Georgia Military College

PATHO HCR 240

Ch 31- Quiz

1)The nurse needs to assess the oxygen status of a client who is suddenly experiencing shortness of breath. The most appropriate noninvasive measurement technique would be:

2. A client with primary lung disease has developed right heart failure. The health care provider would document this as:

3. A client is diagnosed with pneumoconiosis. Which aspect of the client's history is most likely the cause of this diagnosis?

4. An older adult client who has been restricted to bed by numerous comorbidities for several weeks has been diagnosed with a large pleural effusion. Which treatment modality is most likely to resolve the client's most recent health problem?

5. A 51-year-old man has been diagnosed with chronic bronchitis after a long history of recurrent coughing. Which statement by the client demonstrates a sound understanding of his new diagnosis?

6. Which factor is most likely to precipitate an asthmatic attack in a child with a diagnosis of extrinsic, or atopic, asthma?

7. Pain is an expected assessment finding in clients who have which lung disease?

8. The parents of a child diagnosed with cystic fibrosis (CF) ask about the risk of any future children having the condition. How should the nurse respond?

9. The parents of a child with cystic fibrosis ask the nurse to explain the sweat test performed on their newborn. How should the nurse respond?

10. A client with asthma comes to the emergency department very anxious due to increasing shortness of breath. Physical assessment reveals tachypnea, and an arterial blood gas shows decreased carbon dioxide levels and hypoxemia. What is the most likely cause?

11. A child is brought to the emergency department with an asthma attack. Assessment revealed the use of accessory muscles, a weak cough, audible wheezing sound, moist skin, and tachycardia. Which drug will the nurse anticipate administering first?

12. A client with a 25-year history of smoking is diagnosed with emphysema. Physical assessment reveals an increased anterior-posterior chest diameter. Which term should the nurse use to document this finding?

13. A client is diagnosed with pulmonary embolism. Which symptom would most likely be present?

14. A client who was hospitalized with bacterial pneumonia has now developed an infection in the pleural cavity. Which terminology correctly identifies this pathophysiologic finding?

15. A client is brought to the emergency department and immediately diagnosed with a tension pneumothorax. The priority intervention would be:

16. A client involved in a car accident is admitted with a chest tube following pneumothorax. He also has an elevated blood alcohol level. When the nurse enters his room, she notes the client is dyspneic, short of breath, and holding his chest tube in his hand. When the nurse pulls the linens back, she finds a “sucking” chest wound. After calling a “code blue,” the next priority intervention would be to:

17. Which client is at risk for developing acute respiratory failure?

18. An adult client with a history of worsening respiratory symptoms has presented for care. Which assessment question will best allow the clinician to address the possibility of chronic bronchitis?

19. A diagnosis of tension pneumothorax would be suspected in which physical assessment finding?

20. A client with pulmonary arterial hypertension asks the health care provider, "Why are you giving me sildenafil? It is my lungs that are my problem, not erectile dysfunction." Which statement by the health care provider is the most appropriate response?

21. The nurse is teaching a group of nursing students about exudative pleural effusion. Which statement by the students verifies that the teaching was effective?

22. The nurse is caring for the following clients. Select the client at highest risk for the development of atelectasis.

23. A child is experiencing an acute exacerbation of asthma. Which quick-acting treatment is most appropriate for this client?

24. As a result of hypoxemia and polycythemia, persons with chronic obstructive bronchitis are prone to which complication?

25. Adverse effects of emboli on pulmonary circulation and airways include:

26. A client arrives in the ED after an automobile accident. Which clinical manifestations lead the nurse to suspect a pneumothorax?
    1. Respiratory rate 34.
    2. Asymmetrical chest movements, especially on inspiration
    3. Diminished breath sounds over painful chest area

27. A moderate hemothorax diagnosis would be confirmed by the presence of which of the following?

28. Which diagnosis puts a client at risk for developing an immunologic form of interstitial lung disease?

29. For which client condition will a pulse oximeter reading be inaccurate?

30. A client reports chest pain to the nurse. Which characteristics of the pain indicate pleuritis?

31. A client reports chest pain to the nurse. Which characteristics of the pain indicate bronchial irritation?

32. What intervention is appropriate for a client with sarcoidosis?

33. A client is brought into the emergency department with severe crushing injuries to the chest wall and signs of respiratory failure following a motor vehicle accident. Which laboratory value would be expected?

34. With acute respiratory distress syndrome (ARDS), a client progressively increases his work of breathing. The physiologic principle behind this respiratory distress is related to:

35. A newly admitted critical head injury client presents to the neuro-ICU. The client is unresponsive to painful stimuli but able to breathe on his own. As the shift progresses, the nurses note a decrease in the client’s respiratory effort. The client cannot maintain his O₂ saturation above 70%. The nurses should anticipate assisting in beginning what type of pulmonary support?

36. Cystic fibrosis (CF) is an autosomal recessive disorder involving the secretion of fluids in specific exocrine glands. The genetic defect in CF inclines a person to chronic respiratory infections from a small group of organisms. Which organisms create chronic infection in a child with cystic fibrosis?

37. A pulmonary embolism occurs when there is an obstruction in the pulmonary artery blood flow. Classic signs and symptoms of a pulmonary embolism include dyspnea, chest pain, and increased respiratory rate. What is a classic sign of pulmonary infarction?

38. Pulmonary hypertension is usually caused by long-term exposure to hypoxemia. When pulmonary vessels are exposed to hypoxemia, what is their response?

39. Which client most likely faces the highest risk of developing secondary pulmonary hypertension?

40. A client sustained a puncture injury to the chest resulting in development of a tension pneumothorax. What is the pathogenesis behind a tension pneumothorax?

41. The nurse is caring for four clients. Select the client at risk for the development of a pulmonary embolism.

42. A client has undergone pulmonary diagnostic studies where the results show a mismatching of ventilation and perfusion. Which diagnosis is most likely associated with this finding?

43. Which is the most common cause of atelectasis?

44. Cystic fibrosis (CF), the major cause of severe chronic respiratory disease in children, is characterized by which diagnostic finding?

45. Common results of respiratory failure are hypoxemia and:

46. A client with a history of emphysema is experiencing hypoxemia after a taxing physical therapy appointment. Which physiologic phenomenon will occur as a consequence of hypoxemia?

47. Which client is showing signs of chronic hypoxemia? A client who is:

48. Which client with a diagnosis of asthma and a history of GI reflux is at greatest risk for developing an asthma attack?

49. A client in the emergency department reports sudden onset of coughing with a feeling of chest tightness. Lung sounds are diminished with wheezing in all lung fields, skin is moist, and the client appears anxious. What is the first intervention the nurse should implement?

50. Which client is exhibiting signs of advanced chronic obstructive pulmonary disease (COPD)? The client who is:

51. A client with cystic fibrosis reports recent weight loss without fever or cough. What interventions will the nurse implement to promote health for the client?

52. Which description of symptoms would the nurse expect to obtain from a client with exacerbation of sarcoidosis?

53. The use of oxygen at a rate above 2 L/minute is inappropriate for a client with:

54. An older adult client who was recently diagnosed with emphysema asks the nurse what caused the disease. Which statement is the best response?

55. A client tells the nurse that he is concerned he may be developing chronic bronchitis and asks how the diagnosis is made. The most appropriate information for the nurse to provide would be:

56. A client with a history of heart failure and COPD (caused by 60 pack/year smoking) presents to the clinic reporting difficulty breathing. Auscultation of breath sounds reveal absent/diminished breath sounds in the right lower lobe. Which other manifestations lead the health care provider to suspect the client may have developed atelectasis?
    1. Respiratory rate—32; pulse rate—122 beats/min.
    2. “Having a hard time catching my breath.”
    3. Using accessory muscles to help him breathe.

57. Atelectasis is the term used to designate an incomplete expansion of a portion of the lung. Depending on the size of the collapsed area and the type of atelectasis occurring, the nurse may see a shift of the mediastinum and trachea. Which way does the mediastinum and trachea shift in compression atelectasis?

58. Bronchiectasis is considered a secondary COPD, and with the advent of antibiotics, it is not a common disease entity. In the past, bronchiectasis often followed specific diseases. Which disease did it not follow?

59. The management of cor pulmonale is directed at the underlying lung disease and heart failure. Why is low-flow oxygen therapy a part of the management of cor pulmonale?

60. A 9-year-old boy has been diagnosed with bronchial asthma. Which factor is most likely contributing to his condition?

61. A 40-year-old male presents to the emergency department reporting chest pain and shortness of breath. The health care provider suspects a pulmonary embolism and orders several diagnostic tests. Select the test that would require further follow-up.

62. A client has developed chronic hypoxia and has developed pulmonary hypertension (HTN). The nurse recognizes that the most likely cause of pulmonary hypertension would be:

63. The nurse is caring for a client diagnosed with pneumonia. The client’s arterial blood gas results identify decreased level oxygen and other laboratory work reveals an increase in lactic levels. How will the nurse interpret these findings?

64. Which individual is experiencing an immunologic lung disorder affecting ventilation that has caused the formation of a granuloma on chest x-ray?

65. Which is a criterion for diagnosing moderately persistent asthma?

66. Which client does the nurse determine will have the most difficulty in instituting an exercise plan?

67. The nurse develops a plan to prevent atelectasis in a postsurgical client. Which intervention will be effective?

68. A nurse caring for a client with asthma monitors respiratory function. Which data indicate the client has severe persistent asthma?

69. The parents of an infant bring the child to the emergency room 3 hours after they put the child to bed in apparent good health. The child is restless, the pulse is 140 beats/min, and lung sounds are diminished in all lung fields with intercostal retractions. What is the most likely cause of these symptoms?

70. A client recently diagnosed with bronchiectasis asks what may have caused the condition. Which response by the nurse is accurate?

71. What description is characteristic of the pathology of interstitial lung disease?

72. Three days following surgical repair of a hip fracture a client becomes anxious and complains of sudden shortness of breath. What disorder is the client most likely experiencing?

73. A child struggling to breathe is brought to the emergency department with a prolonged bronchospasm and severe hypoxemia. Assessment revealed the use of accessory muscles, a weak cough, audible wheezing sound, moist skin, and tachycardia. What is the most likely diagnosis?

74. A client recently had surgery for a hip fracture. Which nursing intervention would be mosteffective for preventing pulmonary emboli in this client?

75. A young adult is brought to the urgent care by a parent. The client states that he just does not feel good. Upon further assessment, the health care provider notes the following:
    1. Unilateral chest pain when the client is asked to cough or move
    2. Rapid respiratory rate
    3. Splinting of the chest
    4. Decreased tidal volume
76. The provider would interpret these manifestations as:

77. When evaluating the pulmonary function test results for a client with COPD, which one correlates to the mismatch of ventilation and perfusion associated with this diagnosis?

78. A teenaged client with cystic fibrosis presents to the clinic. The health care provider (HCP) knows that cystic fibrosis (CF) causes severe chronic respiratory disease in children. In addition, the HCP should also focus his or her assessment on which of the other body systems affected by CF?

79. Many pharmaceutical agents may cause pulmonary damage. The nurse knows that which cardiac medication has been associated with toxic effects in the lungs?

80. A short, nonsmoking middle-aged man presents to the emergency room with left-sided chest pain and a cough. He says that the pain started abruptly, just after lunch, and that breathing and coughing make it worse. He denies recent injury. He is breathing shallowly and rapidly and expresses fear that he may be having a “heart attack.” Breath sounds are normal, and he is not cyanotic. Which condition is most likely causing his symptoms?

81. A farmer is admitted with hypersensitivity pneumonitis. Which factor could have caused his condition?

82. Unilateral chest pain associated with respiratory movements is usually described as which of the following?

83. With bronchiectasis, persistent airway obstruction and chronic infection results in which physiologic response?

84. Which manifestation typically accompanies an asthmatic attack?

85. A client with pulmonary hypertension may display which clinical manifestations?
    1. Shortness of breath
    2. Decreased exercise tolerance
    3. Swelling [edema] in their legs and feet

86. A nurse caring for a client with asthma monitors respiratory function. Which data indicate the client has moderate persistent asthma?

87. A nurse caring for a client with asthma monitors respiratory function. Which data indicate the client has mild intermittent asthma?