Cardiopulmonary Physiology Review
Questions
Course Introduction
Cardiopulmonary Physiology explores the fundamental principles governing the function and integration of the heart, lungs, and vascular system. This course covers the mechanisms of cardiac muscle contraction, electrical activity of the heart, regulation of heart rate and blood pressure, pulmonary ventilation and gas exchange, acid-base balance, and the physiological adjustments during exercise and disease states. Through lectures, laboratory exercises, and clinical case studies, students gain a thorough understanding of how the cardiopulmonary system maintains homeostasis and responds to physiological stress, laying the groundwork for advanced studies and clinical practice in health sciences.
Recommended Textbook
Egans Fundamentals of Respiratory Care 11th Edition by Robert M. Kacmarek
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56 Chapters
3426 Verified Questions
3426 Flashcards
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Chapter 1: History of Respiratory Care
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Sample Questions
Q1) According to the AARC's "2015 and Beyond" project, all of the following are included in the seven major competencies required by Respiratory Therapists by the Year 2015 except:
A) chronic disease state management.
B) bronchoscopy.
C) evidence-based medicine and respiratory care protocols.
D) leadership.
Answer: B
Q2) Which of the following was one of the first positive-pressure ventilators developed?
A) MA-1
B) Bird Mark 7
C) Dräger Pulmotor
D) Engstrom
Answer: C
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Chapter 2: Delivering Evidence-Based Respiratory Care
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Sample Questions
Q1) What voluntary accrediting agency monitors quality in respiratory care departments?
A) JRCRTE
B) AARC
C) FDA
D) The Joint Commission
Answer: D
Q2) Current Joint Commission standards for accreditation emphasize which of the following?
A) Continual quality improvement
B) Therapist-driven protocols
C) License and registration of health care providers
D) Health, welfare, and safety of patients using respiratory care equipment
Answer: A
Q3) What are the key outcomes that are looked at in different types of studies?
A) Patient survival
B) Discharge from ICU
C) Organ system failure
D) All of the above
Answer: D
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Chapter 3: Quality, Patient Safety, and Communication, and Recordkeeping
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Sample Questions
Q1) Nonverbal communication includes which of the following?
1) Gesture
2) Touch
3) Voice tone
4) Space
A)1 and 3 only
B)1 only
C)2 and 4 only
D)1, 2, 3, and 4
Answer: D
Q2) What was one of The Joint Commission's (TJC) goals for 2010?
A) To improve accuracy of patient identification
B) To lessen costs
C) To enforce proper infection control
D) To have more case studies
Answer: A
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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) Which of the following is the most common source of patient infections?
A) Large volume nebulizers
B) Small volume nebulizers
C) Internal circuits of a ventilator
D) Oxygen therapy devices
Q3) Which of the following steps for disinfection of a bronchoscope is false?
A) The first step is cleaning the scope.
B) Disinfection is done by immersion in a liquid disinfectant.
C) The device is stored lying flat to promote drying.
D) Drying techniques can include forced air.
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Chapter 5: Ethical and Legal Implications of Practice
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Sample Questions
Q1) In most professions, specific guidance in resolving ethical dilemmas is provided by which of the following?
A) An ethical theory
B) A code of ethics
C) Civil statutes
D) Criminal statutes
Q2) Divisions of public law (the relationships of private parties and the government) include:
1) Administrative
2) Civil
3) Criminal
A)2 and 3 only
B)1 and 2 only
C)1 and 3 only
D)1, 2, and 3
Q3) Which of the following is not a common element in a professional practice act?
A) Scope of professional practice
B) Requirements and qualifications for licensure
C) Penalties and sanctions for unauthorized practice
D) Professional code of ethics
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Chapter 6: Physical Principles of Respiratory Care
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Sample Questions
Q1) The resistance to flow of a fluid through a tube can be computed according to which of the following formulas?
A) Resistance = flow \(\times\) viscosity
B) Resistance = flow ÷ pressure
C) Resistance = pressure ÷ flow
D) Resistance = flow \(\times\) pressure
Q2) What are the forms of vaporization?
1) Boiling
2) Freezing
3) Evaporation
4) Sublimation
A)1 only
B)1 and 2 only
C)1 and 3 only
D)1, 2, and 4 only
Q3) Under conditions of turbulent flow, what is the driving pressure?
A) Proportional to the square of the flow
B) Inversely proportional to the flow
C) Linearly proportional to the flow
D) Inversely proportional to the density
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Chapter 7: E-Medicine in Respiratory Care
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Sample Questions
Q1) Which of the following is/are advantage(s) of a wireless hand-held computer for charting patient care?
1) Documentation is more legible.
2) Documentation is available to others more quickly.
3) It is less expensive.
4) There is improved fulfillment of physicians' orders.
A)1 only
B)1 and 2 only
C)2, 3 and 4 only
D)1, 2, and 4 only
Q2) The process by which the underlying primary, secondary, and other notable causes of a medical error are identified is referred to as?
A) Continuous quality improvement
B) A root-cause analysis
C) Value-based purchasing
D) Web analytic
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9
Chapter 8: Fundamentals of Respiratory Care Research
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Sample Questions
Q1) Which of the following describes a database that is a structured collection of facts?
A) Synthesized databases
B) Portal databases
C) Electronic journal databases
D) Bibliographic databases
Q2) What entity is responsible for approving experimental procedures prior to collecting data?
A) AARC
B) IRB
C) NBRC
D) NIH
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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Chapter 9: The Respiratory System
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Sample Questions
Q1) What is called the "functional unit of the lungs"?
A) Only the alveoli
B) Acinus
C) Alveolar-capillary membranes
D) Terminal bronchioles
Q2) Approximately what percent of the normal changes in thoracic volume during quiet inspiration is due to the action of the diaphragm?
A) 15
B) 25
C) 50
D) 75
Q3) Why is pulmonary surfactant such an important biologic substance?
A) It clears out cellular debris.
B) It is an alveolar macrophage.
C) It promotes lung contraction aiding exhalation.
D) It promotes lung stability.
Q4) Infants are more susceptible to profound hypoxemia than are adults.
A)True
B)False
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Chapter 10: The Cardiovascular System
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Sample Questions
Q1) The apex of the heart (tip of the left ventricle) lies just above the diaphragm at a level corresponding to which intercostal space?
A) Fourth
B) Fifth
C) Sixth
D) Seventh
Q2) What in essence is Frank-Starling's law of the heart?
A) The greater the stretch, the stronger the contraction.
B) The less the afterload, the greater the ejection fraction.
C) Describes the inverse relationship between diameter and resistance to flow.
D) Curves show the hysteresis variations between systole and diastole.
Q3) Stroke volume can be calculated using which formula?
A) Ejection fraction \(\times\) heart rate
B) End-diastolic volume - end-systolic volume
C) Ejection fraction \(\times\) end-systolic volume
D) Cardiac output ÷ end-diastolic volume
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Chapter 11: Ventilation
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Sample Questions
Q1) A fibrotic lung would exhibit which of the following characteristics?
A) Decreased airway resistance
B) Decreased lung compliance
C) Decreased PVR
D) Decreased surface tension
Q2) Which of the following diseases or disorders is most likely to result in an increased V<sub>D</sub>/V<sub>T</sub> ratio?
A) Atelectasis
B) Pneumonia
C) Pulmonary embolus
D) Pulmonary fibrosis
Q3) Which of the following statements about alveolar pressure (P<sub>alv</sub>) during normal quiet breathing is true?
A) It is positive during inspiration and negative during expiration.
B) It is the same as intrapleural pressure (P<sub>pl</sub>).
C) It is negative during inspiration and positive during expiration.
D) It always remains less than atmospheric pressure.
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13
Chapter 12: Gas Exchange and Transport
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Sample Questions
Q1) Compared to normal levels, a shift in the HbO<sub>2</sub> curve to the right has which of the following effects?
1) The affinity of Hb for O<sub>2</sub> decreases.
2) The Hb saturation for a given PO<sub>2</sub> falls.
3) The Hb saturation for a given PO<sub>2</sub> rises.
A)1 only
B)1 and 2 only
C)2 and 3 only
D)1, 2, and 3
Q2) A healthy person breathing 100% O<sub>2</sub> at sea level would have PAO<sub>2</sub> of approximately what level?
A) 149 mm Hg
B) 670 mm Hg
C) 713 mm Hg
D) 760 mm Hg
Q3) When is the rate of gaseous diffusion across a biological membrane decreased?
A) The diffusion distance is small.
B) The gas diffusion constant increases.
C) The partial pressure gradient is low.
D) The surface area is large.
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Chapter 13: Solutions, Body Fluids, and Electrolytes
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Sample Questions
Q1) Positive ions are referred to as:
A) anions.
B) cations.
C) covalents.
D) electrolytes.
Q2) Which of the following is a facet of blood proteins?
A) Blood proteins are composed of amino acids held together by fatty acids.
B) Deoxygenated hemoglobin (Hb) is unable to accept H<sup>+ </sup>ions.
C) In an alkaline environment, blood proteins can act as bases.
D) The imidazole group on amino acids is the key binding site for other amino acids.
Q3) Signs and symptoms of hyperkalemia would include which of the following?
1) Cardiac arrest
2) Electrocardiogram abnormalities
3) Metabolic alkalosis
4) Ventricular arrhythmias
A)1, 2, and 4 only
B)2 and 3 only
C)2, 3, and 4 only
D)1, 2, 3, and 4
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Page 15
Chapter 14: Acid-Base Balance
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Sample Questions
Q1) Using the Henderson-Hasselbalch equation, determine the accuracy of the gas below. To be considered accurate, it must be within 0.03 pH unit. pH = 7.35, PCO<sub>2</sub> = 77 mm Hg, HCO<sub>3</sub><sup>-</sup> = 41 mEq/L
A) This gas is completely accurate.
B) This gas is accurate as the calculated pH is 7.32.
C) This gas is accurate as the calculated pH is 7.38.
D) This gas is inaccurate according to the H-H equation.
Q2) An ABG result shows the pH to be 7.56 and the HCO<sub>3</sub><sup>-</sup> to be 23 mEq/L. Which of the following is the most likely disorder?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Q3) What is the limiting factor for H<sup>+</sup> excretion in the renal tubules?
A) Excessive amounts of Cl<sup>-</sup>
B) Excessive amounts of HCO<sub>3</sub><sup>-</sup>
C) Insufficient buffers
D) Insufficient sodium
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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) What group of nerve cells senses and responds to changes in the chemical composition of its fluid environment?
A) Chemoreceptors
B) Gamma-efferent system
C) Muscle spindle fibers
D) Proprioceptors
Q3) What is the response of a patient with chronic hypercapnia to a sudden acute rise in carbon dioxide?
A) In almost all of these patients, there will be no response.
B) The patient's drive to breathe will be increased.
C) This will further depress his or her respiratory centers.
D) This will induce apnea and sudden death.
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17
Chapter 16: Bedside Assessment of the Patient
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Sample Questions
Q1) Which of the following is least likely to cause tachycardia?
A) Fever
B) Severe pain
C) Hypotension
D) Hypothermia
Q2) What term best describes a loud, high-pitched continuous sound heard (often with the unaided ear) primarily over the larynx or trachea during inhalation in patients with upper airway obstruction?
A) Stridor
B) Rhonchi
C) Crackles
D) Wheeze
Q3) What is the advantage of COPD patients breathing through pursed lips during exhalation?
A) Helps the patient focus on breathing.
B) Promotes more complete emptying of the lungs.
C) Reduces the patient's anxiety level.
D) Improves arterial pH levels.
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18
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) An ICU patient in septic shock shows the following electrolyte panel results: a serum Na<sup>+</sup> of 150 mmol/L, a total CO<sub>2</sub> of 18 mmol/L, lactate of 4 mmol/L, and a serum Cl<sup> </sup> level of 110 mmol/L. The patient is hypotensive and the RT is unable to obtain an ABG for analysis. What conclusion(s) can be drawn regarding this patients acid-base status?
1. The anion gap is decreased.
2. Metabolic acidosis is present.
3. Anion gap is increased.
4. Lactic acidosis is present.
A) 1, 2, and 4 only
B) 1 only
C) 2 and 4 only
D) 2, 3, and 4 only
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Page 19
Chapter 18: Interpreting the Electrocardiogram
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Sample Questions
Q1) What structure serves as the backup pacemaker for the heart?
A) Atrioventricular (AV) node
B) Sinoatrial (SA) node
C) Bundle of His
D) Purkinje fibers
Q2) Which of the following medications is used to treat symptomatic sinus bradycardia?
A) Atropine
B) Digitalis
C) Propranol
D) Lidocaine
Q3) What condition is often associated with right-axis deviation?
A) Cor pulmonale
B) Congestive heart failure (CHF)
C) Mitral valve prolapse
D) Left ventricular hypertrophy
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Chapter 19: Analysis and Monitoring of Gas Exchange
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Sample Questions
Q1) During a single-breath capnogram, the sharp downstroke and return to baseline that normally occurs after the end-tidal point indicates what?
A) Exhalation of mainly dead space gas
B) Inspiration of fresh respiratory gas
C) Exhalation of mixed alveolar and dead space gas
D) Exhalation of mainly alveolar gas
Q2) A PaO<sub>2</sub> below what value would be considered moderate hypoxemia?
A) 75 mm Hg
B) 65 mm Hg
C) 55 mm Hg
D) Depends on the FiO<sub>2</sub>
Q3) What is the most common source of error and false alarms with pulse oximetry?
A) Presence of HbCO
B) Patient motion artifact
C) Presence of vascular dyes
D) Ambient light detection
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Chapter 20: Pulmonary Function Testing
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Sample Questions
Q1) You perform a series of pulmonary function tests on a patient with a potentially infectious disease carried via the airborne route. Which of the following infection-control procedures should you implement?
1) Wear a respirator or close-fitting surgical mask.
2) Dispose of, sterilize, or disinfect the tubing circuit after testing.
3) Clean the interior surface of the spirometer before the next test.
A)1 only
B)1 and 2 only
C)2 and 3 only
D)1, 2, and 3
Q2) What is the most common measurement of pulmonary mechanics during pulmonary function testing?
A) Tidal volume
B) Forced vital capacity
C) Residual volume
D) Inspiratory reserve volume
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22
Chapter 21: Review of Thoracic Imaging
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Sample Questions
Q1) In which of the following situations is obtaining a chest radiograph least useful?
A) Following intubation
B) Following placement of a central venous pressure line
C) When the static pressure drops by 2 cm H<sub>2</sub>O during CMV
D) When the patient's oxygenation status deteriorates for no known reason
Q2) In the standard posteroanterior chest film, the heart shadow should be less than what proportion of the chest width?
A) 33%
B) 40%
C) 50%
D) 65%
Q3) What problem exists when interpreting an overexposed chest film?
A) There is difficulty in seeing the peripheral blood vessels.
B) The ribs appear wider than normal.
C) The heart shadow is blurred.
D) The lymph nodes in the mediastinum cannot be seen.
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Chapter 22: Flexible Bronchoscopy and the Respiratory Therapist
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Sample Questions
Q1) When is endobronchial biopsy performed?
A) To obtain a sputum sample from a visible endobronchial lesion.
B) To obtain a tissue sample from a visible endobronchial lesion.
C) It is used with transbronchial needle aspiration.
D) It is used during bronchial stent placement.
Q2) What is the major challenge of ultrathin bronchoscopy?
A) Bronchoscopy kinking during procedure
B) The equipment is expensive
C) Issues with CT guidance equipment
D) Maintaining proper anatomical orientation in the peripheral airways
Q3) During bronchoscopy of an intubated patient receiving mechanical ventilation, what should the RT be aware of?
A) Risks are minimal since the patient already has a secured airway.
B) The resistance imposed by the bronchoscope may cause tracheal pressures to increase noticeably.
C) Albuterol should be available to address and airway resistance changes.
D) Inspiratory and expiratory effort (measured by tracheal pressure) appears minimally affected in most patients.
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Chapter 23: Nutrition Assessment
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Sample Questions
Q1) What percent of the patient's caloric intake should come from fat in most circumstances?
A) 10% to 15%
B) 20% to 30%
C) 30% to 40%
D) 40% to 50%
Q2) If your patient is 2 m in height and weighs 80 kg, what is his body mass index (BMI)?
A) 40 kg/m<sup>2</sup>
B) 30 kg/m<sup>2</sup>
C) 20 kg/m<sup>2</sup>
D) 15 kg/m<sup>2</sup>
Q3) Morbid obesity is defined as a BMI over what value?
A) 20 kg/m<sup>2</sup>
B) 25 kg/m<sup>2</sup>
C) 30 kg/m<sup>2</sup>
D) 35 kg/m<sup>2</sup>
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Chapter 24: Pulmonary Infections
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Sample Questions
Q1) Which of the following types of pneumonia suggests that the patient acquired it through inhalation of infectious particles?
A) Cytomegalovirus
B) Haemophilus influenzae
C) Histoplasmosis
D) Staphylococcus
Q2) A 45-year-old patient diagnosed with pneumonia has received appropriate antibiotic therapy. Radiographic resolution is most often seen within what time period?
A) 1 week
B) 1 month
C) 6 months
D) 1 year
Q3) What has been found to be a common cause of pneumonia in HIV-positive patients?
A) Klebsiella
B) Pneumocystis jiroveci
C) Staphylococcus
D) Streptococcus pneumoniae
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26
Chapter 25: Obstructive Lung Disease: Chronic Obstructive
Pulmonary Disease Copd, Asthma, and Related Diseases
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Q1) Which medication is a once-daily combination of a beta-2 agonist and an inhaled corticosteroid?
A) Combivent Respimat
B) Advair
C) Flovent
D) Breo Ellipta
Q2) An asthma patient's best effort produces a PEFR of 55% of personal best. What is indicated at this time?
A) Patient should lie down and try to relax.
B) Patient should probably seek medical attention now.
C) Patient should retry the PEFR maneuver.
D) Patient should take his or her controller medications.
Q3) What pathophysiologic characteristic of asthma has been most recently emphasized in the description and subsequent treatment of this disease?
A) Hyperactivity of the airways
B) Hyperinflation of the lung parenchyma
C) Inflammation of the airways
D) Mucus plugging of the airways
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Chapter 26: Interstitial Lung Disease
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Q1) Which of the following is found almost universally in patients with interstitial lung disease (ILD)?
A) Airway dilation
B) Bronchoconstriction
C) Compensatory cytokine release
D) Decreased compliance
Q2) 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
Q3) Which of the following interstitial lung diseases (ILDs) is not occupationally related?
A) Asbestosis
B) Berylliosis
C) Sarcoidosis
D) Silicosis
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28
Chapter 27: Pleural Diseases
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Q1) What diagnostic procedure or technique is most commonly used to diagnose the presence of a pleural effusion?
A) Chest radiography
B) Pleuroscopy
C) Thoracentesis
D) Thoracoscopy
Q2) What is a common clinical finding even with small pleural effusions?
A) Air bronchograms
B) Arrhythmias
C) Dyspnea
D) Tachycardia
Q3) Which of the following procedures would you recommend to assess her situation at this time?
A) Chest x-ray
B) Auto-PEEP maneuver
C) Measure her compliance manually
D) CT scan of the chest
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Chapter 28: Pulmonary Vascular Disease
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Sample Questions
Q1) What is the 5-year survival rate for patients with untreated idiopathic pulmonary artery hypertension (IPAH)?
A) 33%
B) 44%
C) 55%
D) 66%
Q2) What is the most commonly used oral anticoagulant?
A) Acetylcholine esterase
B) Heparin
C) Streptokinase
D) Warfarin
Q3) 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%
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Page 30
Chapter 29: Acute Respiratory Distress Syndrome
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Q1) What ventilatory strategy has been found to be useful for avoiding barotrauma in the treatment of patients with ARDS?
A) Prolonged expiratory time
B) Permissive hypercapnia
C) Inverse ratio ventilation
D) Intermittent mandatory ventilation
Q2) Which of the following explains the basis for permissive hypercapnia as a ventilator strategy for ARDS?
A) Introduction of CO<sub>2</sub> into the breathing circuit to stimulate spontaneous breaths.
B) Use of lower tidal volumes and accepting a gradual rise in PCO<sub>2</sub> to avoid associated hazards of high P<sub>aw</sub>.
C) Allow patients with ARDS to breathe spontaneously to build their respiratory muscular endurance.
D) To use exhaled CO<sub>2</sub> to increase residual volume and improve gas exchange.
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Chapter 30: Trauma, Burns and Near Drowning
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Q1) Your patient is brought in by EMS after being pulled from a house fire. She is complaining of difficulty breathing, has burnt nasal hairs, soot in the oral pharynx, and stridor. The physician asks for a treatment suggestion regarding her respiratory needs. What would you suggest?
A) Racemic epinephrine
B) Hyperbaric oxygen therapy
C) Nonrebreathing mask at 15 L/min
D) Intubations and mechanical ventilation
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
Q3) How should tidal volume be determined for an obese patient?
A) Based on actual body weight
B) Based on predicted body weight
C) Based on chest rise
D) Based on arterial blood gas results
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Chapter 31: Lung Cancer
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Sample Questions
Q1) Which of the following pulmonary function tests are frequently used to determine tolerance to resectional surgery?
1) FEV<sub>1</sub>
2) FEF<sub>25% to 75%</sub>
3) FVC
4) DLCO
A)1 only
B)1 and 4 only
C)2 and 4 only
D)2, 3, and 4 only
Q2) What type of lung cancer usually is seen as a central lesion that may obstruct airways and lead to atelectasis?
A) Adenocarcinoma
B) Squamous cell
C) Large cell
D) Bronchogenic carcinoma
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Chapter 32: Neuromuscular and Other Diseases of the
Chest Wall
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Sample Questions
Q1) At what level do the nerves that innervate the diaphragm exit the spine?
A) C1-3
B) C3-5
C) C6-7
D) T1-3
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) Which of the following would not be considered a common pulmonary consequence of neuromuscular disease?
A) Sleep apnea
B) Aspiration
C) Cor pulmonale
D) Pneumothorax
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Page 34
Chapter 33: Disorders of Sleep
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Sample Questions
Q1) What is the amount of CPAP that is typically required to abolish upper airway obstruction in patients with OSA?
A) 3 to 5 cm H<sub>2</sub>O
B) 10 to 20 cm H<sub>2</sub>O
C) 2.5 to 7.5 cm H<sub>2</sub>O
D) 7.5 to 12.5 cm H<sub>2</sub>O
Q2) The definition of sleep apnea uses what criteria for defining an episode of apnea?
A) 5 sec
B) 10 sec
C) 15 sec
D) 20 sec
Q3) What is the name of the respiratory pattern where a crescendo-decrescendo pattern of hyperpnea alternates with periods of apnea?
A) Cheyne-Stokes
B) Kussmaul
C) Agonal
D) Biot's
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Chapter 34: Neonatal and Pediatric Respiratory Disorders
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Sample Questions
Q1) What therapy has been shown to reduce the rate of loss of lung function in patients with cystic fibrosis?
A) High doses of ibuprofen
B) Continuous oxygen therapy
C) Corticosteroids
D) Inhaled DNase
Q2) Which of the following is the most common radiographic finding that suggests the presence of epiglottitis?
A) Thumb sign
B) Flail chest
C) Sail sign
D) Steeple sign
Q3) What treatment usually causes improvement in the initial treatment of transient tachypnea of the newborn?
A) Mechanical ventilation with PEEP
B) Oxygen with low FiO<sub>2</sub>
C) Bronchodilators
D) Mucolytics
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Chapter 35: Airway Pharmacology
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Sample Questions
Q1) In addition to nitric oxide, which of the following inhalational agents have been approved by the U.S. Food and Drug Administration for the treatment of pulmonary hypertension?
1) Treprostenil
2) Epoprostenol
3) Iloprost
4) Alprostadil
A)2 only
B)1 and 3 only
C)1, 2, 3, and 4
D)2 and 4 only
Q2) Which of the following are LABA bronchodilators?
1) Indacaterol
2) Olodaterol
3) Albuterol
4) Salmeterol
A)1 and 3 only
B)1, 2, and 3 only
C)1, 2, and 4 only
D)1, 2, 3, and 4
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Page 37
Chapter 36: Airway Management
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Sample Questions
Q1) Which of the following techniques may be used to diagnose injury associated with artificial airways?
1) Laryngoscopy or bronchoscopy
2) Physical examination
3) Air tomography
4) Pulmonary function studies
A)1 and 2 only
B)1 and 3 only
C)2, 3, and 4 only
D)1, 2, 3, and 4
Q2) What is the primary indication for tracheostomy?
A) When a patient loses pharyngeal or laryngeal reflexes
B) When a patient has a long-term need for an artificial airway
C) When a patient has been orally intubated for more than 24 hr
D) When a patient has upper airway obstruction due to secretions
Q3) What is the primary indication for tracheal suctioning?
A) Presence of pneumonia
B) Presence of atelectasis
C) Ineffective coughing
D) Retention of secretions
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Chapter 37: Emergency Cardiovascular Life Support
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Sample Questions
Q1) A patient with supraventricular tachycardia (SVT) at a rate of 195/min is developing symptoms of shock and unconsciousness. At this time, what would you recommend?
A) Vagal stimulation through carotid sinus massage
B) Administration of a strong beta-adrenergic agent
C) Synchronous electrical shock (cardioversion)
D) Administration of a bolus of intravenous lidocaine
Q2) Which of the following are differences between cardioversion and defibrillation?
1) In cardioversion, the countershock is synchronized with the R wave.
2) In defibrillation, more energy is applied.
3) In cardioversion, the countershock is synchronized with the R wave.
4) In defibrillation, more energy is applied.
A)1 only
B)1 and 2 only
C)2 only
D)3 and 4 only
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Chapter 38: Humidity and Bland Aerosol Therapy
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Sample Questions
Q1) In checking a servo-controlled heated-wire humidifier system, you notice that a few drops of condensate tend to form but only near the patient's airway. Based on this observation, what can you conclude?
A) The gas at the airway is fully saturated.
B) The temperature setting of the heater is too high.
C) The airway temperature exceeds the dew point.
D) The temperature setting of the heater is too low.
Q2) Which of the following are true when heated-wire circuits are used with heated humidifiers except:
A) the humidifier operates at a higher temperature.
B) there is less condensate and a reduced need for drainage.
C) cost savings (less water and staff time) are realized.
D) there is less infection risk for both patient and caregivers.
Q3) The aerosol output (in mg/L) of an ultrasonic nebulizer depends mainly on which of the following?
A) Signal amplitude
B) Chamber baffling
C) Source current
D) Signal frequency
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Page 40
Chapter 39: Aerosol Drug Therapy
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Sample Questions
Q1) Which of the following is false about the optimal technique for using a small-volume jet nebulizer (SVN) for aerosol drug delivery?
A) SVNs are less technique- and device-dependent.
B) Slow inspiration improves SVN aerosol deposition.
C) Deep breathing or breath-holding improves SVN deposition.
D) Use of a mouthpiece or mask provides similar results.
Q2) What is the preferred method for delivering bronchodilators to spontaneously breathing and intubated, ventilated patients?
A) Dry powder inhaler
B) Small-volume jet nebulizer
C) Metered dose inhaler
D) Hand-bulb atomizer
Q3) 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
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Chapter 40: Storage and Delivery of Medical Gases
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Sample Questions
Q1) Which of the following medical gases can be stored in cylinders as liquids at room temperature?
1) CO<sub>2</sub>
2) O<sub>2</sub>
3) N<sub>2</sub>O
A)1 only
B)1 and 2 only
C)1 and 3 only
D)1, 2, and 3
Q2) Where do respiratory therapists typically find DISS connections?
1) At the outlets of pressure-reducing valves attached to cylinders
2) At the nurse station
3) At the station outlets of central piping systems
4) At the inlets of blenders, flowmeters, ventilators, and other pneumatic equipments
A)1 and 2 only
B)1, 2, and 3 only
C)1, 3, and 4 only
D)3 and 4 only
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42
Chapter 41: Medical Gas Therapy
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Sample Questions
Q1) At what level of carboxyhemoglobin saturation is hyperbaric oxygen (HBO) therapy indicated for an adult patient?
A) Greater than 10%
B) Greater than 15%
C) Greater than 20%
D) Greater than 25%
Q2) What temperature is required to maintain a neutral thermal environment (NTE) in an Oxy-Hood for infants weighing 2500 g or more?
A) 25° C
B) 30° C
C) 35° C
D) 40° C
Q3) To minimize the risk of retinopathy of prematurity (ROP), the American Academy of Pediatrics recommends keeping the PaO<sub>2</sub> below what level?
A) 60 mm Hg
B) 70 mm Hg
C) 80 mm Hg
D) 90 mm Hg
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Chapter 42: Lung Expansion Therapy
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Sample Questions
Q1) Which of the following are true about intermittent positive-pressure breathing?
1) During inspiration, pressure in the alveoli decreases.
2) The pressure gradients of normal breathing are reversed.
3) During inspiration, alveolar pressure may exceed pleural pressure.
4) Energy stored during inspiration causes a passive exhalation.
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 are contraindications for continuous positive airway pressure (CPAP) therapy?
1) Hemodynamic instability
2) Hypoventilation
3) Facial trauma
4) Low intracranial pressures
A)1 and 3 only
B)2 and 3 only
C)1, 2, and 3 only
D)2, 3, and 4 only
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44
Chapter 43: Airway Clearance Therapy Act
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Sample Questions
Q1) Retention of secretions can result in full or partial airway obstruction. Mucus plugging can result in which of the following?
1) Hypoxemia
2) Atelectasis
3) Shunting
A)1, 2, and 3
B)1 and 2 only
C)1 and 3 only
D)2 and 3 only
Q2) A typical mechanical insufflation-exsufflation treatment session should continue until what point?
1) Secretions are cleared.
2) The vital capacity (VC) returns to baseline.
3) The SpO<sub>2</sub> returns to baseline.
A)2 and 3 only
B)1 and 2 only
C)1, 2, and 3
D)1 and 3 only
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Chapter 44: Respiratory Failure and the Need for
Ventilatory
Support
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Sample Questions
Q1) Which of the following indicators are useful in assessing respiratory muscle strength?
1) Maximum voluntary ventilation (MVV)
2) Forced vital capacity (FVC)
3) Dead space-to-tidal volume ratio (V<sub>D</sub>/V<sub>T</sub>)
4) Maximum inspiratory pressure (MIP)
A)1 and 3 only
B)2 and 4 only
C)3 and 4 only
D)1, 2, and 4 only
Q2) Inadequate respiratory muscle strength is likely when a patient's MVV is which of the following?
A) Less than 2 times the resting V<sub>E</sub>
B) Greater than 3 times the resting V<sub>E</sub>
C) Less than 200 L/min
D) Greater than 120 L/min
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Chapter 45: Mechanical Ventilators
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Sample Questions
Q1) Which of the following ventilator control systems are considered closed loop?
1) Orientation based
2) Servo
3) Adaptive
4) Optimal
A)1 and 3 only
B)1, 2, and 3 only
C)3 and 4 only
D)2, 3, and 4 only
Q2) What is the name of a breath where a patient is able to change the inspiratory time?
A) Patient cycled
B) Patient triggered
C) Machine triggered
D) Machine cycled
Q3) During mechanical ventilation, what variable causes a breath to end?
A) Limit
B) Cycle
C) Trigger
D) Baseline
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Page 47
Chapter 46: Physiology of Ventilatory Support
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Sample Questions
Q1) Which of the following is the explanation for the increased ratio when excessive positive end expiratory pressure (PEEP) is used?
A) Diversion of blood from ventilated alveoli to hypoventilated alveoli
B) Diversion of blood from hypoventilated alveoli to ventilated alveoli
C) Shunt-like effect
D) Hyperexpansion
Q2) Which of the following modes of ventilatory support would result in the highest mean airway pressure?
A) Volume-controlled intermittent mandatory ventilation
B) (Volume-controlled intermittent mandatory ventilation) + pressure-supported ventilation
C) Pressure-controlled intermittent mandatory ventilation
D) Volume-controlled continuous mandatory ventilation
Q3) Which of the following is the consequence of decreased resistance or compliance?
A) It takes more time to fill the alveoli.
B) It takes more time to empty the alveoli.
C) It takes less time to fill and more time to empty the alveoli.
D) It takes less time to fill and empty the alveoli.
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Chapter 47: Patient Ventilator Interaction
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Sample Questions
Q1) What is the normal trigger delay?
A) Less than 100 msec
B) Less than 150 msec
C) Less than 200 msec
D) Less than 250 msec
Q2) Your patient who is orally intubated and receiving mechanical ventilation was just repositioned by the nursing staff following their bedsheets being changed. Suddenly, airway pressures and tidal volumes rapidly decrease. Which of the following explains this finding?
A) Pneumothorax.
B) A dislodged mucus plug is obstructing the endotracheal tube.
C) Acute bronchospasm.
D) Movement of the endotracheal tube.
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) For adults with otherwise normal lungs who are receiving ventilatory support in the continuous mandatory ventilation control or assist-control mode, inspiratory flow should be set to provide what 1:E?
A) 2:1
B) 3:1
C) 1:1
D) 1:2
Q2) When adjusting a patient's oxygenation during mechanical ventilatory support, what should your goal be?
A) SaO<sub>2</sub> of 80% to 90%
B) PaO<sub>2</sub> of 100 to 150 mm Hg
C) SaO<sub>2 </sub>of 95% to 100%
D) PaO<sub>2 </sub>of 60 to 100 mm Hg
Q3) Air trapping is a major concern in patients with what diagnosis when using the assist-control mode?
A) Pneumonia
B) Chronic obstructive pulmonary disease (COPD)
C) Chest trauma
D) Neuromuscular disease
Page 50
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Chapter 49: Noninvasive Ventilation
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Sample Questions
Q1) Which of the following is the most important advantage of noninvasive ventilators over other types of ventilators?
A) Cost
B) Ability to trigger and cycle appropriately when small-to-moderate air leaks are present
C) Ability to remove CO<sub>2</sub>
D) Ability to oxygenate
Q2) What is the recommended initial setting for ventilating pressure when delivering noninvasive ventilation in the pressure triggered timed mode?
A) 2 to 5 cm H<sub>2</sub>O
B) 5 to 8 cm H<sub>2</sub>O
C) 8 to 12 cm H<sub>2</sub>O
D) 12 to 20 cm H<sub>2</sub>O
Q3) Which level of positive end-expiratory pressure (PEEP) is necessary to prevent rebreathing of carbon dioxide?
A) 1 to 3 cm H<sub>2</sub>O
B) 3 to 5 cm H<sub>2</sub>O
C) 5 to 7 cm H<sub>2</sub>O
D) 7 to 9 cm H<sub>2</sub>O
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Page 51
Chapter 50: Extracorporeal Life Support Ecls
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Sample Questions
Q1) How can the RT monitor for clots in the oxygenator?
A) Draw blood and monitor the PT, PTT, and INR.
B) Monitor pre- and postoxygenator pressures.
C) Observe the tubing for any clots.
D) Use pulse oximetry and capnometry.
Q2) Venoarterial is the preferred method for use of ECMO when cardiovascular support is not required.
A)True
B)False
Q3) Which of the following factors affect ACTs level of a patient receiving ECMO?
1) Hypothermia
2) Thrombocytopenia
3) Anemia
4) Hypofibrinogenemia
A)1 and 3 only
B)1, 2, and 3 only
C)2 and 4 only
D)1, 2, 3, and 4
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Chapter 51: Monitoring the Patient in the Intensive Care Unit
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Sample Questions
Q1) Which of the following are associated with an increase in central venous pressure?
1) Right heart failure
2) Pulmonary valvular stenosis
3) Pulmonary embolism
4) Dehydration
A)1 and 3 only
B)1, 2, and 3 only
C)2 and 4 only
D)1, 2, 3, and 4
Q2) Which of the following should be considered first if medical and mechanical problems have been excluded and the patient continues to fight the ventilator or exhibit high levels of agitation or distress?
A) Paralytics
B) Sedatives
C) Narcotics
D) Anesthetics
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Chapter 52: Discontinuing Ventilatory Support
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Sample Questions
Q1) Which of the following are disadvantages of using the T tube method for weaning?
1) More staff time required
2) Abrupt transition sometimes difficult
3) High imposed work of breathing
4) Lack of alarm systems
A)1 and 3 only
B)1, 2, and 4 only
C)3 and 4 only
D)2 and 4 only
Q2) A physician is using a pressure support protocol to wean a patient off ventilatory support. The patient is now at a 5 cm H<sub>2</sub>O pressure level and has a spontaneous respiratory rate of 21/min. Other cardiovascular and respiratory signs indicate that the patient remains stable. Which of the following actions would you recommend at this point?
A) Switch the patient to 5 cm H<sub>2</sub>O continuous positive airway pressure (CPAP) through the endotracheal tube.
B) Extubate the patient and provide supplemental O<sub>2</sub>.
C) Switch the patient to intermittent mandatory ventilation at a rate of 2/min.
D) Decrease the pressure support level to 3 cm H<sub>2</sub>O.
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Page 54
Chapter 53: Neonatal and Pediatric Respiratory Care
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Sample Questions
Q1) Signs of infant respiratory distress that indicate a potential need for continuous positive airway pressure (CPAP) include which of the following?
1) Cyanosis
2) Radiograph indicating hyaline membrane disease or respiratory distress syndrome
3) Grunting
4) Severe retractions
A)3 and 4 only
B)1, 2, and 3 only
C)2 and 4 only
D)1, 2, 3, and 4
Q2) You are called to the NICU to assess the blood pressure of a neonate who weighs 750 g. You determine that the pressure is normal. Which of the following pressure did you obtain?
A) 40/25
B) 45/35
C) 55/40
D) 55/25
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Chapter 54: Patient Education and Health Promotion
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Q1) Teaching physical skills to patients is learning in what domain?
A) Cognitive
B) Affective
C) Psychomotor
D) Analytical
Q2) Teaching facts to patients involves learning in what domain?
A) Cognitive
B) Affective
C) Psychomotor
D) Analytical
Q3) The objective that states "Verbalize willingness to use oxygen properly and safely" falls in which domain?
A) Cognitive
B) Affective
C) Psychomotor
D) Analytical
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Chapter 55: Cardiopulmonary Rehabilitation
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Sample Questions
Q1) What is the term used to describe the restoration of individuals to the fullest possible medical, mental, emotional, social, and vocational potential?
A) Disease prevention
B) Rehabilitation
C) Intensive care
D) Homecare
Q2) Under which of the following conditions would you recommend ending a cardiopulmonary exercise evaluation?
1) Electrocardiogram indicating sinus tachycardia
2) 10% fall from baseline oxyhemoglobin (HbO<sub>2</sub>) saturation
3) Fall in systolic blood pressure of more than 20 mm Hg
4) Request from the patient to terminate the test
A)2, 3, and 4 only
B)1, 2, and 3 only
C)1, 2, 3, and 4
D)1, 2, and 4 only
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Chapter 56: Respiratory Care in Alternative Settings
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Sample Questions
Q1) Most portable home liquid O<sub>2</sub> systems can provide low-flow O<sub>2</sub> (2 L/min) for approximately how long?
A) 1 to 3 hr
B) 3 to 5 hr
C) 8 to 12 hr
D) 5 to 8 hr
Q2) For which of the following categories of disorders is respiratory home care considered appropriate?
1) Cystic fibrosis
2) Chronic neuromuscular disorders
3) Acute restrictive disorders
4) Pulmonary obstructive lung disease
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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