251 terms

Fundamentals of Respiratory Care Part 1

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"?
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?
When was positive end-expiratory pressure (PEEP) first introduced to treat patients with acute respiratory distress syndrome?
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?
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?
What term is used to describe the process in which a government agency gives an individual permission to practice an occupation?
What agency is responsible for ensuring quality in respiratory care through voluntary certification and registration?
HIPAA was established in 1996 to set standards related to sharing confidential health history information about patients. What does the letter "P" stand for?
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?
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?
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)?
Approximately what percent of patients receiving mechanical ventilation develop pneumonia as a complication?
What is the most common route of pathogen transmission in the hospital setting?
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?
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?
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?
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?
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?
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?
A respiratory therapist who engages in a questionable business practice is committing what type of malpractice?
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?
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?
Which of the following would be the worst heat conductor?
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?
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?
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?
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)?
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?
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?
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?
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?
During which phase of fetal development do mature alveoli appear?
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?
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?
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?
The diaphragm is innervated by which of the following nerves?
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?
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?
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.
To what structures do the parietal pleural membranes adhere or cover?
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?
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?
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?
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?
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?
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?
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"?
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?
Why are the vessels of the venous system, particularly the small venules and veins, termed capacitance vessels?
They can alter their capacity to maintain adequate perfusion.
What circulatory system is referred to as a low-pressure, low-resistance system?
pulmonary vascular bed
Which of the following equations would you use to compute total peripheral resistance (CO = cardiac output)?
(mean aortic pressure - right atrial pressure) ¸ CO
Which of the following statements is true?
SVR is normally approximately 10 times higher than PVR.
The underlying goal of the body's cardiovascular control mechanisms is to ensure that all tissues receive which of the following?
perfusion according to their metabolic needs
The cardiovascular system regulates perfusion mainly by altering which of the following?
capacity and resistance of blood vessels
What is the primary function of local or intrinsic cardiovascular control mechanisms?
alter local blood flow according to tissue needs
Which of the following formulas is used to calculate the total amount of blood pumped by the heart per minute, or cardiac output?
rate ´ SV
What is a normal cardiac ejection fraction?
Where are the central centers responsible for regulating the cardiovascular system located?
What is the affect on the cardiovascular medullary centers when the cerebral carbon dioxide is low?
Considering the negative feedback system for the control of blood pressure, when a blood pressure rise is noted in the arterial receptors, what is the expected response?
decreased inotropic state
The first heart sound is associated with what mechanical event of the cardiac cycle?
atrioventricular valve closure
Toward the end of systole, as repolarization starts (indicated by the T wave), the ventricles begin to relax. Which of the following will occur next?
arterial pressures exceed ventricular pressures
The semilunar valves close when which of the following occurs?
The pressures in the atria exceed those in the ventricles.
The second heart sound is associated with what mechanical event of the cardiac cycle?
semilunar valve closure
The dicrotic notch recorded in the aorta immediately follows what mechanical event of the cardiac cycle?
closure of the aortic valve
What is the primary function of the lungs?
gas exchange
During each cycle of normal resting ventilation, a volume of gas is moved into and out of the respiratory tract. This cyclical volume is called the:
tidal volume (VT)
Which of the following pressure gradients is responsible for maintaining alveolar inflation?
transpulmonary pressure gradient (Palv - Ppl)
Which of the following statements about alveolar pressure (Palv) during normal quiet breathing is true?
It is negative during inspiration and positive during expiration.
What term is used to note the difference between inspiratory lung volume and expiratory lung volume at any given pressure?
The presence of surfactant in the alveoli tends to do which of the following?
decrease surface tension
How is compliance computed?
change in volume/change in pressure
Normal lung compliance is approximately which of the following?
0.20 L/cm H2O
Total lung-thorax compliance in normal subjects is about what level?
0.1 L/cm H2O
What is the term for the impedance to ventilation caused by the movement of gas through the conducting system of the lungs?
airway resistance
Normal Raw is approximately which of the following?
0.5 to 2.5 cm H2O/L/sec
According to Poiseuille's law, which of the following statements are true if we wish to maintain a constant flow of gases?
Halving the tube radius will require a 16-time increase in driving pressure.
Which of the following statements about the equal pressure point (EPP) is true?
The EPP normally occurs at volumes greatly below the FRC.
For healthy individuals at rest, which of the following statements about exhalation is true?
Exhalation will be passive, due to inspiratory stored potential energy.
Why is the total mechanical work of breathing difficult to assess during spontaneous breathing?
Respiratory muscle activity contributes to inflation resistance.
On inspecting a volume-pressure curve of the lungs and thorax, an increase in the mechanical work of breathing above normal would always be indicated by which of the following?
increase in the area of the volume-pressure curve
In health, about what proportion of the total work of breathing is attributable to frictional resistance to gas and tissue movement?
In individuals with disorders characterized by an increased frictional work of breathing, such as emphysema, which of the following breathing patterns results in the minimum work?
slow and deep breathing
All of the following will cause an increase in the pressure energy required for inspiration EXCEPT which one?
increased compliance
increased compliance
In a normal individual, what is the oxygen cost of breathing as a percentage of the body's total oxygen consumption?
In a normal individual lying on the right side (right side down), which of the following conditions would be true?
The right lung would receive the most ventilation.
Which of the following statements apply to a lung unit with higher resistance than normal?
There will be less volume change for a given pressure change.
Which of the following formulas are used to compute the time constant of a lung unit?
resistance ´ compliance
Which of the following lung units would empty and fill most slowly?
a unit with high resistance and high compliance
For a given transpulmonary pressure gradient and inflation time, which of the following lung units would exhibit the greatest change in volume?
a unit with normal resistance and normal compliance
If a patient has a VT of 370 ml and a respiratory rate of 20 breaths per minute, what is the minute ventilation?
7.40 L/min
A normal 150-lb man is breathing at a rate of 17 with a tidal volume of 450 ml. By estimation, what is his approximate alveolar ventilation?
5.10 L/min
Blockage of the pulmonary arterial circulation to a portion of the lung would cause which of the following?
increase in alveolar dead space
Which is the correct formula to calculate the alveolar minute ventilation of a spontaneously breathing subject?
f ´ (VT - VDSphys)
In clinical practice measuring the physiologic dead space ventilation is achieved by using which formula?
modified Bohr equation
In normal individuals, approximately what fraction of the VT is wasted ventilation (does not participate in gas exchange)?
Which of the following diseases or disorders is most likely to result in an increased VD/VT ratio?
pulmonary embolus
What will happen if the rate of breathing increases without any change in total minute ventilation (mc243-1.jpgEconstant)?
The VA per minute will decrease.
How can the body effectively compensate for an increased VDphy?
increased tidal volume
For carbon dioxide levels to remain constant during exercise, which of the following factors must be elevated?
alveolar ventilation
Hypoventilation is defined as:
elevated blood carbon dioxide level
A patient has a PCO2 of 56 mm Hg. Based on this information, what can be concluded?
The patient is hypoventilating.
Given a constant carbon dioxide production, how will changing the level of VA affect the PaCO2?
An increase in VA will decrease PaCO2.
What is the normal increase in ventilation that occurs with increased metabolic rates called?
What is the single best indicator of the adequacy or effectiveness of VA?
Which of the following statements is NOT true about type 1 and type 2 diabetes?
1. Genetics may play a role in both type 1 and type 2.
2. Type 2 is much more common than type 1.
3. Type 1 is most often due to increased caloric intake.
4. Type 1 often occurs initially in childhood.
Type 1 is most often due to increased caloric intake.
Which of the following factors is important in determining the quality of care delivered by a respiratory therapist?
1. experience
2. education
3. training
4. all the above ***
5. none of the above
Which of the following is/are characteristics of a respiratory care professional?
1. adheres to a code of ethics
2. participates in continuing education activities
3. all the above ***
4. obtains professional credentials
5. completes an accredited education program
Respiratory care plans may be monitored by which of the following?
1. all the above ***
2. computerized case study exercises
3. patient scenarios
4. experienced care plan auditors
5. comparison of therapist's patient assessment with the department's "gold standard" assessment
All of the following factors increase the risk of surgical patients for developing postoperative pneumonia except:
1. history of smoking
2. obesity
3. all the above ***
4. prolonged intubation
Which of the following diseases is transmitted primarily by airborne transmission?
1. measles
2. smallpox
3. tuberculosis
4. all the above ***
The AARC Code of Ethics holds professionals to which of following principles?
I. actively maintaining and improving one's competence
II. following sound scientific procedures and ethical principles in research
III. promoting disease prevention and wellness
IV. striving to improve the access, efficacy, and cost of patient care
V. respecting and protecting the rights of patients they treat

1. I, II, III, and V
2. II, III, IV, and V
3. III, IV, and V
4. I, II, III, IV, and V ***
Divisions of public law (the relationships of private parties and the government) include:
I. administrative
II. civil
III. criminal

1. I, II, and III
2. I and II ***
3. I and III
4. II and III
Which of the following is/are legitimate defenses against an intentional tort?
I. lack of intent to harm the patient
II. performance of ordinary procedures
III. informed consent given by patient

1. II and III
2. I, II, and III
3. I and II
4. I and III ***
What conditions are necessary to incur liability under the doctrine of respondeat superior?
I. The injury caused must be the result of an act of negligence.
II. The act must occur within the subordinate's scope of employment.
III. The act must involve willful intent on the part of the subordinate.

1. I and III
2. I, II, and III
3. I and II ***
4. II and III
All of the following are common elements in a professional practice act except:
1. requirements and qualifications for licensure
2. scope of professional practice
3. professional code of ethics
Which of the following statements correctly describe(s) gases?
I. Gases exhibit the phenomenon of flow.
II. Molecular forces of attraction are minimal.
III. Gases are easily compressible.
IV. Gases expand to fill their container.

1. I and II
2. I, II, III, and IV ***
3. II, III, and IV
4. I, II, and III
By which of the following means can the internal energy of a substance be increased?
I. cooling the substance
II. performing work on the substance
III. heating the substance

1. II
2. I, II, and III
3. I and II
4. II and III ***
According to Pascal's principle, the pressure exerted by a liquid in a container depends on which of the following?
I. depth of the liquid
II. density of the liquid
III. shape of the container

1. I, II, and III
2. I and III ***
3. II and III
4. I and II
Which of the following is/are good clinical examples of the principle of capillary action?
I. capillary stick blood samples
II. absorbent humidifier wicks
III. certain surgical dressings

1. II and III
2. I and II
3. II
4. I, II, and III ***
Which of the following is/are TRUE about boiling?
I. Boiling a liquid requires more energy than does evaporating it.
II. A liquid's boiling point varies with the atmospheric pressure.
III. The greater the ambient pressure, the lower is the boiling point.

1. I, II, and III ***
2. I and III
3. II and III
4. I and II
Which of the following properties of gases distinguish them from liquids—that is, are unique to the gaseous phase of matter?
I. Gases fill the available space.
II. Gases exhibit viscosity.
III. Gases exert pressure.
IV. Gases are readily compressed.
V. Gases are capable of flow.

1. I and IV
2. I, III, and IV ***
3. II, III, and IV
4. II, III, IV, and V
Which of the following occurs when the temperature of a gas rises?
I. The kinetic activity of the gas increases.
II. The rate of molecular collisions increases.
III. The pressure exerted by the gas rises.

1. II and III
2. I and II
3. I, II, and III ***
4. III
Which of the following factors determine how much of a given gas can dissolve in a liquid?
I. solubility coefficient of the gas
II. temperature of the liquid
III. gas pressure above the liquid

1. I, II, and III ***
2. II and III
3. I and II
4. I and III
Which of the following medical gases can be maintained in the liquid form at room temperature?
I. nitrous oxide
II. carbon dioxide
III. oxygen
IV. helium

1. II, III, and IV
2. II and IV
3. II and III
4. I and II ***
According to Poiseuille's law, the pressure needed to drive a fluid through a tube will increase under which of the following conditions?
I. increased fluid viscosity
II. decreased tube length
III. decreased rate of flow
IV. decreased tube radius

1. I and IV ***
2. I and II
3. I, III, and IV
4. II, III, and IV
Which of the following conditions tend to cause laminar flow to become turbulent (producing a high Reynold's number)?
I. high linear gas velocity
II. high gas density
III. low gas viscosity
IV. large tube diameter

1. II and III ***
2. II, III, and IV
3. I, II, III, and IV
4. I, II, and IV
Which of the following design components of an air injector would result in entraining the greatest amount of air?
I. small orifice jet
II. large entrainment ports
III. low-velocity gas flow

1. I and III
2. I and II ***
3. III
4. I, II, and III
For which of the following purposes might a Venturi tube be used?
I. to restore fluid pressure distal to a restricted orifice
II. to help keep entrainment ratios constant with varying flows
III. to make possible entrainment of large volumes of gas

1. I, II, and III ***
2. I and II
3. I and III
4. II and III
Abnormalities of the placenta that can cause intrauterine growth retardation or fetal asphyxia include which of the following?
I. abnormal implantation of the placenta
II. separation of the placenta from the uterine wall
III. decreased placental blood flow

1. I, II, and III ***
2. II and III
3. I and II
4. I and III
Which of the following muscles are considered primary muscles of ventilation?
I. diaphragm
II. intercostals
III. scalenes
IV sternomastoid

1. I and II
2. I, II, III, and IV ***
3. I, III, and IV
4. III only
Which of the muscles below when stimulated will contract and push up on the diaphragm?
I. external intercostals
II. external obliques
III. internal obliques
IV. rectus abdominous

1. I and IV
2. II, III, and IV
3. I, II, III, and IV
4. I, II, and III ***
The pulmonary arterial circulation does which of the following?
I. delivers oxygenated blood back to the heart
II. delivers unoxygenated blood to the lungs
III. originates on the left side of the heart
IV. originates on the right side of the heart

1. I and III
2. II and III
3. I and IV
4. II and IV ***
Compared with the systemic circulation, pressure in the normal pulmonary circulation is:
1. higher
2. lower ***
3. the same
What may happen if the irritant receptors in the lung are stimulated?
I. bronchoconstriction
II. reflex closure of the glottis
III. reflex slowing of the heart (bradycardia)

1. I and III
2. II and III
3. II only
4. I, II, and III ***
What can the release of histamine and other chemical mediators from the mast cells in the airways cause?
I. bronchoconstriction
II. bronchodilation
III. vasoconstriction
IV. vasodilation

1. II and IV
2. II and III
3. I and IV ***
4. I and III
Identify functions of airway mucus in the normal lung.
I. increased mucus production decreases bronchospasm
II. protect the airways from excessive water loss
III. shield the airway from toxic particles
IV. trap inhaled contaminants

1. I and IV
2. I, II, and III
3. III, and IV
4. II, III, and IV ***
Mixing of venous blood with arterial blood (a right-to-left shunt) occurs normally because of which of the following?
I. congenital cardiac defects
II. bronchial venous drainage
III. thebesian venous drainage in the heart

1. I only
2. I, II, and III ***
3. II and III
4. II only
Central control of vasomotor tone has its greatest impact on which of the following vessels?
I. arterioles (resistance vessels)
II. veins (capacitance vessels)
III. microcirculation (exchange vessels)

1. III only
2. I and II ***
3. I, II, and III
4. II and III
Which of the following are true of the force against which the left ventricle must pump?
I. referred to as left ventricular afterload
II. equivalent to systemic vascular resistance
III. helps to determine left ventricular stroke volume

1. I and II
2. I, II, and III ***
3. II and III
4. I and III
Which of the following would have a negative impact on cardiac contractility?
I. acidosis
II. digitalis
III. hypoxia
IV. norepinephrine

1. II and IV
2. IV only
3. I, II, and III
4. I and III ***
Significant loss of blood volume causes an increase in which of the following?
I. vascular tone
II. secretion of antidiuretic hormone (ADH)
III. heart rate

1. I, II, and III ***
2. I and II
3. II and III
4. I and III
What happens during normal inspiration?
I. The Ppl decreases further below atmospheric.
II. The transpulmonary pressure gradient widens.
III. Palv drops below that at the airway opening.

1. I and III
2. II and III
3. I, II, and III ***
4. I only
What forces must be overcome to move air into the respiratory system?
I. tissue movement
II. elastic forces of lung tissue
III. airway resistance
IV. surface tension forces

1. I, II, III, and IV ***
2. II and IV
3. IV only
4. I, II, and III
What is the effect of surface tension forces in the air-filled lung?
I. It increases the elastic recoil of the lung (promoting collapse).
II. It makes the lung harder to inflate than if it were filled with fluid.
III. It decreases the lung's elasticity as volume increases.

1. I and III
2. I and II ***
3. I, II, and III
4. II
A lung that loses elastic fibers (as in emphysema) would exhibit which of the following characteristics?
increased pulmonary compliance

What occurs at a lung volume equivalent to the functional residual capacity (FRC)?;
I. The forces of the chest wall and lungs are in balance.
II. Chest wall expansion is offset by lung contraction.
III. Opposing chest wall-lung forces generate negative Ppl.

1. I and II
2. I, II, and III ***
3. I and III
4. II and III
Which of the following factors affects Raw?
I. pattern of gas flow (e.g., laminar versus turbulent)
II. characteristics of the gas being breathed
III. diameter and length of the airways
IV. variations in lung compliance

1. IV only
2. I, II, III, and IV ***
3. II and IV
4. I, II, and III
On inspecting a volume-pressure curve for a patient with restrictive lung disease, which of the following abnormalities would you expect to find?
I. decrease in the slope of the volume-pressure curve
II. increase in the area of the volume-pressure curve
III. positive Ppl during exhalation

1. I, II, and III ***
2. I and II
3. I and III
4. II only
Quality in the practice of respiratory care encompasses which of the following?
1. method or manner in which care is provided
all of the above ***
3. personnel performing care
4. equipment used
5. level of experience of respiratory care providers