11/29 quiz
Which is indicative of a left tension pneumothorax? Select one: a. Course crackles throughout the left chest b. Tracheal deviation to the left c. Absent breath sounds on the left d. Respiratory acidosis
C
Two primary acid-base disorders that are present independently are referred to as
mixed acid-base imbalance
Decreased neuromuscular excitability is often the result of
hypercalcemia and hypermagnesemia.
To best prevent emphysema, a patient is instructed to stop smoking since cigarette smoke
impairs a1-antitrypsin, allowing elastase to predominate
Empyema is defined as an Select one: a. exudative bronchitis. b. infection in the pleural space. c. infection localized in the lung. d. infection in the blood.
B
Which acid are the kidneys unable to excrete? A. Metabolic B. Carbonic C. Bicarbonate D. Ammonia
B
A patient with a productive cough and parenchymal infiltrates on x-ray is demonstrating symptomology of Select one: a. bacterial pneumonia. b. viral pneumonia. c. tuberculosis. d. acute respiratory distress syndrome.
A
Air that enters the pleural space during inspiration but is unable to exit during expiration creates a condition called Select one: a. tension pneumothorax. b. open pneumothorax. c. pleural effusion. d. empyema.
A
All obstructive pulmonary disorders are characterized by Select one: a. resistance to airflow. b. hyperresponsiveness. c. decreased residual volumes. d. decreased lung compliance.
A
Effects of hypernatremia on the central nervous system typically include Select one: a. confusion. b. excitation. c. insomnia. d. hallucinations.
A
Fully compensated respiratory acidosis is demonstrated by A. pH 7.36, PaCO2 55, HCO3 36 B. pH 7.45, PaCO2 40, HCO3 28 C. pH 7.26, PaCO2 60, HCO3 26 D. pH 7.40, PaCO2 40, HCO3 24
A
Two primary acid-base disorders that are present independently are referred to as A. metabolic acidosis B. metabolic alkalosis C. respiratory alkalosis D. mixed acid-base imbalance
D
Osmoreceptors located in the hypothalamus control the release of a. angiotensin. b. atrial natriuretic peptide. c. aldosterone. d. vasopressin (antidiuretic hormone, ADH).
d
The hallmark manifestation of acute respiratory distress syndrome is Select one: a. tachycardia. b. hypotension. c. frothy secretions. d. hypoxemia.
D
Respiratory acidosis may be caused by A. hyperventilation B. massive blood transfusion C. tissue hypoxia D. hypoventilation
D
Accumulation of fluid in the pleural space is called Select one: a. an abscess. b. pleurisy. c. flail chest. d. pleural effusion.
D
The increased anterior-posterior chest diameter associated with obstructive lung disease is caused by
increased residual lung volumes.
Manifestations from sodium imbalances occur primarily due to Select one: a. cellular fluid shifts. b. vascular collapse. c. hyperosmolarity. d. hypervolemia.
A
Pneumocystitis is a term that refers to a Select one: a. fungal pneumonia secondary to HIV. b. viral pneumonia found in transplant recipients. c. non-infectious inflammation in the lung. d. pneumonia secondary to bladder infection.
A
Respiratory acidosis is associated with A. increased carbonic acid B. hypokalemia C. increased neuromuscular excitability D. increased pH
A
Respiratory alkalosis is caused by A. hyperventilation B. pneumonia C. chest muscle weakness D. pulmonary edema
A
Signs and symptoms of clinical dehydration include Select one: a. decreased urine output. b. increased skin turgor. c. increased blood pressure. d. decreased heart rate.
A
The body compensates for metabolic alkalosis by A. hypoventilation B. decreasing arterial carbon dioxide C. increasing bicarbonate ion excretion D. hyperventilation
A
The electrolyte that has a higher concentration in the extracellular fluid that in the intracellular fluid is? A. sodium B. phosphate C. magnesium D. potassium
A
The finding of ketones in the blood suggests that a person may have A. metabolic acidosis B. metabolic alkalosis C. respiratory acidosis D. respiratory alkalosis
A
The organism that causes pulmonary tuberculosis is Select one: a. Mycobacterium tuberculosis. b. Haemophilus tuberculosis. c. Tuberculosis tuberculoci. d. Mycococcidio tuberculosis.
A
Uncompensated metabolic alkalosis would result in A. increased pH, increased HCO3 B. increased pH, decreased HCO3 C. decreased pH, increased HCO3 D. decreased pH, decreased HCO3
A
What age group has a larger volume of extracellular fluid than intracellular fluid? A. Infants B. Adolescents C. Young Adults D. Older Adults
A
Widespread atelectasis, non-cardiogenic pulmonary edema, and diffuse, fluffy alveolar infiltrates on chest radiograph are characteristic of Select one: a. acute respiratory distress syndrome. b. chronic obstructive pulmonary disease. c. asthma. d. cor pulmonale.
A
Clinical manifestations of pleural effusion include (Select all that apply.) Select one or more: a. dyspnea. b. sharp pain in expiration. c. productive cough. d. diminished breath sounds. e. a tracheal shift, if large.
A, D, E
A patient exhibiting respiratory distress as well as a tracheal shift should be evaluated for Select one: a. pneumonia. b. pneumothorax. c. pulmonary edema. d. pulmonary embolus.
B
A patient has been hospitalized several times in 6 months with severe ECV depletion and hypokalemia resulting from chronic laxative abuse. Which blood gas results should be relayed to the physician? A. pH in high part of normal range, PaO2 normal, PaCO2 normal, bicarbonate normal B. pH in high part of normal range, PaO2 normal, PaCO2 high bicarbonate high C. pH in low part of normal range, PaO2 normal, PaCO2 low, bicarbonate low D. pH in low part of normal range, PaO2 normal, PaCO2 normal, bicarbonate normal
B
A person with acute hypoxemia may have hyperventilation and develop A. respiratory acidosis B. respiratory alkalosis C. metabolic alkalosis D. metabolic acidosis
B
Chronic bronchitis often leads to cor pulmonale because of Select one: a. ventricular hypoxia. b. increased pulmonary vascular resistance. c. left ventricular strain. d. hypervolemia.
B
Diarrhea and other lower intestinal fluid losses will contribute to A. metabolic alkalosis B. metabolic acidosis C. respiratory acidosis D. mixed acid-base disorders
B
Early manifestations of a developing metabolic acidosis include A. coma B. headache C. muscle cramps D. short and shallow respirations
B
Excessive antidiuretic hormone (ADH) secretion can cause _____ concentration. Select one: a. increased serum sodium b. decreased serum sodium c. increased serum potassium d. decreased serum potassium
B
Hypernatremia may be caused by Select one: a. decreased aldosterone secretion. b. decreased antidiuretic hormone secretion. c. compulsive water drinking. d. excessive dietary potassium.
B
Viral pneumonia is characterized by Select one: a. a productive cough. b. a dry cough. c. exudative consolidation. d. significant ventilation-perfusion imbalance.
B
Vomiting of stomach contents or continuous nasogastric suctioning may predispose to development of A. carbonic acid defecit B. metabolic acid deficit C. metabolic acidosis D. carbonic acid excess
B
Which disorder is caused by inhalation of organic substances? Select one: a. Diffuse interstitial lung disease b. Hypersensitivity pneumonitis c. Sarcoidosis d. Acute respiratory distress syndrome
B
Which clinical manifestation is not likely the result of a tuberculosis infection? Select one: a. Productive cough b. Low-grade fever c. Night sweats d. Cyanosis
D
How is a patient hospitalized with a malignant tumor that secretes parathyroid hormone-related peptide monitored for the resulting electrolyte imbalance? A. Serum calcium, Chvostek and Trousseau signs B. Serum calcium, bowel function, level of conciousness C. Serum potassium, Chvostek and Trousseau signs D. Serum potassium, bowel function, level of consciousness
B. Serum calcium, bowel function, level of conciousness
What are the clinical manifestations of extracellular fluid volume deficit? A. Thirst, dry mucous membranes, and diarrhea B. Weak pulse, low blood pressure, and increased heart rate C. Cardiac dysrhythmias, paresthesias, and muscle weakness D. Confusion, lethargy, coma, and perhaps seizures
B. Weak pulse, low blood pressure, and increased heart rate
The imbalance that occurs with oliguric renal failure isA. metabolic alkalosis B. hyperkalemia C. hypokalemia D. hypophosphatemia
B. hyperkalemia
The fraction of total body water (TBW) volume contained in the intracellular space in adults is A. three-fourths B. two-thirds C. one-half D. one-third
B. two-thirds
Cystic fibrosis is associated with
Bronchiectasis
A 3 year old is diagnosed with starvation ketoacidosis. What signs and symptoms should you anticipate in your assessment? A. Slow, shallow breathing, belligerence, hyperexcitability B. Slow, shallow breathing, numbness and tingling around his mouth C. Rapid, deep breathing, lethargy, abdominal pain D. Rapid, deep breathing, tremors, elevated blood pressure
C
A major cause of treatment failure in tuberculosis is Select one: a. resistant organism. b. allergy to drugs used. c. noncompliance. d. immunosuppression.
C
A person who experiences a panic attack and develops hyperventilation symptoms may experience A. neuromuscular depression B. anxiety acidosis C. numbness and tingling in the extremities D. acute compensatory metabolic acidosis
C
Bacterial pneumonia leads to hypoxemia due to Select one: a. cardiogenic pulmonary edema. b. upper airway obstruction. c. accumulation of alveolar exudates. d. interstitial edema.
C
Causes of metabolic acidosis include A. hyperventilation B. massive blood transfusion C. tissue anoxia D. hypoventilation
C
Clinical manifestations of hyponatremia include Select one: a. weak pulse, low blood pressure, and increased heart rate. b. thirst, dry mucous membranes, and diarrhea. c. confusion, lethargy, coma, and perhaps seizures. d. cardiac dysrhythmias, paresthesias, and muscle weakness.
C
Diarrhea causes A. respiratory acidosis B. respiratory alkalosis C. metabolic acidosis D. metabolic alkalosis
C
If an individual has a fully compensated metabolic acidosis, the blood pH is A. high B. low C. in the normal range D. either high or low, depending on the type of compensation
C
Neuromuscular disorders impair lung function primarily due to Select one: a. inflammatory events in the lung. b. secondary pneumonia. c. weak muscles of respiration. d. inactivity secondary to the disorder.
C
The arterial blood gas pH = 7.52, PaCO2 = 30 mm Hg, HCO3 = 24 mEq/L demonstrates A. metabolic acidosis B. respiratory acidosis C. respiratory alkalosis D. mixed alkalosis
C
The major buffer in the extracellular fluid is A. hemoglobin B. albumin C. bicarbonate D. phosphate
C
The patient who requires the most careful monitoring for development of metabolic acidosis is a patient who A. is in the diuretic phase of acute renal failure B. has had hypokalemia for over a week C. has had diarrhea for over a week D. has newly diagnosed Cushing syndrome
C
What is the most likely explanation for a diagnosis of hypernatremia in an elderly patient receiving tube feeding? Select one: a. Too much sodium in the feedings b. Excess of feedings c. Inadequate water intake d. Kidney failure
C
Total body water in older adults is A. increased due to decreased adipose tissue and decreased bone mass B. increased due to decreased renal function and hormonal fluctuations C. decreased due to increased adipose tissue and decreased muscle mass D. decreased due to renal changes that cause diuresis with sodium execretion
C. decreased due to increased adipose tissue and decreased muscle mass
A patient with flail chest will demonstrate Select one: a. absence of chest movement with breaths. b. no inspiratory breath sounds. c. fluttering chest movements on expirations. d. outward chest movement on expiration.
D
COPD leads to a barrel chest, because it causes Select one: a. pulmonary edema. b. muscle atrophy. c. prolonged inspiration. d. air trapping.
D
Emesis causes A. respiratory acidosis B. respiratory alkalosis C. metabolic acidosis D. metabolic alkalosis
D
Metabolic alkalosis is often accompanied by A. hypernatremia B. hyponatremia C. hyperkalemia D. hypokalemia
D
Renal compensation for respiratory acidosis is evidenced by A. decreased carbon dioxide B. elevated carbon dioxide C. decreased bicarbonate ion concentration D. elevated bicarbonate ion concentration.
D
The ? system compensates for metabolic acidosis and alkalosis? A. gastrointestinal B. renal C. cardiac D. respiratory
D
What form of oral rehydration, bottled water or salty broth, is best suited for a patient who is demonstrating signs of clinical dehydration? A. Bottled water, because he is so weak that he might choke on the fluid when he swallows, and water would be less damaging to the lungs than salty soup B. Bottled water, because it will rehydrate his cells C. Salty soup, because he needs nutrition as well as fluid D. Salty soup, because it will provide some sodium to help hold the fluid in his blood vessels and interstitial fluid
D
What is likely to lead to hyponatremia?
Frequent nasogastric tube irrigation with water
Which assessment would support a diagnosis of Type A COPD rather than Type B COPD?
Normal PaCO2, scant sputum, accessory muscle use, barrel chest
When preparing for the admission of a client diagnosed with bronchiectasis, the nurse will: a. put a sputum cup and a box of tissues on the bedside table. b. remove the telephone to reduce myocardial oxygen demand. c. add a box of surgical masks to the nursing supplies near the door. d. remove the water pitcher to comply with anticipated fluid restrictions.
a
Individuals who have chronic bronchitis most often have: a) a productive cough b) normal lung sounds c) a barrel chest d) substantial weight loss
a) a productive cough
When a client diagnosed with COPD type A asks, "Why is my chest so big and round?", the nurse responds that a, "Loss of elastic tissue in your lungs allows your airways to close and trap air, which makes your chest round." b. "Swelling and mucus in your airways causes air to be trapped in your lungs, which makes your chest round." c. "Coughing caused by your condition has changed the structure of your airways, which makes your chest round." d. "Scar tissue in your lungs makes them stiff and more full of air than usual, which makes your chest round."
a. "Loss of elastic tissue in your lungs allows your airways to close and trap air, which makes your chest round."
A person with acute hypoxemia may have hyperventilation and developA. respiratory acidosis B. respiratory alkalosis C. metabolic alkalosis D. metabolic acidosis
b
The characteristic x-ray findings in tuberculosis include a. diffuse white-out. b. Ghon tubercles. c. bibasilar infiltrates. d. tracheal deviation.
b
The person at highest risk for developing hypernatremia is a person who a. self-administers a daily tap water enema to manage a partial bowel obstruction. b. receives tube feedings because he or she is comatose after a stroke. c. has ectopic production of ADH from small cell carcinoma of the lung. d. is receiving IV 0.9% NaCl at a fast rate.
b
When a parent of a toddler recently diagnosed with pneumococcal pneumonia asks why their child is so much sicker than a classmate was when they were diagnosed with pneumonia, the nurse replies a. "It sounds as if the classmate was just lucky and less exposed at daycare." b. "It sounds like your child has a case of bacterial pneumonia, while the classmate had viral pneumonia." c. "It sounds as if your child is having a severe reaction to bacterial pneumonia. It hits some children harder than others." d. "It sounds as if your child has a case of viral pneumonia, while the classmate had bacterial pneumonia."
b. "It sounds like your child has a case of bacterial pneumonia, while the classmate had viral pneumonia."
Hyperaldosteronism causes a. ECV deficit and hyperkalemia. b. ECV excess and hypokalemia. c. hyponatremia and hyperkalemia. d. excessive water reabsorption without affecting sodium concentration.
b. ECV excess and hypokalemia.
When exposed to inhaled allergens, a patient with asthma produces large quantities of a. IgG. b. IgE. c. IgA. d. IgM.
b. IgE
After evaluation, a child's asthma is characterized as "extrinsic." This means that the asthma is a. of unknown pathogenesis. b. associated with specific allergic triggers. c. associated with respiratory infections. d. induced by psychological factors (stress).
b. associated with specific allergic triggers.
A restrictive respiratory disorder is characterized by a. increased total lung capacity. b. decreased residual volume. c. inspiratory wheezing. d. expiratory wheezing.
b. decreased residual volume.
Which electrolyte imbalances cause increased neuromuscular excitability?a.Hypokalemia and hyperphosphatemia b.Hyperkalemia and hypophosphatemia c.Hypocalcemia and hypomagnesemia d.Hypercalcemia and hypermagnesemia
c. Hypocalcemia and hypomagnesemia
Abnormalities in intracellular regulation of enzyme activity and cellular production of ATP are associated with a. hyponatremia. b. hypocalcemia. c. hypophosphatemia. d. hypokalemia.
c. hypophosphatemia.
The inward-pulling force of particles in the vascular fluid is called _____ pressure. a. capillary hydrostatic b. interstitial osmotic c. capillary osmotic d. interstitial hydrostatic
c. interstitial osmotic
Copious amounts of foul-smelling sputum are generally associated with: a) emphysema b) epiglottis c) pulmonary edema d) bronchiectasis
d) bronchiectasis
How do clinical conditions that increase vascular permeability cause edema? a. Through altering the negative charge on the capillary basement membrane, which enables excessive fluid to accumulate in the interstitial compartment b. By causing movement of fluid from the vascular compartment into the intracellular compartment, which leads to cell swelling c. Through leakage of vascular fluid into the interstitial fluid, which increases interstitial fluid hydrostatic pressure d. By allowing plasma proteins to leak into the interstitial fluid, which draws in excess fluid by increasing the interstitial fluid osmotic pressure
d. By allowing plasma proteins to leak into the interstitial fluid, which draws in excess fluid by increasing the interstitial fluid osmotic pressure
A patient has a positive Chvostek sign. The nurse interprets this as a sign of:a. hypercalcemia. b. hypermagnesemia. c. decreased neuromuscular excitability. d. increased neuromuscular excitability.
d. increased neuromuscular excitability.
The ________ system compensates for metabolic acidosis and alkalosis. a. gastrointestinal b. renal c. cardiovascular d. respiratory
d. respiratory
