Unit 8 Pulmonary Cumulative Quiz

Question 1

J-receptors (juxtapulmonary capillary receptors) are located near the capillaries in the alveolar septa. They are sensitive to increased __________ capillary pressure, which stimulates them to initiate rapid, shallow breathing, hypotension, and bradycardia

Answer 1

Pulmonary capillary pressure

Question 2

Hypoxemia caused by inadequate ventilation of well-perfused areas of the lung is a form of mismatching called_____

Answer 2

Shunting

Question 3

A patient has an acute infection of B-lymphocytes related to the epstein barr virus, which has resulted in lymph node enlargement, splenomegaly, hepatomegaly, and malaise (feel cruddy and super tired). Which condition should the nurse suspect?

Answer 3

mono

Question 4

What is the most effective way to prevent pulmonary embolism (PE) in post-surgical patients?

Answer 4

Prevent deep vein thrombosis formation

PE is most commonly results from embolization of a clot from deep vein thrombosis (DVT) involving the lower leg; thus, preventing these will help prevent PE

Fluid intake will help but is not as important as preventing DVT

Question 5

What problem should the nurse suspect for a client with hypotension, hypoxemia, and tracheal deviation to the left, with labs that reveal the air pressure in the pleural cavity is greater than barometric atmospheric pressure?

Answer 5

Tension pneumothorax

Tracheal deviation suggests tension pneumothorax, not pleural effusion. With open pneumothorax, a sucking sound would be heard without tracheal deviation.

Question 6

Describe the risks and pathophysiology associated with aspiration pneumonia

Answer 6

Pneumonia is when there is an infection in the lung that leads to inflammation. In aspiration pneumonia, a food substance enters the airways. This triggers an inflammatory response since the body treats it as any other foreign substance and that can lead to severe infection. An NG tube can illicit the same inflammatory response if contents accidentally go into the lungs.

Question 7

What is the pathophysiology behind Multiple Myeloma

Answer 7

Plasma cell cancer. Slow spread of malignant cells. Tumor IN bone marrow destroys bone. Less osteocytes to rebuild bone and produce RBCs. 50% of dx cases found with kdney problems. MM can cause nervous system damage when WBCs enter CNS, CSF, or meninge. We believe MM causes mutations and lifestyle choices determinants increase chances of getting MM.

Question 8

To rid the body of excess carbon dioxide, the rate and depth of respiration are ___________.

Answer 8

increased

Question 9

Overactivity of the RAAS results in primary hypertension by causing both retention of salt and water and _______

Answer 9

Increased vascular resistance

Question 10

Describe the difference between preload and afterload, and explain the condition that are most likely to increase the afterload of the heart

Answer 10

Preload is volume and pressure in ventricle after filling with blood (diastole). Determined by how much blood is left at the end of contraction (ESV) and venous blood return during diastole. After load is the force of resistance that the heart has to overcome to pump blood. Preload is after diastole, after load is before systole.

Afterload is commonly caused by HTN and HF

Question 11

A 50-year-old male is diagnosed with pulmonary embolism (PE). Which of the following symptoms most likely occurred before treatment was initiated?

Answer 11

Chest pain and shortness of breath

A person with PE ususalyy presents with sudden onset of pleuritic chest pain, dyspnea, tachypnea, tachycardia, and unexplained anxiety. Individuals with PE do not experience a cough or wheezing. Kussmaul respirations are associated with acidosis

Question 12

Diffusion of respiratory gases takes place across the ______ _______.

Answer 12

Diffusion of respiratory gases takes place across the alveolocapillary membrane. The visceral and parietal pleurae are the linings of the lung; gas exchange does not occur here. THe respiratory center is where impulses to the respiratory muscles are generated.

Question 13

What action would the nurse avoid when assessing a pediatric patient who present with high fever, inspiratory stridor, severe respiratory distress, drooling, and dysphagia?

Answer 13

Examining throat for redness

The child’s presentation is suspect for epiglottis. Any irritation of the throat in a client with epiglottis can lead to further laryngospasm and a total occlusion of the airway.

Examination of the throat should not be attempted as it may trigger laryngospasm and cause respiratory collapse. It is appropriate to attempt to keep the child calm, listen, and count the child’s RR and HR

Question 14

List the stages of atherosclerosis

Answer 14

Stage 1- Damage to the endothelium of a. Think smoking, HTN, toxins, viruses, and immune rxns.

Stage 2- Foam cells create a fatty streak when macrophages invade intima and engulf oxidized LDLs (foam cells).

STage 3- Fibrous plaque is formed as macrophages release growth factors which cause collagen to cover fatty streak.

Stage 4 Complicated plaques where they rupture. Leads to platelet adhesion, clotting cascade, and rapid thtombus formation.

Question 15

These types of respirations are characterized by alternating periods of deep and shallow breathing, with periods of apnea lasting from 15 to 60 seconds.

Answer 15

Cheyne-Stokes respirations

Question 16

The _______ ______ are sensitive to very small changes in the pH of CSF and can maintain a normal PaCO2
Central Chemoreceptors

Answer 16

Central Chemoreceptors

Question 17

A 10-year-old is brought to the ER with prolonged bronchospasm and severe hypoxemia that has not responded to his treatments. The symptomology supports which diagnosis?

• exercise-induced asthma
• COPD
• Status asthmaticus
• Bronchiectasis

Answer 17

Status asthmaticus

When bronchospasm is not reversed by the ususal measure, the individual is considered to have severe bronchospasm or status asthmaticus since exercise-induced asthma resolves itself.

COPD is manifested by air trapping and hypercapnia, not by bronchospasm

Bronchiectasis is manifested by bronchiolar changes, not by bronchospasm

Question 18

The standard method of diagnosis for Cystic Fibrosis is the sweat test, which reveals sweat ______ concentration in excess of 60 milliequivalents per liter

Answer 18

Sweat Chloride concentration

Question 19

Explain how atelectasis can result in V/Q mismatch or shunt

Answer 19

V is amount of air into alveoli aka VENTILATION, Q is amount of blood that makes it to the capillaries surrounding the alveoli aka PERFUSION. If there is not enough air, then blood cannot be properly oxygenated. V/Q mismatch is an imbalance between ventilation and perfusion. A shunt is a type of V/Q mismatch that is quite bad. When a lung collapses then the amount of oxygenated blood will drop because the alveoli have been damaged, ventilation has decreased, meanwhile, perfusion has not changed. A shunt is the result of hypoxia caused by inadequate ventilation.

Question 20

Surfactant facilitates alveolar distention and ventilation by:

Answer 20

Decreasing surface tension in alveoli

Question 21

A patient involved in a motor vehicle accident experiences a severe head injury and dies as a result of the loss of respiration. The nurse suspects the area of the brain most likely damaged is the:

Answer 21

Brain stem

The respiratory center in the brainstem controls respiration by transmitting impulses to the respiratory muscles, causing them to contract and relax. Respirations are not controlled by the cerebral cortex, the thalamus, or the basal ganglia

Question 22

Type II alveolar cells produce _____

Answer 22

Surfactant

Question 23

Describe what each segment of the ECG/EKG represents

Answer 23

P- wave is (R) atrial depolarization when the action begins after SA node starts it

• PR interval is the time between atrial activation to ventricle activation. Wildfire spreading from A to V.
• QRS interval captures the period of ventricular depolarization. Amp varies among ppl.
• T-wave is ventricular repolarization, when part is over.
• ST wave encompasses the depolarization and repolarization of the ventricles.

Question 24

Most oxygen is transported bound to

Answer 24

Hgb

Question 25

A 50-year-old is diagnosed with lung cancer. The health history includes a 30-year history of smoking, exposure to air pollution, asbestos, and radiation. What had the greatest impact on the development of his cancer?

Answer 25

Cigarette smoke

The most common cause of lung cancer is tobacco smoking./ While considered risk factors, neither exposure to radiation, asbestos, nor air pollution is the most common of the known triggers

Question 26

Aspiration of oral secretions increases a client’s risk for _______

Answer 26

pneumonia

Question 27

The oxyhemoglobin dissociation curve is shifted to the _________ by acidosis (low pH) and hypercapnia (increased PaCO2, and more oxygen is then released to the cells)

Answer 27

Right

Question 28

The nurse is reviewing labs for all assigned patients and learns that one of the patients has a higher number of bands. The patient has an acute infection with a white blood cell count of 15,000 and the bands making up 10% of that total. What description would the nurse anticipate for this condition?

Answer 28

Shift to the left

Question 29

______ _______ is the amount of air that can be forcibly expired after a maximal inspiration

Answer 29

vital capacity