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RES 110 & 121 Exam

Cardiopulminary Science & Respiratory Skills

QuestionsAnswers
Define autonomy ethical principal which acknowledges patient's person liberty and their right to decide upon their best course
Define veracity ethical principal which binds the healthcare giver and the patient to tell the truth
Who discovered the fudamentals of gas exchange Lavoiser
Who discovered that animals can't live in an environment which will not support a flame Leonardo Da Vinci
What is the purpose of the AARC promote education,lobby congress,promote professionalism and act as a "voice" for its members
Robert Boyle discovered what important gas law pressure varies inversely with volume(boyle's law)
Who established the Pneumatic Inst. of Bristol Beddoes
Define beneficence the ethical principle that requires the respiratory therapist to actively contribute to the well-being of the patient he serves
Who performed the first recorded respiratory physiology experiment Aristole
Who is the Father of Inhalation Therapy Beddoes
In what section of the patient history can a detailed descrption of the patient's current symptom be found history of present illness
The( )respiratory therapist is the highest credential in the profession registered
Responsible for the clinical function of the Respiratory Care Dept Medical Director
What is the most essential aspect of providing quality respiratory care care being provided is indicated, care is delivered competently and appropiately, patient is appropriately evaluated by physican before care is initiated
What is the chief reason that the respiratory care protocols were developed and are currently being used in hospitals throughout North America enhance efficiency of respiratory care personnel in providing patient care
Respiratory Care education programs are reviewed by what committe to ensure quality Commission for Accredidation of Respiratory Care
Lifting heavy objects is best done with which of the following techniques straight spine and bent legs
To determine ant recent trends in a patinet pulse, respiration, blood pressure, you would go to which section of the medical records vital sign sheets
What organization is responsible for credentialing respiratory therapist NBRC
What term is used to describe the process in which a government agency gives an individual permission to practice an occupation Licensure
What simple question does ethics try to answer How should we act
Approximately what percent of patients receiving mechanical ventilation develop pneumonia as a complication 25%
Who is considered to be the "father of medicine" Hippocrates
Factors most critical in determining when a patient can be ambulated stability of vital signs and absence of severe pain
Considered the primary source of infection in the healthcare setting humans
What is NOT an expected role of a respiratory therapist selling oxygen therapy devices to patients
What are characteristics of a respiratory care profesional participates in continuing education activities,obtains professional credentials, adheres to acode of ethics and completes an accredited education program
Which ethical principle obliges a respiratory therapist to uphold a patient's right to refuse a treatment autonomy
How do endotracheal tubes increase the risk of infection impeding local host defenses and provding surfaces for biofilms to develop
Who discovered oxygen in 1774 and described it as "dephlogisticated air" John Priestly
Key factors determining the extent of harm caused by an electrical current duration for which the current is applied, path the current takes through the body, and amount of current flowing through the body
HIPPA was established in 1996 to set standards related to sharing confidential health history information about patients. What does the "P" stand for portability
What ethical principle can be used to justify the pain that might occur in drawing blood from a patient for a dignostic test double effect
What vaccination does OSHA require hospital employers to provide Hepatitis B
Who is credited with first describing the law of partial pressures for a gas mixture John Dalton
Which of the following organs is the most sensitive to the effects of electrical shock heart
Responibility for the technical direction of a respiratory care department lies with whom Department Manager
The debate over prolongation of life versus relief of suffering in elderly patients mainly involves differing opinions regarding what ethical principle Beneficence
What is NOT TRUE regarding the use of soaps to clean equipment have good bacterial activity
What is TRUE regarding the use of soaps to clean equipment work poorly in hard water and can help remove organic material
What was the primary duty of the first inhalation therapit support oxygen therapy
Statement that is true regarding the use of oxygen oxygen accelerates the rate of combustion and increased oxygen concentration accelerates the rate of combustion
What voluntary accrediting agency monitors quality in respiratory care departments JCAHO
What type of advanced directives can patients use to help resolve ethical dilemmas involving their life- sustaining care durable power of attorney and living will
When did the designation "respiratory therapist" become standard 1974
In the standard approach to hospital fires,the RACE plan has been suggested. What does the letter "C" stand for in this application contain
Treatment based on careful review of available literature is known as evidence-based medicine
Has played a major role in increasing the cost of healthcare compensatory justice
What is the most common, efficent and easiest sterilization method steam sterilization
Who was the first to develop the large-scale production of oxygenin1907 Karl von Lindi
Factors tha can have an impact on the outcomes of therapeutic communication between patient and practitioner Verbal and nonverbal components of expession, environmental factors(eg noise, privacy), values and beliefs of both patient and practitioner, sensory and emotional factors(eg. fear, pain)
When a respiratory therapist defers a patient's question about a condition to the attending physician. What ethical principle is being practiced role fidelity
What is NOT a category under Expanded Precautions standard
What two names are linked with the development of the iron lung, which was extensively used to treat the polio epidemic in the 1950's Drinker and Emerson
A therapist who says "Please explain that to me again" to a patient during an interview is using what interpersonal communication technique clarifying
What is the minimum recommended time for handwashing in the healthcare environment 15 seconds
Was one of the first positive-pressure ventilators development Drager Pulmotor
What branch of law is concerned with the recognition and enforcement of the rights and duties of private individuals and organizations civil
In 1846, who developed a water seal spirometer, which allowed accurate measurement of the patient's vital capacity Hutchinson
To confirm a physicians prescription for a drug that you need to give to a patient, you would go to which section of the medical record physician orders
What is the term for a civil wrong committed against an individual or property, for which a court provides a remedy in the form of damages tort
what was the name of the first professional organization for the field of respiratory care inhalation therapy association
To determine the most recent medical status of a patient whom you are about to start treating, you would go to which section of the medical record progress sheet
what is NOT considered an intentional tort negligent practice
what organization has developed an examination to enable respiratory therapists to become licensed national board for respiratory care
what is the correct way to sign a medical record entry C. White,LRCP,CRT
A physician orders an incorrect dose in a prescription for a powerful bronchodilator drug for an asthmatic pt. The respiratory therapist gives the prescribed dose, the patient has a fatal response and dies, who could a suit of negligence be bought against respiratory therapist, attending ohysician, and dispensing pharmacist
The majority of respiratory care education programs in the United States offer what degree Associates
The AARC is the professional organization of radiologic technologist in the USA false
Sixteen inhales plus 16 exhales equals 32 respirations per minute false
The practice of universal precautions assumes that all patients are potentially infected true
Sitting or standing with your arms crossed sends a message of unacceptance true
What nerve innervates many different locations throughout the body vagus
Terminal air spaces that serve as sites for gas exchange are alveoli
The presence of an abundance of goblet cells is indicative of a heavy smoker
Type I cells comprise what % of the surface area of the lungs 95
The law that states that a bubble will shrink to its smallest size is what law Laplace
There are how many alveoli in the human lung 300,000,000
What connects the upper and lower airways larynx
Type II pneumocytes are located in the alveoli
The canals of Lambert provide collateral ventilation
Support is provided to the trachea by cartilage
The trachea divides into right and left mainstream bronchi
Difficult or labored breathing is dyspnea
Core temperature is most accurate when taken rectal
The primary muscle for ventilation is the diaphragm
The point at which the trachea divides into right and left mainstream bronchi is the carina
If an individual has 16 respirations per minute, they would have how many inspirations and expirations 16;16
The primary organ for gas exchange in the fetus is the fetus placenta
When performing physical assessment , the "placing of hands" to detect physical signs is palpation
A respiratory therapy practitioner is auscultating the chest of a pt. who has pneumonia and notes popping sounds in the left lower lobe @the end of inspiration. What terms should be recorded in the chart to describe the sounds crackles
The functions of the upper airway include conducting gases, heat exchange and humidification
The larynx functions as aid in the cough reflex, serves as conducting airway and participates in speech
The uvula is a cone- shaped process midline to the soft palate and monitors flow when a person coughs, sneezes or vomits
The narrowest portion of the infant airway is the cricoid cartilage
The adult trachea is how long 11cm
Type II make surfactant, are highly metabolic, and store surfactant
A patient states he has trouble sleeping unless he uses two pillows, This comment is indicative orthopnea
Most correctly describes the anatomic pathway of air to AC membrane terminal bronchioles, respiratory bronchioles, alveolar ducts, alveolar sacs
Patient XY is now running a fever, the temperature went from 36.7 degrees Celsius to 37.7 degrees Celsius. You should expect increased oxygen demand and increased inspiratory rate
Gas exchange begin in the respiratory bronchioles
The alveolar duct ends in a cluster of alveolar sac, has smooth muscle present, is comprised of simple squamous epithelium, and extends from the 24th to the 27th generation
The narrowest portion of the adult airway glottis
The bronchioles, as are the bronchi and trachea are composed of pseudostratified ciliated epithelial
Alveolar ventilation is the portion of gas available for gas exchange
Rate * tidal volume Ve(minute ventilation)
How many segments are in the left lung 8
The nose performs many vital functions. Some are warm, filter, humidifies, conducting airway and aids in phonation
By the time that inspired air reaches the carina, it has a relative humidity of 100%
The right mainstream bronchus is ( ) the left mainstream bronchus shorter and wider
Which of the following muscles are considered accessory muscles of ventilation scalene and sternocleidomastoid
Which breathing pattern would MOST LIKELY be seen in s diabetic patient Kussmaul's breathing
What nerve innervates the diaphragm phrenic
This muscle is recruited after 3/4 of vital capacity has been inspired sternocleidomastoid
Mucus is made by what goblet cells and sub mucosal glands
When performing a visual assessment, the observation of the breathing pattern is inspection
A greater than 10mmHg drop in blood pressure on inspiration is pulse paradoxus
If a patient is breathing erratically with periods of apnea, he has which of biots
What is the most common complaint in pulmonary disease cough
An example of POMR method of documentation is the SOAP charting
The normal value for the resting pulse rate of the adult is 60-100bpm
Which of the following methods of temperature measurement is recommended for neonates axillary
Increased PEEP would increase continuous pressure in the intra pleural space, impede venous return, and decrease blood pressure
The respiratory components of the medulla and pons include medullary, apneustic, pneumotaxic, and pontine
The peripheral chemo receptors are activated by a Po2 of 60mmHg
When the apneustic center is stimulated ( ) becomes very ( ) inspiration; long
Protects the lungs from excessive inflation Hering- Breuer reflex
What is the response of the central chemoreceptors to a low CSF PCO2 decrease the respiratory rate
Stimulation of the irritant reflex causes cough, bronchoconstriction and increase tidal volume
The juxtapulmonary receptors are activated by pulmonary edema and microemboli
The rate of breathing is based upon emotion, carbon dioxide in the blood and metabolic status
Peripheral Chemoreceptors respond to fluctuating levels of oxygen in the bloodstream
The kidney compensates for high carbon dioxide level by producing a high level of bicarbonate(HCO3)
As PaCo2 increases the cerebrospinal fluid becomes acidotic
A distance of 4-12 feet from the patient is considered social space
The bleating sound, usually distorted by asking the patient to say "E" that changes to "A" egophony
A harsh crowing sound usually heard on inspiration stridor
A pt. who has mucus that is the color of red currant jelly usually has been infected with Klebsiella
Observationof the "big picture" with regard to the pt. and their environment occurs in the social
Breath sounds that are normally heard over the periphey of the the lungs vesicular
Blood pressure is measured in mmHg
What is the most common complaint in pulmonary disease cough
The act of tapping on a surface is in an effort to evaluate the underlying tissue percussion
A bluish color of the skin caused by a decrease in the oxygen saturation cyanosis
The primary purpose of the respiratory system continouous absorption of oxygen and excretion of carbon dioxide
By what mechanism does gas exchange across the lung occur simple diffusion
In patients with chronic respiratory disease what does pedal edemal indicate right ventricular failure
During exam of pt. extremities you press firmly for a brief period on a fingernail. You observe that it takes 5 seconds for the color to return to the nail bed. This is consistent with reduction in cardiac output or poor peripherial perfusion
The fetus is potentially viable if born at the end of which stage of development canalicular
During ausculation of a pt.'s chest, you hear abnormal discontinuous "bubbling" sounds at the lung bases. What best describes this crackles heard at lung bases
What does the presence of stridor indicate upper airway obstruction
The patency of small airways is maintained by traction of surrounding elastic tissue and transmural pressure gradients
Identify functions of airway mucus in the normal lung increase mucus production decreases bronchospasm, shield the airway from toxic particles and trap inhaled contaminants
Associated with tripodding severe pulmonary hyperinflation
What factor contributes to increased likelihood of an upper airway obstruction in an infant compared to an adult tongue that is proportionaly larger
What pulmonary disorder could lead to acute flattening of the diaphragm Asthma
Terminal bronchioles are the Smallest of the purely conducting airways
During posterior thoracic palpation of an adult you notice little/no movement on the right side during full deep breath. What would this condition explain? Right sided pleural effusion, atelectasis of the right lower lobe and right lobar consolidation
At what point does the trachea branch into two mainstream bronchi Carina
why do most aspirated objects and fluids end up in the right mainstream bronchus instead of the left mainstream bronchus the right bronchus is more in line with the trachea
what portion of the left lung corresponds anatomically to the middle lobe of the right lung lingula
What position is used to open the airway in an unconscious patient sniff position
What is the function of the very small amount of pleural fluid found in the pleural space reduces friction
what may cause the trachea to shift to the right right upper lobe atelectasis
what is the most common cause of jugular venous disturtion (JVD) right sided heart failure
what disease is associated with barrel chest emphysema
What results in partial or total obstruction of the airway in an unconcious patient relaxation of tongue an hypopharyngeal muscles
what is the cartilage that is commonly reffered to as the adam's apple? thyroid
what breathing pattern is associated with severe atelectasis rapid and shallow
a patient with asthma would tend to exhibit prolong exhalation
Cheyne-Stokes increased and decreased in depth and rate with periods of apnea(congestive heart failure)
Kussmaul Deep and fast breathing(diabetes/ metabolic acidosis)
Tachypnea rapid/fast breathing (excercise)
Apnea no breathing
eupena normal breath sounds
Bronchiovesicular heard around the sternum; softer and slightly lower in pitch
vesicular heard over lung parenchyma; represent atteneated turbulent flow sounds from the larger airways; very soft and low pitched
bronchial high pitch, slightly longer expiration than inspiration
Ventimask set at 24% O2 has the flowmeter running @ 4LPM. What would increase the O2 concentration decresing the air entrainment port size and increasing the oxygen- orifice diameter
What device would be contraindicated for a patient whose upper airway has been by passed simple bubble humidifier
Relative Humidity content divided by capacity*100
Gas flowing in a streamlined fashion is called laminar
The partial pressure of oxygen in room air, assuming dry, with a barometric pressure of 750mmHg is 157.5mmHg
What is the total pressure of a gas mixture if PO2=90mmhg,PCO2=50mmHg,PN2=573mmHg and PH2O=47mm 760mmHg
The accuracy of the Thorpe tube flow meter depends upon the position of the needle valve, pressure compensation, and condition of the flow meter
The Bourdon gauge is the flow meter of choice when O2 tank is on its side and is actually a pressure gauge
the temperature is 25 degrees Celsius what is it on the Kelvin scale 298 K
another way to express 37 degree Celsius, 100% RH, atmospheric pressure is BTPS
According to Graham's Law which of the following gases would diffuse most quickly 0.543 gm./ liter
if the temperature of the room is raised and NO humidity is added relative humidity will decrease
What is the PIO2 of air if the barometer pressure is 630mm What is the PIO2 of air if the barometric pressure is 630mmHg 132mmHg
The pin-in-hole combination for oxygen is 2 & 5
the pin-in-hole combination for air is 1 & 5
The 5th floor called "code red" meaning fire. What should the respiratory therapist do first shut off the zone valve
The force opposing the deformation of a fluid viscosity
A patient is on a nasal cannula running @ 6 LPM. The therapist adds some extra tubing so that the patient can walk, this would decrease the resistant to gas flow and increase the resistance to gas flow causing a more turbulent flow
A patient is receiving O2 @ 5LPM. His respiratory rate is normal and consistent. What is the approx. FIO2 he is receiving 40%
How should the reservoir bag on a non rebreather mask be set when this device is used on a patient remain partially inflated @ end-inspiration
The minimum flow that should be used to deliver O2 to a simple mas is 5LPM
The ( ) was designed for the connecting valves of large cylinders ASSS
A humidifier is a device that produces water vapor
A pressure of 760mmHg, temperature of 0 degree Celsius and water vapor pressure of 0mmHg describes STPD
The law that states that the pressure difference needed to drive a fluid through a tube in a streamline fashion is directly proportional to the viscosity, length of the tube, rate of flow, and inversely proportional to the fourth power of the radius is Poiseuille's Law
As a gas temperature increases, it's ability from a to hold water increases
A change in the state of matter from a liquid to gas vaporization
The primary factor influencing the efficiency of a humidifier temperature
The reason for the minimum flow rate to a mask is to flush out exhaled CO2
What would increase the likelihood of generating laminar air flow increasing the radius of the tube
Oxygen concentrations that use semipermeable membranes can achieve ( ) O2 @ flows of 1-10LPM 40
If the temperature of a saturated gas decreases, which of the following will occur condensation develops
Which of the following factors will decrease the FIO2 delivered by a low flow O2 system Short inspiratory time, fast rate breathing, lower O2 input, and large minute ventilation
If you have to deliver medical gas to a patient from a compressed gas cylinder, which of the following devices is responsible only flowmeter
how can one determine whether a pressure reducing valve uses multiple stages for pressure reduction? By noting the # of pressure relief vents
What design components of an air injector would result in entraining the greatest amount of air small orifice jet and large entrainment ports
A cooperative and alert postoperative patient taking food orally requires a small increment of FIO2 to be provided continuously. Precise FIO2 concentrations aren't needed. What device would be best to use nasal cannula
What device is used to reduce the pressure and control the flow of a compressed medical gas regulator
According to Bernoulli's principle, as a fluid flows through a narrow passage or sticture, what will occur lateral pressure will fall
What is a false staement about low flow devices The greater thepatient's inspiratory flow, the greater is the FIO2
What is the usual method for monitoring the remaining contents in a gas filled cylinder read the pressure gauge
Which of the following methods of heat transfer requires no direct contact between the warmer and cooler substances radiation
What can properly applied O2 therapy decrease ventilatory demand, work of breathing and cardiac output
By what means is oxygen for medical use in a hospital most commonly produced fractional distillation
A patient has recorded body temp of 106 degrees of Fahrenheit. What is it in degrees Celsius 41 degrees Celsius
The pin index safety system was created to avoid accidental use of inaccurate flow meters for various gases false
A smaller surface area will increase the efficiency of a humidifier false
Absolute zero
Boyles Law p1v1=p2v2 (temp/mass)
Charles Law v1/t1=v2/t2 (pressure/mass)
Gay Lussacs Law p1/t1=p2/t2 (volume/mass)
Combined gas law formula p1v1/t1=p2v2/t2
What agency is responsible for transporting medical gases DOT
Which organization is responsible for the purity of medical gases FDA
nasal cannula is a low flow device that operates on 4-10 liter of flow and does not need humidity
casscade humidifier works with high flow devices; some of its parts are inlet source, diffusion grid and water reservior
list the pulse sites radial,carotid, femoral, brachial and dorsal pedis
What effect does temperature have on the efficiency of humidifiers increase the temperature you increase the humidity
whateffect does the water level have on the efficency of a humidifier decrease water level and you decrease humidity
Differentiate between a high flow device and a low flow device high flow devices meet inspiratory demand and low flow devices don not
Name three examples of low flow devices nasal cannula, partial rebreather and non rebreather mask
tidal volume of 500ml respiratory rate of 12. What is the minute volume Ve=rr*Vt 12*500=6000 6.0 L
The patient is inhaling. What receptors would make him stop inhalation to bgin exhalation Hering Breuer
During each cycle of normal resting ventilation a volume of gas is moved into and out of the respiratory tract. This cyclical volume is called tidal volume
Which of the following pressures vary throughout the normal breathing cycle alveloar pressure(Palv) and pleural pressuer(Ppl)
What is the primary goal of humidty therapy maintain normal physiologic conditions
Which of the following would indicate a need for O2 therapy for an adult or child SaO2 less than 90% and PaO2 less tha 60mmHg
You start a Chronic Obstructive Pulmonary Disease (COPD) patient on a nasal cannula @ 2L/min. What is the max time that should pass before assessing the patient's PaO2/SaO2 2 hours
Which of the following patient categories are @ high risk for developing atelectasis those who are heavily sedated, those with abdominal and thoracic pain, those with neuromuscular disorders
Alveolar pressure(Palv) during normal breathing is negative during inspiration and positive during expiration
Inhalation of of dry gases can increase viscosity of secretions, impair mucocillary motility and increase airway irritability
Which of the following inspired conditions should be maintained when delivering medical gases directly into the trachea through an endotracheal tube or a tracheotomy tube 100% Relative Humdity @ 32-35 degrees of Celsiuis
Which of the following signs and symptoms are associated with the presence of hypoxemia tachypnea, tachycardia, and cyanosis
What clinical finding would indicate the development of atelectasis opacified areas on the chest x-ray film, tachypnea and diminished/bronchial breath sounds
Simple unheated bubble humidifiers are commonly used to humidify gases with what type of systems oronasal oxygen delivery
What is consistent with the radiographic appearence after prolonged exposure to O2 patchy infiltrates
A patient with chronic hypercapnia placed on a FIO2 of 0.6 starts hypoventilating. What is the probalble cause of this phenomenon O2 induced hypoventilation
What happens during normal inspiration Ppl decreases further below atmospheric, transpulmonary pressure gradient widens and Palv drops below that At the airway opening
To minimize the risk of retinopathy of prematurity(ROP), The American Academy of Pediatrics recommends keeping the PaO2 below what level 80mmHg
To ensure a stable FIO2 under varying patient demands, What must an O2 delivery system do provide all the gas needed by the patient during inspiration
Which type of humidifier "traps" the patient's body heat and expired water vapor to raise the humidity of inspired gas heat moisture exchanger
What is the effect of surface tension forces in the air filled lung it increases the elastic recoil of the lung(promoting collapse), it makes the lung harder to inflate than if it were filled with water
A cooperative and alert postoperative patient taking food orally requires a small increment in FIO2 to be provided continuously. Precise FIO2 concentrations are not needed. What device would be best to use nasal cannula
What type of patient would you select a heated humidifier? A patient receiving oxygen through a bypassed upper airway
The presence of surfactant in the alveoli tends to decrease surface tension
How is compliance computed change in volume/change in pressure
Normal lung compliance is approximately 0.20L/cmH20
You enterthe room of a patient who is receiving nasal O2 through a bubble humidifier @ 5L/min. You immediately notice that the humidifier pressure relief is popping off. What is the appropriate action for this situation look for crimped or twisted delivery tubing
What is FALSE in reference to air entrainment systems their FIO2 values are directly proportional to their total flow
Which of the following factors determine the actual O2 provided by an air entrainment system O2 input flow to the jet and resistance down stream from the jet
A patient receiving 35% O2 through an air entrainment mask set @ ^L/min input flow becomestachypneic. You notice that the SpO2 has fallen from 91% to 87%. What action would be appropriate increase the device's flow to 10L/min
You design an air entrainment system that mixes air with O2 at a fixed ratio of 1:7(1L air to 7L O2)About what O2 will this device provide 90%
A45 year old patinet with congestive heart failure receiving O2 through a 35% air entrainment mask; witha an O2 input of 6L/min. What is the total gas flow 34L/min
cylinder duration of FLOW formula psi * tank factor/ flow
tank factors E cylinder = 0.28 G cylinder = 2.41 H cylinder = 3.14
cylinder colors oxygen=green, carbondioxide=gray, helium=brown, heliox=green/brown, nitrous oxide=blue, nitic oxide=teal/black
formula for minute volume Ve(minute volume)= rr * Vt(tidal volume)
filled oxygen tanks will always equal 2200psi
entrainment ratios 100=0,80=0.3, 70=0.6| 60=1,50=1.7| 45=2, 40=3, 35=5,30=8| 28=10, 24=25
Fahrenheit to Kelvin Celsius= 5/9 * (Fahrenheit-32) THEN K=C - 273
Celsius to Kelvin K=C + 273
duration of GAS duration of gas(min)= amt of gas in cylinder/flow(L/min)
Ideal body weight(men) IBW(lbs)=106 + 6[height(in)-60]
Ideal body weight(women) IBW(lbs)=105 + 5[height(in)-60]
Formula for Relative Humidity RH= Content/Capacity * 100
Desired FIO2 formula Desired FIO2= PaO2(desired) * FIO2(known)/PaO2(known)
Rule of 5's multiply FIO2 by 5 and will give you the PaO2OF NORMAL person
Created by: cdmccray