Therapeutics II Test 3 Review

Question 1

The short-term application of inspiratory positive pressure to a spontaneously breathing Pt best defines?

Accepted Answer

Intermittent positive-pressure breathing

Question 2

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

Accepted Answer

Preoperatively, before undergoing the surgical procedure

Question 3

Which of the following groups of patients is not at risk for developing postoperative atelectasis?

Accepted Answer

Those with pneumonia

Question 4

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

Accepted Answer

They have proved less effective than volumetric systems.

Question 5

How can the transpulmonary pressure gradient be increased?

Accepted Answer

Decreasing pleural pressure, Increasing alveolar pressure

Question 6

Which of the following is an absolute contraindication for using intermittent positive-pressure breathing?

Accepted Answer

Tension pneumothorax

Question 7

Which of the following are contraindications for continuous positive airway pressure (CPAP) therapy?

Accepted Answer

Hemodynamic instability, Hypoventilation, Facial trauma

Question 8

What should the monitoring of patients using incentive spirometry include?

Accepted Answer

Maintenance of breath-hold, Volume and flow goals achieved, Patient effort and motivation, Number of breaths per session

Question 9

Prior to starting intermittent positive-pressure breathing(IPPB) on a new patient, what should the practitioner explain?

Accepted Answer

What the expected results are., How the IPPB treatment will feel., Why the physician ordered the treatment., What the IPPB treatment will do.

Question 10

Which of the following are true about intermittent positive-pressure breathing?

Accepted Answer

Energy stored during inspiration causes a passive exhalation., During inspiration, alveolar pressure may exceed pleural pressure., The pressure gradients of normal breathing are reversed.

Question 11

Which of the following are appropriate volume goals for intermittent positive-pressure breathing (IPPB) therapy?

Accepted Answer

10 to 15 ml/kg ideal body weight, At least 30% of the inspiratory capacity (IC)

Question 12

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

Accepted Answer

Repetitive, shallow breathing

Question 13

When adjusting the sensitivity control on an IPPB device, which of the following parameters are you changing?

Accepted Answer

Effort required to cycle the device "on" (begin inspiration)

Question 14

Which of the following situations is a contraindication for incentive spirometry?

Accepted Answer

A patient whose vital capacity is less than 10 ml/kg, A patient who cannot cooperate or follow instructions, An unconscious patient

Question 15

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

Accepted Answer

Increased cardiac output

Question 16

Which of the following parameters should be evaluated after intermittent positive-pressure breathing therapy?

Accepted Answer

Vital signs, Breath sounds, Sensorium

Question 17

Which of the following are potential desirable outcomes of intermittent positive-pressure breathing (IPPB) therapy?

Accepted Answer

Increased cough and secretion clearance, Improved oxygenation, Improved breath sounds

Question 18

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

Accepted Answer

Exhale normally, then inhale deeply, then hold your breath for 5 to 10 sec.

Question 19

In terms of machine performance, what do large negative pressure swings early in inspiration typically indicate?

Accepted Answer

Incorrect sensitivity

Question 20

Which of the following are essential components of a continuous positive airway pressure (CPAP) flow system?

Accepted Answer

Blended source of pressurized gas, Low-pressure or disconnect alarm, Expiratory threshold resistor, Nonrebreathing circuit with reservoir bag

Question 21

When checking a Pt&#x27;s IPPB circuit before use, you notice that the device will not cycle off, What is your next action?

Accepted Answer

Check the circuit for leaks.

Question 22

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

Accepted Answer

Sensitivity −1 to −2 cm H2O; pressure 10 to 15 cm H2O; moderate flow

Question 23

Which of the following clinical findings indicate the development of atelectasis?

Accepted Answer

Tachypnea, Diminished or bronchial breath sounds, Opacified areas on the chest x-ray film

Question 24

During admin of a CPAP mask to a Pt w/atelectasis,its difficult to maintain the prescribed airway press. Explanation?

Accepted Answer

System or mask leaks

Question 25

A postop Pt using IS complains of dizziness & numbness around the mouth after therapy sessions. What is the cause?

Accepted Answer

Hyperventilation

Question 26

Successful application of incentive spirometry depends on:

Accepted Answer

the effectiveness of patient teaching.

Question 27

Which of the following should be charted in the Pt&#x27;s medical record after completion of an IPPB treatment?

Accepted Answer

Duration of therapeutic session, Any side effects, Results of pretreatment and posttreatment assessment

Question 28

Persistent breathing at small tidal volumes typically results in which of the following?

Accepted Answer

Compression atelectasis

Question 29

In a postop woman do IS, she does a sustained maximal inspiration maneuver at a rate of 10 to 12/min. Recommended?

Accepted Answer

Take a 30-sec rest period between breaths.

Question 30

For Pts receiving IS, what is the minimum number of sustained maximal inspirations per hour that you would recommend?

Accepted Answer

5 to 10

Question 31

Which of the following possesses the most significant risk for hypoventilation?

Accepted Answer

CPAP

Question 32

Incentive spirometry devices can generally be categorized as which of the following?

Accepted Answer

Volume-oriented, Flow-oriented

Question 33

Which of the outcomes would indicate improvement in a Pt previously diagnosed w/atelectasis who has been receiving IS ?

Accepted Answer

Decreased respiratory rate, Improved chest radiograph, Improved PaO2

Question 34

Which of the following are the hazards and complications of incentive spirometry?

Accepted Answer

Hyperventilation, Barotrauma, Fatigue, Discomfort secondary to inadequate pain control

Question 35

Which of the following Pt groups should be considered for lung expansion therapy using IPPB?

Accepted Answer

Pts w/ diagnosed atelectasis who are not responsive to other therapies, Pts at high risk for atelectasis who cannot cooperate with other methods

Question 36

What is the minimum airway pressure at which the esophagus opens, allowing gas to pass directly into the stomach?

Accepted Answer

20 cm H2O

Question 37

Which of the following mechanisms probably contribute to the beneficial effects of CPAP in treating atlectasis?

Accepted Answer

Increased efficiency of secretion removal, Recruitment of collapsed alveoli, Improved distribution of ventilation, Decreased work of breathing

Question 38

Which of the following patient categories are at high risk for developing atelectasis?

Accepted Answer

Those with neuromuscular disorders, Those with abdominal or thoracic pain, Those who are heavily sedated

Question 39

Which of the following are potential hazards or complications of incentive spirometry?

Accepted Answer

Fatigue, Pulmonary barotrauma, Respiratory alkalosis

Question 40

Which of the following machine performance characteristics should be monitored during IPPB therapy?

Accepted Answer

Sensitivity, Peak pressure, Flow setting

Question 41

Which of the following has a direct relationship w/ the degree to which atelectasis can present itself with a postop Pt?

Accepted Answer

Spontaneous respiratory rate

Question 42

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

Accepted Answer

Respiratory alkalosis

Question 43

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

Accepted Answer

Semi-Fowler&#x27;s

Question 44

In the sustained maximal inspiration maneuver during IS, the Pt should be instructed to sustain the breath for at least?

Accepted Answer

5 to 10 sec

Question 45

A 28-yr old w/ no history of lung disease underwent cesarean section 16 hr earlier. Which would prevent atelectastasis..

Accepted Answer

Incentive spirometry

Question 46

Which of the following are potential contraindications for intermittent positive-pressure breathing?

Accepted Answer

Hemodynamic instability, Recent esophageal surgery, Tension pneumothorax

Question 47

In order to eliminate leaks in an alert Pt receiving IPPB therapy, which of the following adjuncts would you first try?

Accepted Answer

Nose clips

Question 48

The general assessment, common to all patients for whom IPPB is ordered, should include which of the following?

Accepted Answer

Appearance and sensorium, Chest auscultation, Measurement of vital signs

Question 49

Which of the following statements are true about intermittent positive-pressure breathing (IPPB)?

Accepted Answer

Bronchial hygiene must be used in conjunction w/ IPPB to manage secretions., IPPB could cause no expansion of regions affected by secretions., IPPB could cause lung overinflation

Question 50

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

Accepted Answer

Gastric distention is a significant risk in obtunded patients., Gastric distention is uncommon in alert and cooperative patients., Gastric distention is most likely at high airway pressures.

Question 51

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

Accepted Answer

Incentive spirometry

Question 52

Which of the following are potential hazards of intermittent positive-pressure breathing (IPPB)?

Accepted Answer

Air trapping, auto-PEEP, Hyperventilation, Nosocomial infection, Increased airway resistance

Question 53

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

Accepted Answer

Slow, deep breaths held at end-inspiration.

Question 54

How do all modes of lung expansion therapy aid lung expansion?

Accepted Answer

Increasing the transpulmonary pressure gradient

Question 55

In administering IPPB therapy, which of the following breathing patterns would be most desirable?

Accepted Answer

6 to 8 breaths/min, inspiration/expiration ratio (I:E) of 1:3

Question 56

Which of the following are potential indications for incentive spirometry?

Accepted Answer

Abdominal surgery in a COPD patient, Presence of pulmonary atelectasis, A restrictive disorder such as quadriplegia

Question 57

Which of the following will make an intermittent positive-pressure breathing (IPPB) device cycle off prematurely?

Accepted Answer

Active resistance to inhalation, Kinked tubing, Airflow obstructed, Occluded mouthpiece

Question 58

Preliminary planning for intermittent positive-pressure breathing (IPPB) should include which of the following?

Accepted Answer

Conducting a baseline assessment of the patient, Setting specific, individual clinical goals or objectives, Evaluating alternative approaches to the patient&#x27;s problem

Question 59

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

Accepted Answer

Diaphragmatic breathing at slow to moderate flows

Question 60

Lung expansion methods that increase the transpulmonary pressure gradients by increasing alveolar pressure include?

Accepted Answer

Intermittent positive-pressure breathing (IPPB), Positive end-expiration pressure therapy, Expiratory positive airway pressure (EPAP)

Question 61

Which of the following are potential complications of continuous positive airway pressure (CPAP) therapy?

Accepted Answer

Barotrauma, Gastric distention

Therapeutics II Test 3 Review

Questions 61

Therapeutics II Test 3 Review

Questions 61