136 Questions
All of the following are elements of patients social and environmental history except.
Drugs and medications
Which statement about the value of visual or analog scales for documenting the level of dyspnea is correct.
They are usually used to evaluate the pt. Perception
Which of the following best describes the team dyspnea.
It is an entirely subjective sensation
What is the name of the reflex response for stimulating the lungs during inspiration causing rapid shallow breathing.
Hering-Breuer reflex
Which of the following are clinical signs of dyspnea.
- Increase work of breathing
- Hyperventilation
- Purses lip breathing
During the interview, a patient states that she is having difficult breathing in the upright position.
Platypea
Dyspnea when lying flat, but is relieved by sitting up describes which of the following.
Orthopnea
Which of the following describes, dyspnea that occurs at night when in the supine position.
PND
Dyspnea that occurs in lateral decubitus position, describes which of the following.
Trepopnea
Platypnea (dyspnea in the upright position) and orthodoxia (decreased saO2, in the upright position) can both result from which condition.
Hepato-pulmonary syndrome
What term is used to describe difficult breathing in the reclining position.
Orthopnea
Patient stated “she experienced shortness of breath during a walk on level ground, which of the following describes her symptoms.
Dyspnea on exertion (DOE)
Which of the following is defined as an unpleasant urge to breathe.
Breathlessness
Which of the following factors has minimal or no impact on the effectiveness of the patients cough.
Pulmonary vascular resistance
Which of the following conditions is most likely to cause a dry, nonproductive cough.
Pulmonary fibrosis
Acute cough (lasting less than 3 weeks) is most likely caused by which of the following.
Self limited viral upper respiratory tract infections
A dry nonproductive cough is typical a Restrictive disease?
True
Effective cough is usually associated with which of the following.
Inflammation obstructive conditions
Purulent (yellow or green) sputum is usually associated with which of the following.
Acute bronchitis
Mucoid (whitish/clear and thick) sputum is usually associated with which of the following.
Chronic bronchitis
Fetid (foul odor) sputum is usually associated with which of the following.
Pulmonary edema Lung absces Cystic fibrosis
What tern is used to describe the chest pain associated with blockage of the coronary arteries.
Angina
Which of the following statements about non-cardiac chest pain is false.
Non-cardiac chest pain is rarely associated with an immediately life threatening condition
Which statement below explains the current theory of the value of fever during infection.
By speeding up the metabolism the body fights infection and repairs damage more quickly
A fever pattern, usually caused by infection, that varies about 1.1c (2 F) each day but does return to normal is called.
Remittant
A fever pattern, usually causes night sweats seen in sepsis patient, refers to.
Intermittent
A fever pattern, in which there is little change (less than 1C).
Sustained
While examining the extremities of a 57 y/o male patient, the RCP detects a firm, non-pitting swelling of the feet and lower legs. This condition is called.
Lymphedema
You are called to the emergency department STAT to treat a trauma patient enroute by ambulance. The ER nurse reports that the EMS crew reports the patient has a Glasgow Coma scale (GCS) scale of 14. Based on this information, the RCP should prepare to perform which of the following.
Prepare to monitor the patient since a GCS score of 14 is a normal finding.
In which of the following patient categories would the intensity of the point of maximal impulse (PMI) be most difficult to palpate.
Right ventricular
In auscultating the heart sounds of a patient with chronic hypoxemia, the RCP notices a marked increase in the intensity of the second heart sound (S2) and no splitting during inhalation. This finding is most consistent with which of the following.
Pulmonary hypertension
Physical examination of a patients illness or injury to the brain or spinal cord is usually, While reviewing the patients chart the RCP notes that the physicians neurological assessment included the word Delirium. What does the term indicate.
The patients speech is incoherent and the patient exhibits continuous, aimless physical activity
A patient who appears weak poorly nourished is said to show the sign of
Cachexia
The second heart sound S2 is created primarily by which of the following?
Closure of the semilunar valves
Pseudocyanosis(bluish tinge to the skin or mucous membrane) is often caused by which of the following?
Ingestion of metals.
Accumulations of fluid in the abdominal cavity are called?
Ascities
On palpating the neck region of a patient on mechanical ventilation, you notice a crackling sound and sensation. What is the most likely cause of this observation?
Subcutaneous emphysema
What term is used to describe the breathing pattern seen in COPD patients when the lower costal margins of the chest wall drew inward with each inspiration?
Hoovers sign
What term is used to describe the breathing pattern seen in COPD patients when the lower costal margins of the chest wall draw inward with each inspiration?
Hoovers sign
What is the advantage of COPD patients breathing through pursed lips during exhalation?
It helps move the equal pressure point closer to the airway opening.
While observing a patients breathing pattern the RCP notes that the depth and rate first increase, then decrease, followed by a period of apnea. Which of the following terms would you use in charting this observation?
Cheyne-stockes breathing
Soft, muffled sounds heard mainly during inspiration over the peripheral lung parenchyma best describe which of the following breath sounds.
Vesicular
Which term best describes a lord, high-pitched continuous sound heard ( often with the unaided ear) primarily over the larynx or trachea during inhalation in patients with upper airway obstruction.
Stridor
Your patient has an abnormal sensorium. Which of the following is most likely true?
The patient is confused about where he or she is.
Loud, tubular breath sounds with an expiratory component equal to the inspiratory component best describes which of the following breath sounds?
Bronchial
Inspiratory crackles in patients without excess secretions are most commonly associated with which of the following?
Collapsed alveoli popping open during inspiration
What is the primary mechanism of crackle production in the airways?
Secretion or fluid movement in the airways
What is the most common cause of inspiratory crackles in patients with diffuse bronchospasm?
Airway obstruction due to bronchospasm
What is the term used to describe the breathing sounds produced when airflow moves secretion or fluid in the airways?
Crackles
In which of the following situations would inspiratory crackles be most likely to occur?
In a patient with collapsed alveoli
What is the term used to describe the breathing pattern characterized by deep inspiratory gasps held for some seconds before expiration?
Apneustic breathing
What does the presence of stridor indicate?
Upper airway obstruction
What type of breath sounds are soft and muffled, heard mainly during inspiration over the peripheral lung parenchyma?
Vesicular
What is the term used to describe the breathing pattern characterized by a series of deep breaths followed by a period of apnea?
Cheyne-Stokes breathing
What is the term used to describe a loud, high-pitched continuous sound heard over the larynx or trachea during inhalation in patients with upper airway obstruction?
Stridor
What is the term used to describe the irregular breathing pattern characterized by an increase in depth and rate, followed by a decrease, and then a period of apnea?
Cheyne-Stokes breathing
What is the term that describes the loud, high-pitched sound associated with upper airway obstruction, often heard without a stethoscope?
Stridor
During a maximal inspiratory effort, about how far can a healthy adult contract the diaphragm?
About 5 cm
What is the definition of tracheostenosis?
Narrowing of the trachea
What prevents solids from taking the shape of their container?
They have powerful IMF
When calculating relative humidity (RH), the term for the actual content or weight of water present in a given volume of air is?
Absolute humidity
Exhalation to a volume below the resting level requires active muscular effort in order to overcome?
The natural tendency of the airways to collapse
What is the highest PAO2 achievable in normal individual breathing room air at sea level?
110 to 120 mmHg
Pulmonary surfactant is secreted by which type of lung cells?
Type II pneumocytes
The normal minute carbon dioxide production (VCO2) for healthy adult at rest is?
About 200 ml/min
A Reynolds number calculation is performed and the Reynolds number is 1000. What type of fluid flow would this number indicate?
Laminar
What is the normal minute carbon dioxide production for healthy adults at rest?
About 200ml/min
Which of the following statements about pulmonary ventilation in the upright adult lung is correct?
Alveoli at the apices expand less than those at the base
What is the best definition of the term extension?
Increase in the angle between the bone
What is the theoretical temperature at which all kinetic energy activity of matter will cease?
0 K
What is the maximum amount of air that can be exhaled after a maximal inspiration?
Vital capacity
A fibrotic lung would exhibit which of the following characteristics?
Decreased lung compliance
What is the most common cause of jugular venous distention?
Right sided heart failure
Pseudocyanosis is often caused by which of the following?
Ingestion of metals
A slow capillary refill time is often associated with which of the following?
Poor cardiac output or peripheral perfusion
Digital clubbing is best assessed by which of the following?
Inspecting the nail bed
What is the normal capillary refill time in healthy individuals?
Less than 3 seconds
What is the most likely cause of a firm, non-pitting swelling of the feet and lower legs?
Right-sided heart failure
Which of the following techniques is effective for communicating empathy to patients?
Appropriate use of touch and use of key words
What is essential to make communication a two-way process?
Feedback from the receiver
Which of the following is an example of a breach in patient confidentiality?
Indicating a patient's HIV positive status during shift report
What can be used to improve one's effectiveness as a sender of messages?
All of the above
Which of the following is not a technique for communicating empathy to patients?
Use of professional authority
What is the purpose of feedback in communication?
To ensure effective communication
Which of the following sterilization techniques is most effective?
Sterilization
What is the primary consideration for ambulating patients with unstable vital signs?
Postpone ambulation until vital signs are stable
What is the purpose of the quench button in an MRI suite?
To collapse the superconductive magnetic field
Which disease is typically transmitted through direct contact?
Smallpox
What is the primary factor that determines the location of aerosol particle deposition in the respiratory tract?
Particles' aerodynamic size
What is the purpose of the quench button in an MRI suite?
To collapse the superconductive magnetic field
What is the primary function of the ground wire and ground prong on an electrical power cord?
To provide a low resistance path directly to ground
What is the primary cause of most fire-related fatalities?
Toxic gases produced by the fire
What is the correct definition of electrical shock?
A person becomes part of a circuit between an electrical energy source and ground
How long does a typical wall-mounted, hand-held fire extinguisher operate?
10 to 18 seconds
What is the primary role of the RT during a disaster situation?
Assuring that the liquid oxygen system is safely shut down
What is the correct operation of a fire extinguisher dependent on?
Correctly selecting and using a fire extinguisher
What is the estimated death rate among patients who develop a ventilator associated pneumonia (VAP)?
25%
Which of the following statements regarding the use of sterile gloves in the hospital setting is false?
The same pair can be used on several patients if only noninvasive procedures are performed.
What is the primary source of conflict in an organization that is the most difficult to control?
Poor communication
Which of the following is an example of a portal of exit?
Draining wounds
A therapist is using which interpersonal communication technique when saying 'Please explain that to me again' to a patient during an interview?
Clarifying
What is the electrical resistance of each limb?
100 ohms
Each hospital radiology department has established what type of areas for safety?
Safety proximity areas referred to as safety zones and Gauss lines
What is the estimated internal body resistance?
About 500 ohms for each limb and about 1,000 ohms for the trunk
Which option is a combination of safety measures established by hospital radiology departments?
I, II, III, and IV
Which option correctly represents the internal body resistance?
About 500 ohms for each limb and about 1,000 ohms for the trunk
What is the primary characteristic of small electric motors in terms of generating sparks?
They are capable of generating large numbers of high energy static sparks.
Which of the following elements would be included in a POMR entry?
The patient's subjective complaints and concerns, the objective data gathered, and the plan to address the problem.
Which of the following factors can have an impact on the outcomes of therapeutic communication between patient and practitioner?
Verbal and nonverbal components of expression, environmental factors, values and beliefs of both patient and practitioner, and sensory and emotional factors.
When assessing each of the seven universally recognized human expressions, what is the most significant factor to consider?
The position of the eyebrows, the eyes, the lips, and the head and arms.
What type of microbes are typically removed by proper handwashing technique?
Microbes that are removed by proper handwashing technique.
Which of the following types of microbes are typically unaffected by surgical hand hygiene and antisepsis?
Some microbes that are highly resistant to surgical hand hygiene and antisepsis.
When using a fire extinguisher to fight a fire, where should the RCP aim the extinguisher?
The base of the flames
What is the first item to be doffed when removing PPE?
The mask or respirator
Which of the following statements about oxygen and fire is true?
Oxygen accelerates the rate of combustion
Which type of fire extinguisher will have a pressure gauge?
Dry chemical extinguishers
Which statement about MRI Zone III is correct?
Zone III is the patient screening and preparation area
When removing PPE, what is the correct order of doffing?
Mask, head cover, gown, gloves
What is the minimum percentage of oxygen required for fire to occur?
21%
Which type of fire extinguisher is most likely to have a pressure gauge?
Carbon dioxide extinguisher
What is the correct statement about MRI Zone III?
Magnetic force in Zone III is about 30 gauss (0.003 Tesla)
What is true about fires in oxygen-enriched atmospheres (OEA)?
Many substances that do not burn in ambient air will burn in an OEA
What are the primary mechanisms by which electric shock causes injury?
Ventricular fibrillation and cardiac standstill
What is the correct statement about fires in oxygen-enriched atmospheres (OEA)?
The fuel burns more intensely in OEA fires
What type of damage can occur due to the heating effect of current passing through the body?
Both A and B
Which communication tool is most appropriate for a change of shift report?
SBAR
When reporting critical laboratory test values, what should the reporter do?
Repeat the values to the receiver at least two times
Which position is recommended to reduce the incidence of ventilator-associated pneumonia (VAP)?
Low Fowler's (15 to 30°)
What is the primary mechanism of crackle production in the airways?
Airway reopening
What is the correct operation of a fire extinguisher dependent on?
The correct technique of use
Which of the following positions is recommended to reduce the incidence of ventilator associated pneumonia (VAP)?
Low Fowler's (15 to 30°)
What is the first item of PPE to be donned?
The mask
What does a hospital electrical wall outlet colored red or one marked with a red dot indicate?
The outlet may function during a power failure
What is the primary source of conflict in an organization?
Poor communication within the organization
What is the purpose of documenting the receiver's full name and title?
To ensure accuracy of the report
What should be done before signing the report?
Verify the order with the physician
Study Notes
Effective Communication
- Appropriate use of touch, use of key words, and use of eye contact are effective techniques for communicating empathy to patients.
- Empathy is essential to make communication a two-way process.
- Feedback from the receiver is critical in making communication a two-way process.
Patient Confidentiality
- Informing a representative of the patient's insurance company about the patient's condition is an exception to maintaining confidentiality.
- Breaches of patient confidentiality include discussing a patient's alcohol use with their family members or indicating a patient's newly diagnosed HIV positive status during shift report.
Infection Control
- Ambulation should not be postponed in patients with unstable vital signs or those who require supplemental oxygen.
- Aerosol particles deposit in the host's respiratory tract based on their aerodynamic size.
- Pertussis is transmitted through direct contact.
Fire Safety and Electrical Shock
- Thermal injury caused by heat and flame is the leading cause of fire-related fatalities.
- Electrical shock occurs when a person becomes part of a circuit between an electrical energy source and ground.
- Internal body resistance is estimated to be about 1200 ohms for each limb and about 15,000 ohms for the trunk.
MRI Safety
- MRI Zone III is the patient screening and preparation area, where hazards include potential biostimulation interference.
- Magnetic force in Zone III is about 30 gauss (0.003 Tesla).
###Conflict Resolution
- The most difficult source of conflict to control in an organization is structural problems.
- Collaborating is a strategy that is both assertive and cooperative but is not useful when hostility exists between parties.
Medical Records and Oxygen Safety
- The medical institution where the care was provided is the legal owner of the medical record.
- Oxygen accelerates the rate of combustion, and fires can burn in atmospheres with less than 21% oxygen.
Fire Extinguishers and PPE
- Carbon dioxide extinguishers will have a pressure gauge.
- The first item of PPE to be donned is the gown, and the first item to be doffed is the gown.
Ventilator Associated Pneumonia (VAP)
- The estimated death rate among patients who develop VAP is as high as 30%.
- Elevating the head of the bed (Low Fowler's position) is recommended to reduce the incidence of VAP.
Electrical Safety
- A hospital electrical wall outlet colored red or marked with a red dot indicates that the outlet is connected to the hospital's special grounding system.
Breathing Patterns
- Cheyne-Stokes breathing is characterized by breaths that increase and decrease in depth and rate with periods of apnea.
- Apneustic breathing is a pattern of breathing characterized by deep inspiratory gasps held for some seconds before expiration.
Breathing Sounds
-
Stridor indicates upper airway obstruction and is often heard without a stethoscope.
-
Vesicular sounds are soft, muffled sounds heard mainly during inspiration over the peripheral lung parenchyma.### Respiratory System
-
Stridor is a loud, high-pitched sound associated with upper airway obstruction, often heard without a stethoscope.
-
A marked increase in the intensity of the second heart sound (S2) and no splitting during inhalation is consistent with pulmonary hypertension.
Heart Sounds
- An intense S2 (lord P2) occurs in pulmonary hypertension.
Diaphragm Movement
- During a maximal inspiratory effort, a healthy adult can contract the diaphragm about 1.5 cm.
Tracheostenosis
- Tracheostenosis is the narrowing of the trachea.
Pulmonary Circulation
- Pulmonary vascular pressure is lower than systemic pressure.
Humidity
- Absolute humidity is the actual content or weight of water present in a given volume of air.
Exhalation
- Exhalation to a volume below the resting level requires active muscular effort to overcome the natural tendency of the airways to collapse.
Gas Diffusion
- The rate of gaseous diffusion across a biological membrane decreases when the diffusion distance is large or the partial pressure gradient is low.
Pulmonary Surfactant
- Pulmonary surfactant is secreted by Type II pneumocytes.
Minute Carbon Dioxide Production
- The normal minute carbon dioxide production (VCO2) for a healthy adult at rest is about 200 ml/min.
Reynolds Number
- A Reynolds number of 1000 indicates laminar fluid flow.
Pulmonary Arterial Blockage
- Blockage of the pulmonary arterial circulation to a portion of the lung would cause an increase in alveolar dead space.
Pressure in the Thoracic Cavity
- During quiet breathing, the pressure in the thoracic cavity (Ppl) normally remains negative relative to atmospheric pressure.
Serous Membrane
- The thin serous membrane that covers the inner layer of the thoracic wall is called the parietal pleura.
PO2 Levels
- The lowest PO2 would normally be found in the tissue cells.
Gas Exchange
- The exchange of gas between the atmosphere and blood is referred to as external respiration.
Extension
- Extension is an increase in the angle between bones.
Blood Gas Analysis
- The partial pressure of oxygen in alveolar gas (PAO2) can be calculated using the PACO2 value from an arterial blood gas (ABG) report.
Vital Capacity
- The maximum amount of air that can be exhaled after a maximal inspiration is the vital capacity (VC).
Pulmonary Capillary Equilibration
- In a normal adult at rest, it takes approximately 0.25 seconds for blood to pass through the pulmonary capillary and equilibrate with oxygen.
Lung Compliance
- A fibrotic lung would exhibit decreased lung compliance.
Body Position
- A patient positioned on their back is in the supine position.
Gas Flow
- Gas flows out of the lungs to the atmosphere during expiration because Ppl is greater than Pao.
Thermodynamics
- 0 K is the theoretical temperature at which all kinetic energy activity of matter will cease.
Jugular Venous Distension
- The most common cause of jugular venous distention (JVD) is right-sided heart failure.
Pseudocyanosis
- Pseudocyanosis is a bluish tinge to the skin or mucous membranes that is not caused by either hypoxemia or peripheral vasoconstriction.
Capillary Refill
- A refill time of 5 seconds or more indicates poor cardiac output or poor peripheral perfusion.
Digital Clubbing
- Digital clubbing is best assessed by shining a light through the nail bed.
Test your knowledge of patients' social and environmental history with this quiz. Identify the element that does not belong to this category. Improve your understanding of patient assessment and diagnosis.
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