Respiratory Therapist Exam Review-chapters 1 & 2
Chapter one review questions, both entry level and written exam
Questions and Answers
- 1.
You have finished charting on your patient when you notice that an error was made. You should do which of the following?
- A.
Tell the nurse so that she will tell the physician
- B.
Tell the nurse so that she will chart the correct information
- C.
Place a line through the error, initial it, and write in the correct information
- D.
Have your supervisor chart the correct information
Correct Answer
C. Place a line through the error, initial it, and write in the correct informationExplanation
When an error is made while charting on a patient, the appropriate action is to place a line through the error, initial it, and then write in the correct information. This ensures that the error is clearly marked and the correct information is recorded. Informing the nurse or supervisor is not necessary in this case as the error can be rectified immediately by the person who made it.Rate this question:
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- 2.
In listening to a patient's lungs, you notice bronchial breath sounds in her right lower lobe. These would indicate which of the following?
- A.
Normal lungs
- B.
Pneumothorax
- C.
Consolidation in her right lower lobe
- D.
Pleural effusion in her right lower lobe
Correct Answer
C. Consolidation in her right lower lobeExplanation
Bronchial breath sounds are harsh and high-pitched sounds heard over the trachea or bronchi, and they are not normally heard in healthy lung tissue. The presence of bronchial breath sounds in the right lower lobe suggests consolidation, which refers to the filling of the alveoli with fluid or solid material. This can be caused by conditions such as pneumonia or lung abscess. Therefore, the correct answer is consolidation in her right lower lobe.Rate this question:
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- 3.
You are called to start a new aerosolized medication treatment. After reading the physician's order, you notice that the drug dosage is outside the normal department guidelines. You should do which of the following?
- A.
Give the treatment as ordered
- B.
Contact the physician to confirm that the order is indeed correct
- C.
Give the treatment as ordered, and leave a note in the chart asking for clarification for the next treatment
- D.
Have the nurse rewrite the order
Correct Answer
B. Contact the pHysician to confirm that the order is indeed correctExplanation
Given the scenario where the drug dosage is outside the normal department guidelines, it is important to ensure patient safety. Contacting the physician to confirm the order is the appropriate course of action as it allows for clarification and verification of the dosage. This step helps to prevent any potential harm to the patient and ensures that the medication is administered correctly.Rate this question:
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- 4.
You are called to the Emergency Department to help care for a patient who was in a car accident and has chest injuries, including broken ribs. While palpating her neck, you feel crepitation. What is the most likely cause of this?
- A.
She has a laryngeal tumor
- B.
Blood is in the back of her throat
- C.
She has aspirated a tooth
- D.
She has an air leak from her lung
Correct Answer
D. She has an air leak from her lungExplanation
The most likely cause of crepitation in the neck while palpating is an air leak from the lung. This can occur due to a pneumothorax, which is a condition where air accumulates in the pleural space between the lung and the chest wall. The presence of broken ribs in the patient suggests the possibility of a traumatic injury to the chest, which could lead to a pneumothorax. The air leak from the lung can cause subcutaneous emphysema, leading to the crepitation felt in the neck. This is a common finding in patients with chest trauma and can be a potentially serious condition requiring immediate medical attention.Rate this question:
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- 5.
You are called ot help in the evaluation of a 55-year old male patient. You notice the following signs and symptoms: oral temperature of 40 degrees C (104.5 F), diaphoresis, respiratory rate of 22, the use of accessory muscles of respiration, and palpable rhonchi in teh right lower love. You would suspect which of the following diagnoses:
- A.
Bacterial pneumonia
- B.
Heart attack
- C.
Pneumothorax
- D.
Viral pneumonia
Correct Answer
A. Bacterial pneumoniaExplanation
Based on the signs and symptoms observed in the patient, such as high fever, diaphoresis (excessive sweating), increased respiratory rate, use of accessory muscles for breathing, and palpable rhonchi (abnormal sounds) in the right lower lobe, the most likely diagnosis would be bacterial pneumonia. Bacterial pneumonia is an infection of the lungs caused by bacteria, which can lead to symptoms such as high fever, difficulty breathing, and abnormal lung sounds. Heart attack and pneumothorax may present with different symptoms, while viral pneumonia may have similar symptoms but is less likely given the severity of the patient's presentation.Rate this question:
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- 6.
Since being told of the diagnosis of cancer, a patient has become argumentative about his care and threatens to hit the nurse and therapist. He should be evaluated for:
- A.
Language barrier problems
- B.
Hypercarbia
- C.
Emotional state
- D.
Hypoxemia
Correct Answer
C. Emotional stateExplanation
The patient's change in behavior, specifically becoming argumentative and making threats, suggests that there may be underlying emotional issues at play. It is important to consider the patient's emotional state in order to understand and address their behavior. This could be a result of fear, anxiety, or frustration related to the cancer diagnosis. Evaluating the patient's emotional state can help healthcare providers provide appropriate support and interventions to address their emotional needs.Rate this question:
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- 7.
To help determine your patient's level of consciousness, you should ask which of the following questions? 1. Do you you know what day this is? 2. Can I see your identification wristband? 3. Do you know where you are? 4. How are you feeling today? 5. Do you know who the president is?
- A.
2, 4
- B.
3
- C.
5
- D.
1, 3
Correct Answer
A. 2, 4Explanation
To help determine a patient's level of consciousness, it is important to ask questions that assess their orientation to person, place, and time. Question 2, "Can I see your identification wristband?" helps determine if the patient is aware of their own identity and location. Question 4, "How are you feeling today?" helps assess the patient's awareness of their current state and overall well-being. These questions provide valuable information about the patient's cognitive function and level of consciousness.Rate this question:
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- 8.
To help you determine whether your patient has orthopnea, you would ask which of the following?
- A.
How many flights of stairs can you climb before you become short of breath?
- B.
Do you know who the governor is?
- C.
Do you need to use extra pillows behind your head and back to keep from getting short of breath when you sleep?
- D.
Do any particular foods seem to make it harder for you to cough up your secretions?
Correct Answer
C. Do you need to use extra pillows behind your head and back to keep from getting short of breath when you sleep?Explanation
The question is asking about a symptom called orthopnea, which is shortness of breath that occurs when lying flat. The correct answer is "Do you need to use extra pillows behind your head and back to keep from getting short of breath when you sleep?" This question specifically addresses the symptom of orthopnea by asking if the patient needs to elevate their head and back with extra pillows to prevent shortness of breath while sleeping. This can help determine if the patient experiences orthopnea.Rate this question:
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- 9.
In observing an infant's chest configuration, you notice that it is the same size in both the AP and lateral dimensions. This would indicate that the patient has:
- A.
A normal chest
- B.
Funnel chest/pectus excavatum
- C.
Pulmonary emphysema with air trapping
- D.
Lordosis
Correct Answer
A. A normal chestExplanation
If an infant's chest configuration is the same size in both the AP (anterior-posterior) and lateral dimensions, it indicates a normal chest. This means that there are no abnormalities or deformities present in the chest structure.Rate this question:
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- 10.
In examining your patient, you notice that she has greatly diminished breath sounds in her right lower lobe, and her trachea has shifted to the right. These signs indicate which condition?
- A.
Right-sided pneumothorax
- B.
Right-sided atelectasis
- C.
Left-sided pneumothorax
- D.
Left-sided pneumonia
Correct Answer
B. Right-sided atelectasisExplanation
Diminished breath sounds and a shift in the trachea to the affected side are indicative of atelectasis, which is the collapse or closure of a lung or part of a lung. In this case, the patient's symptoms suggest right-sided atelectasis, as the breath sounds are diminished in the right lower lobe and the trachea is shifted to the right. Atelectasis can be caused by various factors, such as blockage of the airway, compression of the lung, or surfactant deficiency.Rate this question:
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- 11.
In palpating your patient for symmetrical chest movements, you notice that his left side does not move as much as his right side. This indicates that he has which condition or conditions? 1. Emphysema 2. Congestive heart failure 3. Left-sided pneumonia 4. Left-sided pneumothorax 5. Right sided pneumonia
- A.
1, 2
- B.
3, 4
- C.
4, 5
- D.
2
Correct Answer
B. 3, 4Explanation
When palpating the patient for symmetrical chest movements, if the left side does not move as much as the right side, it indicates that the patient may have left-sided pneumonia or left-sided pneumothorax. Left-sided pneumonia refers to an infection in the left lung, which can cause decreased movement on that side. Left-sided pneumothorax refers to the presence of air in the left pleural space, which can also cause decreased chest movement on the left side. Therefore, the correct answer is 3, 4.Rate this question:
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- 12.
You are called to the Emergency Department to help evaluate a pediatric patient. On entering the room you observe the patient's breathing effort and can hear a harsh, high-pitched sound on inspiration. Which of the following is true?
- A.
Sounds are tracheal and normal
- B.
Sounds are bronchovesicular and not normal
- C.
Sounds are stridorous and indicate a respiratory emergency
- D.
Sounds are bronchial and indicate a respiratory emergency
Correct Answer
C. Sounds are stridorous and indicate a respiratory emergencyExplanation
Stridor is a harsh, high-pitched sound that is heard on inspiration and indicates a partial obstruction in the upper airway. It is a respiratory emergency because it suggests that the patient's airway is compromised and immediate intervention is required to ensure adequate breathing. Tracheal sounds are normal and are heard over the trachea, while bronchial sounds are abnormal and indicate a problem in the larger airways. Bronchovesicular sounds are normal and are heard over the main bronchi.Rate this question:
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- 13.
You are called to evaluate a patient's breathing pattern. You notice that the patient's tidal volumes go from small to large to small and then stop for 10 seconds before starting up again. The pattern repeats itself. This patient's breathing pattern would be best called:
- A.
Eupnea
- B.
Obstructed expiration
- C.
Kussmaul's respiration
- D.
Cheyne-Stokes respiration
Correct Answer
D. Cheyne-Stokes respirationExplanation
The patient's breathing pattern, characterized by tidal volumes going from small to large to small and then stopping for 10 seconds before starting up again, is consistent with Cheyne-Stokes respiration. This is a cyclic pattern of breathing commonly seen in patients with heart failure, brain damage, or other conditions affecting the respiratory centers in the brain. It is characterized by periods of gradually increasing and decreasing tidal volumes, followed by a period of apnea.Rate this question:
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- 14.
A tension pneumothorax is identified by which of the following? 1. Chest x-ray film shows a shift of the mediastinum toward the affected lung 2. chest x-ray film shows elevation of the hemidiaphragm on the affected side 3. The patient's vital signs suddenly deteriorate 4. chest x-ray film shows a depression of the hemidiaphragm on the affected side. 5. Chest x-ray film shows a shift of the mediastinum away from the affected lung. 6. Vital signs are essentially unchanged.
- A.
1, 2, 6
- B.
3, 4, 5
- C.
1, 2, 3
- D.
1, 3, 4
Correct Answer
B. 3, 4, 5Explanation
A tension pneumothorax is identified by the sudden deterioration of the patient's vital signs, the elevation of the hemidiaphragm on the affected side on a chest x-ray film, and the shift of the mediastinum away from the affected lung on a chest x-ray film.Rate this question:
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- 15.
Your patient is complaining of localized pain over the lower right area of the chest while breathing. when you auscultate her chest, you hear a rasping noise at her point of pain on both inspiration and expiration. This is most likely:
- A.
Pleural friction rub
- B.
Normal breath sounds
- C.
Wheeze
- D.
Rhonchi
Correct Answer
A. Pleural friction rubExplanation
The patient's complaint of localized pain over the lower right area of the chest while breathing, along with the presence of a rasping noise at the point of pain on both inspiration and expiration, suggests a pleural friction rub. A pleural friction rub is a specific type of abnormal breath sound that occurs when the inflamed pleural surfaces rub against each other during respiration. This rubbing sound is typically heard on both inspiration and expiration and is associated with conditions such as pleurisy or pneumonia.Rate this question:
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- 16.
Your patient has distended external jugular veins, even though her head and body are raised 45 degrees above her legs. This would indicate that she:
- A.
Is hypertensive
- B.
Is fluid overloaded
- C.
Has emphysema
- D.
Is dehydrated
Correct Answer
B. Is fluid overloadedExplanation
The distended external jugular veins in the patient suggest that she is fluid overloaded. When there is an excess of fluid in the body, it can cause increased pressure in the veins, leading to their distention. This can be observed in the external jugular veins, which are located in the neck. Hypertension, emphysema, and dehydration would not typically cause distended external jugular veins.Rate this question:
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- 17.
Tactile fremitus would be reduced in all of the following conditions EXCEPT:
- A.
Pneumothorax
- B.
COPD
- C.
Pulmonary edema
- D.
Pleural effusion
Correct Answer
C. Pulmonary edemaExplanation
Pulmonary edema is a condition characterized by the accumulation of fluid in the lungs, which can cause the lung tissue to become congested and stiff. This increased fluid in the lungs can enhance the transmission of vibrations during tactile fremitus, resulting in increased tactile fremitus. Therefore, tactile fremitus would not be reduced in pulmonary edema.Rate this question:
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- 18.
A frail, thin patient known to have lung cancer is admitted ot the hospital. His family members are also present. What should be asked of them to make sure the proper level of care is delivered?
- A.
The last time he ate
- B.
The last time he had a bowel movement
- C.
Whether any advance directives have been documented
- D.
Whether he has brought his home care medications with him
Correct Answer
C. Whether any advance directives have been documentedExplanation
To ensure that the proper level of care is delivered, it is important to ask the patient's family members whether any advance directives have been documented. Advance directives are legal documents that outline the patient's preferences for medical treatment in case they become unable to communicate their wishes. Knowing if any advance directives exist will help healthcare providers make informed decisions about the patient's care and ensure that their wishes are respected.Rate this question:
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- 19.
It is most important to ask a patient with a broken ankle form a recent slip on an icy sidewalk about which of the following?
- A.
Level of pain
- B.
Level of consciousness
- C.
Work of breathing
- D.
Emotional state
Correct Answer
A. Level of painExplanation
When a patient has a broken ankle from a recent slip on an icy sidewalk, it is most important to ask about the level of pain they are experiencing. This is crucial because pain can indicate the severity of the injury and help determine the appropriate course of treatment. Additionally, assessing the level of pain can help monitor the effectiveness of any pain management interventions that may be administered.Rate this question:
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- 20.
All of the following could result in a mediastinal shift on a chest x-ray EXCEPT
- A.
Right-sided hemothorax
- B.
Bilateral lower lobe pneumonia
- C.
Left-sided tension pneumothorax
- D.
Right lower lobe atelectasis
Correct Answer
B. Bilateral lower lobe pneumoniaExplanation
A mediastinal shift on a chest x-ray occurs when there is a displacement of the structures in the mediastinum, which is the central area of the chest. This can be caused by various conditions such as hemothorax, tension pneumothorax, and atelectasis. However, bilateral lower lobe pneumonia typically does not cause a mediastinal shift. Pneumonia is an infection that primarily affects the lung tissue, and it does not usually lead to significant displacement of the mediastinal structures. Therefore, bilateral lower lobe pneumonia is the exception in this case.Rate this question:
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- 21.
A patient who is suffering respiratory distress would exhibit all of the following EXCEPT:
- A.
Normal respiratory rate
- B.
Nasal flaring
- C.
Intercostal retractions
- D.
Use of accessory muscles of inspiration
Correct Answer
A. Normal respiratory rateExplanation
A patient who is suffering from respiratory distress would exhibit nasal flaring, intercostal retractions, and use of accessory muscles of inspiration. However, a normal respiratory rate would not be expected in a patient experiencing respiratory distress.Rate this question:
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- 22.
An adult patient with a history of smoking has shown an increased anteroposterior diameter and depressed hemidiaphragms on a PA chest radiograph. It is most likely that hte patient
- A.
Has pulmonary fibrosis
- B.
Has emphysema
- C.
Would have normal findings if an AP chest radiograph were taken.
- D.
Has left ventricular failure
Correct Answer
B. Has empHysemaExplanation
The patient is an adult with a history of smoking, and the PA chest radiograph shows increased anteroposterior diameter and depressed hemidiaphragms. These findings are consistent with emphysema, a condition characterized by the destruction of the alveoli in the lungs, leading to air trapping and hyperinflation. Smoking is a common cause of emphysema, and the radiographic findings align with the disease. Pulmonary fibrosis would typically present with a reticular or nodular pattern on imaging, which is not mentioned in the question. Left ventricular failure would typically manifest with cardiomegaly and signs of fluid congestion, which are not described in the radiograph findings. Therefore, the most likely explanation is that the patient has emphysema.Rate this question:
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- 23.
After 2 days of vomiting and diarrhea caused by the flu, a 50-year-old patient is admitted. Her ECG shows five PVCs in 1 minute and flat T waves. What laboratory test would you recommend?
- A.
Urinalysis
- B.
Arterial blood gas analysis
- C.
Electrolytes
- D.
Complete blood count
Correct Answer
C. ElectrolytesExplanation
After experiencing vomiting and diarrhea for two days, the patient's ECG shows five PVCs in one minute and flat T waves. These findings suggest an electrolyte imbalance, which can occur due to dehydration caused by the flu. Therefore, it would be appropriate to recommend an electrolyte test to assess the levels of various electrolytes such as sodium, potassium, and calcium in the patient's blood. This test will help identify any abnormalities and guide the appropriate treatment for the patient.Rate this question:
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- 24.
A 48-year-old patient with an extensive smoking history usually coughs out about 20 mL of sputum every day. He developed a "chest cold" 4 days ago and has noticed increased shortness of breath and thicker secretions. What should be done at this time?
- A.
Have him increase the flow on his home oxygen concentrator
- B.
Get a sputum sample for a culture-and sensitivity study
- C.
Have him perform a 6-minute walk test
- D.
Perform percussion to determine the hemidiaphragm positions
Correct Answer
B. Get a sputum sample for a culture-and sensitivity studyExplanation
The patient's symptoms of increased shortness of breath and thicker secretions after developing a "chest cold" suggest a possible respiratory infection. Getting a sputum sample for a culture and sensitivity study can help identify the specific pathogen causing the infection and determine the most effective antibiotic treatment. This is important in guiding appropriate therapy and preventing further complications. Increasing the flow on his home oxygen concentrator may not address the underlying infection. Performing a 6-minute walk test or percussion to determine the hemidiaphragm positions are not relevant in this context.Rate this question:
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- 25.
A recently home-delivered baby is brought in to the Emergency Department by the paramedics. The physician asks you to hellp evaluate her condition. Normal vital signs for a term newborn include all of the following EXCEPT:
- A.
Heart rate of 130/min
- B.
Rectal temperature of 36.5 degrees Celsius
- C.
Blood pressure of 64/40 mm Hg
- D.
Respiratory rate of 20/min
Correct Answer
D. Respiratory rate of 20/minExplanation
Normal vital signs for a term newborn include a heart rate of 130/min, a rectal temperature of 36.5 degrees Celsius, a blood pressure of 64/40 mm Hg. However, a respiratory rate of 20/min is not considered normal for a term newborn. The normal respiratory rate for a term newborn is typically higher, around 30-60 breaths per minute. Therefore, a respiratory rate of 20/min would be considered abnormal and may indicate a potential issue with the baby's respiratory system.Rate this question:
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- 26.
You are assisting with the delivery of a high-risk infant. After evaluating the infant, you give it a 5-minute Apgar score of 8 and recommend that the nurse and physician:
- A.
Give the infant supplemental oxygen
- B.
Give the mother supplemental oxygen
- C.
Begin bag-mask rescue breathing on the infant
- D.
Give the infant to the mother as soon as possible for bonding
Correct Answer
D. Give the infant to the mother as soon as possible for bondingExplanation
Giving the infant to the mother as soon as possible for bonding is the correct answer because a 5-minute Apgar score of 8 indicates that the infant is in good condition and does not require immediate medical intervention. Bonding between the mother and the infant is important for establishing a strong emotional connection and promoting breastfeeding. It is also beneficial for the infant's overall well-being and development.Rate this question:
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- 27.
You are called to the Pediatrics Department to help in the evaluation and care of a 4-year-old girl who has been sick with a bad cold for the past 2 days. The nurse shows you a lateral neck radiograph of the child and asks for your opinion. You notice a clear air column through the upper airway but a pointed narrowing of the tracheal air column below the larynx. You tell the nurse that you suspect the child has:
- A.
Laryngotracheobronchitis
- B.
Aspirated a coin
- C.
Epiglottitis
- D.
Bilateral upper lobe pneumonia
Correct Answer
A. LaryngotracheobronchitisExplanation
Based on the information provided, the lateral neck radiograph shows a clear air column through the upper airway but a pointed narrowing of the tracheal air column below the larynx. This is consistent with the characteristic findings of laryngotracheobronchitis, also known as croup. Croup is a viral infection that causes inflammation and narrowing of the upper airway, leading to symptoms such as a barking cough, hoarseness, and difficulty breathing. Therefore, the correct answer is Laryngotracheobronchitis.Rate this question:
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- 28.
A young adult who had surgery for a deviated nasal septum was accidentally given 2 L of intravenous fluid in 1 hour. Which of the following signs cause you to suspect that the patient is fluid overloaded? 1. Tachycardia 2. Bradycardia 3. High urine specific gravity 4. Peripheral edema in the dependent parts of the body 5. Low urine specific gravity
- A.
1, 4, 5
- B.
3, 4
- C.
1, 3
- D.
2, 5
Correct Answer
A. 1, 4, 5Explanation
Tachycardia, peripheral edema in the dependent parts of the body, and low urine specific gravity are signs that suggest fluid overload. Tachycardia occurs because the body tries to compensate for the increased fluid volume by increasing the heart rate. Peripheral edema in the dependent parts of the body occurs because the excess fluid accumulates in the lower extremities due to gravity. Low urine specific gravity indicates that the kidneys are not able to effectively concentrate urine, which can be a result of fluid overload.Rate this question:
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- 29.
Patients with heart or lung disease commonly have shifting of mediastinal structures. In evaluating patients with cardiopulmonary disease, which of the following could result in a mediastinal shift being seen on a chest radiograph? 1. Right-sided hemothorax 2. Bilateral lower lobe pneumonia 3. Left-sided tension pneumothorax 4. right lower lobe atelectasis 5. Fibrosis of the left lung
- A.
3
- B.
4, 5
- C.
1, 2, 3
- D.
1, 3, 4, 5
Correct Answer
D. 1, 3, 4, 5Explanation
Patients with heart or lung disease commonly have shifting of mediastinal structures. A mediastinal shift can be seen on a chest radiograph in several conditions. A right-sided hemothorax can cause a shift of the mediastinal structures towards the unaffected side. A left-sided tension pneumothorax can cause a shift of the mediastinal structures towards the unaffected side as well. Right lower lobe atelectasis can cause a shift of the mediastinal structures towards the affected side. Fibrosis of the left lung can cause a shift of the mediastinal structures towards the affected side. Therefore, options 1, 3, 4, and 5 can all result in a mediastinal shift being seen on a chest radiograph in patients with cardiopulmonary disease.Rate this question:
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- 30.
The radiologist remarks to you during the viewing of a 65-year-old patient's posteroanterior (PA) chest radiograph that the patient has an enlarged left side of the heart. This indicates to you that:
- A.
The patient has an athletic heart
- B.
The patient has a left pleural effusion
- C.
The patient has an abnormal heart
- D.
The patient has a left middle lobe infiltrate
Correct Answer
C. The patient has an abnormal heartExplanation
The radiologist's remark about an enlarged left side of the heart suggests that the patient has an abnormal heart. This could be indicative of conditions such as cardiomegaly, left ventricular hypertrophy, or other structural abnormalities. It is important to further investigate and evaluate the patient's cardiac health to determine the underlying cause and appropriate treatment.Rate this question:
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- 31.
A patient has acute respiratory distress syndrome (ARDS) and is significantly hypoxemic. It is likely that the patient will exhibit all of the following EXCEPT:
- A.
A normal respiratory rate
- B.
Nasal flaring
- C.
Intercostal retractions
- D.
Use of accessory muscles of inspiration
Correct Answer
A. A normal respiratory rateExplanation
In acute respiratory distress syndrome (ARDS), the patient experiences a severe decrease in oxygen levels in the blood. This condition leads to increased work of breathing and respiratory distress. The patient is expected to exhibit symptoms such as nasal flaring, intercostal retractions, and the use of accessory muscles of inspiration. However, a normal respiratory rate is not expected in ARDS. The body compensates for the low oxygen levels by increasing the respiratory rate in an attempt to improve oxygenation. Therefore, a normal respiratory rate would be inconsistent with the clinical presentation of ARDS.Rate this question:
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- 32.
An adult patient with a history of COPD and left ventricular failure has been hospitalized. A series of diagnositc procedures is being performed. The preferred radiographic position to minimize distortion of the heart is:
- A.
Anteroposterior
- B.
Posteroanterior
- C.
Lateral
- D.
Oblique
Correct Answer
B. PosteroanteriorExplanation
The preferred radiographic position to minimize distortion of the heart is posteroanterior. This positioning involves taking the X-ray from behind the patient and directing the X-ray beam towards their chest. This position helps to reduce the magnification and distortion of the heart, allowing for a clearer and more accurate image. This is particularly important in a patient with COPD and left ventricular failure, as it helps to visualize the heart and assess its condition more effectively.Rate this question:
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- 33.
A patient who is intubated has been moved from teh Operating Room to the Intensive Care Unit. Concern is voiced that the endotracheal tube has been moved. What is the best way to determine its location?
- A.
Palpate the larynx
- B.
Listen to stomach sounds
- C.
Percuss the patient's chest
- D.
Get a chest x-ray
Correct Answer
D. Get a chest x-rayExplanation
The best way to determine the location of the endotracheal tube in an intubated patient who has been moved to the Intensive Care Unit is to get a chest x-ray. This imaging technique will provide a clear visualization of the tube's position within the patient's chest, ensuring that it is correctly placed in the trachea and not causing any complications. Palpating the larynx, listening to stomach sounds, or percussing the patient's chest may not provide accurate information about the tube's location and can lead to misinterpretation. A chest x-ray is the most reliable method to confirm the correct placement of the endotracheal tube.Rate this question:
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- 34.
A 65-year old patient with repeated episodes of congestive heart failure has a chest radiograph taken. It shows the left costophrenic angle to be blunted with an air/fluid level with a meniscus in the left lower lung area. How should this be interpreted?
- A.
Pleural effusion of the left lung
- B.
Pulmonary edema of the left lung
- C.
Pneumonia of the left lung
- D.
Pulmonary embolism of the left lung
Correct Answer
A. Pleural effusion of the left lungExplanation
The blunting of the left costophrenic angle with an air/fluid level and a meniscus in the left lower lung area on the chest radiograph is indicative of a pleural effusion in the left lung. Pleural effusion refers to the accumulation of fluid in the pleural space, which can occur due to various causes, including congestive heart failure. This finding is consistent with the patient's repeated episodes of congestive heart failure and is suggestive of fluid collecting in the pleural space of the left lung.Rate this question:
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- 35.
A 3-day-old newborn is brought into the Emergency Department with her father after they were involved in an automobile accident. The newborn is showing signs of respiratory distress with cyanosis and tachycardia. What test would you recommend to determine whether she has a pneumothorax?
- A.
Arterial blood gases
- B.
Apgar score
- C.
Transillumination
- D.
Thoracentesis
Correct Answer
C. TransilluminationExplanation
Transillumination is the recommended test to determine whether the newborn has a pneumothorax. Transillumination involves shining a light through the chest wall to assess for the presence of air or fluid. In the case of a pneumothorax, the light will not pass through the affected area, indicating the presence of air in the pleural space. This test is non-invasive and can provide valuable information to aid in diagnosis and management of the newborn's respiratory distress.Rate this question:
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- 36.
You have been assisting with the insertion of a flow-directed, balloon-tipped pulmonary artery catheter. After the procedure, a chest radiograph was taken. It would be acceptable to take a mixed-venous blood sample from the catheter if the tip were found in the:
- A.
Right pulmonary artery
- B.
Superior vena cava
- C.
Aortic arch
- D.
Right ventricle
Correct Answer
A. Right pulmonary arteryExplanation
It would be acceptable to take a mixed-venous blood sample from the catheter if the tip were found in the right pulmonary artery. This is because the right pulmonary artery is the vessel that carries deoxygenated blood from the right ventricle of the heart to the lungs for oxygenation. Therefore, a blood sample taken from this location would accurately reflect the mixed-venous blood, which represents the oxygen content of blood returning to the heart from the body's tissues.Rate this question:
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- 37.
The respiratory therapist has instructed a 16-year-old asthma patient in the proper use of a metered-dose inhaler with reservoir and the bronchodilator medication. The patient has shown the proper drug administration and breathing pattern. What should be recommended now?
- A.
Continue to administer the treatment because the patient is a minor
- B.
Have the parent administer the treatment because the patietn is a minor
- C.
With the parent's permission, begin a patient-driven medication protocol
- D.
Delegate the treatments to a nurse
Correct Answer
C. With the parent's permission, begin a patient-driven medication protocolExplanation
The patient has demonstrated the proper use of the inhaler and medication, indicating that they are capable of self-administering their treatment. Since the patient is a minor, it is important to involve the parent in the decision-making process. By beginning a patient-driven medication protocol with the parent's permission, the patient can take responsibility for managing their asthma while still receiving guidance and support from their parent. This approach promotes independence and self-care while ensuring that the parent remains involved in the treatment process.Rate this question:
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- 38.
You are assisting in the delivery of a high-risk neonate. At 1 minute after birth, the following are noted:
- Heart rate is 90 beats/min
- There is a weak cry
- Arms and legs show some flexion
- The baby grimaces when a nasal catheter is inserted into a nostril
- Extremities are blue with a pink body (acrocyanosis)
- A.
3
- B.
5
- C.
7
- D.
9
Correct Answer
B. 5Explanation
The Apgar score is a quick assessment tool used to evaluate the physical condition of a newborn immediately after birth. It consists of five components: heart rate, respiratory effort, muscle tone, reflex irritability, and color. Each component is scored from 0 to 2, with a maximum total score of 10. A score of 5 indicates that the neonate's condition is moderately depressed. In this case, the heart rate is slightly low, there is a weak cry, some flexion is noted in the arms and legs, and the baby grimaces when stimulated. However, the acrocyanosis (blue extremities) suggests some degree of oxygenation.Rate this question:
- 39.
An elderly patient with congestive heart failure has been treated with the diurectic furosemide (Lasix). Which serum electrolyte is the most important to monitor in this situation?
- A.
Potassium
- B.
Chloride
- C.
Calcium
- D.
Sodium
Correct Answer
A. PotassiumExplanation
In patients with congestive heart failure, the use of diuretics like furosemide can cause excessive loss of potassium through increased urine output. Low potassium levels can lead to cardiac arrhythmias and worsen heart failure symptoms. Therefore, monitoring serum potassium levels is crucial in this situation to prevent potential complications and ensure the patient's safety.Rate this question:
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- 40.
After feeling a sudden chest pain and shortness of breath while lifting weights, a 37-year-old man drove himself to the Emergency Department. After starting oxygen therapy on the patient, the respiratory therapist performed a physical exam. Pertinent findings included a hyperresonant percussion note on the right side and tracheal shift to the left. Based on these findings, what is the patient's most likely problem?
- A.
Broken ribs on the right side
- B.
Right-sided pneumothorax
- C.
Broken clavicle on the right side
- D.
Acute myocardial infarction
Correct Answer
B. Right-sided pneumothoraxExplanation
Based on the given information, the patient's most likely problem is a right-sided pneumothorax. The hyperresonant percussion note on the right side suggests the presence of air in the pleural space, which is characteristic of a pneumothorax. The tracheal shift to the left indicates a tension pneumothorax, which is a medical emergency. The other options, such as broken ribs, broken clavicle, or acute myocardial infarction, do not explain the hyperresonant percussion note and tracheal shift.Rate this question:
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- 41.
A hospitalized patient who recovered from a Clostridium botulinum infection received several respiratory care services. How should a nondisposable plastic pulmonary function testing mouthpiece be sterilized before being reused?
- A.
Steam autoclave for 15 minutes
- B.
Soak in glutaraldehyde solution for 10 hours
- C.
Pasteurize for 20 minutes
- D.
Soak in an alcohol solution for 15 minutes
Correct Answer
B. Soak in glutaraldehyde solution for 10 hoursExplanation
The correct answer is to soak the nondisposable plastic pulmonary function testing mouthpiece in a glutaraldehyde solution for 10 hours. Glutaraldehyde is a high-level disinfectant that is effective against a wide range of microorganisms, including Clostridium botulinum. Soaking the mouthpiece in this solution for 10 hours ensures thorough sterilization before reuse. The other options, such as steam autoclaving, pasteurizing, or soaking in an alcohol solution, may not provide the same level of sterilization as the glutaraldehyde solution.Rate this question:
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- 42.
Select all of the following that can be used in the home to reduce the chance of bacterial growth in a small-volume nebulizer or other respiratory care equipment. 1. Soak the equipment in white vinegar 2. Put the equipment in the oven, and turn on the broiler for 10 minutes. 3. Rinse a nebulizer in salt water (normal saline) 4. Wash the equipment in hot water with a detergent
- A.
1, 4
- B.
1, 2
- C.
1, 3, 4
- D.
1, 2, 3, 4
Correct Answer
A. 1, 4Explanation
Soaking the equipment in white vinegar can help reduce bacterial growth because vinegar has antimicrobial properties. Washing the equipment in hot water with a detergent can also help remove bacteria. Therefore, options 1 and 4 are correct as they both provide methods to reduce bacterial growth in respiratory care equipment.Rate this question:
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- 43.
After use of a mechanical ventilator has been discontinued, what is the best method to sterilize the reusable main-flow bacteria filter?
- A.
Wrapping it and soaking it in acetic acid
- B.
Pasteurization
- C.
Glutaraldahyde soak
- D.
Steam autoclaving
Correct Answer
D. Steam autoclavingExplanation
Steam autoclaving is the best method to sterilize the reusable main-flow bacteria filter. Steam autoclaving uses high pressure and high temperature steam to kill microorganisms, including bacteria, viruses, and spores. This method is highly effective in sterilizing medical equipment and is commonly used in healthcare settings. Wrapping and soaking the filter in acetic acid, pasteurization, and glutaraldehyde soak are not as effective as steam autoclaving for sterilization purposes.Rate this question:
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- 44.
A batch of respiratory care equipment has gone through the gas sterilization process with ethylene oxide. Routine surveillance of the equipment shows that spores of Bacillus subtilis have survived the process What should be done next?
- A.
Use the equipment because this organism does not cause illness.
- B.
Aerate the gas as usual, and put into use
- C.
Resterilize the equipment, and check for destruction of the spores
- D.
Wipe off the equipment with 70% alcohol to remove the spores from the equipment
Correct Answer
C. Resterilize the equipment, and check for destruction of the sporesExplanation
The correct answer is to resterilize the equipment and check for destruction of the spores. This is because the presence of surviving spores indicates that the initial sterilization process was not effective in eliminating all potential pathogens. Resterilizing the equipment will ensure that it is safe for use, and checking for destruction of the spores will confirm that the process has been successful. Using the equipment without resterilization or simply wiping off the spores may still pose a risk of contamination.Rate this question:
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- 45.
A retired home care paitent living on a fixed income needs to be able to disinfect her respiratory therapy equipment. Which of the following would be best for her?
- A.
Acetic acid
- B.
Acid glutaraldehyde
- C.
Ethylene oxide system
- D.
Warm, soapy water
Correct Answer
A. Acetic acidExplanation
Acetic acid would be the best option for the retired home care patient living on a fixed income to disinfect her respiratory therapy equipment. Acetic acid is a common household item, also known as vinegar, which is easily accessible and affordable. It has antimicrobial properties and can effectively kill bacteria and viruses. Additionally, it is safe to use and does not leave any harmful residue on the equipment. Therefore, using acetic acid as a disinfectant would be a practical and cost-effective solution for the patient.Rate this question:
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- 46.
What is the most cost-effective way for a respiratory care department to disinfect large amount of reusable plastic tubing and oxygen masks?
- A.
70% ethyl alcohol
- B.
Steam autoclave
- C.
Pasteurization
- D.
Dry heat
Correct Answer
C. PasteurizationExplanation
Pasteurization is the most cost-effective way for a respiratory care department to disinfect large amounts of reusable plastic tubing and oxygen masks. Pasteurization is a process that uses heat to kill bacteria, viruses, and other microorganisms. It is a widely used method in the food industry to kill pathogens while preserving the quality of the product. In the context of disinfecting medical equipment, pasteurization can effectively eliminate harmful microorganisms without causing damage to the plastic materials. Additionally, pasteurization is a relatively simple and inexpensive process compared to other methods such as steam autoclave or dry heat.Rate this question:
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- 47.
A contaminated Bird Mark 7 intermittent positive-pressure breathing (IPPB) unit must be sterilized before use with another patient. What is the best method?
- A.
Pasteurization
- B.
Ethylene oxide
- C.
10-Hour soak in glutaraldehyde
- D.
Steam autoclave
Correct Answer
B. Ethylene oxideExplanation
Ethylene oxide is the best method for sterilizing a contaminated Bird Mark 7 IPPB unit before use with another patient. Ethylene oxide is a gas that is commonly used for sterilization because it is highly effective in killing bacteria, viruses, and other microorganisms. It can penetrate through various materials and reach all areas of the equipment, ensuring thorough sterilization. Additionally, ethylene oxide does not require high temperatures or moisture, making it suitable for sensitive equipment like the IPPB unit.Rate this question:
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- 48.
A 48-year-old patient had an exacerbation of his COPD related to spring allergies. As he is being prepared for discharge from the hospital, what should the respiratory therapist recommend?
- A.
Get an influenza vaccination as soon as possible
- B.
Get a tuberculosis skin test as soon as possible
- C.
Have a throat swab performed to check on a possible Streptococcus infection
- D.
Get an influenza vaccination in the fall
Correct Answer
D. Get an influenza vaccination in the fallExplanation
The respiratory therapist should recommend getting an influenza vaccination in the fall. This is because the patient is being discharged from the hospital after an exacerbation of COPD related to spring allergies. The influenza vaccine is recommended for patients with chronic respiratory conditions like COPD to prevent complications from influenza, which can be more severe in these individuals. Getting the vaccination in the fall ensures that the patient is protected during the influenza season, which typically occurs in the winter months.Rate this question:
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- 49.
A home care company has found that several of its tracheostomy patients have Escherichia coli tracheal infections. What is the most likely cause of the infections?
- A.
Poor hand-washing technique by visiting respiratory therapists
- B.
Contaminated tracheostomy tubes from the manufacturer
- C.
Contaminated bottles of sterile water from the manufacturer
- D.
Poor hand-washing technique by patients' family members
Correct Answer
A. Poor hand-washing technique by visiting respiratory therapistsExplanation
The most likely cause of the Escherichia coli tracheal infections in the home care company's tracheostomy patients is poor hand-washing technique by visiting respiratory therapists. This is because respiratory therapists are directly involved in the care of tracheostomy patients and if they do not practice proper hand hygiene, they can introduce bacteria, such as Escherichia coli, into the patients' trachea. The other options, such as contaminated tracheostomy tubes or bottles of sterile water from the manufacturer, or poor hand-washing technique by patients' family members, may also contribute to infections but are less likely compared to the respiratory therapists' hand-washing technique.Rate this question:
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- 50.
A respiratory therapist notices that two people in the Emergency Department waiting room are coughing regularly. All of the following should be done EXCEPT
- A.
Have the two coughingn people sit near each other to minimize their contact with other people in the waiting room
- B.
Have each person wear a face mask while waiting
- C.
Give facial tissues to the two people
- D.
Have both people sit at least 3 feet away from anyone else
Correct Answer
A. Have the two coughingn people sit near each other to minimize their contact with other people in the waiting roomExplanation
The correct answer is to have the two coughing people sit near each other to minimize their contact with other people in the waiting room. This is because if the two individuals are sitting near each other, they are more likely to spread their respiratory illness to each other and potentially to others in the waiting room. The other options, such as having each person wear a face mask, giving them facial tissues, and having them sit at least 3 feet away from anyone else, are all appropriate measures to prevent the spread of respiratory illnesses.Rate this question:
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Quiz Review Timeline +
Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.
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Current Version
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Mar 21, 2023Quiz Edited by
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Sep 01, 2012Quiz Created by
M4morey
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