In terms of other volumes and capacities, the vital capacity (VC) can be defined as:

a. TLC - ERV

b. VT + IRV + ERV

c. ERV + RV

d. IC + RV

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?

a. early stage of an asthmatic episode

b. acute ventilatory failure

c. diabetic ketoacidosis

d. chronic ventilatory failure

Why does blood drawn from an umbilical artery catheter in neonates who have a patent ductus arteriosus sometimes reflect low arterial oxygen saturation?

a. because of anatomic differences among neonates

b. because air embolization is a frequent complication when drawing blood from the catheter

c. because of the location of the arterial catheter

d. because fibrin frequently accumulates at the tip of the arterial catheter

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

d. no resuscitative measure

From a normal spirogram you can obtain

1 IC      2 FVC       3 ERV       4 RV

a. 1 and 2         b. 1,2 and 3      c. 1,2,3 and 4    d. 4 only

A full term baby arrives at your warmer. One minute after birth, her heart rate is 1101 beats/minute; her RR is 40 breaths/minute; she is crying and shows peripheral cyanosis; some flexion of her extremities is displayed; and, she sneezed when the nurse passed a suction catheter into her nose.

What is this newborn's 1 minute APGAR score?

a. 0               b. 4             c. 6             d. 8

A patient is asked to perform a FVC. The result on the first attempt is 3.2 L, the next attempt is 2.2 L and the third attempt is 3.9 L.

The most likely explanation for these results is:

a. obstructive disease

b. restrictive disease

c. poor effort

d. respiratory failure

A lateral neck X-ray obtained from a 3-year-old child experiencing respiratory distress demonstrates radio opacity of the supraglotic oropharynx and glottic edema. Which of the following conditions does this child likely have?

a. epiglottitis   

b. laryngotracheobronchitis

c. foreign body aspiration

d. tracheomalacia

If tests show  

IC 3.2 L

IRV   500 ml

FRC      3.9 L

RV        1.2 L

What is the VC in this case?

a. 5.6 L            b. 4.1 L            c. 3.3 L           d. 2.6 L

The medication used to close PDA by inhibition of prostaglandin is:

a. Vecuronium

b. Indomethacin

c. Tensilon (edruphonium)

d. Cromolyn Sodium

Given the following cardiovascular data, calculate the patient's stroke volume:

blood pressure: 125/80 mmHg           C.O.: 6.0 L/min

Heart rate: 75 beats/min      C.I.: 2.65 L/min/m2

a.         45 ml

b.         65 ml

c.         70 ml

d.         80 ml

Which of the following is a restrictive disease?

a. epiglottis

b. kyphoscoliosis

c. cystic fibrosis

d. croup

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 only        

c. II, IV, V only           d. I, III, IV, V only

Which of the following is the most sensitive indicator of left ventricular function?

a. systolic pressure of the pulmonary artery

b. pulmonary capillary wedge pressure

c. cardiac output

d. diastolic pressure of the pulmonary artery

A patient has the following values

FEF 200-1200    110%

FEF 25 75         115%

FEV 1                 90%

FVC                   45%

This data would suggest:

a. restrictive diseases        b. obstructive disease

c. combined obstructive and restrictive    d. normal function

The classic pathology of a pulmonary embolism includes all of the following except:

a. acute dyspnea

b. hypertension

c. shunting in the pulmonary system

d. chest pain

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           d. 3 and 4

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, IV only       d. I, II, III, IV

You have been summoned to assist in the evaluation of a child suspected of having epiglottitis. Whish of the following findings would assist in the differential diagnosis of epiglottitis by providing proof positive of the malady?

a. a "steeple sign," as viewed in an anteroposterior radiograph

b. presence of a "barky" cough

c. neck radiograph

d. the presence of parainfluenza virus

e. None of the above

After initiating transcutaneous oxygen monitoring, how many minutes should the respiratory therapist wait for the sensor to stabilize before documentation of the readings

a. 5 min

b. 10 min

c. 15 min

d. 30 min

Which of the following drugs would be least useful when intubating a patient?

a. pavulon

b. morphine

c. ventolin

d. anectine

If the practitioner is asked to estimate an new born infants gestational age - the scoring system that should be used is the

a. APGAR 

b. Ballard

c. Glasgow

d. Apache II

Which bronchodilator would be appropriate to administer to an asthmatic during an attack?

a. Cromolyn sodium

b. Albuterol

c. Vanceril

d. Racemic epinephrine

A patient who has venous distension of the jugular vein 3 cm above the sternal angle while lying supine, semifowlers is likely to have:

a. Right ventricular failure

b. Normal venous pressure

c. Decreased venous return

d. Right atrial hypertrophy

Pursed-lip breathing might provide expiratory resistance during mild exercise. Which type of patient is most likely to benefit from this maneuver?

a. Patients with air trapping associated with chronic obstructive pulmonary disease

b. Patients with alveolar infiltrates associated with acute infection

c. Patients with alveolar or interstitial fibrosis

d. Patients with thoracic wall deformities.

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.

c. The patient is alkalotic.

d. The patient is polycythemic.

Which percussion note is characteristic of air trapping in the lungs?

a. Normal

b. Hyperlucent

c. Dull/Opaque

d. hyperresonant

Which lung sounds might sometimes disappear as a result of an effective cough generated by the patient?

a. crackles

b. bronchovesicular

c. vesicular

d. rhonchi

The most effective method for the administration of artificial surfactant is by:

A. intramuscular injection          

B. aerosolization

C. intravenous injection 

D. instillation into the ET tube

The RV must be known in order to measure the TLC and FRC.

TRUE

FALSE

In which of the following conditions may lung volumes be reduced (restrictive process) without a reduction in lung or chest wall compliance?

a. Fibrotic lung disease

b. Kyphoscoliosis

c. Chronic lung inflammation     

d. Neuromascular diseases

"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

Which of the following volumetric divisions of the lung cannot be measured by   simple spirometry?

I. FRC       II. ERV     III. RV      IV. TLC

a. I, III, and IV         b. I and II

c. II, III, and IV        d. I, II, III, and IV

Characteristic of restrictive lung diseases is a decrease in vital capacity.

TRUE

FALSE

A patient has a vital capacity of 4200 ml, a functional residual capacity of 5500 ml, and expiratory reserve volume of 1200 ml. What is her residual volume?

a. 9700 ml

b. 3000 ml

c. 4300 ml

d. 6700 ml

A patient has an expired minute ventilation of 10,700 ml and ventilator rate of 21/min. What is his average tidal volume?

a. 440 ml

b. 635 ml

c. 725 ml

d. 510 ml

In patients with severe obstructive lung diseases, the vital capacity is generally

reduced. In these patients, the most probable mechanism causing the decrease in vital capacity is:

a. An increase in inspiratory capacity

b. A decrease in chest wall compliance

c. An increase in lung compliance

d. An increase in residual volume

A patient with COPD has a normal VC of 3300 ml and an FVC of 2600 ml. Which of the following mechanisms best explains this difference?

a. Muscle fatigue during the forced expiration

b. Airway collapse during the forced expiration

c. Decreased compliance during the forced expiration

d. Failure to close the glottis during the forced expiration

The FEF25-75 may detect changes in the lung function that are not apparent from the FEF200-1200­.

TRUE

FALSE

In both the helium dilution test and nitrogen washout FRC determinations, the patient should be connected to the system at:

a. Full forced inspiration

b. End-tidal expiration

c. End-tidal inspiration

d. Full forced expiration

A patient has an FRC via helium dilution of 2400 cc and FRC via body

plethysmography (body "box") of 3400 cc. Which of the following statements could help explain this difference?

a. The body box tends to overestimate actual FRC

b. The helium dilution test was obviously in error 

c. The body box measures the entire thoracic gas

d. Airway obstruction causes low results via helium dilution

A lung capacity consists of two or more lung volumes.

TRUE

FALSE

Within three seconds after initiating a forced vital capacity (FVC) maneuver, a patient with normal lungs should be able to exhale what percent of the FVC?

a. 35-50% of the FVC

b. 50-70% of the FVC

c. 70-83% of the FVC

d.94-97% of the FVC

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, 200-1200 (FEF200-1200)

Which of the following are true regarding the maximum voluntary ventilation (MVV)?

I. The MVV may be normal in restrictive conditions

II. Test results are highly dependent on patient effort

III. Test results reflect airway resistance and muscle status

IV. Normal values vary substantially in the population

a. I, II and Ill          c. I, III, and IV

b. I and IV                d. I, II, III, and IV

Relaxation of airway smooth muscle in the presence of reversible airflow obstruction is a general indication for the use of:

a. mucolyticsI

b. adrenergic bronchodilators

c. antiinfective agents

d. steroids

Theophylline and caffeine are examples of.

a. B agonists

b. methylxanthines

c. corticosteroids

d. anticholinergics

How is functional residual capacity (FRC) affected by surfactant therapy?

a. no effect

b. unknown effect

c. decreases

d. increases

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 based on arterial waveform, inflate at dicrotic notch, deflate near patient aortic end diastolic pressure

d. Initiate based on arterial waveform, deflate at dicrotic notch, inflate at patient aortic end diastolic pressure

e. Initiate based on arterial waveform, inflate at peak of patient systolic pressure, deflate at dicrotic notch.

Initial intra-aortic balloon deflation is adjusted to occur:

a. at the beginning of diastole    c. at ventricular depolarization

b. at the beginning of systole    d. at ventricular depolarization

When initiating balloon counterpulsation, you can best evaluate the effect of your timing adjustments by initially setting the assist ratio at:

a. 1:1

b. 1:2

c. 1:4

d. 1:8

The following results of a PFT (pulmonary function test) were obtained:

These results can be described as:

a. severe obstructive     b. severe restrictive

c. mild restrictive           d. moderate restrictive and obstructive

An FVC that is decreased and a FEV 1 that is normal would indicate:

a. obstructive disease  

b. restrictive disease

c. both obstructive and restrictive disease         

d. diffusion defect

In order for patients with obstructive lung disease to be considered to have a significant reversible component, the post-bronchodilator FEV 1 should be at least what percentage greater than the pre-treatment FEV 1?

a. 10%

b. 15% 

c. 20%

d. 25%

Which of the following would most accurately describe a patient diagnosed with pulmonary fibrosis?

Radiolucency and Functional Residual Capacity (FRC) are increased in patients who have?

a. pulmonary embolism

b. sarcoidosis

c. pulmonary emphysema

d. pulmonary edema

Calculate the CO of a patient whose pulse is 80 and left ventricular ejection is 50 ml.

A. 3.0 LPM

B. 4.0 LPM

C. 5.0 LPM

D. 6.0 LPM

Pre and post bronchodilator spirometry is performd on a patient with the following results.

These results can be described as:

a. normal spirometry      b. reversible obstructive disease

c. restrictive disease     d. both obstructive and restrictive disease

Which of the following tests is said to be "least effort dependent"

a. FVC

b. FEV 1

c. FEF200 - 1200

d. FEF 25 - 75%

e. MVV

Closing volume is measured using

a. the single breath nitrogen test

b. body plethysmography

c. the helium dilution method

d. the nitrogen washout test

Most restrictive lung diseases are characterized by

a. decreased flows and increased airway resistance

b. decreased compliance and increased airway resistance

c. increased compliance and increased airway resistance

d. decreased lung volumes and decreased compliance

Pulmonary function values that show obstructive disease include:

I. increased airway resistance

II. decreased lung volumes

III. decreased forced expiratory flows

IV. air trapping

a. I, II and III      b. II and IV     c. I,III and IV     d. I, II, III and IV

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 affecting the patient?

a. tension pneumothorax

b. lung abscess

c. atelectasis

d. pleural effusion