Question 1

Which of the following physical examination findings is NOT found in patients with primary pulmonary hypertension?

Accepted Answer

A) cyanosis 
B) diastolic heart murmur 
C) digital clubbing 
D) loud second heart sound (P2) 
A) cyanosis 
B) diastolic heart murmur 
C) digital clubbing 
D) loud second heart sound (P2)

Question 2

A D-dimer test is performed in a patient in whom a pulmonary embolism is suspected. The value comes back at 379 mg/L. What does this suggest?

Accepted Answer

A) almost completely establishes the presence of pulmonary embolism 
B) almost completely rules out pulmonary embolism 
C) establishes roughly a 50/50 chance of pulmonary embolism 
D) is indeterminate but highly suggestive of pulmonary embolism 
A) almost completely establishes the presence of pulmonary embolism 
B) almost completely rules out pulmonary embolism 
C) establishes roughly a 50/50 chance of pulmonary embolism 
D) is indeterminate but highly suggestive of pulmonary embolism

Question 3

What IV infusion has been found to improve exercise capacity, hemodynamic variables, and survival in patients with severe IPAH?

Accepted Answer

A) Bosentan 
B) Epoprostenol 
C) Methylprednisolone 
D) Sildenafil 
A) Bosentan 
B) Epoprostenol 
C) Methylprednisolone 
D) Sildenafil

Question 4

Which of the diagnostic tests for pulmonary embolism is probably the safest and the most consistently accurate?

Accepted Answer

A) impedance plethysmography 
B) MRI 
C) pulmonary angiogram 
D) spiral CT 
A) impedance plethysmography 
B) MRI 
C) pulmonary angiogram 
D) spiral CT

Question 5

A patient with pulmonary emboli has severe hypoxemia, acute right-sided heart failure, and shock. What treatment should be given at this time?

Accepted Answer

A) acetylcholine esterase 
B) heparin 
C) streptokinase 
D) warfarin 
A) acetylcholine esterase 
B) heparin 
C) streptokinase 
D) warfarin

Question 6

Which of the following physical examination findings are consistent with the diagnosis of pulmonary embolism?
I.congestive heart failure
II.inspiratory crackles on auscultation
III.loud P2
IV.tachypnea

Accepted Answer

A) II, III, and IV 
B) I and IV 
C) III only 
D) I, II, III, and IV 
A) II, III, and IV 
B) I and IV 
C) III only 
D) I, II, III, and IV

Question 7

On average, how long does the diagnosis of idiopathic pulmonary artery hypertension (IPAH) follow the onset of the disease?

Accepted Answer

A) 6 months 
B) 1 year 
C) 18 months 
D) 2 years 
A) 6 months 
B) 1 year 
C) 18 months 
D) 2 years

Question 8

What is the most commonly used oral anticoagulant?

Accepted Answer

A) acetylcholine esterase 
B) heparin 
C) streptokinase 
D) warfarin 
A) acetylcholine esterase 
B) heparin 
C) streptokinase 
D) warfarin

Question 9

Approximately what percentage of patients with pulmonary embolism have a normal ECG?

Accepted Answer

A) 10% to 15% 
B) 25% to 30% 
C) 40% to 60% 
D) 70% to 75% 
A) 10% to 15% 
B) 25% to 30% 
C) 40% to 60% 
D) 70% to 75%

Question 10

Which of the following pathophysiologic changes in the lung is not typically associated with pulmonary embolism?

Accepted Answer

A) bronchoconstriction 
B) decreased ciliary mobility 
C) increased dead space ventilation 
D) reduced surfactant production 
A) bronchoconstriction 
B) decreased ciliary mobility 
C) increased dead space ventilation 
D) reduced surfactant production

Question 11

Which of the following medications should be used for in hospital prophylactic deep venous thrombosis therapy?

Accepted Answer

A) acetylcholine esterase 
B) albuterol 
C) aspirin 
D) heparin 
A) acetylcholine esterase 
B) albuterol 
C) aspirin 
D) heparin

Question 12

What is the most common symptom in patients with pulmonary embolism?

Accepted Answer

A) dyspnea 
B) hemoptysis 
C) pain 
D) palpitations 
A) dyspnea 
B) hemoptysis 
C) pain 
D) palpitations

Question 13

At rest, what level does the mean pulmonary artery pressure need to reach before it is considered pulmonary hypertension?

Accepted Answer

A) >10 mm Hg 
B) >15 mm Hg 
C) >20 mm Hg 
D) >25 mm Hg 
A) >10 mm Hg 
B) >15 mm Hg 
C) >20 mm Hg 
D) >25 mm Hg

Question 14

What is the fastest way to achieve therapeutic levels of heparin in the treatment of acute deep venous thrombi?

Accepted Answer

A) continuous drip system 
B) follow established nomogram 
C) large bolus at 10 µg/kg 
D) IV injections while tracking blood levels 
A) continuous drip system 
B) follow established nomogram 
C) large bolus at 10 µg/kg 
D) IV injections while tracking blood levels

Question 15

Which of the following arterial blood gas findings is seen in most patients with pulmonary embolism?

Accepted Answer

A) hypercapnia 
B) hypoxemia 
C) low pH 
D) normal SaO2 
A) hypercapnia 
B) hypoxemia 
C) low pH 
D) normal SaO2

Question 16

In patients suspected of having pulmonary emboli in whom noninvasive studies do not give a definite diagnosis, what diagnostic procedure is the test of choice?

Accepted Answer

A) CT 
B) MRI 
C) pulmonary angiography 
D)  $\dot { V } / \dot { Q }$ 
A) CT 
B) MRI 
C) pulmonary angiography 
D)  $\dot { V } / \dot { Q }$

Question 17

Primary pulmonary hypertension is more common in males than in females.

Accepted Answer

A) True 
 B)False

Question 18

What is the most important factor contributing to the onset of pulmonary hypertension in the patient with COPD?

Accepted Answer

A) Alveolar hypoxia 
B) Compression of pulmonary vasculature 
C) Left ventricular failure 
D) Loss of vascular surface 
A) Alveolar hypoxia 
B) Compression of pulmonary vasculature 
C) Left ventricular failure 
D) Loss of vascular surface

Question 19

What drug would be the first used in the treatment of choice for pulmonary emboli?

Accepted Answer

A) heparin 
B) streptokinase 
C) urokinase 
D) warfarin 
A) heparin 
B) streptokinase 
C) urokinase 
D) warfarin

Question 20

Which of the following treatments is least useful in the treatment of the patient with idiopathic pulmonary artery hypertension?

Accepted Answer

A) oxygen 
B) steroids 
C) vasodilators 
D) warfarin 
A) oxygen 
B) steroids 
C) vasodilators 
D) warfarin

Exam 26: Pulmonary Vascular Disease

Which of the following physical examination findings is NOT found in patients with primary pulmonary hypertension?

A D-dimer test is performed in a patient in whom a pulmonary embolism is suspected. The value comes back at 379 mg/L. What does this suggest?

What IV infusion has been found to improve exercise capacity, hemodynamic variables, and survival in patients with severe IPAH?

Which of the diagnostic tests for pulmonary embolism is probably the safest and the most consistently accurate?

A patient with pulmonary emboli has severe hypoxemia, acute right-sided heart failure, and shock. What treatment should be given at this time?

Which of the following physical examination findings are consistent with the diagnosis of pulmonary embolism? I.congestive heart failure II.inspiratory crackles on auscultation III.loud P2 IV.tachypnea

On average, how long does the diagnosis of idiopathic pulmonary artery hypertension (IPAH) follow the onset of the disease?

What is the most commonly used oral anticoagulant?

Approximately what percentage of patients with pulmonary embolism have a normal ECG?

Which of the following pathophysiologic changes in the lung is not typically associated with pulmonary embolism?

Which of the following medications should be used for in hospital prophylactic deep venous thrombosis therapy?

What is the most common symptom in patients with pulmonary embolism?

At rest, what level does the mean pulmonary artery pressure need to reach before it is considered pulmonary hypertension?

What is the fastest way to achieve therapeutic levels of heparin in the treatment of acute deep venous thrombi?

Which of the following arterial blood gas findings is seen in most patients with pulmonary embolism?

In patients suspected of having pulmonary emboli in whom noninvasive studies do not give a definite diagnosis, what diagnostic procedure is the test of choice?

Primary pulmonary hypertension is more common in males than in females.

What is the most important factor contributing to the onset of pulmonary hypertension in the patient with COPD?

What drug would be the first used in the treatment of choice for pulmonary emboli?

Which of the following treatments is least useful in the treatment of the patient with idiopathic pulmonary artery hypertension?

History of Respiratory Care

Quality and Evidence-Based Respiratory Care

Patient Safety, Communication, and Record Keeping

Principles of Infection Control

Ethical and Legal Implications of Practice

Physical Principles of Respiratory Care

Computer Applications in Respiratory Care

The Respiratory System

The Cardiovascular System

Ventilation

Gas Exchange and Transport

Solutions, Body Fluids, and Electrolytes

Acid-Base Balance

Regulation of Breathing

Bedside Assessment of the Patient

Interpretation of Clinical Laboratory Data

Interpreting the Electrocardiogram

Analysis and Monitoring of Gas Exchange

Pulmonary Function Testing

A Review of Thoracic Imaging

Nutrition Assessment

Pulmonary Infections

Obstructive Lung Disease: Copd, Asthma, and Related Diseases

Interstitial Lung Disease

Pleural Diseases

Acute Lung Injury, Pulmonary Edema, and Multiple System Organ

Lung Cancer

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Disorders of Sleep

Neonatal and Pediatric Respiratory Disorders

Airway Pharmacology

Airway Management

Emergency Cardiovascular Life Support

Humidity and Bland Aerosol Therapy

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Storage and Delivery of Medical Gases

Medical Gas Therapy

Lung Expansion Therapy

Bronchial Hygiene Therapy

Respiratory Failure and the Need for Ventilatory Support

Mechanical Ventilators

Physiology of Ventilatory Support

Initiating and Adjusting Ventilatory Support

Noninvasive Positive Pressure Ventilation

Monitoring and Management of the Patient in the Intensive Care Unit

Discontinuing Ventilatory Support

Neonatal and Pediatric Respiratory Care

Patient Education and Health Promotion

Cardiopulmonary Rehabilitation

Respiratory Care in Alternative Settings

Filters

Which of the following physical examination findings are consistent with the diagnosis of pulmonary embolism? I.congestive heart failure II.inspiratory crackles on auscultation III.loud P₂ IV.tachypnea