RCP 370 FINALS!!!!!!!

A 50-year-old patient has a heart rate by palpation of 120 bpm. How should this be interpreted?

A 50-year-old patient has a heart rate by palpation of 120 bpm. How should this be interpreted?

Tachycardia

A 50-year-old patient is said to have hypotension if her:

blood pressure is 85/55mmHg

In which of the following conditions would a dull percussion note most likely be heard?

• Atelectasis

• Pleural thickening

• Consolidation

While assessing an unconscious patient, the respiratory therapist observes that the patient’s breathing becomes progressively faster and deeper and then progressively becomes slower and shallower. After that, there is a period of apnea before the cycle begins again. This breathing pattern would be identified as:

Cheyne-Stokes

Which of the following are benefits of pursed-lip breathing?

• Stabilizes the airways

• Reduces air trapping during exhalation

• Improves breathing efficiency and gas mixing

The respiratory therapist is examining a patient in the medical ward and notes that the trachea is deviated to the right. Which of the following may be causing the tracheal deviation to the right?

• Atelectasis of the right upper lobe

The respiratory therapist is performing palpation on a patient recently admitted to the medical ward. The therapist notes increased tactile fremitus over the right lung. Which of the following could most likely be the cause for this physical examination finding?

Right sided atelectasis

Moderate hypoxemia in adults is indicated with an SpO₂ value between ________ and _________.

86%-90%

Adult normal temperature is define as:

98.6F

In a state of hyperthermia blood vessels: 

Vasodilate

A respiratory therapist is assessing a patient in the intensive care unit and notices a significant decrease in systolic blood pressure during inspiration. What condition is most commonly associated with this clinical finding?

Pulsus paradoxus

A respiratory rate of 25 bpm is define as: 

Tachypnea

A respiratory rate of 9 is define as:

bradypnea

A blood pressure of 145/95 is termed.

Hypertension

Clinical signs of hypothermia include all of the following except:

Hypertension

Which of the following is NOT a standard site for checking a pulse

Axillary

Which of the following breathing patterns is typically observed as a compensatory mechanism for metabolic acidosis, such as in diabetic ketoacidosis (DKA)?

Kussmauls respiration

Which of the following breathing patterns is characterized by alternating periods of rapid, deep respirations followed by irregular abrupt periods of apnea?

Biot respiration

Tripoding is defined as:

Leaning forward with arms and elbows supported on a table

Crepitus is defined as:

Crackling or popping sound/sensation palpated over the skin

Subcutaneous emphysema is best described as the presence of air or gas in which of the following locations?

Under the skin

Which of the following is considered a normal tidal volume for a healthy adult?

500mL

Which of the following is considered a symptom that a patient with pulmonary disease may complain about?

Feeling of breathlessness

Which of the following terms is used to describe shortness of breath in the reclining position?

orthopnea

What ventilatory pattern occurs when lung compliance decreases?

Rate generally increases while the tidal volume simultaneously decreases

As you assess the respiratory status of a patient you notice they have jugular venous distention. Which of the following conditions is most likely the cause of this clinical manifestation?

Congestive heart failure

What chemoreceptors respond primarily to low oxygen levels in the blood?

Peripheral

How does nasal flaring improve breathing?

Provides a larger orifice for gas to enter the lungs during inhalation

Which clinical manifestation is characterized by bulbous swelling of the terminal phalanges of the fingers and toes and is observed in patients with chronic respiratory disorders? 

Digital Clubbing

Which clinical manifestation is characterized by the presence of fluid in the tissues, primarily in the arms and ankles, and is commonly seen in patients with CHF, cor pulmonale, and hepatic cirrhosis?

Peripheral edema

Which clinical manifestation is characterized by the enlargement or distension of the jugular veins, often observed in patients with congestive heart failure, cor pulmonale, and other conditions causing increased central venous pressure?

Jugular venous distension

The term hemoptysis refers to:

blood or blood tinged sputum from the tracheobronchial tree

Which term is defined as the ease with which the elastic forces of the lungs accept a volume of inspired air?

Compliance

Which term is defined as the tendency of the structure to return to its original form after being stretched or recoil?

Elastance/elasticity

Which of the following terms describes a patient’s severe resistance to taking deep breaths due to pleuritic chest pain?

Splinting

Which of the following is not an objective sign of dyspnea?

Sensation of suffocation

How do each the following factors individually affect airway resistance?

Increases Airway Resistance

In a normal healthy adult the inspiratory-expiratory ratio is about ___________

1:2

After receiving IPPB treatment, a patient coughs up pink frothy secretions. Which of the following statements accurately describes the significance of this type of sputum production?

It indicates possible pulmonary edema

Upon entering a 75-year-old patient's room, the RT notices that the patient's face and hands are blue-gray. What is the most likely clinical manifestation of this finding?

Cyanosis due to hypoxemia

Which of the following best differentiates pleuritic chest pain from nonpleuritic chest pain?

Pleuritic chest pain is typically sharp and worsens with deep breathing or coughing, while nonpleuritic chest pain is a dull ache that is not affected by respiration

C(Cystic Fibrosis

B(Bronchitis)

A(Asthma)

B(bronchitis)

E(Emphysema)

The FRC, RV and TLC can be measured indirectly by all of the following methods EXCEPT:

Forced Vital Capacity

Which time period is most commonly used for the Forced Expiratory Volume Timed (FEVT) and serves as a key indicator of airway obstruction?

1 second

Which medical device is used to measure lung volumes and capacities?

Spirometer

What does the Forced Expiratory Flow 25%–75% (FEF25%–75%) measure, and which airways does it evaluate?

It measures the average flow rate of air during the middle portion of the FVC and evaluates the status of the small to medium-sized airways

During a spirometry evaluation, if the physician wants to assess the larger airways of a patient after the FVC maneuver, which parameter would be most appropriate?

Forced Expiratory Flow 25%-75%

Which pulmonary function test is used to measure the volume of air a patient can forcefully and rapidly exhale until empty after maximal inhalation?

Forced Vital Capacity (FVC

If a patient with periodic asthma symptoms has normal pulmonary function test results, what additional test can help confirm or rule out asthma? 

Methacholine Challenge Test

What does an FEV1/FVC ratio below 70% typically indicate in a pulmonary function test?

Obstructive Lung Disease

A 72-year-old patient with a history of chronic obstructive pulmonary disease (COPD) presents with signs of severe respiratory distress. Upon assessment, the maximum inspiratory pressure (MIP) is measured at -18 cm H₂O. The patient also exhibits difficulty in coughing effectively and has abnormal blood gas values showing elevated carbon dioxide levels and decreased oxygen saturation. Based on the assessment findings, which of the following actions would this indicate?

1. Begin ventilatory support to assist with breathing and ventilation

After performing a pulmonary function study, the RT finds that the results indicate obstructive lung disease and a decreased Diffusing Capacity of the Lung for Carbon Monoxide (DLCO). What is the best interpretation of these findings?

The patient has emphysema

In the normal healthy adult MIP is:

-80 to -100 cmH2O

A respiratory therapist needs to assess the muscle strength of a patient with myasthenia gravis. Which test should be used to check the patient’s respiratory muscle strength?

Maximum Inspiratory Pressure (MIP)

An asthmatic patient is asked to take a deep breath and then exhale quickly into a handheld device. Which of the following tests is used to assess the patient’s asthma control and airway function?

Methacholine Challenge Test

A patient with acute alveolar hyperventilation shows symptoms like dizziness and tingling. What is the most likely underlying cause of these symptoms?

Hypoxemia

A patient with a history of smoking and COPD presents in severe respiratory distress and acute bronchitis. Her previous baseline ABG was:

pH: 7.37
PaCO2: 62 mmHg
HCO3–: 35 mEq/L
PaO2: 56 mmHg

The current ABG results are:

pH: 7.18
PaCO2: 90 mmHg
HCO3–: 38 mEq/L
PaO2: 36 mmHg
Question:

What is the clinical interpretation of these ABG values (in addition to hypoxemia)?

Acute ventilatory failure superimposed on chronic ventilatory failure

How is most of the oxygen carried? 

Bound to hemoglobin

The normal range for PaO2/FiO2 ratio: 

350-450

A P/F ratio of < 200 indicates:

Poor Lung Function

Calculate total oxygen content (CaO2) of arterial blood with the following:

Hb = 15 g/dL

SaO2 = 96% = 0.96

PaO2 = 80 mmHg

Formula: CaO₂ = (Hb × 1.34 × SaO₂) + (PaO₂ × 0.003)

19.5mL/dL of O2

Hypoxemia

Inadequate level of blood oxygenation

Hypoxia

Inadequate level of tissue oxygenation

Which condition involves blood flowing directly from the right side of the heart to the left side without passing through the lungs for oxygenation, and is approximately 3-5% of the cardiac output?

Anatomic Shunt

Calculate the alveolar oxygen pressure (PAO2) given the following parameters:

FiO2: 30%
Barometric Pressure (PB): 760 mmHg
Partial Pressure of Carbon Dioxide (PaCO2): 40 mmHg
Respiratory Quotient (RQ): 0.8

 

Formula: PAO₂ = FiO₂(P_B - PH₂O) - PaCO₂ ÷ 0.8

163 mmHg

Clinically, the V̇O2 (oxygen consumption) decreases in response to which of the following?

1. Exercise

2. Hyperthermia

3. Increased body size

4. Peripheral shunting

Peripheral shunting

Which condition is characterized by an increased number of red blood cells in the blood due to chronic hypoxia, leading to a higher hemoglobin concentration and hematocrit levels?

Polycythemia

A patient has a PaO₂ of 90 mmHg while receiving 50% FiO₂. What is the P/F ratio for this patient?

180

What term describes the condition where the right side of the heart becomes strained and enlarged due to chronic lung problems, such as chronic hypoxia, causing it to work harder?

Cor pulmonale

Which term is used to describe a patient's state of awareness regarding person, place, and time, and can indicate conditions such as decreased perfusion state and cerebral hypoxia?

Sensorium

During a capillary refill test, what does it indicate if the nail beds remain white and do not turn pink within two seconds after pressure is released?

Inadequate perfusion

Normal cardiac output ranges from 4 to 8 liters per minute.

True

Which of the following are associated with extrinsic asthma?
1. Furred animal dander
2. Mold
3. Emotional stress
4. Cold air

• furred animal dander

• Mold

Which of the following factors are associated with intrinsic asthma?
1. Emotional stress
2. Cockroach allergen
3. GERD
4. Dust mites

• Emotional stress

• GERD

If a beta₂-agonist agent and an anticholinergic agent were administered concurrently to a patient during an acute asthma episode, what result would be expected?

Bronchial smooth muscle relaxation will occur

During a chest assessment of a patient experiencing an asthmatic episode, which of the following findings is most likely?
1. Inverse I:E ratio
2. Decreased vocal fremitus
3. Increased vesicular breath sounds
4. Hyperresonant percussion note

• Decreased vocal fremitus

• Hyperresonant percussion note

Which of the following ABG values would be consistent with ventilatory failure with hypoxemia in a patient with severe status asthmaticus?
1. Increased PaCO₂
2. Decreased PaO₂
3. Increased pH
4. Decreased pH

• Increased PaCO2

• Decreased PaO2

• Decreased pH

A sputum sample from a patient has been sent to the laboratory for analysis. Which of the following findings could help confirm the diagnosis of extrinsic asthma?

Increased IgE level

What findings on a chest radiograph would be expected during a prolonged asthma episode?
1. Depressed diaphragm
2. Increased anterior-posterior diameter
3. Asymmetric lung inflation
4. Translucent lung fields

• Depressed diaphragm

• Increased anterior-posterior diameter

• Translucent lung fields

What is the name for the microscopic structures formed from the breakdown of eosinophils in allergic asthma?

• Charcot-Leyden crystals

Which of the following recurrent symptoms are commonly associated with asthma?
1. Cough
2. Chest tightness
3. Fever
4. Wheeze

• Cough

• Chest tighness

• Wheeze

What is the term for an inspiratory fall in systolic blood pressure exceeding 10 mm Hg?

• Pulsus paradoxus

A fractional concentration of exhaled nitric oxide level greater than _____ ppb is an indication of airway inflammation requiring controller medication increase.

• 50

What are anatomical alterations of the lungs in the asthma population?

1. Smooth muscle constriction
2. Excessive mucus production
3. Whitish bronchial secretions
4. Hyperinflation
5. Mucus plugging

• all listedont

Controller medications

Reliever medications

Add-on-therapies

• Decrease airway inflammation

• Provide as needed relief of asthma symptoms, prevention of exercise induced bronchoconstriction

• For severe asthma, tiotropium,

Define status asthmaticus.

Asthma episode that does not respond to conventional pharmacologic therapy.

For asthma the evidence of reversible airflow limitation can be confirmed when FEV1 is:

FEV1 > 12% (or 200 ml) after inhaling a bronchodilator

The presence of allergic asthma can be assessed with all of the following except:

ABG

During an asthma episode, the smooth muscles of the bronchi may hypertrophy as much as:

Three times normal thickness

After the inhalation of a bronchodilator, what percentage increase in peak expiratory flow rate (PEFR) is typically required to demonstrate reversible airflow limitation consistent with asthma?

20% or greater

How long must asthma be controlled before the treatment regimen can be stepped down, with the aim of establishing the lowest step and dose of treatment that maintains control?

At least 3 months

Which of the following have gained a widespread acceptance for assessing and monitoring a patient’s airflow limitation?

1. PEFR
2. FEF200–1200
3. FEV1
4. FEV1/FVC ratio

• PEFR

• FEV1

• FEV1/FVC ratio

A patient’s clinical history presents the following: Daytime asthma symptoms more than twice per week, no limitation in activities, no nocturnal symptoms or awakening, the need for reliever/rescue medications once per week, and normal PEFR and FEV1. Which of the following would best classify this patient's level of asthma control?

Partially controlled

___________ is a condition defined by a persistent cough with sputum production lasting for at least 3 months over two consecutive years.

Chronic bronchitis

A condition defined by the weakening and permanent enlargement of air spaces beyond the terminal bronchioles, along with the destruction of alveolar walls, is called __________

Emphysema

A FEV1/FVC ratio of less than 70% is used to confirm the diagnosis of __________.

Obstructive lung disorder

What term is used to describe the presence of two or more diseases or medical conditions occurring simultaneously?

Comorbidities

During a pulmonary function test (PFT), the respiratory therapist notes that both functional residual capacity (FRC) and residual volume (RV) are increased. This finding is most indicative of:

Air trapping

Which clinical manifestation, often associated with hyperinflation of the lungs, is commonly seen in patients with Chronic Obstructive Pulmonary Disease (COPD)?

Barrel chest

Upon examining the sputum of a COPD patient, you observe that it is copious and purulent. This finding is most indicative of which disease process?

chronic. bronchitis