Question 1

A patient with pulmonary edema is cyanotic and complaining of difficulty breathing. What should be recommended by the respiratory therapist?

Accepted Answer

A)  Provide supplemental oxygen. 
B)  Begin mechanical ventilation. 
C)  Have the patient use pursed-lip breathing. 
D)  Begin bronchopulmonary hygiene therapy. 
A)  Provide supplemental oxygen. 
B)  Begin mechanical ventilation. 
C)  Have the patient use pursed-lip breathing. 
D)  Begin bronchopulmonary hygiene therapy. A

Question 2

Pulmonary edema manifests itself clinically as a(n) _____ disorder.

Accepted Answer

A)  restrictive pulmonary 
B)  obstructive pulmonary 
C)  equally restrictive and obstructive 
D)  obstructive cardiac 
A)  restrictive pulmonary 
B)  obstructive pulmonary 
C)  equally restrictive and obstructive 
D)  obstructive cardiac A

Question 3

All of the following are causes of cardiogenic pulmonary edema EXCEPT:

Accepted Answer

A)  myocardial infarction. 
B)  mitral valve disease. 
C)  allergic reaction to drugs. 
D)  congenital heart defects. 
A)  myocardial infarction. 
B)  mitral valve disease. 
C)  allergic reaction to drugs. 
D)  congenital heart defects. C

Question 4

The respiratory therapist is asked to evaluate a patient with suspected congestive heart failure. Which of the following laboratory tests should the respiratory therapist recommend to evaluate the patient for possible congestive heart failure?

Accepted Answer

A)  Brain natriuretic peptide (BNP) 
B)  Lactic dehydrogenase (LDH) 
C)  Aspartate aminotransferase (AST) 
D)  Alanine aminotransferase (ALT) 
A)  Brain natriuretic peptide (BNP) 
B)  Lactic dehydrogenase (LDH) 
C)  Aspartate aminotransferase (AST) 
D)  Alanine aminotransferase (ALT)

Question 5

A patient has a decreased oncotic pressure. What can be done to increase it?

Accepted Answer

A)  High-salt diet 
B)  Mannitol 
C)  Albumin withheld 
D)  Morphine sulfate 
A)  High-salt diet 
B)  Mannitol 
C)  Albumin withheld 
D)  Morphine sulfate

Question 6

A patient with cardiogenic pulmonary edema would be expected to have all of the following chest radiograph findings EXCEPT:

Accepted Answer

A)  depressed diaphragms. 
B)  pleural effusion. 
C)  cardiomegaly. 
D)  bilateral "butterfly" pattern fluffy infiltrates. 
A)  depressed diaphragms. 
B)  pleural effusion. 
C)  cardiomegaly. 
D)  bilateral "butterfly" pattern fluffy infiltrates.

Question 7

As pulmonary edema progressively worsens, the fluid moves in which of the following sequences?

Accepted Answer

A)  Peribronchial interstitial spaces, bronchi, trachea 
B)  Alveoli , bronchioles, bronchi 
C)  Bronchioles, bronchi, trachea 
D)  Pulmonary capillaries, alveoli, bronchioles 
A)  Peribronchial interstitial spaces, bronchi, trachea 
B)  Alveoli , bronchioles, bronchi 
C)  Bronchioles, bronchi, trachea 
D)  Pulmonary capillaries, alveoli, bronchioles

Question 8

The major pathologic or structural changes seen in the lungs with pulmonary edema include:
1) atelectasis.
2) bronchospasm.
3) high surface tension of alveolar fluids.
4) alveolar flooding.

Accepted Answer

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

Question 9

Lymphatic insufficiency could be caused by:
1) lung transplantation.
2) lymphangitic carcinomatosis.
3) removal of pleural fluid.
4) decreased oncotic pressure.

Accepted Answer

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

Question 10

What is the normal hydrostatic pressure in the pulmonary capillaries?

Accepted Answer

A)  0 to 5 mm Hg 
B)  5 to 10 mm Hg 
C)  10 to 15 mm Hg 
D)  15 to 20 mm Hg 
A)  0 to 5 mm Hg 
B)  5 to 10 mm Hg 
C)  10 to 15 mm Hg 
D)  15 to 20 mm Hg

Question 11

All of the following are positive risk factors for coronary heart disease (CHD) EXCEPT:

Accepted Answer

A)  elevated homocysteine level. 
B)  elevated vitamin E level. 
C)  hypertension. 
D)  diabetes mellitus. 
A)  elevated homocysteine level. 
B)  elevated vitamin E level. 
C)  hypertension. 
D)  diabetes mellitus.

Question 12

A patient has noncardiogenic pulmonary edema. What chest radiograph findings would be expected?
1) "Bat's wings" pattern fluffy infiltrates
2) Normal cardiac silhouette
3) Fluffy densities near the hilum
4) Pleural effusion

Accepted Answer

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

Question 13

The respiratory therapist is asked to recommend a medication to reduce afterload for a patient with cardiogenic pulmonary edema. The therapist could recommend all of the following EXCEPT:

Accepted Answer

A)  captopril. 
B)  norepinephrine (Levophed). 
C)  enalapril (Vasotec). 
D)  nitroprusside (Nitropress). 
A)  captopril. 
B)  norepinephrine (Levophed). 
C)  enalapril (Vasotec). 
D)  nitroprusside (Nitropress).

Question 14

Which of the following is/are considered noncardiogenic cause(s) of increased capillary permeability?
1) Therapeutic lung radiation
2) Cigarette smoke
3) Acute respiratory distress syndrome (ARDS)
4) Inhaled phosgene

Accepted Answer

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

Question 15

A patient with cardiogenic pulmonary edema has had intravascular catheters placed for monitoring purposes. Which of the following values would be expected?
1) Decreased SV
2) Increased PCWP
3) Increased CVP
4) Decreased RAP

Accepted Answer

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

Question 16

Mask CPAP is used with pulmonary edema patients because it does all of the following EXCEPT:

Accepted Answer

A)  decrease vascular congestion. 
B)  reduce work of breathing. 
C)  it is less expensive than mechanical ventilation. 
D)  improve lung compliance. 
A)  decrease vascular congestion. 
B)  reduce work of breathing. 
C)  it is less expensive than mechanical ventilation. 
D)  improve lung compliance.

Question 17

All of the following may be causes of cardiogenic pulmonary edema EXCEPT:

Accepted Answer

A)  dysrhythmias. 
B)  systemic hypertension. 
C)  congenital heart defects. 
D)  excessive fluid administration. 
E)  pulmonary embolism. 
A)  dysrhythmias. 
B)  systemic hypertension. 
C)  congenital heart defects. 
D)  excessive fluid administration. 
E)  pulmonary embolism.

Question 18

Management of cardiogenic pulmonary edema includes giving a patient which of the following types of medications?
1) Afterload reducer
2) Positive inotropic medication
3) Preload reducing medication
4) Positive chronotropic medication

Accepted Answer

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

Exam 20: Pulmonary Edema

A patient with pulmonary edema is cyanotic and complaining of difficulty breathing. What should be recommended by the respiratory therapist?

Pulmonary edema manifests itself clinically as a(n) _____ disorder.

All of the following are causes of cardiogenic pulmonary edema EXCEPT:

The respiratory therapist is asked to evaluate a patient with suspected congestive heart failure. Which of the following laboratory tests should the respiratory therapist recommend to evaluate the patient for possible congestive heart failure?

A patient has a decreased oncotic pressure. What can be done to increase it?

A patient with cardiogenic pulmonary edema would be expected to have all of the following chest radiograph findings EXCEPT:

As pulmonary edema progressively worsens, the fluid moves in which of the following sequences?

The major pathologic or structural changes seen in the lungs with pulmonary edema include: 1) atelectasis. 2) bronchospasm. 3) high surface tension of alveolar fluids. 4) alveolar flooding.

Lymphatic insufficiency could be caused by: 1) lung transplantation. 2) lymphangitic carcinomatosis. 3) removal of pleural fluid. 4) decreased oncotic pressure.

What is the normal hydrostatic pressure in the pulmonary capillaries?

All of the following are positive risk factors for coronary heart disease (CHD) EXCEPT:

A patient has noncardiogenic pulmonary edema. What chest radiograph findings would be expected? 1) "Bat's wings" pattern fluffy infiltrates 2) Normal cardiac silhouette 3) Fluffy densities near the hilum 4) Pleural effusion

The respiratory therapist is asked to recommend a medication to reduce afterload for a patient with cardiogenic pulmonary edema. The therapist could recommend all of the following EXCEPT:

Which of the following is/are considered noncardiogenic cause(s) of increased capillary permeability? 1) Therapeutic lung radiation 2) Cigarette smoke 3) Acute respiratory distress syndrome (ARDS) 4) Inhaled phosgene

A patient with cardiogenic pulmonary edema has had intravascular catheters placed for monitoring purposes. Which of the following values would be expected? 1) Decreased SV 2) Increased PCWP 3) Increased CVP 4) Decreased RAP

Mask CPAP is used with pulmonary edema patients because it does all of the following EXCEPT:

All of the following may be causes of cardiogenic pulmonary edema EXCEPT:

Management of cardiogenic pulmonary edema includes giving a patient which of the following types of medications? 1) Afterload reducer 2) Positive inotropic medication 3) Preload reducing medication 4) Positive chronotropic medication

The Patient Interview

The Physical Examination and Its Basis in Physiology

Pulmonary Function Study Assessments

Arterial Blood Gas Assessments

Oxygenation Assessments

Cardiovascular System Assessments

Radiologic Examination of the Chest

Other Important Tests and Procedures

The Therapist-Driven Protocol Program and the Role of the Respiratory Therapist

Respiratory Failure and the Mechanical Ventilation Protocol

Recording Skills: The Basis for Data Collection, Organization, Assessment Skill

Chronic Obstructive Pulmonary Disease (COPD), Chronic Bronchitis, and Emphysema

Asthma

Bronchiectasis

Cystic Fibrosis

Pneumonia

Lung Abscess

Tuberculosis

Fungal Diseases of the Lung

Pulmonary Vascular Disease: Pulmonary Embolism and Pulmonary Hypertension

Flail Chest

Pneumothorax

Pleural Effusion and Empyema

Kyphoscoliosis

Interstitial Lung Diseases

Cancer of the Lung

Acute Respiratory Distress Syndrome

Guillain-Barré Syndrome

Myasthenia Gravis

Sleep Apnea

Clinical Manifestations Common with Newborn and Early Childhood Respiratory Dis

Meconium Aspiration Syndrome

Transient Tachypnea of the Newborn

Respiratory Distress Syndrome

Pulmonary Air Leak Syndromes

Respiratory Syncytial Virus (Bronchiolitis or Pneumonitis)

Bronchopulmonary Dysplasia

Congenital Diaphragmatic Hernia

Congenital Heart Diseases

Croup Syndrome: Laryngotracheobronchitis and Acute Epiglottitis

Near Drowning/Wet Drowning

Smoke Inhalation, Thermal Injuries, and Carbon Monoxide Intoxication

Atelectasis

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