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81 Cards in this Set
- Front
- Back
Normal person's arterial carbon dioxide pressure? 25-35 35-45 45-60 60-80 |
35-45 |
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Normal person's venous oxygen pressure? 35-4545-80 80-100 100-120 |
35-45 |
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What will not be seen in the arterial blood gas values of a patient with ACUTE VENTILATOR FAILURE? acidic pH near-normal bicarb level alkaline pH high carbon dioxide level |
alkaline pH |
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What causes stimulation of the peripheral chemoreceptors to increase the ventilator rate? pain or anxiety PaCO2 of about 40 PaO2 of about 60 venous pH of 7.30-7.40 |
PaO2 of about 60 |
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Your patient has had chronic ventilator failure for several years. What is the primary factor that determines her breathing pattern? muscle efficiency ventilation efficiency heart function work efficiency |
work efficiency |
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An anion gap of 15 would indicate what? |
Metabolic acidosis |
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Common causes of metabolic acidosis include all of the following except? diabetic ketoacidosis shallow breathing from a sedative overdose lactic acidosis renal failure |
shallow breathing from a sedative overdose |
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your patient with chronic ventilator failure and hypoxemia has been given supplemental oxygen. Within an hour, he is found to be breathing shallowly and very lethargic. The physician suspects that he was given too much oxygen. What physiologic effects could have led to this? (multiple multiple) 1.oxygen induced redistribution of the V/Q ratio 2.oxygen induced peripheral chemoreceptor depression 3.respiratory acidosis 4.increased shunt percentage |
1,2 |
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Which of the following would be found in a stable patient with longstanding obstructive lung disease? Low bicarb, low co2 low bicarb, high co2 high bicarb, low co2 high bicarb, high co2 |
high bicarb, high co2 |
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Common causes of metabolic alkalosis include? diuretic therapy vomiting excessive sodium bicarb administration gastric suctioning |
all of them |
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When a sample of arterial blood is analyzed for the pressure of oxygen and carbon dioxide, the value comes from the? |
blood plasma |
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oxygen consumption: 1. increases with exercise 2. is the amount of oxygen used by the body 3. is inversely related to co2 production 4. is about 250 mL/min in the resting adult |
1,2,4 |
|
normal pH of arterial blood |
7.35-7.45 |
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polycythemia: 1. is a condition of too many red blood cells 2. is a condition of too few red blood cells 3. is caused by lack of iron in the diet 4. is the body's response to chronic hypoxemia |
1,4 |
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what will NOT be seen in the arterial blood gas values of a patient with acute alveolar hyperventilation |
acidic pH |
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What is the most common cause for a patient to have alveolar hyperventilation singultus pain/anxiety croup hypoxemia |
hypoxemia |
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Your patient has acute ventilator failure and academia. What should be done? |
begin mechanical ventilation |
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If a patient has chronic ventilator failure, the pH is corrected toward normal by what? |
kidneys retain bicarb |
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In order to determine if a patient's acidosis is from a metabolic disorder, the physician decides to measure the anion gap. What is a normal anion gap? |
9-14 |
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The physician is concerned that your patient may be sensitive to uncontrolled oxygen administration because of her long-standing chronic ventilator failure and hypoxemia. As the respiratory therapist, what should be recommended? variable oxygen% despite her breathing pattern fixed oxygen% despite her breathing pattern 80% helium 20% oxygeb mechanical ventilation |
fixed oxygen% despite her breathing pattern |
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What would be found in a patient with a combined metabolic and respiratory acidosis? |
low bicarb, high co2 |
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During their advanced stages, which of the following are associated with chronic ventilatory failure? 1.asthma 2.bronchiectasis 3.cystic fibrosis 4.emphysema |
not asthma 2,3,4 |
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Lactic acidosis develops from which of the following? 1.inadequate tissue oxygenation 2.renal failure 3.inadequate insulin level 4.anaerobic metabolism 5.inadequate glucose level |
1,4 |
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During acute alveolar hyperventilation, the blood: 1.PCO2 increases 2.HCO3- increases 3.HCO3- decreases 4.pH increases |
3,4 |
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Clinically, the patient's C(a-v) O2 increases in response to which of the following? 1.hypothermia 2.decreased cardiac output 3.seizures 4.cyanide poisoning |
2,3 |
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In the patient with severe emphysema, which of the following oxygenation indicies are commonly seen? |
decreased SvO2, increased O2 ER |
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Culture and sensitivity tests do what? |
determine the antibiotics best suited for combating an infection |
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What is therapeutic bronchoscopy NOT used for? |
bronchiectasis evaluation |
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Diagnostic of a thoracentesis can be used to what? |
determine the etiology of a pleural lung effusion |
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After a thoracentesis procedure, it is important to monitor the patient for what? |
pneumothorax |
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In a normal differential white blood cell count, what would have the highest number? |
neutrophils |
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Postural drainage, percussion, and vibration are part of what TDP? |
bronchopulmonary hygeine therapy |
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A 45 year old woman has acute respiratory failure. She is cyanotic with unstable vital signs. What TDP's should be implemented? |
oxygen therapy and mechanical ventilation |
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An obese patient had upper abdominal surgery 2 days earlier. He has a weak nonproductive cough and a pulse oximeter reading of 84% on room air. What TDP's should be implemented? |
hyperinflation therapy and oxygen therapy |
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Which of the following are associated with the bronchospasm clinical scenario? 1.increased airway resistance 2.decreased FRC 3.bronchial breath sounds 4.hyperresonant percussion note |
1,4
|
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Which of the following are associated with the consolidation clinical scenario? 1.increased opacity on the chest radiograph 2.decreased FRC 3.bronchial breath sounds 4.hyperresonant percussion note |
NOT hyperresonant percussion note 1,2,3 only |
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Term used for red blood cells? |
erythrocytes |
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Formed element found in circulating blood? |
platelets |
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term used for white blood cells? |
leukocytes |
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what white blood cell is NOT a granulocyte? |
lymphocyte |
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What type of white blood cell typically is most prevalent in the circulating blood? |
neutrophil |
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Term that describes immature neutrophil? |
band |
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Normal percentage of lymphocytes in circulating white blood cells? |
20-45% |
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Type of white blood cell responsible for phagocytosis? |
monocyte |
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Term that describes an overall abnormal decrease in white blood cell count? |
leukopenia |
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Term that describes anemia due to low hemoglobin levels? |
hypochromic |
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A patient with a platelet count of about 80,000/mm3 is likely to have what condition? |
excessive bleeding |
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What problem is associated with an abnormal INR value? |
bleeding |
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what symptom is commonly seen with hyponatremia? |
confusion |
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Your patient has been found to have TB in several organs of the body. What term is used to describe this situation? |
disseminated TB |
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mycobacterium TB is particularly damaging to the lungs because of the healing of a tubercle micropulmonary emboli the increased mucus production the irreversible bronchospasm that is causes |
the healing of a tubercle
|
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Your patient has postprimary TB. What are the major pathologic or structural changes associated with it? 1.cavity formation 2.laryngeal edema 3.dilated and distorted bronchi 4.fibrosis of lung pharenchyma |
NOT laryngeal edema 1,3,4 only |
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A patient who has an uncontrolled TB infection will NOT show what? |
high fever |
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Mycobacterium TB is most readily transmitted through what? |
coughing |
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When a person has TB spread through the body, where is it NOT found? |
lower lobes |
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Most effective medication used to treat a TB infection is? rifampin penicillin streptomycin isoniazid |
rifampin
|
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Which of the following clinical manifestations are associated with TB? 1.dull percussion note 2.bronchospasm 3.hyperresonant percussion note 4.crackles |
1,4 |
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A patient with an advanced case of TB may have the following radiologic findings: 1.bronchial tumors 2.hyperlucent lung fields 3.retraction of lung segments 4.right-sided heart enlargement |
3,4 |
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What parts of the lungs are most commonly affected by a fungal infection? |
upper lobes |
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Fungal lung infections are usually spread by what? |
inhaling spores |
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Which type of fungal lung infection frequently results in productive cough with purulent sputum? |
blastomycosis |
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A skin test is available to confirm what fungal infection? |
coccidiodomycosis |
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After cleaning out his chicken coop, a farmer has developed a fungal lung infection. What type of infection is it most likely to be? |
histoplasmosis |
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In the midwestern part of the united states, what is the most common fungal infection of the lungs |
histoplasmosis |
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drug of choice for the treatment of a fungal lung disease is? |
fungizone |
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During the advances stages of a fungal lung infection, which of the following is commonly seen on the chest radiograph? hyperinflation spherical nodules right shift of the heart cavities |
cavities |
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As pulmonary edema progressively worsens, the fluid moves in what following sequence? peribronchial interstitial spaces, bronchi, trachea alveoli, bronchioles, bronchi bronchioles, bronchi, trachea pulmonary capillaries, alveoli, bronchioles |
alveoli, bronchioles, bronchi |
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Pulmonary edema manifests itself clinically as what type of disorder? |
restrictive pulmonary disorder |
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The major pathologic or structural changes seen in the lungs with pulmonary edema include: 1.atelectasis 2.bronchospasm 3.high surface tension of alveolar fluid 4.alveolar flooding |
NOT bronchospasm 1,3,4 only |
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normal hydrostatic pressure in the pulmonary capillaries? |
10-15 mmHg |
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Which of the following are considered noncardiogenic causes of of increases capillary permeablity? 1.therapeutic lung radiation 2.cigarette smoke 3.acute respiratory distress syndrome 4.inhales phosgene |
NOT cigarette smoke 1,3,4 only |
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Management of cardiogenic pulmonary edema includes the following: 1.giving the patient a low salt intake diet 2.giving the patient a medication to lower blood pressure 3.giving the patient a diuretic drug 4.performing balloon angioplasty on the patient |
1,2,3 |
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Your patient with pulmonary edema is cyanotic and and complaining of difficulty breathing. What should be recommended by the respiratory therapist? |
provide supplemental oxygen |
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Your patient with cardiogenic pulmonary edema has had intravascular catheters placed for monitoring purposes. Which of the following would be expected? 1.decreased SV 2.increased PCWP 3.increased CVP 4.decreased RAP |
NOT RAP 1,2,3 only |
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Your patient with cardiogenic pulmonary edema would be expected to have all of the following chest radiograph findings EXCEPT: depressed diaphragms pleural effusion cardiomegaly bilateral "butterfly" pattern fluffy infiltrates |
depressed diaphragms |
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A pulmonary embolism causes which of the following major pathologic and structural changes in the lungs? 1.alveolar consolidation 2.mucosal edema 3.alveolar atelectasis 4.pleural friction rub |
1,3 |
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predisposing factors of pulmonary emboli include: 1.varicose veins 2.smoking 3.obesity 4.congestive heart failure |
All |
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The sudden onset of which of the following signs and symptoms indicate a pulmonary embolism? 1.wheezing 2.coughing out blood-streaked sputum 3.cyanosis 4.sudden shortness of breath |
All
|
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Your patient is suspected of having one or more pulmonary emboli. He is tested by inhaling a radioactive gas and receiving an intravenous injection of radiolabeled particles. Which test results on his ventilation-perfusion lung scans will prove he has a pulmonary embolism? |
Decreased blood flow and normal ventilation through the lungs |
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While assessing a patient who was involved in a serious car crash and hit his steering wheel, you notice that his left anterior chest wall caves in during inspiration. What would cause this? |
flail chest segment |
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A flail chest is defined as: 1.one fractured rib or two adjacent fractured ribs 2.three or more adjacent fractured ribs 3.single rib fractures 4.double rib fracture |
2,4 |