Patho Exam #4- Chapter 26

An 80-year-old female is in the hospital for a bone fracture. While there she develops a large, nonlethal pulmonary embolus. Which of the following is a direct result of the obstruction to pulmonary blood flow? A. Risk of cerebral emboli B. Systemic hypertension C. Pulmonary hypertension D. Pulmonary edema

Pulmonary hypertension

A 25-year-old male presents with chronic bronchitis of 5 months' duration. Which of the following is the most significant concern for the nurse to monitor in this patient? A. Left heart failure B. Immunosuppression C. Pulmonary embolus D. Recurrent pulmonary infections

Recurrent pulmonary infections

A 30-year-old male prison inmate contracted tuberculosis during an outbreak. While planning interactions, the nurse realizes the patient can transmit this disease through: A. Fecal-oral contact B. Skin contact C. Blood transfusions D. Airborne droplets

Airborne droplets

Which of the following assessment findings would be expected in pulmonary embolism (PE)? (Select all that apply.) A. Fever B. Hemoptysis C. Chest pain D. Tachycardia E. Tachypnea F. All of the above

All of the above

A 53-year-old male with a 20-year history of smoking is diagnosed with emphysema. When the nurse is asked what causes this, what is the nurse's best response? Changes in his lungs are caused by: A. Viral infections B. Alpha-1-antitrypsin deficiency C. Fibrotic lung disease D. Destruction of alveolar macrophages

Alpha-1-antitrypsin deficiency

When the pulmonologist discusses the condition in which a series of alveoli in the left lower lobe receive adequate ventilation but do not have adequate perfusion, which statement indicates the nurse understands this condition? When this occurs in a patient it is called: A. A low ventilation-perfusion ratio B. Alveolar dead space C. A right-to-left shunt D. Pulmonary hypotension

Alveolar dead space

Which of the following shows a correct cause and effect sequence in the development of acute respiratory distress syndrome (ARDS)? A. Hyaline membrane formation and fibrosis causing pulmonary edema B. Increased alveolocapillary membrane permeability causing metabolic alkalosis C. Impaired alveolar compliance causing decreased surfactant production D. Alveolocapillary membrane injury causing a massive inflammatory response

Alveolocapillary membrane injury causing a massive inflammatory response

A 50-year-old male with a 30-year history of smoking was diagnosed with lung cancer. He was previously exposed to air pollution, asbestos, and radiation at his job. Which of the following should the nurse realize had the greatest impact on the development of his cancer? A. Asbestos B. Cigarette smoke C. Radiation D. Air pollution

Cigarette smoke

A nurse recalls asthma is classified by: A. Genetic traits B. Clinical severity C. Treatment outcomes D. Pathophysiologic differences

Clinical severity

A 57-year-old male presents with cough, sputum production, dyspnea, and decreased lung volume. He is diagnosed with pneumoconiosis. When taking the patient's history, which finding is the most probable cause of his illness? A. Allergic reactions B. Autoimmune disease C. Flail chest D. Inhalation of silica, asbestos, mica

Inhalation of silica, asbestos, mica

When the nurse is asked what causes asthma, how should the nurse respond? 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

Interactions between genetic and environmental factors

Which of the following patients is at highest risk for developing pulmonary embolism (PE)? A. 36-year-old woman with a history of alcohol abuse who is recovering from a gastric ulcer B. 21-year-old male with a hemophilia bleeding disorder C. 72-year-old male who is recovering from hip replacement surgery in the hospital D. 28-year-old woman who had a baby 6 months earlier

72-year-old male who is recovering from hip replacement surgery in the hospital

A nurse is monitoring a patient for pulmonary hypertension. Which mean pulmonary artery pressure reading will indicate to the nurse that pulmonary hypertension is occurring? Pulmonary artery pressure above _____ mm Hg.

25

A 50-year-old diabetic male did not take his medication and is now in metabolic acidosis. He is experiencing Kussmaul respirations. What type of breathing will the nurse observe upon assessment? A. A slightly increased ventilatory rate, large tidal volumes, and no expiratory pause B. Very slow inhalations and rapid expirations C. Rapid respirations with periods of apnea D. Audible wheezing or stridor

A slightly increased ventilatory rate, large tidal volumes, and no expiratory pause

A 26-year-old female recently underwent surgery and is now experiencing dyspnea, cough, fever, and leukocytosis. Tests reveal that she has a collapsed lung caused by removal of air from obstructed alveoli. What condition will the nurse observe on the chart? A. Absorption atelectasis B. Compression atelectasis C. Hypoventilation D. Bronchiectasis

Absorption atelectasis

A 42-year-old female presents with dyspnea; rapid, shallow breathing; inspiratory crackles; decreased lung compliance; and hypoxemia. Tests reveal a fulminant form of respiratory failure characterized by acute lung inflammation and diffuse alveolocapillary injury. Which of the following is the most likely diagnosis the nurse will observe on the chart? A. Postoperative respiratory failure B. Acute respiratory distress syndrome (ARDS) C. Sarcoidosis D. Malignant respiratory failure

Acute respiratory distress syndrome (ARDS)

A 60-year-old female with a 25-year history of smoking is diagnosed with emphysema. She has an increased anterior-posterior chest diameter. The nurse attributes this finding to: A. Increased flow rates B. Alveolar destruction C. Decreased inspiratory reserve volumes D. Air trapping

Air trapping

A 30-year-old male prison inmate contracted tuberculosis during an outbreak. When the nurse reviews the lab results, the organism that caused this condition is a: A. Fungus B. Virus C. Bacterium D. Parasite

Bacterium

A 70-year-old female is in the hospital for pelvic fracture. She develops pulmonary thromboembolism. The nurse realizes this embolus is composed of: A. Air B. Tissue fragment C. Blood clot D. Fat

Blood clot

A 45-year-old male undergoes lung transplantation. He now suffers from airway occlusion secondary to fibrosis. Which diagnosis will the nurse see on the chart? A. Bronchiolitis B. Bronchiectasis C. Compression atelectasis D. Bronchiolitis obliterans

Bronchiolitis obliterans

A 50-year-old male is diagnosed with pulmonary embolism (PE). Which of the following symptoms most likely occurred before treatment? A. Chest pain and shortness of breath B. Kussmaul respirations and back pain C. Shallow respirations and wheezing D. Dry cough and inspiratory crackles

Chest pain and shortness of breath

A 30-year-old female received a severe head injury in a motor vehicle accident. She is now experiencing respiratory abnormalities characterized by alternating periods of deep and shallow breathing with periods of apnea. What term should the nurse use when charting this condition? A. Frank-Starling B. Apnea C. Cheyne-Stokes D. Orthopnea

Cheyne-Stokes

A 25-year-old male presents with chronic bronchitis of 5 months' duration. When obtaining the patient's history, which of the following findings is most likely to cause this condition? A. Air pollution B. Recurrent pneumonias C. Cigarette smoke D. Chronic asthma

Cigarette smoke

A 65-year-old female with emphysema presents to the ER for difficulty breathing. Physical exam reveals bluish skin and mucous membranes. How should the nurse chart this condition? Patient has: A. Ischemia B. Hematemesis C. Hemoptysis D. Cyanosis

Cyanosis

A 15-year-old female is diagnosed with restrictive lung disease caused by fibrosis. The patient had a pulmonary functions test. Which of the following findings is expected? A. Increased compliance B. Decreased functional residual capacity C. Increased tidal volume D. Decreased respiratory rate

Decreased functional residual capacity

A group of mountain climbers experience confusion, tachycardia, edema, and decreased renal output after climbing Mount Rainier. A nurse recalls this condition is caused by: A. Hypoventilation B. Decreased inspired oxygen C. Diffusion abnormalities D. Bronchoconstriction

Decreased inspired oxygen

When the nurse observes a diagnosis of nosocomial pneumonia, the patient generally acquires this pneumonia: A. In the winter season B. At day care centers C. On airplanes D. During hospitalization

During hospitalization

Individuals with a recent diagnosis of emphysema should be assessed for which most common presenting factor? A. Cor pulmonale B. Cyanosis C. A productive cough D. Dyspnea

Dyspnea

A 30-year-old male is involved in a motor vehicle accident and sustains trauma to the lungs and chest wall. He experiences respiratory failure. Which of the following lab values would the nurse expect? A. Elevated PaCO2 B. Elevated pH C. Low hematocrit D. Electrolyte imbalances

Elevated PaCO2

An 80-year-old female develops pneumonia in the hospital. She becomes cyanotic, tachycardic, and develops a fever and cough. Chest x-ray reveals pus in the pleural space. Which of the following is the most likely diagnosis documented on the chart? A. Empyema B. Emphysema C. Chyle D. Pleurisy

Empyema

A nurse is preparing to teach the staff about asthma. Which information should the nurse include? Airway hyper-responsiveness in asthma is related to: A. Exposure to an allergen causing mast cell degranulation B. Hereditary decrease in IgE responsiveness C. The release of stress hormones D. Increased sympathetic nervous system response

Exposure to an allergen causing mast cell degranulation

Which of the following are characteristic of idiopathic pulmonary arterial hypertension (IPAH)? (Select all that apply.) A. Fatigue B. Weight gain C. Jugular vein distention D. Male gender E. Dyspnea

Fatigue Jugular vein distention Male gender Dyspnea

A 28-year-old male reports to his primary care provider that he has had a cold for a week and is coughing up bloody secretions. When giving report, what term should the nurse use to describe this condition? A. Hemoptysis B. Cyanosis C. Hematemesis D. Rhinitis

Hemoptysis

A 20-year-old male is in acute pain. An arterial blood gas reveals decreased carbon dioxide (CO2 ) levels. Which of the following does the nurse suspect is the most likely cause? A. Hyperventilation B. Apnea C. Hypoventilation D. Cyanosis

Hyperventilation

Which patient would the nurse assess for paroxysmal nocturnal dyspnea (PND)? A patient with: A. Pulmonary fibrosis B. Asthma C. Left ventricular failure D. Hypotension

Left ventricular failure

A 53-year-old male with a 20-year history of smoking is diagnosed with emphysema. When a staff member asks why the patient's airways are obstructed, how should the nurse respond? The airways are obstructed because of: A. Airway edema B. Infection and inflammation C. Loss of elastic recoil D. Excessive mucus production

Loss of elastic recoil

A 60-year-old female with emphysema is having difficulty expiring a given volume of air. When giving report, the nurse will relay that the patient is most likely experiencing _____ pulmonary disease. A. Restrictive B. Pleuritic C. Obstructive D. Atelectatic

Obstructive

A nurse is preparing to teach the staff about asthma. Which information should the nurse include? Airway obstruction contributing to increased airflow resistance and hypoventilation in asthma is caused by: A. Type II alveolar cell injury and decreased surfactant B. Mucus secretion, bronchoconstriction, and airway edema C. Alveolar fibrosis and pulmonary edema D. Collapse of the cartilaginous rings in the bronchi

Mucus secretion, bronchoconstriction, and airway edema

A 60-year-old male with a 40-year history of smoking presents with chest pain, cough, sputum production, and pneumonia. Tests reveal widespread metastatic cancer, and the primary care provider plans radiation therapy. Which of following is the most likely type of cancer to be documented on the chart? A. Small cell carcinoma B. Basal cell carcinoma C. Non-small cell carcinoma D. Adenoma

Non-small cell carcinoma

A 20-year-old male presents to his primary care provider reporting difficulty breathing when lying down. What term should the nurse use to document this condition? A. Apnea B. Dyspnea C. Orthopnea D. Tachypnea

Orthopnea

A 47-year-old male is diagnosed with pulmonary edema. Which assessment findings will the nurse observe? A. Pink, frothy sputum B. Thick mucus secretions C. Hypocapnia D. Wheezing

Pink, frothy sputum

A 65-year-old male recently had a cerebrovascular accident that resulted in dysphagia. He now has aspiration of gastric contents. The nurse assesses the patient for which complication? A. Emphysema B. Pneumonia C. Pneumothorax D. Bronchiectasis

Pneumonia

A 60-year-old male undergoes surgery for a bone fracture. Which of the following nursing measures would be most effective for preventing pulmonary embolism (PE) in this patient? A. Promote aggressive fluid intake. B. Check hematocrit and hemoglobin levels frequently during the postoperative period. C. Ensure that patient uses supplemental oxygen. D. Prevent deep vein thrombosis formation.

Prevent deep vein thrombosis formation

When a patient has a massive pulmonary embolism (PE), what complications will the nurse monitor for? A. Disseminated intravascular coagulation (DIC) B. Damage to the lung microcapillaries C. Chronic obstructive pulmonary disease (COPD) D. Shock and death

Shock and death

A nurse remembers a low ventilation-perfusion ratio results in: A. Increased dead space B. Alveolar collapse C. Shunting D. Bronchoconstriction

Shunting

A 54-year-old male is diagnosed with empyema. Upon receiving and reviewing the culture result, which organism does the nurse suspect is the most likely cause? A. Klebsiella pneumonia B. Staphylococcus aureus C. Moraxella catarrhalis D. Virus

Staphylococcus aureus

A 10-year-old male is brought to the ER with prolonged bronchospasm and severe hypoxemia. The most likely diagnosis on the chart is: A. Chronic obstructive pulmonary disease (COPD) B. Status asthmaticus C. Exercise-induced asthma D. Bronchiectasis

Status asthmaticus

A 50-year-old male presents with hypotension, hypoxemia, and tracheal deviation to the left. Tests reveal that the air pressure in the pleural cavity exceeds barometric pressure in the atmosphere. Based upon these assessment findings, what does the nurse suspect the patient is experiencing? A. Open pneumothorax B. Tension pneumothorax C. Transudative pneumothorax D. Pleural effusion

Tension pneumothorax

A 22-year-old female presents with chronic bronchitis. Tests reveal closure of the airway during expiration. While planning care, a nurse recalls this condition is most likely caused by: A. Hyperventilation B. Ventilation-perfusion mismatch C. Thick mucus from hypertrophied glands D. Thinning smooth muscle in the bronchioles

Thick mucus from hypertrophied glands

A 60-year-old female with a history of cirrhosis presents with dyspnea, impaired ventilation, and pleural pain. A diagnosis of pleural effusion is made, and a watery fluid is drained. When giving report, the nurse will refer to this fluid as: A. Purulent B. Exudative C. Infected D. Transudative

Transudative

A patient asks what causes pneumonia. How should the nurse reply? Pneumonia is caused by: A. Chronic lung changes seen with aging B. Viral or bacterial infections C. Atelectasis D. Use of anesthetic agents in surgery

Viral or bacteria infections