Practice that has to do with Chapter 26

Which principle should the nurse remember while planning care for a
patient with respiratory problems? Diffusion of respiratory gases takes
place at the:
A. Alveolocapillary membrane
B. Visceral pleurae
C. Parietal pleurae
D. Respiratory center
Alveolocapillary membrane
A nurse is teaching about the functions of the pulmonary system. Which
information should the nurse include? One of the functions of the
pulmonary system is the:
A. Expelling of bacteria B. Exchange of gases between the environment and blood
C. Movement of blood into and out of the capillaries
D. Principle mechanism for cooling of the heart
Exchange of gases between the environment and blood
During inspiration, muscular contraction of the diaphragm causes air to
move into the lung. The mechanisms that drive air movement during
inspiration are a(n):
A. Decrease in intra-alveolar pressure and shortening of the rib cage
B. Decrease in the size of the thorax and alveolar expansion C. Increase in the size of the thorax and a decrease in intrapleural pressure
D. Increase in atmospheric pressure and intrapleural pressure
Increase in the size of the thorax and a decrease in intrapleural pressure
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An aide asks a nurse how surfactant works. How should the nurse respond?
Surfactant facilitates alveolar distention and ventilation by:
A. Decreasing thoracic compliance
B. Attracting water to the alveolar surface
C. Decreasing surface tension in alveoli
D. Increasing diffusion in alveoli
Decreasing surface tension in alveoli
Which principle should the nurse remember while planning care for a
patient with a respiratory problem? Under most circumstances, increased
work of breathing results in:
A. Increased partial pressure of O2 in the lungs
B. Increased oxygen consumption
C. Decreased PaCO2
D. Alterations in alveolar perfusion
Increased oxygen consumption
A patient wants to know how carbon dioxide is transported in the body.
How should the nurse respond? Carbon dioxide (CO2) is mainly transported
in the blood:
A. Attached to oxygen (O2)
B. Dissolved in red blood cells
C. Combined with albumin D. In the form of bicarbonate
In the form of bicarbonate
Which of the following terms should the nurse use when there is a
balance between outward recoil of the chest wall and inward recoil of
lungs at rest?
A. Functional residual capacity (FRC) is reached.
B. Vital capacity (VC) is reached.
C. Total lung capacity (TLC) is reached.
D. Residual volume (RV) is reached.
Functional residual capacity (FRC) is reached.
If an individual with respiratory difficulty were retaining too much
carbon dioxide, which of the following compensatory responses would the
nurse expect to be initiated? A. Increase in respiratory rate
B. Decrease in ventilation rate
C. Increase in tidal volume
D. Vasodilation of the pulmonary arterioles
Increase in respiratory rate
A nurse remembers the majority of total airway resistance occurs in the:
A. Bronchi
B. Nose
C. Oral pharynx
D. Diaphragm
Nose
The nurse is describing the receptors in the lung that decrease
ventilatory rate and volume when stimulated. Which receptors is the
nurse discussing?
A. Carbon dioxide receptors
B. Baroreceptors
C. Stretch receptors
D. Chemoreceptors
Stretch receptors
A nurse recalls the pleural membranes are examples of _____ membranes.
A. Mucous
B. Serous
C. Synovial
D. Peritoneal
Serous
While reviewing the results of the pulmonary functions test, the nurse
is aware that the maximum amount of gas that can be displaced (expired)
from the lung is called:
A. Vital capacity (VC)
B. Total lung capacity
C. Functional capacity
D. Residual volume
Vital capacity (VC)
While auscultating a patient’s lungs, a nurse recalls the alveoli in the
apexes of the lungs are _____ than alveoli in the bases.
A. Larger
B. More numerous
C. More compliant
D. Less perfused
Larger
After entering a room of chemical fog, a 20-year-old male cannot stop
sneezing. Which of the following structures is primarily responsible for
his sneezing?
A. Upper respiratory tract mucosa
B. Irritant receptors in the trachea and large airways C. Irritant receptors in the nostrils
D. Upper respiratory nasal hairs and turbinates
Irritant receptors in the nostrils
Students in a histology class are assigned to identify regions of the
lung. The slide shows a basement membrane, capillary lumen, and
macrophages. The students are looking at the:
A. Trachea
B. Bronchioles
C. Alveoli
D. Bronchus
Alveoli
While planning care for a patient with respiratory difficulty and
retaining too much carbon dioxide, which principle should the nurse
recall? _______ would be stimulated in an attempt to maintain a normal
homeostatic state.
A. Irritant receptors
B. Stretch receptors
C. Peripheral chemoreceptors D. Central chemoreceptors
Central chemoreceptors
If a patient’s hemoglobin concentration (Hb) is 14 g/100 ml and arterial
oxygen saturation (SaO2) is 98%, what would be his arterial oxygen
content? Remember that 1.34 ml O2 is the maximum amount of oxygen that
can be transported per gram of hemoglobin. Hint: O2 content = (1.34 ´
Hb) SaO2
A. 13.72 ml O2 per 100 ml blood
B. 15.38 ml O2 per 100 ml blood
C. 18.76 ml O2 per 100 ml blood
D. 19.30 ml O2 per 100 ml blood
18.76 ml O2 per 100 ml blood
A 42-year-old male was involved in a motor vehicle accident during which
he suffered a severe head injury. He died shortly after the accident
from loss of respiration. The nurse suspects the area of the brain most
likely involved is the:
A. Cerebral cortex
B. Thalamus
C. Basal ganglia
D. Brainstem
Brainstem
The pulmonologist is presenting a workshop over the lungs. Which
information should be included? The lung receives parasympathetic
innervation by the _____ nerve.
A. Vagus
B. Phrenic
C. Brachial
D. Pectoral
Vagus
An 80-year-old male presents to his primary care provider reporting
difficulty breathing. Pulmonary function tests reveal that he has
increased residual volume. A nurse suspects the most likely cause of
this disorder is _____ in lung compliance.
A. An increase
B. A decrease
C. No change
D. An absence
An increase
The nurse is describing the movement of blood into and out of the
capillary beds of the lungs to the body organs and tissues. What term
should the nurse use to describe this process?
A. Perfusion
B. Ventilation
C. Diffusion
D. Circulation
Perfusion
The nurse is describing the slit-shaped space between the true vocal
cords. What term should the nurse use?
A. Glottis
B. Epiglottis
C. Larynx
D. Carina
Glottis
What is the partial pressure of oxygen in the lung given the following
conditions? Percentage of oxygen in air: 20 Barometric pressure: 700 mm Hg
A. 111 mm Hg
B. 124 mm Hg
C. 131 mm Hg
D. 140 mm Hg
140 mm Hg
In a patient with acidosis or a fever, the nurse would expect the
oxyhemoglobin dissociation curve to shift:
A. To the right, causing more O2 to be released to the cells
B. To the left, allowing less O2 to be released to the cells
C. Downward, allowing less O2 to dissolve in the plasma
D. Upward, allowing more O2 to dissolve in the plasma
To the right, causing more O2 to be released to the cells
The pressure required to inflate an alveolus is inversely related to:
A. Wall thickness
B. Surface tension
C. Minute volume
D. Alveolar radius
Alveolar radius
The pulmonologist talks about the receptors that respond to increased
pulmonary capillary pressure. What term will indicate the nurse
understands? They are called:
A. Irritant receptors
B. Chemoreceptors
C. Stretch receptors D. J receptors
J receptors
A newborn is in respiratory distress and requires ventilation. Tests
reveal that he does not produce surfactant due to the absence of:
A. Mucus-producing cells B. Type II alveolar cells
C. Alveolar macrophages
D. Goblet cells
Type II alveolar cells
The nasopharynx is lined with a ciliated mucosal membrane with a highly
vascular blood supply. The nurse is discussing the functions of this
membrane. Which information should be included? One function of the
membrane is to:
A. Absorb air
B. Humidify air
C. Cool air
D. Exchange gases
Humidify air
A consequence of alveolar hypoxia is:
A. Reactive vasodilation
B. Local bronchoconstriction
C. Decreased respiratory rate D. Pulmonary artery vasoconstriction
Pulmonary artery vasoconstriction
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. Pulmonary hypotension
B. A low ventilation-perfusion ratio
C. A right-to-left shunt D. Alveolar dead space
Alveolar dead space
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. Transudative pneumothorax
B. Pleural effusion
C. Tension pneumothorax
D. Open pneumothorax
Tension pneumothorax
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. 36-year-old woman with a history of alcohol abuse who is recovering from a gastric ulcer C. 72-year-old male who is recovering from hip replacement surgery in the hospital
D. 28-year-old woman who had a baby 6 months earlier
72-year-old male who is recovering from hip replacement surgery in the hospital
A 50-year-old male is diagnosed with pulmonary embolism (PE). Which of the following symptoms most likely occurred before treatment?
A. Chest pain and shortness of breath
B. Shallow respirations and wheezing
C. Dry cough and inspiratory crackles
D. Kussmaul respirations and back pain
Chest pain and shortness of breath
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. Check hematocrit and hemoglobin levels frequently during the postoperative period.
C. Promote aggressive fluid intake.
D. Prevent deep vein thrombosis formation.
Prevent deep vein thrombosis formation
A 47-year-old male is diagnosed with pulmonary edema. Which assessment findings will the nurse observe?
A. Pink, frothy sputum
B. Wheezing
C. Thick mucus secretions
D. Hypocapnia
Pink, frothy sputum
A nurse remembers a low ventilation-perfusion ratio results in:
A. Alveolar collapse
B. Shunting
C. Bronchoconstriction
D. Increased dead space
Shunting
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. Frank-Starling
B. Orthopnea
C. Apnea
D. Cheyne-Stokes
Cheyne-Stokes
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. Hemoptysis
C. Rhinitis
D. Cyanosis
Hemoptysis
Which patient would the nurse assess for paroxysmal nocturnal dyspnea (PND)? A patient with:
A. Asthma
B. Pulmonary fibrosis
C. Hypotension
D. Left ventricular failure
Left ventricular failure
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 pH
C. Low hematocrit
D. Elevated PaCO2
Elevated PaCO2
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
Dyspnea
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. Alveolar destruction
C. Decreased inspiratory reserve volumes
D. Increased flow rates
Air trapping
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. Decreased inspired oxygen
B. Diffusion abnormalities
C. Hypoventilation
D. Bronchoconstriction
Decreased inspired oxygen
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. Risk of cerebral emboli
C. Pulmonary edema
D. Systemic hypertension
Pulmonary hypertension
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. Hypoventilation
C. Bronchiectasis
D. Absorption atelectasis
Absorption atelectasis
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. Atelectatic
C. Pleuritic
D. Obstructive
Obstructive
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. Moraxella catarrhalis
B. Klebsiella pneumonia
C. Virus
D. Staphylococcus aureus
Staphylococcus aureus
Which of the following are characteristic of idiopathic pulmonary arterial hypertension (IPAH)? (Select all that apply.)
A. Weight gain
B. Fatigue
C. Male gender
D. Dyspnea
E. Jugular vein distention
Fatigue, Dyspnea, JVD
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.
25
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. Collapse of the cartilaginous rings in the bronchi
D. Mucus secretion, bronchoconstriction, and airway edema
Mucus secretion, bronchoconstriction, and airway edema
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. Chronic obstructive pulmonary disease (COPD)
B. Exercise-induced asthma C. Status asthmaticus
D. Bronchiectasis
Status asthmaticus
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. Decreased functional residual capacity
B. Increased compliance
C. Increased tidal volume
D. Decreased respiratory rate
Decreased functional residual capacity
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. Alpha-1-antitrypsin deficiency
B. Viral infections
C. Fibrotic lung disease
D. Destruction of alveolar macrophages
Alpha-1-antitrypsin deficiency
Which of the following assessment findings would be expected in pulmonary embolism (PE)? (Select all that apply.)
A. Tachypnea
B. Chest pain
C. Hemoptysis
D. Tachycardia
E. Fever
Tachypnea, Chest pain, Tachycardia
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. Pneumothorax
C. Bronchiectasis
D. Emphysema
Pneumonia
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
Dyspnea
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. Tachypnea
B. Orthopnea
C. Apnea
D. Dyspnea
Orthopnea
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. Apnea
C. Cyanosis
D. Hypoventilation
Hyperventilation
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. Excessive use of antibiotics as a young child
C. Interactions between genetic and environmental factors
D. Autoimmunity
Interactions between genetic and environmental factors
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. Allergic reactions
C. Flail chest
D. Autoimmune disease
Inhalation of silica, asbestos, mica
A pulmonologist is discussing the base of the lungs with staff. Which
information should be included? At the base of the lungs:
A. Alveolar gas pressure exceeds arterial perfusion pressure.
B. Arterial perfusion pressure and alveolar gas pressure are less than at
the apex.
C. Arterial perfusion pressure exceeds alveolar gas pressure.
D. Arterial perfusion and alveolar gas pressure are equal.
Arterial perfusion pressure exceeds alveolar gas pressure.
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. Sarcoidosis
B. Acute respiratory distress syndrome (ARDS)
C. Malignant respiratory failure
D. Postoperative respiratory failure
Acute respiratory distress syndrome (ARDS)
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. Cigarette smoke
B. Asbestos
C. Air pollution
D. Radiation
Cigarette smoke
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. Hypocapnia
B. Hypoxemia
C. Hypoxia
D. Ischemia
Hypoxemia
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. The release of stress hormones
B. Exposure to an allergen causing mast cell degranulation
C. Hereditary decrease in IgE responsiveness
D. Increased sympathetic nervous system response
Exposure to an allergen causing mast cell degranulation
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. Hyperventilation
C. Ventilation-perfusion mismatch
D. Thinning smooth muscle in the bronchioles
Thick mucus from hypertrophied glands
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. Tissue fragment
B. Fat
C. Blood clot
D. Air
Blood clot
A patient asks what causes pneumonia. How should the nurse reply? Pneumonia is caused by:
A. Atelectasis
B. Chronic lung changes seen with aging
C. Viral or bacterial infections
D. Use of anesthetic agents in surgery
Viral or bacterial infection
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
Bronchiolitis obliterans
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. Small cell carcinoma
B. Adenoma
C. Basal cell carcinoma
D. Non-small cell carcinoma
Non-small cell carcinoma
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. Chyle
B. Empyema
C. Emphysema
D. Pleurisy
Empyema
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. Chronic obstructive pulmonary disease (COPD)
B. Exercise-induced asthma
C. Status asthmaticus
D. Bronchiectasis
Status asthmaticus
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. Loss of elastic recoil
B. Airway edema
C. Infection and inflammation
D. Excessive mucus production
Loss of elastic recoil
When a patient has a massive pulmonary embolism (PE), what complications will the nurse monitor for?
A. Shock and death
B. Disseminated intravascular coagulation (DIC)
C. Chronic obstructive pulmonary disease (COPD)
D. Damage to the lung microcapillaries
Shock and death
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. Rapid respirations with periods of apnea
B. A slightly increased ventilatory rate, large tidal volumes, and no expiratory pause
C. Audible wheezing or stridor
D. Very slow inhalations and rapid expirations
A slightly increased ventilatory rate, large tidal volumes, and no expiratory pause
Which of the following shows a correct cause and effect sequence in the development of acute respiratory distress syndrome (ARDS)?
A. Hyaline membrane formation and fibrosis causing pulmonary edema
B. Impaired alveolar compliance causing decreased surfactant production
C. Alveolocapillary membrane injury causing a massive inflammatory response
D. Increased alveolocapillary membrane permeability causing metabolic alkalosis
Alveolocapillary membrane injury causing a massive inflammatory response

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