Deck 4: Medicated Aerosol Treatments

Question 1

Patients who are prescribed inhaled corticosteroids should be instructed to do which of the following to prevent an opportunistic oral infection?

A)Have routine throat cultures to detect an oral infection.
B)Use prophylactic antifungal medication.
C)Decrease the dosage if signs of infection occur.
D)Rinse the mouth and throat with mouthwash or water after inhalation of the corticosteroid.

Answer 1

Rinse the mouth and throat with mouthwash or water after inhalation of the corticosteroid.

Question 2

Which of the following devices would be suitable for the delivery of medications,such as bronchodilators,via the inhalation route? I.A BAN AeroGen
II)An MDI with a holding chamber
III)An LVN HEART
IV)A DPI

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

Answer 2

I,II,III,and IV

Question 3

In order for nasal sprays to deposit in the nasal cavity,the particle size should be:

A)>10 microns
B)5 to 10 microns
C)1 to 5 microns
D)<1 micron

Answer 3

>10 microns

Question 4

The recommended procedure to follow when using an SVN during mechanical ventilation includes all of the following except:

A)Use a flow rate of 30 lpm
B)Place the nebulizer 30 cm back from the patient wye
C)Turn on the flow-by or flow trigger
D)Use a tidal volume of 500 cc when possible

Question 5

Which of the following factors will improve aerosol particle size and increase aerosol delivery to the patient? I.Flow rates of 6-8 liters/min
II)A dead volume of 3-6 ml
III)A fill volume of 4-6 ml

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

Question 6

If the optimal breathing pattern is followed with an inspiratory breath hold,the result is:

A)Minimal inertial impaction of aerosol particles.
B)Maximum penetration of aerosol particles.
C)Deposition of very small,stable particles onto the lung tissue.
D)Laminar flow of the carrier gas.

Question 7

The nebulizer that is most efficient in reducing the amount of wasted medication during exhalation is:

A)An MDI.
B)An SVN.
C)A BAN.
D)A DPI.

Question 8

When taking several medications with an MDI,the patient should be instructed to take which drug first?

A)Cromolyn sodium
B)Vanceril
C)Azmacort
D)Albuterol

Question 9

If a spacer is not available for use with an MDI,how should you instruct the patient to use the inhaler?

A)Place the inhaler between your teeth and bite down before depressing the canister.
B)Hold the MDI 3 to 4 centimeters away from your open mouth before depressing the canister.
C)Place the inhaler mouthpiece inside your mouth as far as possible before depressing the canister.
D)The inhaler should never be used without a spacer or holding device.

Question 10

You are called to instruct a patient about the proper procedure for using an MDI.You would instruct the patient to activate the medication in the inhaler:

A)Just before inspiration.
B)Just as inspiration has begun.
C)At the end of exhalation.
D)After inhaling as deeply as possible.

Question 11

Aerosol deposition is defined as:

A)Particles falling out of suspension.
B)The depth to which the aerosol particles reach within the lungs.
C)The velocity at which the aerosol particles travel.
D)The ability of an aerosol particle to stay in suspension.

Question 12

Which of the following devices is the most capable of creating very stable aerosols?

A)DPI
B)MDI
C)SVN
D)USN

Question 13

All except which of the following are advantages of using a spacer or a holding chamber?

A)It increases the flow rate of the aerosol particles as they move through the spacer.
B)It allows the patient to direct the flow of aerosol into and through the oral cavity.
C)It aids in coordinating activating the device and taking a breath.
D)It allows time to vaporize the aerosol particle to the point of 1 to 5 microns.

Question 14

If an aerosol particle cannot navigate around a branching of the airway and is deposited onto the oncoming airway wall,it has been affected by:

A)Deposition.
B)Inertial impaction.
C)Stability.
D)Penetration.

Question 15

Advantages of delivering aerosolized drugs via inhalation include all of the following except:

A)Smaller drug dosage.
B)Quick drug response.
C)Variable dosage.
D)fewer side effects.

Question 16

While treating a 3-year-old patient at a hospital clinic,you are asked to select an aerosol device for bronchodilator therapy at home.The most appropriate device for this patient is:

A)A bulb nebulizer.
B)A dry powder inhaler.
C)An MDI with a spacer.
D)An MDI.

Question 17

Aerosol penetration is defined as:

A)The removal of the particles from suspension.
B)The depth to which the aerosol particles reach within the lungs.
C)The velocity at which the aerosol particles travel.
D)The ability of an aerosol particle to stay in suspension.

Question 18

Drugs delivered by the inhalation route are affected by which of the following factors? I.The properties of the drug being aerosolized
II)The device used to generate the aerosol
III)The characteristics of the airway
IV)The breathing pattern of the patient

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

Question 19

The best deposition into the lower airways is achieved with aerosol particles of which size?

A)>10 microns
B)5 to 10 microns
C)1 to 5 microns
D)<1 micron

Question 20

You are called to the ICU to give a stat bronchodilator treatment to a comatose patient.Which of the following devices would be most appropriate for this patient?

A)An MDI with a holding chamber
B)A DPI
C)An SVN with a mask
D)A BAN with a mouthpiece

Question 21

______ 7.Penetration refers to an aerosol particle falling out of suspension as it travels through the tracheobronchial tree.

Question 22

______ 2.The inhalation route of drug administration delivers a precise dose of medication to the lungs with each aerosol treatment.

Question 23

______ 4.Medicated aerosol refers to a suspension of a liquid or solid drug in a carrier gas.

Question 24

______ 9.An aerosol particle that is smaller than 0.5 microns will penetrate to the lower airways where it is needed.

Question 25

______ 8.Rapid inspiratory flows cause aerosol particles to deposit higher in the respiratory tract.

Question 26

Smaller doses of drug administered via the inhalation route are effective because there is no first-pass effect in the GI tract.

Question 27

DPIs deliver aerosolized medication to the lungs by:

A)Mixing the drug with a propellant.
B)Using an internal power source.
C)Requiring the patient to generate sufficient inspiratory flow rates.
D)Using an external gas source.

Question 28

______ 6.The gas powering a nebulizer during aerosol therapy should be set at a flow rate of 10 to 12 lpm.

Question 29

If the inspiratory time is prolonged to improve aerosol delivery during mechanical ventilation,the respiratory therapist must monitor the patient for which of the following?

A)Bronchospasm
B)Auto-PEEP
C)Increased secretions
D)Decreased oxygenation TRUE/FALSE
Write 'T' if the statement is true and 'F' if the statement is false.

Question 30

Side effects of continuous nebulization of albuterol include all except which of the following?

A)Hypoglycemia
B)Tachycardia
C)Arrhythmia
D)Hypokalemia

Question 31

______ 13.When administering a spontaneous aerosol treatment with an SVN,a mouthpiece is recommended for better deposition than with a mask.

Question 32

______ 14.A DPI contains liquid aerosol particles that are released when the device is activated.

Question 33

______ 11.SVNs are the most efficient type of nebulizer for delivering aerosolized medication to the lungs.

Question 34

While on a routine home visit,a patient informs you that he has not used his MDI for 2 weeks and asks if the medication is still good.You should tell the patient to:

A)Discard the MDI canister.
B)Use the MDI as instructed.
C)Prime the valve before use.
D)Call his physician for help.

Question 35

______ 15.The AARC guidelines recommend that when you use SVNs during mechanical ventilation,they should be changed every other day.
FILL-IN-THE-BLANK
Write the word or phrase that best completes each statement.

Question 36

______ 10.The difference between a spacer and a holding chamber is that there is a one-way valve within a holding chamber.

Question 37

______ 12.An inspiratory hold after a slow,deep inspiration will optimize penetration and deposition of aerosol particles within the lungs.

Question 38

______ 5.Aerosol particles that are 10 to 15 microns deposit in the large bronchi.

Question 39

______ 1.The majority of an aerosolized drug does not deposit in the lungs,even under optimal conditions.

Question 40

You are called to the emergency room to administer a bronchodilator to a patient diagnosed with status asthmaticus.EMS gave her two treatments with an SVN prior to her arrival in the ER.What device would you recommend?

A)An MDI with a spacer
B)A DPI
C)A BAN
D)A HEART nebulizer

Question 41

Explain why a slow inspiration improves aerosol medication delivery within the lungs.

Question 42

The category of drugs that desensitize the allergic response and prevents asthma is ____________.

Question 43

Propellant-based delivery devices called ________________ create very stable aerosols capable of reaching the lower airways.

Question 44

A nebulizer that is designed for continuous nebulization bronchodilator therapy is ________________.

Question 45

A slow inspiration produces more ____________ flow and improves penetration of aerosol particles.

Question 46

Mucolytics can be administered by nebulization and by ____________.

Question 47

List the guidelines for patient selection for DPI use.

Question 48

Adding diluent to a nebulizer along with the medication ________________ the amount of drug that is nebulized.

Question 49

When delivering aerosolized drugs by SVN to mechanically ventilated patients,the respiratory therapist should adjust the flow rate to ____________ and the tidal volume to ____________.

Question 50

A breath-actuated nebulizer is capable of delivering a dose that is____________ times greater than with continuous nebulization.

Question 51

What are the advantages of SVNs?

Question 52

One factor that determines an aerosol particle's size is the ________________.

Question 53

Newer propellants used in MDIs are ________________.

Question 54

Aerosol particles are measured in ________________.

Question 55

One factor that determines the depth of penetration of an aerosol particle is the ________________.

Question 56

A nebulizer should be placed ________________ back from the patient wye of the ventilator circuit.

Question 57

State a clinical condition that would require delivery of medicated aerosols to the upper airway.

Question 58

Heated and humidified gas in ventilator circuits cause aerosol particles to ________________ in size.

Question 59

Patients using DPIs must be able to generate inspiratory flow rates of at least ________________.