Deck 35: Alterations of Pulmonary Function

Question 1

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

A) Alternating periods of deep and shallow breathing
B) Pulmonary fibrosis
C) Chronic obstructive pulmonary disease
D) Slightly increased ventilatory rate, large tidal volumes, and no expiratory pause

Answer 1

Slightly increased ventilatory rate, large tidal volumes, and no expiratory pause

Question 2

The collapse of lung tissue caused by the lack of collateral ventilation through the pores of Kohn is referred to as what type of atelectasis?

A) Compression
B) Perfusion
C) Absorption
D) Hypoventilation

Answer 2

Absorption

Question 3

What is the most common cause of pulmonary edema?

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

Answer 3

Left-sided heart failure

Question 4

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

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

Question 5

What causes pneumoconiosis?

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

Question 6

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

Question 7

Which pleural abnormality involves a site of pleural rupture that acts as a one-way valve,permitting air to enter on inspiration but preventing its escape by closing during expiration?

A) Spontaneous pneumothorax
B) Tension pneumothorax
C) Open pneumothorax
D) Secondary pneumothorax

Question 8

With a total hemoglobin of 9 g/dl,how many grams per deciliter of hemoglobin must become desaturated for cyanosis to occur?

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

Question 9

Which term is used to identify a circumscribed area of suppuration and destruction of lung parenchyma?

A) Consolidation
B) Cavitation
C) Empyema
D) Abscess

Question 10

In which type of pleural effusion does the fluid become watery and diffuse out of the capillaries as a result of increased blood pressure or decreased capillary oncotic pressure?

A) Exudative
B) Purulent
C) Transudative
D) Large

Question 11

Which condition is not a cause of chest wall restriction?

A) Pneumothorax
B) Severe kyphoscoliosis
C) Gross obesity
D) Neuromuscular disease

Question 12

High altitudes may produce hypoxemia through which mechanism?

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

Question 13

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

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

Question 14

What term is used to describe the selective bulbous enlargement of the distal segment of a digit that is commonly associated with diseases that interfere with oxygenation of the blood?

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

Question 15

Which statement is true regarding ventilation?

A) Hypoventilation causes hypocapnia.
B) Hyperventilation causes hypercapnia.
C) Hyperventilation causes hypocapnia.
D) Hyperventilation results in an increased partial pressure of arterial carbon dioxide (PaCO2).

Question 16

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), decreased pH, and decreased partial pressure of arterial oxygen (PaO2)
C) Stimulation of stretch or J-receptors
D) Fatigue of the intercostal muscles and diaphragm

Question 17

Sitting up in a forward-leaning position generally relieves which breathing disorder?

A) Hyperpnea
B) Orthopnea
C) Apnea
D) Dyspnea on exertion

Question 18

Which condition is capable of producing alveolar dead space?

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

Question 19

Pulmonary edema and pulmonary fibrosis cause hypoxemia by which mechanism?

A) Creating alveolar dead space
B) Decreasing the oxygen in inspired gas
C) Creating a right-to-left shunt
D) Impairing alveolocapillary membrane diffusion

Question 20

Pulmonary edema usually begins to develop at a pulmonary capillary wedge pressure or left atrial pressure of how many millimeters of mercury (mm Hg)?

A) 10
B) 20
C) 30
D) 40

Question 21

Which of the following 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

Clinical manifestations of decreased exercise tolerance,wheezing,shortness of breath,and productive cough are indicative of which respiratory disorder?

A) Chronic bronchitis
B) Emphysema
C) Pneumonia
D) Asthma

Question 23

What medical term is used to identify the accumulation of air in the pleural space?

A) Flail chest
B) Pneumothorax
C) Pleural effusion
D) Exudate effusion

Question 24

The progression of chronic bronchitis is best halted by which intervention?

A) Regular use of bronchodilators
B) Smoking cessation
C) Postural chest drainage techniques
D) Identification of early signs of infection

Question 25

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

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

Question 26

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 27

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

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

Question 28

In tuberculosis,the body walls off the bacilli in a tubercle by stimulating which action?

A) Macrophages that release tumor necrosis factor-alpha (TNF-a)
B) Phagocytosis by neutrophils and eosinophils
C) Formation of immunoglobulin G to initiate the complement cascade
D) Apoptotic infected macrophages that activate cytotoxic T cells

Question 29

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 30

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 and respiratory bronchioles 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 and respiratory bronchioles

Question 31

Which condition is a fulminant form of respiratory failure characterized by acute lung inflammation and diffuse alveolocapillary injury?

A) Acute respiratory distress syndrome (ARDS)
B) Pneumonia
C) Pulmonary emboli
D) Acute pulmonary edema

Question 32

Clinical manifestations of inspiratory and expiratory wheezing,dyspnea,nonproductive cough,and tachypnea are indicative of which condition?

A) Chronic bronchitis
B) Emphysema
C) Pneumonia
D) Asthma

Question 33

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 34

Which statement about the late asthmatic response is true?

A) Norepinephrine causes bronchial smooth muscle contraction and mucus secretion.
B) The release of toxic neuropeptides contributes to increased bronchial hyperresponsiveness.
C) The release of epinephrine causes bronchial smooth muscle contraction and increases capillary permeability.
D) Immunoglobulin G initiates the complement cascade and causes smooth muscle contraction and increased capillary permeability.

Question 35

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 36

What is the initial step in the management of emphysema?

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

Question 37

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

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

Question 38

Clinical manifestations that include unexplained weight loss,dyspnea on exertion,use of accessory muscles,and tachypnea with prolonged expiration are indicative of which respiratory disorder?

A) Chronic bronchitis
B) Emphysema
C) Pneumonia
D) Asthma

Question 39

Clinical manifestations of inspiratory crackles,increased tactile fremitus,egophony,and whispered pectoriloquy are indicative of which respiratory condition?

A) Chronic bronchitis
B) Emphysema
C) Pneumonia
D) Asthma

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

Which inflammatory mediators are produced in asthma? (Select all that apply.)

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

Question 42

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 43

Match the descriptions with the corresponding terms.
Bronchiectasis

A)Passage of fluid and solid particles into the lung
B)Inflammatory obstruction of small airways
C)Excessive amount of connective tissue in the lung
D)Lung tissue collapse
E)Abnormal dilation of the bronchi

Question 44

Which statement is true regarding hypoxemia?

A) Hypoxemia results in the increased oxygenation of arterial blood.
B) Respiratory alterations cause hypoxemia.
C) Hypoxemia results in the decreased oxygenation of tissue cells.
D) Various system changes cause hypoxemia.

Question 45

What medical term is used to identify the presence of pus in the pleural space?

A) Plural effusion
B) Asthma
C) Empyema
D) Pneumonia

Question 46

Match the descriptions with the corresponding terms.
Atelectasis

A)Passage of fluid and solid particles into the lung
B)Inflammatory obstruction of small airways
C)Excessive amount of connective tissue in the lung
D)Lung tissue collapse
E)Abnormal dilation of the bronchi

Question 47

Which medication classification is generally included in the treatment of silicosis?

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

Question 48

Which clinical manifestation is associated with pulmonary hypertension? (Select all that apply.)

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

Question 49

Fluid in the pleural space characterizes which condition?

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

Question 50

Which characteristics are symptomatic of a flail chest? (Select all that apply.)

A) Involves the fracture of several consecutive ribs.
B) Involves multiple fractures to individual ribs.
C) Can involve the fracture of the sternum.
D) Is generally a result of the inflammatory process.
E) Is more common among the older adult population.

Question 51

Which statements regarding Mycobacterium tuberculosis are true regarding the bacilli's ability to go into dormancy? (Select all that apply.)

A) Neutrophils and macrophages all play a role in its dormancy.
B) Mycobacterium tuberculosis is capable of dormancy but for only a short period.
C) The immune system is the controlling factor regarding its length of dormancy.
D) The bacilli are sealed off in tubercles to allow for dormancy.
E) An attack by lymphocytes brings the bacilli out of their dormant state.

Question 52

Match the descriptions with the corresponding terms.
Aspiration

A)Passage of fluid and solid particles into the lung
B)Inflammatory obstruction of small airways
C)Excessive amount of connective tissue in the lung
D)Lung tissue collapse
E)Abnormal dilation of the bronchi

Question 53

Match the descriptions with the corresponding terms.
Pulmonary fibrosis

A)Passage of fluid and solid particles into the lung
B)Inflammatory obstruction of small airways
C)Excessive amount of connective tissue in the lung
D)Lung tissue collapse
E)Abnormal dilation of the bronchi

Question 54

What are the causes of dyspnea? (Select all that apply.)

A) Decreased pH, increased partial pressure of arterial carbon dioxide (PaCO2) and decreased partial pressure of arterial oxygen (PaO2)
B) Decreased blood flow to the medulla oblongata
C) Stimulation of stretch or J-receptors
D) Presence of anxiety
E) Presence of pain

Question 55

Match the descriptions with the corresponding terms.
Bronchiolitis

A)Passage of fluid and solid particles into the lung
B)Inflammatory obstruction of small airways
C)Excessive amount of connective tissue in the lung
D)Lung tissue collapse
E)Abnormal dilation of the bronchi

Question 56

Which statements are true regarding exudative effusion? (Select all that apply.)

A) Exudative effusion contains high concentrations of white blood cells.
B) Exudative effusion produces a very thick exudate.
C) Exudative effusion may occur in response to an inflammatory process.
D) The presence of a malignant cancer can trigger exudative effusion.
E) Exudative effusion is a result of increased capillary permeability.