Question 1

The death of lung tissue that may result from an obstruction of the pulmonary artery is called a:

Accepted Answer

A)  pulmonary embolism. 
B)  pleural effusion. 
C)  pulmonary infarction. 
D)  pulmonary empyema. 
A)  pulmonary embolism. 
B)  pleural effusion. 
C)  pulmonary infarction. 
D)  pulmonary empyema. C

Question 2

The respiratory therapist is listening to the heart sounds of a patient with a suspected pulmonary embolus. The therapist could expect to hear:
1) increased second heart sound (S2).
2) increased splitting of the second heart sound (S2).
3) third heart sound (S3).
4) fourth heart sound (S4).

Accepted Answer

A) 1 
B) 2, 3 
C) 2, 3, 4 
D) 1, 2, 3 
A) 1 
B) 2, 3 
C) 2, 3, 4 
D) 1, 2, 3 D

Question 3

A pulmonary embolism causes which of the following major pathologic and structural changes in the lungs?
1) Alveolar consolidation
2) Mucosal edema
3) Alveolar atelectasis
4) Pleural friction rub

Accepted Answer

A) 1, 3 
B) 2, 4 
C) 2, 3, 4 
D) 1, 2, 3 
A) 1, 3 
B) 2, 4 
C) 2, 3, 4 
D) 1, 2, 3 A

Question 4

The best test for diagnosing a suspected pulmonary embolism is a(n):

Accepted Answer

A)  spiral volumetric computerized tomography pulmonary angiogram. 
B)  ultrasonography. 
C)  D-dimer blood test. 
D)  chest radiograph. 
A)  spiral volumetric computerized tomography pulmonary angiogram. 
B)  ultrasonography. 
C)  D-dimer blood test. 
D)  chest radiograph.

Question 5

Therapies used to treat pulmonary hypertension include:
1) albuterol.
2) diuretics.
3) digoxin.
4) reteplase.

Accepted Answer

A) 1 
B) 2, 3 
C) 2, 3, 4 
D) 1, 2, 3 
A) 1 
B) 2, 3 
C) 2, 3, 4 
D) 1, 2, 3

Question 6

Which of the following are preventive measures taken with patients at high risk for thromboembolic disease?
1) Drink lots of water.
2) Dangle your legs over the edge of the bed before getting up.
3) Walk frequently.
4) Wear compression stockings.

Accepted Answer

A) 1, 3 
B) 2, 4 
C) 1, 3, 4 
D) 1, 2, 3 
A) 1, 3 
B) 2, 4 
C) 1, 3, 4 
D) 1, 2, 3

Question 7

Which of the following are associated with the formation of a deep vein thrombosis (DVT)?
1) Blood vessel injury
2) Age greater than 40 years
3) Hypercoagulability
4) Venous stasis

Accepted Answer

A) 1 
B) 2, 3 
C) 2, 3, 4 
D) 1, 3, 4 
A) 1 
B) 2, 3 
C) 2, 3, 4 
D) 1, 3, 4

Question 8

Predisposing factors of pulmonary emboli include:
1) varicose veins.
2) smoking.
3) obesity.
4) asthma.

Accepted Answer

A) 2, 4 
B) 1, 3 
C) 1, 2, 4 
D) 1, 2, 3 
A) 2, 4 
B) 1, 3 
C) 1, 2, 4 
D) 1, 2, 3

Question 9

The sudden onset of which of the following signs and symptoms indicates a pulmonary embolism?
1) Bradycardia
2) Coughing out blood-streaked sputum
3) Cyanosis
4) Sudden shortness of breath

Accepted Answer

A) 3, 4 
B) 1, 2 
C) 2, 3, 4 
D) 1, 2, 3 
A) 3, 4 
B) 1, 2 
C) 2, 3, 4 
D) 1, 2, 3

Question 10

Which of the following are major mechanisms that contribute to the pulmonary hypertension commonly seen in a patient with a pulmonary embolism?
1) Decreased cross-sectional area of the pulmonary vascular system
2) Vasoconstriction induced by alveolar hypoxia
3) Reflexes from the aortic and carotid sinus baroreceptors
4) Vasoconstriction induced by humoral agents

Accepted Answer

A) 1, 4 
B) 2, 3 
C) 1, 2, 4 
D) 2, 3, 4 
A) 1, 4 
B) 2, 3 
C) 1, 2, 4 
D) 2, 3, 4

Question 11

Medications may be used to prevent pulmonary emboli include:
1) enoxaparin.
2) dalteparin.
3) tinzaparin.
4) reteplase.

Accepted Answer

A) 1 
B) 2, 3 
C) 2, 3, 4 
D) 1, 2, 3 
A) 1 
B) 2, 3 
C) 2, 3, 4 
D) 1, 2, 3

Question 12

A patient's D-dimer blood test results show a value of 550 ng/mL. How should these results be interpreted?

Accepted Answer

A)  The patient does not have a pulmonary embolism. 
B)  The patient's anticoagulant level is acceptable. 
C)  The patient has increased level of fibrinogen. 
D)  The patient is having a heart attack. 
A)  The patient does not have a pulmonary embolism. 
B)  The patient's anticoagulant level is acceptable. 
C)  The patient has increased level of fibrinogen. 
D)  The patient is having a heart attack.

Question 13

Bronchospasm may happen after a pulmonary embolism. Which of the following can lead to this bronchospasm?
1) Localized hypoxemia
2) Localized hypercapnia
3) Localized hypocapnia
4) Release of cellular mediators from platelets

Accepted Answer

A) 1, 2 
B) 2, 4 
C) 1, 2, 3 
D) 1, 3, 4 
A) 1, 2 
B) 2, 4 
C) 1, 2, 3 
D) 1, 3, 4

Question 14

A pulmonary embolus produces which of the following ventilation-perfusion abnormalities?

Accepted Answer

A)  True shunting 
B)  Shunt effect 
C)  Dead-space effect 
D)  True dead space 
A)  True shunting 
B)  Shunt effect 
C)  Dead-space effect 
D)  True dead space

Question 15

Which of the following conditions is an indication of magnetic resonance imaging (MRI) use in a patient with a suspected pulmonary embolism?
1) Pregnancy
2) Asthma
3) End-stage renal disease
4) Emphysema

Accepted Answer

A) 1, 3 
B) 1, 2, 4 
C) 2, 3, 4 
D) 1, 2, 3 
A) 1, 3 
B) 1, 2, 4 
C) 2, 3, 4 
D) 1, 2, 3

Question 16

Which of the following are included in the management of pulmonary embolism?
1) Oxygen
2) Vitamin K
3) Heparin
4) Warfarin

Accepted Answer

A) 1, 4 
B) 2, 3 
C) 1, 3, 4 
D) 1, 2, 3 
A) 1, 4 
B) 2, 3 
C) 1, 3, 4 
D) 1, 2, 3

Question 17

In order to prevent pulmonary emboli, a filter may be placed into which of the following vessels to prevent clots from being carried into the pulmonary circulation?

Accepted Answer

A)  Subclavian vein 
B)  Pulmonary artery 
C)  Femoral artery 
D)  Inferior vena cava 
A)  Subclavian vein 
B)  Pulmonary artery 
C)  Femoral artery 
D)  Inferior vena cava

Question 18

A pulmonary angiogram is usually ordered:

Accepted Answer

A)  as the first test to identify a pulmonary embolism. 
B)  when other tests for a pulmonary embolism are inconclusive. 
C)  in conjunction with a magnetic resonance image to identify a pulmonary embolism. 
D)  in conjunction with an extremity venogram to identify a pulmonary embolism. 
A)  as the first test to identify a pulmonary embolism. 
B)  when other tests for a pulmonary embolism are inconclusive. 
C)  in conjunction with a magnetic resonance image to identify a pulmonary embolism. 
D)  in conjunction with an extremity venogram to identify a pulmonary embolism.

Question 19

A patient is on warfarin therapy for the prevention of deep venous thrombosis (DVT). The respiratory therapist should advise the patient to avoid eating or drinking:

Accepted Answer

A)  broccoli and spinach. 
B)  orange juice. 
C)  coffee. 
D)  peppers and onions. 
A)  broccoli and spinach. 
B)  orange juice. 
C)  coffee. 
D)  peppers and onions.

Exam 21: Pulmonary Vascular Disease: Pulmonary Embolism and Pulmonary Hypertension

The death of lung tissue that may result from an obstruction of the pulmonary artery is called a:

The respiratory therapist is listening to the heart sounds of a patient with a suspected pulmonary embolus. The therapist could expect to hear: 1) increased second heart sound (S2). 2) increased splitting of the second heart sound (S2). 3) third heart sound (S3). 4) fourth heart sound (S4).

A pulmonary embolism causes which of the following major pathologic and structural changes in the lungs? 1) Alveolar consolidation 2) Mucosal edema 3) Alveolar atelectasis 4) Pleural friction rub

The best test for diagnosing a suspected pulmonary embolism is a(n):

Therapies used to treat pulmonary hypertension include: 1) albuterol. 2) diuretics. 3) digoxin. 4) reteplase.

Which of the following are preventive measures taken with patients at high risk for thromboembolic disease? 1) Drink lots of water. 2) Dangle your legs over the edge of the bed before getting up. 3) Walk frequently. 4) Wear compression stockings.

Which of the following are associated with the formation of a deep vein thrombosis (DVT)? 1) Blood vessel injury 2) Age greater than 40 years 3) Hypercoagulability 4) Venous stasis

Predisposing factors of pulmonary emboli include: 1) varicose veins. 2) smoking. 3) obesity. 4) asthma.

The sudden onset of which of the following signs and symptoms indicates a pulmonary embolism? 1) Bradycardia 2) Coughing out blood-streaked sputum 3) Cyanosis 4) Sudden shortness of breath

Medications may be used to prevent pulmonary emboli include: 1) enoxaparin. 2) dalteparin. 3) tinzaparin. 4) reteplase.

A patient's D-dimer blood test results show a value of 550 ng/mL. How should these results be interpreted?

Bronchospasm may happen after a pulmonary embolism. Which of the following can lead to this bronchospasm? 1) Localized hypoxemia 2) Localized hypercapnia 3) Localized hypocapnia 4) Release of cellular mediators from platelets

A pulmonary embolus produces which of the following ventilation-perfusion abnormalities?

Which of the following conditions is an indication of magnetic resonance imaging (MRI) use in a patient with a suspected pulmonary embolism? 1) Pregnancy 2) Asthma 3) End-stage renal disease 4) Emphysema

Which of the following are included in the management of pulmonary embolism? 1) Oxygen 2) Vitamin K 3) Heparin 4) Warfarin

In order to prevent pulmonary emboli, a filter may be placed into which of the following vessels to prevent clots from being carried into the pulmonary circulation?

A pulmonary angiogram is usually ordered:

A patient is on warfarin therapy for the prevention of deep venous thrombosis (DVT). The respiratory therapist should advise the patient to avoid eating or drinking:

The Patient Interview

The Physical Examination

The Pathophysiologic Basis for Common Clinical Manifestations

Pulmonary Function Testing

Blood Gas Assessment

Assessment of Oxygenation

Assessment of the Cardiovascular System

Radiologic Examination of the Chest

Other Important Tests and Procedures

The Therapist-Driven Protocol Program

Respiratory Insufficiency, Respiratory Failure and Ventilatory Management Protocols

Recording Skills and Intra-Professional Communication

Chronic Obstructive Pulmonary Disease, Chronic Bronchitis and Emphysema

Asthma

Cystic Fibrosis

Bronchiectasis

Atelectasis

Pneumonia, Lung Abscess Formation, and Important Fungal Diseases

Tuberculosis

Pulmonary Edema

Flail Chest

Pneumothorax

Pleural Effusion and Empyema

Kyphoscoliosis

Cancer of the Lung, Prevention and Palliation

Interstitial Lung Diseases

Acute Respiratory Distress Syndrome

Guillain-Barré Syndrome

Myasthenia Gravis

Cardiopulmonary Assessment and Care of Patients With Neuromuscular Disease

Sleep Apnea

Newborn Assessment and Management

Pediatric Assessment, Protocols, and Pals Management

Meconium Aspiration Syndrome

Transient Tachypnea of the Newborn

Respiratory Distress Syndrome

Pulmonary Air Leak Syndrome

Respiratory Syncytial Virus Infection Bronchiolitis

Chronic Lung Disease of Infancy

Congenital Diaphragmatic Hernia

Congenital Heart Disease

Croup and Croup-Like Syndromes: Laryngotracheobronchitis, Bacterial Tracheitis, and Acute Epiglottitis

Near Drowningwet Drowning

Smoke Inhalation, Thermal Injuries, and Carbon Monoxide Intoxication

Filters

The respiratory therapist is listening to the heart sounds of a patient with a suspected pulmonary embolus. The therapist could expect to hear: 1) increased second heart sound (S₂). 2) increased splitting of the second heart sound (S₂). 3) third heart sound (S₃). 4) fourth heart sound (S₄).