Fundamentals W11 Quiz
Fundamentals of Airway Clearance Techniques Quiz
Test your knowledge of airway clearance techniques and concepts in respiratory therapy. This comprehensive quiz consists of 58 multiple-choice questions designed to assess your understanding of crucial airway management strategies.
- Key topics include airway clearance methods, cough reflex phases, and patient care considerations.
- Ideal for students, educators, and professionals in respiratory health fields.
Which of the following airway clearance techniques would you recommend for a patient with a neurologic abnormality (bulbar palsy) and intact upper airway? 1. Postural drainage, percussion, and vibration 2. Positive expiratory pressure therapy 3. Mechanical insufflation-exsufflation
1 & 3 only
2 & 3 only
1 & 2 only
1, 2 & 3
A physician orders bronchodilator drug therapy in combination with positive expiratory pressure (PEP). Which of the following methods could you use to provide this combined therapy? 1. Attach a dry powder inhaler in-line with the PEP apparatus. 2. Attach a metered dose inhaler to the system’s one-way valve inlet. 3. Place a small volume nebulizer in-line with the PEP apparatus.
2 & 3 only
1 and 2 only
1, 2 & 3
1 & 3 only
Which of the following are true about the FET? 1. It causes less bronchiolar collapse than traditional coughing. 2. It occurs from mid to low lung volume without glottis closure. 3. It has a period of diaphragmatic breathing and relaxation. 4. It occurs from mid to high lung volume without glottis closure.
1, 2 & 3 Only
1 & 3 only
3 & 4 only
2, 3 and 4
What is the movement of small volumes of air back and forth in the respiratory tract at high frequencies (12 to 25 Hz) called?
1. Tidal Breathing
2. Active cycle breathing
3. Oscillation
4. Huffing
What happens during the exsufflation phase of mechanical insufflation-exsufflation? 1. Airway pressure is abruptly decreased to -30 to -50 cm H2O. 2. Negative airway pressure is maintained for 2 to 3 sec. 3. Peak expiratory “cough” flows reach near normal values.
1 and 2 only
2 and 3 only
1 and 3 only
1, 2 and 3
A patient recovering from anesthesia after abdominal surgery is having difficulty developing an effective cough. Which of the following phases of the cough reflex are primarily affected in this patient?
Irritation
Inspiration
Compression
Expulsion
A physician orders postural drainage for a patient with aspiration pneumonia in the anterior segments of the upper lobes. Which of the following positions would you recommend for this patient?
Head down, patient prone with a pillow under abdomen
Patient supine with a pillow under knees, bed flat
Head down, patient supine with a pillow under knees
Patient prone with a pillow under abdomen, bed flat
Which of the following conditions are associated with chronic production of large volumes of sputum? 1. Bronchiectasis 2. Pulmonary fibrosis 3. Cystic fibrosis 4. Chronic bronchitis
1, 3, and 4 only
2 and 4 only
2, 3 and 4
3 and 4
Key consideration in teaching a patient to develop an effective cough regimen includes which of the following? 1. Strengthening of the expiratory muscles 2. Instruction in breathing control 3. Instruction in proper positioning
2 and 3
1 and 2
1, 2 and 3
1 and 3
Maintaining an open glottis during coughing (as with the FET) can help to minimize increases in pleural pressure and lessen the likelihood of bronchiolar collapse. Which of the following techniques can aid the practitioner in teaching the patient this maneuver?
Having the patient inhale slowly through the nose
Having the patient phonate or “huff” during expiration
Having the patient “tense” the neck muscles while coughing
Telling the patient to exert effort, as in straining at stool
Proper instructions for positive expiratory pressure include which of the following? 1. Take in a breath that is larger than normal, but do not fill lungs completely. 2. Exhale forcefully and maintain an expiratory pressure of 10 to 20 cm H2O. 3. After 10 to 20 breaths, take two or three “huff”’ coughs, and rest as needed. 4. Repeat the cycle 8 to 10 times, not to exceed 30 min.
2, 3 and 4
1 and 3
3 and 4
1, 2 and 3
Which of the following are typical of high-frequency external chest wall compression therapy? 1. 30-min therapy sessions 2. Long inspiratory oscillations 3. One to six sessions per day 4. Oscillations at 20 to 25 Hz
1 and 3 only
1, 2 and 3 only
3 and 4 only
2, 3 and 4 only
Which of the following measures would you use to ask patients for the presence of copious mucus production?
1 pint
1 ounce
1 gallon
1 tablespoon
Which of the following should be considered when selecting an airway clearance strategy? 1. Patient’s goals, motivation, and preferences 2. Effectiveness and limitations of technique or method 3. Patient’s age, ability to learn, and tendency to fatigue 4. Need for assistants, equipment, and cost
1, 2 and 3 only
1, 3 and 4 only
2 and 3 only
1, 2, 3, and 4
If tolerated, a specified postural drainage position should be maintained for at least how long?
1 to 2 min
10 to 20 min
20 to 30 min
3 to 15 min
Which of the following conditions impair secretion clearance by affecting the cough reflex? 1. Muscular dystrophy 2. Amyotrophic lateral sclerosis 3. Chronic bronchitis 4. Cerebral palsy
1 and 3 only
1, 2, and 4 only
3 and 4 only
2, 3 and 4 only
Why is strenuous patient coughing during postural drainage in a head-down position contraindicated?
It can impair the mucociliary clearance mechanism.
It can increase expiratory airway resistance (Raw).
It can cause air trapping and pulmonary distension.
It can markedly increase intracranial pressure (ICP).
Which of the following can provoke a cough? 1. Anesthesia 2. Foreign bodies 3. Infection 4. Irritating gases
2 and 4
1, 2 and 3
3 and 4
2, 3, and 4
A patient about to receive postural drainage and percussion is attached to an electrocardiographic (ECG) monitor and is receiving both intravenous (IV) solutions and O2 (through a nasal cannula). Which of the following actions would be appropriate for this patient?
Cancel the therapy because the patient cannot be repositioned.
Inspect and adjust the equipment to ensure function during therapy.
Turn off the ECG monitor, but keep the IV line and O2 going.
Turn off the IV line, but keep the monitor on and the O2 going.
Conditions that can affect airway patency and cause abnormal clearance of secretions include which of the following? 1. Foreign bodies 2. Tumors 3. Inflammation 4. Bronchospasm
1, 2, and 3
2 and 4
2, 3 and 4
1, 2, 3 and 4
What factors can hinder effective coughing? 1. Artificial airways 2. Neuromuscular disease 3. Systemic overhydration 4. Pain or fear of pain
1, 2, and 4 only
2 and 4 only
1 and 3 only
3 and 4 only
For which of the following patients directed coughing might be contraindicated? 1. Patient with poor coronary artery perfusion 2. Postoperative upper-abdominal surgery patient 3. Long-term care patient with retained secretions 4. Patient with an acute unstable spinal injury
2 and 3
1, 2 and 3
1 and 4
2, 3, and 4
Which of the following best describes positive expiratory pressure (PEP) therapy?
Expiration against a variable flow resistance
Expiration against a fixed threshold resistance
Inspiration against a variable flow resistance
Inspiration against a fixed threshold resistance
Advantages of the flutter valve over other airway clearance methods include which of the following? 1. Good patient acceptance 2. Greater effectiveness 3. Full portability 4. Independent use
1 and 3
1, 2 and 3
2 and 4
1, 3 and 4
While reviewing the chart of a patient receiving postural drainage therapy, you notice that the patient tends to undergo mild desaturation during therapy (a drop in SpO2 from 93% to 89% to 90%). Which of the following would you recommend to manage this problem?
Discontinue the postural drainage therapy entirely.
Decrease the frequency of treatments
Discontinue the percussion and vibration only.
Increase the patient’s FiO2 during therapy
Which of the following are mandatory components of the preassessment for postural drainage? 1. Vital signs 2. Bedside pulmonary function tests 3. Auscultation
1 and 2 only
2 and 4 only
1 and 3 only
1, 2 and 3 only
In assessing an adult outpatient for airway clearance therapy, you notice the following: (1) no history of cystic fibrosis or bronchiectasis, (2) sputum production of 30 to 50 ml/day, (3) an effective cough, and (4) good hydration. Which of the following would you recommend?
Postural drainage, percussion, and vibration
Positive expiratory pressure therapy
Mechanical insufflation-exsufflation
Intrapulmonary percussive ventilation
Which of the following determines effectiveness of high-frequency external chest wall compression therapy? 1. Compression frequency 2. Largest volumes 3. Flow bias
1 only
2 only
1 and 3 only
2 and 3 only
A patient with abdominal muscle weakness is having difficulty developing an effective cough. Which of the following phases of the cough reflex are primarily affected in this patient? 1. Irritation 2. Inspiration 3. Compression 4. Expulsion
1, 2 and 3
2 and 4
2, 3, and 4
3 and 4
In general, chest physical therapy can be expected to improve airway clearance when a patient’s sputum production exceeds what volume?
30 ml/day
20 ml/day
15 ml/day
10 ml/day
What duration of time and pressure is recommended when using MIE devices to clear airways secretions in adults?
10 to 30 cm H2O at 1 to 3 sec
30 to 50 cm H2O at 1 to 3 sec
30 to 50 cm H2O at 5 to 10 sec
10 to 30 cm H2O at 5 to 10 sec
Which of the following are necessary for normal airway clearance? 1. Patent airway 2. Functional mucociliary escalator 3. Effective cough 4. Normal pulmonary compliance
1 and 4 only
1, 2 and 3 only
2 and 3 only
2 and 4 only
Which of the following is the only absolute contraindication to turning?
When the patient cannot or will not change body position
When poor oxygenation is associated with unilateral lung disease
When the patient has or is at high risk for atelectasis
When the patient has unstable spinal cord injuries
Patients can control a flutter valve’s pressure by changing what?
Their inspiratory flow
The angle of the device
Their expiratory flow
The expired volume
Properly performed chest vibration is applied at what point?
Throughout inspiration
At the end of expiration
At the start of inspiration
Throughout expiration
Contraindications for positive airway pressure therapies include which of the following? a. Intracranial pressure exceeding 20 mm Hg b. Recent facial, oral, or skull surgery or trauma c. Preexisting pulmonary barotrauma (e.g., pneumothorax) d. Air trapping/pulmonary overdistention in chronic obstructive pulmonary disease
1 and 3
1, 2 and 3
3 and 4
2, 3, and 4
Partial airway obstruction can result in which of the following? 1. Increased work of breathing 2. Air trapping or overdistention 3. Increased expiratory flows 4. Ventilation/perfusion ratio imbalances
1 and 2 only
1, 2, and 3 only
3 and 4 only
2, 3 and 4 only
Which of the following laboratory data are essential in assessing a patient’s need for airway clearance therapy? 1. Chest radiograph 2. Pulmonary function tests 3. Hematology results 4. ABGs/oxygen saturation
1, 2, and 4
1 and 3
3 and 4
1, 2, 3, and 4
What are the best documented preventive uses of airway clearance therapy? 1. Prevent retained secretions in the acutely ill. 2. Maintain lung function in cystic fibrosis. 3. Prevent postoperative pulmonary complications.
1, 2, and 3
1 and 2 only
1 and 3 only
2 and 3 only
A patient recovering from abdominal surgery is having difficulty developing an effective cough. Which of the following actions would you recommend to aid this patient in generating a more effective cough? 1. Coordinating coughing with pain medication 2. Using the forced expiration technique (FET) 3. Supplying manual epigastric compression 4. “Splinting” the operative site
1, 2, and 4
1, 2, and 3
3 and 4 only
2, 3, and 4 only
Indications for directed coughing include which of the following? 1. Enhance other airway clearance therapies. 2. Help patients with tuberculosis clear secretions. 3. Help prevent postoperative pulmonary complications. 4. Obtain sputum specimens for diagnostic analysis.
1 and 3
1, 2 and 3
3 and 4
1, 3 and 4
A typical mechanical insufflation-exsufflation treatment session should continue until what point? 1. Secretions are cleared. 2. The vital capacity (VC) returns to baseline. 3. The SpO2 returns to baseline.
2 and 3 only
1 and 2 only
1, 2 and 3
1 and 3 only
Absolute contraindications for postural drainage include which of the following? 1. Head and neck injury (until stabilized) 2. Active hemorrhage with hemodynamic instability 3. Uncontrolled airway at risk for aspiration
1 and 2
2 and 3
1 and 3
1, 2, and 3
Which of the following can impair mucociliary clearance in intubated patients? 1. Use of respiratory stimulants 2. Tracheobronchial suctioning 3. Inadequate humidification 4. High inspired oxygen concentrations
1 and 3 only
1, 2 and 3
3 and 4 only
2, 3, and 4
Directed coughing is useful in helping to maintain airway clearance in which of the following cases? 1. Bronchiectasis 2. Acute asthma 3. Cystic fibrosis 4. Spinal cord injury
1 and 3 only
1, 3, and 4 only
1, 2, and 3 only
1 only
Percussion should not be performed over which of the following areas? 1. Surgery sites 2. Bony prominences 3. Fractured ribs
3 only
1 and 2 only
2 and 3 only
1, 2, and 3
Whether using traditional methods or the FET, a period of diaphragmatic breathing and relaxation should always follow attempts at coughing. What is the purpose of this approach?
To restore the patient’s SO2
To restore lung volume and minimize fatigue
To allow the patient time to ask questions
To decrease the likelihood of acute air trapping
Which of the following occur(s) during the compression phase of a cough? 1. Expiratory muscle contraction 2. Opening of the glottis 3. Rapid drop in alveolar pressure
1 only
1 and 3
2 and 3
1 and 2
A physician orders postural drainage for a patient with aspiration pneumonia in the superior segments of the left lower lobe. Which of the following positions would you recommend for this patient?
Patient prone with a pillow under abdomen, bed flat
Head down, patient prone with a pillow under abdomen
Head down, patient supine with a pillow under knees
Patient supine with a pillow under knees, bed flat
What is the ideal patient position for directed coughing?
Sitting with one shoulder rotated inward, the head and spine slightly flexed
Supine, with knees slightly flexed and feet braced
Prone, with the head and spine slightly flexed
Supine, with forearms relaxed and feet supported
Which of the following are hazards or complication of postural drainage therapy? 1. Cardiac arrhythmias 2. Increased intracranial pressure 3. Acute hypotension 4. Pulmonary barotraumas
1 and 3
1, 2 and 3
3 and 4
2, 3, and 4
Primary objectives for turning include which of the following? 1. Prevent postural hypotension. 2. Promote lung expansion. 3. Prevent retention of secretions. 4. Improve oxygenation.
1 and 3
1, 2 and 3
3 and 4
2, 3 and 4
If a patient’s chest radiograph shows infiltrates in the posterior basal segments of the lower lobes, what postural drainage position would you recommend?
Head down, patient supine with a pillow under knees
Patient prone with a pillow under head, bed flat
Patient supine with a pillow under knees, bed flat
Head down, patient prone with a pillow under abdomen
Which of the following are contraindications for directed coughing? a. The presence of infection spread by droplet nuclei b. Elevated intracranial pressure or intracranial aneurysm c. Reduced coronary artery perfusion d. Necrotizing pulmonary infection
1 and 3
1, 2 and 3
3 and 4
2, 3, and 4
Which of the following are advantages of the Acapella over the flutter? 1. It can customize frequency. 2. It can be used in any posture. 3. It is more portable. 4. It can customize flow resistance.
1, 2 and 4
3 and 4
1, 2, 3, and 4
1 and 3
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?
Maintain the drainage position while carefully watching the patient.
Move the patient to the sitting position until the cough subsides.
Stop the treatment at once and report the incident to the nurse.
Drop the head of the bed farther and encourage more coughing.
A physician orders postural drainage for a patient with an abscess in the right middle lobe. Which of the following positions would you recommend for this patient?
Head down, patient prone with a pillow under abdomen
Head down, patient supine with a pillow under knees
Patient supine with a pillow under knees, bed flat
Head down, patient half-rotated to left, right lung up
A normal cough reflex includes which of the following phases? 1. Irritation 2. Inspiration 3. Compression 4. Expulsion
1 only
1, 2, 3, and 4
2 and 3
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