Cardiopulmonary Review Questions #1 Flashcards by Madelynn Kahl

Which lung segment would require the patient to be in sitting when performing postural drainage?

apical segments of the upper lobe
posterior segments of the upper lobe
posterior basal segment
right middle lobe

Apical segments of the upper lobe

How well did you know this?

Not at all

Perfectly

The most appropriate indication for suctioning is:

consolidation
pleural effusion
pneumonia
retained secretions

Retained secretions

How well did you know this?

Not at all

Perfectly

If percussion is being performed to the anterior segments of the upper lobe, what is the proper patient positioning and location of percussion
?

The patient is in supine with percussion performed below the clavicle

How well did you know this?

Not at all

Perfectly

Which lobe is being drained if the patient is positioned in prone with the foot of the bed elevated 18 inches and percussion and vibration are performed over the lower ribs on the left and right side of the chest.

Posterior basal segment of the lower lobe

How well did you know this?

Not at all

Perfectly

Which of the following conditions is a contraindication for postural drainage performed in the Trendelenburg position?

uncontrolled hypertension
atelectasis
impaired cough
retained secretions

uncontrolled hypertension

How well did you know this?

Not at all

Perfectly

Which position best facilitates postural drainage to the bilateral posterior segment of the upper lobe for a patient with orthopnea?

prone, with bed flat
supine, with bed flat
seated, leaning back 30 degrees
seated, leaning forward 30 degrees

Seated, leaning forward 30 degrees

Orthopnea refers to difficulty breathing when lying flat. Seated, leaning forward will expose the area to be percussed and allow gravity to drain the posterior segment of the upper lobe. The position will also allow the patient to breathe easier since they are in an upright position.

How well did you know this?

Not at all

Perfectly

Which of the following airway clearance techniques can a patient perform independently after proper instruction?

percussion
vibration
high frequency chest compression
active cycle of breathing techniques

active cycle of breathing techniques

A patient can perform active cycle of breathing techniques without needing any additional devices. This technique works to clear secretions through breathing control phases, thoracic expansion exercises, and forced expiratory techniques.

How well did you know this?

Not at all

Perfectly

Which of the following muscles is most active during huffing and coughing?

rectus abdominis
anterior scalene
upper trapezius
external intercostals

rectus abdominis

How well did you know this?

Not at all

Perfectly

Which of the following occurs during a huff compared to a directed cough?

glottis remains closed decreasing risk of airway collapse
glottis remains open increasing risk of airway collapse
glottis remains closed increasing risk of airway collapse
glottis remains open decreasing risk of airway collapse

Glottis remains open decreasing risk airway collapse

How well did you know this?

Not at all

Perfectly

When using an oral airway oscillation device, how many exhalation repetitions would be the most desirable before the two large exhalations?

5
15
25
35

When using an oral airway oscillation device such as the Flutter or Acapella, 10-20 active exhalations should be performed through the device followed by two large exhalations and finally a huff or cough to clear secretions.

How well did you know this?

Not at all

Perfectly

Vibration following postural drainage should be performed:

with cupped hands during expiration
with cupped hands during inspiration
with total palmar contact during expiration
with total palmar contact during inspiration

With total palmar contact during expiration

How well did you know this?

Not at all

Perfectly

Which airway clearance technique would most likely be considered too aggressive for a patient with sternal precautions following a recent surgery?

vibration
percussion
autogenic drainage
postural drainage

percussion

How well did you know this?

Not at all

Perfectly

Which piece of objective data would most likely result in a therapist determining that a patient is unable to participate in a scheduled airway clearance session?

blood pressure: 145/87 mm Hg
heart rate of 101 beats per minute
oxygen saturation of 88%
intracranial pressure of 22 mm Hg

Intracranial pressure of 22 mm Hg

Intracranial pressure greater than 20 mm Hg is contraindicated for postural drainage because the required positioning may further elevate intracranial pressure.

How well did you know this?

Not at all

Perfectly

Which of the following airway clearance techniques is not considered a manual technique?

percussion
suctioning
autogenic drainage
manual compression

autogenic drainage

Autogenic drainage uses controlled breathing to mobilize secretions by varying expiratory airflow without using postural drainage positions or coughing. Since autogenic drainage does not require the assistance of another person or equipment, it can be performed during activities of daily living.

How well did you know this?

Not at all

Perfectly

Which lung segment would be most difficult to treat if a patient is unable to tolerate being positioned in prone?

posterior basal segments of the lower lobe
apical segments of the upper lobe
posterior segments of the upper lobe
anterior segments of the lower lobe

Posterior basal segments of the lower lobe

How well did you know this?

Not at all

Perfectly

What is the double-walled connective tissue sac that surrounds the outside of the heart and great vessels?

endocardium
epicardium
myocardium
pericardium

Pericardium

How well did you know this?

Not at all

Perfectly

Which value represents the total blood volume in an adult?

3 liters
5 liters
7 liters
9 liters

5 liters

How well did you know this?

Not at all

Perfectly

Which structure serves as a conduit for both food and air?

nose
larynx
pharynx
trachea

pharynx

How well did you know this?

Not at all

Perfectly

Which structure is a flexible tube composed of C-shaped cartilaginous rings?

pharynx
larynx
trachea
alveoli

trachea

How well did you know this?

Not at all

Perfectly

Which of the following coronary arteries typically supplies blood to the atrioventricular node?

right coronary artery
left coronary artery
left anterior descending artery
left circumflex artery

Right coronary artery

The right coronary artery supplies blood to the atrioventricular node in 90% of individuals. The left circumflex artery supplies blood to the atrioventricular node in the remaining 10%.

How well did you know this?

Not at all

Perfectly

Where does the right coronary artery supply bood?

The right atrium and right ventricle along with the bottom portion of the left ventricle. The right coronary artery branches from the aorta near the point where the aorta and left ventricle meet.

How well did you know this?

Not at all

Perfectly

Which of the following structures transports deoxygenated blood?

aorta
pulmonary artery
pulmonary vein
arteriole

pulmonary artery

How well did you know this?

Not at all

Perfectly

From where does the superior vena cava bring deoxygenated blood to?

Brings deoxygenated blood from the head, neck, and arms to the right atrium

How well did you know this?

Not at all

Perfectly

Which muscle does the subclavian artery course through?

scalenes
sternocleidomastoid
longus colli
platysma

scalenes

How well did you know this?

Not at all

Perfectly

Normal expiration at rest is accomplished by: contraction of the rectus abdominis relaxation of the rectus abdominis contraction of the diaphragm and the intercostal muscles relaxation of the diaphragm and the intercostal muscles

Relaxation of the diaphragm and the intercostal muscles. Normal expiration is a passive process which is achieved through the elastic recoil of the lung tissue and relaxation of the intercostals and diaphragm muscles. As the intercostals relax, the ribs drops to their pre-inspiratory position and the diaphragm returns to its elevated dome position high in the thorax.

Which of the following muscles is a primary contributor to forced expiration? rectus abdominis posterior scalene pectoralis major serratus anterior scalene

rectus abdominis

The cardiac notch is located in which structure? heart diaphragm right lung left lung

left lung - this indentation accommodates for the location of the heart making the left lung smaller than the right

Hair-like projections which function to remove particles from the airways are known as: cilia carina lingula parenchyma

cilia

Approximately how much of the total blood volume is located in the venous system? 25 percent 67 percent 75 percent 80 percent

67% Approximately two-thirds of total blood volume is stored within the venous vasculature. Veins have a greater ability to distend compared to arteries and therefore can expand to accommodate higher volumes of blood.

What is the name of the middle layer of an artery?

The tunica media is in between the tunica externa and tunica interna. The media is made of smooth muscle fibers

In fetal heart circulation, which structure connects the two atria? ligamentum arteriosum ductus arteriosus foramen ovale patent ductus arteriosus

Foramen ovale The foramen ovale connects the two atria and allows blood entering the right heart to bypass the pulmonary circuit and the collapsed, nonfunctional fetal lungs.

Which characteristic has a direct relationship with an individual’s lung volume? age weight height gender

height

Which arteries are considered branches of the left coronary artery? right marginal artery and posterior descending artery posterior descending artery and circumflex artery circumflex artery and left anterior descending artery left anterior descending artery and right marginal artery

Circumflex artery and left anterior descending artery

Where is pleural fluid located? between the visceral pleura and the lungs between the visceral and parietal pleura between the chest cavity and the parietal pleura between the alveoli and the vascular capillaries

between the visceral and parietal pleura

Which type of blood cell would not be classified as a white blood cell? basophils erythrocytes lymphocytes monocytes

erythrocytes - these are red blood cells that make up 40% of blood volume

Blood from the medial side of the lower extremity is drained by the: small saphenous vein great saphenous vein iliac artery femoral artery

great saphenous vein

What visceral structure divides the thorax mid-sagittally between the two lungs? diaphragm sternum pleural plexus mediastinum

mediastinum

Which heart valve connects to the chordae tendineae in the right ventricle? pulmonary valve aortic valve bicuspid valve tricuspid valve

tricuspid valve The chordae tendineae connect the tricuspid valve to the papillary muscles in the right ventricle. The tricuspid valve is located between the right atrium and the right ventricle.

Which of the following pieces of equipment would not be used when performing an ankle-brachial index measurement? watch stethoscope Doppler ultrasound sphygmomanometer

watch

Which ankle-brachial index (ABI) value would be most consistent with a patient that is experiencing the initial symptoms of peripheral arterial disease? 0.35 0.68 0.89 1.15

0.89

Which scenario is most likely based on a recorded ankle-brachial index measurement of 0.84? normal mild arterial disease moderate arterial disease severe arterial disease

mild arterial disease The ankle-brachial index (ABI) can be used to provide a ratio of systolic blood pressure of the lower extremity compared to the upper extremity. An ABI of 0.84 is far enough from the ideal ABI value of 1.0 to indicate the presence of mild arterial disease, but not far enough below 1.0 to indicate more significant involvement.

Which of the following signs or symptoms would most likely lead a health care provider to perform an ankle-brachial index measurement on a patient? dizziness heart palpitations angina claudication

claudication

Which diagnostic test would be most beneficial to compare the relative perfusion pressure in the upper extremities compared to the lower extremities? ankle-brachial index computed tomography Doppler ultrasonography plethysmography

ABI

Which ankle-brachial index measurement would be most consistent with a patient experiencing intermittent claudication during exercise? 1.20 1.00 0.85 0.65

0.65 The ankle-brachial index (ABI) expresses the ratio of systolic blood pressure of the lower extremities compared to the systolic blood pressure of the upper extremities. An ideal ABI is 1.0, while an ABI of 0.65 would be representative of a moderate blockage that may be associated with intermittent claudication during exercise.

Which of the following arteries would be least likely used when measuring a patient’s ankle-brachial index? radial artery brachial artery posterior tibial artery dorsalis pedis artery

radial artery

Which ankle-brachial index measurement is most consistent with non-compressible vessels? 1.40 1.20 1.00 0.90

1.40

Lower blood pressure in the lower extremities as compared to the upper extremities could be suggestive of: neurologic disease congestive heart failure vascular disease left ventricular hypertrophy

vascular disease

When determining a patient’s ankle-brachial index, which of the following is considered normal? 90 mm Hg brachial artery, 135 mm Hg posterior tibialis artery 80 mm Hg brachial artery, 120 mm Hg posterior tibialis artery 130 mm Hg brachial artery, 110 mm Hg posterior tibialis artery 125 mm Hg brachial artery, 130 mm Hg posterior tibialis artery

125 mm Hg brachial artery, 130 mm Hg posterior tibialis artery The ankle-brachial index (ABI) compares systolic blood pressures at the ankle and arm to check for peripheral artery disease. The ABI is calculated by dividing the lower extremity (posterior tibialis artery) value by the upper extremity (brachial artery) value. A normal value is considered 1.0-1.3, while values from 0.80-0.99 are indicative of a mild blockage.

Which pH value is most consistent with the presence of acidemia? 7.3 7.4 7.5 7.6

7.3

Which of the following is considered a normal bicarbonate level in the blood? 25 mEq/L 30 mEq/L 35 mEq/L 40 mEq/L

25 mEq/L

Which of the following arterial blood gasses is the metabolic component of an arterial blood gas analysis? CO2 PaCO2 SaO2 HCO3

HCO3

Which of the following is considered the gold standard for measuring oxygen saturation? arteriogram pulmonary function testing pulse oximetry arterial blood gas analysis

arterial blood gas

The oxygen-carrying capacity of the body is dependent on: concentration of plasma concentration of hemoglobin heart rate respiratory rate

Concentration of hemoglobin

The respiratory component of the acid-base balance of the body is best determined by: pH PCO2 HCO3- base excess

PCO2

A low pH and elevated PCO2 due to alveolar hypoventilation can result in: metabolic acidosis metabolic alkalosis respiratory acidosis respiratory alkalosis

respiratory acidosis

What impact will hyperventilation have on a patient’s arterial blood gas? lower the pH decrease the PaO2 decrease the PaCO2 increase the PaCO2

Decrease the PaCO2

Which of the following would indicate a need for oxygen therapy? SpO2 below 90% SpO2 below 95% SpO2 below 98% SpO2 of 99%

below 90%

What is the approximate percentage of oxygen available for breathing at sea level? 10 percent 15 percent 21 percent 25 percent

21 percent

Which rate is the most appropriate when deflating a blood pressure cuff when assessing blood pressure? 1-2 mm Hg per second 2-3 mm Hg per second 3-4 mm Hg per second 4-5 mm Hg per second

2-3 mm Hg per second

Which recorded blood pressure value is associated with a hypertensive crisis? 110 mm Hg diastolic 150 mm Hg systolic 130 mm Hg diastolic 170 mm Hg systolic

130 mm Hg diastolic A hypertensive crisis occurs when measured blood pressure is greater than 180 mm Hg and/or greater than 120 mm Hg DBP. If blood pressure is 180/120 or greater and with other associated symptoms of potential organ damage such as chest pain, shortness of breath, back pain, numbness/weakness, change in vision, or difficulty speaking then this would be considered a hypertensive emergency. This type of scenario warrants immediate medical attention including calling 911.

Which patient age group would be most likely to have the lowest recorded diastolic blood pressure? infants children adolescents elderly

infants

Which phase of Korotkoff sounds are associated with the first faint, clear tapping sounds detected by auscultation? Phase I Phase II Phase IV Phase V

Phase I

Which condition would most likely be associated with a decrease in blood pressure? anxiety dehydration exercise muscle contraction

dehydration

When taking a blood pressure measurement, which sound is most associated with the diastolic blood pressure value? sound becoming crisper sound lasting longer sound disappearing sound amplification

Sound disappearing

Which of the following blood pressure values would fall into the category of “Elevated” for an adult? 137/85 mm Hg 123/78 mm Hg 130/100 mm Hg 140/95 mm Hg

123/78

How should a patient be positioned when taking their blood pressure? patient resting their arm at their side patient holding their arm at shoulder height patient resting their arm on a table at chest height patient holding their arm above shoulder height

patient resting their arm on a table at chest height

Which of the following is consistent with the mean pressure in the venous system? 2 mm Hg 12 mm Hg 22 mm Hg 32 mm Hg

2 mm Hg The mean venous pressure throughout the venous vasculature is approximately 2 mm Hg. This pressure is highest distally and lowest proximally at the junction of the vena cava and right atrium.

Using a blood pressure cuff that is too small for an obese patient will cause the arterial pressure reading to be: too low too high normal continually variable

too high

Central venous pressure measures filling pressure of the: right atrium left atrium right ventricle left ventricle

right atrium Central venous pressure is obtained via a catheter introduced at a vein and advanced to the inferior or superior vena cava or right atrium.

Which of the following changes in vital signs is associated with normal aging? an increase in susceptibility to hyperthermia a decrease in respiratory rate an increase in blood pressure a decrease in heart rate

an increase in BP

The pulse pressure of a patient with a systolic blood pressure of 119 mm Hg and a diastolic blood pressure of 79 mm Hg would be: 40 mm Hg 90 mm Hg 100 mm Hg 198 mm Hg

40 mm Hg Pulse pressure is the mathematical difference between the systolic and diastolic blood pressures. This value represents the force that the heart generates with each contraction. A value greater than 40 mm Hg indicates an increased risk of cardiovascular disease.

What cardiac measure is determined by the formula: cardiac output x total peripheral resistance? blood pressure stroke volume forced expiratory volume tidal volume

blood pressure

When assessing blood pressure, how high above a patient’s normal systolic blood pressure should a sphygmomanometer cuff be inflated? 10 mm Hg 25 mm Hg 40 mm Hg 50 mm Hg

Which lung segment would require the patient to be in sitting when performing postural drainage? apical segments of the upper lobe posterior segments of the upper lobe posterior basal segment right middle lobe

Apical segments of the upper lobe

The most appropriate indication for suctioning is: consolidation pleural effusion pneumonia retained secretions

retained secretions

Which segment is being drained with patient in supine with a level bed and percussion being performed below clavicles apical segments of the upper lobes anterior segments of the upper lobes superior segments of the lower lobes posterior basal segments of the lower lobes

anterior segments of the upper lobes

What segment is being drained with the patient in supine and foot of bed elevated 18 inches apical segment of upper lobe middle lobe posterior basal segment of lower lobe superior segment of lower lobe

Posterior basal segment of lower lobe

Which of the following conditions is a contraindication for postural drainage performed in the Trendelenburg position? uncontrolled hypertension atelectasis impaired cough retained secretions

Uncontrolled hypertension

Which position best facilitates postural drainage to the bilateral posterior segment of the upper lobe for a patient with orthopnea? prone, with bed flat supine, with bed flat seated, leaning back 30 degrees seated, leaning forward 30 degrees

Seated, leaning forward 30 degrees Orthopnea refers to difficulty breathing when lying flat. Seated, leaning forward will expose the area to be percussed and allow gravity to drain the posterior segment of the upper lobe. The position will also allow the patient to breathe easier since they are in an upright position.

Which of the following airway clearance techniques can a patient perform independently after proper instruction? percussion vibration high frequency chest compression active cycle of breathing techniques

Active cycle of breathing techniques

Which of the following muscles is most active during huffing and coughing? rectus abdominis anterior scalene upper trapezius external intercostals

Rectus abdominis

Which of the following occurs during a huff compared to a directed cough? glottis remains closed decreasing risk of airway collapse glottis remains open increasing risk of airway collapse glottis remains closed increasing risk of airway collapse glottis remains open decreasing risk of airway collapse

Glottis remains open decreasing risk of airway collapse

When using an oral airway oscillation device, how many exhalation repetitions would be the most desirable before the two large exhalations? 5 15 25 35

15 Ideal is between 10-20

Vibration following postural drainage should be performed: with cupped hands during expiration with cupped hands during inspiration with total palmar contact during expiration with total palmar contact during inspiration

With total palmar contact during expiration

Which airway clearance technique would most likely be considered too aggressive for a patient with sternal precautions following a recent surgery? vibration percussion autogenic drainage postural drainage

Percussion

Which piece of objective data would most likely result in a therapist determining that a patient is unable to participate in a scheduled airway clearance session? blood pressure: 145/87 mm Hg heart rate of 101 beats per minute oxygen saturation of 88% intracranial pressure of 22 mm Hg

Intracranial pressure of 22 mmHg

Which of the following airway clearance techniques is not considered a manual technique? percussion suctioning autogenic drainage manual compression

autogenic drainage

Which lung segment would be most difficult to treat if a patient is unable to tolerate being positioned in prone? posterior basal segments of the lower lobe apical segments of the upper lobe posterior segments of the upper lobe anterior segments of the lower lobe

Posterior basal segments of the lower lobe