Practice Test Questions for Exam 4

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Multiple organ dysfunction syndrome (MODS) can be caused by:

a. septic shock.
b. prolonged tissue hypoxia.
c. uncontrolled systemic inflammation.
d. all of the above.

d. all of the above.

A person is unresponsive to verbal stimuli, has a heart rate = 150, cool, clammy skin, elevated serum levels of amylase, LDH, CK, SGOT, creatinine and urea, arterial pH = 7.24, PaO2 = 53 mm Hg, and BP = 76/52 but improving in response to fluid and vasoconstricting medications. This person is most likely in which of the following stages of shock?

a. initial stage
b. compensatory stage
c. progressive stage
d. irreversible stage
e. recovery stage

c. progressive stage

3. Which of the following statements about the etiology of septic shock is FALSE?

a. It can be caused by endotoxin from gram-negative bacteria.
b. It can be caused by gram-positive bacteria.
c. It is never caused by fungal infections.
d. It can be caused by translocation of bacteria from the intestinal tract into the blood.

c. It is never caused by fungal infections.

(1) Atelectasis is a type of restrictive pulmonary disorder.

(2) Post-operative atelectasis can be prevented by deep breathing and coughing.

a. both 1 and 2 are true
b. both 1 and 2 are false
c. 1 is true and 2 is false
d. 1 is false and 2 is true

a. both 1 and 2 are true

A pleural effusion can be caused by:

a. an increase in plasma oncotic pressure.
b. hypotension.
c. inflammation of the pleural membranes.
d. all of the above.

c. inflammation of the pleural membranes.

6. Which of the following statements about inflammation and untreated asthma is (are) true?

a. Airway inflammation is only present in the most severe stage of asthma.
b. Airway inflammation is not present an any form of asthma.
c. Airway inflammation is only present during an actual asthma attack.
d. Airway inflammation is present in all forms of persistent asthma (mild, moderate
& severe persistent asthma).

d. Airway inflammation is present in all forms of persistent asthma (mild, moderate
& severe persistent asthma).

7. If an individual with asthma has peak expiratory flow readings consistently in the green zone, it indicates:

a. that their asthma is well controlled.
b. that peak flow rates are 50 to 80 percent of that person's normal peak flow and their therapy needs to be re-evaluated.
c. that the peak flow is 60 to 80% of that person's predicted normal range and the person should take a dose of their long acting bronchodilator as soon as possible.
d. a medical alert because the peak flow is less than 50% of the normal range for that person indicating significant airway obstruction.

a. that their asthma is well controlled

8. Measurement of exhaled nitric oxide is used in the diagnosis of:

a. atelectasis.
b. pulmonary fibrosis.
c. asthma.
d. ataxic breathing.

c. asthma.

9. Which of the following are appropriate interventions for a patient with cardiogenic
pulmonary edema?

a. diuretics
b. administration of a medication that is a venous dilator
c. position the patient with the head of the bed elevated
d. all of the above

d. all of the above

10. Which of the following organisms is the most common cause of community-acquired
pneumonia?

a. Streptococcus pneumoniae
b. Pneumocystis carinii
c. mycoplasma pneumoniae
d. E. coli
e. Pseudomonas

a. Streptococcus pneumoniae

11. Which of the following statements about the treatment of pulmonary hypertension is true?

a. The treatment of primary and secondary pulmonary hypertension is always exactly the
same.
b. Secondary pulmonary hypertension is treated primarily by inhalation of nitric oxide.
c. Primary pulmonary hypertension may need to be treated by a lung transplant.
d. Primary pulmonary hypertension is treated with medications that cause systemic
hypotension.

c. Primary pulmonary hypertension may need to be treated by a lung transplant.

12. In a premature infant with infant respiratory distress syndrome (IRDS), which of the
following is (are) likely to be present?

a. restriction of lung expansion
b. lung injury caused by oxidative stress
c. below normal amount of surfactant in the alveoli
d. all of the above

d. all of the above

13. For a patient with ARDS the PaO2/FiO2 ratio will be:

a. greater than 500
b. between 400 and 500
c. between 200 and 300
d. less than 200

d. less than 200

Respiratory acidosis can result from:

A) increased minute ventilation.
B) decreased PaCO2.
C) tissue hypoxia.
D) reduced tidal volumes.

D) reduced tidal volumes.

In acute respiratory distress syndrome (ARDS), alveolar damage and impaired surfactant secretion lead to each of the following problems except:

A) pulmonary edema.
B) atelectasis.
C) air trapping.
D) pulmonary thrombus formation.

C) air trapping.

Why does airway obstruction in chronic lung disease cause hypercapnia?

A) Airway obstruction causes pulmonary edema.
B) Airway obstruction causes alveolar destruction.
C) Airway obstruction causes prolonged inspiration and rapid expirations.
D) Airway obstruction causes air trapping.

D) Airway obstruction causes air trapping.

When exposed to inhaled allergens, a child with asthma produces large quantities of what?

IgE

In individuals with asthma, exposure to an allergen leads to which of the following pathophysiological events?

A) Loss of elastin and increased airway compliance
B) Pulmonary edema and increased alveolar compliance
C) Type II alveolar cell injury and decreased surfactant
D) Bronchoconstriction and airway edema

D) Bronchoconstriction and airway edema

When conducting a physical assessment of an individual during an acute asthma episode, you would expect to observe all of the following except:

A) the use of accessory breathing muscles.
B) expiratory wheezing.
C) the absence of pulsus paradoxus.
D) coughing.

C) the absence of pulsus paradoxus.

What is a frequent complication of chronic bronchitis related to the hypersecretion of mucus?

Recurrent infections

Pneumonia leads to hypoxemia due to:

A) cardiogenic pulmonary edema.
B) upper airway obstruction.
C) the accumulation of exudates and fibrin deposition.
D) the decreased fraction of inspired oxygen

C) the accumulation of exudates and fibrin deposition.

All of the following physical and laboratory findings are indicative of a bacterial pneumonia except:

A) fever.
B) infiltrates on the chest X-ray film.
C) an increased white blood cell count.
D) a dry cough.

D) a dry cough.

Staff at an inner-city homeless shelter send 46-year-old Henry Ship by ambulance to a local hospital after he begins coughing up blood. On arrival at the emergency room, he is feverish and says that he has felt very fatigued for several weeks. He also reports experiencing night sweats. Mr. Ship's symptoms are most likely caused by:

A) viral pneumonia.
B) a pulmonary embolus.
C) tuberculosis.
D) aspiration pneumonia.

C) tuberculosis.

Risk factors for tuberculosis (TB) include:

A) age.
B) immunosuppression.
C) gender.
D) excessive use of antibiotics.

B) immunosuppression.

By what mechanism is severe acute respiratory distress syndrome (SARS) transmitted?

Droplet inhalation

Which of the following patients is at highest risk for developing a pulmonary embolism?

A) A 25-year-old male with asthma
B) A 28-year-old female in the first trimester of pregnancy
C) A 42-year-old female with a broken arm
D) A 67-year-old male hospitalized with a deep vein thrombosis in the femoral vein

D) A 67-year-old male hospitalized with a deep vein thrombosis in the femoral vein

Chronic pulmonary hypertension can eventually cause which of the following complications?

A) Pulmonary emboli
B) Congestive heart failure
C) Chronic obstructive pulmonary disease
D) Cor pulmonale

D) Cor pulmonale

Metaplastic changes to bronchial epithelial tissues are frequently caused by what?

Cigarette smoking

Signs and symptoms of dyspnea include:

A) decreased work of breathing.
B) feeling short of breath.
C) a failure to use accessory breathing muscles.
D) an improvement of symptoms with exercise.

B) feeling short of breath.

A high ventilation/perfusion (V/Q) ratio can be caused by:

A) increased dead space.
B) alveolar collapse.
C) obstruction to pulmonary blood flow.
D) bronchoconstriction.

C) obstruction to pulmonary blood flow.

Respiratory failure is defined by which one of the following laboratory alterations?

A) High PaO2
B) High PaCO2
C) Low hematocrit
D) High blood pH

B) High PaCO2

Lung injury that results in diffuse pulmonary inflammation and infiltrates and that is followed by development of a hyaline membrane at the alveolocapillary interface is a condition known as:

A) sarcoidosis.
B) emphysema.
C) chronic obstructive pulmonary disease (COPD).
D) acute respiratory distress syndrome (ARDS).

D) acute respiratory distress syndrome (ARDS).

Non-cardiogenic pulmonary edema most often is caused by:

A) congestive heart failure.
B) systemic infection (sepsis).
C) dehydration.
D) anemia.

B) systemic infection (sepsis).

Pulmonary edema and pneumothorax are examples of ______ pulmonary disease.

A) malignant
B) restrictive
C) obstructive
D) pleuritic

B) restrictive

Air that enters the pleural space during inspiration and is unable to exit during expiration creates a condition called:

A) tension pneumothorax.
B) open pneumothorax.
C) pleural effusion.
D) empyema.

A) tension pneumothorax.

Which of the following characteristics is not typical of asthma?

A) Asthma is a chronic inflammatory disorder.
B) Asthma is caused by bronchial hyperresponsiveness.
C) Asthma causes alveolar collapse.
D) Genetic susceptibility plays a role in the development of asthma.

C) Asthma causes alveolar collapse.

A life-threatening complication of asthma is:

A) exercise-induced asthma.
B) chronic obstructive pulmonary disease.
C) status asthmaticus.
D) bronchiectasis.

C) status asthmaticus.

Airway obstruction in chronic bronchitis is generally the result of:

A) thick mucous secretions and smooth muscle hypertrophy.
B) loss of alveolar elastin.
C) the accumulation of pulmonary edema.
D) hyperplasia of bronchial cartilage.

A) thick mucous secretions and smooth muscle hypertrophy.

Individuals who have recently developed chronic bronchitis most often present with:

A) productive cough.
B) wheezing.
C) a barrel chest.
D) severe dyspnea.

A) productive cough.

The increased anterior-posterior chest diameter associated with obstructive lung disease is caused by:

A) increased pulmonary blood flow.
B) increased expiratory flow rates.
C) increased residual lung volumes.
D) decreased chest wall compliance.

C) increased residual lung volumes.

Which of the following measures is most effective for preventing pulmonary emboli in patients who are recovering from a major surgery?

A) Ambulate patients frequently to prevent blood clot formation.
B) Ensure that patients use supplemental oxygen.
C) Prevent the development of anemia.
D) Promote aggressive fluid intake.

A) Ambulate patients frequently to prevent blood clot formation.

Primary pulmonary hypertension usually is caused by:

A) chronic pulmonary disease.
B) right-sided heart failure.
C) hereditary traits.
D) pulmonary emboli.

C) hereditary traits.

_____ is a term that signifies right-sided heart failure secondary to pulmonary hypertension.

Cor pulmonale

_____ atelectasis is the collapse of lung tissue caused by external pressure exerted by a tumor, fluid, or air.

Compression

What is inflammation of the pleura that causes pain on inspiration called?

Pleurisy

Which of the following sexually transmitted diseases is associated with urinary tract infections?

A) Herpes simplex virus
B) Candida albicans
C) Human papillomavirus
D) Trichomoniasis

B) Candida albicans

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