quiz 4
When exposed to inhaled allergens, a patient with asthma produces large quantities of Group of answer choices
IgE
Signs and symptoms of clinical dehydration include
decreased urine output.
A common characteristic of viral pneumonia is
dry cough
Pneumocystitis is a term that refers to a
fungal pneumonia secondary to HIV.
Early manifestations of a developing metabolic acidosis include
headache
The hallmark manifestation of acute respiratory distress syndrome is
hypoxemia.
To best prevent emphysema, a patient is instructed to stop smoking since cigarette smoke
impairs α1-antitrypsin, allowing elastase to predominate
Respiratory acidosis is associated with
increased carbonic acid.
A patient has a positive Chvostek sign. The nurse interprets this as a sign of
increased neuromuscular excitability.
Uncompensated metabolic alkalosis would result in
increased pH, increased HCO3-
Emesis causes
metabolic alkalosis
A person who experiences a panic attack and develops hyperventilation symptoms may experience
numbness and tingling in the extremities.
Asthma is categorized as a(n)
obstructive pulmonary disorder.
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?
pH in high part of normal range, PaO2 normal, PaCO2 high, bicarbonate high
Accumulation of fluid in the pleural space is called
pleural effusion.
When preparing for the admission of a client diagnosed with bronchiectasis, the nurse will
put a sputum cup and a box of tissues on the bedside table.
The nurse provides teaching regarding dietary intake of potassium to avoid an electrolyte imbalance when a patient
has chronic heart failure that is treated with diuretics.
The patient who requires the most careful monitoring for development of metabolic acidosis is a patient who
has had diarrhea for over a week.
A person who has hyperparathyroidism is likely to develop
hypercalcemia.
An increase in the resting membrane potential (hyperpolarized) is associated with
hypokalemia.
Metabolic alkalosis is often accompanied by
hypokalemia.
A person who overuses magnesium-aluminum antacids for a long period of time is likely to develop
hypophosphatemia
Abnormalities in intracellular regulation of enzyme activity and cellular production of ATP are associated with
hypophosphatemia.
A major risk factor for the development of active pulmonary tuberculosis (TB) disease is
immunosuppression
To best prevent emphysema, a patient is instructed to stop smoking since cigarette smoke
impairs α1-antitrypsin, allowing elastase to predominate.
Chronic bronchitis often leads to cor pulmonale because of
increased pulmonary vascular resistance.
What age group has a larger volume of extracellular fluid than intracellular fluid?
infants
The primary cause of infant respiratory distress syndrome is
lack of surfactant.
Vomiting of stomach contents or continuous nasogastric suctioning may predispose to development of
metabolic acid deficit.
Diarrhea and other lower intestinal fluid losses will contribute to
metabolic acidosis.
The finding of ketones in the blood suggests that a person may have
metabolic acidosis.
Clinical manifestations of moderate to severe hypokalemia includeClinical manifestations of moderate to severe hypokalemia include
muscle weakness and cardiac dysrhythmias.
A major cause of treatment failure in tuberculosis is Group of answer choices
noncompliance.
A patient with flail chest will demonstrate
outward chest movement on expiration.
Emphysema results from destruction of alveolar walls and capillaries, which is because of
release of proteolytic enzymes from immune cells.
The ________ system compensates for metabolic acidosis and alkalosis.
respiratory
A person with acute hypoxemia may hyperventilate and develop
respiratory alkalosis.
The arterial blood gas pH = 7.52, PaCO2 = 30 mm Hg, HCO3- = 24 mEq/L demonstrates
respiratory alkalosis.
Airway obstruction in chronic bronchitis is because of
thick mucus, fibrosis, and smooth muscle hypertrophy.
Causes of metabolic acidosis include
tissue anoxia
Osmoreceptors located in the hypothalamus control the release o
vasopressin (antidiuretic hormone, ADH).
Neuromuscular disorders impair lung function primarily because of
weak muscles of respiration.
Clinical manifestations of extracellular fluid volume deficit include
weak pulse, low blood pressure, and increased heart rate.
When a client diagnosed with COPD type A asks, "Why is my chest so big and round?", the nurse responds that
"Loss of elastic tissue in your lungs allows your airways to close and trap air, which makes your chest round."
The fraction of total body water (TBW) volume contained in the intracellular space in adults is
2/3
Which clinical manifestation is not likely the result of a tuberculosis infection?
Cyanoisis
Hyperaldosteronism causes
ECV excess and hypokalemia.
What is likely to lead to hyponatremia?
Frequent nasogastric tube irrigation with water
The characteristic x-ray findings in tuberculosis include
Ghon tubercles.
What is the most likely explanation for a diagnosis of hypernatremia in an elderly patient receiving tube feeding?
Inadequate water intake
In individuals who have asthma, exposure to an allergen to which they are sensitized leads to which pathophysiologic event?
Inflammation, mucosal edema, and bronchoconstriction
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
It sounds like your child has a case of bacterial pneumonia, while the classmate had viral pneumonia."
A 3-year-old is diagnosed with starvation ketoacidosis. What signs and symptoms should you anticipate in your assessment? Group of answer choices
Rapid, deep breathing, lethargy, abdominal pain
A patient diagnosed with chronic compensated heart failure reports that, "My feet swell if I eat salt but I don't understand why" The nurse's best response is Group of answer choices
Salt holds water in your blood and makes more pressure against your blood vessels, so fluid leaks out into your tissues and makes them swell."
How is a patient hospitalized with a malignant tumor that secretes parathyroid hormone-related peptide monitored for the resulting electrolyte imbalance?
Serum calcium, bowel function, level of consciousness
The assessment findings of a 5-year-old with a history of asthma include extreme shortness of breath, nasal flaring, coughing, pulsus paradoxus, and use of accessory respiratory muscles. There is no wheezing and the chest is silent in many areas. How should you interpret your assessment?
The child may be having such a severe asthma episode that the airways are closed, so start oxygen and get the doctor immediately.
Croup is characterized by
a barking cough
Bacterial pneumonia leads to hypoxemia caused by
accumulation of alveolar exudates.
Widespread atelectasis, non-cardiogenic pulmonary edema, and diffuse, fluffy alveolar infiltrates on chest radiograph are characteristic of
acute respiratory distress syndrome.
COPD leads to a barrel chest, because it causes
air trapping Destruction of alveolar walls reduces lung elastic recoil, which allows airway collapse during exhalation. Air enters the alveoli during inhalation, but has difficulty escaping during exhalation. When air is trapped in the alveoli, residual volume increases, causing a barrel chest. Destruction of alveolar walls does not cause pulmonary edema, muscle atrophy, or prolonged inspiration.
After evaluation, a child's asthma is characterized as "extrinsic." This means that the asthma is
associated with specific allergic triggers.
The inward-pulling force of particles in the vascular fluid is called _____ pressure.
capillary osmotic
The person at highest risk for developing hypernatremia is a person who Group of answer choices
receives tube feedings because he or she is comatose after a stroke.
Clinical manifestations of hyponatremia include
confusion, lethargy, coma, and perhaps seizures.
Excessive antidiuretic hormone (ADH) secretion can cause _____ concentration.
decreased serum sodium
Clinical manifestations of severe symptomatic hypophosphatemia are caused by
deficiency of ATP.
Lack of α-antitrypsin in emphysema causes
destruction of alveolar tissue
Which acid are the kidneys unable to excrete?
Bicarbonate
How do clinical conditions that increase vascular permeability cause edema?
By allowing plasma proteins to leak into the interstitial fluid, which draws in excess fluid by increasing the interstitial fluid osmotic pressure
Which disorder is caused by inhalation of organic substances?
Hypersensitivity pneumonitis
Which electrolyte imbalances cause increased neuromuscular excitability?
Hypocalcemia and hypomagnesemia
When a parent asks how they will know if their 2-month-old baby, who is throwing up and has frequent diarrhea, is dehydrated, the nurse's best response is
If the soft spot on the top of his head feels sunken in and his mouth is dry between his cheek and his gums, then he is probably dehydrated."
The organism that causes pulmonary tuberculosis is
Mycobacterium tuberculosis.
The electrolyte that has a higher concentration in the extracellular fluid than in the intracellular fluid is _____ ions.
Na
The major buffer in the extracellular fluid is Group of answer choices
bicarbonate
Copious amounts of foul-smelling sputum are generally associated with
bronchiectasis.
Cystic fibrosis is associated with
bronchiectasis.
Manifestations from sodium imbalances occur primarily as a result of
cellular fluid shifts.
A patient, who is 8 months pregnant, has developed eclampsia and is receiving intravenous magnesium sulfate to prevent seizures. To determine if her infusion rate is too high, you should regularly
check the patellar reflex; if it becomes weak or absent, her infusion rate probably is too high and she is at risk for respiratory depression or cardiac arrest.
Hypernatremia may be caused by
decreased antidiuretic hormone secretion.
Total body water in older adults is
decreased because of increased adipose tissue and decreased muscle mass.
