Chapter 5: Pulmonary Function Measurements
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Q1) Which of the following conditions is classified as a restrictive pulmonary disease with normal compliance?
A) ARDS
B) Pulmonary fibrosis
C) Neuromuscular disease
D) Pneumonia
Q2) Which of the following are characteristics of PEF?
I.It reflects large airway function.
II.PEF in normal adults may exceed 10 L/sec.
III.It is an effort-dependent test.
IV.PEF is useful in assessing gross changes in airway function and evaluating the response to bronchodilator drugs.
A) III, IV
B) I, II, III
C) I, II, IV
D) I, II, III, IV
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Chapter 6: Pulmonary Blood Flow
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Q1) In drawing blood from the proximal channel of a pulmonary artery catheter the attempt is to measure which of the following pressures?
A) CVP
B) PAP
C) PCWP
D) BP
Q2) What is the name of the pressure that is essentially equal to the left ventricular end-diastolic pressure?
A) Ejection pressure
B) Filling pressure
C) Pulmonary pressure
D) CVP
Q3) What is the normal value for the PCWP?
A) 2 mm Hg
B) 4 mm Hg
C) 25 mm Hg
D) 4 to 12 mm Hg
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Chapter 7: Gas Diffusion
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Q1) What is the most common cause of resting hypoxemia?
A) A mismatch between ventilation and diffusion
B) A mismatch between ventilation and permeability
C) A mismatch between ventilation and dead space
D) A mismatch between ventilation and blood flow
Q2) Why is N<sub>2</sub>O the ideal gas for measuring the extent to which pulmonary blood contributes to the diffusion rate?
A) Blood can absorb N<sub>2</sub>O at a greater rate than N<sub>2</sub>O can diffuse across the alveolar capillary membrane.
B) If N<sub>2</sub>O is inhaled, the pulmonary capillary blood reaches its maximum capacity for N<sub>2</sub>O almost instantly.
C) If N<sub>2</sub>O is inhaled, the pulmonary capillary blood reaches its maximum capacity for N<sub>2</sub>O slowly.
D) Blood can absorb N<sub>2</sub>O at a slower rate than N<sub>2</sub>O can diffuse across the alveolar capillary membrane.
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Chapter 8: Oxygen Equilibrium and Transport
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Q1) Which of the following statements relate to the HbO<sub>2 </sub>equilibrium curve?
I.Large PO<sub>2</sub> changes cause small to minimal changes in oxygen content, especially at the extreme flat right end (60 to 100 mm Hg).
II.Small PO<sub>2</sub> changes cause large blood oxygen content changes in the middle, steep portion of the curve (20 to 60 mm Hg).
III.Large PO<sub>2</sub> changes cause large changes in oxygen content at the extreme flatter ends of the curve, especially the flat right end (60 to 100 mm Hg).
IV.Small PO<sub>2</sub> changes cause small blood oxygen content changes in the middle, steep portion of the curve (20 to 60 mm Hg).
A) I, II
B) I, II, III, IV
C) II, III
D) I, II, III
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Chapter 9: Carbon Dioxide Equilibrium and Transport
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Q1) During cardiac resuscitation a 63-year-old man receives sodium bicarbonate for a profound metabolic acidosis.Why should the respiratory therapist increase ventilation at this point?
A) To eliminate the additional CO<sub>2</sub> generated by lactic acid buffering.
B) To counteract the effect of the sodium bicarbonate on the pH.
C) To eliminate the additional CO<sub>2</sub> generated by increased hydrogen ion production.
D) To counteract the effect of the sodium bicarbonate on the lactic acid.
Q2) Although CO<sub>2</sub> is technically not an acid, what is the reason for CO<sub>2</sub> being conceptualized as though it were an acid?
A) Its high affinity for acids in solution
B) Its immediate formation of H<sub>2</sub>CO<sub>3</sub><sup>-</sup> in physiological fluids
C) Its release in circulation as a volatile acid
D) Its counteraction of HCO<sub>3</sub><sup>-</sup> formation
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Chapter 10: Acid-Base Regulation
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Q1) Which of the following systems has the greatest buffering capacity?
A) Hb
B) HCO<sub>3</sub><sup>-</sup>
C) Organic phosphates
D) Plasma proteins
Q2) Which of the following organs is responsible for the physical removal of H<sup>+</sup>?
A) Kidneys
B) Lungs
C) Intestine
D) Pancreas
Q3) Which of the following disturbances in the pH may potentially occur in patients with nasogastric suction catheters?
A) Respiratory alkalosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Metabolic acidosis
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Chapter 11: Control of Ventilation
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Q1) Which of the following describes Biot's breathing?
A) Tidal volume gradually increases and then gradually decreases to complete apnea without changes in respiratory rate. Then the tidal volume gradually increases again.
B) The respiratory rate and tidal volume gradually increase and then gradually decrease to complete apnea. Then the tidal volume and breathing frequency gradually increase again.
C) The respiratory rate gradually increases and then gradually decreases to complete apnea but tidal volume has essentially the same depth. Then the breathing frequency gradually increases again.
D) Tidal volume gradually decreases to complete apnea. Then the tidal volume gradually increases again, repeating the cycle.
Q2) Which of the following peripheral chemoreceptors has the greatest influence over the respiratory centers?
A) Aortic bodies
B) Carotid bodies
C) Femoral bodies
D) Brachial bodies
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Chapter 12: Ventilation-Perfusion Relationships
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Q1) Which of the following statements explains why the mere breathing of 100% oxygen increases the P(A-a)O<sub>2</sub>?
A) Because 100% oxygen impairs gas transfer from the alveolus to the blood.
B) Because 100% oxygen improves gas transfer from the alveolus to the blood.
C) Because of the unique way hemoglobin binds O2.
D) Because 100% oxygen does not change gas transfer from the alveolus to the blood.
Q2) Which of the following is an indicator of the severity of the dead space?
A) PaO<sub>2</sub>
B) P(A-a)O<sub>2</sub>
C) PaO<sub>2</sub>/FIO<sub>2</sub>
D)P \( \overline{\mathrm{E}} \) CO<sub>2</sub>
Q3) Which level of calculated shunt fraction is associated with the least significant clinical effect?
A) 10% or less
B) 20% or less
C) 30% or less
D) Less than 50%
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Chapter 13: Clinical Assessment of Acid-Base and Oxygenation Status
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Q1) If Hb and cardiac output are normal, PaO<sub>2</sub> must acutely decrease to which of the following levels before clinical manifestations appear?
A) 71 to 80 mm Hg
B) 61 to 70 mm Hg
C) 50 to 60 mm Hg
D) 40 to 49 mm Hg
Q2) What is the most common cause of hyperventilation in patients with pulmonary disease?
A) Acidosis
B) Hypercapnia
C) Hypoxemia-induced respiratory alkalosis
D) Hypercapnia not refractory to oxygen therapy
Q3) When has partial acid-base compensation occurred?
A) When PaCO<sub>2</sub> and HCO<sub>3</sub><sup>-</sup> go in opposite directions
B) When PaCO<sub>2</sub> and HCO<sub>3</sub>- go in the same direction
C) When pH is within the normal range
D) When the noncausative component (either PaCO<sub>2</sub> or HCO<sub>3</sub><sup>-</sup>) is also abnormal in a way that brings the pH back toward the normal range
Page 15
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Chapter 14: Physiological Basis for Oxygenation and Lung Protection Strategies
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Q1) Which of the following levels of tidal volume is associated with a 22% reduction in mortality of patients with ARDS?
A) 5 mL/kg
B) 6 mL/kg
C) 7 mL/kg
D) 10 mL/kg
Q2) Which of the following substances are examples of inflammatory mediators?
I.Cytokines
II.Endotoxins
III.Prostaglandins
IV.Oxygen radicals
A) I, II, III
B) III, IV
C) I, II, III, IV
D) II, III
Q3) Which of the following is an absolute contraindication for CPAP?
A) ARDS
B) Patients who cannot sustain adequate spontaneous ventilation
C) Patients with unilateral lung disease
D) Patients with increased intracranial pressures
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Chapter 15: Physiology of Sleep Disordered Breathing
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Q1) What is the goal of titrating PAP for individuals with sleep disorders?
A) Using PAP pressure to reduce AHI to 10 or less per hour while the patient is in the prone position
B) Using PAP pressure to reduce AHI to 5 or less per hour while the patient is in the supine position
C) Using PAP pressure to reduce AHI to 10 or less per hour while the patient is in the supine position
D) Using PAP pressure to reduce AHI to 15 or less per hour while the patient is in the semi-Fowler's position
Q2) Which of the following is the most vulnerable position for the patient with OSA?
A) Prone
B) Supine
C) Side
D) Fowler's
Q3) What is the gold standard test to determine the presence of a sleep disorder?
A) PSG
B) ABG
C) CT of the upper airway
D) V/Q scan
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Chapter 16: Fetal and Newborn Cardiopulmonary Physiology
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Q1) When is a small amount of surfactant present in infants born prematurely?
A) 20 weeks' gestation
B) 24 weeks' gestation
C) 28 weeks' gestation
D) 35 weeks' gestation
Q2) When does the ductus arteriosus anatomically close?
A) 1 to 2 weeks
B) 2 to 4 weeks
C) 4 to 6 weeks
D) 2 months
Q3) Which of the following are congenital anomalies during the embryonic period?
I.Tracheoesophageal fistula
II.Choanal atresia
III.Pulmonary hypoplasia
IV.Duchenne's disease
A) I, II, III
B) II, III
C) I, II, III, IV
D) II, III, IV
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Chapter 17: Functional Anatomy of the Cardiovascular System
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Q1) What is the overall effect of ADH?
A) It decreases reabsorption of sodium.
B) It increases reabsorption of water.
C) It decreases circulating blood volume and pressure.
D) It increases reabsorption of sodium.
Q2) Where can the normal PMI be felt and sometimes seen?
A) At the intersection of the third intercostal space and the midclavicular line
B) At the intersection of the fourth intercostal space and the midclavicular line
C) At the intersection of the fifth intercostal space and the midclavicular line
D) At the intersection of the sixth intercostal space and the midclavicular line
Q3) Other than the heart's ability to pump blood out of the right atrium, pressure in the right atrium is determined by which of the following?
A) The diastolic pressure
B) The systolic pressure
C) The rate at which blood flows in from the vena cavae
D) The rate at which blood flows in from the pulmonary veins
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Chapter 18: Cardiac Electrophysiology
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Q1) What is the name of the ventricular rhythm associated with the pacemaker function taken over by the Purkinje system?
A) Ventricular arrhythmia
B) Ventricular escape
C) Dominant rhythm
D) Ventricular ectopy
Q2) If AV impulses fail to reach the ventricles after few seconds, what will the heart rate be?
A) 70 to 80 beats/min
B) 15 to 40 beats/min
C) 40 to 60 beats/min
D) 50 to 70 beats/min
Q3) In which of the following clinical conditions are calcium channel blockers indicated?
A) Coronary artery disease
B) Hypotension
C) Asthma
D) Congestive heart failure
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Chapter 19: The Electrocardiogram and Cardiac Arrhythmias In Adults
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Q1) No relationship exists between P waves and QRS complexes in which type of AV block?
A) First-degree
B) Type I second-degree
C) Type II second-degree
D) Third-degree
Q2) What is the most lethal of all cardiac arrhythmias?
A) SVT
B) VF
C) VT
D) Multifocal PVCs
Q3) Atrial depolarization is represented by which of the following waves in the ECG?
A) P
B) QRS
C) T
D) U
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Chapter 20: Control of Cardiac Output and Hemodynamic
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Q1) When the balloon-tipped catheter wedges in a small pulmonary arteriole, the blood pressure measured through the distal lumen is approximately the same as which of the following?
A) Right atrium
B) Right ventricle
C) Left atrium
D) Left ventricle
Q2) Which of the following are the major vascular factors that determine venous return and cardiac output?
I.Right atrial pressure
II.Mean filling pressure of the systemic circulation
III.Vascular resistance to blood flow between the peripheral vessels and the right atrium
IV.Capillary pressure
A) I, II
B) III, IV
C) I, II, III, IV
D) I, II, III
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Chapter 21: Filtration, Urine Formation, and Fluid Regulation
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Q1) Which of the following is the main factor determining the degree of filtration across the glomerular membrane?
A) Glomerular blood's oncotic pressure
B) Glomerular blood's hydrostatic pressure
C) Tubular hydrostatic pressure
D) Tubular oncotic pressure
Q2) Which of the following are structures that help compose the nephron?
I.Bowman's capsule
II.Proximal convoluted tubule
III.Loop of Henle
IV.Collecting duct
A) I, II, III
B) I, IV
C) I, II, III, IV
D) II, III
Q3) Which of the following is the best clinical indicator of perfusion adequacy?
A) Skin color
B) Blood pressure
C) Heart rate
D) Urine output
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Chapter 22: Electrolyte and Acid-Base Regulation
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Q1) Which of the following is a pulmonary manifestation of the nephrotic syndrome?
A) Pleural effusion
B) Pulmonary edema
C) Pneumonia
D) Pulmonary infiltrate
Q2) What is the normal range for BUN?
A) 2 to 8 mg/dL
B) 8 to 20 mg/dL
C) 20 to 30 mg/dL
D) 30 to 40 mg/dL
Q3) What is required for active transport across the cell membrane?
A) Calcium
B) Sodium
C) ATP
D) Potassium
Q4) Primary active transport accounts for what percentage of sodium reabsorption?
A) 50%
B) 60%
C) 70%
D) 80%
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Chapter 23: Cardiopulmonary Response to Exercise in Health and
Disease
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Q1) Which of the following measurements can be obtained with a metabolic cart?
I.Inhaled oxygen concentration
II.Tidal volume
III.Respiratory rate
IV.Minute ventilation
A) I, II
B) III, IV
C) I, II, III, IV
D) II, III
Q2) What is the name of the process for determining the resting energy expenditure and caloric nutritional needs in critically ill patients?
A) Oxygen transport studies
B) Caloric work rate
C) CO<sub>2 </sub>production rate
D) Indirect calorimetry
Q3) The VD/VT falls to approximately what level during exercise?
A)0.3 to 0.4
B)0.2 to 0.3
C)0.15 to 0.2
D)0.05 to 0.1
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Chapter 24: Aging and the Cardiopulmonary System
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Q1) Which of the following functional changes are consistent with aging?
I.Loss of elastic tissue
II.Loss of alveolar complexity
III.Decreased gas exchange
IV.Decreased surface area
A) I, II
B) I, III, IV
C) I, II, III, IV
D) II, III
Q2) Which of the following are the major adaptations to impairments in the cardiovascular system?
I.Left ventricular hypertrophy
II.Increased heart rate
III.Increased atrial contribution to diastolic filling
IV.Decreased vascular resistance
A) I, II, III
B) II, III, IV
C) I, III
D) I, IV
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