Ch 16 17 18 pneumonia, lung abscess, tuberculosis
if a patient has pneumonia, which of the following can increase the risk of life-threatening illness or death? 1. weakened immune 2. COPD 3. Marfan's syndrome 4. heart disease a. 1 3 b. 2 4 c. 1 2 3 d. 1 2 4
1 2 4
which of the following can cause pneumonia? 1. bacteria 2. viruses 3. prions 4. fungi a. 1 2 b. 2 3 c. 1 2 4 d. 1 2 3 4
1 2 4
a patient has postprimary TB. What are the major pathological or structural changes associated with it? 1. cavity formation 2. laryngeal edema 3. dilated and distorted bronchi 4. fibrosis of lung parenchyma a. 2 3 b. 3 4 c. 1 2 3 d. 1 3 4
1 3 4
which of the following clinical manifestations are associated with TB? 1. dull percussion 2. bronchospasm 3. hyperresonant percussion note 4. crackles a. 1 4 b. 2 3 c. 1 2 d. 2 3 4
1 4
Which of the following are predisposing factors to aspiration of oropharyngeal secretions and/or gastric contents into the lower respiratory tract? 1. General anesthesia 2. Head trauma 3. Seizure disorder 4. Alcohol abuse
1,2,3,4
Which of the following conditions can result in a lung abscess? 1. Penetrating chest wound 2. Septic embolism 3. Aspirated foreign body 4. Bronchogenic cyst
1,2,3,4
Following a cerebrovascular accident, a patient lying in the supine position aspirated gastric contents. In what area(s) of the lungs would a lung abscess be most likely to develop? 1. Posterior segments of the upper lobes 2. Apical segments of the upper lobes 3. Superior segments of the lower lobes 4. Anterior segments of both lower lobes
1,3
Which of the following can occur when tissue necrosis occurs in a lung abscess? 1. Fluid can rupture into a bronchus. 2. Broncholithiasis can occur. 3. Bronchospasm can close off the affected bronchi. 4. Fluid can rupture into the intrapleural space.
1,4
when a patient has pneumonia, which of the following would be found in the alveolar effusion fluids? 1. mucus 2. serum fluid 3. saliva 4. red blood cells a. 1 3 b. 2 4 c. 2 3 d. 1 2 3 4
2 4
a patient has bilateral pneumonia. What findings can be expected on the CT scan? 1. depressed diaphragms 2. elongated heart 3. air bronchograms 4. consolidation a. 3 4 b. 1 2 c. 2 3 4 d. 1 2 3 4
3 4
a patient with an advanced case of TB may have which of the following radiologic findings? 1. bronchial tumors 2. hyperlucent lung fields 3. retraction of lung segments 4. right sided heart enlargement a. 2 b. 2 3 c. 3 4 d. 1 3 4
3 4
An unconscious patient aspirated gastric contents. Which of the following anaerobic microorganisms would likely now be found in her lower respiratory tract? 1. Legionella pneumophila 2. Pseudomonas aeruginosa 3. Peptococci 4. Bacteroides fragilis
3,4
a negative tuberculin test would be demonstrated by an induration(wheal) of what size? a. 4 mm or less b. 8 mm or greater c. 6 mm or less d. 10 mm or greater
4 mm or less
risk factors predisposing a person to TB include all of the following except: a. having HIV/AIDS b. being immunosuppressed c. African American Or Hispanic heritage d. malnutrition
African American Or Hispanic heritage
A patient with an abscess has produced a large volume of brown-colored, putrid sputum. What type of microorganism would most likely result in brown, putrid sputum production?
Anaerobic bacteria
non-tuberculosis mycobacteria such as mycobacterium avium and mycobacterium kansasii are associated with which one of the following diseases? a. COPD b. bronchiectasis c. status asthmaticus d. cystic fibrosis
COPD
all of the following are considered to be normal causative agents for community-acquired pneumonia EXCEPT: a. staphylococcal pneumonia b. haemophilus influenzae c. Legionella pneumophila d. Candida albicans
Candida albicans
What is the standard treatment for a lung abscess caused by an anaerobic pathogen?
Clindamycin
What is the recommended treatment for a lung abscess caused by methicillin-resistant Staphylococcus aureus (MRSA)?
Linezolid
What is the term for the fibrinous membrane that surrounds a lung abscess?
Pyogenic membrane
During the early stages of a lung abscess, the pathologic process is identical to that of:
acute pneumonia
physical assessment findings on a patient with pneumonia would include all of the following EXCEPT: a. bradycardia b. whispered pectoriloquy c. dull percussion note d. increase vocal fremitus
bradycardia
A 28-year-old patient who has dogs, parakeets, and cats as pets has been admitted with pneumonia. It is suspected that she acquired the infection from one of her pets. What organism is likely to be found in her sputum? a. bacteroides melaninogenicus b. staphylococcus aureus c. chlamydia psittaci d. haemophilus influenzae
chlamydia psittaci
microbacterium tuberculosis is most readily transmitted through: a. drinking milk from or the milking of infected cows b. shaking hands and then rubbing your c. coughing d. accidental direct inoculation
coughing
a patient has been found to have tuberculosis and several organs of the body. What term is used to describe the situation? a. primary TB b. postprimary TB c. disseminated TB d. multi-organ TB
disseminated TB
the preferred stain that is used to identify the TV organism is called: a. Gram stain b. fluorescent acid fast stain c. Ziehl-Neelsen d. gentian violet
fluorescent acid fast stain
mycobacterium tuberculosis is primarily damaging to the lungs because of the: a. healing from a tubercle b. formation of micro pulmonary emboli c. increase mucus production d. irreversible bronchospasm that it causes
healing from a tubercle
a patient who has an uncontrolled tuberculosis infection will show all of the following signs except: a. weight loss b. high fever c. bloody sputum d. night sweats
high fever
pulmonary function testing results on a patient with an advanced case of TV will display all of the following except: a. increased RV b. decreased IRV c. decreased VC d. decrease TLC
increased RV
a first-line agent used to treat a TB infection is: a. Gentamycin b. penicillin c. streptomycin d. isoniazid
isoniazid
what medication is used to treat a person who has converted to a positive TB skin test but does not have active disease? a. virazole b. isoniazid c. Rifampin d. tetracycline
isoniazid
when a person has TB spread throughout the body, and is found in all of the following except: a. upper lobes b. kidneys c. brain d. lower lobes
lower lobes
the respiratory therapist is educating a patient just diagnosed with tuberculosis. Which of the following statements should the therapist tell the patient regarding tuberculosis? a. take the medication with a glass of water half hour before meals b. if you skip a dose of medication, double up the next dose c. don't take the medication if you have a fever or flu like symptoms d. make sure to take the full prescribed course of therapy
make sure to take the full prescribed course of therapy
ventilator-acquired pneumonia (VAP) is defined as pneumonia that develops: a. between 24 and 48 hours after endotracheal intubation b. more than 48 to 72 hours after endotracheal intubation c. less than 24 hours after mechanical ventilation is started d. more than 48 to 72 hours after mechanical ventilation is started
more than 48 to 72 hours after endotracheal intubation
In the early stages of a lung abscess, a patient would most likely have a:
nonproductive, hacking cough.
which of the following pulmonary infections is most commonly seen in patients with AIDS? a. anaerobic b. pneumocystis jiroveci c. streptococcus pneumoniae d. Legionella pneumophila
pneumocystis jiroveci
a patient has a bacterial pneumonia. What kills the invading bacteria? a. macrophages b. red blood cells c. polymorphonuclear leukocytes d. serum fluid
polymorphonuclear leukocytes
in which of the following ways is tuberculosis generally not spread? a. inhaling droplets of aerosol from an infected person b. drinking unpasteurized milk from cattle infected with the pathogen c. laceration with contact of infected secretions during post-mortem autopsy d. sharing utensils and glassware with an infected person
sharing utensils and glassware with an infected person
a respiratory therapist has a positive TB skin test after having contact with a patient with active TB. which of the following actions would most likely be taken regarding the positive skin test? a. the therapist will be started on a 1 year course of isoniazid prophylactically b. the test will be followed with monthly chest x-rays to detect changes in the lung parenchyma c. the therapist will be on paid administrative leave for 3 months until it is ensured that she is noncontagious d. therapist will be required to wear a mask at work for 3 months until it is established that she is noncontagious
the therapist will be started on a 1 year course of isoniazid prophylactically
a patient has a plural effusion related to her pneumonia. Which of the following should the respiratory therapist recommend to treat the pleural effusion? a. hyperinflation therapy b. supplemental oxygen c. thoracentesis d. percussion and postural drainage
thoracentesis
overall, most cases of pneumonia are caused by: a. viruses b. gram-negative bacteria c. protozoa d. fungi
viruses
All of the following are parasites associated with lung abscesses EXCEPT
Streptococcus pyogenes
The respiratory therapist heard a pleural friction rub while performing a chest assessment on a patient with a lung abscess. What does this likely indicate?
The abscess is located near the pleural surface.
