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Cluster 1 > Cluster 1 (Diagnostics) > Flashcards

Cluster 1 (Diagnostics) Flashcards

1
Q

Lung function is considered normal when values are within range of predicted?
A. 80-120%
B. 100- 120%
C. 60- 80%
D. 80-90%

A

A. 80- 120%

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2
Q

Which of the following methods allow indirect measurement of RV capacities containing it?
1. He dillution
2. End- Tidal Co2
3. nitrogen Washout
4. Body plethysmography

A. 1, 3, 4
B. 3, 4
C. 1, 2 , 3 , 4
D. 1, 4

A

A. 1, 3, 4

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3
Q

Which among the ff statements regarding bronchovocation studies is/ are true?
i. the study should always be asymptomatic at the time the study is performed
ii. the subject should abstain from taking bronchoactive drugs within a certain period of time before the test
iii. the test is performed by starting with a large dose of methacholine chloridew and giving progressively smaller doses
iv. there should be at least seven progressively larger doses given in the study

A. 2
B. 2, 3, 4
C. 1, 2, 4
D. 1, 2, 3, 4

A

C. 1, 2, 4

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4
Q

Which of the ff should an RT do before performing spirometry

A. Administer an anticholinergic bronchodilator
B. Ask the patient their current height and weight
C. Demonstrate how to correctly perform the test maneuvers
D. Explain that they will be required to perform 3 maneuvers

A

C. Demonstrate how to correctly perform the test maneuvers

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4
Q

A 15 yr old nonsmoking boy performs routine spirometry required for his high school basketball program. He is 190 cm tall and weighs 82 kg. The PFT lab of a local clinic provides the ff. FVC: 4.40L; FRC: 3.12L; VT: 0.76L; ERV: 1.77L. What is his estimated RV?
A. 1.05L
B. 1.35L
C. 3.45L
D. 5.73L

A

B. 1.35L

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4
Q

The ff data are obtained during a PFT:
TLC: 4.45L 93% pred
FVC: 2.30L 81% pred
FEV1: 1.76L 78% pred
DLCO: 10.1 50% pred

With which are these data most consistent?

A. Neuromuscular disease
B. Pulmonary Vascular Disease
C. Interstitial Lung Disease
D. Emphysema

A

B. Pulmonary Vascular Disease

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5
Q

An 81- yr old man with labored and rapid breathing was evaluated in the PFT lab and found to have: FVC=3.70L; ERV= 0.50L; & IRV=2.70L. What is his TLC?
A.4.70L
B. 5.45L
C. 5. 76L
D.6.65L

A

D. 6.65L

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6
Q

Normal values of PFT depends on?
1. Height
2. Weight
3. Age
4. Lung Condition

A. 1 and 3
B. 1 and 2
C. 1, 2, and 3
D. 1, 2, 3 and 4

A

A. 1 and 3 only

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6
Q

With a DLCO - SB test
1. An alveolar sample may be taken after the first 150 mL has been exhaled by the subject
2. The inspired gas gebnerally contains ).3% CO and 100% He
3. The breath hold time should be as close to 10 seconds as possible
4. Both the inspiratory and expiratory vital capacity maneuvers should be performed asa rapidly as possible

A. 1 and 3 only
B. 3 and 4 only
C. 2, 3, and 4
D. 1,2,3,4

A

C. 2, 3, and 4

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7
Q

When measuring difusing capacity:
A. O2 is better test gas than carbon monoxide
B. The Unit of measure is mmHg/ minute/ mL of CO
C. The test gas must be capable of combining with haemoglobin
D. The factors affecting diffusion are independent of ventilation/ perfusion relationships in the lung

A

C. the test gas must be capable of combining with haemoglobin

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8
Q

In doing lung volume determinations for children:
A. Indirect spirometry methods cannot be used
B. It is not possible to make us of body plethysmography methods for infants
C. Body plethysmography must be performed using smaller, pediatric-type body plethysmography
D. Determination of a value for total lung capacity is possible only if the subject can cooperate in making a measurement of vital capacity

A

D. Determination of a value for total lung capacity is possible only if the subject can cooperate in making a measurement of vital capacity

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9
Q

All of the ff anthropometric measurement are essential for pft except
A. Height
B. Percent body fat
C. Gender
D. Age

A

B. Percent body fat

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10
Q

Which of the following explains the lack of response to bronchodilators by some patients with severe emphysema

A. Airway Obstruction is caused by severe airway bronchospasm
B. Airway Obstruction is caused by passive airway compression and collapse during expiration
C. Airway Obstruction is associated with air trapping
D. Airway Obstruction with hyperinflation is not sensitive to bronchodilators

A

B. Airway Obstruction is caused by passive airway compression and collapse during expiration

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11
Q

Which of the following is the major feature of pulmonary obstructive disease
A. Increased RV
B. Decreased VC
C. Reduced MEFR
D. Increased TLC

A

C. Reduced MEFR

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12
Q

Regarding DLCO test result
1. Emphysema generally increases DLCO value
2. Chronic bronchitis generally decreases DLCO values
3. Exercise generally increases DLCO values
4. Asbestosis generally decreases DLCO values

A. 2 only
B. 3 & 4 only
C. 1,2,3
D.1,3,4

A

B. 3 & 4 only

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13
Q

Which of the following PFTs would best determine the patient’s ability to cough

A. VT
B. FRC
C. Alveolar minute ventilation
D. MIP

A

D. MIP

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14
Q

A PFT performed on a 56 y/o man with smoking history shows increased TLC and RV, with decreased DLCO. What is the most probable diagnosis?

A. Emphysema
B. Pneumonia
C. Sarcoidosis
D. Pneumoconiosis

A

A. Emphysema

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15
Q

The ff data are obtained from a subject complaining of shortness of breath:
Pred Found %Pred
TLCpl 6.59 4.12 63
RVpl 2.43 3.01 124
FVC 4.16 1.14 28
FEV1 3.16 1.16 37
FEV1 76 99
/FCV
MEP +190 63 33
MIP - 101 -56 55

These data are most consistent with which disease entity
A. Obesity
B. Pectus Excavatum
C. Pulmonary Fibrosis
D. Myasthenia Gravis

A

D. Myasthenia Gravis

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16
Q

Which of the following statement regarding myasthenia gravis is false
A. The patient has decreased lung compliance
B. FEV1 may be decreased or normal
C. TLC is decreased
D. FEV1/FVC is markly decreased

A

D. FEV1/FVC is markly decreased

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17
Q

A 20 year old man complains of shortness of breath with exercise. The ff results of spirometry are obtained:
Mea. Pred %Pred Post %
BD Ch
ang
e
FVC(L) 4.98 5.83 85 5.98 20
FEV1 3.18 4.68 65 3.50 10

Which of the ff statements best describes these findings?
A. Result are of normal spirometry
B. There is moderate obstruction with significant response to bronchodilator
C. There is moderate obstruction without significant response to bronchodilators
D. Results are inconsistent and must be repeated

A

B. There is moderate obstruction with significant response to bronchodilator

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18
Q

Which of the ff is an absolute contraindication of bronchoprovocation test
A. Result are of normal spirometry
B. There is moderate obstruction without significant response to bronchodilators
C. There is moderate obstruction without significant response to bronchodilators
D. Results are inconsistent and must be repeated

A

A. Result are of normal spirometry

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19
Q

A patient with cystic fibrosis may present with an increased:
A. FRCpl and RV/TLC ratio
B. FVC and FEV1
C. VA and DLCO
D. RTI within the last 6 weeks

A

A. FRCpl and RV/TLC ratio

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20
Q

What conclusions can you draw from the ff data, obtained on a 67 year old, 76kg man admitted for pulmonary complications arising from silicosis?

             Actual    Pred   %Pred TLC              4.34      7.73    56% FVC              2.86      4.74    60% FRC              1.73      4.36    40% %FEV1                       96%   83% RV                   1.45    2.63     55% FEF200-1200 6.89    6.71   103% VC                   2.89    4.74    61% FEF 25%-75% 2.78   2.88     96%

A. Result indicate generalized airway obstruction
B. Result indicated normal pulmonary function
C. Results indicate a combined disease process
D. Result indicate a restrictive lung disorder

A

D. Result indicate a restrictive lung disorder

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21
Q

A 25 yr old patient with suspected asthma performed spirometry. Her FVC IS 3.2L, and her FEV1 is 2.2L Which of the ff should the pulmonary function technologist do next?

A. Administer a bronchodilator
B. Evaluate for a possible restrictive order
C. Perform a bronchial challenge test
D. Check oxygen saturation by pulse oximetry

A

A. Administer a bronchodilator

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22
Q

A 25 yr old male has an uncorrected DLCO of 24.9 mL/min/mm Hg (69% of predicted) but no history of pulmonary disease. Which of the ff might explain these findings?

i. Left-to-Right Shunt
ii. Carboxyhemoglobinemia
iii. Congestive heart failure
iv. Anemia

A. i and ii
B. iii and iv
C. i, ii, and iii
D. ii, iii, and iv

A

D. ii, iii, and iv

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23
Q

A primary flow measuring spirometer that has a flow restrictive structure in the path of gas stream

A. Thermal anemometers
B. Differential-pressure pneumotachometer
C. Ultrasonic sensor spirometers
D. None of the above

A

B. Differential-pressure pneumotachometer

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24
Q

Which of the ff is necessary to assure comprehensive quality for helium dilution and nitrogen washout testing

A. Thermal Anemometers
B. Differential-pressure pneumotachometer
C. Ultrasonic sensor spirometer
D. None of the above

A

B. Differential-pressure pneumotachometer

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25
Q

Your patient is performing residual volume test on a water seal spirometer in the PFT laboratory. After breathing on the system for 1 minute, he takes out the mouthpiece and complains of being short of breath. What is the most likely the problem in the pulmonary function system?

A. The CO2 absorber was accidentally left in the circuit
B. There is too much water around the spirometer bell
C. The CO2 absorber has been left out of the circuit
D. Nose clips were left off the patient

A

C. The CO2 absorber has been left out of the circuit

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26
Q

A nitrogen washout test for RV has been performed on a px for 7 minutes and has not reached the desired nitrogen percentage. What could explain this situation?

A. There is an O2 leak in the system
B. The patient has abnormally high respiratory exchange ratio
C. The patient has severe air trapping
D. Nitrogen has been absorbed into the patient’s tissue

A

C. The patient has severe air trapping

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27
Q

Upon inspection of a portable spirometer’s FVC curve obtained on an adult client, the RT determine that the back extrapolated volume is excessive. Prior to repeating the maneuver, which of the following instructions would the RT provide his patient?
A. Don’t hesitate
B. blow out longer
C. blow out faster
D. breath deeper

A

A. Don’t hesitate

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28
Q

Smokers will commonly have carboxyhemoglobin levels as high as

A. 10%
B. 20%
C. 30%
D.40%

A

A. 10%

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29
Q

Which of the ff. is not stated purpose of PFT?

A. To identify the risk of postoperative complications
B. Evaluating the probability of getting a pulmonary disease
C. To assess the patient’s qualification for disability

A

B. Evaluating the probability of getting a pulmonary disease

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30
Q

Which of the ff is the correct calculation of percentage change for bronchodilator benefit study?

A. (% change= Post FEV1 - Pre FEV1 x100)/ Pre FEV1
B. (% change= Pre FEV1 - Post FEV1 x100)/ Pre FEV1
C.(% change= Pre FEV1 - Post FEV1 x100)/ Post FEV1
D. (% change= Post FEV1 - Pre FEV1 x100)/ Post FEV1

A

A. (% change= Post FEV1 - Pre FEV1 x100)/ Pre FEV1

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31
Q

Clark electrodes in a blood gas analyzer use which of the ff principles?

A. Dalton’s law
B. Fick’s Law
C. Henry’s Law
D. Boyle’s Law

A

D. Boyle’s Law

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32
Q

In which type of patient is a carbon dioxide response curve test indicated

A. History of COPD
B. History of Asthma Attacks
C. History of ARDS
D. History of asbestos exposure

A

A. History of COPD

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33
Q

The proper starting point for FRC measurement via helium dilution or nitrogen washout is:

A. end of a maximum exhalation
B. end of maximum inhalation
C. end of a normal resting inspiration
D. end of a normal resting exhalation

A

D. end of a normal resting exhalation

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34
Q

Before having the patient perform a FVC test, the water sealed spirometer should have all the ff. done, except:

A. Make sure that the circuit is airtight
B. Place a carbon dioxide absorbing material line with the circuit
C. Pump a 3-L volume into and put of the circuit to check for leaks
D. Check the kymograph speeds

A

B. Place a carbon dioxide absorbing material line with the circuit

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35
Q

Sarcoidosis is a systemic disorder that usually causes which of the ff.
A. Make sure that the circuit is airtight
B. An obstructive ventilatory defect
C. Hyperactive airways
D. Primary pulmonary hypertension

A

A. Make sure that the circuit is airtight

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36
Q

For which of the ff conditions might pulmonary function testing be contraindicated?

A. Vocal cord dysfunction
B. CHF
C. Untreated pneumothorax
D. Bronchiolitis obliterans

A

C. Untreated pneumothorax

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37
Q

Vocal cord dysfunction will typically affect the flow-volume loop in what way?

A. Blunt the expiratory portion if the curve
B. Blunt both the inspiratory and expiratory portions of curve
C. Blunt the inspiratory portion o9f the curve
D. Have no effect on the curve but cause inspiratory stridor

A

C. Blunt the inspiratory portion o9f the curve

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38
Q

A patient has suspected diagnosis of asthma. Which of the following tests would be the least helpful in assessing the patient for this condition?

A. Before and after bronchodilator study
B. Flow-volume loop
C. Diffusion study
D. Bronchoprovocation

A

C. Diffusion study

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39
Q

Which of the following are characteristics findings in patients with emphysema?
1. Ventilator Muscle Atrophy
2. Flattening of the hemi- diaphragms
3. An increase AP diameter on a chest radiograph
4. A decreased FEV1

A. 1,2,3
B.1,2,4
C.1,3,4
D.2,3,4

A

D.2,3,4

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40
Q

A RT instructed a patient to take deep breath and then exhales as quickly as possible. The RT observed a recording of the fastest air movement. Which of the following was measured?

A. Peak Flow
B. Vital Capacity
C. FEV1
D.FEF25-75%

A

A. Peak Flow

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41
Q

Which of the ff statement is/are true of the MEP Test

  1. A pressure of -20 to 25cmH20 usually is adequate
  2. A pressure of +20 to +25 cmH20 usually is adequate
  3. A pressure of +40 cmH20 is usually adequate
  4. A good indicator of the patient’s ability to cough

A.1, 2
B.2,3
C. 1,3,4
D.4

A

B.2,3

42
Q

After bronchodilator therapy you record the ff PFT data on a 67 yr old male COPD patient who reports dyspnea on exertion ; FEV1/FVC= 64% FEV1=66% predicted. You would characterize the stage of the patient’s COPD as:
A. Mild
B. Moderate
C. Severe
D. Very Severe

A

B. Moderate

43
Q

Which of the ff. determines the shape of the “effort-independent” portion of the expiratory F-V curve?
1. Abdominal pressure during forced expiration
2. Elastic Recoil of the lung
3. Flow resistance in the small airways
4. Cross-sectional area of the trachea
A. 1,2
B.2,3
C.1,3,4
D.4

A

B.2,3

44
Q

A 62 year old female complaining of shortness of breath has the ff. spirometery results. Ambient temperature of 26 C ( conversion factor= 1.068).
Trial 1 Trial 2 Trial 3
FEV1 2.10 1.96 1.99
FVC 2.65 3.11 2.99

What is the subject’s reportable FEV1 in BTPS conditions?
A.2.10L
B.2.17L
C. 2.24L
D.2.65L

A

C. 2.24L

45
Q

A person’s C(a-v)O2 increases in all of the ff except?

A. Seizures
B.Hyperthermia
C. Peripheral Shunting
D. exercise

A

C. Peripheral Shunting

46
Q

An alert anxious 60 yr old man with a history of CHF presents with respiratory distress. Auscultation reveals bilateral inspiratory crackles. He has peripheral edema. ABG results drawn on partial rebreathing mask show:
pH=7.45
PaCO= 35mmHg
PaO2= 40mmHg
HCO3=23mEq/L

The most appropriate therapy for improving oxygenation would be:
A. Intubation and mechanical ventilation
B. Administration of O2 therapy via non rebreathing mask
C. Administration of O2 therapy via CPAP
D. Administration of bronchodilator therapy via SVN

A

C. Administration of O2 therapy via CPAP

47
Q

A patient with severe COPD is on a 2 L/min nasal cannula. ABGS are drawn and after interpreting the results, the liter flow is increased to 5L/min and another ABG sample 1 hour later. The ABG result are
2L/min 5L/min
pH 7.34 7.28
PaCO2 62 torr 81 torr
PaO2 46 torr 84 torr
HCO3 35mEq/L 35mEq/L
BE +12 +12

While on 5L/min cannula, the patient seems lethargic and drowsy. Based on the information, the respiratory therapist should recommend which of the following?

A. Institute noninvasive ventilation
B. Place on nonrebreathing mask at 12 L/min
C. Decrease liter flow to 3L/min
D. Place on CPAP of 4cm H2O and FIO2 of 0.40

A

C. Decrease liter flow to 3L/min

48
Q

A sample of blood has been taken from the patient’s pulmonary artery. What mixed venous oxygen saturation value would indicate a normal value?

A. 40 mmHg
B. 75%
C. 95mmHg
D. 97%

A

B. 75%

49
Q

A 54 year old widower with a history of COPD and was rushed to the emergency department with increasing shortness of breath, pyrexia, and productive cough with yellow-green sputum. He has difficulty in communicating because of his inability to complete a sentence. One of his sons, Jay says he has been unwell for 3 days. Upon examination, crackles and wheezes can be heard in the lower lobes; he has a tachycardia and a bounding pulse. Measurement of ABG shows pH 7.3, PaCO2 68mmHg, HCO3 28mmol/L and PaO2 60mmHg. How would you interpret this?

A. Respiratory Acidosis, Uncompensated
B. Respiratory Acidosis, Partially Compensated
C. Metabolic Alkalosis, Uncompensated
D. Metabolic Acidosis, Partially Compensated

A

B. Respiratory Acidosis, Partially Compensated

50
Q

Which of the ff. statements is correct regarding the measurement of blood gas values in infants and children?
i. the brachial and femoral sites are most often used
ii. The modified allen’s test must be performed prior to arterial puncture done on radial artery
iii. Umbilical catheterization can only be performed within 6 hours of birth
iv. Frequent arterial sampling in infants can result in significant problems with anemia

A. i
B. ii
C. ii & iv
D. ii, iii, & iv

A

C. ii & iv

51
Q

The RCP wants to assess Arterial blood pressure and ABGs. This can be done by insertion of line?
A. Central venous
B. Pulmonary Artery
C. Arterial
D.Any of the above

A

C. Arterial

52
Q

Which of the ff. most accurately represents an average C(a-v)O2 for a critically ill patient with good cardiovascular reserves?
A. 11 vol%
B. 3.5 vol%
C. 5 vol%
D. 7.5 vol%

A

C. 5 vol%

53
Q

You have just obtained blood from the patient’s radial artery to determine ABG results As you run the blood through the blood gas analyzer you notice you failed to remove the air bubble from the sample. The blood gas result most likely reflects values a

A. high pH andd low PO2
B. low PCO2 and high PO2
C. low PCO2 and high PO2
D. high PCO2 and high PO2

A

C. low PCO2 and high PO2

54
Q

A P50 measurement referes to which of the ff?

A. The amount of oxygen diffusion in fluids
B. The PO2 when hemoglobin is 50% saturated with oxygen
C. The partial pressure of fetal hemoglobin at 50 % saturation
D. The partial pressure of oxygen consumed by the oxygen electrode

A

B. The PO2 when hemoglobin is 50% saturated with oxygen

55
Q

What is the main compensatory mechanism for metabolic acidosis?
A. excretion of HCO3
B. hyperventilation
C. hypoventilation
D. retention of CO2

A

B. hyperventilation

56
Q

Which of the ff variables can be calculated from measured ABG values?
i. The partial pressure of oxygen at which hemoglobin is 50% saturated (P50)
ii. pH
iii. PCO2
iv. HCO3-
v. SaO2

A. i, iii, iv
B. ii, iv, v
C. i, iv, v
D. ii, iii

A

C. i, iv, v

57
Q

What type of calibration should be performed after an electrode is changed?

A. Quality control
B. Three-point
C. two-point
D.One-point

A

B. Three-point

58
Q

An elementary student, was rushed to the hospital due to vomiting and a decreased level of consciousness. The patient displays slow and deep (Kussmaul breathing), and he is lethargic and irritable in response to stimulation. He appears to be dehydrated-his eyes are sunken and mucous membranes are dry- and he has two weeks history of polydipsia, polyuria, and weight loss. Measurement of ABG shows pH7.0, PaO2 90mmHg, and HCO3 12mmol/L; other results are Na+ 126mmol/L, K+ 5mmol/L, and CI- 95mmol/L. What is your assessment?

A. Respiratory Acidosis, Uncompensated
B. Respiratory Acidosis, Partially Compensated
C. Metabolic Alkalosis, Uncompensated
D. Metabolic Acidosis, Partially, Compensated

A

D. Metabolic Acidosis, Partially, Compensated

59
Q

The two- point calibration for the pH electrode uses two buffers. Which of the following pH values are correct for these two buffers?
1. 6.839
2. 6.840
3. 7.384
4. 7.495

A. i &iii
B. iii & iv
C. ii & iv
D. ii & iii

A

D. ii & iii

60
Q

Quality Control includes which of the ff?
i. Analyzing unknown samples and submitting to the sponsoring organization
ii. Assessing control sample measurements against defined limits
iii. Addressing problems through corrective actions.
iv. Identifying problems
A. i and ii
B. iii and iv
C. ii, iii, &iv
D. i, ii, iii, iv

A

C. ii, iii, &iv

61
Q

Which of the ff would represent V/Q scan suggesting pulmonary embolism

A. large segmental areas with normal ventilation and nortmal perfusion
B. large segmental areas with no ventilation and no perfusion
C. large segmental areas with normal ventilation but no perfusion
D. large segmental areas with no ventilation but no perfusion

A

C. large segmental areas with normal ventilation but no perfusion

62
Q

A Co-oximeter identifies the different types of hemoglobin through the use of:

A. Fiberoptics
B. Optical plethysmography
C. Spectrophotometry
D. Potentiometric measurements

A

C. Spectrophotometry

63
Q

A patient is brought to the emergency room suffering from smoke inhalation after being pulled from a burning house. What would you recommend to best determine the severity of the patient’s smoke inhalation?
A. Pulse oximeter
B. ABG
C. CO-oximeter
D. Transcutaneous PaO2 monitoring

A

C. CO-oximeter

64
Q

A patient has been experiencing a moderate asthmatic attack for 30 minutes. Which of the ff. arterial blood gas results would you expect to observe if the patient was on room air?
A. pH -7.42, PaCO2-44 torr, PaO2 -81torr
B. pH -7.08, PaCO2 -74 torr, PaO2 -50torr
C. pH -7.51, PaCO2 -27 torr, PaO2 -60torr
D. pH -7.55, PaCO2 -22 torr, PaO2 -93torr

A

C. pH -7.51, PaCO2 -27 torr, PaO2 -60torr

65
Q

Which of the ff blood gas results would be considered normal on severe COPD patient?

A. pH - 7.28, PcO2 -40 torr, PO2 -56 torr, HCO3 -30 mEq/L
B. pH - 7.56, PcO2 -28 torr, PO2 -60 torr, HCO3 -28 mEq/L
C. pH - 7.28, PcO2 -40 torr, PO2 -56 torr, HCO3 -30 mEq/L
D. pH - 7.38, PcO2 -60 torr, PO2 -57 torr, HCO3 -33 mEq/L

A

D. pH - 7.38, PcO2 -60 torr, PO2 -57 torr, HCO3 -33 mEq/L

66
Q

Which of these arterial blood gases would be most beneficial to a patient on ventilator with closed head injury?

A. pH- 7.59, PcO2- 18 torr, PO2- 90 torr
B. pH- 7.25, PcO2- 55 torr, PO2- 50 torr
C. pH- 7.44, PcO2- 40 torr, PO2- 80 torr
D. pH- 7.52, PcO2- 28 torr, PO2- 94 torr

A

D. pH- 7.52, PcO2- 28 torr, PO2- 94 torr

67
Q

A 17 y/o old boy is admitted to the emergency room with multiple rib fractures ff. a motor vehicle accident. A ABG measurement reveals the ff. result on room air:
pH - 7.50
PCO2- 30 torr
HCO3 - 25mEq/L
PO2 - 58 torr

These data indicate which of the ff.
I. Decrease (P (A-a) gradient
II. Hyperventilation
III. Respiratory Acidosis
A. I
B. II
C. I & II
D. II & III

A

B. II

68
Q

In which of the ff. condition would a ventilation scan be normal but a perfusion scan reveal areas of absent blood flow?

A. Lung CA
B. Pulmonary Embolism
C. Pneumonia
D. Emphysema

A

B. Pulmonary Embolism

69
Q

A patient with P/F ratio of 400 has:

A. normal oxygenation
B. mild ARDS
C. moderate ARDS
D. severe ARDS

A

A. normal oxygenation

70
Q

A postop patient receiving incentive spirometry treatments complains of dizziness and tingling in the extremities ff. therapy. Which of the ff. is the most likely cause of these symptoms?

A. the patient is hypoxemic
B. the patient is inhaling too rapidly
C. the patient is hyperventilating
D. the patient is breathing too slow

A

C. the patient is hyperventilating

71
Q

A cigarette vendor was brought to the emergency department of a hospital after she fell into the ground and hurt her left leg. She is noted to be tachycardic and tachypneic. Painkillers were carried out to lessen her pain. Suddenly, she started complaining that she still in pain and now experiencing muscle cramps, tingling, and paraesthesia. Measurement of ABG reveals pH 7.6, PaO2 120mmHg, PaCO2 31 mmHg, and HCO3 25mmol/L. What does this mean?

A. Respiratory Alkalosis, Uncompensated
B. Respiratory Acidosis, Partially Compensated
C. Metabolic Alkalosis, Uncompensated
D. Metabolic Acidosis, Partially Compensated

A

A. Respiratory Alkalosis, Uncompensated

72
Q

CO-oximeters routinely measure which of the following?

  1. Carboxyhemoglobin (HbCO)
    2.Fetal hemoglobin
  2. Sulfhemoglobin
  3. Oxyhemoglobin (O2Hb)
    5.Methemoglobin (metHb)

A. I & II
B. I, IV, & V
C. I, II, III, IV, V
D. II, III, & V

A

B. I, IV, & V

73
Q

To validate the readings provided by transcutaneous blood gas monitor, you should:

A. perform 2 point calibration of the monitor
B. compare the monitor’s readings to a concurrent ABG
C. change the placement of the sensor every 2-6 hours
D. re-membrane the sensor and adjust its temperature

A

B. compare the monitor’s readings to a concurrent ABG

74
Q

A PaCO2 measurement of 56 torr is indicative of:

A. Acidosis
B. Hypoventilation
C. Hypoxia
D. All of the above

A

B. Hypoventilation

75
Q

A patient with a bilirubin level of 28 mg/dL has arterial blood drawn for CO-oximetry. The RT should expect a(n)______ measurement

A. Accurate O2Hb
B. Higher-than actual O2Hb
C. Lower-than-actual O2Hb
D. Higher-than-actual HbCO

A

C. Lower-than-actual O2Hb

76
Q

A patient has been admitted to Emergency Department for carbon monoxide poisoning. The therapist sets up a non-rebreathing mask with 15 LPM of oxygen and performs an ABG with co-oximetry 20 minutes later. In the evaluation of the patient’s clinical status, the following data should not be used.

A. COHb and CaO2
B. COHb and O2Hb
C. O2Hb and CaO2
D.PaO2 and SpO2

A

D.PaO2 and SpO2

77
Q

In regard to the calibration of blood gas analyzer, a (n):

A. Liquid mixture is used to calibrate the pH, PCO2, and PO2 electrode
B. Gas mixture is used to calibrate the pH, PCO2, and PO2 electrode
C. One-point calibration is done every hour
D. Two-point calibration is done at least three times daily

A

D. Two-point calibration is done at least three times daily

78
Q

A patient in the post-anesthesia care unit is recovering from an abdominal surgery. She is receiving 2LPM of oxygen via nasal cannula. Her VS are normal and the monitor show SPO2 readings between 95% and 97%. The ABG shows pH= 41 torr, PaCO2= 46 torr, PaO2=41 torr, PaO2 =41 torr. What should the RT do?

A. Change the oxygen flow to 5LPM
B. Repeat ABG
C. Change to 60% air entrainment mask
D. Keep current oxygen therapy and monitor the patient

A

B. Repeat ABG

79
Q

Which of the ff. statements is true concerning the operation of a transcutaneous carbon dioxide electrode?

A. PtcO2 readings are slightly lower than the PaCO2 value
B. Electrodes should be calibrated when they are repositioned
C. Heating PtCO2 to 43 C will adversely affect its operation
D. Before its use, the electrode should be calibrated to 20% and 40% CO2

A

B. Electrodes should be calibrated when they are repositioned

79
Q

Which of the ff cayse erroneous transcutaneous oxygen (Ptco2) readings

I. Hypovolemia
II. Hypothermia
III. Septic Shock
IV. Asthma

A. I & III
B.I & IV
C. I, II, III
D. II, III,IV

A

C. I, II, III

80
Q

A 44 year old patient in post- anesthesia care unit is recovering from an abdominal surgery. She is receiving 2 LPM of oxygen via Nasal Cannula. Her VS are normal and the monitor range from 98-100%. All ABG values are within normal limits except the PaO2 is 156 torr. The Co-oximetry results are: O2Hb= 84%, COHb= 14%, Total Hb =15 Gm%, MetHb= 0.3%. Since the patient is unresponsive, the likely the cause for this condition is:

A. Carbon Monoxide poisoning
B. Narcotic overdose
C. Central Sleep Apnea
D. Cerebral Vascular Accident

A

A. Carbon Monoxide poisoning

81
Q

A 12 yrs. old female, well known to the hospital, is admitted in mild acute respiratory distress. 2 hours prior to admission she had been helping her grandmother with “spring cleaning”. She was later diagnosed with extrinsic asthma. The ABGs of the patient would most likely reveal which of ff?
A. Normal ABG values
B. Normal oxygenation with hypercapnia
C. Normal oxygenation with hypocapnia
D. Hypoxemia with hypocapnia

A

D. Hypoxemia with hypocapnia

81
Q

A fireman is being treated in the emergency department for physical exhaustion and smoke inhalation. He is receiving 5LPM of oxygen via nasal cannula in the ambulance and in the emergency department. The blood gases and SpO2 show: pH=7.48, PaCO2= 32 torr, PaO2= 140 torr, SpO2=99%. What should the therapist do or recommend at this time?

A. Perform co-oximetry study
B. Reduce oxygen flow to 2LPM
C. Recommend pulmonary lavage
D. Discontinue oxygen therapy

A

A. Perform co-oximetry study

82
Q

Heating the skin at the attachment site of TCM causes?
A. increased perfusion
B. increased O2 consumption
C. increased sweating
D. decrease capillary shunt

A

A. increased perfusion

83
Q

A patient with known to mild COPD has returned from abdominal surgery and has orders for mask CPAP at 10cmH20. ABG’s prior to application of CPAP show pH =7.37, PaCO2=45, PaO2=49, FiO2=0.6. Ff. application of CPAP, ABG’s show pH=7.34, PaCO2=54 PaO2=40, FiO2=0.6. Your recommendation is to:
A. Raise CPAP to 15 cmH20
B. Raise FiO2 to 0.8
C. Initiate mechanical ventilation
D. Maintain present settings

A

D. Maintain present settings

84
Q

You are preparing to perform a right radial arterial puncture on a patient and are doing the Allen’s test prior to the puncture. The response to the test is for the patient’s hand to “ pink up” upon pressure being released. The results are consistent with:
I. Occluded radial artery
II. Patent ulnar artery
III. Occluded Ulnar Artery
IV. Patent brachial Artery

A. I
B. I,II
C. I,II,III,IV
D. II, III, IV

A

B. I,II

84
Q

The best overall indicator of the adequacy of tissue oxygenation is consider the

A. PaO2
B.PEO2
C. PvO2
D. PA-aO2

A

C. PvO2

84
Q

While performing a procedure with co-oximeter, the RRT notices consistently high hemoglobin readings, What appropriate action (s) need (s) to be taken to correct this problem?

I. Assure that the correct diluent is being used
II. Assure that the specimen is well mixed
III. Assure patency of the diluent feed line

A. II
B. I, II
C. I, III
D. I, II, III

A

D. I, II, III

84
Q

The baby was rushed to the ER ff. her mother’s complaint that the infant has been irritable, difficult to breastfeed and has had diarrhea for the past 3 days. The infant’s respiratory rate is elevated and the fontanels are sunken. The ER physician orders ABG result show pH 7.39, PaCO2 27 mmHg and HCO3 19 mEq/L What does this mean?

A. Respiratory Alkalosis, Fully Compensated
B. Metabolic Acidosis, Uncompensated
C. Metabolic Acidosis, Fully Compensated
D. Respiratory Acidosis, Uncompensated

A

C. Metabolic Acidosis, Fully Compensated

85
Q

Which of the following condition can cause blood gas analyzer electrode data to shift?
I. Protein contamination of the membrane
II. Contamination of the calibration standards
III. Air bubbles under the electrode membrane
IV. An aging mercury battery

A. II, III
B. II, IV
C. III, IV
D.I, II, III

A

B. II, IV

85
Q

Low Capillary perfusion A 340-pound, 5ft. 4in., 38 years old female was admitted to the hospital lethargic and somnolent. The ff. ABG data were obtained:
PO2 49 mmHg
PCO2 76 mmHg
pH 7.33
Which condition is the patient most likely experiencing?

A. Sleep apnea syndrome
B. Emotional stress or anxiety
C. Pulmonary embolism
D. Pulmonary Fibrosis

A

A. Sleep apnea syndrome

86
Q

For a 12-lead electrocardiogram, the V2 electrode is placed at the:

A. 4th intercostals space, midclavicular line
B. 4th intercostals space, left sternum
C. Between V1 and V3 electrodes
D. 3rd intercostals space midclavicular line

A

B. 4th intercostals space, left sternum

86
Q

In atrial flutter, the key consideration in determining treatment is the?

A. Atrial Rate
B. Ventricular Rate
C. Configuration of the flutter waves
D. both A and B

A

B. Ventricular Rate

86
Q

Which of the ff. is the correct sequence of structures in the heart’s conducting system?

I. AV bundles
II. AV node
III. Purkinje fibers
IV. SA node

A. I, II, III, IV
B. IV, II, III, I
C. IV, II, I, III
D. II, IV, I, III

A

C. IV. SA node
, II. AV node, I. AV bundles, III. Purkinje fibers

87
Q

Which of the ff. is the correct sequence of events during ventricular diastole?

I. When ventricular blood pressure become less than atrial pressure, AV valves open.
II. Atria contract and force their blood into the ventricles
III. Semilunar Valve close
IV. Ventricles relax and blood pressure I ventricles decrease

A. IV, III, I, II
B. II, III, I, IV
C. I, III, II, IV
D.IV, I, III, II

A

A. IV. Ventricles relax and blood pressure I ventricles decrease, III. Semilunar Valve close, I. When ventricular blood pressure become less than atrial pressure, AV valves open., II. Atria contract and force their blood into the ventricles

88
Q

Which one of the ff. events does not occur during ventricular systole?

A. Ventricular pressure decreases
B. AV valve close
C. Semilunar valves open
D. All of these events occur during ventricular systole

A

D. All of these events occur during ventricular systole

88
Q

Which one of the ff. events does not occur during ventricular diastole?
A. Ventricular pressure decreases
B. AV valve close
C. Semilunar valves open
D. All of these events occur during ventricular systole

A

B. AV valve close

89
Q

Which one of the following is the highest blood pressure in the aorta?
A. Pulmonary Pressure
B. Systolic Pressure
C. Diastolic Pressure
D. None of the above

A

B. Systolic Pressure

90
Q

Your patient’s ECG shows positively deflected QRS complexes in lead I and AVF. You determine he has?

A. normal axis
B. LAD
C. RAD
D. both B and C

A

A. normal axis

91
Q

Which limb lead (s) normally display (s) a (n) inverted electrocardiogram(s)?
I. aVR
II. lead III
III. lead I
IV. aVF

A. I.
B. IV.
C. I, III
D.I, IV

A

A. I. aVR

92
Q

Where should the positive electrode for lead V5 be positioned?

A. Right side of the sternum, fourth intercostal space
B. Left midaxillary line at the same level as V4
C. Left side of the sternum, fourth intercostal space
D. Left anterior axillary line at the same level as V4

A

D. Left anterior axillary line at the same level as V4

93
Q

A standard 12 lead ECG provides views of the heart in ___.

A. the frontal plane only
B. the sagittal plane only
C. the horizontal plane only
D. both the frontal and the horizontal planes

A

D. both the frontal and the horizontal planes

94
Q

REspiratory alkalosis can be caused by which of the following:
I. Encephalitis
II. Diuretic therapy
III. Renal dysfunction
IV nasogastric suctioning
V. Excessive mechanical ventilatory support

A. II and III
B. I and V
C. II, IV, V
D. I, II, and IV

A

B. I and V

95
Q

The term “ Wenckebach” is associated with;
A. Sinus Tachycardia
B. First degree heart block
C. Second degree heart block type I
D. Second Degree heart block type II

A

C. Second degree heart block type I

96
Q

A client experiencing sinus bradycardia with a pulse rate of 40 beats per minute, blood pressure of 80/50 mmHg complains of dizziness, Which medication would be used to treat his bradycardia?
A. Lidocaine
B. Bretylium
C. Atropine
D. Dobutamine

A

C. Atropine

97
Q

An ECG taken during a routine check up reveals that the client had silent myocardial infarction. On a 12-lead ECG, which leads record electrical events in the septal region of the left ventricle?

A. Leads I, AVL, V5 and V6
B. Leads II, III, and AVF
C. Leads V1 and V2
D. Leads V3 and V4

A

C. Leads V1 and V2

Cluster 1 (4 decks)

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