Question 1

What definition of atelectasis would best fit that of a premature newborn with respiratory distress syndrome (RDS)?&#10;A) Partial or total collapse of previously expanded lung regions&#10;B)Free pleural air compressed the lungs&#10;C)Enlarged heart causes compression of the lungs&#10;D)The lungs remain unexpanded since birth

Accepted Answer

In a premature newborn with RDS, the lungs may remain unexpanded since birth due to insufficient surfactant, leading to atelectasis.

Question 2

Which of the following is the least commonly found type of postoperative atelectasis?&#10;A) Primary lobule&#10;B)Lung segment&#10;C)Lung lobe&#10;D)Entire lung

Accepted Answer

In postoperative atelectasis, entire lung collapse is the least commonly found type. Primary lobule, lung segment, and lung lobe atelectasis are more commonly observed.

Question 3

After open heart surgery, your 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

1, 3

Accepted Answer

Chest physical therapy can help to mobilize and remove excess secretions from the lungs. Incentive spirometry can help to improve lung function and prevent atelectasis by encouraging deep breathing and sustained inspiration. CPAP and inhaled sympathomimetic medications may also be helpful in certain cases, but are not the best initial choices for managing bronchitis with increased secretions and atelectasis after open heart surgery.

Question 4

Which of the following is/are precipitating factors 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

Accepted Answer

Supine position and obesity can decrease the ability to generate a negative intrapleural pressure due to increased pressure on the chest wall. Malnutrition may decrease the patient's respiratory muscle strength, further compromising their ability to generate negative pressure. A large tidal volume on the mechanical ventilator may not necessarily decrease the ability to generate negative pressure but may cause volutrauma and barotrauma if the tidal volume is excessively high.

Question 5

All of the following conditions can lead to atelectasis, EXCEPT:&#10;A) Chronic obstructive pulmonary disease (COPD)&#10;B)Acute respiratory distress syndrome (ARDS)&#10;C)Pleural effusion&#10;D)Pneumothorax

Accepted Answer

While COPD can cause air trapping, it typically does not lead to atelectasis. Atelectasis is more commonly caused by external pressure on the lung or blockage of the airways, as in options B, C, and D.

Question 6

After gastric bypass surgery, your patient is showing tachypnea. What is the best explanation for this?&#10;A) Diaphragmatic apraxia&#10;B)Postoperative pain&#10;C)Low-grade fever&#10;D)Anesthetic sedation

Accepted Answer

Postoperative pain can lead to tachypnea as the patient tries to reduce the pain by taking shallow, rapid breaths.

Question 7

Which of the following patients should be placed on short-term mechanical ventilation because of the high risk of postoperative atelectasis?&#10;A) Appendectomy&#10;B)Tracheostomy&#10;C)Bronchoscopy for tumor biopsy&#10;D)Cardiac surgery

Accepted Answer

Cardiac surgery is associated with a high risk of postoperative atelectasis due to the prolonged anesthesia and mechanical ventilation, as well as incisional pain that limits deep breathing and coughing. Patients who undergo cardiac surgery are typically placed on short-term mechanical ventilation to prevent atelectasis and improve oxygenation. The other options listed are not necessarily associated with a high risk of postoperative atelectasis and may not require mechanical ventilation.

Question 8

Your patient has a tumor blocking the left mainstem bronchus. What additional factor would favor the development of atelectasis?&#10;A) Breathing a nitric oxide mix (iNO)&#10;B)Breathing a helium/oxygen mix (heliox)&#10;C)Breathing a high percentage of oxygen&#10;D)Breathing a low percentage of oxygen

Accepted Answer

Breathing a high percentage of oxygen can lead to absorption atelectasis, as the increase in oxygen concentration can lead to decreased nitrogen concentration in the alveoli, causing them to collapse. This effect is more pronounced when there is a blockage (such as the tumor in this case) in the airway. Choices A and B are not relevant to the development of atelectasis in this scenario. Choice D may actually improve atelectasis, as a low concentration of oxygen can decrease the risk of absorption atelectasis.

Question 9

A 40-year-old patient was in an automobile 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

Accepted Answer

Adequate pain management can help the patient breathe more deeply and cough effectively, which can help resolve atelectasis. Removing the pleural fluid can help re-expand the lung and improve ventilation.

Question 10

After surgery, your patient must lie supine in bed. Because of this, atelectasis is thought to have developed. What chest radiograph finding would confirm this?&#10;A) Depression of the hemidiaphragms&#10;B)Pulmonary interstitial emphysema (PIE)&#10;C)Increased density in both upper lobe areas&#10;D)Increased density in both posterior lower lobe areas

Accepted Answer

Atelectasis is typically characterized by increased density in the affected area of the lung. The posterior lower lobes are commonly affected in supine patients, making option D the best choice. The other options are either not specific to atelectasis or do not match the typical presentation.

Question 11

Commonly found 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

Accepted Answer

The answer of Commonly found chest assessment findings in a...

Question 12

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

Accepted Answer

The answer of Which of the following are precipitating factors...

Question 13

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

Accepted Answer

The answer of A patient with atelectasis is being monitored...

Question 14

All of the following would be found in a patient with atelectasis, EXCEPT&#10;A) Normal shunt fraction&#10;B)Whispered pectoriloquy&#10;C)Chest radiograph shows increased density in areas of atelectasis&#10;D)Diminished breath sounds

Accepted Answer

The answer of All of the following would be found...

Question 15

Examples of the types of surgical procedures that often result in atelectasis include all of the following, EXCEPT:&#10;A) Open heart surgery&#10;B)Craniotomy&#10;C)Gallbladder removal&#10;D)Splenectomy

Accepted Answer

The answer of Examples of the types of surgical procedures...

Deck 42: Postoperative Atelectasis