Contemporary Topics - Quiz 4 (Ch 7, 8, 10)

Which of the following are hazards of IPPB therapy? 1. Excessive ventilation 2. Increased cardiac output 3. Decreased intracranial pressure (ICP) a. 1 only b. 2 only c. 1 and 3 only d. 2 and 3 only

a. 1 only

The respiratory therapist is administering PEP therapy to a patient with atelectasis. Which of the following would indicate the atelectasis is improving? a. decreased late inspiratory crackles b. decreased inspiratory wheezes c. reduced inspiratory stridor d. coarse crackles that clear with coughing

a. decreased late inspiratory crackles

Prior to intiating postural drainage and percussion on a patient with a head injury, the respiratory therapist observes the patient's ICP reading to be at 22 mmHg. Which of the following should the therapist do at this time? a. do not give the treatment & consult with physician b. proceed with the patient in the supine position c. proceed with the treatment but avoid the Trendelenburg position for more than 3 mins d. proceed with the treatment in all positions but Trendelenburg

a. do not give the treatment & consult with physician

Which of the following conditions shifts the HbO2 dissociation curve to the right? a. hypercapnia b. hypothermia c. alkalemia d. HbCo

a. hypercapnia

The respiratory therapist is administering IPPB and the patient complains of feeling light-headed and dizzy. What should the therapist do to correct this? a. instruct the patient to pause longer between breaths b. instruct the patient to take deeper breaths c. increase the inspiratory pressure c. decrease the inspiratory flow

a. instruct the patient to pause longer between breaths

The respiratory therapist receives an order for postural drainage on a pt to mobilize secretions from the anterior segment of the right upper lobe of the lung. How should the patient be positioned for the lung to drain most effectively? a. patient lying supine w/pillows under knees b. patient lying on R side in Trendelenburg position c. patient lying on stomach in Trendelenburg position d. patient lying on L side, rotated back 25 degrees, with the bed flat

a. patient lying supine w/pillows under knees

While evaluating a postoperative pt for which incentive spirometry has been ordered, the respiratory therapist obtains a vital capacity of 6mL/kg of body weight. The therapist should do which of the following? a. recommend IPPB in place of incentive spirometry b. start the treatment as ordered c. measure the patient's Vt d. recommend a bronchodilator using a handheld nebulizer

a. recommend IPPB in place of incentive spirometry

The initial inspiratory goal for a patient receiving incentive spirometry should be: a. twice the pt's measured Vt b. equal to the pt's measured Vt c. at least 1500 mL d. 5 mL/kg of body weight

a. twice the pt's measured Vt

The respiratory therapist reviewing ABGs obtained earlier in the day from a patient on 35% air-entrainment mask. The ABG values are as follows: pH ---------- 7.43 PaCo2 ------ 29 PaO2 ------- 70 HCO3 ------ 18 What is the correct interpretation? a. Partially compensated met acidosis, normal oxygenation b. Fully compensated resp alkalosis, mild hypoxemia c. Uncompensated resp alkalosis, normal oxygenation d. Fully compensated metabolic acidosis, mild hypoxemia

b. Fully compensated resp alkalosis, mild hypoxemia

Which of the following ABG measurements determins how well a patient's lungs are being ventilated? a. pH b. PaCo2 c. PaO2 d. HCO3-

b. PaCO2

A 34-year old patient using a 40% aerosol mask has RLL pneumonia. He becomes SOB and his SpO2 decreases from 96% to 89% when lying on his right side. What should the therapist recommend? a. Increase the O2 to 80% b. Place the pt on his left side c. Place the pt on CPAP d. Suction the pt

b. Place the pt on his left side

The respiratory therapist has received an order for postural drainage and percussion for a 34 year old patient whose chest x-ray shows atelectasis of the posterior basal segment of the right lower lobe. The patient should be placed in which of the following positions to help drain this segment? a. Lying on left side with bed flat b. Prone, with head of bed down c. Lying on left side with head of bed down d. Supine, with head of bed down

b. Prone, with head of bed down

Upon initiation of PEP therapy via face mask, the respiratory therapist notices that the device is unable to maintain a constant pressure during exhalation. To correct this problem, the therapist should evaluate for which of the following? a. inadequate inspiratory flow b. leaks around the mask c. inadequate system pressure d. evidence of obstructive lung disease

b. leaks around the mask

During an IPPB treatment, the patient suddenly complains of chest pain and becomes short of breath. On assessing the patient you auscultate the chest and hear decreasing breath sounds on the left. These finding are consistent with which of the following? a. atelectasis b. left- sided pneumothorax c. pulmonary embolism d. pleural effusion

b. left- sided pneumothorax

While administering postural drainage to a patient on a 2LPM N/C, the respiratory therapist observes frequent cardiac arrhythmias on the cardiac monitor. Which of the following should the therapist do at this time? a. continue the treatment but avoid the Trendelenburg position b. stop treatment, return the pt to the previous resting position, increase the liter flow to 5LPM & notify physician c. Allow pt to rest for 3 mins and begin therapy again d. increase liter flow to 3 LPM and continue the treatment

b. stop the treatment, return the patient to the previous resting position, increase the liter flow to 5LPM and notify physician

The following blood gases are obtained on a severe, cyanotic COPD pt on 2 LPM nasal cannula: pH -------- 7.51 PaCO2 ---- 29 PaO2 ------ 155 HCO3 ------ 34 Which of the following most likely accounts for these ABG values? a. the pt's cannula flow was higher than 2 LPM at the time of arterial stick b. there is air in the blood sample c. the blood was inadvertently obtained from a vein d. these represent a normal blood gas for a severe COPD pt

b. there is air in the blood sample

Incentive spirometry is ordered for a patient after abdmnl surgery. Which of the followign statements by the respiratory care practitioner would be most appropriate in the initial explanation of the therapy to the patient? a. "You may experience pain and light-headedness from this therapy" b. "We are trying to improve your inspiratory capacity" c. "This therapy will help you take deep breaths and expand your lungs" d. "Your doc has ordered this therapy to prevent atelectasis"

c. "This therapy will help you take deep breaths and expand your lungs"

The RRT has received an order to deliver IPPB to a pt w/ head trauma. What modifications in therapy may benefit this patient? 1. Use higher flow rate 2. Use lower peak pressures 3. Set the sensitivity to -5 cmH2o a. 1 only b. 2 only c. 1 and 2 only d. 2 and 3 only

c. 1 and 2 only

The info below has been obtained from a pt on an aerosol mask @ 40% O2. pH ---------- 7.42 PaCo2 ------ 36 mmHg PaO2 ------- 122 mmHg HCO3 ------- 26 mEq/L What is this pt's P(A-a)O2 if barometric pressure is 747? a. 45 mmHg b. 77 mmHg c. 113 mmHg d. 235 mmHg

c. 113 mmHg

Which of the following increases the delivered Vt to a patient taking an IPPB treatment? 1. Increasing flow rate 2. Increasing inspiratory pressure 3. Decreasing sensitivity 4. Decreasing flow rate a. 1 and 2 only b. 1 and 3 only c. 2 and 4 only d. 1, 2, and 3 only

c. 2 and 4 only

Postural drainage and percussion are not indicated in which of the following conditions? a. bronchiectasis b. cystic fibrosis c. pulmonary edema d. acute atelectasis

c. pulmonary edema

A patient receiving PEP therapy through a mouthpiece at 15cmH2o has minimal secretion production. Auscultation reveals retained secretions. The respiratory therapist should recommend which of the following? a. decrease the PEP to 10cmH2o b. Discontinue tx & begin percussion & postural drainage c. Increase the PEP to 20 cmH2o d. Administer the treatment w/ a mask in place of mouthpiece

c. Increase the PEP to 20 cmH2o

A patient on a mechanical ventilator has the following ABG results: pH --------- 7.27 PaCO2 ----- 28 PaO2 ------- 88 HCO3 ------ 27 Based on this data, the respiratory therapist should recommend which of the following? a. increase the Vt b. decrease the ventilator rate c. Repeat the blood gas evaluation since these results indicate a lab error d. Decrease the FiO2

c. Repeat the blood gas evaluation since these results indicate a lab error

When coordinating the sequence of the following therapies relating to bronchopulmonary clearance, which should the respiratory therapist do first? a. percussion b. deep breathing therapy c. bronchodilator therapy d. postural drainage

c. bronchodilator therapy

Which of the following blood gas measurements determines the level of tissue oxygenation? a. pH b. PaCo2 c. PaO2 d. PvO2

d. PvO2

A pt w/ a 2LPM nasal cannula has the following ABG: pH ---------- 7.51 PaCO2 ----- 27 mmHg PaO2 ------- 62 mmHg HCo3 ------ 23 mEq/L These results indicate which of the following conditions? a. uncompensated respiratory acidosis b. chronic respiratory alkalosis c. compensated metabolic alkalosis d. acute respiratory alkalosis

d. acute respiratory alkalosis

The respiratory therapist has received an order to obtain an ABG sample from the pt, but the Allen's test indicates collateral circulation is NOT present in the right wrist. At this time, the therapist would: a. obtain blood from the right radial artery b. obtain blood from the right brachial artery c. wait for the physician to evaluate collateral circulation d. check collateral circulation in the left wrist

d. check collateral circulation in the left wrist

Sustained maximal inspiratory maneuvers performed with an incentive spirometer would be MOST effective in the: a. treatment of pneumonia b. prevention of pneumonia c. treatment of preexisting atelectasis d. prevention of atelectasis

d. prevention of atelectasis

While the RRT is administering IPPB, the patient begins coughing up large amounts of blood. The therapist should: a. continue the treatment and notify the physician that chest radiograph is needed b. Decrease inspiratory pressure c. stop the tx briefly and resume it when the pt is feeling better d. stop the tx and notify physician

d. stop the tx and notify physician

The following ABGs have been recorded for a patient on a 35% air-entrainment mask: pH ----------- 7.51 PaCO2 ------- 42 PaO2 --------- 79 HCO3 -------- 33 What is the correct interpretation of this blood gas? a. partially compensated respiratory alkalosis b. fully compensated metabolic alkalosis c. uncompensated respiratory alkalosis d. uncompensated metabolic alkalosis

d. uncompensated metabolic alkalosis