Control and Prevention (CDC) guidelines for patients with interstitial lung disease (ILD)?
A) Measles vaccine
B) Mumps vaccine
C) Pneumococcal vaccine
D) Varicella vaccine
Q3) What is the primary pathologic change that occurs in interstitial lung disease?
A) Alveolar-capillary membrane structures replaced by fibrotic tissue
B) Bronchial submucosal gland hypertrophy
C) Bronchoconstriction of medium to small airways
D) Increased sputum production
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28
Chapter 27: Pleural Diseases
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Q1) What is a common complication of pleurodynia?
A) Atelectasis
B) Insomnia
C) Pneumonia
D) Pneumothorax
Q2) What type of pleural problem is most likely to develop from rupture of the thoracic duct?
A) Chylothorax
B) Hemothorax
C) Hydrothorax
D) Pneumothorax
Q3) What underlying lung disease is most often present in a patient with secondary spontaneous pneumothorax?
A) Asthma
B) Chronic obstructive pulmonary disease (COPD)
C) Interstitial pulmonary fibrosis
D) Pneumonia
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Chapter 28: Pulmonary Vascular Disease
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Q1) A D-dimer test is performed in a patient in whom a pulmonary embolism is suspected. The value comes back at 379 mg/L. What does this suggest?
A) Almost completely establishes the presence of pulmonary embolism.
B) Almost completely rules out pulmonary embolism.
C) Establishes roughly a 50/50 chance of pulmonary embolism.
D) Is indeterminate but highly suggestive of pulmonary embolism.
Q2) Approximately what percentage of patients with pulmonary embolism have a normal ECG?
A) 10% to 15%
B) 25% to 30%
C) 40% to 60%
D) 70% to 75%
Q3) What treatment is initiated in patients suspected of pulmonary emboli, and continued until pulmonary emboli is ruled out?
A) Antiarrhythmia
B) Anticoagulation
C) Corticosteroids
D) Diuretics
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Chapter 29: Acute Respiratory Distress Syndrome
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Q1) Which of the following mechanisms ultimately leads to ARDS regardless of the etiology?
A) Disruption of the endothelial and epithelial barriers
B) Alveolar flooding
C) Interstitial damage
D) Increased oncotic pressure
Q2) What is recommended in terms of fluid management of patients with ARDS?
A) Conservative
B) Aggressive volume replacement
C) Increased dieresis
D) Only administer colloids
Q3) What mode of mechanical ventilation is designed to increase the mean airway pressure to allow recruitment of alveoli while allowing the patient to spontaneously breathe?
A) Inverse ratio ventilation
B) High-frequency ventilation
C) Intermittent mandatory ventilation
D) Airway pressure-release ventilation
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Chapter 30: Trauma, Burns and Near Drowning
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Sample Questions
Q1) When assessing an obese patient, an approach to noninvasive ventilation includes:
1) obtain an arterial blood gas analysis to assess baseline gas exchange.
2) monitor vital signs, gas exchange, respiratory rate, tidal volume, and comfort of the patient.
3) explain the indications of noninvasive ventilation to the patient and the possible outcomes.
4) suggested initial settings are 5 cm H<sub>2</sub>O of pressure support and 5 cm H<sub>2</sub>O of PEEP.
A)1 and 2 only
B)1, 2, and 3 only
C)3 and 4 only
D)1, 2, and 4 only
Q2) From 2005 to 2009 in the United States, approximately how many deaths were due to drowning?
A) 4000
B) 6000
C) 8000
D) 10000
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Chapter 31: Lung Cancer
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Sample Questions
Q1) Other causes of lung cancer include:
1) asbestos.
2) arsenic.
3) chromium.
4) microwave radiation.
A)2, 3, and 4 only
B)2 and 3 only
C)1 and 4 only
D)1, 2, and 3 only
Q2) What minimum size does a lesion in the lung need to be in order to be called a nodule?
A) 1 cm
B) 2 cm
C) 3 cm
D) 4 cm
Q3) Which of the following is the most common type of lung cancer?
A) Large cell
B) Adenocarcinoma
C) Squamous cell
D) Small cell
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Chapter 32: Neuromuscular and Other Diseases of the Chest
Wall
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Sample Questions
Q1) Cobb angles are used to measure the severity in which disorder of the thoracic cage?
A) Ankylosing spondylitis
B) Flail chest
C) Scoliosis
D) Pectus excavatum
Q2) Which of the following is a clinical condition that typically does not precipitate rapid respiratory failure in patients with significant neuromuscular weakness?
A) Pulmonary edema
B) Pneumonia
C) Mucous plugging
D) Lung cancer
Q3) Pulmonary function testing in patients with neuromuscular weakness would show normal values for which of the following?
A) Diffusing capacity of the lungs (DLCO)
B) Vital capacity
C) Forced expiratory volume in 1 second
D) Total lung capacity
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Chapter 33: Disorders of Sleep
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Sample Questions
Q1) Which of the following physical exam findings are associated with obstructive sleep apnea?
1) Large tonsils
2) Microcephaly
3) Macroglossia
4) Deviated nasal septum
A)1 and 3 only
B)1, 2, and 3 only
C)3 and 4 only
D)2, 3, and 4 only
Q2) Which of the following characteristics are typically associated with sleep apnea?
1) Male patient
2) Over the age of 40 years
3) Hypotensive
4) Loud snoring during sleep
A)1 and 3 only
B)1, 2, and 4 only
C)3 and 4 only
D)2, 3, and 4 only
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Chapter 34: Neonatal and Pediatric Respiratory Disorders
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Sample Questions
Q1) What percentage of births will present with meconium-stained amniotic fluid?
A) 2%
B) 12%
C) 25%
D) 50%
Q2) What modality is believed to be the cause of a decrease in the reported incidence of epiglottitis over the past decade?
A) Vaccine
B) Better diet
C) Improved epidemiology reporting
D) Better quality of air
Q3) Which of the following infant characteristics is associated with an increased risk of SIDS?
A) Female gender
B) Preterm birth
C) High Apgar score
D) Full-term birth
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Chapter 35: Airway Pharmacology
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Sample Questions
Q1) Which phase describes the time course and disposition of a drug in the body based on its absorption, distribution, metabolism, and elimination?
A) Pharmaceutical
B) Pharmacognosy
C) Pharmacokinetic
D) Pharmacodynamic
Q2) Zileuton belongs to which of the following categories?
A) Cromolyn-like agents
B) Leukotriene modifiers
C) Anti-IgE agents
D) Anti-IgA agents
Q3) Which of the following lung availability/total systemic availability (L/T) ratios is consistent with an efficient aerosol delivery?
A) 0.46
B) 0.23
C) 0.1
D) 0.6
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Chapter 36: Airway Management
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Sample Questions
Q1) Ideally, the distal tip of a properly positioned endotracheal tube (in an adult man) should be positioned approximately how far above the carina?
A) 1 to 3 cm
B) 3 to 6 cm
C) 7 to 9 cm
D) 4 to 6 in
Q2) Total application time for endotracheal suction in adults should not exceed which of the following?
A) 20 to 25 sec
B) 15 to 20 sec
C) 10 to 15 sec
D) 3 to 5 sec
Q3) What is the average distance from the tip of a properly positioned oral endotracheal tube to the incisors of an adult man?
A) 16 to 18 cm
B) 19 to 21 cm
C) 21 to 23 cm
D) 24 to 26 cm
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Chapter 37: Emergency Cardiovascular Life Support
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Sample Questions
Q1) To help open the airway of a conscious adult with complete airway obstruction, what would you do?
A) Apply back blows, followed by chest thrusts.
B) Try to ventilate the victim at a high rate.
C) Decompress the stomach with epigastric pressure.
D) Apply repeated strong abdominal thrusts.
Q2) How long will the apneic patient take to die without intervention?
A) 1 min
B) 3 to 5 min
C) 4 to 6 min
D) 10 to 20 min
Q3) What is the leading cause of death among adults over the age of 40 in the United States?
A) Chronic pulmonary disease
B) Sudden cardiac arrest
C) Motor vehicle trauma
D) Airway obstruction
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Chapter 38: Humidity and Bland Aerosol Therapy
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Sample Questions
Q1) What is the goal of using an unheated bubble humidifier with oronasal O<sub>2</sub> delivery systems?
A) Raise the humidity of the gas to ambient levels.
B) Fully saturate the inspired gas to body temperature, ambient pressure, saturated (BTPS) conditions.
C) Cool the gas down to below room temperature.
D) Fully saturate the inspired gas to ambient temperature, ambient pressure, saturated (ATPS) conditions.
Q2) Which of the following principles is used by the ultrasonic nebulizer to produce aerosol droplets?
A) Evaporative cooling
B) Mechanical baffling
C) Fractional distillation
D) High-frequency vibrations
Q3) When is a heat and moisture exchanger (HME) performing well?
A) Condensate appears in the attached flex tube.
B) No condensate is visible on the filter or insert.
C) The HME temperature is at least 40° C.
D) Condensate is visible on the filter or insert.
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Page 40
Chapter 39: Aerosol Drug Therapy
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Sample Questions
Q1) What is the best way to confirm that an asthmatic outpatient can properly self-manage a newly prescribed aerosol drug therapy?
A) Have the patient describe the proper procedural steps.
B) Have the patient provide a repeat or return demonstration.
C) Have the patient take a written or oral quiz on technique.
D) Have the patient maintain detailed treatment logs.
Q2) What is the average mean mass aerodynamic diameter (MMAD) generated by the vibrating mesh nebulizers?
A) 1 to 2 µm
B) 2 to 3 µm
C) 3 to 4 µm
D) 5 to 6 µm
Q3) To minimize a patient's infection risk between drug treatments with a small-volume jet nebulizer (SVN), what would you do?
A) Rinse the SVN with sterile water; air dry.
B) Carefully repackage the SVN in its wet state.
C) Rinse the SVN with tap water; run until dry.
D) Throw out the SVN after every treatment.
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Chapter 40: Storage and Delivery of Medical Gases
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Sample Questions
Q1) What is the indexed safety system for threaded high-pressure connections between large compressed gas cylinders and their attachments?
A) Pin-Indexed Safety System (PISS)
B) Diameter-Index Safety System (DISS)
C) American Standard Safety System (ASSS)
D) CGA System
Q2) According to the U.S. Department of Commerce, a gas cylinder that is color coded blue should contain which of the following?
A) Air
B) He
C) N<sub>2</sub>O
D) O<sub>2</sub>
Q3) Cylinders of liquid gases are filled according to what specification?
A) Filling density
B) Critical weight
C) Elastic expansion
D) Filling pressure
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Chapter 41: Medical Gas Therapy
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Sample Questions
Q1) Which of the following are components of a typical O<sub>2</sub> blender?
1) Precision metering device or mixture control
2) Audible dual low-pressure alarm system
3) Pressure regulating and equalizing valves
4) Variable-size air-entrainment port
A)2 and 4 only
B)1, 2, and 3 only
C)3 and 4 only
D)1, 3, and 4 only
Q2) You design an air-entrainment system that mixes air with O<sub>2</sub> at a fixed ratio of 1:7. Approximately what O<sub>2</sub> concentration will this device provide?
A) 33%
B) 40%
C) 80%
D) 90%
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43
Chapter 42: Lung Expansion Therapy
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Sample Questions
Q1) Correct instruction in the technique of incentive spirometry should include which of the following?
A) Use of accessory muscles at high inspiratory flows
B) Diaphragmatic breathing at slow to moderate flows
C) "Panting" at volumes approaching total lung capacity
D) Use of accessory muscles at low inspiratory flows
Q2) When checking a patient's intermittent positive-pressure breathing (IPPB) circuit before use, you notice that the device will not cycle off, even when you occlude the mouthpiece. What would be the most appropriate action in this case?
A) Secure a new IPPB ventilator.
B) Check the circuit for leaks.
C) Decrease the flow setting.
D) Increase the pressure setting.
Q3) Which of the following modes of lung expansion therapy is physiologically most normal?
A) Continuous positive airway pressure
B) Incentive spirometry
C) Positive end expiratory pressure
D) Intermittent positive-pressure breathing therapy
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Page 44
Chapter 43: Airway Clearance Therapy Act
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Sample Questions
Q1) Which of the following drug categories can impair mucociliary clearance in intubated patients?
1) General anesthetics
2) Bronchodilators
3) Opiates
4) Narcotics
A)1 and 3 only
B)1, 2, and 3 only
C)3 and 4 only
D)1, 3, and 4 only
Q2) Which of the following responses indicate that postural drainage should be terminated?
1) Severe tachycardia
2) Complaint of discomfort
3) Irregular blood pressure
4) Severe bradycardia
A)1 and 3 only
B)1, 2, and 3 only
C)2 and 4 only
D)1, 3, and 4 only
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Page 45
Chapter 44: Respiratory Failure and the Need for
Ventilatory Support
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Sample Questions
Q1) Your patient is hypoventilating. Which of the following would be likely findings?
A) A normal P(A-a)O<sub>2 </sub>with a marked response to an increase in FiO<sub>2</sub>
B) An increases P(A-a)O<sub>2 </sub>with a marked response to an increase in FiO<sub>2</sub>
C) A normal P(A-a)O<sub>2 </sub>with no response to an increase in FiO<sub>2</sub>
D) A increased P(A-a)O<sub>2 </sub>with no response to an increase in FiO<sub>2</sub>
Q2) Which of the following measures should be used in assessing the adequacy of a patient's alveolar ventilation?
1) PaO<sub>2</sub>
2) Arterial pH
3) PaCO<sub>2</sub>
4) HCO<sub>3</sub><sup>-</sup>
A)2 and 4 only
B)1 and 3 only
C)2 and 3 only
D)1, 2, and 4 only
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Chapter 45: Mechanical Ventilators
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Sample Questions
Q1) During mechanical ventilation, a spontaneous breath is defined as one that:
A) initiated and terminated by the machine.
B) begun by the patient and ended by the machine.
C) initiated and terminated by the patient.
D) begun by the machine and ended by the patient.
Q2) A volume-cycled ventilator provides gas under positive pressure during inspiration until what point?
A) The patient receives a preselected volume of gas.
B) An adjustable, preselected airway pressure is reached.
C) The inspiratory time equals or exceeds the expiratory time.
D) A preselected volume of gas is expelled from the device.
Q3) A time-cycled constant flow generator is set up with a flow of 35 L/min and an inspiratory time of 1.7 sec. What is the approximate V<sub>T</sub>?
A) 750 ml (0.75 L)
B) 1000 ml (1.00 L)
C) 1900 ml (1.90 L)
D) 1200 ml (1.20 L)
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Chapter 46: Physiology of Ventilatory Support
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Sample Questions
Q1) Types of damage associated with pulmonary barotrauma include which of the following?
1) Pneumoconiosis
2) Pneumomediastinum
3) Pneumothorax
4) Subcutaneous emphysema
A)1 and 3 only
B)1, 2, and 3 only
C)3 and 4 only
D)2, 3, and 4 only
Q2) Physiological effects of adding a volume-limited inflation hold to mandatory breaths include which of the following?
1) Decreased PaCO<sub>2</sub>
2) Increased inspiratory time
3) Decreased V<sub>D</sub>/V<sub>T</sub>
4) Longer expiratory times
A)2 and 4 only
B)1, 2, 3, and 4
C)3 and 4 only
D)1, 2, and 3 only
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Page 48
Chapter 47: Patient Ventilator Interaction
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Sample Questions
Q1) Your patient has relatively normal lungs and is receiving mechanical ventilation following surgery. You observe double triggering. What is the most likely cause?
A) The termination criteria is set too low.
B) The flow rate is too slow.
C) Auto-PEEP.
D) The inspiratory time is too short.
Q2) Which of the following is considered a patient-related cause of poor patient-ventilator interaction?
A) Abnormal respiratory drive
B) Asynchrony
C) Inadequate ventilatory support
D) Inadequate FiO<sub>2</sub>
Q3) Which of the following is a technique for minimizing the effects of auto-PEEP?
A) Secretion management
B) Minimizing bronchodilator therapy
C) Increasing inspiratory time
D) Smaller sized endotracheal tubes
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Chapter 48: Initiating and Adjusting Invasive Ventilatory Support
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Sample Questions
Q1) A chronic obstructive pulmonary disease (COPD) patient receiving ventilatory support in the CMV assist-control mode at a rate of 14 and a V<sub>T</sub> of 750 ml exhibits clinical signs of air trapping. Which of the following would you recommend to correct this problem?
1) Decrease "E" time.
2) Increase the inspiratory flow rate.
3) Decrease the assist-control rate.
A)1 and 2 only
B)1 and 3 only
C)2 and 3 only
D)1, 2, and 3
Q2) A physician orders intubation and mechanical ventilation in the continuous mandatory ventilation assist-control mode for a 125-lb adult woman with normal lungs. Which of the following initial settings would you recommend? Rate V<sub>T</sub>
A) 10 breaths/min 550 ml
B) 14 breaths/min 400 ml
C) 18 breaths/min 450 ml
D) 12 breaths/min 470 ml
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Chapter 49: Noninvasive Ventilation
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Sample Questions
Q1) Which of the following restrictive thoracic diseases are successfully managed with noninvasive ventilation (NIV)?
1) Postpolio syndrome
2) Neuromuscular disease
3) Spinal cord injuries
4) Severe kyphoscoliosis
A)1, 2, and 4 only
B)1, 2, 3, and 4
C)2 and 4 only
D)2, 3, and 4 only
Q2) Which of the following is/are characteristics of most noninvasive ventilators?
1) Electrically powered
2) Blower driven
3) Microprocessor controlled
4) Double-circuit design
A)1 only
B)1, 2, and 3 only
C)1, 2, 3, and 4
D)1 and 4 only
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Chapter 50: Extracorporeal Life Support Ecls
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Sample Questions
Q1) How is the ECMO system powered?
A) A pump
B) A piston
C) A compressor
D) Gravity
Q2) What is a major advantage of ECMO?
A) Mortality rate is much lower than conventional ventilation.
B) The need for hemodynamic monitoring is reduced.
C) It can be used on premature infants less than 28 weeks.
D) The potential of ventilator induced lung injury is reduced.
Q3) During VV ECMO, where are cannulas typically placed?
1) Right internal jugular vein
2) Left femoral vein
3) Right atrium
4) Femoral artery
A)1 and 3 only
B)1, 2, and 3 only
C)3 and 4 only
D)2, 3, and 4 only
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Page 52
Chapter 51: Monitoring the Patient in the Intensive Care Unit
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Sample Questions
Q1) Which of the following are global monitoring indexes?
1) APACHE
2) APS
3) TISS
4) ATS
A)1 and 3 only
B)1, 2, and 3 only
C)2 and 4 only
D)1, 2, 3, and 4
Q2) What is the normal mean pulmonary artery pressure?
A) 5 mm Hg
B) 10 mm Hg
C) 15 mm Hg
D) 20 mm Hg
Q3) What is the normal disparity between end-tidal PCO<sub>2</sub> and PaCO<sub>2</sub>?
A) End-tidal PCO<sub>2</sub> is 1 to 5 mm Hg less than PaCO<sub>2</sub>
B) End-tidal PCO<sub>2</sub> is 5 to 10 mm Hg less than PaCO<sub>2</sub>
C) End-tidal PCO<sub>2</sub> is 1 to 5 mm Hg higher than PaCO<sub>2</sub>
D) End-tidal PCO<sub>2</sub> is 5 to 10 mm Hg higher than PaCO<sub>2</sub>
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Chapter 52: Discontinuing Ventilatory Support
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Sample Questions
Q1) Which of the following health care disciplines should be involved in the care of a patient who is considered difficult to wean?
1) Physical therapy
2) Speech therapy
3) Social services
4) Occupational therapy
A)1 and 2 only
B)2 and 3 only
C)1, 2, and 4 only
D)1, 2, 3, and 4
Q2) Which of the following indicate that an adult patient is ready to be weaned from ventilatory support?
1) PAO<sub>2</sub> - PaO<sub>2</sub> = 430 on 100% O<sub>2</sub>
2) V<sub>D</sub>/V<sub>T</sub> = 0.55
3) MIP = -33 cm H<sub>2</sub>O
4) PO<sub>2</sub> = 76 mm Hg on 40% O<sub>2</sub>
A)1 and 3 only
B)1, 2, and 3 only
C)3 and 4 only
D)2, 3, and 4 only
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Chapter 53: Neonatal and Pediatric Respiratory Care
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Sample Questions
Q1) Which of the following maternal factors is/are related to the health of the fetus and the outcomes of pregnancy?
1) Maternal age
2) Prior maternal disease
3) Maternal drug use
4) Maternal birth history
A)1, 2, and 3 only
B)2 and 4 only
C)1, 2, 3, and 4
D)3 and 4 only
Q2) Which of the following is considered a limitation of the high-flow nasal cannula?
A) It does not meet patient's flow needs.
B) The amount of airway positive pressure cannot be measured.
C) It does not provide for appropriate CO<sub>2</sub> clearance.
D) It does not reduce the use of noninvasive positive-pressure ventilation.
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55
Chapter 54: Patient Education and Health Promotion
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Sample Questions
Q1) Which of the following is used to evaluate the affective and psychomotor domains?
A) Verbal exam
B) Demonstration
C) Written exam
D) Performance checklist
Q2) What percentage of smokers has been reported to want to stop the smoking habit?
A) 10%
B) 25%
C) 50%
D) 70%
Q3) Teaching facts to patients involves learning in what domain?
A) Cognitive
B) Affective
C) Psychomotor
D) Analytical
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Chapter 55: Cardiopulmonary Rehabilitation
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Sample Questions
Q1) For which of the following patients would you recommend an open-ended format for a pulmonary rehabilitation program?
1) Those with scheduling difficulties
2) Those who require individual attention
3) Those who are self-directed
A)2 and 3 only
B)1 and 2 only
C)1, 2, and 3
D)1 and 3 only
Q2) Which of the following exercises are useful for reconditioning the upper extremities of patients undergoing pulmonary rehabilitation?
1) Using a rowing machine
2) Using an arm ergometer
3) Pedaling a stationary bicycle
4) Using free hand weights
A)1, 2, 3, and 4
B)1 and 3 only
C)1, 2, and 4 only
D)2 and 4 only
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Chapter 56: Respiratory Care in Alternative Settings
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Sample Questions
Q1) Complications associated with insertion of a transtracheal O<sub>2</sub> catheter include all of the following except:
A) bleeding.
B) pneumothorax.
C) bronchospasm.
D) abscess.
Q2) A home care patient with kyphoscoliosis requires intermittent positive pressure breathing (IPPB) treatments twice per day with O<sub>2</sub>. A local charitable organization has given the family a pneumatically powered IPPB device for this purpose. Which of the following gas sources would you recommend to drive this device?
1) Liquid O<sub>2</sub> reservoir
2) O<sub>2</sub> concentrator
3) Compressed gas cylinder
A)1 and 2 only
B)2 and 3 only
C)3 only
D)1, 2, and 3
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58