WorksheetsRehab 105 Long Quiz 2 - Endterms
Total questions: 50
Worksheet time: 50mins
A patient with a long history of cigarette smoking has been admitted to the hospital and presents with tachycardia, signs of lung infection, abnormal breath sounds in the lower lobes, and dullness to percussion. What should the therapists intervention focus on with his patient?
getting pt to quit smoking
breathing reeducation to increase efficiency of ventilation
airway clearance and secretion removal
graded inspiratory muscle training
A chest tube gets dislodged during physical therapy treatment. If the therapist fails to cover the defect, what could the patient develop?
pulmonary embolism
pulmonary edema
pneumothorax
aspiration pneumonia
Following a motor vehicular accident, a patient with chest trauma developed atelectasis. What is the LEAST appropriate intervention to help with the immediate management of atelectasis?
pain reduction techniques
segmental breathing
incentive spirometry
paced breathing
Following a hard tackle, a football player exhibits signs of fractured ribs and a pneumothorax. When auscultating during inhalation over the injured area, what would the physical therapist expect to hear?
soft, rustling sounds on inhalation
decreased or no breath sounds
crackles
wheezes
An adult with no significant past medical history presents to the emergency room with complaints of fever, shaking chills, and a worsening productive cough. The patient has chest pains over the posterior base of the left thorax, which are made worse upon inspiration. What would be an expected physical finding for this patient?
symmetrical breathing
crackles over the left thorax
increased chest excursion
slower respiratory rate
A PT should be alert to recognize the signs and symptoms associated with the onset of aspiration pneumonia. Which patient diagnosis is the MOST susceptible to develop this form of pneumonia?
a circumferential burn of the thorax associated with significant pain
severe scoliosis with compression of internal organs, including the lungs
amyotrophic lateral sclerosis (ALS) with dysphagia and diminished gag reflex
a complete spinal cord lesion at T2 with diminished coughing ability and forced vital capacity (FVC)
A patient with bacterial pneumonia has crackles and wheezes in the left lateral basal segment and decreased breath sounds throughout. The patient is on 4L of oxygen by nasal cannula with a resulting arterial oxygen saturation (SaO2) of 90%. Respiratory rate is 28. What is the MOST BENEFICIAL intervention for this case.
postural drainage, percussion, and shaking over the appropriate area on the left lateral thorax for secretion removal
positioning in left side-lying to improve ventilation/perfusion ratio
postural drainage, percussion, and shaking to the right basilar segments in order to keep the right lung healthy
breathing exercises encouraging expansion of the right lateral basilar thorax, because the left side is not currently participating in gas exchange.
A patient with no significant past medical history who now presents with bacterial pneumonia in the right anterior base would present with which of the following exam findings?
decreased breath sounds throughout all lung fields, increased SaO2 febrile
bronchial breath sounds at the right anterior base, increased SaO2 febrile
crackles in inspiration only at right anterior base, decreased SaO2 and productive cough x 3 days
wheezes on inspiration only throughout the right lung field, decreased SaO2 and dry cough x 1 day
A patient in the ICU is referred to physical therapy and presents with significant shortness of breath. Notable on physical examination is a deviated trachea to the left. Which of the following processes would account for such a finding.
right lung collapse
left pleural effusion
right hemothorax
left pneumothorax
A 72 year old patient is walking on a treadmill in the physical therapy department while vital signs and pulse oximetry are being monitored. It is noted that the patient's arterial oxygen saturation (SpO2) drops from 95% to 92%. What is the therapist's BEST response to this change.
place a 40% O2 face mask on the patient for the remainder of the exercise session
not use supplemental O2
place 2L of O2 by nasal cannula on the patient for the remainder of the exercise session
place a 100% O2 face mask on the patient for the remainder of the exercise session
A patient with a recent history of of rib fractures suddenly becomes short of breath during a bout of coughing. The patient looks panicked and complains of sharp pain in the left chest. A quick screen shows a deviated trachea to the right, among other signs and symptoms. What is the MOST likely diagnosis based on these symptoms?
pulmonary emboli
pneumothorax
angina
mucous plugging of an airway
A patient has a very large right-sided bacterial pneumonia. Oxygen level is dangerously low. Which of the following body positions is MOST likely to improve this patient's arterial oxygen pressure (PaO2)?
prone lying with the head of the bed in trendelenburg position
right side-lying with the head of the bed in flat position
left side-lying with the head of the bed in flat position
supine lying with the head of the bed in trendelenburg position
In a patient with pneumothorax, what is usually the first and also considered the primary symptom?
(a)
Upon assessment, initial findings reveal decreased breath sounds and decreased fremitus. This finding is most likely indicative of:
pulmonary edema
pleural effusion
pulmonary embolism
atelectasis
The cause of this classification of atelectasis based on physiology is the loss of contact between the parietal and visceral pleurae, loss of surfactant, and replacement of parenchymal tissue by scarring or infiltrative disease.
(a)
This type of atelectasis occurs when there is a presence of local or generalized fibrotic changes in the lung or pleura that prevents its full expansion.
resorption atelectasis
compression atelectasis
contraction atelectasis
NOTA
There may be no obvious signs or symptoms of atelectasis.
The most common classification of atelectasis based on physiology is non-obstructive atelectasis.
first statement is true, second statement is false
first statement is false, second statement is true
both statements are true
both statements are false
This condition is caused by an abnormal build-up of fluid in the lungs leading to impaired gas exchange and may cause respiratory failure.
(a)
There is no one single test for confirming that breathlessness is caused by pulmonary edema. It is often multifactorial.
TRUE
FALSE
Gold standard for diagnosing pulmonary embolism:
(a)
Drug of choice for pulmonary embolism.
(a)
Accumulation of air or gas in the pleural space.
(a)
The only reliable means to quantify the amount of hemothorax.
(a)
Most common fatal lung malignancy resulting to 95% of cases.
(a)
The most common early symptom in a patient with a tumor within the bronchus.
(a)
What nerve is affected or invaded causing paralysis of the diaphragm?
(a)
This condition results from the involvement of lower part of the brachial plexus (C8 ,T1,T2) causing severe pain of the shoulder and inferior surface of the arm.
pancoast tumor
horner syndrome
laryngeal nerve palsy
paralysis of the diaphragm
Small cell lung cancer is also called oatcell carcinoma because of the oat-grain appearance. This condition results from invasion of the pleura and the mediastinal lymph node that can be seen in non smokers.
first statement is true, second statement is false
first statement is false, second statement is true
both statements are true
both statements are false
The early bronchial carcinoma that responds to chemotherapy even in its later stage.
(a)
A systemic disease of unknown cause involving any organ and is characterized by noncaseating granulomas present diffusely throughout the body.
sarcoidosis
silicosis
asbestosis
pneumoconiosis
This is a form or type of respiratory failure characterized by rapid onset of widespread inflammation in the lungs. This results after a systemic or pulmonary insult.
acute respiratory distress syndrome
status asthmaticus
sarcoidosis
chronic obstructive pulmonary disease
A decrease in Tidal Volume (TV) is most likely a result of:
chronic obstructive pulmonary disease
restrictive lung disease
acute respiratory distress syndrome
chronic asthma
Nearly all cases of pulmonary embolism arises from what condition?
(a)
This condition occurs when two or more contiguous ribs are fractured in at least two locations usually due to a motor vehicular injury or overzealous cardiac resuscitation.
(a)
Blunt trauma is the main cause of a hemothorax.
TRUE
FALSE
A pneumothorax is also known as a "sucking chest wound".
TRUE
FALSE
In an open pneumothorax, definitive treatment includes covering the wound with an occlusive dressing that is taped on three sides.
TRUE
FALSE
After blunt trauma, a hemothorax usually is due to multiple rib fractures.
TRUE
FALSE
Smoking is the most common factor that causes adenocarcinoma.
TRUE
FALSE
Oatcell carcinoma is also considered as a systemic disease.
TRUE
FALSE
Average V/Q ratio:
0.8
0.9
8.0
9.0
This lung capacity is defined as the maximum amount of air a person can expel from the lungs after first filling the lungs to the maximum and expiring to the maximum. What is the normal value for this capacity?
4500 mL
4600 mL
3500 mL
3600 mL
This rib motion increases vertical dimension due to the pull of the central tendon of the diaphragm.
caliper motion
bucket handle motion
pump handle motion
piston motion
Primary muscles for inspiration except:
diaphragm
internal intercostals
external intercostals
scalene
The amount of air inspired after resting expiration.
VC
IRV
IC
ERV
The amount of air left in lungs after resting expiration.
VC
FRC
ERV
RV
In the event of a normal breathing cycle, what in the normal occurrence during inspiration?
Alveolar pressure = ATM pressure
Alveolar pressure is less than ATM pressure
Alveolar pressure is greater than ATM pressure
NOTA
The dorsal part of the medulla is responsible for:
rate
rhythm
AOTA
NOTA
How many generations does the lower respiratory tract have?
21
22
23
24
Normal value for ERV:
(a)
