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1.  To continuously monitor the adequacy of ventilation of a patient in ICU being supported by mask BiPAP, you would recommend which of the following?

 

A. transcutaneous PCO2
B. pulse oximetry
C. ABG analysis
D. vital capacity

 

2.  You obtain an expired carbon monoxide (CO) reading of 18 ppm on a COPD patient participating in a pulmonary rehabilitation program. Based on this finding, you can conclude that the patient:

 

A. can be classified as a nonsmoker
B. has abstained for more than 12 hours
C. has been exposed to secondhand smoke
D. has smoked within the prior 12-24 hours

 

3.  Which of the following would you recommend to provide graphic data useful in evaluating the ventilator-patient interface?

 

A. capnography
B. pulse oximetry
C. hemoximetry
D. electrocardiography

 

4.  While reviewing the flow sheet of a patient receiving artificial ventilatory support, you note a progressive rise in heart rate over the last two hours. Which of the following actions would you recommend to help identify the cause of this problem?

 

A. measure the patient’s inspiratory force
B. obtain a sputum sample for culture
C. draw and analyze an arterial blood gas
D. check the patient’s intake and output record

 

5.  Which of the following is a complication of pulmonary artery catheter angiography?

 

A. hypoxemia
B. myocardial infarction
C. cerebral artery occlusion
D. cardiac arrhythmias

 

6.  Which of the following tests would you recommend in order to identify the cause of dyspnea and factors limiting a patient’s exercise tolerance?

 

A. 6-minute walking distance
B. overnight oximetry assessment
C. peak expiratory flow rate
D. comprehensive exercise test

 

7.  Based on an overnight oximetry test, a patient suspected of having sleep-disordered breathing exhibits an oxygen desaturation index (ODI) of 48/hr. Which of the following would you recommend?

 

A. CPAP titration at home or in the sleep lab
B. full nocturnal diagnostic polysomnography
C. surgical correction of the airway obstruction
D. no action needed; test results are normal

 

8.  Which of the following imaging procedures is used to evaluate the arteries for abnormalities such as aneurysm, atherosclerosis, embolism, occlusion, stenosis, thrombosis, trauma, or vasculitis?

 

A. angiography
B. PET scanning
C. standard radiography
D. V/Q scanning

 

9.  Which of the following would you recommend to help guide a physician in locating the appropriate needle insertion site for thoracentesis performed at the bedside?

 

A. ultrasound
B. CT scan
C. thoracic MRI
D. bronchoscopy

 

10.  At highest risk for progression to active tuberculosis if infected and thus highest priority for PPD testing would be a person

 

A. with HIV infection
B. who is an IV drug user
C. living in a nursing home
D. less the 5 years old

 

11.  In reviewing a patient’s chart you note a history of COPD and a Body Mass Index of 15. Which of the following tests would you recommend?

 

A. polysomnography
B. exercise stress test
C. metabolic study
D. bronchoscopy

 

12.  For which of the following situations would you recommend transcutaneous monitoring of PO2 or PCO2?

 

A. assessing oxygenation status in suspected CO poisoning
B. titrating FIO2 levels in patients receiving oxygen therapy
C. spot checking blood oxygen levels in postoperative patients
D. monitoring ventilation during noninvasive support (NPPV)

 

13.  CO-oximetry analysis should be performed whenever the following information is needed:

 

A. total CO2 content
B. acid-base status
C. HCO3 concentration
D. abnormal Hb levels

 

14.  A premature infant receiving positive pressure ventilation exhibits acute respiratory distress, asymmetrical chest motion and hypotension. Which of the following procedures would you initially recommend?

 

A. chest transillumination
B. arterial blood gas
C. A-P chest radiograph
D. capillary heal stick
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15.  A doctor orders a blind bronchoalveolar lavage (“mini BAL”) procedure for a patient in ICU. What potential diagnosis is the doctor trying to confirm?

 

A. ventilator-associated pneumonia
B. bronchial hyperresponsiveness
C. acute pulmonary embolism
D. idiopathic pulmonary fibrosis

 

16.  Based on smoking history and physical exam, a patient is suspected of having bronchogenic carcinoma. Which of the following tests would you recommend to confirm or rule-out this diagnosis?

 

A. a normal chest radiograph
B. tissue biopsy via fiberoptic bronchoscopy
C. cytologic examination of the sputum
D. computerized axial tomography

 

17.  A doctor wants your recommendation on how to monitor the cardiopulmonary status of a patient undergoing a bronchoscopy procedure during moderate sedation. You should recommend the following:

 

A. pulmonary function testing
B. noninvasive pulse oximetry
C. frequent ABGs via radial puncture
D. transcutaneous PaO2 monitoring

 

18.  For which of the following situations would you recommend transcutaneous monitoring of PO2 or PCO2?

 

A. assessing tissue perfusion status in wound care management
B. titrating FIO2 levels in patients receiving oxygen therapy
C. spot checking blood oxygen levels on postoperative patients
D. assessing oxygenation status in suspected CO poisoning

 

19.  The best bedside measure for assessing the integrated function of the respiratory muscles and mechanical properties of the lungs and thorax is the:

 

A. minute ventilation
B. vital capacity
C. maximum inspiratory force
D. functional residual capacity


20.  Which of the following tests should you recommend for a patient with suspected hepatitis and history of alcohol and drug abuse?

 

A. cardiac enzymes
B. complete blood count
C. liver enzymes
D. partial prothrombin time

 

21.  A patient in ICU suddenly deteriorates. The attending doctor wants to rule out acute pulmonary embolism as the cause. Which of the following laboratory tests would be most helpful to this end?

 

A. d-dimer
B. PaCO2
C. hematocrit
D. troponin I

 

22.  A patient is admitted with signs and symptoms and a history consistent with bronchiectasis. Which of the following tests would you recommend to confirm or rule out this diagnosis?

 

A. fiberoptic bronchoscopy
B. high-resolution CT scanning
C. pulmonary function testing
D. standard chest X-ray

 

23.  In patients with suspected pulmonary thromboembolism whose ordinary X-rays are negative, which of the following procedures can best help establish the diagnosis?

 

A. cardiac enzyme determinations
B. arterial blood gas analysis
C. cardiovascular stress testing
D. ventilation/perfusion scans

 

24.  Your patient in ICU is suspected of having developed a bacterial ventilator-associated pneumonia. Which of the following procedures would you recommend as best able to diagnose the cause of this problem?

 

A. sputum culture and sensitivity
B. chest X-ray
C. bronchoalveolar lavage
D. CT scan

 

25.  You normally should recommend AGAINST performing a diagnostic bronchoscopy procedure on a patient with

 

A. active hemoptysis
B. severe hypoxemia
C. X-ray signs of atelectasis
D. unexplained wheezing

 

26.  Analysis of exhaled nitric oxide (FeNO) would be most helpful for:

 

A. treating pulmonary hypertension
B. assessing presence of air trapping
C. titrating asthma drugs and dosages
D. treating refractory hypoxemia

 

27.  Inspection of a trauma patient’s chest wall and thorax reveals no obvious abnormalities.  Which of the following should you INITIALLY recommend to determine the extent of the trauma?

 

A. ventilation/perfusion scan
B. thoracic ultrasound
C. fiberoptic bronchoscopy
D. pulmonary angiography

 

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