Test Bank for Wilkins’ Clinical Assessment in Respiratory Care, 9th Edition by Albert J. Heuer, Chapters 1 - 21

Wilkins' Clinical Assessment in Respiratory Care, Contents: Chapter 1. Preparing for the Patient Encounter Chapter 2. The Medical History and the Interview Chapter 3. Cardiopulmonary Symptoms Chapter 4. Vital Signs Chapter 5. Fundamentals of Physical Examination Chapter 6. Neurologic Assessment Chapter 7. Clinical Laboratory Studies Chapter 8. Interpretation of Blood Gases Chapter 9. Pulmonary Function Testing Chapter 10. Chest Imaging Chapter 11. Electrocardiography Chapter 12. Neonatal and Pediatric Assessment Chapter 13. Older Patient Assessment Chapter 14. Monitoring in Critical Care Chapter 15. Vascular Pressure Monitoring Chapter 16. Cardiac Output Measurement Chapter 17. Bronchoscopy Chapter 18. Nutritional Assessment Chapter 19. Sleep and Breathing Assessment Chapter 20. Home Care Patient Assessment Chapter 21. Documentation Chapter 1: Preparing for the Patient Encounter Test Bank MULTIPLE CHOICE 1. Which of the following activities is not part of the role of respiratory therapists (RTs) in patient assessment? a. Assist the physician with diagnostic reasoning skills. b. Help the physician select appropriate pulmonary function tests. c. Interpret arterial blood gas values and suggest mechanical ventilation changes. d. Document the patient diagnosis in the patient’s chart. ANSWER: D RTs are not qualified to make an official diagnosis. This is the role of the attending physician. REF: Table 1-1, pg. 4 OBJ: 9 2. In which of the following stages of patient–clinician interaction is the review of physician orders carried out? a. Treatment stage b. Introductory stage c. Preinteraction stage d. Initial assessment stage ANSWER: C Physician orders should be reviewed in the patient’s chart before the physician sees the patient. REF: Table 1-1, pg. 4 OBJ: 9 3. In which stage of patient–clinician interaction is the patient identification bracelet checked? a. Introductory stage b. Preinteraction stage c. Initial assessment stage d. Treatment stage ANSWER: A The patient ID bracelet must be checked before moving forward with assessment and treatment. REF: Table 1-1, pg. 4 OBJ: 9 4. What should be done just before the patient’s ID bracelet is checked? a. Check the patient’s SpO2. b. Ask the patient for permission. c. Check the chart for vital signs. d. Listen to breath sounds. ANSWER: B It is considered polite to ask the patient for permission before touching and reading his or her ID bracelet. REF: pg. 3 OBJ: 3 | 5 5. What is the goal of the introductory phase? a. Assess the patient’s apparent age. b. Identify the patient’s family history. c. Determine the patient’s diagnosis. d. Establish a rapport with the patient. ANSWER: D The introductory phase is all about getting to know the patient and establishing a rapport with him or her. REF: Table 1-1, pg. 4 OBJ: 3 6. Which of the following behaviors is not consistent with resistive behavior of a patient? a. Crossed arms b. Minimal eye contact c. Brief answers to questions d. Asking the purpose of the treatment ANSWER: D If a patient asks about the purpose of the treatment you are about to give, this generally indicates that he or she is not upset. REF: Table 1-1, pg. 4 OBJ: 3 7. What is the main purpose of the initial assessment stage? a. To identify any allergies to medications b. To document the patient’s smoking history c. To personally get to know the patient better d. To verify that the prescribed treatment is still needed and appropriate ANSWER: D When you first see the patient, you are encouraged to perform a brief assessment to make sure the treatment order by the physician is still appropriate. The patient’s status may have changed abruptly recently. REF: Table 1-1, pg. 4 OBJ: 3 8. What is the appropriate distance for the social space from the patient? a. 3 to 5 feet b. 4 to 12 feet c. 6 to 18 feet d. 8 to 20 feet ANSWER: B The social space is 4 to 12 feet. REF: pg. 5 OBJ: 5 9. What is the appropriate distance for the personal space? a. 0 to 18 inches b. 18 inches to 4 feet c. 4 to 12 feet d. 6 to 15 feet ANSWER: B The personal space is about 2 to 4 feet from the patient. REF: pg. 5 OBJ: 5 10. Which of the following activities is best performed in the personal space? a. The interview b. The introduction c. The physical examination d. Listening for breath sounds ANSWER: A The interview is best performed with you sitting about 2 to 4 feet from the patient. If you sit farther away, the patient will have to answer your questions in a louder voice, and because some of the information may be private, this would diminish communication. REF: Table 1-1, pg. 4 OBJ: 5 11. What type of behavior is least appropriate in the patient’s intimate space? a. Eye contact b. Pulse check c. Auscultation d. Simple commands ANSWER: A Eye contact is inappropriate in the intimate space and will make the patient very uncomfortable. REF: pg. 3 OBJ: 5 12. You are riding in an elevator at the hospital where you are employed as an RT. The elevator is full, but standing next to you is Joe, the RT who is scheduled to relieve you. He turns to you and asks, “How is Mr. Copper doing?” Earlier in the day, Mr. Copper had a cardiac arrest, and he is now being mechanically ventilated. How should you respond to Joe? a. “He took a turn for the worse.” b. “He is fine.” c. “Let’s talk later in the report room.” d. “He is on a ventilator and will keep you very busy.” ANSWER: C The patient’s right to privacy prevents care providers from discussing a patient’s clinical status in public places. All answers other than “c” are unethical; giving such answers could cause an RT to be in legal trouble and get fired. REF: Table 1-2, pgs. 4-5 OBJ: 6 13. In 1996, Congress passed the HIPAA. What does the letter “P” stand for? a. Patient b. Payment c. Portability d. Personal ANSWER: C HIPAA stands for Health Insurance Portability and Accountability Act. REF: pg. 4 OBJ: 6 14. Which of the following techniques for expressing genuine concern is the most difficult to use appropriately? a. Touch b. Posture c. Eye contact d. Proper introductions ANSWER: A Touch is most difficult to use properly because gender and cultural differences often become an issue. REF: Table 1-1, pgs. 3-4 OBJ: 5 | 7 15. Which of the following techniques is not associated with the demonstration of active listening? a. Good eye contact b. Taking notes while a patient is talking c. Asking for clarification d. Use of touch ANSWER: D Use of touch helps with demonstrating empathy but has little to do with active listening. REF: pg. 2 OBJ: 2 16. Two respiratory care students are taking their lunch break and want to compare notes about patients they have seen during the morning. Which of the following locations would be considered a violation of HIPAA standards? a. The unit nursing station in front of the unit clerk’s desk b. A table in the cafeteria with no one within hearing distance c. The respiratory department report room d. The intensive care unit (ICU) staff break room ANSWER: A Patient Health Information (PHI) should be discussed only in nonpublic areas of the hospital. The space in front of the unit clerk’s desk is likely to be occupied with members of the public asking for information. REF: Table 1-2, pgs. 4-5 OBJ: 6