Deck 17: Flexible Fiber-Optic Bronchoscopy

Question 1

The respiratory therapist (RT) who is assisting the pulmonologist during bronchoscopy should have medication cups of xylocaine, normal saline, and ________ ready before beginning the procedure.

A) acetylcysteine
B) epinephrine
C) sterile water
D) midazolam

Answer 1

epinephrine

Question 2

Which of the following criteria must be met before a patient is discharged after bronchoscopy?
1) Gag reflex is present
2) Stable vital signs
3) No bleeding is present
4) Ability to swallow without pain

A)1 and 3
B)2 and 3
C)1, 2, and 3
D)2, 3, and 4

Answer 2

1, 2, and 3

Question 3

The bronchoscopy technique that flushes 100 mL of normal saline through the scope's suction channel in four or five increments of 20 to 30 mL to distend the distal bronchioles and fill the alveoli, thereby washing out samples of any microorganisms, is which of the following?

A) Rigid bronchoscopy
B) Bronchoalveolar lavage
C) Bronchial fluoroscopy
D) Transbronchial biopsy

Answer 3

Bronchoalveolar lavage

Question 4

What is the maximum depth that the standard adult bronchoscope can visualize in some patients?

A) Third-level bronchi
B) Fourth-level bronchi
C) Fifth-level bronchi
D) Sixth-level bronchi

Question 5

To obtain a sample how are lung brushings handled?

A) They are flushed in a saline wash.
B) They are secured in gauze and labeled.
C) They are preserved in formaldehyde.
D) They are smeared onto a glass slide.

Question 6

What is the advantage of using fluoroscopy during bronchoscopy for peripheral lesions?

A) Less contamination of samples
B) Increased diagnostic yield
C) Increased sample size
D) Less tissue destruction

Question 7

What is the most common indication for the use of bronchoscopy?

A) To retrieve inhaled foreign objects
B) To obtain microbiologic samples
C) To help diagnose abnormalities seen on chest roentgenogram
D) To treat hemoptysis

Question 8

What is the primary purpose of bronchoscopy in a patient with interstitial lung disease?

A) To perform microscopic assessment of the biopsy sample, which often is diagnostic
B) To stop massive hemoptysis
C) To identify the causative agent
D) To remove excessive secretions

Question 9

For what purpose are lasers used during bronchoscopy?

A) To obliterate obstructing tumors
B) To stop excessive bleeding
C) To open mucus-plugged airways
D) To improve visualization of smaller airways

Question 10

What aerosolized medication is administered to most patients before the bronchoscopic procedure is begun?

A) Albuterol
B) Racemic epinephrine
C) Fentanyl
D) Lidocaine

Question 11

In which patients or situations is hypoxemia most likely to develop?

A) Patients who have not been well sedated
B) Prolonged bronchoscopic procedures
C) Patients with pronounced anxiety
D) Patients who experience vagal stimulation during a procedure

Question 12

What is the most common complication associated with bronchoscopy?

A) A complication associated with medications used in the procedure
B) Pneumothorax
C) Secondary infection
D) Excessive bleeding

Question 13

Which of the following conditions is the rigid bronchoscope most likely to be used?

A) Pneumonia
B) Massive hemoptysis
C) Tumor
D) Interstitial lung disease

Question 14

Which of the following would prevent a physician from performing bronchoscopy?
1) PaO₂ of 45 mm Hg
2) International normalized ratio (INR) of 4.5
3) PaCO₂ of 38 mm Hg
4) Current heart rate of 120 beats/min and rhythm of atrial fibrillation

A)1 and 2
B)3 and 4
C)1, 2, and 4
D)2, 3, and 4

Question 15

What is the most common sign of xylocaine overdose during bronchoscopy?

A) Tachycardia
B) Bradycardia
C) Seizures
D) Apnea

Question 16

What is the smooth-cusped flexible forceps used for during bronchoscopy?

A) To clean the suction channel of the bronchoscope
B) To obtain microbiologic samples
C) To cut into large, bulky airway lesions
D) To obtain a biopsy of the lung parenchyma

Question 17

What are double-shielded brushes used for during bronchoscopy?

A) To clean the fiber-optics
B) To obtain microbiologic samples
C) To assist in cleaning the smaller airways of mucous plugs
D) To assist in diagnosing malignant tumors

Question 18

What is the primary purpose of bronchoscopy in a patient with pneumonia?

A) To obtain biopsy specimens
B) To identify the causative organism
C) To control hemoptysis
D) To remove secretions