NURS 123 final practice quiz

jasmine's version from 2016-03-18 04:59

Section 1


Question Answer
Where in the respiratory tract do the majority of foreign objects aspirated by children finally lodge? Bronchus; Approximately 75 percent of aspirated foreign bodies lodge in this
What are the clinical manifestations of bacterial pneumonia in children? High fever, productive cough, and pleuritic chest pain
Which statement best describes cystic fibrosis? It is best described as a pulmonary disorder involving an abnormal expression of a protein-producing viscous mucus that obstructs the airways, pancreas, sweat ducts, and vas deferens
Cystic fibrosis is caused by which process? Autosomal recessive inheritance; It is associated with defective epithelial ion transport
What are the abnormalities in cytokines found in children with cystic fibrosis? Deficit of IL-10 and an excess of IL-1, IL-8, and TNF-alpha; All changes conducive to promoting inflammation
Between which months of age does sudden infant death syndrome most often occur? 2 and 4; It is low during first month and unusual after 6 months
What is the most common predisposing factor to obstructive sleep apnea in children? Adenotonsillar hypertrophy, which causes physical impingement on the nasopharyngeal airway
What is the primary cause of respiratory distress syndrome (RDS) of the newborn? A surfactant deficiency
The primary problem in respiratory distress syndrome (RSD) of the newborn is Atelectasis
Which of the following shows a correct sequence of events after atelectasis develops in respiratory distress syndrome of the newborn? Pulmonary hypo-perfusion, hypoxic vasoconstriction, right-to-left shunt
Which statement about the advances in the treatment of respiratory distress syndrome (RDS) of the newborn is false? Administering oxygen to mothers during preterm labor to increase their arterial oxygen before birth of the fetus; Administering glucocorticoids to women in preterm labor accelerates the maturation of the fetus's lungs; Instilling exogenous surfactant down an endotracheal tube of infants weighing less than 1000 g; and Supporting the infant's respiratory function by using continuous positive airway pressure (CPAP) are all true
The risk for respiratory distress syndrome (RDS) decreases for premature infants when they are born after how many weeks of gestation? 30
Which type of croup is most common? Viral
Why is nasal congestion a serious threat to young infants? They are obligatory nose breathers
Chest wall compliance in infants is what compared to adults? Higher than
The chief predisposing factor for respiratory distress syndrome of the newborn is Premature birth

Section 2

Question Answer
Which inflammatory mediators are produced in asthma? Histamine, prostaglandins, and leukotrienes
What medical term is used to identify the accumulation of air in the pleural space? Pneumothorax; Pneumothorax is the presence of air or gas in the pleural space caused by a rupture in the visceral pleura (which surrounds the lungs) or the parietal pleura and chest wall
Clinical manifestations of inspiratory crackles, increased tactile fremitus, egophony, and whispered pectoriloquy are indicative of which respiratory condition? Pneumonia; Physical examination may reveal signs of pulmonary consolidation, encompassing all of these and supporting a diagnosis
Pulmonary artery hypertension (PAH) results from which alteration? Narrowed pulmonary capillaries; It is characterized by endothelial dysfunction with an overproduction of vasoconstrictors (i.e., thromboxane and endothelin), and decreased production of vasodilators (i.e., nitric oxide and prostacyclin), resulting in narrowed pulmonary capillaries
Squamous cell carcinoma of the lung is best described as a tumor that causes which alterations? Airway obstruction and atelectasis; Typically, the tumors are centrally located near the hila and project into bronchi. Because of this central location, non-productive cough or hemoptysis (coughing up blood) is common. Pneumonia and atelectasis are often associated with squamous cell carcinoma. Chest pain is a late symptom associated with large tumors. These tumors can remain fairly well localized, and tend not to metastasize until late in the course of the disease
What medical term is used to identify the presence of pus in the pleural space? Empyema
Fluid in the pleural space characterizes which condition? Pleural effusion
Which of the following is true regarding respiratory alkalosis? The PaCO2 is less than 35 mmHg
Which of the following parameters is the respiratory component of acid-base status? PaCO2
What define acidosis in a human? pH <7.35
What is the normal value for arterial pH? 7.35 to 7.45
What could cause tissue hypoxia with normal arterial oxygenation? Inadequate cardiac output
Which of the following would be the best indicator of tissue oxygenation? PvO2
What is the normal value for CaO2? 16-20 vol%
Which of the following shifts the oxyhemoglobin dissociation curve to the left? Fetal hemoglobin
What is the most common physiologic cause of hypoxemia in patients with lung disease?V/Q mismatch
Which statement is true regarding hypoxemia? It occurs when the patient’s PaO2 is lower than predicted; It indicates tissue oxygenation is inadequate, always considered a severe disorder, and independent of age of patient are not correct
What is the primary method of transporting oxygen in the blood? Bound to hemoglobin
Pinking up of the hand is normal if it occurs within how many seconds? 10-15
Which of the following systems is the primary operant to rid the body of fluid accumulation in non-pathologic conditions? Lymphatic

Section 3

Question Answer
Which of the following factors are associated with a higher risk for ARDS? Gastric aspiration and septic shock
Malignant tumors Invade surrounding tissues, and cause necrosis
Which ethnic group has the greatest number of people with cystic fibrosis? Whites
Cystic fibrous patients can have Malnutrition; Meconium ileus (bowel obstruction), and excessive, viscous pulmonary secretions
Management of a patient with bronchiectasis may include Expectorants, Early childhood immunizations, and lung resection
Patients with bronchiectasis can have the following anatomic alterations hyperinflation and consolidation
As a respiratory therapist, you are performing a chest assessment. What findings would be common in a patient during an asthma attack? Decreased vocal fremitus (heard by stethoscope on chest wall with certain spoken words) and hyper-resonant percussion note
A patient with a severe asthma attack has many mucus plugs. What structural changes can be expected because of this? Atelectasis
Atelectasis Partial or complete collapse of the lung
Which of the following are associated with chronic bronchitis? Cyanosis, Purulent sputum, Right heart failure, and elevated CO2 level
A patient with emphysema will often have the following clinical manifestations? Barrel chest and Pursed-lip breathing
The management of chronic obstructive pulmonary disease (COPD) includes Annual influenza immunization; Bronchopulmonary hygiene procedures; Lung volume-reduction surgery; and Smoking cessation
Which of the following are anatomic alterations found with emphysema? Hyperinflation, Decreased surface area for gas exchange, and Weakened distal airways
Emphysema Is most closely associated with chronic bronchitis, and leads to the destruction of alveolar walls
Emphysema is Destruction of alveoli, abnormal permanent enlargement of gas-exchange airways accompanied by destruction of alveolar walls without obvious fibrosis, and enlargement and destruction of alveolar walls with loss of elasticity and trapping of air
Obstruction results from Changes in lung tissues rather than mucus productions and inflammation as in chronic bronchitis
The major mechanism of airflow limitation is Loss of elastic recoil
Pneumonia is infection of The lower respiratory tract caused by bacteria, viruses, fungi, protozoa, parasites; Mortality is highest among the elderly
Risk factors for pneumonia include Elderly age, immunocompromise, underlying disease, alcoholism, smoking, endotracheal intubation, malnutrition, immobilization
Most common community acquired pneumonia is caused by Streptococcus pheumoniae
Mycoplasma pneumoniae is common among The young, living in group housing, barracks, etc

Section 4


Question Answer
What are some causes of dynamic hyperinflation? Increased airway resistance, and decreased expiratory flow rate
Ventilatory support may be indicated when the VC falls below what level? 10 ml/kg; 30, 45, and 65 ml/kg are not correct
Which of the following is the cardinal sign of increased work of breathing? Tachypnea
What is a cardinal sign and what are the five cardinal signs? It is the primary or major clinical sign symptom by which a diagnosis is made; Rubor (redness), Calor (increased heat), Tumor (swelling), Dolor (pain), and Functio laesa (loss of function)
Which of the following are associated with hypercapnic respiratory failure due to decreased ventilatory drive? Brainstem lesions, encephalitis, and hypothyroidism
Which of the following clinical signs is most often associated with hypoxemia due to shunt? “White” chest radiograph
Hypoxemia can be caused by which of the following? diffusion impairment, alveolar hypoventilation, V/Q mismatch, and intrapulmonary shunting
Ventilation-Perfusion (V/Q) ratioThe ratio between the amount of air getting to the alveoli (the alveolar ventilation, V, in mL/min), and the amount of blood being sent to the lungs (the cardiac output, Q, in mL/min).
Ventilation-Perfusion (V/Q) mismatch A defect which occurs in the lungs whereby ventilation (the exchange of air between the lung and environment) and perfusion (the passage of blood through the lungs) are not evenly matched; Typically found with COPD
A diagnosis of respiratory failure can be made if which of the following are present? PaO2 55 mmHg, FlO2 0.21, PB 760 mmHg, and PaCO2 57 mmHg, FlO2 0.21, PB 760 mmHg
What is the normal anion gap if potassium is not considered in the equation? 8-16 mEq/L
What problem is associated with an abnormal International Normalized Ratio (INR) value? Bleeding
What does it mean when the INR is too high? The blood is too thin
What does it mean when the INR is too low? The blood is too thick
What term describes an abnormal decrease in red blood cell count? Anemia
What is the lifespan of a red blood cell? 120 days