Deck 16: Pulmonary Anatomy and Physiology

Question 1

A patient in diabetic ketoacidosis would exhibit what alteration to the pulmonary system?

A) Breathe faster to increase pH
B) Breathe slower to increase pH
C) Breathe faster to decrease pH
D) Breathe slower to decrease pH

Answer 1

Breathe faster to decrease pH

Question 2

Which range would be considered normal for pulmonary artery systolic pressures?

A) 15 to 30 mm Hg
B) 4 to 12 mm Hg
C) 25 to 35 mm Hg
D) 1 to 11 mm Hg

Answer 2

15 to 30 mm Hg

Question 3

Which statement best describes the left bronchus?

A) The left bronchus has a slight angle of 20 to 30 degrees from the midline.
B) The two mainstem bronchi are structurally and functionally similar.
C) The left bronchus is slightly narrower.
D) The bronchi are the end units of the bronchial tree.

Answer 3

The left bronchus is slightly narrower.

Question 4

A patient has sustained a stroke and is no longer able to control his epiglottis.Why should the nurse be concerned about the patient?

A) The patient is at increased risk of aspiration.
B) The patient will need surgery to close his epiglottis.
C) The patient will need a tracheostomy to breathe.
D) The patient is at risk for a pneumothorax.

Question 5

What substance do Alveolar type II cells secrete?

A) Trypsin
B) Chyme
C) Amylase
D) Surfactant

Question 6

What is the main function of the conducting airways?

A) Gas exchange
B) Cool the inhaled air
C) Remove moisture from inhaled air
D) Prevent the entry of foreign material

Question 7

If a patient sustained an injury to the apneustic center in the lower pons area,in which area should the nurse most expect the patient to exhibit problems?

A) Respiratory rate
B) Triggering exhalation
C) Respiratory rhythm
D) Depth of respiration

Question 8

What are the primary functions of the pulmonary system?

A) Gas exchange and the movement of air in and out of the lungs
B) Gas exchange and the transfer of oxygen to the tissues
C) The movement of blood in and out of the lungs and the removal of waste products
D) Gas exchange and the prevention of infections

Question 9

Which pulmonary alteration increases the work of breathing in the patient with emphysema?

A) Decreased lung recoil
B) Decreased chest wall compliance
C) Increased lung compliance
D) Increased airway resistance

Question 10

At what anatomic site does the trachea divide into the right and left mainstem bronchi?

A) Posterior larynx
B) Cricoid cartilage
C) Epiglottis
D) Major carina

Question 11

Which physiologic mechanism is a passive event in a spontaneously breathing patient?

A) Coughing
B) Inhalation
C) Exhalation
D) Yawning

Question 12

A shift to the left of the oxyhemoglobin dissociation curve would cause which physiologic alteration?

A) Better tissue perfusion
B) Lower SpO₂
C) Decreased hemoglobin affinity for O₂
D) Impaired tissue oxygen delivery

Question 13

What anatomic regions are considered physiologic dead space?

A) Respiratory bronchiole and unperfused alveoli
B) Trachea and perfused alveoli
C) Trachea and unperfused alveoli
D) Trachea and mainstem bronchi

Question 14

Which artery(s)have the lowest oxygen saturation?

A) Aorta
B) Subclavian
C) Carotid
D) Pulmonary

Question 15

The oxygen saturation of a healthy individual rarely reaches 100% on room air.This can best be explained by what concept?

A) Physiologic shunting
B) Alveolar capillary diffusion
C) Collateral air passages
D) Anatomic dead space

Question 16

Which pulmonary condition is related to a lack of surfactant?

A) Pulmonary embolus
B) Pulmonary hypertension
C) Pulmonary atelectasis
D) Pulmonary edema

Question 17

Which V/Q ratio would most suggest intrapulmonary shunting?

A) 0.8
B) 2.2
C) 0.4
D) V/Q ratios are not related to shunting.

Question 18

Which part of the pulmonary anatomy does most of the work of breathing?

A) Pleura
B) Intercostal muscles
C) Diaphragm
D) Sternocleidomastoid

Question 19

Normally,the central chemoreceptors responsible for triggering ventilation changes respond to which of the following?

A) Increased PaCO₂
B) Increased HCO₃¯
C) Decreased PaO₂
D) Increased PaO₂

Question 20

Patients who have aspiration pneumonitis often present with right lower lobe involvement more than left lower lobe involvement.Why does this occur?

A) The left mainstem bronchus angles down more than the right.
B) More people are right-side dominant.
C) The right mainstem bronchus angles down more than the left.
D) The right mainstem bronchus is narrower than the left.

Question 21

Which factor will result in a shift of the oxyhemoglobin dissociation curve to the left?

A) Increased PaCO₂
B) Increased pH
C) Increased temperature
D) Increased 2,3-DPG

Question 22

The lobes are divided into 18 segments.How many are on the right lung?

A) 3
B) 8
C) 10
D) 15

Question 23

A patient is admitted with an acute exacerbation of asthma.Respirations are 28 breaths/min.Blood gases reveal an uncompensated respiratory acidosis.The patient's work effort for breathing is increased due to which pathophysiologic mechanism?

A) Increased lung compliance
B) Decreased lung recoil
C) Increased chest wall compliance
D) Increased airway resistance

Question 24

How much of the basal oxygen consumption is required by the pulmonary system during normal quiet breathing?

A) 10% to 20%
B) 5% to 10%
C) 3% to 5%
D) 1% to 2%

Question 25

Which statement about methemoglobin is true?

A) Methemoglobin does not carry oxygen.
B) Methemoglobin occurs when carbon monoxide combines with hemoglobin.
C) Carbon dioxide is carried on methemoglobin.
D) Hemoglobin S is responsible for methemoglobin.

Question 26

Which pleura adheres to the lungs?

A) Parietal
B) Visceral
C) Intrapleural
D) Surfactant

Question 27

Oxygen saturation of left atrial blood is normally between 96% and 99%.What is the explanation for less than 100% saturation?

A) As blood passes to the alveolar-capillary membrane, a predicted percentage of hemoglobin will not bind with oxygen.
B) During normal respiration, the majority of alveoli are not expanded.
C) Venous blood from the bronchial circulation is returned to the left atrium.
D) A small amount of blood leaks from the right atrium to the left atrium with each ventricular contraction.

Question 28

Which nerve stimulates movement of the diaphragm?

A) Musculocutaneous nerve
B) Phrenic nerve
C) Median nerve
D) Axillary nerve

Question 29

Based on the oxyhemoglobin dissociation curve,respiratory acidosis will have which effect?

A) A shifting of the curve to the left
B) Increased oxygen saturation
C) Enhanced oxygen delivery at the tissue level
D) Hypothermia

Question 30

A patient is admitted with community-associated pneumonia.Respirations are 32 breaths/min.Temperature is 102° F (38.6° C).Based on the readings the nurse would expect the oxyhemoglobin dissociation curve to shift.What other factors would cause the curve to shift in the same direction?

A) Decreased 2,3-DPG
B) Increased pH
C) Increased CO₂
D) Increased O₂

Question 31

Which physiologic alteration will stimulate the central chemoreceptors?

A) Decreased PaO₂
B) Increased PaO₂
C) Decreased SaO₂
D) Increased PaCO₂

Question 32

What is the most important function of type I alveolar epithelial cells?

A) They comprise 90% of total alveolar surface in the lungs for gas exchange.
B) The ability to produce, store, and secrete pulmonary surfactant.
C) The ability to trap foreign particles for auto digestion.
D) The maintenance, repair, and restoration of the mucociliary escalator.

Question 33

What is the movement of air into and out of the lungs termed?

A) Ventilation
B) Respiration
C) Diffusion
D) Perfusion

Question 34

Atelectasis can cause a shunt-producing ventilation-perfusion mismatch.Which pathophysiologic mechanism explains how this occurs?

A) An alveolus that is receiving perfusion exceeding ventilation
B) An alveolus that is receiving ventilation exceeding perfusion
C) An alveolus that is receiving ventilation but not perfusion
D) An alveolus that is not receiving perfusion or ventilation

Question 35

Trauma to which vertebrae will cause ventilation dysfunction?

A) C3 to C5
B) C5 to T₃
C) T₄ to T₆
D) T7 to T10

Question 36

What is the portion of total ventilation that participates in gas exchange termed?

A) Alveolar dead space
B) Anatomic dead space
C) Physiologic dead space
D) Alveolar ventilation

Question 37

Which statement describes the relationship between the pulmonary circulation and the pulmonary vascular bed?

A) The pulmonary circulation is a high-pressure system with normal pressures averaging 100/60 to 120/70 mm Hg.
B) Because of the low pulmonary arterial pressures, the right ventricular wall thickness needs to be only one-third that of the left ventricle.
C) Pulmonary hypertension is defined as increased pulmonary artery systolic pressure above 20 mm Hg.
D) The most common cause of pulmonary hypertension is right-sided heart failure.

Question 38

Which factor will increase diffusion of gases across the alveolar capillary membrane?

A) A decrease in the surface area of the membrane
B) An increase in the thickness of the membrane
C) An increase in the driving pressure of the gas
D) A decrease in the solubility coefficient of the gas

Question 39

Muscles of exhalation include which of the following?

A) Abdominal
B) Diaphragm
C) External intercostals
D) Internal intercostals
E) Scalene

Question 40

The lymphatic system plays which of the following important roles?

A) Ridding lung tissue of excess CO₂
B) Connecting the thebesian veins to the coronary circulation
C) Removing fluid from the lungs
D) Producing immune responses
E) Removing cell debris from the lungs