Question 1

What instructions would you give a patient who is to have a bronchoscopy procedure?

Accepted Answer

The patient should have the procedure explained thoroughly as well as what to expect during the procedure.He should be instructed not to eat food or drink liquids for at least 6 to 8 hours before the test.The patient should be instructed to take their oral medicines with a small sip of water.The patient should arrive 1 1/2 hours before the bronchoscopy is scheduled.Explain that the medication they receive during the bronchoscopy makes them sleepy so they should plan to have someone drive home.They should take their inhaled medicines as they normally do.They should also know what to expect after the treatment as well as the possible complications.

Question 2

A patient vomits and aspirates after ingestion of excessive amounts of ethanol.The resident asks the respiratory therapy practitioner for recommendations.The practitioner should recommend which of the following?

Accepted Answer

A)  Wang needle aspiration 
B)  Sputum sample for cytology 
C)  Diagnostic bronchoscopy 
D)  Therapeutic bronchoscopy 
A)  Wang needle aspiration 
B)  Sputum sample for cytology 
C)  Diagnostic bronchoscopy 
D)  Therapeutic bronchoscopy C

Question 3

A patient's chest radiograph indicates a right lower lobe infiltrate with atelectasis.The resident asks the respiratory therapy practitioner for recommendations.The practitioner should recommend which of the following?

Accepted Answer

A)  Diagnostic bronchoscopy with a Wang needle 
B)  Small volume nebulizer with a mucolytic medication 
C)  Diagnostic bronchoscopy 
D)  Therapeutic bronchoscopy 
A)  Diagnostic bronchoscopy with a Wang needle 
B)  Small volume nebulizer with a mucolytic medication 
C)  Diagnostic bronchoscopy 
D)  Therapeutic bronchoscopy D

Question 4

A patient is being prepared to undergo a diagnostic bronchoscopic procedure.During the preparation of the patient,a small volume nebulizer is used to aerosolize 2% lidocaine to the airway.Which of the following is NOT a hazard of the medication?

Accepted Answer

A)  Vertigo 
B)  Dizziness 
C)  Respiratory depression 
D)  Difficulty focusing the eyes 
A)  Vertigo 
B)  Dizziness 
C)  Respiratory depression 
D)  Difficulty focusing the eyes

Question 5

Which type of brush/needle/mechanical device is/are used to sample an area of interest that lies on the opposite side of the bronchial wall from where the bronchoscope is located?

Accepted Answer

A)  Sheathed cytology brush 
B)  Unsheathed cytology brush 
C)  Forceps 
D)  Wang needle 
A)  Sheathed cytology brush 
B)  Unsheathed cytology brush 
C)  Forceps 
D)  Wang needle

Question 6

Which type of testing and analysis performed on bronchoscopic sample would be performed to detect cancerous cells?

Accepted Answer

A)  Cytologic testing 
B)  Microbiologic testing 
C)  Histological testing 
D)  Protozoal testing 
A)  Cytologic testing 
B)  Microbiologic testing 
C)  Histological testing 
D)  Protozoal testing

Question 7

The practitioner being oriented on the pediatric unit finds that one of the duties she will be performing will be helping with bronchoscopy procedures.Why would bronchoscopies be performed on pediatric patients?

Accepted Answer

There are several reasons for performing

Question 8

Which type of sample obtained by bronchoscopic analysis should be fixated in a formalin solution?

Accepted Answer

A)  Sample for cytological analysis 
B)  Sample for histological analysis 
C)  Sample for microbiological analysis 
D)  Sample for fungal analysis 
A)  Sample for cytological analysis 
B)  Sample for histological analysis 
C)  Sample for microbiological analysis 
D)  Sample for fungal analysis

Question 9

A pulmonologist performs a fiberoptic bronchoscopy on an outpatient with recurrent bouts of pneumonia.During post-procedure instruction,the patient should be informed to contact the physician if which of the following occurs?

Accepted Answer

A)  Dyspnea, wheezing or hemoptysis 
B)  Fever or chest pain 
C)  Ringing in the ears or constipation 
D)  a and b 
A)  Dyspnea, wheezing or hemoptysis 
B)  Fever or chest pain 
C)  Ringing in the ears or constipation 
D)  a and b

Question 10

Bronchoscopy is visual examination of the tracheobronchial tree.This procedure may be performed __________________

Accepted Answer

A)  with a fiberoptic bronchoscope. 
B)  with a rigid bronchoscope 
C)  anywhere, because emergency equipment is not needed. 
D)  a and b 
A)  with a fiberoptic bronchoscope. 
B)  with a rigid bronchoscope 
C)  anywhere, because emergency equipment is not needed. 
D)  a and b

Question 11

______________ is performed to obtain lower respiratory tract secretions or tissue samples for cytological,histological,or microbiological study.

Accepted Answer

A)  Therapeutic bronchoscopy 
B)  Diagnostic bronchoscopy 
C)  Bronchoalveolar lavage 
D)  Rigid bronchoscopy 
A)  Therapeutic bronchoscopy 
B)  Diagnostic bronchoscopy 
C)  Bronchoalveolar lavage 
D)  Rigid bronchoscopy

Question 12

Which type of brush/needle/mechanical device is/are used to obtain a sample that cannot become contaminated during retrieval through the suction channel?

Accepted Answer

A)  Unsheathed cytology brush 
B)  Sheathed cytology brush 
C)  Forceps 
D)  Wang needle 
A)  Unsheathed cytology brush 
B)  Sheathed cytology brush 
C)  Forceps 
D)  Wang needle

Question 13

__________________ is performed to remove excessive pulmonary secretions or foreign material suspected of causing lobar or segmental atelectasis.

Accepted Answer

A)  Therapeutic bronchcoscopy 
B)  Diagnostic bronchoscopy 
C)  Bronchoalveolar lavage 
D)  Rigid bronchoscopy 
A)  Therapeutic bronchcoscopy 
B)  Diagnostic bronchoscopy 
C)  Bronchoalveolar lavage 
D)  Rigid bronchoscopy

Question 14

What procedure should follow a bronchoscopic procedure involving a transbronchial biopsy?

Accepted Answer

A)  Microscopic sputum examination 
B)  Chest x-ray 
C)  Mechanical ventilation 
D)  Bronchoalveolar lavage 
A)  Microscopic sputum examination 
B)  Chest x-ray 
C)  Mechanical ventilation 
D)  Bronchoalveolar lavage

Question 15

A rigid bronchoscope cannot remove large foreign body in the tracheobronchial tree in the airways lower than the _________________

Accepted Answer

A)  trachea. 
B)  mainstem bronchi. 
C)  segmental bronchi. 
D)  terminal bronchioles. 
A)  trachea. 
B)  mainstem bronchi. 
C)  segmental bronchi. 
D)  terminal bronchioles.

Question 16

A resident is called to the medical intensive care unit to perform an intubation of a COPD patient with acute respiratory failure.A several unsuccessful attempts the physician asks the respiratory care practitioner for recommendations.Which of the following should the practitioner recommend?

Accepted Answer

A)  Use a rigid bronchoscope to expose the larynx and facilitate the placement of the endotracheal tube 
B)  Perform a diagnostic bronchoscopy with a flexible bronchoscope to remove all tissue that may be obstructing the view of the airway 
C)  Perform a therapeutic bronchoscopy with a flexible bronchoscope to facilitate the placement of the endotracheal tube 
D)  Use a bronchoscope to locate the tracheal rings to mark the area where a surgeon can perform an emergency tracheotomy 
A)  Use a rigid bronchoscope to expose the larynx and facilitate the placement of the endotracheal tube 
B)  Perform a diagnostic bronchoscopy with a flexible bronchoscope to remove all tissue that may be obstructing the view of the airway 
C)  Perform a therapeutic bronchoscopy with a flexible bronchoscope to facilitate the placement of the endotracheal tube 
D)  Use a bronchoscope to locate the tracheal rings to mark the area where a surgeon can perform an emergency tracheotomy

Question 17

A diagnostic bronchoscopy is ordered on a patient with a 5 mm lesion on a chest radiograph.The patient has excessive secretions in the airway inhibiting taking a sample of the lesion.Which medication should be recommended to help clear the dry the secretions in the airway to better visualize the area to be sampled?

Accepted Answer

A)  Epinephrine 
B)  Diazepam 
C)  Lidocaine 
D)  Atropine 
A)  Epinephrine 
B)  Diazepam 
C)  Lidocaine 
D)  Atropine

Question 18

Patient monitoring should be done before,during,and after bronchoscopic procedures.Which of the following is important to monitor?

Accepted Answer

A)  Patient's level of consciousness 
B)  Patient vital signs, including heart rhythm 
C)  Patient's subjective response to the procedure 
D)  a, b, and c 
A)  Patient's level of consciousness 
B)  Patient vital signs, including heart rhythm 
C)  Patient's subjective response to the procedure 
D)  a, b, and c

Question 19

Which of the following is NOT an absolute contraindication for a flexible bronchoscopy?

Accepted Answer

A)  The need to evaluate problems associated with endotracheal or tracheostomy tubes (tracheal damage, airway obstruction, or tube placement) in an end-stage COPD patient 
B)  Absence of consent from the patient or his/her representative unless a medical emergency exists and patient is not competent to give permission 
C)  Absence of an experienced bronchoscopist to perform or closely and directly supervise the procedure 
D)  Lack of adequate facilities and personnel to care for such emergencies such as cardiopulmonary arrest, pneumothorax, or bleeding 
A)  The need to evaluate problems associated with endotracheal or tracheostomy tubes (tracheal damage, airway obstruction, or tube placement) in an end-stage COPD patient 
B)  Absence of consent from the patient or his/her representative unless a medical emergency exists and patient is not competent to give permission 
C)  Absence of an experienced bronchoscopist to perform or closely and directly supervise the procedure 
D)  Lack of adequate facilities and personnel to care for such emergencies such as cardiopulmonary arrest, pneumothorax, or bleeding

Question 20

Bronchoscopy is commonly performed for two reasons:

Accepted Answer

A)  identification and assessment. 
B)  bronchoscopic and radiographic. 
C)  therapeutic and diagnostic. 
D)  cytological and infection control. 
A)  identification and assessment. 
B)  bronchoscopic and radiographic. 
C)  therapeutic and diagnostic. 
D)  cytological and infection control.

Exam 18: Bronchoscopy Assisting

What instructions would you give a patient who is to have a bronchoscopy procedure?

A patient vomits and aspirates after ingestion of excessive amounts of ethanol.The resident asks the respiratory therapy practitioner for recommendations.The practitioner should recommend which of the following?

A patient's chest radiograph indicates a right lower lobe infiltrate with atelectasis.The resident asks the respiratory therapy practitioner for recommendations.The practitioner should recommend which of the following?

A patient is being prepared to undergo a diagnostic bronchoscopic procedure.During the preparation of the patient,a small volume nebulizer is used to aerosolize 2% lidocaine to the airway.Which of the following is NOT a hazard of the medication?

Which type of brush/needle/mechanical device is/are used to sample an area of interest that lies on the opposite side of the bronchial wall from where the bronchoscope is located?

Which type of testing and analysis performed on bronchoscopic sample would be performed to detect cancerous cells?

The practitioner being oriented on the pediatric unit finds that one of the duties she will be performing will be helping with bronchoscopy procedures.Why would bronchoscopies be performed on pediatric patients?

Which type of sample obtained by bronchoscopic analysis should be fixated in a formalin solution?

A pulmonologist performs a fiberoptic bronchoscopy on an outpatient with recurrent bouts of pneumonia.During post-procedure instruction,the patient should be informed to contact the physician if which of the following occurs?

Bronchoscopy is visual examination of the tracheobronchial tree.This procedure may be performed __________________

______________ is performed to obtain lower respiratory tract secretions or tissue samples for cytological,histological,or microbiological study.

Which type of brush/needle/mechanical device is/are used to obtain a sample that cannot become contaminated during retrieval through the suction channel?

__________________ is performed to remove excessive pulmonary secretions or foreign material suspected of causing lobar or segmental atelectasis.

What procedure should follow a bronchoscopic procedure involving a transbronchial biopsy?

A rigid bronchoscope cannot remove large foreign body in the tracheobronchial tree in the airways lower than the _________________

A resident is called to the medical intensive care unit to perform an intubation of a COPD patient with acute respiratory failure.A several unsuccessful attempts the physician asks the respiratory care practitioner for recommendations.Which of the following should the practitioner recommend?

Patient monitoring should be done before,during,and after bronchoscopic procedures.Which of the following is important to monitor?

Which of the following is NOT an absolute contraindication for a flexible bronchoscopy?

Bronchoscopy is commonly performed for two reasons:

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

Hyperinflation Therapy

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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