Question 1

As pulmonary edema progressively worsens, the fluid moves in the following sequence:

Accepted Answer

Pulmonary edema occurs when fluid accumulates in the lungs, specifically in the alveoli (air sacs) where gas exchange occurs. As the edema worsens, the fluid moves from the alveoli to the bronchioles and then to the larger bronchi. It does not typically move to the trachea or peribronchial interstitial spaces. Therefore, choice B is the best answer.

Question 2

Mask CPAP is used with pulmonary edema patients because it does all of the following EXCEPT:

Accepted Answer

While mask CPAP can decrease vascular congestion, reduce work of breathing, and improve lung compliance, it is not necessarily less expensive than mechanical ventilation. The cost can vary depending on the specific equipment used and the length of time the patient requires treatment. Therefore, the statement that it is less expensive than mechanical ventilation is not always true.

Question 3

The major pathologic or structural changes seen in the lungs with pulmonary edema include:
1) atelectasis.
2) bronchospasm.
3) high surface tension of alveolar fluids.
4) alveolar flooding.

Accepted Answer

Pulmonary edema is characterized by the accumulation of fluid in the lung interstitium and alveoli. This leads to the structural changes seen in the lungs, including atelectasis (due to collapse of alveoli), high surface tension of alveolar fluids (due to the presence of excess fluid), and alveolar flooding (due to the accumulation of fluid in the alveoli). Bronchospasm is not typically seen in pulmonary edema.

Question 4

Pulmonary edema manifests itself clinically as a/an:

Accepted Answer

Pulmonary edema is a condition characterized by the accumulation of fluid in the lungs, which leads to impaired gas exchange and difficulty breathing. This leads to a decrease in lung compliance, making it difficult to fully expand the lungs. This means that there is a restriction in the lungs' ability to inflate and transmit oxygen to the blood, which is a characteristic feature of restrictive pulmonary disorders. Therefore, A is the best choice.

Question 5

Your patient has noncardiogenic pulmonary edema. What chest radiograph findings would be expected?
1) "Bat's wings" pattern fluffy infiltrates
2) Normal cardiac silhouette
3) Fluffy densities near the hilum
4) Pleural effusion

Accepted Answer

Noncardiogenic pulmonary edema typically presents with a normal cardiac silhouette and fluffy densities near the hilum on a chest radiograph.

Question 6

Management of cardiogenic pulmonary edema includes the following:
1) giving the patient a low salt intake diet.
2) giving the patient a medication to lower blood pressure.
3) giving the patient a diuretic drug.
4) performing balloon angioplasty on the patient.

Accepted Answer

Management of cardiogenic pulmonary edema typically involves reducing fluid overload with diuretics, controlling blood pressure, and dietary modifications like a low salt diet. Balloon angioplasty is not a direct treatment for pulmonary edema but may be used to address underlying coronary artery disease.

Question 7

Which of the following is/are considered noncardiogenic cause(s) of increased capillary permeability?
1) Therapeutic lung radiation
2) Cigarette smoke
3) Acute respiratory distress syndrome (ARDS)
4) Inhaled phosgene

Accepted Answer

Among the many causes of noncardiogenic pulmonary edema are therapeutic lung radiation, ARDS, and inhaled phosgene. Cigarette smoke is associated with lung cancer and chronic obstructive pulmonary disease but does not cause increased capillary permeability.

Question 8

All of the following are causes of cardiogenic pulmonary edema EXCEPT:

Accepted Answer

Cardiogenic pulmonary edema is caused by fluid accumulation in the lungs due to increased pressure in the heart. This can be caused by heart disease like myocardial infarction and mitral valve disease, as well as congenital heart defects. However, an allergic reaction to drugs is not a common cause of cardiogenic pulmonary edema.

Question 9

Your patient with cardiogenic pulmonary edema has had intravascular catheters placed for monitoring purposes. Which of the following values would be expected?
1) Decreased SV
2) Increased PCWP
3) Increased CVP
4) Decreased RAP

Accepted Answer

In cardiogenic pulmonary edema, there is typically decreased stroke volume (SV), increased pulmonary capillary wedge pressure (PCWP), and increased central venous pressure (CVP) due to heart failure and fluid overload. Right atrial pressure (RAP) is usually increased, not decreased.

Question 10

What is the normal hydrostatic pressure in the pulmonary capillaries?

Accepted Answer

The answer of What is the normal hydrostatic pressure in...

Question 11

All of the following are positive risk factors for coronary heart disease (CHD) EXCEPT:

Accepted Answer

Elevated vitamin E level is not a positive risk factor for CHD. In fact, studies have shown that high doses of vitamin E supplements may increase the risk of CHD. The other choices are positive risk factors for CHD.

Question 12

Lymphatic insufficiency could be caused by:
1) lung transplantation.
2) lymphangitic carcinomatosis.
3) removal of pleural fluid.
4) decreased oncotic pressure.

Accepted Answer

Lung transplantation and lymphangitic carcinomatosis can both damage or obstruct the lymphatic vessels, leading to lymphatic insufficiency. Removal of pleural fluid and decreased oncotic pressure do not directly affect lymphatic function.

Question 13

Your patient with cardiogenic pulmonary edema would be expected to have all of the following chest radiograph findings EXCEPT:

Accepted Answer

Depressed diaphragms are not typically seen in cardiogenic pulmonary edema. Instead, the chest radiograph would typically demonstrate bilateral "butterfly" pattern fluffy infiltrates, cardiomegaly, and potentially a pleural effusion.

Question 14

Your patient has a decreased oncotic pressure. What can be done to increase it?

Accepted Answer

Administering mannitol can help increase oncotic pressure by drawing fluid into the vascular space, although it's not a direct method to increase oncotic pressure. However, the most direct method would be administering albumin, which is not listed as an option.

Question 15

Your patient with pulmonary edema is cyanotic and complaining of difficulty breathing. What should be recommended by the respiratory therapist?

Accepted Answer

providing supplemental oxygen is the initial treatment for a patient with pulmonary edema who is cyanotic and having difficulty breathing. This will help improve oxygenation and decrease the workload on the heart. The other options may be appropriate treatments, but oxygen supplementation is the immediate priority.

Quiz 19: Pulmonary Edema

As pulmonary edema progressively worsens, the fluid moves in the following sequence:

Mask CPAP is used with pulmonary edema patients because it does all of the following EXCEPT:

The major pathologic or structural changes seen in the lungs with pulmonary edema include: 1) atelectasis. 2) bronchospasm. 3) high surface tension of alveolar fluids. 4) alveolar flooding.

Pulmonary edema manifests itself clinically as a/an:

Your patient has noncardiogenic pulmonary edema. What chest radiograph findings would be expected? 1) "Bat's wings" pattern fluffy infiltrates 2) Normal cardiac silhouette 3) Fluffy densities near the hilum 4) Pleural effusion

Management of cardiogenic pulmonary edema includes the following: 1) giving the patient a low salt intake diet. 2) giving the patient a medication to lower blood pressure. 3) giving the patient a diuretic drug. 4) performing balloon angioplasty on the patient.

Which of the following is/are considered noncardiogenic cause(s) of increased capillary permeability? 1) Therapeutic lung radiation 2) Cigarette smoke 3) Acute respiratory distress syndrome (ARDS) 4) Inhaled phosgene