Deck 33: Comprehensive Management of Individuals in the Intensive Care Unit

Question 1

What is the best initial treatment choice(s)for a patient in the ICU?

A) Supplemental oxygen
B) Intubation and mechanical ventilation
C) Pharmacologic agents
D) Various conservative, noninvasive measures

Answer 1

D
Conservative,noninvasive measures should be used first,including mobilization and recumbency,before the use of additional invasive monitoring.The therapist should aim to avoid,reduce,or postpone the need for respiratory support.

Question 2

What change in an ICU patient is associated with reduced cardiac output,reduced blood pressure,hypoxemia,hypercapnia,and increased cranial pressure?

A) Impairment of neuromuscular status
B) Length of stay
C) Maximized oxygen transport
D) Mechanical ventilation will be necessary

Answer 2

A
All of the above may have an indirect impairment on a patient's neuromuscular status but do not indicate neurologic dysfunction.Musculoskeletal and neurologic complications can become life threatening and need to be detected and managed early.

Question 3

What is the primary intervention choice to maximize oxygen transport?

A) Acute mobilization and upright positioning
B) Ventilation and mobilization
C) Acute mobilization only
D) Positioning with restricted mobility

Answer 3

A
Mobilization and recumbency are essential factors for normal oxygen transport.Their removal has dire consequences for patients with or without cardiovascular and pulmonary dysfunction.

Question 4

What is the main purpose of supplemental oxygen?

A) Prevent desaturation with exercise
B) For use before and after suctioning
C) Maintain PaO₂ within an optimal range
D) Minimize the effects of acidemia

Question 5

Which of the following is not a relative contraindication of manual airway clearance interventions?

A) Hemorrhage
B) Acute chest trauma
C) Gastric reflux
D) All of these are relative contraindications

Question 6

In addition to movement and body position,what benefits are provided for a patient when using breathing and coughing maneuvers?

A) Increase minute ventilation
B) Increase respiratory rate
C) Increase tidal volume
D) Improve venous blood gases

Question 7

What would be the best way to wean an obese patient from the use of a mechanical ventilator?

A) Wean in a semirecumbent position.
B) Wean in a supine position.
C) Wean in a 90-degree upright position.
D) Wean in a prone position.

Question 8

In addition to age and comorbidity,what risk factors might indicate a suboptimal clinical outcome for an ICU patient?

A) Acute renal failure
B) Cardiac arrest
C) Peritoneal dialysis
D) All of the above

Question 9

Which of the following is a contraindication for manual techniques performed in the head-down position?

A) Hemorrhage
B) Acute chest trauma
C) Myocardial infarction
D) Gastric reflux

Question 10

When establishing treatment goals for an ICU patient,what information is necessary for the physical therapist to consider?

A) State of patient arousal
B) Acid-base imbalances
C) Balance of electrolytes
D) All of the above

Question 11

Which monitoring system give the therapist information of fluid loading and the ability of the right side of the heart to cope with changes in circulating body fluids?

A) Central venous pressure
B) Swan-Ganz catheter
C) ECG
D) Cardiovascular stress alert

Question 12

What might be the cause for apparent impairment of neuromuscular status in a patient in the ICU?

A) Increased cardiac output
B) Increased blood pressure
C) Decreased intracranial pressure
D) Hypercapnia

Question 13

Which of the following medications might help a patient cooperate and tolerate a physical therapy treatment session better?

A) Beta-blocker
B) Bronchodilator
C) Vasopressor agent
D) Narcotics

Question 14

What would be the most appropriate way to address a pressure sore developing on the sacrum of a patient in the ICU to prevent further deterioration?

A) Provide a special mattress for the patient.
B) Begin a regular positioning program to relieve pressure on sacrum.
C) Begin routine skin examinations to monitor the sacrum.
D) Smooth the patient's hospital gown when he or she returns to bed.

Question 15

What is the purpose of a Swan-Ganz catheter?

A) Gives an indication of fluid loading
B) Measures the ability of the right side of the heart to cope with changes in circulating body fluids
C) Gives pressures for pulmonary artery pressure and wedge pressure
D) Measures pulmonary sufficiency

Question 16

Which type of infection control measures should be used for a patient in respiratory isolation before entering the patient's room?

A) Hand washing
B) Masking
C) Gloving
D) Masking and gloving

Question 17

Which of the following is not included in the tripod approach to patient management?

A) Clinical experience
B) Diagnostic skills
C) Knowledge of underlying pathophysiology
D) Physiologic and scientific evidence for treatment interventions

Question 18

How should the therapist adjust treatment as a patient shifts from active care to palliative care?

A) Continue active treatments as originally planned
B) Shift to comfort and symptom management.
C) Discontinue treatment.
D) Educate the patient and family regarding end of life.

Question 19

What type of foods might be limited for the patient in ICU?

A) Carbohydrates
B) Proteins
C) Fats
D) Dairy

Question 20

Which of the following is the priority of treatment for a patient who is critically ill?

A) Making the patient comfortable
B) Optimizing oxygen delivery through the use of mechanical ventilators
C) Optimizing oxygen delivery through noninvasive interventions
D) Patient and family education regarding diagnosis