1. Which of the following diseases is not commonly classified under obstructive lung disease?
Chronic Obstructive Pulmonary Disease (COPD)
Asthma
Bronchiectasis
Pulmonary Fibrosis: Pulmonary Fibrosis
Final Exam Critical Care Fall 2024
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1. Which of the following diseases is not commonly classified under obstruc-
tive lung disease?
Chronic Obstructive Pulmonary Disease (COPD)
Asthma
Bronchiectasis
Pulmonary Fibrosis: Pulmonary Fibrosis
2. The respiratory therapist in the ICU is called to assess a patient with ARDS.
The patient is SOB. The x-ray shows "white" chest radiograph and the PAO2
is 60 mm Hg on an FiO2 of 100%. Which of the following is indicated?
Shunting
Alveolar hyperventilation
Decreased CO2
Perfusion impairment: Shunting
3. Which of the following are causes of hypoxemia?
1. Ventilation/perfusion (V/Q) mismatch
2. Alveolar hypoventilation
3. Diffusion impairment
4. Increased inspired O2: 1,2, and 3 only
4. Which of the following patients are at greatest risk for developing
auto-PEEP during mechanical ventilation?
Those with acute lung injury
Those with COPD
Those with congestive heart failure
Those with bilateral pneumonia: Those with COPD
5. In intubated patients, what do sources of increased imposed work of breath-
ing include?
1. Endotracheal tube
2. Ventilator circuit
3. Auto-PEEP: 1,2 and 3
6. A patient with a 10-year history of chronic bronchitis and an acute viral
pneumonia exhibits the following blood gas results breathing room air: pH =
7.22; PCO2 = 67; HCO3- = 26; PO2 = 60. Which of the following best describes
this patient's condition?
Chronic hypoxemic respiratory failure
Acute hypercapnic respiratory failure
Chronic hypercapnic respiratory failure
Acute hypoxemic respiratory failure: Acute hypercapnic respiratory failure
7. What is the normal range for PaO2/FiO2?
Option 1
, Final Exam Critical Care Fall 2024
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350 to 450
250 to 350
150 to 250
75 to 150: 350 to 450
8. You determine that an acutely ill patient can generate an MIP of -18 cm H2O.
Based on this information, what might you conclude?
The patient has inadequate respiratory muscle strength.
The patient has inadequate alveolar ventilation.
The patient has an excessive work of breathing
The patient has an unstable or irregular ventilatory drive.: The patient has
inadequate respiratory muscle strength.
9. Which of the following MIP measures taken on an adult patient indicates
inadequate respiratory muscle strength?
-90 cm H2O
-70 cm H2O
-40 cm H2O
-15 cm H2O: -15 cm H2O
10. A need for some form of ventilatory support is usually indicated when an
adult's rate of breathing rises above what level?
35/min
30/min
25/min
20/min: 35/min
11. Mr. Adam is in the ICU on an FiO2 of 100%. An arterial blood gas reveals
the following information: pH of 7.18, PaCO2 of 59 mm Hg, PaO2 of 65 mm Hg,
HCO3 of 24 mEq/L What action would you recommend?
Provide ventilatory support.
Put the patient on steroids.
Give patient chest PT.
Put the patient on CPAP: Provide ventilatory support.
12. In patients suffering from acute respiratory acidosis, below what pH level
are intubation and ventilatory support generally considered?
7.2
7.3
7.1
7.0: 7.2
13. Which of the following is the cardinal sign of increased work of breathing?
Hyperventilation
Retractions
, Final Exam Critical Care Fall 2024
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Bradycardia
Tachypnea: Retractions
14. Which of the following information best helps to distinguish chronic hyper-
capnic respiratory failure from acute hypercapnic respiratory failure?
Long-standing dyspnea that worsens on exertion
Forced expiratory volume in 1 sec to forced vital capacity ratio (FEV1/FVC) of
less than 75% predicted
Kidneys retain bicarbonate to elevate the blood pH
Physical signs of hypoxemia, such as cyanosis and clubbing: Kidneys retain
bicarbonate to elevate the blood pH
15. Which of the following is a feature of Guillain-Barré?
Ascending muscle weakness
Descending muscle weakness
Limited to lower extremities
Limited to trunk: Ascending muscle weakness
16. Which of the following are associated with hypercapnic respiratory failure
due to respiratory muscle weakness or fatigue?
1. Hyperthyroidism
2. Myasthenia gravis
3. Amyotrophic lateral sclerosis
4. Guillain-Barré syndrome: 2,3, and 4 only
17. A patient with an opiate drug overdose is unconscious and exhibits the
following blood gas results breathing room air: pH = 7.19; PCO2 = 89; HCO3-
= 27; PO2 = 48. Which of the following best describes this patient's condition?
Chronic hypoxemic respiratory failure
Chronic hypercapnic respiratory failure
Acute hypoxemic respiratory failure
Acute hypercapnic respiratory failure: Acute hypercapnic respiratory failure
18. What is the optimal treatment of intrapulmonary shunt?
Increase the FiO2.
Decrease the FiO2.
Surgery.
Alveolar recruitment.: Alveolar recruitment.
19. What is the normal P(A-a)O2 range while breathing room air?
25 to 50 mm Hg
10 to 25 mm Hg
Greater than 25 mm Hg
Less than 10 mm Hg: 10 to 25 mm Hg
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