Respiratory Therapy 3 Flashcards

Health Care
Terms Definitions
Refractory Hypoxemia is:

a. Hypercapnia non-respondent to oxygen
b. Hyperoxemia non-respondent to oxygen
c. Hypoxemia non-respondent to oxygen
d. Hypoxemia respondent to oxygen
The intra-aortic balloon pump accomplishes its intended purpose by which of the following methods?
A. Synchronized pumping of arterial blood 
B. Inflating on the P-wave
C. Inflating on the T-wave
D. Deflating precisely at diastole
Which resuscitative measure is indicated at delivery for a vigorous neonate with light, thin meconium in the amniotic fluid?

a. intubation and controlled mechanical ventilation
b. aggressive pharyngeal suctioning
c. bag-mask ventilation with oxygen
"Combined" lung disease is characterized by:

a. Decreased flows and decreased volumes
b. Increased flows and decreased volumes
c. Decreased flows and normal volumes
d. Normal flows and decreased volumes
The term "status asthmaticus" describes:

a. Asthma during childhood
b. A resolved asthmatic condition
c. Asthma when bronchospasm no longer responds to bronchodilators d. An emotional asthmatic trigger
Which pulmonary function variable would increase in a person with emphysema?
a. FEV 1
b. RV
c. FEF 200-1200
d. FEF 25-75
When using a disposable drainage system continuous bubbling should be seen in the
A drainage compartment 
B water seal compartment 
C suction control compartment
D drainage and water seal compartments
Timing of the intra-aortic balloon pump is critical; simply turning on the pump without first synchronizing balloon inflation and deflation with cardiac efforts, would be disastrous for the patient. By which of the following methods is it possible to init
Closing volume is measured using

a. the single breath nitrogen test
b. body plethysmography
c. the helium dilution method
d. the nitrogen washout test
The pulmonologist determines a patient has dyspnea, diminished breath sounds with a dull percussion note on the left. The chest radiograph indicates a tracheal shift to the right. Which of the following disease states should the therapist suspect is affec
Common effects of hypoxemia include all of the following except:
a. tachycardia
b. pulmonary vasoconsstriction
c. hyperventilation
d. decreased cardiac output
Following the removal of an endotracheal tube, cool high humidity therapy would be given to prevent the following:
I. Laryngeal edema and inflammation
II. Bronchospasm    III. Hypoxia       IV. Infection
a. I only
b. I, II only
c. I, II, II
The most common symptom of thromboembolism is:

a. Hemoptysis
b. Cough
c. Leg pain
d. Dyspnea
Shunting can be defined as:

a          perfusion in excess of ventilation
b.         perfusion without ventilation
c.         ventilation without perfusion
d.         lack of respiration
e.         a and b a
E (?)
The respiratory care practitioner is using a 12 Fr suction catheter to suction a female patient who is intubated with a 7.0 mm ET tube. The practitioner is having difficulty the thick secretions. Which of the following should be done to help improve secre
Oxygen therapy offers little benefit to which of the following?
I. histotoxic hypoxia
II. deadspace disorders
III. right to left shunts
IV. circulatory or (stagnant) hypoxia
a.         I and II
b.         III only
Sputum culture and sensitivity would be most helpful for evaluating which of the following clinical conditions?
a. pneumonitis
b. pleural effusion
c. pneumothorax
d. pulmonary edema
Rib spreading, an increase in radiolucency, and lowering of the diaphragm seen on a chest x-ray would indicate:
a. A tension pneumothorax
c. A pneumonectomy
d. Chest trauma
e. Congestive heart failure
A COPD patient breathing spontaneously on an F 102 of 0.6 becomes drowsy and unresponsive. The patient's reaction is most likely the result of:
a. insufficient oxygenation
b. decreased venous return
c. increased Paco2
d. excessive ventilation
When the patient develops atelectasis what happens to V/Q?
a. Increased
b. Decreased
c. Not affected
For the most accurate determination of Pv02, blood should be aspirated from the:
A. right atrium 
B. right ventricle 
C. internal jugular vein 
D. pulmonary artery
When first selecting timing points for a patient of IABP, which of the following is the proper sequence:
A. Initiate based on ECG, deflate between P and QRS, inflate on T
B. Initiate based on ECG, inflate between P and QRS, deflate on T
C. Initiate b
Which of the following clinical signs are included in the Apgar score for clinically evaluating a neonate?
I. heart rate
II. ventilatory rate III. color
IV. reflex irritability V. muscle tone

A. I, II, III, IV, V          B. I, II, III
Which of the following changes occurs in hypovolemic shock?
I. Increased heart rate           
II. Decreased right atrial pressure
III. Increased mean pulmonary artery pressure 
IV. Increased mean femoral artery pressure 
V. Decreas
Which of the following is a restrictive disease?
a. epiglottis
b. kyphoscoliosis
c. cystic fibrosis
d. croup
A mixed venous sample, used to determine C(a-v)02, is obtained from which of the following?
I. Central Line
II. Arterial catheter
III. Pulmonary artery catheter
IV. Central Venous Catheter
a. I, II only              b. III only
c. III,
If the practitioner is asked to estimate an new born infants gestational age - the scoring system that should be used is the

b. Ballard
c. Glasgow
d. Apache II
Digital clubbing is the result of:
a. chronic hypercapnia
b. chronic hypoxemia
c. acute hypercapnia
d. acute hypoxemia
Which of the following would best determine the diagnosis of asthma versus emphysema?
a. pre and post bronchodilator study
b. oxygen saturation monitoring
c. sputum culture
d. complete blood count
Which of the following conditions is likely to cause an abnormal elevation of the right hemidiaphragm?
I. pulmonary emphysema
II. right phrenic nerve damage
III. fibrosis or scarring of the right lung
IV. left-sided pneumothorax

a. I, II only  
Which of the following modalities are initially indicated for a patient having an acute asthma attack?
I. Oxygen
II. Bronchodilators
III. Mechanical ventilation
IV. Hydration
a. I and II only     b. I and III only     c. I, II and III only
Which of the following cannot be determined with direct methods?
I. total lung capacity TLC
II. inspiratory capacity IC
III. vital capacity VC
IV. functional residual capacity FRC

a. I        b. IV        c. II and IV      d.
The average urine output for the normal individual is between:

a. 0.5 to 1.0 ml/kg/hr
b. 10 to 20 ml/kg/hr
c. 40 to 50 ml/kg/hr
d. 50 to 80 ml/kg/hr
Placing a suction catheter into your patient's trachea and applying vacuum causes:
I. transient hypoxemia
Il. removal of secretions
III. stopping of the hypoxic drive because of vagal stimulation
IV. removal of air from the lungs
a. I, IV    

Which method of determining the FRC of a pulmonary emphysema patient will render the largest FRC value?

a. closed-circuit helium dilution
b. open-circuit nitrogen washout
c. body plethysmography
d. single-breath nitrogen washout

Which of the following is a characteristic of emphysema?
a.         loss of elastic tissue
b.         gradual destruction of large airways
c.         decrease in lung size
d.         decrease in airway resistance
The most commonly used gas used to inflate the balloon on the Intra-aortic catheter is:
A. Helium
B. Carbon dioxide 
C. Nitrogen
D. Oxygen
There are many types of shock. Which of the following can lead to shock?
I. An anaphylactic reaction
II. Blood loss following an accident
III. Tachycardia
IV. A systemic septic reaction

A. I only    B. I and III    C. I, II and IV    
Which of the following is the most common cause of iatrogenic congestive heart failure?

A. Fluid overload
B. Decreased ventricular contractility
C. Mitral stenosis
D. Pericardial effusion
The FEF25-75 may detect changes in the lung function that are not apparent from the FEF200-1200­.
A physician writes an order for the RRT to perform pulse oximetry on a patient receiving supplemental oxygen. Which of the following conditions or situations might produce erroneous data?

a. The patient is hypercapneic.
b. The patient is hypotensive.
A patient enters the ED complaining of shortness of breath and mild nausea. The ED doctor orders an arterial puncture for analysis. Results show:
PO2 40 torr        PCO2 65 torr        ­PH 7.18
Which clinical condition matches this data?
Which of the following test of airflow volumes tends to be the most responsive to bronchodilator therapy?

a. Forced expiratory flow, 25%-75% (FEF25-75)
b. Peak expiratory flow (PEF)
c. Maximum voluntary ventilation (MVV)
d. Forced expiratory flow,
Your patient had her spleen removed 2 days ago and is awake and cooperative but is still reluctant to take a deep breath. The physician asks for your recommendation to prevent the development of atelectasis. You would suggest which of the following?
A patient can be awakened only with extreme difficulty. When awakened the patient responds correctly. This condition would be defined as
a. lethargic
b. delirious 
c. obtunded
d. confused
What does phase IV of the following nitrogen elimination study demonstrate?

a. FRC
b. Tidal volume
c. Anatomical deadspace
d. Mixing of inspired gases
e. Closing volume
Which of the following situations can produce erroneous results for the FEF 25-75% obtained from a FVC (forced vital capacity) maneuver?

a. maximum forced expiratory effort to residual volume
b. termination of the FVC between the FRC and the residual
A (?)
Before drawing a blood gas sample from the radial artery, you should perform which test of adequate perfusion?

a. Allen's test
b. Modified Allen's test
c. Measure a blood pressure
d. P(A - a)O2
As inspired air reaches the carina, it should be 100% saturated at body temperature, which represents how many milligrams of water per liter of air?
a. 32
b. 44
c. 47
d. 54
An air bubble in an arterial blood sample will never:
a.         Increase the P02
b.         Decrease the P02
c.         Increase the PC02
d.         Decrease the PC02
The IABP can be set to augment every heart beat or every third heart beat or every sixth heart beat. When timing the pump the ratio of assisted beats to unassisted beats is:
A. 1:1 B 1:2 C. 1:4 D. 1:6 E. 1:8
In order to evaluate the severity of a Myasthenia Gravis crisis the practitioner should measure

1. VD/VT      2. MIP      3. QS/QT      4. FVC      5. MW

a. 2,4, and 5      b. 1 and 2         c. 3 only       
Stridor may be treated by all of the following methods except?

a. steroids
b. warm mist
c. oxygen
d. nebulized racemic epinephrine
Which of the following could not be a causative factor bringing on an increased incidence of an intrinsic asthma attack?

a. Infection
b. Pollen
c. Emotional upset
d. Exercise
The normal MVV in a healthy man age 20 is:
a. 601/min
b. 100
c. 170
d. 240
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