Deck 21: Pulmonary Vascular Disease: Pulmonary Embolism and Pulmonary Hypertension

Question 1

Bronchospasm may happen after a pulmonary embolism. Which of the following can lead to this bronchospasm?
1) Localized hypoxemia
2) Localized hypercapnia
3) Localized hypocapnia
4) Release of cellular mediators from platelets

A)1, 2
B)2, 4
C)1, 2, 3
D)1, 3, 4

Answer 1

1, 3, 4

Question 2

Therapies used to treat pulmonary hypertension include:
1) albuterol.
2) diuretics.
3) digoxin.
4) reteplase.

A)1
B)2, 3
C)2, 3, 4
D)1, 2, 3

Answer 2

2, 3

Question 3

A patient's D-dimer blood test results show a value of 550 ng/mL. How should these results be interpreted?

A) The patient does not have a pulmonary embolism.
B) The patient's anticoagulant level is acceptable.
C) The patient has increased level of fibrinogen.
D) The patient is having a heart attack.

Answer 3

The patient has increased level of fibrinogen.

Question 4

A pulmonary angiogram is usually ordered:

A) as the first test to identify a pulmonary embolism.
B) when other tests for a pulmonary embolism are inconclusive.
C) in conjunction with a magnetic resonance image to identify a pulmonary embolism.
D) in conjunction with an extremity venogram to identify a pulmonary embolism.

Question 5

In order to prevent pulmonary emboli, a filter may be placed into which of the following vessels to prevent clots from being carried into the pulmonary circulation?

A) Subclavian vein
B) Pulmonary artery
C) Femoral artery
D) Inferior vena cava

Question 6

The sudden onset of which of the following signs and symptoms indicates a pulmonary embolism?
1) Bradycardia
2) Coughing out blood-streaked sputum
3) Cyanosis
4) Sudden shortness of breath

A)3, 4
B)1, 2
C)2, 3, 4
D)1, 2, 3

Question 7

Medications may be used to prevent pulmonary emboli include:
1) enoxaparin.
2) dalteparin.
3) tinzaparin.
4) reteplase.

A)1
B)2, 3
C)2, 3, 4
D)1, 2, 3

Question 8

A pulmonary embolism causes which of the following major pathologic and structural changes in the lungs?
1) Alveolar consolidation
2) Mucosal edema
3) Alveolar atelectasis
4) Pleural friction rub

A)1, 3
B)2, 4
C)2, 3, 4
D)1, 2, 3

Question 9

Which of the following are included in the management of pulmonary embolism?
1) Oxygen
2) Vitamin K
3) Heparin
4) Warfarin

A)1, 4
B)2, 3
C)1, 3, 4
D)1, 2, 3

Question 10

Which of the following are preventive measures taken with patients at high risk for thromboembolic disease?
1) Drink lots of water.
2) Dangle your legs over the edge of the bed before getting up.
3) Walk frequently.
4) Wear compression stockings.

A)1, 3
B)2, 4
C)1, 3, 4
D)1, 2, 3

Question 11

Predisposing factors of pulmonary emboli include:
1) varicose veins.
2) smoking.
3) obesity.
4) asthma.

A)2, 4
B)1, 3
C)1, 2, 4
D)1, 2, 3

Question 12

The death of lung tissue that may result from an obstruction of the pulmonary artery is called a:

A) pulmonary embolism.
B) pleural effusion.
C) pulmonary infarction.
D) pulmonary empyema.

Question 13

A patient is on warfarin therapy for the prevention of deep venous thrombosis (DVT). The respiratory therapist should advise the patient to avoid eating or drinking:

A) broccoli and spinach.
B) orange juice.
C) coffee.
D) peppers and onions.

Question 14

A pulmonary embolus produces which of the following ventilation-perfusion abnormalities?

A) True shunting
B) Shunt effect
C) Dead-space effect
D) True dead space

Question 15

The best test for diagnosing a suspected pulmonary embolism is a(n):

A) spiral volumetric computerized tomography pulmonary angiogram.
B) ultrasonography.
C) D-dimer blood test.
D) chest radiograph.

Question 16

Which of the following conditions is an indication of magnetic resonance imaging (MRI) use in a patient with a suspected pulmonary embolism?
1) Pregnancy
2) Asthma
3) End-stage renal disease
4) Emphysema

A)1, 3
B)1, 2, 4
C)2, 3, 4
D)1, 2, 3

Question 17

Which of the following are major mechanisms that contribute to the pulmonary hypertension commonly seen in a patient with a pulmonary embolism?
1) Decreased cross-sectional area of the pulmonary vascular system
2) Vasoconstriction induced by alveolar hypoxia
3) Reflexes from the aortic and carotid sinus baroreceptors
4) Vasoconstriction induced by humoral agents

A)1, 4
B)2, 3
C)1, 2, 4
D)2, 3, 4

Question 18

Which of the following are associated with the formation of a deep vein thrombosis (DVT)?
1) Blood vessel injury
2) Age greater than 40 years
3) Hypercoagulability
4) Venous stasis

A)1
B)2, 3
C)2, 3, 4
D)1, 3, 4

Question 19

The respiratory therapist is listening to the heart sounds of a patient with a suspected pulmonary embolus. The therapist could expect to hear:
1) increased second heart sound (S₂).
2) increased splitting of the second heart sound (S₂).
3) third heart sound (S₃).
4) fourth heart sound (S₄).

A)1
B)2, 3
C)2, 3, 4
D)1, 2, 3