Fundamentals of Respiratory Care Part 1

251 terms by DonaldJohn 

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Test 1 (no multiples/multiples)

Where are the majority of respiratory therapists employed?

hospitals or acute care settings

Who is considered to be the "father of medicine"?

Hippocrates

In 1662, a chemist published a book that described the relationship between gas, volume, and pressure. What was the chemist's name?

Robert Boyle

Who discovered oxygen in 1774 and described it as "dephlogisticated air"?

Joseph Priestley

What was the primary duty of the first inhalation therapists?

support oxygen therapy

When did the designation "respiratory therapist" become standard?

1974

When was positive end-expiratory pressure (PEEP) first introduced to treat patients with acute respiratory distress syndrome?

1967

Who introduced the first laryngoscope, in 1913?

Chevalier Jackson

In 1846, who developed a water seal spirometer, which allowed accurate measurement of the patient's vital capacity?

Hutchinson

What was the name of the first professional organization for the field of respiratory care?

Inhalation Therapy Association

What organization has developed an examination to enable respiratory therapists to become licensed?

National Board for Respiratory Care

The majority of respiratory care education programs in the United States offer what degree?

associate's degree

Which of the following is NOT predicted to be a growing trend in respiratory care for the future?

increased use of intravascular lines for patient monitoring

Who is professionally responsible for the clinical function of the respiratory care department?

medical director

For the CRT credential, what does the letter "T" stand for?

therapist

What term is used to describe the process in which a government agency gives an individual permission to practice an occupation?

licensure

What agency is responsible for ensuring quality in respiratory care through voluntary certification and registration?

NBRC

HIPAA was established in 1996 to set standards related to sharing confidential health history information about patients. What does the letter "P" stand for?

portability

Responsibility for the technical direction of a respiratory care department lies with whom?

department manager

The responsibilities of a respiratory care department manager include all of the following except:

regulate medications delivered by respiratory care staff

Which of the following is an essential element of a comprehensive protocol program?

carefully structured assessment tool and care plan form

What voluntary accrediting agency monitors quality in respiratory care departments?

JCAHO

To monitor correctness of respiratory care plans, which of the following should be used?

care plan auditors and case study exercises

What system has the federal government developed to evaluate the quality of care given to Medicare beneficiaries?

peer review organizations (PROs)

What term is used in current health care that refers to an organized strategy of delivering care to a large group of individuals?

management

Treatment based on careful review of available literature is known as:

evidence-based medicine

About how many people die each year in the United States from hospital-acquired infections (HAIs)?

90,000

Approximately what percent of patients receiving mechanical ventilation develop pneumonia as a complication?

25%

What is the most common route of pathogen transmission in the hospital setting?

contact

Which of the following is an example of indirect contact transmission involving fomites?

use of a dirty nebulizer on another patient

If you are caring for a patient who is suspected of having SARS, at what distance from the patient is it recommended to wear an effective filtration mask?

6 feet

What vaccination does OSHA require hospital employers to provide?

hepatitis B

What should be used to wipe down the surface of devices that cannot be immersed in water?

70% ethyl alcohol

Which of the following organisms is NOT destroyed by a disinfection agent?

bacterial spores

Which of the following statements is NOT true regarding the use of phenolics as a disinfectant?

They are ineffective on surfaces shortly after application.

Which of the following statements is NOT true regarding the use of glutaraldehyde?

It can retain activity up to 90 days once activated.

What is the most common, efficient, and easiest sterilization method?

steam sterilization

Which of the following is the most common source of patient infections?

large-volume nebulizers

Which of the following statements is NOT true regarding the use of sterile gloves in the hospital setting?

The same pair can be used on numerous patients if noninvasive procedures are done.

Which of the following is NOT one of the five key recommended components of an infection control program in the hospital setting?

development

All of the following sanctions can apply when one breaks a law except:

professional censure

What ethical issue has recently become a significant concern for respiratory therapists and all health care providers due to a congressional act?

patient's right to privacy

Contemporary ethical principles have evolved from all of the following sources except:

psychoanalysis (Freud)

Which ethical principle obliges a respiratory therapist to uphold a patient's right to refuse a treatment?

autonomy

A health professional who withholds the truth from a patient, saying it is for her own good, is engaged in what practice?

benevolent deception

What ethical principle can be used to justify the pain that might occur in drawing blood from a patient for a diagnostic test?

double effect

The debate over prolongation of life versus relief of suffering in elderly patients mainly involves differing opinions regarding what ethical principle?

beneficence

Under what conditions can the principle of confidentiality be breached?

when the welfare of the community or a vulnerable individual is at stake

The moral basis for rationing health care services falls under what ethical principle?

distributive justice

When a respiratory therapist defers a patient's questions about a condition to the attending physician, what ethical principle is being practiced?

role fidelity

A clinician who justifies support for withdrawing life support from a patient because "in the end, it would be best for all involved" is applying what ethical viewpoint?

consequentialism

What is the term for a civil wrong committed against an individual or property, for which a court provides a remedy in the form of damages?

tort

In a case of professional negligence, all of the following are required to support a claim of res ipsa loquitur except:

Evidence must exist to show that the defendant acted with malfeasance or intent.

A nurse who practices below a reasonable standard of care is committing what type of malpractice?

civil

A respiratory therapist who engages in a questionable business practice is committing what type of malpractice?

ethical

HIPAA primarily is referred to as the Privacy Rule and is concerned with PHI. What do the letters PHI stand for?

protected health information

At what temperature does all kinetic activity of matter cease?

0°K

What term is used for the transfer of heat by the direct interaction of atoms or molecules in a hot area with atoms or molecules in a cooler area?

conduction

Which of the following would be the worst heat conductor?

air

Which of the following is a good clinical example of using the principle of convection to transfer heat?

heated, enclosed infant incubators

Which of the following methods of heat transfer requires no direct contact between the warmer and cooler substances?

radiation

Which of the following is FALSE about evaporation?

The process of evaporation warms the surrounding air.

Which of the following equations can be used to calculate the pressure exerted by a liquid?

liquid pressure = liquid density ´ liquid depth

Which of the following is FALSE about viscosity?

Viscosity is most important under conditions of turbulent flow.

After placing a liquid into a small-diameter glass tube, you observe the formation of a convex (upwardly curved) meniscus. What conclusion is correct?

Strong cohesive forces exist among the liquid molecules.

Which of the following liquids has the lowest surface tension?

ethyl alcohol

Which of the following is FALSE about liquid bubbles?

Inflation pressure can be lowered if surface tension is increased.

What is the phenomenon whereby a liquid in a small tube tends to move upward against the force of gravity?

Capillary action

What is the change in state of a substance from liquid to gaseous form occurring below its boiling point?

evaporation

Which of the following is/are TRUE about molecular water vapor?

all the above

What is the equilibrium condition in which a gas holds all the water vapor molecules that it can?

saturation

What is the absolute humidity (water vapor content) of saturated gas at normal body temperature (37°C)?

43.8 mg/L

What is the water vapor pressure of saturated gas at normal body temperature (37°C)?

47.0 mm Hg

What is the term for the ratio of the actual water vapor present in a gas compared with the capacity of that gas to hold the vapor at a given temperature?

relative humidity

What is the term for the temperature at which the water vapor in a gas begins to condense back into a liquid?

dew point

The American National Standards Institute has set a water vapor content level of 30 mg/L as the minimum absolute humidity required for patients whose upper airways have been bypassed. This equals what body humidity (BH)?

68%

What is the term for the ratio of the amount of water vapor in a volume of gas compared to the amount of the water in gas saturated at a normal body temperature of 37°C?

percent body humidity (BH)

In International System (SI) units, what is any quantity of matter that contains 6.023 ´ 1023 atoms, molecules, or ions?

mole (mol)

According to Avogadro's law, under standard conditions of temperature and pressure (0°C and 760 mm Hg), 1 mol of any gas occupies which of the following?

22.40 L

What is the physical process whereby atoms or molecules tend to move from an area of higher concentration or pressure to an area of lower concentration or pressure?

diffusion

According to Graham's law, which of the following gases would diffuse most quickly?

Gas density X 0.543 g/L

A mercury barometer reads 770 mm Hg. What is the actual atmospheric pressure in g/cm2?

1047.0 g/cm2

From a bedside capnograph (CO2 measuring device), you obtain a "dry" gas reading of 5.3% CO2 in a patient's exhaled gas. Given a barometric pressure of 765 mm Hg, what is the partial pressure of CO2 in this patient's exhaled gas?

41 mm Hg

In the lung's alveoli, there are four gases mixed together: oxygen, carbon dioxide, nitrogen, and water vapor. At a normal barometric pressure of 760 mm Hg, alveolar O2 exerts a partial pressure of 100 mm Hg, CO2 40 mm Hg, and water vapor 47 mm Hg. What is the alveolar partial pressure of nitrogen?

573 mm Hg

If a given mass of a gas is maintained at a constant temperature, what will decreasing its pressure do?

increase its volume

Respiratory therapists must ensure that any oil or dust is cleared from high-pressure medical-gas delivery systems before pressurization. Why is this action needed?

Adiabatic compression could ignite the oil or dust.

What temperature is necessary to liquefy oxygen at 1 atm pressure?

-183.0° C

What is the pattern of flow in which a fluid moves in discrete cylindrical streamlines?

laminar

By what mechanism does gas exchange across the lung occur?

simple diffusion

Which chromosome has been found to carry the defective gene responsible for the development of cystic fibrosis?

7

What genetic disorder has been linked to emphysema?

a1-antitrypsin deficiency

The fetus is potentially viable if born prematurely after how many weeks of gestation?

24 to 26 weeks

The fetus is potentially viable if born at the end of which stage of development?

canalicular

During which phase of fetal development do mature alveoli appear?

alveolar

Which of the following is an index commonly used to determine relative lung maturity?

L:S ratio

What maintains lung inflation during fetal development?

fetal lung fluid

What percentage of right ventricular output is circulated through the fetal lungs?

10%

During a vaginal delivery, what facilitates the removal of fetal lung fluid from the pulmonary system?

thoracic compression

How short could the trachea of small preterm infant to be?

2 cm

Approximately how many alveoli are there in a 10-year-old's lung?

500 million

What is rather unique regarding the blood supply to the lung?

It receives blood from right and left ventricles.

What is the physiologic result of the infant's more compliant thorax compared with that of an adult?

They breathe larger tidal volumes based on IBW.

What is the name of the external landmark that identifies the point at which the trachea branches into the right and left mainstem bronchi?

angle of Louis

Approximately what percent of the normal changes in thoracic volume during quiet inspiration is due to the action of the diaphragm?

75

How far is the diaphragm pulled down during tidal breathing?

1 to 2 cm

What pulmonary disorder could lead to acute flattening of the diaphragm?

asthma

The diaphragm is innervated by which of the following nerves?

phrenic

The nerves that innervate the diaphragm arise from which area?

spinal nerves C3 to C5

What is the lowest level on the spinal cord that an injury could cause diaphragmatic impairment or paralysis?

C3

Which accessory muscles are active during resting and active inspiration and pull up on all the ribs expanding the thorax?

external intercostals

Which of the following is the most important ventilatory function of the scalene muscles?

lift upper chest particularly during times of high ventilatory demand

As ventilatory muscles, the sternomastoids do which of the following?

elevate the upper chest, increasing chest anteroposterior diameter

When a COPD patient leans forward braced in a tripod position, this lends particular advantage to which accessory muscles of inspiration?

pectoralis

Which accessory muscles of ventilation work to pull the ribs closer together?

internal intercostals

The abdominal muscles can actually contribute to inspiration by contraction at the end of exhalation.

true

To what structures do the parietal pleural membranes adhere or cover?

lung

What is the function of the very small amount of pleural fluid that is found in the pleural space?

reduces friction

What is the name given to the acute angle formed by the costal pleura joining the diaphragmatic pleura?

costophrenic angle

What is the mediastinum?

structure separating the right and left thoracic cavities

Why is the left lung narrower than the right lung?

There is upward pressure of the abdominal contents.

What forces establish the subatmospheric pressure found in the pleural space?

equal opposing tendency of the chest wall to expand and lung to collapse.

How would lung perfusion in a "zone 1" area best be described?

reduced

How does the lung parenchyma receive most of its oxygen?

from the alveolar gases

How does the body compensate for a pulmonary embolus that occludes a branch of the pulmonary artery?

Increased bronchial arterial flow to the area

What does the detection of lymphatic channels on standard chest radiographs indicate?

system that is overwhelmed by excessive fluid

What is the affect of damage to the recurrent laryngeal nerves?

vocal cord impairment or paralysis

What determines the airway diameter in the normal lung?

balance between sympathetic and parasympathetic tone

What is the name of the reflex associated with the sensory stimulation of the pulmonary stretch receptors that stimulates a deeper breath upon inspiration?

Head's paradoxical

What are the three bony projections that arise from the lateral walls of the nasal cavity that enhance filtration and humidification?

turbinates

What is your primary concern if you discover that a patient does not have a gag reflex?

fear of aspiration of bacteria or food

Into what structure do the eustachian tubes drain?

nasopharynx

Three folds of tissue between the posterior base of the tongue and the epiglottis form a small space that is a key landmark in oral intubation. What is this called?

vallecula

What position is used to open the airway in an unconscious patient?

sniff position

The adult trachea is approximately how long?

10 to 12 cm

At what point does the trachea branch into two mainstem bronchi?

carina

Why do most aspirated objects and fluids end up in the right mainstem bronchus instead of the left mainstem bronchus?

The right bronchus is more in line with the trachea.

What type of flow is seen in and beyond the terminal bronchioles?

laminar

What is the common name given to classify the airway from the nares to the terminal bronchioles?

conducting airways

What is normal amount of anatomic deadspace found in a healthy lung?

2 ml/kg ideal body weight

What is called the "functional unit of the lungs"?

acinus

What type of alveolar cells cover over 90% of the surface area of the alveolar-capillary membrane?

type I cells

What are the free-wandering phagocytic cells that ingest foreign material in the respiratory zone of the lungs?

alveolar macrophages

To what does the term "faster-weaker" refer when discussing the alveolar-capillary membrane?

thinnest portion of the alveolar-capillary membrane

The mitral (bicuspid) valve does which of the following?

prevents atrial backflow during ventricular contraction

The semilunar (pulmonary and aortic) valves do which of the following?

separate the ventricles from their arterial outflow tracts

The branches of the left coronary artery DO NOT supply which area of the heart?

sinus node

Before draining into the right atrium, where do the large veins of the coronary circulation gather together?

coronary sinus

What in essence is Frank-Starling's law of the heart?

the greater the stretch, the stronger the contraction

Which vessels in the body act like faucets, controlling the flow of blood into the capillary beds?

arterioles

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