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RTP 1300 final review

Total questions: 59

Worksheet time: 45mins

Name
Class
Date
1.

Which structure would most likely be affected by decreased breath sounds in the lower lobes and shortness of breath?

a)

alveoli

b)

bronchi

c)

trachea

d)

diaphragm

2.

What is the path of deoxygenated blood from the body to the lungs?

a)

left atrium > pulmonary arteries

b)

right ventricle> right atrium> lungs

c)

left atrium> left ventricle> pulmonary veins

d)

right atrium> right ventricle> pulmonary artery> lungs

3.

Air enters the pleural space in a pneumothorax. What effect does this have on lung function?

a)

lung compliance will increase

b)

lung compliance will decrease

c)

pleural pressure decreases

d)

enhances alveolar gas exchange

4.

What is the diagnosis for a patient experiencing paradoxical chest movement after trauma?

a)

flail chest

b)

rib fracture

c)

pneumothorax

d)

diaphragmatic hernia

5.

Gas exchange in the lungs primarily occurs where?

a)

veins

b)

arteries

c)

arterioles

d)

pulmonary capillaries

6.

What changes in the lungs leads to hyperinflation in patients with COPD?

a)

loss of lung elasticity

b)

increased lung elasticity

c)

overproduction of surfactant

d)

constriction of the trachea

7.

What is the main consequence of a pulmonary embolism on lung physiology?

a)

decreased alveolar deadspace

b)

increased alveolar deadspace

c)

decreased RAW

d)

decreased CL

8.

True or False: Fluid in the alveoli affects gas exchange because of decreased diffusion

a)

true

b)

false

9.

What happens physiologically during bronchoconstriction in asthma?

a)

increased lung CL

b)

increased RAW

c)

decreased alveolar pressure

d)

decreased surfactant production

10.

Fluid in the alveoli decreases gas exchange by

a)

increasing diffusion

b)

increasing surface area

c)

decreasing diffusion

d)

increasing lung compliance

11.

Which of the following occurs in emphysema? Select all that apply

a)

decreased lung elasticity

b)

increased lung compliance

c)

increased RAW

d)

decreased RAW

12.

What causes an increase in tidal volume (Vt) during exercise?

a)

increased diaphragm and intercostal muscle activity

b)

increased RAW

c)

decreased lung CL

d)

decreased respiratory center activity

13.

True or false. The Bohr effect is best described by decreased 02 binding at high CO2 levels

a)

true

b)

false

14.

What is the function of surfactant in the lungs?

a)

reduces surface tension in the alveoli

b)

increases RAW

c)

enhances 02 diffusion

d)

increases alveolar elasticity

15.

True or false. An increase in lung compliance can be seen in emphysema

a)

true

b)

false

16.

Which of the following can cause a right shift of the 02 dissociation curve?

a)

increased pH

b)

Increased 2,3, DPG

c)

decreased temperature

d)

decreased CO2

17.

How does a bronchodilator affect RAW in an asthmatic patient?

a)

decreases RAW

b)

increases RAW

c)

Has no effect on RAW

18.

True or false. PaCO2 levels are decreased in hypoventilation

a)

true

b)

false

19.

What does it mean when a patient with CHF experiences orthopnea?

a)

shortness of breath is relieved by sitting in an upright position

b)

the patient is breathing shallow and slow

c)

the patient is breathing fast and deep

d)

the patient is breathing deep and fast with periods of apnea

20.

What role does the medulla oblongata play in respiration

a)

controls cardiac output

b)

controls cardiac output

c)

automatically controls the rate and depth of breathing

d)

adjusts surfactant production

21.

An increase in pH will shift the 02 dissociation curve

a)

to the right

b)

to the left

c)

upside down

d)

no change

22.

What effect does hypoxia have on the pulmonary arteries?

a)

vasoconstriction

b)

vasodilation

c)

no effect

23.

True or false: the diaphragm is the most important muscle during respiration?

a)

true

b)

false

24.

What happens to lung volumes in restrictive lung diseases?

a)

FRC increases

b)

TLC increases

c)

RV increases

d)

VC decreases

25.

Which condition would lead to a decrease in lung CL? Select all that apply

a)

pulmonary fibrosis

b)

atelectasis

c)

pneumonia

d)

emphysema

26.

True or False. Decreased alveolar surface area is a complication that can affect gas exchange

a)

True

b)

False

27.

What is the correct formula for CaO2?

a)

[(Pb-H2O) FiO2]-(PaCo2 x 1.25)

b)

(1.34 x Hbg x 1) + (0.003x PA02)

c)

(1.34 x Hbg x SaO2%) + (0.003 x PaO2)

d)

(1.34 x Hbg x SvO2%) + (0.003 x PvO2)

28.

What is the correct formula for DO2 (total oxygen delivery)?

a)

CO x CaO2

b)

SV x HR

c)

VT x RR

d)

Ca02- Cv02

29.

What is the correct formula for O2ER (oxygen extraction ratio)

a)

lQt [C(a-v)O2]

b)

SV x HR

c)

CaO2/CvO2

d)

CaO2-CvO2/CaO2

30.

What is the most likely impact on 02 transport on a patient that has a significantly decreased Hb but a normal PaO2 and an SaO2 of 98%

a)

decreased 02 content

b)

increased 02 content

c)

no effect on 02 transport

31.

What is the correct formula for VO2?

a)

CaO2-CaO2

b)

Qt (CaO2-CvO2)

c)

CvO2-CaO2

d)

none of the above

32.

How will hypovolemic shock affect DO2?

a)

Increases DO2

b)

Decreased DO2

c)

no effect on DO2

33.

Which condition is most likely indicated with a reduced FEV1 but a normal TLC?

a)

COPD

b)

pneumonia

c)

pleural effusion

d)

pulmonary fibrosis

34.

In a patient with restrictive lung disease, which PFT result would be expected?

a)

increased RV

b)

decreased TLC

c)

increased DLCO

d)

decreased FEV1/FVC

35.

A COPD patient's PFT shows a decreased DLCO. What is most likely the cause of this?

a)

pulmonary edema

b)

increased alveolar surface area

c)

increased hemoglobin levels

d)

destruction of the alveolar walls

36.

A patient with pneumonia has impaired gas exchange. Which factor is most likely contributing to the diffusinon impairment?

a)

increased V/Q ratio

b)

increased deadspace

c)

thickened ACM

d)

decreased tidal volume

37.

A patient is experiencing shortness of breath and pulmonary edema due to heart failure. How does pulmonary edema affect diffusion in the lungs?

a)

decreases RAW

b)

increased alveolar surface area

c)

increased the distance for gas diffusion

d)

decreases the pressure gradient for oxygen diffusion

38.

A significantly reduced DLCO would most likely indicate what?

a)

pulmonary fibrosis

b)

asthma

c)

pulmonary embolism

d)

chronic bronchitis

39.

A COPD patient presents with dyspnea and increased WOB. On exam, the therapist notes a prolonged expiratory phase and accessory muscle use to breathe. What is most likely the cause of this abnormal breathing?

a)

decreased lung compliance

b)

metabolic acidosis

c)

increased RAW

d)

restrictive lung disease

40.

What effect does hyperventilation have on PaCO2 and blood pH

a)

decreased PaCO2, increased pH

b)

increased PaCO2, decreased pH

c)

increased PaCO2, increased pH

d)

decreased PaCO2, decreased pH

41.

Which breathing pattern is described by deep labored breathing with an abnormally high respiratory rate and can be seen with metabolic acidosis?

a)

Kussmaul

b)

Biot's

c)

Cheyne-Stokes

d)

Apnea

42.

Which part of the brain is most likely affected in a brain injury patient who is demonstrating irregular, gasping respirations

a)

parietal lobe

b)

temporal lobe

c)

medulla oblongata

d)

cerebellum

43.

A patient with a history of opioid use is demonstrating periods of apnea, followed by rapid, shallow breaths. What is this breathing pattern?

a)

Biot's

b)

Kussmaul

c)

Orthopnea

d)

Eupnea

44.

Irregular, gasping breaths with long inspiratory pauses can be described as what breathing pattern?

a)

cheyne-stokes

b)

eupnea

c)

tachypnea

d)

apneustic

45.

What breathing pattern would you most likely observe in a Guillain-Barre patient who is showing signs of hypoventilation

a)

rapid and shallow

b)

apnea

c)

slow and shallow

d)

kussmaul respirations

46.

How does severe kyphoscoliosis affect ventilation?

a)

increases FRC

b)

increases RAW

c)

increases Vt

d)

decreases lung cL

47.

What affect does severe hypoventilation have on PaCO2?

a)

PaCO2 will decrease

b)

PaCO2 will remain the same

c)

PaCO2 will increase

48.

Interpret the ABG:

pH 7.28

PaCo2 57 mm Hg

HCO3 24 mEq/L

a)

metabolic acidosis

b)

respiratory alkalosis

c)

respiratory acidosis

d)

metabolic alkalosis

49.

A V/Q mismatch indicates a discrepancy between the air reaching the alveoli and the blood perfusing the alveoli

a)

true

b)

false

50.

True or False: an increase in temperature causes a right shift in the oxygen disassociation curve

a)

true

b)

false

51.

What is the stretch receptor reflex in the lungs that inhibit over inflation?

a)

Hering-Breuer

b)

baroreceptor

c)

sneeze

d)

irritant reflex

52.

What is the correct formula for VE?

a)

RR x Vt

b)

Vt/RR

c)

(Vt-VD) x RR

d)

FEV1 x RR

53.

What is the physiologic reason for hyperventilation in a patient with metabolic acidosis?

a)

increased response to oxygen

b)

increased deadspace ventilation

c)

compensation by decreasing CO2 levels

d)

increased lung cL

54.

How would administering a blood transfusion affect 02 transport on a patient with a PaO2 of 55 mmHg, a SaO2 of 85% and a Hbg level of 8g/dL?

a)

it would decrease CaO2 and PaO2

b)

It would increase SaO2 but decrease PaO2

c)

it would increase o2 transport by increasing the CaO2

55.

An increased A-a gradient indicates what about gas exchange in the lungs?

a)

CO2 retention is causing hypoxia

b)

the patient has decreased lung elasticity

c)

There is a V/Q mismatch

d)

the patient has increase lung compliance

56.

A patient with a spinal cord injury above the level of C3 is experiencing respiratory failure. Why is this injury likely to result in ventilatory failure?

a)

increased alveolar surface area

b)

loss of control over the diaphragm

c)

increased lung cL

d)

enhanced neural control of breathing

57.

How does a pulmonary embolism affect ventilation and perfusion?

a)

normal ventilation with decreased perfusion

b)

increased perfusion to alveoli and decreased ventilation

c)

decreased ventilation and perfusion to the affected area

d)

increased ventilation with normal perfusion

58.

A patients PaO2 is 50 mmHg despite being on 100% Fio2. What is the likely cause of the patients refractory hypoxemia?

a)

decreased Vt

b)

Increased PVR

c)

increased lung cL

d)

shunting of blood past non-ventilated alveoli

59.

How is mucociliary transport affected in the lungs of a patient with cystic fibrosis?

a)

thick mucus impairs the movement of cilia, reducing the clearance of mucus from the airways

b)

cilia move too quickly, causing mucus to be cleared faster than normal

c)

mucus becomes too thin, causing cilia to overwork

d)

cilia become longer, leading to excessive mucus produciton