Deck 4: Hyperinflation Therapy Equipment

Question 1

Which of the following hyperinflation techniques relies on the patient's ventilatory muscles to achieve hyperinflation goals?
I. intermittent positive pressure breathing (IPPB)
II. incentive spirometry
III. intrapulmonary percussive ventilation
IV. positive expiratory pressure (PEP) therapy

A) I and III
B) I and IV
C) II and III
D) II and IV

Answer 1

II and IV

Question 2

Assessment of outcomes according to the American Association for Respiratory Care (AARC) Clinical Practice Guideline: Incentive Spirometry includes which of the following?
I. decreased respiratory rate
II. resolution of fever
III. increased vital capacity (VC)
IV. normal chest X-ray

A) I
B) I and II
C) I, II, and III
D) I, II, III, and IV

Answer 2

I, II, III, and IV

Question 3

An inspiratory muscle trainer uses which of the following to vary inspiratory pressures?

A) adjusting magnetic attraction against a diaphragm
B) changing the size of an orifice
C) adjusting pressure on a single-stage reducing valve
D) changing the position of a needle valve

Answer 3

B

Question 4

Which of the following are hazards or complications of Intermittent Positive-Pressure Breathing (IPPB) according to the American Association for Respiratory Care (AARC) Clinical Practice Guideline: Intermittent Positive-Pressure Breathing?
I. increased airway resistance
II. barotrauma
III. impedance of venous return
IV. gastric distension

A) I
B) I and II
C) I, II, and III
D) I, II, III, and IV

Question 5

When performing positive end expiratory pressure (PEP) therapy, a desired pressure range to achieve during exhalation is:

A) 5 to 10 cmH₂O
B) 10 to 15 cmH₂O
C) 15 to 20 cmH₂O
D) greater than 20 cmH₂O

Question 6

Hazards and complications of incentive spirometry include which of the following according to the American Association for Respiratory Care (AARC) Clinical Practice Guideline: Incentive Spirometry?
I. hyperventilation
II. hypoxia secondary to interruption of oxygen therapy
III. ineffectiveness unless closely supervised
IV. fatigue

A) I
B) I and II
C) I, II, and III
D) I, II, III, and IV

Question 7

Which of the following are indications for intermittent positive pressure breathing (IPPB) according to the American Association for Respiratory Care (AARC) Clinical Practice Guideline: Intermittent Positive-Pressure Breathing?
I. pulmonary atelectasis
II. short-term ventilatory support
III. delivery of a medication
IV. inability to clear secretions

A) I
B) I and II
C) I, II, and III
D) I, II, III, and IV

Question 8

The term sustained maximal inspiration (SMI) as used by the American Association for Respiratory Care (AARC) Clinical Practice Guideline: Incentive Spirometry means:

A) positive expiratory pressure (PEP) mask therapy
B) flutter valve therapy
C) deep breathing and coughing
D) incentive spirometry

Question 9

Indications for incentive spirometry include which of the following according to the American Association for Respiratory Care (AARC) Clinical Practice Guideline: Incentive Spirometry?
I. conditions predisposing atelectasis
II. presence of atelectasis
III. restrictive lung defect associated with neuromuscular disorders
IV. delivery of a medication

A) I
B) I and II
C) I, II, and III
D) I, II, III, and IV

Question 10

A patient is using a flow-dependent incentive spirometer. The patient is achieving an inspiratory flow of 275 mL/sec. The patient is able to sustain this flow for 3 seconds. What volume did the patient inhale?

A) 275 mL
B) 550 mL
C) 825 mL
D) 1,100 mL

Question 11

Indications for incentive spirometry include which of the following according to the American Association for Respiratory Care (AARC) Clinical Practice Guideline: Use of Positive Airway Pressure Adjuncts to Bronchial Hygiene Therapy?
I. air trapping in asthma and COPD
II. mobilization of secretions
III. prevention or reversal of atelectasis
IV. optimization of bronchodilator delivery

A) I
B) I and II
C) I, II, and III
D) I, II, III, and IV

Question 12

The Bird Mark 7AA regulates gas pressure using:
I. single-stage reducing valves
II. magnetic attraction and gas pressure across a diaphragm
III. needle valves
IV. differential pressure transducers

A) I and II
B) II and III
C) I, II, and III
D) I, II, III, and IV

Question 13

Which of the following devices are similar in the way pressure is delivered?
I. Mercury Medical, Inc., Resistex PEP valve
II. DHD Healthcare, Inc., Acapella
III. Flutter valve
IV. DHD Healthcare, Inc., Coach

A) I and III
B) I and IV
C) II and III
D) II and IV

Question 14

A patient is using a flow-dependent incentive spirometer. The patient is achieving an inspiratory flow of 275 mL/sec. The patient is able to sustain this flow for 4 seconds. What volume did the patient inhale?

A) 275 mL
B) 550 mL
C) 825 mL
D) 1,100 mL

Question 15

Hazards and complications of positive expiratory pressure (PEP) therapy include which of the following according to the American Association for Respiratory Care (AARC) Clinical Practice Guideline: Use of Positive Airway Pressure Adjuncts to Bronchial Hygiene Therapy?
I. increased work of breathing
II. increased intracranial pressure
III. cardiovascular compromise
IV. pulmonary barotraumas

A) I
B) I and II
C) I, II, and III
D) I, II, III, and IV

Question 16

When instructing a patient to use an incentive spirometer, you should tell the patient
I. "Put the mouthpiece in your mouth and inhale as quickly as possible until your lungs are full."
II. "Put the mouthpiece in your mouth and inhale slowly until your lungs are full."
III. "When your lungs are full, briefly hold your breath."
IV. "Put the mouthpiece into your mouth and blow hard."

A) I and III
B) II and III
C) III
D) IV

Question 17

Positive expiratory pressure (PEP) therapy adjusts the level of positive pressure by:

A) adjusting magnetic attraction against a diaphragm
B) changing the size of an orifice
C) adjusting pressure on a single-stage reducing valve
D) changing the position of a needle valve

Question 18

A patient is using a Tri-flow incentive spirometer. She can raise the second ball to the top of the chamber for 2 seconds. How much volume did the patient inhale?

A) 300 mL
B) 400 mL
C) 800 mL
D) 2,000 mL

Question 19

Which of the following adjuncts are helpful when using an inspiratory muscle trainer?
I. a manometer
II. nose clips
III. a nebulizer
IV. supplemental oxygen via nasal cannula

A) I
B) I and II
C) I, II, and III
D) I, II, III, and IV

Question 20

What should you instruct the patient to do following 10 to 20 breaths when using a positive expiratory pressure (PEP) therapy device?

A) rest before the next repetition of breaths
B) take in a deep breath and hold it
C) sit down
D) cough

Question 21

When using the BirdMark 7A ventilator, manipulating the flow-rate control to increase the flow will cause the:
I. tidal volume to decrease
II. tidal volume to increase
III. inspiratory time to increase
IV. inspiratory time to decrease

A) I and III
B) I and IV
C) II and III
D) II and IV

Question 22

When using the BirdMark 7A ventilator, manipulating the flow-rate control to decrease the flow will cause the:
I. tidal volume to decrease
II. tidal volume to increase
III. inspiratory time to increase
IV. inspiratory time to decrease

A) I and III
B) I and IV
C) II and III
D) II and IV

Question 23

The flow-rate control on the BirdMark 7A ventilator works by:

A) adjusting magnetic attraction against a diaphragm
B) changing the size of an orifice
C) adjusting pressure on a single-stage reducing valve
D) changing the position of a needle valve

Question 24

The spring tension on the venturi gate of the BirdMark 7A exerts a force equivalent to:

A) 2 cmH₂O
B) 6 cmH₂O
C) 10 cmH₂O
D) 12 cmH₂O

Question 25

You are using a BirdMark 7A ventilator for IPPB therapy. You notice that before the ventilator delivers a breath, the pressure manometer indicates a -8 cmH₂O. What control should you manipulate?

A) pressure
B) flow rate
C) sensitivity
D) air mix

Question 26

When using a BirdMark 7A, changing the pressure control to increase the pressure will cause the:
I. tidal volume to decrease
II. tidal volume to increase
III. inspiratory time to increase
IV. inspiratory time to decrease

A) I and III
B) I and IV
C) II and III
D) II and IV

Question 27

What flow pattern is delivered when the air mix control is pushed in and the BirdMark 7A is operating on source gas (venturi not being used)?

A) rectangular
B) sinusoidal
C) oscillating
D) ascending ramp

Question 28

The apnea (expiratory timing) control should not be used during intermittent positive-pressure breathing (IPPB) therapy, due to:

A) asynchrony
B) pressure delivery
C) high oxygen concentration delivery
D) excessive expiratory time

Question 29

Peak flow through the BirdMark 7A when using the venturi (air mix) can be up to:

A) 15 L/min
B) 30 L/min
C) 50 L/min
D) 80 L/min

Question 30

Sensitivity is adjusted in the BirdMark 7A ventilator by:

A) adjusting magnetic attraction against a diaphragm
B) changing the size of an orifice
C) adjusting pressure on a single-stage reducing valve
D) changing the position of a needle valve

Question 31

The center body of the BirdMark 7A ventilator contains:
I. the ceramic switch and clutch plates
II. the venturi
III. the timing cartridge
IV. the flow-rate control

A) I
B) I and II
C) I, II, and III
D) I, II, III, and IV

Question 32

You are using the BirdMark 7A for IPPB therapy. What prevents gas from escaping from the circuit to the ambient air during inspiration?

A) the pressure in the circuit
B) the use of nose clips during IPPB therapy
C) the exhalation valve
D) flow through the nebulizer

Question 33

The venturi gate on the BirdMark 7A will close when pressure in the pressure chamber reaches approximately:

A) 2 cmH₂O
B) 6 cmH₂O
C) 10 cmH₂O
D) 12 cmH₂O

Question 34

Pressure is adjusted in the BirdMark 7A ventilator by:

A) adjusting magnetic attraction against a diaphragm
B) changing the size of an orifice
C) adjusting pressure on a single-stage reducing valve
D) changing the position of a needle valve

Question 35

When using the BirdMark 7A ventilator, changing the pressure control to decrease the pressure will cause the:
I. tidal volume to decrease
II. tidal volume to increase
III. inspiratory time to increase
IV. inspiratory time to decrease

A) I and III
B) I and IV
C) II and III
D) II and IV

Question 36

F_IO₂ delivery increases during inspiration while the BirdMark 7A is operating using air mix. Which of the following contribute to this fact?
I. Increasing pressure in the pressure chamber decreases air entrainment.
II. At 12 cmH₂O, the venturi gate closes.
III. After about 12 cmH₂O, gas flow through the circuit is source gas.
IV. Excess flow (source gas) is directed through the timing cartridge.

A) I
B) I and II
C) I, II, and III
D) I, II, III, and IV

Question 37

You are using a BirdMark 7A ventilator during IPPB therapy. You need to decrease tidal volume. How can you decrease tidal volume without altering inspiratory time?
I. increase the pressure
II. decrease the pressure
III. increase the flow rate
IV. decrease the flow rate

A) I and III
B) I and IV
C) II and III
D) II and IV

Question 38

For intermittent positive-pressure breathing (IPPB) therapy, when adjusted correctly the sensitivity on the BirdMark 7A should be set for:

A) 1 to 2 cmH₂O below ambient
B) 2 to 5 cmH₂O below ambient
C) 5 to 8 cmH₂O below ambient
D) greater than 8 cmH₂O below ambient

Question 39

You are using a BirdMark 7A ventilator during IPPB therapy. You need to increase tidal volume. How can you increase tidal volume without altering inspiratory time?
I. increase the pressure
II. decrease the pressure
III. increase the flow rate
IV. decrease the flow rate

A) I and III
B) I and IV
C) II and III
D) II and IV

Question 40

Which of the following characteristics are true regarding the BirdMark 7A ventilator's classification?
I. electrically powered
II. pneumatically powered
III. time or pressure triggered
IV. pressure cycled

A) I and III
B) I, III, and IV
C) II and III
D) II, III, and IV

Question 41

Which of the following positive expiratory pressure (PEP) therapy devices requires a flowmeter and supplemental gas flow to generate the expiratory pressure?

A) Mercury Medical Resistex PEP therapy device
B) Portex Medical TheraPEP therapy device
C) DHD Acapella PEP device
D) Smiths-Medical EzPAP PEP device

Question 42

Which of the following are contraindications for the use of The Vest?

A) bullous lung disease
B) asthma
C) unstable thoracic injuries
D) cystic fibrosis

Question 43

The Lung Flute operates by means of:

A) an orifice that may be changed in size
B) a magnet and a diaphragm opposing one another
C) a vibrating reed
D) a weighted ball resting against a conical seat

Question 44

The primary difference between the Percussionaire IPV-2 and IPV-1C is:

A) demand CPAP
B) system pressure regulation
C) impact control regulation
D) automated rate control

Question 45

Which of the following are true regarding The Vest?
I. It has an air-pulse unit.
II. It uses a pneumatic vest.
III. It operates at frequencies between 5 and 25 times per second.
IV. It is manually triggered.

A) I
B) I and II
C) I, II, and III
D) I, II, III, and IV

Question 46

Which of the following positive expiratory pressure (PEP) devices deliver vibrating pressure pulses?

A) Mercury Medical Resistex PEP therapy device
B) Portex Medical TheraPEP therapy device
C) DHD Acapella PEP device
D) Smiths-Medical EzPAP PEP device

Question 47

Which of the following percussors used for chest physiotherapy are handheld?
I. Flimm Fighter
II. Neocussor
III. Vibramatic
IV. Fluid Flo2500

A) I and II
B) I, II, and III
C) II and III
D) II, III, and IV

Question 48

You are using the BirdMark 7A ventilator for IPPB therapy. The ventilator cycles on and off rapidly, frustrating your patient. What control should you manipulate?

A) pressure
B) flow rate
C) sensitivity
D) air mix

Question 49

The Phasitronentrains room air through a venturi at a ratio of:

A) 1:2
B) 1:3
C) 1:4
D) 1:5

Question 50

Frequency (breath rate) on the Percussionaire IPV-1C is controlled by the:

A) system pressure control
B) impact control
C) percussion control
D) demand CPAP control

Question 51

Which of the following adjuncts for chest physiotherapy may be used for chest physiotherapy on premature infants?

A) Flimm Fighter
B) DHD Palm Cups
C) Vibramatic
D) Neocussor

Question 52

When you are using the Percussionaire IPV-1C, it is recommended that system pressure initially be set at:

A) 20 psi
B) 30 psi
C) 40 psi
D) 50 psi

Question 53

The exhalation port on the Phasitronis opened and closed by:

A) an inflatable mushroom valve
B) a sliding venturi
C) a spring
D) a diaphragm

Question 54

Which of the following adjuncts for chest physiotherapy help compensate for poor manual percussion technique?

A) Flimm Fighter
B) DHD Palm Cups
C) Vibramatic
D) Kimvent Neonate Percussor

Question 55

Which of the following are true regarding the Emerson CoughAssist MI-E?
I. It applies positive pressure.
II. It applies negative pressure.
III. It is electrically powered.
IV. It can generate 60 cmH₂O pressure.

A) I
B) I and II
C) I, II, and III
D) I, II, III, and IV

Question 56

The power source of The Vest is a:

A) a battery
B) a compressed-gas source
C) AC electrical power
D) manual

Question 57

Which of the following are true regarding the Percussionaire Corporation IPV1C ventilator?
I. Frequencies between 100 and 250 breaths per minute are possible.
II. Aerosol delivery is provided.
III. Small tidal volumes are delivered with each breath.
IV. Each breath is manually triggered.

A) I
B) I and II
C) I, II, and III
D) I, II, III, and IV

Question 58

Volume delivery for the Percussionaire IPV-1C ventilator is controlled by the:

A) system pressure control
B) impact control
C) percussion control
D) demand CPAP control

Question 59

When the patient depresses the thumb button on the IPV-1C circuit:

A) aerosol delivery begins
B) percussive ventilation begins
C) inspiration ends
D) pressure delivery is increased

Question 60

Which of the following percussors used for chest physiotherapy have adjustable frequency controls?
I. Flimm Fighter
II. Neocussor
III. Vibramatic

A) I
B) II
C) II and III
D) III

Question 61

Which of the following percussors is pneumatically powered?

A) Flimm Fighter
B) Vibramatic
C) Neocussor
D) Fluid Flo2500