Deck 22: Obstructive Pulmonary Disorders

Question 1

Chronic bronchitis often leads to cor pulmonale because of

A) ventricular hypoxia.
B) increased pulmonary vascular resistance.
C) left ventricular strain.
D) hypervolemia.

Answer 1

increased pulmonary vascular resistance.

Question 2

To best prevent emphysema,a patient is instructed to stop smoking since cigarette smoke

A) impairs a₁-antitrypsin, allowing elastase to predominate.
B) paralyzes the cilia, causing impaired mucociliary clearance.
C) predisposes to respiratory infections.
D) introduces carcinogens into the lungs.

Answer 2

impairs a₁-antitrypsin, allowing elastase to predominate.

Question 3

Lack of a-antitrypsin in emphysema causes

A) chronic mucous secretion and airway fibrosis.
B) destruction of alveolar tissue.
C) pulmonary edema and increased alveolar compliance.
D) bronchoconstriction and airway edema.

Answer 3

destruction of alveolar tissue.

Question 4

Asthma is categorized as a(n)

A) restrictive pulmonary disorder.
B) infective pulmonary disorder.
C) obstructive pulmonary disorder.
D) type of acute tracheobronchial obstruction.

Question 5

When a client diagnosed with COPD type A asks,"Why is my chest so big and round?",the nurse responds that

A) "Loss of elastic tissue in your lungs allows your airways to close and trap air, which makes your chest round."
B) "Swelling and mucus in your airways causes air to be trapped in your lungs, which makes your chest round."
C) "Coughing caused by your condition has changed the structure of your airways, which makes your chest round."
D) "Scar tissue in your lungs makes them stiff and more full of air than usual, which makes your chest round."

Question 6

When preparing for the admission of a client diagnosed with bronchiectasis,the nurse will

A) put a sputum cup and a box of tissues on the bedside table.
B) remove the telephone to reduce myocardial oxygen demand.
C) add a box of surgical masks to the nursing supplies near the door.
D) remove the water pitcher to comply with anticipated fluid restrictions.

Question 7

All obstructive pulmonary disorders are characterized by

A) resistance to airflow.
B) hyperresponsiveness.
C) decreased residual volumes.
D) decreased lung compliance.

Question 8

Emphysema results from destruction of alveolar walls and capillaries,which is because of

A) release of proteolytic enzymes from immune cells.
B) air trapping with resultant excessive alveolar pressure.
C) excessive a₁-antitrypsin.
D) autoantibodies against pulmonary basement membrane.

Question 9

In individuals who have asthma,exposure to an allergen to which they are sensitized leads to which pathophysiologic event?

A) Loss of alveolar elastin and premature closure of airways
B) Pulmonary edema and decreased alveolar compliance
C) Mast cell degranulation that causes decreased surfactant
D) Inflammation, mucosal edema, and bronchoconstriction

Question 10

Cystic fibrosis is associated with

A) asthma.
B) chronic bronchitis.
C) bronchiectasis.
D) emphysema.

Question 11

Obstructive disorders are associated with

A) low residual volumes.
B) low expiratory flow rates.
C) increased expiratory reserve volume.
D) decreased total lung capacity.

Question 12

COPD leads to a barrel chest,because it causes

A) pulmonary edema.
B) muscle atrophy.
C) prolonged inspiration.
D) air trapping.

Question 13

Allergic (extrinsic)asthma is associated with

A) hyporesponsiveness of airways.
B) unknown precipitating factors.
C) IgE-mediated airway inflammation.
D) irreversible airway obstruction.

Question 14

Croup is characterized by

A) a productive cough.
B) a barking cough.
C) an inability to cough.
D) drooling, sore throat, and difficulty swallowing.

Question 15

The hypersecretion of mucus resulting for chronic bronchitis is the result of

A) recurrent infection.
B) destruction of alveolar septa.
C) reduced inflammation.
D) barrel chest.

Question 16

Copious amounts of foul-smelling sputum are generally associated with

A) emphysema.
B) epiglottitis.
C) pulmonary edema.
D) bronchiectasis.

Question 17

After evaluation,a child's asthma is characterized as "extrinsic." This means that the asthma is

A) of unknown pathogenesis.
B) associated with specific allergic triggers.
C) associated with respiratory infections.
D) induced by psychological factors (stress).

Question 18

Which assessment would support a diagnosis of type A COPD rather than type B COPD

A) Copious sputum, dyspnea, cor pulmonale
B) Noisy breath sounds, fatigue, high PaCO₂, overweight
C) Normal PaCO₂, scant sputum, accessory muscle use, barrel chest
D) Barrel chest, productive cough, cyanosis, very decreased PaO₂

Question 19

When exposed to inhaled allergens,a patient with asthma produces large quantities of

A) IgG.
B) IgE.
C) IgA.
D) IgM.

Question 20

Which pulmonary function test result is consistent with a diagnosis of asthma?

A) Reduced forced expiratory volume in 1 second (FEV1)
B) Decreased functional residual capacity
C) Increased FEV1
D) Reduced total lung volume

Question 21

An acute asthma attack is associated with (Select all that apply.)

A) bronchoconstriction.
B) bronchial mucosal edema.
C) hypersecretion of mucus.
D) alveolar collapse.
E) hypoxemia.

Question 22

The assessment findings of a 5-year-old with a history of asthma include extreme shortness of breath,nasal flaring,coughing,pulsus paradoxus,and use of accessory respiratory muscles.There is no wheezing and the chest is silent in many areas.How should you interpret your assessment?

A) The child probably has consolidated pneumonia; oxygen should be started immediately.
B) Since there is not wheezing, asthma is the problem, but oxygen should be started immediately anyway.
C) The signs and symptoms are consistent with asthma; start oxygen and then check to see that your stethoscope is working properly.
D) The child may be having such a severe asthma episode that the airways are closed, so start oxygen and get the doctor immediately.

Question 23

Which complication of asthma is life threatening?

A) Exercise-induced asthma
B) Late phase response
C) Status asthmaticus
D) Mast cell degranulation

Question 24

The increased anterior-posterior chest diameter associated with obstructive lung disease is caused by

A) increased pulmonary blood flow.
B) increased expiratory flow rates.
C) increased residual lung volumes.
D) decreased chest wall compliance.

Question 25

Which is true about epiglottitis? (Select all that apply.)

A) Is usually caused by H. influenzae type B
B) Can be caused by bacterial infection
C) Usually occurs in children
D) Is characterized by pain with swallowing
E) Generally resolves without intervention

Question 26

Characteristics of asthma include (Select all that apply.)

A) chronic inflammatory disorder.
B) airway hyperresponsiveness.
C) alveolar collapse.
D) genetic susceptibility.
E) airway remodeling.

Question 27

Airway obstruction in chronic bronchitis is because of

A) thick mucus, fibrosis, and smooth muscle hypertrophy.
B) loss of alveolar elastin.
C) pulmonary edema.
D) hyperplasia and deformation of bronchial cartilage.

Question 28

When assessing an individual during an acute asthma episode,you should expect to find (Select all that apply.)

A) use of accessory breathing muscles.
B) expiratory wheezing.
C) foul-smelling sputum.
D) coughing.
E) feeling of chest tightness.

Question 29

Individuals who have chronic bronchitis most often have

A) a productive cough.
B) normal lung sounds.
C) a barrel chest.
D) substantial weight loss.