Egan Fundamentals Of Respiratory Care 10th Edition Kacmarek Stoller – Test Bank

 

 

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Sample Test

Chapter 03: Patient Safety, Communication, and Record Keeping

Test Bank

 

MULTIPLE CHOICE

 

1.    Which of the following is/are a potential area of risk to patients receiving respiratory care?

a.

movement or ambulation

b.

electrical shock

c.

fire hazards

d.

all the above

 

 

ANS:  C

The key areas of potential risk are (1) patient movement and ambulation, (2) electrical hazards, and (3) fire hazards.

 

DIF:    Recall             REF:   p. 42              OBJ:   2| 3

 

2.    Lifting heavy objects is best done with which of the following techniques?

a.

straight spine, bent legs

b.

straight spine, straight legs

c.

bent spine, bent legs

d.

bent spine, straight legs

 

 

ANS:  A

Note that the correct technique calls for a straight spine and use of the leg muscles to lift the object.

 

DIF:    Application    REF:   p. 42              OBJ:   1

 

3.    Which of the following factors are most critical in determining when a patient can be ambulated?

4.    willingness of patient

5.    stability of vital signs

6.    absence of severe pain

a.

2 and 3

b.

1 and 2

c.

1, 2, and 3

d.

1 and 3

 

 

ANS:  A

Ambulation should begin as soon as the patient is physiologically stable and free of severe pain.

 

DIF:    Application    REF:   p. 42              OBJ:   2

 

4.    Which of the following statements is false about patient ambulation?

a.

Ambulation is necessary for normal body functioning.

b.

Patients must be carefully monitored during ambulation.

c.

Chairs or emergency supports must available during ambulation.

d.

Patients with intravenous (IV) lines should not be ambulated.

 

 

ANS:  D

Place all equipment (e.g., intravenous [IV] equipment, nasogastric tube, surgical drainage tubes) close to the patient to prevent dislodging during ambulation.

 

DIF:    Application    REF:   p. 42              OBJ:   2

 

5.    Which of the following parameters should be monitored during ambulation?

6.    skin color

7.    breathing rate and effort

8.    level of consciousness

9.    urine output

a.

1 and 2

b.

3 and 4

c.

1, 2, and 3

d.

1, 2, 3, and 4

 

 

ANS:  C

Skin color, breathing rate and effort, and level of consciousness provide clues to how well the patient is tolerating ambulation.

 

DIF:    Application    REF:   p. 43              OBJ:   2

 

6.    Which of the following terms describes the power potential behind electrical energy?

a.

voltage

b.

current

c.

Ohms

d.

resistance

 

 

ANS:  A

Voltage is the power potential behind the electrical energy.

 

DIF:    Recall             REF:   p. 44              OBJ:   3

 

7.    Which of the following is used to report electrical current?

a.

Ohms

b.

voltage

c.

amps

d.

cycles

 

 

ANS:  C

Current is the flow of electricity from a point of higher voltage to one of lower voltage and is reported in amperes (or amps).

 

DIF:    Recall             REF:   p. 44              OBJ:   3

 

8.    What is the primary factor determining the effect of an electrical shock?

a.

current

b.

temperature

c.

resistance

d.

voltage

 

 

ANS:  A

It is important to note that current represents the greatest danger to you or your patients when electrical shorts occur.

 

DIF:    Recall             REF:   p. 45              OBJ:   4

 

9.    Which of the following is/are key factor(s) determining the extent of harm caused by an electrical current?

10.  duration for which the current is applied

11.  path the current takes through the body

12.  amount of current flowing through the body

a.

1 and 2

b.

2 and 3

c.

1, 2, and 3

d.

1 and 3

 

 

ANS:  C

The harmful effects of current depend on (1) the amount of current flowing through the body, (2) the path it takes, and (3) the duration the current is applied.

OBJ : 4

DIFF: Application

REF : Pg: 45

 

DIF:    Application    REF:   p. 45              OBJ:   4

 

10.  If 120 Volts are applied to a system with 1,000 Ohms of resistance, what is the current?

a.

100 amps

b.

100 Ohms

c.

120 milliamps

d.

120 amps

 

 

ANS:  C

The current is now calculated as amps = 120 V/1,000 Ohms = 0.12 amps or 120 milliamps.

 

DIF:    Analysis         REF:   p. 45              OBJ:   3

 

11.  Which of the following organs is the most sensitive to the effects of electrical shock?

a.

liver

b.

heart

c.

kidneys

d.

lungs

 

 

ANS:  B

Because the heart is susceptible to any current level above 100 milliamps, the 120 milliamps represents a potentially fatal shock.

 

DIF:    Recall             REF:   p. 45              OBJ:   4

 

12.  In which of the following clinical situations is the normally high resistance of the skin bypassed?

13.  in patients with external pacemaker wires

14.  in patients with saline-filled catheters

15.  in patients with intact, dry skin

a.

2 and 3

b.

1, 2, and 3

c.

1 and 2

d.

3

 

 

ANS:  C

Current can readily flow into the body, causing damage to vital organs when the skin is bypassed via conductors such as pacemaker wires or saline-filled intravascular catheters.

 

DIF:    Application    REF:   p. 45              OBJ:   4

 

13.  When a relatively high current (usually greater than 1 mA, or 1/1000 A) is applied externally to the skin, which of the following conditions exists?

a.

macroshock hazard

b.

grounding hazard

c.

microshock hazard

d.

isolation hazard

 

 

ANS:  A

A macroshock exists when a high current (usually greater than 1 milliamp) is applied externally to the skin.

 

DIF:    Application    REF:   p. 46              OBJ:   4

 

14.  When a small, usually imperceptible current (usually less than 1 mA) is allowed to bypass the skin and follow a direct, low resistance pathway into the body, which of the following conditions exists?

a.

macroshock hazard

b.

grounding hazard

c.

isolation hazard

d.

microshock hazard

 

 

ANS:  D

A microshock exists when a small, usually imperceptible current (less than 1 milliamp) bypasses the skin and follows a direct, low-resistance path into the body.

 

DIF:    Application    REF:   p. 46              OBJ:   4

 

15.  High amperage (6 amps or more) applied externally to the skin can cause which of the following?

16.  sustained myocardial contraction

17.  respiratory paralysis

18.  skin burns

a.

1 and 2

b.

2 and 3

c.

1, 2, and 3

d.

1 and 3

 

 

ANS:  C

Table 3-1 summarizes the different effects of these two types of electrical shock.

 

DIF:    Recall             REF:   p. 47              OBJ:   4

 

16.  Which of the following currents passing through the chest can cause ventricular fibrillation, diaphragm dysfunction (due to severe, persistent contraction), and death?

a.

100 mA

b.

100 A

c.

100 mA

d.

10 mA

 

 

ANS:  A

Higher currents (exceeding 100 milliamps [mA]) that pass through the chest can cause ventricular fibrillation, diaphragm dysfunction (due to severe, persistent contraction), and death. Table 3-1 summarizes the different effects of these two types of electrical shock.

 

DIF:    Analysis         REF:   p. 45              OBJ:   4

 

17.  What is the primary purpose of grounding all electrical equipment used in the hospital setting?

a.

to prevent the dangerous buildup of voltage in the equipment

b.

to make the equipment more secure and less likely to break down

c.

to avoid excessive energy costs

d.

to convert electrical power from DC to AC

 

 

ANS:  A

In these cases, the third (ground) wire prevents the dangerous buildup of voltage that can occur on the metal frames of some electrical equipment.

 

DIF:    Application    REF:   p. 46              OBJ:   3

 

18.  Where do most hospital fires initially start?

a.

clinical laboratory

b.

kitchen

c.

electrical engineering post

d.

patient’s room

 

 

ANS:  B

About 90% of fires in health care facilities occur in hospitals and the most common site for the origin of the fire is the kitchen.

 

DIF:    Recall             REF:   p. 47              OBJ:   6

 

19.  Which of the following is true about fires in oxygen-enriched atmospheres?

20.  They are more difficult to put out.

21.  They burn more quickly.

22.  They burn more intensely

a.

1 and 2

b.

2 and 3

c.

1 and 3

d.

1, 2, and 3

 

 

ANS:  D

Fires in oxygen-enriched atmospheres are larger, more intense, faster burning, and more difficult to extinguish.

 

DIF:    Application    REF:   p. 47              OBJ:   7

 

20.  Which of the following conditions must be met for a fire to occur?

21.  temperature high enough for combustion

22.  presence of oxygen

23.  presence of flammable material

a.

1 and 2

b.

2 and 3

c.

1 and 3

d.

1, 2, and 3

 

 

ANS:  D

For a fire to start, three conditions must exist: (1) flammable material must be present, (2) oxygen must be present, and (3) the flammable material must be heated to or above its ignition temperature.

 

DIF:    Application    REF:   p. 48              OBJ:   7

 

21.  Which of the following statements is/are true regarding the use of oxygen?

22.  Oxygen is flammable.

23.  Oxygen accelerates the rate of combustion.

24.  Increased oxygen concentration accelerates the rate of combustion.

a.

1 and 2

b.

2 and 3

c.

1 and 3

d.

1, 2, and 3

 

 

ANS:  B

Although oxygen is nonflammable, it greatly accelerates the rate of combustion. Burning speed increases with an increase in either the concentration or partial pressure of oxygen.

 

DIF:    Recall             REF:   p. 48              OBJ:   7

 

22.  How can the risk of fire because of static electrical discharge in the presence of oxygen be minimized?

a.

Use only wool or polyester fabrics in the area of use.

b.

Keep oxygen concentrations well below 21%.

c.

Maintain high relative humidity in the area of use.

d.

Keep oxygen in high-pressure storage cylinders.

 

 

ANS:  C

The minimal risk that may be present can be further reduced by maintaining high relative humidity (greater than 60%).

 

DIF:    Application    REF:   p. 48              OBJ:   7

 

23.  In the standard approach to hospital fires, the RACE plan has been suggested. What does the letter “C” stand for in this approach?

a.

capture

b.

contain

c.

call for help

d.

collapse

 

 

ANS:  B

The third step is to contain the fire as much as possible by closing doors and turning oxygen zone valves off.

 

DIF:    Application    REF:   p. 48              OBJ:   7

 

24.  Nonverbal communication includes all of the following except:

a.

gesture

b.

touch

c.

discussion

d.

space

 

 

ANS:  C

Nonverbal communication includes gestures, facial expressions, eye movements and contact, voice tone, space, and touch.

 

DIF:    Recall             REF:   p. 49              OBJ:   9

 

25.  Which of the following components of communication is a method used to transmit messages?

a.

sender

b.

channel

c.

receiver

d.

feedback

 

 

ANS:  B

The channel of communication is the method used to transmit messages.

 

DIF:    Application    REF:   p. 49              OBJ:   9

 

26.  Which of the following is a method for communicating empathy to your patients?

27.  use of touch

28.  use of key words

29.  use of eye contact

30.  use of the authority

a.

1, 2, and 3

b.

1 and 3

c.

1, 2, 3, and 4

d.

2, 3, and 4

 

 

ANS:  A

The use of touch and proper eye contact can demonstrate genuine concern for your patient. Key words and phrases such as “I understand” can let the patient know you are listening and interested.

 

DIF:    Application    REF:   p. 50              OBJ:   9

 

27.  Which of the following factors can have an impact on the outcomes of therapeutic communication between patient and practitioner?

28.  verbal and nonverbal components of expression

29.  environmental factors (e.g., noise, privacy)

30.  values and beliefs of both patient and practitioner

31.  sensory and emotional factors (e.g., fear, pain)

a.

1, 2, and 3

b.

1 and 3

c.

1, 2, 3, and 4

d.

2, 3, and 4

 

 

ANS:  C

Many factors affect communication in the health care setting (Figure 3-11).

 

DIF:    Application    REF:   p. 50              OBJ:   9

 

28.  Basic purposes of communication include all of the following except:

a.

change others’ values orientation

b.

obtain or relay information

c.

give instructions (teach)

d.

persuade others to take action

 

 

ANS:  A

Key purposes of communication are summarized in Box 3-1.

 

DIF:    Application    REF:   p. 51              OBJ:   11

 

29.  All of the following techniques can be used to improve one’s effectiveness as a sender of messages except:

a.

share information rather than telling

b.

emphasize agreement over disagreement

c.

eliminate threatening behavior

d.

use effective nonverbal communication

 

 

ANS:  B

Others will not always agree with what you say. Do not become defensive when others disagree with you; simply try to understand their perspective and be open to their input.

 

DIF:    Application    REF:   p. 52              OBJ:   12

 

30.  All of the following techniques can be used to improve one’s listening skills except:

a.

resist distractions

b.

maintain composure and control emotions

c.

keep an open mind (be objective)

d.

judge the sender’s delivery, not the content

 

 

ANS:  D

The content of what is being said is the issue to focus on. How it is delivered is not that important. Some people are more articulate than others but the message is most important.

 

DIF:    Application    REF:   p. 52              OBJ:   12

 

31.  Maintaining eye contact, leaning toward the patient, and nodding your head are all good examples of what communication technique?

a.

clarifying

b.

empathizing

c.

attending

d.

reflecting

 

 

ANS:  C

Attending involves the use of gestures and posture that communicate one’s attentiveness. Attending also involves confirming remarks such as, “I see what you mean.”

 

DIF:    Application    REF:   p. 52              OBJ:   12

 

32.  Techniques to help ensure that understanding is taking place between the parties involved in an interaction include which of the following?

33.  clarifying

34.  paraphrasing

35.  perception checking

36.  attending

a.

1, 2, and 3

b.

1 and 3

c.

1, 2, 3, and 4

d.

2, 3, and 4

 

 

ANS:  C

All four techniques can be useful to enhance communication.

 

DIF:    Application    REF:   p. 52              OBJ:   12

 

33.  A therapist who says “Please explain that to me again” to a patient during an interview is using what interpersonal communication technique?

a.

clarifying

b.

paraphrasing

c.

perception checking

d.

reflecting feelings

 

 

ANS:  A

Requesting clarification lets the patient know you are trying to understand him or her.

 

DIF:    Recall             REF:   p. 52              OBJ:   12

 

34.  A patient’s response to an interview question is initially unclear. Which of the following responses on your part would be most appropriate?

a.

“Please go on.”

b.

“You seem to be anxious.”

c.

“Please explain that to me again.”

d.

“Yes, I think I understand.”

 

 

ANS:  C

Requesting clarification is done by asking the patient to explain his or her thought again.

 

DIF:    Application    REF:   p. 52              OBJ:   12

 

35.  A therapist who says “You seem to be anxious about your surgery” to a patient just admitted for bypass surgery is using what interpersonal communication technique?

a.

clarifying

b.

paraphrasing

c.

perception checking

d.

reflecting feelings

 

 

ANS:  D

Reflecting feelings is the process of telling patients about how you perceive their feelings. It encourages patients to discuss their feelings further.

 

DIF:    Application    REF:   p. 53              OBJ:   11

 

36.  Key barriers to effective interpersonal communication include all of the following except:

a.

use of symbols or words with different meanings

b.

value systems that are different or not accepted

c.

similar perceptions of the problem

d.

feelings of personal insecurity by one or both parties

 

 

ANS:  C

Similar perceptions of the problem promote communication and are not a barrier.

 

DIF:    Application    REF:   p. 52              OBJ:   13

 

 

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