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

Question 1

The respiratory therapist is listening to the heart sounds of a patient with a suspected pulmonary embolus. The therapist could expect to hear all of the following EXCEPT:

A) increased second heart Sound (S2).
B) increased splitting of the second heart sound (S2).
C) third heart sound (S3).
D) fourth heart sound (S4).

Answer 1

fourth heart sound (S4).

Question 2

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

A) broccoli.
B) spinach.
C) liver.
D) grapefruit.
E) orange juice.

Answer 2

orange juice.

Question 3

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

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

Answer 3

1, 2, 3, 4

Question 4

All of the following are preventive measures taken with patients at high risk for thromboembolic disease EXCEPT:

A) Drink lots of water.
B) Dangle your legs over the edge of the bed before getting up.
C) Walk frequently.
D) Wear compression stockings.

Question 5

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, 4

Question 6

All of the following medications may be used to prevent pulmonary emboli EXCEPT:

A) enoxaparin.
B) dalteparin.
C) tinzaparin.
D) reteplase.

Question 7

Which of the following is/are major mechanism(s) that contribute to the pulmonary hypertension commonly seen in a patient with a pulmonary embolism?
1) Decreased cross-section 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
B) 2, 3
C) 1, 2, 4
D) 1, 2, 3, 4

Question 8

Which of the following fibrinolytic agents are used to treat a pulmonary embolism?
1) Urokinase
2) Vitamin K
3) Heparin
4) Streptokinase

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

Question 9

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 10

The sudden onset of which of the following signs and symptoms indicates a pulmonary embolism?
1) Wheezing
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, 4

Question 11

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 12

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, 3
D) 1, 3, 4

Question 13

All of the following are associated with the formation of a deep vein thrombosis (DVT) EXCEPT:

A) blood vessel injury.
B) age greater than 40 years.
C) hypercoagulability.
D) venous stasis.

Question 14

A pulmonary embolus produces which of the following ṽ/Ó abnormalities?

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

Question 15

A patient's D-dimer blood test results show a value of 250 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 a pulmonary embolism.
D) The patient has a deep vein thrombosis.

Question 16

The duplex venous ultrasonography test is used to:

A) diagnose a blood clot below the knee.
B) identify a saddle embolism.
C) diagnose a blood clot behind the knee or thigh.
D) identify a pulmonary infarction.

Question 17

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

A) spiral computerized tomography scan.
B) pulmonary function test.
C) electrocardiogram.
D) chest radiograph.

Question 18

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) Thoracic duct
D) Inferior vena cava
E) Femoral artery