Module 8 Pathophysiology – Flashcards

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question
A 25-year-old male presents with chronic bronchitis of 5 months' duration. When obtaining the patient's history, which of the following findings is most likely to cause this condition?
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Cigarette smoke
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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.
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An increase
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While auscultating a patient's lungs, a nurse recalls the alveoli in the apexes of the lungs are _____ than alveoli in the bases.
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Larger
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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?
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Tension pneumothorax
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When the nurse is asked what causes asthma, how should the nurse respond? Asthma is thought to be caused by:
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Interactions between genetic and environmental factors
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A 9-year-old male contracted influenza. Which of the following complications is of greatest concern to the nurse?
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Bronchiolitis obliterans
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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?
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A slightly increased ventilatory rate, large tidal volumes, and no expiratory pause
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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:
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Increased oxygen consumption
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A patient asks how oxygen is transported in the body. What is the nurse's best response? Most of the oxygen (O2) is transported:
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Bound to hemoglobin
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A 2-year-old female fell in a swimming pool and nearly drowned. She then developed acute respiratory distress syndrome (ARDS). Which of the following should the nurse assess the patient for?
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Hypoxemia
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A young patient is admitted to the pediatric unit with cystic fibrosis (CF) exacerbation. The nurse monitors the patient closely because the main cause of death in a child with CF is:
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Respiratory failure
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A patient asks what causes pneumonia. How should the nurse reply? Pneumonia is caused by:
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Viral or bacterial infections
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The nurse is describing the receptors in the lung that decrease ventilatory rate and volume when stimulated. Which receptors is the nurse discussing?
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Stretch receptors
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A 2-year-old male presents with fever and cough. He is diagnosed with pneumonia. While planning treatment for this patient, the nurse recognizes that which of the following is the most likely cause?
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Viruses
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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:
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Humidify air
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A 65-year-old female with emphysema presents to the ER for difficulty breathing. Physical exam reveals bluish skin and mucous membranes. How should the nurse chart this condition? Patient has:
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Cyanosis
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The pressure required to inflate an alveolus is inversely related to:
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Alveolar radius
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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?
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Cheyne-Stokes
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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?
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Increase in respiratory rate
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A 7-month-old male presents with cystic fibrosis (CF) accompanied by failure to thrive and frequent, loose, and oily stools. Sweat testing reveals increased chloride. Which of the following should the nurse observe for that would accompany this disease?
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A thick mucus
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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:
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Brainstem
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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:
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Vital capacity (VC)
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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:
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Mucus secretion, bronchoconstriction, and airway edema
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A 10-year-old male is brought to the ER with prolonged bronchospasm and severe hypoxemia. The most likely diagnosis on the chart is:
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Status asthmaticus
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To prevent sudden infant death syndrome, the nurse should instruct parents to:
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Always lay infants down on their backs to sleep
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A 30-year-old male prison inmate contracted tuberculosis during an outbreak. While planning interactions, the nurse realizes the patient can transmit this disease through:
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Airborne droplets
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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:
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Decreased inspired oxygen
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A 6-month-old female presents with rhinorrhea, cough, poor feeding, lethargy, and fever. She is diagnosed with bronchiolitis. Which of the following will the nurse most likely observe on the culture report?
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Respiratory syncytial virus
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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?
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Hemoptysis
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A nurse remembers a low ventilation-perfusion ratio results in:
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Shunting
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A newborn has respiratory distress syndrome. A nurse recalls cardiovascular alterations seen in respiratory distress syndrome include:
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Opening of fetal shunt pathways
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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?
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Absorption atelectasis
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An aide asks a nurse how surfactant works. How should the nurse respond? Surfactant facilitates alveolar distention and ventilation by:
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Decreasing surface tension in alveoli
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A geneticist is discussing cystic fibrosis (CF). Which information should be included? CF is an _____ disease.
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Autosomal recessive
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During a respiratory assessment of an infant with respiratory distress syndrome, a sinking in the supraclavicular and intercostal areas of the thorax was noted with inspiration. This observation is documented as:
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Retractions
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A 14-year-old male is experiencing an asthma exacerbation. When reviewing the lab results, which of the following cells in the submucosa promote this inflammatory response and will be elevated?
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Eosinophils
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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:
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Air trapping
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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.
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Obstructive
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An 11-year-old female presents with a low-grade fever and cough. She is diagnosed with atypical pneumonia. What type of pneumonia does the nurse suspect the patient is experiencing?
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Mycoplasma pneumonia
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The nurse is describing the slit-shaped space between the true vocal cords. What term should the nurse use?
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Glottis
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A 5-month-old female is found dead in her crib. The coroner ruled sudden infant death syndrome (SIDS) as the cause of death. Which of the following risk factors is most likely associated with SIDS?
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Frequent respiratory infections
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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?
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Empyema
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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?
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Staphylococcus aureus
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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?
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Elevated PaCO2
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A 47-year-old male is diagnosed with pulmonary edema. Which assessment findings will the nurse observe?
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Pink, frothy sputum
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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?
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Pulmonary hypertension
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While planning care, a nurse recalls respiratory distress and hypoxemia in laryngotracheobronchitis are caused by:
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Mucosal edema
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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?
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Acute respiratory distress syndrome (ARDS)
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Which of the following patients is at highest risk for developing pulmonary embolism (PE)?
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72-year-old male who is recovering from hip replacement surgery in the hospital
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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:
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Alveoli
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A 1-year-old female is diagnosed with croup. When the parent asks what caused this, what is the nurse's best response? The most likely cause of this disease is:
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Viral infection
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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?
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Non-small cell carcinoma
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A 2-week-old female presents with fever, cough, respiratory distress, and empyema. Which of the following is the most likely diagnosis the nurse will observe on the chart?
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Staphylococcal pneumonia
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A pulmonologist is discussing the base of the lungs with staff. Which information should be included? At the base of the lungs:
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Arterial perfusion pressure exceeds alveolar gas pressure.
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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?
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Functional residual capacity (FRC) is reached.
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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
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140 mm Hg
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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?
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Inhalation of silica, asbestos, mica
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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?
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Pneumonia
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A consequence of alveolar hypoxia is:
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Pulmonary artery vasoconstriction
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Individuals with a recent diagnosis of emphysema should be assessed for which most common presenting factor?
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Dyspnea
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Which patient would the nurse assess for paroxysmal nocturnal dyspnea (PND)? A patient with:
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Left ventricular failure
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A nurse recalls asthma is classified by:
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Clinical severity
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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?
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Decreased functional residual capacity
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The pulmonologist is presenting a workshop over the lungs. Which information should be included? The lung receives parasympathetic innervation by the _____ nerve.
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Vagus
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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?
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Hyperventilation
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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:
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Exchange of gases between the environment and blood
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A nurse remembers the majority of total airway resistance occurs in the:
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Nose
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A nurse recalls the pleural membranes are examples of _____ membranes.
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Serous
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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:
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Alpha-1-antitrypsin deficiency
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A newborn has respiratory distress syndrome. A nurse monitors the newborn for atelectasis because of:
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A lack of surfactant
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When the nurse observes a diagnosis of nosocomial pneumonia, the patient generally acquires this pneumonia:
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During hospitalization
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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?
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Dyspnea
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An infant was born 10 weeks premature and put on mechanical ventilation. Two months later he presents with hypoxemia and hypercapnia. Which of the following is the most likely diagnosis the nurse will observe documented on the chart?
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Bronchopulmonary dysplasia (BPD)
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While reviewing lab results, to help confirm a diagnosis of cystic fibrosis in a 1-year-old child which substance will be present in the child's sweat?
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Sodium chloride
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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?
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Orthopnea
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A 70-year-old female is in the hospital for pelvic fracture. She develops pulmonary thromboembolism. The nurse realizes this embolus is composed of:
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Blood clot
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The pulmonologist talks about the receptors that respond to increased pulmonary capillary pressure. What term will indicate the nurse understands? They are called:
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J receptors
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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?
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Perfusion
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In a patient with acidosis or a fever, the nurse would expect the oxyhemoglobin dissociation curve to shift:
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To the right, causing more O2 to be released to the cells
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A nurse is preparing to teach the staff about asthma. Which information should the nurse include? Airway hyper-responsiveness in asthma is related to:
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Exposure to an allergen causing mast cell degranulation
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A 5-year-old male presents with high fever, inspiratory stridor, severe respiratory distress, drooling, and dysphagia. Which of the following behaviors by the student nurse would be a cause for concern?
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The student nurse examines the throat for redness.
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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.
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Central chemoreceptors Reference/Notes:
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A nurse is teaching about sudden infant death syndrome (SIDS). Which information should the nurse include? SIDS peaks between _____ and ____months of age.
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3, 4
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A 60-year-old female with a history of cirrhosis presents with dyspnea, impaired ventilation, and pleural pain. A diagnosis of pleural effusion is made, and a watery fluid is drained. When giving report, the nurse will refer to this fluid as:
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Transudative
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A 50-year-old male is diagnosed with pulmonary embolism (PE). Which of the following symptoms most likely occurred before treatment?
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Chest pain and shortness of breath
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A newborn has respiratory distress syndrome (RDS). The nurse reports this condition appeared:
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Within minutes of birth
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A newborn is in respiratory distress and requires ventilation. Tests reveal that he does not produce surfactant due to the absence of:
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Type II alveolar cells
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A nurse is teaching staff about pulmonary edema. Which information should the nurse include? The most common cause of pulmonary edema is:
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Left heart failure
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Which of the following shows a correct cause and effect sequence in the development of acute respiratory distress syndrome (ARDS)?
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Alveolocapillary membrane injury causing a massive inflammatory response
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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:
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Thick mucus from hypertrophied glands
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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?
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Cigarette smoke
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A 13-year-old female is diagnosed with asthma. Which of the following should the nurse teach the patient to recognize as part of an asthmatic attack?
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Wheezing
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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?
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Irritant receptors in the nostrils
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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:
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Loss of elastic recoil
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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:
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In the form of bicarbonate
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Which principle should the nurse remember while planning care for a patient with respiratory problems? Diffusion of respiratory gases takes place at the:
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Alveolocapillary membrane
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A 25-year-old male presents with chronic bronchitis of 5 months' duration. Which of the following is the most significant concern for the nurse to monitor in this patient?
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Recurrent pulmonary infections
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While planning care for a child with asthma, which of the following is characteristic of asthma?
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Prolonged expirations
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A 10-year-old male was diagnosed with obstructive sleep apnea. When the parents ask what treatment comes next, how should the nurse respond? The treatment that will most likely be tried first is:
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Tonsillectomy and adenoidectomy (T&A)
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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
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18.76 ml O2 per 100 ml blood
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A newborn has respiratory distress syndrome. When obtaining the patient's history, which of the following is the most important predisposing factor for this condition?
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Premature birth
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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:
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Alveolar dead space
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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):
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Increase in the size of the thorax and a decrease in intrapleural pressure
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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?
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Bronchiolitis obliterans
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A 30-year-old male prison inmate contracted tuberculosis during an outbreak. When the nurse reviews the lab results, the organism that caused this condition is a:
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Bacterium
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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?
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Hypoxemia
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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?
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Prevent deep vein thrombosis formation.
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