Clinical Practice in Respiratory Therapy Practice Questions
Course Introduction
Clinical Practice in Respiratory Therapy provides students with hands-on experience in the assessment, treatment, and management of patients with cardiopulmonary disorders. Through supervised clinical rotations in various healthcare settings, students apply theoretical knowledge and develop competency in procedures such as airway management, mechanical ventilation, pulmonary function testing, and patient education. Emphasis is placed on interprofessional collaboration, evidence-based practice, ethical decision-making, and effective communication to ensure safe and effective patient care in both acute and chronic care environments.
Recommended Textbook
Clinical Manifestations and Assessment of Respiratory Disease 7th Edition by Terry Des Jardins
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44 Chapters
673 Verified Questions
673 Flashcards
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Chapter 1: The Patient Interview
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Sample Questions
Q1) Which of the following would NOT be found on a history form?
A) Age
B) Chief complaint
C) Present health
D) Family history
E) Health insurance provider
Answer: E
Q2) To have the most productive interviewing session, the respiratory therapist must avoid all of the following types of verbal messages EXCEPT:
A) confrontation.
B) giving advice.
C) using avoidance language.
D) distancing.
Answer: A
Q3) For there to be a successful interview, the respiratory therapist must:
A) provide leading questions to guide the patient.
B) be an active listener.
C) reassure the patient.
D) use medical terminology to show knowledge of the subject matter.
Answer: B
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Chapter 2: The Physical Examination and Its Basis in Physiology
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Sample Questions
Q1) The respiratory therapist is monitoring the blood pressure of a patient in the emergency department and notes that the blood pressure is 15 mm Hg less on inspiration than on expiration. Which of the following would most likely result in this finding?
A) The patient is hypovolemic.
B) The patient has a pulmonary embolism.
C) The patient is having a myocardial infarction.
D) The patient is having a severe exacerbation of asthma.
Answer: D
Q2) A 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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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 the FEV<sub>1</sub>:
A) is reduced and FEV1% is normal.
B) and FEV<sub>1</sub>% are both increased.
C) and FEV<sub>1</sub>% are both reduced.
D) is increased and FEV1% is decreased.
Answer: C
Q2) A respiratory therapist has just performed a pulmonary function study and notes that the results show obstructive lung disease with a decreased DLCO value. Which of the following is the best interpretation of these results?
A) The patient has pulmonary fibrosis.
B) The patient has asthma.
C) The patient has cystic fibrosis.
D) The patient has emphysema.
E) The patient has chronic bronchitis.
Answer: D
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Chapter 4: Arterial Blood Gas Assessments
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Sample Questions
Q1) The most common cause of acute alveolar hyperventilation is:
A) hypoxemia.
B) metabolic alkalosis.
C) tachycardia.
D) supplemental oxygen administration.
Q2) Which of the following would be found in a stable patient with long-standing obstructive lung disease?
A) Low bicarbonate level and low carbon dioxide level
B) Low bicarbonate level and high carbon dioxide level
C) High bicarbonate level and low carbon dioxide level
D) High bicarbonate level and high carbon dioxide level
Q3) Common causes of metabolic acidosis include all of the following EXCEPT:
A) diabetic ketoacidosis.
B) shallow breathing from a sedative overdose.
C) lactic acidosis.
D) renal (kidney) failure.
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6
Chapter 5: Oxygenation Assessments
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Sample Questions
Q1) When a sample of arterial blood is analyzed for the pressure of oxygen (PaO<sub>2</sub>), the value comes from the:
A) blood plasma.
B) leukocytes.
C) hemoglobin.
D) erythrocytes.
Q2) A condition that will cause anemic hypoxia is:
A) cyanide poisoning.
B) decreased cardiac output or heart failure.
C) polycythemia.
D) carbon monoxide poisoning.
Q3) A sample of blood has been taken from a patient's pulmonary artery. What mixed venous oxygen saturation value (SvO<sub>2</sub>) would indicate that the patient is normal?
A) 40 mm Hg
B) 95 mm Hg
C) 75%
D) 97%
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7
Chapter 6: Cardiovascular System Assessments
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Sample Questions
Q1) A central venous pressure (CVP) catheter is used to:
A) measure left atrial pressure.
B) measure left ventricular work.
C) monitor right ventricular function.
D) monitor left ventricular function.
Q2) When reviewing a cardiac rhythm strip, the respiratory therapist notices 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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Sample Questions
Q1) The chest radiograph shows blunting of the patient's costophrenic angles. What does this suggest?
A) The patient did not take a deep enough breath.
B) Lung cancer
C) Pleural fluid
D) Underpenetrated exposure on the film
Q2) A patient has had a ventilation-perfusion scan. What would be identified from the ventilation scan?
A) Location of a lung abscess
B) Alveolar consolidation
C) Location of a pulmonary embolism
D) Location of an airway obstruction
Q3) The heart shadow on a chest radiograph will show up larger than normal on a(n):
A) AP film.
B) PA film.
C) left lateral film.
D) computed tomography (CT) scan.
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Chapter 8: Other Important Tests and Procedures
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Sample Questions
Q1) In response to a viral infection, which of the following can be expected to be seen in the white blood cell count?
A) Increased lymphocytes
B) Decreased monocytes
C) Increased basophils
D) Decreased platelets
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) The respiratory therapist is reviewing the electronic medical record of a patient recently admitted to the medical floor. The therapist notes that a sputum sample was sent to the lab for an acid-fast smear and culture. How should the therapist interpret this information?
A) Suspect that the patient has Mycoplasma pneumoniae pneumonia.
B) Suspect that the patient has Rickettsiae pneumonia.
C) Suspect that the patient has Pneumocystis jiroveci (carinii) pneumonia.
D) Suspect that the patient has Mycobacterium tuberculosis pneumonia.
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Page 10
Chapter 9: The Therapist-Driven Protocol Program and the
Role of the Respiratory Therapist
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Sample Questions
Q1) Which of the following protocols would be indicated when a patient with increased alveolar-capillary membrane thickening has increased opacity on the chest radiograph, bronchial breath sounds, and a dull percussion note?
A) Aerosolized medication protocol
B) Lung expansion protocol
C) Oxygen therapy protocol
D) Bronchopulmonary hygiene protocol
Q2) 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. Which therapist-driven protocol(s) should be implemented?
1) Bronchopulmonary hygiene therapy
2) Lung expansion
3) Oxygen therapy
4) Aerosolized medication therapy
A) 1
B) 3, 4
C) 2, 3
D) 1, 3, 4
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Chapter 10: Respiratory Failure and the Mechanical
Ventilation Protocol
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Sample Questions
Q1) What effect would a pulmonary embolism have on the VD/VT and the /Ó ratio?
A) The VD/VT would increase and the /Ó would decrease.
B) The VD/VT would decrease and the /Ó would increase.
C) The VD/VT and the /Ó ratios would both increase.
D) The VD/VT and the /Ó ratios would both decrease.
Q2) What is the primary pathophysiologic mechanism in alveolar hypoventilation?
A) Decreased minute ventilation
B) Increased ventilation/perfusion ratio
C) Decreased venous admixture
D) Decreased inspired oxygen pressure
Q3) All of the following are contraindications for noninvasive ventilation (NIV) EXCEPT:
A) facial and head trauma.
B) community-acquired pneumonia.
C) copious, viscous sputum.
D) severe upper GI bleeding.
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Chapter 11: Recording Skills: The Basis for Data Collection,
Organization, Assessment Skill
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Sample Questions
Q1) Which of the following statements is TRUE regarding Health Insurance Portability and Accountability Act (HIPAA) regulations?
A) A bank can check for a preexisting condition.
B) The patient controls access to his or her medical records.
C) Psychotherapy and medical records are treated equally.
D) An employer can check for a preexisting condition.
Q2) Computer-based records are commonly used for which of the following?
1) Retrieving pulmonary function studies
2) Storing treatment information
3) Storing admission data
4) Ordering patient supplies
A) 3, 4
B) 1, 2
C) 1, 2, 3
D) 1, 2, 3, 4
Q3) When reviewing a SOAPIER progress note, the R stands for:
A) revisions made in the original plan.
B) reimbursement by the insurance carrier.
C) respiratory care notes.
D) resuscitation status of the patient.
Page 13
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Chapter 12: Chronic Obstructive Pulmonary Disease (COPD),
Chronic Bronchitis, and Emphysema
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Sample Questions
Q1) Which of the following clinical manifestations are associated with late-stage chronic bronchitis?
1) Rhonchi
2) Cor pulmonale
3) Digital clubbing
4) Stocky, overweight build
A) 1, 2
B) 2, 3
C) 1, 3, 4
D) 1, 2, 3, 4
Q2) What is the term for the inward movement of the lateral chest wall during inspiration?
A) Truman's sign
B) Burton's sign
C) Carr's sign
D) Hoover's sign
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Chapter 13: Asthma
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Sample Questions
Q1) Which of the following factors are associated with intrinsic asthma?
1. Emotional stress
2) Cockroach allergen
3) GERD
4) Dust mites
A) 2, 4
B) 1, 3
C) 2, 3, 4
D) 1, 2, 3, 4
Q2) All of the following symptoms are commonly associated with asthma EXCEPT recurrent:
A) cough.
B) chest tightness.
C) fever.
D) wheeze.
Q3) At what age does asthma severity peak in males?
A) 1 and 3 years
B) 5 and 7 years
C) 18 and 20 years
D) 30 and 32 years
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Chapter 14: Bronchiectasis
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Sample Questions
Q1) For religious reasons, a young couple has not given their 4-year-old daughter the usual childhood immunizations. She has been repeatedly hospitalized with pulmonary infections. What should the respiratory therapist caring for the child tell the parents that the child is at risk of developing?
A) Chronic bronchitis
B) Asthma
C) Bronchiectasis
D) Left ventricular hypertrophy
Q2) In developed countries, the most common cause of acquired bronchiectasis is:
A) emphysema.
B) lung abscess.
C) cystic fibrosis.
D) pulmonary fibrosis.
Q3) Which of the following is the usual characteristic of the sputum of a patient with bronchiectasis?
A) It is usually sweet or musky smelling.
B) When examined microscopically there are Kirshman's spirals.
C) It contains eosinophils.
D) It is usually voluminous and tends to settle into several different layers.
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Page 16
Chapter 15: Cystic Fibrosis
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Sample Questions
Q1) The major pathologic or structural changes associated with cystic fibrosis include:
1) partial airway obstruction leading to hyperinflation.
2) bronchospasm.
3) thick, tenacious mucus.
4) total airway obstruction leading to atelectasis.
A) 1, 2
B) 3, 4
C) 1, 3, 4
D) 1, 2, 3, 4
Q2) Which of the following are commonly used in the management of cystic fibrosis?
1) Pancreatic enzymes and vitamins
2) Antibiotics
3) Postural drainage
4) Expectorants
A) 1, 4
B) 2, 3
C) 1, 2, 3
D) 1, 2, 3, 4
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Chapter 16: Pneumonia
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Sample Questions
Q1) A 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
Q2) Which of the following can cause pneumonia?
1) Bacteria
2) Viruses
3) Prions
4) Fungi
A) 1, 2
B) 2, 3
C) 1, 2, 4
D) 1, 2, 3, 4
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Chapter 17: Lung Abscess
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Sample Questions
Q1) In the early stages of a lung abscess, a patient would most likely have a:
A) nonproductive, hacking cough.
B) productive cough with foul-smelling, grey sputum.
C) productive cough with hemoptysis.
D) productive cough with copious white sputum.
Q2) During the early stages of a lung abscess, the pathologic process is identical to that of:
A) pulmonary edema.
B) bronchopulmonary dysplasia.
C) acute pneumonia.
D) pulmonary fibrosis.
Q3) A patient with an abscess has produced a large volume of brown-colored, putrid sputum. What type of microorganism would most likely result in brown, putrid sputum production?
A) Fungi
B) Viruses
C) Aerobic bacteria
D) Anaerobic bacteria
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19
Chapter 18: Tuberculosis
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Sample Questions
Q1) A patient who has an uncontrolled tuberculosis infection will show all of the following signs EXCEPT:
A) weight loss.
B) high fever.
C) bloody sputum.
D) night sweats.
Q2) Nontuberculous mycobacteria such as Mycobacterium avium and Mycobacterium kansasii are associated with which one of the following diseases?
A) COPD
B) Bronchiectasis
C) Status asthmaticus
D) Cystic fibrosis
Q3) When a person has TB spread throughout the body, it is found in all of the following EXCEPT:
A) upper lobes.
B) kidneys.
C) brain.
D) lower lobes.
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Chapter 19: Fungal Diseases of the Lung
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Sample Questions
Q1) Which of the following is NOT considered to cause an opportunistic fungal infection?
A) Candida albicans
B) Aspergillus
C) Coccidioides immitis
D) Cryptococcus neoformans
Q2) Anatomic alterations found in the lungs of patients with a fungal infection include:
1) fibrosis of lung parenchyma.
2) alveolar-capillary destruction.
3) hyperinflation.
4) mucosal edema.
A) 1, 2
B) 2, 3
C) 3, 4
D) 1, 2, 4
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Chapter 20: Pulmonary Edema
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Sample Questions
Q1) All of the following are causes of cardiogenic pulmonary edema EXCEPT:
A) myocardial infarction.
B) mitral valve disease.
C) allergic reaction to drugs.
D) congenital heart defects.
Q2) Lymphatic insufficiency could be caused by:
1) lung transplantation.
2) lymphangitic carcinomatosis.
3) removal of pleural fluid.
4) decreased oncotic pressure.
A) 1, 2
B) 3, 4
C) 1, 2, 4
D) 1, 2, 3, 4
Q3) All of the following may be causes of cardiogenic pulmonary edema EXCEPT: A) dysrhythmias.
B) systemic hypertension.
C) congenital heart defects.
D) excessive fluid administration.
E) pulmonary embolism.
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Chapter 21: Pulmonary Vascular Disease: Pulmonary
Embolism and Pulmonary Hypertension
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Sample Questions
Q1) The death of lung tissue that may result from an obstruction of the pulmonary artery is called a:
A) pulmonary embolism.
B) pleural effusion.
C) pulmonary infarction.
D) pulmonary empyema.
Q2) Which of the following is/are major mechanism(s) that contribute to the pulmonary hypertension commonly seen in a patient with a pulmonary embolism?
1) Decreased cross-section area of the pulmonary vascular system
2) Vasoconstriction induced by alveolar hypoxia
3) Reflexes from the aortic and carotid sinus baroreceptors
4) Vasoconstriction induced by humoral agents
A) 1
B) 2, 3
C) 1, 2, 4
D) 1, 2, 3, 4
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23
Chapter 22: Flail Chest
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Sample Questions
Q1) Which of the following accurately describes a flail chest?
A) Double fractures of 2 adjacent ribs
B) Double fractures of 3 adjacent ribs
C) Single fracture of 3 adjacent ribs
D) Triple fractures of 2 adjacent ribs
Q2) Which of the following initial blood gas results would a respiratory therapist expect to find in a patient with a mild flail chest?
A) Elevated pH and elevated SaO<sub>2</sub>
B) Decreased pH and decreased SaO<sub>2</sub>
C) Increased pH and decreased SaO<sub>2</sub>
D) Decreased pH and increased SaO<sub>2</sub>
Q3) How many days of ventilatory support are anticipated for a patient with a flail chest to allow sufficient time for bone healing?
A) 3 to 5 days
B) 5 to 10 days
C) 12 to 15 days
D) 18 to 21 days
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24
Chapter 23: Pneumothorax
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Sample Questions
Q1) A 40-year-old patient requires placement of a thoracostomy chest tube. All of the following are recommended for the procedure EXCEPT:
A) application of -5-cm H<sub>2</sub>O pressure to the chest tube.
B) use of a No. 28 to 36 French gauge tube.
C) placement of the tube at the apex of the lung.
D) clamping and removing the tube within 24 hours of insertion.
Q2) According to the way gas enters the pleural space, a pneumothorax will be classified as:
1) intrinsic.
2) extrinsic.
3) open.
4) closed.
A) 2, 3
B) 1, 4
C) 3, 4
D) 1, 2
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25
Chapter 24: Pleural Effusion and Empyema
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Sample Questions
Q1) A patient has a pleural effusion from an unknown cause. A fluid sample has been taken for analysis. To help identify the cause of the effusion, all of the following tests should be performed EXCEPT:
A) specific gravity.
B) biochemical makeup.
C) cytologic examination.
D) bacterial culture.
Q2) While reviewing an upright chest radiograph of a patient with a pleural effusion, the respiratory therapist observes a fluid density in the right lung area that extends upward around the anterior, lateral, and posterior thoracic walls. What is this characteristic sign called?
A) Meniscus sign
B) Scarf sign
C) Transudate sign
D) Kerley B lines
Q3) The anatomic alteration caused by a pleural effusion is:
A) pulmonary fibrosis.
B) separation of the visceral and parietal pleura.
C) adhesion of the visceral and parietal pleura.
D) pulmonary edema.
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Chapter 25: Kyphoscoliosis
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Sample Questions
Q1) Which of the following chest assessment findings are associated with kyphoscoliosis?
1) Crackles or wheezing
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) All of the following are orthotic braces used in the management of scoliosis EXCEPT _____ brace.
A) Boston
B) Milwaukee
C) Chicago
D) Charleston bending
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Chapter 26: Interstitial Lung Diseases
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Sample Questions
Q1) All of the following are anatomic alterations of the lungs that may be found with the chronic stage of interstitial lung disease (ILD) EXCEPT:
A) honeycombing.
B) edema.
C) interstitial thickening.
D) granulomas.
Q2) Which of the following organs are affected by systemic scleroderma?
1) Skin
2) Reproductive organs
3) Lungs
4) Brain
A) 1, 3
B) 2, 4
C) 1, 2, 3
D) 1, 2, 3, 4
Q3) All of the following are associated with lymphangioleiomyomatosis (LAM) EXCEPT:
A) recurrent chylothoraces and recurrent pneumothoraces.
B) increased airway obstruction.
C) postmenopausal women are primarily affected.
D) airway smooth muscle is affected.
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Chapter 27: Cancer of the Lung
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Sample Questions
Q1) The most common cause of lung cancer is:
A) cigarette smoking.
B) air pollution.
C) exposure to asbestos.
D) exposure to radon gas.
Q2) Which of the following is (are) non-small cell lung cancer(s)?
1) Large cell carcinoma
2) Squamous carcinoma
3) Adenocarcinoma
4) Oat cell carcinoma
A) 1
B) 4
C) 1, 2, 3
D) 2, 3, 4
Q3) Which form of lung cancer has the poorest prognosis?
A) Large cell carcinoma
B) Adenocarcinoma
C) Small cell carcinoma
D) Squamous cell carcinoma
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Page 29
Chapter 28: Acute Respiratory Distress Syndrome
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Sample Questions
Q1) Which of the following are causes of ARDS?
1) Liver failure
2) Heroin abuse
3) Septicemia
4) Goodpasture's syndrome
A) 1, 4
B) 2, 3
C) 2, 3, 4
D) 1, 2, 3, 4
Q2) ARDS can result from the inhalation of all of the following EXCEPT:
A) FIO<sub>2</sub> >0.60 for prolonged exposure.
B) nitrogen dioxide.
C) very dry air.
D) chlorine gas.
Q3) What initial tidal volume setting on the ventilator would be recommended for a 70-kg adult male with ARDS?
A) 350 mL
B) 420 mL
C) 560 mL
D) 700 mL
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Chapter 29: Guillain-Barré Syndrome
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Sample Questions
Q1) In the United States and Europe, what is the most common subtype of GBS?
A) Miller Fisher syndrome (MFS)
B) Acute motor axonal neuropathy (AMAN)
C) Acute pandysautonomic neuropathy (APN)
D) Acute inflammatory demyelinating polyneuropathy (AIDP)
Q2) Which of following has been shown to shorten the course of a severe case of Guillain-Barré syndrome?
A) Renal dialysis
B) Plasmapheresis
C) Blood transfusion
D) NSAIDs
Q3) A 75-kg, 50-year-old male patient has Guillain-Barré syndrome. His most recent assessment indicates his VC is 900 mL and NIF is -16 cm H<sub>2</sub>O. What plan should the respiratory therapist recommend?
A) Initiate EMG monitoring.
B) Initiate continuous positive airway pressure (CPAP).
C) Initiate mechanical ventilation.
D) Reassess the patient each hour.
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Chapter 30: Myasthenia Gravis
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Sample Questions
Q1) During a myasthenia crisis, a patient was placed on mechanical ventilation but is now stable. What will the chest radiograph most likely show?
A) Normal lungs
B) Mediastinal shift
C) Pericardial tamponade
D) Ground glass appearance
Q2) Which of the following values would be associated with impending ventilatory failure in a patient with myasthenia gravis?
1) NIF -15cm H<sub>2</sub>O
2) VC 10 mL/kg
3) PaCO<sub>2</sub>43 mm Hg
4) pH 7.36
A) 1
B) 1, 2
C) 2, 4
D) 1, 2, 3
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Chapter 31: Sleep Apnea
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Sample Questions
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) Mixed sleep apnea has which of these traits?
1) Obstructive apnea traits
2) Central apnea traits
3) Usually begins as central apnea
4) Usually ends as central apnea
A) 2, 4
B) 1, 3
C) 1, 2, 3
D) 1, 2, 4
Q3) Which of the following cardiac dysrhythmias is life threatening?
A) Atrioventricular block
B) Sinus bradycardia
C) Ventricular tachycardia
D) Premature ventricular contraction
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Page 33
Chapter 32: Clinical Manifestations Common with Newborn and
Early Childhood Respiratory Dis
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Sample Questions
Q1) Apnea of prematurity can be defined as:
1) respiratory pause causing bradycardia.
2) cycles of short breathing pauses followed by faster breathing.
3) no breathing for >20 seconds.
4) sudden apnea and death (crib death).
A) 4
B) 2
C) 1, 3
D) 3, 4
Q2) PPHN usually appears:
A) in utero during the last trimester.
B) within 1 hour of birth.
C) within the first 12 hours of birth.
D) between the 1st and 6th days of life.
Q3) 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
Page 34
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Chapter 33: Meconium Aspiration Syndrome
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Sample Questions
Q1) Indications that a newborn has aspirated meconium include all of the following EXCEPT:
A) high Apgar score.
B) meconium in amniotic fluid.
C) newborn is not actively breathing.
D) meconium staining on skin.
Q2) Infants who are older than 42 weeks' gestation are at greater risk for MAS because they have:
1) a full bowel.
2) strong peristalsis.
3) amniotic fluid in their stomach.
4) sphincter tone.
A) 1, 3
B) 2, 4
C) 2, 3, 4
D) 1, 2, 4
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Chapter 34: Transient Tachypnea of the Newborn
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Q1) All of the following radiologic findings would be expected in a 12-hour-old neonate with TTN EXCEPT:
A) air bronchograms.
B) fluid in the interlobular fissures.
C) elevated diaphragms.
D) prominent perihilar streaking.
Q2) Which of the following clinical manifestations are associated with the more negative intrapleural pressures needed during inspiration?
1) Thick, tenacious secretions
2) Intercostal retractions
3) Nasal flaring
4) Mediastinal shift
A) 1, 3
B) 2, 3
C) 2, 3, 4
D) 1, 2, 3, 4
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36
Chapter 35: Respiratory Distress Syndrome
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Sample Questions
Q1) The hyaline membrane seen in the alveoli of a neonate with RDS is similar to the anatomic alteration found in what other pulmonary disease?
A) Bacterial pneumonia
B) Pulmonary fibrosis
C) Acute respiratory distress syndrome (ARDS)
D) Meconium aspiration syndrome (MAS)
Q2) What is the primary cause of RDS in the newborn?
A) Underdevelopment of alveolar type I cells
B) Deficiency or abnormality of pulmonary surfactant
C) Hypoxia causing pulmonary hypoperfusion
D) Excessive amniotic fluid in the lungs
Q3) It is likely that a neonate with RDS will have which of the following chest radiograph findings?
A) Airway dilation and distortion
B) Fluffy infiltrates in the bases of the lungs
C) Ground-glass appearance
D) Cardiomegaly
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Chapter 36: Pulmonary Air Leak Syndromes
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Sample Questions
Q1) An intubated, mechanically ventilated neonate developed a pneumothorax of the right lung. What could the respiratory therapist recommend to help the injured lung to heal?
A) Selectively place the endotracheal tube into the left mainstem bronchus.
B) Selectively place the endotracheal tube into the right mainstem bronchus.
C) Replace the endotracheal tube with a tracheostomy tube.
D) Change to continuous positive airway pressure (CPAP).
Q2) A physician is performing transillumination to determine whether a neonate has a pneumothorax. What finding would confirm the presence of a pneumothorax?
A) The trachea will be illuminated.
B) Light will shine through the hole in the lung.
C) There will be increased illumination on the unaffected side.
D) There will be increased illumination on the affected side.
Q3) Which of the following conditions is described as dissection of gas into the fascial planes of the skin and neck?
A) ASIHD
B) Intravascular air embolism
C) PIE
D) Subcutaneous emphysema
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Page 38
Chapter 37: Respiratory Syncytial Virus (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) Which of the following characteristics would put an adult at increased risk for a severe case of RSV?
1) Compromised immune system
2) History of asthma
3) Under 30 years of age
4) More than 65 years of age
A) 1, 4
B) 2, 3
C) 1, 2, 3
D) 1, 2, 4
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Chapter 38: Bronchopulmonary Dysplasia
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Sample Questions
Q1) An infant is beginning to develop BPD. What can be given to promote pulmonary vasodilation?
A) Furosemide (LasixÒ)
B) Inhaled nitric oxide (iNO)
C) Inhaled albuterol
D) FIO<sub>2</sub> >50%
Q2) If a patient has an advanced stage of BPD, what cardiac problem may be identified on the chest radiograph?
A) Pneumomediastinum
B) Cardiac tamponade
C) Change in point of maximum impulse
D) Cor pulmonale
Q3) What is the most common chronic lung disease of premature infants?
A) BPD
B) Asthma
C) Cystic fibrosis
D) TTN
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Chapter 39: Congenital Diaphragmatic Hernia
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Sample Questions
Q1) What pulmonary change is associated with a Bochdalek hernia?
A) Pulmonary hypoplasia
B) Respiratory distress syndrome (RDS)
C) Pulmonary edema
D) Meconium aspiration
Q2) What additional procedures or treatments might be required for a patient with a CDH and significant pulmonary hypoplasia?
A) Plasmapheresis
B) ECMO
C) Cardiac pacemaker
D) Bronchoscopy
Q3) A newborn infant shows respiratory distress upon delivery. He is observed to have a scaphoid abdomen. Auscultation reveals diminished breath sounds with heart sounds on the right side of the chest. What is the infant's most likely diagnosis?
A) Tension pneumothorax
B) CDH
C) Pneumoperitoneum
D) Abdominal aortic aneurysm
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Chapter 40: Congenital Heart Diseases
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Q1) Which of the following are considered to be noncyanotic defects?
1) PDA
2) ASD
3) TOF
4) VSD
A) 1, 2
B) 2, 3
C) 1, 2, 4
D) 1, 2, 3, 4
Q2) What is the most common congenital heart disorder?
A) ASD
B) VSD
C) TGA
D) TOF
Q3) Which cardiac anomaly is associated with coeur-en-sabot on a chest radiograph?
A) TOF
B) ASD
C) VSD
D) PDA
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Page 42
Chapter 41: Croup Syndrome: Laryngotracheobronchitis and
Acute Epiglottitis
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Sample Questions
Q1) The respiratory therapist is assigned to the pediatric unit of the hospital. The physician who is caring for a 3-year-old boy with LTB asks what respiratory therapy treatments should be given. The respiratory therapist should suggest which of the following?
1) Racemic epinephrine
2) Cool mist tent
3) Antibiotics
4) Endotracheal or tracheostomy tube
A) 1, 2
B) 2, 4
C) 1, 2, 3
D) 1, 2, 3, 4
Q2) Childhood vaccination is done to prevent which of the following possible causes of epiglottitis?
A) Haemophilus influenza type B
B) Streptococcus pneumoniae
C) Diphtheria
D) Parainfluenza viruses
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Chapter 42: Near Drowning/Wet Drowning
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Sample Questions
Q1) In the United States, what percentage of pediatric drowning victims are male?
A) 20%
B) 40%
C) 60%
D) 80%
Q2) Hospital management of near-drowning victims includes all of the following EXCEPT:
A) measurement of arterial blood gas values.
B) rewarming if the patient is hypothermic.
C) measurement of venous blood gas values.
D) chest radiography.
Q3) The pulmonary function findings for a wet drowning victim would reveal:
A) increased IRV.
B) increased DLCO.
C) decreased VC.
D) increased TLC.
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Chapter 43: Smoke Inhalation, Thermal Injuries, and Carbon
Monoxide Intoxication
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Sample Questions
Q1) Late-stage complications of extensive body surface burns include:
1) sepsis.
2) upper airway obstruction.
3) pneumonia.
4) pulmonary embolism.
A) 1, 2
B) 3, 4
C) 2, 3
D) 1, 3, 4
Q2) Which portion of the pulmonary system will be affected by the inhalation of low-water solubility gases such as hydrogen chloride and phosgene?
A) Distal airways and alveoli
B) Pulmonary vascular bed
C) Upper airway
D) Pulmonary lymphatic system
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Page 45
Chapter 44: Atelectasis
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Sample Questions
Q1) A patient with atelectasis is being monitored by bedside spirometry. What findings would correspond with atelectasis?
1) Decreased IC
2) Increased PEFR
3) Decreased VC
4) Increased DLCO
A) 2
B) 1, 3
C) 1, 2, 4
D) 1, 2, 3, 4
Q2) All of the following conditions can lead to atelectasis EXCEPT:
A) chronic obstructive pulmonary disease (COPD).
B) acute respiratory distress syndrome (ARDS).
C) pleural effusion.
D) pneumothorax.
Q3) All of the following would be found in a patient with atelectasis EXCEPT:
A) normal shunt fraction.
B) whispered pectoriloquy.
C) chest radiograph shows increased density in areas of atelectasis.
D) diminished breath sounds.
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