National Physical Therapy Examination (NPTE) Practice Exam

A patient with right lower lobe atelectasis and no adventitious breath sounds would benefit most from which intervention?

1. Percussion and vibration in left Trendelenburg position

2. Vigorous percussion and vibration with nebulizer

3. Spirometry with segmental breathing exercises

4. Practice of incisional splinting for coughing techniques

The correct answer is: Spirometry with segmental breathing exercises

The correct choice is spirometry with segmental breathing exercises, as this intervention is particularly effective for the management of atelectasis. Atelectasis in the right lower lobe suggests that there is a collapse or incomplete expansion of this segment of the lung, which can occur due to various factors, including reduced lung volume from pain, immobility, or secretions. Spirometry encourages the patient to take deep, full breaths, which can help to reinflate the collapsed alveoli in the affected lobe. Segmental breathing exercises target the specific area of the lung that is affected, promoting better expansion of the right lower lobe and improving gas exchange. By using these exercises, the patient is able to mobilize secretions and promote lung re-expansion more effectively than with passive techniques alone. Other interventions such as percussion and vibration, while useful in other contexts, may not provide the same direct benefit in facilitating lung re-expansion without accompanying difficulties like airway secretions or ineffective ventilation. Similarly, the practice of incisional splinting for coughing techniques does not directly address the need to expand the atelectatic area. Therefore, using spirometry along with targeted breathing exercises is the most beneficial approach in this situation.