Critical Care Monitoring
Exam Answer Key
Course Introduction
Critical Care Monitoring is a specialized course that focuses on the principles and practices of monitoring critically ill patients in intensive care settings. Students will learn to interpret and utilize various monitoring devices and modalities, including hemodynamic, respiratory, neurological, and renal monitoring systems. The course covers the physiological basis of monitoring, the selection and application of monitoring tools, detection of clinical deterioration, and the interpretation of complex data to support appropriate clinical decision-making. Emphasis is placed on evidence-based practices, teamwork, and communication within the multidisciplinary critical care team to improve patient outcomes.
Recommended Textbook
Wilkins Clinical Assessment in Respiratory Care 7th Edition by Al Heuer PhD
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21 Chapters
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Chapter 1: Preparing for the Patient Encounter
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Sample Questions
Q1) Which of the following techniques is not associated with the demonstration of active listening?
A)Good eye contact
B)Taking notes while a patient is talking
C)Asking for clarification
D)Use of touch
Answer: D
Q2) According to the American Association for Respiratory Care (AARC), patient discharge plans should include which of the following?
A)Transportation for the patient when the patient goes home
B)Ascertaining that once the patient has been discharged, the patient has adequate financial resources to pay rent and utilities
C)Notification of the patient's family and/or other caregivers of the patient's imminent discharge
D)Methods for the ongoing assessment of outcomes
Answer: D
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Chapter 2: The Medical History and the Interview
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Sample Questions
Q1) A pertinent positive is defined as:
A)Any positive response made by the patient during the interview.
B)A direct question asked during the interview that elicits a positive response.
C)An affirmative response by the patient when asked whether he or she needs a breathing treatment.
D)An affirmative response to an important interview question about the patient's symptoms.
Answer: D
Q2) One disadvantage of using the pack-year method for calculating cigarette consumption is that:
A)The method is not used widely throughout the United States.
B)Advanced mathematical calculations are required to obtain the figure.
C)The method does not reveal how many packs per day were smoked over how many years.
D)The values are more meaningful to RTs and physicians than to other healthcare providers.
Answer: C
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Chapter 3: Cardiopulmonary Symptoms
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Sample Questions
Q1) Gastroesophageal reflux is caused by:
A)High activity levels in gastric muscles.
B)Blockage of the duodenum.
C)Abnormal opening of the pyloric sphincter.
D)Abnormal opening of the cardiac (lower esophageal) sphincter.
Answer: D
Q2) Which of the following terms best describes foul-smelling sputum?
A)Fetid
B)Mucoid
C)Purulent
D)Mucopurulent
Answer: A
Q3) Excessive sputum production is associated with all the following conditions except: A)Allergies.
B)Cigarette smoking.
C)Airway infection.
D)Pleural infection.
Answer: D
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Chapter 4: Vital Signs
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Sample Questions
Q1) The normal pulse rate range for adults is _____ beats/min.
A)60 to 100
B)70 to 110
C)80 to 120
D)90 to 160
Q2) Which of the following statements best reflects the importance of comparing changes in vital signs?
A)It allows assessment of important subjective patient data.
B)It allows recognition of the development of a particular problem.
C)It allows detection of additional symptoms.
D)It does not allow changes in therapy.
Q3) A pulse rate above the normal range is the definition of which of the following terms?
A)Tachypnea
B)Arrhythmia
C)Bradycardia
D)Tachycardia
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Chapter 5: Fundamentals of Physical Examination
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Sample Questions
Q1) Which of the following mechanisms is responsible for production of an abnormal third heart sound?
A)Forceful opening of the aortic valve
B)Forceful closure of the pulmonic valve
C)Rapid filling of the atrium during ventricular systole
D)Rapid filling of the ventricles immediately after systole
Q2) The bell portion of the stethoscope is best designed to listen to _____-pitched _____ sounds.
A)low; lung
B)low; heart
C)high; lung
D)high; heart
Q3) The muscles of inspiration include all of the following except:
A)the diaphragm,
B)the sternocleidomastoids,
C)the scalene muscles.
D)the rectus abdominus muscle.
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Chapter 6: Neurologic Assessment
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Sample Questions
Q1) Which of the following respiratory patterns consists of phases of hyperpnea that regularly alternate with episodes of apnea?
A)Biot breathing
B)Ataxic breathing
C)Apneustic breathing
D)Cheyne-Stokes respiration
Q2) Which of the following is not an important factor in determining the needed frequency of the neurologic assessment?
A)Patient's diagnosis
B)Acuity of the condition
C)How rapidly changes are occurring or are expected to occur
D)Shift change
Q3) The main goal of assessing mental status is to determine which of the following?
A)Consciousness
B)Awareness
C)Thinking
D)CNS dysfunction
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8
Chapter 7: Clinical Laboratory Studies
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Sample Questions
Q1) Which of the following terms describes an abnormal increase in the proportion of circulating immature neutrophils?
A)Neutrophilia
B)Left shift
C)Leukopenia
D)Leukocytosis
Q2) Which of the following terms is used to describe an abnormally low potassium level?
A)Hyponatremia
B)Hypokalemia
C)Hypochloremia
D)Hypocalcemia
Q3) In which of the following conditions would secondary polycythemia not be expected?
A)Pulmonary fibrosis
B)Pulmonary embolism
C)Living at high altitude
D)Congenital heart disease
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Chapter 8: Interpretation of Blood Gases
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Sample Questions
Q1) The acid-base status is classified as which of the following?
A)Uncompensated metabolic alkalosis
B)Partially compensated metabolic alkalosis
C)Uncompensated respiratory acidosis
D)Partially compensated respiratory acidosis
Q2) Which of the following tests is performed to check the collateral circulation of the radial artery before puncture?
A)Wilson's test
B)Perfusion scan
C)Sack's test
D)Allen's test
Q3) What is often the first clinical sign that suggests the presence of hypoxemia?
A)Hypotension
B)Confusion
C)Decreased level of consciousness
D)Exertional dyspnea
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Chapter 9: Pulmonary Function Testing
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Sample Questions
Q1) The concentration of carbon monoxide used in a DLCO study is approximately:
A)0.1%.
B)0.4%.
C)1.4%.
D)10%.
Q2) To determine whether there is a positive response to bronchodilator therapy, improvement must be seen in all of the following values except: A)FVC.
B)FEV1.
C)FEF25% to 75%.
D)FEF75% to 85%.
Q3) Which of the following tests is often used preoperatively to evaluate whether the patient may have postoperative complications?
A)ABG analysis
B)IC measurement
C)MVV test
D)PEF test
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Chapter 10: Chest Imaging
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Sample Questions
Q1) The presence of "hot spots" in a positron emission tomography (PET) scan is indicative of:
A)metabolically active tumor or infection.
B)pneumothorax.
C)pulmonary embolism.
D)atelectasis.
Q2) On a PA film, what number of posterior ribs visible above the diaphragm indicates a good inspiratory effort?
A)10
B)8
C)6
D)5
Q3) The ability of x-rays to penetrate matter is inversely proportional to which of the following physical properties of matter?
A)Viscosity
B)Density
C)Weight
D)Diffusion
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Chapter 11: Interpretation of Electrocardiogram Tracings
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Sample Questions
Q1) Which chamber normally has the largest muscle mass?
A)Left atrium
B)Left ventricle
C)Right atrium
D)Right ventricle
Q2) In the terminology for three of the limb leads-aVR, aVL, and aVF-what does the letter "A" stand for?
A)Atrial
B)Assisted
C)Ambient
D)Augmented
Q3) What is indicated by high-voltage R waves in the QRS complex?
A)Axis deviation
B)Atrial enlargement
C)Myocardial ischemia
D)Ventricular enlargement
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Chapter 12: Neonatal and Pediatric Assessment
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Sample Questions
Q1) Which of the following conditions is a result of a bacterial disease?
A)Asthma
B)Croup
C)Epiglottitis
D)Respiratory Distress Syndrome (RDS)
Q2) Which of the following is part of the biophysical evaluation of a fetus performed by ultrasound?
A)Reactive heart rate
B)Fetal brain development
C)Fetal gastrointestinal function
D)Body size
Q3) Which of the following conditions is associated with an infant born early in gestation?
A)Meconium aspiration
B)Respiratory distress syndrome (RDS)
C)Persistent pulmonary hypertension
D)Perinatal asphyxia
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14
Chapter 13: Older Patient Assessment
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Sample Questions
Q1) Which of the following would explain the presence of "clubbing" in the aged?
A)COPD
B)Simple aging process
C)CHF
D)Connective tissue disorders
Q2) The normal resting respiratory rate in elderly patients is in what range?
A)10 to 18 breaths/min
B)12 to 21 breaths/min
C)14 to 23 breaths/min
D)16 to 25 breaths/min
Q3) Which of the following PaO values would be normal for an 80-year-old individual who is breathing room air?
A)60 mm Hg
B)65 mm Hg
C)50 mm Hg
D)85 mm Hg
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15
Chapter 14: Respiratory Monitoring in Critical Care
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Sample Questions
Q1) The normal compensatory mechanism for a left shift in the oxygen dissociation curve is a(n):
A)increase in tidal volume.
B)increase in cardiac output.
C)increase in respiratory rate.
D)decrease in body temperature.
Q2) Which of the following ventilator changes is most likely to increase the functional reserve capacity (FRC) and reduce the extent of acute lung injury?
A)Increased FIO
B)Increased flow
C)Increased PEEP
D)Decreased inspiratory time
Q3) When the dead space-to-tidal volume ratio (V /V ) is calculated, V refers to the _____ dead space.
A)alveolar
B)anatomic
C)ventilatory
D)physiologic
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Chapter 15: Vascular Pressure Monitoring
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Sample Questions
Q1) The CVP can be used to estimate left ventricular filling pressures if there is no left ventricular dysrhythmia and the ejection fraction is greater than:
A)0.20.
B)0.30.
C)0.40.
D)0.50.
Q2) Monitoring of the CVP is indicated when there is a need to assess:
A)the circulating blood volume.
B)the degree of venous return.
C)the right ventricular function.
D)all of the above.
Q3) A difference between the pulmonary artery diastolic pressure and the pulmonary capillary wedge pressure greater than 5 mm Hg is seen in which of the following conditions?
A)ARDS
B)Sepsis
C)Excessive positive end-expiratory pressure (PEEP)
D)All of the above
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17
Chapter 16: Cardiac Output Measurement
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Sample Questions
Q1) All the following are true about the ejection fraction except:
A)the normal value is about 65% to 70%.
B)it can be calculated from a nomogram.
C)the percentage is the end-diastolic volume ejected with each beat.
D)it represents the difference between end-diastolic and end-systolic volumes.
Q2) When the Fick method is used to calculate cardiac output, if C(a - v)O is greater than expected and VO is normal, cardiac output probably will be:
A)normal.
B)less than expected.
C)greater than expected.
D)unknown-insufficient information is available to answer the question.
Q3) The cardiac output of the right ventricle is the same as the cardiac output of the left ventricle.Compared with the left ventricle, the cardiac work index of the right ventricle is: A)less.
B)the same.
C)somewhat greater.
D)much greater.
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Chapter 17: Bronchoscopy
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Sample Questions
Q1) What is the most common indication for the use of a bronchoscope?
A)To retrieve inhaled foreign objects
B)To obtain microbiologic samples
C)To help diagnose abnormalities seen on chest roentgenogram
D)To treat hemoptysis
Q2) What is the most common sign of xylocaine overdose during bronchoscopy?
A)Tachycardia
B)Bradycardia
C)Seizures
D)Apnea
Q3) What is the primary purpose of bronchoscopy in a patient with interstitial lung disease?
A)To perform microscopic assessment of the biopsy sample, which often is diagnostic
B)To stop massive hemoptysis
C)To identify the causative agent
D)To remove excessive secretions
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Chapter 18: Nutrition Assessment
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Sample Questions
Q1) Which of the following are associated with increased metabolism?
1)Severe burns
2)Severe infection
3)Multiple traumas
4)Hyperthyroidism
A)1, 2, 3
B)1, 3
C)2, 4
D)1, 2, 3, 4
Q2) Which of the following is not associated with a high-fat diet?
A)Increased risk of heart disease
B)Decreased tissue oxygenation
C)Decreased DLCO
D)Increased carbon dioxide production
Q3) What test is most useful for screening a patient for protein malnutrition?
A)Serum albumin level
B)Triceps skinfold
C)Creatinine-height index
D)BMI
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Chapter 19: Sleep and Breathing Assessment
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Sample Questions
Q1) To meet the definitive criteria for sleep apnea, how many seconds of air flow cessation during sleep must be documented?
A)4 seconds
B)6 seconds
C)8 seconds
D)10 seconds
Q2) According to the National Heart Lung and Blood Institute (NHLBI), approximately how many Americans suffer from some type of sleep disorder?
A)10 million
B)20 million
C)30 million
D)40 million
Q3) What is the most common complaint of patients with obstructive sleep apnea?
A)Snoring
B)Headache
C)Bedwetting
D)EDS
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Chapter 20: Home Care Patient Assessment
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Sample Questions
Q1) What should the home care RT do if a patient cannot demonstrate proper use of his metered-dose inhaler (MDI)?
A)Contact the physician.
B)Switch the patient to a small-volume nebulizer.
C)Discontinue the use of the MDI.
D)Call the patient's nurse.
Q2) In which of the following skills is it most important for a home care respiratory therapist (RT) to be proficient?
A)Decision making.
B)Time management.
C)Patient assessment.
D)Communication and teaching skills.
Q3) What is the primary role of an RT in home care?
A)Communicate with other team members
B)Do the paper work associated with home care
C)Provide education and equipment setup
D)Give treatments as needed
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22
Chapter 21: Documentation
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Sample Questions
Q1) Which of the following charting methods has been promoted with implementation of rapid response teams (RRTs)?
A)PIP
B)SOAP
C)SBAR
D)APIE
Q2) All of the following are examples of "objective" data, except:
A)laboratory results.
B)observation of a patient's sleep apnea.
C)the patient's report of the amount of sputum that he or she produces daily.
D)the physician's interpretation of the patient's electrocardiogram (ECG).
Q3) The absence of information or the lack of documented recognition of specific problems could result in which one of the following situations?
A)Malpractice
B)Reduction in salary for an RT
C)Reduction in workload
D)Probation status for the clinician at fault
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