pathophysiology exam
A child is brought to the emergency department struggling to breathe with a prolonged bronchospasm
and severe hypoxemia. Assessment revealed the use of accessory muscles, a weak cough, audible
wheezing sound, moist skin, and tachycardia. Which of the following is the most likely diagnosis?
a) Pulmonary embolism
b) Severe asthma attack
c) Chronic obstructive pulmonary disease
d) Cystic fibrosis
b) Severe asthma attack
A client with a history of heart failure and COPD (caused by 60 pack/year smoking) presents to the
clinic with the following complaints: 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? Select all that apply.
a) "Having a hard time catching my breath."
b) Respiratory rate—32; pulse rate—122 beats/minute.
c) Using accessory muscles to help him breathe.
d) "Seems like I'm not making much water (decreased urine production)."
e) Copious amounts of thick, green sputum.
a) "Having a hard time catching my breath."
b) Respiratory rate—32; pulse rate—122 beats/minute.
c) Using accessory muscles to help him breathe.
The nurse is caring for the following clients. Select the client at highest risk for the development of
atelectasis.
a) The client who is mobile within 24 hours after abdominal surgery
b) The client who is postop total knee replacement and receiving client-controlled analgesia
c) The client with a lower leg cast who changes position every 2 hours
d) The client diagnosed with pneumonia who performs frequent coughing and deep breathing
exercises
b) The client who is postop total knee replacement and receiving client-controlled analgesia
,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?
a) Staphylococcus aureus and hepatitis C
b) Pseudomonas aeruginosa and Escherichia coli
c) Haemophilus influenzae and influenza A
d) Pseudomonas aeruginosa and Staphylococcus aureus
d) Pseudomonas aeruginosa and Staphylococcus aureus
The health care provider suspects a newly admitted client may have a hemothorax. The client most
likely experienced:
a) Renal failure
b) Pneumonia
c) Congestive heart failure
d) Fractured or dislocated ribs
d) Fractured or dislocated ribs
Unilateral chest pain associated with respiratory movements is usually described as which of the
following?
a) Bronchitic
b) Myocardial
c) Pleuritic
d) Musculoskeletal
c) Pleuritic
A car accident client 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:
a) Try to calm the patient down by maintaining therapeutic communication
b) Apply a Vaseline gauze (airtight) dressing over the insertion site
c) Observe and wait for the code blue team to bring equipment
d) Place the client's meal napkin over the wound
b) Apply a Vaseline gauze (airtight) dressing over the insertion site
,An elderly client who has been restricted to bed by numerous comorbidities for several weeks has
been diagnosed with a large pleural effusion. Which of the following treatment modalities is most
likely to resolve the client's most recent health problem?
a) Thoracentesis
b) Supplementary oxygen therapy
c) Administration of bronchodilators
d) Administration of corticosteroids
a) Thoracentesis
Acute-onset bronchial asthma causes wheezing and breathlessness as a result of which of the
following?
a) Pulmonary hypertension
b) Alveolar collapse
c) Compression atelectasis
d) Airway inflammation
d) Airway inflammation
When CO2 levels in the blood rise, a state of hypercapnia occurs in the body. What factors contribute
to hypercapnia? (Select all that apply.)
a) Abnormalities in respiratory function
b) Decrease in carbon dioxide production
c) Changes in neural control of respiration
d) Disturbance in gas exchange function
e) Alteration in carbon dioxide production
a) Abnormalities in respiratory function
c) Changes in neural control of respiration
d) Disturbance in gas exchange function
e) Alteration in carbon dioxide production
A client has just been admitted to the postsurgical unit following a below-the-knee amputation. Which
of the following measures should her care team prioritize to prevent atelectasis during the client's
immediate recovery?
a) Bedrest and supplementary oxygen by nasal cannula
b) Adequate hydration and a high-humidity environment
c) Administration of bronchodilators by nebulizer
d) Deep-breathing exercises and early mobilization
, d) Deep-breathing exercises and early mobilization
The nurse determines that the client has clubbing of the fingertips. Which is the best intervention?
a) Assess peripheral capillary refill.
b) Monitor the client's heart rate.
c) Call the health care provider.
d) Check the patient's O2 saturation level.
d) Check the patient's O2 saturation level.
Which of the following statements concerning hypoxemia are true? (Select all that apply.)
a) Normally, serum lactate levels are between 1 and 0.5 mmol/L.
b) When hypoxemia occurs, metabolic acidosis is a possible outcome.
c) The condition depends on the body's ability to adapt to lowered oxygen levels.
d) The brain is vulnerable to hypoxia.
e) With hypoxemia, aerobic metabolism replaces anaerobic metabolism.
a) Normally, serum lactate levels are between 1 and 0.5 mmol/L.
b) When hypoxemia occurs, metabolic acidosis is a possible outcome.
c) The condition depends on the body's ability to adapt to lowered oxygen levels.
d) The brain is vulnerable to hypoxia.
Which of the following is most likely to precipitate an asthmatic attack in a child with a diagnosis of
extrinsic, or atopic, asthma?
a) Cold weather
b) Respiratory tract infections
c) Stress
d) Pet dander
d) Pet dander
The nurse needs to assess the oxygen status of a client who is suddenly experiencing shortness of
breath. The most appropriate noninvasive measurement techniques would be:
a) Pulse oximetry
b) Assessment of the rate and depth of respiration
c) Pulmonary function tests
d) Arterial blood gas analysis
a) Pulse oximetry
A child is brought to the emergency department struggling to breathe with a prolonged bronchospasm
and severe hypoxemia. Assessment revealed the use of accessory muscles, a weak cough, audible
wheezing sound, moist skin, and tachycardia. Which of the following is the most likely diagnosis?
a) Pulmonary embolism
b) Severe asthma attack
c) Chronic obstructive pulmonary disease
d) Cystic fibrosis
b) Severe asthma attack
A client with a history of heart failure and COPD (caused by 60 pack/year smoking) presents to the
clinic with the following complaints: 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? Select all that apply.
a) "Having a hard time catching my breath."
b) Respiratory rate—32; pulse rate—122 beats/minute.
c) Using accessory muscles to help him breathe.
d) "Seems like I'm not making much water (decreased urine production)."
e) Copious amounts of thick, green sputum.
a) "Having a hard time catching my breath."
b) Respiratory rate—32; pulse rate—122 beats/minute.
c) Using accessory muscles to help him breathe.
The nurse is caring for the following clients. Select the client at highest risk for the development of
atelectasis.
a) The client who is mobile within 24 hours after abdominal surgery
b) The client who is postop total knee replacement and receiving client-controlled analgesia
c) The client with a lower leg cast who changes position every 2 hours
d) The client diagnosed with pneumonia who performs frequent coughing and deep breathing
exercises
b) The client who is postop total knee replacement and receiving client-controlled analgesia
,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?
a) Staphylococcus aureus and hepatitis C
b) Pseudomonas aeruginosa and Escherichia coli
c) Haemophilus influenzae and influenza A
d) Pseudomonas aeruginosa and Staphylococcus aureus
d) Pseudomonas aeruginosa and Staphylococcus aureus
The health care provider suspects a newly admitted client may have a hemothorax. The client most
likely experienced:
a) Renal failure
b) Pneumonia
c) Congestive heart failure
d) Fractured or dislocated ribs
d) Fractured or dislocated ribs
Unilateral chest pain associated with respiratory movements is usually described as which of the
following?
a) Bronchitic
b) Myocardial
c) Pleuritic
d) Musculoskeletal
c) Pleuritic
A car accident client 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:
a) Try to calm the patient down by maintaining therapeutic communication
b) Apply a Vaseline gauze (airtight) dressing over the insertion site
c) Observe and wait for the code blue team to bring equipment
d) Place the client's meal napkin over the wound
b) Apply a Vaseline gauze (airtight) dressing over the insertion site
,An elderly client who has been restricted to bed by numerous comorbidities for several weeks has
been diagnosed with a large pleural effusion. Which of the following treatment modalities is most
likely to resolve the client's most recent health problem?
a) Thoracentesis
b) Supplementary oxygen therapy
c) Administration of bronchodilators
d) Administration of corticosteroids
a) Thoracentesis
Acute-onset bronchial asthma causes wheezing and breathlessness as a result of which of the
following?
a) Pulmonary hypertension
b) Alveolar collapse
c) Compression atelectasis
d) Airway inflammation
d) Airway inflammation
When CO2 levels in the blood rise, a state of hypercapnia occurs in the body. What factors contribute
to hypercapnia? (Select all that apply.)
a) Abnormalities in respiratory function
b) Decrease in carbon dioxide production
c) Changes in neural control of respiration
d) Disturbance in gas exchange function
e) Alteration in carbon dioxide production
a) Abnormalities in respiratory function
c) Changes in neural control of respiration
d) Disturbance in gas exchange function
e) Alteration in carbon dioxide production
A client has just been admitted to the postsurgical unit following a below-the-knee amputation. Which
of the following measures should her care team prioritize to prevent atelectasis during the client's
immediate recovery?
a) Bedrest and supplementary oxygen by nasal cannula
b) Adequate hydration and a high-humidity environment
c) Administration of bronchodilators by nebulizer
d) Deep-breathing exercises and early mobilization
, d) Deep-breathing exercises and early mobilization
The nurse determines that the client has clubbing of the fingertips. Which is the best intervention?
a) Assess peripheral capillary refill.
b) Monitor the client's heart rate.
c) Call the health care provider.
d) Check the patient's O2 saturation level.
d) Check the patient's O2 saturation level.
Which of the following statements concerning hypoxemia are true? (Select all that apply.)
a) Normally, serum lactate levels are between 1 and 0.5 mmol/L.
b) When hypoxemia occurs, metabolic acidosis is a possible outcome.
c) The condition depends on the body's ability to adapt to lowered oxygen levels.
d) The brain is vulnerable to hypoxia.
e) With hypoxemia, aerobic metabolism replaces anaerobic metabolism.
a) Normally, serum lactate levels are between 1 and 0.5 mmol/L.
b) When hypoxemia occurs, metabolic acidosis is a possible outcome.
c) The condition depends on the body's ability to adapt to lowered oxygen levels.
d) The brain is vulnerable to hypoxia.
Which of the following is most likely to precipitate an asthmatic attack in a child with a diagnosis of
extrinsic, or atopic, asthma?
a) Cold weather
b) Respiratory tract infections
c) Stress
d) Pet dander
d) Pet dander
The nurse needs to assess the oxygen status of a client who is suddenly experiencing shortness of
breath. The most appropriate noninvasive measurement techniques would be:
a) Pulse oximetry
b) Assessment of the rate and depth of respiration
c) Pulmonary function tests
d) Arterial blood gas analysis
a) Pulse oximetry
