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Download Clinical Manifestations Assessment of Respiratory Disease 6th Edition Jardins Test Bank all chapters
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Chapter 10: Recording Skills: The Basis for Data Collection, Organization, Assessment
Skills, and Treatment Plans
MULTIPLE CHOICE
1. According to the chapter text, which of the following are basic methods to record
assessment data?
1. Computer documentation
2. Charting by exception
3. Source-oriented record
4. Problem-oriented medical record
a. 1, 2
b. 2, 3
c. 1, 3, 4
d. 1, 2, 3, 4
ANS: C
Widely accepted methods to record patient data include computer documentation,
source-oriented record (also called a traditional chart), and the problem-oriented medical
record. Charting by exception is not widely used and not presented in the chapter.
REF: p. 155
2. A patient who had pneumonia, and her family, are suing the hospital, physician, and
respiratory therapist. How can the patient’s medical care and treatment be proved?
a. Care is documented in the chart.
b. The patient’s testimony
c. The physician’s testimony
d. The respiratory therapist’s testimony
ANS: A
The patient’s medical chart is a legal document accepted in court. While testimony is
valuable, people can forget and lie. What is documented in the chart is considered to be
proof.
REF: p. 155
REF: p. 155
5. When reviewing a SOAPIER progress note, all of the following would be found in the O
area EXCEPT:
a. hemodynamic data.
b. patient’s admission complaint.
c. blood pressure.
d. sputum production.
ANS: B
The O stands for objective data such as hemodynamic data, blood pressure, sputum
production, etc. The patient’s admission complaint would be found in the history.
REF: p. 155
REF: p. 156
REF: p. 157
REF: p. 157
9. Many respiratory therapists now use portable devices for bedside computer charting. These
units are referred to as:
a. point-of-care systems.
b. laptop computers.
c. i-pods.
d. MP3 players.
ANS: A
Point-of-care hand-held computers are used for charting at the bedside. Laptop computers
may be dedicated for use with a portable pulmonary function testing unit. An i-pod is a
personal communication device, and an MP3 player is a personal music device.
REF: p. 157
10. Which of the following is a Health Insurance Portability and Accountability Act (HIPAA)
rule?
a. A bank can check for a preexisting condition.
b. The patient controls access to his/her medical records.
c. Psychotherapy and medical records are treated equally.
d. An employer can check for a preexisting condition.
ANS: B
With the HIPAA, the patient controls access to his/her medical records. Banks and
employers are prevented from accessing the patient’s medical information without
permission. Psychotherapy records are given extra protection.
Series I. Nemocera.—In this section the habit occurs in no less than five
families, viz.:
Blepharoceridae. Curupira; in the female only; larva aquatic.
Culicidae. Culex, Mosquitoes; in the female only; other genera, with one or
two exceptions, do not suck blood; larvae aquatic.
Chironomidae. Ceratopogon, Midge; in the female only; exceptional even
in the genus, though the habit is said to exist in one or two less
known, allied genera; larval habits not certain; often aquatic; in C.
bipunctatus the larva lives under moist bark.
Psychodidae. Phlebotomus: in the female only (?); quite exceptional in the
family; larva aquatic or in liquid filth.
Simuliidae. Simulium, sand-flies; general in the family (?), which, however,
is a very small one; larva aquatic, food probably mixed vegetable and
animal microscopic organisms.
Series II. Brachycera. Tabanidae. Gad-flies: apparently general in the
females of this family; the habits of the exotic forms but little known; in
the larval state, scarcely at all known; some are aquatic.
Series IV. Cyclorrhapha Schizophora: Stomoxys, Haematobia; both sexes
(?); larvae in dung. [The Tse-tse flies, Glossina, are placed in this family,
though their mode of parturition is that of the next section].
Series V. Pupipara. The habit of blood-sucking is probably common to all the
group and to both sexes. The flies, with one exception, frequent
Vertebrates; in many cases living entirely on their bodies, and
apparently imbibing much blood; the larvae are nourished inside the
flies, not on the imbibed blood, but on a milky secretion from the mother.
Sub-Order Aphaniptera. Fleas. The habit of blood-sucking is common to all
the members and to both sexes. The larvae live on dried animal matter.
Thirty years or more ago the Russian naturalist, Wagner, made the
very remarkable discovery that the larva of a Cecidomyiid produces
young; and it has since been found by Meinert and others that this
kind of paedogenesis occurs in several species of the genera
Miastor and Oligarces. The details are briefly as follows:—A female
fly lays a few, very large, eggs, out of each of which comes a larva,
that does not go on to the perfect state, but produces in its interior
young larvae that, after consuming the interior of the body of the
parent larva, escape by making a hole in the skin, and thereafter
subsist externally in a natural manner. This larval reproduction may
be continued for several generations, through autumn, winter, and
spring till the following summer, when a generation of the larvae
goes on to pupation and the mature, sexually perfect fly appears.
Much discussion has taken place as to the mode of origination of the
larvae; Carus and others thought they were produced from the
rudimental, or immature ovaries of the parent larva. Meinert, who
has made a special study of the subject,[370] finds, however, that this
is not the case; in the reproducing larva of the autumn there is no
ovary at all; in the reproducing larvae of the spring-time rudimentary
ovaries or testes, as the case may be, exist; the young are not,
however, produced from these, but from germs in close connection
with the fat-body. In the larvae that go on to metamorphosis the
ovaries continue their natural development. It would thus appear that
the fat-body has, like the leaf of a Begonia, under certain
circumstances, the power, usually limited to the ovaries, of producing
complete and perfect individuals.
The habits of many of the larvae are very peculiar, owing to their
spinning or exuding a mucus, that reminds one of snail-slime; they
are frequently gregarious, and some of them have likewise, as we
shall subsequently mention, migratory habits. Perris has described
the very curious manner in which Sciophila unimaculata forms its
slimy tracks;[371] it stretches its head to one side, fixes the tip of a
drop of the viscous matter from its mouth to the surface of the
substance over which it is to progress, bends its head under itself so
as to affix the matter to the lower face of its own body; then stretches
its head to the other side and repeats the operation, thus forming a
track on which it glides, or perhaps, as the mucus completely
envelops its body, we should rather call it a tunnel through which the
maggot slips along. According to the description of Hudson[372] the
so-called New Zealand Glow-worm is the larva of Boletophila
luminosa; it forms webs in dark ravines, along which it glides, giving
a considerable amount of light from the peculiarly formed terminal
segment of the body. This larva is figured as consisting of about
twenty segments. The pupa is provided with a very long, curiously-
branched dorsal structure: the fly issuing from the pupa is strongly
luminous, though no use can be discovered for the property either in
it or in the larva. The larva of the Australian Ceroplatus mastersi is
also luminous. Another very exceptional larva is that of Epicypta
scatophora; it is of short, thick form, like Cecidomyiid larvae, and has
a very remarkable structure of the dorsal parts of the body; by
means of this its excrement, which is of a peculiar nature, is spread
out and forms a case for enveloping and sheltering the larva.
Ultimately the larval case is converted into a cocoon for pupation.
This larva is so different from that of other Mycetophilidae, that Perris
was at first unable to believe that the fly he reared really came from
this unusually formed larva. The larva of Mycetobia pallipes (Fig.
221) offers a still more remarkable phenomenon, inasmuch as it is
amphipneustic instead of peripneustic (that is to say, it has a pair of
stigmata at the termination of the body and a pair on the first thoracic
segment instead of the lateral series of pairs we have described as
normal in Mycetophilidae). This larva lives in company with the
amphipneustic larva of Rhyphus, a fly of quite another family, and
the Mycetobia larva so closely resembles that of the Rhyphus, that it
is difficult to distinguish the two. This anomalous larva gives rise, like
the exceptional larva of Epicypta, to an ordinary Mycetophilid fly.[373]
But the most remarkable of all the Mycetophilid larvae are those of
certain species of Sciara, that migrate in columns, called by the
Germans, Heerwurm. The larva of Sciara militaris lives under layers
of decomposing leaves in forests, and under certain circumstances,
migrates, sometimes perhaps in search of a fresh supply of food,
though in some cases it is said this cannot be the reason. Millions of
the larvae accumulate and form themselves by the aid of their
viscous mucus into great strings or ribbons, and then glide along like
serpents: these aggregates are said to be sometimes forty to a
hundred feet long, five or six inches wide, and an inch in depth. It is
said that if the two ends of one of these processions be brought into
contact, they become joined, and the monstrous ring may writhe for
many hours before it can again disengage itself and assume a
columnar form. These processional maggots are met with in
Northern Europe and the United States, and there is now an
extensive literature about them.[374] Though they sometimes consist
of almost incredible numbers of individuals, yet it appears that in the
Carpathian mountains the assemblages are usually much smaller,
being from four to twenty inches long. A species of Sciara is the
"Yellow-fever fly" of the Southern United States. It appears that it has
several times appeared in unusual numbers and in unwonted
localities at the same time as the dreaded disease, with which it is
popularly supposed to have some connection.
There are more than 1000 species of these flies known, and many
genera. They form three sub-families, which are by some considered
distinct families, viz.: Ptychopterinae, Limnobiinae or Tipulidae
Brevipalpi, Tipulinae or Tipulidae Longipalpi.