Deck 17: Atelectasis

Question 1

A patient has a tumor blocking the left mainstem bronchus. What additional factor would favor the development of atelectasis?

A) Breathing a nitric oxide mix (iNO)
B) Breathing a helium/oxygen mix (heliox)
C) Breathing a high percentage of oxygen
D) Breathing a low percentage of oxygen

Answer 1

Breathing a high percentage of oxygen

Question 2

After gastric bypass surgery, a patient is showing tachypnea. What is the best explanation for this?

A) Diaphragmatic apraxia
B) Postoperative pain
C) Low-grade fever
D) Anesthetic sedation

Answer 2

Postoperative pain

Question 3

Common chest assessment findings in a patient with atelectasis include:
1) decreased tactile fremitus.
2) dull percussion note.
3) crackles.
4) bronchial breath sounds.

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

Answer 3

2, 3, 4

Question 4

After open heart surgery, a patient has developed bronchitis with increased secretions and atelectasis. What respiratory therapy procedures should initially be recommended?
1) Chest physical therapy
2) Continuous positive airway pressure (CPAP)
3) Incentive spirometry
4) Inhaled sympathomimetic medication

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

Question 5

After surgery, a patient must lie supine in bed. Because of this, atelectasis is thought to have developed. What chest radiograph finding would confirm this?

A) Depression of the hemidiaphragms
B) Pulmonary interstitial emphysema (PIE)
C) Increased density in both upper lobe areas
D) Increased density in both posterior lower lobe areas

Question 6

The development of immediate postoperative atelectasis is commonly related to which of the following?

A) Inappropriate tidal volumes settings during surgery
B) The patient's comorbidities
C) Medication reactions and side effects
D) Excessive bronchial secretions

Question 7

What definition of primary atelectasis would best fit that of a premature infant with respiratory distress syndrome (RDS)?

A) Partial or total collapse of previously expanded lung regions
B) Free pleural air compressed the lungs
C) Congenital heart defect causing compression of the lungs
D) The failure of the lungs to expand at birth

Question 8

Examples of the types of surgical procedures that often result in atelectasis include:
1) open heart surgery.
2) craniotomy.
3) gallbladder removal.
4) splenectomy.

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

Question 9

Which of the following conditions is least likely to lead to atelectasis?

A) Chronic obstructive pulmonary disease (COPD)
B) Acute respiratory distress syndrome (ARDS)
C) Pleural effusion
D) Pneumothorax

Question 10

Several pathophysiologic mechanisms operating simultaneously may lead to an increased ventilatory rate. These may include which of the following?
1) Stimulation of central chemoreceptors
2) Decreased lung compliance-increased ventilatory rate relationship
3) Stimulation of J receptors
4) Pain

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

Question 11

The following would be found in a patient with atelectasis:
1) Normal shunt fraction
2) Whispered pectoriloquy
3) Chest radiograph shows increased density in areas of atelectasis
4) Diminished breath sounds

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

Question 12

Precipitating factors for retained secretions include:
1) decreased mucociliary transport.
2) excessive secretions.
3) overhydration.
4) general anesthesia.

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

Question 13

Which of the following are precipitating factors for retained secretions that commonly lead to atelectasis?
1) Asthma
2) General anesthesia
3) Gastric aspiration
4) Smoking history

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

Question 14

A 40-year-old patient was in a motor vehicle accident. Among his injuries and related problems are three broken ribs on the right side, pleural fluid in the right pleural space, and atelectasis of both lungs. What should be done to help with the atelectasis problem?
1) Adequate pain management
2) Mechanical ventilation to stabilize the broken ribs
3) Remove the pleural fluid
4) Selective intubation of the right mainstem bronchus

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

Question 15

Which of the following patients should be placed on short-term mechanical ventilation because of the high risk for postoperative atelectasis?

A) Appendectomy
B) Tracheostomy
C) Bronchoscopy for tumor biopsy
D) Cardiac surgery

Question 16

Which of the following are precipitating factors that can decrease the patient's ability to generate a negative intrapleural pressure?
1) Supine position
2) Large tidal volume on the mechanical ventilator
3) Malnutrition
4) Obesity

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

Question 17

A patient with atelectasis is being monitored by bedside spirometry. What findings would correspond with atelectasis?
1) Decreased IC
2) Increased PEFR
3) Decreased VC
4) Increased DLCO

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

Question 18

The respiratory therapist is performing chest assessment on a post-op cholecystectomy patient who has developed cough, fever, and tachypnea. Which of the following would the therapist expect to find confirming the suspicion of post-op atelectasis in this patient?

A) Decreased tactile and vocal fremitus
B) Hyperresonant percussion note
C) Bronchial breath sounds
D) Wheezes