Question 1

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

Accepted Answer

A)  their inspiratory flow
B)  the angle of the device
C)  their expiratory flow
D)  the expired volume

Question 2

A patient with a tracheostomy tube is having difficulty developing an effective cough. Which of the following phases of the cough reflex are primarily affected in this patient?

Accepted Answer

A)  irritation
B)  inspiration
C)  compression
D)  expulsion

Question 3

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?
I.irritation
II.inspiration
III.compression
IV.expulsion

Accepted Answer

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

Question 4

Primary objectives for turning include all of the following except to:

Accepted Answer

A)  prevent postural hypotension
B)  promote lung expansion
C)  prevent retention of secretions
D)  improve oxygenation

Question 5

In setting up a postural drainage treatment schedule for a postoperative patient, which of the following information would you try to obtain from the patient's nurse?
I.patient's medication schedule
II.patient's meal schedule
III.location of surgical incision

Accepted Answer

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

Question 6

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

Accepted Answer

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

Question 7

Which of the following acutely ill patients is LEAST likely to benefit from application of chest physical therapy?

Accepted Answer

A)  patient with acute lobar atelectasis
B)  patient with copious amounts of secretions
C)  patient with an acute exacerbation of chronic obstructive pulmonary disease (COP
D)  
D)  patient with low  V˙/Q˙\dot { V } / \dot { Q }V˙/Q˙​  due to unilateral infiltrates

Question 8

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

Accepted Answer

A)  1 pint
B)  1 ounce
C)  1 gallon
D)  1 tablespoon

Question 9

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?

Accepted Answer

A)  Maintain the drainage position while carefully watching the patient.
B)  Move the patient to the sitting position until the cough subsides.
C)  Stop the treatment at once and report the incident to the nurse.
D)  Drop the head of the bed farther and encourage more coughing.

Question 10

Which of the following clinical signs indicate that a patient is having a problem with retained secretions?
I.lack of sputum production
II.labored breathing
III.development of a fever
IV.increased inspiratory and expiratory crackles

Accepted Answer

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

Question 11

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

Accepted Answer

A)  It can impair the mucociliary clearance mechanism.
B)  It can increase expiratory airway resistance (Raw) .
C)  It can cause air trapping and pulmonary distension.
D)  It can markedly increase intracranial pressure (ICP) .

Question 12

What are the best documented preventive uses of bronchial hygiene therapy?
I.prevent retained secretions in the acutely ill
II.maintain lung function in cystic fibrosis
III.prevent postoperative pulmonary complications

Accepted Answer

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

Question 13

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

Accepted Answer

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

Question 14

Which of the following is not an advantage of the Acapella over the flutter?

Accepted Answer

A)  It can customize frequency.
B)  It can be used in any posture.
C)  It is more portable.
D)  It can customize flow resistance.

Question 15

What factors can hinder effective coughing?
I.artificial airways
II.neuromuscular disease
III.systemic dehydration
IV.pain or fear of pain
V.use of expectorants

Accepted Answer

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

Question 16

Which of the following is false about the FET?

Accepted Answer

A)  It causes less bronchiolar collapse than traditional coughing.
B)  It occurs from mid to low lung volume without glottis closure.
C)  It has a period of diaphragmatic breathing and relaxation.
D)  It occurs from mid to high lung volume without glottis closure.

Question 17

Conditions that can affect airway patency and cause abnormal clearance of secretions include which of the following?
I.foreign bodies
II.tumors
III.inflammation
IV.bronchospasm

Accepted Answer

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

Question 18

Which of the following occur(s)  during the compression phase of a cough?
I.expiratory muscle contraction
II.opening of the glottis
III.rapid drop in alveolar pressure

Accepted Answer

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

Question 19

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?

Accepted Answer

A)  Increase the patient's FIO2 during therapy.
B)  Discontinue the postural drainage therapy entirely.
C)  Discontinue the percussion and vibration only.
D)  Decrease the frequency of treatments.

Question 20

What is the ideal patient position for directed coughing?

Accepted Answer

A)  sitting with one shoulder rotated inward, the head and spine slightly flexed
B)  supine, with knees slightly flexed and feet braced
C)  prone, with the head and spine slightly flexed
D)  supine, with forearms relaxed and feet supported

Exam 40: Bronchial Hygiene Therapy

What factors can hinder effective coughing? I.artificial airways II.neuromuscular disease III.systemic dehydration IV.pain or fear of pain V.use of expectorants

Correct AnswerverifiedShow Answer

What is the ideal patient position for directed coughing?

Correct AnswerverifiedShow Answer

Conditions that can affect airway patency and cause abnormal clearance of secretions include which of the following? I.foreign bodies II.tumors III.inflammation IV.bronchospasm

Correct AnswerverifiedShow Answer

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

Correct AnswerverifiedShow Answer

What are the best documented preventive uses of bronchial hygiene therapy? I.prevent retained secretions in the acutely ill II.maintain lung function in cystic fibrosis III.prevent postoperative pulmonary complications

Correct AnswerverifiedShow Answer

A patient with a tracheostomy tube is having difficulty developing an effective cough. Which of the following phases of the cough reflex are primarily affected in this patient?

Correct AnswerverifiedShow Answer

Which of the following is not an advantage of the Acapella over the flutter?

Correct AnswerverifiedShow Answer

Primary objectives for turning include all of the following except to:

Correct AnswerverifiedShow Answer

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

Correct AnswerverifiedShow Answer

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?

Correct AnswerverifiedShow Answer

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

Correct AnswerverifiedShow Answer

Which of the following occur(s) during the compression phase of a cough? I.expiratory muscle contraction II.opening of the glottis III.rapid drop in alveolar pressure

Correct AnswerverifiedShow Answer

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

Correct AnswerverifiedShow Answer

In setting up a postural drainage treatment schedule for a postoperative patient, which of the following information would you try to obtain from the patient's nurse? I.patient's medication schedule II.patient's meal schedule III.location of surgical incision

Correct AnswerverifiedShow Answer

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?

Correct AnswerverifiedShow Answer

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

Correct AnswerverifiedShow Answer

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? I.irritation II.inspiration III.compression IV.expulsion

Correct AnswerverifiedShow Answer

Which of the following is false about the FET?

Correct AnswerverifiedShow Answer

Which of the following acutely ill patients is LEAST likely to benefit from application of chest physical therapy?

Correct AnswerverifiedShow Answer

Which of the following clinical signs indicate that a patient is having a problem with retained secretions? I.lack of sputum production II.labored breathing III.development of a fever IV.increased inspiratory and expiratory crackles

Correct AnswerverifiedShow Answer

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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?

Correct Answer
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