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RES 280 FINAL REVIEW

RESPIRATORY THERAPY REVIEW

Question	Answer
Which of the following is FALSE about invasive pressure monitoring?	Laboratory analysis of gas exchange is usually noninvasive in nature
If patient pain or anxiety occurs during arterial puncture, which of the following will occur?	Hyperventilation
How is pH defined?	Negative logarithm of the H+ ion concentration of a solution.
The ease with which a gas dissolves into a solvent is at least partially determined by which of the following?	Gas temperature
An adult's insensible water through the lungs averages what level?	200 ml/day
What is a normal K+ blood level?	3.5 to 5.0 mEq/L.
If airway humidification is inadequate, a patient with a tracheostomy can have additional water losses as high as what level?	If airway humidification is inadequate, a patient with a tracheostomy can have additional water losses as high as what level?
Which of the following describes serum Ca2+?	Serum Ca2+ is present in three forms: ionized, protein bound, and complex.
Signs and symptoms of hyperkalemia would NOT include which of the following?	Metabolic alkalosis
What type of solution could have 1 gEq of solute per L of solution?	normal
During recovery from a serious surgery or trauma, how much water is likely to be produced in a 24-hour period by the catabolism of fat and proteins?	1000 ml
By what process is water replenished? I. Absorption II. Ingestion III. Metabolism	II & III Ingestion & Metabolism
A serum value of 140 mEq/L of Na is equivalent to how many mg/dl?	322 mg/dl
What is the relation between pure water and acid-base balance?	The concentrations of both H+ and OH- ions are equal.
A solution holding the maximum amount of solute in a given volume at a constant temperature is said to be what?	Saturated
Which of following is NOT a nonhydroxide base?	Ammonium
Clinical symptoms of hyponatremia would NOT include which of the following?	Bradycardia
Clinical manifestations of hypocalcemia would NOT include which of the following?	Depressed tendon reflexes
Patients with what condition are prone to evaporative water loss through the lungs? I. Artificial airways II. Hypothermia III. Increased ventilation	I and III I. Artificial airways III. Increased ventilation
You prepare a solution by combining 5 g of glucose with 95 g of water. What type of solution are you making?	Percent
What is the normal range for serum phosphate?	1.2 to 2.3 mEq/L.
Intracellular water represents about what proportion of total body water?	2/3
Which of the following drugs can be used to temporarily lower K+ in severe hyperkalemia?	Insulin
Pick the correct statement as it relates to hemoglobin and acid-base buffering.	Deoxygenated hemoglobin is a fairly strong base.
How is the gram-equivalent (gEq) weight of a substance computed?	Dividing its gram atomic weight by its valence.
What is the smallest fluid subcompartment of extracellular water?	Transcellular
Supply the definition for a base substance.	Any compound that will accept a proton.
Which of the following describe roles played by HCO3-? I. HCO3- levels vary directly with Cl- levels. II. It is the primary vehicle for blood carbon dioxide transport. III. It plays a key role in acid-base homeostasis.	II and III II. It is the primary vehicle for blood carbon dioxide transport. III. It plays a key role in acid-base homeostasis.
Which of the following is FALSE regarding body fluids and electrolytes?	Interstitial fluid contains substantially more protein than does plasma.
In which of the following solutions do the molecules of solute remain intact?	Nonpolar covalent
An adult's insensible water loss averages what level?	900
Which of the following is FALSE regarding water balance and the gastrointestinal tract?	The gastrointestinal tract is responsible for the most sensible fluid loss.
What is the most common cause of hyperkalemia?	Renal failure
What is the gEq weight of an acid?	Amount of the acid containing 1 mol of replaceable H+ ions.
Which patients are prone to K+ depletion and hypokalemia? I. Postsurgical patients II. Those with renal disease III. Trauma victims	I, II, and III
Positive ions are referred to as what?	Cations
Hypokalemia disturbs cellular function in ALL but one of the following systems. Which one does it NOT affect?	Hepatic
Which of the following describes an aspect of pH?	Any solution with a pH of 7 is neutral.
Which of the following are true regarding water in the human body? II. Total body water depends on an individual's weight and sex. III. Water constitutes about 45% to 80% of an individual's body weight.	II and III II. Total body water depends on an individual's weight and sex. III. Water constitutes about 45% to 80% of an individual's body weight.
What is the most prominent anion in the body?	Cl-
Where is most of the Mg 2+ found in the body?	In the cells
Which answer best describes the relationship between K+ movement and acid-base balance?	Excess extracellular H+ ions are exchanged for intracellular K+.
The most important physiological characteristic of solutions is their ability to exert pressure.	True
What is the attractive force of solute particles in a concentrated solution? Diffusion pressure Gas pressure Hydrostatic pressure Osmotic pressure	Osmotic pressure
What is the average urine output in a healthy adult?	1000 to 1200 ml/day
Water can be lost from the body through what organ systems? I. Gastrointestinal tract II. Liver III. Lungs IV. Skin	I, III, and IV
The combination of red blood cells in plasma is a good example of what? Student Answer: Colloid Mixture Solution Suspension	Suspension
Which of the following is an isotonic solution? Student Answer: 0.09% NaCl 0.90% NaCl 9.00% NaCl 19.0% NaCl	0.90% NaCl
If a 60% solution (A) were exposed to a 10% solution (B) across a semipermeable membrane, what would be the strength of each solution following equilibrium?	Solution A 35%/solution B 35%
What are the main intracellular electrolytes? I. K+ II. Na+ III. Phosphate IV. Sulfate	I, III, and IV
What is a characteristic of an acid? Student Answer: Absorbs H+ ions Accepts a proton Is a proton donor Produces OH- ions	Is a proton donor
Which of the following is NOT a major extracellular electrolyte? Student Answer: Cl- HCO3- K+ Na+	K+
Splitting of the second heart sound (S2) is normally most pronounced during which of the following? Student Answer: Exhalation Breath holding Inhalation Forced exhalation	Inhalation
In what space is the patient interview conducted by the clinician? Student Answer: Social space Personal space Intimate space Critical space	Personal space
To minimize bony interference with percussion on the posterior chest wall, the practitioner should have the patient do which of the following?	Raise his arms above his shoulders.
What change in the patient's respiratory breathing pattern is commonly seen with significant fever? Student Answer: Slower rate More rapid rate More prolonged expiratory time More prolonged inspiratory time	More rapid rate
What two factors determine cardiac output? Student Answer: Ventricular filling and heart rate Stroke volume and heart rate Stroke volume and respiratory rate Heart rate and tidal volume	Stroke volume and heart rate
Your patient has an abnormal sensorium. Which of the following is most likely true? He knows his name. He is confused about where he is. He is aware of the correct day. He knows the name of the hospital he has been taken to.	He is confused about where he is.
What term is used to describe difficult breathing in the reclining position? Student Answer: Orthopnea Platypnea Eupnea Apnea	Orthopnea
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? Stridor Rhonchi Crackles Wheeze	Stridor
Which of the following changes in the characteristics of wheezing indicate improvement in airway obstruction following bronchodilator therapy?	Lower pitch, shorter duration
Which of the following conditions would tend to shift the point of maximal impulse (PMI) farther to the left? I. Pulmonary emphysema II. Collapse of the left lower lobe. III. Collapse of the right lower lobe. IV. Right-sided tension pneumothorax	II and IV II. Collapse of the left lower lobe. IV. Right-sided tension pneumothorax
11. Question : What is the technical term for secretions from the tracheobronchial tree that have not been contaminated by the mouth? Student Answer: Sputum Phlegm Mucus Pus	Phlegm
What term is used to describe an abnormal anteroposterior curvature of the spine? Student Answer: Scoliosis Pectus excavatum Kyphosis Pectus carinatum	Kyphosis
In patients with chronic respiratory disease, what does pedal edema indicate? Student Answer: Right ventricular failure Impaired pulmonary diffusion Systemic hypertension Left ventricular hypertrophy	Right ventricular failure
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?	I and II I. Central nervous system disorder II. Congestive heart failure
During auscultation of a patient's chest, you hear coarse crackles throughout both inspiration and expiration. These sound clear when the patient coughs. Which of the following is the most likely cause of these adventitious sounds?	Movement of excessive secretions in the airways.
Why should the respiratory therapist perform a blood pressure assessment fairly quickly?	The procedure cuts off blood flow to the forearm temporarily.
What is indicated by the presence of central cyanosis? Student Answer: Respiratory failure Circulatory failure Anemia Hypotension	Respiratory failure
Which of the following is/are advantages of the digital blood pressure measurement devices? Student Answer: They reduce the risk of human error. They reduce the cost. They have an alarm. They measure blood pressure and stroke volu	They reduce the risk of human error.
In auscultating the precordium of a patient, you hear a high-pitched "whooshing" noise occurring simultaneously with S1. This finding is most consistent with which of the following?	Incompetent mitral valve
While palpating the thorax of a patient who repeats the words "ninety-nine," you note a localized area of decreased tactile fremitus on the lower right side. Which of the following could explain this finding?	II, III, and IV II. Right-sided lower pneumothorax. III. Right-sided lower pleural effusion. IV. Obstruction of a bronchus in the right lung.
During examination of a patient's extremities, you press firmly for a brief period on a fingernail. You observe that it takes about 5 seconds for the color to return to the nail bed. This finding is most consistent with which of the following?	Reduction in cardiac output or poor peripheral perfusion.
An increase in intensity and clarity of vocal resonance because of enhanced transmission of sound is referred to as which of the following? Student Answer: Bronchophony Vesicularity Pectoriloquy Egophony	Bronchophony
What is the normal range for pulse pressure? Student Answer: 20 to 35 mm Hg 30 to 60 mm Hg 30 to 40 mm Hg 30 to 60 mm Hg	30 to 40 mm Hg
The vibration created by percussion penetrates the lung to about what depth? Student Answer: 1 to 2 cm 3 to 5 cm 5 to 7 cm 8 to 10 cm	5 to 7 cm
While palpating the chest of a patient who repeats the words "ninety-nine," you note an area of increased tactile fremitus over the left lower lobe. Which of the following could explain this finding? I. Pneumothorax II. Emphysema III. Pneumonia	III. Pneumonia
On palpating the neck region of a patient on a mechanical ventilator, you notice a crackling sound and sensation. What is the most likely cause of this observation?	Subcutaneous emphysema
While percussing a patient's chest wall, you encounter an area that produces a decreased resonance to percussion. Which of the following are potential causes of this finding?	II. Pleural effusion III. Pneumonia IV. Atelectasis
Diastolic murmurs are generally associated with which of the following? I. Stenotic semilunar valve II. Incompetent atrioventricular (AV) valve III. Incompetent semilunar valve IV. Stenotic atrioventricular valve	III and IV
What is the most common cause of jugular venous distention (JVD)? Student Answer: Right-sided heart failure Arterial hypoxemia Tension pneumothorax Acute systemic hypertension	Right-sided heart failure
What term is used to describe sputum that has pus in it? Student Answer: Fetid Mucoid Purulent Tenacious	Purulent
During posterior thoracic palpation of an adult, you notice little or no movement on the right side during a full, deep breath. Which of the following conditions could explain this finding?	II. Right-sided pleural effusion III. Atelectasis of the right lower lobe IV. Right lobar consolidation
The total carbon dioxide (CO2) value is linked to what electrolyte in the blood serum? Student Answer: Sodium Potassium Bicarbonate (HCO3-) Chloride	Bicarbonate (HCO3-)
Which of the following is NOT one of the formed elements in the blood? Student Answer: Leukocytes Erythrocytes Thrombocytes Electrolytes	Electrolytes
Which of the following values represents a normal serum potassium level? Student Answer: 137 to 147 mEq/L 98 to 105 mEq/L 7 to 20 mEq/L 3.5 to 4.8 mEq/L	3.5 to 4.8 mEq/L
What is the upper limit of normal for the fasting blood glucose level? Student Answer: 50 mg/dl 85 mg/dl 105 mg/dl 140 mg/dl	140 mg/dl
What term is used to describe a red blood cell (RBC) count that is above normal values? Student Answer: Leukocytosis Leukopenia Anemia Polycythemia	Polycythemia
What term is used to describe a platelet count below normal? Student Answer: Anemia Leukopenia Thrombocytopenia Neutropenia	Thrombocytopenia
What term is used to describe a white blood cell (WBC) count that is above normal values? Student Answer: Leukocytosis Leukopenia Neutropenia Polycythemia	Leukocytosis
What is the name used for immature neutrophils? Student Answer: Segs Bands Polys Monos	Bands
What type of white blood cell increases in response to allergic reactions? Student Answer: Neutrophils Eosinophils Lymphocytes Monocytes	Eosinophils
What is the normal anion gap? Student Answer: 5 to 10 mEq/L 8 to 16 mEq/L 25 to 32 mEq/L 35 to 45 mEq/L	8 to 16 mEq/L
What term is used to describe a white blood cell (WBC) count that is below normal values? Student Answer: Anemia Thrombocytopenia Leukopenia Hyponatremia	Leukopenia
What term is used to describe the increase in neutrophils due to recruitment of marginated cells back into the circulating blood? Student Answer: Acute neutropenia Pseudoneutrophilia Thrombocytopenia An acute left shift	Pseudoneutrophilia
Your patient has an elevated aspartate aminotransferase (AST). What two organs are most likely diseased? Student Answer: Heart and brain Liver and kidney Brain and kidney heart and liver	heart and liver
What is indicated by an elevation of the anion gap? Student Answer: Respiratory failure Metabolic alkalosis Metabolic acidosis Renal failure	Metabolic acidosis
What term is used to describe a red blood cell (RBC) count that is below normal values? Student Answer: Leukocytosis Leukopenia Anemia Polycythemia	Anemia
What test is useful for evaluating the blood-clotting ability of your patient? Student Answer: Red blood cell count Platelet count Neutrophil count Hematocrit	Platelet count
What type of white blood cell increases in response to viral infections? Student Answer: Neutrophils Eosinophils Lymphocytes Monocytes	Lymphocytes
Which of the following tests is used to evaluate renal function? Student Answer: Creatinine Protein level Serum enzymes Sweat chloride	Creatinine
What abnormality in the complete blood count is often seen in a patient with chronic lung disease that causes significant hypoxemia? Student Answer: Leukocytosis Anemia Polycythemia Leukopenia	Polycythemia
Which of the following is NOT a cause of leukopenia? Student Answer: Chemotherapy Bone marrow disease Radiation therapy Antibiotics	Antibiotics
Which of the following statements is NOT true about type 1 and type 2 diabetes?	Type 1 is most often due to increased caloric intake.
Which of the following criteria applies to third-degree block?	There is no relationship between the P waves and the QRS complexes.
What is implied by an abnormally prolonged PR interval? Student Answer: Atrioventricular block Bundle-branch block Myocardial infarction Valvular detachment	Atrioventricular block
Why is the electrical impulse temporarily delayed at the atrioventricular (AV) node?	To allow better filling of the ventricles.
Which of the following medications is used to treat sinus bradycardia? Student Answer: Atropine Digitalis Propranolol Lidocaine	Atropine
What term is used to define the ability of certain cardiac cells to depolarize without stimulation? Student Answer: Automaticity Polarization Contraction Repolarization	Automaticity
Which of the following ECG abnormalities is most life threatening? Student Answer: Narrow QRS complex Shortened PR interval Elevated ST segment Peak P waves	Elevated ST segment
Which of the following axis placements represents right-axis deviation? Student Answer: +60 +90 +120 +190	+120
What is suggested by inverted T waves on the ECG? Student Answer: Atrial enlargement Myocardial ischemia Ventricular hypertrophy Dextrocardia	Myocardial ischemia
What structure normally paces the healthy heart? Student Answer: Atrioventricular (AV) node Sinoatrial (SA) node Bundle of His Purkinje fibers	Sinoatrial (SA) node
Which of the following is NOT a common characteristic of a premature ventricular complex (PVC)? Student Answer: No P wave prior to the QRS complex Widened QRS complex Bizarre QRS complex Narrow QRS	Narrow QRS
Which of the following is NOT a common cause of ventricular tachycardia? Student Answer: Myocardial infarction Coronary artery disease Hypertensive heart disease Pericarditis	Pericarditis
At what part of the cardiac conduction system does the electrical impulse travel most rapidly? Student Answer: Bundle of His Bundle branches Intraatrial pathways Purkinje fibers	Purkinje fibers
What medication is most useful for the treatment of premature ventricular contractions? Student Answer: Digoxin Atropine Lidocaine Digitalis	Lidocaine
The ECG you are looking at has one P wave for every QRS complex and the PR interval is 0.30 second. What is your interpretation? First-degree heart block Right-axis deviation Third-degree heart block Atrial hypertrophy	First-degree heart block
Which of the following waves represents depolarization of the ventricles? Student Answer: P wave QRS wave T wave U wave	QRS wave
Which of the following waves represents repolarization of the ventricles? Student Answer: P QRS T U	T
For which of the following arrhythmias would an electronic pacemaker be indicated? Student Answer: First-degree block Sinus tachycardia Third-degree block Ventricular fibrillation	Third-degree block
Which of the following clinical conditions is not associated with tachycardia? Student Answer: Anxiety Hypoxemia Pain Hypothermia	Hypothermia
What is the normal period of time for the PR interval? Student Answer: Not longer than 0.20 second Not longer than 0.30 second Not longer than 0.45 second Not longer than 0.50 second	Not longer than 0.20 second
What structure serves as the backup pacemaker for the heart? Student Answer: atrioventricular (AV) node sinoatrial node bundle of His Purkinje fibers	atrioventricular (AV) node
The QRS of an ECG falls on a dark vertical line of the ECG paper. Subsequent QRS complexes fall on every other dark line (10 mm apart). What is the ventricular rate? Student Answer: 300/min 200/min 150/min 100/min	150/min
What condition is often associated with right-axis deviation? Student Answer: Cor pulmonale Congestive heart failure (CHF) Mitral valve prolapse Left ventricular hypertrophy	Cor pulmonale
An occasional premature ventricular complex (PVC) is not of major concern.	true
Which blood gas analyzer electrode uses a separate reference electrode? Student Answer: O2 pH Clark HCO3-	ph
What is a normal end-tidal PETCO2 range? Student Answer: 30 to 38 mm Hg 35 to 43 mm Hg 38 to 46 mm Hg 42 to 50 mm Hg	35 to 43 mm Hg
Continuous SpO2 monitoring (versus a spot check) is indicated in all of the following situations except. Student Answer: Exercise testing Sleep studies Bronchoscopy O2 therapy	O2 therapy
During capnography monitoring of a mechanically ventilated patient, you note that the PETCO2 has dropped to 0 mm Hg. All of the following are possible causes of this finding except.	Increased cardiac output
What is a normal level for CaO2? Student Answer: 12 to 15 ml/100 ml 14 to 16 ml/100 ml 18 to 20 ml/100 ml 16 to 22 ml/100 ml	18 to 20 ml/100 ml
A mixed venous blood sample obtained from a pulmonary artery catheter sample has a PO2 of 85 mm Hg and a hemoglobin saturation of 95%. Which of the following is likely?	I. The pulmonary artery catheter balloon was not deflated. III. The blood sample was withdrawn too quickly.
Treatment parameters that should be assessed as part of arterial blood sampling include all of the following except.	Time of last incentive breathing exercise.
Under ideal conditions, pulse oximeter readings patients usually fall in what range of those obtained with invasive hemoximetry? Student Answer: 1% to 2% 2% to 3% 3% to 5% 5% to 7%	3% to 5%
What is the normal range for end-tidal CO2 as measured by capnography? Student Answer: 0% to 5% 5% to 6% 6% to 8% 35% to 45%	5% to 6%
Possible complications of capillary blood gas sampling include all of the following except: Student Answer: infection. hematoma. hemorrhage. hypotension.	hypotension.
Warming a capillary bed to 42° C has which of the following effects? I. It constricts the underlying blood vessels. II. It increases blood flow well above tissue needs. III. It "arterializes" the capillary blood.	II and III
Factors contributing to imprecision (random) errors during blood gas analysis include all of the following except. Student Answer: Sample contamination Contaminated buffers Statistical probability Sample mishandling	Contaminated buffers
Which of the following should be monitored during the sampling of arterial blood? I. Blood pressure proximal to puncture site. II. Presence of pulsatile blood return. III. Presence of air bubbles or clots in sample. IV. Appearance of puncture site.	II, III, and IV
A PaO2 below what value would be considered severe hypoxemia? Student Answer: 60 mm Hg 50 mm Hg 40 mm Hg depends on the FIO2	40 mm Hg
A practitioner forgets to ice an ABG sample and leaves it at room temperature for 45 minutes. Which of the following parameters can you predict will increase in this sample during that period? I. PCO2 II. pH III. PO2	I. PCO2
ou are asked to provide continuous monitoring of the FIO2 provided by a humidified O2 delivery system using a galvanic cell analyzer. Where would you install the analyzer's sensor?	Proximal to the heated humidifier.
What is the process of testing a new blood gas analyzer to confirm a manufacturer's claims? Student Answer: Automated calibration Performance validation Proficiency testing Preventive maintenance	Performance validation
An outpatient scheduled for an arterial blood sample enters the pulmonary lab 20 minutes late and out of breath, having run up four flights of stairs. What should you do?	Wait 5 minutes before taking the sample.
Factors contributing to bias (systematic) errors during blood gas analysis include all of the following except. Student Answer: Incorrect procedures Statistical probability Contaminated buffers Component failure	Statistical probability
Through which pulmonary artery catheter port would you obtain a mixed venous blood sample? Student Answer: Proximal (right atrium) port Catheter thermistor connector Distal (catheter tip) port Balloon inflation port	Distal (catheter tip) port
What is the quality control procedure of analysis and reporting on externally provided control media with unknown values? Student Answer: Automated calibration Performance validation Proficiency testing Preventive maintenance	Proficiency testing
To validate patient readings obtained from a transcutaneous blood gas monitor, what should you do?	Compare the monitor's readings to those obtained with a concurrent ABG sample.
All of the following sites are used for arterial blood sampling by percutaneous needle puncture except: Student Answer: Femoral Radial Brachial Carotid	Carotid
How often should blood gas calibration verification by control media take place?	At least two levels of control media should be analyzed every 8 hours.
Which of the following is NOT a use of capnometry? Student Answer: To assess blood flow during cardiac arrest. To determine PEEP levels. To detect esophageal intubation. To assess the condition of the alveolar-capillary membrane.	To assess the condition of the alveolar-capillary membrane.
Which of the following changes would occur if an arterial blood sample of a patient breathing room air were exposed to a large air bubble?I. Decreased PCO2 II. Decreased pH III. Increased PO2	I. Decreased PCO2 II. Increased PO2

Created by: avalles

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