Question 1

Which of the following are potential hazards of intermittent positive-pressure breathing (IPPB)?
I.air-trapping, auto-PEEP
II.hyperventilation
III.nosocomial infection
IV.increased airway resistance

Accepted Answer

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

Question 2

How can the transpulmonary pressure gradient be increased?
I.increasing alveolar pressure
II.decreasing pleural pressure
III.decreasing transthoracic pressure

Accepted Answer

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

Question 3

Preliminary planning for intermittent positive-pressure breathing (IPPB) should include which of the following?
I.evaluating alternative approaches to the patient's problem
II.setting specific, individual clinical goals or objectives
III.conducting a baseline assessment of the patient

Accepted Answer

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

Question 4

Which of the following is not a potential hazard of intermittent positive-pressure breathing?

Accepted Answer

A) increased cardiac output 
B) respiratory alkalosis 
C) pulmonary barotrauma 
D) gastric distention

Question 5

In teaching a patient to perform the sustained maximal inspiration maneuver during incentive spirometry, what would you say?

Accepted Answer

A) "Exhale normally, then inhale as deeply as you can, then hold your breath for 5 to 10 seconds." 
B) "Inhale as deeply as you can, then blow out as much air as you can as fast as possible." 
C) "Exhale normally, then inhale as deeply as you can, then hold your breath for 10 to 20 seconds." 
D) "Exhale as much as you can, then inhale as deeply as you can, then relax and let it out."

Question 6

Which of the following are appropriate initial settings for intermittent positive-pressure breathing given to a new patient?

Accepted Answer

A) sensitivity -2 cm H2O; pressure 20 to 25 cm H2O; high flow 
B) sensitivity -3 to -4 cm H2O; pressure 5 to 10 cm H2O; moderate flow 
C) sensitivity -1 to -2 cm H2O; pressure 10 to 15 cm H2O; moderate flow 
D) sensitivity -8 cm H2O; pressure 15 cm H2O; moderate flow

Question 7

Which of the following modes of lung expansion therapy is physiologically most normal?

Accepted Answer

A) continuous positive airway pressure 
B) incentive spirometry 
C) positive end-expiratory pressure 
D) intermittent positive-pressure breathing therapy

Question 8

In administering intermittent positive-pressure breathing therapy, which of the following breathing patterns would be most desirable?

Accepted Answer

A) 6 to 8 breaths/min, inspiration/expiration ratio (I:
E)  of 1:3 
B) 8 to 10 breaths/min, I:E of 1:1 
C) 12 to 15 breaths/min, I:E of 1:2 
D) 6 to 8 breaths/min, I:E of 1:1

Question 9

Which of the following statements is not true about intermittent positive-pressure breathing (IPPB)?

Accepted Answer

A) IPPB could cause lung overinflation. 
B) IPPB could cause no expansion of regions affected by secretions. 
C) Bronchial hygiene must be used in conjunction with IPPB to adequately manage secretions. 
D) IPPB should be the single treatment modality for resorption atelectasis.

Question 10

Which of the following positions is ideal for intermittent positive-pressure breathing therapy?

Accepted Answer

A) semi-Fowler's 
B) standing 
C) supine 
D) prone

Question 11

Which of the following patient groups should be considered for lung expansion therapy using intermittent positive-pressure breathing (IPPB)?
I.patients with clinically diagnosed atelectasis who are not responsive to other therapies
II.patients at high risk for atelectasis who cannot cooperate with other methods
III.all obese patients who have undergone abdominal surgery

Accepted Answer

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

Question 12

Which of the following is false about gastric distention with intermittent positive-pressure breathing (IPPB)?

Accepted Answer

A) Gastric distention is uncommon in alert and cooperative patients. 
B) Gastric distention is most likely at high airway pressures. 
C) Gastric distention is a significant risk in obtunded patients. 
D) Gastric distention is a relatively harmless effect of IPPB.

Question 13

In order to eliminate leaks in an alert patient receiving intermittent positive-pressure breathing therapy, which of the following adjuncts would you first try?

Accepted Answer

A) flanged mouthpiece 
B) form-fitting mask 
C) nasopharyngeal airway 
D) nose clips

Question 14

Which of the following patient categories are at high risk for developing atelectasis?
I.those who are heavily sedated
II.those with abdominal or thoracic pain
III.those with neuromuscular disorders

Accepted Answer

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

Question 15

Which of the following mechanisms probably contribute to the beneficial effects of continuous positive airway pressure (CPAP) in treating atelectasis?
I.recruitment of collapsed alveoli
II.decreased work of breathing
III.improved distribution of ventilation
IV.increased efficiency of secretion removal

Accepted Answer

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

Question 16

Lung expansion methods that increase the transpulmonary pressure gradients by increasing alveolar pressure include which of the following?
I.incentive spirometry (IS)II.positive end-expiration pressure therapy
III.intermittent positive-pressure breathing (IPPB)IV.expiratory positive airway pressure (EPAP)

Accepted Answer

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

Question 17

What is the optimal breathing pattern for intermittent positive-pressure breathing (IPPB) treatment of atelectasis?

Accepted Answer

A) slow, deep breaths held at end-inspiration 
B) rapid, deep breaths held at end-inspiration 
C) slow, shallow breaths held at end-inspiration 
D) rapid, shallow breaths held at end-inspiration

Question 18

What should the monitoring of patients using incentive spirometry include?
I.number of breaths per session
II.volume and flow goals achieved
III.maintenance of breath-hold
IV.patient effort and motivation

Accepted Answer

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

Question 19

In observing a postoperative woman conduct incentive spirometry, you note repetitive performance of the sustained maximal inspiration maneuver at a rate of about 10 to 12/min. Which of the following would you recommend to her?

Accepted Answer

A) decrease the treatment frequency to 4 times/day. 
B) increase her breathing rate to 12 to 15/min. 
C) take a 30-second rest period between breaths. 
D) repeat the treatment every 30 minutes.

Question 20

What is the most common complication associated with intermittent positive-pressure breathing (IPPB)?

Accepted Answer

A) air-trapping 
B) oral bleeding 
C) respiratory alkalosis 
D) gastric distention

Exam 39: Lung Expansion Therapy

Which of the following are potential hazards of intermittent positive-pressure breathing (IPPB) ? I.air-trapping, auto-PEEP II.hyperventilation III.nosocomial infection IV.increased airway resistance

How can the transpulmonary pressure gradient be increased? I.increasing alveolar pressure II.decreasing pleural pressure III.decreasing transthoracic pressure

Preliminary planning for intermittent positive-pressure breathing (IPPB) should include which of the following? I.evaluating alternative approaches to the patient's problem II.setting specific, individual clinical goals or objectives III.conducting a baseline assessment of the patient

Which of the following is not a potential hazard of intermittent positive-pressure breathing?

In teaching a patient to perform the sustained maximal inspiration maneuver during incentive spirometry, what would you say?

Which of the following are appropriate initial settings for intermittent positive-pressure breathing given to a new patient?

Which of the following modes of lung expansion therapy is physiologically most normal?

In administering intermittent positive-pressure breathing therapy, which of the following breathing patterns would be most desirable?

Which of the following statements is not true about intermittent positive-pressure breathing (IPPB) ?

Which of the following positions is ideal for intermittent positive-pressure breathing therapy?

Which of the following is false about gastric distention with intermittent positive-pressure breathing (IPPB) ?

In order to eliminate leaks in an alert patient receiving intermittent positive-pressure breathing therapy, which of the following adjuncts would you first try?

Which of the following patient categories are at high risk for developing atelectasis? I.those who are heavily sedated II.those with abdominal or thoracic pain III.those with neuromuscular disorders

What is the optimal breathing pattern for intermittent positive-pressure breathing (IPPB) treatment of atelectasis?

What should the monitoring of patients using incentive spirometry include? I.number of breaths per session II.volume and flow goals achieved III.maintenance of breath-hold IV.patient effort and motivation

In observing a postoperative woman conduct incentive spirometry, you note repetitive performance of the sustained maximal inspiration maneuver at a rate of about 10 to 12/min. Which of the following would you recommend to her?

What is the most common complication associated with intermittent positive-pressure breathing (IPPB) ?