Deck 5: Restrictive Lung Dysfunction

Question 1

The MOST common body organ involved in direct metastasis from small cell carcinoma is which of the following?

A)Adrenal gland
B)Liver
C)Pancreas
D)Central nervous system

Answer 1

D
Seventy-five percent of small cell carcinoma metastasizes to the central nervous system,65% to the liver,58% to the adrenal gland,30% to the pancreas,285 to bone,20% to the genitourinary system,10% to the thyroid,and 10% to the spleen.

Question 2

Which of the following types of bronchogenic carcinoma rapidly involves the vascular channels,lymph nodes,and soft tissue and is known to metastasize widely and early typically before the lung cancer diagnosis is made?

A)Small cell carcinoma
B)Squamous cell carcinoma
C)Adenocarcinoma
D)Large cell carcinoma

Answer 2

A
Small cell carcinoma tumors do not extend into the bronchial lumen,but spread through the submucosa and can cause obstructive and restrictive dysfunction.This type of lung cancer rapidly involves the vascular channels,lymph nodes,and soft tissue.It is known to metastasize widely and early,often before the lung cancer diagnosis is made.

Question 3

In a patient with adult respiratory distress syndrome (ARDS),fat emboli would be categorized as which of the following types of causes for ARDS?

A)Inhaled toxin
B)Trauma
C)Shock
D)Metabolic

Answer 3

B
Several categories exist to describe the varied primary causes of ARDS and fat emboli are categorized as trauma.

Question 4

A patient with restrictive lung disease develops a rise in pulmonary circulation pressure subsequently increasing the work of the right ventricle.This is BEST described as:

A)tachypnea.
B)hypoxemia.
C)pulmonary hypertension.
D)low lung volume.

Question 5

Ventilation-perfusion mismatching in restrictive lung disease leads to which of the following classic signs?

A)Tachypnea
B)Hypoxemia
C)Low lung volume
D)Pulmonary hypertension

Question 6

Which of the following pathological occurrences associated with respiratory distress syndrome (RDS)in premature infants causes the overall retractive forces of the lung to be greater than normal?

A)Inadequate surfactant production
B)Alveolar septal thickening
C)Abnormal alveolar epithelial permeability
D)Pulmonary hypertension

Question 7

Which of the following specific types of pneumonia is considered a fungal pneumonia and is closely associated with AIDS?

A)Haemophilus influenzae
B)Klebsiella pneumoniae
C)Pneumocystis carinii
D)Chlamydia psittaci

Question 8

The distribution of inspired air and pulmonary blood flow becomes less homogeneous with increasing age.This age-related change contributes MOST to which of the following clinical manifestations?

A)Left shift of lung compliance curve
B)Sleep ventilation is altered
C)Decreased maximal ventilatory effort
D)Reduced diffusing capacity

Question 9

Which of the following specific types of pneumonia consists of a water-borne organism that can be emanated from an air-conditioning unit?

A)Steptococcus pneumoniae
B)Klebsiella pneumonia
C)Pseudomonas aeruginosa
D)Legionella pneumophila

Question 10

In a patient with restrictive lung disease energy expenditure is increased due to the increase in work of breathing and accessory muscle use.Which of the following exercise prescriptions would be MOST appropriate?

A)Upper extremity ergometer at low intensity for 5 continuous minutes
B)Upper extremity resistance training at moderate intensity,three sets of 8
C)Low-intensity walking in intervals with walking time equal to rest time
D)Moderate-intensity walking in intervals with rest time greater than walk time

Question 11

Which of the following types of bronchogenic carcinoma arises from the bronchial mucosa after repeated inflammation or irritation such as cigarette smoking?

A)Small cell carcinoma
B)Squamous cell carcinoma
C)Adenocarcinoma
D)Large cell carcinoma

Question 12

Which of the following aspects of pulmonary ventilation leads to the requirement of increased transpulmonary pressure for a given volume of air in patients with restrictive lung disease?

A)Decreased lung compliance
B)Low chest wall compliance
C)Decreased inspiratory reserve volume (IRV)
D)Increased work of breathing

Question 13

Which of the following types of bronchogenic carcinoma is the least responsive to radiation?

A)Small cell carcinoma
B)Squamous cell carcinoma
C)Adenocarcinoma
D)Large cell carcinoma

Question 14

Which of the following statements BEST describes a cause of compression atelectasis?

A)Extrabronchial compression from a tumor or enlarged lymph node
B)Complication of either a lobar or segmental pneumonia
C)Unwillingness by the patient to deep breath or cough
D)Expanding volume outside of the alveoli

Question 15

Which of the following causes of restrictive lung disease is characterized by necrosis of the respiratory epithelium in the affected bronchioles?

A)Bronchiolitis obliterans
B)Bronchopulmonary dysplasia
C)Idiopathic pulmonary fibrosis
D)Asbestosis

Question 16

The key to medical treatment of pneumonia is which of the following?

A)Determining if it is community acquired or nosocomial
B)Identifying the microbe (virus versus bacteria)
C)Identifying specific risk factors
D)Determining the area of lung affected

Question 17

Hallmark symptoms of restrictive lung disease include dyspnea,an emaciated appearance,and which of the following?

A)Chest wall pain
B)Wet,productive cough
C)Dry,nonproductive cough
D)Fatigue

Question 18

The primary causative factor of lung cancer is which of the following?

A)Asbestos
B)Passive smoking
C)Cigarette smoking
D)Air pollution

Question 19

A patient is 1 day postlumbar fusion surgery.Upon initial evaluation by the physical therapist,the patient was recorded to have an SpO₂ of 92% on 2 L of O₂ via a nasal cannula.The physical therapist suspects acute atelectasis due to postoperative pain.Of the following,which is the BEST immediate intervention to improve oxygenation in this patient?

A)Use of an incentive spirometry.
B)Teach the patient pursed lip breathing.
C)Encourage the patient to sit in a chair.
D)Use of a lumbar corset.

Question 20

Survivors of pediatric respiratory distress syndrome who have been ventilated mechanically and received high concentrations of oxygen over a prolonged period of time may develop which of the following pulmonary restrictive lung diseases?

A)Idiopathic pulmonary fibrosis
B)Bronchopulmonary dysplasia
C)Atelectasis
D)Pneumonia

Question 21

Which of the following factors related to surgery contributes MOST to decreases in ventilator response to hypercapnia and hypoxia?

A)Surgical site
B)Surgical incision
C)Placement of the endotracheal tube
D)Anesthetic agent

Question 22

A free-floating segment of ribs that can be identified by its paradoxical movement is termed:

A)lung contusion.
B)rib fractures.
C)flail chest.
D)empyema.

Question 23

In patients with rheumatoid arthritis,an inflammatory reaction in the lung may occur,including patchy infiltrates,which can resolve or progress to fibrotic changes.This inflammatory reaction in the lungs is termed:

A)pneumonitis.
B)interstitial fibrosis.
C)pulmonary vasculitis.
D)obliterative bronchiolitis.

Question 24

Of the following connective tissue disorders,which one is associated with the highest incidence of pulmonary involvement?

A)Rheumatoid arthritis
B)Systemic lupus erythematosus
C)Scleroderma
D)Polymyositis

Question 25

Which of the following lung pathologies may result in a condition known as fibrothorax if the pleural space is not evacuated effectively?

A)Open pneumothorax
B)Tension pneumothorax
C)Hemothorax
D)Pulmonary laceration

Question 26

Which of the following is the MOST common lung problem in patients with polymyositis?

A)Interstitial pneumonitis
B)Bronchiolitis obliterans
C)Diffuse pulmonary infiltrates
D)Aspiration pneumonia

Question 27

The inhalation of carbon monoxide,a gas present in smoke,leads to which of the following pathological conditions?

A)Edema of the laryngeal and tracheal mucosa
B)Damage to the mucociliary clearance mechanism
C)Inactivation of surfactant and pneumonitis
D)Decreases in the oxygen-carrying capacity of the blood

Question 28

Which of the following pathological changes in lung function is a result of excess soft tissue in the abdominal wall,forcing the diaphragm upward at rest?

A)Decreases the compliance of the thorax.
B)Forces early closure of the small airways and alveoli.
C)Decreases carbon dioxide production from the lungs.
D)Increases ventilator drive.

Question 29

Which of the following oncology diagnosis tends to be the highest risk for developing radiation pneumonitis or fibrosis?

A)Hodgkin's disease
B)Breast cancer
C)Bone marrow transplant
D)Lung cancer

Question 30

On a chest radiograph,the classic finding of an elevated hemidiaphragm indicates which of the following musculoskeletal causes of restrictive lung dysfunction?

A)Kyphoscoliosis
B)Ankylosing spondylitis
C)Diaphragmatic paresis
D)Pectus excavatum

Question 31

A 59-year-old male has fallen off a ladder at his home and hit a retaining wall on the way down fracturing several ribs on the right side.He was admitted to the hospital for pain control,close observation,and physical therapy.The primary goal for physical therapy is which of the following?

A)The patient will demonstrate appropriate splinting using a small pillow to reduce pain.
B)The patient will demonstrate log roll to the left side with contact guard assist to improve bed mobility.
C)The patient will ambulate in the hall 150 feet with supervision.
D)The patient will perform deep breathing using incentive spirometry to reestablish a normal breathing pattern.

Question 32

Which of the following spinal cord levels if injured would result in diaphragmatic dysfunction?

A)C4-5
B)T1-2
C)T4-5
D)T7-8

Question 33

Which of the following drugs is given for ventricular dysrhythmias and may lead to pulmonary complications if prescribed in a high dose?

A)Nitrofurantoin
B)Suflatalazine
C)Penicillamine
D)Amiodarone

Question 34

A patient who is status postsurgical repair of a right hip fracture is at risk for thrombus formation and potentially pulmonary emboli.Which of the following interventions would be BEST recommended to this patient following discharge home to prevent a deep vein thrombus?

A)Pneumatic calf compression
B)Regular ambulation throughout the day
C)Passive stretch of the calf on the surgical limb
D)Elevation of the lower extremities

Question 35

Pulmonary edema is an increase in the amount of fluid within the lung.Which of the following BEST describes the results of a chest x-ray indicating pulmonary edema?

A)Diffuse scattered fluffy shadows
B)Diffuse haze/lung white out
C)Homogeneous opacity of fluid density
D)Increased vascular markings in the hilar region

Question 36

Which of the following statements BEST defines congestive atelectasis resulting from a pulmonary emboli?

A)Lack of blood flow to the alveolar wall
B)Decrease in alveolar surfactant
C)Edema and hemorrhage into the surrounding lung
D)Increase in alveolar dead space

Question 37

Exudative pleural effusion is characterized by high protein content and accumulates due to changes in permeability of the pleural surfaces.Which of the following is a cause of exudative pleural effusion?

A)Congestive heart failure
B)Cirrhosis
C)Bacterial pneumonia
D)Pulmonary emboli

Question 38

Common techniques such as deep breathing exercises,early patient mobilization,and incentive spirometry are MOST likely implemented to treat which of the following conditions?

A)Pulmonary embolus
B)Postoperative atelectasis
C)Venous thromboembolism
D)Aspiration pneumonia

Question 39

Penetrating wounds to the thorax are commonly caused by shooting or stabbing.An injury described as air entering the pleural space that cannot escape into the external environment is termed:

A)tension pneumothorax.
B)open pneumothorax.
C)hemothorax.
D)pulmonary laceration.

Question 40

Which of the following chemotherapeutic drugs is used as an anti-inflammatory agent to treat rheumatoid arthritis and may lead to interstitial lung disease?

A)Cytarabine
B)Methotrexate
C)Melphalan
D)Azathioprine