Question 1

Your patient just had an anteroposterior chest film taken. When you view the film, what may be a consideration?

Accepted Answer

A) The lungs may appear smaller than they really are. 
B) The heart may appear less dense then it really is. 
C) The ribs may appear more horizontal than normal. 
D) The heart may appear larger then it really is. 
A) The lungs may appear smaller than they really are. 
B) The heart may appear less dense then it really is. 
C) The ribs may appear more horizontal than normal. 
D) The heart may appear larger then it really is. D

Question 2

What term is used to describe the predominance of edema in the hilar regions of both lungs with progressively less edema in the more peripheral areas of the lungs as seen on the chest film?

Accepted Answer

A) bat's wing 
B) hilar wings 
C) butterfly wings 
D) heart wings 
A) bat's wing 
B) hilar wings 
C) butterfly wings 
D) heart wings A

Question 3

Computed tomography (CT) scanning of the chest would be LEAST useful for which of the following?

Accepted Answer

A) to evaluate the large vessels of the mediastinum 
B) to evaluate the pleura 
C) to evaluate lung masses 
D) to evaluate patients with asthma 
A) to evaluate the large vessels of the mediastinum 
B) to evaluate the pleura 
C) to evaluate lung masses 
D) to evaluate patients with asthma D

Question 4

What is the earliest sign of a left-sided pleural effusion on an upright chest radiograph?

Accepted Answer

A) an increased distance between the inferior margin of the left lung and the stomach gas bubble 
B) inability to see small pulmonary blood vessels over the left lower lung 
C) a widened mediastinum 
D) elevation of the right hemidiaphragm 
A) an increased distance between the inferior margin of the left lung and the stomach gas bubble 
B) inability to see small pulmonary blood vessels over the left lower lung 
C) a widened mediastinum 
D) elevation of the right hemidiaphragm

Question 5

What is indicated by the presence of gas bubbles within the pleural fluid without prior surgery or needle insertion?

Accepted Answer

A) hemothorax 
B) pneumothorax 
C) empyema 
D) CHF 
A) hemothorax 
B) pneumothorax 
C) empyema 
D) CHF

Question 6

Which of the following findings on the chest radiograph is considered a secondary sign of emphysema?

Accepted Answer

A) flattening of the diaphragm 
B) widening of the cardiac shadow 
C) narrowing of the space between the ribs 
D) blunting of the costophrenic angle 
A) flattening of the diaphragm 
B) widening of the cardiac shadow 
C) narrowing of the space between the ribs 
D) blunting of the costophrenic angle

Question 7

What abnormality may appear to be present on the chest x-ray but is simply due to abnormal rotation of the patient during production of the film?

Accepted Answer

A) enlarged lungs 
B) enlarged heart 
C) widened mediastinum 
D) thickened pleura 
A) enlarged lungs 
B) enlarged heart 
C) widened mediastinum 
D) thickened pleura

Question 8

Which of the following statements is NOT true regarding the recognition and treatment of a tension pneumothorax as seen on the chest radiograph?

Accepted Answer

A) The hemidiaphragm on the affected side will be pushed downward. 
B) The mediastinum will be pushed towards the unaffected side. 
C) It requires immediate insertion of a chest tube. 
D) The patient should be intubated. 
A) The hemidiaphragm on the affected side will be pushed downward. 
B) The mediastinum will be pushed towards the unaffected side. 
C) It requires immediate insertion of a chest tube. 
D) The patient should be intubated.

Question 9

In what pulmonary condition does the chest radiograph often "lag behind" the clinical status of the patient?

Accepted Answer

A) pulmonary embolism 
B) emphysema 
C) pneumonia 
D) congestive heart failure 
A) pulmonary embolism 
B) emphysema 
C) pneumonia 
D) congestive heart failure

Question 10

What are the two most common reasons for placing a chest tube?

Accepted Answer

A) pneumothorax and pleural effusion 
B) pneumothorax and empyema 
C) hemothorax and hydrothorax 
D) to place medicine in the pleural space and to withdraw excess fluid 
A) pneumothorax and pleural effusion 
B) pneumothorax and empyema 
C) hemothorax and hydrothorax 
D) to place medicine in the pleural space and to withdraw excess fluid

Question 11

In which of the following would loculation of pleural fluid NOT be as likely to occur?

Accepted Answer

A) empyema 
B) exudative fluid 
C) hemothorax 
D) congestive heart failure 
A) empyema 
B) exudative fluid 
C) hemothorax 
D) congestive heart failure

Question 12

In the standard posteroanterior chest film, what proportion of the chest width should the heart shadow not exceed?

Accepted Answer

A) 33% 
B) 40% 
C) 50% 
D) 65% 
A) 33% 
B) 40% 
C) 50% 
D) 65%

Question 13

What problem exists when interpreting an over exposed chest film?

Accepted Answer

A) There is difficulty in seeing the peripheral blood vessels. 
B) The ribs appear wider than normal. 
C) The heart shadow is blurred. 
D) The lymph nodes in the mediastinum cannot be seen. 
A) There is difficulty in seeing the peripheral blood vessels. 
B) The ribs appear wider than normal. 
C) The heart shadow is blurred. 
D) The lymph nodes in the mediastinum cannot be seen.

Question 14

What chest x-ray view is best used to identify excess pleural fluid?

Accepted Answer

A) posteroanterior 
B) anteroposterior 
C) lateral decubitus 
D) apical lordotic 
A) posteroanterior 
B) anteroposterior 
C) lateral decubitus 
D) apical lordotic

Question 15

Why should a chest radiograph be obtained following placement of the central venous pressure catheter?

Accepted Answer

A) to confirm proper placement 
B) to allow better interpretation of the results 
C) to identify when to change the line 
D) all the above 
A) to confirm proper placement 
B) to allow better interpretation of the results 
C) to identify when to change the line 
D) all the above

Question 16

What is the most common cause of lobar atelectasis?

Accepted Answer

A) bronchial obstruction 
B) loss of surfactant 
C) viral pneumonia 
D) pleurisy 
A) bronchial obstruction 
B) loss of surfactant 
C) viral pneumonia 
D) pleurisy

Question 17

Which of the following is NOT a typical cause of atelectasis?

Accepted Answer

A) abdominal surgery 
B) rib fracture 
C) hepatomegaly 
D) pleurisy 
A) abdominal surgery 
B) rib fracture 
C) hepatomegaly 
D) pleurisy

Question 18

What is the most common cause of cephalization as seen on the upright chest film?

Accepted Answer

A) renal failure 
B) left heart failure 
C) hypoxemia 
D) empyema 
A) renal failure 
B) left heart failure 
C) hypoxemia 
D) empyema

Question 19

What term is used to describe the shadows seen on the chest film when the alveoli fill with pus, fluid, or blood?

Accepted Answer

A) consolidates 
B) infiltrates 
C) alveolar lesions 
D) densities 
A) consolidates 
B) infiltrates 
C) alveolar lesions 
D) densities

Question 20

What is indicated by an air-fluid level in the pleural space?

Accepted Answer

A) tension pneumothorax 
B) hydropneumothorax 
C) pleural effusion 
D) an aerobic infection 
A) tension pneumothorax 
B) hydropneumothorax 
C) pleural effusion 
D) an aerobic infection

Exam 20: A Review of Thoracic Imaging

Your patient just had an anteroposterior chest film taken. When you view the film, what may be a consideration?

What term is used to describe the predominance of edema in the hilar regions of both lungs with progressively less edema in the more peripheral areas of the lungs as seen on the chest film?

Computed tomography (CT) scanning of the chest would be LEAST useful for which of the following?

What is the earliest sign of a left-sided pleural effusion on an upright chest radiograph?

What is indicated by the presence of gas bubbles within the pleural fluid without prior surgery or needle insertion?

Which of the following findings on the chest radiograph is considered a secondary sign of emphysema?

What abnormality may appear to be present on the chest x-ray but is simply due to abnormal rotation of the patient during production of the film?

Which of the following statements is NOT true regarding the recognition and treatment of a tension pneumothorax as seen on the chest radiograph?

In what pulmonary condition does the chest radiograph often "lag behind" the clinical status of the patient?

What are the two most common reasons for placing a chest tube?

In which of the following would loculation of pleural fluid NOT be as likely to occur?

In the standard posteroanterior chest film, what proportion of the chest width should the heart shadow not exceed?

What problem exists when interpreting an over exposed chest film?

What chest x-ray view is best used to identify excess pleural fluid?

Why should a chest radiograph be obtained following placement of the central venous pressure catheter?

What is the most common cause of lobar atelectasis?

Which of the following is NOT a typical cause of atelectasis?

What is the most common cause of cephalization as seen on the upright chest film?

What term is used to describe the shadows seen on the chest film when the alveoli fill with pus, fluid, or blood?

What is indicated by an air-fluid level in the pleural space?

History of Respiratory Care

Quality and Evidence-Based Respiratory Care

Patient Safety, Communication, and Record Keeping

Principles of Infection Control

Ethical and Legal Implications of Practice

Physical Principles of Respiratory Care

Computer Applications in Respiratory Care

The Respiratory System

The Cardiovascular System

Ventilation

Gas Exchange and Transport

Solutions, Body Fluids, and Electrolytes

Acid-Base Balance

Regulation of Breathing

Bedside Assessment of the Patient

Interpretation of Clinical Laboratory Data

Interpreting the Electrocardiogram

Analysis and Monitoring of Gas Exchange

Pulmonary Function Testing

Nutrition Assessment

Pulmonary Infections

Obstructive Lung Disease: Copd, Asthma, and Related Diseases

Interstitial Lung Disease

Pleural Diseases

Pulmonary Vascular Disease

Acute Lung Injury, Pulmonary Edema, and Multiple System Organ

Lung Cancer

Neuromuscular and Other Diseases of the Chest Wall

Disorders of Sleep

Neonatal and Pediatric Respiratory Disorders

Airway Pharmacology

Airway Management

Emergency Cardiovascular Life Support

Humidity and Bland Aerosol Therapy

Aerosol Drug Therapy

Storage and Delivery of Medical Gases

Medical Gas Therapy

Lung Expansion Therapy

Bronchial Hygiene Therapy

Respiratory Failure and the Need for Ventilatory Support

Mechanical Ventilators

Physiology of Ventilatory Support

Initiating and Adjusting Ventilatory Support

Noninvasive Positive Pressure Ventilation

Monitoring and Management of the Patient in the Intensive Care Unit

Discontinuing Ventilatory Support

Neonatal and Pediatric Respiratory Care

Patient Education and Health Promotion

Cardiopulmonary Rehabilitation

Respiratory Care in Alternative Settings

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