Question 1

What is the main clinical risk facing a patient with epiglottitis?

Accepted Answer

A)  Secretions will block the trachea. 
B)  The epiglottis will bleed. 
C)  The laryngeal inlet may become covered by the epiglottis. 
D)  The vocal cords will spasm and close the laryngeal inlet. 
A)  Secretions will block the trachea. 
B)  The epiglottis will bleed. 
C)  The laryngeal inlet may become covered by the epiglottis. 
D)  The vocal cords will spasm and close the laryngeal inlet. C

Question 2

In evaluating a 16-month-old boy, the respiratory therapist finds him to be in mild respiratory distress, without a fever, but with a barking-type cough. A lateral neck x-ray taken in the emergency department shows a "steeple point" narrowing of the trachea. Based on this information, which of the following would the respiratory therapist conclude is the most probable diagnosis?

Accepted Answer

A)  Acute bronchitis 
B)  Epiglottitis 
C)  Bronchiolitis 
D)  LTB 
A)  Acute bronchitis 
B)  Epiglottitis 
C)  Bronchiolitis 
D)  LTB D

Question 3

The respiratory therapist is assigned to the pediatric unit of the hospital. The physician who is caring for a 3-year-old boy with LTB asks what respiratory therapy treatments should be given. The respiratory therapist should suggest which of the following?
1) Racemic epinephrine
2) Cool mist tent
3) Antibiotics
4) Endotracheal or tracheostomy tube

Accepted Answer

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

Question 4

The medication racemic epinephrine (Micronefrin, Vaponefrin) is given to a patient with LTB because it:

Accepted Answer

A)  is an effective bronchodilator. 
B)  causes mucosal vasoconstriction. 
C)  causes bradycardia. 
D)  has an appealing taste and smell. 
A)  is an effective bronchodilator. 
B)  causes mucosal vasoconstriction. 
C)  causes bradycardia. 
D)  has an appealing taste and smell.

Question 5

Management of LTB usually includes all of the following EXCEPT:

Accepted Answer

A)  close observation for breathing difficulties. 
B)  having the child drink fluids. 
C)  placement into a cool aerosol tent. 
D)  endotracheal intubation. 
A)  close observation for breathing difficulties. 
B)  having the child drink fluids. 
C)  placement into a cool aerosol tent. 
D)  endotracheal intubation.

Question 6

The diagnosis of LTB is made by all of the following EXCEPT the child:

Accepted Answer

A)  has inspiratory stridor and barking cough. 
B)  has a normal temperature or low fever. 
C)  has a significant fever. 
D)  can drink without difficulty. 
A)  has inspiratory stridor and barking cough. 
B)  has a normal temperature or low fever. 
C)  has a significant fever. 
D)  can drink without difficulty.

Question 7

A patient has been diagnosed with bacterial epiglottitis. Which of the following antibiotics should the respiratory therapist most likely recommend?

Accepted Answer

A)  Amikacin (Amikin) 
B)  Tobramycin (Nebcin) 
C)  Cefalexin (Keflex) 
D)  Ampicillin/sulbactam (Unasyn) 
A)  Amikacin (Amikin) 
B)  Tobramycin (Nebcin) 
C)  Cefalexin (Keflex) 
D)  Ampicillin/sulbactam (Unasyn)

Question 8

Most cases of LTB occur during which season(s) of the year?
1) Spring
2) Summer
3) Fall
4) Winter

Accepted Answer

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

Question 9

The barking sound heard in a patient with LTB is caused by which of the following?

Accepted Answer

A)  Partial lower airway obstruction 
B)  Partial upper airway obstruction 
C)  Expiration against a partially closed glottis 
D)  Pharyngeal edema 
A)  Partial lower airway obstruction 
B)  Partial upper airway obstruction 
C)  Expiration against a partially closed glottis 
D)  Pharyngeal edema

Question 10

Which of the following is/are commonly seen on the lateral neck x-ray of a patient with LTB?
1) "Pencil point" narrowing of the upper airway
2) Haziness in the subglottic area
3) Classic "thumb sign"
4) "Steeple point" narrowing of the upper airway

Accepted Answer

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

Question 11

All of the following would be expected during the assessment of a young child with LTB EXCEPT:

Accepted Answer

A)  decreased respiratory rate. 
B)  diminished breath sounds. 
C)  use of accessory muscles. 
D)  hypoxemia. 
A)  decreased respiratory rate. 
B)  diminished breath sounds. 
C)  use of accessory muscles. 
D)  hypoxemia.

Question 12

A patient has epiglottitis. This condition will affect which of the following?
1) Pharynx
2) Aryepiglottic folds
3) False vocal cords
4) Trachea

Accepted Answer

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

Question 13

The diagnosis of epiglottitis is aided by:
1) laying the patient down and observing the throat with a tongue blade.
2) visualization of the throat during tracheal intubation.
3) observing if the patient can swallow.
4) observing how the patient holds his or her tongue.

Accepted Answer

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

Question 14

When a patient has laryngotracheobronchitis (LTB), which of the following is the primary anatomic alteration that is found?

Accepted Answer

A)  Edema of the mucous membranes 
B)  Airway smooth muscle contraction 
C)  Excessive alveolar fluid 
D)  Epiglottitis 
A)  Edema of the mucous membranes 
B)  Airway smooth muscle contraction 
C)  Excessive alveolar fluid 
D)  Epiglottitis

Question 15

The treatment of epiglottitis includes:
1) antibiotics specific to the virus causing the illness.
2) antibiotics specific to the bacteria causing the illness.
3) supplemental oxygen by face mask.
4) endotracheal intubation.

Accepted Answer

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

Question 16

All of the following anatomic alterations may be found in a patient with LTB EXCEPT:

Accepted Answer

A)  increased secretions. 
B)  ineffective cilia. 
C)  narrowed airway lumen. 
D)  excessive surfactant production. 
A)  increased secretions. 
B)  ineffective cilia. 
C)  narrowed airway lumen. 
D)  excessive surfactant production.

Question 17

Childhood vaccination is done to prevent which of the following possible causes of epiglottitis?

Accepted Answer

A)  Haemophilus influenza type B 
B)  Streptococcus pneumoniae 
C)  Diphtheria 
D)  Parainfluenza viruses 
A)  Haemophilus influenza type B 
B)  Streptococcus pneumoniae 
C)  Diphtheria 
D)  Parainfluenza viruses

Exam 41: Croup Syndrome: Laryngotracheobronchitis and Acute Epiglottitis

What is the main clinical risk facing a patient with epiglottitis?

The medication racemic epinephrine (Micronefrin, Vaponefrin) is given to a patient with LTB because it:

Management of LTB usually includes all of the following EXCEPT:

The diagnosis of LTB is made by all of the following EXCEPT the child:

A patient has been diagnosed with bacterial epiglottitis. Which of the following antibiotics should the respiratory therapist most likely recommend?

Most cases of LTB occur during which season(s) of the year? 1) Spring 2) Summer 3) Fall 4) Winter

The barking sound heard in a patient with LTB is caused by which of the following?

Which of the following is/are commonly seen on the lateral neck x-ray of a patient with LTB? 1) "Pencil point" narrowing of the upper airway 2) Haziness in the subglottic area 3) Classic "thumb sign" 4) "Steeple point" narrowing of the upper airway

All of the following would be expected during the assessment of a young child with LTB EXCEPT:

A patient has epiglottitis. This condition will affect which of the following? 1) Pharynx 2) Aryepiglottic folds 3) False vocal cords 4) Trachea

The diagnosis of epiglottitis is aided by: 1) laying the patient down and observing the throat with a tongue blade. 2) visualization of the throat during tracheal intubation. 3) observing if the patient can swallow. 4) observing how the patient holds his or her tongue.

When a patient has laryngotracheobronchitis (LTB), which of the following is the primary anatomic alteration that is found?

The treatment of epiglottitis includes: 1) antibiotics specific to the virus causing the illness. 2) antibiotics specific to the bacteria causing the illness. 3) supplemental oxygen by face mask. 4) endotracheal intubation.

All of the following anatomic alterations may be found in a patient with LTB EXCEPT:

Childhood vaccination is done to prevent which of the following possible causes of epiglottitis?

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 Edema

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

Near Drowning/Wet Drowning

Smoke Inhalation, Thermal Injuries, and Carbon Monoxide Intoxication

Atelectasis

Filters