Question 1

About what range of drug dosages can be provided with each firing of a metered-dose inhaler?

Accepted Answer

A) 5 to 50 mg 
B) 50 to 100 mg 
C) 5 to 50$\mu$g 
D) 50 $\mu$g to 5 mg 
A) 5 to 50 mg 
B) 50 to 100 mg 
C) 5 to 50$\mu$g 
D) 50 $\mu$g to 5 mg

Question 2

The small-particle aerosol generator (SPAG) produces a small monodisperse aerosol through which of the following?

Accepted Answer

A) aerosol impaction by sequential baffling 
B) particle evaporation in a glass drying chamber 
C) use of an inert liquefied gas propellant 
D) aerosol generation using vibrational energy 
A) aerosol impaction by sequential baffling 
B) particle evaporation in a glass drying chamber 
C) use of an inert liquefied gas propellant 
D) aerosol generation using vibrational energy

Question 3

A physician orders continuous bronchodilator therapy with 1:200 albuterol for an asthmatic patient at the dosage of 20 mg/hr. How much 1:200 albuterol will be needed for the first hour of treatment?

Accepted Answer

A) 2 ml 
B) 3 ml 
C) 4 ml 
D) 5 ml 
A) 2 ml 
B) 3 ml 
C) 4 ml 
D) 5 ml

Question 4

All of the following drug formulation characteristics affect the performance of small-volume jet nebulizers except:

Accepted Answer

A) homogeneity 
B) surface tension 
C) viscosity 
D) potency 
A) homogeneity 
B) surface tension 
C) viscosity 
D) potency

Question 5

On the average, what is the range of the actual pulmonary deposition of small-volume jet nebulizer aerosolized drugs in intubated patients receiving mechanical ventilation?

Accepted Answer

A) 1.5% to 3.0% 
B) 3.5% to 6.0% 
C) 6.5% to 9.0% 
D) 9.5% to 15.0% 
A) 1.5% to 3.0% 
B) 3.5% to 6.0% 
C) 6.5% to 9.0% 
D) 9.5% to 15.0%

Question 6

A patient on mechanical ventilation was given 4 puffs of albuterol 5 minutes ago through a metered-dose inhaler (MDI) and holding chamber placed 18 inches from the circuit's airway connector. The patient continues to exhibit clinical signs of increased airway resistance but has demonstrated no apparent side effects from the drug. Which of the following would you recommend at this time?

Accepted Answer

A) Discontinue the albuterol and switch to a systemic bronchodilator. 
B) Repeat administration until the desired response is achieved. 
C) Remove the circuit-holding chamber and repeat MDI actuation. 
D) Move the MDI closer to the patient's airway and repeat use. 
A) Discontinue the albuterol and switch to a systemic bronchodilator. 
B) Repeat administration until the desired response is achieved. 
C) Remove the circuit-holding chamber and repeat MDI actuation. 
D) Move the MDI closer to the patient's airway and repeat use.

Question 7

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

Accepted Answer

A) mode of support 
B) presence of positive end-expiratory pressure 
C) VT 
D) duty cycle 
A) mode of support 
B) presence of positive end-expiratory pressure 
C) VT 
D) duty cycle

Question 8

Indications for assessment of patient's response to bronchodilator therapy include all of the following except to:

Accepted Answer

A) confirm whether the therapy works as intended 
B) individualize the dose, frequency, or type of medication 
C) help follow the patient's status during long-term therapy 
D) quantify the degree of bronchial hyperresponsiveness 
A) confirm whether the therapy works as intended 
B) individualize the dose, frequency, or type of medication 
C) help follow the patient's status during long-term therapy 
D) quantify the degree of bronchial hyperresponsiveness

Question 9

What is the primary fate of inhaled aerosol particles that are between 1 and 0.5 $\mu$m?

Accepted Answer

A) Most are cleared during exhalation. 
B) Most deposit in the central airways. 
C) Most deposit in the upper airway. 
D) Most deposit in the alveoli. 
A) Most are cleared during exhalation. 
B) Most deposit in the central airways. 
C) Most deposit in the upper airway. 
D) Most deposit in the alveoli.

Question 10

Which of the following are true about a solution that is being aerosolized by an ultrasonic nebulizer?
I.	The solute concentration decreases.
II.	The temperature of the solution increases.
III.	The solute concentration increases.
IV.	The temperature of the solution decreases.

Accepted Answer

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

Question 11

Most of the spray generated by the majority of metered-dose inhalers consists of which of the following?

Accepted Answer

A) active drug 
B) propellant 
C) surfactant agents 
D) water solution 
A) active drug 
B) propellant 
C) surfactant agents 
D) water solution

Question 12

To assess the effectiveness of a particular aerosol delivery device selection, what would you evaluate?
I.patient's technique in using the device
II.patient's response to and compliance with procedure
III.objective measures of improvement (e.g., peak flow)

Accepted Answer

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

Question 13

Which of the following factors affect pulmonary deposition of an aerosol?
I.size of the particles
II.shape and motion of the particles
III.physical characteristics of the airways

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 14

What is the preferred method for delivering bronchodilators to spontaneously breathing and intubated, ventilated patients?

Accepted Answer

A) dry powder inhaler 
B) small-volume jet nebulizer 
C) metered-dose inhaler 
D) hand-bulb atomizer 
A) dry powder inhaler 
B) small-volume jet nebulizer 
C) metered-dose inhaler 
D) hand-bulb atomizer

Question 15

On the average, what percentage of an aerosol drug delivery device's output actually deposits in the lungs?

Accepted Answer

A) less than 10% 
B) 10% to 20% 
C) 20% to 30% 
D) 30% to 40% 
A) less than 10% 
B) 10% to 20% 
C) 20% to 30% 
D) 30% to 40%

Question 16

Side effects of environmental exposure to ribavirin or pentamidine aerosols include all of the following except:

Accepted Answer

A) bronchospasm 
B) skin rashes 
C) conjunctivitis 
D) tachyphylaxis 
A) bronchospasm 
B) skin rashes 
C) conjunctivitis 
D) tachyphylaxis

Question 17

Proper use of a dry power inhaler (DPI) requires that the patient be able to do which of the following?

Accepted Answer

A) generate inspiratory flows of 60 L/min or higher 
B) exhale forcibly through the device before drug delivery 
C) inhale slowly (less than 0.5 L/sec) and perform a breath-hold 
D) coordinate firing of the DPI with inspiration 
A) generate inspiratory flows of 60 L/min or higher 
B) exhale forcibly through the device before drug delivery 
C) inhale slowly (less than 0.5 L/sec) and perform a breath-hold 
D) coordinate firing of the DPI with inspiration

Question 18

To monitor a patient for the possibility of reactive bronchospasm during aerosol drug therapy, what should you do?
I.	Measure pre- and post-peak flow and/or percentage forced expiratory volume in 1 second (%FEV1).
II.	Auscultate for adventitious breath sounds.
III.	Carefully observe the patient’s response.
IV.	Communicate with the patient during therapy.

Accepted Answer

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

Question 19

Advantages of small-volume ultrasonic nebulizers for drug delivery include all of the following except:

Accepted Answer

A) greater respirable drug mass 
B) less dead space and waste 
C) increased mobility 
D) decreased cost 
A) greater respirable drug mass 
B) less dead space and waste 
C) increased mobility 
D) decreased cost

Question 20

Exhalation into which device can result in loss of drug delivery?

Accepted Answer

A) small-volume jet nebulizers 
B) metered-dose inhaler 
C) dry power inhaler 
D) ultrasonic nebulizer 
A) small-volume jet nebulizers 
B) metered-dose inhaler 
C) dry power inhaler 
D) ultrasonic nebulizer

Exam 36: Aerosol Drug Therapy

About what range of drug dosages can be provided with each firing of a metered-dose inhaler?

The small-particle aerosol generator (SPAG) produces a small monodisperse aerosol through which of the following?

A physician orders continuous bronchodilator therapy with 1:200 albuterol for an asthmatic patient at the dosage of 20 mg/hr. How much 1:200 albuterol will be needed for the first hour of treatment?

All of the following drug formulation characteristics affect the performance of small-volume jet nebulizers except:

On the average, what is the range of the actual pulmonary deposition of small-volume jet nebulizer aerosolized drugs in intubated patients receiving mechanical ventilation?

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

Indications for assessment of patient's response to bronchodilator therapy include all of the following except to:

What is the primary fate of inhaled aerosol particles that are between 1 and 0.5 μ\muμ m?

Which of the following are true about a solution that is being aerosolized by an ultrasonic nebulizer? I. The solute concentration decreases. II. The temperature of the solution increases. III. The solute concentration increases. IV. The temperature of the solution decreases.

Most of the spray generated by the majority of metered-dose inhalers consists of which of the following?

To assess the effectiveness of a particular aerosol delivery device selection, what would you evaluate? I.patient's technique in using the device II.patient's response to and compliance with procedure III.objective measures of improvement (e.g., peak flow)

Which of the following factors affect pulmonary deposition of an aerosol? I.size of the particles II.shape and motion of the particles III.physical characteristics of the airways

What is the preferred method for delivering bronchodilators to spontaneously breathing and intubated, ventilated patients?

On the average, what percentage of an aerosol drug delivery device's output actually deposits in the lungs?

Side effects of environmental exposure to ribavirin or pentamidine aerosols include all of the following except:

Proper use of a dry power inhaler (DPI) requires that the patient be able to do which of the following?

Advantages of small-volume ultrasonic nebulizers for drug delivery include all of the following except:

Exhalation into which device can result in loss of drug delivery?

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

Filters

What is the primary fate of inhaled aerosol particles that are between 1 and 0.5 $\mu$ m?