Test Bank Chapter 23- Disorders of Ventilation and Gas Exchange

1. A client with a history of emphysema is experiencing hypoxemia after a taxing physical therapy appointment. Which of the following physiologic phenomena will occur as a consequence of hypoxemia? A) Peripheral vasodilation B) Necrosis C) Hypoventilation D) Increased heart rate Ans: D Feedback: Consequences of hypoxemia include peripheral vasoconstriction, hyperventilation, and increased heart rate. Mild to moderate hypoxemia does not result in cell death and necrosis. 2. 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 corticosteroids D) Administration of bronchodilators Ans: A Feedback: With large effusions, thoracentesis may be used to remove fluid from the intrapleural space and allow for reexpansion of the lung. 3. Pleuritic chest pain associated with respiratory movements is usually described as: A) Bilateral B) Localized C) Continuous D) Substernal Ans: B Feedback: Pleuritis is usually unilateral and tends to be localized to the lower and lateral part of the chest; pain worsens with chest movements, such as deep breathing and coughing that accentuate pressure changes in the pleural cavity and increase movement of the inflamed or injured pleural surfaces. Musculoskeletal pain usually is bilateral and may occur as the result of frequent, forceful coughing. The pain associated with irritation of the bronchi usually is substernal and dull. Myocardial pain usually is located in the substernal area and is not affected by respiratory movements. 4. A man sustained a puncture injury to his chest that caused a tension pneumothorax to form. This is a life-threatening condition because: A) Expired air exits the bleeding wound. B) Trapped, inspired air collapses the lung. C) The opposite lung hyperinflates. D) Blebs on the lung surface rupture. Ans: B Feedback: Tension pneumothorax occurs when the intrapleural pressure exceeds atmospheric pressure. It is a life-threatening condition and occurs when injury to the chest or respiratory structures permits air to enter but not leave the pleural space. Spontaneous pneumothorax occurs when an air-filled bleb, or blister, on the lung surface ruptures. Rupture of these blebs allows atmospheric air from the airways to enter the pleural cavity. This results in a rapid increase in pressure in the chest with a compression atelectasis of the unaffected lung.