ALL ANSWER KEYS INCLUDED
ANSWER KEYS
,CHAPTER OBJECTIVES
1. Define respiratory care. (Q: 4, 15)
2. Summarize some of the major events in the history of science and medicine. (Q: 18)
3. Explain how the respiratory care profession got started. (Q: 20)
4. Describe the historical development of the major clinical areas of respiratory care. (Q:
21)
5. Name some of the important historical figures in respiratory care. (Q: 24)
6. Describe the major respiratory care educational, credentialing, and
professional associations. (Q: 16)
7. Explain how the important respiratory care organizations got started. (Q: 16)
8. Describe the development of respiratory care education. (Q: 17)
9. Predict future trends for the respiratory care profession. (Q: 23)
WORD WIZARD
Reference: Glossary
1. M. physician assistant
2. A. AARC
3. F. respiratory therapy
4. E. respiratory care (Number 3 and 4 are often interchanged.)
5. I. aerosol medications
6. H. oxygen (O2) therapy
7. C. NBRC
8. J. mechanical ventilation
9. B. CoARC
10. D. cardiopulmonary system
11. L. pulmonary function testing
12. N. respiratory care practitioner(s)
13. G. respiratory therapist(s) (The terms in 13 and 14 are often interchanged.)
14. K. airway management
MEET THE OBJECTIVES
15. References: Pages 4, 11
The actual definition of respiratory therapy is “the health care discipline that specializes
in the promotion of optimal cardiopulmonary function and health.”
Main concepts may include the assessment, treatment, management, control, diagnostic
evaluation, education, and care of patients with deficiencies and abnormalities of the
,cardiopulmonary system. Respiratory care is increasingly involved in the prevention of
respiratory disease, the management of patients with chronic respiratory disease, and the
promotion of health and wellness.
The Inhalation Therapy Association (ITA) was the first professional association in
respiratory care. The ITA became the American Association for Inhalation Therapists
(AAIT) in 1954, the American Association for Respiratory Therapy (ARRT) in 1973, and
the American Association for Respiratory Care (AARC) in 1982.
16. Reference: Page 14
The first course in inhalation therapy was offered in 1950. Programs in the 1960s
focused on teaching students the proper application of O2 therapy, O2 delivery
systems, humidifiers, and nebulizers and the use of various IPPB devices. The new
standard requires an associate degree for entry into the profession. There will be a need
for individuals with more education so more baccalaureate and graduate education is
needed. Technician programs no longer exist.
SUMMARY CHECKLIST
17. Reference: Page
4 Prevent; treat
18. Reference: Page 11
AARC; 1947; the Inhalation Therapy Association
19. Reference: Page
9 Polio
FOOD FOR THOUGHT
20. The general answer is management, supervision, research, and education. You
can also become a case manager, a drug representative, or go on for graduate
education in anesthesia or as a physician assistant.
21. This question is a simple classic that has many possible answers.
Dr. David Pierson promoted the science of respiratory care and the use of protocols. He
helped us elevate our practice. Joseph Priestley discovered O2, and Thomas Beddoes
first used it. I would like to be a therapist who becomes a pioneer of a new and vital
technique.
,CHAPTER OBJECTIVES
1. Understand the elements for delivering quality respiratory care. (Q: 5)
2. Explain how respiratory care protocols improve the quality of respiratory care services.
(Q: 6, 7)
3. Understand the evidence-based medicine. (Q: 9)
WORD WIZARD
1. CoARC Responsible for quality of schools
2. The Joint Commission Uses site visits to check quality of care
3. Evidence-based medicine Uses meta-analyses to find best care
4. NBRC Responsible for quality of credentialing exams
MEET THE OBJECTIVES
5. Reference: Page 20
A. Equipment
B. Personnel
C. Method of delivery of services
6. Reference: Page 31
A. Institutional: Skills check-offs and classes and competencies
B. Governmental: Monitors like CMS or The Joint Commission accredits institutions
based on quality monitoring standards over nine or more areas.
7. Reference: Tables 2-1, 2-2, 2-3, and 2-5
Protocols improve the allocation of respiratory resources by reducing misallocations
such as over-ordering. Protocols also reduce costs. Care may be enhanced.
8. Reference: Pages 36-38
The ARDSNet studies produced scientific evidence. When analyzed, they showed that
you could decrease patient mortality by following specific guidelines for volume
ventilation. Using 4 to 8 ml/kg as the breath size saved lives.
SUMMARY CHECKLIST
Reference: Page 38
9. Misallocation
,10. Protocols
11. Registered (RRT)
12. National Board for Respiratory Care (NBRC)
13. Evidence-based
CASE STUDIES
Case 1
Reference: Page 26, Figure 2-2
14. A. SOB
B. Tachycardia
C. Diaphoresis, confusion, etc.
15. The pulse oximeter shows a good saturation. The patient has no clinical signs of
hypoxemia and no history that suggests heart or lung disease. Respiratory rate and
heart rate are normal. Oxygen (O2) therapy is not indicated.
16. Place the patient on room air and recheck the saturation. The history of abdominal
surgery suggests starting the patient on postoperative protocol like incentive
spirometry. Discontinue the O2 if the saturations are good.
Case 2
Reference: Page 25, Figure 2-1
17. He has a history of smoking, lung disease, and has had surgery. His x-ray
shows atelectasis. He is wheezing, so he needs a bronchodilator.
Step 1: Patient is alert
Step 2: Can take a deep breath
Step 3: Does not meet MDI criteria
Step 4: Select SVN
WHAT DOES THE NBRC SAY?
18. Reference: Page 26, Figure 2-2
A. O2 therapy
19. Reference: Page 27, Mini Clini
D. Aerosolized bronchodilator therapy
20. Reference: Page 26, Figure 2-2
A. Increase the liter per minute flow to the cannulas.
,FOOD FOR THOUGHT
21. Reference: Pages 24, 27; Boxes 2-2, 2-5, and 2-6
Successful protocol programs involve many elements, including collaboration with
physicians and nurses, trained therapists, committed medical direction, and active
quality monitoring. Failure to take all of these actions could result in poor outcomes.
Protocols themselves must be well designed. Quality assurance efforts are also
complex. Timely audits must be conducted, and follow-up actions to resolve problem
areas must be taken.
22. Reference: Page 38
Meta-analysis analyzes and summarizes all the research findings on a topic into one
result using the best studies (weighted). A standard literature search cannot combine
the various studies. Meta-analysis is better, but you need enough quality studies to
perform the analysis, making it limited, for example, in evaluating new therapies.
,Chapter 03: Quality, Patient Safety, and Communication, and Recordkeeping
Answer Key for the Workbook
CHAPTER OBJECTIVES
1. Describe how to apply good body mechanics and posture to moving patients. (Q: 3)
2. Describe how to ambulate a patient and the potential benefits of ambulation. (Keep
it Moving, Q: 19, 20)
3. Write definitions of key terms associated with electricity, including voltage, current,
and resistance. (Word Wizard, Q: 2)
4. Identify the potential physiologic effects that electrical current can have on the body.
(Word Wizard)
5. State how to reduce the risk of electrical shock to patients and yourself. (Word Wizard)
6. Identify key statistics related to the incidence and origin of hospital fires.
7. List the conditions needed for fire and how to minimize fire hazards. (Word Wizard)
8. Identify impediments to care and risk in the direct patient environment. (Word Wizard)
9. State how communication can affect patient care. (Q: 22)
10. Describe the two patient identifier systems.
11. List the factors associated with the communication process. (Q: 5)
12. Describe how to improve your communication effectiveness. (Q: 6, 16)
13. Describe how to recognize and help resolve interpersonal or organizational sources
of conflict. (Q: 7)
14. List the common components of a medical record. (Q: 8)
15. State the legal and practical obligations involved in recordkeeping. (Q: 9)
16. Describe how to maintain a problem-oriented medical record. (Q: 9)
WORD WIZARD
Reference: Pages 43-47
current; ground; macro; micro; ground
Burn, Baby, Burn
Reference: Pages 48-49
nonflammable; combustible; cigarettes
KEEP IT MOVING!
4 Dangle the patient.
3 Sit them up.
5 Assist to a standing position.
6 Encourage slow, easy breathing.
1 Lower the bed and lock the wheels.
,2 Move the IV pole close to the patient.
7 Provide support while walking.
MEET THE OBJECTIVES
1. Reference: Page 42
A. Patient movement and ambulation
B. Electrical hazards
C. Fire hazards
2. Reference: Page 42
A. Bed rest promotes atelectasis, can cause bed sores.
B. Ambulation reduces length of stay, maintains normal body functions.
3. Reference: Page 42
Minimizes the likelihood of injuries.
4. Reference: Page 43
Level of consciousness, color, breathing, strength, and complaints
5. Reference: Page 49, Figure 3-9
A. Attitude
B. Culture
C. Self-concepts
D. Feelings
E. Prior experiences
6. Reference: Page 52
A. Share information instead of telling.
B. Relate to people instead of controlling.
C. Value disagreement as much as agreement.
D. Eliminate threatening behavior.
E. Use effective nonverbal communication.
Students are expected to elaborate on two of these areas! You will find considerable
additional information that can be used for discussion.
7. Reference: Pages 53-54
A. Poor communication: Supervisor not willing to accept different points of view for
dealing with a difficult patient.
B. Structural problems: Conflict increases in larger organizations.
C. Personal behavior: Personalities, attitudes, and behavior traits.
D. Role conflict: Clinical supervisor trying to manage staff and students at the same time.
8. Reference: Pages 55-57
Health care records are written pictures of occurrences and situations pertaining to a
, patient throughout his or her stay in a health care institution.
Medical records are the property of the institution.
Only those individuals directly caring for the patient may view the patient’s medical
records.
9. Reference: Page 57
A. Legal: No documentation means that no care was given.
B. Practical: Briefness (using standard terms)
10. Reference: Rule of thumb, Box 3-4
Meaning Example
S Subjective “My chest hurts when I breathe.”
O Objective Awake, alert, and oriented. HR 98, RR 25, BP 118/80.
Bronchial breath sounds in right lower lobe.
A Assessment Pneumonia continues.
P Plan Postural drainage and percussion every 4 hr.
SUMMARY CHECKLIST
11. Ambulation
12. Microshock
13. Grounding
14. Oxygen (O2)
15. Communication
16. Conflict
17. Legal
18. Document
CASE STUDIES
Case 1
Reference: Pages 42-43
19. Portable O2 source: E cylinder or liquid.
20. Color, breathing (rate, pattern, use of accessory muscles), strength, patient
complaints (shortness of breath). A pulse oximeter might be useful in evaluating
adequacy of oxygenation.
Case 2
Reference: Pages 44-47, 53-54
ANSWER KEYS
,CHAPTER OBJECTIVES
1. Define respiratory care. (Q: 4, 15)
2. Summarize some of the major events in the history of science and medicine. (Q: 18)
3. Explain how the respiratory care profession got started. (Q: 20)
4. Describe the historical development of the major clinical areas of respiratory care. (Q:
21)
5. Name some of the important historical figures in respiratory care. (Q: 24)
6. Describe the major respiratory care educational, credentialing, and
professional associations. (Q: 16)
7. Explain how the important respiratory care organizations got started. (Q: 16)
8. Describe the development of respiratory care education. (Q: 17)
9. Predict future trends for the respiratory care profession. (Q: 23)
WORD WIZARD
Reference: Glossary
1. M. physician assistant
2. A. AARC
3. F. respiratory therapy
4. E. respiratory care (Number 3 and 4 are often interchanged.)
5. I. aerosol medications
6. H. oxygen (O2) therapy
7. C. NBRC
8. J. mechanical ventilation
9. B. CoARC
10. D. cardiopulmonary system
11. L. pulmonary function testing
12. N. respiratory care practitioner(s)
13. G. respiratory therapist(s) (The terms in 13 and 14 are often interchanged.)
14. K. airway management
MEET THE OBJECTIVES
15. References: Pages 4, 11
The actual definition of respiratory therapy is “the health care discipline that specializes
in the promotion of optimal cardiopulmonary function and health.”
Main concepts may include the assessment, treatment, management, control, diagnostic
evaluation, education, and care of patients with deficiencies and abnormalities of the
,cardiopulmonary system. Respiratory care is increasingly involved in the prevention of
respiratory disease, the management of patients with chronic respiratory disease, and the
promotion of health and wellness.
The Inhalation Therapy Association (ITA) was the first professional association in
respiratory care. The ITA became the American Association for Inhalation Therapists
(AAIT) in 1954, the American Association for Respiratory Therapy (ARRT) in 1973, and
the American Association for Respiratory Care (AARC) in 1982.
16. Reference: Page 14
The first course in inhalation therapy was offered in 1950. Programs in the 1960s
focused on teaching students the proper application of O2 therapy, O2 delivery
systems, humidifiers, and nebulizers and the use of various IPPB devices. The new
standard requires an associate degree for entry into the profession. There will be a need
for individuals with more education so more baccalaureate and graduate education is
needed. Technician programs no longer exist.
SUMMARY CHECKLIST
17. Reference: Page
4 Prevent; treat
18. Reference: Page 11
AARC; 1947; the Inhalation Therapy Association
19. Reference: Page
9 Polio
FOOD FOR THOUGHT
20. The general answer is management, supervision, research, and education. You
can also become a case manager, a drug representative, or go on for graduate
education in anesthesia or as a physician assistant.
21. This question is a simple classic that has many possible answers.
Dr. David Pierson promoted the science of respiratory care and the use of protocols. He
helped us elevate our practice. Joseph Priestley discovered O2, and Thomas Beddoes
first used it. I would like to be a therapist who becomes a pioneer of a new and vital
technique.
,CHAPTER OBJECTIVES
1. Understand the elements for delivering quality respiratory care. (Q: 5)
2. Explain how respiratory care protocols improve the quality of respiratory care services.
(Q: 6, 7)
3. Understand the evidence-based medicine. (Q: 9)
WORD WIZARD
1. CoARC Responsible for quality of schools
2. The Joint Commission Uses site visits to check quality of care
3. Evidence-based medicine Uses meta-analyses to find best care
4. NBRC Responsible for quality of credentialing exams
MEET THE OBJECTIVES
5. Reference: Page 20
A. Equipment
B. Personnel
C. Method of delivery of services
6. Reference: Page 31
A. Institutional: Skills check-offs and classes and competencies
B. Governmental: Monitors like CMS or The Joint Commission accredits institutions
based on quality monitoring standards over nine or more areas.
7. Reference: Tables 2-1, 2-2, 2-3, and 2-5
Protocols improve the allocation of respiratory resources by reducing misallocations
such as over-ordering. Protocols also reduce costs. Care may be enhanced.
8. Reference: Pages 36-38
The ARDSNet studies produced scientific evidence. When analyzed, they showed that
you could decrease patient mortality by following specific guidelines for volume
ventilation. Using 4 to 8 ml/kg as the breath size saved lives.
SUMMARY CHECKLIST
Reference: Page 38
9. Misallocation
,10. Protocols
11. Registered (RRT)
12. National Board for Respiratory Care (NBRC)
13. Evidence-based
CASE STUDIES
Case 1
Reference: Page 26, Figure 2-2
14. A. SOB
B. Tachycardia
C. Diaphoresis, confusion, etc.
15. The pulse oximeter shows a good saturation. The patient has no clinical signs of
hypoxemia and no history that suggests heart or lung disease. Respiratory rate and
heart rate are normal. Oxygen (O2) therapy is not indicated.
16. Place the patient on room air and recheck the saturation. The history of abdominal
surgery suggests starting the patient on postoperative protocol like incentive
spirometry. Discontinue the O2 if the saturations are good.
Case 2
Reference: Page 25, Figure 2-1
17. He has a history of smoking, lung disease, and has had surgery. His x-ray
shows atelectasis. He is wheezing, so he needs a bronchodilator.
Step 1: Patient is alert
Step 2: Can take a deep breath
Step 3: Does not meet MDI criteria
Step 4: Select SVN
WHAT DOES THE NBRC SAY?
18. Reference: Page 26, Figure 2-2
A. O2 therapy
19. Reference: Page 27, Mini Clini
D. Aerosolized bronchodilator therapy
20. Reference: Page 26, Figure 2-2
A. Increase the liter per minute flow to the cannulas.
,FOOD FOR THOUGHT
21. Reference: Pages 24, 27; Boxes 2-2, 2-5, and 2-6
Successful protocol programs involve many elements, including collaboration with
physicians and nurses, trained therapists, committed medical direction, and active
quality monitoring. Failure to take all of these actions could result in poor outcomes.
Protocols themselves must be well designed. Quality assurance efforts are also
complex. Timely audits must be conducted, and follow-up actions to resolve problem
areas must be taken.
22. Reference: Page 38
Meta-analysis analyzes and summarizes all the research findings on a topic into one
result using the best studies (weighted). A standard literature search cannot combine
the various studies. Meta-analysis is better, but you need enough quality studies to
perform the analysis, making it limited, for example, in evaluating new therapies.
,Chapter 03: Quality, Patient Safety, and Communication, and Recordkeeping
Answer Key for the Workbook
CHAPTER OBJECTIVES
1. Describe how to apply good body mechanics and posture to moving patients. (Q: 3)
2. Describe how to ambulate a patient and the potential benefits of ambulation. (Keep
it Moving, Q: 19, 20)
3. Write definitions of key terms associated with electricity, including voltage, current,
and resistance. (Word Wizard, Q: 2)
4. Identify the potential physiologic effects that electrical current can have on the body.
(Word Wizard)
5. State how to reduce the risk of electrical shock to patients and yourself. (Word Wizard)
6. Identify key statistics related to the incidence and origin of hospital fires.
7. List the conditions needed for fire and how to minimize fire hazards. (Word Wizard)
8. Identify impediments to care and risk in the direct patient environment. (Word Wizard)
9. State how communication can affect patient care. (Q: 22)
10. Describe the two patient identifier systems.
11. List the factors associated with the communication process. (Q: 5)
12. Describe how to improve your communication effectiveness. (Q: 6, 16)
13. Describe how to recognize and help resolve interpersonal or organizational sources
of conflict. (Q: 7)
14. List the common components of a medical record. (Q: 8)
15. State the legal and practical obligations involved in recordkeeping. (Q: 9)
16. Describe how to maintain a problem-oriented medical record. (Q: 9)
WORD WIZARD
Reference: Pages 43-47
current; ground; macro; micro; ground
Burn, Baby, Burn
Reference: Pages 48-49
nonflammable; combustible; cigarettes
KEEP IT MOVING!
4 Dangle the patient.
3 Sit them up.
5 Assist to a standing position.
6 Encourage slow, easy breathing.
1 Lower the bed and lock the wheels.
,2 Move the IV pole close to the patient.
7 Provide support while walking.
MEET THE OBJECTIVES
1. Reference: Page 42
A. Patient movement and ambulation
B. Electrical hazards
C. Fire hazards
2. Reference: Page 42
A. Bed rest promotes atelectasis, can cause bed sores.
B. Ambulation reduces length of stay, maintains normal body functions.
3. Reference: Page 42
Minimizes the likelihood of injuries.
4. Reference: Page 43
Level of consciousness, color, breathing, strength, and complaints
5. Reference: Page 49, Figure 3-9
A. Attitude
B. Culture
C. Self-concepts
D. Feelings
E. Prior experiences
6. Reference: Page 52
A. Share information instead of telling.
B. Relate to people instead of controlling.
C. Value disagreement as much as agreement.
D. Eliminate threatening behavior.
E. Use effective nonverbal communication.
Students are expected to elaborate on two of these areas! You will find considerable
additional information that can be used for discussion.
7. Reference: Pages 53-54
A. Poor communication: Supervisor not willing to accept different points of view for
dealing with a difficult patient.
B. Structural problems: Conflict increases in larger organizations.
C. Personal behavior: Personalities, attitudes, and behavior traits.
D. Role conflict: Clinical supervisor trying to manage staff and students at the same time.
8. Reference: Pages 55-57
Health care records are written pictures of occurrences and situations pertaining to a
, patient throughout his or her stay in a health care institution.
Medical records are the property of the institution.
Only those individuals directly caring for the patient may view the patient’s medical
records.
9. Reference: Page 57
A. Legal: No documentation means that no care was given.
B. Practical: Briefness (using standard terms)
10. Reference: Rule of thumb, Box 3-4
Meaning Example
S Subjective “My chest hurts when I breathe.”
O Objective Awake, alert, and oriented. HR 98, RR 25, BP 118/80.
Bronchial breath sounds in right lower lobe.
A Assessment Pneumonia continues.
P Plan Postural drainage and percussion every 4 hr.
SUMMARY CHECKLIST
11. Ambulation
12. Microshock
13. Grounding
14. Oxygen (O2)
15. Communication
16. Conflict
17. Legal
18. Document
CASE STUDIES
Case 1
Reference: Pages 42-43
19. Portable O2 source: E cylinder or liquid.
20. Color, breathing (rate, pattern, use of accessory muscles), strength, patient
complaints (shortness of breath). A pulse oximeter might be useful in evaluating
adequacy of oxygenation.
Case 2
Reference: Pages 44-47, 53-54
