Question 1

Which of the following are hazards of IS?
I.Exacerbation of bronchospasm
II.Hyperventilation
III.Barotrauma
IV.Oxygen induced hypoventilation

Accepted Answer

A)  I and III 
B)  II and IV 
C)  I, II, III, and IV 
D)  I, II, and III 
A)  I and III 
B)  II and IV 
C)  I, II, III, and IV 
D)  I, II, and III D

Question 2

All hyperinflation modalities provide methods for increasing _____________

Accepted Answer

A)  expiratory flow rates. 
B)  inspiratory volumes. 
C)  peak expiratory flow rate. 
D)  residual volume. 
A)  expiratory flow rates. 
B)  inspiratory volumes. 
C)  peak expiratory flow rate. 
D)  residual volume. B

Question 3

A surgeon orders lung expansion therapy for an obtunded 68-year-old,170-lb (77.3 kg,IBW)man who has developed atelectasis after thoracic surgery.On baseline assessment,the patient cannot perform an IC or VC maneuver,but has no evidence of retained secretions.Which type of hyperinflation therapy would you recommend?

Accepted Answer

Intermittent Positive Pressure Breathing (IPPB)should be ordered for this patient to reverse the atelectasis.First,after the atelectasis is diagnosed,the patient's vital capacity or inspiratory capacity should be measured.Since the patient's lung volumes cannot be measured,IPPB is indicated.Since the patient can not understand how to perform the lung measurements,the patient probably cannot cooperate to perform other types of therapy that require cooperation.

Question 4

How does expiration take place after a positive-pressure breath during an IPPB treatment?

Accepted Answer

A)  The elastic recoil of the lungs and thorax allows the patient to exhale 
B)  The sensitivity is set to allow the ventilator to be 'sensitive' to the patient when exhalation is started 
C)  The expiratory timer is set to limit the amount of time inspiration takes place 
D)  The flow rate through the Venturi is cut off cycling the ventilator into expiration 
A)  The elastic recoil of the lungs and thorax allows the patient to exhale 
B)  The sensitivity is set to allow the ventilator to be 'sensitive' to the patient when exhalation is started 
C)  The expiratory timer is set to limit the amount of time inspiration takes place 
D)  The flow rate through the Venturi is cut off cycling the ventilator into expiration

Question 5

An increase in ________ will enable the patient to generate greater flows and volumes during a cough.

Accepted Answer

A)  peak pressure 
B)  tidal volume 
C)  residual volume 
D)  intrathoracic pressure 
A)  peak pressure 
B)  tidal volume 
C)  residual volume 
D)  intrathoracic pressure

Question 6

Which control would increase the tidal volume delivered to the patient on a pressure ventilator (e.g.Bird Mark 7)?

Accepted Answer

A)  Tidal volume 
B)  Flow rate 
C)  Pressure 
D)  Sensitivity 
A)  Tidal volume 
B)  Flow rate 
C)  Pressure 
D)  Sensitivity

Question 7

A patient with COPD is being administered IPPB therapy for atelectasis.Oxygen is being used as the source gas.During the therapy the patient becomes lethargic and drowsy,and the patient's respiratory rate decreases from 20 to 6/minute.What is the most likely reason for this occurrence?

Accepted Answer

A)  The patient is sleep deprived and the relief of the work of breathing has relaxed the patient 
B)  The patient is experiencing interruption of the hypoxic drive 
C)  The patient is hyperventilating and is experiencing the signs of increased alveolar ventilation 
D)  The patient is experiencing decreased cardiac output and is having ventilation/perfusion mismatching 
A)  The patient is sleep deprived and the relief of the work of breathing has relaxed the patient 
B)  The patient is experiencing interruption of the hypoxic drive 
C)  The patient is hyperventilating and is experiencing the signs of increased alveolar ventilation 
D)  The patient is experiencing decreased cardiac output and is having ventilation/perfusion mismatching

Question 8

During IPV how is the peak inspiratory pressure determined?

Accepted Answer

A)  Measuring the heart rate 
B)  Measuring the respiratory rate 
C)  Observing the pressure manometer 
D)  Auscultate the breath sounds 
A)  Measuring the heart rate 
B)  Measuring the respiratory rate 
C)  Observing the pressure manometer 
D)  Auscultate the breath sounds

Question 9

The following breathing pattern is ideal for which type of hyperinflation therapy? The patient should be instructed to hold the lips tightly around the mouthpiece and to depress the thumb button.Once the button has been depressed,percussive ventilation will begin.The patient should be instructed to inhale and allow the device to fill the lungs and to percuss them for approximately 5 seconds.After the lungs are full,the patient releases the thumb button and exhales completely through the mouthpiece.This process should be repeated until all of the medication in the nebulizer has been delivered.

Accepted Answer

A)  PEP therapy 
B)  IPPB therapy 
C)  IPV therapy 
D)  Incentive spirometry 
A)  PEP therapy 
B)  IPPB therapy 
C)  IPV therapy 
D)  Incentive spirometry

Question 10

Which modality utilizes the patient's own muscular effort to accomplish hyperinflation of the lungs?

Accepted Answer

A)  Incentive spirometry 
B)  Intermittent positive pressure breathing 
C)  Intermittent percussive ventilation 
D)  Positive airway pressure therapy 
A)  Incentive spirometry 
B)  Intermittent positive pressure breathing 
C)  Intermittent percussive ventilation 
D)  Positive airway pressure therapy

Question 11

Which of the following is an absolute contraindication of IPPB therapy?

Accepted Answer

A)  Tension pneumothorax 
B)  Radiographic evidence of blebs 
C)  Pneumothorax with a functioning chest tube 
D)  a and c 
A)  Tension pneumothorax 
B)  Radiographic evidence of blebs 
C)  Pneumothorax with a functioning chest tube 
D)  a and c

Question 12

The effectiveness of any hyperinflation therapy is dependent on _____________

Accepted Answer

A)  patient effort. 
B)  patient cooperation. 
C)  the patient's diagnosis. 
D)  a and b 
A)  patient effort. 
B)  patient cooperation. 
C)  the patient's diagnosis. 
D)  a and b

Question 13

Which of the following volumes would indicate that a 55-kg,post-operative male patient needs IPPB?

Accepted Answer

A)  Vital capacity of 0.75 L 
B)  Inspiratory capacity of 1/2 of predicted 
C)  Vital capacity of 450 ml 
D)  Inspiratory capacity 1.2 L, predicted inspiratory capacity of 2.9 L 
A)  Vital capacity of 0.75 L 
B)  Inspiratory capacity of 1/2 of predicted 
C)  Vital capacity of 450 ml 
D)  Inspiratory capacity 1.2 L, predicted inspiratory capacity of 2.9 L

Question 14

Which of the following is NOT an indication for incentive spirometry?

Accepted Answer

A)  Presence of pulmonary atelectasis 
B)  Inability to clear secretions adequately because of pathology that severely limits the ability to cough effectively 
C)  Presence of a restrictive lung defect associated with quadriplegic and/or dysfunctional diaphragm 
D)  Presence of conditions predisposing to the development of pulmonary atelectasis 
A)  Presence of pulmonary atelectasis 
B)  Inability to clear secretions adequately because of pathology that severely limits the ability to cough effectively 
C)  Presence of a restrictive lung defect associated with quadriplegic and/or dysfunctional diaphragm 
D)  Presence of conditions predisposing to the development of pulmonary atelectasis

Question 15

Which of the following volumes would indicate that a 70-kg,post-operative open heart male patient needs IS as hyperinflation therapy? (Predicted vital capacity [VC] 4.1L,predicted inspiratory capacity [IC] 2.5L)

Accepted Answer

A)  IC of 1.0L 
B)  VC of 0.07L 
C)  IC of 0.75L 
D)  VC of 0.60L 
A)  IC of 1.0L 
B)  VC of 0.07L 
C)  IC of 0.75L 
D)  VC of 0.60L

Question 16

The respiratory care department puts you in charge of the hyperinflation monitoring committee.What should be monitored to determine the type and the effectiveness of the hyperinflation therapy?

Accepted Answer

The type of therapy needs to be document

Question 17

What is the ideal breathing pattern for IPPB therapy?

Accepted Answer

A)  Instruct the patient to inhale, which will trigger the respirator. Tell the patient to inhale with the ventilator. At the end of the inspiratory phase, instruct the patient to pause briefly before exhaling, to allow for a more even deposition of the aerosol. Have the patient exhale passively. 
B)  Instruct the patient to inhale and exhale passively. This will eliminate any air trapping. 
C)  Instruct the patient to inhale, which will trigger the respirator. Tell the patient to inhale with the ventilator. Have the patient exhale actively to eliminate any air that may have been trapped during inhalation.. 
D)  Instruct the patient to exhale completely, inhale actively with the ventilator. At the end of the inspiratory phase, instruct the patient have the patient exhale passively. 
A)  Instruct the patient to inhale, which will trigger the respirator. Tell the patient to inhale with the ventilator. At the end of the inspiratory phase, instruct the patient to pause briefly before exhaling, to allow for a more even deposition of the aerosol. Have the patient exhale passively. 
B)  Instruct the patient to inhale and exhale passively. This will eliminate any air trapping. 
C)  Instruct the patient to inhale, which will trigger the respirator. Tell the patient to inhale with the ventilator. Have the patient exhale actively to eliminate any air that may have been trapped during inhalation.. 
D)  Instruct the patient to exhale completely, inhale actively with the ventilator. At the end of the inspiratory phase, instruct the patient have the patient exhale passively.

Question 18

While delivering IPPB,which I:E ratio would cause the least decrease of a patient's cardiac output or increase in a patient's intracranial pressure?

Accepted Answer

A)  1:1 
B)  1:2 
C)  1:3 
D)  2:1 
A)  1:1 
B)  1:2 
C)  1:3 
D)  2:1

Question 19

After a maximum inspiratory effort when a patient is utilizing an incentive spirometer,what should the patient do?

Accepted Answer

A)  Cough 
B)  Exhale forcefully 
C)  Perform a 3 to 5 second breath hold 
D)  Perform pursed lip breathing 
A)  Cough 
B)  Exhale forcefully 
C)  Perform a 3 to 5 second breath hold 
D)  Perform pursed lip breathing

Question 20

What is the purpose of the delivery of small volumes of gas at a high frequency (100 to 250/min)to the airways via a mouthpiece that serve to increase mean airway pressure?

Accepted Answer

A)  To break up secretions 
B)  To distribute ventilation more evenly 
C)  To decrease mean airway pressure 
D)  a and b 
A)  To break up secretions 
B)  To distribute ventilation more evenly 
C)  To decrease mean airway pressure 
D)  a and b

Exam 17: Hyperinflation Therapy

Which of the following are hazards of IS? I.Exacerbation of bronchospasm II.Hyperventilation III.Barotrauma IV.Oxygen induced hypoventilation

All hyperinflation modalities provide methods for increasing _____________

How does expiration take place after a positive-pressure breath during an IPPB treatment?

An increase in ________ will enable the patient to generate greater flows and volumes during a cough.

Which control would increase the tidal volume delivered to the patient on a pressure ventilator (e.g.Bird Mark 7)?

A patient with COPD is being administered IPPB therapy for atelectasis.Oxygen is being used as the source gas.During the therapy the patient becomes lethargic and drowsy,and the patient's respiratory rate decreases from 20 to 6/minute.What is the most likely reason for this occurrence?

During IPV how is the peak inspiratory pressure determined?

Which modality utilizes the patient's own muscular effort to accomplish hyperinflation of the lungs?

Which of the following is an absolute contraindication of IPPB therapy?

The effectiveness of any hyperinflation therapy is dependent on _____________

Which of the following volumes would indicate that a 55-kg,post-operative male patient needs IPPB?

Which of the following is NOT an indication for incentive spirometry?

Which of the following volumes would indicate that a 70-kg,post-operative open heart male patient needs IS as hyperinflation therapy? (Predicted vital capacity [VC] 4.1L,predicted inspiratory capacity [IC] 2.5L)

The respiratory care department puts you in charge of the hyperinflation monitoring committee.What should be monitored to determine the type and the effectiveness of the hyperinflation therapy?

What is the ideal breathing pattern for IPPB therapy?

While delivering IPPB,which I:E ratio would cause the least decrease of a patient's cardiac output or increase in a patient's intracranial pressure?

After a maximum inspiratory effort when a patient is utilizing an incentive spirometer,what should the patient do?

What is the purpose of the delivery of small volumes of gas at a high frequency (100 to 250/min)to the airways via a mouthpiece that serve to increase mean airway pressure?

Basics of Asepsis

Basic Patient Assessment: Vital Signs and Breath Sounds

Advanced Patient Assessment: Inspection, Palpation, and Percussion

Radiologic Assessment

Pulmonary Function Testing

Electrocardiography

Phlebotomy

Arterial Blood Gas Sampling

Hemodynamic Monitoring

Noninvasive Monitoring

Documentation and Goals Assessment

Oxygen Supply Systems

Oxygen Administration

Introduction to Respiratory Care Pharmacology

Humidity and Aerosol Therapy

Bronchial Hygiene Therapy

Bronchoscopy Assisting

Equipment Processing and Surveillance

Emergency Airway Management

Artificial Airway Care

Chest Tubes

Insertion and Maintenance of Intravenous Lines

Noninvasive Positive-Pressure Ventilation

Continuous Mechanical Ventilation

Advanced Modes of Mechanical Ventilation

Wave Form Analysis

Weaning and Discontinuance of Mechanical Ventilation

Neonatal Mechanical Ventilation

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