KETTERING CSE PRACTICE QUESTIONS WITH CORRECT ANSWERS LATEST UPDATE
2025/2026
Emphysema/Chronic Bronchitis - Answers Weakening and permanent enlargement of the air
spaces distal to the terminal bronchioles often accompanied by hypertrophy of the goblet cells
and mucus glands.
Emphysema/Chronic Bronchitis Patient Assessment - Answers General Appearance:
Barrel Chest
Increased AP diameter
Clubbing
Cyanosis
Respiratory Pattern:
Dyspnea
Accessory Muscle Use
Pursed lip breathing
Breath Sounds:
Diminished aeration with bilateral expiratory wheeze
Ronchi (more prevalent with Chronic Bronchitis)
Diagnostic Chest Percussion:
Tympanic or hyperrasonant
Cough:
Congested
Productive of thick sputum
,Side note: Chronic Bronchitis is a confirmed diagnosis with a daily, productive cough for a
minimum of 3 consecutive months each year for a minimum of 2 consecutive years
Emphysema/Chronic Bronchitis Diagnostic Testing - Answers Chest X-Ray:
Hyperlucency
Hyperinflation
Increased A-P diameter
Flattened Diaphragm
ABGs:
Compensated respiratory acidosis with hypoxemia and hypercapnia
PFTs:
Decreased flows (FEV1, FEV1/FVC, FEF 25-75%)
FEV1/FVC < 70% confirms obstructions
Also: Increased FRC and normal Increased TLC
Airflow Severity (FEV1.0) post Bronchodilator - Answers Mild: FEV1 > 80% predicted
Moderate: FEV1 50-79% predicted
Severe: FEV1 30-49% predicted
Very Severe: FEV1 <30% predicted
Emphysema/Chronic Bronchitis Treatments (In-Patient) - Answers -Management of
exacerbations
-Medications: bronchodilators for bronchodilation or relief of bronchospasm, antibiotic for
infection
- Supplemental O2 for hypoxemia (low Fio2 24%-28%)
-NPPV where PH is <7.35 and Paco2 is >45 torr is the first mode of ventilation for patients with
persistent hypoxemia, unresponsive to O2 therapy and increased WOB.
,-Intubation and mechanical ventilatory support is used in instances of acute hypercapnia
respiratory failure, where PH is 7.30 and PaCO2 is > 50 torr with severe hypoxemia
Emphysema/Chronic Bronchitis (outpatient) rehab/homecare - Answers -F/u examination
following discharge: known to decrease morbidity
-Outpatient follow up within 3-4 weeks, then second follow up with the next 3 months
-Spirometry: PFT testing, PEFR to monitor Progress
-ABG: to monitor progress
-Review therapy meds, techniques, (O2, MDI with spacers)
-Refer patient and family to appropriate exacerbation of ventilatory failure (nutiritional
management, avoiding infections, excercise program, methods to aid in secretions clearance,
home O2 and aerosol therapy, medication and their use.
-Refer to smoking cessation program
Short Acting Bronchodilators (SABA) - Answers Albuterol (ventolin)
Xopenex
Ipratropium bromide (Atrovent)
Long Acting Bronchodilators (LABA) - Answers Salmeterol (seravent)
Tiotropium (Spiriva)
Fomoterol (floradil)
Afromoteral (brovana)
Steroids for Inflammation - Answers Fluticasone (flovent)
Budesonide (pulmicort)
Combination MDI's - Answers Salmeterol, Fluticasone (Advair)
Fomoterol, Budesonide (Symbicort)
Asmanex - Answers Mometasone (ICS)
Emphysema/Chronic Bronchitis Breathing Controls - Answers Positional (upright)
Pursed lip relaxation techniques
Emphysema/Chronic Bronchitis Airway clearance - Answers IS/SMI
, Coughing
increase water consumption
room humidification
also exercise daily, to improve strength and endurance
healthy diet to improve strength, and weight-loss
Emphysema - Answers Thin underweight
Pink puffer
Chronic Bronchitis - Answers Blue Bloater, stocky overweight
confirmed with a dialy productive cough for a minimum of 3 months each year for a minimum of
2 years
Asthma - Answers a chronic inflammatory, obstructive, non contagious airway disease with
varying levels of severity, characterized by exacerbations of wheezing and coughing, episodes
occur when the patient is exposed to a specific trigger, such as dust, grass, pollen, smoke,
animal dander, etc..
Asthma Patient Assessment - Answers Shortness of breath:
chest tightness, pursed lip breathing
Appearance of the chest:
Increased AP Diameter during episode
Respiratory Pattern:
Accessory muscle use
Retractions (especially in children)
Diagnostic Chest Percussion:
Hypperresonant/ tympanic note
2025/2026
Emphysema/Chronic Bronchitis - Answers Weakening and permanent enlargement of the air
spaces distal to the terminal bronchioles often accompanied by hypertrophy of the goblet cells
and mucus glands.
Emphysema/Chronic Bronchitis Patient Assessment - Answers General Appearance:
Barrel Chest
Increased AP diameter
Clubbing
Cyanosis
Respiratory Pattern:
Dyspnea
Accessory Muscle Use
Pursed lip breathing
Breath Sounds:
Diminished aeration with bilateral expiratory wheeze
Ronchi (more prevalent with Chronic Bronchitis)
Diagnostic Chest Percussion:
Tympanic or hyperrasonant
Cough:
Congested
Productive of thick sputum
,Side note: Chronic Bronchitis is a confirmed diagnosis with a daily, productive cough for a
minimum of 3 consecutive months each year for a minimum of 2 consecutive years
Emphysema/Chronic Bronchitis Diagnostic Testing - Answers Chest X-Ray:
Hyperlucency
Hyperinflation
Increased A-P diameter
Flattened Diaphragm
ABGs:
Compensated respiratory acidosis with hypoxemia and hypercapnia
PFTs:
Decreased flows (FEV1, FEV1/FVC, FEF 25-75%)
FEV1/FVC < 70% confirms obstructions
Also: Increased FRC and normal Increased TLC
Airflow Severity (FEV1.0) post Bronchodilator - Answers Mild: FEV1 > 80% predicted
Moderate: FEV1 50-79% predicted
Severe: FEV1 30-49% predicted
Very Severe: FEV1 <30% predicted
Emphysema/Chronic Bronchitis Treatments (In-Patient) - Answers -Management of
exacerbations
-Medications: bronchodilators for bronchodilation or relief of bronchospasm, antibiotic for
infection
- Supplemental O2 for hypoxemia (low Fio2 24%-28%)
-NPPV where PH is <7.35 and Paco2 is >45 torr is the first mode of ventilation for patients with
persistent hypoxemia, unresponsive to O2 therapy and increased WOB.
,-Intubation and mechanical ventilatory support is used in instances of acute hypercapnia
respiratory failure, where PH is 7.30 and PaCO2 is > 50 torr with severe hypoxemia
Emphysema/Chronic Bronchitis (outpatient) rehab/homecare - Answers -F/u examination
following discharge: known to decrease morbidity
-Outpatient follow up within 3-4 weeks, then second follow up with the next 3 months
-Spirometry: PFT testing, PEFR to monitor Progress
-ABG: to monitor progress
-Review therapy meds, techniques, (O2, MDI with spacers)
-Refer patient and family to appropriate exacerbation of ventilatory failure (nutiritional
management, avoiding infections, excercise program, methods to aid in secretions clearance,
home O2 and aerosol therapy, medication and their use.
-Refer to smoking cessation program
Short Acting Bronchodilators (SABA) - Answers Albuterol (ventolin)
Xopenex
Ipratropium bromide (Atrovent)
Long Acting Bronchodilators (LABA) - Answers Salmeterol (seravent)
Tiotropium (Spiriva)
Fomoterol (floradil)
Afromoteral (brovana)
Steroids for Inflammation - Answers Fluticasone (flovent)
Budesonide (pulmicort)
Combination MDI's - Answers Salmeterol, Fluticasone (Advair)
Fomoterol, Budesonide (Symbicort)
Asmanex - Answers Mometasone (ICS)
Emphysema/Chronic Bronchitis Breathing Controls - Answers Positional (upright)
Pursed lip relaxation techniques
Emphysema/Chronic Bronchitis Airway clearance - Answers IS/SMI
, Coughing
increase water consumption
room humidification
also exercise daily, to improve strength and endurance
healthy diet to improve strength, and weight-loss
Emphysema - Answers Thin underweight
Pink puffer
Chronic Bronchitis - Answers Blue Bloater, stocky overweight
confirmed with a dialy productive cough for a minimum of 3 months each year for a minimum of
2 years
Asthma - Answers a chronic inflammatory, obstructive, non contagious airway disease with
varying levels of severity, characterized by exacerbations of wheezing and coughing, episodes
occur when the patient is exposed to a specific trigger, such as dust, grass, pollen, smoke,
animal dander, etc..
Asthma Patient Assessment - Answers Shortness of breath:
chest tightness, pursed lip breathing
Appearance of the chest:
Increased AP Diameter during episode
Respiratory Pattern:
Accessory muscle use
Retractions (especially in children)
Diagnostic Chest Percussion:
Hypperresonant/ tympanic note
