NPTE-PT Cardiopulmonary Assessment and Management 2 — Questions and Answers
Question 1: A patient with COPD has a PaCO2 of 55 mmHg and pH of 7.32. Which acid-base disturbance does this represent?
- Respiratory alkalosis
- Metabolic acidosis
- Respiratory acidosis (Correct answer)
- Metabolic alkalosis
Correct answer: Respiratory acidosis
Elevated PaCO2 (>45 mmHg) combined with decreased pH (<7.35) indicates respiratory acidosis.
Question 2: During auscultation, a physical therapist hears a high-pitched, continuous musical sound during expiration. This is best described as:
- Crackles
- Wheezing (Correct answer)
- Rhonchi
- Stridor
Correct answer: Wheezing
Wheezing is a high-pitched, continuous, musical sound caused by narrowed airways, most commonly heard during expiration.
Question 3: A patient post-CABG is on day 2. The therapist notices the patient's SpO2 drops from 95% to 88% during ambulation. The MOST appropriate action is:
- Continue ambulation and recheck in 5 minutes
- Stop activity, apply supplemental oxygen, and notify nursing (Correct answer)
- Increase ambulation pace to improve cardiac output
- Document and proceed with the session
Correct answer: Stop activity, apply supplemental oxygen, and notify nursing
An SpO2 drop below 90% during activity is a contraindication to continuing exercise and requires immediate supplemental oxygen and medical notification.
Question 4: Which breathing pattern is characterized by alternating periods of hyperpnea and apnea, often seen in patients with heart failure or neurological damage?
- Kussmaul breathing
- Biot's breathing
- Cheyne-Stokes respiration (Correct answer)
- Apneustic breathing
Correct answer: Cheyne-Stokes respiration
Cheyne-Stokes respiration features a cyclic pattern of gradual increase and decrease in tidal volume followed by apnea, associated with heart failure or brain injury.
Question 5: A physical therapist is treating a patient with left-sided heart failure. Which pulmonary finding is MOST expected on auscultation?
- Expiratory wheezes bilaterally
- Bilateral basilar crackles (Correct answer)
- Absent breath sounds at the apex
- Pleural friction rub
Correct answer: Bilateral basilar crackles
Left-sided heart failure causes pulmonary edema, leading to bilateral basilar crackles from fluid accumulation in the lung bases.
Question 6: When performing airway clearance with postural drainage, which position is used to drain the right middle lobe?
- Prone with pillow under abdomen
- Left side-lying with bed tilted head-down (Correct answer)
- Right side-lying with bed flat
- Supine with bed tilted head-down
Correct answer: Left side-lying with bed tilted head-down
The right middle lobe is drained with the patient in left side-lying position with a slight head-down tilt to use gravity effectively.
Question 7: A patient's ECG shows a heart rate of 150 bpm with narrow QRS complexes and no identifiable P waves. This rhythm is MOST consistent with:
- Ventricular tachycardia
- Atrial flutter
- Atrial fibrillation (Correct answer)
- Junctional tachycardia
Correct answer: Atrial fibrillation
Atrial fibrillation presents with an irregularly irregular rhythm, absent P waves, and narrow QRS complexes at an elevated ventricular rate.
NPTE-PT Cardiopulmonary Assessment and Management 2
A patient with COPD has a PaCO2 of 55 mmHg and pH of 7.32.
Which acid-base disturbance does this represent?