Question 1

Advantages of the flutter valve over other bronchial hygiene methods include all of the following except:

Accepted Answer

The flutter valve has been shown to be equally or less effective than other bronchial hygiene methods, such as chest physiotherapy and nebulized saline. However, it does offer advantages in terms of good patient acceptance, full portability, and independent use, making it a convenient and accessible option for patients with chronic respiratory conditions.

Question 2

Which of the following airway clearance techniques would you recommend for a patient with a neurologic abnormality (bulbar palsy) and intact upper airway?
I.postural drainage, percussion, and vibration
II.positive expiratory pressure therapy
III.mechanical insufflation-exsufflation

Accepted Answer

The answer of Which of the following airway clearance techniques...

Question 3

The airway clearance technique that uses a pneumatic device to deliver compressed gas minibursts to the airway at rates above 100/min best describes which of the following?

Accepted Answer

The answer of The airway clearance technique that uses a...

Question 4

Which of the following best describes positive expiratory pressure (PEP) therapy?

Accepted Answer

The answer of Which of the following best describes positive...

Question 5

All of the following are typical of high-frequency external chest wall compression therapy except:

Accepted Answer

High-frequency external chest wall compression therapy typically involves oscillations at a high frequency (5 to 25 Hz) and one to six sessions per day lasting around 30 minutes each. Long inspiratory oscillations are not characteristic of this therapy.

Question 6

Which of the following parts are required to conduct high-frequency external chest wall compression?
I.variable air-pulse generator
II.expiratory flow resistor with one-way valve
III.nonstretch inflatable thoracic vest

Accepted Answer

A variable air-pulse generator and a nonstretch inflatable thoracic vest are required for high-frequency external chest wall compression. An expiratory flow resistor with a one-way valve is not typically used in this procedure.

Question 7

Which of the following airway clearance techniques would you recommend for a 15-month-old infant with cystic fibrosis?

Accepted Answer

Postural drainage, percussion, and vibration are commonly used airway clearance techniques for infants with cystic fibrosis. Positive expiratory pressure therapy and intrapulmonary percussive ventilation may be more appropriate for older children or adults. Mechanical insufflation-exsufflation may be used in some cases but is not typically a first-line therapy for infants.

Question 8

Which of the following determines effectiveness of high-frequency external chest wall compression therapy?
I.compression frequency
II.largest volumes
III.flow bias

Accepted Answer

The effectiveness of high-frequency external chest wall compression therapy is determined by compression frequency (I) and flow bias (III). The largest volumes (II) do not determine the effectiveness of the therapy.

Question 9

Patients can control a flutter valve's pressure by changing what?

Accepted Answer

The pressure in a flutter valve is controlled by the patient's expiratory flow. As the patient exhales, the air flow creates oscillations within the device, which in turn generates positive pressure and vibration in the airways. The patient can adjust the pressure by changing the intensity and speed of their exhalation.

Question 10

In assessing an adult outpatient for bronchial hygiene 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?

Accepted Answer

Based on the assessment findings, the patient does not have significant sputum production or an ineffective cough, indicating that postural drainage, percussion, and vibration may not be necessary. Furthermore, the patient is well-hydrated, making hydration therapy unnecessary. Mechanical insufflation-exsufflation and intrapulmonary percussive ventilation may be too aggressive for this patient's needs. Positive expiratory pressure therapy is a gentle technique that can help mobilize and clear secretions in patients with mild to moderate sputum production and an effective cough. Therefore, B is the best choice for this patient.

Question 11

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?
I.	Attach a dry powder inhaler in-line with the PEP apparatus.
II.	Attach a metered-dose inhaler to the system’s one-way valve inlet.
III.	Place a small-volume nebulizer in-line with the PEP apparatus.

Accepted Answer

II and III are correct methods for combining bronchodilator drug therapy with positive expiratory pressure (PEP). Attaching a metered-dose inhaler to the system’s one-way valve inlet and placing a small-volume nebulizer in-line with the PEP apparatus are both feasible methods. Dry powder inhalers, however, are not designed to be used in-line with PEP devices due to their need for a rapid and forceful inhalation directly from the device, which is not compatible with the PEP therapy's method of operation.

Question 12

Which of the following is true about exercise and airway clearance?
I.	Exercise can enhance mucus clearance.
II.	Exercise can improve pulmonary function.
III.	Exercise can improve   
$\dot { V } / \dot { Q }$ matching.
IV.Exercise can cause desaturation in some patients.

Accepted Answer

Exercise can enhance mucus clearance, improve pulmonary function, improve $\dot { V } / \dot { Q }$ matching, and cause desaturation in some patients, making all statements true.

Question 13

What is the movement of small volumes of air back and forth in the respiratory tract at high frequencies (12 to 25 Hz) called?

Accepted Answer

The movement of small volumes of air back and forth in the respiratory tract at high frequencies (12 to 25 Hz) is called oscillation.

Answer: D
 Huffing is a forced expiratory technique that is used to clear mucus from the airways by exhaling forcefully while keeping the glottis open. It is not specifically related to the high-frequency movement of air in the respiratory tract. Tidal breathing refers to normal breathing at rest, while active cycle breathing is a breathing technique used in respiratory therapy to help clear mucus from the airways.

Question 14

Which of the following should be considered when selecting a bronchial hygiene strategy?
I.patient's goals, motivation, and preferences
II.effectiveness and limitations of technique or method
III.patient's age, ability to learn, and tendency to fatigue
IV.need for assistants, equipment, and cost

Accepted Answer

All of the options listed should be considered when selecting a bronchial hygiene strategy as they each have important implications for the patient's ability to effectively perform and benefit from the chosen technique or method. Patient goals, motivation, and preferences will influence compliance and program adherence; the effectiveness and limitations of a technique or method will impact its overall value as a therapeutic intervention; patient age, ability to learn, and tendency to fatigue must be considered when deciding on an appropriate approach; and the need for assistants, equipment, and cost will affect practicalities of implementing the technique or method.

Question 15

Proper instructions for positive expiratory pressure include all of the following except:

Accepted Answer

The correct instruction for positive expiratory pressure should not include exhaling forcefully, as it involves maintaining a moderate, steady expiratory pressure to keep airways open, not a forceful exhalation.

Question 16

Which of the following is not an advantage of the Acapella over the flutter?

Accepted Answer

The Acapella device is not necessarily more portable than the flutter device. Both devices are designed to be portable, but the Acapella's main advantages are its ability to be used in any posture and its customizable frequency and flow resistance.

Question 17

In theory, how does positive expiratory pressure (PEP) help to move secretions into the larger airways?
I.filling underaerated segments through collateral ventilation
II.preventing airway collapse during expiration
III.causing bronchodilation during inspiration

Accepted Answer

Positive expiratory pressure (PEP) helps move secretions into the larger airways by filling underaerated segments through collateral ventilation and preventing airway collapse during expiration. It does not cause bronchodilation during inspiration. Therefore, the best choice is B (I and II).

Quiz 40: Bronchial Hygiene Therapy

Advantages of the flutter valve over other bronchial hygiene methods include all of the following except:

Which of the following airway clearance techniques would you recommend for a patient with a neurologic abnormality (bulbar palsy) and intact upper airway? I.postural drainage, percussion, and vibration II.positive expiratory pressure therapy III.mechanical insufflation-exsufflation

The airway clearance technique that uses a pneumatic device to deliver compressed gas minibursts to the airway at rates above 100/min best describes which of the following?

Which of the following best describes positive expiratory pressure (PEP) therapy?

All of the following are typical of high-frequency external chest wall compression therapy except:

Which of the following parts are required to conduct high-frequency external chest wall compression? I.variable air-pulse generator II.expiratory flow resistor with one-way valve III.nonstretch inflatable thoracic vest

Which of the following airway clearance techniques would you recommend for a 15-month-old infant with cystic fibrosis?

Which of the following determines effectiveness of high-frequency external chest wall compression therapy? I.compression frequency II.largest volumes III.flow bias

Patients can control a flutter valve's pressure by changing what?

In assessing an adult outpatient for bronchial hygiene 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?

Which of the following is true about exercise and airway clearance? I. Exercise can enhance mucus clearance. II. Exercise can improve pulmonary function. III. Exercise can improve V˙/Q˙\dot { V } / \dot { Q }V˙/Q˙​ matching. IV.Exercise can cause desaturation in some patients.

What is the movement of small volumes of air back and forth in the respiratory tract at high frequencies (12 to 25 Hz) called?

Which of the following should be considered when selecting a bronchial hygiene strategy? I.patient's goals, motivation, and preferences II.effectiveness and limitations of technique or method III.patient's age, ability to learn, and tendency to fatigue IV.need for assistants, equipment, and cost

Proper instructions for positive expiratory pressure include all of the following except:

Which of the following is not an advantage of the Acapella over the flutter?

In theory, how does positive expiratory pressure (PEP) help to move secretions into the larger airways? I.filling underaerated segments through collateral ventilation II.preventing airway collapse during expiration III.causing bronchodilation during inspiration

Which of the following is true about exercise and airway clearance? I. Exercise can enhance mucus clearance. II. Exercise can improve pulmonary function. III. Exercise can improve $\dot { V } / \dot { Q }$ matching. IV.Exercise can cause desaturation in some patients.