Deck 6: Pulmonology

Question 1

In most people:

A) The left lung is larger than the right
B) The right lung is larger than the left
C) The two lungs are of roughly equal size
D) The left lung is composed of three lobes and the right of two lobes

Answer 1

The right lung is larger than the left

Question 2

Inhaled gases enter the lungs by traveling through which of the following paths:

A) From the nose, to the larynx, to the pharynx, to the trachea
B) From the nose, to the pharynx, to the bronchi, to the trachea
C) From the nose, to the pharynx, to the larynx, to the trachea, and into the bronchi
D) From the nose, to the bronchi, to the trachea, to the pharynx, and then to the larynx

Answer 2

From the nose, to the pharynx, to the larynx, to the trachea, and into the bronchi

Question 3

Gas exchange primarily occurs in which portion of the pulmonary anatomy?

A) Through the smooth muscle cells in the walls of the bronchi and bronchioles
B) Through the pulmonary arteries and veins
C) Through the cell membranes of the alveoli and the endothelium of the pulmonary capillaries
D) Through the parasympathetic fibers of the vagus nerve

Answer 3

Through the cell membranes of the alveoli and the endothelium of the pulmonary capillaries

Question 4

The ridge at the inferior portion of the trachea where it divides into the two primary bronchi is known as the:

A) Cardia
B) Carina
C) Catarrh
D) Terminal bronchiole

Question 5

The mucus membranes of the trachea and bronchi are lined by thread-like projections that help sweep dust and other inhaled substances away from the lower respiratory tract. These structures are known as:

A) Cilia
B) Capillaries
C) Microtubules
D) Axons

Question 6

The lungs are enclosed in a double-layered serous membrane. Choose the most accurate description of this structure and its function from the following choices:

A) The visceral pleura surround the lung and its interlobar fissures; the parietal pleura surround the chest cavity. In a healthy person, the two membranes are separated by a small amount of lubricating fluid.
B) The visceral pleura surround the lung but not its interlobar fissures; the parietal pleura surround the chest cavity. In a healthy person, the two membranes are separated by a small amount of lubricating fluid.
C) The visceral pleura surround the chest cavity; the parietal pleura surround the lung and its interlobar fissures.
D) The visceral pleura surround the chest cavity; the parietal pleura surround the lungs but not their interlobar fissures.

Question 7

The pulmonary arteries:

A) Carry oxygen-poor blood to the lungs from the right ventricle of the heart
B) Carry oxygen-poor blood to the lungs from the left ventricle of the heart
C) Carry oxygen-rich blood to the lungs from the right ventricle of the heart
D) Carry oxygen-rich blood from the lungs to the right atrium of the heart

Question 8

Ventilation of the lungs is:

A) The exchange of gases at the alveolar-capillary membrane
B) The movement of blood into and out of the lungs
C) The movement of gases into and out of the lungs
D) The accidental inhalation of foreign substances from the oropharynx into the lungs

Question 9

The pneumocytes of the lungs:

A) Prevent blood from leaking from the pulmonary capillaries into the gas exchange units of the lungs
B) Prevent gas from escaping from the pleura of the lungs
C) Regulate the movement of the muscles of respiration
D) Permit gas exchange in the alveoli and produce surfactant

Question 10

Organisms that rely upon oxygen to produce energy during cellular respiration are known as _________________. The cellular organelles in which cellular respiration occurs are the _______________.

A) Anaerobes; mitochondria
B) Aerobes; mitochondria
C) Anaerobes; lysosomes
D) Aerobes; lysosomes

Question 11

When assessing a patient with an acute respiratory illness and a cough, which one of the following questions is the LEAST useful?

A) Do your ribs hurt when you take a deep breath?
B) What color is your sputum?
C) Do you have a fever?
D) Do you smoke?
E) Are you wheezing?

Question 12

A class of antihypertensive drugs well known to cause chronic cough is:

A) ACE inhibitors
B) Beta blockers
C) Calcium channel blockers
D) Diuretics

Question 13

Coughing up bloody mucus is called:

A) Hematemesis
B) Hematochezia
C) Hemoptysis
D) Hematuria

Question 14

Wheezing is a sound heard:

A) In the anterior chest only
B) In the upper lobes of the lung only
C) Primarily during inspiration
D) Primary during expiration

Question 15

A newborn infant of 34 weeks' gestation with a low Apgar score, cyanosis, nasal flaring, and grunting respirations is most likely to have:

A) Pneumococcal pneumonia
B) Respiratory distress syndrome of the preterm infant
C) Influenza A
D) Nosocomial pneumonia

Question 16

Acute respiratory failure is suggested by which of the following?

A) Severe cough
B) Fevers over 103°F
C) Arterial oxygen tension >70 torr (mm Hg)
D) Arterial carbon dioxide levels >70 torr (mm Hg)

Question 17

The most common reason that a newborn fails to thrive in its first few minutes of life is:

A) Hepatic failure
B) Kidney failure
C) Respiratory failure
D) Stroke

Question 18

A patient with stridor has:

A) A long and steady gait
B) A high-pitched sound heard during inspiration
C) A musical sound heard during expiration
D) An unpredictable and violent temper

Question 19

Thoracentesis is the insertion of a needle into which of the following spaces?

A) The peritoneum
B) The pleural space
C) The subarachnoid space
D) A joint space

Question 20

A pulmonary embolism threatens the respiratory status of a patient in which of the following ways?

A) It increases pulmonary perfusion
B) It decreases pulmonary perfusion
C) It increases alveolar ventilation
D) It decreases alveolar ventilation

Question 21

Pulmonary edema threatens the respiratory status of a patient in which of the following ways?

A) It increases pulmonary perfusion
B) It decreases pulmonary perfusion
C) It increases alveolar ventilation
D) It decreases alveolar ventilation

Question 22

A collapse of a lung or a unit of a lung, making it airless and unventilated, is called ______________.

A) Splinting
B) Surfactant
C) Atelectasis
D) Rhoncus

Question 23

Which of the following is (are) UNCHARACTERISTIC of asthma?

A) Disease recurrence
B) Wheezing
C) Coughing
D) Triggered by allergens
E) None of the above

Question 24

The most common cause of chronic obstructive pulmonary disease (COPD) is:

A) Bronchodilators
B) Air pollution caused by factories
C) Exposure to asbestos
D) Tobacco smoking
E) Alpha₁-antitrypsin deficiency

Question 25

After blunt trauma to the chest, a man suffers several left-sided rib fractures. He has pain when he tries to inhale or exhale. On assessment he is exquisitely sensitive to percussion of the left side of the chest, where a dull sound is heard. A chest x-ray shows fluid in the pleural space, but no collapse of the lung, no displacement of the trachea, and no elevation of the diaphragm. This patient has suffered which of the following injuries?

A) Hemothorax
B) Pneumothorax
C) Tension pneumothorax
D) Serious liver injury

Question 26

A useful drug to administer to a 23-year-old male with a temperature of 99°F, heart rate of 110, blood pressure of 160/98 mm Hg, respirations of 24 bpm, and oxygen saturation of 91% during an acute asthma attack is:

A) Diltiazem, orally
B) Propranolol, intravenously
C) Clonidine transdermally
D) Nebulized albuterol
E) Sublingual nitroglycerin

Question 27

Which of the following cells secretes surfactant?

A) Type II alveolar cells
B) Ameloblasts
C) Germ cells
D) Juxtaglomerular cells

Question 28

Ambient air contains:

A) Higher levels of nitrogen than are found in the atmosphere
B) Higher levels of oxygen than are found atmospherically
C) Lower levels of oxygen than are found in the atmosphere
D) The same levels of oxygen, nitrogen, and carbon dioxide as are found in the atmosphere

Question 29

A patient with a newly diagnosed pulmonary embolism should be treated with:

A) Aspirin, immediately, then heparin, then warfarin
B) Aspirin, then heparin
C) Heparin, then warfarin
D) Warfarin

Question 30

A tetanus-prone wound may have any or all the following characteristics, EXCEPT:

A) It is made by a sharp, clean object, like a scalpel
B) Its edges are jagged and it is deep
C) It has dirt and debris visible within it
D) It is made by an animal bite

Question 31

Clinicians often speak of "community-acquired" pneumonias, as opposed to pneumonias that occur in hospitalized or institutionalized patients. Common causes of community-acquired pneumonias include:

A) Pseudomonas aeruginosa
B) Chlamydophila pneumophila
C) Legionella pneumophila
D) Bordetella pertussis
E) Streptococcus pneumoniae

Question 32

Most episodes of acute bronchitis in young, otherwise healthy individuals are caused by:

A) Bacteria, like staphylococci and streptococci
B) Fungi, like Candida albicans
C) Parasites, like Plasmodium falciparum
D) Viruses, like rhinovirus and corona viruses

Question 33

Most episodes of acute bronchitis in young, otherwise healthy individuals are treatable with antibiotics.

A) True
B) False
C) It is difficult to generalize

Question 34

The influenza virus is:

A) A common cause of diarrhea
B) A common cause of recurrent genital and oral skin infections
C) A common cause of respiratory illness, characterized by fever, sore throat, and headache
D) A common cause of chronic connective tissue disease

Question 35

Several lung diseases are caused by the inhalation of toxic substances. Which of the following occupational diseases is not caused by inhalation?

A) Asbestosis
B) Pneumoconiosis
C) Leptospirosis
D) Silicosis

Question 36

Another name for chronic airflow obstruction is:

A) Gastric outlet obstruction
B) Aortic obstruction
C) Foreign body airway obstruction
D) Chronic obstructive lung disease

Question 37

A local police department responds to a political demonstration by dispersing a crowd of people with oleoresin capsicum, an aerosolized riot control agent. Common side effects of this agent include all of the following EXCEPT:

A) Asthma
B) Coughing
C) Dermatitis
D) Hypoglycemia

Question 38

An accepted use of hyperbaric oxygen therapy is in the care of patients with:

A) Carbon dioxide retention
B) Carbon monoxide intoxication
C) Hyperkalemia
D) Organophosphate toxicity

Question 39

One side effect of beta-adrenergic blocking agents that is not typical of the side effect profile of the calcium channel blockers is:

A) Hypotension
B) Slowing of the heart rate (bradycardia)
C) Asthma
D) Fatigue

Question 40

Which one of the following agents is LEAST likely to produce hypoventilation (which one is least likely to interfere with an individual's respiratory rate)?

A) Morphine sulfate (a narcotic)
B) Lorazepam (a benzodiazepine)
C) Diltiazem (a calcium channel blocker)
D) Desipramine (a tricyclic antidepressant)
E) Gabapentin (an anticonvulsant)

Question 41

Two common causes of chronic cough in outpatients are:

A) Lung cancer
B) Laryngoesophageal reflux
C) Postnasal drainage
D) Pulmonary embolism

Question 42

During tracheobronchial suctioning of an intubated patient in the Intensive Care Unit, which of the following practices should be used?

A) The patient should be ventilated before the procedure with 100% oxygen
B) The patient should be disconnected from cardiac monitoring leads
C) Negative pressure suctioning should be avoided
D) The trachea should be scraped until a small amount of blood appears in the suction trap

Question 43

Invasive methods for obtaining a sputum sample for laboratory analysis include:

A) Suctioning the airways
B) Performing bronchoscopic suctioning
C) Lavaging the lower airways and removing a specimen bronchoscopically
D) Having the patient expectorate a specimen

Question 44

Which of the following are potential complications of thoracentesis?

A) Pain
B) Infection
C) Bleeding
D) Pneumothorax

Question 45

Which of the following is the most likely complication of patient-controlled analgesia?

A) Hyperventilation
B) Hypoventilation
C) Agitation
D) Sedation

Question 46

Postoperative atelectasis can be prevented with which of the following maneuvers?

A) Incentive spirometry
B) Placing a cotton-tipped swab in a patient's nostril
C) Positive pressure ventilation
D) Deep suctioning of the lower airways

Question 47

Which of the following are common triggers of asthma attack?

A) Viral infections of the respiratory tract
B) Pollen
C) Tobacco smoke
D) Exercising in cold weather

Question 48

Matching
A wide variety of devices, tools, and technologies are employed in health care. Identify from the following lists the most appropriate description or use of the tools or materials.

-Bag-mask device

A) A device that measures the oxygen concentration of blood transcutaneously
B) A device used to aerosolize medications so they can be inhaled
C) A device used to provide positive pressure breaths to a patient manually
D) A device used to provide positive pressure breaths to a patient automatically, typically worn on the face or nose
E) A device inserted into the mouth of a comatose patient, to allow oxygen and other gases to enter and exit the trachea
F) A handheld device used to improve through practice a patient's inspiratory volumes and airflow

Question 49

Matching
A wide variety of devices, tools, and technologies are employed in health care. Identify from the following lists the most appropriate description or use of the tools or materials.

-Nebulizer

A) A device that measures the oxygen concentration of blood transcutaneously
B) A device used to aerosolize medications so they can be inhaled
C) A device used to provide positive pressure breaths to a patient manually
D) A device used to provide positive pressure breaths to a patient automatically, typically worn on the face or nose
E) A device inserted into the mouth of a comatose patient, to allow oxygen and other gases to enter and exit the trachea
F) A handheld device used to improve through practice a patient's inspiratory volumes and airflow

Question 50

Matching
A wide variety of devices, tools, and technologies are employed in health care. Identify from the following lists the most appropriate description or use of the tools or materials.

-Oximeter

A) A device that measures the oxygen concentration of blood transcutaneously
B) A device used to aerosolize medications so they can be inhaled
C) A device used to provide positive pressure breaths to a patient manually
D) A device used to provide positive pressure breaths to a patient automatically, typically worn on the face or nose
E) A device inserted into the mouth of a comatose patient, to allow oxygen and other gases to enter and exit the trachea
F) A handheld device used to improve through practice a patient's inspiratory volumes and airflow

Question 51

Matching
A wide variety of devices, tools, and technologies are employed in health care. Identify from the following lists the most appropriate description or use of the tools or materials.

-Continuous positive airway pressure mask

A) A device that measures the oxygen concentration of blood transcutaneously
B) A device used to aerosolize medications so they can be inhaled
C) A device used to provide positive pressure breaths to a patient manually
D) A device used to provide positive pressure breaths to a patient automatically, typically worn on the face or nose
E) A device inserted into the mouth of a comatose patient, to allow oxygen and other gases to enter and exit the trachea
F) A handheld device used to improve through practice a patient's inspiratory volumes and airflow

Question 52

Matching
A wide variety of devices, tools, and technologies are employed in health care. Identify from the following lists the most appropriate description or use of the tools or materials.

-Incentive spirometer

A) A device that measures the oxygen concentration of blood transcutaneously
B) A device used to aerosolize medications so they can be inhaled
C) A device used to provide positive pressure breaths to a patient manually
D) A device used to provide positive pressure breaths to a patient automatically, typically worn on the face or nose
E) A device inserted into the mouth of a comatose patient, to allow oxygen and other gases to enter and exit the trachea
F) A handheld device used to improve through practice a patient's inspiratory volumes and airflow

Question 53

Matching
A wide variety of devices, tools, and technologies are employed in health care. Identify from the following lists the most appropriate description or use of the tools or materials.

-Oropharyngeal airway

A) A device that measures the oxygen concentration of blood transcutaneously
B) A device used to aerosolize medications so they can be inhaled
C) A device used to provide positive pressure breaths to a patient manually
D) A device used to provide positive pressure breaths to a patient automatically, typically worn on the face or nose
E) A device inserted into the mouth of a comatose patient, to allow oxygen and other gases to enter and exit the trachea
F) A handheld device used to improve through practice a patient's inspiratory volumes and airflow