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RESPIRATORY CARE: PRINCIPLES AND PRACTICE, 4TH EDITION BY
DEAN R. HESS, NEIL R. MACINTYRE, WILLIAM F. GALVIN, AND SHELLEY
C. MISHOE EXAM QUESTIONS LATEST VERSION 2026 - 2027
Respiratory Care: Principles and Practice, 4th Edition by Dean R. Hess, Neil R.
MacIntyre, William F. Galvin, and Shelley C. Mishoe.
Summarized 10-Point Exam Coverage
Based on the textbook's table of contents, this exam covers the following ten core
domains:
1. Respiratory Assessment: History and physical examination, respiratory
monitoring, hemodynamic monitoring, and arterial blood gas analysis.
2. Diagnostic Procedures: Blood chemistries, hematology, cardiac assessment,
thoracic imaging, pulmonary function testing, and polysomnography.
3. Respiratory Therapeutics: Therapeutic gases, humidity and aerosol therapy,
airway clearance, airway management, and mechanical ventilation.
4. Advanced Therapeutics and Special Populations: Noninvasive ventilation,
neonatal/pediatric care, extracorporeal life support, pulmonary rehabilitation,
and home care.
5. Disease Management: Principles of disease management, patient education,
and infection control.
6. Obstructive and Restrictive Diseases: Asthma, COPD, interstitial lung disease,
and cystic fibrosis.
7. Critical Care and Systemic Disorders: ARDS, heart failure, trauma, burns, and
neuromuscular dysfunction.
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8. Sleep and Perioperative Care: Sleep-disordered breathing, postoperative care,
and lung transplant management.
9. Applied Sciences: Respiratory anatomy, ventilation, oxygenation, respiratory
mechanics, control of breathing, and physical principles.
10. Professional Practice: History of the profession, ethics, healthcare economics,
and evidence-based practice.
Part I: Respiratory Assessment (Questions 1–60)
Chapter 1: History and Physical Examination
1. Which of the following components of the patient history is most critical for the
respiratory therapist to obtain when assessing a patient with a suspected respiratory
disorder?
A. The patient’s dietary preferences and exercise habits
B. The patient’s chief complaint, history of present illness, and past medical history
C. The patient’s insurance coverage and billing information
D. The patient’s family’s opinions on respiratory therapy
Correct Answer: B
Rationale: The chief complaint, history of present illness, and past medical history
provide essential information about the onset, duration, and progression of respiratory
symptoms, as well as underlying conditions that may affect treatment.
2. Which of the following physical examination findings is most consistent with a patient
experiencing severe respiratory distress?
A. Nasal flaring, accessory muscle use, and paradoxical breathing
B. Clear breath sounds and a regular respiratory rate
C. Pink, warm extremities and a relaxed posture
D. A respiratory rate of 12 breaths per minute with normal depth
Correct Answer: A
Rationale: Nasal flaring, accessory muscle use, and paradoxical breathing (inward
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movement of the abdomen during inspiration) are classic signs of severe respiratory
distress and increased work of breathing.
3. Which of the following techniques is used to assess the patient’s tactile fremitus
during a physical examination of the chest?
A. Placing the hands on the chest wall and feeling for vibrations while the patient speaks
B. Tapping the chest wall with the fingers to assess underlying structures
C. Listening to breath sounds with a stethoscope
D. Inspecting the chest for symmetry and deformities
Correct Answer: A
Rationale: Tactile fremitus is assessed by placing the hands on the chest wall and
feeling for vibrations while the patient speaks. Increased fremitus suggests
consolidation; decreased fremitus suggests pleural effusion or pneumothorax.
Chapter 2: Respiratory Monitoring
4. Which of the following parameters is most commonly monitored using pulse oximetry
in the respiratory care setting?
A. Arterial partial pressure of oxygen (PaO₂)
B. Arterial oxygen saturation (SpO₂)
C. Arterial partial pressure of carbon dioxide (PaCO₂)
D. Arterial pH
Correct Answer: B
Rationale: Pulse oximetry measures arterial oxygen saturation (SpO₂) non-invasively by
detecting the absorption of light by oxygenated and deoxygenated hemoglobin.
5. Which of the following best describes the purpose of capnography in respiratory
monitoring?
A. To measure oxygen saturation in the blood
B. To measure the partial pressure of carbon dioxide in exhaled gas (EtCO₂)
C. To measure lung volumes and capacities
D. To measure airway resistance
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Correct Answer: B
Rationale: Capnography measures the partial pressure of carbon dioxide in exhaled gas
(end-tidal CO₂ or EtCO₂), providing information about ventilation and perfusion.
Chapter 3: Hemodynamic Monitoring
6. Which of the following best describes the purpose of a pulmonary artery catheter in
hemodynamic monitoring?
A. To measure central venous pressure (CVP) and pulmonary artery pressure (PAP)
B. To measure arterial blood gases
C. To measure oxygen saturation only
D. To measure lung compliance
Correct Answer: A
Rationale: A pulmonary artery catheter (Swan-Ganz catheter) is used to measure
central venous pressure (CVP), pulmonary artery pressure (PAP), pulmonary capillary
wedge pressure (PCWP), and cardiac output.
Chapter 4: Arterial Blood Gas Sampling, Analysis, and Interpretation
7. Which of the following ABG values is most consistent with acute respiratory acidosis?
A. pH 7.30, PaCO₂ 55 mm Hg, HCO₃⁻ 24 mEq/L
B. pH 7.50, PaCO₂ 30 mm Hg, HCO₃⁻ 24 mEq/L
C. pH 7.30, PaCO₂ 30 mm Hg, HCO₃⁻ 18 mEq/L
D. pH 7.50, PaCO₂ 50 mm Hg, HCO₃⁻ 30 mEq/L
Correct Answer: A
Rationale: Acute respiratory acidosis is characterized by a decreased pH (<7.35),
increased PaCO₂ (>45 mm Hg), and normal or near-normal HCO₃⁻ (because renal
compensation has not yet occurred).
Chapter 5: Blood Chemistries and Hematology
8. Which of the following laboratory findings is most indicative of anemia in a patient
with chronic respiratory disease?
A. Elevated hemoglobin and hematocrit
B. Decreased hemoglobin and hematocrit
RESPIRATORY CARE: PRINCIPLES AND PRACTICE, 4TH EDITION BY
DEAN R. HESS, NEIL R. MACINTYRE, WILLIAM F. GALVIN, AND SHELLEY
C. MISHOE EXAM QUESTIONS LATEST VERSION 2026 - 2027
Respiratory Care: Principles and Practice, 4th Edition by Dean R. Hess, Neil R.
MacIntyre, William F. Galvin, and Shelley C. Mishoe.
Summarized 10-Point Exam Coverage
Based on the textbook's table of contents, this exam covers the following ten core
domains:
1. Respiratory Assessment: History and physical examination, respiratory
monitoring, hemodynamic monitoring, and arterial blood gas analysis.
2. Diagnostic Procedures: Blood chemistries, hematology, cardiac assessment,
thoracic imaging, pulmonary function testing, and polysomnography.
3. Respiratory Therapeutics: Therapeutic gases, humidity and aerosol therapy,
airway clearance, airway management, and mechanical ventilation.
4. Advanced Therapeutics and Special Populations: Noninvasive ventilation,
neonatal/pediatric care, extracorporeal life support, pulmonary rehabilitation,
and home care.
5. Disease Management: Principles of disease management, patient education,
and infection control.
6. Obstructive and Restrictive Diseases: Asthma, COPD, interstitial lung disease,
and cystic fibrosis.
7. Critical Care and Systemic Disorders: ARDS, heart failure, trauma, burns, and
neuromuscular dysfunction.
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8. Sleep and Perioperative Care: Sleep-disordered breathing, postoperative care,
and lung transplant management.
9. Applied Sciences: Respiratory anatomy, ventilation, oxygenation, respiratory
mechanics, control of breathing, and physical principles.
10. Professional Practice: History of the profession, ethics, healthcare economics,
and evidence-based practice.
Part I: Respiratory Assessment (Questions 1–60)
Chapter 1: History and Physical Examination
1. Which of the following components of the patient history is most critical for the
respiratory therapist to obtain when assessing a patient with a suspected respiratory
disorder?
A. The patient’s dietary preferences and exercise habits
B. The patient’s chief complaint, history of present illness, and past medical history
C. The patient’s insurance coverage and billing information
D. The patient’s family’s opinions on respiratory therapy
Correct Answer: B
Rationale: The chief complaint, history of present illness, and past medical history
provide essential information about the onset, duration, and progression of respiratory
symptoms, as well as underlying conditions that may affect treatment.
2. Which of the following physical examination findings is most consistent with a patient
experiencing severe respiratory distress?
A. Nasal flaring, accessory muscle use, and paradoxical breathing
B. Clear breath sounds and a regular respiratory rate
C. Pink, warm extremities and a relaxed posture
D. A respiratory rate of 12 breaths per minute with normal depth
Correct Answer: A
Rationale: Nasal flaring, accessory muscle use, and paradoxical breathing (inward
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movement of the abdomen during inspiration) are classic signs of severe respiratory
distress and increased work of breathing.
3. Which of the following techniques is used to assess the patient’s tactile fremitus
during a physical examination of the chest?
A. Placing the hands on the chest wall and feeling for vibrations while the patient speaks
B. Tapping the chest wall with the fingers to assess underlying structures
C. Listening to breath sounds with a stethoscope
D. Inspecting the chest for symmetry and deformities
Correct Answer: A
Rationale: Tactile fremitus is assessed by placing the hands on the chest wall and
feeling for vibrations while the patient speaks. Increased fremitus suggests
consolidation; decreased fremitus suggests pleural effusion or pneumothorax.
Chapter 2: Respiratory Monitoring
4. Which of the following parameters is most commonly monitored using pulse oximetry
in the respiratory care setting?
A. Arterial partial pressure of oxygen (PaO₂)
B. Arterial oxygen saturation (SpO₂)
C. Arterial partial pressure of carbon dioxide (PaCO₂)
D. Arterial pH
Correct Answer: B
Rationale: Pulse oximetry measures arterial oxygen saturation (SpO₂) non-invasively by
detecting the absorption of light by oxygenated and deoxygenated hemoglobin.
5. Which of the following best describes the purpose of capnography in respiratory
monitoring?
A. To measure oxygen saturation in the blood
B. To measure the partial pressure of carbon dioxide in exhaled gas (EtCO₂)
C. To measure lung volumes and capacities
D. To measure airway resistance
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Correct Answer: B
Rationale: Capnography measures the partial pressure of carbon dioxide in exhaled gas
(end-tidal CO₂ or EtCO₂), providing information about ventilation and perfusion.
Chapter 3: Hemodynamic Monitoring
6. Which of the following best describes the purpose of a pulmonary artery catheter in
hemodynamic monitoring?
A. To measure central venous pressure (CVP) and pulmonary artery pressure (PAP)
B. To measure arterial blood gases
C. To measure oxygen saturation only
D. To measure lung compliance
Correct Answer: A
Rationale: A pulmonary artery catheter (Swan-Ganz catheter) is used to measure
central venous pressure (CVP), pulmonary artery pressure (PAP), pulmonary capillary
wedge pressure (PCWP), and cardiac output.
Chapter 4: Arterial Blood Gas Sampling, Analysis, and Interpretation
7. Which of the following ABG values is most consistent with acute respiratory acidosis?
A. pH 7.30, PaCO₂ 55 mm Hg, HCO₃⁻ 24 mEq/L
B. pH 7.50, PaCO₂ 30 mm Hg, HCO₃⁻ 24 mEq/L
C. pH 7.30, PaCO₂ 30 mm Hg, HCO₃⁻ 18 mEq/L
D. pH 7.50, PaCO₂ 50 mm Hg, HCO₃⁻ 30 mEq/L
Correct Answer: A
Rationale: Acute respiratory acidosis is characterized by a decreased pH (<7.35),
increased PaCO₂ (>45 mm Hg), and normal or near-normal HCO₃⁻ (because renal
compensation has not yet occurred).
Chapter 5: Blood Chemistries and Hematology
8. Which of the following laboratory findings is most indicative of anemia in a patient
with chronic respiratory disease?
A. Elevated hemoglobin and hematocrit
B. Decreased hemoglobin and hematocrit
