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NPTE Exam > Cardiopulmonary Review Questions #1 > Flashcards

Cardiopulmonary Review Questions #1 Flashcards

1
Q

Which lung segment would require the patient to be in sitting when performing postural drainage?

apical segments of the upper lobe
posterior segments of the upper lobe
posterior basal segment
right middle lobe

A

Apical segments of the upper lobe

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2
Q

The most appropriate indication for suctioning is:

consolidation
pleural effusion
pneumonia
retained secretions

A

Retained secretions

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3
Q

If percussion is being performed to the anterior segments of the upper lobe, what is the proper patient positioning and location of percussion
?

A

The patient is in supine with percussion performed below the clavicle

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4
Q

Which lobe is being drained if the patient is positioned in prone with the foot of the bed elevated 18 inches and percussion and vibration are performed over the lower ribs on the left and right side of the chest.

A

Posterior basal segment of the lower lobe

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5
Q

Which of the following conditions is a contraindication for postural drainage performed in the Trendelenburg position?

uncontrolled hypertension
atelectasis
impaired cough
retained secretions

A

uncontrolled hypertension

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6
Q

Which position best facilitates postural drainage to the bilateral posterior segment of the upper lobe for a patient with orthopnea?

prone, with bed flat
supine, with bed flat
seated, leaning back 30 degrees
seated, leaning forward 30 degrees

A

Seated, leaning forward 30 degrees

Orthopnea refers to difficulty breathing when lying flat. Seated, leaning forward will expose the area to be percussed and allow gravity to drain the posterior segment of the upper lobe. The position will also allow the patient to breathe easier since they are in an upright position.

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7
Q

Which of the following airway clearance techniques can a patient perform independently after proper instruction?

percussion
vibration
high frequency chest compression
active cycle of breathing techniques

A

active cycle of breathing techniques

A patient can perform active cycle of breathing techniques without needing any additional devices. This technique works to clear secretions through breathing control phases, thoracic expansion exercises, and forced expiratory techniques.

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8
Q

Which of the following muscles is most active during huffing and coughing?

rectus abdominis
anterior scalene
upper trapezius
external intercostals

A

rectus abdominis

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9
Q

Which of the following occurs during a huff compared to a directed cough?

glottis remains closed decreasing risk of airway collapse
glottis remains open increasing risk of airway collapse
glottis remains closed increasing risk of airway collapse
glottis remains open decreasing risk of airway collapse

A

Glottis remains open decreasing risk airway collapse

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10
Q

When using an oral airway oscillation device, how many exhalation repetitions would be the most desirable before the two large exhalations?

5
15
25
35

A

15

When using an oral airway oscillation device such as the Flutter or Acapella, 10-20 active exhalations should be performed through the device followed by two large exhalations and finally a huff or cough to clear secretions.

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11
Q

Vibration following postural drainage should be performed:

with cupped hands during expiration
with cupped hands during inspiration
with total palmar contact during expiration
with total palmar contact during inspiration

A

With total palmar contact during expiration

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12
Q

Which airway clearance technique would most likely be considered too aggressive for a patient with sternal precautions following a recent surgery?

vibration
percussion
autogenic drainage
postural drainage

A

percussion

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13
Q

Which piece of objective data would most likely result in a therapist determining that a patient is unable to participate in a scheduled airway clearance session?

blood pressure: 145/87 mm Hg
heart rate of 101 beats per minute
oxygen saturation of 88%
intracranial pressure of 22 mm Hg

A

Intracranial pressure of 22 mm Hg

Intracranial pressure greater than 20 mm Hg is contraindicated for postural drainage because the required positioning may further elevate intracranial pressure.

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14
Q

Which of the following airway clearance techniques is not considered a manual technique?

percussion
suctioning
autogenic drainage
manual compression

A

autogenic drainage

Autogenic drainage uses controlled breathing to mobilize secretions by varying expiratory airflow without using postural drainage positions or coughing. Since autogenic drainage does not require the assistance of another person or equipment, it can be performed during activities of daily living.

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15
Q

Which lung segment would be most difficult to treat if a patient is unable to tolerate being positioned in prone?

posterior basal segments of the lower lobe
apical segments of the upper lobe
posterior segments of the upper lobe
anterior segments of the lower lobe

A

Posterior basal segments of the lower lobe

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16
Q

What is the double-walled connective tissue sac that surrounds the outside of the heart and great vessels?

endocardium
epicardium
myocardium
pericardium

A

Pericardium

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17
Q

Which value represents the total blood volume in an adult?

3 liters
5 liters
7 liters
9 liters

A

5 liters

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18
Q

Which structure serves as a conduit for both food and air?

nose
larynx
pharynx
trachea

A

pharynx

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19
Q

Which structure is a flexible tube composed of C-shaped cartilaginous rings?

pharynx
larynx
trachea
alveoli

A

trachea

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20
Q

Which of the following coronary arteries typically supplies blood to the atrioventricular node?

right coronary artery
left coronary artery
left anterior descending artery
left circumflex artery

A

Right coronary artery

The right coronary artery supplies blood to the atrioventricular node in 90% of individuals. The left circumflex artery supplies blood to the atrioventricular node in the remaining 10%.

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21
Q

Where does the right coronary artery supply bood?

A

The right atrium and right ventricle along with the bottom portion of the left ventricle. The right coronary artery branches from the aorta near the point where the aorta and left ventricle meet.

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22
Q

Which of the following structures transports deoxygenated blood?

aorta
pulmonary artery
pulmonary vein
arteriole

A

pulmonary artery

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23
Q

From where does the superior vena cava bring deoxygenated blood to?

A

Brings deoxygenated blood from the head, neck, and arms to the right atrium

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24
Q

Which muscle does the subclavian artery course through?

scalenes
sternocleidomastoid
longus colli
platysma

A

scalenes

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25
Q

Normal expiration at rest is accomplished by:

contraction of the rectus abdominis
relaxation of the rectus abdominis
contraction of the diaphragm and the intercostal muscles
relaxation of the diaphragm and the intercostal muscles

A

Relaxation of the diaphragm and the intercostal muscles.

Normal expiration is a passive process which is achieved through the elastic recoil of the lung tissue and relaxation of the intercostals and diaphragm muscles. As the intercostals relax, the ribs drops to their pre-inspiratory position and the diaphragm returns to its elevated dome position high in the thorax.

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26
Q

Which of the following muscles is a primary contributor to forced expiration?

rectus abdominis
posterior scalene
pectoralis major
serratus anterior scalene

A

rectus abdominis

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27
Q

The cardiac notch is located in which structure?

heart
diaphragm
right lung
left lung

A

left lung - this indentation accommodates for the location of the heart making the left lung smaller than the right

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28
Q

Hair-like projections which function to remove particles from the airways are known as:

cilia
carina
lingula
parenchyma

A

cilia

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29
Q

Approximately how much of the total blood volume is located in the venous system?

25 percent
67 percent
75 percent
80 percent

A

67%

Approximately two-thirds of total blood volume is stored within the venous vasculature. Veins have a greater ability to distend compared to arteries and therefore can expand to accommodate higher volumes of blood.

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30
Q

What is the name of the middle layer of an artery?

A

The tunica media is in between the tunica externa and tunica interna. The media is made of smooth muscle fibers

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31
Q

In fetal heart circulation, which structure connects the two atria?

ligamentum arteriosum
ductus arteriosus
foramen ovale
patent ductus arteriosus

A

Foramen ovale

The foramen ovale connects the two atria and allows blood entering the right heart to bypass the pulmonary circuit and the collapsed, nonfunctional fetal lungs.

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32
Q

Which characteristic has a direct relationship with an individual’s lung volume?

age
weight
height
gender

A

height

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33
Q

Which arteries are considered branches of the left coronary artery?

right marginal artery and posterior descending artery
posterior descending artery and circumflex artery
circumflex artery and left anterior descending artery
left anterior descending artery and right marginal artery

A

Circumflex artery and left anterior descending artery

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34
Q

Where is pleural fluid located?

between the visceral pleura and the lungs
between the visceral and parietal pleura
between the chest cavity and the parietal pleura
between the alveoli and the vascular capillaries

A

between the visceral and parietal pleura

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35
Q

Which type of blood cell would not be classified as a white blood cell?

basophils
erythrocytes
lymphocytes
monocytes

A

erythrocytes - these are red blood cells that make up 40% of blood volume

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36
Q

Blood from the medial side of the lower extremity is drained by the:

small saphenous vein
great saphenous vein
iliac artery
femoral artery

A

great saphenous vein

37
Q

What visceral structure divides the thorax mid-sagittally between the two lungs?

diaphragm
sternum
pleural plexus
mediastinum

A

mediastinum

38
Q

Which heart valve connects to the chordae tendineae in the right ventricle?

pulmonary valve
aortic valve
bicuspid valve
tricuspid valve

A

tricuspid valve

The chordae tendineae connect the tricuspid valve to the papillary muscles in the right ventricle. The tricuspid valve is located between the right atrium and the right ventricle.

39
Q

Which of the following pieces of equipment would not be used when performing an ankle-brachial index measurement?

watch
stethoscope
Doppler ultrasound
sphygmomanometer

A

watch

40
Q

Which ankle-brachial index (ABI) value would be most consistent with a patient that is experiencing the initial symptoms of peripheral arterial disease?

0.35
0.68
0.89
1.15

A

0.89

41
Q

Which scenario is most likely based on a recorded ankle-brachial index measurement of 0.84?

normal
mild arterial disease
moderate arterial disease
severe arterial disease

A

mild arterial disease

The ankle-brachial index (ABI) can be used to provide a ratio of systolic blood pressure of the lower extremity compared to the upper extremity. An ABI of 0.84 is far enough from the ideal ABI value of 1.0 to indicate the presence of mild arterial disease, but not far enough below 1.0 to indicate more significant involvement.

42
Q

Which of the following signs or symptoms would most likely lead a health care provider to perform an ankle-brachial index measurement on a patient?

dizziness
heart palpitations
angina
claudication

A

claudication

43
Q

Which diagnostic test would be most beneficial to compare the relative perfusion pressure in the upper extremities compared to the lower extremities?

ankle-brachial index
computed tomography
Doppler ultrasonography
plethysmography

A

ABI

44
Q

Which ankle-brachial index measurement would be most consistent with a patient experiencing intermittent claudication during exercise?

1.20
1.00
0.85
0.65

A

0.65

The ankle-brachial index (ABI) expresses the ratio of systolic blood pressure of the lower extremities compared to the systolic blood pressure of the upper extremities. An ideal ABI is 1.0, while an ABI of 0.65 would be representative of a moderate blockage that may be associated with intermittent claudication during exercise.

45
Q

Which of the following arteries would be least likely used when measuring a patient’s ankle-brachial index?

radial artery
brachial artery
posterior tibial artery
dorsalis pedis artery

A

radial artery

46
Q

Which ankle-brachial index measurement is most consistent with non-compressible vessels?

1.40
1.20
1.00
0.90

A

1.40

47
Q

Lower blood pressure in the lower extremities as compared to the upper extremities could be suggestive of:

neurologic disease
congestive heart failure
vascular disease
left ventricular hypertrophy

A

vascular disease

48
Q

When determining a patient’s ankle-brachial index, which of the following is considered normal?

90 mm Hg brachial artery, 135 mm Hg posterior tibialis artery
80 mm Hg brachial artery, 120 mm Hg posterior tibialis artery
130 mm Hg brachial artery, 110 mm Hg posterior tibialis artery
125 mm Hg brachial artery, 130 mm Hg posterior tibialis artery

A

125 mm Hg brachial artery, 130 mm Hg posterior tibialis artery

The ankle-brachial index (ABI) compares systolic blood pressures at the ankle and arm to check for peripheral artery disease. The ABI is calculated by dividing the lower extremity (posterior tibialis artery) value by the upper extremity (brachial artery) value. A normal value is considered 1.0-1.3, while values from 0.80-0.99 are indicative of a mild blockage.

49
Q

Which pH value is most consistent with the presence of acidemia?

7.3
7.4
7.5
7.6

A

7.3

50
Q

Which of the following is considered a normal bicarbonate level in the blood?

25 mEq/L
30 mEq/L
35 mEq/L
40 mEq/L

A

25 mEq/L

51
Q

Which of the following arterial blood gasses is the metabolic component of an arterial blood gas analysis?

CO2
PaCO2
SaO2
HCO3

A

HCO3

52
Q

Which of the following is considered the gold standard for measuring oxygen saturation?

arteriogram
pulmonary function testing
pulse oximetry
arterial blood gas analysis

A

arterial blood gas

53
Q

The oxygen-carrying capacity of the body is dependent on:

concentration of plasma
concentration of hemoglobin
heart rate
respiratory rate

A

Concentration of hemoglobin

54
Q

The respiratory component of the acid-base balance of the body is best determined by:

pH
PCO2
HCO3-
base excess

A

PCO2

55
Q

A low pH and elevated PCO2 due to alveolar hypoventilation can result in:

metabolic acidosis
metabolic alkalosis
respiratory acidosis
respiratory alkalosis

A

respiratory acidosis

56
Q

What impact will hyperventilation have on a patient’s arterial blood gas?

lower the pH
decrease the PaO2
decrease the PaCO2
increase the PaCO2

A

Decrease the PaCO2

57
Q

Which of the following would indicate a need for oxygen therapy?

SpO2 below 90%
SpO2 below 95%
SpO2 below 98%
SpO2 of 99%

A

below 90%

58
Q

What is the approximate percentage of oxygen available for breathing at sea level?

10 percent
15 percent
21 percent
25 percent

A

21 percent

59
Q

Which rate is the most appropriate when deflating a blood pressure cuff when assessing blood pressure?

1-2 mm Hg per second
2-3 mm Hg per second
3-4 mm Hg per second
4-5 mm Hg per second

A

2-3 mm Hg per second

60
Q

Which recorded blood pressure value is associated with a hypertensive crisis?

110 mm Hg diastolic
150 mm Hg systolic
130 mm Hg diastolic
170 mm Hg systolic

A

130 mm Hg diastolic

A hypertensive crisis occurs when measured blood pressure is greater than 180 mm Hg and/or greater than 120 mm Hg DBP. If blood pressure is 180/120 or greater and with other associated symptoms of potential organ damage such as chest pain, shortness of breath, back pain, numbness/weakness, change in vision, or difficulty speaking then this would be considered a hypertensive emergency. This type of scenario warrants immediate medical attention including calling 911.

61
Q

Which patient age group would be most likely to have the lowest recorded diastolic blood pressure?

infants
children
adolescents
elderly

A

infants

62
Q

Which phase of Korotkoff sounds are associated with the first faint, clear tapping sounds detected by auscultation?

Phase I
Phase II
Phase IV
Phase V

A

Phase I

63
Q

Which condition would most likely be associated with a decrease in blood pressure?

anxiety
dehydration
exercise
muscle contraction

A

dehydration

64
Q

When taking a blood pressure measurement, which sound is most associated with the diastolic blood pressure value?

sound becoming crisper
sound lasting longer
sound disappearing
sound amplification

A

Sound disappearing

65
Q

Which of the following blood pressure values would fall into the category of “Elevated” for an adult?

137/85 mm Hg
123/78 mm Hg
130/100 mm Hg
140/95 mm Hg

A

123/78

66
Q

How should a patient be positioned when taking their blood pressure?

patient resting their arm at their side
patient holding their arm at shoulder height
patient resting their arm on a table at chest height
patient holding their arm above shoulder height

A

patient resting their arm on a table at chest height

67
Q

Which of the following is consistent with the mean pressure in the venous system?

2 mm Hg
12 mm Hg
22 mm Hg
32 mm Hg

A

2 mm Hg

The mean venous pressure throughout the venous vasculature is approximately 2 mm Hg. This pressure is highest distally and lowest proximally at the junction of the vena cava and right atrium.

68
Q

Using a blood pressure cuff that is too small for an obese patient will cause the arterial pressure reading to be:

too low
too high
normal
continually variable

A

too high

69
Q

Central venous pressure measures filling pressure of the:

right atrium
left atrium
right ventricle
left ventricle

A

right atrium

Central venous pressure is obtained via a catheter introduced at a vein and advanced to the inferior or superior vena cava or right atrium.

70
Q

Which of the following changes in vital signs is associated with normal aging?

an increase in susceptibility to hyperthermia
a decrease in respiratory rate
an increase in blood pressure
a decrease in heart rate

A

an increase in BP

71
Q

The pulse pressure of a patient with a systolic blood pressure of 119 mm Hg and a diastolic blood pressure of 79 mm Hg would be:

40 mm Hg
90 mm Hg
100 mm Hg
198 mm Hg

A

40 mm Hg

Pulse pressure is the mathematical difference between the systolic and diastolic blood pressures. This value represents the force that the heart generates with each contraction. A value greater than 40 mm Hg indicates an increased risk of cardiovascular disease.

72
Q

What cardiac measure is determined by the formula: cardiac output x total peripheral resistance?

blood pressure
stroke volume
forced expiratory volume
tidal volume

A

blood pressure

73
Q

When assessing blood pressure, how high above a patient’s normal systolic blood pressure should a sphygmomanometer cuff be inflated?

10 mm Hg
25 mm Hg
40 mm Hg
50 mm Hg

A

25

74
Q

Which lung segment would require the patient to be in sitting when performing postural drainage?

apical segments of the upper lobe
posterior segments of the upper lobe
posterior basal segment
right middle lobe

A

Apical segments of the upper lobe

75
Q

The most appropriate indication for suctioning is:

consolidation
pleural effusion
pneumonia
retained secretions

A

retained secretions

76
Q

Which segment is being drained with patient in supine with a level bed and percussion being performed below clavicles

apical segments of the upper lobes
anterior segments of the upper lobes
superior segments of the lower lobes
posterior basal segments of the lower lobes

A

anterior segments of the upper lobes

77
Q

What segment is being drained with the patient in supine and foot of bed elevated 18 inches

apical segment of upper lobe
middle lobe
posterior basal segment of lower lobe
superior segment of lower lobe

A

Posterior basal segment of lower lobe

78
Q

Which of the following conditions is a contraindication for postural drainage performed in the Trendelenburg position?

uncontrolled hypertension
atelectasis
impaired cough
retained secretions

A

Uncontrolled hypertension

79
Q

Which position best facilitates postural drainage to the bilateral posterior segment of the upper lobe for a patient with orthopnea?

prone, with bed flat
supine, with bed flat
seated, leaning back 30 degrees
seated, leaning forward 30 degrees

A

Seated, leaning forward 30 degrees

Orthopnea refers to difficulty breathing when lying flat. Seated, leaning forward will expose the area to be percussed and allow gravity to drain the posterior segment of the upper lobe. The position will also allow the patient to breathe easier since they are in an upright position.

80
Q

Which of the following airway clearance techniques can a patient perform independently after proper instruction?

percussion
vibration
high frequency chest compression
active cycle of breathing techniques

A

Active cycle of breathing techniques

81
Q

Which of the following muscles is most active during huffing and coughing?

rectus abdominis
anterior scalene
upper trapezius
external intercostals

A

Rectus abdominis

82
Q

Which of the following occurs during a huff compared to a directed cough?

glottis remains closed decreasing risk of airway collapse
glottis remains open increasing risk of airway collapse
glottis remains closed increasing risk of airway collapse
glottis remains open decreasing risk of airway collapse

A

Glottis remains open decreasing risk of airway collapse

83
Q

When using an oral airway oscillation device, how many exhalation repetitions would be the most desirable before the two large exhalations?

5
15
25
35

A

15

Ideal is between 10-20

84
Q

Vibration following postural drainage should be performed:

with cupped hands during expiration
with cupped hands during inspiration
with total palmar contact during expiration
with total palmar contact during inspiration

A

With total palmar contact during expiration

85
Q

Which airway clearance technique would most likely be considered too aggressive for a patient with sternal precautions following a recent surgery?

vibration
percussion
autogenic drainage
postural drainage

A

Percussion

86
Q

Which piece of objective data would most likely result in a therapist determining that a patient is unable to participate in a scheduled airway clearance session?

blood pressure: 145/87 mm Hg
heart rate of 101 beats per minute
oxygen saturation of 88%
intracranial pressure of 22 mm Hg

A

Intracranial pressure of 22 mmHg

87
Q

Which of the following airway clearance techniques is not considered a manual technique?

percussion
suctioning
autogenic drainage
manual compression

A

autogenic drainage

88
Q

Which lung segment would be most difficult to treat if a patient is unable to tolerate being positioned in prone?

posterior basal segments of the lower lobe
apical segments of the upper lobe
posterior segments of the upper lobe
anterior segments of the lower lobe

A

Posterior basal segments of the lower lobe

NPTE Exam (54 decks)

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