Deck 20: Pulmonary Edema

Question 1

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

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

Answer 1

1, 3, 4

Question 2

The respiratory therapist is asked to evaluate a patient with suspected congestive heart failure. Which of the following laboratory tests should the respiratory therapist recommend to evaluate the patient for possible congestive heart failure?

A) Brain natriuretic peptide (BNP)
B) Lactic dehydrogenase (LDH)
C) Aspartate aminotransferase (AST)
D) Alanine aminotransferase (ALT)

Answer 2

Brain natriuretic peptide (BNP)

Question 3

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

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

Answer 3

1, 2

Question 4

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

A) depressed diaphragms.
B) pleural effusion.
C) cardiomegaly.
D) bilateral "butterfly" pattern fluffy infiltrates.

Question 5

Management of cardiogenic pulmonary edema includes giving a patient which of the following types of medications?
1) Afterload reducer
2) Positive inotropic medication
3) Preload reducing medication
4) Positive chronotropic medication

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

Question 6

The respiratory therapist is asked to recommend a medication to reduce afterload for a patient with cardiogenic pulmonary edema. The therapist could recommend all of the following EXCEPT:

A) captopril.
B) norepinephrine (Levophed).
C) enalapril (Vasotec).
D) nitroprusside (Nitropress).

Question 7

A 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

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

Question 8

Pulmonary edema manifests itself clinically as a(n) _____ disorder.

A) restrictive pulmonary
B) obstructive pulmonary
C) equally restrictive and obstructive
D) obstructive cardiac

Question 9

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

A) Provide supplemental oxygen.
B) Begin mechanical ventilation.
C) Have the patient use pursed-lip breathing.
D) Begin bronchopulmonary hygiene therapy.

Question 10

What is the normal hydrostatic pressure in the pulmonary capillaries?

A) 0 to 5 mm Hg
B) 5 to 10 mm Hg
C) 10 to 15 mm Hg
D) 15 to 20 mm Hg

Question 11

All of the following may be causes of cardiogenic pulmonary edema EXCEPT:

A) dysrhythmias.
B) systemic hypertension.
C) congenital heart defects.
D) excessive fluid administration.
E) pulmonary embolism.

Question 12

A 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

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

Question 13

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

A) myocardial infarction.
B) mitral valve disease.
C) allergic reaction to drugs.
D) congenital heart defects.

Question 14

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.

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

Question 15

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

A) decrease vascular congestion.
B) reduce work of breathing.
C) it is less expensive than mechanical ventilation.
D) improve lung compliance.

Question 16

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

A) elevated homocysteine level.
B) elevated vitamin E level.
C) hypertension.
D) diabetes mellitus.

Question 17

As pulmonary edema progressively worsens, the fluid moves in which of the following sequences?

A) Peribronchial interstitial spaces, bronchi, trachea
B) Alveoli , bronchioles, bronchi
C) Bronchioles, bronchi, trachea
D) Pulmonary capillaries, alveoli, bronchioles

Question 18

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

A) High-salt diet
B) Mannitol
C) Albumin withheld
D) Morphine sulfate