Fundamentals W11 Quiz (2024)

Which of the following airway clearance techniques would you recommend for a patient with a neurologic abnormality (bulbar palsy) and intact upper airway? 1. Postural drainage, percussion, and vibration 2. Positive expiratory pressure therapy 3. Mechanical insufflation-exsufflation

A physician orders bronchodilator drug therapy in combination with positive expiratory pressure (PEP). Which of the following methods could you use to provide this combined therapy? 1. Attach a dry powder inhaler in-line with the PEP apparatus. 2. Attach a metered dose inhaler to the system’s one-way valve inlet. 3. Place a small volume nebulizer in-line with the PEP apparatus.

Which of the following are true about the FET? 1. It causes less bronchiolar collapse than traditional coughing. 2. It occurs from mid to low lung volume without glottis closure. 3. It has a period of diaphragmatic breathing and relaxation. 4. It occurs from mid to high lung volume without glottis closure.

What is the movement of small volumes of air back and forth in the respiratory tract at high frequencies (12 to 25 Hz) called?

What happens during the exsufflation phase of mechanical insufflation-exsufflation? 1. Airway pressure is abruptly decreased to -30 to -50 cm H2O. 2. Negative airway pressure is maintained for 2 to 3 sec. 3. Peak expiratory “cough” flows reach near normal values.

A patient recovering from anesthesia after abdominal surgery is having difficulty developing an effective cough. Which of the following phases of the cough reflex are primarily affected in this patient?

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?

Which of the following conditions are associated with chronic production of large volumes of sputum? 1. Bronchiectasis 2. Pulmonary fibrosis 3. Cystic fibrosis 4. Chronic bronchitis

Key consideration in teaching a patient to develop an effective cough regimen includes which of the following? 1. Strengthening of the expiratory muscles 2. Instruction in breathing control 3. Instruction in proper positioning

Maintaining an open glottis during coughing (as with the FET) can help to minimize increases in pleural pressure and lessen the likelihood of bronchiolar collapse. Which of the following techniques can aid the practitioner in teaching the patient this maneuver?

Proper instructions for positive expiratory pressure include which of the following? 1. Take in a breath that is larger than normal, but do not fill lungs completely. 2. Exhale forcefully and maintain an expiratory pressure of 10 to 20 cm H2O. 3. After 10 to 20 breaths, take two or three “huff”’ coughs, and rest as needed. 4. Repeat the cycle 8 to 10 times, not to exceed 30 min.

Which of the following are typical of high-frequency external chest wall compression therapy? 1. 30-min therapy sessions 2. Long inspiratory oscillations 3. One to six sessions per day 4. Oscillations at 20 to 25 Hz

Which of the following measures would you use to ask patients for the presence of copious mucus production?

Which of the following should be considered when selecting an airway clearance strategy? 1. Patient’s goals, motivation, and preferences 2. Effectiveness and limitations of technique or method 3. Patient’s age, ability to learn, and tendency to fatigue 4. Need for assistants, equipment, and cost

If tolerated, a specified postural drainage position should be maintained for at least how long?

Which of the following conditions impair secretion clearance by affecting the cough reflex? 1. Muscular dystrophy 2. Amyotrophic lateral sclerosis 3. Chronic bronchitis 4. Cerebral palsy

Why is strenuous patient coughing during postural drainage in a head-down position contraindicated?

Which of the following can provoke a cough? 1. Anesthesia 2. Foreign bodies 3. Infection 4. Irritating gases

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?

Conditions that can affect airway patency and cause abnormal clearance of secretions include which of the following? 1. Foreign bodies 2. Tumors 3. Inflammation 4. Bronchospasm

What factors can hinder effective coughing? 1. Artificial airways 2. Neuromuscular disease 3. Systemic overhydration 4. Pain or fear of pain

For which of the following patients directed coughing might be contraindicated? 1. Patient with poor coronary artery perfusion 2. Postoperative upper-abdominal surgery patient 3. Long-term care patient with retained secretions 4. Patient with an acute unstable spinal injury

Which of the following best describes positive expiratory pressure (PEP) therapy?

Advantages of the flutter valve over other airway clearance methods include which of the following? 1. Good patient acceptance 2. Greater effectiveness 3. Full portability 4. Independent use

While reviewing the chart of a patient receiving postural drainage therapy, you notice that the patient tends to undergo mild desaturation during therapy (a drop in SpO2 from 93% to 89% to 90%). Which of the following would you recommend to manage this problem?

Which of the following are mandatory components of the preassessment for postural drainage? 1. Vital signs 2. Bedside pulmonary function tests 3. Auscultation

In assessing an adult outpatient for airway clearance therapy, you notice the following: (1) no history of cystic fibrosis or bronchiectasis, (2) sputum production of 30 to 50 ml/day, (3) an effective cough, and (4) good hydration. Which of the following would you recommend?

Which of the following determines effectiveness of high-frequency external chest wall compression therapy? 1. Compression frequency 2. Largest volumes 3. Flow bias

A patient with abdominal muscle weakness is having difficulty developing an effective cough. Which of the following phases of the cough reflex are primarily affected in this patient? 1. Irritation 2. Inspiration 3. Compression 4. Expulsion

In general, chest physical therapy can be expected to improve airway clearance when a patient’s sputum production exceeds what volume?

What duration of time and pressure is recommended when using MIE devices to clear airways secretions in adults?

Which of the following are necessary for normal airway clearance? 1. Patent airway 2. Functional mucociliary escalator 3. Effective cough 4. Normal pulmonary compliance

Which of the following is the only absolute contraindication to turning?

Patients can control a flutter valve’s pressure by changing what?

Properly performed chest vibration is applied at what point?

Contraindications for positive airway pressure therapies include which of the following? a. Intracranial pressure exceeding 20 mm Hg b. Recent facial, oral, or skull surgery or trauma c. Preexisting pulmonary barotrauma (e.g., pneumothorax) d. Air trapping/pulmonary overdistention in chronic obstructive pulmonary disease

Partial airway obstruction can result in which of the following? 1. Increased work of breathing 2. Air trapping or overdistention 3. Increased expiratory flows 4. Ventilation/perfusion ratio imbalances

Which of the following laboratory data are essential in assessing a patient’s need for airway clearance therapy? 1. Chest radiograph 2. Pulmonary function tests 3. Hematology results 4. ABGs/oxygen saturation

What are the best documented preventive uses of airway clearance therapy? 1. Prevent retained secretions in the acutely ill. 2. Maintain lung function in cystic fibrosis. 3. Prevent postoperative pulmonary complications.

A patient recovering from abdominal surgery is having difficulty developing an effective cough. Which of the following actions would you recommend to aid this patient in generating a more effective cough? 1. Coordinating coughing with pain medication 2. Using the forced expiration technique (FET) 3. Supplying manual epigastric compression 4. “Splinting” the operative site

Indications for directed coughing include which of the following? 1. Enhance other airway clearance therapies. 2. Help patients with tuberculosis clear secretions. 3. Help prevent postoperative pulmonary complications. 4. Obtain sputum specimens for diagnostic analysis.

A typical mechanical insufflation-exsufflation treatment session should continue until what point? 1. Secretions are cleared. 2. The vital capacity (VC) returns to baseline. 3. The SpO2 returns to baseline.

Absolute contraindications for postural drainage include which of the following? 1. Head and neck injury (until stabilized) 2. Active hemorrhage with hemodynamic instability 3. Uncontrolled airway at risk for aspiration

Which of the following can impair mucociliary clearance in intubated patients? 1. Use of respiratory stimulants 2. Tracheobronchial suctioning 3. Inadequate humidification 4. High inspired oxygen concentrations

Directed coughing is useful in helping to maintain airway clearance in which of the following cases? 1. Bronchiectasis 2. Acute asthma 3. Cystic fibrosis 4. Spinal cord injury

Percussion should not be performed over which of the following areas? 1. Surgery sites 2. Bony prominences 3. Fractured ribs

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?

Which of the following occur(s) during the compression phase of a cough? 1. Expiratory muscle contraction 2. Opening of the glottis 3. Rapid drop in alveolar pressure

A physician orders postural drainage for a patient with aspiration pneumonia in the superior segments of the left lower lobe. Which of the following positions would you recommend for this patient?

What is the ideal patient position for directed coughing?

Which of the following are hazards or complication of postural drainage therapy? 1. Cardiac arrhythmias 2. Increased intracranial pressure 3. Acute hypotension 4. Pulmonary barotraumas

Primary objectives for turning include which of the following? 1. Prevent postural hypotension. 2. Promote lung expansion. 3. Prevent retention of secretions. 4. Improve oxygenation.

If a patient’s chest radiograph shows infiltrates in the posterior basal segments of the lower lobes, what postural drainage position would you recommend?

Which of the following are contraindications for directed coughing? a. The presence of infection spread by droplet nuclei b. Elevated intracranial pressure or intracranial aneurysm c. Reduced coronary artery perfusion d. Necrotizing pulmonary infection

Which of the following are advantages of the Acapella over the flutter? 1. It can customize frequency. 2. It can be used in any posture. 3. It is more portable. 4. It can customize flow resistance.

Soon after you initiate postural drainage in a Trendelenburg position, the patient develops a vigorous and productive cough. Which of the following actions would be appropriate at this time?

A physician orders postural drainage for a patient with an abscess in the right middle lobe. Which of the following positions would you recommend for this patient?

A normal cough reflex includes which of the following phases? 1. Irritation 2. Inspiration 3. Compression 4. Expulsion