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Comprehensive Unit 3.2 Review Incentive Spirometry
Name: roster # date: 2004
Unit 3.2 Review 1
1. Tidal volume is:
a. normal breathing
b. about 10% of the TLC
c. all the air in the lungs
d. all the air but the RV
e. a and b
2. Total lung capacity is:
a. normal breathing is called this
b. all the air in the lungs
c. all the air but the residual volume
3. Irritation is the phase of the cough in which:
a. the person must pull 12-15 ml/ kg IBW into his lungs
b. the person gets tactile stimulation to the airways or is asked to cough by the RCP
c. the distribution of gases to the lower airways can happen
d. the person opens the glottis and as much as 300-500 lpm flows out as fast as possible
e. the glottis is closed but the patient is creating strong intrathoracic pressure
4. Deep inspiration is the phase of the cough in which
a. the person must pull 12-15 ml/ kg IBW into his lungs
b. the person gets tactile stimulation to the airways or is asked to cough by the RN or RCP
c. the distribution of gases to the lower airways can happen
d. the person opens the glottis and as much as 300-500 lpm flows out as fast as possible
e. the glottis is closed but the patient is creating strong intrathoracic pressure
5. Breath hold is the phase of the cough where:
a. the person must pull 12-15 ml/ kg IBW into his lungs
b. the person gets tactile stimulation to the airways or is asked to cough by the RN or RCP
c. the distribution of gases to the lower airways can happen
d. the person opens the glottis and as much as 300-500 lpm flows out as fast as possible
e. the glottis is closed but the patient is creating strong intrathoracic pressure
6. Compression is the phase of the cough in which:
a. the person must pull 12-15 ml/ kg IBW into his lungs
b. the person gets tactile stimulation to the airways or is asked to cough by the RN or RCP
c. the distribution of gases to the lower airways can happen
d. the person opens the glottis and as much as 300-500 lpm flows out as fast as possible
e. the glottis is closed but the patient is creating strong intrathoracic positive pressure
7. Expulsion is the phase of the cough in which
a. the person must pull 12-15 ml/ kg IBW into his lungs
b. the person gets tactile stimulation to the airways or is asked to cough by the RN or RCP
c. the distribution of gases to the lower airways can happen
d. the person opens the glottis and as much as 300-500 lpm flows out as fast as possible
e. the glottis is closed but the patient is creating strong intrathoracic pressure
8. The mechanism by which many drug & alcohol overdose patients choke to death is due to their inability to recognize:
a. irritation
b. inspiration
c. breath hold
d. compression
e. expulsion
9. While the person with a chest incisions who is in a lot of pain, may have problems with a deep inspiration and a breath hold, the person with abdominal incisions might have more problems with the--- phase[s] because of the abdominal muscles he would have to use.
a. irritation
b. compression
c. expulsion
d. a and b
e. b and c
10. The breath hold should last at least --- seconds to get the gas deep into the peripheral portions of the lung.
a. 3-5
b. 5-10
c. 10-15
d. 15-20
11. While most folks can perform a minimal IC of 12-15 ml/kg of IBW in order to cough, most deep breaths are ___ x that minimal number.
a. 2-3
b. 3-5
c. 10-15
d. 15-20
12. A post-op patient will have trouble coughing effectively because:
a. Skeletal muscles are traumatized & are not coordinated well
b. The incisions hurt these muscles
c. The patient is immobile or splints
d. A and b only
e. A, b and c
13. When the patient is lying on his back, the parts of the lung that get less air are:
a. The upper anterior [front part] of the lung
b. The upper posterior [back] of the lung
c. The lower anterior [front] of the lung
d. The lower posterior [back] of the lung
14. Pain medication not only blunts the ventilatory drive, it may:
a. Make the patient breath shallowly
b. Make the patient unaware of irritations
c. Both
15. The problem with the presence of the endotracheal tube in the patient's airway during surgery is that:
a. He cannot do the compression phase because the vocal cords are kept open
b. The tube is an irritate that will cause an increase in secretions
c. Both
16. When a patient has had a thorocotomy [chest incision] this type of incision will:
a. Collapse the lung
b. Allow air from outside the chest to enter the thorax that is supposed to be in a vacuum
c. Require the patient to pull more negative pressure to breath
d. All of these
e. Only a & b
17. The thorocotomy patient whose sternum is not wired is most at risk because:
a. He can get infections more easily
b. The chest cannot rise
c. he cannot create the negative pressure in the chest
d. A and b
e. b & c
18. Post-op atelectasis is a problem because it increases/ decreases the work of breathing [WOB] as the lung gets smaller and stiffer.
a. increases
b. decreases
19. Post-op atelectasis Decreases/ Increases the total surface area for gas exchange in the alveoli so that oxygen and carbon dioxide cannot move effectively
a. increases
b. decreases
20. TRUE/ FALSE In the post-op atelectasis patient, retained secretions will become infected and bacterial pneumonia can result.
21. The signs & symptoms [s/s] of post-op atelectasis include:
a. Wheezing
b. Decreased breath sounds in the basal, posterior parts of the lung
c. You may hear inspiratory crackles in the upper areas
d. A, b and c
e. B and c
22. The patient with post-op atelectasis may suffer from poor chest excursion. This means that:
a. The chest is moving oddly and excessively
b. The chest is not moving as deeply as it should
23. Because there is increased WOB in a person with post-op atelectasis, there may be increased/ decreased use of accessory muscles
a. increased
b. decreased
24. The person with post-op atelectasis may have/ will not have a fever & chest pain.
a. may have
b. may not have
25. TRUE/FALSE The person with post-op atelectasis will NEVER have dullness to percussion over the areas of consolidation.
26. TRUE/FALSE If the x-ray doesn't show signs of atelectasis, there is no post-op atelectasis.
27. Correction: The first methods you want to use to avoid the chances of post-op atelectasis include:
a. cough, deep breath and turn once a day
b. cough, deep breath and turn every 2-4 hours
c. incentive spirometry
d. IPPB or BiPAP
e. a and c
f. b and c
28. If these first methods are tried and the patient still gets post-op atelectasis, the RCP should recommend:
a. cough, deep breath and turn once a day
b. cough, deep breath and turn every 2-4 hours
c. incentive spirometry
d. IPPB or BiPAP
e. a and c
f. b and c
29. Indications for incentive spirometry include:
a. presence of conditions leading to post-op atelectasis
b. surgery in COPD patients
c. both
30. A person who has had surgery on the right hand would/ or would not need Incentive Spirometry.
a. would
b. would not
31. A person who has a neuromuscular disorder such as muscular dystrophy:
a. can always be managed with incentive spirometry
b. maybe be managed with incentive spirometry, only if he can manage an Vital Capacity of 10 ml/kg IWB
32. Contraindications to incentive spirometry include:
a. artificial airways
b. small children or retarded folks who cannot cooperate
c. persons whose IC is less than 1/3 of their predicted IC
d. a, b and c
e. b and c only
33. Hazards of Incentive spirometry include
a. the treatment is ineffective and the atelectasis is getting worse
b. the patient is developing major consolidation because IS is not enough
c. the patient doesn't cooperate because he is in too much pain
d. bronchospasm
e. all of these
34. Calculate the ideal body weight in kilograms of a male whose height is 5 feet 6 inches.
a. 105
b. 310
c. 64
35. Calculate the ideal body weight in kilograms of the female patient whose height is 5 feet 4 inches:
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a. 120
b. 54.5
c. 544
d. 264
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NOTE: to calculate minimal goal we can use 12-15 ml/kg IBW. For the exam, we will use 12 ml/kg IBW, but in the next few questions, I happened to use 15 ml/kg.
36. For the gentleman in question #34, if he is to cough effectively he must move 15 ml per kg or --- ml of IC on his incentive Spirometer.
a. 120
b. 1575
c. 960
d. 1250
37. For the lady in question #35, for her to cough effectively, the minimum goal on her IS should be set at:
a. 1800
b. 816
c. 1662
38. If this lady in question #37 was in perfect health, you could expect her IC to be about 3 x her minimal goal or:
a. 5.4 liters
b. 2.44 liters
c. 4.9 liters
39. The Total lung capacity [TLC] consists of:
a. IRV + Vt
b. IRV + Vt + ERV + RV
c. ERV + RV
d. IRV + Vt + ERV
40. The Vital capacity [VC] consists of:
a. IRV + Vt
b. IRV + Vt + ERV + RV
c. ERV + RV
d. IRV + Vt + ERV
41. The Inspiratory capacity[IC] consists of:
a. IRV + Vt
b. IRV + Vt + ERV + RV
c. ERV + RV
d. IRV + Vt + ERV
42. The Functional residual capacity FRC] consists of:
a. IRV + Vt
b. IRV + Vt + ERV + RV
c. ERV + RV
d. IRV + Vt + ERV