Respiratory - 11/15 Quiz

Question 1

Pressure of the air in the pleural space is the same as barometric pressure because the air drawn into the pleural space during inspiration is forced back out during expiration.

Answer 1

Communicating pneumothorax

Question 2

Pressure of the air in the pleural space exceeds barometric pressure because air enters during inspiration but cannot exit during expiration.

Answer 2

Tension pneumothorax

Question 3

Alternating periods of deep and shallow breathing; apnea lasting 15 to 60 seconds, followed by ventilations that increase in volume until a peak is reached, after which ventilation decreases again to apnea (e.g., CHF, sleep apnea)

Answer 3

Cheyne-Stokes (breathing pattern)

Question 4

Increased ventilatory rate, small tidal volume

Answer 4

Restricted (breathing pattern)

Question 5

Rhythmic and effortless with normal tidal volume

Answer 5

Eupnea (breathing pattern)

Question 6

Irregular, quick inspirations with an expiratory pause

Answer 6

Gasping (breathing pattern)

Question 7

Increased ventilatory rate, small tidal volume, increased effort, prolonged expiration, wheezing

Answer 7

Obstructed (breathing pattern)

Question 8

Increased ventilatory rate, very large tidal volume, no expiratory pause

Answer 8

Kussmaul (breathing pattern) - DKA DM I & renal failure patients

Question 9

waking up with dyspnea during the night and needing to sit upright or stand to breathe

Answer 9

Paroxysmal nocturnal dyspnea

Question 10

Rib fractures that disrupt the mechanics of breathing can cause a portion of the chest wall to collapse ________ during inspiration, an acute condition known as _______ chest.

Answer 10

inward; flail

Question 11

A person who has pneumothorax has _____ in the pleural space.

Answer 11

air

Question 12

A person who has _______ has persistent abnormal dilations of the bronchi and a chronic cough that produces large amounts of purulent _______.

Answer 12

bronchiectasis; sputum

Question 13

Pulmonary fibrosis is an excessive amount of ______ tissue in the lungs and causes ______ lung compliance.

Answer 13

fibrotic; decreased

Question 14

In asthma, long-term airway damage that is irreversible is known as airway _________.

Answer 14

remodeling

Question 15

During an acute asthma episode, inflammatory mediators cause inflammation, hypersecretion of ______, and bronchial smooth muscle ________.

Answer 15

mucus; constriction

Question 16

An asthma episode that does not resolve with usual treatment is called ______ ________.

Answer 16

status asthmaticus

Question 17

Genetic deficiency of ____ __________ causes early-onset emphysema because this enzyme normally inhibits the action of _________ _________ that can destroy lung tissue.

Answer 17

alpha-1 antitrypsin; proteolytic enzyme

Question 18

Alveolar ventilation is inadequate in relationship to the metabolic demands; leads to respiratory acidosis

Answer 18

hypoventilation

Question 19

Alveolar ventilation exceeds the metabolic demands; leads to respiratory alkalosis from hypocapnia.

Answer 19

hyperventilation

Question 20

Head injuries causes…(hypo/hyper-ventilation)

Answer 20

hyperventilation

Question 21

Airway obstruction causes… (hypo/hyper-ventilation)

Answer 21

hypoventilation

Question 22

Respiratory muscle weakness causes… (hypo/hyper-ventilation)

Answer 22

hypoventilation

Question 23

Reduced compliance of chest wall causes… (hypo/hyper-ventilation)

Answer 23

hypoventilation

Question 24

Anxiety causes… (hypo/hyper-ventilation)

Answer 24

hyperventilation

Question 25

A person who has ….. has persistent abnormal dilations of the bronchi and a chronic cough that produces large amounts of purulent …..

Answer 25

bronchiectasis; pus-like sputum

Question 26

Most common cause of pulmonary edema

Answer 26

left-sided heart failure

Question 27

Pink frothy sputum, dyspnea, hypoxemia, increased work of breathing, crackles/rales, dullness on percussion, hypoventilation with hypercapnia

Answer 27

Pulmonary edema

Question 28

Cor pulmonale …-sided HF

Pulmonary edema …-sided HF

Answer 28

Right

Left

Question 29

Conditions related to \_\_\_\_\_ :
lung fluid increases,
systemic inflammatory response occurrence,
lungs dry out,
lung volume decreased
hypoxemia (always at end phase)

Answer 29

Acute Respiratory Distress Syndrome (ARDS)

Question 30

RN receives report on pt w/ARDS who has been intubated for 6 days and had progressive hypoxemia that responds poorly to high levels of oxygen. This pt is in which phase of ARDS case management?

Answer 30

fibro-proliferative:

fibrotic and proliferative phase at same time

Question 31

Airway obstruction is worse with expiration.
More force/time is required to expire given vol of air; emptying lungs is slowed.
unifying s/sx: wheeze & dyspnea.
Inc. WOB, vent-perf mismatch, dec. FEV1 (in 1 second).

Answer 31

Obstructive pulmonary disease

Question 32

Types of obstructive pulmonary disease

Answer 32

asthma, chronic bronchitis, emphysema, COPD

Question 33

Life threatening bronchospasms not reversed by usual measures

Answer 33

Status asthmaticus

Question 34

Albuterol nebulizer

Answer 34

quick-relief agent

beta-adrenergic agonist

Question 35

Oral prednisone

Answer 35

long-term control

steroid inflammatory

Question 36

Ipratropium inhaler

Answer 36

quick-relief agent

anticholinergic

Question 37

Salmeterol inhaler

Answer 37

long-term control

beta-adrenergic agonist

Question 38

The pulmonary vasoconstriction leading to development of cor pulmonale in patient with COPD results from…

Answer 38

alveolar hypoxia and hypercapnia

pulmonary HTN -> vasoC

Question 39

Abnormal permanent enlargement of gas-exchange airways accompanied by destruction of alveolar walls w/o obvious fibrosis.

Answer 39

Emphysema

Question 40

Inherited deficiency of enzyme α1-antitrypsin;

Involves entire acinus, damage is more randomly distributed, involves LOWER lobes of lung.

Answer 40

Primary emphysema;

Panlobular/Panacinar

Question 41

Main cause is cigarette smoke. Possible contributors: air pollution, occupational exposures, childhood resp. infxns.;
Septal destruction occurs in respiratory bronchioles & alveolar ducts, usu in UPPER lobes, alveolar sac remains intact, tends to occur in smokers w/chronic bronchitis.

Answer 41

Secondary emphysema;

Centrilobular/Centriacinar

Question 42

Pneumonia acquired <48 hours of hospitalization.

Streptococcus pneumoniae

Answer 42

community-acquired

Question 43

Pneumonia acquired >48 hours of hospitalization.

Staph, or commonly Gram-Neg e.coli, pseudo, kleb, enterob.

Answer 43

hospital acquired; nosocomial infection