Question 1

Which of the following is NOT a potential contraindication for intermittent positive-pressure breathing?

Accepted Answer

A) hemodynamic instability 
B) recent esophageal surgery 
C) tension pneumothorax 
D) neuromuscular disorders 
A) hemodynamic instability 
B) recent esophageal surgery 
C) tension pneumothorax 
D) neuromuscular disorders D

Question 2

All of the following parameters should be evaluated after intermittent positive-pressure breathing therapy except:

Accepted Answer

A) vital signs 
B) sensorium 
C) breath sounds 
D) temperature 
A) vital signs 
B) sensorium 
C) breath sounds 
D) temperature D

Question 3

A postoperative patient using incentive spirometry complains of dizziness and numbness around the mouth after therapy sessions. What is the most likely cause of these symptoms?

Accepted Answer

A) gastric insufflation 
B) hyperventilation 
C) pulmonary barotrauma 
D) respiratory acidosis 
A) gastric insufflation 
B) hyperventilation 
C) pulmonary barotrauma 
D) respiratory acidosis B

Question 4

Prior to starting intermittent positive-pressure breathing (IPPB) on a new patient, what should the practitioner explain?
I.why the physician ordered the treatment
II.what the IPPB treatment will do
III.how the IPPB treatment will feel
IV.what the expected results are

Accepted Answer

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

Question 5

What is the major contributing factor in the development of postoperative atelectasis?

Accepted Answer

A) uncontrolled hyperpyrexia 
B) central nervous system overstimulation 
C) decreased cardiac output 
D) repetitive, shallow breathing 
A) uncontrolled hyperpyrexia 
B) central nervous system overstimulation 
C) decreased cardiac output 
D) repetitive, shallow breathing

Question 6

When checking a patient's intermittent positive-pressure breathing (IPPB) breathing circuit before use, you notice that the device will not cycle off, even when you occlude the mouthpiece. What would be the most appropriate action in this case?

Accepted Answer

A) Secure a new IPPB ventilator. 
B) Check the circuit for leaks. 
C) Decrease the flow setting. 
D) Increase the pressure setting. 
A) Secure a new IPPB ventilator. 
B) Check the circuit for leaks. 
C) Decrease the flow setting. 
D) Increase the pressure setting.

Question 7

An alert and cooperative 28-year-old woman with no prior history of lung disease underwent cesarean section 16 hours earlier. Her x-ray film currently is clear. Which of the following approaches to preventing atelectasis would you recommend for this patient?

Accepted Answer

A) incentive spirometry 
B) PEEP therapy 
C) deep breathing exercises 
D) intermittent positive-pressure breathing therapy 
A) incentive spirometry 
B) PEEP therapy 
C) deep breathing exercises 
D) intermittent positive-pressure breathing therapy

Question 8

During administration of a continuous positive airway pressure flow mask to a patient with atelectasis, you find it difficult to maintain the prescribed airway pressure. Which of the following is the most common explanation?

Accepted Answer

A) system or mask leaks 
B) outflow obstruction 
C) inadequate system flow 
D) inadequate trigger 
A) system or mask leaks 
B) outflow obstruction 
C) inadequate system flow 
D) inadequate trigger

Question 9

Which of the following clinical findings indicate the development of atelectasis?
I.opacified areas on the chest x-ray film
II.inspiratory and expiratory wheezing
III.tachypnea
IV.diminished or bronchial breath sounds

Accepted Answer

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

Question 10

Ideally, when should high-risk surgical patients be oriented to incentive spirometry?

Accepted Answer

A) postoperatively, after full recovery from the anesthesia 
B) preoperatively, before undergoing the surgical procedure 
C) postoperatively, while they are still in the recovery room 
D) postoperatively, but no sooner than 24 hours after surgery 
A) postoperatively, after full recovery from the anesthesia 
B) preoperatively, before undergoing the surgical procedure 
C) postoperatively, while they are still in the recovery room 
D) postoperatively, but no sooner than 24 hours after surgery

Question 11

Which of the following is FALSE about flow-oriented incentive spirometry devices?

Accepted Answer

A) Inspired volume is estimated as the product of flow and time. 
B) Motivation is based on keeping the indicator balls elevated. 
C) They have proved less effective than volumetric systems. 
D) They provide only an indirect measure of inspired volume. 
A) Inspired volume is estimated as the product of flow and time. 
B) Motivation is based on keeping the indicator balls elevated. 
C) They have proved less effective than volumetric systems. 
D) They provide only an indirect measure of inspired volume.

Question 12

The short-term application of inspiratory positive pressure to a spontaneously breathing patient best defines which of the following?

Accepted Answer

A) sustained maximal inspiration 
B) intermittent positive-pressure breathing 
C) continuous positive iarway pressure 
D) positive end-expiration pressure 
A) sustained maximal inspiration 
B) intermittent positive-pressure breathing 
C) continuous positive iarway pressure 
D) positive end-expiration pressure

Question 13

A surgeon orders lung expansion therapy for an obtunded 68-year-old, 170-lb 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 of the following would you recommend?

Accepted Answer

A) intermittent positive-pressure breathing (IPP
B)  at 6 to 8 breaths/min at 10 to 15 ml/kg 
B) continuous positive airway pressure therapy at 12 cm H2O for 24 hours 
C) positive end-expiratory pressure therapy with bronchodilator and bronchial hygiene 
D) incentive spirometry 10 times an hour at an initial volume of 600 to 800 ml 
A) intermittent positive-pressure breathing (IPP
B)  at 6 to 8 breaths/min at 10 to 15 ml/kg 
B) continuous positive airway pressure therapy at 12 cm H2O for 24 hours 
C) positive end-expiratory pressure therapy with bronchodilator and bronchial hygiene 
D) incentive spirometry 10 times an hour at an initial volume of 600 to 800 ml

Question 14

Which of the following are potential complications of continuous positive airway pressure (CPAP) therapy?
I.barotrauma
II.hyperventilation
III.gastric distention
IV.hypercapnia

Accepted Answer

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

Question 15

Which of the following initial flow settings would you select when setting up a continuous positive airway pressure flow-mask system for a patient with atelectasis?

Accepted Answer

A) 2 to 3 times the patient's minute ventilation 
B) at least 6 to 10 L/min 
C) 4 times the patient's minute ventilation 
D) 10 times the patient's VT 
A) 2 to 3 times the patient's minute ventilation 
B) at least 6 to 10 L/min 
C) 4 times the patient's minute ventilation 
D) 10 times the patient's VT

Question 16

Persistent breathing at small tidal volumes can result in which of the following?

Accepted Answer

A) reabsorption atelectasis 
B) spontaneous pneumothorax 
C) passive atelectasis 
D) respiratory alkalosis 
A) reabsorption atelectasis 
B) spontaneous pneumothorax 
C) passive atelectasis 
D) respiratory alkalosis

Question 17

All of the following machine performance characteristics should be monitored during intermittent positive-pressure breathing therapy except:

Accepted Answer

A) flow setting 
B) sensitivity 
C) humidity output 
D) peak pressure 
A) flow setting 
B) sensitivity 
C) humidity output 
D) peak pressure

Question 18

Correct instruction in the technique of incentive spirometry should include which of the following?

Accepted Answer

A) use of accessory muscles at high inspiratory flows 
B) diaphragmatic breathing at slow to moderate flows 
C) "panting" at volumes approaching total lung capacity 
D) use of accessory muscles at low inspiratory flows 
A) use of accessory muscles at high inspiratory flows 
B) diaphragmatic breathing at slow to moderate flows 
C) "panting" at volumes approaching total lung capacity 
D) use of accessory muscles at low inspiratory flows

Question 19

Which of the following are essential components of a continuous positive airway pressure (CPAP) flow system?
I.blended source of pressurized gas
II.nonrebreathing circuit with reservoir bag
III.low-pressure or disconnect alarm
IV.expiratory threshold resistor

Accepted Answer

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

Question 20

Incentive spirometry devices can generally be categorized as which of the following?
I.pressure-oriented
II.flow-oriented
III.volume-oriented

Accepted Answer

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

Exam 39: Lung Expansion Therapy

Which of the following is NOT a potential contraindication for intermittent positive-pressure breathing?

All of the following parameters should be evaluated after intermittent positive-pressure breathing therapy except:

A postoperative patient using incentive spirometry complains of dizziness and numbness around the mouth after therapy sessions. What is the most likely cause of these symptoms?

Prior to starting intermittent positive-pressure breathing (IPPB) on a new patient, what should the practitioner explain? I.why the physician ordered the treatment II.what the IPPB treatment will do III.how the IPPB treatment will feel IV.what the expected results are

What is the major contributing factor in the development of postoperative atelectasis?

When checking a patient's intermittent positive-pressure breathing (IPPB) breathing circuit before use, you notice that the device will not cycle off, even when you occlude the mouthpiece. What would be the most appropriate action in this case?

An alert and cooperative 28-year-old woman with no prior history of lung disease underwent cesarean section 16 hours earlier. Her x-ray film currently is clear. Which of the following approaches to preventing atelectasis would you recommend for this patient?

During administration of a continuous positive airway pressure flow mask to a patient with atelectasis, you find it difficult to maintain the prescribed airway pressure. Which of the following is the most common explanation?

Which of the following clinical findings indicate the development of atelectasis? I.opacified areas on the chest x-ray film II.inspiratory and expiratory wheezing III.tachypnea IV.diminished or bronchial breath sounds

Ideally, when should high-risk surgical patients be oriented to incentive spirometry?

Which of the following is FALSE about flow-oriented incentive spirometry devices?

The short-term application of inspiratory positive pressure to a spontaneously breathing patient best defines which of the following?

A surgeon orders lung expansion therapy for an obtunded 68-year-old, 170-lb 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 of the following would you recommend?

Which of the following are potential complications of continuous positive airway pressure (CPAP) therapy? I.barotrauma II.hyperventilation III.gastric distention IV.hypercapnia

Which of the following initial flow settings would you select when setting up a continuous positive airway pressure flow-mask system for a patient with atelectasis?

Persistent breathing at small tidal volumes can result in which of the following?

All of the following machine performance characteristics should be monitored during intermittent positive-pressure breathing therapy except:

Correct instruction in the technique of incentive spirometry should include which of the following?

Which of the following are essential components of a continuous positive airway pressure (CPAP) flow system? I.blended source of pressurized gas II.nonrebreathing circuit with reservoir bag III.low-pressure or disconnect alarm IV.expiratory threshold resistor

Incentive spirometry devices can generally be categorized as which of the following? I.pressure-oriented II.flow-oriented III.volume-oriented

History of Respiratory Care

Quality and Evidence-Based Respiratory Care

Patient Safety, Communication, and Record Keeping

Principles of Infection Control

Ethical and Legal Implications of Practice

Physical Principles of Respiratory Care

Computer Applications in Respiratory Care

The Respiratory System

The Cardiovascular System

Ventilation

Gas Exchange and Transport

Solutions, Body Fluids, and Electrolytes

Acid-Base Balance

Regulation of Breathing

Bedside Assessment of the Patient

Interpretation of Clinical Laboratory Data

Interpreting the Electrocardiogram

Analysis and Monitoring of Gas Exchange

Pulmonary Function Testing

A Review of Thoracic Imaging

Nutrition Assessment

Pulmonary Infections

Obstructive Lung Disease: Copd, Asthma, and Related Diseases

Interstitial Lung Disease

Pleural Diseases

Pulmonary Vascular Disease

Acute Lung Injury, Pulmonary Edema, and Multiple System Organ

Lung Cancer

Neuromuscular and Other Diseases of the Chest Wall

Disorders of Sleep

Neonatal and Pediatric Respiratory Disorders

Airway Pharmacology

Airway Management

Emergency Cardiovascular Life Support

Humidity and Bland Aerosol Therapy

Aerosol Drug Therapy

Storage and Delivery of Medical Gases

Medical Gas Therapy

Bronchial Hygiene Therapy

Respiratory Failure and the Need for Ventilatory Support

Mechanical Ventilators

Physiology of Ventilatory Support

Initiating and Adjusting Ventilatory Support

Noninvasive Positive Pressure Ventilation

Monitoring and Management of the Patient in the Intensive Care Unit

Discontinuing Ventilatory Support

Neonatal and Pediatric Respiratory Care

Patient Education and Health Promotion

Cardiopulmonary Rehabilitation

Respiratory Care in Alternative Settings

Filters