Deck 29: Individuals With Acute Medical Conditions

Question 1

All of the following are reasons why should forceful coughing be avoided in cystic fibrosis EXCEPT:

A) forceful coughing does not result in mucus expulsion.
B) forceful coughing results in increased intrathoracic pressure.
C) forceful coughing contributes to airway closure.
D) forceful coughing can reduce cardiac output.

Answer 1

A
Forceful coughing does result in mucus expulsion; however,because of the deleterious side effects and benefits and effectiveness of huffing,coughing is not the treatment or modality of choice in patients who present with cystic fibrosis.

Question 2

Which of the following is LEAST appropriate for a patient with hypertension?

A) Smoking cessation
B) Nutritional counseling
C) Aerobic exercise
D) Resistance training

Answer 2

D
Although the literature does support the association between resistance training and decreased blood pressure over time,it is the least appropriate option in this case.Resistance training can lead to increased intrathoracic pressure,thus providing an overall increase in blood pressure.In individuals with very high baseline blood pressures,resistance training requiring the Valsalva maneuver can prove to be a dangerous choice.

Question 3

You are following a 5-year-old girl with cystic fibrosis.She presents with constant mucociliary clearance issues and productive coughing.You decide to implement a home program for postural drainage and percussion but realize that the caregiver has rheumatoid arthritis in her hands and will not be able to provide the necessary treatment.Which of the following options should be used to assist this patient with her secretion clearance at home?

A) Flutter device
B) High-frequency chest wall oscillation
C) Active cycle of breathing
D) All of the above

Answer 3

D
There are many alternatives to postural drainage and percussion discussed in this chapter.A flutter device,high-frequency chest wall oscillation,and active cycle of breathing would all be considered viable options if percussion is unable to be performed within the home.

Question 4

Which of the following would NOT be considered typical treatment for an individual with COPD?

A) Beta-blockers
B) Supplemental oxygen
C) Bronchodilators
D) Antibiotics

Question 5

Interstitial pulmonary fibrosis is:

A) most often seen in health care workers.
B) strongly associated with smoking.
C) sometimes associated with pulmonary hypertension.
D) not responsive to pharmacologic management.

Question 6

Atelectasis is associated with:

A) increased lung compliance.
B) mechanical ventilation.
C) highly mobile patients.
D) total collapse of the lung parenchyma.

Question 7

All of the following are true with regard to chronic bronchitis EXCEPT:

A) chronic bronchitis is common in smokers.
B) chronic bronchitis can be diagnosed after 1 year.
C) chronic bronchitis occurs in the presence of decreased functional cilia.
D) chronic bronchitis is characterized by tenacious, purulent sputum.

Question 8

You have been consulted to evaluate and treat a patient in the cardiac step-down unit.The patient is 2 days post acute myocardial infarction.Upon meeting the patient,you assess the vital signs and objectively get the following measures: blood pressure (BP),134/65 mm Hg; heart rate (HR),99 beats/min; and pulse oximeter reading,98%.Which of the following treatment decisions would be MOST appropriate?

A) Ten minutes of ambulation in the hallway with a HR of 119 beats/min
B) Ten minutes of biking with a HR of 135 beats/min
C) Ten minutes of running on treadmill with a HR of 165 beats/min
D) All of the above are contraindicated

Question 9

Pneumonia:

A) rarely results in morbidity and mortality in hospitalized patients.
B) decreased in the presence of artificial airways.
C) transmitted through contact.
D) often preceded by atelectasis.

Question 10

Which of the following exercises should be avoided to minimize cardiovascular strain in patient with high risk for cardiovascular dysfunction?

A) Warm-up ankle pumps
B) Recumbent biking
C) Wall sits
D) Upper extremity ergometer

Question 11

Which of the following strategies will help a patient during an asthma attack?

A) Attempt to have the patient increase his or her ventilatory rate.
B) Attempt use of a CO₂ rebreathing bag.
C) Increase the patient's activity.
D) Provide environmental stimulation.

Question 12

All of the following statements about cystic fibrosis are true EXCEPT:

A) cystic fibrosis is only genetic in origin.
B) lung involvement is the only clinical manifestation.
C) cystic fibrosis can result in hyperinflation of the chest.
D) chronic staphylococcal infections accompany cystic fibrosis.

Question 13

All of the following examination findings are typical of patients with bronchiolitis EXCEPT:

A) productive cough.
B) rhonchi on auscultation.
C) diminished breath sounds.
D) pain or difficulty with inhalation.

Question 14

Which of the following pharmacologic approaches is MOST common to address hypertension?

A) Beta-blockers
B) Antihistamines
C) Inotropic agents
D) Digoxin

Question 15

Your patient is a 67-year-old man who presents to therapy with weakness and decreased endurance after shoulder surgery.The patient also has a history of stable angina.While walking on the treadmill to warm up at 3.0 mph,the patient complains of pain in his chest that is consistent with his angina pain.Which of the following is the MOST appropriate decision at this point in the treatment interaction?

A) Continue the patient at the current pace.
B) Decrease the treadmill to sub pain threshold, assess vital signs, and continue exercise.
C) Discontinue walking on treadmill and immediately call 911.
D) Discontinue walking on treadmill and try resistance training instead.

Question 16

Which of the following statements regarding hypertension is FALSE?

A) Essential hypertension is the most common type of hypertension.
B) Salt consumption has been linked with hypertension.
C) Hypertension treatment typically includes the use of vasodilators.
D) Hypertension is not typically associated with heart failure.

Question 17

You are treating a 4-year-old child diagnosed with acute bacterial pneumonia.She is currently an inpatient at a children's hospital,and you have been consulted to evaluate and treat her.Which of the following treatment techniques would be LEAST appropriate to focus on with this patient?

A) Blowing bubbles to increase tidal volumes
B) Percussion to assist with airway clearance
C) Postural drainage to target involved segments
D) Low-intensity aerobic conditioning

Question 18

Patients with tuberculosis present with:

A) dry, nonproductive cough.
B) weight gain.
C) fever.
D) increased appetite.

Question 19

A patient with acute exacerbation of chronic bronchitis:

A) is cachectic and red or pink in color.
B) has increased vital capacity.
C) uses less accessory muscles.
D) intermittently exhibits sternal retractions.

Question 20

Emphysema is characterized by:

A) productive cough.
B) bronchial breath sounds in peripheral lobes.
C) decreased lung elastic recoil.
D) absence of bullae.