Cardiopulmonary pathology is the study of diseases that affect the heart and lungs. As a respiratory therapist, it’s essential that you have a solid understanding of this area of medicine.
After all, the respiratory system is responsible for exchanging oxygen and carbon dioxide between the bloodstream and the lungs. When something goes wrong with this process, it can have serious consequences on the entire body.
In this study guide, we’ve listed several practice questions on the topic of cardiopulmonary pathology. This can help you practice, prepare, and learn the information you need in order to pass your final exam on this topic.
Note: We didn’t include the correct answers on this page so that you can test your knowledge. If you want to see the correct answers, you can download them for FREE using the link below.
Pathology Final Exam Practice Questions:
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:
PaCO2 97 mmHg
HCO3 37 mmHg
PaO2 40 mmHg
Based on this data, what treatment would you recommend?
A. Recommend administration of 50% FiO2 via venturi mask and monitor closely
B. Administer K+ and Cl- solutions via an IV
C. Recommend initiation of BiPAP ventilation and 40% FiO2
D. Recommend intubation and mechanical ventilation with 100% FiO2
2. A 74-year-old man with a long history of emphysema and chronic bronchitis enters the ER in 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)?
PaCO2 68 mmHg
PaO2 49 mmHg
HCO3- 53 mEq/L
A. Acute alveolar hyperventilation
B. Acute ventilatory failure
C. Acute alveolar hyperventilation superimposed on chronic ventilatory failure
D. Acute ventilatory failure superimposed on chronic ventilatory failure
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:
PaCO2 68 mmHg
HCO3- 37 mM/L
PaO2 49 mmHg
What treatment would you recommend for this patient?
A. Recommend administration of K+ and Cl- IV solution
B. Mechanical ventilation with a FiO2 of 60%
C. Recommend administration of BiPAP and FiO2 of 100%
D. Administer 30% O2 via a venturi mask and suggest a course of antibiotic therapy
4. A bony abnormality that exists when the sternum bulges outward (pigeon breast) is known as:
A. Pectus excavatum
D. Pectus carinatum
5. In which of the pulmonary disorders would you expect to see a faster respiratory rate and decreased tidal volume?
A. Pulmonary fibrosis
D. Chronic bronchitis
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 be documented as:
A. Hypocarbia and hypochromia
B. Hypocalcemia and hypocapnia
C. Hypoglycemia and hypoxemia
D. Hypochloremia and hypokalemia
7. An abnormal pulsation that exists as a result of right ventricular heart failure is known as:
B. Abdominal paradox
C. Right ventricular heave
D. Cor pulmonale
8. Confusion and agitation may be seen in patients with severe hypoxemia. This is due to the effects of:
B. Cerebral hypoxia
D. Cor Pulmonale
9. The decrease of white blood cells is known as:
10. Diffusion of oxygen from the air through the A/C membrane to the blood is known as:
A. External respiration
B. Internal respiration
C. Marked breathing
D. External resonance
A. Pleural effusion of the RLL
B. Pneumothorax of the LLL
C. Pneumonia of the RLL
D. Atelectasis of the RLL
12. Guillian-Barre is which type of dysfunction?
B. Pulmonary dysfunction
13. Hepatomegaly, jugular venous distension, and a right ventricular heave are consistent with what clinical condition?
A. Right heart failure
B. Congestive heart failure
C. Tension pneumothorax
D. Severe asthma
14. How far above the carina should the tip of the endotracheal tube be seen on the chest x-ray?
A. 5 to 7 cm
B. 4 to 6 cm
C. 2 to 3 cm
D. 7 to 9 cm
15. Increased resonance to percussion is associated with which of the following conditions?
B. Lung tumor
D. Pleural Effusion
16. Inward movement of the abdomen with each inspiratory effort is known as:
A. Paradoxical pulse
D. Abdominal paradox
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.
A. Acidosis; vasoconstriction
B. Alkalosis; vasodilatation
C. Alkalosis; vasoconstriction
D. Acidosis; vasodilatation
18. Oxygenation failure is present when the PaO2 falls below what value despite a FiO2 of 50%?
A. 55 mmHg
B. 60 mmHg
C. 65 mmHg
D. 50 mmHg
19. Which of the following are initial treatments for a patient who presents to the ER with the diagnosis of an overdose?
A. Stomach lavage
B. Possible dialysis to excrete drugs
C. Immediate intubation and mechanical ventilation
D. All of the above
20. The following data are collected from a patient’s chart:
HCO3- 19 mEq/liter
PaCO2- 32 torr
PaO2- 95 torr
Hb- 6 gm/dl
Which of the following lab values is most important in assessing this patient’s oxygen-carrying capacity?
21. The main goal of mechanical ventilation with chronic CO2 retention is:
A. Return pH to a patient’s normal baseline values
B. Increase the minute ventilation
C. Return the PaO2 to the patient’s normal baseline values
D. Reduce the patient’s maximum inspiratory pressure
22. The lowest acceptable PaO2 for a 75-year-old patient is about:
A. 70 mmHg
B. 55 mmHg
C. 60 mmHg
D. 65 mmHg
23. The most common cause of hypoxemia is:
A. Anatomic shunt
B. V/Q mismatch
C. Low metabolic rate
24. What change in the patient’s vital signs is expected as a result of fever?
B. Increase in respiratory rate
C. Increase in blood pressure
25. What clinical condition is most closely associated with harsh bronchial breath sounds over the affected region?
B. Excessive airway secretions
D. Narrow airways
27. What condition is often associated with abdominal paradox?
A. Diaphragm fatigue
B. Severe asthma
C. Cor Pulmonale
D. Heart failure
28. What is the correct interpretation of the following ABG values ( in addition to hypoxemia)?
PaCO2- 77 mmHg
PaO2- 54 mmHg
HCO3- 25 mEq/L
A. Acute ventilatory failure on chronic ventilatory failure
B. Acute alveolar hyperventilation (respiratory alkalosis)
C. Acute ventilatory(respiratory) failure
D. Acute alveolar hyperventilation superimposed on chronic ventilatory failure
29. What method of weaning helps the patient overcome the workload imposed by the resistance of the artificial airway?
B. Pressure support
C. All of the above
D. T –piece
30. What term is used to describe shortness of breath in the upright position?
31. What term is used to describe sputum that appears to contain pus?
32. What term is used to describe sputum that is clear and thick?
33. What term is used to describe the lateral curvature of the spine?
A. Pectus carinatum
D. Pectus excavatum
34. What test is most useful for evaluating renal function?
A. Platelet Count
B. Creatinine and BUN
C. Blood glucose
D. Sweat chloride
35. What treatment alternative is most appropriate when the patient’s ventilation is adequate and the problem with oxygenation is likely to resolve quickly?
A. Intermittent Mandatory Ventilation
B. Mechanical ventilation
C. Mechanical ventilation with PEEP
D. Mask CPAP
36. What treatment alternative is often needed when the patient has refractory hypoxemia due to shunting?
A. Mechanical ventilation
B. Increased FiO2
C. Mechanical ventilation with PEEP
D. Intermittent Mandatory Ventilation
37. What type of white blood cell is most responsible for responding to allergic reactions?
38. What type of white blood cell would most likely be elevated if a patient had an acute viral infection?
39. Wheezing is:
A. Produced by bronchospasm
B. Usually heard as a high-pitched sound
C. A cardinal finding of asthma
D. All of the above
40. When lung compliance decreases as in restrictive diseases, which of the following is seen?
A. Ventilatory rate usually decreases
B. Tidal volume usually increases
C. Ventilatory rate usually increases
D. Tidal volume usually increases
41. Which of the following are acceptable methods for weaning patients from mechanical ventilation?
A. Pressure support ventilation
C. T-piece trials
D. All of the above
42. Which of the following best describes a patient being treated effectively for a shunt-like effect?
A. Post-op patient receiving supplemental FiO2 via an oxygen mask
B. Patient on a ventilator suffering from pulmonary embolism
C. Patient receiving 5 cmH2O PEEP via mechanical ventilation due to aspiration pneumonia
D. Patient receiving 5 cmH2O mask CPAP at an FiO2 of 100% due to end-stage pulmonary fibrosis
43. Which of the following characteristics is typical for Pleuritic chest pain?
A. A dull pressure sensation
B. May radiate to the arm
C. Increases with inspiration
D. Centrally located
44. Which of the following clinical findings would be associated with a patient diagnosed with COPD?
A. Increased consolidation
B. Decreased V/Q ratio
C. Increased FEV1
D. Increased airway resistance
45. Which of the following conditions is NOT likely to cause hemoptysis?
A. Pulmonary embolism
B. Bronchogenic carcinoma
C. Heart failure
46. Which of the following conditions is most likely to produce a dry cough?
A. Cystic Fibrosis
B. Heart Failure
47. Which of the following conditions is most likely to produce an abnormal white shadow on the chest x-ray?
48. Which of the following parameters is most indicative of the patient’s tissue oxygenation status?
B. Blood pressure
C. Pulse pressure
D. Heart rate
49. Which of the following represents compensated metabolic alkalosis?
A. pH 7.45; PaCO2 61; HCO3- 41
B. pH 7.52; PaCO2 45; HCO2- 29
C. pH 7.45; PaCO2 26; HCO3- 19
D. pH 7.55; PaCO2 21; HCO3- 17
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?
A. Renal failure
B. Heart failure as the result of an MI
C. Enlarged liver
A. The patient has 3.44 grams of desaturated Hb
B. The patient has 1.32 grams of desaturated Hb
C. The patient is cyanotic
D. None of the above
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?
C. Weakened diaphragm
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:
A. Clubbing of the digits
B. Capillary refill time of 6 seconds
D. Coarse breath sounds in the lung bases
54. You obtain the following ABGs and get the following results:
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)
55. Your patient has a PaO2 of 38 mmHg. This is best described as:
A. Mild hypoxemia
B. Severe hypoxemia
C. Moderate hypoxemia
D. Depends on
56. Your patient has been living at high altitude for several years. What lab result do you expect?
57. Which of the following represents a normal Albumin level?
A. 6.0 g/dL
B. 4.0 g/dL
C. 3.0 g/dL
D. 7.5 g/dL
58. A lab method used to confirm the identity of microbes and the antibiotics that these microbes are sensitive to is known as:
A. Gram stain
C. Culture and sensitivity (C&S)
D. Acid-fast stain
59. Which of the following describes an intrapulmonary shunt?
A. Ventilation in excess of perfusion
B. Perfusion is completely absent
C. Lung regions with poorly ventilated alveoli but properly perfused with blood
D. Lung regions with well-ventilated alveoli but poorly perfused with blood
61. A patient comes into ER with slow, shallow breathing and is slow to arouse. What should be done first?
B. Mechanical Ventilation
62. All the following are opioids except which of the following?
63. A new patient was admitted and has been diagnosed with pneumonia. The patient has an oxygen saturation of 87% on 2 L/min nasal cannula. Which of the following would cause the patient to be hypoxemic?
1. Capillary shunting
2. Diffusion defect
3. Alveolar consolidation
Select all that apply:
A. 1 and 2
B. 2 and 3
C. 1 and 3
D. All of the above
64. A 16-year-old patient has been admitted and shows signs of poor body development. Upon assessment, you also noted digital clubbing, hyperresonance to percussion, and a productive cough. It has also been reported that the patient has foul-smelling stools. Which of the following conditions are these findings consistent with?
A. Acute respiratory distress syndrome
B. Heart failure
C. Acute bronchitis
D. Cystic fibrosis
65. While reviewing the chest x-ray of a 57-year-old male patient, you noted blunting of the left costophrenic angle. It also states in the patient’s chart that he has a history of CHF. Which of the following best describes this finding?
A. There is a pneumothorax on the left side
B. There is a pleural effusion on the left side
C. There is pulmonary edema in the left lung
D. There is pneumonia in the left lower lobe
66. You were called by the physician to perform a Tensilon test on a new patient. This test is commonly used to confirm the diagnosis for which of the following conditions?
A. Myasthenia gravis
B. Guillain-Barré syndrome
C. Multiple sclerosis
67. While assessing a 49-year-old male patient, you notice swelling in the lower limbs. This is most likely indicative of which of the following?
B. Chronic hypertension
C. Right ventricular insufficiency
D. Left ventricular insufficiency
68. A patient would have reduced tactile fremitus in all of the following conditions except?
C. Pulmonary edema
D. Pleural effusion
69. A 56-year-old male patient has been admitted and diagnosed with Guillain-Barré syndrome. In order to determine the patient’s need for ventilatory support, which of the following values is the most critical to monitor?
A. Residual volume
B. Inspiratory capacity
C. Peak inspiratory flow
D. Expiratory reserve volume
70. A sweat chloride test can be used to diagnose which of the following conditions?
A. Muscular dystrophy
B. Amyotrophic lateral sclerosis
D. Cystic fibrosis
71. A 61-year-old female patient is receiving mechanical ventilation. Over the last three days, her fluid intake has stayed the same but her output fluid level measurements have been decreasing. Her peak airway pressure has been steadily increasing over this same time period. Which of the following is the most likely cause of this problem?
A. Ventilator-associated pneumonia
B. Acute respiratory distress syndrome
C. Pulmonary arterial hypertension
D. Cardiogenic pulmonary edema
72. A 69-year-old female patient has been diagnosed with pneumonia. The physician asks you to assess the patient. Which of the following breath sounds would you expect to hear upon auscultation?
73. A 64-year old female patient was admitted and the physician suspects that a pneumothorax is present. Which of the following percussion notes would you expect to find in this patient?
A. Increased resonance
B. Flat percussion note
C. Dull percussion note
D. Hyperresonant percussion note
74. It has been determined that a patient in the ICU that is receiving mechanical ventilation has ARDS. Which of the following would you expect to find in this patient?
A. Refractory hypoxemia
B. Metabolic alkalosis
C. Increased lung volumes
D. Increased compliance
75. A 66-year-old female patient arrives in the emergency room with chest tightness, dyspnea, and shortness of breath. The doctor ordered a blood test to check troponin and BNP but the results were negative. Her ABG results show partially compensated respiratory acidosis. Which of the following is likely the issue in this case?
C. Exacerbation of COPD
D. Myocardial infarction
B. Lung cancer
C. Pulmonary embolism
77. You are called to help treat a patient with a neuromuscular condition. The patient is showing signs of paralysis that started in the feet but has extended upwards throughout the remainder of the body. Which of the following conditions is most likely present?
A. Guillain-Barré syndrome
B. Myasthenia gravis
D. Drug overdose
78. A recent post-operative patient is being treated with incentive spirometry. The patient’s inspiratory capacity has decreased over the past few days and their level of dyspnea has been increasing. The chest x-ray shows consolidation in the lung bases with no shift of the trachea. Which of the following has most likely developed?
B. Pleural effusion
79. While reviewing a patient’s chest x-ray, it shows that there is a shift of the trachea and mediastinum to the left side. There is also a complete opacification on the left side as well. These findings indicate which of the following?
A. Diffuse pulmonary emphysema
B. Right-sided pleural effusion
C. A pneumothorax of the right lung
D. Atelectasis of the left lung
80. While reviewing the chest x-ray of a 47-year-old male patient, you note that the heart is shifted to the patient’s right. Which of the following is the most likely cause of this finding?
A. Atelectasis of the left side
B. Tension pneumothorax on the left side
C. Tension pneumothorax on the right side
D. Pleural effusion on the right side
81. While listening to the breath sounds of a 55-year-old patient, you hear a creaking or grating sound. The sound gets louder with deep breathing but is not affected by coughing. Which of the following conditions is most likely present?
C. Chronic bronchitis
D. Pulmonary edema
82. You are called to perform a chest assessment of a new patient. Upon assessment, you notice that the patient has a paradoxical chest wall movement. Which of the following best describes this finding?
A. Chronic bronchitis
B. Flail chest
C. Exacerbation of COPD
D. Tension pneumothorax
83. A new patient just finished a cardiothoracic surgery procedure. Upon assessment, you noticed that the patient has a paradoxical pulse. Which of the following conditions is most likely?
B. COPD exacerbation
C. Myocardial infarction
D. Cardiac tamponade
84. While assessing a female patient on her posterior side, palpitation reveals minimal diaphragmatic movement on the right side as she takes a deep breath. Her movement on the left side is normal. Which of the following conditions best explains this finding?
A. Pulmonary emphysema
B. Atelectasis in the left lower lobe
C. Phrenic nerve paralysis on the left side
D. A pleural effusion on the right side
85. A 68-year-old female patient was admitted to the emergency department with shortness of breath and low blood pressure. Upon initial assessment, you note the following: Reduced chest expansion, hyperresonance to percussion, absent of breath sounds, tactile fremitus, and a tracheal shift to the right. Which of the following do these findings suggest?
A. Pleural effusion on the left side
B. Pneumothorax on the left side
C. Atelectasis on the left side
D. Consolidation on the left side
86. You are asked to assess a 39-year-old man that was admitted through the emergency department with an abrupt onset of fever and chills. The man shows signs of bilateral rhonchi with a productive cough and his SpO2 is 88% on room air. What should you recommend?
A. Intubate and provide mechanical ventilation with 40% oxygen
B. Provide noninvasive positive pressure ventilation using a full face mask
C. Implement postural drainage and percussion with directed coughing
D. Provide oxygen therapy, give an antibiotic, and obtain a sputum sample for Culture and Sensitivity
87. You heard bronchial breath sounds over the patient’s right middle lobe while performing a routine assessment. Due to this finding, which of the following conditions would you expect to be present?
D. Pleural effusion
88. Upon assessment of a new patient who was just admitted, you noticed that they have pink frothy secretions. This is most likely indicates which of the following:
B. Cor pulmonale
C. Left ventricular failure
D. An electrolyte imbalance
89. The most likely cause of stridor in an adult patient would be which of the following?
D. Post-extubation edema
90. After reviewing the chest radiograph of a 71-year-old male, you noticed a large area of consolidation in the right lung. Which of the following is the most likely cause of this problem?
A. Pulmonary barotrauma
B. Tension pneumothorax
C. Interstitial emphysema
D. Lobar pneumonia
91. A 60-year-old patient has been admitted and is showing signs of fever, diaphoresis, use of accessory muscles, and a respiratory rate or 22 breaths/min. Auscultation revealed rhonchi in the lower lobes. Which of the following would you suspect?
A. Heart attack
C. COPD exacerbation
D. Bacterial pneumonia
92. You have a patient that complains of left-sided chest pain while receiving mechanical ventilation. While assessing the patient, you note tachypnea, a weak and thready pulse, tracheal deviation to the right, and decreased breath sounds and hyperresonance on the left. Which of the following would you recommend?
B. A bronchoscopy
C. The insertion of a chest tube
D. A thoracentesis
93. You received an order from a new resident to administer an albuterol treatment to a CHF patient with acute pulmonary edema for wheezing. What should you do in this case?
A. Recommend acetylcysteine instead of albuterol
B. Perform the therapy with supplemental oxygen
C. Perform the treatment as ordered
D. Recommend a diuretic and oxygen therapy
94. A patient is the emergency room is suspected to have a pulmonary embolism. In order to confirm this suspicion, which of the following laboratory tests would you recommend?
B. Troponin I
D. Arterial blood gas
95. While assessing a 54-year-old male patient, you note that he has diminished breath sounds in the right lower lobe with a trachea that has shifted to the right. What is most likely the cause of these findings?
A. Pneumothorax on the left side
B. Pneumonia on the left side
C. Pneumothorax on the right side
D. Atelectasis on the right side
96. In which of the following conditions would postural drainage be most helpful?
A. Pleural effusion
B. Cystic fibrosis
97. Which of the following procedures would be most beneficial in preventing atelectasis in a 59-year-old female patient that is less than 24 hours post-surgery?
A. Albuterol via SVN four times daily
B. Pursed-lip breathing as needed
C. Inspiratory resistance exercises three times daily
D. Incentive spirometry maneuver 10 times per hour
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As previously mentioned, respiratory therapists are required to become experts on the topic of cardiopulmonary pathology. That is why this is a critically important topic for students to learn and understand.
Not to mention, there will be several questions on the TMC exam on this very topic.
- Rrt, Des Terry Jardins MEd, and Burton George Md Facp Fccp Faarc. Clinical Manifestations and Assessment of Respiratory Disease. 8th ed., Mosby, 2019.
- Faarc, Kacmarek Robert PhD Rrt, et al. Egan’s Fundamentals of Respiratory Care. 12th ed., Mosby, 2020.
- Faarc, Heuer Al PhD Mba Rrt Rpft. Wilkins’ Clinical Assessment in Respiratory Care. 8th ed., Mosby, 2017.