2808NRS Human Pathophysiology and Pharmacology 2 (Module 2)

Beschreibung

Module 2 EOT Exam Revision
Kathleen Jackson
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Kathleen Jackson
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Zusammenfassung der Ressource

Frage 1

Frage
What is a low level of arterial oxygen termed?
Antworten
  • hypocapnia
  • hypoxaemia
  • normoxia
  • hypoxia

Frage 2

Frage
Central cyanosis:
Antworten
  • 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

Frage 3

Frage
Blood is considered to be acidotic as soon as:
Antworten
  • 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

Frage 4

Frage
Orthopnoea is:
Antworten
  • noisy breathing with stridor or rhonchi.
  • difficulty breathing when lying down.
  • waking up suddenly, coughing, and struggling for breath.
  • very deep, rapid respirations.

Frage 5

Frage
Digital clubbing is a sign of:
Antworten
  • chronic hypocapnia
  • chronic hyperoxia
  • chronic hypoxia
  • chronic hypercapnia

Frage 6

Frage
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:
Antworten
  • haemoptysis
  • hypothermia
  • cyanosis
  • haematemesis

Frage 7

Frage
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:
Antworten
  • hyperpnoea
  • dyspnoea
  • orthopnoea
  • cyanosis

Frage 8

Frage
Reduced oxygenation of arterial blood is called:
Antworten
  • hypoxaemia
  • ischaemia
  • hypoxia
  • hypocapnia

Frage 9

Frage
Paroxysmal nocturnal dyspnoea generally occurs with:
Antworten
  • left ventricular failure
  • hypertension
  • pulmonary fibrosis
  • asthma

Frage 10

Frage
A 30-year-old male is experiencing respiratory failure. Which of the following lab values would be expected?
Antworten
  • low Pa O2
  • normal blood pH
  • low PaCO2
  • electrolyte imbalances

Frage 11

Frage
A 1-year-old female is diagnosed with croup. Which of the following symptoms is most likely present?
Antworten
  • respiratory stridor and barking cough
  • haemoptysis and mucus production
  • high fever and dry cough
  • drooling and snoring

Frage 12

Frage
A 30-year-old male prison inmate contracted tuberculosis during an outbreak. The organism that caused this condition is a:
Antworten
  • fungus
  • bacterium
  • parasite
  • virus

Frage 13

Frage
A 1-year-old female is diagnosed with croup. The most likely cause of this disease is:
Antworten
  • acute hyperventilation
  • bacterial infection
  • viral infection
  • allergy

Frage 14

Frage
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?
Antworten
  • parainfluenza virus
  • respiratory syncytial virus
  • group A beta-haemolytic streptococcus
  • haemophilus B influenzae

Frage 15

Frage
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.
Antworten
  • bronchiolitis
  • tonsillitis
  • histoplasmosis
  • pneumonia

Frage 16

Frage
Pneumonia is caused by:
Antworten
  • chronic lung changes seen with ageing
  • atelectasis
  • viral or bacterial infections
  • use of anaesthetic agents in surgery

Frage 17

Frage
What disease of the lungs is a contagious, airborne bacterial infection that causes fibrotic, calcified lesions that are visible on an X-ray?
Antworten
  • legionellosis
  • tuberculosis
  • diphtheria
  • lobar pneumonia

Frage 18

Frage
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.
Antworten
  • rhinitis
  • laryngeal pneumonia
  • croup
  • pertussis

Frage 19

Frage
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?
Antworten
  • radiation
  • cigarette smoke
  • asbestos
  • air pollution

Frage 20

Frage
Which type of lung cancer is most commonly associated with a history of smoking?
Antworten
  • small cell carcinoma
  • squamous cell carcinoma
  • mesothelioma
  • adenocarcinoma

Frage 21

Frage
Clinical manifestations of acute sinusitis usually include:
Antworten
  • 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

Frage 22

Frage
What are typical signs and symptoms of epiglottitis?
Antworten
  • Sudden fever, sore throat, and drooling saliva
  • Hyperinflation of the chest and stridor
  • Hoarse voice and barking cough
  • Sneezing, mild cough, and fever

Frage 23

Frage
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?
Antworten
  • 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.

Frage 24

Frage
What would be the most effective compensation for chronic respiratory acidosis?
Antworten
  • The kidneys reabsorbing more hydrogen ions
  • The kidneys producing more lactic acid
  • The kidneys eliminating more bicarbonate ions
  • The kidneys producing more bicarbonate ions

Frage 25

Frage
Which patient is most likely to have abnormalities in breathing regulation?
Antworten
  • 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

Frage 26

Frage
The production of yellowish-green, cloudy, thick sputum is often an indication of:
Antworten
  • damage of lung tissue due to smoking
  • emphysema
  • bacterial infection
  • cancer tumour

Frage 27

Frage
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:
Antworten
  • 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.

Frage 28

Frage
Which of the following describes lobar pneumonia?
Antworten
  • 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

Frage 29

Frage
What are early signs and symptoms of infectious rhinitis?
Antworten
  • Copious purulent sputum, particularly in the morning.
  • Serous nasal discharge, congestion, and sneezing.
  • Harsh barking cough and wheezing.
  • Purulent nasal discharge and periorbital pain.

Frage 30

Frage
Anxiety-provoked hyperventilation will:
Antworten
  • 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

Frage 31

Frage
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?
Antworten
  • hypoventilation
  • hyperventilation
  • pain neurons producing bicarbonate buffer
  • apnoea

Frage 32

Frage
Changes in PCO2 tend to affect the pH of blood.
Antworten
  • 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.

Frage 33

Frage
Obstruction in the upper airway is usually indicated by:
Antworten
  • rales
  • wheezing
  • stridor
  • orthopnoea

Frage 34

Frage
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:
Antworten
  • haematemesis.
  • haemoptysis.
  • cyanosis.
  • rhinitis.

Frage 35

Frage
How does severe hypoxia develop with pneumonia?
Antworten
  • Oxygen diffusion is impaired by the congestion
  • Acidosis depresses respirations
  • Too painful to breath
  • Inflammatory exudate absorbs oxygen from the alveolar air

Frage 36

Frage
A 20-year-old male presents to his GP complaining of shortness of breath when lying down. This condition is referred to as:
Antworten
  • dyspnoea on exertion.
  • orthostatic tachypnoea.
  • orthopnoea.
  • sleep apnoea.

Frage 37

Frage
A pneumonia that occurs 48 hours or more after admission to the hospital is considered
Antworten
  • hospital-acquired pneumonia.
  • health care–associated.
  • viral pneumonia.
  • community-acquired pneumonia.

Frage 38

Frage
What would hypercapnia cause?
Antworten
  • Respiratory acidosis
  • Decreased respirations
  • Decreased carbonic acid in the blood
  • Increased blood Ph

Frage 39

Frage
Light bubbly or crackling breathing sounds associated with serous secretions are called:
Antworten
  • rhonchi
  • wheezing
  • rales
  • stridor

Frage 40

Frage
The extrinsic form of asthma is characterised by:
Antworten
  • 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

Frage 41

Frage
Which one of the following antiasthma agents acts directly on intracellular cAMP levels?
Antworten
  • Methylxanthines
  • β agonists
  • Leukotriene receptor antagonists
  • Muscarinic antagonists

Frage 42

Frage
A 13-year-old female is diagnosed with asthma. Which of the following should she recognise as part of an asthmatic attack?
Antworten
  • bradycardia
  • headache
  • chest pain
  • wheezing

Frage 43

Frage
Asthma is thought to be caused by:
Antworten
  • an autosomal recessive trait.
  • excessive use of antibiotics as a young child.
  • interactions between genetic and environmental factors.
  • autoimmunity.

Frage 44

Frage
In asthma, _____ is (are) reduced.
Antworten
  • dead space
  • expiratory flow rates
  • lung volumes
  • air trapping

Frage 45

Frage
A 52-year-old female presents with chronic bronchitis. Tests reveal closure of the airway during expiration. This condition is most likely caused by:
Antworten
  • thinning smooth muscle in the bronchioles
  • hyperventilation
  • ventilation-perfusion mismatch
  • thick mucus from hypertrophied glands

Frage 46

Frage
Individuals with a recent diagnosis of emphysema most often present with:
Antworten
  • dyspnoea
  • cyanosis
  • cor pulmonale
  • a productive cough

Frage 47

Frage
A 53-year-old male with a 20-year history of smoking is diagnosed with emphysema. His airways are obstructed because of:
Antworten
  • infection and inflammation
  • airway oedema
  • excessive mucous production
  • loss of elastic recoil

Frage 48

Frage
A 60-year-old female with emphysema is having difficulty expiring a given volume of air. She is most likely experiencing _____ pulmonary disease.
Antworten
  • restrictive
  • pleuritic
  • atelectatic
  • obstructive

Frage 49

Frage
A 45-year-old male presents with chronic bronchitis of 5 months’ duration. Which of the following is most likely to cause this condition?
Antworten
  • cigarette smoke
  • chronic asthma
  • air pollution
  • recurrent pneumonia

Frage 50

Frage
Which of the following activities does NOT require muscle contractions and energy?
Antworten
  • Forced expiration
  • Quiet expiration
  • Quiet inspiration
  • Forced inspiration

Frage 51

Frage
Which of the following causes bronchodilation?
Antworten
  • Drugs that block b2-adrenergic receptors
  • Noradrenaline
  • Histamine
  • Parasympathetic nervous system

Frage 52

Frage
What is the pathophysiology of an acute attack of extrinsic asthma?
Antworten
  • Hyporesponsive mucosa
  • Continuous severe attacks unresponsive to medication
  • A hypersensitivity reaction involving release of chemical mediators
  • Gradual degeneration and fibrosis

Frage 53

Frage
Which of the following is typical of progressive emphysema?
Antworten
  • Tidal volume increases.
  • Forced expiratory volume increases.
  • Residual lung volume increases.
  • Vital capacity increases.

Frage 54

Frage
Cystic fibrosis is transmitted as a/an:
Antworten
  • chromosomal defect.
  • X-linked recessive gene.
  • autosomal dominant gene.
  • autosomal recessive gene.

Frage 55

Frage
Infant respiratory distress syndrome is initiated by:
Antworten
  • excessive production of mucus and elastic tissue
  • insufficient production of mucus and elastic tissue
  • excessive production of surfactant
  • insufficient production of surfactant

Frage 56

Frage
An iatrogenic cause of pulmonary oedema is:
Antworten
  • left sided heart failure
  • trauma resulting in pulmonary bleeding
  • incorrect insertion of nasogastric feeding tube
  • kidney failure

Frage 57

Frage
The term atelectasis describes:
Antworten
  • fibrotic restriction on lung expansion
  • over inflation of the lungs
  • dilation of bronchi, but not of alveoli
  • partial or complete collapse of a lung

Frage 58

Frage
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.
Antworten
  • asbestos fibres
  • coal dust particles
  • silicate particles
  • all answers are correct

Frage 59

Frage
Restrictive lung disorders may be divided into two groups based on:
Antworten
  • 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.

Frage 60

Frage
Which of the following is a manifestation of a simple closed pneumothorax?
Antworten
  • Asymmetrical chest movements
  • Tracheal deviation toward the unaffected lung
  • Increased breath sounds on the affected side
  • Decreased respiratory rate

Frage 61

Frage
What is caused by frequent inhalation of irritating particles such as silica?
Antworten
  • Frequent bronchospasm
  • Fibrosis and loss of compliance
  • Distorted shape of the thorax
  • Increased number of mucus-producing glands

Frage 62

Frage
Pulmonary oedema causes severe hypoxia because of:
Antworten
  • 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

Frage 63

Frage
A COPD patient asks what medications are prescribed to help his breathing.
Antworten
  • Atenolol, a beta-blocker
  • Salbutemol, a bronchodilator
  • Alprazolam, a benzodiazepine
  • Sildenafil, a vasodilator

Frage 64

Frage
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)?
Antworten
  • 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

Frage 65

Frage
The primary pathophysiological problem faced by sufferers of emphysema is:
Antworten
  • bronchoconstriction
  • lack of expiratory recoil
  • inability to draw sufficient air into the upper airways
  • occlusion due to excessive mucus production

Frage 66

Frage
Which of the following should not be applied, or advised, to someone suffering chronic bronchitis?
Antworten
  • keep well hydrated
  • cough suppressant
  • bronchodilator
  • mucolytic agents

Frage 67

Frage
A patient is in an urgent care center with an acute asthma attack, which medication will be used for initial treatment?
Antworten
  • An anticholinergic such as ipratropium
  • A short-acting beta2 agonist
  • A corticosteroid
  • A long-acting beta2 agonist

Frage 68

Frage
A group of common chronic respiratory disorders characterized by tissue degeneration and respiratory obstruction is called:
Antworten
  • Mesothelioma
  • COPD
  • CF
  • Pulmonary fibrosis

Frage 69

Frage
All of the following are expected with infant respiratory distress syndrome EXCEPT:
Antworten
  • fluid and protein in the alveoli
  • pulmonary vasoconstriction
  • severe hypoxia
  • respiratory alkalosis

Frage 70

Frage
________ describes any parenchymal lung disease caused by inhalation of inorganic dusts.
Antworten
  • Pneumonia
  • Infant Respiratory Distress syndrome
  • Pneumoconiosis
  • Hypersensitive pneumonitis

Frage 71

Frage
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)?
Antworten
  • Increased FVC
  • Reduced FEV1/FVC
  • Decreased total lung capacity
  • Reduced expiratory flow rates

Frage 72

Frage
Transudative pleural effusion arises because of:
Antworten
  • constriction of bronchial airways
  • decreased levels of proteins in blood
  • decreased capillary hydrostatic pressure
  • all answers are correct

Frage 73

Frage
Cystic fibrosis, as manifested in the lungs, is characterised by:
Antworten
  • hyperplasia of smooth muscle cells
  • presence of abnormally viscous mucus
  • an abnormal fibrotic response
  • production of copious watery mucus

Frage 74

Frage
Which of the following is NOT a cause of pulmonary oedema?
Antworten
  • Hyperproteinemia
  • Left-sided congestive heart failure
  • Inhalation of toxic gases
  • Excessive blood volume (overload)

Frage 75

Frage
Which statement does NOT apply to emphysema?
Antworten
  • 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.

Frage 76

Frage
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
Antworten
  • 1, 2
  • 1, 3
  • 2, 3
  • 2, 4

Frage 77

Frage
Alpha-1 antitrypsin deficiency is associated with:
Antworten
  • asthma
  • emphysema
  • cystic fibrosis
  • chronic bronchitis

Frage 78

Frage
Why does asthma result in fluid accumulation in the pulmonary interstitium?
Antworten
  • 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.

Frage 79

Frage
A patient is admitted for a relapse for sarcoidosis. Knowing this is usually caused by an inflammatory process, the nurse can anticipate administering.
Antworten
  • a corticosteroid.
  • an salmeterol inhaler.
  • aspirin.
  • a bronchodilator.

Frage 80

Frage
Which of the following statements best captures the etiology of the acute response phase of extrinsic (atopic) asthma?
Antworten
  • 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.

Frage 81

Frage
What is the cause of chronic bronchitis?
Antworten
  • 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.

Frage 82

Frage
Destruction of alveolar walls and septae is a typical change in:
Antworten
  • cystic fibrosis.
  • emphysema.
  • acute asthma.
  • chronic bronchitis.

Frage 83

Frage
With a tension pneumothorax, which factors contribute to severe hypoxia?
Antworten
  • 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.

Frage 84

Frage
Hypertrophy of goblet cells, decreased activity of the mucociliary escalator, and cor pulmonale, are most likely to occur in:
Antworten
  • acute bronchitis
  • chronic bronchitis
  • asthma
  • early stage emphysema

Frage 85

Frage
Why does cor pulmonale develop with chronic pulmonary disease?
Antworten
  • 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.

Frage 86

Frage
Loss of interstitial elasticity in the lungs is a hallmark of:
Antworten
  • emphysema
  • chronic bronchitis
  • asthma
  • all of the above

Frage 87

Frage
Which of the following is typical of chronic bronchitis?
Antworten
  • Decreased activity of the mucous glands
  • Overinflation of bronchioles
  • Air trapping by excessive mucus plugs
  • Formation of blebs or bullae on the lung surface

Frage 88

Frage
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
Antworten
  • 1,4,3,5,2
  • 5,3,4,1,2
  • 3,5,4,1,2
  • 3,4,5,1,2

Frage 89

Frage
What causes the expanded anteroposterior (A-P) thoracic diameter (barrel chest) in patients with emphysema?
Antworten
  • Dilated bronchi and increased mucous secretions
  • Recurrent damage to lung tissues
  • Air trapping and hyperinflation
  • Persistent coughing to remove mucus
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