Question 1

A 60-year-old female with emphysema is having difficulty expiring a given volume of air.When giving report,the nurse will relay that the patient is most likely experiencing _____ pulmonary disease.
A) Restrictive
B) Obstructive
C) Atelectatic
D) Pleuritic

Accepted Answer

Emphysema is a form of obstructive pulmonary disease.
Emphysema is a form of obstructive pulmonary disease,not restrictive.
Emphysema is a form of obstructive pulmonary disease,not atelectatic.
Emphysema is a form of obstructive pulmonary disease,not pleuritic.

Question 2

A 53-year-old male with a 20-year history of smoking is diagnosed with emphysema.When a staff member asks why the patient's airways are obstructed,how should the nurse respond? The airways are obstructed because of:
A) Excessive mucus production
B) Loss of elastic recoil
C) Infection and inflammation
D) Airway edema

Accepted Answer

The major mechanism of airflow limitation is loss of elastic recoil.
The major mechanism of airflow limitation is loss of elastic recoil,not excessive mucus as with bronchitis.
The major mechanism of airflow limitation is loss of elastic recoil,not infection.
The major mechanism of airflow limitation is loss of elastic recoil,not airway edema.

Question 3

An 80-year-old female develops pneumonia in the hospital.She becomes cyanotic,tachycardic,and develops a fever and cough.Chest x-ray reveals pus in the pleural space.Which of the following is the most likely diagnosis documented on the chart?
A) Empyema
B) Emphysema
C) Pleurisy
D) Chyle

Accepted Answer

The presence of microorganisms in the pleural space is termed empyema.
The presence of microorganisms in the pleural space is termed empyema; emphysema is a total lung disorder.
Pleurisy causes pain with inspiration.
Chyle is milky fluid with lymph and fat.

Question 4

A 22-year-old female presents with chronic bronchitis.Tests reveal closure of the airway during expiration.While planning care,a nurse recalls this condition is most likely caused by:
A) Thick mucus from hypertrophied glands
B) Ventilation-perfusion mismatch
C) Hyperventilation
D) Thinning smooth muscle in the bronchioles

Accepted Answer

Chronic bronchitis is defined by hypersecretion of thick mucus.
Ventilation-perfusion mismatch may occur,but chronic bronchitis is defined as hypersecretion of mucus.
Chronic bronchitis is defined as hypersecretion of mucus; dyspnea may occur,but hyperventilation is not expected.
Chronic bronchitis is defined as hypersecretion of mucus; thickening of smooth muscle occurs,not thinning.

Question 5

Individuals with a recent diagnosis of emphysema should be assessed for which most common presenting factor?
A) A productive cough
B) Cyanosis
C) Dyspnea
D) Cor pulmonale

Accepted Answer

Dyspnea is the most common presenting factor of emphysema.
Dyspnea,not a productive cough,is the most common presenting factor of emphysema.
Dyspnea,not cyanosis,is the most common presenting factor of emphysema.
Dyspnea,not cor pulmonale,is the most common presenting factor of emphysema.

Question 6

A 57-year-old male presents with cough,sputum production,dyspnea,and decreased lung volume.He is diagnosed with pneumoconiosis.When taking the patient's history,which finding is the most probable cause of his illness?
A) Inhalation of silica, asbestos, mica
B) Autoimmune disease
C) Allergic reactions
D) Flail chest

Accepted Answer

The dusts of silica,asbestos,and coal are the most common causes of pneumoconiosis.
The dusts of silica,asbestos,and coal are the most common causes of pneumoconiosis; it is not an autoimmune disorder.
The dusts of silica,asbestos,and coal are the most common causes of pneumoconiosis; it is not an allergic response.
The dusts of silica,asbestos,and coal are the most common causes of pneumoconiosis; it is not due to flail chest.

Question 7

Which of the following shows a correct cause and effect sequence in the development of acute respiratory distress syndrome (ARDS)?
A) Impaired alveolar compliance causing decreased surfactant production
B) Alveolocapillary membrane injury causing a massive inflammatory response
C) Hyaline membrane formation and fibrosis causing pulmonary edema
D) Increased alveolocapillary membrane permeability causing metabolic alkalosis

Accepted Answer

All disorders causing ARDS cause massive pulmonary inflammation that injures the alveolocapillary membrane and produces severe pulmonary edema and inflammation.
All disorders causing ARDS cause massive pulmonary inflammation that injures the alveolocapillary membrane and produces severe pulmonary edema and inflammation.It does not affect surfactant.
ARDS does not cause hyaline formation.
Metabolic alkalosis occurs late,but inflammation occurs first.

Question 8

A 42-year-old female presents with dyspnea; rapid,shallow breathing; inspiratory crackles; decreased lung compliance; and hypoxemia.Tests reveal a fulminant form of respiratory failure characterized by acute lung inflammation and diffuse alveolocapillary injury.Which of the following is the most likely diagnosis the nurse will observe on the chart?
A) Acute respiratory distress syndrome (ARDS)
B) Sarcoidosis
C) Postoperative respiratory failure
D) Malignant respiratory failure

Accepted Answer

The patient is experiencing ARDS.
The patient's symptoms demonstrate ARDS,not sarcoidosis.
The patient's symptoms demonstrate ARDS,not postoperative respiratory failure.
The patient is experiencing ARDS,not malignant respiratory failure.

Question 9

A 25-year-old male presents with chronic bronchitis of 5 months' duration.When obtaining the patient's history,which of the following findings is most likely to cause this condition?
A) Chronic asthma
B) Air pollution
C) Cigarette smoke
D) Recurrent pneumonias

Accepted Answer

The most likely cause of chronic bronchitis is cigarette smoke.
The most likely cause of chronic bronchitis is cigarette smoke,not chronic asthma.
Air pollution may contribute,but smoking is the most common cause.
Recurrent infections could contribute,but smoking is the most common cause.

Question 10

A nurse is preparing to teach the staff about asthma.Which information should the nurse include? Airway hyper-responsiveness in asthma is related to:
A) Increased sympathetic nervous system response
B) The release of stress hormones
C) Exposure to an allergen causing mast cell degranulation
D) Hereditary decrease in IgE responsiveness

Accepted Answer

Hyper-responsiveness is due to mast cell degranulation.
An increased sympathetic response would lead to bronchiolar dilation.
Hyper-responsiveness is due to mast cell degranulation,not to release of stress hormones.
Hyper-responsiveness is due to mast cell degranulation; heredity is associated with asthma,but the problem is the mast cells.

Question 11

A 10-year-old male is brought to the ER with prolonged bronchospasm and severe hypoxemia.The most likely diagnosis on the chart is:
A) Exercise-induced asthma
B) Chronic obstructive pulmonary disease (COPD)
C) Status asthmaticus
D) Bronchiectasis

Accepted Answer

When bronchospasm is not reversed by usual measures,the individual is considered to have severe bronchospasm or status asthmaticus.
When bronchospasm is not reversed by usual measures,the individual is considered to have severe bronchospasm or status asthmaticus; exercise-induced asthma resolves.
COPD is manifested by air trapping and hypercapnia,not by bronchospasm.
Bronchiectasis is manifested by bronchiolar changes,not bronchospasm.

Question 12

A nurse is preparing to teach the staff about asthma.Which information should the nurse include? Airway obstruction contributing to increased airflow resistance and hypoventilation in asthma is caused by:
A) Type II alveolar cell injury and decreased surfactant
B) Alveolar fibrosis and pulmonary edema
C) Mucus secretion, bronchoconstriction, and airway edema
D) Collapse of the cartilaginous rings in the bronchi

Accepted Answer

The mediators of asthma cause vasodilation,increased capillary permeability,mucosal edema,bronchial smooth muscle contraction (bronchospasm),and mucus secretion from mucosal goblet cells with narrowing of the airways and obstruction to airflow.
Acute respiratory distress syndrome involves type II injury.
Alveolar fibrosis with pulmonary edema is not associated with asthma.
Asthma is not associated with collapse of bronchiolar rings.

Question 13

A nurse recalls asthma is classified by:
A) Pathophysiologic differences
B) Clinical severity
C) Genetic traits
D) Treatment outcomes

Accepted Answer

The National Asthma Education and Prevention Program offers stepwise guidelines for the diagnosis and management of chronic asthma based on clinical severity.
The National Asthma Education and Prevention Program offers stepwise guidelines for the diagnosis and management of chronic asthma based on clinical severity,not pathophysiologic differences.
The National Asthma Education and Prevention Program offers stepwise guidelines for the diagnosis and management of chronic asthma based on clinical severity,not genetic traits.
The National Asthma Education and Prevention Program offers stepwise guidelines for the diagnosis and management of chronic asthma based on clinical severity,not treatment outcomes.

Question 14

A 15-year-old female is diagnosed with restrictive lung disease caused by fibrosis.The patient had a pulmonary functions test.Which of the following findings is expected?
A) Increased compliance
B) Increased tidal volume
C) Decreased respiratory rate
D) Decreased functional residual capacity

Accepted Answer

Fibrosis progressively obliterates the alveoli,respiratory bronchioles,and interstitium (fibrosing alveolitis),which can result in chronic pulmonary insufficiency,and functional residual capacity declines.
Compliance decreases in restrictive disease.
In restrictive disease,tidal volume decreases.
Respirations may increase with restrictive disease.

Question 15

A 25-year-old male presents with chronic bronchitis of 5 months' duration.Which of the following is the most significant concern for the nurse to monitor in this patient?
A) Left heart failure
B) Pulmonary embolus
C) Immunosuppression
D) Recurrent pulmonary infections

Accepted Answer

Recurrent pulmonary infections are a significant concern for this patient.
Recurrent infections,not left heart failure,are a significant concern for a patient with bronchitis.
Recurrent infections,not pulmonary embolus,are a significant concern for a patient with bronchitis.
Recurrent infections,not immunosuppression,are a significant concern for a patient with bronchitis.

Question 16

A 53-year-old male with a 20-year history of smoking is diagnosed with emphysema.When the nurse is asked what causes this,what is the nurse's best response? Changes in his lungs are caused by:
A) Viral infections
B) Destruction of alveolar macrophages
C) Alpha-1-antitrypsin deficiency
D) Fibrotic lung disease

Accepted Answer

Changes in the lungs are associated with alpha-1-antitrypsin deficiency.
Changes in the lungs are associated with alpha-1-antitrypsin deficiency; it is not due to viral infections.
Changes in the lungs are associated with alpha-1-antitrypsin deficiency; it is not due to alveolar macrophage destruction.
Changes in the lungs are associated with alpha-1-antitrypsin deficiency; it is not due to fibrotic lung disease.

Question 17

When the nurse is asked what causes asthma,how should the nurse respond? Asthma is thought to be caused by:
A) An autosomal recessive trait
B) Autoimmunity
C) Excessive use of antibiotics as a young child
D) Interactions between genetic and environmental factors

Accepted Answer

Asthma is an interaction between genetic and environmental factors.
Asthma is both genetic and environmental,but is not recessive.
Asthma is both genetic and environmental,but is not an autoimmune response.
Asthma is not due to excessive antibiotic use in childhood.

Question 18

A 60-year-old female with a 25-year history of smoking is diagnosed with emphysema.She has an increased anterior-posterior chest diameter.The nurse attributes this finding to:
A) Air trapping
B) Decreased inspiratory reserve volumes
C) Increased flow rates
D) Alveolar destruction

Accepted Answer

Air trapping expands the thorax,putting the respiratory muscles at a mechanical disadvantage.
Air trapping expands the thorax,putting the respiratory muscles at a mechanical disadvantage.
Air trapping,not increased flow rates,expands the thorax,putting the respiratory muscles at a mechanical disadvantage.
Air trapping,not alveolar destruction,expands the thorax putting the respiratory muscles at a mechanical disadvantage.

Question 19

A 54-year-old male is diagnosed with empyema.Upon receiving and reviewing the culture result,which organism does the nurse suspect is the most likely cause?
A) Virus
B) Staphylococcus aureus
C) Klebsiella pneumonia
D) Moraxella catarrhalis

Accepted Answer

The most likely cause of empyema is Staphylococcus aureus.
The most likely cause of empyema is Staphylococcus aureus; it is not due to a virus.
The most likely cause of empyema is Staphylococcus aureus; it is not due to Klebsiella.
The most likely cause of empyema is Staphylococcus aureus; it is not due to Moraxella catarrhalis.

Question 20

A patient asks what causes pneumonia.How should the nurse reply? Pneumonia is caused by:
A) Use of anesthetic agents in surgery
B) Atelectasis
C) Chronic lung changes seen with aging
D) Viral or bacterial infections

Accepted Answer

Pneumonia is caused by a viral or bacterial infection.
Pneumonia is caused by a viral or bacterial infection; infections are not caused by anesthetic agents.
Pneumonia is caused by a viral or bacterial infection; atelectasis does not cause pneumonia.
Pneumonia is caused by a viral or bacterial infection; lung changes in aging are normal changes,not infectious.

Quiz 26: Alterations of Pulmonary Function

A 60-year-old female with emphysema is having difficulty expiring a given volume of air.When giving report,the nurse will relay that the patient is most likely experiencing _____ pulmonary disease.

A 53-year-old male with a 20-year history of smoking is diagnosed with emphysema.When a staff member asks why the patient's airways are obstructed,how should the nurse respond? The airways are obstructed because of:

An 80-year-old female develops pneumonia in the hospital.She becomes cyanotic,tachycardic,and develops a fever and cough.Chest x-ray reveals pus in the pleural space.Which of the following is the most likely diagnosis documented on the chart?

A 22-year-old female presents with chronic bronchitis.Tests reveal closure of the airway during expiration.While planning care,a nurse recalls this condition is most likely caused by:

Individuals with a recent diagnosis of emphysema should be assessed for which most common presenting factor?

A 57-year-old male presents with cough,sputum production,dyspnea,and decreased lung volume.He is diagnosed with pneumoconiosis.When taking the patient's history,which finding is the most probable cause of his illness?

Which of the following shows a correct cause and effect sequence in the development of acute respiratory distress syndrome (ARDS) ?

A 25-year-old male presents with chronic bronchitis of 5 months' duration.When obtaining the patient's history,which of the following findings is most likely to cause this condition?

A nurse is preparing to teach the staff about asthma.Which information should the nurse include? Airway hyper-responsiveness in asthma is related to:

A 10-year-old male is brought to the ER with prolonged bronchospasm and severe hypoxemia.The most likely diagnosis on the chart is:

A nurse is preparing to teach the staff about asthma.Which information should the nurse include? Airway obstruction contributing to increased airflow resistance and hypoventilation in asthma is caused by:

A nurse recalls asthma is classified by:

A 15-year-old female is diagnosed with restrictive lung disease caused by fibrosis.The patient had a pulmonary functions test.Which of the following findings is expected?

A 25-year-old male presents with chronic bronchitis of 5 months' duration.Which of the following is the most significant concern for the nurse to monitor in this patient?

A 53-year-old male with a 20-year history of smoking is diagnosed with emphysema.When the nurse is asked what causes this,what is the nurse's best response? Changes in his lungs are caused by:

When the nurse is asked what causes asthma,how should the nurse respond? Asthma is thought to be caused by:

A 60-year-old female with a 25-year history of smoking is diagnosed with emphysema.She has an increased anterior-posterior chest diameter.The nurse attributes this finding to:

A 54-year-old male is diagnosed with empyema.Upon receiving and reviewing the culture result,which organism does the nurse suspect is the most likely cause?

A patient asks what causes pneumonia.How should the nurse reply? Pneumonia is caused by: