Scenario Questions Flashcards
When providing vibration chest physiotherapy, what is the recommended frequency?
10-15 Hz
When doing percussion therapy, what is the recommended frequency?
5-6 Hz
A 12 year old patient with cystic fibrosis has had PEP therapy started at 5cmH2O. After a few minutes of use, the patient fails to cough productively. What should be done now?
Increase the PEP level to 10cmH2O
You are called to the Pediatric Department to help in the evaluation and care for a 4 year old girl who has been sick with a bad cold for the past 2 days. The nurse shows you a lateral neck radiograph of the child and asks your opinion. You notice a clear air column through the upper airway but a pointed narrowing of the tracheal air column below the larynx. You tell the nurse that you suspect the child has:
Laryngotrachealbronchitis (LTB), aka croup
A child presents w/ a high fever, severe sore throat, dysphagia with drooling, cough, progressing rapidly over a few hours to stridor, muffled voice without hoarseness, air hunger, and cyanosis. Sever intercostal retractions, along with nasal flaring, bradypnea, and dyspnea are present. The child assumes a characteristic position of sitting upright with the chin thrust forward and the neck hyperextended in a tripod position. Bacterial epiglottitis is suspected. What is the next necessary action?
A. Secure an intravenous line for sedation
B. Lay the child flat and provide flow-by oxygen
C. Visualization of the upper airway
D. Obtain upper airway radiographic imaging
E. Call supporting services
A. Secure an intravenous line for sedation
Which of the following is/are commonly culture from the mucus in the tracheobronchial tree of a patient with cystic fibrosis?
I. Klebsiella
II. Pseudomonas aeruginosa
III. Haemophilus influenzae
IV. Staphylococcus aureus
II. Pseudomonas aeruginosa
III. Haemophilus influenzae
IV. Staphylococcus aureus
There are several phases of a normal cough to create sufficient cough flow for effective pulmonary clearance. The patient w/ neuromuscular weakness:
A. Does not have true impairment of cough flows, because it is relative to the reduced vital capacity
B. Is able to produce high expiratory flows but does not generate enough volume to an effective cough
C. Is unable to produce peak cough flows
D. Has impaired glottic closure and diaphragmatic force for an effective cough
E. May have difficulty with any of the phases of an effective cough
E. May have difficulty with any of the phases of an effective cough
A teenager has a temperature of 38.5 degrees C, a RR of 28 breaths per min, increased thoracic anteroposterior diameter, minimal subcostal retractions and fine and coarse crackles heard over the R and L super lobe. Further evaluation reveals mild digital clubbing of the fingers. This child probably has the following underling disease:
A. GERD B. ARDS C. Cystic Fibrosis D Bilateral bronchomalachia E. Asthma
C. Cystic Fibrosis
Which infant is especially at risk for severe or life-threatening RSV bronchiolitis infections:
A. Infant w/ congenital heart disease
B. Immune-compromised children
C. All of the above
D. Premature babies
C. All of the above
In the ER, the RT is asked to give a 2 year old in respiratory distress an albuterol tx. Pretreatment assessment reveals a mildly uncomfortable afebrile child w/ a RR of 36 breaths per minute, mild subcostal retractions, and expiratory wheezes best heard over the right middle and lower lobes. Post-treatment assessment is unchanged except that the RR is now 32 breaths per minute. A brief hx reveals that coughing began abruptly several days ago and wheezing was noted this morning. The family has no hx of atopic disease. The child was previously healthy with no history of chest disease. The respiratory therapist speaks with the attending physician and suggest that the child most likely has the following disorder/disease:
A. Pneumonia B. Cystic Fibrosis C. Laryngeal cleft D. Double outlet right ventricle E. foreign body aspiration
A. Pneumonia
What do postural drainage, positive expiratory pressure therapy, autogenic drainage, forced expiration techniques, and high-frequency chest compressions have in common?
A. They work toward increasing the functional residual capacity of patients
B. They are intended to promote the ability of patients to generate effective coughs.
C. They dislodge mucus from the bronchial walls of patients.
D. They attempt to prevent dynamic airway collapse
D. They attempt to prevent dynamic airway collapse
What is the most important variable used to assess the efficiency of CPT?
Amount of mucus obtained during and after treatment
By which of the following mechanisms are high-frequency chest compressions purported to mobilize tracheobronchial secretions?
A. By mechanically lysing long molecules of mucus into smaller, more mobile segments
B. By dislodging mucus directly from bronchial walls
C. By advancing the mucociliary escalator at a faster than normal rate
D. By generating high expiratory air velocities
D. By generating high expiratory air velocities
Which of the following conditions may bronchial hygiene therapy be considered for infants or children?
- Hyaline membrane disease
- foreign body aspiration
- cystic fibrosis
- neuromuscular disease
- foreign body aspiration
- cystic fibrosis
- neuromuscular disease
Answer: 2, 3, 4 only
A respiratory therapist has been assigned to administer ACT to a number of patients on the ward. In which of the following conditions may ACT be beneficial?
A. Lung abscess
B. Bronchiolitis
C. Asthma
D. Pneumonia
A. Lung abscess
Lung abscess is a pus-filled cavity in the lung surrounded by inflamed tissue.
