CRE Patient Assessment & Diagnosis 3

Question 1

A patient is being assessed for nocturnal hypoventilation. Which study is most definitive to diagnose obesity hypoventilation syndrome (OHS)?

Accepted Answer

Daytime ABG showing PaCO2 > 45 mmHg with BMI ≥ 30

Answer

OHS is diagnosed by daytime hypercapnia (PaCO2 > 45 mmHg) in an obese patient (BMI ≥ 30) without other explanatory cause.

Question 2

On chest radiograph, which finding is most consistent with a large pleural effusion?

Accepted Answer

Opacification of the costophrenic angle with tracheal deviation away from the affected side

Answer

A large pleural effusion causes opacification and blunting of the costophrenic angle, with mass effect shifting the trachea away from the effusion.

Question 3

Which finding on pulmonary function testing suggests a fixed upper airway obstruction such as tracheal stenosis?

Accepted Answer

Flattening of both the inspiratory and expiratory limbs of the flow-volume loop

Answer

Fixed upper airway obstruction produces plateau (flattening) on both the inspiratory and expiratory limbs of the flow-volume loop.

Question 4

A patient with suspected pulmonary hypertension undergoes a right heart catheterization. Which mean pulmonary arterial pressure (mPAP) confirms the diagnosis?

Accepted Answer

≥ 20 mmHg

Answer

Current guidelines (updated 2022) define pulmonary hypertension as a mean PAP ≥ 20 mmHg at rest during right heart catheterization.

Question 5

When assessing a patient's breathing pattern, Kussmaul respirations are most characteristic of which condition?

Accepted Answer

Diabetic ketoacidosis

Answer

Kussmaul respirations are deep, rapid breaths driven by the body's attempt to compensate for metabolic acidosis, as seen in diabetic ketoacidosis.

(CRE) Certified Respiratory Educator Practice Test

(CRE) Certified Respiratory Educator Practice Test

CRE Patient Assessment & Diagnosis 3