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301Final Study Guide
301 Final Study Guide
| Question | Answer |
|---|---|
| abnormal breathing pattern seen as a sinking inward motion of the abdomen with each inspiratory effort | Abdominal paradox |
| inward movement of the lower lateral margins of the chest wall with each inspiratory effort owing to a low, flat diaphragm as seen in emphysema | Hoover sign |
| deep and labored breathing pattern often associated with severe metabolic acidosis, particularly diabetic ketoacidosis | Kussmaul respirations |
| difficult breathing in the standing position, which is relieved in the lying or recumbent position | Platypnea |
| alternating strong and weak beats | Pulsus alternans |
| abnormal decrease in pulse pressure with each inspiratory effort | Pulsus paradoxus |
| general term referring to the relative state of a patient's consciousness or alertness | Sensorium |
| cycles of respiration that are increasingly deeper then shallower with possible periods of apnea | Ceyne-stokes |
| prolonged inspiratory phases | Apneustic breathing |
| the difference between the systolic and diastolic pressure readings | Pulse Pressure |
| Large cylinders and attachments | American Standard Safety System (ASSS) |
| Controls both pressure and flow | Regulator |
| Low pressure gas connectors | Diameter-index safety system (DISS) |
| Constant pressure flowmeter device. Measures true flow. | Thorpe tube |
| Small Cylinders | Pin-Index Safety system (PISS) |
| Used in combination with adjustable reducing valve. Ideal for patient transports. | Bourbon Gauge |
| Reduce gas pressure to useable level | Reducing Valve |
| Regulating agency | DOT |
| Fractional distillation | Oxygen production |
| Can manage severe cases of airway obstruction | Helium |
| Low flow O2 delivery systems used in respiratory care include all of the following except: A. Nasal Cannula B. Nasal Catheter C. Air entrainment mask D. Transtracheal catheter | C. Air entrainment mask |
| You enter the room of a patient who is receiving nasal O2 through a bubble humidifier at 5 L/min. You immediately notice that the humidifier pressure relief is popping off. Which of the following actions would be most appropriate in this situation? | Look for crimped or twisted delivery tubing |
| A physician orders 2 L/min O2 through a simple mask to a 33 year old postoperative women with moderate hypoxemia breathing room air (PaO2 = 52 mmHg). What would be the correct action at this time? | Recommend a flow of at least 5 L/min to wash out carbon dioxide |
| A true high flow O2 delivery system should provide at least what flow? | 60 L/min |
| An O2 delivery device takes separate pressurized air and O2 sources as input, then mixes these gases through a precision valve. What does this describe? | O2 blending system |
| What best defines an aerosol? | suspension of liquid or solid particles in a gas |
| Which of the following factors affect pulmonary deposition of an aerosol? I. size of particles II. shape and motion of the particles III. physical characteristics of the airways | I, II, III |
| Which of the following techniques will increase aerosol deposition by sedimentation in the lungs | 10 second breath hold |
| Where do most aerosol particles that are less than 3 micrometers deposit? | Alveoli |
| What is the primary hazard of aerosol drug therapy? | drug reactions |
| All of the following drugs or drug categories have been associated with increased airway resistance and bronchospasm during aerosol administration except: A. Albuterol B. Steroids C. Antibiotics D. Acetylcysteine | A. Albuterol |
| Drug aerosol delivery systems include all of the following except: A. DPIs B. Spinning disc nebulizer C. MDIs D. Small volume jet nebulizers | B. Spinning disc nebulizer |
| Before inspiration and actuation of a metered-dose inhaler, the patient should exhale to which of the following? | functional residual capacity |
| To ensure delivery of the proper drug dosage w/ a MDI, which of the following must be done be4 its use?I. The canister valve stem should be cleaned with a pin. II. The can should be warmed to hand or body temp. III. The can should be vigorously shaken. | II and III |
| Which of the following groups of patients are most likely to have difficulty using a simple metered-dose inhaler for aerosol drug therapy? I. patients in acute distress II. infants and young children III. elderly persons | I, II, and III |
| Which of the following devices depends on the patient’s inspiratory effort to dispense the dose? | dry power inhaler |
| During aerosol delivery using a SVN set at 8 L/min, a pt asks that the head of the bed be lowered to a semi-Fowler’s position. After doing so, u observe a sig drop in SVN aerosol output,despite there being 3 ml of soln left.How do you correct the problem? | Reposition the patient so that the SVN is more upright. |
| Normally, when using a 50-psi flowmeter to drive a small-volume jet nebulizer, to what should you set the flow? | 6 to 10 L/min |
| To minimize a patient’s infection risk between drug treatments with a small-volume jet nebulizer (SVN), what would you do? | Rinse the SVN with sterile water; air dry. |
| A physician has ordered the antiviral agent ribavirin (Virazole) to be administered by aerosol to an infant with bronchiolitis. Which of the following devices would you recommend in this situation? | small-particle aerosol generator (SPAG) |
| Persistent breathing at small tidal volumes can result in which of the following? | compression atelectasis |
| Which of the following patient categories are at high risk for developing atelectasis? I. those who are heavily sedated II. those with abdominal or thoracic pain III. those with neuromuscular disorders | I, II, and III |
| What is the major contributing factor in the development of postoperative atelectasis? | repetitive, shallow breathing |
| Which of the following clinical findings indicate the development of atelectasis? I. opacified areas on the chest x-ray film II. inspiratory and expiratory wheezing III. tachypnea IV. diminished or bronchial breath sounds | I, III, and IV |
| How do all modes of lung expansion therapy aid lung expansion? | increasing the transpulmonary pressure gradient |
| How can the transpulmonary pressure gradient be increased? I. increasing alveolar pressure II. decreasing pleural pressure III. decreasing transthoracic pressure | I and II |
| Lung expansion methods that increase the transpulmonary pressure gradients by increasing alveolar pressure include which of the following? I. Incentive spirometry (IS) II. PEEP therapy III. IPPB therapy IV. expiratory positive airway pressure (EPAP) | II, III, and IV |
| Which of the following modes of lung expansion therapy is physiologically most normal? | incentive spirometry |
| An alert and cooperative 28 yr old woman w/ no prior history of lung disease underwent cesarean section 16 hours earlier. Her x-ray film currently is clear. Which of the following approaches to preventing atelectasis would you recommend for this patient? | incentive spirometry |
| 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 | I, II, and III |
| Which of the following is not a potential hazard or complication of incentive spirometry? | decreased cardiac output |
| A postoperative patient using incentive spirometry complains of dizziness and numbness around the mouth after therapy sessions. What is the most likely cause of these symptoms? | hyperventilation |
| Which of the outcomes would indicate improvement in a pt previously diagnosed with atelectasis who has been receiving IS? I. improved PaO2 II. decreased respiratory rate III. improved chest radiograph IV. decreased FVC V. tachycardia | I, II, and III |
| Ideally, when should high-risk surgical patients be oriented to incentive spirometry? | preoperatively, before undergoing the surgical procedure |
| In teaching a patient to perform the sustained maximal inspiration maneuver during incentive spirometry, what would you say? | “Exhale normally, then inhale as deeply as you can, then hold your breath for 5 to 10 seconds.” |
| The short-term application of inspiratory positive pressure to a spontaneously breathing patient best defines which of the following? | intermittent positive-pressure breathing |
| Intermittent positive-pressure breathing is associated with a passive exhalation. | True |
| Which of the following patient groups should be considered for lung expansion therapy using intermittent positive-pressure breathing (IPPB)? | I. patients with clinically diagnosed atelectasis who are not responsive to other therapies II. patients at high risk for atelectasis who cannot cooperate with other methods |
| What is the optimal breathing pattern for intermittent positive-pressure breathing (IPPB) treatment of atelectasis? | slow, deep breaths held at end-inspiration |
| Which of the following is an absolute contraindication for using intermittent positive-pressure breathing? | tension pneumothorax |
| In order to eliminate leaks in an alert patient receiving intermittent positive-pressure breathing therapy, which of the following adjuncts would you first try? | nose clips |
| During administration of a continuous positive airway pressure flow mask to a patient with atelectasis, you find it difficult to maintain the prescribed airway pressure. Which of the following is the most common explanation? | system or mask leaks |
| Which of the following is/are necessary for normal airway clearance? I. patent airway II. functional mucociliary escalator III. effective cough | I, II, III |
| All of the following drug categories can impair mucociliary clearance in intubated patients except: | bronchodilators |
| All of the following are goals of airway clearance therapy except: | Reverse the underlying disease process. |
| All of the following are considered airway clearance therapies except: | incentive spirometry |
| The application of gravity to achieve specific clinical objectives in respiratory care best describes which of the following? | postural drainage therapy |
| Properly performed chest vibration is applied at what point? | throughout expiration |
| 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? | Move the patient to the sitting position until the cough subsides. |
| All of the following would indicate a successful outcome for postural drainage therapy except: | decreased sputum production |
| What is the point in the respiratory track where inspired gas reaches body temperature, ambient pressure, saturated (BTPS) conditions? | isothermic saturation boundary |
| What is the primary goal of humidity therapy? | maintain normal physiologic conditions |
| Indications for warming inspired gases include all of the following except: | reducing upper airway inflammation or swelling |
| Inhalation of dry gases can do which of the following? I. increase viscosity of secretions II. impair mucociliary motility III. increase airway irritability | I, II, and II |
| What device adds molecular water to gas? | humidifier |
| Factors affecting a humidifier’s performance include all of the following except: | outlet size |
| What is the most important factor determining a humidifier’s performance? | temperature |
| The greater the temperature of the gas, the: | more water vapor it can hold |
| What is the simplest way to increase the humidity output of a humidifier? | Increase the temperature of either the water or the gas |
| Which of the following types of humidifiers are used in clinical practice? I. heat-moisture exchanger II. passover humidifier III. bubble humidifier | I, II, and III |
| Simple unheated bubble humidifiers are commonly used to humidify gases with what type of systems? | nasal oxygen delivery |
| What is the goal of using an unheated bubble humidifier with nasal oxygen delivery systems? | Raise the humidity of the gas to ambient levels. |
| The relief valve on a bubble humidifier serves which of the following functions? I. It indicates when flow has been interrupted. II. It protects the device from pressure damage. III. It warns you when the water level is low. | I and II |
| To protect against obstructed or kinked tubing, simple bubble humidifiers incorporate which of the following? | pressure relief valve |
| When checking an oxygen delivery system that incorporates a bubble humidifier running at 6 L/min, you occlude the delivery tubing, and the humidifier pressure relief immediately pops off. What does this indicate? | normal, leak-free system |
| A design that increases surface area and enhances evaporation by incorporating an absorbent material partially submerged in a water reservoir that is surrounded by a heating element best describes what type of humidifier? | wick |
| Which type of humidifier “traps” the patient’s body heat and expired water vapor to raise the humidity of inspired gas? | heat-moisture exchanger |
| Hazards and complications of bland aerosol therapy include all of the following except: | hemoconcentration |
| What is the most common device used to generate bland aerosols? | large-volume jet nebulizer |
| Which of the following nebulizers uses a piezoelectric transducer to generate liquid particle aerosols? | ultrasonic nebulizer |
| All of the following sites are used for arterial blood sampling by percutaneous needle puncture except: | carotid |
| Indications for arterial blood sampling by percutaneous needle puncture include all of the following except the need to: | assess the adequacy of tissue oxygenation |
| Why is the radial artery the preferred site for arterial blood sampling? I. It is near the surface&easy to palpate and stabilize. II. The ulnar artery normally provides good collateral circulation. III. The radial artery is not near any large veins. | I, II, and III |
| All of the following are grounds for finding an alternative site for arterial puncture except: | anticoagulation therapy |
| Precautions and/or possible complications of arterial puncture include which of the following? I. arteriospasm II. embolization III. infection IV. hemorrhage | I, II, III, and IV |
| Which of the following describes the correct procedure for an Allen test? | Compress both the radial and ulnar arteries, then release the ulnar artery. |
| You are asked to calibrate an O2 analyzer. Which of the following gases would you use for this procedure? I. 100% oxygen. II. 50% oxygen. III. 21% oxygen (room air). | I and III |
| Which blood gas analyzer electrode uses a separate reference electrode? | pH |
| To measure PCO2, blood gas analyzers use what electrode? | Severinghaus |
| How is the accuracy of a blood gas analyzer determined? | comparing the analyzer’s measurements to known values |
| What is indicated by rounding of the costophrenic angles seen on the posteroanterior or lateral chest film? | pleural effusion |
| What chest x-ray view is best used to identify a pleural effusion? | lateral decubitus |
| Which of the following values represents a normal serum potassium level? | 3.5 to 4.8 mEq/L |
| Which of the following tests is used to evaluate renal function? | creatinine |
| What type of white blood cell increases in response to allergic reactions? | eosinophils |
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hmahr2
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