NBCOT Cardiopulmonary Questions and Answers Already Graded A

NBCOT Cardiopulmonary Questions and Answers Already Graded A An OTR® is providing occupational therapy services to a client in acute care who was diagnosed with a pulmonary embolism. What is the most typical cause of a pulmonary embolism? A. Deep vein thrombosis B. Pulmonary hypertension C. Pulmonary edema D. Lung cancer The right answer is A Most pulmonary embolisms are caused by a deep vein thrombosis in a lower extremity. Smith-Gabai, H. (2011). The pulmonary system. In H. Smith-Gabai (Ed,), Occupational therapy in acute care (pp. 147-182). Bethesda, MD: AOTA Press; p. 165. Explanations of Incorrect Answers B, C, D: Clients with pulmonary hypertension, pulmonary edema, and lung cancer are not at high risk for pulmonary embolism. When evaluating a client in a skilled nursing facility, the OTR® notes that the client's skin has a yellowish cast, the fingernail beds are bluish in color, and the client has noticeable edema in both lower extremities. What condition would MOST likely cause these symptoms? A. Right-sided congestive heart failure B. Left-sided congestive heart failure C. Aortic stenosis D. Aortic insufficiency The right answer is A When the right side of the heart fails, blood flows back into the venous system. Symptoms of right-sided heart failure include cyanotic nail beds, jaundice, and lower-extremity edema. Smith-Gabai, H. (2011). The cardiac system. In H. Smith-Gabai (Ed.), Occupational therapy in acute care (pp. 75-120). Bethesda, MD: AOTA Press; p. 99. Explanations of Incorrect Answers B: When the left side of the heart fails, blood flows back into the lungs, causing difficulty breathing, anxiety, and cerebral hypoxia. C, D: Aortic stenosis and aortic insufficiency have symptoms similar to those of left-sided heart failure. An OTR® is working with a client with chronic obstructive pulmonary disease (COPD) on a morning ADL routine. Which treatment strategy BEST describes how this client can be independent in showering? A. Use a shower chair, bathe with hot water from a handheld shower, use relaxation breathing, and inhale on exertion B. Use a shower chair, bathe with warm water from a handheld shower, use pursed lip breathing, and exhale on exertion C. Sit in the tub for support, bathe with hot water from the tub spout, pace by washing one extremity at a time and then resting, and lean backward in the tub D. Sit in the tub for support, bathe with cool water from the tub spout, use a fan to decrease humidity, and rest arms on the sides of the tub The right answer is B Using a shower chair, bathing with warm water from a handheld shower, using pursed lip breathing, and exhaling on exertion all contribute to independent showering for a client with COPD. Huntley, N. (2008). Cardiac and pulmonary diseases. In M. V. Radomski & M. C. Trombly Latham (Eds.), Occupational therapy for physical dysfunction (6th ed., pp. ). Baltimore: Lippincott Williams & Wilkins. Explanations of Incorrect Answers A: Hot water adds to humidity and makes breathing more difficult. The client should use pursed lip rather than relaxation breathing techniques and should exhale rather than inhale on exertion. C: Using a shower chair takes less energy than getting into and out of a tub. Hot water adds to humidity and makes breathing more difficult. Leaning forward in the tub releases the diaphragm and makes breathing easier. D: Using a shower chair takes less energy than getting into and out of a tub. Cool water may chill the client and require more energy for tasks. Resting the arms on the thighs, not on the sides of tub, releases the diaphragm and makes breathing easier. An OTR® is working with a client who suddenly complains of pressure and tightness in the chest. The client's symptoms resolve with rest and a nitroglycerin tablet administered under the tongue. What condition is the client MOST likely to have experienced during the treatment session?