Question 1

Why does it take approximately 24 hr for a full ventilatory response to develop to acute hypoxemia?

Accepted Answer

A)  Initial cerebrospinal fluid alkalemia blunts the hypoxic ventilatory stimulus. 
B)  Peripheral chemoreceptors are slow to respond to decreased blood O2 levels. 
C)  Renal compensation for respiratory alkalosis increases chemoreceptor sensitivity. 
D)  A full ventilatory response is not possible until after the muscles become fatigued. 
A)  Initial cerebrospinal fluid alkalemia blunts the hypoxic ventilatory stimulus. 
B)  Peripheral chemoreceptors are slow to respond to decreased blood O2 levels. 
C)  Renal compensation for respiratory alkalosis increases chemoreceptor sensitivity. 
D)  A full ventilatory response is not possible until after the muscles become fatigued.

Question 2

The medulla oblongata contains which of the following areas?
1) Apneustic center
2) Dorsal respiratory group neurons (DRGs)
3) Pneumotaxic center
4) Ventral respiratory group neurons (VRGs)

Accepted Answer

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

Question 3

To which anatomic structures do the ventral respiratory centers send motor signals during inspiration?
1) Diaphragm
2) Larynx
3) Pharynx
4) Sternocleidomastoids

Accepted Answer

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

Question 4

In what manner would O2 therapy induce worsening   mismatch and thus a further elevation in CO2 in a chronically hypercapnic patient?

Accepted Answer

A)  By improving blood flow to poorly ventilated alveoli 
B)  By decreasing blood flow to poorly ventilated alveoli 
C)  Causing bronchoconstriction, which worsens gas flow to lowareas 
D)  Causing bronchodilation, which improves gas flow to poorly ventilated alveoli 
A)  By improving blood flow to poorly ventilated alveoli 
B)  By decreasing blood flow to poorly ventilated alveoli 
C)  Causing bronchoconstriction, which worsens gas flow to lowareas 
D)  Causing bronchodilation, which improves gas flow to poorly ventilated alveoli

Question 5

When given high concentrations of O2, a patient with chronic hypercapnia may develop a more serious respiratory acidosis. Which of the following might be contributing to the patient's increased PCO2?
1) Worsening ventilation-perfusion (VV/QQ) balance
2) Desensitization of the carotid bodies
3) Removal of the hypoxic stimulus

Accepted Answer

A) 1 and 2 only 
B) 1 only 
C) 1 and 3 only 
D) 1, 2, and 3 
A) 1 and 2 only 
B) 1 only 
C) 1 and 3 only 
D) 1, 2, and 3

Question 6

What group of nerve cells senses and responds to changes in the chemical composition of its fluid environment?

Accepted Answer

A)  Chemoreceptors 
B)  Gamma-efferent system 
C)  Muscle spindle fibers 
D)  Proprioceptors 
A)  Chemoreceptors 
B)  Gamma-efferent system 
C)  Muscle spindle fibers 
D)  Proprioceptors

Question 7

Which of the following centers responds more strongly to high levels of CO2?

Accepted Answer

A)  Aortic chemoreceptors 
B)  Carotid chemoreceptors 
C)  Central chemoreceptors 
D)  Ventral respiratory centers 
A)  Aortic chemoreceptors 
B)  Carotid chemoreceptors 
C)  Central chemoreceptors 
D)  Ventral respiratory centers

Question 8

What reflex is associated with the sensory stimulation of the pulmonary stretch receptors that stimulate a deeper breath upon inspiration?

Accepted Answer

A)  Carotid 
B)  Head's paradoxical 
C)  Hering-Breuer 
D)  J receptor 
A)  Carotid 
B)  Head's paradoxical 
C)  Hering-Breuer 
D)  J receptor

Question 9

A patient in the emergency room is displaying prolong inspiratory gasps interrupted by occasional expirations, what serious injury should be suspected on this patient?
1) Pneumotaxic center has been severed.
2) Vagus nerve has been severed.
3) Glossopharyngeal nerve has been severed.

Accepted Answer

A) 2 and 3 only 
B) 1 and 2 only 
C) 1 and 3 only 
D) 1, 2, and 3 
A) 2 and 3 only 
B) 1 and 2 only 
C) 1 and 3 only 
D) 1, 2, and 3

Question 10

In the face of hyperoxia, what is the response of the peripheral chemoreceptors to hypercapnia?

Accepted Answer

A)  There is a decreased drive to breathe. 
B)  There is an increased drive to breathe. 
C)  There is insufficient information. 
D)  There is virtually no response. 
A)  There is a decreased drive to breathe. 
B)  There is an increased drive to breathe. 
C)  There is insufficient information. 
D)  There is virtually no response.

Question 11

Why does splashing cold water on the skin stimulate ventilation?

Accepted Answer

A)  It decreases medullary inspiratory activity causing hyperpnea. 
B)  Hering-Breuer inflation reflex. 
C)  It increases medullary inspiratory activity causing hyperpnea. 
D)  J receptor. 
A)  It decreases medullary inspiratory activity causing hyperpnea. 
B)  Hering-Breuer inflation reflex. 
C)  It increases medullary inspiratory activity causing hyperpnea. 
D)  J receptor.

Question 12

Adjustment of respiratory muscle contractions to accommodate varying loads is regulated by which of the following?

Accepted Answer

A)  Medullary respiratory centers 
B)  Muscle spindle fiber feedback 
C)  Pontine apneustic center 
D)  Pontine pneumotaxic center 
A)  Medullary respiratory centers 
B)  Muscle spindle fiber feedback 
C)  Pontine apneustic center 
D)  Pontine pneumotaxic center

Question 13

Which of the following will occur during even strenuous exercise in a normal healthy individual?

Accepted Answer

A)  Blood gases remain stable. 
B)  The arterial PCO2 rises. 
C)  The arterial pH falls. 
D)  The arterial PO2 falls. 
A)  Blood gases remain stable. 
B)  The arterial PCO2 rises. 
C)  The arterial pH falls. 
D)  The arterial PO2 falls.

Question 14

Coexisting arterial hypoxemia, acidemia, and high PaCO2 (i.e., asphyxia) will have what effect on the peripheral chemoreceptors?

Accepted Answer

A)  There is a decreased drive to breathe. 
B)  There is a maximally increased drive to breathe. 
C)  There is insufficient information to make a determination. 
D)  There is virtually no response. 
A)  There is a decreased drive to breathe. 
B)  There is a maximally increased drive to breathe. 
C)  There is insufficient information to make a determination. 
D)  There is virtually no response.

Question 15

A healthy 33-year-old woman relocates to an area approximately 8000 ft above sea level. On her first day, she begins to hyperventilate, but in 24 hr she shows signs of recovery. What is the probable cause of her condition?

Accepted Answer

A)  Hypoxemia-mediated hyperventilation 
B)  Hypercapnia 
C)  Hyperoxia-mediated hyperventilation 
D)  Increased H+ 
A)  Hypoxemia-mediated hyperventilation 
B)  Hypercapnia 
C)  Hyperoxia-mediated hyperventilation 
D)  Increased H+

Question 16

What receptors cause a rapid shallow breathing pattern when stimulated by pulmonary disease?

Accepted Answer

A)  Irritant receptors 
B)  J receptors 
C)  Muscle spindles 
D)  Peripheral proprioceptors 
A)  Irritant receptors 
B)  J receptors 
C)  Muscle spindles 
D)  Peripheral proprioceptors

Question 17

What centers are located in the pons of the brainstem?
1) Apneustic center
2) Dorsal respiratory neurons
3) Pneumotaxic center

Accepted Answer

A) 1, 2, and 3 
B) 2 and 3 only 
C) 1 and 3 only 
D) 1 and 2 only 
A) 1, 2, and 3 
B) 2 and 3 only 
C) 1 and 3 only 
D) 1 and 2 only

Question 18

How should O2 therapy be administered to chronically hypercapnic patients?

Accepted Answer

A)  Avoid giving any supplemental O2. 
B)  Give as much O2 as possible (60% to 100%). 
C)  Withhold O2 until the patient is intubated. 
D)  Give as much O2 as required to maintain adequate oxygenation. 
A)  Avoid giving any supplemental O2. 
B)  Give as much O2 as possible (60% to 100%). 
C)  Withhold O2 until the patient is intubated. 
D)  Give as much O2 as required to maintain adequate oxygenation.

Question 19

What stimulates the Hering-Breuer inflation reflex?

Accepted Answer

A)  The DRG when it is time to end inspiratory efforts. 
B)  The stretch of receptors at high lung volumes. 
C)  The VRG when it is time for inspiration. 
D)  Very low lung volumes stimulate inspiration. 
A)  The DRG when it is time to end inspiratory efforts. 
B)  The stretch of receptors at high lung volumes. 
C)  The VRG when it is time for inspiration. 
D)  Very low lung volumes stimulate inspiration.

Question 20

Failure to switch off the brainstem inspiratory neurons can result in which of the following?

Accepted Answer

A)  Apnea 
B)  Apneustic breathing 
C)  Biot's breathing 
D)  Cheyne-Stokes breathing 
A)  Apnea 
B)  Apneustic breathing 
C)  Biot's breathing 
D)  Cheyne-Stokes breathing

Exam 15: Regulation of Breathing

Why does it take approximately 24 hr for a full ventilatory response to develop to acute hypoxemia?

The medulla oblongata contains which of the following areas? 1) Apneustic center 2) Dorsal respiratory group neurons (DRGs) 3) Pneumotaxic center 4) Ventral respiratory group neurons (VRGs)

To which anatomic structures do the ventral respiratory centers send motor signals during inspiration? 1) Diaphragm 2) Larynx 3) Pharynx 4) Sternocleidomastoids

In what manner would O2 therapy induce worsening mismatch and thus a further elevation in CO2 in a chronically hypercapnic patient?

What group of nerve cells senses and responds to changes in the chemical composition of its fluid environment?

Which of the following centers responds more strongly to high levels of CO2?

What reflex is associated with the sensory stimulation of the pulmonary stretch receptors that stimulate a deeper breath upon inspiration?

A patient in the emergency room is displaying prolong inspiratory gasps interrupted by occasional expirations, what serious injury should be suspected on this patient? 1) Pneumotaxic center has been severed. 2) Vagus nerve has been severed. 3) Glossopharyngeal nerve has been severed.

In the face of hyperoxia, what is the response of the peripheral chemoreceptors to hypercapnia?

Why does splashing cold water on the skin stimulate ventilation?

Adjustment of respiratory muscle contractions to accommodate varying loads is regulated by which of the following?

Which of the following will occur during even strenuous exercise in a normal healthy individual?

Coexisting arterial hypoxemia, acidemia, and high PaCO2 (i.e., asphyxia) will have what effect on the peripheral chemoreceptors?

A healthy 33-year-old woman relocates to an area approximately 8000 ft above sea level. On her first day, she begins to hyperventilate, but in 24 hr she shows signs of recovery. What is the probable cause of her condition?

What receptors cause a rapid shallow breathing pattern when stimulated by pulmonary disease?

What centers are located in the pons of the brainstem? 1) Apneustic center 2) Dorsal respiratory neurons 3) Pneumotaxic center

How should O2 therapy be administered to chronically hypercapnic patients?

What stimulates the Hering-Breuer inflation reflex?

Failure to switch off the brainstem inspiratory neurons can result in which of the following?

History of Respiratory Care

Delivering Evidence-Based Respiratory Care

Quality, Patient Safety, and Communication, and Recordkeeping

Principles of Infection Prevention and Control

Ethical and Legal Implications of Practice

Physical Principles of Respiratory Care

E-Medicine in Respiratory Care

Fundamentals of Respiratory Care Research

The Respiratory System

The Cardiovascular System

Ventilation

Gas Exchange and Transport

Solutions, Body Fluids, and Electrolytes

Acid-Base Balance

Bedside Assessment of the Patient

Interpreting Clinical and Laboratory Data

Interpreting the Electrocardiogram

Analysis and Monitoring of Gas Exchange

Pulmonary Function Testing

Review of Thoracic Imaging

Flexible Bronchoscopy and the Respiratory Therapist

Nutrition Assessment

Pulmonary Infections

Obstructive Lung Disease: Chronic Obstructive Pulmonary Disease Copd, Asthma, and Related Diseases

Interstitial Lung Disease

Pleural Diseases

Pulmonary Vascular Disease

Acute Respiratory Distress Syndrome

Trauma, Burns and Near Drowning

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

Aerosol Drug Therapy

Storage and Delivery of Medical Gases

Medical Gas Therapy

Lung Expansion Therapy

Airway Clearance Therapy Act

Respiratory Failure and the Need for Ventilatory Support

Mechanical Ventilators

Physiology of Ventilatory Support

Patient Ventilator Interaction

Initiating and Adjusting Invasive Ventilatory Support

Noninvasive Ventilation

Extracorporeal Life Support Ecls

Monitoring 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

In what manner would O₂ therapy induce worsening mismatch and thus a further elevation in CO₂ in a chronically hypercapnic patient?

Which of the following centers responds more strongly to high levels of CO₂?

Coexisting arterial hypoxemia, acidemia, and high PaCO₂ (i.e., asphyxia) will have what effect on the peripheral chemoreceptors?

How should O₂ therapy be administered to chronically hypercapnic patients?