Cardiovascular and Pulmonary

Physical Therapy Evidence to Practice

5th Edition Frownfelter Test Bank
Go to download the full and correct content document:
https://testbankfan.com/product/cardiovascular-and-pulmonary-physical-therapy-evid
ence-to-practice-5th-edition-frownfelter-test-bank/
More products digital (pdf, epub, mobi) instant
download maybe you interests ...

Manual of I.V. Therapeutics Evidence Based Practice for

Infusion Therapy 6th Edition Phillips Test Bank

https://testbankfan.com/product/manual-of-i-v-therapeutics-
evidence-based-practice-for-infusion-therapy-6th-edition-
phillips-test-bank/

Pedrettis Occupational Therapy Practice Skills for

Physical Dysfunction 7th Edition Pendleton Test Bank

https://testbankfan.com/product/pedrettis-occupational-therapy-
practice-skills-for-physical-dysfunction-7th-edition-pendleton-
test-bank/

Understanding Nursing Research Building an Evidence

Based Practice 5th Edition Burns Test Bank

https://testbankfan.com/product/understanding-nursing-research-
building-an-evidence-based-practice-5th-edition-burns-test-bank/

Research in Nursing Evidence for Best Practice 5th

Edition Richardson-Tench Test Bank

https://testbankfan.com/product/research-in-nursing-evidence-for-
best-practice-5th-edition-richardson-tench-test-bank/
Essentials of Cardiopulmonary Physical Therapy 4th
Edition Hillegass Test Bank

https://testbankfan.com/product/essentials-of-cardiopulmonary-
physical-therapy-4th-edition-hillegass-test-bank/

Principles and Practice of Radiation Therapy 4th

Edition Washington Test Bank

https://testbankfan.com/product/principles-and-practice-of-
radiation-therapy-4th-edition-washington-test-bank/

Family Therapy History Theory and Practice 6th Edition

Gladding Test Bank

https://testbankfan.com/product/family-therapy-history-theory-
and-practice-6th-edition-gladding-test-bank/

Principles and Practice of Radiation Therapy 3rd

Edition Washington Test Bank

https://testbankfan.com/product/principles-and-practice-of-
radiation-therapy-3rd-edition-washington-test-bank/

Practice of Nursing Research Appraisal Synthesis and

Generation of Evidence 7th Edition Grove Test Bank

https://testbankfan.com/product/practice-of-nursing-research-
appraisal-synthesis-and-generation-of-evidence-7th-edition-grove-
test-bank/
Frownfelter: Cardiovascular and Pulmonary Physical Therapy, 5th
Edition
Chapter 6: Cardiovascular and Pulmonary Manifestations of Systemic Conditions

Test Bank

1. The heart and lungs should be seen as a continuous system in as much as changes in
one will ultimately affect the other. If the right side of the heart falters in operation, it
could result in increased pressure and create a condition known as:

a. right heart failure.

b. pulmonary failure.
c. left heart failure.
d. pulmonary hypertension.

Answer: a
Right-sided heart failure is a description of right arterial pressure increases or increased
central venous pressure; all signal a problem with the right side of the heart.

2. A patient seen by a physical therapist is suspect of having right-sided heart failure.

This condition is likely to lead to because blood is not forwarded to
the lungs effectively.

a. pulmonary vasodilation
b. hyperkalemia
c. hypoxemia
d. hypoventilation

Answer: c
A condition in which little oxygen is available in the blood for perfusion results from the
right side of the heart’s inability to properly profuse the lungs because of failure.

3. A patient with left-sided heart failure would likely have changes in which of the
following systems?

a. Integumentary system
b. Endocrine system
c. Metabolic system
d. Lymphatic system

Answer: d
The resulting pulmonary edema from the left-sided heart failure will alter the lymphatic
drainage in the lungs, thereby creating changes in the lymphatic system.

Copyright © 2012 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank 6-2

4. Pleural fluid accumulations and effusion of the thorax can lead to which of the
following conditions?

a. Atelectasis
b. Decreased hydrostatic pressure
c. Increased oncotic pressure
d. Starling deficit

Answer: a
Atelectasis can result from an increased thoracic effusion as the hydrostatic pressure
increases.

5. Lymphatic vessels are located in the pleurae and not the alveolar capillary spaces of
the pulmonary system. These vessels drain fluid into the .

a. interlobular septae
b. hilar vessels
c. subpleural spaces
d. lung parenchyma

Answer: b
All lymphatic vessels from the pleurae empty into the hilar vessels before draining into
the primary tracheobronchial lymph nodes.

6. Polycythemia increases the mass of the red blood cells, thereby elevating the
hematocrit. One possible concern for the physical therapist treating a patient with this
condition is:

a. low oxygen saturation.

b. thromboemboli.
c. hypoxemia.
d. hyperemia.

Answer: b
The increased mass of red blood cells and elevated hematocrit increase the viscosity of
the blood; the increased viscosity places the patient at risk for thromboemboli.

7. Reduced lung compliance resulting from an increased fibrotic event of the lung
parenchyma would be related to changes of what origin?

a. Musculoskeletal conditions
b. Neurologic conditions
c. Gastrointestinal conditions
d. Connective tissue conditions

Answer: d

Copyright © 2012 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank 6-3

The increased fibrotic changes are related to connective tissue involvement and would
result in reduced lung compliance.

8. A patient seen by a physical therapist after a stroke with the clinical presentation of
abdominal muscle weakness and pharyngeal weakness is at risk for:

a. diaphragmatic excursion.
b. aspiration.
c. unilateral posture.
d. impaired biomechanics.

Answer: b
The lack of pharyngeal control coupled with weakness in the abdominals makes the risk
of aspiration real considering that the right mainstem bronchus is nearly continuous in
angulation with the trachea. This particular patient would have a difficult, if not
impossible, time generating a cough to clear any potential foreign object from blocking
the trachea.

9. A physical therapist completes an evaluation of a child with cerebral palsy. As part of

the physical therapy interventions, physical therapist is planning to educate the parents or
caregivers. What items will be most appropriate to include to maintain optimal
cardiovascular and pulmonary health?

a. Consideration of a scoliosis screen

b. Consideration of seating adaptations
c. Consideration of the risk for aspiration
d. Consideration for supplemental oxygen
Answer: c

This special population of individuals has poor gag, cough, and swallow reflexes and is at
a greater risk for aspiration.

10. Patients with Parkinson disease are typically have increased muscle tone and
subsequent rigidity. As part of a planned program of intervention, the physical therapist
should consider which of the following?

a. Program of general muscle strengthening

b. Program of cardiovascular endurance training
c. Program of stretching and tone reduction activities
d. Program of tone reduction and thoracic mobility activities

Answer: d
Patients with Parkinson require tonal reduction techniques; the thoracic mobility
activities will assist in decreasing trunk rigidity and tone in addition to improving
pulmonary ventilation, thereby assisting in decreasing the cardiovascular and pulmonary
deficits.

Copyright © 2012 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank 6-4

11. A physical therapist completes an examination for a patient with quadriplegia. As part
of the plan of care, the therapist should likely address which of the following?

a. Impaired cough
b. Sitting posture
c. Upper body strengthening
d. Cardiovascular endurance

Answer: a
Patients with quadriplegia have impaired cough function and often require the
intervention of a physical therapist to provide instruction in ways to produce a forceful
cough.

12. A physical therapist is conducting a systems review of a potential patient with a

history of alcohol abuse. During the conversation, the patient reveals the onset of
increasing difficulty getting cuts and nosebleeds to clot. What should the therapist do?

a. Instruct the patient to take more iron.

b. Question the patient about his or her medications.
c. Advise the patient to stop taking aspirin.
d. Consider liver dysfunction and consult with the physician.

Answer: d
Given the history of alcohol abuse and the recent inability to clot, the patient likely has
liver failure; the liver is responsible for the production of anticoagulants and
procoagulants.

13. A physical therapist is conducting a medical record review in the acute care setting
and finds the following notes in the patient’s chart from the pulmonologist: “interstitial
and alveolar inflammation and alveolar hemorrhage.” The physical therapist should
consider that the patient may have which of the following conditions?

a. Renal–pulmonary syndrome
b. Hepatic syndrome
c. Hematologic syndrome
d. Hypoxic vasoconstriction

Answer: a
These two symptoms may present with the third of pulmonary vasculature dysfunction.
All are characteristics of the renal–pulmonary syndrome, which ultimately can lead to
restrictive and obstructive conditions of the pulmonary system.

14. For patients diagnosed with sickle cell anemia, all of the following are characteristics
of the condition EXCEPT:

Copyright © 2012 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank 6-5

a. vitamin K deficiency.
b. pleuritic chest pain.
c. abnormal pulmonary function test results.
d. erythrocyte rigidity.

Answer: a
Erythrocyte are not dependent on an adequate amount or utilization of vitamin K;
therefore, there is no explanation for why it would be seen in a condition that affects the
red blood cell.

15. What substance is responsible for stimulating the synthesis of surfactant, which
assists in holding the alveolar sac open for oxygenation to occur?

a. Thyroid hormone
b. Antidiuretic hormone
c. Corticotrophin hormone
d. Lipolytic hormone

Answer: a
Thyroid hormone is responsible for influencing the synthesis of surfactant.

16. Abnormalities seen in red blood cells that would affect the ability of the cell to
transport oxygen might be seen clinically as which symptom?

a. Hemoptysis
b. Hemorrhage
c. Dyspnea
d. Pleuritic chest pain

Answer: c
Red blood cells’ inability to transport oxygen would manifest clinically as tachypnea,
dyspnea, or cyanosis. Although the other responses indicate a hematologic disorder, those
symptoms are not specific to oxygen transportation.

17. A patient with the diagnosis of hypothyroidism might experience all of the following
clinical signs and symptoms related to the cardiovascular and pulmonary system
EXCEPT:

a. sleep apnea.
b. decreased vital capacity.
c. pleural effusions.
d. pericardial effusions.

Answer: b

Copyright © 2012 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank 6-6

Hypothyroidism is a condition that affects multiple systems. In relation to the pulmonary

system, the most dramatic effect is edematous effusions. This collection of fluid results in
pleural and pericardial effusions; sleep apnea is another condition of hypothyroidism.

18. A patient with a long-standing history of diabetes is seen for participation in a

wellness program. The physical therapist completes a history and systems review. What
would be the most appropriate test and measures to complete before the patient begins
activity?

a. Pulmonary function test

b. Ankle-brachial index
c. Distal pulses and sensation
d. Vital signs (blood pressure and heart rate)

Answer: c
Although the other tests and measures listed provide important pieces of information,
determining the presence of a distal pulse and accompanying sensation are paramount.
These two measures allow the physical therapist to plan the intensity of activities based
on the status of the extremities.

19. A patient with a diagnosis of HIV is complaining of dyspnea and hemoptysis. The
patient describes the presence of a cough, and plain radiographs demonstrate diffuse
pulmonary infiltrates. This patient has had several bouts of pneumonia within the past
year; he has sought treatment but finds it difficult to stay on a regimen given his travel
(the patient resides abroad). He is likely to be diagnosed with which condition?

a. Pneumocystis carinii pneumonia

b. Tuberculosis
c. Klebsiella pneumonia
d. Legionella pneumonia

Answer: a
P. carinii pneumonia is fairly common among the patient population described; the other
forms of pneumonia would require further testing to identify specifically. Advances in
treatment and monitoring decrease the chances of those in the United States developing
the condition, but the same cannot be said for those abroad.

20. A young female athlete is seen by a physical therapist. The athlete’s primary
complaints are fatigue and an inability to catch her breath. The therapist determines that
she has a nutritional disorder, anorexia nervosa. All of the following would be consistent
with this diagnosis EXCEPT:

a. obstructive sleep apnea.

b. ineffective cough.
c. respiratory muscle weakness.
d. cardiac dysrhythmias.

Copyright © 2012 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank 6-7

Answer: a
Obstructive sleep apnea is typical in individuals who are obese, and not those with
anorexia nervosa.

Copyright © 2012 by Mosby, Inc., an affiliate of Elsevier Inc.

Another random document with
no related content on Scribd:
The Project Gutenberg eBook of The giant horse
of Oz
 This ebook is for the use of anyone anywhere in the United
States and most other parts of the world at no cost and with
almost no restrictions whatsoever. You may copy it, give it away
or re-use it under the terms of the Project Gutenberg License
included with this ebook or online at www.gutenberg.org. If you
are not located in the United States, you will have to check the
laws of the country where you are located before using this
eBook.

Title: The giant horse of Oz

Author: Ruth Plumly Thompson

Illustrator: John R. Neill

Other: L. Frank Baum

Release date: March 15, 2024 [eBook #73170]

Language: English

Original publication: New York, NY: The Reilly & Lee Co, 1928

Credits: Greg Weeks, Mary Meehan and the Online Distributed

Proofreading Team at http://www.pgdp.net

*** START OF THE PROJECT GUTENBERG EBOOK THE GIANT

HORSE OF OZ ***
THE GIANT HORSE OF OZ

By RUTH PLUMLY THOMPSON

Founded on and continuing the Famous Oz Stories

By
L. FRANK BAUM
"Royal Historian of Oz"

Illustrated by
JOHN R. NEILL

The Reilly & Lee Co.

Chicago, New York

Made in U. S. A.
 Copyright, 1928
By
The Reilly & Lee Co.

All Rights Reserved

The Giant Horse of Oz
Hello Girls and Boys, Hello!
Wherever you are, Hello!
Wherever you are and whoever you be
Here's the best of wishes from Oz and me!

Your letters have been so gay,

And so many have come this year,
Placed end to end they would reach
From the Emerald City to here!

And when you have read this book,

I know you will write again,
For I'd like to hear what you think
Of the Medicine Man and Ben.

And this latest happening in Oz.

High doings! High times, sky high!
Imagine a ride on a real HIGH HORSE!
Ever hear of one? (Neither did I!)

But the Prince of the Ozure Isles

And Trot galloped off on one,
And his legs stretched up and his legs stretched down
And how that High Horse could run!

But so you can read it yourself,

I'd better stop now, and here.
Best luck to you all! Best love! and
I'll write a new book next year!

RUTH PLUMLY THOMPSON.

110 Schoolhouse Lane, Ardmore, Pennsylvania

 List of Chapters
1 The King of the Ozure Isles
2 The Golden Pear
3 The Strange Public Benefactor
4 Finding a Mortal Maiden
5 In the Cave of Quiberon
6 The Wicked Soothsayer
7 The Trials of Tattypoo
8 The Man in the Bottle
9 King of the Uplanders
10 High Times Up Town
11 The King of Cave City
12 Escape from Cave City
13 The Round-abouties
14 A Meeting of Celebrities
15 The Shutter Faces
16 The Lost Queen Returns
17 A Royal Welcome
18 The Tale of Tattypoo
19 Another Wishing Pill
20 Rulers East and North
 CHAPTER 1
The King of the Ozure Isles
Far to the North, walled in on all sides by the craggy slopes of the
Munchkin Mountains, lies the great Lost Lake of Orizon. And glittering
on its blue bosom, like a large and lovely necklace, rest the Ozure
Isles of Oz. Now Oz itself, this mysterious land about which we read
and hear so often, is a large oblong Kingdom divided into four smaller
Kingdoms with the Emerald City in the exact center. Here dwells
Ozma, the present ruler, a little fairy of great gentleness and power.
While all the Kingdoms in Oz are subject to Ozma, each has its own
special sovereign.
For instance, the Northern Country of the Gillikens is governed by the
Good Witch Tattypoo; The Red Land of the Quadlings, by Glinda the
Good Sorceress of the South; the Western and Yellow Empire of the
Winkies is under the kindly control of Nick Chopper, the Tin
Woodman of Oz; the blue Munchkin Country is governed by a King of
whom nothing much has been heard for many a long year. But be
that as it may, it is in the Munchkin Country that the great Lost Lake
of Orizon lies.

The waters of Orizon are deep, salt and dashing, so that it is more
like an inland sea than a lake. On ancient Oz maps Orizon is marked
by a large blue circle, but so steep and impenetrable are the paths
over the mountains, so beset with dangerous beasts and yawning
chasms, few travelers have glimpsed its sparkling waters, or the
islands rising so dazzlingly from its center. On Oz maps to-day,
Orizon is not shown at all, and the Lost Lake and its jeweled islands
have long since been forgotten by the merry inhabitants of Ozma's
Kingdom.
Except for the blue gulls that circle endlessly over the Sapphire City
of Cheeriobed, no one thinks of, or visits the Ozure Isles, at all. Yet in
the whole curious Land of Oz is no Kingdom more interesting or
delightful. There are five of the Ozure Isles, each small and sparkling
with flashing cliffs of iridescent gems and shores honeycombed with
caves and jeweled grottoes. Instead of pebbles, the beaches are
strewn with precious stones, opals, rubies and amethyst, turquoise
and pearls, but more numerous than any other of the precious stones
are the glittering sapphires that color the whole island realm with their
dazzling blue light, and from which Cheeriobed, the King, has
fashioned his capital City.
The Ozurians number one thousand and seven and are a tall fair
haired race of Munchkins. In olden days they were the happiest, most
care-free people in Oz, but that was before Mombi, the wicked witch
of the North, stole the young Queen and sent the monster Quiberon
to guard the waters of Orizon. Since then, the good King and his
subjects have been virtual prisoners on the islands. The great flock of
sea horses on which they were wont to ride to the mainland have
been destroyed by this pitiless monster and only when Quiberon is
sleeping dare the inhabitants venture down to the shore. You see in
aquariums, the sea horses that abound in our own tropical waters.
Well, the sea horses of Orizon were like that, only as large as Arabian
steeds, with flashing manes, great winged fins and powerful shining
tails. To ride upon their backs must have been more pleasurable than
anything I can imagine and their loss was one of the greatest griefs
this island monarch had suffered. One would wonder that so
unfortunate a King could endure life at all.
But Cheeriobed was so kind and gay and so naturally merry that even
in the face of all his misfortunes he was calm and uncomplaining and
often had whole days at a time when he forgot to be unhappy. Upon
his shimmering islands grew everything necessary for comfort and
ease and his subjects were light hearted and industrious and always
obedient to his desires. Then, to see the sun flashing on the jeweled
rocks and sparkling shores of the Ozure Isles by day and the moon
silvering the spires of the Sapphire City by night would lift the
heaviest heart. To further lighten the sorrows of this good King, there
was Philador, his son. Nowhere in the four Kingdoms of Oz lived a
gayer, handsomer and more companionable little fellow. Then too,
Cheeriobed was fortunate enough to have at his castle a juggler who
could balance ten chairs and some more things upon his chin, a
minstrel who knew a thousand songs, and a carpet that could beat
itself. So on the rare occasions when Quiberon lay dozing, life was
gay and happy in the blue castle.
On one such calm and sunny morning, Cheeriobed, his throne drawn
close to the great windows, was gazing dreamily off toward the
Munchkin Mountains. He was thinking of the old happy days and only
half listening to the strumming of Umtillio, the minstrel. At his side,
Toddledy, faithful scribe and Prime Moneyster was balancing the
castle accounts, while Palumbo, the court juggler, balanced seven
books, three ink wells and a gold chair on the tip of his nose.
"Has your Highness ever considered," panted Palumbo, speaking
with difficulty because of the books and ink bottles—"Has your
Highness ever considered how the noses and chins in this Kingdom
have been neglected? With a little training, I could teach the Islanders
to carry their entire possessions in this careless and interesting
fashion. Take your own nose for instance—" The King passed his
hand uneasily over his nose and Toddledy looking up from his
accounts began to mutter crossly under his breath. "Take your own
nose," continued Palumbo persuasively, "with a little practice you
could balance the fire tongs, the screen and the sapphire clock itself
upon the tip. We'll begin with a few simple exercises."
Paying no attention to Toddledy, the Court Juggler set down the
books and ink bottles and lifted the huge clock from the mantel. "Now
then," he puffed earnestly, "if your Highness will kneel and turn the
head to the left." Cheeriobed with a resigned wink at his Prime
Moneyster had just got down upon his knees, when a shuddering
explosion shook the castle. The jeweled chandeliers rattled like
castanets, ornaments left their accustomed places and flew through
the air, chairs slid into corners, and the carpet that could shake itself,
shook off three tables and a chair and rolling up so rapidly it caught
Umtillio unawares, reared stiffly on end and stood in a corner.
Cheeriobed had fallen heavily to the floor and small wonder. At the
first tremor Palumbo had dropped the sapphire clock upon his head
and taken to his heels.
"Quiberon!" quavered Toddledy, rushing over to the window and
drawing aside the blue curtains, "Great Totomos—what does he want
now?"
As if to answer the old Prime Moneyster the castle rocked more
violently than ever. The waters of Orizon below began to toss and
bubble, and presently from their churning depths rose the frightful
head of Mombi's monster. No sea serpent was ever uglier than
Quiberon, fire shot from his eye and smoke from his nostrils. He had
the head scales and talons of a dragon and the long hideous body of
a giant fear-fish. As Toddledy clutched at the curtains to keep from
falling, Quiberon sent a great cloud of smoke upward. It twisted,
curled and spiraled, forming itself finally into a long black sentence,
the words hanging like a dark threat in the clear morning air.
"Send a mortal maiden to wait upon me or in three days I will destroy
you utterly!" As Toddledy with smarting eyes read this monstrous
message, Quiberon showed all of his red tusks and dove beneath the
waves. At the same instant Akbad the Soothsayer came tearing into
the throne room.
"Dunce!" shrieked Akbad, shaking his long finger under Toddledy's
nose, "why do you stand there idle when the whole Kingdom is in
danger? The King is in danger, the Prince is in danger, I, Akbad the
Soothsayer, am in danger of being destroyed utterly. Utterly! Utterly!
Utterly!"
Racing around in a frenzied circle, Akbad began to tear out handfuls
of his hair and cast it upon the floor. His loud outcries aroused the
unconscious monarch. Rubbing the lump that the sapphire clock had
raised upon his forehead, Cheeriobed rose and unsteadily made his
way to the window. The black sentence was growing fainter but was
still legible. After reading it twice, the unhappy monarch groaned
heavily and dropped his head upon the sapphire sill. "Where are we
to find a mortal maiden and even if we do find one, who would
condemn her to such a fate?" mourned the King.
"Here comes Jewlia," panted Toddledy, ducking his head as a small
Ozurian came sailing through the window. Each of the Ozure
Islanders took turns serving Quiberon and the last to take charge of
his cavern was Jewlia, the Court Jeweler's daughter. Not caring for
land food Quiberon had never molested the keepers of his cavern. So
far, he had satisfied himself with devouring the sea horses,
preventing any of the Ozure Islanders from leaving the Islands and