403 Final Review

Front 1

Normal person's arterial carbon dioxide pressure?

25-35

35-45

45-60

60-80

Back 1

35-45

Front 2

Normal person's venous oxygen pressure?

35-45
45-80
80-100
100-120

Back 2

35-45

Front 3

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

Back 3

alkaline pH

Front 4

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

Back 4

PaO2 of about 60

Front 5

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

Back 5

work efficiency

Front 6

An anion gap of 15 would indicate what?

Back 6

Metabolic acidosis

Front 7

Common causes of metabolic acidosis include all of the following except?

diabetic ketoacidosis

shallow breathing from a sedative overdose

lactic acidosis

renal failure

Back 7

shallow breathing from a sedative overdose

Front 8

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

Back 8

1,2

Front 9

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

Back 9

high bicarb, high co2

Front 10

Common causes of metabolic alkalosis include?

diuretic therapy

vomiting

excessive sodium bicarb administration

gastric suctioning

Back 10

all of them

Front 11

When a sample of arterial blood is analyzed for the pressure of oxygen and carbon dioxide, the value comes from the?

Back 11

blood plasma

Front 12

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

Back 12

1,2,4

Front 13

normal pH of arterial blood

Back 13

7.35-7.45

Front 14

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

Back 14

1,4

Front 15

what will NOT be seen in the arterial blood gas values of a patient with acute alveolar hyperventilation

Back 15

acidic pH

Front 16

What is the most common cause for a patient to have alveolar hyperventilation

singultus

pain/anxiety

croup

hypoxemia

Back 16

hypoxemia

Front 17

Your patient has acute ventilator failure and academia. What should be done?

Back 17

begin mechanical ventilation

Front 18

If a patient has chronic ventilator failure, the pH is corrected toward normal by what?

Back 18

kidneys retain bicarb

Front 19

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?

Back 19

9-14

Front 20

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

Back 20

fixed oxygen% despite her breathing pattern

Front 21

What would be found in a patient with a combined metabolic and respiratory acidosis?

Back 21

low bicarb, high co2

Front 22

During their advanced stages, which of the following are associated with chronic ventilatory failure?

1.asthma

2.bronchiectasis

3.cystic fibrosis

4.emphysema

Back 22

not asthma 2,3,4

Front 23

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

Back 23

1,4

Front 24

During acute alveolar hyperventilation, the blood:

1.PCO2 increases

2.HCO3- increases

3.HCO3- decreases

4.pH increases

Back 24

3,4

Front 25

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

Back 25

2,3

Front 26

In the patient with severe emphysema, which of the following oxygenation indicies are commonly seen?

Back 26

decreased SvO2, increased O2 ER

Front 27

Culture and sensitivity tests do what?

Back 27

determine the antibiotics best suited for combating an infection

Front 28

What is therapeutic bronchoscopy NOT used for?

Back 28

bronchiectasis evaluation

Front 29

Diagnostic of a thoracentesis can be used to what?

Back 29

determine the etiology of a pleural lung effusion

Front 30

After a thoracentesis procedure, it is important to monitor the patient for what?

Back 30

pneumothorax

Front 31

In a normal differential white blood cell count, what would have the highest number?

Back 31

neutrophils

Front 32

Postural drainage, percussion, and vibration are part of what TDP?

Back 32

bronchopulmonary hygeine therapy

Front 33

A 45 year old woman has acute respiratory failure. She is cyanotic with unstable vital signs. What TDP's should be implemented?

Back 33

oxygen therapy and mechanical ventilation

Front 34

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?

Back 34

hyperinflation therapy and oxygen therapy

Front 35

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

Back 35

1,4

Front 36

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

Back 36

NOT hyperresonant percussion note

1,2,3 only

Front 37

Term used for red blood cells?

Back 37

erythrocytes

Front 38

Formed element found in circulating blood?

Back 38

platelets

Front 39

term used for white blood cells?

Back 39

leukocytes

Front 40

what white blood cell is NOT a granulocyte?

Back 40

lymphocyte

Front 41

What type of white blood cell typically is most prevalent in the circulating blood?

Back 41

neutrophil

Front 42

Term that describes immature neutrophil?

Back 42

band

Front 43

Normal percentage of lymphocytes in circulating white blood cells?

Back 43

20-45%

Front 44

Type of white blood cell responsible for phagocytosis?

Back 44

monocyte

Front 45

Term that describes an overall abnormal decrease in white blood cell count?

Back 45

leukopenia

Front 46

Term that describes anemia due to low hemoglobin levels?

Back 46

hypochromic

Front 47

A patient with a platelet count of about 80,000/mm3 is likely to have what condition?

Back 47

excessive bleeding

Front 48

What problem is associated with an abnormal INR value?

Back 48

bleeding

Front 49

what symptom is commonly seen with hyponatremia?

Back 49

confusion

Front 50

Your patient has been found to have TB in several organs of the body. What term is used to describe this situation?

Back 50

disseminated TB

Front 51

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

Back 51

the healing of a tubercle

Front 52

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

Back 52

NOT laryngeal edema

1,3,4 only

Front 53

A patient who has an uncontrolled TB infection will NOT show what?

Back 53

high fever

Front 54

Mycobacterium TB is most readily transmitted through what?

Back 54

coughing

Front 55

When a person has TB spread through the body, where is it NOT found?

Back 55

lower lobes

Front 56

Most effective medication used to treat a TB infection is?

rifampin

penicillin

streptomycin

isoniazid

Back 56

rifampin

Front 57

Which of the following clinical manifestations are associated with TB?

1.dull percussion note

2.bronchospasm

3.hyperresonant percussion note

4.crackles

Back 57

1,4

Front 58

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

Back 58

3,4

Front 59

What parts of the lungs are most commonly affected by a fungal infection?

Back 59

upper lobes

Front 60

Fungal lung infections are usually spread by what?

Back 60

inhaling spores

Front 61

Which type of fungal lung infection frequently results in productive cough with purulent sputum?

Back 61

blastomycosis

Front 62

A skin test is available to confirm what fungal infection?

Back 62

coccidiodomycosis

Front 63

After cleaning out his chicken coop, a farmer has developed a fungal lung infection. What type of infection is it most likely to be?

Back 63

histoplasmosis

Front 64

In the midwestern part of the united states, what is the most common fungal infection of the lungs

Back 64

histoplasmosis

Front 65

drug of choice for the treatment of a fungal lung disease is?

Back 65

fungizone

Front 66

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

Back 66

cavities

Front 67

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

Back 67

alveoli, bronchioles, bronchi

Front 68

Pulmonary edema manifests itself clinically as what type of disorder?

Back 68

restrictive pulmonary disorder

Front 69

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

Back 69

NOT bronchospasm

1,3,4 only

Front 70

normal hydrostatic pressure in the pulmonary capillaries?

Back 70

10-15 mmHg

Front 71

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

Back 71

NOT cigarette smoke

1,3,4 only

Front 72

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

Back 72

1,2,3

Front 73

Your patient with pulmonary edema is cyanotic and and complaining of difficulty breathing. What should be recommended by the respiratory therapist?

Back 73

provide supplemental oxygen

Front 74

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

Back 74

NOT RAP

1,2,3 only

Front 75

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

Back 75

depressed diaphragms

Front 76

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

Back 76

1,3

Front 77

predisposing factors of pulmonary emboli include:

1.varicose veins

2.smoking

3.obesity

4.congestive heart failure

Back 77

All

Front 78

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

Back 78

All

Front 79

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?

Back 79

Decreased blood flow and normal ventilation through the lungs

Front 80

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?

Back 80

flail chest segment

Front 81

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

Back 81

2,4