Deck 29: Alterations of Pulmonary Function
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Deck 29: Alterations of Pulmonary Function
1
A 15 year old is diagnosed with restrictive lung disease caused by fibrosis.Which pulmonary function test finding is expected?
A) Increased compliance
B) Increased tidal volume
C) Decreased respiratory rate
D) Decreased functional residual capacity
A) Increased compliance
B) Increased tidal volume
C) Decreased respiratory rate
D) Decreased functional residual capacity
Decreased functional residual capacity
2
A 50 year old presents with hypotension, hypoxemia, and tracheal deviation to the left.Tests reveal that the air pressure in the pleural cavity exceeds barometric pressure in the atmosphere.Based upon these assessment findings, what does the nurse suspect the patient is experiencing?
A) Pleural effusion
B) Tension pneumothorax
C) Open pneumothorax
D) Transudative pneumothorax
A) Pleural effusion
B) Tension pneumothorax
C) Open pneumothorax
D) Transudative pneumothorax
Tension pneumothorax
3
As a result of a severe head injury, a patient is now experiencing respiratory abnormalities characterized by alternating periods of deep and shallow breathing with periods of apnea.What term should the nurse use when charting this condition?
A) Cheyne-Stokes
B) Frank-Starling
C) Apnea
D) Orthopnea
A) Cheyne-Stokes
B) Frank-Starling
C) Apnea
D) Orthopnea
Cheyne-Stokes
4
A 57 year old presents with cough, sputum production, dyspnea, and decreased lung volume and is diagnosed with pneumoconiosis.When taking the patient's history, which finding is the most probable cause of the illness?
A) Inhalation of silica
B) Autoimmune disease
C) Allergic reactions
D) Flail chest
A) Inhalation of silica
B) Autoimmune disease
C) Allergic reactions
D) Flail chest
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5
A patient's arterial blood gas reveals decreased carbon dioxide (CO2) levels.What is the most likely cause of this situation?
A) Hyperventilation
B) Hypoventilation
C) Apnea
D) Cyanosis
A) Hyperventilation
B) Hypoventilation
C) Apnea
D) Cyanosis
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6
A 26 year old recently underwent surgery and is now experiencing dyspnea, cough, fever, and leukocytosis.Tests reveal a collapsed lung caused by the removal of air from obstructed alveoli.Which term is used to document this condition?
A) Compression atelectasis
B) Bronchiectasis
C) Absorption atelectasis
D) Hypoventilation
A) Compression atelectasis
B) Bronchiectasis
C) Absorption atelectasis
D) Hypoventilation
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7
The most common cause of pulmonary edema is:
A) right heart failure.
B) left heart failure.
C) asthma.
D) lung cancer.
A) right heart failure.
B) left heart failure.
C) asthma.
D) lung cancer.
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8
Which assessment findings will the nurse observe in a patient diagnosed with severe pulmonary edema?
A) Thick mucous secretions
B) Pink, frothy sputum
C) Hypocapnia
D) Wheezing
A) Thick mucous secretions
B) Pink, frothy sputum
C) Hypocapnia
D) Wheezing
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9
When giving report, what term should the nurse use to describe the coughing up of bloody secretions?
A) Hematemesis
B) Cyanosis
C) Rhinitis
D) Hemoptysis
A) Hematemesis
B) Cyanosis
C) Rhinitis
D) Hemoptysis
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10
A low ventilation-perfusion ratio of the lung will result in:
A) increased dead space.
B) shunting.
C) alveolar collapse.
D) bronchoconstriction.
A) increased dead space.
B) shunting.
C) alveolar collapse.
D) bronchoconstriction.
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11
A 60 year old with a history of cirrhosis presents with dyspnea, impaired ventilation, and pleural pain.A diagnosis of pleural effusion is made, and a watery fluid is drained.When giving report, the nurse will refer to this fluid as:
A) exudative.
B) purulent.
C) infected.
D) transudative.
A) exudative.
B) purulent.
C) infected.
D) transudative.
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12
What type of breathing will the nurse observe while assessing a patient experiencing both metabolic acidosis and Kussmaul respirations?
A) Audible wheezing or stridor
B) Increased rate, large tidal volumes, and no expiratory pause
C) Rapid respirations with periods of apnea
D) Very slow inhalations and rapid expirations
A) Audible wheezing or stridor
B) Increased rate, large tidal volumes, and no expiratory pause
C) Rapid respirations with periods of apnea
D) Very slow inhalations and rapid expirations
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13
A 10 year old develops pneumonia.Physical exam reveals subcostal and intercostal retractions.The child reports that breathing is difficult with feelings that, "I cannot get enough air." What term should the nurse use to document this condition?
A) Cyanosis
B) Dyspnea
C) Hyperpnea
D) Orthopnea
A) Cyanosis
B) Dyspnea
C) Hyperpnea
D) Orthopnea
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14
An 80 year old develops pneumonia in the hospital.An assessment identifies that the patient is cyanotic and tachycardic and has developed a fever and a cough.Chest x-ray reveals pus in the pleural space.This symptomology supports which medical diagnosis?
A) Empyema
B) Emphysema
C) Pleurisy
D) Chyle
A) Empyema
B) Emphysema
C) Pleurisy
D) Chyle
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15
Which of the following lab values would the nurse expect in a patient who has sustained trauma to the lungs and chest wall and is experiencing respiratory failure?
A) Electrolyte imbalances
B) Elevated PaCO2
C) Low hematocrit
D) Elevated pH
A) Electrolyte imbalances
B) Elevated PaCO2
C) Low hematocrit
D) Elevated pH
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16
A nurse is reviewing the results of an arterial blood gas (ABG) and finds reduced oxygenation of arterial blood.What term should the nurse use to describe this condition?
A) Ischemia
B) Hypoxia
C) Hypoxemia
D) Hypocapnia
A) Ischemia
B) Hypoxia
C) Hypoxemia
D) Hypocapnia
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17
What phrase describes the condition in which a series of alveoli in the left lower lobe receive adequate ventilation but lack adequate perfusion?
A) A right-to-left shunt
B) Alveolar dead space
C) A low ventilation-perfusion ratio
D) Pulmonary hypotension
A) A right-to-left shunt
B) Alveolar dead space
C) A low ventilation-perfusion ratio
D) Pulmonary hypotension
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18
Which organism does the nurse suspect is the most likely cause of empyema?
A) Virus
B) Staphylococcus aureus
C) Fungus
D) Moraxella catarrhalis
A) Virus
B) Staphylococcus aureus
C) Fungus
D) Moraxella catarrhalis
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19
A 65 year old diagnosed with emphysema presents to the ER for difficulty breathing.Physical exam reveals both bluish skin and mucous membranes.What term will the nurse use to document these observations?
A) Cyanosis
B) Hemoptysis
C) Hematemesis
D) Ischemia
A) Cyanosis
B) Hemoptysis
C) Hematemesis
D) Ischemia
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20
A 20 year old presents reporting difficulty breathing when lying down.What term should the nurse use to document this condition?
A) Dyspnea
B) Orthopnea
C) Apnea
D) Tachypnea
A) Dyspnea
B) Orthopnea
C) Apnea
D) Tachypnea
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21
What is the most likely cause of chronic bronchitis in a 25 year old?
A) Chronic asthma
B) Air pollution
C) Cigarette smoke
D) Recurrent pneumonias
A) Chronic asthma
B) Air pollution
C) Cigarette smoke
D) Recurrent pneumonias
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22
A 60 year old undergoes surgery for a bone fracture.Which nursing measure would be most effective for preventing pulmonary embolism (PE) in this patient?
A) Ensure that patient uses supplemental oxygen.
B) Prevent deep vein thrombosis formation.
C) Check hematocrit and hemoglobin levels frequently during the postoperative period.
D) Promote aggressive fluid intake.
A) Ensure that patient uses supplemental oxygen.
B) Prevent deep vein thrombosis formation.
C) Check hematocrit and hemoglobin levels frequently during the postoperative period.
D) Promote aggressive fluid intake.
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23
Airway hyperresponsiveness in asthma is related to:
A) increased sympathetic nervous system response.
B) the release of stress hormones.
C) exposure to an allergen causing mast cell degranulation.
D) hereditary decrease in IgE responsiveness.
A) increased sympathetic nervous system response.
B) the release of stress hormones.
C) exposure to an allergen causing mast cell degranulation.
D) hereditary decrease in IgE responsiveness.
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24
The patient generally acquires nosocomial pneumonia:
A) at day care centers.
B) on airplanes.
C) during hospitalization.
D) in the winter season.
A) at day care centers.
B) on airplanes.
C) during hospitalization.
D) in the winter season.
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25
A 70 year old hospitalized for a pelvic fracture develops a pulmonary embolism.The nurse realizes this embolus is most commonly composed of:
A) fat.
B) air.
C) tissue fragment.
D) blood clot.
A) fat.
B) air.
C) tissue fragment.
D) blood clot.
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26
A 20-year history of smoking causes airways to be obstructed as a result of:
A) excessive mucus production.
B) loss of elastic recoil.
C) infection and inflammation.
D) airway edema.
A) excessive mucus production.
B) loss of elastic recoil.
C) infection and inflammation.
D) airway edema.
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27
A 10 year old is brought to the ER with prolonged bronchospasm and severe hypoxemia.The symptomology supports which diagnosis?
A) Exercise-induced asthma
B) Chronic obstructive pulmonary disease (COPD)
C) Status asthmaticus
D) Bronchiectasis
A) Exercise-induced asthma
B) Chronic obstructive pulmonary disease (COPD)
C) Status asthmaticus
D) Bronchiectasis
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28
A 22 year old presents with chronic bronchitis.Tests reveal closure of the airway during expiration.This condition is most likely caused by:
A) thick mucus from hypertrophied glands.
B) ventilation-perfusion mismatch.
C) hyperventilation.
D) thinning smooth muscle in the bronchioles.
A) thick mucus from hypertrophied glands.
B) ventilation-perfusion mismatch.
C) hyperventilation.
D) thinning smooth muscle in the bronchioles.
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29
A 30 year old is diagnosed with emphysema.Changes in this patient's lungs are caused by:
A) viral infections.
B) destruction of alveolar macrophages.
C) alpha1-antitrypsin deficiency.
D) fibrotic lung disease.
A) viral infections.
B) destruction of alveolar macrophages.
C) alpha1-antitrypsin deficiency.
D) fibrotic lung disease.
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30
A 60 year old with a 25-year history of smoking is diagnosed with emphysema.Assessment shows an increased anterior-posterior chest diameter.The nurse attributes this finding to:
A) air trapping.
B) decreased inspiratory reserve volumes.
C) increased flow rates.
D) alveolar destruction.
A) air trapping.
B) decreased inspiratory reserve volumes.
C) increased flow rates.
D) alveolar destruction.
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31
A 50-year-old male is diagnosed with pulmonary embolism (PE).Which of the following symptoms most likely occurred before treatment is initiated?
A) Dry cough and inspiratory crackles
B) Shallow respirations and wheezing
C) Chest pain and shortness of breath
D) Kussmaul respirations and back pain
A) Dry cough and inspiratory crackles
B) Shallow respirations and wheezing
C) Chest pain and shortness of breath
D) Kussmaul respirations and back pain
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32
Individuals with a recent diagnosis of emphysema should be assessed for which most common presenting factor?
A) A productive cough
B) Cyanosis
C) Dyspnea
D) Cor pulmonale
A) A productive cough
B) Cyanosis
C) Dyspnea
D) Cor pulmonale
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33
Airway obstruction contributing to increased airflow resistance and hypoventilation in asthma is caused by:
A) type II alveolar cell injury and decreased surfactant.
B) alveolar fibrosis and pulmonary edema.
C) mucous secretion, bronchoconstriction, and airway edema.
D) collapse of the cartilaginous rings in the bronchi.
A) type II alveolar cell injury and decreased surfactant.
B) alveolar fibrosis and pulmonary edema.
C) mucous secretion, bronchoconstriction, and airway edema.
D) collapse of the cartilaginous rings in the bronchi.
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34
The organism that causes tuberculosis is a:
A) bacterium.
B) fungus.
C) virus.
D) parasite.
A) bacterium.
B) fungus.
C) virus.
D) parasite.
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35
The patient diagnosed with tuberculosis can transmit this disease through:
A) skin contact.
B) fecal-oral contact.
C) airborne droplets.
D) blood transfusions.
A) skin contact.
B) fecal-oral contact.
C) airborne droplets.
D) blood transfusions.
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36
A 42 year old presents with dyspnea; rapid, shallow breathing; inspiratory crackles; decreased lung compliance; and hypoxemia.Tests reveal a fulminant form of respiratory failure characterized by acute lung inflammation and diffuse alveolocapillary injury.What is the most likely diagnosis supported by the patient's condition?
A) Acute respiratory distress syndrome (ARDS)
B) Sarcoidosis
C) Postoperative respiratory failure
D) Malignant respiratory failure
A) Acute respiratory distress syndrome (ARDS)
B) Sarcoidosis
C) Postoperative respiratory failure
D) Malignant respiratory failure
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37
Asthma is thought to be caused by:
A) an autosomal recessive trait.
B) autoimmunity.
C) excessive use of antibiotics as a young child.
D) interactions between genetic and environmental factors.
A) an autosomal recessive trait.
B) autoimmunity.
C) excessive use of antibiotics as a young child.
D) interactions between genetic and environmental factors.
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38
Which of the following patients is at highest risk for developing pulmonary embolism (PE)?
A) A 21-year-old male with a hemophilia bleeding disorder
B) A 28-year-old woman who had a baby 6 months earlier
C) A 36-year-old woman with a history of alcohol abuse who is recovering from a gastric ulcer
D) A 72-year-old male who is recovering from hip replacement surgery in the hospital
A) A 21-year-old male with a hemophilia bleeding disorder
B) A 28-year-old woman who had a baby 6 months earlier
C) A 36-year-old woman with a history of alcohol abuse who is recovering from a gastric ulcer
D) A 72-year-old male who is recovering from hip replacement surgery in the hospital
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39
Aspiration of oral secretions increases a patient's risk for which complication?
A) Pneumonia
B) Bronchiectasis
C) Pneumothorax
D) Emphysema
A) Pneumonia
B) Bronchiectasis
C) Pneumothorax
D) Emphysema
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40
Pneumonia is caused by:
A) use of anesthetic agents in surgery.
B) atelectasis.
C) chronic lung changes seen with aging.
D) viral or bacterial infections.
A) use of anesthetic agents in surgery.
B) atelectasis.
C) chronic lung changes seen with aging.
D) viral or bacterial infections.
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41
A 50 year old is diagnosed with lung cancer.The health history includes a 30-year history of smoking, exposure to air pollution, asbestos, and radiation.What had the greatest impact on the development of his cancer?
A) Radiation
B) Cigarette smoke
C) Asbestos
D) Air pollution
A) Radiation
B) Cigarette smoke
C) Asbestos
D) Air pollution
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42
Which is a characteristic of idiopathic pulmonary arterial hypertension (IPAH)? (Select all that apply.)
A) Male gender
B) Fatigue
C) Dyspnea
D) Jugular vein distention
E) Weight gain
A) Male gender
B) Fatigue
C) Dyspnea
D) Jugular vein distention
E) Weight gain
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43
Which assessment finding would be expected in pulmonary embolism (PE)? (Select all that apply.)
A) Chest pain
B) Tachycardia
C) Tachypnea
D) Fever
E) Hemoptysis
F)None of above
A) Chest pain
B) Tachycardia
C) Tachypnea
D) Fever
E) Hemoptysis
F)None of above
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