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Exam 39: Lung Expansion Therapy

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Question 21

Multiple Choice

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Which of the outcomes would indicate improvement in a patient previously diagnosed with atelectasis who has been receiving incentive spirometry? I.improved PaO₂ II.decreased respiratory rate III.improved chest radiograph IV.decreased forced vital capacity (FVC) V.tachycardia

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

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Question 22

Multiple Choice

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

A) inadequate flow setting
B) incorrect sensitivity
C) inadequate pressure setting
D) inadequate humidity

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Question 23

Multiple Choice

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A surgeon writes an order for lung expansion therapy for a 28-year-old 110-lb woman who has undergone lower abdominal surgery. In evaluating this patient at the bedside, you obtain a VC of 800 ml and an IC of 44% predicted. Although a chest radiograph indicates basal atelectasis, she has no problem with retained secretions. What lung expansion treatment would you recommend?

Which of the following will make an intermittent positive-pressure breathing (IPPB) device cycle off prematurely? I.airflow obstructed II.kinked tubing III.occluded mouthpiece IV.active resistance to inhalation

Which of the following is not a potential hazard or complication of incentive spirometry?

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

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

Which of the following situations is a contraindication for incentive spirometry? I.a patient whose vital capacity is less than 10 ml/kg II.a patient who cannot cooperate or follow instructions III.an unconscious patient

For patients receiving incentive spirometry, what is the minimum number of sustained maximal inspirations (SMIs) per hour that you would recommend?

When adjusting the sensitivity control on an intermittent positive-pressure breathing device, which of the following parameters are you changing?

The general assessment, common to all patients for whom intermittent positive-pressure breathing (IPPB) is ordered, should include which of the following? I.measurement of vital signs II.appearance and sensorium III.chest auscultation IV.arterial blood gas analysis V.peak expiratory flow rates

Which of the following are contraindications for continuous positive airway pressure (CPAP) therapy? I.hemodynamic instability II.hypoventilation III.facial trauma IV.low intracranial pressures

Intermittent positive-pressure breathing is associated with a passive exhalation.

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

Which of the following are appropriate volume goals for intermittent positive-pressure breathing (IPPB) therapy? I.10 to 15 ml/kg ideal body weight II.at least 30% of the inspiratory capacity (IC) III.pressure level as high as 30 to 35 cm H₂O

Which of the following are potential indications for incentive spirometry? I.a restrictive disorder such as quadriplegia II.abdominal surgery in a COPD patient III.presence of pulmonary atelectasis

Successful application of incentive spirometry depends on:

In performing the sustained maximal inspiration maneuver during incentive spirometry, the patient should be instructed to sustain the breath for at least how long?

Which of the following is false about intermittent positive-pressure breathing?

While monitoring a patient receiving +12 cm H₂O flow-mask continuous positive airway pressure, you note that the pressure drops to +6 cm H₂O during inspiration, but returns to +12 cm H₂O during exhalation. Which of the following would likely correct this problem?