Path Exam2

Which of the following demonstrates a compensatory response of the lungs when an acid-base imbalance occurs: When there is an accumulation of CO2, the lungs will increase ventilation to blow off more CO2 When there is an accumulation of CO2, the lungs will increase ventilation to blow off more HCO3- When there is a decrease in the amount of CO2, the lungs will decrease ventilation to retain more HCO3- When there is a decrease in the amount of CO2, the lungs will decrease ventilation and retain more O2

When there is an accumulation of CO2, the lungs will increase ventilation to blow off more CO2

The nurse is caring for a client with an acid-base imbalance. Which of these does the nurse recognize is correct regarding compensation? An increased pH is demonstrated. A pH moves toward the normal range. A decreased pH is demonstrated. There is no alteration in the blood gas values.

A pH moves toward the normal range.

Where would the nurse see evidence of subcostal retractions? Drawing in of the skin between each rib with inspiration Drawing in of the abdomen just below the rib cage with inspiration Drawing in of the skin above the collar bone or sternum with inspiration Drawing in of the middle of the chest along the sternum with inspiration

Drawing in of the abdomen just below the rib cage with inspiration

Which of the following demonstrates normal breathing? ​ Dyspnea ​ Cheyne-Stokes respirations ​ Tachypnea ​ Eupnea

Eupnea

The nursing student is learning about acid-base imbalances. He correctly identifies which of the following are causes of metabolic acidosis? Select all that apply. ​ Excessive diarrhea ​ Aspirin overdose​ Excessive vomiting ​ Renal failure​ Panic attack​ Lactic acid accumulation​ Increased release of aldosterone ​

Excessive diarrhea ​ Aspirin overdose​ Renal failure​ Lactic acid accumulation

The nurse knows that chronic pain lacks which of the characteristic pain-related reactions? Increased heart rate Loss of appetite Disturbed sleep patterns Depression

Increased heart rate

The mycobacterium tuberculosis bacteria is transmitted by? ​ Skin to skin contact with infected secretions ​ Ingestion of infected secretions ​ Inhalation of infected secretions in the air ​ Sharing of needles in IV drug usage ​

Inhalation of infected secretions in the air ​

The floor nurse is receiving report from the ER nurse for her new patient that will be coming to the floor soon. The ER nurse describes a patient that is having dyspnea, crackles, pink frothy sputum, and a PCO2 value of 55. She is afebrile and her respiratory rate is 28 breaths per minute. The physician has diagnosed the patient with pulmonary edema. The floor nurse looks in the patient chart to verify the patients past medical history, knowing that the patient is high risk of pulmonary edema with which of the following medical conditions? Select all that apply. ​ Left sided heart failure​ Chronic abdominal pain​ Severe hypertension ​ Renal failure ​ Atelectasis ​

Left sided heart failure​ Severe hypertension ​ Renal failure ​

Acids are removed by the body most quickly by which organ(s)? A)Kidneys B)Liver C)Heart D)Lungs

Lungs

Analyze the following ABG: pH 7.46, PCO2 42, HCO3-30, PO2 84 Respiratory Acidosis Respiratory Alkalosis Metabolic Acidosis Metabolic Alkalosis Normal ABG

Metabolic Alkalosis

A client tells the nurse that the client has been taking Alka-Seltzer (bicarbonate—antacid) four times a day for the past 2 weeks for an upset stomach. Arterial blood gases reveal pH 7.55; serum HCO3− 37 mEq/L (37 mmol/L). The nurse suspects the client may be experiencing: Metabolic acidosis Respiratory acidosis Respiratory alkalosis Metabolic alkalosis

Metabolic alkalosis

A female patient presents to the emergency department and reports "I was all of a sudden short of breath and couldn't take a deep breath, and I am having a lot of pain in my chest". She is demonstrating tachypnea, dyspnea, oxygen saturation of 79% on room air, and a high V/Q. The physician determines that the patient has developed a pulmonary embolism (PE). Which of the following are risk factors to develop this condition? Select all that apply. ​ Pregnancy, post-partum, birth control pills ​ Atherosclerosis, venipuncture, and indwelling catheters​ Atrial fibrillation, venous insufficiency ​ Malignancy and smoking ​ Heart rhythm that is sinus rhythm ​

Pregnancy, post-partum, birth control pills ​ Atherosclerosis, venipuncture, and indwelling catheters​ Atrial fibrillation, venous insufficiency ​ Malignancy and smoking

When testing nociceptive stimuli to elicit a withdrawal reflex in the body, what stimuli are commonly used? Weak electrical current Skin temperature damp cotton ball Water heated to 5°C above skin temperature Pressure from a sharp object

Pressure from a sharp object

The renal control mechanism of restoring the acid-base balance is accomplished through which process? Regulation of the production of carbonic acid Reabsorption of HCO3 and excretion of H+ restores acid-base balance through the renal control mechanisms. Reabsorption of hydrogen and excretion of carbonic acid Stimulation of the chemoreceptors in the brain stem

Reabsorption of HCO3 and excretion of H+ restores acid-base balance through the renal control mechanisms.

Analyze the following ABG: pH 7.31, PCO2 46, HCO3- 25, PO2 81 Respiratory Acidosis Respiratory Alkalosis Metabolic Acidosis Metabolic Alkalosis Normal ABG

Respiratory Acidosis

A patient develops acute respiratory failure from an opioid overdose. The nurse anticipates which condition when the ABG is drawn? ​ Metabolic acidosis due to the excessive accumulation of H+ ions ​ Respiratory acidosis due to the excessive accumulation of CO2​ Metabolic alkalosis due to the excessive accumulation of HCO3-​ Respiratory alkalosis due to excessive respirations and blowing off CO2 ​

Respiratory acidosis due to the excessive accumulation of CO2​

Pulmonary hypertension is an elevation of pressure in the pulmonary circulation. Over time, this increase in pressure will most likely cause which condition? Tension pneumothorax Pneumonia Left sided heart failure Right sided heart failure

Right sided heart failure

Which types of damage can cause visceral pain? Select all that apply. Distention Direct pressure Inflammatory chemicals Strong contractions Ischemia

Strong contractions Ischemia Distention

A 25-year-old woman who works as an air-traffic controller presents with facial pain and severe headache. She reports that she sometimes feels the pain in her neck or ear and that it is particularly bad during very busy times at the airport. What is the most likely diagnosis? Migraine headache Cluster headache Sinus headache Temporomandibular joint syndrome

Temporomandibular joint syndrome

Which of the following structures allow for gas exchange and are part of the respiratory airways? Terminal end of bronchioles and alveoli Nasopharynx and trachea Oropharynx and larynx Trachea and bronchi

Terminal end of bronchioles and alveoli

The patient with metabolic acidosis demonstrates a potassium value of 5.5meq/L. The nurse understands that what mechanism contributed to this electrolyte abnormality? ​ When there is metabolic acidosis, the respiratory system compensated and caused us to retain more potassium ​ The kidneys tried to compensate by excreting excessive potassium due to the renin angiotensin aldosterone system ​ The chemical buffers tried to compensate leading to an increased serum potassium in exchange for H+ going into the cells ​ When there is metabolic acidosis, the kidneys cannot compensate and will cause excessive excretion of potassium ​

The chemical buffers tried to compensate leading to an increased serum potassium in exchange for H+ going into the cells ​

What is the nurse's expectation about a client's ability to compensate for a metabolic blood gas disorder? The client will compensate with the same system. The client will not be able to compensate. The client will compensate with the respiratory system. The client's breathing will slow down.

The client will compensate with the respiratory system.

Which of the following is most correct when describing the differences in function between the conducting airways and the respiratory airways? Select all that apply. ​ The conducting airways are responsible for moving air in and out of the lungs, warming and humidifying the air and trap inhaled irritants and microorganisms. ​ The respiratory airways facilitate the movement of gases between the alveoli and the blood ​ The respiratory airways are responsible for moving air in and out of the lungs, warming and humidifying the air and trap inhaled irritants and microorganisms. ​ The conducting airways airways facilitate the movement of gases between the alveoli and the blood ​

The conducting airways are responsible for moving air in and out of the lungs, warming and humidifying the air and trap inhaled irritants and microorganisms. ​ The respiratory airways facilitate the movement of gases between the alveoli and the blood ​

Analyze the ABG: ​ pH 7.31​ pCO2 60 ​ HCO3- 24​ How will the body compensate for this abnormality?​ The respiratory system will hyperventilate to blow off more CO2​ The respiratory system will hypoventilate to retain more CO2 ​ The metabolic system (kidneys) will retain more H+ and excrete more HCO3-​ The metabolic system (kidneys) will excrete more H+ and retain more HCO3-​

The metabolic system (kidneys) will excrete more H+ and retain more HCO3-​

A client arrives in the clinic and informs the nurse that he is having pain in the left knee that has lasted for several weeks. The physician orders an x-ray of the left hip and knee. The client tells the nurse that the pain is in the knee, not the hip. What is the best response by the nurse? "The physician must have misunderstood what you were saying. We will change the order." "The pain you are having may be referred pain, which can cause the pain in the knee resulting from a hip problem." "The pain you are having is most likely caused by a disturbance in your nerve transmission." "You only think that the pain is in the knee when it really is in your hip.

"The pain you are having may be referred pain, which can cause the pain in the knee resulting from a hip problem."

The movement of blood into and out of the capillary beds of the lungs to the body organs and tissues is called: A)Perfusion B)Ventilation C)Diffusion D)Circulation

A)Perfusion

Which of the following disorders is likely to lead to both hyperkalemia and metabolic acidosis? A)Renal failure B)Pulmonary disorders C)Cushing syndrome D)Diabetes insipidus

A)Renal failure

An ABG is done with the following results: elevated pH, decreased PCO2, and slightly decreased HCO3. Analyze the ABG: A)Respiratory alkalosis with renal compensation B)Respiratory acidosis with renal compensation C)Metabolic alkalosis with respiratory compensation D)Metabolic acidosis with respiratory compensation

A)Respiratory alkalosis with renal compensation

A patient aspirated during surgery and upon arrival to the surgical unit presents with a rapid onset of dyspnea, hypoxemia, and chest xray reveals pulmonary infiltrates. The patient is most likely experiencing which condition: Pulmonary embolism Acute respiratory distress syndrome Pleural effusion Pulmonary fibrosis

Acute respiratory distress syndrome

Which of the following best describes the difference between an open and tension pneumothorax? ​ An open pneumothorax will move air in and out of the chest wall cavity during inspiration and expiration, whereas a tension pneumothorax only permits air to move into the chest wall during inspiration​ An open pneumothorax will move air into the pleural space with inspiration, but not out during expiration, while a tension pneumothorax will move are into the thorax with inspiration and move air out during expiration​ Open pneumothorax will always cause hemothorax to develop, while a tension pneumothorax is only caused by air due to blunt force trauma to the chest ​ Tension pneumothorax will occur spontaneously and are seen more commonly in tall thin males, while open pneumothorax will occur in those with underlying lung diseases when the blebs on the apex of the lung rupture​

An open pneumothorax will move air in and out of the chest wall cavity during inspiration and expiration, whereas a tension pneumothorax only permits air to move into the chest wall during inspiration​

Which of the following demonstrate obstructive airway disorders? Select all that apply. ​ Asthma ​ COPD ​ Cystic Fibrosis ​ Pulmonary Fibrosis ​ Cor Pulmonale ​

Asthma ​ COPD ​ Cystic Fibrosis ​

The most common cause of pulmonary edema is: A)Right heart failure B)Left heart failure C)Asthma D)Lung cancer

B)Left heart failure

Tuberculosis is transmitted through: A)Skin contact B)Fecal-oral contact C)Airborne droplets D)Blood transfusions

C)Airborne droplets

An ABG shows reduced oxygenation of arterial blood. What is the term should for this condition? A)Ischemia B)Hypoxia C)Hypoxemia D)Hypocapnia

C)Hypoxemia

In the case of emphysema (one of the COPDs), too much carbon dioxide is retained. Which of the body's compensatory responses is expected to reduce the amount of CO2? A)Increase in tidal volume (amount of air inspired) B)Decrease in ventilation rate C)Increase in respiratory rate D)Vasodilation of the pulmonary arterioles

C)Increase in respiratory rate

A person with a long history of cigarette smoking has an arterial blood gas (ABG) done with the following results: decreased pH, increased CO2, and normal bicarbonate ion. Analyze the ABG: A)Respiratory alkalosis B)Metabolic acidosis C)Respiratory acidosis D)Metabolic alkalosis

C)Respiratory acidosis

A severe type of headache that occurs more frequently in men than women and is described as having unrelenting, unilateral pain located most frequently in the orbit is called what? Migraine headache Tension headache Cluster headache Chronic daily headache

Cluster headache

The nursing student is explaining the difference between community acquired pneumonia and hospital acquired pneumonia to her classmates. Which of the following is accurate for these conditions? ​ Community acquired pneumonia is diagnosed 48 hours after admission into the hospital while hospital acquired pneumonia is always diagnosed at the time of admission to the hospital ​ Community acquired pneumonia is diagnosed within the first two days of being hospitalized, while pneumonia that develops after 2 days into a hospitalization is called hospital acquired pneumonia​ Hospital acquired pneumonia is caused by bacteria commonly found in the community and is more resistant to antibiotic therapy​ Community acquired pneumonia is most often caused by resistant bacteria and requires more aggressive antibiotic therapy ​

Community acquired pneumonia is diagnosed within the first two days of being hospitalized, while pneumonia that develops after 2 days into a hospitalization is called hospital acquired pneumonia​

Asthma is thought to be caused by: A)An autosomal recessive trait B)Autoimmunity C)Excessive use of antibiotics as a young child D)Interactions between genetic and environmental factors

D)Interactions between genetic and environmental factors

Hypoxemia is defined as? ​ Decreased oxygen in the arterial blood ​ Decreased oxygen to the tissues ​ Movement of blood through the gas exchange portions of the lung ​ Movement of air into and out of the lungs

Decreased oxygen in the arterial blood ​

A patient with diabetes mellitus has just undergone a right, below the knee amputation following gangrene infection. A few days post-op, the patient confides in the nurse that he still feels his right foot. Knowing the pathophysiologic principles behind this, the nurse can: Administer a psychotropic medication to help the patient cope with the loss of his leg. Explain that many amputees have this sensation and that one theory surmises the end of a regenerating nerve becomes trapped in the scar tissue of the amputation site Call the physician and ask them for an order for a psychological consult. Educate the patient that this area has an usually abnormal increase in sensitivity to sensation but that it will go away with time.

Explain that many amputees have this sensation and that one theory surmises the end of a regenerating nerve becomes trapped in the scar tissue of the amputation site

A patient reports experiencing seeing flickering lights for about 10 minutes before developing nausea and a pounding right-sided headache. Which of the following factors would correspond to a diagnosis of migraine headache? Select all that apply. Family history of migraine hH Duration of 1-2 days Occurring with menstruation Triggered by sexual activity

Family history of migraine Duration of 1-2 days Occurring with menstruation

Analyze the following ABG: pH 7.44, PCO2 32, HCO3- 21, PO2 90 Fully Compensated Metabolic Alkalosis Fully Compensated Respiratory Acidosis Fully Compensated Respiratory Alkalosis Fully Compensated Metabolic Acidosis Normal ABG

Fully Compensated Respiratory Alkalosis

Analyze the following ABG: ​ pH 7.45 ​ PCO2 58​ HCO3: 29 ​ Fully compensated respiratory alkalosis ​ Fully compensated metabolic alkalosis ​ Partially compensated respiratory alkalosis ​ Partially compensated metabolic alkalosis

Fully compensated metabolic alkalosis ​

Respiratory alkalosis can be caused by a respiratory rate in excess of that which maintains normal plasma PCO2 levels. What is a common cause of respiratory alkalosis? Hyperventilation Hypo-ventilation Kussmaul breathing Cluster breathing

Hyperventilation

The conducting airways consists of which structures? ​ Terminal end of the bronchioles and alveoli ​ Nose and trachea ​ Nasopharynx, oropharynx, larynx, trachea, bronchi, and bronchioles ​ Larynx and bronchi ​

Nasopharynx, oropharynx, larynx, trachea, bronchi, and bronchioles ​

Which of the following types of pain is characterized by severe, brief, often repetitive pain? Neuropathic pain Neuralgia Tic douloureux Postherpetic neuralgia

Neuralgia

Which of the following will conduct injurious stimuli to alert the body of potential damage? Nociceptors Thermoreceptors Proprioceptors Odorant

Nociceptors

Analyze the following ABG: pH 7.37, PCO2 42, HCO3- 25, PO2 82 Respiratory Acidosis Respiratory Alkalosis Metabolic Acidosis Metabolic Alkalosis Normal ABG

Normal ABG

Which of the following indicates a state of alkalosis? pH 7.35, PCO2 37, and HCO3- 24 pH 7.48, PCO2 32, and HCO3- 26 pH 7.30, PCO2 50, and HCO3- 30 pH 7.33, PCO2 36, and HCO3- 20

pH 7.48, PCO2 32, and HCO3- 26