Potpourri
A patient with bronchiectasis has a productive cough. Which of the following should the respiratory therapist be evaluating about the patient’s sputum?
1. Color
2. Odor
3. Frequency of cough
4. Consistency
1,2,4
The respiratory therapist should evaluate a patient’s sputum for color, odor, amount, consistency, and any other significant factors. This could include time of greater or smaller amounts or a change in consistency after inhaling a mucolytic medication.
A dull percussion note would be heard in which of the following situations?
1. Atelectasis
2. Pleural thickening
3. Chronic obstructive pulmonary disease (COPD)
4. Consolidation
1,2,4
Because of hyperinflation, a patient with COPD would have a hyperresonant percussion note. All of the other listed options would result in a dull percussion note.
A 50-year-old patient has a heart rate by palpation of 120 bpm. How should this be interpreted?
Tachycardia:
In an adult, a heart rate of greater than 100/minute is considered to be tachycardia. A heart rate of less than 60/minute in an adult is considered to be bradycardia. Palpation and auscultation are both acceptable to check heart rate.
Benefits of pursed-lip breathing include that it:
1. stabilizes airways.
2. offsets air trapping on exhalation.
3. generates a better gas mixing breathing pattern.
4. increases the respiratory rate.
1,2,3
All of the listed options are benefits of pursed-lip breathing in a patient with an airway obstruction problem such as asthma or COPD.
Xanthines:
A. Caffeine
B. Albuterol
C. Pentamidine
D. Aminophylline
A and D
When a patient has pneumonia, which of the following would be found in the alveolar effusion fluids?
1. Mucus
2. Macrophages
3. Saliva
4. Red blood cells
1, 3, 4
Coarse crackles are associated with:
1. inspiration typically.
2. air passing through an airway intermittently occluded by mucus.
3. bronchial asthma.
4. expiration typically.
2, 4
Coarse crackles are associated with air passing through an airway intermittently occluded by mucus; they are more typically heard during inspiration, not expiration. Wheezes are an expiratory sound associated with bronchial asthma.
Tachypnea may be the result of:
1. hypoxemia.
2. hypothermia.
3. fever.
4. sedation.
1,3
Tachypnea may be the result of hypoxemia, fever, and other causes. Hypothermia and sedation will usually result in bradycardia.
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?
A. Atelectasis
B. Tumor mass on the right
C. A right sided tension pneumothorax
D. A right sided pleural effusion
A. Atelectasis
A number of abnormal pulmonary conditions can cause the trachea to deviate from its normal position. For example, a tension pneumothorax, pleural effusion, or tumor mass may push the trachea to the unaffected side (in this case to the left), whereas atelectasis pulls the trachea to the affected side (in this case to the right).
A patient comes into the emergency department with a complaint of centrally located, constant chest pain. What is his most likely problem?
A. Fractured rib
B. MI
C. Pleurisy
D. Pneumothorax
B. MI
Often a patient with myocardial ischemia will complain of centrally located, constant chest pain. The pain may also radiate down an arm or up the neck.
The majority of the mucous blanket consists of:
A. glycoproteins.
B. carbohydrates.
C. lipids.
D. water.
D. Water
Which of the following are considered accessory muscles of expiration?
1. Trapezius
2. Scalenes
3. External obliques
4. Transversus abdominis
1, 3, 4
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's Stokes
The abnormal breathing pattern called Cheyne-Stokes is identified by progressively faster and deeper breathing that then progressively becomes slower and shallower. After that there is a period of apnea before the cycle begins again. Tachypnea is rapid breathing. Kussmaul breathing is consistently fast and deep breathing. Hyperventilation is confirmed by a low carbon dioxide level.
The respiratory therapist is monitoring the blood pressure of a patient in the emergency department and notes that the blood pressure is 15 mm Hg less on inspiration than on expiration. Which of the following would most likely result in this finding?
A. MI
B. Asthma
C. Pulmonary embolism
D. Hypovolemia
B. Asthma
A change in blood pressure that is more than 10 mm Hg lower on inspiration than on expiration is known as pulsus paradoxus. This exaggerated waxing and waning of arterial blood pressure can be detected with a sphygmomanometer or, in severe cases, by palpating the pulse at the wrist or neck. Commonly associated with severe asthmatic episodes, pulsus paradoxus is believed to be caused by the major intrapleural pressure swings that occur during inspiration and expiration.
Fluticasone Propiate/Salmeterol, Breo Ellipta, Flunisolide, Ciclesonide, and Budesonide are all:
Corticosteroids
A condition that will cause hypoxic hypoxia is:
A. cyanosis.
B. decreased cardiac output or heart failure.
C. hypoventilation from an overdose of a sedative medication.
D. carbon monoxide poisoning.
D. carbon monoxide poisoning.
A patient is complaining of a constant chest pain that is centrally located, does not worsen with deep inspiration, but does radiate? Which of the following disorders is associated with these complaints?
A. Pneumonia
B. Lung cancer
C. Pulmonary hypertension
D. Tuberculosis
C. Pulmonary hypertension
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?
A. right sided atelectasis
B. right sided tumor
C. right sided pleural effusion
D. Right sided pneumothorax
A. right sided atelectasis
Tactile fremitus decreases when anything obstructs the transmission of vibration. Such conditions include tumors or thickening of the pleural cavity, pleural effusion, and pneumothorax. Tactile fremitus increases in patients with atelectasis
When would induced hypothermia be indicated?
A. Brain Surgery
B. Carbon monoxide poisoning
C. Fever
D. MI
A. Brain Surgery
Induced hypothermia may involve only a portion of the body or the whole body. Induced hypothermia is often indicated before certain surgeries, such as heart or brain surgery, or after return of spontaneous circulation after a cardiac arrest.
Non steroidal anti-asthma medications
A. Cromolyn
B. Benralizumab
C. Montelukast
D. Aztreonam
A, B, C
A. Cromolyn
B. Benralizumab
C. Montelukast
A condition that will cause anemic hypoxia is:
A. cyanide poisoning.
B. decreased cardiac output or heart failure.
C. polycythemia.
D. carbon monoxide poisoning.
D. carbon monoxide poisoning.
As you assess the respiratory status of a patient you notice they have jugular venous distention. Which of the following conditions is the most likely cause of this finding?
A. Congestive heart failure
B. Pneumonia
C. Lung cancer
D. Pulmonary infarction
A. Congestive heart failure
Which of the following is considered a normal tidal volume for an ARDS patient?
4 to 6 mL/kg
Mycobacterium tuberculosis is particularly damaging to the lungs because of the:
A. healing of a tubercle.
B. formation of micropulmonary emboli.
C. increased mucus production.
D. irreversible bronchospasm that it causes
healing of a tubercle.
Relief of allergic reactions. May also be used for preop sedation, Parkinson's disease and motion sickness.
Antihistamines