Patient Assessment in Respiratory Therapy
Pre-Test Questions
Course Introduction
This course provides an in-depth exploration of the principles and techniques utilized in the assessment of patients with respiratory conditions. Emphasizing both theoretical knowledge and practical skills, students learn to perform comprehensive patient evaluations, including history taking, physical examination, and the interpretation of diagnostic data relevant to respiratory therapy. Key topics include assessment of breath sounds, evaluation of arterial blood gases, pulmonary function testing, and the use of monitoring devices. Through interactive case studies and clinical simulations, students develop the critical thinking and clinical reasoning necessary to formulate effective care plans and contribute to multidisciplinary patient management.
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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2
Chapter 1: The Patient Interview
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13 Verified Questions
13 Flashcards
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Sample Questions
Q1) The respiratory therapist is conducting a patient interview. The main purpose of this interview is to:
A) review data with the patient.
B) gather subjective data from the patient.
C) gather objective data from the patient.
D) fill out the history form or checklist.
Answer: B
Q2) Which of the following are the most important components of a successful interview?
A) Communication and understanding
B) Authority and the use of medical terminology
C) Providing assurance and giving advice
D) Asking leading questions and anticipating patient responses to questions
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) Tachypnea may be the result of:
1) hypoxemia.
2) hypothermia.
3) fever.
4) sedation.
A) 2, 4
B) 1, 3
C) 2, 3, 4
D) 1, 2, 3, 4
Answer: B
Q2) A patient comes into the emergency department with a complaint of centrally located, constant chest pain. What is his most likely problem?
A) Pleurisy
B) Myocardial ischemia
C) Pneumothorax
D) Fractured rib
Answer: B
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Chapter 3: Pulmonary Function Study Assessments
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13 Verified Questions
13 Flashcards
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Sample Questions
Q1) The pulmonary diffusion capacity of the carbon monoxide test is used to:
A) assess the patient's blood carbon monoxide level.
B) remove carbon monoxide from the patient's blood.
C) measure the residual volume.
D) assess the alveolar-capillary membrane.
Answer: D
Q2) Which of the following forced vital capacity test times should be interpreted as normal?
A) Less than 4 seconds
B) 4 to 6 seconds
C) 6 to 8 seconds
D) 8 to 10 seconds
Answer: B
Q3) The FEF<sub>25%-75%</sub> is used to evaluate:
A) flow in large airways.
B) restrictive lung disease.
C) maximum breathing effort.
D) flow in medium-size to small airways.
Answer: D
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Page 5
Chapter 4: Arterial Blood Gas Assessments
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Sample Questions
Q1) Which of the following would be a normal person's venous oxygen pressure (PaO<sub>2</sub>)?
A) 35 to 45 mm Hg
B) 45 to 80 mm Hg
C) 80 to 100 mm Hg
D) 100 to 120 mm Hg
Q2) The respiratory therapist is assessing a patient with end-stage COPD who was admitted to the medical ward for an exacerbation of COPD due to increasing sputum purulence. The therapist notes the following ABG results in the patient's electronic medical record: pH 7.52, PaCO<sub>2</sub> 51; HCO<sub>2</sub> 40; PaO<sub>2</sub>
46. Which of the following is the best interpretation of these ABG results?
A) Chronic ventilatory failure with hypoxemia
B) Acute ventilatory failure with hypoxemia
C) Partially compensated metabolic alkalosis with hypoxemia
D) Partially compensated respiratory acidosis with hypoxemia
E) Acute alveolar hyperventilation superimposed on chronic ventilatory failure
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Chapter 5: Oxygenation Assessments
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Sample Questions
Q1) The respiratory therapist is evaluating a patient in the intensive care unit who shows signs of tissue hypoxia. Laboratory results reveal the following: HgB 14.8 grams, CaO<sub>2</sub> 19.6 vol. %, PaO<sub>2</sub> 102 mm Hg, a-v difference 9.8 vol. %, PvO<sub>2</sub> 24 mm Hg. Based on these results, which of the following types of hypoxia does this patient have?
A) Hypoxic hypoxia
B) Anemic hypoxia
C) Circulatory hypoxia
D) Histotoxic hypoxia
Q2) Polycythemia is:
1) a condition of too many red blood cells.
2) a condition of too few red blood cells.
3) caused by lack of iron in the diet.
4) the body's response to chronic hypoxemia.
A) 1, 2
B) 2, 3
C) 1, 4
D) 2, 4
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Chapter 6: Cardiovascular System Assessments
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Sample Questions
Q1) A pulmonary artery (Swan-Ganz) catheter can be used for all of the following EXCEPT:
A) measuring cardiac output.
B) arterial blood sampling.
C) measuring left atrial pressure.
D) measuring pulmonary artery pressure.
Q2) The T wave represents:
A) depolarization of the ventricles.
B) repolarization of the ventricles.
C) depolarization of the atria.
D) repolarization of the atria.
Q3) Which of the following is found when a patient has sinus arrhythmia?
1) Rate decreases during expiration.
2) Rate decreases during inspiration.
3) Rate varies by more than 10% from beat to beat.
4) Rate increases during inspiration.
A) 3
B) 2, 3
C) 1, 4
D) 1, 3, 4
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Chapter 7: Radiologic Examination of the Chest
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Sample Questions
Q1) The respiratory therapist is called to evaluate a patient with a suspected pulmonary embolus. The respiratory therapist would MOST likely recommend which of the following diagnostic procedures to help determine if the patient has a pulmonary embolus?
A) CTPA
B) Fluoroscopy
C) PET scan
D) MRI scan
E) CT scan
Q2) 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.
Q3) 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
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Page 9
Chapter 8: Other Important Tests and Procedures
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Sample Questions
Q1) For blood urea nitrogen (BUN) and creatinine values:
A) serum creatinine is a protein produced in the kidneys.
B) BUN and serum creatinine values that are higher than the normal range indicate renal failure.
C) urea is a waste product of carbohydrate metabolism in the intestines.
D) BUN values that are below normal indicate renal failure.
Q2) After a thoracentesis procedure, it is important to monitor the patient for:
A) bronchospasm.
B) hemoptysis.
C) increased blood urea nitrogen (BUN).
D) pneumothorax.
Q3) Culture and sensitivity tests:
A) stain a microorganism as gram positive or gram negative.
B) determine the shape of the organisms present.
C) identify the DNA of organisms present in the sputum.
D) determine the antibiotic(s) best suited for combating an infection.
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Chapter 9: The Therapist-Driven Protocol Program and the
Role of the Respiratory Therapist
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Sample Questions
Q1) Postural drainage, percussion, and vibration are part of what TDP?
A) Lung expansion protocol
B) Bronchopulmonary hygiene therapy protocol
C) Aerosolized medication therapy protocol
D) Oxygen therapy protocol
Q2) According to the aerosolized medication therapy protocol, the respiratory therapist may select medications from all of the following categories EXCEPT _____ agents.
A) antiinflammatory
B) sympathomimetic
C) parasympatholytic
D) antimicrobial
Q3) A TDP can be started after:
A) the nurse finishes his or her assessment.
B) the treatment option is selected.
C) a physician's order for the TDP is received.
D) authorization is received from the patient's insurance carrier.
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11
Chapter 10: Respiratory Failure and the Mechanical
Ventilation Protocol
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6 Flashcards
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Sample Questions
Q1) 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.
Q2) 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.
Q3) All of the following are causes of hypercapnic respiratory failure EXCEPT:
A) impending ventilatory failure.
B) apnea.
C) severe refractory hypoxemia.
D) acute ventilatory failure.
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Chapter 11: Recording Skills: The Basis for Data Collection,
Organization, Assessment Skill
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Sample Questions
Q1) In which section of the SOAPIER format should the patient's response to a specific treatment modality be recorded?
A) Assessment
B) Implementation
C) Observation
D) Evaluation
Q2) Which agency should be notified if violations of HIPAA regulations have occurred?
A) HHS
B) FDA
C) CDC
D) Joint Commission
Q3) When reviewing a SOAPIER progress note, all of the following would be found in the O area EXCEPT:
A) hemodynamic data.
B) patient's admission complaint.
C) blood pressure.
D) sputum production.
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Page 13
Chapter 12: Chronic Obstructive Pulmonary Disease
(COPD), Chronic Bronchitis, and Emphysema
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Sample Questions
Q1) Which of the following is true of the diffusing capacity test (DLCO) findings in a patient with COPD?
A) Normal in all cases
B) Decreased in emphysema
C) Decreased in chronic bronchitis
D) Increased in all cases
Q2) Which of the following are anatomic alterations found with chronic bronchitis?
1) Increased size of submucosal bronchial glands
2) Destruction of pulmonary capillaries
3) Chronic bronchial wall inflammation and thickening
4) Bronchospasm
A) 2, 3
B) 3, 4
C) 1, 2, 3
D) 1, 3, 4
Q3) In the United States, the primary factor leading to the development of COPD is:
A) a1-antitrypsin deficiency.
B) recurrent respiratory infections.
C) socioeconomic status.
D) tobacco smoking.
Page 14
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Chapter 13: Asthma
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Sample Questions
Q1) If a beta?-agonist agent and an anticholinergic agent were administered concurrently to a patient during an acute asthma episode, what result would be expected?
A) Bronchial smooth muscle contraction will occur.
B) Airway edema will increase.
C) The medications oppose each other, resulting in no airway changes.
D) Bronchial smooth muscle relaxation will occur.
Q2) Which of the following ABG values would be consistent with ventilatory failure with hypoxemia in a patient with severe status asthmaticus?
1) Increased PaCO<sub>2</sub>
2) Decreased SaO<sub>2</sub>
3) Increased pH
4) Decreased pH
A) 1, 2
B) 2, 3
C) 1, 2, 4
D) 1, 3, 4
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Page 15
Chapter 14: Bronchiectasis
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Sample Questions
Q1) Which of the following pulmonary function testing values would be found in a patient with severe, obstructive bronchiectasis?
A) Decreased RV/TLC ratio
B) Increased PEFR
C) Increased FEF<sub>25%-75%</sub>
D) Decreased FEF<sub>25%-75%</sub>
Q2) One of the main challenges in caring for a patient with bronchiectasis is:
A) contending with bronchospasm.
B) removing excessive bronchopulmonary secretions.
C) returning the FRC to within normal limits.
D) maximizing gas exchange across the alveolar-capillary membrane.
E) rehydrating dried secretions.
Q3) A mother brought her 2-year-old son to the physician. He has been coughing up secretions and having wheezy breathing ever since choking on food 6 months ago. The physician diagnosed the boy with bronchiectasis. What could be the cause?
A) Cystic fibrosis
B) Measles
C) Asthma
D) Aspiration
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Page 16
Chapter 15: Cystic Fibrosis
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Sample Questions
Q1) Which of the following may be recommended to reduce bronchial inflammation in a 12-year-old child with cystic fibrosis?
A) High-dose ibuprofen
B) High-dose acetaminophen
C) High-dose naproxen
D) High-dose corticosteroids
Q2) A cystic fibrosis patient in generally good condition may be a candidate for which of the following?
A) Cryosurgery
B) Total DNA replacement
C) Diaphragmatic pacemaker
D) Lung transplant
Q3) All of the following can be used in the diagnosis of cystic fibrosis EXCEPT:
A) an elevated potassium level in the sweat.
B) an elevated chloride level in the sweat.
C) genetic testing of the patient and/or parents.
D) chronic lung infections from an early age.
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17
Chapter 16: Pneumonia
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Sample Questions
Q1) Ventilator-acquired pneumonia (VAP) is defined as pneumonia that develops:
A) between 24 and 48 hours after endotracheal intubation.
B) more than 48 to 72 hours after endotracheal intubation.
C) less than 24 hours after mechanical ventilation is started.
D) more than 48 to 72 hours after mechanical ventilation is started.
Q2) A patient has a pleural effusion related to her pneumonia. Which of the following should the respiratory therapist recommend to treat the pleural effusion?
A) Hyperinflation therapy
B) Supplemental oxygen
C) Thoracentesis
D) Percussion and postural drainage
Q3) Overall, most cases of pneumonia are caused by:
A) viruses.
B) gram-negative bacteria.
C) protozoa.
D) fungi.
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18
Chapter 17: Lung Abscess
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Sample Questions
Q1) 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.
Q2) Following a cerebrovascular accident, a patient lying in the supine position aspirated gastric contents. In what area(s) of the lungs would a lung abscess be most likely to develop?
1) Posterior segments of the upper lobes
2) Apical segments of the upper lobes
3) Superior segments of the lower lobes
4) Anterior segments of both lower lobes
A) 1
B) 1, 3
C) 1, 4
D) 1, 2, 3
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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) The respiratory therapist is educating a patient just diagnosed with tuberculosis. Which of the following statements should the therapist tell the patient regarding tuberculosis?
A) Take the medication with a glass of water 1/2 hour before meals.
B) If you skip a dose of medication, double up at the next dose.
C) Don't take the medication if you have a fever or flulike symptoms.
D) Make sure to take the full prescribed course of therapy.
Q3) In which of the following ways is tuberculosis generally NOT spread?
A) Inhaling droplets of aerosol from an infected person
B) Drinking unpasteurized milk from cattle infected with the pathogen
C) Laceration with contact of infected secretions during postmortem autopsy
D) Sharing utensils and glassware with an infected person
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Chapter 19: Fungal Diseases of the Lung
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Sample Questions
Q1) What is considered to be the gold standard for the diagnosis of histoplasmosis?
A) Fungal stain
B) Blood serum antigen levels
C) Chest x-ray
D) Fungal culture
E) Skin test
Q2) A patient has an Aspergillus niger infection. What should be used to treat it?
A) Fluconazole (Diflucan)
B) Ribavirin (Virazole)
C) Metronidazole (Flagyl)
D) Ketoconazole (Nizoral)
Q3) Which type of fungal lung infection frequently results in productive cough with purulent sputum?
A) Staphylococcal infection
B) Blastomycosis
C) Klebsiella infection
D) Histoplasmosis
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21
Chapter 20: Pulmonary Edema
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Sample Questions
Q1) Which of the following is/are considered noncardiogenic cause(s) of increased capillary permeability?
1) Therapeutic lung radiation
2) Cigarette smoke
3) Acute respiratory distress syndrome (ARDS)
4) Inhaled phosgene
A) 1
B) 2, 3
C) 1, 3, 4
D) 1, 2, 3, 4
Q2) 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.
Q3) What is the normal hydrostatic pressure in the pulmonary capillaries?
A) 0 to 5 mm Hg
B) 5 to 10 mm Hg
C) 10 to 15 mm Hg
D) 15 to 20 mm Hg
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Chapter 21: Pulmonary Vascular Disease: Pulmonary
Embolism and Pulmonary Hypertension
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Sample Questions
Q1) The respiratory therapist is listening to the heart sounds of a patient with a suspected pulmonary embolus. The therapist could expect to hear all of the following EXCEPT:
A) increased second heart Sound (S2).
B) increased splitting of the second heart sound (S2).
C) third heart sound (S3).
D) fourth heart sound (S4).
Q2) A pulmonary embolism causes which of the following major pathologic and structural changes in the lungs?
1) Alveolar consolidation
2) Mucosal edema
3) Alveolar atelectasis
4) Pleural friction rub
A) 1, 3
B) 2, 4
C) 2, 3, 4
D) 1, 2, 3, 4
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Chapter 22: Flail Chest
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Sample Questions
Q1) What is the primary cause of hypoxemia in a patient with a severe flail chest?
A) Myocardial contusion
B) Hemorrhage
C) Pulmonary edema
D) Alveolar atelectasis
Q2) A patient with a flail chest is experiencing pendelluft. Which of the following would be expected in a patient with a flail chest with pendelluft?
1) Hypoventilation
2) Hypertension
3) Cyclical deeper and then more shallow breathing
4) Rebreathing dead-space gas
A) 1, 4
B) 1, 3
C) 2, 3, 4
D) 1, 2, 3, 4
Q3) When a patient has a flail chest, what happens during the ventilatory cycle?
A) The I:E ratio becomes inverse.
B) Air leaks out through the flail area.
C) Air leaks in through the flail area.
D) Air is shunted from one lung to the other.
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Chapter 23: Pneumothorax
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Sample Questions
Q1) What is the primary cause of hypotension in a patient with a large pneumothorax?
A) Pain
B) Decreased venous return to the heart
C) Tracheal compression
D) Atelectasis
Q2) If the patient has a tension pneumothorax, all of the following chest radiograph findings would be expected EXCEPT:
A) elevated diaphragm.
B) mediastinal shift to the unaffected side.
C) increased translucency on the side of the pneumothorax.
D) atelectasis.
Q3) A pneumothorax manifests itself clinically as a primary _____ disorder.
A) restrictive
B) obstructive
C) restrictive disorder with a secondary obstructive
D) obstructive disorder with secondary restrictive
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25
Chapter 24: Pleural Effusion and Empyema
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Sample Questions
Q1) The anatomic alteration caused by a pleural effusion is:
A) pulmonary fibrosis.
B) separation of the visceral and parietal pleura.
C) adhesion of the visceral and parietal pleura.
D) pulmonary edema.
Q2) Which of the following are chest radiograph findings associated with a large pleural effusion?
1) Blunting of the costophrenic angle
2) Fluid level on the affected side
3) Mediastinal shift toward the unaffected side
4) Elevated hemidiaphragm on the affected side
A) 1, 3
B) 2, 4
C) 1, 2, 4
D) 1, 2, 3
Q3) What is the most common cause of a chylothorax?
A) Thoracic duct trauma
B) Abdominal tumor
C) GERD
D) Pyloric stenosis
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Chapter 25: Kyphoscoliosis
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Sample Questions
Q1) In a case of severe kyphoscoliosis, which of the following chest radiograph findings would be expected?
1) Enlarged heart
2) Areas of atelectasis
3) Increased lung opacity
4) Thoracic deformity
A) 1, 4
B) 2, 3
C) 2, 3, 4
D) 1, 2, 3, 4
Q2) For best results, how many hours per day should a SpineCor brace be worn?
A) 8
B) 10
C) 16
D) 20
Q3) In which of the following is bracing the primary form of treatment?
A) Adolescents with idiopathic scoliosis (AIS)
B) Patients with congenital scoliosis
C) Patients with neuromuscular scoliosis
D) Infants with idiopathic scoliosis
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Chapter 26: Interstitial Lung Diseases
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Sample Questions
Q1) Which ILD is a smoking-related condition characterized by star-shaped nodules in the midlung?
A) PLCH
B) LIP
C) BOOP
D) CWP
Q2) Which of the following chest radiograph findings would be associated in a patient with ILD?
1) Pleural effusion
2) Honeycombing
3) Cavity formation
4) Increased translucency
A) 1, 4
B) 2, 3
C) 1, 2, 4
D) 1, 2, 3
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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 the most common form of lung cancer among those who have never smoked cigarettes or other tobacco products?
A) Squamous cell carcinoma
B) Adenocarcinoma
C) Large cell carcinoma
D) Small cell carcinoma
Q3) Malignant tumors:
1) invade surrounding tissues.
2) grow slowly.
3) cause necrosis.
4) may be metastatic.
A) 1
B) 4
C) 2, 4
D) 1, 3, 4
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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) The chest radiograph finding indicative of severe ARDS is:
A) "ground-glass" appearance of the lungs.
B) pleural effusion.
C) bilateral hyperinflation of the lungs.
D) tracheal deviation.
Q3) 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.
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Page 30
Chapter 29: Guillain-Barré Syndrome
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Sample Questions
Q1) The peripheral nervous system problems found with Guillain-Barré syndrome (GBS) include:
1) loss of reflexes.
2) increased reflex reactions.
3) flaccid paralysis of skeletal muscles.
4) tetany of skeletal muscles.
A) 3
B) 4
C) 1, 3
D) 2, 4
Q2) A patient with Guillain-Barré syndrome developed atelectasis. His chest radiograph findings would be expected to show:
A) "ground-glass" appearance.
B) "honeycombing."
C) increased opacity.
D) blunted costophrenic angles.
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Chapter 30: Myasthenia Gravis
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Q1) If a patient with myasthenia gravis is given edrophonium, what response would be expected?
A) Diaphragmatic strength will increase for 12 to 24 hours.
B) Strength will temporarily improve for 10 minutes.
C) Muscle strength will increase for 48 to 72 hours.
D) Muscle strength will decrease for 10 minutes.
Q2) Complications commonly associated with long-term use of steroids in the management of myasthenia gravis include all of the following EXCEPT:
A) infections.
B) cataracts.
C) pulmonary edema.
D) osteoporosis.
Q3) A physician recommended a thymectomy for a patient with generalized myasthenia gravis. The primary benefit of this procedure is to:
A) eliminate the source of AChR antibodies.
B) block the antigen-antibody reactions.
C) remove the source of cholinesterase.
D) cure the ocular myasthenia gravis.
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Chapter 31: Sleep Apnea
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Q1) Which of the following may be used in the management of a patient with central sleep apnea?
1) Acetazolamide
2) Oxygen therapy
3) Inhaled bronchodilator medications
4) Adaptive servo-ventilation (VPAP)
A) 1, 3
B) 2, 4
C) 1, 2, 4
D) 1, 2, 3, 4
Q2) Which of the following cardiac dysrhythmias is life threatening?
A) Atrioventricular block
B) Sinus bradycardia
C) Ventricular tachycardia
D) Premature ventricular contraction
Q3) All of the following are found during rapid eye movement sleep EXCEPT:
A) the diaphragm functions normally.
B) the person is easy to awaken.
C) dreaming occurs.
D) skeletal muscles are paralyzed.
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Chapter 32: Clinical Manifestations Common with Newborn and
Early Childhood Respiratory Dis
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Q1) A premature infant is suspected of having persistent pulmonary hypertension of the newborn. How is this diagnosis confirmed?
A) Arterial blood gas analysis
B) Chest radiography
C) Pulmonary angiography
D) Echocardiography
E) Cardiac catheterization
Q2) A premature infant is found to be "bobbing" her head. This is important because it can be a sign of which of the following?
A) Hypoxemia
B) Renal failure
C) Intracranial hemorrhage
D) Respiratory distress
E) Septic shock
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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Q1) 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
Q2) Risk factors for the development of MAS include: 1) being postterm.
2) a mother who is hypertensive.
3) a mother who is toxemic.
4) being the first twin born.
A) 1, 4
B) 2, 3
C) 2, 3, 4
D) 1, 2, 3
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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) At what gestational age is TTN most common?
A) 26 to 28 weeks' gestational age
B) 28 to 30 weeks' gestational age
C) 34 to 36 weeks' gestational age
D) 38 to 40 weeks' gestational age
Q3) All of the following are usually performed in the general management of a patient with TTN EXCEPT:
A) oxygen therapy administration.
B) administration of diuretics.
C) proper stabilization.
D) ruling out other serious conditions.
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36
Chapter 35: Respiratory Distress Syndrome
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Q1) Which of the following is usually seen in the lungs of a neonate with RDS?
A) Alveolar collapse (atelectasis)
B) Segmental atelectasis
C) Lobar atelectasis
D) Pulmonary fibrosis
Q2) The respiratory pattern of a neonate with RDS will have which of these characteristics?
1) Respiratory rate of about 50/min
2) Respiratory rate of >60/min
3) Cyclical breathing pattern
4) Hard and deep breaths
A) 1
B) 2, 3
C) 1, 4
D) 2, 4
Q3) The neonate with RDS would have a phosphatidylglycerol (PG) level that is:
A) present.
B) absent.
C) above normal.
D) below normal.
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Chapter 36: Pulmonary Air Leak Syndromes
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Q1) 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
Q2) During the physical exam of a neonate with early pulmonary air leak syndromes, what respiratory rate would be expected?
A) <20 breaths/min
B) 20 to 30 breaths/min
C) 40 to 60 breaths/min
D) >60 breaths/min
Q3) 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.
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Chapter 37: Respiratory Syncytial Virus (Bronchiolitis or Pneumonitis)
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Q1) Several small children who attend the same day care facility have become sick with RSV. The owner of the day care can expect them to recover within:
A) 4 to 6 days.
B) 3 to 8 days.
C) 1 to 2 weeks.
D) greater than 3 weeks.
Q2) Which of the following are major pathologic or structural changes associated with RSV?
1) Dilation and distortion of the airways
2) Inflammation of the peripheral airways
3) Alveolar hyperinflation
4) Pulmonary edema
A) 1, 4
B) 2, 3
C) 2, 3, 4
D) 1, 2, 3, 4
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Chapter 38: Bronchopulmonary Dysplasia
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Q1) A neonate is reported to have classic Stage IV BPD with emphysematous lung changes. What pulmonary function test finding(s) would confirm this?
1) Increased RV/TLC ratio
2) Increased FRC
3) Decreased VC
4) Increased RV
A) 3
B) 1, 2
C) 2, 3, 4
D) 1, 2, 4
Q2) What is the most significant treatment of the neonate for the prevention of BPD?
A) Corticosteroids
B) Diuretic therapy
C) Vitamin E therapy
D) Exogenous surfactant
Q3) Which of the following can increase an infant's likelihood of developing BPD?
A) Use of inhaled parasympatholytic agents
B) Patent ductus arteriosus (PDA)
C) High Apgar scores
D) Meconium aspiration syndrome (MAS)
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Chapter 39: Congenital Diaphragmatic Hernia
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Q1) What is the medical term for the condition associated with some cases of CDH in which the heart is pushed to the right side of the chest?
A) Morgagni's movement
B) Dextrocardia
C) Ambidextrocardia
D) Bochdalek's shift
Q2) What initial ventilator setting(s) would be recommended for a newborn with a CDH?
1) PEEP of 2-3 cm H<sub>2</sub>O
2) FIO<sub>2</sub> of 1.0
3) Peak inspiratory pressure of 18-20 cm H<sub>2</sub>O
4) Respiratory rate of 40 breaths/min
A) 2
B) 3, 4
C) 1, 2, 3
D) 1, 2, 3, 4
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Chapter 40: Congenital Heart Diseases
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Q1) Which cardiac anomaly is associated with coeur-en-sabot on a chest radiograph?
A) TOF
B) ASD
C) VSD
D) PDA
Q2) What is the most common form of TGA?
A) a-TGA
B) b-TGA
C) c-TGA
D) d-TGA
Q3) 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
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Page 42
Chapter 41: Croup Syndrome: Laryngotracheobronchitis and
Acute Epiglottitis
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Q1) In evaluating a 16-month-old boy, the respiratory therapist finds him to be in mild respiratory distress, without a fever, but with a barking-type cough. A lateral neck x-ray taken in the emergency department shows a "steeple point" narrowing of the trachea. Based on this information, which of the following would the respiratory therapist conclude is the most probable diagnosis?
A) Acute bronchitis
B) Epiglottitis
C) Bronchiolitis
D) LTB
Q2) The medication racemic epinephrine (Micronefrin, Vaponefrin) is given to a patient with LTB because it:
A) is an effective bronchodilator.
B) causes mucosal vasoconstriction.
C) causes bradycardia.
D) has an appealing taste and smell.
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Chapter 42: Near Drowning/Wet Drowning
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Q1) Warming techniques for a cold-water near-drowning victim include all of the following EXCEPT:
A) cooling the extremities and warming the body core.
B) warming the inspired oxygen.
C) heated intravenous solutions.
D) heated lavage of the pericardial space.
Q2) Favorable prognostic factors in clean water near-drowning include:
1) greater effort to reach the surface.
2) alcohol in the victim.
3) colder water.
4) younger age.
A) 1, 2
B) 3, 4
C) 2, 3, 4
D) 1, 2, 3, 4
Q3) After an extended time underwater, a near-drowning victim will most likely have:
A) tachypnea.
B) a normal respiratory rate.
C) bradypnea.
D) apnea.
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Chapter 43: Smoke Inhalation, Thermal Injuries, and Carbon
Monoxide Intoxication
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Sample Questions
Q1) A patient with carbon monoxide poisoning has a COHb level of 20%. If the patient is given 100% oxygen, what will the approximate COHb level be in 1 hour?
A) 15%
B) 10%
C) 5%
D) 2.5%
Q2) All of the following classes of medications are commonly used in the care of patients with smoke inhalation injury EXCEPT:
A) parasympatholytics.
B) mucolytics.
C) sympathomimetics.
D) monoclonal antibody.
Q3) The long-term effects of a smoke inhalation injury are:
A) obstructive lung disorders.
B) restrictive lung disorders.
C) obstructive and restrictive lung disorders.
D) neither obstructive nor restrictive lung disorders, since there is normally complete recovery.
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Chapter 44: Atelectasis
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Q1) A 40-year-old patient was in a motor vehicle accident. Among his injuries and related problems are three broken ribs on the right side, pleural fluid in the right pleural space, and atelectasis of both lungs. What should be done to help with the atelectasis problem?
1) Adequate pain management
2) Mechanical ventilation to stabilize the broken ribs
3) Remove the pleural fluid
4) Selective intubation of the right mainstem bronchus
A) 1, 3
B) 2, 4
C) 1, 2, 3
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.
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