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Question 1 1 pts

A 40-year-old woman has well-controlled asthma. What is her risk of morbidity from anesthesia compared to that of a patient who does not have asthma?

Much higher

Higher

The same

Lower

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Question 2 1 pts Skip to question text.

A previously healthy patient presents to the emergency department with symptoms of pneumonia. He had a bout of seasonal influenza, but the symptoms resolved several weeks before the current illness. What is the likelihood that the etiology of his community acquired pneumonia will be determined?

20%

30%

40%

50%

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Question 3 1 pts

Which of the following endothelial mediators may cause the vasoconstriction and vascular remodeling characteristic of pulmonary arterial hypertension?

I. Endothelin

II. Prostacyclin

III. Thromboxane

I

I and II

II and III

I, II, and III

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Question 4 1 pts Skip to question text.

All of the following are advantages of enteral tube feedings compared with total parenteral nutrition in the postoperative patient except

I. Increased integrity of the gastrointestinal system

II. Increased immune defenses

III. Decreased nosocomial infections

I only

II only

I and II

I, II, and III

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Question 5 1 pts

Which of the following drug therapies are effective therapies for acute respiratory distress syndrome (ARDS)?

None

Antibiotics

Antiinflamatories

Corticosteroids

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Question 6 1 pts

The respiratory therapist needs to collect a sputum specimen from a patient who has not been able to produce an adequate amount. Which of the following is the first step in collecting an induced sputum sample?

Brushing teeth and gums

Gargling

Inhale 3% saline for 20 minutes

Cough every five minutes

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Question 7 1 pts

Which of the following are found in high quantities in the BAL fluid in patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS)?

Erythrocytes

Eosinophils

Neutrophils

Platelets

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Question 8 1 pts

A patient is brought to the emergency department after inhaling chemical vapors. What is the likelihood that she will develop symptoms of acute respiratory distress syndrome (ARDS) within the next 24 hours?

25%

50%

75%

100%

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Question 9 1 pts

A male patient arrives at the emergency department after being struck in the chest with a ball during the company softball game. The highest rate of mortality for ALI occurs within what period after onset.

24 hours

48 hours

72 hours

96 hours

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Question 10 1 pts

Why is Haemophilis influenzae a gram-negative bacterium?

It turns brown when exposed to alcohol in Gram staining.

The ions turn negative when exposed to alcohol in Gram staining.

It loses its stain when exposed to alcohol in Gram staining.

The organism dies when exposed to alcohol in Gram staining.

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Question 11 1 pts

Which of the following is a goal of the treatment of pulmonary hypertension that results from cardiac disease?

Anticoagulation

Bronchodilators

Treatment of pulmonary hypertension

Treatment of the underlying cardiac defect

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Question 12 1 pts

For mild cases of postoperative atelectasis, which of the following are effective forms of therapy?

I. Coughing

II. Deep breathing

III. Ambulation

I

I, II, and III

I and III

II and III

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Question 13 1 pts

A patient presents at the emergency department with fatigue, tachypnea, exertional dydpnea, and cough. Examination of the lower extremities shows pitting edema. The patient is likely to have

COPD

Cor pulmonale

Pulmonary arterial hypertension

Pulmonary embolism

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Question 14 1 pts Skip to question text.

A patient has been treated for exacerbations related to cystic fibrosis. An antibiotoc course of treatment was included in this round of therapy. Which of the following types of testing should occur towards the end of therapy to ensure effectiveness of the therapy?

Chest radiograph

ECG

Pulmonary function

Puls oximetry

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Question 15 1 pts

Which of the following is the preferred hypoglycemic agent for the treatment of cystic fibrosis-related diabetes (CRFD)?

Exenatide

Insulin

Pramlintide

Victoza

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Question 16 1 pts

Mean airway pressure, FIO2, and Pa O2 are used the in acute respiratory syndrome (ARDS) to calculate the

Operating index

Opportunistic infection

Oxygen initiation

Oxygenation index

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Question 17 1 pts

Which of the following is an adverse effect of using calcium channel blockers on patients with pulmonary arterial hypertension?

Constipation

Dizziness

Hypotension

Hypertension

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Question 18 1 pts

All of the following are advantages of patient-controlled analgesia (PCA) EXCEPT

Active patient involvement

Addiction

Better pain control

Rapid analgesic action

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Question 19 1 pts

All of the following are indications for inferior vena cava filter placement except

Contraindications to anticoagulation

Cor pulmonale

Deep vein thrombosis

Recurrent embolism

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Question 20 1 pts

All of the following persistent chest radiographic abnormalities would be present in a patient with cystic fibrosis EXCEPT

Atelectasis

Bronchiectasis

Granuloma

Hyperinflation

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Question 21 1 pts

Which of the following is the most accurate diagnostic test for pulmonary embolism?

Chest computed tomographic angiography

Echocardiography

ECG

Pulmonary angiography

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Question 22 1 pts

A patient has been in the hospital for 10 days and is now presenting with fever, chills, and cough productive of yellow sputum. The chest radiograph shows diffuse infiltrates. Which of the following organisms should the respiratory therapist suspect?

Haemophilus influenzae

Legionella pneumophilia

Proteus mirabilis

Pseudomonas aeruginosa

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Question 23 1 pts

The use of inhaled aminoglycosides for Pseudomonas aeruginosa has which of the following benefits?

Achieving high drug levels in proximal airway secretions

Creates systemic levels of toxicity

Distal secretions are also exposed.

High risk of antimicrobial resistance

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Question 24 1 pts Skip to question text.

A patient presents to the emergency department with nonbacterial pneumonia. The patient asks for an antibiotic, and the physician refuses to prescribe one. Which of the following are reasons why?

I) Antibiotics are not effective against nonbacterial infections.

II) There is a risk of developing antibiotic-resistant pathogens.

III) The patient will do better with hospital admission and intubation.

I only

II only

I and II

I, II, and III

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Question 25 1 pts

Which of the following is the most important factor to predict the risk of postoperative pulmonary complications?

Duration of surgery

Fluid management

Surgical incision site

Type of anesthesia

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Question 26 1 pts

In the immediate post-operative period, which of the following suggests that the diaphragm is functional and airway protection is sufficient?

She is speaking.

She lift her head for 5 seconds.

She is breathing.

She can move her extremities.

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Question 27 1 pts

When treating a patient with idiopathic pulmonary arterial hypertension, which international normalized ratio (INR) of wafarin is considered therapeutic?

0.5 – 1.0

1.0 – 2.0

1.5 – 2.0

1.5 – 2.5

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Question 28 1 pts Skip to question text.

A 30-year-old woman has been diagnosed with community-acquired pneumonia. The physician determines, based on the Pneumonia Severity Index (PSI), that she can be treated as an outpatient. Which of the following risk classes is the patient likely to be in?

I. Risk class I

II. Risk class II

III. Risk class III

I

I and II

II and III

I, II, and III

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Question 29 1 pts

A patient has smoked two packs of cigarettes per day for 20 years. He is being prepared for surgery. How many pack years would this represent?

10

20

30

40

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Question 30 1 pts

A patient presents at the hospital with acute respiratory distress syndrome (ARDS). If the medical team wants to rule out cardiogenic causes for pulmomary edema, which measurement should it take using a pulmonry artery catheter?

Forced expiratory volume

Inspiratory capacity

Positive end expiratory pressure

Pulmonary artery wedge pressure

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Question 31 1 pts

A patient with COPD presents to the emergency department with an exacerbation. He does not have S pneumonae or H influenzae. The respiratory therapist should suspect organism?

Escheria coli

Lactobacillus

Moraxella catarrhalis

Staphalococcus salivarius

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Question 32 1 pts

The airway secretions of cystic fibrosis patients are difficult to clear because of

I. Lower viscosity

II. Higher viscosity

III. Lower tenacity

IV. Higher tenacity

I and III

I and IV

II and III

III and IV

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Question 33 1 pts

Which of the following are often found on the chest radiographs of patients with acute respiratory distress syndrome (ARDS)?

Silhouette sign

Bilateral opacities

Increased vascular markings

Unilateral whiteout

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Question 34 1 pts Skip to question text.

A 30-year-old athletic male presenta to the emergency department with swelling, pain, and discoloration of the lower left leg. The respiratory therapist suspects there is little risk of acute DVT or PE. Which of the following laboratory tests could rule out these conditions?

Arterial blood gas

Basic metabolic panel

D-dimer

Hematocrit

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Question 35 1 pts

A 30-year-old woman with cystic fibrosis presents to the emergency department with chest pain, dyspnea, and blood-stained sputum. It is likely that the patient will need to be treated for?

Pulmonary Exacerbation

Hemoptysis

Pneumothorax

Respiratory failure

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Question 36 1 pts

Which of the following causes of pulmonary hypertension are the result of hypoxemia?

Familial pulmonary arterial hypertension

Human immunideficiency virus

Hypoventilation and sleep-disordered breathing

Left-sided vavular heart disease

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Question 37 1 pts

A patient C is receiving unfractionated heparin by continuous IV infusion. What laboratory test is used to monitor the therapy?

Activated partial thromboplastin time (aPTT)

Infusion rate

INR

Patient’s weight

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Question 38 1 pts

All of the following airway clearance techniques used for cystic fibrosis patients can be used independently EXCEPT

Active cycle of breathing

Autogenic drainage

High frequency chest wall compressions

Percussion

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Question 39 1 pts

A patient receives ciprofloxacin to prevent infection by Pseudomonas aeruginosa. How long does it take for resistant Pseudomonas aeruginosa to develop?

1-2 weeks

3-4 weeks

5-6 weeks

this can not be predicted

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Question 40 1 pts

If a patient is suffering from massive bleeding due to hemoptysis, which of the following procedures is the therapy of choice?

Antibiotics

Bronchial artery embolization

Laser therapy

Surgery

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Question 41 1 pts

A respiratory therapist is evaluating a patient for pneumonia. Which of the following should her sputum specimen contain before subjecting it to a Gram stain?

10 or more neutrophils and up to 5 epithelial cells per microscopic field

15 or more neutrophils and up to 5 epithelial cells per microscopic field

20 or more neutrophils and up to 10 epithelial cells per microscopic field

25 or more neutrophils and up to 10 epithelial cells per microscopic field

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Question 42 1 pts

A 50-year-old man is 5 feet, 5 inches tall and weighs 275 pounds. He is scheduled to have bariatric surgery. The medical team should treat this patient as someone who is

Normal weight

Overweight

Obese

Morbidly obese

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Question 43 1 pts

A post-operative patient has serum albumin level of 1.8 g/dL and she appears malnourished. Which of the following options is most likely to be effective?

High calorie diet

Enteral tube feeding

Total parenteral nutrition

Liquid diet

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Question 44 1 pts

A patient is undergoing lung-protective ventilation because of acute respiratory distress syndrome (ARDS). Which of the following is the ideal setting for tidal volume (VT)?

2 to 4 mL/kg ideal body weight

4 to 8 mL/kg ideal body weight

8 to 12 mL/kg ideal body weight

10 to 15 mL/kg ideal body weight

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Question 45 1 pts Skip to question text.

A patient with an FEV1 of 22% of predicted has respiratory failure . The patient is not being considered for lung transplant at this time. If the patient were to be intubated and mechanically ventilated, what is the likelihood that the patient will ever be successfully liberated from mechanical ventilation?

None

Very low

Low

High

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Question 46 1 pts

Which of the following scans are virtually diagnostic when acute PE is clinically likely?

Chest radiograph

Chest computed tomograhic angiography

Echocardiography

High probability V ?/Q ? scans

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Question 47 1 pts

All of the following are complications of placing a patient with acute respiratory distress syndrome (ARDS) in the prone position EXCEPT

Aspiration of stomach contents

Ocular injury

Pressure necroses

Removal of tubes and lines

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Question 48 1 pts

Research shows that alveolar stretch can propagate systemic inflation and eventually lead to which of the following?

Atelectasis

COPD

Lung cancer

Multiple organ dysfunction

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Question 49 1 pts

A patient has HIV/AIDS with a CD4 count below 200/?L. Which of the following types of pneumonia is the respiratory therapist likely to have to treat the patient for?

Bacterial pneumonia

Mycobacterial pneumonia

Pneumocystis pneumonia

Tuberculosis

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Question 50 1 pts

A patient has acute respiratory distress syndrome (ARDS). Which of the following positions would be most effective in restoring ventilation to the dorsal areas of the patient’s lungs?

Fowler’s

Left lateral recumbent

Prone

Supine

Question 51 1 pts

Which of the following are nonpharmacological treatments for chronic cardiac failure?

I. Sodium restriction

II. Exercise

III. Reduce or eliminate alcohol consumption

IV. Treatment of comorbidities

I, II, and III

I, III, and IV

II, III, and IV

I, II, III, and IV

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Question 52 1 pts

Which treatment consists primarily of either balloon angioplasty or placement of stents in occluded or stenotic coronary arteries?

Coronary revascularization

Heart transplantation

Percutaneous coronary intervention

Pharmacotherapy

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Question 53 1 pts

A patient has been referred to the sleep clinic because his wife complains of his excessive snoring. The patient undergoes an 8-hour polysomnography, and his apnea-hypopnea index is 15. This means the patient’s sleep apnea is

Nonexistent

Mild

Moderate

Severe

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Question 54 1 pts

Which technique for monitoring cardiac function uses a catheter inserted into the pulmonary artery?

Computed tomographic angiography

Echocardiography

Hemodynamic monitoring

Radionucleotide imaging

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Question 55 1 pts

In which patients with obstructive sleep apnea is uvulopalatopharyngoplasty most effective?

Patients with mild to moderate sleep apnea

Overweight patients with mild to moderate sleep apnea

Patients with severe apnea

Overweight patients with severe apnea

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Question 56 1 pts

How might the use of antidepressants help patients who have obstructive sleep apnea?

I. They increase REM sleep time.

II. They decrease REM sleep time.

III. They reduce upper airway narrowing.

IV. They stimulate ventilation

I, II, and III

I, II, and IV

II, III, and IV

I, II, III, and IV

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Question 57 1 pts

A patient D has unilateral diaphragm weakness following cardiac surgery. How well is the patient expected to be able to tolerate this condition?

The patient should tolerate the condition well.

The patient may need ventilatory support at night.

The patient will need ventilatory support during exercise.

The patient will need continuous ventilatory support.

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Question 58 1 pts

Which of the following is a test of central respiratory drive that is independent of underlying respiratory mechanics?

Noninvasive ventilation

Inspired partial pressure of O2

P0.1

VO2 max

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Question 59 1 pts

What is the product of stroke volume and heart rate?

Blood pressure

Cardiac output

Preload

Venous return

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Question 60 1 pts

Why is overnight pulse oximetry an important evaluation tool to diagnose neuromuscular dysfunction?

Patients with neuromuscular dysfunction often have sleep disorders, too.

People breathe differently at night than they do during the day.

The patient is easier to monitor when he/she is sleeping.

Sleep-related breathing disorders often precede changes in daytime gas exchange abnormalities.

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Question 61 1 pts

Which of the following are nonmedical treatments for obstructive sleep apnea?

I. Treatment for hypothyroidism

II. Weight loss

III. Sleeping in a nonsupine position

IV. Smoking cessation

I, II, and III

I, III, and IV

II, III, and IV

I, II, III, and IV

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Question 62 1 pts

Which of the following factors might result in a false-negative polysomnogram?

I. Inadequate amount of sleep

II. Reduced REM sleep

III. Sleeping in a supine position

IV. Recent weight loss

I, II, and III

I, II, and IV

II, III, and IV

I, II, III, and IV

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Question 63 1 pts

The most commonly used diuretic used for cardiac failure is

Carbonic anyhrdase inhibitors

Digitalis

Loop diuretics

Potassium-sparing

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Question 64 1 pts

What is the maximum peak alveolar pressure that should be applied in a patient with cardiac failure who is mechanically ventilated?

10 cm H2O

20 cm H2O

30 cm H2O

40 cm H2O

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Question 65 1 pts

For clinical purposes, which of these is a reasonable estimate of afterload?

Diastolic blood pressure

Arterial blood pressure

Venous blood pressure

Systolic blood pressure

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Question 66 1 pts

When using bilevel positive airway pressure airway machines, what is usually the difference between between the set inspiratory and expiratory pressures?

About 2 cm H2O

About 4 cm H2O

About 6 cm H2O

About 8 cm H2O

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Question 67 1 pts

A patient is undergoing polysomnography at the sleep clinic. The respiratory therapist records the number of apneas, hyponeas, and respiratory arousals during each hour of sleep. This combined number is known as the

Apnea index

Apnea-hyponea index

Respiratory disturbance index

Respiratory effort-related arousals index

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Question 68 1 pts

Which type of positive airway pressure titrating machine detects airway narrowing and adjusts the pressure until airflow becomes normal again?

Auto-titrating positive airway pressure machines

Continuous positive airway pressure machines

Expiratory positive airway pressure machines

Inspiratory positive airway pressure machines

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Question 69 1 pts

Which of the following are goals of treatment for chronic cardiac failure?

I. Symptom control

II. Improvement of quality of life

III. Return to normal heart function

IV. Prevent or delay complications

I, II, and III

I, II, and IV

II, III, and IV

I, II, III, and IV

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Question 70 1 pts

At which percentage of predicted maximum inspiratory mouth pressure does hypercapnia ensue?

20%

30%

40%

50%

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Question 71 1 pts

What is the most commonly used CPAP pressure range for treating obstructive sleep apnea (OSA)?

Between 6 and 8 cm H2O

Between 8 and 10 cm H2O

Between 10 and 12 cm H2O

Between 12 and 14 cm H2O

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Question 72 1 pts

Which of the following is the most common neuromuscular transmission disorder?

Amyotrophic lateral sclerosis

Gullian-Barré syndrome

Muscular dystrophy

Myasthenia gravis

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Question 73 1 pts

Which diagnostic technique provides direct imaging of the coronary arteries and is used to assess the extent and severity of coronary artery disease?

Computed tomographic angiography

Coronary angiography

Echocardiography

Radionucleotide imaging

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Question 74 1 pts

A condition characterised by continued chest and abdominal efforts to breathe during periods of airflow cessation is known as

Complex apnea

Central apnea

Mixed apnea

Obstructive apnea

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Question 75 1 pts

Basilar infiltrates with pulmonary vascular redistribution on a patient’s chest radiograph is indicative of which condition?

Atelectasis

COPD

Pneumothorax

Pulmonary edema

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Question 76 1 pts

Which of following is the greatest challenge in the detection of respiratory muscle weakness?

Detecting the disease early enough

Preventing aspiration

Preventing cor pulmonale

Preventing recurrent respiratory infections

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Question 77 1 pts

In a patient with ambulatory multiple sclerosis, what is the exected pulmonary function test results?

Severely abnormal

Below normal

Normal

Above normal

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Question 78 1 pts

Which of the following is the best indicator of the possibility of sleep apnea in a patient, indicating a need for further testing?

Body mass index

Cholesterol

Neck circumference

Weight

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Question 79 1 pts Skip to question text.

Which of the following sleep-related breathing disorders, identifiable from a sleep study, are common in patients with neuromuscular disease?

I. Increased awakenings

II. Inhibition of inspiratory muscle activity during REM sleep

III. Sleep fragmentation

I

I and II

II and III

I, II, and III

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Question 80 1 pts

What is one problem associated with auto-titrating positive airway pressure machines for a patient with obstructive sleep apnea?

The mask covers only the nose.

They are less expensive than conventional CPAP machines.

They may not be able to treat a patient with central apnea.

They can overcompensate if there is leakage around the mask or if the mouth is open.

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Question 81 1 pts

Which of the following abnormalities commonly occurs in patients with moderately advanced neuromuscular disease?

Low functional residual capacity

High PaO2

Low vital capacity

High residual capacity

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Question 82 1 pts

What percentage of patients with obstructive sleep apnea use continuous positive airway pressure regularly?

35%

45%

55%

65%

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Question 83 1 pts

What level of continuous positive airway pressure (CPAP) should be used for a patient who presents with acute cardiogenic pulmonary edema?

1-5 cm H2O

5-10 cm H2O

10-15 cm H2O

15-20 cm H2O

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Question 84 1 pts

Which form of positive airway pressure therapy applies constant flow during sleep from an airflow generator?

Bilevel positive airway pressure

Continuous positive airway pressure

Expiratory positive airway pressure

Inspiratory positive airway pressure

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Question 85 1 pts

All of the following are mechanisms of pulmonary edema EXCEPT

Decreased capillary permeability

Decreased blood oncotic pressure

Increased capillary permeability

Increased pulmonary capillary pressure

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Question 86 1 pts

An elderly women occassionally experiences fatigue, dyspnea, and angina when engaging in normal activities. According the the New York Heart Association’s classification of symptoms, what class of heart disease does this patient have?

Class I

Class II

Class III

Class IV

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Question 87 1 pts

A flow-volume loop that shows sawtoothing of the flow contour can be evidence of which disease?

Amyptrophic lateral sclerosis

Gullian-Barré syndrome

Muscular dystrophy

Parkinson’s disease

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Question 88 1 pts

Why would measurement of maximal ventlation be dangerous for patients with myastenia gravis?

It may precipitate acute respiratory failure.

The maneuver will not give an accurate reading in patients with myasthenia gravis.

The maneuver is used to test respiratory muscle endurance.

The patient’s diaphragm may rupture.

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Question 89 1 pts

Why are arterial blood gas measurements unreliable as a tool for diagnosing neuromuscular dysfunction for patients who are not on ventilatory support?

Abnormalities in arterial blood gas values occur late in the disease process.

Hypoxemia is a normal part of neuromuscular dysfunction.

Pulse oximetry is an insensitive indicator of hypoventilation.

Hypercarbia does not occur until late in the disease process.

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Question 90 1 pts

Which of the following is the major reason for the failure of positive airway pressure therapy?

Difficulty in setting proper inspiratory and expiratory pressures

Lack of patient compliance

Patient gets entangled in equipment

Patient develops rhinorrhea

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