NSG 3850 EXAM 2 QUESTIONS AND ANSWERS
The amount of gas remaining in the lungs after a maximal expiration is called the
a. residual volume.
b. functional residual capacity.
c. expiratory reserve volume.
d. vital capacity. - Answers - ANS: A
Residual volume is the amount of gas remaining in the lungs after a maximal expiration.
Functional residual capacity is the amount of gas left in the lungs at the end of a normal
expiration. Expiratory reserve volume is the amount of gas expired beyond tidal volume.
Vital capacity is the total volume of gas that can be exhaled during maximal expiration.
An increase in filtration of fluid from the pulmonary capillaries into the interstitium occurs
with ________ pressure.
a. increased capillary colloid
b. increased capillary hydrostatic
c. decreased capillary hydrostatic
d. decreased interstitial colloid - Answers - ANS: B
When capillary hydrostatic pressure exceeds capillary colloid osmotic pressure, fluid
moves from the capillary to the interstitium. Increased capillary colloid pressure,
decreased capillary hydrostatic pressure, or decreased interstitial colloid pressure would
all prevent fluid movement out of the capillaries.
The central chemoreceptors for respiratory control are
a. located in the carotid artery.
responsive primarily to changes in pH and CO2.
b. responsive primarily to hypoxemia.
c. less important than the peripheral
d. chemoreceptors in maintaining respiration. - Answers - ANS: B
Central chemoreceptors for respiratory control are responsive primarily to changes in
pH and CO2. The central chemoreceptors are located in the medullary center, are
responsive to pH and CO2, and are more important than the peripheral chemoreceptors
in controlling respirations.
The peripheral chemoreceptors
a. are located in the medulla oblongata.
b. lead to hypoventilation when stimulated.
c. respond to the arterial oxygen level.
d. are unresponsive to pH and CO2 levels. - Answers - ANS: C
The peripheral chemoreceptors respond to reduced arterial oxygen (hypoxemia). The
peripheral chemoreceptors are located in the aortic arch and carotid bodies, lead to
hyperventilation when stimulated, and respond to pH and CO2 levels in addition to
arterial oxygen level.
Hypoxic pulmonary vasoconstriction
,a. diverts blood to hypoxic regions.
b. increases blood flow to the base of the lung.
c. can lead to secondary pulmonary hypertension.
d. is always detrimental to the patient. - Answers - ANS: C
Increased resistance to blood flow resulting from hypoxic vasoconstriction can lead to
secondary pulmonary hypertension. Hypoxic pulmonary vasoconstriction diverts blood
to nonhypoxic regions, diverts blood to any area of the lung needed, and is helpful in
maintaining adequate oxygenation.
Most of the carbon dioxide in blood is
a. transported as bicarbonate.
b. transported on the hemoglobin molecule.
c. transported as carbonic acid.
d. dissolved in plasma. - Answers - ANS: A
Sixty to seventy percent of carbon dioxide in blood is transported as bicarbonate. Only
20% to
30% is carried on the hemoglobin molecule. An insignificant amount of carbon dioxide in
blood is transported as carbonic acid. Only 5% to 10% is dissolved in plasma.
Shifts in the oxyhemoglobin dissociation curve represent the
a. effect of carbonic anhydrase on the uptake of CO2.
b. ability of blood to pick up more CO2 when PaO2 is low.
c. amount of hydrogen in solution in the blood.
d. changes in hemoglobin affinity for oxygen. - Answers - ANS: D
Shifts in the oxyhemoglobin dissociation curve represent the changes in hemoglobin
affinity for oxygen. Shifts in the oxyhemoglobin dissociation curve do not represent the
effect of carbonic anhydrase on the uptake of CO2, the ability of blood to pick up more
CO2 when PaO2 is low, or the amount of hydrogen in solution in the blood.
Surfactant is a phospholipid that reduces
a. pulmonary vascular capacitance.
b. elastic recoil force.
c. alveolar surface tension.
d. pulmonary capillary fragility. - Answers - ANS: C
Surfactant reduces alveolar surface tension. Surfactant does not reduce pulmonary
vascular capacitance, elastic recoil force, or pulmonary capillary fragility.
Secondary pulmonary hypertension is most often caused by
a. increased pulmonary blood flow.
b. increased pulmonary vascular resistance.
c. increased left atrial pressure.
d. decreased alveolar compliance. - Answers - ANS: B
Secondary pulmonary hypertension is most often caused by increased pulmonary
vascular resistance. Although increased pulmonary blood flow and increased left atrial
pressure can lead to secondary pulmonary hypertension, the most common cause is
,increased pulmonary vascular resistance. Decreased alveolar compliance does not
cause pulmonary hypertension.
The pulmonary structure that has the least pulmonary blood flow is
a. lung apex.
b. middle lung.
c. lower lung.
d. zone 4. - Answers - ANS: A
Zone 1 (apex) has no perfusion and is equivalent to dead space. Zone 2 (middle lung) is
intermittently perfused. Zone 3 (lower lung) is continuously perfused. There is no zone
4.
Autonomic nervous system stimulation effects on the respiratory system include
a. parasympathetic stimulation dilates airways.
b. sympathetic stimulation constricts airways.
c. sympathetic stimulation relaxes bronchial smooth muscle.
d. the autonomic system has no effect on the respiratory system. - Answers - ANS: C
Sympathetic nervous system stimulation relaxes bronchial smooth muscle.
Parasympathetic stimulation constricts airways. Sympathetic stimulation dilates airways.
The autonomic nervous system does affect the respiratory system by relaxing the
pulmonary blood vessels.
Primary pulmonary hypertension is
a. more common in men.
b. readily treatable.
c. caused by genetic mutation.
d. rapidly progressive. - Answers - ANS: D
Primary pulmonary hypertension is rapidly progressive. Primary pulmonary
hypertension is more common in women and is not responsive to treatment. While
primary pulmonary hypertension may be genetic in some individuals, the cause is
unknown.
Hypoventilation causes
a. hypoxemia.
b. respiratory alkalosis.
c. increased minute ventilation.
d. decreased PaCO2. - Answers - ANS: A
Hypoventilation causes increased PaCO2 and resultant hypoxemia. Hypoventilation
does not cause increased minute ventilation. Hyperventilation causes respiratory
alkalosis and decreased PaCO2.
Which person is at greatest risk for developing a pulmonary embolism?
a. A 25-year-old man with asthma
b. A 28-year-old woman in the first trimester of a normal pregnancy
c. A 42-year-old woman with a broken ankle
, d. A 67-year-old man with a deep vein thrombosis in the femoral vein - Answers - ANS:
D
The presence of deep vein thrombosis in the lower limbs is the most important risk
factor for pulmonary embolism. Older age is also a risk factor. Asthma is not a specific
risk factor for pulmonary embolism. The risk of developing blood clots and pulmonary
emboli occurs later in pregnancy. Fractures of the pelvis or long bones can lead to fat
emboli to the lung, but not fractures to small bones.
Chronic pulmonary hypertension can eventually cause which complication?
a. Pulmonary emboli
b. Respiratory acidosis
c. Chronic obstructive pulmonary disease
d. Right heart failure - Answers - ANS: D
Increased right ventricular afterload from pulmonary hypertension can lead to right heart
failure, also known as cor pulmonale. Chronic pulmonary hypertension is not a risk
factor for pulmonary emboli. Chronic respiratory acidosis is a common cause of
pulmonary
hypertension, rather than a complication of it. Chronic pulmonary hypertension does not
cause chronic obstructive pulmonary disease; COPD may cause chronic pulmonary
hypertension.
Virchow's triad can result in
a. decreased pulmonary arterial pressure.
b. alveolar collapse.
c. pulmonary embolus.
d. bronchoconstriction. - Answers - ANS: C
Virchow's triad consists of three physiologic factors that can predispose patients to
thrombus formation, increasing the risk of PE. In Virchow's triad, pulmonary arterial
pressure increases. Alveolar collapse and bronchoconstriction are not a result of
Virchow's triad.
Right-sided heart failure secondary to pulmonary hypertension is also called
a. diastolic heart failure.
b. high output failure.
c. coronary disease.
d. cor pulmonale. - Answers - ANS: D
Cor pulmonale is right-sided heart failure secondary to pulmonary hypertension. Cor
pulmonale, not diastolic heart failure, is right-sided heart failure secondary to pulmonary
hypertension. High output failure refers to left or biventricular failure caused by high
output conditions such as sepsis or anemia. Coronary disease is atherosclerosis of the
coronary arteries.
"My doctor said I have cor pul-something, which is a heart problem," says Mr.
Garabedian. "I thought I just had these bad lungs that can't be fixed. How can that make
my heart go bad?" Which mechanism leads to the development of cor pulmonale, which
should serve as the basis for your response to Mr. Garabedian?
The amount of gas remaining in the lungs after a maximal expiration is called the
a. residual volume.
b. functional residual capacity.
c. expiratory reserve volume.
d. vital capacity. - Answers - ANS: A
Residual volume is the amount of gas remaining in the lungs after a maximal expiration.
Functional residual capacity is the amount of gas left in the lungs at the end of a normal
expiration. Expiratory reserve volume is the amount of gas expired beyond tidal volume.
Vital capacity is the total volume of gas that can be exhaled during maximal expiration.
An increase in filtration of fluid from the pulmonary capillaries into the interstitium occurs
with ________ pressure.
a. increased capillary colloid
b. increased capillary hydrostatic
c. decreased capillary hydrostatic
d. decreased interstitial colloid - Answers - ANS: B
When capillary hydrostatic pressure exceeds capillary colloid osmotic pressure, fluid
moves from the capillary to the interstitium. Increased capillary colloid pressure,
decreased capillary hydrostatic pressure, or decreased interstitial colloid pressure would
all prevent fluid movement out of the capillaries.
The central chemoreceptors for respiratory control are
a. located in the carotid artery.
responsive primarily to changes in pH and CO2.
b. responsive primarily to hypoxemia.
c. less important than the peripheral
d. chemoreceptors in maintaining respiration. - Answers - ANS: B
Central chemoreceptors for respiratory control are responsive primarily to changes in
pH and CO2. The central chemoreceptors are located in the medullary center, are
responsive to pH and CO2, and are more important than the peripheral chemoreceptors
in controlling respirations.
The peripheral chemoreceptors
a. are located in the medulla oblongata.
b. lead to hypoventilation when stimulated.
c. respond to the arterial oxygen level.
d. are unresponsive to pH and CO2 levels. - Answers - ANS: C
The peripheral chemoreceptors respond to reduced arterial oxygen (hypoxemia). The
peripheral chemoreceptors are located in the aortic arch and carotid bodies, lead to
hyperventilation when stimulated, and respond to pH and CO2 levels in addition to
arterial oxygen level.
Hypoxic pulmonary vasoconstriction
,a. diverts blood to hypoxic regions.
b. increases blood flow to the base of the lung.
c. can lead to secondary pulmonary hypertension.
d. is always detrimental to the patient. - Answers - ANS: C
Increased resistance to blood flow resulting from hypoxic vasoconstriction can lead to
secondary pulmonary hypertension. Hypoxic pulmonary vasoconstriction diverts blood
to nonhypoxic regions, diverts blood to any area of the lung needed, and is helpful in
maintaining adequate oxygenation.
Most of the carbon dioxide in blood is
a. transported as bicarbonate.
b. transported on the hemoglobin molecule.
c. transported as carbonic acid.
d. dissolved in plasma. - Answers - ANS: A
Sixty to seventy percent of carbon dioxide in blood is transported as bicarbonate. Only
20% to
30% is carried on the hemoglobin molecule. An insignificant amount of carbon dioxide in
blood is transported as carbonic acid. Only 5% to 10% is dissolved in plasma.
Shifts in the oxyhemoglobin dissociation curve represent the
a. effect of carbonic anhydrase on the uptake of CO2.
b. ability of blood to pick up more CO2 when PaO2 is low.
c. amount of hydrogen in solution in the blood.
d. changes in hemoglobin affinity for oxygen. - Answers - ANS: D
Shifts in the oxyhemoglobin dissociation curve represent the changes in hemoglobin
affinity for oxygen. Shifts in the oxyhemoglobin dissociation curve do not represent the
effect of carbonic anhydrase on the uptake of CO2, the ability of blood to pick up more
CO2 when PaO2 is low, or the amount of hydrogen in solution in the blood.
Surfactant is a phospholipid that reduces
a. pulmonary vascular capacitance.
b. elastic recoil force.
c. alveolar surface tension.
d. pulmonary capillary fragility. - Answers - ANS: C
Surfactant reduces alveolar surface tension. Surfactant does not reduce pulmonary
vascular capacitance, elastic recoil force, or pulmonary capillary fragility.
Secondary pulmonary hypertension is most often caused by
a. increased pulmonary blood flow.
b. increased pulmonary vascular resistance.
c. increased left atrial pressure.
d. decreased alveolar compliance. - Answers - ANS: B
Secondary pulmonary hypertension is most often caused by increased pulmonary
vascular resistance. Although increased pulmonary blood flow and increased left atrial
pressure can lead to secondary pulmonary hypertension, the most common cause is
,increased pulmonary vascular resistance. Decreased alveolar compliance does not
cause pulmonary hypertension.
The pulmonary structure that has the least pulmonary blood flow is
a. lung apex.
b. middle lung.
c. lower lung.
d. zone 4. - Answers - ANS: A
Zone 1 (apex) has no perfusion and is equivalent to dead space. Zone 2 (middle lung) is
intermittently perfused. Zone 3 (lower lung) is continuously perfused. There is no zone
4.
Autonomic nervous system stimulation effects on the respiratory system include
a. parasympathetic stimulation dilates airways.
b. sympathetic stimulation constricts airways.
c. sympathetic stimulation relaxes bronchial smooth muscle.
d. the autonomic system has no effect on the respiratory system. - Answers - ANS: C
Sympathetic nervous system stimulation relaxes bronchial smooth muscle.
Parasympathetic stimulation constricts airways. Sympathetic stimulation dilates airways.
The autonomic nervous system does affect the respiratory system by relaxing the
pulmonary blood vessels.
Primary pulmonary hypertension is
a. more common in men.
b. readily treatable.
c. caused by genetic mutation.
d. rapidly progressive. - Answers - ANS: D
Primary pulmonary hypertension is rapidly progressive. Primary pulmonary
hypertension is more common in women and is not responsive to treatment. While
primary pulmonary hypertension may be genetic in some individuals, the cause is
unknown.
Hypoventilation causes
a. hypoxemia.
b. respiratory alkalosis.
c. increased minute ventilation.
d. decreased PaCO2. - Answers - ANS: A
Hypoventilation causes increased PaCO2 and resultant hypoxemia. Hypoventilation
does not cause increased minute ventilation. Hyperventilation causes respiratory
alkalosis and decreased PaCO2.
Which person is at greatest risk for developing a pulmonary embolism?
a. A 25-year-old man with asthma
b. A 28-year-old woman in the first trimester of a normal pregnancy
c. A 42-year-old woman with a broken ankle
, d. A 67-year-old man with a deep vein thrombosis in the femoral vein - Answers - ANS:
D
The presence of deep vein thrombosis in the lower limbs is the most important risk
factor for pulmonary embolism. Older age is also a risk factor. Asthma is not a specific
risk factor for pulmonary embolism. The risk of developing blood clots and pulmonary
emboli occurs later in pregnancy. Fractures of the pelvis or long bones can lead to fat
emboli to the lung, but not fractures to small bones.
Chronic pulmonary hypertension can eventually cause which complication?
a. Pulmonary emboli
b. Respiratory acidosis
c. Chronic obstructive pulmonary disease
d. Right heart failure - Answers - ANS: D
Increased right ventricular afterload from pulmonary hypertension can lead to right heart
failure, also known as cor pulmonale. Chronic pulmonary hypertension is not a risk
factor for pulmonary emboli. Chronic respiratory acidosis is a common cause of
pulmonary
hypertension, rather than a complication of it. Chronic pulmonary hypertension does not
cause chronic obstructive pulmonary disease; COPD may cause chronic pulmonary
hypertension.
Virchow's triad can result in
a. decreased pulmonary arterial pressure.
b. alveolar collapse.
c. pulmonary embolus.
d. bronchoconstriction. - Answers - ANS: C
Virchow's triad consists of three physiologic factors that can predispose patients to
thrombus formation, increasing the risk of PE. In Virchow's triad, pulmonary arterial
pressure increases. Alveolar collapse and bronchoconstriction are not a result of
Virchow's triad.
Right-sided heart failure secondary to pulmonary hypertension is also called
a. diastolic heart failure.
b. high output failure.
c. coronary disease.
d. cor pulmonale. - Answers - ANS: D
Cor pulmonale is right-sided heart failure secondary to pulmonary hypertension. Cor
pulmonale, not diastolic heart failure, is right-sided heart failure secondary to pulmonary
hypertension. High output failure refers to left or biventricular failure caused by high
output conditions such as sepsis or anemia. Coronary disease is atherosclerosis of the
coronary arteries.
"My doctor said I have cor pul-something, which is a heart problem," says Mr.
Garabedian. "I thought I just had these bad lungs that can't be fixed. How can that make
my heart go bad?" Which mechanism leads to the development of cor pulmonale, which
should serve as the basis for your response to Mr. Garabedian?
