Question 1

A 56-year-old patient arrives to the ER with extreme shortness of breath. Upon observation, you note that the patient has an increased AP chest diameter, using accessory muscles and pursed-lips to breathe. The following ABG results are available. Based on this data, what treatment would you recommend?

pH 7.28
PaCO2 97 mmHg
HCO3 37 mmHg
PaO2 40 mmHg

  1. Recommend administration of 50% FiO2 via venturi mask and monitor closely
  2. Administer K+ and Cl- solutions via an IV
  3. Recommend initiation of BiPAP ventilation and 40% FiO2
  4. Recommend intubation and mechanical ventilation with 100% FiO2

 

Question 2

A 74-year-old man with a long history of emphysema and chronic bronchitis enters the ER is respiratory distress. His RR is 34/minute and labored. His HR is 115/minute and BP is 170/120. What is the clinical interpretation of the following ABG (in addition to hypoxemia)?

pH 7.51
PaCO2 68 mmHg
PaO2 49 mmHg
HCO3- 53 mEq/L

  1. Acute alveolar hyperventilation
  2. Acute ventilatory failure
  3. Acute alveolar hyperventilation superimposed on chronic ventilatory failure
  4. Acute ventilatory failure superimposed on chronic ventilatory failure

 

Question 3

A 74-year-old patient with a long history of COPD enters the ER in respiratory distress. His respiratory rate is 34/min and labored. His heart rate is 115/min and temperature is 101.9 degrees F. His ABG values are as follows:

pH 7.57
PaCO2 68 mmHg
HCO3- 37 mM/L
PaO2 49 mmHg

What treatment would you recommend for this patient?

  1. Recommend administration of K+ and Cl- IV solution
  2. Mechanical ventilation with a FiO2 of 60%
  3. Recommend administration of BiPAP and FiO2 of 100%
  4. Administer 30% O2 via a venturi mask and suggest a course of antibiotic therapy

 

Question 4

A bony abnormality that exist when the sternum bulges outward (pigeon breast) is known as:

  1. Pectus excavatum
  2. Kyphosis
  3. Scoliosis
  4. Pectus carinatum

 

Question 5

In which of the pulmonary disorders would you expect to see a faster respiratory rate and decreased tidal volume?

  1. Pulmonary fibrosis
  2. Emphysema
  3. Pneumonia
  4. Chronic bronchitis

 

Question 6

A patient’s electrolyte panel reveals a K+ level of 3.0 mEq/L and a Cl- level of 73 mEq/L. This would documented as:

  1. Hyocarbia and hypochromia
  2. Hypocalcemia and hypocapnia
  3. Hypoglycemia and hypoxemia
  4. Hypochloremia and hypokalemia

 

Question 7

An abnormal pulsation that exist as a result of right ventricular heart failure is known as:

  1. clubbing
  2. abdominal paradox
  3. right ventricular heave
  4. cor pulmonale

 

Question 8

Confusion and agitation may be seen in patients with severe hypoxemia. This is due to the effects of:

  1. Hepatomegaly
  2. Cerebral hypoxia
  3. Hyperventilation
  4. Cor Pulmonale

 

Question 9

Decrease of white blood cells is known as:

  1. leukocytosis
  2. leukopenia
  3. anemia
  4. polycythemia

 

Question 10

Diffusion of oxygen from the air through the A/C membrane to the blood is known as:

  1. external respiration
  2. internal respiration

 

Question 11

During an assessment of a patient, the RCP places her hand on a patient’s right lower lobe and asks the patient to repeat “99”. Findings include decreased tactile fremitus in the RLL as compared to the left. This finding is consistent with:

  1. Pleural effusion of the RLL
  2. Pneumothorax of the LLL
  3. Pneumonia of the RLL
  4. Atelectasis of the RLL

 

Question 12

Guillian-Barre is which type of dysfunction?

  1. CNS
  2. Pulmonary dysfunction
  3. Neuromuscular
  4. Musculoskeletal

 

Question 13

Hepatomegaly, jugular venous distension, and a right ventricular heave are consistent with what clinical condition?

  1. Right heart failure
  2. Congestive heart failure
  3. Tension pneumothorax
  4. Severe asthma

 

Question 14

How far above the carina should the tip of the endotracheal tube be seen on the chest x-ray?

  1. 5 to 7 cm
  2. 4 to 6 cm
  3. 2 to 3 cm
  4. 7 to 9 cm

 

Question 15

Increased resonance to percussion is associated with which of the following conditions?

  1. Pneumonia
  2. Lung tumor
  3. Emphysema
  4. Pleural Effusion

 

Question 16

Inward movement of the abdomen with each inspiratory effort is known as:

  1. Paradoxical pulse
  2. Respiratory alternans
  3. Heptatmegaly
  4. Abdominal paradox

 

Question 17

It is best to hyperventilate a ventilated patient with a head injury. This helps by producing _______________, which in turn will result in _______________ and reduce the ICP.

  1. Acidosis; vasoconstriction
  2. Alkalosis; vasodilatation
  3. Alkalosis; vasoconstriction
  4. Acidosis; vasodilatation

 

Question 18

Oxygenation failure is present when the PaO2 falls below what value despite a FiO2 of 50%?

  1. 55 mmHg
  2. 60 mmHg
  3. 65 mmHg
  4. 50 mmHg

 

Question 19

Which of the following are initial treatments for a patient who presents to the ER with the diagnosis of overdose?

  1. Stomach lavage
  2. Possible dialysis to exrete drugs
  3. Immediate intubation and mechanical ventilation
  4. High ventilatory rates to produce respiratory alkalosis

 

Question 20

The following data are collected from a patient’s chart:

PH- 7.44
HCO3- 19 mEq/liter
PaCO2- 32 torr
SaO2- 95%
PaO2- 95 torr
Hb- 6 gm/dl

Which of the following lab values is most important in assessing this patient’s oxygen-carrying capacity?

  1. pH
  2. PaO2
  3. Hb
  4. SaO2

 

Question 21

The goal of mechanical ventilation with chronic CO2 retention is:

  1. Return pH to patient’s normal baseline values
  2. Increase the minute ventilation
  3. Return the PaCO2 to patient’s normal baseline values
  4. Reduce the patent’s maximum inspiratory pressure

 

Question 22

The lowest acceptable PaO2 for an 75-year-old patient is about:

  1. 70 mmHg
  2. 55 mmHg
  3. 60 mmHg
  4. 65 mmHg

 

Question 23

The most common cause of hypoxemia is:

  1. Anatomic shunt
  2. V/Q mismatch
  3. Low metabolic rate
  4. Hyperventilation

 

Question 24

What change in the patient’s vital signs is expected as a result of fever?

  1. Decrease in blood pressure
  2. Increase in respiratory rate
  3. Increase in blood pressure
  4. Decrease in heart rate

 

Question 25

What clinical condition is most closely associated with harsh bronchial breath sounds over the affected region?

  1. Pneumonia
  2. Pneumothorax
  3. Emphysema
  4. Asthma

 

Question 26

What clinical condition is most likely to produce coarse crackles?

  1. Atelectasis
  2. Excessive airway secretions
  3. Sudden opening of peripheral airways
  4. Narrow airways

 

Question 27

What condition is often associated with abdominal paradox?

  1. Diaphragm fatigue
  2. Severe asthma
  3. Cor Pulmonale
  4. Heart failure

 

Question 28

What is the correct interpretation of the following ABG values ( in addition to hypoxemia)?

pH- 7.17
PaCO2- 77 mmHg
PaO2- 54 mmHg
HCO3- 25 mEq/L

  1. Acute ventilatory failure on chronic ventilatory failure
  2. Acute alveolar hyperventilation (respiratory alkalosis)
  3. Acute ventilatory(respiratory) failure
  4. Acute alveolar hyperventilation superimposed on chronic ventilatory failure

 

Question 29

What method of weaning helps the patient overcome the workload imposed by the resistance of the artificial airway?

  1. IMV/SIMV
  2. Pressure support
  3. All of the above
  4. T –piece


Question 30

What term is used to describe shortness of breath in the upright position?

  1. Eupnea
  2. Apnea
  3. Platypnea
  4. Orthopnea

 

Question 31

What term is used to describe sputum that appears to contain pus?

  1. Fetid
  2. Purulent
  3. Phlegm
  4. Mucoid

 

Question 32

What term is used to describe sputum that is clear and thick?

  1. Mucoid
  2. Fetid
  3. Purulent
  4. Phlegm

 

Question 33

What term is used to describe the lateral curvature of the spine?

  1. Pectus carinatum
  2. Scoliosis
  3. Kyphosis
  4. Pectus excavatum

 

Question 34

What test is most useful for evaluating renal function?

  1. Platelet Count
  2. Creatinine and BUN
  3. Blood glucose
  4. Sweat chloride

 

Question 35

What treatment alternative is most appropriate when the patient’s ventilation is adequate and the problem with oxygenation is likely to resolve quickly?

  1. Intermittent Mandatory Ventilation
  2. Mechanical ventilation
  3. Mechanical ventilation with PEEP
  4. Mask CPAP

 

Question 36

What treatment alternative is often needed when the patient has refractory hypoxemia due to shunting?

  1. Mechanical ventilation
  2. Increased FiO2
  3. Mechanical ventilation with PEEP
  4. Intermittent Mandatory Ventilation

 

Question 37

What type of white blood cell is most responsible for responding to allergic reactions?

  1. Neutrophils
  2. Eosinophils
  3. Monocytes
  4. Lymphocytes

 

Question 38

What type of white blood cell would most likely be elevated if a patient had an acute viral infection?

  1. Monocyte
  2. Neutrophil
  3. Eosinophil
  4. Lymphocyte

 

Question 39

Wheezing is:

  1. Produced by bronchospasm
  2. Generally auscultated during inspiration
  3. A cardinal finding of asthma
  4. Usually heard as a high-pitched sound

 

Question 40

When lung compliance decreases as in restrictive diseases, which of the following is seen?

  1. Ventilatory rate usually decreases
  2. Tidal volume usually decreases
  3. Ventilatory rate usually increases
  4. Tidal volume usually increases

 

Question 41

Which of the following are acceptable methods for weaning patients from mechanical ventilation?

  1. Pressure support ventilation
  2. IMV/SIMV mode of ventilation
  3. T-piece trials

 

Question 42

Which of the following best describes a patient being treated effectively for a shunt-like effect?

  1. Post-op patient receiving supplemental FiO2 via an oxygen mask
  2. Patient on a ventilator suffering from pulmonary embolism
  3. Patient receiving 5 cmH2O PEEP via mechanical ventilation due to aspiration pneumonia
  4. Patient receiving 5 cmH2O mask CPAP at an FiO2 of 100% due to end-stage pulmonary fibrosis

 

Question 43

Which of the following characteristics is typical for Pleuritic chest pain?

  1. A dull pressure sensation
  2. May radiate to the arm
  3. Increases with inspiration
  4. Centrally located

 

Question 44

Which of the following clinical findings would be associated with a patient diagnosed with COPD?

  1. Air trapping
  2. Decreased V/Q ratio
  3. Increased FEV1
  4. Increased airway resistance
  5. Prolonged expiration

 

Question 45

Which of the following conditions is NOT likely to cause hemoptysis?

  1. Pulmonary embolism
  2. Bronchogenic carcinoma
  3. Heart failure
  4. Pneumonia

 

Question 46

Which of the following conditions is most likely to produce a dry cough?

  1. Cystic Fibrosis
  2. Heart Failure
  3. Asthma
  4. Bronchitis

 

Question 47

Which of the following conditions is most likely to produce an abnormal white shadow on the chest x-ray?

  1. Pneumothorax
  2. Pneumonia
  3. Emphysema
  4. Asthma

 

Question 48

Which of the following paramaters is most indicative of the patient’s tissue oxgyenation status?

  1. Sensorium
  2. Blood pressure
  3. Pulse pressure
  4. Heart rate

 

Question 49

Which of the following represents compensated metabolic alkalosis?

  1. pH 7.45; PaCO2 61; HCO3- 41
  2. pH 7.52; PaCO2 45; HCO2- 29
  3. pH 7.45; PaCO2 26; HCO3- 19
  4. pH 7.55; PaCO2 21; HCO3- 17

 

Question 50

While listening to a 53-year-old-male patient, the RCP notices that the patient has a S3 galloping heart sound. This could be caused by which of the following?

  1. Renal failure
  2. Heart failure as the result of a MI
  3. Enlarged liver
  4. COPD

 

Question 51

While reviewing a patient’s chart, the respiratory therapist notices the patient’s Hb level is 11g/dL and the SpO2 is 88%. Which of the following is true regarding this situation?

  1. The patient has 3.44 grams of desaturated Hb
  2. The patient has 1.32 grams of desaturated Hb
  3. The patient is not likely cyanotic

 

Question 52

While reviewing the chart of a patient with lobar pneumonia, the respiratory care practitioner notices that the respiratory rate for the last 24 hours has been between 28 to 42 /min on a 50% venturi mask. Which of the following most likely caused the increased respiratory rate?

  1. Hypothermia
  2. Hypoxemia
  3. Weakened diaphragm
  4. Hyperalkemia

 

Question 53

You are assessing a patient and determine that the patient’s blood pressure is 70/53 mmHg and the patient has a temperature of 90.5 degrees F. From this information, you would expect:

  1. Clubbing of the digits
  2. Capillary refill time of 6 seconds
  3. Full and bounding pulse rate of 88 bpm
  4. Coarse breath sounds in the lung bases

 

Question 54

You obtain the following ABGs and get the following results:

pH- 7.28
PaCO2- 110 mmHg
PaO2- 45 mmHg
HCO3- 37 mEq/L

You observe that the pH is too high for the PaCO2. What would the pH be if this were an acute situation? (Use 7.40 as your baseline pH and 40 as your baseline PaCO2)

  1. 7.00
  2. 7.10
  3. 7.05
  4. 7.15

 

Question 55

Your patient has a PaO2 of 38 mmHg. This is best described as:

  1. Mild hypoxemia
  2. Severe hypoxemia
  3. Moderate hypoxemia
  4. Depends on patient’s age

 

Question 56

Your patient has been living at high altitude for several years. What lab result do you expect?

  1. Leukocytosis
  2. Lymphocytosis
  3. Leukopenia
  4. Polycythemia

 

Question 57

Which of the following represents a normal Albumin level?

  1. 6.0 g/dL
  2. 4.0 g/dL
  3. 3.0 g/dL
  4. 7.5 g/dL

 

Question 58

A lab method used to confirm the identity of microbes and the antibiotics that these microbes are sensitive to is known as:

  1. Gram stain
  2. WBC
  3. Culture and sensitivity (C&S)
  4. Acid fast stain

 

Question 59

Which of the following describes an intrapulmonary shunt?

  1. Ventilation in excess of perfussion
  2. Perfussion in excess of ventilation
  3. Lung regions with poorly ventilated alveoli but properly perfussed with blood
  4. Lung regions with well ventilated alveoli but poorly perfussed with blood

 

Question 60

Inverse I:E ratio ventilation is a strategy sometimes used to improve oxygenation in which of the following disorders?

  1. Exacerbation of COPD
  2. Pulmonary Edema
  3. ARDS
  4. Head tramua