Deck 26: Alterations of Pulmonary Function

Question 1

A 28-year-old male reports to his primary care provider that he has had a cold for a week and is coughing up bloody secretions.When giving report,what term should the nurse use to describe this condition?

A) Hematemesis
B) Cyanosis
C) Rhinitis
D) Hemoptysis

Answer 1

Hemoptysis

Question 2

A 47-year-old male is diagnosed with pulmonary edema.Which assessment findings will the nurse observe?

A) Thick mucus secretions
B) Pink, frothy sputum
C) Hypocapnia
D) Wheezing

Answer 2

Pink, frothy sputum

Question 3

A nurse is reviewing the results of an 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

Answer 3

Hypoxemia

Question 4

A 30-year-old male is involved in a motor vehicle accident and sustains trauma to the lungs and chest wall.He experiences respiratory failure.Which of the following lab values would the nurse expect?

A) Electrolyte imbalances
B) Elevated PaCO₂
C) Low hematocrit
D) Elevated pH

Question 5

Which patient would the nurse assess for paroxysmal nocturnal dyspnea (PND)? A patient with:

A) Pulmonary fibrosis
B) Asthma
C) Left ventricular failure
D) Hypotension

Question 6

A 20-year-old male presents to his primary care provider reporting difficulty breathing when lying down.What term should the nurse use to document this condition?

A) Dyspnea
B) Orthopnea
C) Apnea
D) Tachypnea

Question 7

A nurse remembers a low ventilation-perfusion ratio results in:

A) Increased dead space
B) Shunting
C) Alveolar collapse
D) Bronchoconstriction

Question 8

A 30-year-old female received a severe head injury in a motor vehicle accident.She 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

Question 9

A 65-year-old female with emphysema presents to the ER for difficulty breathing.Physical exam reveals bluish skin and mucous membranes.How should the nurse chart this condition? Patient has:

A) Cyanosis
B) Hemoptysis
C) Hematemesis
D) Ischemia

Question 10

A 50-year-old diabetic male did not take his medication and is now in metabolic acidosis.He is experiencing Kussmaul respirations.What type of breathing will the nurse observe upon assessment?

A) Audible wheezing or stridor
B) A slightly increased ventilatory rate, large tidal volumes, and no expiratory pause
C) Rapid respirations with periods of apnea
D) Very slow inhalations and rapid expirations

Question 11

A 26-year-old female recently underwent surgery and is now experiencing dyspnea,cough,fever,and leukocytosis.Tests reveal that she has a collapsed lung caused by removal of air from obstructed alveoli.What condition will the nurse observe on the chart?

A) Compression atelectasis
B) Bronchiectasis
C) Absorption atelectasis
D) Hypoventilation

Question 12

A nurse is teaching staff about pulmonary edema.Which information should the nurse include? The most common cause of pulmonary edema is:

A) Right heart failure
B) Left heart failure
C) Asthma
D) Lung cancer

Question 13

A 50-year-old male 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

Question 14

A 60-year-old female 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

Question 15

A 65-year-old male recently had a cerebrovascular accident that resulted in dysphagia.He now has aspiration of gastric contents.The nurse assesses the patient for which complication?

A) Pneumonia
B) Bronchiectasis
C) Pneumothorax
D) Emphysema

Question 16

A 20-year-old male is in acute pain.An arterial blood gas reveals decreased carbon dioxide (CO₂)levels.Which of the following does the nurse suspect is the most likely cause?

A) Hyperventilation
B) Hypoventilation
C) Apnea
D) Cyanosis

Question 17

A 45-year-old male undergoes lung transplantation.He now suffers from airway occlusion secondary to fibrosis.Which diagnosis will the nurse see on the chart?

A) Compression atelectasis
B) Bronchiectasis
C) Bronchiolitis
D) Bronchiolitis obliterans

Question 18

A 10-year-old female develops pneumonia.Physical exam reveals subcostal and intercostal retractions.She reports that breathing is difficult and she feels she cannot get enough air.What term should the nurse use to document this condition?

A) Cyanosis
B) Dyspnea
C) Hyperpnea
D) Orthopnea

Question 19

A group of mountain climbers experience confusion,tachycardia,edema,and decreased renal output after climbing Mount Rainier.A nurse recalls this condition is caused by:

A) Bronchoconstriction
B) Hypoventilation
C) Decreased inspired oxygen
D) Diffusion abnormalities

Question 20

When the pulmonologist discusses the condition in which a series of alveoli in the left lower lobe receive adequate ventilation but do not have adequate perfusion,which statement indicates the nurse understands this condition? When this occurs in a patient it is called:

A) A right-to-left shunt
B) Alveolar dead space
C) A low ventilation-perfusion ratio
D) Pulmonary hypotension

Question 21

A 60-year-old female with emphysema is having difficulty expiring a given volume of air.When giving report,the nurse will relay that the patient is most likely experiencing _____ pulmonary disease.

A) Restrictive
B) Obstructive
C) Atelectatic
D) Pleuritic

Question 22

A 53-year-old male with a 20-year history of smoking is diagnosed with emphysema.When a staff member asks why the patient's airways are obstructed,how should the nurse respond? The airways are obstructed because of:

A) Excessive mucus production
B) Loss of elastic recoil
C) Infection and inflammation
D) Airway edema

Question 23

An 80-year-old female develops pneumonia in the hospital.She becomes cyanotic,tachycardic,and develops a fever and cough.Chest x-ray reveals pus in the pleural space.Which of the following is the most likely diagnosis documented on the chart?

A) Empyema
B) Emphysema
C) Pleurisy
D) Chyle

Question 24

A 22-year-old female presents with chronic bronchitis.Tests reveal closure of the airway during expiration.While planning care,a nurse recalls 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

Question 25

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

Question 26

A 57-year-old male presents with cough,sputum production,dyspnea,and decreased lung volume.He is diagnosed with pneumoconiosis.When taking the patient's history,which finding is the most probable cause of his illness?

A) Inhalation of silica, asbestos, mica
B) Autoimmune disease
C) Allergic reactions
D) Flail chest

Question 27

Which of the following shows a correct cause and effect sequence in the development of acute respiratory distress syndrome (ARDS)?

A) Impaired alveolar compliance causing decreased surfactant production
B) Alveolocapillary membrane injury causing a massive inflammatory response
C) Hyaline membrane formation and fibrosis causing pulmonary edema
D) Increased alveolocapillary membrane permeability causing metabolic alkalosis

Question 28

A 42-year-old female 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.Which of the following is the most likely diagnosis the nurse will observe on the chart?

A) Acute respiratory distress syndrome (ARDS)
B) Sarcoidosis
C) Postoperative respiratory failure
D) Malignant respiratory failure

Question 29

A 25-year-old male presents with chronic bronchitis of 5 months' duration.When obtaining the patient's history,which of the following findings is most likely to cause this condition?

A) Chronic asthma
B) Air pollution
C) Cigarette smoke
D) Recurrent pneumonias

Question 30

A nurse is preparing to teach the staff about asthma.Which information should the nurse include? Airway hyper-responsiveness 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

Question 31

A 10-year-old male is brought to the ER with prolonged bronchospasm and severe hypoxemia.The most likely diagnosis on the chart is:

A) Exercise-induced asthma
B) Chronic obstructive pulmonary disease (COPD)
C) Status asthmaticus
D) Bronchiectasis

Question 32

A nurse is preparing to teach the staff about asthma.Which information should the nurse include? 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) Mucus secretion, bronchoconstriction, and airway edema
D) Collapse of the cartilaginous rings in the bronchi

Question 33

A nurse recalls asthma is classified by:

A) Pathophysiologic differences
B) Clinical severity
C) Genetic traits
D) Treatment outcomes

Question 34

A 15-year-old female is diagnosed with restrictive lung disease caused by fibrosis.The patient had a pulmonary functions test.Which of the following findings is expected?

A) Increased compliance
B) Increased tidal volume
C) Decreased respiratory rate
D) Decreased functional residual capacity

Question 35

A 25-year-old male presents with chronic bronchitis of 5 months' duration.Which of the following is the most significant concern for the nurse to monitor in this patient?

A) Left heart failure
B) Pulmonary embolus
C) Immunosuppression
D) Recurrent pulmonary infections

Question 36

A 53-year-old male with a 20-year history of smoking is diagnosed with emphysema.When the nurse is asked what causes this,what is the nurse's best response? Changes in his lungs are caused by:

A) Viral infections
B) Destruction of alveolar macrophages
C) Alpha-1-antitrypsin deficiency
D) Fibrotic lung disease

Question 37

When the nurse is asked what causes asthma,how should the nurse respond? 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

Question 38

A 60-year-old female with a 25-year history of smoking is diagnosed with emphysema.She has 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

Question 39

A 54-year-old male is diagnosed with empyema.Upon receiving and reviewing the culture result,which organism does the nurse suspect is the most likely cause?

A) Virus
B) Staphylococcus aureus
C) Klebsiella pneumonia
D) Moraxella catarrhalis

Question 40

A patient asks what causes pneumonia.How should the nurse reply? 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

Question 41

A 50-year-old male with a 30-year history of smoking was diagnosed with lung cancer.He was previously exposed to air pollution,asbestos,and radiation at his job.Which of the following should the nurse realize had the greatest impact on the development of his cancer?

A) Radiation
B) Cigarette smoke
C) Asbestos
D) Air pollution

Question 42

An 80-year-old female is in the hospital for a bone fracture.While there she develops a large,nonlethal pulmonary embolus.Which of the following is a direct result of the obstruction to pulmonary blood flow?

A) Pulmonary hypertension
B) Systemic hypertension
C) Pulmonary edema
D) Risk of cerebral emboli

Question 43

Which of the following assessment findings 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

Question 44

A 70-year-old female is in the hospital for pelvic fracture.She develops pulmonary thromboembolism.The nurse realizes this embolus is composed of:

A) Fat
B) Air
C) Tissue fragment
D) Blood clot

Question 45

A 60-year-old male undergoes surgery for a bone fracture.Which of the following nursing measures 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.

Question 46

Which of the following patients is at highest risk for developing pulmonary embolism (PE)?

A) 21-year-old male with a hemophilia bleeding disorder
B) 28-year-old woman who had a baby 6 months earlier
C) 36-year-old woman with a history of alcohol abuse who is recovering from a gastric ulcer
D) 72-year-old male who is recovering from hip replacement surgery in the hospital

Question 47

A 30-year-old male prison inmate contracted tuberculosis during an outbreak.While planning interactions,the nurse realizes the patient can transmit this disease through:

A) Skin contact
B) Fecal-oral contact
C) Airborne droplets
D) Blood transfusions

Question 48

A 60-year-old male with a 40-year history of smoking presents with chest pain,cough,sputum production,and pneumonia.Tests reveal widespread metastatic cancer,and the primary care provider plans radiation therapy.Which of following is the most likely type of cancer to be documented on the chart?

A) Adenoma
B) Non-small cell carcinoma
C) Small cell carcinoma
D) Basal cell carcinoma

Question 49

A 50-year-old male is diagnosed with pulmonary embolism (PE).Which of the following symptoms most likely occurred before treatment?

A) Dry cough and inspiratory crackles
B) Shallow respirations and wheezing
C) Chest pain and shortness of breath
D) Kussmaul respirations and back pain

Question 50

Which of the following are 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

Question 51

When a patient has a massive pulmonary embolism (PE),what complications will the nurse monitor for?

A) Damage to the lung microcapillaries
B) Chronic obstructive pulmonary disease (COPD)
C) Disseminated intravascular coagulation (DIC)
D) Shock and death

Question 52

When the nurse observes a diagnosis of nosocomial pneumonia,the patient generally acquires this pneumonia:

A) At day care centers
B) On airplanes
C) During hospitalization
D) In the winter season

Question 53

A 30-year-old male prison inmate contracted tuberculosis during an outbreak.When the nurse reviews the lab results,the organism that caused this condition is a:

A) Bacterium
B) Fungus
C) Virus
D) Parasite

Question 54

A nurse is monitoring a patient for pulmonary hypertension.Which mean pulmonary artery pressure reading will indicate to the nurse that pulmonary hypertension is occurring? Pulmonary artery pressure above _____ mm Hg.