Deck 26: Alterations of Pulmonary Function

Question 1

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 be expected?

A) Electrolyte imbalances
B) Low PaCO₂
C) Low hematocrit
D) Low blood pH

Answer 1

Low PaCO₂

Question 2

A 65-year-old male recently had a cerebrovascular accident that resulted in dysphagia. He now has aspiration of gastric contents. This condition could cause:

A) pneumonitis and pneumonia.
B) bronchiectasis.
C) pneumothorax.
D) emphysema.

Answer 2

pneumonitis and pneumonia.

Question 3

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. This condition is referred to as:

A) Cheyne-Stokes.
B) Frank-Starling.
C) apnea.
D) orthopnea.

Answer 3

Cheyne-Stokes.

Question 4

A 10-year-old female develops pneumonia following a urinary tract infection. Physical exam reveals subcostal and intercostal retractions. She reports that breathing is difficult and she feels she cannot get enough air. This condition is referred to as:

A) cyanosis.
B) dyspnea.
C) hyperpnea.
D) orthopnea.

Question 5

A 20-year-old male presents to his physician complaining of difficulty breathing when lying down. This condition is referred to as:

A) dyspnea on exertion.
B) orthopnea.
C) apnea.
D) tachypnea.

Question 6

The condition in which a series of alveoli in the left lower lobe receive adequate ventilation but do not have adequate perfusion is called:

A) a right-to-left shunt.
B) alveolar dead space.
C) a low ventilation to perfusion ratio.
D) pulmonary hypotension.

Question 7

A low ventilation-perfusion ratio results in:

A) increased dead space.
B) shunting.
C) alveolar collapse.
D) bronchoconstriction.

Question 8

A 28-year-old male complains to his physician that he has had a cold for a week and is coughing up bloody secretions. This condition is referred to as:

A) hematemesis.
B) cyanosis.
C) rhinitis.
D) hemoptysis.

Question 9

A 45-year-old male undergoes lung transplantation. He now suffers from airway occlusion secondary to fibrosis. The most likely diagnosis is:

A) compression atelectasis.
B) bronchiectasis.
C) bronchiolitis.
D) bronchiolitis obliterans.

Question 10

A 47-year-old male is diagnosed with pulmonary edema. Which of the following would be expected with this condition?

A) Thick mucous secretions
B) Pink, frothy sputum
C) Hypocapnia
D) Wheezing

Question 11

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. This fluid is referred to as:

A) exudative.
B) purulent.
C) infected.
D) transudative.

Question 12

A 20-year-old male is in acute pain. An arterial blood gas reveals decreased carbon dioxide levels. Which of the following is the most likely cause?

A) Hyperventilation
B) Hypoventilation
C) Apnea
D) Cyanosis

Question 13

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. The most likely diagnosis is:

A) pleural effusion.
B) tension pneumothorax.
C) open pneumothorax.
D) transudative pneumothorax.

Question 14

The most common cause of pulmonary edema is:

A) right heart failure.
B) left heart failure.
C) asthma.
D) lung cancer.

Question 15

A group of mountain climbers experience confusion, tachycardia, edema, and decreased renal output after climbing Mount Rainier. This condition is caused by:

A) bronchoconstriction.
B) hypoventilation.
C) decreased inspired oxygen.
D) diffusion abnormalities.

Question 16

A 65-year-old female with emphysema presents to the ER for difficulty breathing. Physical exam reveals bluish skin and mucous membranes. This condition is referred to as:

A) cyanosis.
B) hemoptysis.
C) hematemesis.
D) ischemia.

Question 17

Paroxysmal nocturnal dyspnea generally occurs with:

A) pulmonary fibrosis.
B) asthma.
C) left ventricular failure.
D) hypertension.

Question 18

A 50-year-old diabetic male did not take his medication and is now in metabolic acidosis. He is experiencing Kussmaul respirations that can be characterized by:

A) audible wheezing or stridor.
B) a slightly increased ventilatory rate, large tidal volumes, and no expiratory pause.
C) rapid respirations with periods of apnea.
D) very slow inhalations and rapid expirations.

Question 19

Reduced oxygenation of arterial blood is called:

A) ischemia.
B) hypoxia.
C) hypoxemia.
D) hypocapnia.

Question 20

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. This condition is called:

A) compression atelectasis.
B) bronchiectasis.
C) absorption atelectasis.
D) hypoventilation.

Question 21

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?

A) Empyema
B) Emphysema
C) Pleurisy
D) Chyle

Question 22

A 22-year-old female presents with chronic bronchitis. Tests reveal closure of the airway during expiration. This condition is most likely caused by:

A) thick mucus from hypertrophied glands.
B) ventilation-perfusion mismatch.
C) hyperventilation.
D) thinning smooth muscle in the bronchioles.

Question 23

Pneumonia is caused by:

A) use of anesthetic agents in surgery.
B) atelectasis.
C) chronic lung changes seen with aging.
D) viral or bacterial infections.

Question 24

A 53-year-old male with a 20-year history of smoking is diagnosed with emphysema. His airways are obstructed because of:

A) excessive mucus production.
B) loss of elastic recoil.
C) infection and inflammation.
D) airway edema.

Question 25

A 15-year-old female is diagnosed with restrictive lung disease caused by fibrosis. Which of the following is expected?

A) Increased residual volume
B) Increased tidal volume
C) Decreased respiratory rate
D) Decreased functional residual capacity

Question 26

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.

Question 27

A 60-year-old female with a 25-year history of smoking is diagnosed with emphysema. She has an increased anterior-posterior chest diameter because of:

A) air trapping.
B) increase inspiratory reserve volumes.
C) increased flow rates.
D) alveolar destruction.

Question 28

Asthma is classified by:

A) pathophysiologic differences.
B) clinical severity.
C) genetic traits.
D) treatment outcomes.

Question 29

A 25-year-old male presents with chronic bronchitis of 5 months' duration. Which of the following is most likely to cause this condition?

A) Chronic asthma
B) Air pollution
C) Cigarette smoke
D) Recurrent pneumonias

Question 30

Airway obstruction contributing to increased airflow resistance and hypoventilation in asthma is caused by:

A) type II alveolar cell injury and decreased surfactant.
B) alveolar fibrosis and pulmonary edema.
C) mucus secretion, bronchoconstriction, and airway edema.
D) collapse of the cartilaginous rings in the bronchi.

Question 31

A 25-year-old male presents with chronic bronchitis of 5 months' duration. Which of the following is the most significant concern in this patient?

A) Left heart failure
B) Pulmonary embolus
C) Immunosuppression
D) Recurrent pulmonary infections

Question 32

A 60-year-old female with emphysema is having difficulty expiring a given volume of air. She is most likely experiencing _____ pulmonary disease.

A) restrictive
B) obstructive
C) atelectic
D) pleuritic

Question 33

A 54-year-old male is diagnosed with empyema. Which of the following is most likely the cause?

A) Virus
B) Staphylococcus aureus
C) Klebsiella pneumoniae
D) Moraxella catarrhalis

Question 34

Individuals with a recent diagnosis of emphysema most often present with:

A) a productive cough.
B) cyanosis.
C) dyspnea.
D) cor pulmonale.

Question 35

Which of the following shows a correct cause and effect sequence in the development of acute respiratory distress syndrome (ARDS)?

A) Impaired alveolar compliance causing decreased surfactant production
B) Alveolocapillary membrane injury causing a massive inflammatory response
C) Hyaline membrane formation and fibrosis causing pulmonary edema
D) Increased alveolocapillary membrane permeability causing metabolic acidosis

Question 36

A 10-year-old male is brought to the ER with prolonged bronchospasm and severe hypoxemia. The most likely diagnosis is:

A) exercise-induced asthma.
B) chronic obstructive pulmonary disease.
C) status asthmaticus.
D) bronchiectasis.

Question 37

Airway hyperresponsiveness in asthma is related to:

A) increased sympathetic nervous system response.
B) the release of stress hormones.
C) exposure to an allergen causing mast cell degranulation.
D) hereditary decrease in IgE responsiveness.

Question 38

A 53-year-old male with a 20-year history of smoking is diagnosed with emphysema. Changes in his lungs are caused by:

A) viral infections.
B) destruction of alveolar macrophages.
C) alpha-1-antitrypsin deficiency.
D) fibrotic lung disease.

Question 39

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?

A) Acute respiratory distress syndrome
B) Sarcoidosis
C) Postoperative respiratory failure
D) Malignant respiratory failure

Question 40

A 57-year-old male presents with cough, sputum production, dyspnea, and decreased lung volume. He is diagnosed with pneumoconiosis. His illness is probably caused by:

A) inhalation of silica, asbestos, mica.
B) autoimmune disease.
C) allergic reactions.
D) flail chest.

Question 41

Which of the following patients is at highest risk for developing a pulmonary embolus?

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

Question 42

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. Which of following is the most likely type of cancer?

A) Adenoma
B) Non-small cell carcinoma
C) Small cell carcinoma
D) Squamous cell carcinoma

Question 43

Which of the following shows a correct sequence of events in pulmonary embolism?

A) Hypoxic vasoconstriction occurs, causing an increase in surfactant production.
B) Dead space develops, causing dislodgement of a portion of the thrombus.
C) Hypoxemia inhibits the production of surfactant, causing alveolar collapse.
D) Alveoli collapse, causing an increase in the ventilation-perfusion ratio.

Question 44

Secondary pulmonary hypertension is usually caused by:

A) chronic pulmonary disease.
B) right heart failure.
C) hereditary traits.
D) orthostatic hypotension.

Question 45

A 30-year-old male prison inmate contracted tuberculosis during an outbreak. He can transmit this disease through:

A) skin contact.
B) fecal-oral contact.
C) airborne droplets.
D) blood transfusions.

Question 46

A massive pulmonary embolism will most likely lead to:

A) damage to the lung microcapillaries.
B) chronic obstructive pulmonary disease.
C) disseminated intravascular coagulation.
D) shock and death.

Question 47

A 70-year-old female is in the hospital for pelvic fracture. She develops pulmonary thromboembolism. This condition is the result of occlusion of a portion of the pulmonary vascular bed by an embolus of:

A) fat.
B) air.
C) tissue fragment.
D) blood clot.

Question 48

An 80-year-old female is in the hospital for bone fracture. While there she develops a large, nonlethal pulmonary embolus. Which of the following is a direct result of the obstruction to blood flow?

A) Pulmonary hypertension
B) Systemic hypertension
C) Pulmonary edema
D) Risk of cerebral emboli

Question 49

A 50-year-old male is diagnosed with pulmonary embolism. Which of the following symptoms most likely occurred before treatment?

A) Dry cough and inspiratory crackles
B) Shallow respirations and wheezing
C) Chest pain and shortness of breath
D) Kussmaul respirations and back pain

Question 50

A 60-year-old male undergoes surgery for a bone fracture. Which of the following measures would be most effective for preventing pulmonary emboli in this patient?

A) Ensure that patient uses supplemental oxygen.
B) Prevent deep vein thrombosis formation.
C) Check hematocrit and hemoglobin levels frequently during the postoperative period.
D) Promote aggressive fluid intake.

Question 51

Pulmonary hypertension is defined as a rise in pulmonary artery pressure of _____ mm Hg above normal.

A) 5 to 10
B) 10 to 15
C) 15 to 20
D) 20 to 25

Question 52

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 most likely had the greatest impact on development of his cancer?

A) Radiation
B) Cigarette smoke
C) Asbestos
D) Air pollution

Question 53

Nosocomial pneumonia is generally acquired:

A) at day care centers.
B) on airplanes.
C) during hospitalization.
D) in the winter season.

Question 54

A 30-year-old male prison inmate contracted tuberculosis during an outbreak. The organism that caused this condition is a:

A) bacterium.
B) fungus.
C) virus.
D) parasite.