Exam 17: Atelectasis

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A 40-year-old patient was in a motor vehicle accident. Among his injuries and related problems are three broken ribs on the right side, pleural fluid in the right pleural space, and atelectasis of both lungs. What should be done to help with the atelectasis problem? 1) Adequate pain management 2) Mechanical ventilation to stabilize the broken ribs 3) Remove the pleural fluid 4) Selective intubation of the right mainstem bronchus

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A

Several pathophysiologic mechanisms operating simultaneously may lead to an increased ventilatory rate. These may include which of the following? 1) Stimulation of central chemoreceptors 2) Decreased lung compliance-increased ventilatory rate relationship 3) Stimulation of J receptors 4) Pain

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D

After surgery, a patient must lie supine in bed. Because of this, atelectasis is thought to have developed. What chest radiograph finding would confirm this?

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D

A patient has a tumor blocking the left mainstem bronchus. What additional factor would favor the development of atelectasis?

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Which of the following are precipitating factors for retained secretions that commonly lead to atelectasis? 1) Asthma 2) General anesthesia 3) Gastric aspiration 4) Smoking history

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Precipitating factors for retained secretions include: 1) decreased mucociliary transport. 2) excessive secretions. 3) overhydration. 4) general anesthesia.

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Which of the following conditions is least likely to lead to atelectasis?

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The respiratory therapist is performing chest assessment on a post-op cholecystectomy patient who has developed cough, fever, and tachypnea. Which of the following would the therapist expect to find confirming the suspicion of post-op atelectasis in this patient?

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What definition of primary atelectasis would best fit that of a premature infant with respiratory distress syndrome (RDS)?

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Which of the following patients should be placed on short-term mechanical ventilation because of the high risk for postoperative atelectasis?

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After open heart surgery, a patient has developed bronchitis with increased secretions and atelectasis. What respiratory therapy procedures should initially be recommended? 1) Chest physical therapy 2) Continuous positive airway pressure (CPAP) 3) Incentive spirometry 4) Inhaled sympathomimetic medication

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A patient with atelectasis is being monitored by bedside spirometry. What findings would correspond with atelectasis? 1) Decreased IC 2) Increased PEFR 3) Decreased VC 4) Increased DLCO

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After gastric bypass surgery, a patient is showing tachypnea. What is the best explanation for this?

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The development of immediate postoperative atelectasis is commonly related to which of the following?

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Common chest assessment findings in a patient with atelectasis include: 1) decreased tactile fremitus. 2) dull percussion note. 3) crackles. 4) bronchial breath sounds.

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Examples of the types of surgical procedures that often result in atelectasis include: 1) open heart surgery. 2) craniotomy. 3) gallbladder removal. 4) splenectomy.

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The following would be found in a patient with atelectasis: 1) Normal shunt fraction 2) Whispered pectoriloquy 3) Chest radiograph shows increased density in areas of atelectasis 4) Diminished breath sounds

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Which of the following are precipitating factors that can decrease the patient's ability to generate a negative intrapleural pressure? 1) Supine position 2) Large tidal volume on the mechanical ventilator 3) Malnutrition 4) Obesity

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