PATHOPHYSIOLOGY NU 545-- UNIT 5-- PULMONARY/ KIDNEY I
QUESTIONS AND ANSWERS 100% CORRECT | LATEST UPDATE 2025
Question 1
A child presents to the emergency department with a sudden onset of a hoarse voice, barking
cough, and inspiratory stridor that began at night. There was no preceding viral illness. This
clinical presentation is most consistent with:
A) Acute bronchitis
B) Epiglottitis
C) Spasmodic Croup
D) Respiratory distress syndrome of the newborn (RDS)
E) Laryngotracheobronchitis
Correct Answer: C) Spasmodic Croup
Rationale: Spasmodic croup is characterized by its sudden, nocturnal onset without a viral
prodrome (preceding cold-like symptoms). The key features are hoarseness, a barking
cough, and stridor, which often resolves as quickly as it develops.
Question 2
Respiratory distress syndrome of the newborn (RDS), also known as hyaline membrane disease,
is a major cause of morbidity and mortality in premature newborns. What is the primary
underlying cause of RDS?
A) An infection with respiratory syncytial virus (RSV).
B) Aspiration of meconium during birth.
C) The immaturity of the lung and a deficiency of surfactant.
D) A congenital heart defect leading to pulmonary congestion.
E) A genetic defect in the cilia of the respiratory tract.
Correct Answer: C) The immaturity of the lung and a deficiency of surfactant.
Rationale: Prematurity is the major predisposing factor for RDS. The immature lungs of a
premature infant have not yet produced a sufficient amount of surfactant, a substance that
reduces surface tension in the alveoli. This deficiency leads to widespread alveolar collapse
(atelectasis), resulting in severe hypoxemia.
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Question 3
Which of the following is a characteristic chest x-ray finding in a newborn with Respiratory
Distress Syndrome (RDS)?
A) A flattened diaphragm and hyperinflated lungs.
B) A "ground glass" appearance with diffuse, fine granular densities.
C) A single, large air-filled cyst (pneumatocele).
D) A prominent pleural effusion.
E) A completely clear and normal-appearing lung field.
Correct Answer: B) A "ground glass" appearance with diffuse, fine granular densities.
Rationale: The widespread atelectasis and alveolar edema in RDS create a characteristic
pattern on a chest radiograph. The fine granular opacities represent the collapsed alveoli,
giving the lungs a diffuse, hazy, or "ground glass" appearance.
Question 4
A patient has a pleural effusion that is found to be watery and low in protein. This type of
effusion, which results from increased hydrostatic pressure or decreased oncotic pressure, is
known as a(n):
A) Exudative effusion
B) Empyema
C) Chylothorax
D) Hemothorax
E) Transudative effusion
Correct Answer: E) Transudative effusion
Rationale: A transudate is a filtrate of plasma that moves across intact capillary walls. It is a
watery fluid with a low concentration of protein and cells. Conditions that increase the
pressure in the capillaries (like congestive heart failure) or decrease the protein in the blood
(like liver or kidney disease) cause this type of effusion.
Question 5
A pleural effusion that is less watery and contains a high concentration of white blood cells and
plasma proteins, typically occurring in response to inflammation or infection, is known as a(n):
A) Exudative effusion
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B) Transudative effusion
C) Hemothorax
D) Chylothorax
E) Hydrothorax
Correct Answer: A) Exudative effusion
Rationale: An exudate is a fluid that leaks from capillaries that have become more
permeable due to inflammation, infection, or malignancy. It is characterized by a high
content of protein, cells, and cellular debris.
Question 6
The basic autonomic rhythm of breathing is generated by a cluster of inspiratory nerve cells
located in the medulla known as the:
A) Ventral respiratory group (VRG)
B) Dorsal respiratory group (DRG)
C) Pneumotaxic center
D) Apneustic center
E) Cerebral cortex
Correct Answer: B) Dorsal respiratory group (DRG)
Rationale: The DRG, located in the dorsal portion of the medulla, contains the primary
inspiratory neurons that send efferent impulses to the diaphragm and intercostal muscles.
It is considered the main pacemaker for setting the basic, quiet rhythm of breathing.
Question 7
The pneumotaxic and apneustic centers, which act as modifiers of the inspiratory depth and rate,
are located in which part of the brainstem?
A) The medulla oblongata
B) The midbrain
C) The pons
D) The cerebellum
E) The diencephalon
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Correct Answer: C) The pons
Rationale: While the primary rhythm generators are in the medulla, the pontine respiratory
centers (pneumotaxic and apneustic) do not generate the rhythm themselves but rather
"fine-tune" it. They receive input from higher brain centers and modulate the output of the
medullary centers to ensure a smooth respiratory pattern.
Question 8
A type of non-small cell lung cancer that typically has a slow growth rate and is located centrally
near the hilus, often projecting into the bronchi, is known as:
A) Adenocarcinoma
B) Large cell carcinoma
C) Squamous cell carcinoma
D) Small cell carcinoma
E) Carcinoid tumor
Correct Answer: C) Squamous cell carcinoma
Rationale: This description is classic for squamous cell carcinoma of the lung. It arises from
the squamous cells that line the large, central airways and is strongly associated with a
history of smoking.
Question 9
If a person aspirates a foreign object, such as a peanut, it is most likely to become lodged in
which part of the lung?
A) The right upper lobe
B) The left upper lobe
C) The right lower lobe
D) The left lower lobe
E) The trachea
Correct Answer: C) The right lower lobe
Rationale: The right mainstem bronchus branches off from the trachea at a more vertical
and direct angle than the left mainstem bronchus. Due to this anatomical difference,
aspirated material is more likely to travel down the path of least resistance and end up in
the right lung, particularly the right lower lobe.
QUESTIONS AND ANSWERS 100% CORRECT | LATEST UPDATE 2025
Question 1
A child presents to the emergency department with a sudden onset of a hoarse voice, barking
cough, and inspiratory stridor that began at night. There was no preceding viral illness. This
clinical presentation is most consistent with:
A) Acute bronchitis
B) Epiglottitis
C) Spasmodic Croup
D) Respiratory distress syndrome of the newborn (RDS)
E) Laryngotracheobronchitis
Correct Answer: C) Spasmodic Croup
Rationale: Spasmodic croup is characterized by its sudden, nocturnal onset without a viral
prodrome (preceding cold-like symptoms). The key features are hoarseness, a barking
cough, and stridor, which often resolves as quickly as it develops.
Question 2
Respiratory distress syndrome of the newborn (RDS), also known as hyaline membrane disease,
is a major cause of morbidity and mortality in premature newborns. What is the primary
underlying cause of RDS?
A) An infection with respiratory syncytial virus (RSV).
B) Aspiration of meconium during birth.
C) The immaturity of the lung and a deficiency of surfactant.
D) A congenital heart defect leading to pulmonary congestion.
E) A genetic defect in the cilia of the respiratory tract.
Correct Answer: C) The immaturity of the lung and a deficiency of surfactant.
Rationale: Prematurity is the major predisposing factor for RDS. The immature lungs of a
premature infant have not yet produced a sufficient amount of surfactant, a substance that
reduces surface tension in the alveoli. This deficiency leads to widespread alveolar collapse
(atelectasis), resulting in severe hypoxemia.
,[Type here]
Question 3
Which of the following is a characteristic chest x-ray finding in a newborn with Respiratory
Distress Syndrome (RDS)?
A) A flattened diaphragm and hyperinflated lungs.
B) A "ground glass" appearance with diffuse, fine granular densities.
C) A single, large air-filled cyst (pneumatocele).
D) A prominent pleural effusion.
E) A completely clear and normal-appearing lung field.
Correct Answer: B) A "ground glass" appearance with diffuse, fine granular densities.
Rationale: The widespread atelectasis and alveolar edema in RDS create a characteristic
pattern on a chest radiograph. The fine granular opacities represent the collapsed alveoli,
giving the lungs a diffuse, hazy, or "ground glass" appearance.
Question 4
A patient has a pleural effusion that is found to be watery and low in protein. This type of
effusion, which results from increased hydrostatic pressure or decreased oncotic pressure, is
known as a(n):
A) Exudative effusion
B) Empyema
C) Chylothorax
D) Hemothorax
E) Transudative effusion
Correct Answer: E) Transudative effusion
Rationale: A transudate is a filtrate of plasma that moves across intact capillary walls. It is a
watery fluid with a low concentration of protein and cells. Conditions that increase the
pressure in the capillaries (like congestive heart failure) or decrease the protein in the blood
(like liver or kidney disease) cause this type of effusion.
Question 5
A pleural effusion that is less watery and contains a high concentration of white blood cells and
plasma proteins, typically occurring in response to inflammation or infection, is known as a(n):
A) Exudative effusion
,[Type here]
B) Transudative effusion
C) Hemothorax
D) Chylothorax
E) Hydrothorax
Correct Answer: A) Exudative effusion
Rationale: An exudate is a fluid that leaks from capillaries that have become more
permeable due to inflammation, infection, or malignancy. It is characterized by a high
content of protein, cells, and cellular debris.
Question 6
The basic autonomic rhythm of breathing is generated by a cluster of inspiratory nerve cells
located in the medulla known as the:
A) Ventral respiratory group (VRG)
B) Dorsal respiratory group (DRG)
C) Pneumotaxic center
D) Apneustic center
E) Cerebral cortex
Correct Answer: B) Dorsal respiratory group (DRG)
Rationale: The DRG, located in the dorsal portion of the medulla, contains the primary
inspiratory neurons that send efferent impulses to the diaphragm and intercostal muscles.
It is considered the main pacemaker for setting the basic, quiet rhythm of breathing.
Question 7
The pneumotaxic and apneustic centers, which act as modifiers of the inspiratory depth and rate,
are located in which part of the brainstem?
A) The medulla oblongata
B) The midbrain
C) The pons
D) The cerebellum
E) The diencephalon
, [Type here]
Correct Answer: C) The pons
Rationale: While the primary rhythm generators are in the medulla, the pontine respiratory
centers (pneumotaxic and apneustic) do not generate the rhythm themselves but rather
"fine-tune" it. They receive input from higher brain centers and modulate the output of the
medullary centers to ensure a smooth respiratory pattern.
Question 8
A type of non-small cell lung cancer that typically has a slow growth rate and is located centrally
near the hilus, often projecting into the bronchi, is known as:
A) Adenocarcinoma
B) Large cell carcinoma
C) Squamous cell carcinoma
D) Small cell carcinoma
E) Carcinoid tumor
Correct Answer: C) Squamous cell carcinoma
Rationale: This description is classic for squamous cell carcinoma of the lung. It arises from
the squamous cells that line the large, central airways and is strongly associated with a
history of smoking.
Question 9
If a person aspirates a foreign object, such as a peanut, it is most likely to become lodged in
which part of the lung?
A) The right upper lobe
B) The left upper lobe
C) The right lower lobe
D) The left lower lobe
E) The trachea
Correct Answer: C) The right lower lobe
Rationale: The right mainstem bronchus branches off from the trachea at a more vertical
and direct angle than the left mainstem bronchus. Due to this anatomical difference,
aspirated material is more likely to travel down the path of least resistance and end up in
the right lung, particularly the right lower lobe.
