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2808NRS Human Pathophysiology and Pharmacology 2 (Module 2)

Description

Module 2 EOT Exam Revision
Kathleen Jackson
Quiz by Kathleen Jackson, updated more than 1 year ago
Kathleen Jackson
Created by Kathleen Jackson over 5 years ago
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Resource summary

Question 1

Question
What is a low level of arterial oxygen termed?
Answer
  • hypocapnia
  • hypoxaemia
  • normoxia
  • hypoxia

Question 2

Question
Central cyanosis:
Answer
  • 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

Question 3

Question
Blood is considered to be acidotic as soon as:
Answer
  • 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

Question 4

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

Question 5

Question
Digital clubbing is a sign of:
Answer
  • chronic hypocapnia
  • chronic hyperoxia
  • chronic hypoxia
  • chronic hypercapnia

Question 6

Question
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:
Answer
  • haemoptysis
  • hypothermia
  • cyanosis
  • haematemesis

Question 7

Question
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:
Answer
  • hyperpnoea
  • dyspnoea
  • orthopnoea
  • cyanosis

Question 8

Question
Reduced oxygenation of arterial blood is called:
Answer
  • hypoxaemia
  • ischaemia
  • hypoxia
  • hypocapnia

Question 9

Question
Paroxysmal nocturnal dyspnoea generally occurs with:
Answer
  • left ventricular failure
  • hypertension
  • pulmonary fibrosis
  • asthma

Question 10

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

Question 11

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

Question 12

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

Question 13

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

Question 14

Question
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?
Answer
  • parainfluenza virus
  • respiratory syncytial virus
  • group A beta-haemolytic streptococcus
  • haemophilus B influenzae

Question 15

Question
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.
Answer
  • bronchiolitis
  • tonsillitis
  • histoplasmosis
  • pneumonia

Question 16

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

Question 17

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

Question 18

Question
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.
Answer
  • rhinitis
  • laryngeal pneumonia
  • croup
  • pertussis

Question 19

Question
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?
Answer
  • radiation
  • cigarette smoke
  • asbestos
  • air pollution

Question 20

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

Question 21

Question
Clinical manifestations of acute sinusitis usually include:
Answer
  • 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

Question 22

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

Question 23

Question
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?
Answer
  • 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.

Question 24

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

Question 25

Question
Which patient is most likely to have abnormalities in breathing regulation?
Answer
  • 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

Question 26

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

Question 27

Question
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:
Answer
  • 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.

Question 28

Question
Which of the following describes lobar pneumonia?
Answer
  • 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

Question 29

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

Question 30

Question
Anxiety-provoked hyperventilation will:
Answer
  • 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

Question 31

Question
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?
Answer
  • hypoventilation
  • hyperventilation
  • pain neurons producing bicarbonate buffer
  • apnoea

Question 32

Question
Changes in PCO2 tend to affect the pH of blood.
Answer
  • 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.

Question 33

Question
Obstruction in the upper airway is usually indicated by:
Answer
  • rales
  • wheezing
  • stridor
  • orthopnoea

Question 34

Question
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:
Answer
  • haematemesis.
  • haemoptysis.
  • cyanosis.
  • rhinitis.

Question 35

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

Question 36

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

Question 37

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

Question 38

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

Question 39

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

Question 40

Question
The extrinsic form of asthma is characterised by:
Answer
  • 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

Question 41

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

Question 42

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

Question 43

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

Question 44

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

Question 45

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

Question 46

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

Question 47

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

Question 48

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

Question 49

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

Question 50

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

Question 51

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

Question 52

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

Question 53

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

Question 54

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

Question 55

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

Question 56

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

Question 57

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

Question 58

Question
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.
Answer
  • asbestos fibres
  • coal dust particles
  • silicate particles
  • all answers are correct

Question 59

Question
Restrictive lung disorders may be divided into two groups based on:
Answer
  • 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.

Question 60

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

Question 61

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

Question 62

Question
Pulmonary oedema causes severe hypoxia because of:
Answer
  • 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

Question 63

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

Question 64

Question
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)?
Answer
  • 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

Question 65

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

Question 66

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

Question 67

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

Question 68

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

Question 69

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

Question 70

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

Question 71

Question
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)?
Answer
  • Increased FVC
  • Reduced FEV1/FVC
  • Decreased total lung capacity
  • Reduced expiratory flow rates

Question 72

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

Question 73

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

Question 74

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

Question 75

Question
Which statement does NOT apply to emphysema?
Answer
  • 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.

Question 76

Question
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
Answer
  • 1, 2
  • 1, 3
  • 2, 3
  • 2, 4

Question 77

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

Question 78

Question
Why does asthma result in fluid accumulation in the pulmonary interstitium?
Answer
  • 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.

Question 79

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

Question 80

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

Question 81

Question
What is the cause of chronic bronchitis?
Answer
  • 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.

Question 82

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

Question 83

Question
With a tension pneumothorax, which factors contribute to severe hypoxia?
Answer
  • 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.

Question 84

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

Question 85

Question
Why does cor pulmonale develop with chronic pulmonary disease?
Answer
  • 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.

Question 86

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

Question 87

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

Question 88

Question
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
Answer
  • 1,4,3,5,2
  • 5,3,4,1,2
  • 3,5,4,1,2
  • 3,4,5,1,2

Question 89

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