Question 1

A patient is ineffectively breathing with a consistent large tidal volume, a variable respiratory rate and short periods of apnea. This patient could be suffering from:

  1. Cystic fibrosis
  2. Airway tumor
  3. Head injury
  4. Asthma

Left sided consolidation of SOB

Question 2

What is the proper rate of external chest compressions for children up to 8 and to the age of puberty?

  1. 60/minute
  2. 90/minute
  3. 100/minute
  4. 120/minute

 

Question 3

Which of the following sets of ABG measurements would be indicative of a renal compensated respiratory acidosis?

  1. pH 7.26, PCO2 60 torr, PO2 68 torr, HCO3- 24 mEq/L, BE 0
  2. pH 7.42, PCO2 39 torr, PO2 87 torr, HCO3- 22 mEq/L, BE –1
  3. pH 7.25, PCO2 61 torr, PO2 75 torr, HCO3- 26 mEq/L, BE +1
  4. pH 7.37, PCO2 58 torr, PO2 60 torr, HCO3- 31 mEq/L, BE +8

 

Question 4

Which of the following conditions will appear hyperlucent with retrosternal air space on a chest x-ray?

  1. AtelectasisII
  2. Pneumothorax
  3. Pneumonia
  4. Emphysema.
  5. Acute asthma

 

Question 5

A patient is being manually ventilated at a rate of 12/min with a bag-valve resuscitation bag. With the oxygen flow running at 8 L/min into the bag, the patient’s PaO2 is 55 torr. Which of the following actions would increase the FiO2 delivered to the patient?I. Increasing the ventilation rate to 30/minII. Increasing the oxygen flow to 15 L/minIII. Ensue that an oxygen reservoir is connected to the bag

  1. Increasing the ventilation rate to 30/min
  2. Increasing the oxygen flow to 15 L/min
  3. Ensue that an oxygen reservoir is connected to the bag

 

Question 6

All of the following are conditions where bronchial and bronchovesicular breath sounds may be heard over consolidated areas EXCEPT:

  1. Pneumonia
  2. Atelectasis
  3. Pulmonary edema
  4. Foreign body aspiration

 

Question 7

Clubbing of the fingers in associated with:

  1. Acute lung disease
  2. Bronchogenic carcionoma
  3. Acute cardiovascular disease
  4. Chronic obstructivelung disease

 

Question 8

Which of the following PaO2 findings is considered severe at any age?

  1. PaO2 of 55 mmHg
  2. PaO2 of 60 mmHg
  3. PaO2 of 65 mmHg
  4. PaO2 of 40 mmHg

 

Question 9

On receiving a new medication nebulizer treatment order, the RCP checks the order and finds the order is written incorrectly. What should the RCP do?

  1. Draw up the medication and give the treatment
  2. Ask the family what medication the patient should receive
  3. Obtain a past home care history
  4. Call the physician and clarify the order

 

Question 10

Which of the following could influence the results of pulse oximetry?

  1. Nail polishII
  2. Motion artifact
  3. Hypotension

 

Question 11

Dark yellow secretions with a foul odor may be due to

  1. BronchiectasisII
  2. AsthmaIII
  3. Pulmonary edema
  4. Lung abscess

 

Question 12

You are called to the ER to assess a patient who has suffered blunt chest trauma in an automobile accident. Which of the following clinical signs could indicate the presence of a pneumothorax?

  1. Subcutaneous emphysema (crepitus)
  2. Paradoxical chest movement
  3. Peripheral edema
  4. Clubbing

 

Question 13

You are preparing to perform a right radial puncture on a patient and are doing the Allen’s test prior to the puncture. The response to the test is for the patient’s hand to “pink up” after pressure is released. The results are consistent with:

  1. Occluded radial artery
  2. Patent ulnar artery
  3. Occluded ulnar artery
  4. Patent brachial artery

 

Question 14

After obtaining a blood gas sample, the respiratory care practitioner fails to rid the sample of an air bubble before analyzing the blood. This could result in:

  1. An abnormal high CO2
  2. An abnormal low pH
  3. An abnormal high O2
  4. An abnormal low CO2

 

Question 15

In order to palpate for symmetrical chest movement of a patient, the respiratory care practitioner should do which of the following?

  1. Order a chest x-ray
  2. Place a hand on the abdomen and observe abdominal movement
  3. Percuss the chest bilaterally
  4. Place a hand on the chest and observe chest movement

 

Question 16

A patient arrives in the emergency room in a full cardiopulmonary arrest with a cervical neck collar in place. The best alternative site that could be used to check the pulse would be the:

  1. Carotid pulse
  2. Femoral pulse
  3. Brachial pulse
  4. Radial pulse

 

Question 17

You are a RCP working in the ER when a MVA victim arrives. You quickly determine that the patient is in severe respiratory distress and has crepitus on the left side of his chest. What should you do to further evaluate these findings?

  1. Collect an ABGs and order a peak flow study
  2. Administer a STAT aerosol treatment with Albuterol and Atrovent
  3. Intubate and ventilate the patient
  4. Collect an ABG and order a STAT chest x-ray

 

Question 18

A patient enters the ER in moderate respiratory distress. The RCP is called to asses the patient and determines the following: intercostal muscle use, stridor, slow respiratory rate with an I:E of 1:1. What are possible causes of these findings?

  1. Croup
  2. Laryngeal edema
  3. COPD
  4. Bronchitis
  5. Airway tumor

 

Question 19

A patient has normal breath sounds following therapy. Which of the following best describes this finding?

  1. Adventitious
  2. Vesicular
  3. Wheezes
  4. Tracheal
Question 20

The respiratory therapist has received an order to obtain ABG levels from a patient, but an Allen’s test indicates collateral circulation is not present in the right wrist. At this time the therapist would:

  1. Obtain blood from the right radial artery
  2. Obtain blood from the right brachial artery
  3. Wait for the physician to evaluate collateral circulation
  4. Check collateral circulation in the left wrist

 

Question 21

Which of the following are possible techniques to accurately check a patient’s pulse rate?

  1. Listen to heart tones with a stethoscope
  2. Locate and palpate the radial artery
  3. Locate and palpate the brachial artery
  4. Locate and palpate the carotid artery

 

Question 22

A RCP is called to give a STAT aerosol treatment with Xopenex to a patient in respiratory distress. The patient appears very fearful and anxious and tells the RCP that he does not want the treatment. What action should the RCP take at this time?

  1. Contact the physician and tell her the patient has refused treatment
  2. Restrain the patient and forced him to take the treatment
  3. Assume the patient doesn’t understand and ask for a translator
  4. Reassure the patient, explain the benefits of the treatment and attempt to give the treatment again

 

Question 23

You are caring for a patient has been previously intubated and note that the patient is exhibiting signs of respiratory distress. Upon auscultation, you note decreased breath sounds on the left and the patient’s SpO2 has dropped from 94% to 87%. What action should you take:

  1. Advanced the tube 2 cm
  2. Withdraw the tube until equal breath sounds are heard
  3. Leave the tube in the present position and monitor closely
  4. Call for a chest x-ray to verify position

 

Question 24

You enter a patient’s room to give a treatment and observe the patient is unconscious and not breathing. Your first action should be which of the following?

  1. Deliver two breaths
  2. Open the airway
  3. Perform abdominal thrust
  4. Call for help

 

Question 25

You are caring for a patient who attempted suicide by inhaling poisonous fumes in a car with the engine running. What level of COHb is lethal for this patient?

  1. 5%
  2. 10%
  3. 15%
  4. 30%

 

Question 26

Pulse oximetry should NOT be recommended to determine oxygenation status in which of the following situations?

  1. A patient receiving a sleep study
  2. A patient arrives in the ER department after being pulled from a burning house.
  3. A post-op patient who is still sedated
  4. A patient receiving a bronchoscopy

 

Question 27

A patient who has overdosed on narcotics has been admitted to the ER. The RCP hears course breath sounds in the right lower lobe and it is determined that the patient has aspirated vomitus. Which of the following chest x-ray findings is consistent with this diagnosis?

  1. Lobar consolidation and air bronchograms on the right
  2. Lobar infiltrates and depressed hemidiaphragms on the right
  3. Bilateral hyperlucent lung fields
  4. Total white-out of chest x-ray

 

Question 28

While ventilating a patient with a manual resuscitator, you notice the bag is not refilling adequately. What could be the cause of this problem?

  1. Reversed or improperly placed one-way valve
  2. Excessive liter flow from flowmeter
  3. Improper sized facemask
  4. Reservoir tubing too short

 

Question 29

An RCP has just performed incentive spirometry on a post-operative patient and when you ask the patient to cough, she states that it is too painful to cough. The RCP should encourage which of the following modifications to coughing?

  1. Manually assisted cough
  2. Mid-inspiratory cough
  3. Cough assisance with splinting
  4. Normal cough

 

Question 30

It is determined that a patient’s respiratory rate is 35 beats/minute. This would be considered normal with which patient age population?

  1. A 19 year-old patient
  2. A 45 year-old patient
  3. A newborn or infant
  4. A 10 year-old patient

 

Question 31

Which of the following methods may best determine decreased cardiac output and perfusion in the extremities?

  1. Obtaining ABG studies and determining the PaO2 level
  2. Assessing the SaO2 level with a pulse oximeter
  3. Assessing capillary refill
  4. Palpating a brachial pulse

 

Question 32

Physical examination of a patient with pleural effusion might reveal which of the following?

  1. Paradoxical respiration
  2. Decreased tactile fremitus
  3. Depressed hemidiaphragms
  4. Diminished breath sounds on the affected side

 

Question 33

You are called to the nursery to help provide emergency care to a 9-month-old infant. The infant has had a cardiac arrest. Which of the following apply to correct technique for providing external chest compressions to this infant?

  1. Sternum should be depressed 3 inches with each compression
  2. A compression: ventilation ratio of 30:1 should be used
  3. Two fingers should be placed just below the nipple line
  4. A compression: ventilation ratio of 5:1 should be used

 

Question 34

You are performing an initial evaluation of a patient who complains of dyspnea. The patient informs you that he becomes dyspneic after climbing one flight of stairs. You would record this as:

  1. Class I dyspnea
  2. Class II dyspnea
  3. Class III dyspnea
  4. Class IV dyspnea

 

Question 35

As you enter the patient’s room to administer a nebulizer treatment, you
notice the patient is breathing rapidly and looks to be in distress. You notice
the following during the physical exam: reduced chest expansion, a
hyperresonant percussion note on the left side, absence of breath sounds
on the left and a tracheal shift to the right. This suggests:

  1. Left sided consolidation
  2. Left sided pneumothorax
  3. Pleural effusion
  4. Right sided pneumothorax

 

Question 36

A term used to describe a condition in which a patient has difficulty breathing while in a supine position is which of the following?

  1. Orthopnea
  2. Hypoventilation
  3. Paroxysmal nocturnal dyspnea
  4. Kussmaul’s respirations

 

Question 37

A patient who is in bed is in respiratory distress, displaying use of accessory muscles and nasal flaring. What is the best explanation for the nasal flaring?

  1. Patient is attempting to decrease airway resistance by dilating nares
  2. Patient is attempting to increase airway resistance by dilating nares
  3. Patient is attempting to decrease lung compliance by dilating nares
  4. Patient is attempting to breathe more shallow by dilating nares

 

Question 38

While palpating the chest, the respiratory care practitioner determines that is decreased vibrations (decreased tactile fremitus) over the right lower lobe. This may be the result of which of the following?

  1. Pneumothroax
  2. Pleural effusion
  3. Pneumonia

 

Question 39

After two attempts at opening the airway and providing ventilation to an infant, you cannot confirm adequate air movement. At this point, what should you do?

  1. Perform a finger sweep in an attempt to restore ventilation
  2. Apply 6 to 10 abdominal thrust
  3. Apply back blows followed by chest thrust
  4. Try to ventilate infant with smaller breaths

 

Question 40

On performing a chest assessment, you hear high-pitched wheezes over both lower lobes. This could be caused by all of the following except:

  1. Laryngospasm
  2. Bronchitis
  3. Airway tumor
  4. Asthma

 

Question 41

A patient coughs up dark, yellow sputum after an IPPB treatment. Which one of the following statements is TRUE in regard to this sputum production?

  1. It can be termed purulent
  2. It is termed hemoptysis
  3. It is often found in patients who have pneumonia
  4. It is a normal color for pulmonary edema

 

Question 42

When asking a patient if she knows what hospital she is in and what day of the week it is, you are trying to assess the patient’s:

  1. Orientation to place and time
  2. Reaction to chronic illness
  3. Understanding of the English language
  4. Cooperation

 

Question 43

Crackles (rales) are generally heard when the patient has:

  1. Pneumothorax
  2. Atelectasis
  3. Pulmonary edema
  4. Pleural effusion

 

Question 44

The compression-breath ratio for one-rescuer CPR on an adult victim is which of the following?

  1. 5:1
  2. 15:2
  3. 5:2
  4. 30:2

 

Question 45

You measure the blood pressure of a patient as 88/53. Which of the following entries would you use to describe this finding?

  1. Patient is hypertensive
  2. Patient is hypotensive
  3. Patient has low pulse pressure
  4. Patient has high pulse pressure

 

Question 46

A patient complaining of chest pressure is sweating profusely. Which of the following should the RCP recommend

  1. Check patient’s BP
  2. Check patient’s pulse and respiratory rate
  3. Administer O2 at 2 lpm BNC

 

Question 47

You are called to ER to see Mr. Jones who is lethargic and cyanotic. He has a history of emphysema. He was complaining of SOB and was placed on 6 L/min via a nasal cannula. His ABGs after 20 minutes are as follows:
pH 7.32
PaCO2 74 torr
PaO2 80 torr
HCO3- 31 mEq/L
What is the cause of his symptoms?

  1. Patient has severe hypoxemia
  2. Decreased hypoxic drive
  3. No need for concern, emphysema patients always have this type of ABGs
  4. Patient has acute bronchospasm

 

Question 48

A patient on 2L/min nasal cannula has the following ABG results:pH 7.51
PaCO2 27 mmHg
PaO2 62 mmHg
HCO3- 23 mEq/LThese results indicate which of the following conditions?

  1. Uncompensated respiratory acidosis
  2. Chronic respiratory alkalosis
  3. Compensated metabolic alkalosis
  4. Acute respiratory alkalosis

 

Question 49

A patient arrives in the ER after being pulled from a burning house. The RCP places a pulse oximeter on the patient’s ear lobe and obtains a SpO2 reading of 93%. An ABG is drawn and the SaO2 analyzed by co-oximetry is 76%. Which of the following is the most likely reason for the discrepancy in the two saturation readings?

  1. The oximeter needs to be calibrated
  2. The co-oximeter electrode is out of calibration
  3. There is an elevated HbCO level
  4. The pulse oximeter probe is loose

 

Question 50

A physical exam reveals the following: decreased expansion, a dull percussion
note on the left lower lobe area, absence of breath sounds in the left lower
lobe and a shift of the trachea to the left. These findings suggest:

  1. Interstitial fibrosis
  2. Left sided atelectasis
  3. Left sided consolidation
  4. Left sided pleural effusion

 

Question 51

A patient with a pH of 7.15 is breathing abnormally. He has an increased respiratory rate and increased tidal volume for his size. This type of breathing pattern is called:

  1. Biot’s respiration
  2. Kussmaul’s respirations
  3. Cheyne-Stokes respirations
  4. Hyperventilation

 

Question 52

During a physical examination, it is determined that a patient has 2+ pitting edema in the extremities. What are possible explanations of this finding?

  1. Patient has pulmonary fibrosis
  2. Patient has CHF
  3. Patient has sepsis
  4. Patient has pneumonia

 

Question 53

Which of the following arteries is palpated to determine absence of a pulse in infants?

  1. Radial artery
  2. Femoral artery
  3. Carotid artery
  4. Brachial artery

 

Question 54

A patient enters the emergency department and on initial examination, the respiratory care practitioner observes paradoxical respirations. Which of the following should the practitioner suspect?

  1. Pulmonary edema
  2. Pneumonia
  3. Flail chest
  4. Pleural effusion

 

Question 55

A patient’s chart has a note on the front stating a “DNR status”. What does this indicate to care givers?

  1. That the patient does not want kidney dialysis
  2. That the patient wants to be an organ donor
  3. That the patient does not want to be resuscitated
  4. That the patient does not want a cardiac pacemaker

 

Question 56

A 3-year-old child enters the ER in mild respiratory distress. The mother of the child suspects that the child has aspirated a coin. What should the RCP recommend?

  1. Lateral x-ray of the chest be taken
  2. PA chest x-ray be taken
  3. A CT scan of the stomach be performed
  4. Lateral x-ray of the neck and upper airway be taken

 

Question 57

A RCP has just administered an IPPB treatment to a patient. The patient’s BBS reveal rhonchi and the therapist encourages the patient to cough by pushing on the abdominal area during the coughing effort. This patient most likely has which of the following diagnosis?

  1. COPD
  2. Neuromuscular defect
  3. Post-operative atelectasis
  4. Cystic fibrosis

 

Question 58

The most effective way to communicate with other members of the health care team about a patient’s condition is by:

  1. Discussing the information during patient rounds with the attending physician
  2. Telling the shift supervisor who will tell the other staff members
  3. Paper clipping a note on the front of the patient’s chart
  4. Recording the information in the patient’s chart

 

Question 59

A patient presents to the ER with the following clinical signs and symptoms: weak pulse, mentally confused, decreased urine output, and decreased blood pressure. Possible causes are:

  1. Patient is in severe pain
  2. Patient has possible blood loss
  3. Patient has taken vasoconstricting drugs
  4. Patient is in shock
Question 60

During a chest physical exam, it is noted that there is decreased tactile fremitus on the right side. This could be due to:

  1. Pneumonia on the right side
  2. Pneumothorax on the right side
  3. Atelectasis on the right side
  4. Severe emphysema

 

Question 61

During a bedside assessment of an adult patient, the respiratory care practitioner hears a harsh, monophonic, inspiratory sound over the larynx. A note should be put in the chart that this represents:

  1. Laryngeal edema
  2. Normal breath sounds
  3. Secretions in the airways
  4. Decreased breath sounds

 

Question 62

Heavy smokers commonly have HbCO levels as high as:

  1. 10%
  2. 20%
  3. 30%
  4. 40%

 

Question 63

Arterial blood gas results obtained from a patient are as follows:
pH 7.24
PaCO2 54 torr
PaO2 81 torr
HCO3- 25 mEq/L
B.E. -1
You would interpret these ABG results as:

  1. Compensated respiratory acidosis
  2. Uncompensated respiratory acidosis
  3. Compensated metabolic acidosis
  4. Uncompensated metabolic acidosis

 

Question 64

While palpating the chest of a patient, you notice that the trachea is shifted to the right, there is flatness to percussion on the right side and increased tactile fremitus. These findings are consistent with which of the following?

  1. Pneumothorax of the left lung
  2. Pulmonary fibrosis in the left lung
  3. Pulmonary effusion of the right lung
  4. Atelectasis of the right lung

 

Question 65

Bilateral, high-pitched polyphonic expiratory wheezes most likely indicate:

  1. Asthma
  2. Pneumonia
  3. Empyema
  4. Pulmonary edema

 

Question 66

A patient displays the following physical findings: prolonged expiratory times, an increased AP chest diameter, use of accessory muscles, depressed hemidiaphragms and diminished breath sounds. These findings suggest:

  1. Bronchial obstruction with atelectasis
  2. Diffuse interstitial fibrosis
  3. Chronic Obstruction Pulmonary Disease
  4. Acute upper airway obstruction

 

Question 67

It is determined that the P50 for a patient is 42 mmHg. Which of the following conditions could this patient be experiencing?

  1. High fever
  2. Exposure to carbon monoxide
  3. Acute acidosisI
  4. Decreased PCO2

 

Question 68

In inspecting an elderly female patient, you note that her spine has an abnormal anteroposterior (AP) curvature of the upper spine which results in a hunchback appearance. Which of the following terms would you use in charting this observation?

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

 

Question 69

A 50-year-old patient has a PaO2 of 72 torr when breathing room air. You would interpret this as:

  1. Normal for a person of this age
  2. Severe hypoxemia
  3. Moderate hypoxemia
  4. Mild hypoxemia

 

Question 70

A patient with pneumonia and fever of 103 degrees F is sitting up in bed. Her respiratory rate is regular and 35 times a minute. Accessory muscles of ventilation are being used. She is demonstrating which of the following?

  1. Kussmaul respirations
  2. Cheyne-Stokes respiration
  3. Tachypnea
  4. Eupnea

 

Question 71

Signs of pneumonia on the chest x-ray may include:

  1. Hyperlucency
  2. Consolidation of the affected area
  3. Flattened diaphragm

 

Question 72

A heart rate of 160 beats/minute could be considered normal for which of the following patient’s?

  1. A neonate at birth
  2. A neonate at 12 hours of age
  3. A 1-year-old child
  4. A 3 –year-old child

 

Question 73

A RCP enters a patient’s room to administer an IPPB treatment. The RCP finds the patient sleepy with slow responses and answers inappropriately to questions. This finding would be termed:

  1. Alert, but confused
  2. Lethargic
  3. Semicomatose
  4. Comatose

 

Question 74

A patient is admitted to the hospital with the diagnosis of a severe intestinal virus. An arterial blood gas sample drawn while the patient is breathing room air reveals the following results:
pH 7.54
PaCO2 38 torr
PaO2 83 torr
HCO3- 33 mEq/L
The patient’s arterial blood gas results indicate:

  1. Respiratory alkalosis
  2. Respiratory acidosis
  3. Metabolic acidosis
  4. Metabolic alkalosis

 

Question 75

A patient has a productive cough of clear to white sputum. What does this indicate about the patient’s secretions?

  1. The secretions contain cellular debris
  2. The patient is likely suffering from asthma
  3. White blood cells are present in the sputum
  4. The sputum is mucoid