Question 1

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

Normally, there are 60% to 70% neutrophils in a WBC count. Fewer basophils, lymphocytes, eosinophils, and other WBC types will be seen.

Question 2

The respiratory therapist is called to evaluate a patient for arterial line placement needed for accessibility and repeated ABG sampling. In evaluating the risk of bleeding, the therapist should establish that the patient has a platelet count of at least ____/mm³ before recommending placement of the arterial line.
A) 1,000
B) 10,000
C) 20,000
D) 50,000
E) 100,000

Accepted Answer

Generally, platelet counts greater than 50,000/mm³ are not associated with spontaneous bleeding. Therefore, various diagnostic or therapeutic procedures, such as bronchoscopy or the insertion of an arterial catheter, are usually safe when the platelet count is greater than 50,000/mm³.

Question 3

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

Because a needle has to be inserted through the chest wall to perform a thoracentesis, pneumothorax is a possible complication. Bronchoscopy could cause bronchospasm or hemoptysis. Increased BUN is associated with kidney failure.

Question 4

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

Hypokalemia is a side effect of diuretic therapy.

Question 5

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 will be seen in response to a viral infection. Monocytes and basophils will increase with a bacterial infection. Platelets are involved in blood clotting.

Question 6

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) 1, 2, 3, 4

Accepted Answer

Infected pleural exudate fluid will show a high white blood cell count and bacteria among other characteristic findings. A transudate will have a low protein level and other characteristic findings. Many red blood cells would indicate a pulmonary embolism.

Question 7

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

The acid-fast smear and culture is performed to determine the presence of acid-fast bacilli (e.g., Mycobacterium tuberculosis). Acid-fast testing is used specifically for Mycobacterium tuberculosis, not any of the other listed microorganisms.

Question 8

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 creatinine values will increase with renal failure. All of the other statements are false.

Question 9

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 actively grow bacteria to determine the antibiotic(s) best suited for combating an infection. The Gram stain procedure is used to classify bacteria as gram positive or gram negative. Microscopic examination is needed to identify the organism's shape. DNA analysis requires special laboratory capabilities.

Question 10

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

After an asthma attack, there will be an increased eosinophil count. The other types of white blood cells will be increased with a bacterial infection.

Question 11

Therapeutic bronchoscopy is used for all of the following EXCEPT:
A) to remove a foreign body.
B) in selective lavage.
C) in bronchiectasis evaluation.
D) to manage life-threatening hemoptysis.

Accepted Answer

Bronchoscopy can be used to observe a patient's airways for bronchiectasis evaluation. However, this is not a therapeutic procedure to treat the condition. All of the other listed options are therapeutically managed by bronchoscopy.

Question 12

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

After the pleural effusion fluid is analyzed, the physician will know its etiology. Then the proper treatment can be done. Bronchoscopy is done to get a secretion sample from the airways. Therapeutic thoracentesis is done to remove air from the pleural space.

Question 13

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, 3, 4

Accepted Answer

Gram staining is done to classify organisms as gram positive or gram negative. Often this will help to guide the selection of an antibiotic until the culture and sensitivity results confirm the best drug.

Quiz 8: Other Important Tests and Procedures

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

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

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?

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

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.

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?

For blood urea nitrogen (BUN) and creatinine values:

Culture and sensitivity tests:

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

Therapeutic bronchoscopy is used for all of the following EXCEPT:

Diagnostic thoracentesis can be used to:

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.