1. The respiratory therapist is conducting an interview on a patient who has just entered the emergency department. The patient states that he has
... [Show More] difficulty breathing when he is lying down and sleeps with three pillows at night. This is indicative of which of the following breathing conditions?
A. tachypnea
B. orthopnea
C. euthopnea
D. dyspnea
2. A 24-year-old comatose woman enters the emergency department with the following arterial blood gases:
pH 7.21
PaCO2 23 torr
PaO2 65 torr
HCO3 8 mEq/L
Which of the following breathing patterns is this patient most likely exhibiting?
A. Cheyne-Stokes
B. Biot’s
C. Kussmaul’s
D. hypopnea
3. A patient is coughing up purulent secretions. This is an indication of which of the following?
A. pleural effusion
B. pneumothorax
C. bacterial pneumonia
D. hemoptisis
4. A hyperresonant lung sound is heard while the respiratory therapist is percussing over the patient’s lower left lung field. This is indicative of which of the following pulmonary conditions?
A. left lower lobe atelectasis
B. left-sided pneumothorax
C. pleural effusion
D. lobar pneumonia
5. While auscultating the chest of a patient in ICU you hear crackles in both lung bases. This is most likely the result of which of the following?
A. pulmonary edema
B. tracheal stenosis
C. bronchoconstriction
D. glottic edema
6. A ventilator patient suddenly becomes restless and agitated and the high pressure alarm begins sounding. The respiratory therapist auscultates diminished breath sounds in the left lung and palpates the trachea right of mid- line. Which of the following has most likely occurred?
A. right-sided pneumothorax
B. massive atelectasis of the left lung
C. ET tube slipped into right mainstem bronchus
D. left-sided tension pneumothorax
7. A patient states that she has been coughing up thick, green, foul-smelling secretions. The respiratory care practitioner would conclude this patient has
A. pulmonary edema.
B. a Pseudomonas infection.
C. hemoptysis.
D. bronchial asthma.
8. A patient who seems unconscious but will awaken when stimulated is said to be
A. lethargic.
B. comatose.
C. obtunded.
D. disoriented.
9. The respiratory therapist is evaluating a patient and observes a six second capillary refill time. This indicates the patient
A. has pulmonary edema.
B. has inadequate perfusion to the extremities.
C. has adequate pulmonary perfusion.
D. has an increased cardiac output.
10. While conducting a pulmonary evaluation on a patient, the respiratory therapist auscultates diminished breath sounds on the right side and palpates the trachea being shifted toward the right side. The therapist should suspect which of the following?
A. right-sided tension pneumothorax
B. massive atelectasis of the right lung
C. left-sided pneumothorax
D. pleural effusion of the left lung
11. Which of the following muscles are utilized during normal breathing?
I. scalenes
II. diaphragm
III. sternomastoid
IV. external intercostals
A. II only
B. I and III only
C. I and IV only
D. II and IV only
12. A 38-year-old woman presents in ER complaining of shortness of breath. A CBC reveals a hemoglobin level of 6 gm%. The respiratory therapist determines her SpO2 is 99%. Which of the following statements are true regarding this patient’s condition?
I. The patient is hypoxic.
II. The patient is most likely cyanotic.
III. Oxygen is not indicated at this time.
A. I only
B. III only
C. I and II only
D. I and III only
13. A patient in the cardiac care unit is hemodynamically unstable with fluctuating arterial blood pressures. Which of the following should the respiratory therapist recommend to best monitor this patient’s hemodynamic status?
A. pulse oximeter
B. radial artery catheter
C. radial artery puncture for ABGs
D. echocardiogram daily
14. The respiratory therapist is reviewing the chart of a patient in ICU who has a Swan-Ganz catheter in place. Which hemodynamic value would best determine the extent of the patient’s left heart failure?
A. central venous pressure (CVP)
B. pulmonary artery pressure (PAP)
C. pulmonary capillary wedge pressure (PCWP)
D. mean arterial pressure
15. To most effectively monitor the hemodynamic status of a patient with ARDS who is being mechanically ventilated, the respiratory therapist should recommend which of the following?
A. Swan-Ganz catheter
B. EKG monitor
C. peripheral arterial line
D. pulse oximeter
16. A 28-week-old neonate is suspected of having a pneumothorax. Which of the following should the respiratory therapist recommend to help diagnose if this condition is present?
I. transillumination of the chest
II. transcutaneous PO2 monitoring
III. chest x-ray
IV. arterial blood gases
A. I and III only
B. I, II and III only
C. II, III and IV only
D. I, III and IV only
17. While assessing a patient’s cardiac status, the respiratory therapist observes the following EKG tracing on the cardiac monitor.
This would be interpreted as
A. sinus bradycardia.
B. ventricular fibrillation.
C. sinus rhythm with occasional PVCs.
D. sinus tachycardia.
18. The respiratory therapist is assessing a patient with emphysema and observes pedal edema and jugular venous distention. The therapist should note in the patient’s chart these signs are most likely the result of
A. systemic hypertension.
B. hypercapnia
C. pulmonary infection
D. right ventricular hypertrophy
19. The respiratory therapist is administering PEP therapy to a patient with atelectasis. Which of the following would indicate the atelectasis is improving?
A. decreased late inspiratory crackles
B. decreased inspiratory wheezes
C. reduced inspiratory stridor
D. coarse crackles that clear with coughing
20. The following arterial blood gas results are recorded for a COPD patient who is breathing spontaneously. It is not noted what FIO2 the patient is on.
pH 7.23
PaCO2 82 torr
PaO2 76 torr
HCO3 36 mEq/L
BE +12
The respiratory therapist should conclude from this information which of the following?
A. The patient has acute respiratory acidemia and is breathing room air.
B. The patient is not a chronic CO2 retainer.
C. The patient is breathing supplemental oxygen.
D. The blood gas sample is most likely venous blood.
21. A patient with ARDS is receiving mechanical ventilation with PEEP. The respiratory therapist has just increased the PEEP level from 8 cm H2O to 12 cm H2O. Which of the following should the therapist assess to determine the patient’s response to this change?
I. blood pressure
II. Dynamic lung compliance
III. Heart rate
IV. Fluid intake and output
A. I and II only
B. I, II and III only
C. I, III and IV only
D. I, II, III and IV
22. The respiratory therapist palpates a “thready” and irregular pulse on a patient with a history of atrial fibrillation. To further assess the patient’s condition, the therapist should recommend which of the following?
A. chest radiograph
B. ECG
C. arterial blood gases
D. pulse oximetry
23. A patient is experiencing cardiac arrhythmias, muscle weakness and an arterial blood gas determines the patient is in metabolic alkalosis. Which of the following is the most appropriate laboratory value to assess at this time?
A. WBC
B. Hb and Hct
C. plasma protein
D. potassium
24. A 2-year-old patient presents in the emergency department coughing with acute shortness of breath. A chest x-ray reveals a radiopaque density at the level of the 5th thoracic vertebrae in the right lung field. The right lung is also hyperinflated. Based on this information, the respiratory therapist should suspect this x-ray is most likely the result of which of the following?
A. atelectasis of the right lower lobe
B. a foreign body lodged in the right mainstem bronchus
C. pneumothorax of the right lung
D. right lower lobe pneumonia
25. The respiratory therapist has just intubated a patient in respiratory failure. To initially assess the position of the endotracheal tube, the therapist should recommend which of the following?
A. measurement of PETCO2
B. arterial blood gas analysis
C. measurement of spontaneous tidal volume
D. measurement of SpO2
26. A severe COPD patient is admitted to the hospital with dyspnea. The patient is unresponsive with a blood pressure of 170/110 mm Hg and a respiratory rate of 38/min. The respiratory therapist should assess which of the following next?
A. Hb and Hct
B. PaCO2
C. SpO2
D. chest x-ray
27. The respiratory therapist is performing a chest examination on a mechanical ventilator patient and observes a dull percussion note over the right lower lobe with decreased expansion of the right lung. The therapist’s assessment may indicate the presence of
A. a right mainstem intubation.
B. a right-sided pneumothorax.
C. a left-sided tension pneumothorax.
D. atelectasis of the right lower lobe.
28. The respiratory therapist is assessing a patient who suffered smoke inhalation as the result of a house fire. The patient is on a nonrebreathing mask at 15 L/min and his ABG results are below.
pH 7.23
PaCO2 21 torr
PaO2 174 torr
HCO3 12 mEq/L
BE -13
SaO2 68%
From this data, which of the following is true regarding this patient’s condition?
I. The patient is hypoxic.
II. The FIO2 should be decreased.
III. The patient is hypoventilating.
IV. The blood gases reveal a partially compensated metabolic acidemia.
A. I and III only
B. I and IV only
C. II and III only
D. I, III and IV only
29. The respiratory therapist is assessing a patient prior to initiation of bronchodilator therapy followed by CPT. The patient states “ I don’t feel short of breath, but I seem to breathe fast and I raise my shoulders with each breath. I sleep well at night using only one pillow.” The therapist can conclude from this interview that the patient most likely has
A. orthopnea.
B. dyspnea.
C. increased work of breathing.
D. bradypnea.
30. The respiratory therapist percusses an area of hyperresonance on a patient on mechanical ventilation. This percussion note is most likely the result of which of the following?
A. pneumothorax
B. atelectasis
C. consolidation
D. pulmonary edema
31. The respiratory therapist is conducting a bedside assessment on a patient with Guillain-Barre syndrome. Which of the following bedside pulmonary function results indicates the need for ventilatory assistance?
A. maximum inspiratory pressure (MIP) of –28 cm H2O
B. decreased peak expiratory flow
C. vital capacity of 8 ml/kg of body weight
D. decreased FEV1
32. The respiratory therapist is assessing a patient in the cardiac ICU. Over the past 36 hours, the patient has been complaining of increasing dyspnea. A chest x-ray reveals diffuse infiltrates. The therapist notes inspiratory crackles while auscultating the chest and observes jugular venous distension. Based on this assessment, which of the following values would most likely be increased?
I. central venous pressure
II. pulmonary capillary wedge pressure
III. cardiac output
A. I only
B. III only
C. I and II only
D. I, II and III
33. A patient enters the emergency department following a motor vehicle accident. The respiratory therapist conducts a chest assessment and notes the trachea is shifted to the left of midline and breath sounds are absent on the right side. The patient’s respiratory rate is 38/min and has a SpO2 of 85%. The therapist should recommend which of the following at this time?
A. Obtain a chest radiograph.
B. Obtain stat ABGs.
C. Intubate and initiate mechanical ventilation.
D. Insert a chest tube on the right side. [Show Less]