Deck 44: Atelectasis

Question 1

Which of the following is (are) precipitating factor(s) 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) 4
B) 1, 3, 4
C) 1, 2, 3
D) 1, 2, 3, 4

Answer 1

1, 3, 4

Question 2

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 2

Breathing a high percentage of oxygen

Question 3

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) 1, 2, 3, 4

Answer 3

1, 3

Question 4

Precipitating factors for retained secretions include all of the following EXCEPT:

A) decreased mucociliary transport.
B) excessive secretions.
C) overhydration.
D) general anesthesia.

Question 5

Examples of the types of surgical procedures that often result in atelectasis include all of the following EXCEPT:

A) open heart surgery.
B) craniotomy.
C) gallbladder removal.
D) splenectomy.

Question 6

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

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

Question 7

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

Question 8

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) 1, 2, 3, 4

Question 9

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

Question 10

Which of the following is the least commonly found type of postoperative atelectasis?

A) Primary lobule
B) Lung segment
C) Lung lobe
D) Entire lung

Question 11

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

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

Question 12

All of the following would be found in a patient with atelectasis EXCEPT:

A) normal shunt fraction.
B) whispered pectoriloquy.
C) chest radiograph shows increased density in areas of atelectasis.
D) diminished breath sounds.

Question 13

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 14

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 15

All of the following conditions can lead to atelectasis EXCEPT:

A) chronic obstructive pulmonary disease (COPD).
B) acute respiratory distress syndrome (ARDS).
C) pleural effusion.
D) pneumothorax.

Question 16

Several pathophysiologic mechanisms operating simultaneously may lead to an increased ventilatory rate. These may include all of the following EXCEPT:

A) stimulation of central chemoreceptors.
B) decreased lung compliance-increased ventilatory rate relationship.
C) stimulation of J receptors.
D) pain.

Question 17

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

A) Partial or total collapse of previously expanded lung regions
B) Free pleural air compressed the lungs
C) Enlarged heart causing compression of the lungs
D) The lungs remaining unexpanded since birth

Question 18

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

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