Question 1

When using a small-bore catheter with a one-way valve such as a Heimlich valve, how can you determine definitively that there is or is not a small air leak?

Accepted Answer

A)  Connect to an underwater seal. 
B)  Increase the FiO2 and note clinical changes. 
C)  Listen for air movement. 
D)  Watch the valve to see if it moves. 
A)  Connect to an underwater seal. 
B)  Increase the FiO2 and note clinical changes. 
C)  Listen for air movement. 
D)  Watch the valve to see if it moves. A

Question 2

Which of the following findings on a radiologic report would indicate the presence of a tension pneumothorax?

Accepted Answer

A)  Bilateral inversion of diaphragm, long narrow heart, and flattened ribs 
B)  Blunting of costophrenic angles, marked interstitial infiltrates, and apical free air 
C)  Contralateral mediastinal shift, diaphragmatic depression, and flattening of ribs 
D)  Ipsilateral mediastinal shift, sail-shape noted right hemithorax, and marked interstitial infiltrates right sided 
A)  Bilateral inversion of diaphragm, long narrow heart, and flattened ribs 
B)  Blunting of costophrenic angles, marked interstitial infiltrates, and apical free air 
C)  Contralateral mediastinal shift, diaphragmatic depression, and flattening of ribs 
D)  Ipsilateral mediastinal shift, sail-shape noted right hemithorax, and marked interstitial infiltrates right sided C

Question 3

What is the primary tool used to diagnose a pneumothorax?

Accepted Answer

A)  Chest radiography 
B)  Computed tomography 
C)  PET scan 
D)  scanning 
A)  Chest radiography 
B)  Computed tomography 
C)  PET scan 
D)  scanning A

Question 4

Which of the following medications is known to cause drug-induced pleural disease?
1) Bleomycin
2) Amiodarone
3) Advair
4) Vilanterol

Accepted Answer

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

Question 5

Which of the following are typical complications of thoracentesis?
1) Infection
2) Intercostal artery laceration
3) Rib fracture
4) Pneumothorax

Accepted Answer

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

Question 6

Describe a secondary spontaneous pneumothorax.

Accepted Answer

A)  Pneumothorax that occurs secondary to cardiac complications 
B)  Pneumothorax that occurs without trauma or any underlying disease 
C)  Pneumothorax that results from nonpenetrating chest trauma 
D)  Pneumothorax that results from underlying lung disease 
A)  Pneumothorax that occurs secondary to cardiac complications 
B)  Pneumothorax that occurs without trauma or any underlying disease 
C)  Pneumothorax that results from nonpenetrating chest trauma 
D)  Pneumothorax that results from underlying lung disease

Question 7

What anatomical position is most likely to show the presence of a small pleural effusion in the upright chest radiograph?

Accepted Answer

A)  Apical regions 
B)  Costophrenic angles 
C)  Fissures 
D)  Subdiaphragmatic region 
A)  Apical regions 
B)  Costophrenic angles 
C)  Fissures 
D)  Subdiaphragmatic region

Question 8

At what anatomic position should an 18-gauge IV catheter be placed to relieve a tension pneumothorax?

Accepted Answer

A)  Just inferior to the second rib 
B)  Just inferior to the third rib 
C)  Just superior to the second rib 
D)  Just superior to the fourth rib 
A)  Just inferior to the second rib 
B)  Just inferior to the third rib 
C)  Just superior to the second rib 
D)  Just superior to the fourth rib

Question 9

What is the most common cause of a chylothorax?

Accepted Answer

A)  Chest trauma 
B)  Malignancy 
C)  Pulmonary embolism 
D)  Surgery 
A)  Chest trauma 
B)  Malignancy 
C)  Pulmonary embolism 
D)  Surgery

Question 10

Pleural fluid with a total protein concentration of less than ____________ of the serum total protein level is one of the indications of transudative pleural effusion.

Accepted Answer

A)  20% 
B)  30% 
C)  40% 
D)  50% 
A)  20% 
B)  30% 
C)  40% 
D)  50%

Question 11

What is the most likely cause of a large unilateral pleural effusion in a 70-year-old patient?

Accepted Answer

A)  Congestive heart failure 
B)  Malignancy 
C)  Pneumonia 
D)  Tuberculosis 
A)  Congestive heart failure 
B)  Malignancy 
C)  Pneumonia 
D)  Tuberculosis

Question 12

What is the most common cause of pleural effusion in the clinical setting?

Accepted Answer

A)  Acute renal failure 
B)  Congestive heart failure 
C)  Liver disease 
D)  Lung cancer 
A)  Acute renal failure 
B)  Congestive heart failure 
C)  Liver disease 
D)  Lung cancer

Question 13

Which of the following statements about pleural fluid is false?

Accepted Answer

A)  Fluid can move easily between each hemithorax. 
B)  Normal protein concentration is between 1.3 and 1.4 g/dl. 
C)  The total volume is approximately 16 ml. 
D)  Total protein concentration is similar to that of interstitial fluid elsewhere in the body. 
A)  Fluid can move easily between each hemithorax. 
B)  Normal protein concentration is between 1.3 and 1.4 g/dl. 
C)  The total volume is approximately 16 ml. 
D)  Total protein concentration is similar to that of interstitial fluid elsewhere in the body.

Question 14

What diagnostic procedure or technique is most sensitive for the identification of pleural effusion?

Accepted Answer

A)  Chest radiography 
B)  Computed tomography 
C)  Pleurodesis 
D)  Thoracoscopy 
A)  Chest radiography 
B)  Computed tomography 
C)  Pleurodesis 
D)  Thoracoscopy

Question 15

What is the primary risk factor associated with spontaneous pneumothoraces?

Accepted Answer

A)  Cigarette smoking 
B)  Heavy exercise 
C)  Obesity 
D)  Urban living 
A)  Cigarette smoking 
B)  Heavy exercise 
C)  Obesity 
D)  Urban living

Question 16

Forty-eight hours after the chest tube insertion Ms. Paul remains on mechanical ventilation. While assessing the chest tube system, you note small bubbles in the water seal chamber generated during peak inspiration. This is an indication of which of the following:

Accepted Answer

A)  normal functioning of the water seal chamber. 
B)  bronchopleural fistula. 
C)  low water level in the chamber. 
D)  high suction pressure from the suction chamber. 
A)  normal functioning of the water seal chamber. 
B)  bronchopleural fistula. 
C)  low water level in the chamber. 
D)  high suction pressure from the suction chamber.

Question 17

For which type of pneumothorax is pleurodesis most commonly indicated?

Accepted Answer

A)  Iatrogenic 
B)  Bronchopleural fistula 
C)  Spontaneous 
D)  Traumatic 
A)  Iatrogenic 
B)  Bronchopleural fistula 
C)  Spontaneous 
D)  Traumatic

Question 18

What is the most common cause of pleural effusion that occurs due to lymphatic obstruction within the mediastinum?

Accepted Answer

A)  Cancer that has metastasized to the mediastinum 
B)  Hepatic hydrothorax 
C)  Malignant pleural effusion 
D)  Tuberculous pleurisy 
A)  Cancer that has metastasized to the mediastinum 
B)  Hepatic hydrothorax 
C)  Malignant pleural effusion 
D)  Tuberculous pleurisy

Question 19

What are the functions of a chest tube in a patient with chest trauma that causes bleeding and pneumothorax?
1) To measure the rate of bleeding
2) To improve ventilation
3) To allow lung reexpansion
4) To allow for application of bleeding control medication

Accepted Answer

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

Question 20

What underlying lung disease is most often present in a patient with secondary spontaneous pneumothorax?

Accepted Answer

A)  Asthma 
B)  Chronic obstructive pulmonary disease (COP
D)  
C)  Interstitial pulmonary fibrosis 
D)  Pneumonia 
A)  Asthma 
B)  Chronic obstructive pulmonary disease (COP
D)  
C)  Interstitial pulmonary fibrosis 
D)  Pneumonia

Exam 27: Pleural Diseases

When using a small-bore catheter with a one-way valve such as a Heimlich valve, how can you determine definitively that there is or is not a small air leak?

Which of the following findings on a radiologic report would indicate the presence of a tension pneumothorax?

What is the primary tool used to diagnose a pneumothorax?

Which of the following medications is known to cause drug-induced pleural disease? 1) Bleomycin 2) Amiodarone 3) Advair 4) Vilanterol

Which of the following are typical complications of thoracentesis? 1) Infection 2) Intercostal artery laceration 3) Rib fracture 4) Pneumothorax

Describe a secondary spontaneous pneumothorax.

What anatomical position is most likely to show the presence of a small pleural effusion in the upright chest radiograph?

At what anatomic position should an 18-gauge IV catheter be placed to relieve a tension pneumothorax?

What is the most common cause of a chylothorax?

Pleural fluid with a total protein concentration of less than ____________ of the serum total protein level is one of the indications of transudative pleural effusion.

What is the most likely cause of a large unilateral pleural effusion in a 70-year-old patient?

What is the most common cause of pleural effusion in the clinical setting?

Which of the following statements about pleural fluid is false?

What diagnostic procedure or technique is most sensitive for the identification of pleural effusion?

What is the primary risk factor associated with spontaneous pneumothoraces?

Forty-eight hours after the chest tube insertion Ms. Paul remains on mechanical ventilation. While assessing the chest tube system, you note small bubbles in the water seal chamber generated during peak inspiration. This is an indication of which of the following:

For which type of pneumothorax is pleurodesis most commonly indicated?

What is the most common cause of pleural effusion that occurs due to lymphatic obstruction within the mediastinum?

What are the functions of a chest tube in a patient with chest trauma that causes bleeding and pneumothorax? 1) To measure the rate of bleeding 2) To improve ventilation 3) To allow lung reexpansion 4) To allow for application of bleeding control medication

What underlying lung disease is most often present in a patient with secondary spontaneous pneumothorax?

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

Regulation of Breathing

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

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

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