KETTERING TMC UPDATED TEST PAPER
QUESTIONS AND ANSWERS SURE A+
✔✔Eupnea - ✔✔normal breathing
✔✔tachypnea - ✔✔fast RR
conditions: fever, hypoxia, pain, CNS problems
✔✔bradypnea - ✔✔slow RR
conditions: sleep (normal), drugs, alcohol, metabolic alkalosis
✔✔Gradually increase then decreasing rate and depth in a cycle lasting from 30-180
seconds *fast slow period of apnea*
*condition*: increased IC pressure, brainstem injury, drug overdose - ✔✔cheyne stokes
✔✔increased respiratory rate and depth with irregular periods of apnea. Each breath
has the same depth *fast irregular w/ apnea*
*Cause: CNS problem* - ✔✔biots breathing
✔✔gasping, labored breathing, also called air hunger
*condition*: hypoxemia, metabolic acidosis, renal failure, diabetic ketoacidosis -
✔✔Kussmaul breathing
✔✔hypertrophy - ✔✔increased [muscle] size
think COPD
✔✔atrophy - ✔✔decreased [muscle] size
think paralysis
✔✔tList 4 changes to a *patient's upper airway* that complicates airway patency
#1 - ✔✔tracheal shift deviation
,✔✔List 4 changes to a *patient's upper airway* that complicates airway patency
#2 - ✔✔bull neck
✔✔List 4 changes to a *patient's upper airway* that complicates airway patency
#3 - ✔✔large tongue (macroglossia)
✔✔List 4 changes to a *patient's upper airway* that complicates airway patency
#4 - ✔✔short mandible
✔✔class 1 - ✔✔mallampati Class -
soft palate, uvula, fauces, pillars visible
✔✔class 2 - ✔✔mallampati class -
soft palate, uvula, fauces visible
✔✔class 3 - ✔✔mallampati class -
soft palate, base of uvula visible
✔✔class 4 - ✔✔mallampati class -
hard palate only visible
✔✔mallampati class - and - are considered *difficult airways and require the use of a
*fiberoptic bronchoscope or a video assist device* - ✔✔class 3 and 4
✔✔normal range for HR - ✔✔60-100
✔✔indications for tachycardia - ✔✔hypoxemia anxiety stress - need o2 therapy
✔✔indications for bradycardia - ✔✔heart failure shock code/emergency - atropine
✔✔adverse reaction/when to stop tx - ✔✔HR change of 20 bpm
✔✔indications of paradoxical pulses/pulsus paradoxus - ✔✔sever air trapping, Pneumo,
status asthmaticus, cardiac tamponade
(pulse/BP varies with respiration)
✔✔pulled toward affected side - ✔✔atelectasis pneumonectomy diaphragmatic
paralysis
✔✔pushed away from affected side - ✔✔pleural effusion tension pneumothorax tumor
(neck or thyroid) mediastinal mass
✔✔vibrations felt on chest wall by hand
, *Increased in consolidation and pulmonary edema*
*decreased in COPD, pneumothorax, and pleural effusion* - ✔✔tactile fremitus
✔✔skind tender around incisions, chest tubes, bruises, burns, or fractures -
✔✔tenderness
✔✔bubbles of air under skin - ✔✔crepitus (subcutaneous emphysema)
✔✔different than therapeutic chest percussion (chest PT) - ✔✔diagnostic chest
percussion
✔✔normal air filled lungs (hollow sound) - ✔✔resonant
✔✔(less air)
normally heard over sternum
areas of atelectasis - ✔✔flat
✔✔(less air)
normally heard over fluid filled organs (heart, liver)
Pleural effusion/pneumonia (thud) - ✔✔dull
✔✔(extra air)
normally heard over air-filled stomach
drum like sound indicating increased volume when heard over lungs - ✔✔tympanic
✔✔(extra air)
booming sound that can be heard on an area of lung were either a *pneumothorax or
emphysema* is present - ✔✔hyperresonant
✔✔normal breath sounds - ✔✔vesicular
✔✔abnormal breath sounds - ✔✔adventitious
✔✔patient instructed to say E and sounds like A (or 99) *indicates consolidation of the
lung tissue as with a pneumonia like condition* - ✔✔egophony
✔✔what breath sounds would be expected in a patient with pulmonary edema - ✔✔fine
crackles (moist crepitant rales)
✔✔large airway secretions
rhonchi that clears with cough
*suction or have patient cough* - ✔✔coarse crackles
QUESTIONS AND ANSWERS SURE A+
✔✔Eupnea - ✔✔normal breathing
✔✔tachypnea - ✔✔fast RR
conditions: fever, hypoxia, pain, CNS problems
✔✔bradypnea - ✔✔slow RR
conditions: sleep (normal), drugs, alcohol, metabolic alkalosis
✔✔Gradually increase then decreasing rate and depth in a cycle lasting from 30-180
seconds *fast slow period of apnea*
*condition*: increased IC pressure, brainstem injury, drug overdose - ✔✔cheyne stokes
✔✔increased respiratory rate and depth with irregular periods of apnea. Each breath
has the same depth *fast irregular w/ apnea*
*Cause: CNS problem* - ✔✔biots breathing
✔✔gasping, labored breathing, also called air hunger
*condition*: hypoxemia, metabolic acidosis, renal failure, diabetic ketoacidosis -
✔✔Kussmaul breathing
✔✔hypertrophy - ✔✔increased [muscle] size
think COPD
✔✔atrophy - ✔✔decreased [muscle] size
think paralysis
✔✔tList 4 changes to a *patient's upper airway* that complicates airway patency
#1 - ✔✔tracheal shift deviation
,✔✔List 4 changes to a *patient's upper airway* that complicates airway patency
#2 - ✔✔bull neck
✔✔List 4 changes to a *patient's upper airway* that complicates airway patency
#3 - ✔✔large tongue (macroglossia)
✔✔List 4 changes to a *patient's upper airway* that complicates airway patency
#4 - ✔✔short mandible
✔✔class 1 - ✔✔mallampati Class -
soft palate, uvula, fauces, pillars visible
✔✔class 2 - ✔✔mallampati class -
soft palate, uvula, fauces visible
✔✔class 3 - ✔✔mallampati class -
soft palate, base of uvula visible
✔✔class 4 - ✔✔mallampati class -
hard palate only visible
✔✔mallampati class - and - are considered *difficult airways and require the use of a
*fiberoptic bronchoscope or a video assist device* - ✔✔class 3 and 4
✔✔normal range for HR - ✔✔60-100
✔✔indications for tachycardia - ✔✔hypoxemia anxiety stress - need o2 therapy
✔✔indications for bradycardia - ✔✔heart failure shock code/emergency - atropine
✔✔adverse reaction/when to stop tx - ✔✔HR change of 20 bpm
✔✔indications of paradoxical pulses/pulsus paradoxus - ✔✔sever air trapping, Pneumo,
status asthmaticus, cardiac tamponade
(pulse/BP varies with respiration)
✔✔pulled toward affected side - ✔✔atelectasis pneumonectomy diaphragmatic
paralysis
✔✔pushed away from affected side - ✔✔pleural effusion tension pneumothorax tumor
(neck or thyroid) mediastinal mass
✔✔vibrations felt on chest wall by hand
, *Increased in consolidation and pulmonary edema*
*decreased in COPD, pneumothorax, and pleural effusion* - ✔✔tactile fremitus
✔✔skind tender around incisions, chest tubes, bruises, burns, or fractures -
✔✔tenderness
✔✔bubbles of air under skin - ✔✔crepitus (subcutaneous emphysema)
✔✔different than therapeutic chest percussion (chest PT) - ✔✔diagnostic chest
percussion
✔✔normal air filled lungs (hollow sound) - ✔✔resonant
✔✔(less air)
normally heard over sternum
areas of atelectasis - ✔✔flat
✔✔(less air)
normally heard over fluid filled organs (heart, liver)
Pleural effusion/pneumonia (thud) - ✔✔dull
✔✔(extra air)
normally heard over air-filled stomach
drum like sound indicating increased volume when heard over lungs - ✔✔tympanic
✔✔(extra air)
booming sound that can be heard on an area of lung were either a *pneumothorax or
emphysema* is present - ✔✔hyperresonant
✔✔normal breath sounds - ✔✔vesicular
✔✔abnormal breath sounds - ✔✔adventitious
✔✔patient instructed to say E and sounds like A (or 99) *indicates consolidation of the
lung tissue as with a pneumonia like condition* - ✔✔egophony
✔✔what breath sounds would be expected in a patient with pulmonary edema - ✔✔fine
crackles (moist crepitant rales)
✔✔large airway secretions
rhonchi that clears with cough
*suction or have patient cough* - ✔✔coarse crackles
