Question 1

A 14-year-old patient has had a serious asthma attack. Her white blood cell count can be expected to show:
A) decreased neutrophils.
B) decreased erythrocytes.
C) increased eosinophils.
D) increased monocytes.

Accepted Answer

Increased eosinophils are commonly associated with asthma and allergic reactions, reflecting an immune response.

Question 2

The respiratory therapist is caring for a patient with a newly diagnosed pleural lesion. The patient cannot undergo a CT scan due to extreme claustrophobia. Which procedure can be performed to diagnose the cause of the lesion?
A) Video-assisted thoracoscopy surgery
B) Navigational bronchoscopy
C) Therapeutic bronchoscopy
D) Acid-fast smear

Accepted Answer

Video-assisted thoracoscopy surgery (VATS) is a minimally invasive surgical technique that allows for the examination of the pleura and can be used to diagnose the cause of a pleural lesion. It is an alternative for patients who cannot undergo a CT scan due to claustrophobia or other reasons.

Question 3

Culture and sensitivity tests:
A) stain a microorganism as gram positive or gram negative.
B) determine the shape of the organisms present.
C) identify the DNA of organisms present in the sputum.
D) determine the antibiotic(s) best suited for combating an infection.

Accepted Answer

Culture and sensitivity tests are used to identify the most effective antibiotics to treat an infection by exposing the bacteria to various antibiotics and observing their responses.

Question 4

Therapeutic bronchoscopy can be used for:
1) bronchiectasis therapy.
2) removal of a foreign body.
3) selective lavage.
4) management of life-threatening hemoptysis.
A)1, 3
B)1, 2, 4
C)2, 3, 4
D)1, 2, 3

Accepted Answer

Therapeutic bronchoscopy is a versatile tool used for various interventions in the respiratory system. It can be used for the removal of foreign bodies from the airways, which is a direct and often life-saving intervention. Selective lavage, which involves washing out parts of the lung, can be performed for various conditions, including to clear mucus plugs or treat certain infections. Management of life-threatening hemoptysis, or coughing up blood, is another critical use of therapeutic bronchoscopy, as it can help identify the source of bleeding and apply treatments such as cold saline, epinephrine, or other methods to stop the bleeding. However, while bronchoscopy can be used to diagnose bronchiectasis and assess its severity, it is not typically used as a therapy for bronchiectasis itself, which is managed through other medical and physical therapies aimed at clearing mucus and preventing infections.

Question 5

The respiratory therapist is reviewing the electronic medical record of a patient recently admitted to the medical floor. The therapist notes that a sputum sample was sent to the lab for an acid-fast smear and culture. How should the therapist interpret this information?
A) Suspect that the patient has Mycoplasma pneumoniae pneumonia.
B) Suspect that the patient has Rickettsiae pneumonia.
C) Suspect that the patient has Pneumocystis jiroveci (carinii) pneumonia.
D) Suspect that the patient has Mycobacterium tuberculosis pneumonia.

Accepted Answer

An acid-fast smear and culture is a diagnostic test specifically used to identify acid-fast bacilli, such as Mycobacterium tuberculosis, which causes tuberculosis (TB). This test is not used for detecting organisms like Mycoplasma pneumoniae, Rickettsiae, or Pneumocystis jiroveci, which cause different types of pneumonia.

Question 6

Gram staining is done to:
1) classify organisms as gram positive or gram negative.
2) identify tuberculosis organisms.
3) speed up the organism culturing process.
4) help guide antibiotic therapy.
A)3
B)1, 4
C)2, 3
D)1, 2, 4

Accepted Answer

Gram staining is a method used to differentiate bacterial species into two large groups (Gram-positive and Gram-negative) based on the physical properties of their cell walls. This differentiation helps in guiding antibiotic therapy, as Gram-positive and Gram-negative bacteria can respond differently to antibiotics. It does not directly speed up culturing processes or identify tuberculosis organisms, which are better identified using acid-fast staining.

Question 7

Which of the following are primary reasons for which an endobronchial ultrasound (EBUS) is recommended?
1) To detect the presence of tumors or pathologically enlarged lymph nodes
2) To diagnose stridor or localized wheezing
3) To diagnose tumors within the lung or mediastinum
4) To diagnose lymph node abnormalities in the mediastinum or hila
A)1, 2
B)2, 3
C)1, 3, 4
D)2, 3, 4

Accepted Answer

Endobronchial ultrasound (EBUS) is primarily recommended for detecting tumors or pathologically enlarged lymph nodes, diagnosing tumors within the lung or mediastinum, and diagnosing lymph node abnormalities in the mediastinum or hila. It allows for real-time imaging and biopsy of the lung, mediastinum, and lymph nodes, making it a valuable tool in the diagnosis and staging of lung cancer and other diseases affecting these areas.

Question 8

In a normal differential white blood cell (WBC) count, which of the following would have the highest number?
A) Neutrophils
B) Basophils
C) Eosinophils
D) Lymphocytes

Accepted Answer

Neutrophils typically make up the highest percentage of white blood cells in a differential count, usually ranging from 40% to 60% of the total WBC count in healthy adults.

Question 9

The respiratory therapist is caring for a patient who is receiving diuretic therapy as part of the medication regimen for her congestive heart failure. Which of the following would the therapist most likely monitor in watching for common side effects associated with diuretic therapy?
A) Hypokalemia
B) Hyperchloremia
C) Hyperbilirubinemia
D) Hyponatremia

Accepted Answer

Diuretics can lead to the loss of potassium, causing hypokalemia, which is a common side effect.

Question 10

A patient has pneumonia and a right pleural effusion. If the pleural exudate fluid is infected, it will show:
1) a low protein level.
2) a high white blood cell count.
3) bacteria.
4) many red blood cells.
A)1, 2
B)2, 3
C)1, 3, 4
D)2, 3, 4

Accepted Answer

When the pleural exudate fluid is infected, it typically shows a high white blood cell count and the presence of bacteria, indicating an infection such as empyema.

Question 11

After a thoracentesis procedure, it is important to monitor the patient for:
A) bronchospasm.
B) hemoptysis.
C) increased blood urea nitrogen (BUN).
D) pneumothorax.

Accepted Answer

Pneumothorax is a potential complication of thoracentesis, where air can enter the pleural space, causing lung collapse. Monitoring for signs of pneumothorax is crucial after the procedure.

Question 12

For blood urea nitrogen (BUN) and creatinine values:
A) serum creatinine is a protein produced in the kidneys.
B) BUN and serum creatinine values that are higher than the normal range indicate renal failure.
C) urea is a waste product of carbohydrate metabolism in the intestines.
D) BUN values that are below normal indicate renal failure.

Accepted Answer

BUN and serum creatinine are waste products filtered out of the blood by the kidneys. Elevated levels of these substances can indicate that the kidneys are not functioning properly, which is a sign of renal failure. Serum creatinine is actually a waste product of muscle metabolism, not produced in the kidneys. Urea is a waste product of protein metabolism, not carbohydrate metabolism. Lastly, BUN values that are below normal do not typically indicate renal failure; instead, they might be associated with other conditions, such as liver disease or malnutrition.

Question 13

Diagnostic thoracentesis can be used to:
A) withdraw a secretion sample from the lung for a sputum smear.
B) withdraw a secretion sample from the lung for a Gram stain.
C) determine the etiology of a pleural effusion.
D) remove air from the pleural space.

Accepted Answer

Diagnostic thoracentesis is a procedure used to remove fluid from the space between the lungs and the chest wall (pleural space) to analyze it and determine the cause of a pleural effusion.

Question 14

In response to a viral infection, which of the following can be expected to be seen in the white blood cell count?
A) Increased lymphocytes
B) Decreased monocytes
C) Increased basophils
D) Decreased platelets

Accepted Answer

Increased lymphocytes are typically observed in response to viral infections as part of the immune response.

Quiz 9: Other Important Tests and Procedures

A 14-year-old patient has had a serious asthma attack. Her white blood cell count can be expected to show:

The respiratory therapist is caring for a patient with a newly diagnosed pleural lesion. The patient cannot undergo a CT scan due to extreme claustrophobia. Which procedure can be performed to diagnose the cause of the lesion?

Culture and sensitivity tests:

Therapeutic bronchoscopy can be used for: 1) bronchiectasis therapy. 2) removal of a foreign body. 3) selective lavage. 4) management of life-threatening hemoptysis.

The respiratory therapist is reviewing the electronic medical record of a patient recently admitted to the medical floor. The therapist notes that a sputum sample was sent to the lab for an acid-fast smear and culture. How should the therapist interpret this information?

Gram staining is done to: 1) classify organisms as gram positive or gram negative. 2) identify tuberculosis organisms. 3) speed up the organism culturing process. 4) help guide antibiotic therapy.

In a normal differential white blood cell (WBC) count, which of the following would have the highest number?

The respiratory therapist is caring for a patient who is receiving diuretic therapy as part of the medication regimen for her congestive heart failure. Which of the following would the therapist most likely monitor in watching for common side effects associated with diuretic therapy?

A patient has pneumonia and a right pleural effusion. If the pleural exudate fluid is infected, it will show: 1) a low protein level. 2) a high white blood cell count. 3) bacteria. 4) many red blood cells.

After a thoracentesis procedure, it is important to monitor the patient for:

For blood urea nitrogen (BUN) and creatinine values:

Diagnostic thoracentesis can be used to:

In response to a viral infection, which of the following can be expected to be seen in the white blood cell count?