National Physical Therapy Examination (NPTE) Practice Exam

What is the correct position for performing postural drainage techniques for the superior segments of the lower lobe in a patient with cystic fibrosis?

1. Head down on the left side, with one-quarter turn from supine

2. Sitting, leaning over a folded pillow at a 30-degree angle

3. Prone with two pillows under the hips

4. Supine with two pillows under knees

The correct answer is: Prone with two pillows under the hips

The correct position for performing postural drainage techniques for the superior segments of the lower lobe is to have the patient in a prone position with two pillows under the hips. This position is ideal because it facilitates drainage from the superior segments of the lower lobes of the lungs, which are located horizontally and higher than the other segments. By placing the patient in this position, gravity assists in the movement of mucus toward the trachea, making it easier for the patient to expel it. The use of two pillows under the hips elevates the pelvis, creating the necessary slope for effective drainage, ensuring that the secretions can be mobilized effectively through the airways. This is particularly important for patients with cystic fibrosis, who often have thick mucus that needs to be cleared to maintain lung function. Other positions may not effectively target the superior segments or may lead to ineffective drainage. For instance, leaning over a folded pillow may provide some benefits for other lung regions, but it is not optimal for the specific requirement of draining the superior segments of the lower lobes. Similarly, the supine position is not suitable as it does not provide the necessary gravitational assistance for drainage from those apex regions effectively.