NURS 272 FINAL WITH CORRECT ANSWERS 2025.

NURS 272 FINAL WITH CORRECT
ANSWERS 2025/2026



*RESPIRATORY SYSTEM* - correct-answers-B&S CH 20, 21, 22, 23, & 24 v v v v v v v v v v




Explain the anatomical components of the respiratory system. - correct-answers-
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> respiratory zone muscles
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- major muscle = diaphragm
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*controlled by the phrenic nerve (C3- v v v v v




C5 of the neck), so any pt w an injury to the spine/phrenic nerve will require ventilatory support!
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- accessory muscles = intercostals, abdominals, trapezius, sternocleidomastoid
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To move air into the lungs...respiratory muscles generate negative intrapleural pressure = allows air i
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nflowing via the pressure gradient btwn atmospheric pressure at the mouth (zero pressure) & alveol
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ar pressure (negative pressure)
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> conduction zone muscles = trachea, bronchi & bronchioles
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- influenced by SNS' B2-adrenergic receptors (relaxation) & acetylcholine receptors (constriction)
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> gas exchange surfaces = alveoli
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-
chronic smoking & chewing tobacco = decr alveoli surface area *important to ask abt smoking histor
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y! v

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atelectasis = alveoli collapse resulting from trapped air or fluid buildup (ex: pts who are bedridden *i
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mportant to encourage mobility & coughing) v v v v v




What are some of the risk factors for pulmonary disease? - correct-answers-> pollution & travel
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> 2nd hand/3rd hand smoke
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> chemical exposure
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> freq respiratory infections
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> pre-existing/congenital conditions (ex: CF, chest injury, living in confined environs)
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What are some of the common diagnostics used to screen for respiratory disease? - correct-
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answers-1) chest X-ray (CXR) v v v v




= 2 view X-
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ray of PA (posterior & anterior) & Lateral (side) to help produce an accurate image of the pt's heart/lu
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ngs/BV/bones v




> looking for inflation of the lungs (COPD), fluid build up (pneumonia & HF), atelectasis, broken bone
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s (ribs), heart size (cardiomyopathy = enlarged heart), foreign bodies
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- most common! cheap & inexpensive
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2) CT scan (contrast)
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= uses contrast dye to produce more detailed images of soft tissue damage/injuries
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> looking for lesions, blood clots, etc
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- make sure to flush dye out to ppx kidney toxicity!
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3) Pulse Oximeter
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= measures SaO2
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> SaO2 = amt of O2 attached to Hgb/how much O2 being perfused via the blood
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factors that influence readings = dark nail polish, long nails, acrylics, cold temp, bright lights, & anyt
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hing that decr circulation to the finger
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- pts w darker skin, will have falsely high readings even when desaturating
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4) Pulmonary function tests
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> looking for lung functioning in cases of COPD & asthma
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5) Sputum Culture
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> looking for lung infection?
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6) ABGs v v




> looking for acid-base imbalances? & desaturation?
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7) Bronchoscopy/Thoracoscopy
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= uses endoscopy to view respiratory structures
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> collecting biopsies & cultures
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- broncho (via mouth) & thoraco (via chest tube)
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- performed in ICU or OR w minimal sedation
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8) Thoracentesis
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> pulling fluid build up in pleural lining off
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- important to assess baseline coagulation (order sets) to ppx excessive post-op bleeding
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9) V/Q Scan v v v




= looks at ventilation (pt uses inhaler) vs. perfusion (radioactive substance is injected into blood)
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> detecting PE = indicated by altered V/Q
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, - no longer commonly used
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10) Mantoux test
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= ID injection
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> testing for TB
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What are the various components of a respiratory assessment? - correct-answers-
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1) lung sounds = use systematic approach! (ex: R > L moving down)
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- clear? bilateral?
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2) breathing patterns = rate & quality
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- tachypnea? dyspnea? SOB?
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- difficulty breathing? shallow?
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3) O2 saturation = 95-99% expected
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4) accessory muscle usage = indicates acute respiratory distress
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5) hypoxia S/Sx
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- early.= restlessness, anxiety, confusion, <95% SaO2
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- compensation = tachypnea, tachycardia, SOB
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- later = bradypnea, bradycardia, hypotension, decr LOC, cyanosis, & pallor
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6) Crepitus (SQ emphysema) = air trapped in/under the skin
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- caused by chest injury, blunt force trauma, etc...
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- palpable as rice krispies under the skin
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7) percussion = using 2 fingers tapping on 2 fingers
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- good for assessing w limited resources
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- dull sound (compromised lung) vs. resonate sound (healthy lung)
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