1. The first step in evaluating patients for participation in a pulmonary rehabilitation program is:
A. a complete blood gas analysis
B. a complete patient history
C. a cardiopulmonary stress test
D. a pulmonary function test
2. A home care patient with obstructive sleep apnea being treated with nasal CPAP
A. recommend switching to a full face mask
B. suggest switching to a high flow nasal cannula
C. recommend decreasing the CPAP pressure
3. Which of the following environmental factors would be most important in considering discharge of a patient to the home care setting?
A. water pressure
B. gas or electric stove
C. year home was built
D. heating/ventilation system
4. Which of the following would normally exclude a patient who requires continuous invasive mechanical ventilation from being discharged to home?
A. need for tracheobronchial suctioning
B. use of volume control ventilation
C. need for high FIO2s and/or high PEEP
D. use of a
5. Which one of the following is a major component common to most pulmonary rehabilitation programs?
A. disease management education
B. support for avocational pursuits/hobbies
C. financial subsidies to pay for medications
D. provision of in-home caregiver support
6. A home care patient with kyphoscoliosis requires IPPB treatments twice per day with oxygen. A local charitable organization has given the family a pneumatically-powered IPPB device for this purpose. Which of the following gas sources would you recommend to drive this device?
B. oxygen concentrator
D. liquid oxygen reservoir
7. A doctor about to follow-up on a patient with moderate COPD after a year in a disease management program asks you advice on what and what not to consider in her evaluation. Which of the following would you recommend NOT evaluating for this patient?
A. adequacy of symptom control
B. need for long-term O2 therapy
C. smoking status
D. effects of drug treatments
8. Which of the following would you consider recommending for a home care patient receiving nasal BiPAP who complains of severe nasal dryness?
A. room nebulizer
B. in-line mesh nebulizer
C. heat and moisture exchanger
D. in-line water humidifier
9. Which of the following measures could be used to evaluate the effectiveness of participation in a pulmonary rehabilitation program?
A. changes in pulmonary diffusing capacity (DLco)
B. changes in activities of daily living (ADLs)
C. changes in arterial blood gas results
D. changes in complete blood count (CBC) values
10. Which of the following should you tell a home care patient to do if her portable O2 concentrator ‘Low Battery’ indicator activates while on a road trip?
A. contact the home care provider
B. remove and charge the battery
C. switch to 12 volt DC power
D. switch to a backup O2 supply
11. When counseling a patient with sleep apnea on ways to improve sleep, you would recommend which one of the following?
A. taking afternoon naps when drowsy
B. avoiding heavy exercise before sleep
C. keeping the bedroom temperature warm
D. regularly taking over-the-counter sleeping pills
12. A physician’s order for a neuromuscular patient being discharged to the home care setting specifies ‘IPPB q4h while awake.’ The patient has no other respiratory care equipment needs. Which of the following devices would you consider most appropriate for this patient?
A. Bird Mark 7
B. Bennett AP-5
C. Bird Mark 8
D. Bennett PR-1
13. The success of a disease management program depends primarily on which of the following?
A. building and maintaining patients’ self-management skills
B. using the newest/most advanced therapy options available
C. referring patients only to board-certified experts in the field
D. keeping track of patient progress via information technology
14. In addition to a ventilator and breathing circuits, which of the following equipment/supplies would be required for a home care patient receiving long-term invasive mechanical ventilation?
A. portable defibrillator
B. intubation tray
D. back-up ventilator
15. To verify proper use of overnight oximetry equipment in a patient’s home, you would:
A. provide simple step-by-step written instructions
B. demonstrate proper set-up and operation of the unit
C. have a home health aide observe the patient overnight
D. require a return demonstration on using the equipment
16. In addition to counseling, which of the following prescription medications may be effective as smoking cessation aid?
A. beclomethasone (Vanceril)
B. formoterol (Foradil)
D. midazolam (Versed)
17. Routine in-home monthly maintenance of an oxygen concentrator should include which of the following?
18. Supportive strategies that can help reinforce smoking cessation counseling and help patients quit include which of the following?
A. creating negative reinforcements for slip-ups/relapses
B. recommending that the patient ‘tough it out’ on their own
C. having the patient stop all habits associated with the desire to smoke
D. helping the patient establish a smoke-free home environment
19. For which of the following sleep apnea treatments is objective compliance data usually available?
B. oral appliances
C. positional therapy
D. aerobic exercise
20. Which of the following is the key to setting and achieving healthy goals in a disease management program?
A. using shared
B. having patients develop action plans
C. tailoring information to patients
D. engaging the entire healthcare team
21. Which of the following is a major component of
A. a high pressure gas source
B. spring-loaded exhalation valve
C. form-fitting nasal mask
D. double-limb breathing circuit
22. Equipment function that lay caregivers of patients receiving home mechanical ventilation should assess regularly include:
23. For patients diagnosed with sleep apnea, education should include discussion of the consequences of untreated disease, to include:
A. low blood pressure
24. To verify that a patient or her family can properly set-up and operate a pulse oximeter for overnight trend recording, you would:
A. provide simple step-by-step written instructions for the patient and patient’s family
B. demonstrate proper set-up and operation of the sensor and oximeter on the patient
C. require a return demonstration to verify proper use of the equipment
D. provide a phone number where the patient can immediately get needed help
25. The correct ORDER of steps to recommend to home caregivers responsible for cleaning nondisposable respiratory care equipment is:
A. disassemble, scrub, rinse/drain, soak in soapy water
B. soak in soapy water, disassemble, scrub, rinse/drain
C. disassemble, rinse/drain, soak in soapy water, scrub
D. disassemble, soak in soapy water, scrub, rinse/drain
26. A home care patient requires a higher FIO2 and as a result, the physician has ordered a change from an O2 concentrator to O2 cylinders. The patient should be told the following to ensure a safe environment:
A. clean the O2 outlet every day by wiping it off with alcohol
B. secure the cylinder to a stand or chain it to the wall
C. lay the cylinder on its side so that is cannot be tipped over
D. ‘wye’ the cylinder and concentrator together to get the needed FIO2
27. Which of the following would you consider to be mandatory components of a disease management for patients with COPD? :
28. Which of the following blood gas abnormalities should you be on guard for when conducting physical reconditioning for a patient with chronic lung disease?
29. Which of the following is a key consideration in planning or providing patient/caregiver education?
A. use only a single teaching method
B. tailor teaching methods to the learners
C. let caregivers determine the objectives
D. limit the time available for questions
30. Which of the following oxygen systems is most suitable for a home care patient with restricted activity?
A. concentrator with cylinder back-up
B. liquid system with conserving device
C. hyperbaric oxygen deliver system
D. large gaseous cylinders