Deck 13: Respiratory System Disorders

Question 1

Oxygen diffuses from the alveoli to the blood because:

A) PO₂ is higher in the blood.
B) PO₂ is lower in the blood.
C) CO₂ is diffusing out of the blood.
D) more CO₂ is diffusing out of cells into the blood.

Answer 1

PO₂ is lower in the blood.

Question 2

Which of the following values is always decreased with respiratory alkalosis (compensated or decompensated)?

A) Serum bicarbonate
B) PaCO₂
C) Serum pH
D) Urine pH

Answer 2

PaCO₂

Question 3

Orthopnea is:

A) very deep, rapid respirations.
B) difficulty breathing when lying down.
C) waking up suddenly, coughing, and struggling for breath.
D) noisy breathing with stridor or rhonchi.

Answer 3

difficulty breathing when lying down.

Question 4

What is the acid-base status of a patient with the following values for arterial blood gases? serum bicarbonate 36.5 mmol/L (normal range: 22-28)
PCO₂ 75 mm Hg (normal range: 35-45)
Serum pH 7.0

A) Compensated metabolic acidosis
B) Decompensated metabolic acidosis
C) Compensated respiratory acidosis
D) Decompensated respiratory acidosis

Question 5

Carbon dioxide is primarily transported in the blood:

A) as dissolved gas.
B) attached to the iron molecule in hemoglobin.
C) as bicarbonate ion.
D) as carbonic acid.

Question 6

What would be the most effective compensation for respiratory acidosis?

A) The kidneys eliminating more bicarbonate ions
B) The kidneys producing more bicarbonate ions
C) The kidneys reabsorbing more hydrogen ions
D) An increase in respiratory rate

Question 7

The central chemoreceptors in the medulla are normally most sensitive to:

A) low oxygen level.
B) low concentration of hydrogen ions.
C) elevated oxygen level.
D) elevated carbon dioxide level.

Question 8

Which of the following activities does NOT require muscle contractions and energy?

A) Quiet inspiration
B) Forced inspiration
C) Quiet expiration
D) Forced expiration

Question 9

The respiratory mucosa is continuous through the:
1) upper and lower respiratory tracts.
2) nasal cavities and the sinuses.
3) nasopharynx and oropharynx.
4) middle ear cavity and auditory tube.

A) 1 only
B) 1, 2
C) 2, 3
D) 1, 3, 4
E) 1, 2, 3, 4

Question 10

What does carbaminohemoglobin refer to?

A) Replacement of oxygen by carbon monoxide on hemoglobin molecules
B) Full saturation of all heme molecules by oxygen
C) Carbon dioxide attached to an amino group on the hemoglobin molecule
D) Oxygen combined with iron in the hemoglobin molecule

Question 11

The maximum volume of air a person can exhale after a maximum inspiration is termed the:

A) expiratory reserve volume.
B) inspiratory reserve volume.
C) total lung capacity.
D) vital capacity.

Question 12

What happens in the lungs when the diaphragm and external intercostal muscles relax?

A) Air is forced out of the lungs.
B) Lung volume increases.
C) Intrapulmonic pressure decreases.
D) Intrapleural pressure decreases.

Question 13

Which of the following causes bronchodilation?

A) Epinephrine
B) Histamine
C) Parasympathetic nervous system
D) Drugs that block b2-adrenergic receptors

Question 14

Approximately what percentage of bound oxygen is released to the cells for metabolism during an erythrocyte's journey through the circulatory system?

A) 80%
B) 25%
C) 10%
D) 50%

Question 15

Which of the following applies to the blood in the pulmonary artery?

A) PCO₂ is low.
B) PO₂ is low.
C) Hydrostatic pressure is very high.
D) It is flowing into the left atrium.

Question 16

The production of yellowish-green, cloudy, thick sputum is often an indication of:

A) bacterial infection.
B) cancer tumor.
C) damage of lung tissue due to smoking.
D) emphysema.

Question 17

What would hypercapnia cause?

A) Increased serum pH
B) Decreased respirations
C) Respiratory acidosis
D) Decreased carbonic acid in the blood

Question 18

Which of the following would result from hyperventilation?

A) Respiratory acidosis
B) Respiratory alkalosis
C) Metabolic alkalosis
D) Metabolic acidosis

Question 19

Light bubbly or crackling breathing sounds associated with serous secretions are called:

A) rhonchi.
B) stridor.
C) rales.
D) wheezing.

Question 20

What does the term hemoptysis refer to?

A) Thick, dark red sputum associated with pneumococcal infection
B) Reddish-brown granular blood found in vomitus
C) Bright red streaks of blood in frothy sputum
D) Bloody exudate in the pleural cavity

Question 21

Which of the following statements does NOT apply to M. tuberculosis?

A) Microbes can survive for a long time inside tubercles.
B) The bacilli can survive some adverse conditions such as drying and heat.
C) Infection is limited to the lungs.
D) The bacilli can be destroyed by antibacterial drugs.

Question 22

How does severe hypoxia develop with pneumonia?

A) Acidosis depresses respirations.
B) Oxygen diffusion is impaired by the congestion.
C) Inflammatory exudate absorbs oxygen from the alveolar air.
D) Infection reduces effective compensation by the heart.

Question 23

Growth and development of a child with cystic fibrosis may be delayed because of:

A) deficit of gastric enzymes for protein digestion.
B) mucus plugs obstructing the flow of pancreatic enzymes.
C) lack of available treatment for steatorrhea.
D) abnormal salivary secretions.

Question 24

What are typical signs and symptoms of epiglottitis?

A) Hyperinflation of the chest and stridor
B) Hoarse voice and barking cough
C) Sudden fever, sore throat, and drooling saliva
D) Sneezing, mild cough, and fever

Question 25

Cystic fibrosis is transmitted as a/an:

A) X-linked recessive gene.
B) autosomal recessive gene.
C) autosomal dominant gene.
D) chromosomal defect.

Question 26

Which of the following confirms the presence of active (reinfection) tuberculosis?

A) A positive skin test for TB
B) A calcified tubercle shown on a chest X-ray
C) Identification of acid-fast bacilli in a sputum sample
D) A history of exposure to individuals being treated for TB

Question 27

Signs and symptoms of acute sinusitis usually include:

A) serous nasal discharge and chronic cough.
B) copious frothy sputum and dyspnea.
C) severe localized pain in the facial bone and tenderness in the face.
D) fetid breath and sore throat.

Question 28

The basic pathophysiology of cystic fibrosis is centered on a/an:

A) defect of the exocrine glands.
B) impaired function of the endocrine glands.
C) chronic inflammatory condition of the lungs.
D) abnormal immune response in the lungs and other organs.

Question 29

Histoplasmosis is caused by a:

A) fungus.
B) virus.
C) bacillus.
D) protozoa.

Question 30

How is primary tuberculosis identified?

A) Cavitation in the lungs and spread of the microbe to other organs
B) Persistent productive cough, low-grade fever, and fatigue
C) Caseation necrosis and formation of a tubercle in the lungs
D) Multiple granulomas in the lungs and rapid spread of the microbe

Question 31

What is the most common cause of viral pneumonia?

A) Rhinovirus
B) Influenza virus
C) Haemophilus influenzae
D) Pneumococcus

Question 32

Rust-colored sputum in a patient with pneumonia usually indicates:

A) secondary hemorrhage in the lungs.
B) Streptococcus pneumoniae is the infecting agent.
C) prolonged stasis of mucous secretions in the airways.
D) persistent coughing has damaged the mucosa in the bronchi.

Question 33

Areas in the United States that show higher rates than the national rate of TB are areas that have a high incidence of:

A) HIV and homelessness.
B) obesity and tobacco use.
C) elderly persons and radon.
D) steroid use and alcoholism.

Question 34

When does active (secondary) infection by Mycobacterium tuberculosis with tissue destruction occur?

A) When host resistance is decreased
B) When a hypersensitivity reaction is initiated
C) When the BCG vaccine is not administered immediately following exposure to the microbe
D) When Ghon complexes form in the lungs

Question 35

Choose the correct information applying to laryngotracheobronchitis:

A) Viral infection in infant under 12 months
B) Viral infection in child, 3 months to 3 years
C) Bacterial infection in infant under 6 months
D) Bacterial infection in child, 3 to 7 years

Question 36

Why does the influenza virus cause recurrent infection in individuals?

A) Elderly patients are predisposed to secondary infections.
B) The virus is transmitted by numerous routes.
C) The virus is very difficult to destroy.
D) Viral mutation reduces immunity from prior infections.

Question 37

What are early signs and symptoms of infectious rhinitis?

A) Purulent nasal discharge and periorbital pain
B) Serous nasal discharge, congestion, and sneezing
C) Copious purulent sputum, particularly in the morning
D) Harsh barking cough and wheezing

Question 38

Which of the following describes lobar pneumonia?

A) Sudden onset of fever and chills, with rales and rusty sputum
B) Insidious onset, diffuse interstitial infection
C) Viral infection causing nonproductive cough and pleuritic pain
D) Opportunistic bacteria causing low-grade fever with cough and thick greenish sputum

Question 39

What is the cause of Legionnaires' disease?

A) Mycoplasma
B) A fungus
C) A gram-negative bacterium
D) Pneumococcus

Question 40

Select the statement related to tuberculosis:

A) The microbe is present in the sputum of all patients with a positive TB skin test.
B) The infection is transmitted primarily by blood from an infected person.
C) TB is usually caused by an acid-fast bacillus, resistant to many disinfectants.
D) The microbe is quickly destroyed by the immune response.

Question 41

Why does hypercalcemia occur with bronchogenic carcinoma?

A) Invasion of the parathyroid gland by the tumor
B) Secretion of parathyroid or parathyroid like hormones by the tumor
C) Destruction of the ribs
D) Failure of the kidney to excrete calcium ions

Question 42

Which of the following is typical of progressive emphysema?

A) Vital capacity increases.
B) Residual lung volume increases.
C) Forced expiratory volume increases.
D) Tidal volume increases.

Question 43

What is a sign indicating total obstruction of the airway by aspirated material?

A) Hoarse cough
B) Rapid loss of consciousness
C) Dyspnea
D) Inflammation of the mucosa

Question 44

What are typical pathological changes with bronchiectasis?

A) Bronchospasm and increased mucous secretion
B) Adhesions and fibrosis in the pleural membranes
C) Airway obstructions and weak, dilated bronchial walls
D) Fixation of the ribs in the inspiratory position

Question 45

Persistent thick mucus in the bronchioles of a child with cystic fibrosis may cause:
1) air trapping.
2) atelectasis.
3) repeated infections.
4) irreversible damage to lung tissue.

A) 1, 2
B) 2, 4
C) 1, 3, 4
D) 1, 2, 3, 4

Question 46

Restrictive lung disorders may be divided into two groups based on:

A) patient history of obesity and exposure to other COPD.
B) smoking history and congenital defects.
C) previous lung disease and cardiovascular disorders.
D) anatomical abnormality and lung disease damage, impairing expansion.

Question 47

What is a common indicator of cystic fibrosis in the newborn?

A) Infant respiratory distress syndrome
B) Failure to excrete meconium
C) Taste of ammonia on the skin
D) Lack of bile secretions

Question 48

What cause the expanded anteroposterior (A-P) thoracic diameter (barrel chest) in patients with emphysema?

A) Air trapping and hyperinflation
B) Persistent coughing to remove mucus
C) Recurrent damage to lung tissues
D) Dilated bronchi and increased mucous secretions

Question 49

What is an early sign of bronchogenic carcinoma?

A) Air trapping and overinflation of the lung
B) Weight loss
C) Bone pain
D) Chronic cough

Question 50

Which of the following are significant signs of bronchiectasis?

A) Persistent nonproductive cough, dyspnea, and fatigue
B) Persistent purulent nasal discharge, fever, and cough
C) Chronic cough, producing large quantities of purulent sputum
D) Wheezing and stridor

Question 51

Destruction of alveolar walls and septae is a typical change in:

A) chronic bronchitis.
B) acute asthma.
C) emphysema.
D) asbestosis.

Question 52

What is the cause of chronic bronchitis?

A) Chronic irritation, inflammation, and recurrent infection of the larger airways
B) A genetic defect causing excessive production of mucus
C) Hypersensitivity to parasympathetic stimulation in the bronchi
D) Deficit of enzymes, preventing tissue degeneration

Question 53

During an acute asthma attack, how does respiratory obstruction occur?
1) Relaxation of bronchial smooth muscle
2) Edema of the mucosa
3) Increased secretion of thick, tenacious mucus
4) Contraction of elastic fibers

A) 1, 2
B) 1, 3
C) 2, 3
D) 2, 4

Question 54

Why does cor pulmonale develop with chronic pulmonary disease?

A) The right ventricle pumps more blood than the left ventricle.
B) Pulmonary fibrosis and vasoconstriction increase vascular resistance.
C) Demands on the left ventricle are excessive.
D) Blood viscosity is increased, adding to cardiac workload.

Question 55

Which of the following is typical of chronic bronchitis?

A) Decreased activity of the mucous glands
B) Fibrosis of the bronchial wall
C) Overinflation of bronchioles and alveoli
D) Formation of blebs or bullae on the lung surface

Question 56

A group of common chronic respiratory disorders characterized by tissue degeneration and respiratory obstruction is called:

A) mesothelioma.
B) COPD.
C) CF.
D) MD.

Question 57

Which of the following predisposes to postoperative aspiration?

A) Reduced pressure of the abdominal organs on the diaphragm
B) Depression of the vomiting center by anesthetics and analgesics
C) Vomiting caused by drugs or anesthesia
D) Lack of food intake for the previous 24 hours

Question 58

Which statement does NOT apply to emphysema?

A) The surface area available for gas exchange is greatly reduced.
B) A genetic defect may lead to breakdown of elastic fibers.
C) The ventilation/perfusion ratio remains constant.
D) Expiration is impaired.

Question 59

What is the pathophysiology of an acute attack of extrinsic asthma?

A) Gradual degeneration and fibrosis
B) Continuous severe attacks unresponsive to medication
C) A hypersensitivity reaction involving release of chemical mediators
D) Hyperresponsive mucosa

Question 60

Cigarette smoking predisposes to malignant neoplasms because smoking:

A) can cause metaplasia and dysplasia in the epithelium.
B) promotes malignant changes in all types of benign tumors in the lungs.
C) causes paraneoplastic syndrome.
D) increases exposure to carbon monoxide in the lungs.

Question 61

Which of the following is a manifestation of a simple closed pneumothorax?

A) Decreased respiratory rate
B) Tracheal deviation toward the unaffected lung
C) Asymmetrical chest movements
D) Increased breath sounds on the affected side

Question 62

How is cardiac output reduced with a flail chest injury?

A) Atelectasis compresses the heart.
B) Venous return is impaired.
C) Intrapleural pressure is decreased.
D) Air pressure continues to increase in the pleural space.

Question 63

With a flail chest injury, events during inspiration include which of the following?

A) Air is sucked into the lung through the chest wall.
B) The mediastinum shifts toward the unaffected side.
C) The floating segment is pushed outward.
D) The trachea deviates toward the affected side.

Question 64

Which of the following statements describe the pathophysiology of adult respiratory distress syndrome?
1) Damage leading to increased permeability of the alveolar capillary membranes
2) Decreased surface tension in the alveoli
3) Excessive fluid and protein interstitially and in the alveoli
4) Multiple diffuse hemorrhages in the lungs

A) 1, 2
B) 1, 3
C) 2, 3
D) 3, 4

Question 65

With a tension pneumothorax, which factors contribute to severe hypoxia?

A) Decreasing compression of the inferior vena cava
B) More air leaving the pleural cavity on expiration than entering with inspiration
C) Shift of the mediastinal contents toward the affected lung
D) Continually increasing pressure on the unaffected lung

Question 66

When does flail chest usually occur?

A) An open puncture wound involves the pleural membranes.
B) The visceral pleura is torn by a fractured rib.
C) Several ribs are fractured at two sites.
D) Increasing fluid in the pleural cavity causes atelectasis.

Question 67

How does total obstruction of the airway lead to atelectasis?

A) Decreased surfactant production impairs lung expansion.
B) The involved lung is compressed.
C) Air is absorbed from the alveoli distal to the obstruction.
D) Air continues to be inspired but is trapped distal to the obstruction.

Question 68

Infant respiratory distress syndrome results from:

A) insufficient surfactant production.
B) incomplete expiration shortly after birth.
C) retention of fluid in the lungs after birth.
D) immature neural control of respirations.

Question 69

Whenever PO₂ levels decrease below normal, PCO₂ levels:

A) increase.
B) decrease also.
C) may or may not change.
D) increase slightly.

Question 70

Laryngotracheobronchitis is typically manifested by:

A) drooling and difficulty swallowing.
B) hoarse voice and barking cough.
C) sore and scratchy throat with fever.
D) wheezing and dyspnea.

Question 71

Which of the following is NOT a cause of pulmonary edema?

A) Left-sided congestive heart failure
B) Excessive blood volume (overload)
C) Inhalation of toxic gases
D) Hyperproteinemia and increasing osmotic pressure of the blood

Question 72

Pulmonary edema causes severe hypoxia because of:

A) decreased diffusion of carbon dioxide from the alveoli.
B) interference with expansion of the lungs.
C) constant cough and hemoptysis.
D) decreased recoil of lungs and ineffective expiration.

Question 73

Which of the following does NOT apply to carbon dioxide?

A) It diffuses across membranes much more easily than does oxygen.
B) It is carried in blood as carbaminohemoglobin.
C) It can be converted into bicarbonate ion.
D) It is replaced on hemoglobin by oxygen in the lungs.

Question 74

What is caused by frequent inhalation of irritating particles such as silica?

A) Fibrosis and loss of compliance
B) Frequent bronchospasm
C) Increased number of mucus-producing glands
D) Distorted shape of the thorax

Question 75

Which of the following is an effect of a large open pneumothorax (sucking wound)?

A) Mediastinal flutter, impairing venous return
B) Increased venous return
C) Progressive atelectasis of both lungs
D) Overexpansion of the unaffected lung

Question 76

Which manifestation(s) of atelectasis is/are associated with airway obstruction?

A) Bradycardia and dyspnea
B) Tracheal deviation toward the unaffected side
C) Decreased breath sounds on the affected side
D) Rales and rhonchi

Question 77

Which of the following is a common source of a pulmonary embolus?

A) Mural thrombus from the left ventricle
B) Thrombus attached to atheromas in the aorta or iliac arteries
C) Thrombus forming in the femoral veins
D) A blood clot in the pulmonary vein

Question 78

Obstruction in the upper airway is usually indicated by:

A) stridor.
B) rales.
C) wheezing.
D) orthopnea.

Question 79

How does a large pleural effusion lead to atelectasis?

A) The cohesion between the pleural membranes is disrupted.
B) There is decreased intrapleural pressure.
C) The mediastinal contents compress the affected side.
D) Pleuritic pain causes very shallow breathing.

Question 80

What is a large-sized pulmonary embolus likely to cause?

A) Hypertension and left-sided heart failure
B) Atelectasis and respiratory failure
C) Hypotension and right-sided heart failure
D) Pleural effusion and atelectasis