1.  What is the primary purpose of the respiratory system?

            a.  continuous absorption of oxygen and excretion of carbon dioxide

            b.  filtering to prevent allergens and microbes from reaching the lungs

            c.  transport oxygenated blood to the tissues

            d.  warm and humidify inspired gas

a.  continuous absorption of oxygen and excretion of carbon dioxide

2.  What is the primary function of the Nasopharynx?

            a.  facilitate digestion

            b.  heat, humidify, and filter gases

            c.  protect the vital organs

            d.  vocalization

b.  heat, humidify, and filter gases

3.  Which of the following muscles are considered primary muscles of ventilation?

1. diaphragm 

 2. intercostal

3.  scalene 

      4. stern mastoid

            a.  1,3, and 4

            b.  1 and 2

            c.  3 only

            d.  1,2,3, and 4

4.  What pulmonary disorder could lead to the elevation of the diaphragm?

            a.  COPD

            b.  asthma

            c.  atelectasis

            d.  emphysema

c.  atelectasis

5.  Which accessory muscles are active during active inspiration and pull up on all the ribs expanding the thorax?

            a.  intercostals

            b.  abdominals

            c.  scalene

            d.  sternocleidomastoids

c.  scalene

6.  When a COPD patient leans forward braced in a tripod position, this lends particular advantage to which accessory muscles of inspiration?

            a.  external intercostals

            b.  pectoralis

            c.  scalenes

            d.  sternocleidomastoids

b.  pectoralis

7.  The pulmonary circulation does which of the following?

            1.  delivers oxygenated blood back to the heart

            2.  delivers unoxygenated blood to the lungs

            3.  originates on the left side of the heart

            4.  originates on the right side of the heart

            a.  1 and 4

            b.  2 and 4

            c.  1 and 3

            d.  2 and 3

b.  2 and 4

8.  How does the pulmonary circulation respond to regional lung hypoxia?

            a.  bronchial artery vasoconstriction

            b.  bronchial artery vasodilation

            c.  pulmonary artery / capillary vasoconstriction

            d.  pulmonary artery / capillary vasodilation

c.  pulmonary artery / capillary vasoconstriction

9.  What is the name of the reflex associated with the sensory stimulation of the pulmonary stretch receptors that stimulates a deeper breath upon inspiration?

            a.  carotid sinus

            b.  Head's paradoxical

            c.  Hering-Breuer

            d.  Vagovagal

c.  Hering-Breuer

10.  Which of the following is NOT a primary function of the nasal cavity?

            a.  conduction of gases

            b.  filtration and defense

            c.  gas exchange

            d.  heat and humidify

c.  gas exchange

11.  Which respond most rapidly to high levels of CO2?

            a.  aortic chemoreceptors

            b.  carotid chemoreceptors

            c.  central chemoreceptors

            d.  ventral respiratory centers

c.  central chemoreceptors

12.  What is the name of the leaf shaped cartilage that extends from the base of the tongue and is attached by ligaments to the thyroid cartilage?

            a.  arytenoid cartilage

            b.  cricoid cartilage

            c.  cuneiform cartilage

            d.  epiglottis

d.  epiglottis

13.  The adult trachea is approximately how long?

            a.  5 to 8 cm

            b.  10 to 16 cm

            c.  19 cm in most patients

            d.  20 to 24 cm

b.  10 to 16 cm

14.  What is the name given to the action produced by the forward stroking of millions of cilia?

            a.  coughing

            b.  mucociliary escalator

            c.  mucus stroking

            d.  the wave

b.  mucociliary escalator 

15.  Pulmonary surfactant is secreted by which type of lung cells?

            a.  alveolar macrophages

            b.  Type I cells (pneumocytes)

            c.  Type II (pneumocytes)

            d.  Type III (pneumocytes)

c.  Type II (pneumocytes

16.  What centers are located in the pons of the brain stem?

            1.  apneustic center

            2.  dorsal respiratory neurons

            3.  pneumotaxic center

            a.  1,2, and 3

            b.  2 and 3

            c.  1 and 3

            d.  1 and 2

c.  1 and 3

17.  The group of nerve cells senses and responds to changes in the chemical composition of its fluid environment?

            a.  chemoreceptors

            b.  Gamma-efferent system

            c.  muscle spindle fibers

            d.  proprioreceptors

a.  chemoreceptors

18.  You observe a patient's breathing pattern as very irregular, with periods of breathing interspersed with long periods of apnea.  Which of the following terms would you use in charting this observation?

            a.  apneustic breathing

            b.  Biot's respiration

            c.  Cheyne-Stokes breathing

            d.  Kussmaul's breathing

b.  Biot's respiration

19.  What term is used to describe difficult breathing in the reclining position?

            a.  orthopnea

            b.  platypnea

            c. eupnea

            d.  apnea

a.  orthopnea

20.  What term is used to describe shortness of breath in the upright position?

            a.  orthopnea

            b.  platypnea

            c. eupnea

            d.  apnea

b.  platypnea

21.  Which of the following terms is used to describe coughing up blood-streaked sputum?

            a.  hematemesis

            b.  hemoptysis

            c.  hemolysis

            d.  hemostasis

b.  hemoptysis

22.  What is the normal range for diastolic blood pressure in the adult patient?

            a.  90 to 140 mmHG

            b.  60 to 90 mmHG

            c.  75 to 100 mmHG

            d.  60 to 100 mmHG

22.  What is the normal range for systolic blood pressure in the adult patient?

            a.  90 to 140 mmHG

            b.  80 to 100 mmHG

            c.  75 to 100 mmHG

            d.  60 to 100 mmHG

a.  90 to 140 mmHG

24.  Which disease is associated with a barrel chest?

            a.  COPD

            b.  heart failure

            c.  pneumonia

            d.  pleural effusions

a.  COPD

25.  Which term is used to describe an abnormal anteroposterior curvature of  the spine?

            a.  scoliosis

            b.  pectus excavatum

            c.  kyphosis

            d.  pectus carinatum

c.  kyphosis

26.  While observing a patient's breathing, you note that the depth and rate first increase, then decrease, followed by a period of apnea.  Which of the following terms would you use in charting this observation?

            a.  apneustic breathing

            b.  Cheyne-Stokes breathing

            c.  Biot's breathing

            d.  paradoxical breathing

b.  Cheyne-Stokes breathing

27.  What breathing pattern is associated with sever Obstructive Disease?

            a.  rapid and deep

            b.  rapid and shallow

            c.  slow and shallow

            d.  slow and deep

b.  rapid and shallow

28.  While percussing a patient's chest wall, you encounter an area that produces a decreased (dull) resonance to percussion.  Which of the following are potential causes of this finding?

            1.  pneumothorax

            2.  pleural effusion

            3.  pneumonia

            4.  atelectasis

            a.  2 and 5

            b.  2 and 4

            c.  2,3, and 4

            d.  1,2,3, and 4

c.  2,3, and 4

29.  What term best describes a loud, high-pitched continuous sound heard (often with the unaided ear) primarily over the larynx or trachea during inhalation in patients with upper airway obstruction?

            a.  stridor

            b.  rhonchi

            c.  crackles

            d.  wheeze

a.  stridor

30.  In which of the following conditions would inspiratory crackles be most likely to occur?

            1.  emphysema

            2.  pulmonary fibrosis

            3.  pneumonia

            4.  pulmonary edema

            5.  atelectasis

            a.  2,3, and 4

            b.  1,3, and 5

            c.  1,4, and 5

            d.  1,2,4, and 5

a.  2,3, and 4

31.  Which of the following abnormalities could the practitioner be on the lookout for during inspection of the extremities?

            1.  digital clubbing

            2.  peripheral cyanosis

            3.  pedal edema

            4.  impaired capillary refill

            5.  low peripheral skin temperature

            a.  2,3,4, and 5

            b.  1,3, and 4

            c.  3,4, and 5

            d.  1,2,3,4, and 5

d.  1,2,3,4, and 5

32.  A 45- year old patient, who has been smoking 2 packs of cigarettes per day for 20 years.  What is the patient's smoking history?

            a. 30 pack-years

            b.  35 pack-years

            c.  40 pack-years

            d.  45 pack-years

c.  40 pack-years

33.  Which of the following statements is/are true regarding compliance?

            I.  Compliance = Elastance

            II.  a compliance increases, elastance decreases

            III.  it can be determined by dividing change in pressure into change in volume

            IV.  a stiff lung has low compliance

            a.  I and II

            b.  II and IV

            c.  I, II, III

            d.  II, III, and IV

            e.  all of the above

d.  II, III, and IV

34.  Which of the following statements is/are true regarding airway resistance?

            I.  It must be overcome in order to maintain a specific flow.

            II. Resistance increases as the lumen of the airway decreases.

            III.  Resistance will decrease WOB.

            IV.  Resistance is similar to Restrictive.

            a.  I and II only

            b.  II and III

            c.  I, II, and IV

            d.  I, II , and III

a.  I and II only

35.  Surface tension is defined as :

            a.  the ease with which a structure can be distorted

            b.  the force necessary to overcome the elastic properties of the lung

            c.  the force exerted by liquid molecules which will collapse a sphere

            d.  the force necessary to expand the alveoli

c.  the force exerted by liquid molecules which will collapse a sphere

36.  What forces must be over come to move air into the respiratory system?

            1.  optic nerves

            2.  elastic forces of lung tissue

            3.  airway resistance

            4.  surface tension forces

            a.  1,2, and 3

            b.  2,3, and 4

            c.  4 only

            d.  1,2,3, and 4

b.  2,3, and 4

37.  How is compliance computed?

            a.  change in pressure/change in flow

            b.  change in pressure/change in volume

            c.  change in volume/change in flow

            d.  change in volume/change in pressure

d.  change in volume/change in pressure

38.  How is airway resistance (Raw) computed?

            a.  change in pressure/change in volume

            b.  change in pressure/flow

            c.  change in volume X change in pressure

            d.  change in volume/change in pressure

b.  change in pressure/flow

39.  For carbon dioxide levels to remain constant during exercise and exertion, which of the following factors must be elevated?

            a.  alveolar ventilation

            b.  dead space ventilation

            c.  hemoglobin

            d.  V/Q ratio

a.  alveolar ventilation

40.  A fibrotic lung would exhibit which of the following characteristics?

            a.  decreased airway resistance

            b.  decreased lung compliance

            c.  decreased respiratory rate

            d.  decreased surface tension

b.  decreased lung compliance

41.  What is the name of the negative feedback reflex associated with the termination of inspiration?

            a.  carotid sinus

            b.  Head's paradoxical

            c.  Hering-Breuer

            d.  vagovagal

c.  Hering-Breuer

42.  Which of the following may cause the trachea to shift to the right?

            a.  right-sided  tension pneumothorax

            b.  right-sided large pleural effusion

            c.  right upper lobe atelectasis

            d.  left lower lobe pneumonia

c.  right upper lobe atelectasis

43.  What breathing pattern (I:E) is best associated with Restrictive Disease?

            a.  1:1

            b.  1:2

            c.  1:4

            d.  4:1

a.  1:1

44.  Deadspace anatomic (Vd ana) is 150 ml, Respiratory Rate (f) is 20, Tidal Volume (Vt) is 500.  Calculate Alveolar Minute Ventilation.

            a.  7000 ml

            b.  8 liters

            c.  6 liters

            d.  not enough information is available

a.  7000 ml

MATCHING (WORD POWER) - Please place the proper letter next to the best term.

1. Syncope _______

2.  angina _______

3.  apnea _______

4.  febrile _______

5.  bradycardia _______

6.  Medulla _______

7.  Hering-Breuer _______

8.  Hering - Breuer _______

9.  Biot's _______

10.  Vesicular  _______

11.  Pneumonia _______

12.  Shock _______

a.  major center for neuro-control

b.  absence of breathing

c.  dizziness

d.  causes decreased resonance or flat percussion

e.  chest pain

f.  low soft breath sound

g.  tactile vibration not felt

h.  caused by increased vascular pressures

i.  oxygenation issues in the blood

j.  increased body temperature

k.  rapid drop in blood pressure

l.  controls depth of inspiration

m.  oxygenation issues in the tissue

n.  subcutaneous air

o.  paradoxical chest movement

p.  PMH (past medical History)

q.  slow heart rate

1. C

2. E

3. B

4. J

5. Q

6. A

7. L

8. M

9. H

10. F

11. D

12. K

1.  On what does the movement of gases between the lungs and the body tissues rapidly depend?

            a.  active transport

            b.  gaseous diffusion

            c.  membrane dialysis

            d.  membrane transport

b.  gaseous diffusion

2.  Which of the following is true regarding the PaCO2?

            1.  Directly proportional to whole body carbon dioxide production

            2.  Inversely proportional to alveolar ventilation

            3.  Normally maintained at about 35 to 45 mmHg

            a.  2 and 3

            b.  1,2, and 3

            c.  1 and 2

            d.  1 and 3

b.  1,2, and 3

3.  What is the primary determinant of the PAO2?

            a.  body's VCO2

            b.  metabolic rate of the body tissues

            c.  PaO2

            d.  PiO2 of inspired gas

d.  PiO2 of inspired gas

4.  Calculate the approximate PAO2 given the following conditions (assume RQ = 0.8) FiO2=40%,

Pa = 770mmHg,  PACO2 = 31 mmHg

            a.  100 mmHg

            b.  135 mmHg

            c.  250 mmHg

            d.  723 mmHg

c.  250 mmHg

5.  A normal person breathing 100% of oxygen at sea level would have approximately PAO2 of about?

            a.  149 mmHg

            b.  670 mmHg

            c.  713 mmHg

            d.  760 mmHg

b.  670 mmHg

6.  Which of the following conditions must exist for gas to move between the alveolus and pulmonary capillary?

            a.  adequate alveolar ventilation

            b.  difference in partial pressure (pressure gradient)

            c.  normal central nervous system (CNS) control mechanism

            d.  efficient amount of blood hemoglobin (Hb)

b.  difference in partial pressure (pressure gradient)

7.  Which of the following gases would diffuse fastest across the alveolar-capillary membrane?

            a.  air

            b.  carbon dioxide

            c.  oxygen

            d.  nitrogen

b.  carbon dioxide

8.  Which of the following gases will NOT diffuse across the alveolar-capillary membrane?

            a.  CO

            b.  carbon dioxide

            c.  oxygen

            d.  nitrogen

d.  nitrogen

9.  What is the normal range of PAO2 - PaO2 for healthy young adults breathing room air?

            a.  9 to 10 mmHg

            b.  10 to 20 mmHg

            c.  20 to 30 mmHg

            d.  50 to 60 mmHg

a.  9 to 10 mmHg

10.  Given the following blood parameters, compute the total oxygen content (dissolved + HbO2) of the blood in ml/dl: Hb=16; PO2=625 Hg; SO2=100%

            a.  17.8 ml/dl

            b.  19.4 ml/dl

            c.  21.4 ml/dl

            d.  23.2 ml/dl

d.  23.2 ml/dl

11.  What is the approximate normal CaO2-CvO2 in a healthy adult at rest?

            a.  5 ml/dl

            b.  15 ml/dl

            c.  20 ml/dl

            d.  250 ml/dl

a.  5 ml/dl

12.  Compared to normal levels, a shift in the HbO2 curve to the right has which of the following affects?

            1.  The affinity of Hb for oxygen decreases

            2.  The Hb saturation for a given PO2 falls

            3.  The Hb saturation for a given PO2 rises

            a.  1 only

            b.  1 and 2

            c.  1 and 3

            d.  1,2, and 3

b.  1 and 2

13.  What happens when the temperature of the blood rises?

            1.  The Hb saturation for a given PO2 falls

            2.  The HbO2 curve shifts to the right

            3.  The affinity of the Hb for oxygen increases

            a.  1 and 2

            b.  1 and 3

            c.  2 only

            d.  1,2, and 3

a.  1 and 2

14.  The affinity of Hb for carbon monoxide (CO) is approximately how many times greater than the affinity for oxygen?

            a.  10 to 50 times greater

            b.  50 to 90 times greater

            c.  150 to 180 times greater

            d.  200 or greater

d.  200 or greater

15.  Which of the following does NOT increase the affinity of Hb for oxygen?

            a.  decreased 2,3 DPG

            b.  Decreased PCO2

            c.  increased pH

            d.  increased temperature

d.  increased temperature

16.  A patient has a P50 value of 29 mmHg.  What does this indicate?

            a.  decreased affinity of Hb for oxygen

            b.  higher than normal Hb saturation for a given PO2

            c.  increased affinity of Hb for oxygen

            d.  normal position in the HbO2

a.  decreased affinity of Hb for oxygen

17.  Which of the following are potential causes of hypoxia?

            1.  Decreased in arterial PO2

            2.  Decreased in available Hb

            3.  Decrease in cardiac output

            a.  1 and 2

            b.  1 and 3

            c.  2 and 3

            d.  1,2,and 3

d.  1,2,and 3

18.  What is the most common cause of hypoxemia in patients with lung disease?

            a.  diffusion defect

            b.  hypoventilation

            c.  right to left shunt

            d.  V/Q mismatch

d.  V/Q mismatch

19.  What is the main cause of refractory hypoxemia in patients with lung disease?

            a.  deadspace

            b.  hypoventilation

            c.  COPD

            d.  Pulmonary Shunt

d.  Pulmonary Shunt

20.  What does V/Q mismatch have the biggest inpact on?

            a.  carbon dioxide elimination

            b.  dissolved HCO3-

            c.  oxygentation

            d.  pH

c.  oxygentation

21.  Which of the following medical gases support combustion?

            1.  O2

            2.  N2O

            3.  compressed air

            4.  CO2

            a.  1 and 4

            b.  2 and 3

            c.  1,2, and 3

            d.  1, 3 and 4

c.  1,2, and 3

22.  Which of the following methods of storing O2 is commonly used in the Hospital setting?

            a.  chemical decomposition

            b.  electrolysis

            c.  fractional distillation

            d.  liquid oxygen

d.  liquid oxygen

23.  Which of the following statements about He is false?

            a.  it is an inert gas

            b.  it is odorless

            c.  it is nonflammable

            d.  it is heavier than air

d.  it is heavier than air

24.  In clinical practice, how is a positive identification made of the contents of a medical gas cylinder?

            a.  noting the color of the cylinder

            b.  inspecting the cylinder threads

            c.  reading the cylinder label

            d.  collecting and analyzing a gas sample

a.  noting the color of the cylinder

            c.  reading the cylinder label

25.  When full, a gas cylinder registers a pressure of 2200 psi.  After a few hours of use, the pressure gauge reads 550 psi.  The cylinder is now how full?

            a.  one half

            b.  one third

            c.  one fourth

            d.  two thirds

c.  one fourth

26.       What is the usual method of monitoring the remaining contents in a gas-filled cylinder?

            a.   Weigh the cylinder.

            b.   Read the pressure gauge.

            c.   Compute the gas density.

            d.   Read the cylinder label.

b.   Read the pressure gauge.

27.       The gauge on an E cylinder of O₂ reads 800 psig. About how long would the contents of this cylinder last, until completely empty, at a flow of 3 L/min?

            a.   1 hour 20 minutes

            b.   1 hour 45 minutes

            c.    2 hours 10 minutes

            d.   2 hours 40 minutes

a.   1 hour 20 minutes

28.       What device is used to reduce the pressure while controlling the flow of a compressed medical gas?

            a.   Reduction gauge

            b.    Regulator

            c.   Flowmeter

            d.   Reducing valve

c.   Flowmeter

29.       If you have to deliver medial gas to a patient from a compressed gas cylinder, which of the following devices would you select to control gas glow?

            a.   Regulator

            b.   Oxygen blender

            c.   Reducing valve

            d.   Bourdon Flowmeter

d.   Bourdon Flowmeter

30.       If you have to deliver medial gas to a patient directly from a hospital bedside outlet station, which of the following devices would you select?

            a.   Thorpe tube flowmeter

            b.   Bourdon-type gauge

            c.   Pressure-reducing valve

            d. Medical gas regulator

a.   Thorpe tube flowmeter

31.       Specific clinical objectives of Oxygen (O₂) therapy include which of the following?

            1.   Decrease the symptoms caused by hypoxemia.

            2.   Decrease the workload hypoxemia imposes on the heart and lungs.

            3.   Correct documented arterial hypoxemia.

              a.       1   and   2

              b.       2   and   3

              c.        1   and   3

              d.       1, 2   and   3

  d.       1, 2   and   3

32.       Properly applied O₂ therapy can decrease which of the following?

            1.    Ventilatory demand

            2.    Work of breathing

            3.    Cardiac output

              a.       1   and   3

              b.       1   and   2

              c.        1,  2,  and  3

              d.       1   and   3

c.          1,  2,  and  3

33.       Which of the following would clearly indicate a need for O₂ therapy for an adult or child?

            1.   SaO₂ less than 90%

            2.   PaCO₂ greater than 45 mmHg

            3.   PaO₂ less than 60 mmHg

              a.       2   and   3

              b.       1   and   2

              c.        1,  2,  and  3

              d.       1   and   3

  d.       1   and   3

34.       Which of the following signs and symptoms are commonly associated with the presence of acute onset hypoxemia?

            1.   Tachypnea

            2.   Tachycardia

            3.   Cyanosis

            4.   Bradycardia

              a.       2   and   3

              b.       1   and   2

              c.        1,  2,  and  3

              d.       1   and   4

c.          1,  2,  and  3

35.       A patient with chronic hypercapnia placed on an FIO₂ of 0.9 starts hypoventilating. What is the possible cause of this phenomenon?

            a.    Decreased cardiac output

b.    O₂ toxicity

c.    O₂-induced hypoventilation

d.    Absorption atelectasis

c.    O₂-induced hypoventilation

36.       Which of the following statements is FALSE about low-flow O₂ delivery systems?

            a.   The greater the patients inspiratory flow, the greater the FIO₂.

            b.   All low flow devices provide variable O₂ concentrations.

            c.   The O₂ provided by a low-flow device is diluted with inspired air.

            d.   The patient’s flow usually exceeds that of the low-flow device.

a.   The greater the patients inspiratory flow, the greater the FIO₂.

37.       Low-flow O₂ delivery systems used in respiratory care include all of the following except:

            a.    Nasal O₂ cannula

            b.    Nasal O₂ catheter

            c.    Air-entrainment mask

            d.    Trans-tracheal catheter

c.    Air-entrainment mask

38.       A 27-year-old woman received from the emergency department is on a nasal cannula at 5 L/min approximately what FIO₂ is this patient receiving?

            a.   28%

            b.   32%

            c.   35%

            d.   40

d.   40

39.       Which of the following is FALSE about the simple O₂ mask?

            a.   It has no valving system or reservoir bag.

            b.   It can easily deliver high FIO₂ values (greater than 0.6 to 0.9)

            c.   It requires a minimal input flow of 6 L/min.

            d.   It generally functions as a variable-performance O₂ system

b.   It can easily deliver high FIO₂ values (greater than 0.6 to 0.9)

40.       A physician orders 3 L/min O₂ through a simple mask to a 33-year-old postoperative woman with moderate hypoxemia breathing room air

(PaO₂ = 52 mmHg). What would be the correct action at this time?

a.carry out the physician's prescription exactly as written

b.  recommend tha the maskbe changed to a cannula at 3 L/min

c.  recommend a flow of at least 5 L/min to wash out carbon dioxide

d.     Do not apply the O₂ until the medical director has been contacted.

b.  Recommend that the mask be changed to a cannula at 3 L/min.

41.       What is the minimum flow setting for a simple mask applied to an adult?

            a.   3 L/min

            b.   6 L/min

            c.   8 L/min

            d.   10 L/min

b.   6 L/min

42.       A patient is receiving O₂ through a non-rebreathing mask set at 8 L/min. You notice that the mask’s reservoir bag collapses completely before the end of each inspiration. Which of the following actions is appropriate in this case?

            a.   Change to a partial rebreather.

            b.   Decrease the liter flow.

            c.   Increase the Liter flow.

            d.   Change to a simple mask.

c.   Increase the Liter flow.

43.       The best high-flow O₂ delivery system should provide at least what total flow?

            a.   60 L/min

            b.   55 L/min

            c.   40 L/min

            d.   30 L/min

c.   40 L/min

44.       Which of the following factors determine the actual O₂ provided by an air-entrainment system?

            1.    O₂ input flow to the jet.

            2.    Air-to-O₂ ratio of the device.

            3.    Resistance downstream from the jet.

              a.       None of the above

              b.       1   and   2

              c.        1,  2,  and  3

              d.       1   and   3

  c.        1,  2,  and  3

45.       A large male patient receiving about 35% O₂ through an air-entrainment mask set at a 6 L/min input flow, becomes tachypneic. Simultaneously, you notice the SpO₂ has fallen from 91% to 87%. Which of the following actions would be most appropriate first step in this situation?

            a.   Switch the patient to a 35% air-entrainment mask.

            b.   Increase the device’s input flow to 10 L/min.

            c.   Switch the patient to a 28% air-entrainment mask.

            d.   Decrease the device’s input flow to 4 L/min.

b.   Increase the device’s input flow to 10 L/min.

46.       A 45-year-old patient with congestive heart failure is receiving O₂ through a 50% air-entrainment mask, with an O₂ input of 10 L/min. What is the total output gas flow?

            a.   16 L/min

            b.   24 L/min

            c.   26 L/min

            d.   36 L/min

c.   26 L/min

47.       What are some key patient considerations in selecting O₂ therapy equipment?

            1.   Type of airway (natural or artificial)

            2.   Severity and cause of the hypoxemia

            3.   Age group (infant, child, adult)

            4. Stability of the minute ventilation

               a.      2   and   4

               b.      1, 2, and   3

               c.       3   and   4

               d.      1, 2, 3   and   4

   d.      1, 2, 3   and   4

48.       A patient receiving 3 L/min O₂ through a nasal cannula has a measured SpO₂ of 94% and no clinical signs of hypoxemia or increased WOB. At this point, what should your recommend?

            a.   Decreasing the flow to 2 L/min and re-checking SpO₂

            b.   Maintaining the therapy as is and rechecking the SpO₂

            c.   Increasing the flow to a 4 L/min and rechecking the SpO₂

            d.    Discontinuing the O₂ therapy

a.   Decreasing the flow to 2 L/min and re-checking SpO₂

Given  BP 647 torr. PaCO₂ 40 torr. PaO₂ 60 torr pH 7.4 Hgb 15 vol% FiO₂ 40%, O₂ liter flow 10 L/min.

Calculate: CaO₂ 

P(A-a)O₂ 

Total Flow

CaO_{2 = 18.54 ml/dl} 

P(A-a)O_{2 = 130 torr}

 Total Flow = 40 L/min

Calculate a Normal Alveolar Minute Volume Given: Patient Weight 140lbs., RR 20, V_t 450

2.     Indications for warming inspired gases include all of the following except:

a. treating a patient whose airways are reactive to cold

b.  providing humidification when the upper airway is bypassed

c.  treating a patient with low body temperature (hypothermia)

d.     Reducing upper airway inflammation or swelling.

d.  Reducing upper airway inflammation or swelling.

3.     Administration of dry gases at flows exceeding 4 L/min can cause which of the following:

d.     1, 2, and 3

d.    1, 2, and 3

4.   Inhalation of dry gases can do which of the following?

            1.   Increase viscosity of secretions

            2.   Impair mucociliary motility

            3.   Increase airway irritability

            a.    1   and   2

            b.    3

            c.    1   and   3

            d.   1, 2, and 3

d.   1, 2, and 3

5.  Which of the following inspired conditions should be maintained when administering oxygen directly into the trachea through an endotracheal tube or tracheostomy?

d.     100% RH at 32^o to 37^o C

d.  100% RH at 32^o to 37^o C

 F6.  Factors affecting a humidifier’s performance include all of the following except

d.  Outlet size

7.     The greater the temperature of the gas, the:

d.     More water vapor is lost

8.  Gas Leaving an unheated humidifier at 10^o C and 100% relative humidity (absolute humidity= 8.9 mg/L) would provide what relative humidity at body temperature?

d.     About 20%

9.  Simple unheated bubble humidifiers are commonly used to humidify gases with what type of systems?

d.     Aerosol drug delivery

10.     Increasing the flow through an unheated bubble humidifier has which effect?

d.     Increasing the relative humidity

a.     Decreasing the water vapor content

b.     Decreasing the relative humidity

11. To protect against obstructed or kinked tubing, simple bubble humidifiers incorporate         which of the following?

d.     Electronic alarm system

12. When checking an oxygen delivery system that incorporates a bubble humidifier running at 6 L/min you occlude the delivery tubing, and the humidifier pressure relief immediately pops off. What does this indicate?

d.     Leak in the delivery tubing

13. Which type of humidifier “traps” the patients body heat and expired water vapor to raise the humidity of inspired gas?

a.      Membrane

b.      bubble

c.       HME

d.      Passover

14. Heat-Moisture exchangers (HMEs) are mainly used to do what? 

a.     Warm and humidify gases delivered to trachea via ventilator circuits

b.     Humidify therapeutic gases delivered at high flows to the lower airway

c.      Provide extra humidity for a patient with thick or retained secretions

d.  Warm and humidify dry therapeutic gases delivered to the upper airway 

a.     Warm and humidify gases delivered to trachea via ventilator circuits

d.  Warm and humidify dry therapeutic gases delivered to the upper airway 

15.    Which of the following methods are used to heat the gas delivered by a heated humidifier?

1.     Using a wraparound heater (yoke or collar)

2.     Placing a heating element in-line with gas flow

3.     Using a reservoir immersion heater

4.     Placing a “hot plate” at humidifier base

a.     2   and   4

b.     1, 2, and 3

c.      3   and   4

d.     1, 2, 3, and 4

16.  The amount of condensation occurring in a heated, humidified gas delivery system depends on which of the following?

            1.  Length, diameter, and mass of the circuit

            2.  Temperature differential along the circuit

            3.  Ambient temperature

            4.  Rate of gas flow through the circuit

            a.  2 and 4

            b.  1,2, and 3

            c.  3 and 4

            d.  1,2,3, and 4

17.  Which of the following is FALSE about heated humidifier condensate?

            a.  It can block or obstruct the delivery circuit

            b.  It must be treated as contaminated waste.

            c.  It requires that circuits be drained frequently.

            d.  It poses minimal infection risk.

18.  For which of the following patients might you recommend bland aerosol therapy administration?

            1.  Patient with upper airway edema.

            2.  Patient with a bypassed upper airway.

            3.  Patient who must provide a sputum specimen.

            a.  1,2, and 3

            b.  2 and 3

            c.  1 and 2

            d.  1 and 3

19.  Common hazards and complications of bland aerosol therapy include all of the following except:

            a.  bronchospasm

            b.  overhydration

            c.  infection

            d.  hemoptysis

20.  What is the most common device used to generate bland aerosols?

            a.  small-volume jet nebulizer

            b.  ultrasonic nebulizer

            c.  large-volume nebulizer

            d.  spinning disk nebulizer

21.  All of the following are true regarding large-volume jet nebulizers except:

            a.  A variable air-entrainment port allows air mixing and different FIO2 values.

            b.  Liquid particles are generated by mechanical vibration energy.

            c.  They are pneumatically powered and attach directly to a flowmeter.

            d.  Baffling causes impaction or removal of large unstable particles.

22.  Which of the following nebulizers uses a piezoelectric transducer to generate liquid particle aerosols?

            a.  hydrodynamic nebulizer

            b.  ultrasonic nebulizer

            c.  jet nebulizer

            d.  centrifugal nebulizer

23.  Which of the following principles is used by ultrasonic nebulizer to produce aerosol?

            a.  evaporative cooling

            b.  mechanical baffling

            c.  fractional distillation

            d.  high-frequency vibrations

24.  For which of the following patients might you recommend bland aerosol therapy via an ultrasonic nebulizer (USN)?

            1.  Patient with upper airway edema.

            2.  Patient with a bypassed upper airway

            3.  Patient who must provide a sputum specimen

            a.  1,2, and 3

            b.  2 and 3

            c.  2

            d.  3

25.  Causes of inadequate mist production with pneumatically powered jet nebulizers include all of the following except:

            a.  inadequate input flow

            b.  siphon tube obstruction

            c.  jet orifice misalignment

            d.  tripped circuit breaker

26.  A patient receiving nasal oxygen at 3 L/min complains of nasal dryness and irritation.  Which of the following actions would be appropriate?

            a.  recommending that the flow be decreased to 2 L/min

            b.  adding a humidifier to the delivery system

            c.  recommending that the flow be increased to 4 L/min

            d.  switching to a simple mask at 3 L/min

27.  When determining a need for O2 therapy, the respiratory therapist should assess which of the following?

            1.  Neurologic status

            2.  Pulmonary status

            3.  Cardiac status

            a.  1 and

            b.  2 and 3

            c.  1 and 3

            d.  1,2, and 3

28.  A patient with chronic hypercapnia placed on an FIO2 of 0.6 starts hyperventilating.  What is the possible cause of this phenomenon?

            a.  decreased cardiac output

            b.  O2-toxicity

            c.  O2-induced hypoventilation

            d.  absorption atelectasis

29.  Which of the following statements is false about low-flow O2 delivery systems?

            a.  The greater the patient's inspiratory flow, the greater the FIO2

            b.  All low-flow devices provide variable O2 concentrations

            c.  The O2 provided by a low-flow device is diluted with air

            d.  The patient's flow usually exceeds that from a low-flow device

30.  Delivery systems that provide only a portion of a patient's inspired gas are referred to as what?

            a.  fixed-performance systems

            b.  low-flow performance systems

            c.  high-flow O2 systems

            d.  air-entrainment systems

31.  A physician orders 2 L/min O2 through a simple mask to a 33-year old postoperative woman with moderate hypoxemia breathing room air (PaO2=52 mmHG).  What would be the correct action at this time?

            a.  Carry out the physician's prescription exactly as written

            b.  Recommend that the mask be changed to a cannula at 2 L/min

            c.  Recommend a flow of at least 4 L/min to wash out carbon dioxide (CO2)

            d.  Do not apply the O2 until the medical director has been contacted.

32.  All of the following are factors that affect the FIO2 when using low-flow oxygen therapy except:

            a.  tidal volume

            b.  respiratory rate

            c.  inspiratory flow rate

            d.  expiratory flow rate

            e.  oxygen flow rate

1.  Given:  Relative Humidity 50%, Humidity Capacity 44 mg/l.  Calculate Humidity deficit.

2.  Given:  Humidity Capacity 44 mg/l.  Ambient Humidity 11 mg/l.  Calculate relative Humidity.

3.  Given: Relative humidity 20%, Humidity Capacity 44 mg/l.  Calculate Humidity Deficit.

1.  Who is credited with first describing the Gas Law which led to the Compliance and Elastance calculations?

            a.  John Dalton

            b.  Joseph Prestly

            c.  Jacque Charles

            d.  Sir Charles Boyles

2.  What was the name of the Current professional organization for the field of respiratory care?

            a.  American Association for Inhalation Therapy

            b.  National Organization for Inhalation Therapy

            c.  Inhalation Therapy Association

            d.  American Association of Respiratory Care

3.  What organization has developed an examination to enable respiratory therapists to become licensed?

            a.  American Respiratory Care Board

            b.  National Board for Respiratory Care

            c.  American Association for Respiratory Care

            d.  National Organization for Respiratory Therapist

4.  Today, respiratory care educational programs in the United States are accredited by what organization?

            a.  National Board for Respiratory Care (NBRC)

            b.  American Association for Respiratory Care (AARC)

            c.  Committee on Accreditation for Respiratory Care (CoARC)

            d.  Joint Review Committee for Respiratory Therapy Education (JRCRTE)

5.  The medical abbreviation bid has what definition?

            a.  Bi-level Proximal Airway Pressure

            b.  Four times per day

            c.  Every 12 hours exactly

            d.  Twice a day

6.  Which of the following muscles are considered primary muscles of ventilation?

            1.  diaphragm

            2.  intercostals

            3.  scalene

            4.  Sternomastoid

            a.  1,3, and 4

            b.  1 and 2

            c.  3 only

            d.  1,2,3, and 4

7.  Which pulmonary disorder could lead to acute flattening of the diaphragm?

            a.  adult respiratory distress syndrome

            b.  Chronic Bronchitis

            c.  atelectasis

            d.  Pneumonia

8.  How does the lung perfusion respond to regional lung hypoxia?

            a.  bronchial artery vasoconstriction

            b.  bronchial artery vasodilation

            c.  pulmonary artery/ capillary vasoconstriction

            d.  pulmonary artery/ capillary vasodilation

9.  What is the name of the reflex associated with the sensory stimulation of the pulmonary stretch receptors that limits inflation upon inspiration?

            a.  carotid sinus

            b.  Head's paradox

            c.  Hering-Breuer

            d.  Pons Vesicular

10.  What is the name of the leaf-shaped cartilage that extends from the base of the tongue and is attached by ligaments to the thyroid?

            a.  arytenoid cartilage

            b.  cricoid cartilage

            c.  cuneiform cartilage

            d.  epiglottis

11.  What is the name given to the action produced by the forward stroking of millions of cilia?

            a.  coughing

            b.  mucociliary escalator

            c.  mucus stroking

12.  What term is used to describe difficult breathing in the reclining position?

            a.  orthopnea

            b.  platypnea

            c.  eupnea

            d.  apnea

13.  What is the normal range for diastolic blood pressure in the adult patient?

            a.  40 to 80 mmHg

            b.  60 to 90 mmHg

            c.  80 to 110 mmHg

            d.  60 to 110 mmHg

14.  Which disease is associated with a barrel chest?

            a.  emphysema

            b.  heart failure

            c.  pneumonia

            d.  pleural effusions

15.  A 55 year old patient, who has been smoking a pack and a half of cigarettes (30 cigarettes) per day for 20 years.  What is the patient's smoking history?

            a.  30 pack-years

            b.  35 pack-years

            c.  40 pack-years

            d.  45 pack-years

16.  Which of the following statements is/are true regarding compliance?

            I.  Compliance = Elastance

            II.  as compliance increases, elastance increases

            III.  it can be determined by dividing change in pressure into change in volume

            IV.  a stiff lung has a low compliance

            a.  I and II

            b.  II and IV

            c.  I, II, and III

            d.  I, III, and IV

            e.  all of the above

17.  Which of the following statements is/are true regarding airway resistance?

            I.  It must be overcome in order to maintain a specific flow.

            II.  Resistance increases as the lumen of the airway decreases.

            III.  Resistance will increase WOB.

            IV.  Resistance is similar to Restrictive.

            a.  I

            b.  II and III

            c.  I and IV

            d.  I, II, and III

18.  What is the primary determinant of the PAO2?

            a.  body's PaCO2

            b.  metabolic rate of the body tissues

            c.  PaO2

            d.  PiO2 in the inspired gas

19.  Which of the following gases would diffuse fastest across the alveolar-capillary membrane?

            a.  air

            b.  carbon dioxide

            c.  oxygen

            d.  Nitrogen

20.  Which happens when the temperature of the blood rises?

            1.  The Hb saturation for a given PO2 falls.

            2.  The HbO2 curve shifts to the right.

            3.  The affinity of the Hb for oxygen increases.

            a.  1 and 2

            b.  1 and 3

            c.  2 only

            d.  1,2, and 3

            a.  1 and 2

21.  Which of the following increases the affinity of Hb for oxygen?

            a.  increased 2,3-DPG

            b.  decreased PCO2

            c.  decreased pH

            d.  High levels of WBCs

22.  A patient has a P50 value of 27 mmHg.  What does this indicate?

            a.  decreased affinity of Hb for oxygen

            b.  higher than normal Hb saturation for a given PO2

            c.  increased affinity of Hb for oxygen

            d.  normal position in the HbO2

23.  Which of the following medical gases support combustion?

            1.  O2

            2.  CO

            3.  Compressed air

            4.  CO2

            a.  1 and 4

            b.  2 and 3

            c.  1 and 3

            d.  1,3 and 4

24.  Clinical objectives of oxygen (O2) therapy include which of the following?

            1.  Decrease the symptoms caused by chronic hypoxemia

            2.  Decrease the workload hypoxemia imposes on the heart and lungs

            3.  Correct documented arterial hypoxemia

            a.  1 and 2

            b.  2 and 3

            c.  1 and 3

            d.  1,2, and 3

25.  Properly applied O2 therapy can decrease which of the following?

            1.  Ventilatory demand

            2.  Work of breathing

            3.  Heart rate

            a.  2 and 3

            b.  1 and 2

            c.  1,2, and 3

            d.  1 and 3

26.  Which of the following would indicate a need for 02 therapy for an adult or child?

            1. SaO2 less than 90%

            2. PaCO2 greater than 40 mmHg

            3. PaO2 less than 60 mmHg

            a.         2   and   3

            b.         1   and   2

            c.          1, 2, and   3

            d.         1   and   3

27.  Low O2 delivery systems used in respiratory care include all of the following except:

            a.   nasal cannula

            b.   nasal O2 catheter

            c.    venturi mask

            d.   NRB at 100%

28. A 27-year old woman received from the emergency department is on a nasal cannula at 3 L/m. Approximately what FiO2 is this patient receiving?

            a.   28%

            b.   32%

            c.   35%

            d.   40%

29. A physician orders 2 L/m O2 through a simple mask to a 33-year old postoperative woman with moderate hypoxemia breathing room air (PaO2=52 mmHg). What would be the correct action at this time?

            a.   Carry out the physician’s prescription exactly as written.

            b.   Recommend that the mask be changed to a cannula at 1 L/m

            c.   Recommend a flow of at least 6 L/m to wash out C02

            d.   do not apply the O2 until the medical director has been contacted.

30. A true high-flow O2 delivery device system should provide at least what flow to guarantee meeting inspiratory demand?

            a.   60 L/m

            b.   50 L/m

            c.   40 L/m

            d.   30 L/m

31. An adult patient receiving 35% O2 through an air-entrainment mask set at 6 L/m input flow becomes tachypneic. Simultaneously, you notice that the SpO2 has fallen from 91% to 87%. Which of the following actions would be most appropriate in this situation?

            a.   switch the patient to a 40% air-entrainment mask at 6 L/m

            b.   Increase the device’s input flow to 10 L/m

            c.   Switch the patient to a 28% air-entrainment mask.

            d.   Decrease the device’s input flow to 4 L/m

32. Which of the following may cause the trachea to shift to the right?

            a.   left-sided tension pneumothorax

            b.   right-sided large pleural effusion

            c.   left upper lobe atelectasis

            d.   left lower lobe pneumonia

33.   What breathing pattern (I:E) is best associated with normal restrictive disease?

            a.   1:1

            b.   1:2

            c.   1:4

            d.   4:1

34. Dead space anatomic (Vd ana) is 100 ml, respiratory rate (f) is 20, tidal volume (Vt) is 400. Calculate alveolar minute ventilation.

            a.   5000 ml

            b.   8 liters

            c.   6 liters

35. What term best describes a loud, high-pitched continuous sound heard (often with the unaided ear) primarily over the larynx or trachea during inhalation in patients with upper airway obstruction?

            a.   stridor

            b.   rhonchi

            c.   crackles

Matching

w.   Slow hear rate

1. A

2. Q

3. O

4. T

5. G

6. H

7. M

8. K

9. S or I

10. D or P

1.  The physical law, which states the method causing ventilation to take place, is:

            a.  Charles' Law

            b.  Henry's Law

            c.  Dalton's Law         

            d.  Boyles' s Law

2.  Oxygen and carbon dioxide are exchanged in the lungs and tissues by the process of:

            a.  dissolution

            b.  osmosis

            c.  diffusion

            d.  filtration

3.  Ventilation is defined as:

            a.  exchange of gases between the lungs and blood

            b.  exchange of gases between blood and tissues

            c.  movement of air in and out of the lungs

            d.  none of the above

4.  BID means:

            a.  once a day

            b.  twice a day

            c.  three times a day

            d.  four times a day

5.  Which of the following is not a function of the nose related to its role in the respiratory system?

            a.  regulating the temperature of inhaled air

            b.  providing moisture for inhaled air

            c.  gas exchange

            d.  filtration of inhaled air

6.  The epiglottis is:

            a.  an opening between the vocal cords

            b.  a cartilage which prevents food from entering the trachea

            c.  a cartilage which serves as an anterior support of the trachea

            d.  an opening into the esophagus

7.  At what point on the tracheobronchial tree does gas exchange begin to occur?

            a.  mainstem bronchi

            b.  terminal bronchioles

            c.  trachea

            d.  alveolar duct

            e.  respiratory bronchioles

8.  The mucociliary cleansing mechanism is found primarily in the:

            a.  alveoli

            b.  trachea and major bronchi

            c.  terminal and respiratory bronchioles

            d.  alveolar ducts

9.  The major muscle of resting exhalation is the:

            a.  diaphragm

            b.  transverse abdominus

            c.  sternocleidomastoid

            d.  internal intercostal

            e.  none of the above

10.  Carbon dioxide is transported in the blood:

            I.  dissolved as a gas

            II.  combined with hemoglobin

            III.  as bicarbonate

            IV.  as carbon tetrachloride

            a.  I, II, IV

            b.  I, II, III

            c.  III, IV

            d.  I, III only

11.  Oxygen is transported in the blood:

            I.  dissolved as a gas

            II.  combined with hemoglobin

            III.  as carbonic acid

            IV.  as nitrous oxide

            a.  I, II, IV

            b.  I, II
            c.  III, IV

            d.  I, III, IV

            e.  II, IV

12. ??? Has to do with peripheral chemoreceptors...

            a.  oxygen

            b.  nitrogen

            c.  carbonis acid

            d.  hemoglobin

13.  The diaphragm is controlled by what nerve?

            a.  hypoglossal

            b.  vagus

            c.  phrenic

            d.  intercostal

14.  Gas exchange between the systemic blood flow and the cells of body tissues is called:

            a.  mechanical ventilation

            b.  external respiration

            c.  breathing

            d.  internal respiration

15.  The maximum amount of air that can be exhaled from the maximum inspiratory level is defined as which of the following?

            a.  vital capacity

            b.  residual volume

            c.  total lung capacity

            d.  functional residual capacity

            e.  expiratory reserve volume

16.  Which of the following statements is/are true regarding compliance?

            I.  Compliance = 1 - elastance

            II.  as compliance increases, elastance decreases

            III.  it can be determined by dividing change in pressure into change in volume

            IV.  a stiff lung has a high compliance

            a.  I and II

            b.  II and III

            c.  I, II,  and III

            d.  II, III, and IV

            e.  all of the above

17.  Which of the following would be indicated by the patient's comment that he has less difficulty breathing when upright than when lying down?

            a.  hyperpnea

            b.  orthopnea

            c.  dyspnea

            d.  eupnea

            e.  tachypnea

18.  Pulmonary surfactant increases surface tension.

            a.  True

            b.  False

19.  A patient's respirations are characterized by a gradual increase and then a gradual decrease if the depth of breathing, followed by a period of apnea.  This pattern is known as which of the folowing?

            a.  Biot's breathing

            b.  Cheyne-Stokes breathing

            c.  Kussmaul's breathing

            d.  paradoxic breathing

            e.  apneustic breathing

20.  When full, cylinders of gaseous oxygen usually contain a pressure of:

            a.  1100 psig

            b.  1000 psig

            c.  2500 psig

            d.  1500 psig

            e.  2200 psig

21.  Which of the following safety systems was designed for use on small medical gas cylinders (A-E) with yoke-type valves?

            a.  Pin Index Safety System

            b.  Diameter Index Safety System

            c.  Color Code Safety System

            d.  American Standard Safety System

22.  When a restriction is placed downstream from a Bourdon flowmeter, the actual flowrate delivered will be:

            a.  higher than the gauge reading

            b.  lower than the gauge reading

            c.  the same as the gauge reading

            d.  lower that the gauge reading at low flow but higher than the gauge reading at high flow

23.  The concentration of oxygen that a patient receives via a nasal cannula does not depend on the:

            a.  liter flow

            b.  patients tidal volume

            c.  type of humidifier used

            d.  patients inspiratory flowrate

24.  Which of the following most correctly defines high flow oxygen delivery systems?

            a.  one that has a high flow rate greater than 30 L/min

            b.  one that requires more that one flowmeter to drive the system properly

            c.  one whose flow rate is sufficient to meet all patient inspiratory demands

            d.  a system that contains a partial rebreathing valve and a reservoir bag

25.  The respiratory therapy practitioner is administering oxygen at 5 L/min via a nasal cannula to a 70 kg patient with a normal ventilatory pattern.  Which of the following most closely approximates this patient's FIO₂?

            a.  30%

            b.  35%

            c.  40%

            d.  45%

            e.  50%

26.        If the air entrainment port of an air entrainment type oxygen mask were to become                     occluded, which of the following would apply?

            1. the FIO2 would decrease

            2. gas flow to the patient would cease completely

            3. the FIO2 would increase

            4. total gas flow to the patient would decrease

                        a. 1,2

                        b. 2, 3

                        c. 3, 4

                        d. 1, 4

                        e. 1

27.       Which of the following oxygen liter flow rates is best recommended when the RCP is employing a non-rebreathing oxygen mask?

            a.   6-8 liters

            b.   6-12 liters

            c.   10-15 liters

            d. adjust so the bag does not collapse during expiration

28.       Which of the following will result in reduction of the amount of ambient gas entrained by an air entrainment type of mask?

            1. a reduction in the jet orifice size

            2. an increase in the FIO2

            3. an increase in the jet orifice size

            4. an increase in entrainment port size

                        a. 1,2

                        b. 2, 3

                        c. 1, 4

                        d. 3, 4

                        e. 3

29.       A patient who is receiving oxygen via a 24 percent air entrainment mask becomes dyspneic when she removes the mask to eat. You should recommend delivering the oxygen via a __________________ during meal times.

            a. nasal catheter at 4 l/m

            b. simple mask at 6 l/m

            c. nasal cannula at 1 l/m

            d. nasal cannula at 4 l/m

            e. nasal cannula at 6 l/m

30.       Mr. Jones has just been extubated following abdominal surgery. He has been ventilated with dry anesthesia for one hour. He is not fully awake, has some mild inspiratory stridor, and has no COPD history. Which of the following O2 delivery devices would you recommend setting up initially:

            a. heated T piece

            b. air entrainment mask

            c. nasal cannula

            d. cool aerosol mask

            e. nasal catheter

31.       Which of the following statements are true concerning the body’s normal initial response to acute hypoxemia?

            1. cardiac output increases

2. pulmonary vasodilation

3. minute ventilation increases

4. bradycardia and hypotension occur

            a. 1, 4

            b. 1, 3

            c. 3, 4

            d. 1, 2, 4

            e, 1, 2, 3

32.       Data necessary to calculate alveolar minute volume include which of the following?

            1. PaCO2

            2. tidal volume

            3. respiratory rate

            4. anatomical dead space

                        a. 1, 4

                        b. 2, 3

                        c. 3, 4

                        d. 1, 2, 4

                        e. 2, 3, 4

33.       A patient with COPD and chronic CO2 retention is admitted to the emergency room with    an acute exacerbation of her condition. The most appropriate oxygen device to use initially is a:

            a. nasal cannula at 2 l/m

            b. nasal cannula at 6 l/m

            c. simple mask at 6 l/m

            d. simple mask at 6 l/m

            e. partial rebreather mask at 10 l/m 

34.       What is the minimal flow rate that could be set on the oxygen flow meter to insure a total flow of 35 l/m through an air entrainment system set at 40% FIO2.

            a. 5 l/m

            b. 7 l/m

            c. 9 l/m

            d. 11 l/m

35.       The RCP is asked to instruct a 61-year-old patient with advanced pulmonary emphysema in breathing retraining exercises. In interviewing the patient, the chief complaint was of his inability to exhale completely. In which of the following exercises should the therapist instruct the patient?

            a. segmental breathing exercises

            b. diaphragmatic breathing

            c. pursed lip breathing

            d. cough instruction

            e. epnuestic breathing

36.       Prone with a pillow under the patient’s abdomen and the bed flat describes the position for draining:

            a. apical segment of the upper lobes

            b. posterior basal segment

            c. lateral basal segment

            d. anterior basal segment

            e. superior segment of the lower lobes

37.       A patient is to receive incentive spirometry. When explaining the therapeutic goals to the patient’s family, the RCP should explain that the therapy primarily:

            a. helps resolve pneumonia

            b. can decrease the chance of lung collapse

            c. should decrease the frequency of the patient’s cough

            d. will increase the stiffness of the lung 

38.       Which of the following does not respond to oxygen therapy very well?

            a. shunt

            b. v/q mismatching

            c. carbon monoxide poisoning

            d. diffusion defect

39.       Incentive breathing ecercises are utililized and effective in:

            1. preventing post-operative atelectasis

            2. detection of acute pulmonary disease

            3. optimizing the cough mechanism

            4. treating bronchospasm associated with asthma

                        a. 1,3

                        b. 3

                        c. 2, 3, 4

                        d. 1, 2, 3

40.       Postural drainage is not indicated or effective for patients with:

            a. asthma

            b. pneumonia           

            c. bronchitis  

            d. pleural effusion

41.       COPD patients must be retaught to use their diaphragm in order to: