Deck 36: Alterations of Pulmonary Function

Question 1

Which condition involves an abnormally enlarged gas-exchange system and the destruction of the lung's alveolar walls?

A)Transudative effusion
B)Emphysema
C)Exudative effusion
D)Abscess

Answer 1

Emphysema

Question 2

A patient reports needing to sit up at night in order to breathe. What term does the healthcare professional document about this condition?

A)Hyperpnea
B)Orthopnea
C)Apnea
D)Atelectasis

Answer 2

Orthopnea

Question 3

Respirations that are characterized by alternating periods of deep and shallow breathing are a result of which respiratory mechanism?

A)Decreased blood flow to the medulla oblongata
B)Increased partial pressure of arterial carbon dioxide (PaCO₂)
C)Stimulation of stretch or J-receptors
D)Fatigue of the intercostal muscles and diaphragm

Answer 3

Decreased blood flow to the medulla oblongata

Question 4

A patient has a transudative pleural effusion but has minimal symptoms. What action by the healthcare professional is best?

A)Prepare for an immediate chest tube insertion.
B)Encourage the patient to use the incentive spirometer.
C)Facilitate a blood draw to check protein stores.
D)Arrange for an oncology consultation.

Question 5

Besides dyspnea, what is the most common characteristic associated with pulmonary disease?

A)Chest pain
B)Digit clubbing
C)Cough
D)Hemoptysis

Question 6

A patient has been diagnosed with pneumoconiosis and asks the healthcare professional to explain this disease. What description by the professional is best?

A)Pneumococci bacteria
B)Inhalation of inorganic dust particles
C)Exposure to asbestos
D)Inhalation of cigarette smoke

Question 7

A patient has a lung problem caused by dysfunction in the pores of Kohn. What action by the healthcare professional is best?

A)Have the patient drink plenty of water.
B)Give the patient supplemental oxygen.
C)Have the patient do breathing exercises.
D)Withhold pain medicine so the patient stays awake.

Question 8

In what form of bronchiectasis do both constrictions and dilations deform the bronchi?

A)Varicose
B)Symmetric
C)Cylindric
D)Saccular

Question 9

A hospitalized patient is complaining of shortness of breath, but the student does not notice cyanosis. The patient's hemoglobin is 9 g/dL, so the student asks the healthcare professional to explain. The professional tells the student that what amount of hemoglobin must be desaturated before cyanosis occurs?

A)3
B)5
C)7
D)9

Question 10

Which condition is capable of producing alveolar dead space?

A)Pulmonary edema
B)Pulmonary emboli
C)Atelectasis
D)Pneumonia

Question 11

A patient is brought to the Emergency Department with a gunshot wound to the chest. The healthcare professional assesses an abnormality involving a pleural rupture that acts as a one-way valve, permitting air to enter on inspiration but preventing its escape by closing during expiration. What action by the healthcare professional is the priority?

A)Draw arterial blood gasses.
B)Assist with a chest tube insertion.
C)Give the patient low-flow oxygen.
D)Assess for clubbing of fingernails.

Question 12

A patient has been diagnosed with acute respiratory distress syndrome (ARDS). For what other health condition should the healthcare professional assess this patient for as the priority?

A)Heart failure
B)Pneumonia
C)Pulmonary emboli
D)Acute pulmonary edema

Question 13

What does the student learn about ventilation?

A)Hypoventilation causes hypocapnia.
B)Hypoventilation causes alkalosis.
C)Hyperventilation causes hypocapnia.
D)Hyperventilation causes acidosis.

Question 14

A patient has long-standing pulmonary disease and chronic hypoxia. The student assesses the patient's fingertips and notices bulbous enlargement of the distal segment of the digits. How does the student document this finding?

A)Edema
B)Clubbing
C)Angling
D)Osteoarthropathy

Question 15

High altitudes may produce hypoxemia through which mechanism?

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

Question 16

A patient has a pulmonary capillary wedge pressure of 30mmHg. What assessment finding by the healthcare professional would be most consistent with this reading?

A)Normal lung sounds
B)Pink, frothy sputum
C)Eupnea
D)Rhonchi

Question 17

A patient has pulmonary edema. For what condition should the healthcare professional assess the patient as the priority?

A)Right-sided heart failure
B)Left-sided heart failure
C)Mitral valve prolapse
D)Aortic stenosis

Question 18

The student asks the healthcare professional to explain how pulmonary edema and pulmonary fibrosis cause hypoxemia. What description by the professional is best?

A)Creates alveolar dead space
B)Decreases the oxygen in inspired gas
C)Creates a right-to-left shunt
D)Impairs alveolocapillary membrane diffusion

Question 19

Kussmaul respirations as a respiratory pattern may be associated with which characteristic(s)?

A)Alternating periods of deep and shallow breathing
B)Increased work of breathing
C)Inadequate alveolar ventilation in relation to metabolic demands
D)Slightly increased ventilatory rate, large tidal volumes, and no expiratory pause

Question 20

Which structure(s) in acute respiratory distress syndrome (ARDS) release inflammatory mediators such as proteolytic enzymes, oxygen-free radicals, prostaglandins, leukotrienes, and platelet-activating factor?

A)Complement cascade
B)Mast cells
C)Macrophages
D)Neutrophils

Question 21

Which of these is the most common route of lower respiratory tract infection?

A)Aspiration of oropharyngeal secretions
B)Inhalation of microorganisms
C)Microorganisms spread to the lung via blood
D)Poor mucous membrane protection

Question 22

What medical term is used for a condition that results from pulmonary hypertension, creating chronic pressure overload in the right ventricle?

A)Hypoxemia
B)Hypoxia
C)Bronchiectasis
D)Cor pulmonale

Question 23

Fluid in the pleural space characterizes which condition?

A)Pleural effusion
B)Atelectasis
C)Bronchiectasis
D)Ischemia

Question 24

Pulmonary edema in acute respiratory distress syndrome (ARDS) is the result of an increase in what?

A)Levels of serum sodium and water
B)Capillary permeability
C)Capillary hydrostatic pressure
D)Oncotic pressure

Question 25

A patient has been diagnosed with primary emphysema but claims there is no history of smoking. What action by the healthcare professional is most appropriate?

A)Facilitate genetic testing on the patient.
B)Ask the family if the patient smokes.
C)Schedule pulmonary function studies.
D)Get baseline arterial blood gasses.

Question 26

Pulmonary artery hypertension (PAH) results from which alteration?

A)Narrowed pulmonary capillaries
B)Narrowed bronchi and bronchioles
C)Destruction of alveoli
D)Ischemia of the myocardium

Question 27

The student asks a professor to explain how tuberculosis (TB) can remain dormant in some people. What explanation by the professor is best?

A)It does not remain dormant but some host defenses can kill the bacteria.
B)The bacilli can become isolated within tubercles in the lungs.
C)Macrophages attack and phagocytize new areas of infection.
D)Virulence factors in the bacilli weaken over time leading to apoptosis.

Question 28

A patient has recently been diagnosed with emphysema. What initial step in management of this disease does the healthcare professional discuss with the patient?

A)Inhaled anticholinergic agents
B)Beta agonists
C)Cessation of smoking
D)Surgical reduction of lung volume

Question 29

A healthcare professional is educating a patient on asthma. The professional tells the patient that the most successful treatment for chronic asthma begins with which action?

A)Avoidance of the causative agent
B)Administration of broad-spectrum antibiotics
C)Administration of drugs that reduce bronchospasm
D)Administration of drugs that decrease airway inflammation

Question 30

A patient has silicosis. Which medication classification does the healthcare professional educate the patient about?

A)Corticosteroids
B)Antibiotics
C)Bronchodilators
D)Expectorants

Question 31

A patient is diagnosed with a pneumothorax and asks the healthcare professional to explain this condition. What statement by the professional is most accurate?

A)Blood in your chest cavity
B)Air in the pleural space
C)Pus in the pleural space
D)Collapse of small airways

Question 32

Which factor contributes to the production of mucus associated with chronic bronchitis?

A)Airway injury
B)Pulmonary infection
C)Increased Goblet cell size
D)Bronchospasms

Question 33

Squamous cell carcinoma of the lung is best described as a tumor that causes which alterations?

A)Abscesses and ectopic hormone production
B)Pneumonia and atelectasis
C)Pleural effusion and shortness of breath
D)Chest wall pain and early metastasis

Question 34

A healthcare professional is educating a patient about asthma. The professional states that good control is necessary due to which pathophysiologic process?

A)Norepinephrine causes bronchial smooth muscle contraction and mucus secretion but it also causes high blood pressure.
B)Uncontrolled inflammation leads to increased bronchial hyperresponsiveness and eventual scarring.
C)The release of epinephrine leads to development of cardiac dysrhythmias.
D)Immunoglobulin G causes smooth muscle contraction which will eventually weaken the respiratory muscles.

Question 35

A patient comes to the Emergency Department with inspiratory and expiratory wheezing, dyspnea, nonproductive cough, and tachypnea. What treatment does the healthcare professional anticipate for this patient as the priority?

A)Sputum culture
B)History of illness exposure
C)Antibiotics
D)Inhaled bronchodilator

Question 36

A patient with emphysema comes to the clinic and reports increased, productive cough. What diagnostic test should the healthcare professional facilitate as the priority?

A)Chest x-ray
B)Peak expiratory flow
C)Pulmonary function tests
D)Sputum culture

Question 37

A patient has been diagnosed with an empyema. What does the healthcare professional tell the patient about this condition?

A)We will have to drain the pus out of your pleural space.
B)You will be given a long course of antiviral medication.
C)These blebs in your lungs can rupture with exercise.
D)We will watch you for respiratory muscle fatigue.

Question 38

In acute respiratory distress syndrome (ARDS), alveoli and respiratory bronchioles fill with fluid as a result of which mechanism?

A)Compression on the pores of Kohn, thus preventing collateral ventilation
B)Increased capillary permeability, which causes alveoli to fill with fluid
C)Inactivation of surfactant and the impairment of type II alveolar cells
D)Increased capillary hydrostatic pressure that forces fluid into the alveoli

Question 39

Which immunoglobulin (Ig) may contribute to the pathophysiologic characteristics of asthma?

A)IgA
B)IgE
C)IgG
D)IgM

Question 40

Which type of pulmonary disease requires more force to expire a volume of air?

A)Restrictive
B)Obstructive
C)Acute
D)Communicable

Question 41

A patient is diagnosed in the Emergency Department with a flail chest. Which assessment findings would the healthcare professional expect to find in this patient? (Select all that apply.)

A)Fracture of several consecutive ribs
B)Multiple fractures to individual ribs
C)Fracture of the sternum
D)A systemic inflammatory process
E)Paradoxical chest wall movement

Question 42

A patient has been diagnosed with tuberculosis (TB). What does the student know about this condition? (Select all that apply.)

A)Foreign-born people have the highest rate in the United States.
B)TB is rapidly becoming resistant to many different antibiotics.
C)It is transmitted through contact with patient secretions.
D)A positive skin test is the only reliable way to diagnose TB.
E)Treatment consists of a combination of antibiotics.

Question 43

What does the student learn about exudative pleural effusion? (Select all that apply.)

A)Contains high concentrations of white blood cells
B)Produces a very thick exudate
C)May occur in response to an inflammatory process
D)The presence of a malignant cancer can trigger exudative effusion.
E)Is the result of increased capillary permeability

Question 44

A patient has dyspnea. Which of these should the healthcare professional assess the patient for? (Select all that apply.)

A)Decreased partial pressure of arterial oxygen (PaO?)
B)Presence of heart disease
C)Recent nasal surgery or trauma
D)Presence of anxiety
E)Presence of pain

Question 45

The student learns that which inflammatory mediators are produced in asthma? (Select all that apply.)

A)Histamine
B)Bradykinin
C)Leukotrienes
D)Prostaglandins
E)Neutrophil proteases

Question 46

A patient has pneumonia. For which clinical manifestations should the healthcare professional assess for? (Select all that apply.)

A)Inspiratory crackles
B)Fremitus
C)Egophony
D)Whispered pectoriloquy
E)Absence of breath sounds

Question 47

Which clinical manifestations would the healthcare professional assess for in a painter with pulmonary hypertension? (Select all that apply.)

A)Systemic blood pressure greater than 130/90 mmHg
B)Rhonchi bilaterally
C)Dyspnea on exertion
D)Peripheral edema
E)Jugular venous distention