Deck 18: Bronchoscopy Assisting

Question 1

A patient's chest radiograph indicates a right lower lobe infiltrate with atelectasis.The resident asks the respiratory therapy practitioner for recommendations.The practitioner should recommend which of the following?

A)Diagnostic bronchoscopy with a Wang needle
B)Small volume nebulizer with a mucolytic medication
C)Diagnostic bronchoscopy
D)Therapeutic bronchoscopy

Answer 1

Therapeutic bronchoscopy

Question 2

A rigid bronchoscope cannot remove large foreign body in the tracheobronchial tree in the airways lower than the _________________

A)trachea.
B)mainstem bronchi.
C)segmental bronchi.
D)terminal bronchioles.

Answer 2

mainstem bronchi.

Question 3

Which of the following are indications of fiberoptic bronchoscopies?
I.The need to reevaluate persistent pulmonary infiltrates
II.The need for aid in difficult intubations
III.The need to obtain upper respiratory tract secretions
IV.Negative sputum cytology results with diagnosed cancer elsewhere in the body

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

Answer 3

I and II

Question 4

Which of the following is NOT an absolute contraindication for a flexible bronchoscopy?

A)The need to evaluate problems associated with endotracheal or tracheostomy tubes (tracheal damage,airway obstruction,or tube placement)in an end-stage COPD patient
B)Absence of consent from the patient or his/her representative unless a medical emergency exists and patient is not competent to give permission
C)Absence of an experienced bronchoscopist to perform or closely and directly supervise the procedure
D)Lack of adequate facilities and personnel to care for such emergencies such as cardiopulmonary arrest,pneumothorax,or bleeding

Question 5

What procedure should follow a bronchoscopic procedure involving a transbronchial biopsy?

A)Microscopic sputum examination
B)Chest x-ray
C)Mechanical ventilation
D)Bronchoalveolar lavage

Question 6

Which of the following are hazards during a bronchoscopic procedure?
I.Vagal response
II.Hemoptysis
III.Increase in PaCO₂
IV.Decrease in PaO₂

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

Question 7

______________ is performed to obtain lower respiratory tract secretions or tissue samples for cytological,histological,or microbiological study.

A)Therapeutic bronchoscopy
B)Diagnostic bronchoscopy
C)Bronchoalveolar lavage
D)Rigid bronchoscopy

Question 8

Bronchoscopy is commonly performed for two reasons:

A)identification and assessment.
B)bronchoscopic and radiographic.
C)therapeutic and diagnostic.
D)cytological and infection control.

Question 9

Which type of brush/needle/mechanical device is/are used to obtain a sample that cannot become contaminated during retrieval through the suction channel?

A)Unsheathed cytology brush
B)Sheathed cytology brush
C)Forceps
D)Wang needle

Question 10

Which type of sample obtained by bronchoscopic analysis should be fixated in a formalin solution?

A)Sample for cytological analysis
B)Sample for histological analysis
C)Sample for microbiological analysis
D)Sample for fungal analysis

Question 11

The need to retrieve a foreign object is done under most circumstances with ______________

A)bronchoalveolar lavage.
B)a Wang needle.
C)a fiberoptic bronchoscope.
D)a rigid bronchoscope.

Question 12

Which type of brush/needle/mechanical device are is/are used to sample areas of interest by "biting" off small chunks of tissue?

A)Unsheathed cytology brush
B)Sheathed cytology brush
C)Forceps
D)Wang needle

Question 13

Which type of brush/needle/mechanical device is/are used to sample an area of interest that lies on the opposite side of the bronchial wall from where the bronchoscope is located?

A)Sheathed cytology brush
B)Unsheathed cytology brush
C)Forceps
D)Wang needle

Question 14

Patient monitoring should be done before,during,and after bronchoscopic procedures.Which of the following is important to monitor?

A)Patient's level of consciousness
B)Patient vital signs,including heart rhythm
C)Patient's subjective response to the procedure
D)a,b,and c

Question 15

A resident is called to the medical intensive care unit to perform an intubation of a COPD patient with acute respiratory failure.A several unsuccessful attempts the physician asks the respiratory care practitioner for recommendations.Which of the following should the practitioner recommend?

A)Use a rigid bronchoscope to expose the larynx and facilitate the placement of the endotracheal tube
B)Perform a diagnostic bronchoscopy with a flexible bronchoscope to remove all tissue that may be obstructing the view of the airway
C)Perform a therapeutic bronchoscopy with a flexible bronchoscope to facilitate the placement of the endotracheal tube
D)Use a bronchoscope to locate the tracheal rings to mark the area where a surgeon can perform an emergency tracheotomy

Question 16

A pulmonologist performs a fiberoptic bronchoscopy on an outpatient with recurrent bouts of pneumonia.During post-procedure instruction,the patient should be informed to contact the physician if which of the following occurs?

A)Dyspnea,wheezing or hemoptysis
B)Fever or chest pain
C)Ringing in the ears or constipation
D)a and b

Question 17

A patient vomits and aspirates after ingestion of excessive amounts of ethanol.The resident asks the respiratory therapy practitioner for recommendations.The practitioner should recommend which of the following?

A)Wang needle aspiration
B)Sputum sample for cytology
C)Diagnostic bronchoscopy
D)Therapeutic bronchoscopy

Question 18

__________________ is performed to remove excessive pulmonary secretions or foreign material suspected of causing lobar or segmental atelectasis.

A)Therapeutic bronchcoscopy
B)Diagnostic bronchoscopy
C)Bronchoalveolar lavage
D)Rigid bronchoscopy

Question 19

Bronchoscopy is visual examination of the tracheobronchial tree.This procedure may be performed __________________

A)with a fiberoptic bronchoscope.
B)with a rigid bronchoscope
C)anywhere,because emergency equipment is not needed.
D)a and b

Question 20

Which type of testing and analysis performed on bronchoscopic sample would be performed to detect cancerous cells?

A)Cytologic testing
B)Microbiologic testing
C)Histological testing
D)Protozoal testing

Question 21

A diagnostic bronchoscopy is ordered on a patient with a 5 mm lesion on a chest radiograph.The patient has excessive secretions in the airway inhibiting taking a sample of the lesion.Which medication should be recommended to help clear the dry the secretions in the airway to better visualize the area to be sampled?

A)Epinephrine
B)Diazepam
C)Lidocaine
D)Atropine

Question 22

What instructions would you give a patient who is to have a bronchoscopy procedure?

Question 23

A patient is being prepared to undergo a diagnostic bronchoscopic procedure.During the preparation of the patient,a small volume nebulizer is used to aerosolize 2% lidocaine to the airway.Which of the following is NOT a hazard of the medication?

A)Vertigo
B)Dizziness
C)Respiratory depression
D)Difficulty focusing the eyes

Question 24

During a bronchoscopic procedure,a patient starts bleeding excessively.The patient should be administered which drug to control the bleeding?

A)Lorazepam
B)Midazolam
C)Epinephrine
D)Lidocaine

Question 25

The practitioner being oriented on the pediatric unit finds that one of the duties she will be performing will be helping with bronchoscopy procedures.Why would bronchoscopies be performed on pediatric patients?

Question 26

A patient has just had a bronchoscopy procedure performed.What precautions and instructions should you give the patient following the procedure?

Question 27

Which of the following Personal Protective Equipment should be used during a bronchoscopic procedure?
I.Mask with face shield
II.Gloves
III.Gown
IV.Shoe covers

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

Question 28

Wheezing may be precipitated by the irritation of the patient's airway by the bronchoscope.This stimulation can result in bronchospasm,causing wheezing.How can this bronchospasm be prevented?

A)Mixing a bronchodilator with the lidocaine administered before the bronchoscopy
B)Administering a sedative to prevent anxiety and anxiety-induced bronchospasm
C)Hyperoxygenating the patient before the bronchoscopy
D)Blocking the sympathetic nervous system