Chapter 39 Lung Expansion Therapy

Chapter 39  Lung Expansion Therapy

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. Persistent breathing at small tidal volumes can result in which of the following?
a.
reabsorption atelectasis
b.
spontaneous pneumothorax
c.
compression atelectasis
d.
respiratory alkalosis

ANS: C
Compression atelectasis is primarily caused by persistent use of small tidal volumes by the patient.

DIF: Recall REF: p. 946 OBJ: 1

2. Which of the following patient categories are at high risk for developing atelectasis?
1. those who are heavily sedated
2. those with abdominal or thoracic pain
3. those with neuromuscular disorders
a.
1 and 2
b.
2 and 3
c.
1 and 3
d.
1, 2, and 3

ANS: D
Patients who have difficulty taking deep breaths without assistance include those with significant obesity, those with neuromuscular disorders, those under heavy sedation, and those who have undergone upper abdominal or thoracic surgery.

DIF: Recall REF: p. 946 OBJ: 1

3. What is the major contributing factor in the development of postoperative atelectasis?
a.
uncontrolled hyperpyrexia
b.
central nervous system overstimulation
c.
decreased cardiac output
d.
repetitive, shallow breathing

ANS: D
Most postoperative patients also have problems coughing effectively because of their reduced ability to take deep breaths.

DIF: Recall REF: p. 946 OBJ: 1

4. Which of the following groups of patients is not at risk for developing postoperative atelectasis?
a.
those with chronic obstructive pulmonary disease
b.
those with a significant history of cigarette smoking
c.
those with impaired mucociliary clearance
d.
those with pneumonia

ANS: D
An ineffective cough impairs normal clearance mechanisms and increases the likelihood of retained secretions and gas absorbtion atelectasis in the patient with excessive mucus production. For this reason, patients with a history of lung disease that causes increased mucus production (e.g., chronic bronchitis) are most prone to develop complications in the postoperative period. Similarly, a significant history of cigarette smoking should alert the respiratory therapist to the high risk for respiratory complications with surgery.

DIF: Recall REF: p. 946 OBJ: 2

5. Which of the following clinical findings indicate the development of atelectasis?
1. opacified areas on the chest x-ray film
2. inspiratory and expiratory wheezing
3. tachypnea
4. diminished or bronchial breath sounds
a.
1, 3, and 4
b.
1, 2, 3, and 4
c.
1 and 4
d.
2, 3, and 4

ANS: A
When the atelectasis involves a more significant portion of the lungs, the patient’s respiratory rate will increase proportionally. Bronchial-type breath sounds may be present as the lung becomes more consolidated with atelectasis. Diminished breath sounds are common when excessive secretions block the airways and prevent transmission of breath sounds. The chest film is often used to confirm the presence of atelectasis.

DIF: Recall REF: p. 947 OBJ: 3