Question 1

According to the oxygen therapy protocol, what should be done with a patient who has severe trauma when hypoxemia is suspected?&#10;A) Begin hyperinflation therapy.&#10;B)Initiate supplemental oxygen.&#10;C)Begin mechanical ventilation.&#10;D)Notify the physician.

Accepted Answer

Initiating supplemental oxygen is the best choice to treat hypoxemia in a trauma patient. Mechanical ventilation and hyperinflation therapy may be needed in severe cases, but these interventions should be ordered by a physician. It is important to notify the physician of any changes in the patient's oxygen status.

Question 2

When performing a therapist-driven protocol (TDP), the severity assessment refers to:&#10;A) the frequency of performing a treatment modality.&#10;B)how sick the patient is.&#10;C)the Department of Homeland Security's threat level.&#10;D)how urgently the physician wants the patient treated.

Accepted Answer

the frequency of performing a treatment modality.

Question 3

Your patient required mechanical ventilation for apnea after an accidental drug overdose. She is now awake. According to the mechanical ventilation protocol, what should be done to initially assess her readiness to be weaned from the ventilator?

A) 1-Minute spontaneous breathing trial
B)30-Minute spontaneous breathing trial
C)Assessment on CPAP
D)Consultation with the physician

Accepted Answer

1-Minute spontaneous breathing trial is the initial assessment to assess readiness to be weaned from the ventilator.

Question 4

An obese patient had upper abdominal surgery 2 days earlier. He has a weak nonproductive cough and a pulse oximeter (SpO₂) reading of 84% on room air. What therapist-driven protocol(s) should be implemented?
1) mechanical ventilation
2) hyperinflation therapy
3) oxygen therapy
4) aerosolized medication

A)1
B)3, 4
C)2, 3
D)1, 3, 4

Accepted Answer

The patient likely has atelectasis due to shallow breathing post-surgery, which can be improved with hyperinflation therapy. Oxygen therapy is also needed to address the low SpO2.

Question 5

A 45-year-old woman has acute respiratory failure. She is cyanotic with unstable vital signs. What therapist-driven protocol(s) should be implemented?
1) Oxygen therapy
2) Aerosolized medication therapy
3) Hyperinflation therapy
4) Mechanical ventilation

A)3
B)1, 4
C)2, 3, 4
D)1, 2, 3, 4

Accepted Answer

In this case, the patient is experiencing acute respiratory failure with unstable vital signs and cyanosis. The best choice(s) for therapy-driven protocols would be oxygen therapy to improve oxygenation, and mechanical ventilation to support respiratory function. Aerosolized medication therapy and hyperinflation therapy may be beneficial in certain cases, but they may not be the most urgent or appropriate interventions for this patient's critical condition. Therefore, the best choice(s) would be 1 and 4, which entail oxygen therapy and mechanical ventilation.

Question 6

A TDP can be started after:&#10;A) the nurse finishes his/her assessment.&#10;B)the treatment is selected.&#10;C)a physician's order for the TDP is received.&#10;D)the patient's insurance carrier is contacted.

Accepted Answer

It is important to have a physician's order for a TDP because it is a medical treatment that requires a licensed healthcare provider to authorize and supervise its administration. The nurse's assessment and treatment selection may inform the physician's decision to order a TDP, but it is not sufficient on its own to start the treatment. Contacting the patient's insurance carrier is also a separate process that does not directly affect the initiation of a TDP.

Question 7

According to the aerosolized medication protocol, a patient with COPD could be treated with all of the following medications EXCEPT:&#10;A) antiinflammatory agents.&#10;B)sympathomimetic agents.&#10;C)parasympatholytic agents.&#10;D)antibiotics.

Accepted Answer

Antibiotics are not typically used in aerosolized medication treatment for COPD, as COPD is a chronic condition and antibiotics are used for short-term treatment of bacterial infections. The other medication types listed (antiinflammatory agents, sympathomimetic agents, and parasympatholytic agents) are commonly used in aerosolized medication treatment for COPD.

Question 8

Postural drainage, percussion, and vibration are part of what TDP?&#10;A) Hyperinflation therapy&#10;B)Bronchopulmonary hygiene therapy&#10;C)Mechanical ventilation&#10;D)Oxygen therapy

Accepted Answer

Postural drainage, percussion, and vibration are all techniques used in bronchopulmonary hygiene therapy, which is used to help mobilize secretions in the lungs and airways. Hyperinflation therapy and mechanical ventilation are used for different purposes (to improve lung function and provide breathing support, respectively), while oxygen therapy is used to increase oxygen levels in the body.

Question 9

Which of the following is/are associated with the consolidation clinical scenario?
1) Increased opacity on the chest radiograph
2) Decreased FRC
3) Bronchial breath sounds
4) Hyperresonant percussion note

A)3
B)2, 4
C)1, 2, 3
D)1, 2, 3, 4

Accepted Answer

Consolidation is characterized by an increased opacity on the chest radiograph due to the accumulation of fluid or inflammatory exudate in the alveoli or interstitial tissues. Decreased FRC is a characteristic feature of consolidation due to the filling of alveolar spaces leading to decreased airspace. Bronchial breath sounds are heard when air passes over a consolidated area due to the loss of alveolar elasticity and increased conduction of sound through dense tissue. Hyperresonant percussion note is not typically associated with consolidation, rather it is associated with pneumothorax or emphysema.

Question 10

Which of the following is/are associated with the consolidation clinical scenario?
1) Increased opacity on the chest radiograph
2) Decreased FRC
3) Bronchial breath sounds
4) Hyperresonant percussion note

A)3
B)2, 4
C)1, 2, 3
D)1, 2, 3, 4

Accepted Answer

A patient with bronchospasm would have increased airway resistance and air trapping. The air trapping would result in a hyperresonant percussion note.

Deck 9: The Therapist-Driven Protocol Program and the Role of the Respiratory Care Practitioner