Test Bank For Wilkins Clinical Assessment in Respiratory Care 8th Edition Heuer
Test Bank For Wilkins Clinical Assessment in Respiratory Care 8th Edition Heuer
Test Bank For Wilkins Clinical Assessment in Respiratory Care 8th Edition Heuer
MULTIPLE CHOICE
6. What type of white blood cell typically is most prevalent in the circulating blood?
a. Monocyte
b. Eosinophil
c. Neutrophil
d. Lymphocyte
ANS: C
The neutrophil is produced by the bone marrow in large quantities.
9. What percentage of normal circulating white blood cells are immature and nonsegmented?
a. 0% to 5%
b. 5% to 10%
c. 10% to 15%
d. 15% to 22%
ANS: A
Normally, a very small portion of circulating white blood cells is nonsegmented.
10. Which of the following types of white blood cells fights bacterial infection?
a. Basophil
b. Monocyte
c. Neutrophil
d. Lymphocyte
ANS: C
The neutrophil is best known for its ability to fight infection.
12. Which of the following terms describes an increase in white blood cell count associated
with a shift of cells from the marginated pool to the circulating pool?
a. Pseudoneutrophilia
b. Pseudoneutropenia
c. Neutropenia
d. Lymphocytosis
ANS: A
When marginated neutrophils shift back into the circulating pool, this is known as
pseudoneutrophilia.
13. Which of the following types of white blood cells is useful against allergic reactions and
defends against parasitic infestations?
a. Monocyte
b. Neutrophil
c. Eosinophil
d. Lymphocyte
ANS: C
The eosinophil is known to react in situations caused by exposure to allergens.
15. What is the normal percentage of lymphocytes in circulating white blood cells?
a. 5% to 10%
b. 15% to 25%
c. 20% to 45%
d. 50% to 70%
ANS: C
Normally, 20% to 45% of circulating white blood cells are lymphocytes.
16. Which of the following types of white blood cells is physically the largest?
a. Basophil
b. Monocyte
c. Neutrophil
d. Lymphocyte
ANS: B
As viewed through the microscope, the monocyte is physically the largest white blood cell.
17. Which of the following types of white blood cells is responsible for phagocytosis?
a. Basophil
b. Monocyte
c. Neutrophil
d. Lymphocyte
ANS: B
The monocyte has the ability to engulf bacteria and foreign dust particles and eliminate
them from the lung.
18. Which of the following terms describes an abnormal increase in the proportion of
circulating immature neutrophils?
a. Neutrophilia
b. Left shift
c. Leukopenia
d. Leukocytosis
ANS: B
When the number of bands circulating in the blood is higher than normal, this is referred to
as a left shift.
19. Which of the following terms describes the change in white blood cell count that often
occurs in patients with tuberculosis?
a. Lymphocytosis
b. Monocytosis
c. Eosinophilia
d. Basophilia
ANS: B
Patients with tuberculosis usually develop monocytosis.
20. Which of the following terms describes an overall abnormal decrease in white blood cell
count?
a. Anemia
b. Leukopenia
c. Leukocytosis
d. Polycythemia
ANS: B
An abnormal drop in the number of circulating white blood cells is known as leukopenia.
21. Which of the following types of leukocytosis is typically seen in patients with viral
infection?
a. Basophilia
b. Neutrophilia
c. Monocytosis
d. Lymphocytosis
ANS: D
Viral infections often cause lymphocytosis.
25. What can be said about the nucleus of the mature circulating red blood cell?
a. It is round.
b. It is absent.
c. It is large and red.
d. It is very small.
ANS: B
The mature red blood cell has no nucleus.
26. What substance is responsible for carrying red blood cell oxygen on to the tissues?
a. Thrombin
b. Cytokines
c. Hemoglobin
d. Prothrombin
ANS: C
Hemoglobin is the major substance found in red blood cells. Its main function is to carry
oxygen.
28. Which of the following terms describes an abnormal decrease in red blood cell count?
a. Anemia
b. Cytothemia
c. Leukopenia
d. Polycythemia
ANS: A
A low red blood cell count is known as anemia.
29. Which of the following terms describes red blood cells that are larger than normal?
a. Macrocytic
b. Hypercytotic
c. Hyperchromic
d. Polycythemic
ANS: A
Red blood cells that are larger than normal are termed macrocytic.
30. The most common type of anemia worldwide is the result of:
a. hemorrhage.
b. gastrointestinal bleeding.
c. iron deficiency.
d. vitamin B12 deficiency.
ANS: C
Iron deficiency is a very common cause of anemia because it reduces the presence of
hemoglobin in the red blood cells.
31. Which of the following terms describes anemia due to low hemoglobin levels?
a. Microcytic
b. Leukopenic
c. Hypocytotic
d. Hypochromic
ANS: D
Chromic refers to color, and hemoglobin is known for giving the red blood cell its bright
red color. Hypochromic refers to red cells that lack hemoglobin.
33. Heavy smokers are prone to what change in the red blood cell count?
a. Secondary polycythemia
b. Microcytic anemia
c. Hypochromic anemia
d. Macrocytic anemia
ANS: A
Heavy smokers have significant carbon monoxide in their blood. This is perceived by the
bone marrow as hypoxia. Thus, the bone marrow increases its production of red blood
cells.
34. In which of the following conditions would spurious polycythemia most likely be seen?
a. Lung cancer
b. Dehydration
c. Fever
d. Hypertension
ANS: B
Dehydration causes an increase in the concentration of red blood cells in the blood and
causes false polycythemia.
35. A patient with a platelet count of about 80,000/mm3 is likely to have what condition?
a. Infection
b. Renal failure
c. Excessive bleeding
d. None of the above, because this is a normal value
ANS: C
A platelet count of 80,000/mm3 is too low. The patient will have problems with bleeding.
36. What problem is associated with an abnormal international normalized ratio (INR) value?
a. Kidney disease
b. Liver failure
c. Bleeding
d. Pulmonary edema
ANS: C
An abnormal INR value suggests problems with blood clotting.
37. Which of the following is considered the major cation of the extracellular fluid?
a. Sodium
b. Calcium
c. Chloride
d. Potassium
ANS: A
Sodium is considered the major cation of the extracellular fluid.
39. What electrolyte abnormality is associated with irregular pulse, muscle weakness, and
abdominal distention?
a. Hyperkalemia
b. Hypokalemia
c. Hyponatremia
d. Hypernatremia
ANS: B
Hypokalemia (reduced potassium concentration) causes an irregular pulse and muscle
weakness.
40. Which of the following terms is used to describe an abnormally low potassium level?
a. Hyponatremia
b. Hypokalemia
c. Hypochloremia
d. Hypocalcemia
ANS: B
A low potassium level is known as hypokalemia.
42. What disease is associated with elevations in sodium and chloride in sweat?
a. Pneumonia
b. Emphysema
c. Renal disease
d. Cystic fibrosis
ANS: D
Patients with cystic fibrosis have elevated sodium and chloride levels in their sweat.
43. During evaluation of the enzymes, what disorder is associated with elevation of the
CK-MB on electrophoresis?
a. Hepatitis
b. Renal failure
c. Metabolic acidosis
d. Myocardial infarction
ANS: D
Elevation of the creatine kinase MB (CK-MB) fraction indicates damage to the heart
muscle.
44. The highest levels of aspartate aminotransferase (AST) are seen in acute:
a. pulmonary infarction.
b. hepatitis.
c. myocardial infarction.
d. renal failure.
ANS: B
AST is an enzyme that is found primarily in the liver. Hepatitis causes damage to the liver
and an abnormal increase in AST.
48. Which of the following terms is used to describe the microorganisms present in the saliva
of a healthy person?
a. Normal flora
b. Acid-fast bacteria
c. Gram-negative pathogens
d. Gram-positive pathogens
ANS: A
The normal flora refers to the microorganisms normally present in the saliva.
49. The purpose of performing the sensitivity test on sputum samples is to:
a. determine the best antibiotic to prescribe.
b. determine the viscosity of the sputum.
c. determine the quality of the sputum sample.
d. identify the general type of organism responsible for the infection.
ANS: A
The sensitivity determines what antibiotics will be most effective against a microorganism
that is causing an infection.
REF: p. 143 OBJ: 18
50. Which of the following organisms is responsible for most cases of bacterial pneumonia?
a. Pseudomonas
b. Klebsiella pneumoniae
c. Staphylococcus aureus
d. Streptococcus pneumoniae
ANS: D
Most community-acquired pneumonias are caused by the Streptococcus organism.
51. What procedure is performed by a pulmonologist to obtain organisms that may be present
deep in the lung in patients with pneumonia?
a. Sputum induction with hypotonic nebulized solution
b. Bronchoalveolar lavage (BAL)
c. Tracheal intubation with lavage
d. Thoracentesis
ANS: B
BAL is done to flush out organisms deep in the lung that cannot be obtained for culture
through less invasive procedures.
52. The classic dividing line between transudates and exudates is a protein level of __ g/dL.
a. 3
b. 6
c. 9
d. 12
ANS: A
Pleural fluid that has a protein concentration of more than 3 g/dL is known as an exudate.
Pleural fluid with a lower concentration of proteins is known as a transudate.
54. For which of the following disorders does a skin test use purified protein derivative
(PPD)?
a. Sarcoidosis
b. Tuberculosis
c. Coccidioidomycosis
d. Histoplasmosis
ANS: B
PPD is injected under the skin when testing for tuberculosis.
55. If an infection is being effectively treated by an antibiotic, which of the following would
be true?
a. The Gram-stained smear will no longer demonstrate the pathogen.
b. The patient’s white blood count will increase.
c. The patient’s platelet count will rapidly increase.
d. The patient will present with foul-smelling sputum.
ANS: A
After a patient has been on a regimen of antimicrobial therapy, the Gram stain and culture
results can change. If the antibiotic is effective against the pathogen causing the infection,
the Gram stain and culture will no longer demonstrate the pathogen, but instead will reveal
organisms consistent with normal flora.
56. A patient presents with a D-dimer of 210 ng/mL. Which of the following would be a
suspected disease process or condition?
1. Streptococcal pneumonia
2. Pleural effusion
3. Pulmonary embolism
4. Tuberculosis
a. 1 and 4
b. 2 and 3
c. 1, 2, and 4
d. 2, 3, and 4
ANS: C
The D-dimer test has high sensitivity; a level below the upper limit of the reference range
can help rule out both systemic thrombosis, such as disseminated intravascular
coagulation, and local thrombosis, such as pulmonary embolism and deep vein thrombosis.
57. A 62 year-old male patients is presenting with shortness of breath and has a BNP level of
590 pg/mL. What is his likely diagnosis?
a. Congestive heart failure
b. Exacerbation of asthma
Test Bank for Wilkins Clinical Assessment in Respiratory Care, 8th Edition Heuer
c. Pneumonia
d. Exacerbation of COPD
ANS: A
BNP is a cardiac neurohormone secreted from membrane granules in the cardiac ventricles
as a response to ventricular volume expansion and pressure overload. BNP levels lower
than 100 pg/mL have a 90% negative predictive value and are thus useful in ruling out
congestive heart failure (CHF). A comparable positive predictive value for ruling in the
diagnosis of CHF occurs with BNP levels greater than 500 pg/mL.
REF: p. XX OBJ: 29