What is a low level of arterial oxygen termed?
hypocapnia
hypoxaemia
normoxia
hypoxia
Central cyanosis:
is due to the formation of excess oxyhaemoglobin
describes bluing colouration in the lips and linings of the mouth
is a consequence of cyanide poisoning
all answers are correct
Blood is considered to be acidotic as soon as:
blood pH remains at 7.4, but signs of acidosis are otherwise evident
blood pH rises above 7.4
blood pH falls below 7.0
blood pH falls below 7.35
Orthopnoea is:
noisy breathing with stridor or rhonchi.
difficulty breathing when lying down.
waking up suddenly, coughing, and struggling for breath.
very deep, rapid respirations.
Digital clubbing is a sign of:
chronic hypocapnia
chronic hyperoxia
chronic hypoxia
chronic hypercapnia
A 65-year-old female with emphysema presents to the ED for difficulty breathing. Physical exam reveals bluish skin and mucous membranes. This condition is referred to as:
haemoptysis
hypothermia
cyanosis
haematemesis
A 10-year-old female develops pneumonia following a urinary tract infection. Physical exam reveals subcostal and intercostal retractions. She reports that breathing is difficult and she feels she cannot get enough air. This condition is referred to as:
hyperpnoea
dyspnoea
orthopnoea
Reduced oxygenation of arterial blood is called:
ischaemia
Paroxysmal nocturnal dyspnoea generally occurs with:
left ventricular failure
hypertension
pulmonary fibrosis
asthma
A 30-year-old male is experiencing respiratory failure. Which of the following lab values would be expected?
low Pa O2
normal blood pH
low PaCO2
electrolyte imbalances
A 1-year-old female is diagnosed with croup. Which of the following symptoms is most likely present?
respiratory stridor and barking cough
haemoptysis and mucus production
high fever and dry cough
drooling and snoring
A 30-year-old male prison inmate contracted tuberculosis during an outbreak. The organism that caused this condition is a:
fungus
bacterium
parasite
virus
A 1-year-old female is diagnosed with croup. The most likely cause of this disease is:
acute hyperventilation
bacterial infection
viral infection
allergy
A 6-month-old female presents with rhinorrhoea, cough, poor feeding, lethargy and fever. She is diagnosed with bronchiolitis. Which of the following is most likely causing her condition?
parainfluenza virus
respiratory syncytial virus
group A beta-haemolytic streptococcus
haemophilus B influenzae
This condition is an inflammatory response with extensive mucus production and submucosal oedema, resulting in widespread obstruction of bronchioles. It is of particular concern when present in infants.
bronchiolitis
tonsillitis
histoplasmosis
pneumonia
Pneumonia is caused by:
chronic lung changes seen with ageing
atelectasis
viral or bacterial infections
use of anaesthetic agents in surgery
What disease of the lungs is a contagious, airborne bacterial infection that causes fibrotic, calcified lesions that are visible on an X-ray?
legionellosis
tuberculosis
diphtheria
lobar pneumonia
This condition involves inflammation of the larynx, trachea and bronchi; is also known as laryngotracheobronchitis; involves copious mucus secretion; has a distinctive barking cough; and is potentially dangerous in infants.
rhinitis
laryngeal pneumonia
croup
pertussis
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 most likely had the greatest impact on development of his cancer?
radiation
cigarette smoke
asbestos
air pollution
Which type of lung cancer is most commonly associated with a history of smoking?
small cell carcinoma
squamous cell carcinoma
mesothelioma
adenocarcinoma
Clinical manifestations of acute sinusitis usually include:
bad breath and sore throat
copious frothy sputum and dyspnoea
severe localized pain in the facial bone and tenderness in the face
serous nasal discharge and chronic cough
What are typical signs and symptoms of epiglottitis?
Sudden fever, sore throat, and drooling saliva
Hyperinflation of the chest and stridor
Hoarse voice and barking cough
Sneezing, mild cough, and fever
A nurse is providing care for an older, previously healthy adult male has been diagnosed with pneumococcal pneumonia. Which of the following signs and symptoms is the nurse most likely to encounter?
The patient will lack lung consolidation and will have little sputum production.
High fever and chills, productive cough, crackles progressing to absence of breath sounds in affected lobes.
Copious bloody sputum and diffuse chest pain and may lose his cough reflex.
Hypotensive and afebrile and may manifest cognitive changes.
What would be the most effective compensation for chronic respiratory acidosis?
The kidneys reabsorbing more hydrogen ions
The kidneys producing more lactic acid
The kidneys eliminating more bicarbonate ions
The kidneys producing more bicarbonate ions
Which patient is most likely to have abnormalities in breathing regulation?
A 23-year-old male who has an injury to his frontal lobe following a sports injury
A 66-year-old male with temporal lobe infarcts secondary to a stroke
A 34-year-old male with damage to his upper and lower pons following a blow to the back of the head
A 45-year-old female with a spinal cord injury at C7 following a motor vehicle accident
The production of yellowish-green, cloudy, thick sputum is often an indication of:
damage of lung tissue due to smoking
emphysema
cancer tumour
A 50-year-old male with diabetes did not take his medication and is now in metabolic acidosis. He is experiencing Kussmaul respirations that can be characterised by:
very slow inhalations and rapid expirations.
rapid respirations with periods of apnoea.
an increased ventilatory rate, large tidal volumes and no expiratory pause.
audible wheezing or stridor.
Which of the following describes lobar pneumonia?
Opportunistic bacteria causing low-grade fever with cough and thick greenish sputum
Viral infection causing nonproductive cough and pleuritic pain
Insidious onset, diffuse interstitial infection
Sudden onset of fever and chills, with rales and rusty sputum
What are early signs and symptoms of infectious rhinitis?
Copious purulent sputum, particularly in the morning.
Serous nasal discharge, congestion, and sneezing.
Harsh barking cough and wheezing.
Purulent nasal discharge and periorbital pain.
Anxiety-provoked hyperventilation will:
increase PCO2 quite markedly, and increase PO2 to a similar extent
decrease PCO2 quite markedly, and increase PO2 to small extent
increase PO2 significantly, and increase PCO2 slightly
will not affect PCO2 but will increase PO2 significantly
A 20-year-old male is in acute pain. An arterial blood gas reveals decreased carbon dioxide levels. Which of the following is the most likely cause?
hypoventilation
hyperventilation
pain neurons producing bicarbonate buffer
apnoea
Changes in PCO2 tend to affect the pH of blood.
False, blood pH is largely unaffected by PCO2.
True, and decreases in PCO2 tend to decrease pH.
True, and increases in PCO2 tend to decrease blood pH.
True, and increases in PCO2 tend to increase pH.
Obstruction in the upper airway is usually indicated by:
rales
wheezing
stridor
A 28-year-old male complains to his GP that he has had a cold for a week and is coughing up bloody secretions. This condition is referred to as:
haematemesis.
haemoptysis.
cyanosis.
rhinitis.
How does severe hypoxia develop with pneumonia?
Oxygen diffusion is impaired by the congestion
Acidosis depresses respirations
Too painful to breath
Inflammatory exudate absorbs oxygen from the alveolar air
A 20-year-old male presents to his GP complaining of shortness of breath when lying down. This condition is referred to as:
dyspnoea on exertion.
orthostatic tachypnoea.
orthopnoea.
sleep apnoea.
A pneumonia that occurs 48 hours or more after admission to the hospital is considered
hospital-acquired pneumonia.
health care–associated.
viral pneumonia.
community-acquired pneumonia.
What would hypercapnia cause?
Respiratory acidosis
Decreased respirations
Decreased carbonic acid in the blood
Increased blood Ph
Light bubbly or crackling breathing sounds associated with serous secretions are called:
rhonchi
The extrinsic form of asthma is characterised by:
the release of chemical mediators from immune cells in lung tissue
an autonomic nervous system imbalance
the dominance of the parasympathetic stimulation of the airways
a tendency to develop in older individuals
Which one of the following antiasthma agents acts directly on intracellular cAMP levels?
Methylxanthines
β agonists
Leukotriene receptor antagonists
Muscarinic antagonists
A 13-year-old female is diagnosed with asthma. Which of the following should she recognise as part of an asthmatic attack?
bradycardia
headache
chest pain
Asthma is thought to be caused by:
an autosomal recessive trait.
excessive use of antibiotics as a young child.
interactions between genetic and environmental factors.
autoimmunity.
In asthma, _____ is (are) reduced.
dead space
expiratory flow rates
lung volumes
air trapping
A 52-year-old female presents with chronic bronchitis. Tests reveal closure of the airway during expiration. This condition is most likely caused by:
thinning smooth muscle in the bronchioles
ventilation-perfusion mismatch
thick mucus from hypertrophied glands
Individuals with a recent diagnosis of emphysema most often present with:
cor pulmonale
a productive cough
A 53-year-old male with a 20-year history of smoking is diagnosed with emphysema. His airways are obstructed because of:
infection and inflammation
airway oedema
excessive mucous production
loss of elastic recoil
A 60-year-old female with emphysema is having difficulty expiring a given volume of air. She is most likely experiencing _____ pulmonary disease.
restrictive
pleuritic
atelectatic
obstructive
A 45-year-old male presents with chronic bronchitis of 5 months’ duration. Which of the following is most likely to cause this condition?
chronic asthma
recurrent pneumonia
Which of the following activities does NOT require muscle contractions and energy?
Forced expiration
Quiet expiration
Quiet inspiration
Forced inspiration
Which of the following causes bronchodilation?
Drugs that block b2-adrenergic receptors
Noradrenaline
Histamine
Parasympathetic nervous system
What is the pathophysiology of an acute attack of extrinsic asthma?
Hyporesponsive mucosa
Continuous severe attacks unresponsive to medication
A hypersensitivity reaction involving release of chemical mediators
Gradual degeneration and fibrosis
Which of the following is typical of progressive emphysema?
Tidal volume increases.
Forced expiratory volume increases.
Residual lung volume increases.
Vital capacity increases.
Cystic fibrosis is transmitted as a/an:
chromosomal defect.
X-linked recessive gene.
autosomal dominant gene.
autosomal recessive gene.
Infant respiratory distress syndrome is initiated by:
excessive production of mucus and elastic tissue
insufficient production of mucus and elastic tissue
excessive production of surfactant
insufficient production of surfactant
An iatrogenic cause of pulmonary oedema is:
left sided heart failure
trauma resulting in pulmonary bleeding
incorrect insertion of nasogastric feeding tube
kidney failure
The term atelectasis describes:
fibrotic restriction on lung expansion
over inflation of the lungs
dilation of bronchi, but not of alveoli
partial or complete collapse of a lung
These inhaled particles are not able to be removal via phagocytosis, an are able to penetrate the alveolar wall. Prolonged exposure may lead to mesothelioma.
asbestos fibres
coal dust particles
silicate particles
Restrictive lung disorders may be divided into two groups based on:
patient history of obesity and exposure to other COPD.
previous lung disease and cardiovascular disorders.
anatomical abnormality and lung disease damage, impairing expansion.
smoking history and congenital defects.
Which of the following is a manifestation of a simple closed pneumothorax?
Asymmetrical chest movements
Tracheal deviation toward the unaffected lung
Increased breath sounds on the affected side
Decreased respiratory rate
What is caused by frequent inhalation of irritating particles such as silica?
Frequent bronchospasm
Fibrosis and loss of compliance
Distorted shape of the thorax
Increased number of mucus-producing glands
Pulmonary oedema causes severe hypoxia because of:
interference with expansion of the lungs
decreased diffusion of carbon dioxide from the alveoli
decreased recoil of lungs and ineffective expiration
constant cough and haemoptysis
A COPD patient asks what medications are prescribed to help his breathing.
Atenolol, a beta-blocker
Salbutemol, a bronchodilator
Alprazolam, a benzodiazepine
Sildenafil, a vasodilator
Which of the following residents of a long-term care facility is most likely to be exhibiting the signs and symptoms of chronic obstructive pulmonary disease (COPD)?
An 81-year-old male who has a productive cough and recurrent respiratory infections
A 79-year-old lifetime smoker who is complaining of shortness of breath and pain on deep inspiration
An 81-year-old smoker who has increased exercise intolerance, a fever, and increased white blood cells
An 88-year-old female who experiences acute shortness of breath and airway constriction when exposed to tobacco smoke
The primary pathophysiological problem faced by sufferers of emphysema is:
bronchoconstriction
lack of expiratory recoil
inability to draw sufficient air into the upper airways
occlusion due to excessive mucus production
Which of the following should not be applied, or advised, to someone suffering chronic bronchitis?
keep well hydrated
cough suppressant
bronchodilator
mucolytic agents
A patient is in an urgent care center with an acute asthma attack, which medication will be used for initial treatment?
An anticholinergic such as ipratropium
A short-acting beta2 agonist
A corticosteroid
A long-acting beta2 agonist
A group of common chronic respiratory disorders characterized by tissue degeneration and respiratory obstruction is called:
Mesothelioma
COPD
CF
Pulmonary fibrosis
All of the following are expected with infant respiratory distress syndrome EXCEPT:
fluid and protein in the alveoli
pulmonary vasoconstriction
severe hypoxia
respiratory alkalosis
________ describes any parenchymal lung disease caused by inhalation of inorganic dusts.
Pneumonia
Infant Respiratory Distress syndrome
Pneumoconiosis
Hypersensitive pneumonitis
Which of the following clinical findings would be most closely associated with a client who has interstitial lung disease in comparison to chronic obstructive pulmonary disease (COPD)?
Increased FVC
Reduced FEV1/FVC
Decreased total lung capacity
Reduced expiratory flow rates
Transudative pleural effusion arises because of:
constriction of bronchial airways
decreased levels of proteins in blood
decreased capillary hydrostatic pressure
Cystic fibrosis, as manifested in the lungs, is characterised by:
hyperplasia of smooth muscle cells
presence of abnormally viscous mucus
an abnormal fibrotic response
production of copious watery mucus
Which of the following is NOT a cause of pulmonary oedema?
Hyperproteinemia
Left-sided congestive heart failure
Inhalation of toxic gases
Excessive blood volume (overload)
Which statement does NOT apply to emphysema?
The surface area available for gas exchange is greatly reduced.
A genetic defect may lead to breakdown of elastic fibers.
Expiration is impaired.
The ventilation/perfusion ratio remains constant.
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
1, 2
1, 3
2, 3
2, 4
Alpha-1 antitrypsin deficiency is associated with:
cystic fibrosis
chronic bronchitis
Why does asthma result in fluid accumulation in the pulmonary interstitium?
because of pulmonary artery hypotension.
because of increased capillary permeability.
because of increased, internal mucous secretion.
None of the above; fluid may accumulate within the lumen of the airways, but it does not accumulate in the lung interstitium.
A patient is admitted for a relapse for sarcoidosis. Knowing this is usually caused by an inflammatory process, the nurse can anticipate administering.
a corticosteroid.
an salmeterol inhaler.
aspirin.
a bronchodilator.
Which of the following statements best captures the etiology of the acute response phase of extrinsic (atopic) asthma?
Chemical mediators are released from presensitized mast cells.
IgG production is heightened as a consequence of exposure to an allergen.
Epithelial injury and edema occur along with changes in mucociliary function.
Airway remodeling results in airflow limitations.
What is the cause of chronic bronchitis?
Deficit of enzymes, preventing tissue degeneration.
Hypersensitivity to parasympathetic stimulation in the bronchi.
Chronic irritation, inflammation, and recurrent infection of the larger airways.
A genetic defect causing excessive production of mucus.
Destruction of alveolar walls and septae is a typical change in:
cystic fibrosis.
emphysema.
acute asthma.
chronic bronchitis.
With a tension pneumothorax, which factors contribute to severe hypoxia?
More air leaving the pleural cavity on expiration than entering with inspiration.
Shift of the mediastinal contents toward the affected lung.
Decreasing compression of the inferior vena cava.
Continually increasing pressure on the unaffected lung.
Hypertrophy of goblet cells, decreased activity of the mucociliary escalator, and cor pulmonale, are most likely to occur in:
acute bronchitis
early stage emphysema
Why does cor pulmonale develop with chronic pulmonary disease?
Demands on the left ventricle are excessive.
Pulmonary fibrosis and vasoconstriction increase vascular resistance.
Blood viscosity is increased, adding to cardiac workload.
The right ventricle pumps more blood than the left ventricle.
Loss of interstitial elasticity in the lungs is a hallmark of:
all of the above
Which of the following is typical of chronic bronchitis?
Decreased activity of the mucous glands
Overinflation of bronchioles
Air trapping by excessive mucus plugs
Formation of blebs or bullae on the lung surface
A physician is providing care for a child who has a diagnosis of cystic fibrosis (CF). Place the following pathphysiological events of CF in chronological order. 1) Airway obstruction 2) Recurrent pulmonary infections 3) Impaired Cl transport 4) Decreased water content of mucociliary blanket 5) Increased Na+ absorption
1,4,3,5,2
5,3,4,1,2
3,5,4,1,2
3,4,5,1,2
What causes the expanded anteroposterior (A-P) thoracic diameter (barrel chest) in patients with emphysema?
Dilated bronchi and increased mucous secretions
Recurrent damage to lung tissues
Air trapping and hyperinflation
Persistent coughing to remove mucus