Deck 35: Intensive Care Management of Individuals With Secondary Cardiovascular and Pulmonary Dysfunction

Question 1

In treating a trauma patient,both active and passive relaxation techniques should be used.Which of the following is not a method of passive relaxation?

A) Use of physical supports
B) Use of body positioning
C) Talking slowly
D) All of these are passive techniques

Answer 1

D
Passive relaxation refers to relaxing the patient using passive procedures including,but not limited to,body positioning,physical supports,talking calmly and slowly,and taking adequate time for conducting treatments.Active relaxation refers to relaxing the patient through participation of the patient in relaxation procedures.

Question 2

Where would you place a chest tube in the treatment of a pneumothorax?

A) Sixth intercostal space in the posterior axillary line
B) Third intercostal space in the posterior axillary line
C) Sixth intercostal space in the midclavicular line
D) Third intercostal space in the midclavicular line

Answer 2

D
For a pneumothorax,the chest tube should be placed in the second or third intercostal space in the midclavicular line.

Question 3

While treating an obese patient,which of the following would not be an appropriate intervention?

A) Placing the patient in a prone position
B) Placing the patient in a half prone position
C) Lower extremity exercises
D) Whole-body ROM exercises

Answer 3

A
The weight of the abdominal viscera limits diaphragmatic descent and elevates its resting position.Placing an obese patient in a prone position can simulate benefits of the upright lean-forward position.

Question 4

What is a major pathophysiological mechanism of significantly impaired cardiovascular and pulmonary function in a very heavy (obese)individual?

A) Decreased pulmonary vascular resistance
B) Decreased right ventricular work
C) Myocardial hypertrophy
D) Alveolar hyperventilation

Question 5

While treating a patient with head injuries,what is a generally accepted increase in intracranial pressure during treatment provided it returns to normal immediately after the removal of the pressure potentiating stimulus?

A) Up to 55 mm Hg
B) Up to 50 mm Hg
C) Up to 40 mm Hg
D) Up to 30 mm Hg

Question 6

You have just finished positioning your obese patient upright in a chair at bedside when you notice the patient slumping.What action should you take?

A) None. The slumping caused by weak postural muscles.
B) Put the patient back to bed because of increased fatigue.
C) Correct the patient position and recheck it frequently.
D) Proceed to standing and walking.

Question 7

What would be an appropriate intervention technique for a patient with multiple fractures and spinal involvement?

A) ROM exercises for the head and neck
B) Aggressive ROM exercises for the shoulders
C) Log-rolling maneuvers
D) Body positioning to upright sitting

Question 8

Which of the following findings would you not expect with a patient with a flail chest segment?

A) Increased elevation of chest segment during inspiration
B) Instability of the chest wall
C) Chest depression over segment during inspiration
D) Asynchronous movement of the chest wall

Question 9

How should you position the bed to reduce intracranial pressure in a patient with a head injury?

A) Head of the bed elevated to 30 to 40 degrees
B) Head of the bed elevated to 50 to 60 degrees
C) Head of the bed declined to 30 to 40 degrees
D) Head of the bed declined to 50 to 60 degrees

Question 10

For which body position should mobilizations be performed for patients with restrictive pulmonary disease secondary to neuromuscular conditions?

A) Standing at the bedside
B) Sitting in bed with head of bed elevated
C) Any position that enhances oxygen transport and its efficiency
D) Sitting in a chair at the bedside

Question 11

What side effect of muscle relaxants and corticosteroids might affect how a patient performs during therapy?

A) Reduced alveolar ventilation
B) Muscle weakness
C) Mucous accumulation
D) Reduced lung volumes

Question 12

While working with a patient,the patient begins to experience deterioration in level of consciousness,pupillary reflexes,ocular reflexes,pattern of respiration,and exaggerated muscle tone and posture.What do you suspect is occurring with this patient?

A) Fatigue from therapy session
B) Cerebral edema with increased intracranial pressure
C) Myocardial infarction
D) Hemorrhage

Question 13

Which of the following does not contribute to impaired mucociliary transport and secretion accumulation?

A) Bronchospasm
B) Increased airway diameter
C) Impaired mobility
D) Inability to cough effectively

Question 14

What signs and symptoms would you expect to see with a patient with advancing cerebral edema?

A) Deterioration in level of consciousness
B) Exaggerated muscle tone and posture
C) Deterioration in pupillary reflexes
D) All are signs or symptoms of advancing cerebral edema

Question 15

What technique is best described as a modified cough with the glottis open and with abdominal support to help mobilize secretions?

A) Tracheal tickle
B) Natural cough
C) Facilitated cough
D) Huffing

Question 16

Which of the following is the optimal resting position for a morbidly obese patient?

A) In bed, supine with extra pillows
B) In bed, with head of bed elevated
C) In bed, prone
D) In bed, side-lying

Question 17

What should not be included during treatment and management of a patient with central nervous system trauma?

A) Occasional turning regimen of the patient
B) Judicious tracheal suctioning
C) Lung hyperventilation with manual breathing bag in nonventilated patient
D) Deep breathing or sighs in ventilated patients

Question 18

Which of the following is not a goal of treatment for a patient with burns?

A) Improving arterial saturation
B) Prevent infection
C) Maintain fluid balance
D) All of the above

Question 19

Where would you place a chest tube in the treatment of a hemothorax?

A) Sixth intercostal space in the posterior axillary line
B) Third intercostal space in the posterior axillary line
C) Sixth intercostal space in the midclavicular line
D) Third intercostal space in the midclavicular line

Question 20

Which of the following body positions will reduce respiratory distress to the greatest extent in a patient with neuromuscular dysfunction?

A) Supine in bed with the feet elevated
B) Sitting in bed with the head of the bed elevated to 30 degrees
C) Upright and leaning forward
D) Sitting in a chair at the bedside