Question 1

Indications for directed coughing include all of the following except to:

Accepted Answer

A) enhance other bronchial hygiene therapies 
B) help patients with tuberculosis clear secretions 
C) help prevent postoperative pulmonary complications 
D) obtain sputum specimens for diagnostic analysis 
A) enhance other bronchial hygiene therapies 
B) help patients with tuberculosis clear secretions 
C) help prevent postoperative pulmonary complications 
D) obtain sputum specimens for diagnostic analysis B

Question 2

Which of the following conditions are associated with chronic production of large volumes of sputum?
I.bronchiectasis
II.pulmonary fibrosis
III.cystic fibrosis
IV.chronic bronchitis

Accepted Answer

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

Question 3

All of the following conditions impair secretion clearance by affecting the cough reflex except:

Accepted Answer

A) muscular dystrophy 
B) amyotrophic lateral sclerosis 
C) chronic bronchitis 
D) cerebral palsy 
A) muscular dystrophy 
B) amyotrophic lateral sclerosis 
C) chronic bronchitis 
D) cerebral palsy C

Question 4

All of the following drug categories can impair mucociliary clearance in intubated patients except:

Accepted Answer

A) general anesthetics 
B) bronchodilators 
C) opiates 
D) narcotics 
A) general anesthetics 
B) bronchodilators 
C) opiates 
D) narcotics

Question 5

Which of the following can provoke a cough?
I.anesthesia
II.foreign bodies
III.infection
IV.irritating gases

Accepted Answer

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

Question 6

Which of the following is NOT a hazard or complication of postural drainage therapy?

Accepted Answer

A) cardiac arrhythmias 
B) increased intracranial pressure 
C) acute hypotension 
D) pulmonary barotraumas 
A) cardiac arrhythmias 
B) increased intracranial pressure 
C) acute hypotension 
D) pulmonary barotraumas

Question 7

Whether using traditional methods or the FET, a period of diaphragmatic breathing and relaxation should always follow attempts at coughing. What is the purpose of this approach?

Accepted Answer

A) restore the patient's SO2 
B) restore lung volume and minimize fatigue 
C) allow the patient time to ask questions 
D) decrease the likelihood of acute air-trapping 
A) restore the patient's SO2 
B) restore lung volume and minimize fatigue 
C) allow the patient time to ask questions 
D) decrease the likelihood of acute air-trapping

Question 8

During chest physical therapy, a patient has an episode of hemoptysis. Which of the following actions would be appropriate at this time?

Accepted Answer

A) Put the patient in a sitting position and have him or her cough strenuously. 
B) Place the patient in a head-down position and call the nurse. 
C) Immediately perform nasotracheal suctioning of the patient. 
D) Stop therapy, sit the patient up, give O2, and contact the physician. 
A) Put the patient in a sitting position and have him or her cough strenuously. 
B) Place the patient in a head-down position and call the nurse. 
C) Immediately perform nasotracheal suctioning of the patient. 
D) Stop therapy, sit the patient up, give O2, and contact the physician.

Question 9

Which of the following is/are necessary for normal airway clearance?
I.patent airway
II.functional mucociliary escalator
III.effective cough

Accepted Answer

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

Question 10

Hazards of positive airway pressure therapies associated with the apparatus used include which of the following?
I.increased work of breathing
II.claustrophobia
III.epistaxis
IV.vomiting and aspiration
V.skin breakdown and discomfort

Accepted Answer

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

Question 11

A patient about to receive postural drainage and percussion is attached to an electrocardiographic (ECG) monitor and is receiving both intravenous (IV) solutions and O2 (through a nasal cannula). Which of the following actions would be appropriate for this patient?

Accepted Answer

A) Cancel the therapy because the patient cannot be repositioned. 
B) Inspect and adjust the equipment to ensure function during therapy. 
C) Turn off the ECG monitor, but keep the IV line and O2 going. 
D) Turn off the IV line, but keep the monitor on and the O2 going. 
A) Cancel the therapy because the patient cannot be repositioned. 
B) Inspect and adjust the equipment to ensure function during therapy. 
C) Turn off the ECG monitor, but keep the IV line and O2 going. 
D) Turn off the IV line, but keep the monitor on and the O2 going.

Question 12

Directed coughing is useful in helping to maintain bronchial hygiene in all of the following cases except:

Accepted Answer

A) bronchiectasis 
B) acute asthma 
C) cystic fibrosis 
D) spinal cord injury 
A) bronchiectasis 
B) acute asthma 
C) cystic fibrosis 
D) spinal cord injury

Question 13

A physician orders postural drainage for a patient with aspiration pneumonia in the anterior segments of the upper lobes. Which of the following positions would you recommend for this patient?

Accepted Answer

A) head down, patient prone with a pillow under abdomen 
B) patient supine with a pillow under knees, bed flat 
C) head down, patient supine with a pillow under knees 
D) patient prone with a pillow under abdomen, bed flat 
A) head down, patient prone with a pillow under abdomen 
B) patient supine with a pillow under knees, bed flat 
C) head down, patient supine with a pillow under knees 
D) patient prone with a pillow under abdomen, bed flat

Question 14

Absolute contraindications for postural drainage include which of the following?
I.head and neck injury (until stabilized)II.active hemorrhage with hemodynamic instability
III.uncontrolled airway at risk for aspiration

Accepted Answer

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

Question 15

A normal cough reflex includes which of the following phases?
I.irritation
II.inspiration
III.compression
IV.expulsion

Accepted Answer

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

Question 16

A nurse explains to you that a certain neuromuscular patient cannot develop a good cough. Which of the following would you consider to manage this patient's clearance problem?
I.combining manual chest compression with suctioning
II.coordinating the coughing regimen with pain medication
III.using the autogenic drainage method
IV.using mechanical insufflation-exsufflation

Accepted Answer

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

Question 17

Which of the following is true about exercise and airway clearance?
I.	Exercise can enhance mucus clearance.
II.	Exercise can improve pulmonary function.
III.	Exercise can improve   
$\dot { V } / \dot { Q }$ matching.
IV.Exercise can cause desaturation in some patients.

Accepted Answer

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

Question 18

All of the following are typical of high-frequency external chest wall compression therapy except:

Accepted Answer

A) 30-minute therapy sessions 
B) oscillations at 5 to 25 Hz 
C) one to six sessions per day 
D) long inspiratory oscillations 
A) 30-minute therapy sessions 
B) oscillations at 5 to 25 Hz 
C) one to six sessions per day 
D) long inspiratory oscillations

Question 19

In which of the following patients would you consider modifying any head-down positions used for postural drainage?
I.a patient with unstable blood pressure
II.a patient with a cerebrovascular disorder
III.a patient with systemic hypertension
IV.a patient with orthopnea

Accepted Answer

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

Question 20

Postural drainage should be considered in all of the following situations except:

Accepted Answer

A) in patients with chronic obstructive lung disease 
B) in patients who expectorate more than 25 to 30 ml sputum per day 
C) in the presence of atelectasis caused by mucus plugging 
D) in patients with cystic fibrosis or bronchiectasis 
A) in patients with chronic obstructive lung disease 
B) in patients who expectorate more than 25 to 30 ml sputum per day 
C) in the presence of atelectasis caused by mucus plugging 
D) in patients with cystic fibrosis or bronchiectasis

Exam 40: Bronchial Hygiene Therapy

Indications for directed coughing include all of the following except to:

Which of the following conditions are associated with chronic production of large volumes of sputum? I.bronchiectasis II.pulmonary fibrosis III.cystic fibrosis IV.chronic bronchitis

All of the following conditions impair secretion clearance by affecting the cough reflex except:

All of the following drug categories can impair mucociliary clearance in intubated patients except:

Which of the following can provoke a cough? I.anesthesia II.foreign bodies III.infection IV.irritating gases

Which of the following is NOT a hazard or complication of postural drainage therapy?

Whether using traditional methods or the FET, a period of diaphragmatic breathing and relaxation should always follow attempts at coughing. What is the purpose of this approach?

During chest physical therapy, a patient has an episode of hemoptysis. Which of the following actions would be appropriate at this time?

Which of the following is/are necessary for normal airway clearance? I.patent airway II.functional mucociliary escalator III.effective cough

Hazards of positive airway pressure therapies associated with the apparatus used include which of the following? I.increased work of breathing II.claustrophobia III.epistaxis IV.vomiting and aspiration V.skin breakdown and discomfort

A patient about to receive postural drainage and percussion is attached to an electrocardiographic (ECG) monitor and is receiving both intravenous (IV) solutions and O2 (through a nasal cannula). Which of the following actions would be appropriate for this patient?

Directed coughing is useful in helping to maintain bronchial hygiene in all of the following cases except:

A physician orders postural drainage for a patient with aspiration pneumonia in the anterior segments of the upper lobes. Which of the following positions would you recommend for this patient?

Absolute contraindications for postural drainage include which of the following? I.head and neck injury (until stabilized)II.active hemorrhage with hemodynamic instability III.uncontrolled airway at risk for aspiration

A normal cough reflex includes which of the following phases? I.irritation II.inspiration III.compression IV.expulsion

Which of the following is true about exercise and airway clearance? I. Exercise can enhance mucus clearance. II. Exercise can improve pulmonary function. III. Exercise can improve V˙/Q˙\dot { V } / \dot { Q }V˙/Q˙​ matching. IV.Exercise can cause desaturation in some patients.

All of the following are typical of high-frequency external chest wall compression therapy except:

In which of the following patients would you consider modifying any head-down positions used for postural drainage? I.a patient with unstable blood pressure II.a patient with a cerebrovascular disorder III.a patient with systemic hypertension IV.a patient with orthopnea

Postural drainage should be considered in all of the following situations except:

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

Lung Expansion 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

A patient about to receive postural drainage and percussion is attached to an electrocardiographic (ECG) monitor and is receiving both intravenous (IV) solutions and O₂ (through a nasal cannula). Which of the following actions would be appropriate for this patient?

Which of the following is true about exercise and airway clearance? I. Exercise can enhance mucus clearance. II. Exercise can improve pulmonary function. III. Exercise can improve $\dot { V } / \dot { Q }$ matching. IV.Exercise can cause desaturation in some patients.