Question 1

Which of the following techniques will increase aerosol deposition by sedimentation in the lungs?

Accepted Answer

A) high inspiratory flow 
B) short inspiratory time 
C) 10-second breath-hold 
D) short expiratory time 
A) high inspiratory flow 
B) short inspiratory time 
C) 10-second breath-hold 
D) short expiratory time C

Question 2

What measure is used to describe the variability of particle diameters in an aerosol?

Accepted Answer

A) MMVC 
B) LSD 
C) MMAD 
D) GSD 
A) MMVC 
B) LSD 
C) MMAD 
D) GSD D

Question 3

Most nebulizers used in respiratory care produce which type of aerosol suspension?

Accepted Answer

A) monodisperse 
B) microaerosol 
C) heterodisperse 
D) macroaerosol 
A) monodisperse 
B) microaerosol 
C) heterodisperse 
D) macroaerosol C

Question 4

Before inspiration and actuation of a metered-dose inhaler, the patient should exhale to which of the following?

Accepted Answer

A) total lung capacity 
B) residual volume 
C) functional residual capacity 
D) expiratory reserve volume 
A) total lung capacity 
B) residual volume 
C) functional residual capacity 
D) expiratory reserve volume

Question 5

Which of the following particle distributions is produced by a typical metered-dose inhaler?

Accepted Answer

A) 3- to 6-$\mu$m mean mass aerodynamic diameter (MMA
D)  
B) 1- to 3-$\mu$m MMAD 
C) 6- to 9-$\mu$m MMAD 
D) less than 1-$\mu$m MMAD 
A) 3- to 6-$\mu$m mean mass aerodynamic diameter (MMA
D)  
B) 1- to 3-$\mu$m MMAD 
C) 6- to 9-$\mu$m MMAD 
D) less than 1-$\mu$m MMAD

Question 6

All of the following circuit-related factors have a major effect on metered-dose inhaler delivery of aerosolized drugs during mechanical ventilation except:

Accepted Answer

A) endotracheal tube size 
B) type of humidifier 
C) relative humidity 
D) temperature 
A) endotracheal tube size 
B) type of humidifier 
C) relative humidity 
D) temperature

Question 7

After administering 12 puffs of metered-dose inhaler (MDI) albuterol to an acutely ill asthmatic patient in the emergency department, assessment indicates no significant improvement in symptoms. Which of the following would you now recommend?

Accepted Answer

A) Switch over to high-dose MDI steroids. 
B) Discontinue the bronchodilator therapy. 
C) Use continuous bronchodilator therapy. 
D) Switch over to an anticholinergic agent. 
A) Switch over to high-dose MDI steroids. 
B) Discontinue the bronchodilator therapy. 
C) Use continuous bronchodilator therapy. 
D) Switch over to an anticholinergic agent.

Question 8

For a hospitalized patient who will require ongoing maintenance bronchodilator therapy after discharge, what should your end goal be?

Accepted Answer

A) complete relief of all patient symptoms 
B) normal airflow and cessation of therapy 
C) effective self-administration of the drug 
D) peak expiratory flow rate that exceeds 70% of "personal best" 
A) complete relief of all patient symptoms 
B) normal airflow and cessation of therapy 
C) effective self-administration of the drug 
D) peak expiratory flow rate that exceeds 70% of "personal best"

Question 9

When using a small-particle aerosol generator (SPAG) to administer ribavirin (Virazole) to an infant, which pair of flow settings is correct? Nebulizer
Drying Chamber

Accepted Answer

A)  $8 \mathrm {~L} / \mathrm { min } \quad8 \mathrm {~L} / \mathrm { min }$ 
B)  $5 \mathrm {~L} / \mathrm { min }\quad 5 \mathrm {~L} / \mathrm { min }$ 
C)  $8 \mathrm {~L} / \mathrm { min } \quad4 \mathrm {~L} / \mathrm { min }$ 
D)  $4 \mathrm {~L} / \mathrm { min }\quad 8 \mathrm {~L} / \mathrm { min }$ 
A)  $8 \mathrm {~L} / \mathrm { min } \quad8 \mathrm {~L} / \mathrm { min }$ 
B)  $5 \mathrm {~L} / \mathrm { min }\quad 5 \mathrm {~L} / \mathrm { min }$ 
C)  $8 \mathrm {~L} / \mathrm { min } \quad4 \mathrm {~L} / \mathrm { min }$ 
D)  $4 \mathrm {~L} / \mathrm { min }\quad 8 \mathrm {~L} / \mathrm { min }$

Question 10

Which of the following would you recommend as initial therapy for a patient admitted to the emergency department with acute airway obstruction (wheezing, cough, dyspnea, peak expiratory flow rate [PEFR] less than 60% predicted)?
I.	Assess dose-response of metered-dose inhaler (MDI) albuterol (up to 12 puffs).
II.	Provide up to three small-volume jet nebulizer (SVN) treatments with albuterol every 20 minutes.
III.	Immediately begin continuous albuterol therapy at 15 mg/hr.

Accepted Answer

A) I or II 
B) I or III 
C) II or III 
D) I, II, and III 
A) I or II 
B) I or III 
C) II or III 
D) I, II, and III

Question 11

To minimize the risk of infection associated with aerosol drug therapy, what should you do?
iI.	Sterilize nebulizers between patients.
II.	Frequently replace in-use units.
III.	Rinse nebulizers with sterile water.

Accepted Answer

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

Question 12

A patient admitted to the emergency department has acute, severe bronchospasm and will likely need high or multiple doses of bronchodilator. Which of the following aerosol drug delivery devices would you recommend in this situation?
I.large-volume continuous nebulizer
II.small-volume jet nebulizer (SVN)III.dry powder inhaler
IV.pressurized metered-dose inhaler and holding chamber

Accepted Answer

A) I or II 
B) II or III 
C) II or IV 
D) III or IV 
A) I or II 
B) II or III 
C) II or IV 
D) III or IV

Question 13

In addition to bedside pulmonary function test measures, what other components of patient assessment are useful in evaluating bronchodilator therapy?
I.patient interview and observation
II.measurement of vital signs
III.chest auscultation
IV.arterial blood gas analysis and oximetry

Accepted Answer

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

Question 14

A semiconscious patient with inadequate spontaneous ventilation requires aerosol drug administration. Which of the following approaches would you recommend?

Accepted Answer

A) large-volume continuous nebulizer 
B) small-volume jet nebulizer (SVN) 
C) SVN with delivery by intermittent positive-pressure breathing 
D) metered-dose inhaler and holding chamber 
A) large-volume continuous nebulizer 
B) small-volume jet nebulizer (SVN) 
C) SVN with delivery by intermittent positive-pressure breathing 
D) metered-dose inhaler and holding chamber

Question 15

Which of the following drugs present the greatest exposure risks for health care workers?
I.	albuterol (Proventil)
II.	pentamidine (Pentam 300)
III.	ribavirin (Virazole)
IV.	acetylcysteine (Mucomyst)

Accepted Answer

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

Question 16

Which of the following aerosols would have the highest rate of deposition by diffusion?

Accepted Answer

A) MMAD of 0.1 $\mu$m 
B) MMAD of 3.0 $\mu$m 
C) MMAD of 10.0 $\mu$m 
D) MMAD of 50.0 $\mu$m 
A) MMAD of 0.1 $\mu$m 
B) MMAD of 3.0 $\mu$m 
C) MMAD of 10.0 $\mu$m 
D) MMAD of 50.0 $\mu$m

Question 17

Which of the following agents has been associated with increased intraocular pressure?

Accepted Answer

A) anticholinergics 
B) epinephrine 
C) $\beta$2-agonists 
D) antibiotics 
A) anticholinergics 
B) epinephrine 
C) $\beta$2-agonists 
D) antibiotics

Question 18

Which of the following factors is most crucial in developing an effective program of aerosol drug self-administration in an adult patient requiring maintenance bronchodilator therapy?

Accepted Answer

A) proper device selection 
B) well-written brochures 
C) reliable peak expiratory flow rate meter 
D) good patient education 
A) proper device selection 
B) well-written brochures 
C) reliable peak expiratory flow rate meter 
D) good patient education

Question 19

Which of the following is false about the use of the peak expiratory flow rate (PEFR) in assessing a patient's response to bronchodilator therapy?

Accepted Answer

A) PEFR and lab spirometry forced vital capacity values may correlate poorly. 
B) PEFR is the standard for determining bronchodilator response. 
C) Some peak flowmeters are more accurate and reliable than others. 
D) The peak flow measure is effort and volume dependent. 
A) PEFR and lab spirometry forced vital capacity values may correlate poorly. 
B) PEFR is the standard for determining bronchodilator response. 
C) Some peak flowmeters are more accurate and reliable than others. 
D) The peak flow measure is effort and volume dependent.

Question 20

What is the most reliable indicator of a change in airway resistance due to bronchodilator administration during mechanical ventilation?

Accepted Answer

A) change in slope of the expiratory flow-volume curve 
B) difference between peak airway and plateau pressures 
C) change in peak expiratory flow during passive exhalation 
D) difference between plateau and baseline (PEEP) pressures 
A) change in slope of the expiratory flow-volume curve 
B) difference between peak airway and plateau pressures 
C) change in peak expiratory flow during passive exhalation 
D) difference between plateau and baseline (PEEP) pressures

Exam 36: Aerosol Drug Therapy

Which of the following techniques will increase aerosol deposition by sedimentation in the lungs?

What measure is used to describe the variability of particle diameters in an aerosol?

Most nebulizers used in respiratory care produce which type of aerosol suspension?

Before inspiration and actuation of a metered-dose inhaler, the patient should exhale to which of the following?

Which of the following particle distributions is produced by a typical metered-dose inhaler?

All of the following circuit-related factors have a major effect on metered-dose inhaler delivery of aerosolized drugs during mechanical ventilation except:

After administering 12 puffs of metered-dose inhaler (MDI) albuterol to an acutely ill asthmatic patient in the emergency department, assessment indicates no significant improvement in symptoms. Which of the following would you now recommend?

For a hospitalized patient who will require ongoing maintenance bronchodilator therapy after discharge, what should your end goal be?

When using a small-particle aerosol generator (SPAG) to administer ribavirin (Virazole) to an infant, which pair of flow settings is correct? Nebulizer Drying Chamber

To minimize the risk of infection associated with aerosol drug therapy, what should you do? iI. Sterilize nebulizers between patients. II. Frequently replace in-use units. III. Rinse nebulizers with sterile water.

In addition to bedside pulmonary function test measures, what other components of patient assessment are useful in evaluating bronchodilator therapy? I.patient interview and observation II.measurement of vital signs III.chest auscultation IV.arterial blood gas analysis and oximetry

A semiconscious patient with inadequate spontaneous ventilation requires aerosol drug administration. Which of the following approaches would you recommend?

Which of the following drugs present the greatest exposure risks for health care workers? I. albuterol (Proventil) II. pentamidine (Pentam 300) III. ribavirin (Virazole) IV. acetylcysteine (Mucomyst)

Which of the following aerosols would have the highest rate of deposition by diffusion?

Which of the following agents has been associated with increased intraocular pressure?

Which of the following factors is most crucial in developing an effective program of aerosol drug self-administration in an adult patient requiring maintenance bronchodilator therapy?

Which of the following is false about the use of the peak expiratory flow rate (PEFR) in assessing a patient's response to bronchodilator therapy?

What is the most reliable indicator of a change in airway resistance due to bronchodilator administration during mechanical ventilation?

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

Pulmonary Vascular Disease

Acute Lung Injury, Pulmonary Edema, and Multiple System Organ

Lung Cancer

Neuromuscular and Other Diseases of the Chest Wall

Disorders of Sleep

Neonatal and Pediatric Respiratory Disorders

Airway Pharmacology

Airway Management

Emergency Cardiovascular Life Support

Humidity and Bland Aerosol Therapy

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

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