Alterations of Pulmonary Function

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Module 12 Exam

Inflammation of the pleura that causes pain on inspiration is called:

A) an abscess.
B) pleurisy.
C) flail chest.
D) pleural effusion.

B) pleurisy.

Pleurisy is inflammation of the pleura that often manifests with pain on inspiration, fever, and chills.

Hypoventilation results in:

A) hypercapnia.
B) respiratory alkalosis.
C) increased minute ventilation.
D) decreased PaCO2.

A) hypercapnia.

Hypoventilation results in increased PaCO2, a condition called hypercapnia.

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

Increased right ventricular afterload from pulmonary hypertension can lead to right ventricular failure. Right ventricular failure due to respiratory disease is also known as "cor pulmonale."

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

Exposure to an allergen results in mast cell degranulation and release of inflammatory mediators that cause bronchoconstriction and airway edema.

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

The presence of deep vein thrombosis in the lower limb is the most important risk factor for pulmonary embolism. Older age is also a risk factor.

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.

Venous stagnation, a major risk factor for deep vein thrombus and pulmonary embolism formation, can be prevented by frequent ambulation after surgery.

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.

Obstruction to pulmonary blood flow results in decreased perfusion and a high V/Q ratio.

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

A) IgG.
B) IgE.
C) IgA.
D) IgM.

B) IgE.

During an allergic response (type I hypersensitivity reaction), plasma cells produce large quantities of IgE.

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.

The only known cause of primary pulmonary hypertension are genetic traits.

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).

ARDS involves a lung-wide inflammatory response to direct or indirect lung injury and manifests with diffuse pulmonary infiltrates and the development of a hyaline membrane.

Which of the following diseases will result in a ventilation/perfusion (V/Q) mismatch?

A) Asthma
B) Pulmonary edema
C) Emphysema
D) All of the above

D) All of the above

All three pulmonary diseases result in V/Q mismatches due to decreased ventilation and/or impaired diffusion of gases at the alveolar/capillary membrane.

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.

During an acute asthma episode, pulsus paradoxus increases.

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

A) Congestive heart failure
B) High output failure
C) Coronary disease
D) Cor pulmonale

D) Cor pulmonale

Cor pulmonale is right-sided heart failure secondary to pulmonary hypertension.

Hypertrophy of the nailbeds due to chronic hypoxemia is called:

A) hemoptysis.
B) clubbing.
C) cyanosis.
D) a bulla.

B) clubbing.

Clubbing is manifested by enlargements at the base of the fingernails.

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

A) Absorption
B) Perfusion
C) Fibrotic
D) Compression

D) Compression

Compression atelectasis occurs when a lung tumor, pulmonary edema, pleural effusion, or pneumothorax creates external pressures that collapse alveoli.

Which of the following conditions causes a decreased drive to breathe that results in hypoxemia and hypercapnia?

A) Emphysema
B) Asthma
C) Central nervous system disorders
D) Neuromuscular disorders

C) Central nervous system disorders

Central nervous system disorders result in a decreased drive to breathe due to damage to the respiratory centers.

The collapse of a previously inflated area of lung tissue is called:

A) aspiration.
B) bronchiectasis.
C) bronchiolitis.
D) atelectasis.

D) atelectasis.

The collapse of a previously inflated area of lung tissue is called atelectasis.

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.

The inflammatory response to lung infection results in the accumulation of fibrous exudates, which cause ventilation/perfusion (V/Q) mismatching and impair the diffusion of oxygen at the alveolocapillary membrane.

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.

Alveolar damage and altered surfactant production have no direct effect on the bronchi and therefore cannot cause 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.

With airway obstruction, air enters the alveoli but has difficulty escaping during exhalation. Air becomes trapped in the alveoli, and expiration must be more forceful and prolonged. When air is trapped, tidal volumes are reduced, causing hypercapnia.

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.

Increased residual lung volumes are a result of air trapping in obstructive lung disease and cause expansion of the chest wall.

A life-threatening complication of asthma is:

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

C) status asthmaticus.

Status asthmaticus is prolonged, severe bronchospasm that can be life-threatening if not reversed.

Cheyne-Stokes respirations are characterized by:

A) audible wheezing or stridor.
B) a slightly increased ventilatory rate, large tidal volumes, and no expiratory pause.
C) rapid respirations alternating with periods of apnea.
D) very slow inhalations and rapid expirations.

C) rapid respirations alternating with periods of apnea.

Apneic spells alternating with hyperventilation are called Cheyne-Stokes respirations and often occur with neurologic injury or profound metabolic alterations.

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.

A dry cough is indicative of a viral pneumonia. Bacterial pneumonia usually manifests with a productive cough.

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).

Inflammation present with systemic infections and sepsis is the main cause of non-cardiogenic pulmonary edema (i.e., acute respiratory distress syndrome, or ARDS).

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

Respiratory failure results in CO2 retention and elevated PaCO2.

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.

Dyspnea is the sensation of feeling short of breath.

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