LONG EXAM I

For patients with normal ventilation/perfusion relationship, the end-tidal PCO2 (PETCO2) is normally about: a. 2 torr lower than the measured PaCO2. b. 10 torr lower than the measured PaCO2. c. 2 torr higher than the measured PaCO2. d. 10 torr higher than the measured PaCO2.

2 torr lower than the measured PaCO2.

At full inspiration, the diaphragm should be observed at about the level of the ? a. 5th to 6th rib anteriorly b. 5th to 6th rib posteriorly c. 3rd to 5th rib anteriorly d. 3rd to 5th rib posteriorly

5th to 6th rib anteriorly

The transport of CO2 and O2 by hemoglobin is partially governed by; a. Haldane effect b. Bohr effect c. Carbamino mechanism d. Carbonate ion e. A and B

A and B

Tympany on percussion will be observed in patients with; a. Large pulmonary cavity b. Tension pneumothorax c. Pleural effusion d. Consolidation e. A and B

A and B

Which of the following is/are associated of neck x-ray? a. Croup b. Epiglottitis c. Bronchiolitis d. A and B only e. B and C only

A and B only

Which of the following pathologic conditions increases vocal fremitus? a. Atelectasis b. Pleural effusion c. Pneumothorax d. Pneumonia e. A and D only

A and D only

Premature atrial contraction is characterized by; a. An absent in P wave b. An increased heart rate c. A premature P wave d. Increased blood pressure e. All of the choices

A premature P wave

Which of the following is/are complication of arterial blood puncture? a. Infection b. Hematoma c. Continues bleeding d. Prolonged clotting time e. A, B and C

A, B and C

Which of the following is/are associated with pleuritic chest pain? a. Lung cancer b. Pneumonia c. Myocardial ischemia d. TB e. A, B and D

A, B and D

A normal chest x-ray is described as; a. The right hemidiaphragm is slightly higher than the left b. Both hemidiaphragms are rounded and dome-shaped c. Has bilateral radiolucency d. Trachea is midline and blunted costophrenic angle e. A, B, and C

A, B, and C

Which of the following statements regarding ventilation and perfusion in the lungsis/are true? a. In the upright position, the lung bases receive a greater proportion of ventilation than the apices b. Alveoli at the top of the lungs, relative to gravity, are larger than those at the lung bases c. Lung perfusion tends to be greater in the most dependent regions than in the least dependent d. A, B, and C e. Dead space ventilation usually causes hypoxia

A, B, and C

Wheezing is; a. Produced by bronchospasm b. Generally auscultated during inspiration c. A cardinal finding of bronchial Asthma d. Usually heard as high-pitched sounds e. A, C and D

A, C and D

A patient on a 2 L/min nasal cannula has the following ABG results: pH = 7.51 PaCo2 = 27 mmHg PaO2 = 62 mmHg HCO3 = 23 mEq/L. These results indicate which of the following conditions? a. Uncompensated respiratory acidosis b. Chronic respiratory alkalosis c. Compensated metabolic alkalosis d. Acute respiratory alkalosis e. None of the choices

Acute respiratory alkalosis

The following are white structures in chest radiograph, EXCEPT; a. Fluid b. Blood c. Air d. Bone e. None of the choices

Air

Which of the following is an abnormal finding in the chest x-ray? a. Costophrenic angle b. Air bronchogram c. Gastric bubble d. Cardiac shadow e. Parietal view

Air bronchogram

A leftward shift of the mediastinum is commonly seen on the chest radiograph in response to; a. Left upper lobe atelectasis b. Left upper lobe fibrosis c. Right upper lobe gas d. Right upper lobe tumor e. All of the choices

All of the choices

Blood-streaked sputum is associated with; a. Cystic fibrosis b. Bronchiectasis c. Lung cancer d. Pulmonary Embolism e. All of the choices

All of the choices

Which of the following is associated with digital clubbing? a. Chronic infection b. Local hypoxia c. Circulating vasodilators d. Arterial hypoxia e. All of the choices

All of the choices

Bronchial breath sounds are likely to be heard in which of the following pathologic conditions? a. Alveolar consolidation b. COPD c. Fluid accumulation in the tracheobronchial tree d. None of the choices e. All of the choices

Alveolar consolidation

Acute respiratory acidosis is due to which of the following? a. CO2 retention with an increase in ph b. Hyperpnea c. Alveolar hyperventilation d. Alveolar hypoventilation e. Hypoxic hypoxia

Alveolar hypoventilation

What is not true with regards to the Allen Test? a. Is a test regularly performed o test for collateral circulation b. Release the pressure on the ulnar artery on: y c. The hand should pink-up within 1-2 seconds after releasing ulnar artery d. An alternate site should be used if the hand does not flush in <10 seconds e. The hand should pink-up within 10 - 15 seconds

An alternate site should be used if the hand does not flush in <10 seconds

Type of chest x-ray that is most commonly done for patients who cannot get out of bed and is also known as supine film is ? a. Anteroposterior view b. Posteroanterrior view c. Lateral view d. Lateral decubitus e. Oblique view

Anteroposterior view

In which of the following pathologic conditions is transmission of the whispered voice of a patient through a stethoscope unusually clear? a. COPD b. Alveolar consolidation c. Atelectasis d. Pneumothorax e. B and C only

B and C only

COPD patient usually exhibits: ? a. Flail chest b. Funnel chest c. Pigeon Chest d. Barrel Chest e. None of the choices

Barrel Chest

Type of breathing pattern which shows consistent shallow respirations with periods of apnea; a. Kussmaul's respiration b. Cheyne Stoke's respiration c. Biot's respiration d. Tachypnea e. None of the above

Biot's respiration

What type of breath sounds would you expect to hear over an area of consolidation lungs? a. Normal breath sounds b. Bronchial breath sounds c. Rales d. Rhonchi e. None of the choices

Bronchial breath sounds

A dull or soft percussion note would likely be heard in which of the following pathologic conditions? a. COPD b. Pneumothorax c. Pleural thickening d. Atelectasis e. C and D only

C and D only

Air bronchograms are seen in the following, EXCEPT; a. Lung consolidation b. Pulmonary edema c. Neoplasm d. CHF e.None of the choices

CHF

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. a. Obtain blood from the right radial artery b. Obtain blood from the brachial artery c. Wait for the physician to evaluate collateral circulation d. Check collateral circulation in the left wrist

Check collateral circulation in the left wrist

pH = 7.38 PaCO2 = 60 mm Hg HCO3 = 30 mEq/L PaO2 = 42 mm Hg a. Chronic respiratory acidosis with severe hypoxemia b. Chronic respiratory acidosis with moderate hypoxemia c. Partially compensated respiratory acidosis with severe hypoxemia d. Partially compensated metabolic acidosis with moderate hypoxemia

Chronic respiratory acidosis with moderate hypoxemia

Which of the following is PaO2 electrode? a. Sanz electrode b. Severinghaus c. Clark electrode d. None of the choices

Clark electrode

The following are factors that affects the accuracy of ABG result, EXCEPT; a. Introduction of air bubbles b. Excessive amount of heparin c. Cold temperature d. All of the choices e. None of the choice

Cold temperature

What is the patient's level of consciousness that does not respond to painful stimuli? a. Stuporous and confused b. Semi-comatose c. Obtunded d. Lethargy e. Comatose

Comatose

pH = 7.21 PaCO2 = 55 mm Hg HCO3 = 18 mEq/L a. Uncompensated respiratory acidosis b. Uncompensated metabolic acidosis c. Combined respiratory and metabolic acidosis d. Combined respiratory and metabolic alkalosis

Combined respiratory and metabolic acidosis

ph = 35 PaCO2 = 30 mm Hg HCO3 = 20 mEq/L a. Compensated respiratory alkalosis b. Compensated metabolic alkalosis c. Compensated respiratory acidosis d. Compensated metabolic acidosis

Compensated metabolic acidosis

pH = 7.37 PaCo2 = 58 mm Hg HCO3 = 35 mEq/L a. Uncompensated respiratory acidosis b. Compensated respiratory acidosis c. Partially compensated respiratory acidosis d. Partially compensated metabolic acidosis

Compensated respiratory acidosis

In Chest radiography, to evaluate the pleural effusion, you should check for the ? a. Silhouette sign b. Costophrenic Angle c. Air Bronchogram d. Film exposure

Costophrenic Angle

Lateral neck x-ray shows a description of "steeple sign" or " picket fence" with this condition a. Croup b. Epiglottitis c. Bronchiolitis d. Bronchitis e. None of the choices

Croup

Which of the following physical findings best match a pleural effusion? a. Decreased tactile fremitus, bronchial breath sounds b. Increased tactile fremitus, bronchial breath sounds c. Increased tactile fremitus, absent breath sounds d. Decreased tactile fremitus, absent breath sounds e. None of the choices

Decreased tactile fremitus, absent breath sounds

Lateral neck x-ray shows a description of "thumb" with this condition; a. Croup b. Epiglottitis c. Bronchiolitis d. Bronchitis e. None of the above

Epiglottitis

Paradoxical chest movement is exhibited by patient with; a. Flail chest b. Funnel chest c. Pigeon chest d. Barrel Chest e. None of the choices

Flail chest

pH = 7.45 PaCO2 = 30 mm Hg HCO3 = 20 mEq/L a. Fully compensated respiratory alkalosis b. Fully compensated metabolic alkalosis c. Uncompensated respiratory alkalosis d. Uncompensated metabolic alkalosis

Fully compensated respiratory alkalosis

The electrodes used to measure different measured parameters are, EXCEPT; a. Sanz electrode b. Severinghaus electrode c. Clark electrode d. Glass electrode e. Sanz, Severinghouse and Clark electrodes

Glass electrode

Augmented lead that connected to left leg (+), right arm and left arm is ? a. Lead aVF b. Lead aVL c. Lead aVR d. Lead aVN e. None of the choices

Lead aVF

Augmented lead that connected to right arm (+), left arm and left leg is ? a. Lead aVF b. Lead aVL c. Lead aVR d. Lead aVN e. None of the choices

Lead aVR

Swelling of the feet and neck vein distention may indicate; a. Increased arterial pressure b. Decreased arterial pressure c. Increased venous pressure d. Decreased venous pressure e. None of the choices

Increased venous pressure

A patient coughs up yellow sputum after IPPB treatment. Which one of the following statements is true in regard to this sputum production? a. It is old and contains little water b. It is termed hemoptysis c. It contains WBCs d. It is a normal color for sputum

It contains WBCs

Color of the skin that indicates increased bilirubin in the blood, tissue and signifies liver disease; a. Pallor b. Jaundice c. Erythema d. Cyanosis e. None of the choices

Jaundice

Which of the following abnormal breathing is commonly associated with diabetic acidosis? a. Orthopnea b. Kussmaul's respiration c. Biot's respiration d. Hypoventilation e. Cheyne-Stokes respiration

Kussmaul's respiration

The x-ray technique most useful in diagnosing pleural effusion is ? a. Fluoroscopy b. Bronchoscopy c. Lordotic view d. Lateral decubitus e. Oblique view

Lateral decubitus

Limb lead that measures the electrical potential between the right arm (-) and the left arm (+) is ? a. Limb Lead III b. Limb Lead II c. Limb Lead I d. Limb Lead IV e. None of the choices

Limb Lead I

The following are causes of respiratory acidosis, EXCEPT; a. Overall hypoventilation b. COPD c. Severe pulmonary edema d. ARDS e. Neurologic hyperventilation syndrome

Neurologic hyperventilation syndrome

Mr. Samson, a patient suffered from severe smoke inhalation, has aHbCO reading of 15 vol% and an SaO2 reading of 83 vol%. Arterial blood gases done on room air show: pH = 7.49, PaO2 = 107 torr, PaCO2 = 30 torr. Based on the patient history and these measurements, the therapist should immediately initiate 100% oxygen via: a. Mechanical ventilator b. BiPAP mask. c. Non-rebreathing mask d. CPAP mask

Non-rebreathing mask

The following are common features observed on the chest radiograph of a CHF patient, EXCEPT; a. Cardiomegaly (cardiothoracic ratio > 50%) b. Cephalization of the pulmonary veins c. Appearance of Kerley B lines d. Alveolar edema often present in a classis perihilar bat wing pattern of density e. None of the choices

None of the choices

The following are common features seen on the chest radiograph in emphysema, EXCEPT; a. Hyperinflation with flattening of the diaphragms b. Increased retrosternal space c. Bullae d. All of the choices e. None of the choices

None of the choices

The following are effective techniques during patient interview, EXCEPT; a. Introduce yourself and establish a rapport with the patient b. Try to avoid leading questions, such as "Are you still short of breath?" c. Always show respect for the patient's attitudes and beliefs. d. Promote a relaxed atmosphere and avoid difficult medical terms. e. None of the choices

None of the choices

The following are main factors that determine the technical quality of the chest radiograph, EXCEPT; a. Inspiration b. Penetration c. Rotation d. None of the choices

None of the choices

The following are signs of respiratory distress in infants, EXCEPT; a. Nasal flaring b. Intercostals retractions c. Sub-costal recessions d. All of the above e. None of the choices

None of the choices

The term used to describe a condition in which a patient has difficulty breathing while in supine position is which of the following? a. Orthopnea b. Hypoventilation c. Paroxysmal nocturnal dyspnea d. Kussmaul's respirations

Orthopnea

For patients with anemia or dysfunctional hemoglobins, the overall oxygenation status should be assessed by the arterial: a. Oxygen tension (PaO2). b. Oxygen saturation (SaO2). c. Oxygen Content (CaO2) d. Oxyhemoglobin Dissociation Curve

Oxygen Content (CaO2)

Represents the time of movement from the atrium to the AV bundle? a. QRS waves b. P-R interval c. S-T segment d. None of the choices

P-R interval

Which of the clinical measurements below indicates an immediate need for mechanical ventilation? a. pH = 6.22 b. PCO2 = 76 torr c. PO2 = 60 torr d. CVP = 3 mm Hg

PCO2 = 76 torr

Which of the following blood gas measurements determines how well patient is being ventilated? a. pH b. PaCO2 c. PaO2 d. HCO3

PaCO2

Which of the following measurements is used to assess a patient's ventilatory status and to guide changes to the mechanical ventilator settings? a. Vital capacity b. PaCO2 c. PaO2 d. Tidal volume and respiratory rate

PaCO2

An assessment technique in which the examiner uses the surface of the hands and fingers to feel for abnormalities; a. Inspection b. Palpation c. Percussion d. Auscultation e. None of the choices

Palpation

pH = 7.30 PaCO2 = 30 mm Hg HCO3 = 18 mEq/L PaO2 = 70 mm Hg a. Partially compensated metabolic acidosis with moderate hypoxemia b. Partially compensated metabolic alkalosis with moderate hypoxemia c. Partially compensated metabolic acidosis with mild hypoxemia d. Partially compensated metabolic alkalosis with mild hypoxemia

Partially compensated metabolic acidosis with mild hypoxemia

Interpret the following ABG results: pH = 7.27 PaCO2 = 58 mm Hg HCO3 = 31mEq/L a. Partially compensated respiratory acidosis b. Uncompensated respiratory acidosis c. Compensated respiratory alkalosis d. Uncompensated metabolic alkalosis

Partially compensated respiratory acidosis

Hyper-resonance can be observed with the following conditions, EXECEPT; a. Acute asthma b. Pneumothorax c. Emphysema d. Pleural effusion e. None of the choices

Pleural effusion

A coarse grating or crunching sound caused by inflamed pleural membranes during breathing is ? a. Stridor b. Pleural friction rub c. Rhonchi d. Rales e. Wheezes

Pleural friction rub

In Chest radiography, the condition that appears as air without lung markings and typically found peripheral to the white line of the visceral pleura ? a. Pneumothorax b. Pleural Effusion c. Pulmonary Edema d. None of the choices

Pneumothorax

In regard to transcutaneous oxygen and carbon dioxide (PtcO2 and PtcCO2) monitoring, all of the following are correct with the exception of: a. PtcO2 and PtcCO2 are useful mainly for adults. b. PtcO2 and PtcCO2 use an external heat source to warm the skin. c. PtcO2 and PtcCO2 require calibration on start up. d. PtcO2 and PtcCO2 require site changes to prevent skin burn.

PtcO2 and PtcCO2 are useful mainly for adults.

A patient enters the emergency room and on initial examination the respiratory therapist observes paradoxical respirations. Which of the following should the therapist suspect? a. Pulmonary edema b. Pneumonia c. Flail chest d. Pleural effusion

Pulmonary edema

Which of the following blood gas measurements determines the level of tissue oxygenation? a. pH b. PaCO2 c. PaO2 d. PvO2

PvO2

Which wave is small downward deflection and that signifies septal depolarization? a. S wave b. Q wave c. R wave d. None of the choices

Q wave

It represents the whole depolarization of the entire ventricle. a. QRS waves b. P-R interval c. S-T segment d. None of the choices

QRS waves

Which wave is the high upward deflection and that signifies left ventricle depolarization? a. P wave b. Q wave c. R wave d. None of the choices

R wave

In reviewing a patient's medical record, the therapist notices that an Allen's Test has been done. The test is done before obtaining an arterial blood sample from the: a. Brachial artery b. Radial artery c. nternal jugular vein d. Femoral artery

Radial artery

The safest and most preferred arterial puncture site for blood gas analysis: a. Radial artery b. Ulnar artery c. Brachial artery d. Femoral artery e. Carotid artery

Radial artery

As blood moves from the lungs to the tissues, the oxyhemoglobin dissociation curve shifts: a. Right b Left c. Up d. Down

Right

Which of the following is pH electrode? a. Sanz electrode b. Severinghaus c. Clark electrode d. None of the choices

Sanz electrode

The conduction system of the heart which functions as the heart's pacemaker is ? a. Sinoatrial node b. Bundle of His c. Atrioventricular node d. None of the choices

Sinoatrial node

A loud high-pitched crowing sounds associated with croup is ? a. Stridor b. Pleural friction rub c. Rhonchi d. Rales e. Wheezes

Stridor

pH = 7.50 PaCO2 = 45 mm Hg HCO3 = 30 mEq/L a. Uncompensated respiratory alkalosis b. Uncompensated respiratory acidosis c. Uncompensated metabolic alkalosis d. Uncompensated metabolic acidosis

Uncompensated metabolic alkalosis

pH = 7.30 PaCO2 = 60 mm Hg HCO3 = 24 mEq/L PaO2 = 49 mm Hg a. Uncompensated respiratory acidosis with moderate hypoxemia b. Uncompensated metabolic acidosis with moderate hypoxemia c. Uncompensated respiratory acidosis with severe hypoxemia d. Uncompensated metabolic acidosis with severe hypoxemia

Uncompensated respiratory acidosis with moderate hypoxemia

pH = 7.30 PaCO2 = 55 mm Hg HCO3 = 20 mEq/L PaO2 = 81 mm Hg a. Combined respiratory and metabolic acidosis with normal oxygenation b. Combined respiratory and metabolic acidosis with mild hypoxemia c. Uncompensated respiratory acidosis with normal oxygenation d. Uncompensated metabolic acidosis with mild hypoxemia

Uncompensated respiratory acidosis with normal oxygenation

pH = 7.50 PaCO2 = 30 mm Hg HCO3 = 24 mEq/L a. Uncompensated respiratory alkalosis b. Uncompensated respiratory acidosis c. Compensated respiratory alkalosis d. Compensated metabolic alkalosis

Uncompensated respiratory alkalosis

A shift towards the trachea or affected sides on palpation indicates; a. Unilateral upper lobe collapse b. Lung tumor c. Pleural effusion d. Pneumothorax

Unilateral upper lobe collapse

The ECG leads that positioned at the 4th intercostal space at the left border of the sternum ? a. V2 b. V3 c. V4 d. V5 e. None of the choices

V2

The ECG leads that positioned at the midclavicular line and at the 5th intercostal space is ? a. V3 b. V5 c. V4 d. V6 e. None of the choices

V4

The ECG leads that positioned at the mid-axillary line of the chest is ? a. V1 b. V5 c. V4 d. V6 e. None of the choices

V6

After analyzing a blood gases sample, the PO2 and PCO2 readings are 38 torr and 46 torr, respectively. The patient's SpO2 at the time of bloodcollection has been 95% on room air. What is the interpretation of these findings? a. Normal. b. Severe hypoxemia. c. Air bubble in sample. d. Venous sample

Venous sample

The vibration caused by phonation and transmitted through the chest is called ? a. Tactile fremitus b. Vocal fremitus c. Rhonchi d. Rales e. None of the choices

Vocal fremitus

Mr. Jones, a patient with COPD, is being treated in the medical ICU for chronic ventilatory failure. Which of the following ABG values shows that the patient has a partially compensated acid-base condition? a. pH = 7.42, PaCO2 = 32 torr b. pH = 7.37, PaCO2 = 49 torr c. pH = 7.33, PaCO2 = 56 torr d. pH = 7.41, PaCO2 = 60 torr

pH = 7.33, PaCO2 = 56 torr

Which of the following blood gas reports shows metabolic alkalosis? a. pH = 7.56, PaCO2 = 30 torr b. pH = 7.18, PaCO2= 60 torr c. pH = 7.48, PaCO2 = 40 torr d. pH = 7.51, PaCO2 = 30 torr

pH = 7.48, PaCO2 = 40 torr