5.5 post pulmo conditions

Question 1

A patient in pulmonary rehabilitation program is positioned in supine with pillow under the knees. The therapist claps between the clavicle and the nipple bilaterally. This technique is utilized for postural drainage of the:
a. Superior segments of lower lobes
b. Anterior basal segments of lower lobes
c. Anterior segments of upper lobes
d. Posterior basal segments of the lower lobes

Question 2

You palpate your patient’s neck and notice that the trachea is shifted to the patient’s left. Which of the following conditions could explain this finding?
a. left ventricular enlargement
b. left upper lobe collapse
c. right lower lobe collapse
d. pleural effusion on the left

Question 3

The most chronic disease of the lungs is:
a. Pulmonary tuberculosis
b. Emphysema
c. Asthma
d. Bronchiectasis

Question 4

The pathology of bronchiectasis involves dilatation of:
a. Alveolar ducts bronchioles
b. Terminal bronchioles
c. Respiratory
d. Alveoli

Question 5

An FEV in one second of lesser than 80% of the vital capacity indicates:
a. Obstructive lung disease
b. Restrictive lung disease
c. None of these
d. Obstructive & restrictive lung disease

Question 6

An order is received to perform chest physiotherapy on a patient status post abdominal surgery. A chart review identifies right atelectasis. The MOST appropriate exercise to teach the patient is:
a. Reflex cough technique
b. Codman’s pendulum exercises
c. Segmental breathing
d. Quick paced shallow breathing

Question 7

Supplemental O2 therapy is indicated for patients with PaO2 continuously:
a. < 65—70 mmHg
b. < 55 – 60 mmHg
c. < 80 – 90 mmHg
d. < 75 – 80 mmHg

Question 8

A 61-year-old male referred to therapist complains of an excessive cough, sputum production, and shortness of breath. The patient indicates that he has been bothered by some combination of these symptoms for over 10 years. The patient’s present condition is MOST indicative of:
a. idiopathic hypoventilation
b. parkinson’s disease
c. chronic hypoxemia
d. chronic bronchitis

Question 9

A therapist positions the patient in sitting prior to administering bronchial drainage. Which lung segment would require the patient to be in this position?
a. Posterior apical segments of the upper lobes
b. Anterior basal segments of the lower lobes
c. Posterior basal segments of the lower lobes
d. Right middle lobe

Question 10

A therapist reviews the medical record of a patient diagnosed with chronic pulmonary disease. The medical record indicates that the patient’s current condition is consistent with chronic respiratory acidosis. Which testing procedure was likely used to identify this condition?
a. Arterial blood gas analysis
b. Pulmonary function testing
c. Graded exercise testing
d. Pulse oximetry

Question 11

A therapist reviews the results of PFT on a 44-year-old female diagnosed with emphysema. Assuming the patient’s testing was classified as unremarkable, which of the following lung volumes would MOST likely approximate 10% of the patient’s total lung capacity?
a. Tidal volume
b. Inspiratory reserve volume
c. Residual volume
d. Functional residual capacity

Question 12

Overinflation of lungs & formation of air pockets:
a. Bullae
b. Pleural rub
c. Atelectasis
d. Pneumothorax

Question 13

Hypertrophy of the right ventricle resulting from disease affecting the lung structure:
a. Tetralogy of Fallot
b. Cor pulmonale
c. CHF
d. Coarctation

Question 14

Pursed lip breathing techniques given to asthmatic promotes greater gas exchange by:
a. Improving the efficiency of the diaphragm
b. Relaxing accessory muscles
c. Producing positive pressure to prevent airway collapse
d. Controlling the depth & rate of breathing

Question 15

The therapist is positioning a patient for postural drainage. To BEST drain the posterior segment of both lower lobes, the patient should be placed in which of the following positions?
a. Prone, head down position at a 45-degree angle
b. Supine, flat surface
c. Sidelying, head elevated at a 30-degree angle
d. Sitting, leaning forward

Question 16

A therapist treats a nine-year-old child diagnosed with cystic fibrosis. As part of the treatment session the therapist attempts to improve the efficiency of the patient’s breathing. The MOST appropriate technique to encourage full expansion at the base of the lungs is:
a. manual percussion over the posterior portion of the ribs with the patient in prone
b. manual contacts with pressure over the lateral borders of the ribs with the patient in supine
c. manual vibration over the lateral portion of the ribs with the patient in sidelying
d. manual cues over the epigastric area with the patient in supine

Question 17

An infant born prematurely in gestational week 25 has neonatal respiratory distress syndrome. Which of the following would be expected in this infant?
a. Arterial PO2 of 100 mmHg
b. Collapse of the small alveoli
c. Increased lung compliance
d. Normal breathing rate

Question 18

The patient you are treating has active pulmonary tuberculosis. To avoid droplet infection, during gait training exercises, how do you position yourself?
a. Diagonal to the patient
b. Behind the patient
c. In front of the patient
d. Beside the patient

Question 19

The most common cause of pulmonary embolism is:
a. Myocardial infarction
b. Clotting disorder
c. Deep vein thrombosis
d. Venous stasis

Question 20

The most common early symptom of bronchial carcinoma is:
a. Hemoptysis
b. Pain
c. Dyspnea
d. Cough

Question 21

A therapist prepares to treat a patient with cystic fibrosis using postural drainage. The MOST appropriate patient position when treating the superior segments of the lower lobes is:
a. Sitting, leaning back at 30-40 degrees angle
b. Head down on left side, ¼ turn backward
c. Supine with two pillows under the knees
d. Prone with two pillows under the hips

Question 22

The ventilatory function of a person with restrictive lung disease would include __________
a. decreased total lung capacity
b. increased vital capacity
c. increased residual volume
d. increased functional residual capacity

Question 23

P-tube insertion for pneumothorax:
a. 1st-2nd ICS
b. 2nd-3rd ICS
c. 8th-9th ICS
d. 6th-7th ICS

Question 24

Is characterized by episodic widespread narrowing of airways & paroxysms of nocturnal expiratory dyspnea?
a. Bronchiectasis
b. Pulmonary edema
c. Atelectasis
d. Asthma
e. Emphysema

Question 25

A therapist positions a patient in sidelying in preparation for postural drainage activities. Which lung segment would be indicated based on the
patient’s position?
a. Apical segment of the upper lobes
b. Lateral basal segment of the lower lobes
c. Anterior segment of the upper lobes
d. Posterior basal segment

Question 26

A type of breathing exercise indicated for patient with high SCI and post-polio syndrome?
a. glossopharyngeal breathing
b. diaphragmatic breathing
c. segmental breathing
d. sustained maximum inspiration

Question 27

Your patient has been given general anesthesia and other pain medications and has been prescribed with extended confinement to bed. To minimize the risk of pulmonary complications, it is your role as the therapist to include which of the following in the rehab management: a. Ankle pumps
b. Glossopharyngeal breathing exercises c. Deep breathing exercises
d. Pursed lip breathing exercises

Question 28

A therapist positions a patient in the recommended position for bronchial drainage to the posterior basal segments of the lower lobes. The most appropriate location for the therapist to direct force is:
a. Middle of the back at the tip of the scapula
b. Between the clavicle & nipple
c. Upper back
d. Lower ribs close to the spine

Question 29

A therapist completes a respiratory assessment on a patient in an acute care hospital. The examination reveals decreased breath sounds and decreased fremitus. This finding is MOST indicative of:
a. pleural effusion
b. pulmonary edema
c. consolidation
d. atelectasis

Question 30

The following are causes of acute alveolar hypoventilation or respiratory failure. Which one is NOT an airway disease?
a. Chronic bronchitis
b. ALS
c. Cystic fibrosis
d. Acute asthma

Question 31

The following are causes of acute alveolar hypoventilation or respiratory failure. Which one is NOT an airway disease?
a. Chronic bronchitis
b. ALS
c. Cystic fibrosis
d. Acute asthma

Question 32

Patient lies prone with pillows under abdomen in a 45-degree head down position. Percussion is applied bilaterally over the lower portion of the ribs. You are draining the:
a. middle lobe
b. posterior segments of the right and left lower lobes
c. lateral segment
d. anterior segments of the right and left lower lobes
e. lingula

Question 33

Characteristics of Cystic Fibrosis:
a. An exocrine gland dysfunction
b. All of these
c. Affects many organ system
d. May produce malabsorption symptoms

Question 34

Which of the following is the most common type of lung cancer?
a. Large cell
b. Adenocarcinoma
c. Squamous cell
d. Oat cell

Question 35

This abnormal deep breathing is usually associated with metabolic acidosis:
a. Biot’s
b. Kussmaul
c. Harrington
d. Cheyne-Stokes

Question 36

Non-continuous breath sound described as sounding like soda pop fizzing or hair rubbing through the fingers next to the ear:
a. Rhonchi
b. Wheezes
c. Rales
d. Friction rub

Question 37

If a patient has smoked 2 packs of cigarettes daily for the past 30 years, what would their pack year history be?
a. 50 pack years
b. 60 pack years
c. 70 pack years
d. 80 pack years

Question 38

To drain the superior segments of lower lobes, the patient lies on:
a. Abdomen, head down, with pillow under hips & foot of bed elevated 20 inches
b. Abdomen with two pillows under hips, bed flat
c. Back with pillow under knees, bed flat
d. Side, head down, pillow under knees, foot of bed elevated 20 inches

Question 39

A 56 y/o female diagnosed with emphysema is referred to therapist. As part of the examination the physical therapist assesses the tactile fremitus by asking the patient to repeat the term “99” several times in succession. The MOST appropriate method when assessing tactile fremitus is:
a. examine voice sounds through auscultation
b. examine vibration using the ulnar border of the hand
c. examine chest excursion with a tape measure
d. examine the intensity and clarity of spoken words using recording device

Question 40

A therapist assesses a patient’s voice sounds as part of a respiratory examination. The therapist positions the stethoscope over the thorax and asked the patient to say “99” which type of voice sound is assessed using this technique?
a. Bronchophony
b. Egophony
c. Pectoriloquy
d. Pneumophony

Question 41

Disorders classified as COPDs include:
I. Pneumonia
II. Emphysema
III. Sleep apnea
IV. Bronchitis
a. I and III
b. II and IV
c. I, II, III
d. II, III, IV
e. All are correct

Question 42

A therapist performs postural drainage to the anterior basal segments of the lower lobes. During the treatment session the patient suddenly complains of dizziness and mild dyspnea. The MOST appropriate therapist action is:
a. reassure the patient that the response is normal
b. assess the patient’s vital signs
c. elevate the patient’s head
d. call for assistance

Question 43

Increased residual volume is least likely to be a finding in pulmonary function testing of a patient with which of the following conditions?
a. Atelectasis
b. Bronchiectasis
c. Chronic bronchitis
d. Emphysema

Question 44

This improves the lung volume and reduces the work of breathing. This is __________.
a. Incentive spirometry
b. Mini-tracheostomy
c. Intermittent positive pressure breathing
d. Continuous positive airways pressure

Question 45

The rehab program for patient with emphysema should incorporate purse lip expiration since it helps to:
a. decrease intrabrochial pressure
b. increase intrabronchial pressure
c. increase abdominal pressure
d. increase intrathoracic pressure

Question 46

Which of these disease processes will not help from percussion and shaking?
a. Pulmonary fibrosis
b. Bacterial pneumonia
c. Bronchiectasis
d. Cystic fibrosis

Question 47

If a patient presents with the following symptoms: hoarse wheezes and altered breath sounds and may be clubbing at the fingers, may be short of breath and fatigue and a large quantity of pus-filled sputum that may also contain blood, you will entertain the presence of ________.
a. chronic bronchitis
b. emphysema
c. asthma
d. bronchiectasis

Question 48

The patients in palliative care has late-stage Bronchial carcinoma, you plan to include all of the following in the treatment plan. The most important of these would be?
a. Coughing techniques
b. Pain control and comfort
c. Modified postural drainage
d. Breathing exercises

Question 49

A therapist listens to the lung sounds of a 56-year-old-male with chronic bronchitis. The patient was admitted to the hospital two days ago after complaining of shortness of breath and difficulty breathing. While performing auscultation the therapist identifies distinct lung sounds with a high constant pitch during exhalation. This type of sound is MOST consistent with:
a. Crackles
b. Rales
c. Rhonchi
d. Wheezes

Question 50

In cases of pleurisy/pleuritis which is recovering, the following may be done by therapist for the patient. Which may NOT be needed?
a. Trunk bending exercises
b. Chest clapping exercises
c. Deep breathing exercises
d. Thoracic expansion exercises