Smartest Pulmonologist Quiz Questions

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  • 1/130 Questions

    A 10-year-old female develops pneumonia. Physical exam reveals subcostal and intercostal retractions. She reports that breathing is difficult and she feels she cannot get enough air. What term should the nurse use to document this condition? 

    • Cyanosis
    • Dyspnea
    • Hyperpnea
    • Orthopnea
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Pulmonology Quizzes & Trivia
About This Quiz

The 'Smartest Pulmonologist Quiz' assesses knowledge on respiratory conditions and their documentation. It covers terms like dyspnea, orthopnea, and Cheyne-Stokes respiration, essential for healthcare professionals, particularly in pulmonology and critical care.

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  • 2. 

    A 20-year-old male presents to his primary care provider reporting difficulty breathing when lying down. What term should the nurse use to document this condition? 

    • Dyspnea

    • Orthopnea

    • Apnea

    • Tachypnea

    Correct Answer
    A. Orthopnea
    Explanation
    Orthopnea is the term used to describe difficulty breathing when lying down. It is a common symptom seen in patients with heart failure or other cardiac conditions. When a person with orthopnea lies flat, fluid can accumulate in the lungs, making it harder to breathe. To relieve this symptom, patients often need to prop themselves up with pillows or sleep in a more upright position. Dyspnea refers to difficulty breathing in general, while apnea refers to the cessation of breathing, and tachypnea refers to rapid breathing.

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  • 3. 

    A 50-year-old diabetic male did not take his medication and is now in metabolic acidosis. He is experiencing Kussmaul respirations. What type of breathing will the nurse observe upon assessment? 

    • Audible wheezing or stridor

    • A slightly increased ventilatory rate, large tidal volumes, and no expiratory pause

    • Rapid respirations with periods of apnea

    • Very slow inhalations and rapid expirations

    Correct Answer
    A. A slightly increased ventilatory rate, large tidal volumes, and no expiratory pause
  • 4. 

    A 30-year-old female received a severe head injury in a motor vehicle accident. She is now experiencing respiratory abnormalities characterized by alternating periods of deep and shallow breathing with periods of apnea. What term should the nurse use when charting this condition? 

    • Cheyne-Stokes

    • Frank-Starling

    • Apnea

    • Orthopnea

    Correct Answer
    A. Cheyne-Stokes
    Explanation
    The nurse should use the term "Cheyne-Stokes" when charting the patient's respiratory abnormalities. Cheyne-Stokes respiration is a pattern of breathing characterized by alternating periods of deep and shallow breathing with periods of apnea. This pattern is often seen in patients with severe head injuries or brain damage. It is important for the nurse to accurately document this condition to ensure appropriate care and monitoring for the patient.

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  • 5. 

    Which patient would the nurse assess for paroxysmal nocturnal dyspnea (PND)? A patient with:

    • Pulmonary fibrosis

    • Asthma

    • Left ventricular failure

    • Hypotension

    Correct Answer
    A. Left ventricular failure
    Explanation
    Paroxysmal nocturnal dyspnea (PND) is a condition characterized by sudden episodes of shortness of breath during sleep. Left ventricular failure, also known as congestive heart failure, is a common cause of PND. In this condition, the heart is unable to pump blood efficiently, leading to fluid accumulation in the lungs. This fluid buildup can cause sudden episodes of breathlessness, especially when lying down at night. Therefore, the nurse would assess the patient with left ventricular failure for symptoms of PND. Pulmonary fibrosis, asthma, and hypotension are not typically associated with PND.

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  • 6. 

    A 20-year-old male is in acute pain. An arterial blood gas reveals decreased carbon dioxide (CO2) levels. Which of the following does the nurse suspect is the most likely cause? 

    • Hyperventilation

    • Hypoventilation

    • Apnea

    • Cyanosis

    Correct Answer
    A. Hyperventilation
    Explanation
    The nurse suspects that hyperventilation is the most likely cause of the decreased carbon dioxide (CO2) levels in the arterial blood gas. Hyperventilation refers to rapid and deep breathing, which leads to excessive elimination of CO2 from the body. This can result in a decrease in CO2 levels in the blood.

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  • 7. 

    65-year-old female with emphysema presents to the ER for difficulty breathing. Physical exam reveals bluish skin and mucous membranes. How should the nurse chart this condition? Patient has: 

    • Cyanosis

    • Hemoptysis

    • Hematemisis

    • Ischemia

    Correct Answer
    A. Cyanosis
    Explanation
    The nurse should chart that the patient has cyanosis. Cyanosis is a condition characterized by bluish skin and mucous membranes due to inadequate oxygenation of the blood. In this case, the patient's difficulty breathing and emphysema may be causing a lack of oxygen exchange in the lungs, leading to cyanosis. Hemoptysis refers to coughing up blood, hematemesis refers to vomiting blood, and ischemia refers to inadequate blood supply to a tissue or organ. None of these terms accurately describe the patient's presentation.

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  • 8. 

    A 28-year-old male reports to his primary care provider that he has had a cold for a week and is coughing up bloody secretions. When giving report, what term should the nurse use to describe this condition? 

    • Hematemesis

    • Cyanosis

    • Rhinitis

    • Hemoptysis

    Correct Answer
    A. Hemoptysis
    Explanation
    The term "hemoptysis" should be used to describe the condition in which the patient is coughing up bloody secretions. Hemoptysis refers specifically to the coughing up of blood or blood-stained sputum from the respiratory tract. This term is appropriate in this case because the patient is experiencing a cold and is coughing up bloody secretions. Hematemesis refers to the vomiting of blood, Cyanosis refers to a bluish discoloration of the skin and mucous membranes due to low oxygen levels in the blood, and Rhinitis refers to inflammation of the nasal passages.

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  • 9. 

    A nurse is reviewing the results of an ABG and finds reduced oxygenation of arterial blood. What term should the nurse use to describe this condition? 

    • Ischemia

    • Hypoxia

    • Hypoxemia

    • Hypocapnia

    Correct Answer
    A. Hypoxemia
    Explanation
    Hypoxemia is the correct term to describe reduced oxygenation of arterial blood. Hypoxemia refers specifically to low levels of oxygen in the blood, which can occur due to various reasons such as lung diseases, heart problems, or low oxygen levels in the environment. Ischemia refers to inadequate blood supply to a specific organ or tissue, while hypoxia is a broader term that refers to a deficiency of oxygen in the body as a whole. Hypocapnia, on the other hand, refers to low levels of carbon dioxide in the blood.

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  • 10. 

    A group of mountain climbers experience confusion, tachycardia, edema, and decreased renal output after climbing Mount Rainier. A nurse recalls this condition is caused by: 

    • Bronchoconstriction

    • Hypoventilation

    • Decreased inspired oxygen

    • Diffusion abnormalities

    Correct Answer
    A. Decreased inspired oxygen
    Explanation
    The group of mountain climbers experienced confusion, tachycardia, edema, and decreased renal output after climbing Mount Rainier. This suggests that they may be suffering from high altitude sickness, also known as acute mountain sickness (AMS). One of the main causes of AMS is decreased inspired oxygen at high altitudes. As the climbers ascend, the air becomes thinner and contains less oxygen, leading to a decrease in the amount of oxygen available for the body to use. This can result in various symptoms, including confusion, increased heart rate (tachycardia), fluid retention (edema), and decreased urine output (decreased renal output).

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  • 11. 

    A nurse remembers a low ventilation-perfusion ratio results in: 

    • Increased dead space

    • Shunting

    • Alveolar collapse

    • Bronchoconstriction

    Correct Answer
    A. Shunting
    Explanation
    A low ventilation-perfusion ratio refers to an imbalance between the amount of air reaching the alveoli and the blood flow through the pulmonary capillaries. In this scenario, shunting occurs, which means that blood is being poorly oxygenated and bypassing the alveoli. This leads to a decrease in oxygenation and an increase in the amount of deoxygenated blood returning to the systemic circulation. Therefore, the correct answer is shunting.

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  • 12. 

    When the pulmonologist discusses the condition in which a series of alveoli in the left lower lobe receive adequate ventilation but do not have adequate perfusion, which statement indicates the nurse understands this condition? When this occurs in a patient it is called: 

    • A right-to-left shunt

    • Alveolar dead space

    • A low ventilation-perfusion ratio

    • Pulmonary hypotension

    Correct Answer
    A. Alveolar dead space
    Explanation
    The correct answer is "Alveolar dead space." When a series of alveoli in the left lower lobe receive adequate ventilation but do not have adequate perfusion, it is referred to as alveolar dead space. This means that the alveoli are not effectively participating in gas exchange, as there is ventilation without proper blood flow. This can result in a decrease in oxygenation and an increase in carbon dioxide levels.

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  • 13. 

    A 30-year-old male is involved in a motor vehicle accident and sustains trauma to the lungs and chest wall. He experiences respiratory failure. Which of the following lab values would the nurse expect? 

    • Electrolyte imbalances

    • Elevated PaCO2

    • Low hematocrit

    • Elevated pH

    Correct Answer
    A. Elevated PaCO2
    Explanation
    In a patient with trauma to the lungs and chest wall, respiratory failure can occur. Elevated PaCO2 (partial pressure of carbon dioxide) is expected in this case. When the lungs are injured, they are unable to effectively remove carbon dioxide from the body, leading to its accumulation in the blood. This results in an increase in PaCO2 levels.

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  • 14. 

    A nurse is teaching staff about pulmonary edema. Which information should the nurse include? The most common cause of pulmonary edema is: 

    • Right heart failure

    • Left heart failure

    • Asthma

    • Lung cancer

    Correct Answer
    A. Left heart failure
    Explanation
    The nurse should include in the teaching that the most common cause of pulmonary edema is left heart failure. Pulmonary edema occurs when there is an accumulation of fluid in the lungs, and left heart failure can lead to an increased pressure in the left side of the heart, causing fluid to back up into the lungs. Right heart failure can also cause pulmonary edema, but it is less common compared to left heart failure. Asthma and lung cancer are not typically associated with the development of pulmonary edema.

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  • 15. 

    A 47-year-old male is diagnosed with pulmonary edema. Which assessment findings will the nurse observe? 

    • Thick mucus secretions

    • Pink, frothy sputum

    • Hypocapnia

    • Wheezing

    Correct Answer
    A. Pink, frothy sputum
    Explanation
    In pulmonary edema, there is an accumulation of fluid in the lungs, leading to difficulty in breathing. The presence of pink, frothy sputum is a characteristic finding in pulmonary edema. This occurs due to the leakage of fluid from the capillaries into the alveoli, causing the sputum to be tinged with blood and have a frothy appearance. Thick mucus secretions, hypocapnia (low levels of carbon dioxide in the blood), and wheezing are not typically associated with pulmonary edema.

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  • 16. 

    A 65-year-old male recently had a cerebrovascular accident that resulted in dysphagia. He now has aspiration of gastric contents. The nurse assesses the patient for which complication? 

    • Pneumonia

    • Bronchiectasis

    • Pneumothorax

    • Emphysema

    Correct Answer
    A. Pneumonia
    Explanation
    After a cerebrovascular accident causing dysphagia, the patient is at risk for aspiration of gastric contents, which can lead to pneumonia. Aspiration pneumonia occurs when food, liquid, or stomach acid is inhaled into the lungs, causing an infection. This is a common complication in patients with dysphagia, as the weakened swallowing muscles make it difficult to prevent food or liquid from entering the airway. Therefore, pneumonia is the most likely complication in this case.

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  • 17. 

    A 26-year-old female recently underwent surgery and is now experiencing dyspnea, cough, fever, and leukocytosis. Tests reveal that she has a collapsed lung caused by removal of air from obstructed alveoli. What condition will the nurse observe on the chart? 

    • Compression atelectasis

    • Bronchiectasis

    • Absorption atelectasis

    • Hypoventilation

    Correct Answer
    A. Absorption atelectasis
    Explanation
    Absorption atelectasis occurs when there is a blockage or obstruction in the airway, preventing air from reaching the alveoli. This leads to the absorption of the air already present in the alveoli, causing the lung to collapse. In this case, the patient recently underwent surgery, which can lead to the accumulation of mucus or other secretions in the airway, causing the obstruction. The symptoms of dyspnea, cough, fever, and leukocytosis are consistent with absorption atelectasis. The nurse would observe this condition on the chart as the likely cause of the patient's collapsed lung.

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  • 18. 

    A 45-year-old male undergoes lung transplantation. He now suffers from airway occlusion secondary to fibrosis. Which diagnosis will the nurse see on the chart? 

    • Compression atelectasis

    • Bronchiectasis

    • Bronchiolitis

    • Bronchiolitis obliterans

    Correct Answer
    A. Bronchiolitis obliterans
    Explanation
    Bronchiolitis obliterans is the most likely diagnosis for the patient with airway occlusion secondary to fibrosis following lung transplantation. Bronchiolitis obliterans is a condition characterized by inflammation and fibrosis of the small airways, leading to their narrowing or complete obstruction. This can result in airway occlusion and subsequent respiratory symptoms. Other options such as compression atelectasis, bronchiectasis, and bronchiolitis are less likely to cause airway occlusion secondary to fibrosis in this scenario.

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  • 19. 

    A 50-year-old male presents with hypotension, hypoxemia, and tracheal deviation to the left. Tests reveal that the air pressure in the pleural cavity exceeds barometric pressure in the atmosphere. Based upon these assessment findings, what does the nurse suspect the patient is experiencing? 

    • Pleural effusion

    • Tension pneumothorax

    • Open pneumothorax

    • Transudative pneumothorax

    Correct Answer
    A. Tension pneumothorax
    Explanation
    The nurse suspects that the patient is experiencing a tension pneumothorax. This is indicated by the tracheal deviation to the left, which suggests a shift in the mediastinum due to increased pressure in the pleural cavity. Hypotension and hypoxemia are also consistent with tension pneumothorax, as the increased pressure can compress the blood vessels and impede blood flow. Pleural effusion involves the accumulation of fluid in the pleural cavity, which is not indicated in this case. Open pneumothorax refers to a hole in the chest wall, which is not mentioned. Transudative pneumothorax is not a recognized medical condition.

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  • 20. 

    A 60-year-old female with a history of cirrhosis presents with dyspnea, impaired ventilation, and pleural pain. A diagnosis of pleural effusion is made, and a watery fluid is drained. When giving report, the nurse will refer to this fluid as: 

    • Exudative

    • Purulent

    • Infected

    • Transudative

    Correct Answer
    A. Transudative
    Explanation
    The correct answer is "Transudative". In this scenario, the patient's history of cirrhosis suggests that the pleural effusion is likely a result of increased hydrostatic pressure in the blood vessels of the liver. Transudative fluid is characterized by a low protein content and is typically caused by systemic factors, such as congestive heart failure or liver disease. Therefore, when giving report, the nurse will refer to this fluid as transudative to indicate its likely origin and composition.

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  • 21. 

    An 80-year-old female develops pneumonia in the hospital. She becomes cyanotic, tachycardic, and develops a fever and cough. Chest x-ray reveals pus in the pleural space. Which of the following is the most likely diagnosis documented on the chart? 

    • Empyema

    • Emphysema

    • Pleurisy

    • Chyle

    Correct Answer
    A. Empyema
    Explanation
    The most likely diagnosis documented on the chart is empyema. Empyema refers to the accumulation of pus in the pleural space, which is the space between the lungs and the chest wall. The patient's symptoms of cyanosis, tachycardia, fever, and cough, along with the chest x-ray findings of pus in the pleural space, are consistent with empyema. Emphysema is a lung condition characterized by the destruction of the lung tissue and is not associated with pus accumulation. Pleurisy refers to inflammation of the pleura, but it does not necessarily involve pus. Chyle is a milky fluid that can accumulate in the pleural space, but it is not typically associated with pneumonia.

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  • 22. 

    A 54-year-old male is diagnosed with empyema. Upon receiving and reviewing the culture result, which organism does the nurse suspect is the most likely cause? 

    • Virus

    • Staphylococcus aureus

    • Klebsiella pneumonia

    • Moraxella catarrhalis

    Correct Answer
    A. Staphylococcus aureus
    Explanation
    Empyema is a condition characterized by the accumulation of pus in the pleural cavity, usually as a result of a bacterial infection. Staphylococcus aureus is a common cause of empyema, especially in adults. This bacterium is known for its ability to cause various types of infections, including skin and soft tissue infections, pneumonia, and bloodstream infections. Therefore, considering the diagnosis of empyema, Staphylococcus aureus is the most likely organism responsible for the infection in this case.

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  • 23. 

    A 15-year-old female is diagnosed with restrictive lung disease caused by fibrosis. The patient had a pulmonary functions test. Which of the following findings is expected? 

    • Increased compliance

    • Increased tidal volume

    • Decreased respiratory rate

    • Decreased functional residual capacity

    Correct Answer
    A. Decreased functional residual capacity
    Explanation
    Restrictive lung disease caused by fibrosis leads to decreased functional residual capacity. Functional residual capacity is the volume of air remaining in the lungs after a normal expiration. In fibrosis, the lung tissue becomes stiff and less elastic, causing a decrease in the ability of the lungs to expand and hold air. This results in a decrease in the functional residual capacity.

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  • 24. 

    A 57-year-old male presents with cough, sputum production, dyspnea, and decreased lung volume. He is diagnosed with pneumoconiosis. When taking the patient’s history, which finding is the most probable cause of his illness? 

    • Inhalation of silica, asbestos, mica

    • Autoimmune disease

    • Allergic reactions

    • Flail chest

    Correct Answer
    A. Inhalation of silica, asbestos, mica
    Explanation
    The most probable cause of the patient's illness is inhalation of silica, asbestos, mica. Pneumoconiosis is a lung disease caused by the inhalation of mineral dust particles, such as silica, asbestos, or mica. These particles can accumulate in the lungs over time, leading to inflammation, scarring, and decreased lung function. The patient's symptoms of cough, sputum production, dyspnea, and decreased lung volume are consistent with the diagnosis of pneumoconiosis caused by the inhalation of these mineral dust particles.

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  • 25. 

    A 42-year-old female presents with dyspnea; rapid, shallow breathing; inspiratory crackles; decreased lung compliance; and hypoxemia. Tests reveal a fulminant form of respiratory failure characterized by acute lung inflammation and diffuse alveolocapillary injury. Which of the following is the most likely diagnosis the nurse will observe on the chart? 

    • Acute respiratory distress syndrome (ARDS)

    • Sarcoidosis

    • Postoperative respiratory failure

    • Malignant respiratory failure

    Correct Answer
    A. Acute respiratory distress syndrome (ARDS)
    Explanation
    The patient's presentation of dyspnea, rapid, shallow breathing, inspiratory crackles, decreased lung compliance, and hypoxemia, along with the findings of acute lung inflammation and diffuse alveolocapillary injury on tests, are consistent with the diagnosis of Acute respiratory distress syndrome (ARDS). ARDS is a severe form of respiratory failure that occurs due to lung injury, leading to inflammation and damage to the alveoli and capillaries in the lungs. It is characterized by the rapid onset of respiratory symptoms and severe hypoxemia. Sarcoidosis, postoperative respiratory failure, and malignant respiratory failure do not typically present with the same clinical features as ARDS.

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  • 26. 

    Which of the following shows a correct cause and effect sequence in the development of acute respiratory distress syndrome (ARDS)? 

    • Impaired alveolar compliance causing decreased surfactant production

    • Alveolocapillary membrane injury causing a massive inflammatory response

    • Hyaline membrane formation and fibrosis causing pulmonary edema

    • Increased alveolocapillary membrane permeability causing metabolic alkalosis

    Correct Answer
    A. Alveolocapillary membrane injury causing a massive inflammatory response
  • 27. 

    A 60-year-old female with emphysema is having difficulty expiring a given volume of air. When giving report, the nurse will relay that the patient is most likely experiencing _____ pulmonary disease. 

    • Restrictive

    • Obstructive

    • Atelectatic

    • Pleuritic

    Correct Answer
    A. Obstructive
    Explanation
    The patient's difficulty expiring a given volume of air suggests that there is an obstruction in their airways, causing air to be trapped. This is a characteristic of obstructive pulmonary disease, such as emphysema. Restrictive pulmonary disease is characterized by difficulty inhaling, not exhaling. Atelectatic refers to collapsed lung tissue, which is not mentioned in the scenario. Pleuritic refers to inflammation of the pleura, the lining of the lungs, which is also not mentioned in the scenario. Therefore, the most likely explanation for the patient's symptoms is obstructive pulmonary disease.

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  • 28. 

    When the nurse is asked what causes asthma, how should the nurse respond? Asthma is thought to be caused by: 

    • An autosomal recessive trait

    • Autoimmunity

    • Excessive use of antibiotics as a young child

    • Interactions between genetic and environmental factors

    Correct Answer
    A. Interactions between genetic and environmental factors
    Explanation
    Asthma is believed to be caused by interactions between genetic and environmental factors. This means that both genetic predisposition and exposure to certain environmental triggers can contribute to the development of asthma. While genetics play a role in determining a person's susceptibility to asthma, environmental factors such as allergens, air pollution, and respiratory infections can also trigger asthma symptoms. Therefore, it is the combination of both genetic and environmental factors that is believed to cause asthma.

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  • 29. 

    A nurse recalls asthma is classified by:

    • Pathophysiologic differences

    • Clinical severity

    • Genetic traits

    • Treatment outcomes

    Correct Answer
    A. Clinical severity
    Explanation
    Asthma is classified based on clinical severity because the severity of symptoms and the frequency of asthma attacks can vary from person to person. By classifying asthma based on clinical severity, healthcare professionals can determine the appropriate treatment plan and medications for each individual. This classification helps in managing and controlling asthma symptoms effectively and reducing the risk of complications.

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  • 30. 

    A nurse is preparing to teach the staff about asthma. Which information should the nurse include? Airway hyper-responsiveness in asthma is related to: 

    • Increased sympathetic nervous system response

    • The release of stress hormones

    • Exposure to an allergen causing mast cell degranulation

    • Hereditary decrease in IgE responsiveness

    Correct Answer
    A. Exposure to an allergen causing mast cell degranulation
    Explanation
    Exposure to an allergen causing mast cell degranulation is an important factor in airway hyper-responsiveness in asthma. Mast cells, which are present in the airways, release various chemicals including histamine when exposed to an allergen. Histamine causes inflammation and constriction of the airways, leading to symptoms of asthma such as wheezing and difficulty breathing. Therefore, understanding the role of allergen exposure and mast cell degranulation is crucial in managing and treating asthma.

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  • 31. 

    A nurse is preparing to teach the staff about asthma. Which information should the nurse include? Airway obstruction contributing to increased airflow resistance and hypoventilation in asthma is caused by: 

    • Type II alveolar cell injury and decreased surfactant

    • Alveolar fibrosis and pulmonary edema

    • Mucus secretion, bronchoconstriction, and airway edema

    • Collapse of the cartilaginous rings in the bronchi

    Correct Answer
    A. Mucus secretion, bronchoconstriction, and airway edema
    Explanation
    The nurse should include information about mucus secretion, bronchoconstriction, and airway edema as the causes of airway obstruction in asthma. These factors contribute to increased airflow resistance and hypoventilation in individuals with asthma.

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  • 32. 

    A 10-year-old male is brought to the ER with prolonged bronchospasm and severe hypoxemia. The most likely diagnosis on the chart is: 

    • Exercise-induced asthma

    • Chronic obstructive pulmonary disease (COPD)

    • Status asthmaticus

    • Bronchiectasis

    Correct Answer
    A. Status asthmaticus
    Explanation
    Status asthmaticus is the most likely diagnosis for a 10-year-old male presenting with prolonged bronchospasm and severe hypoxemia. Status asthmaticus is a severe and life-threatening form of asthma that does not respond to standard treatment. It is characterized by persistent bronchospasm, airway inflammation, and impaired gas exchange. This condition requires immediate medical attention and aggressive treatment to prevent respiratory failure and other complications.

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  • 33. 

    A 22-year-old female presents with chronic bronchitis. Tests reveal closure of the airway during expiration. While planning care, a nurse recalls this condition is most likely caused by: 

    • Thick mucus from hypertrophied glands

    • Ventilation-perfusion mismatch

    • Hyperventilation

    • Thinning smooth muscle in the bronchioles

    Correct Answer
    A. Thick mucus from hypertrophied glands
    Explanation
    Chronic bronchitis is characterized by inflammation and narrowing of the airways, leading to difficulty in breathing. The thick mucus from hypertrophied glands is the most likely cause of this condition. The hypertrophied glands produce excessive mucus, which can obstruct the airways and lead to closure of the airway during expiration. This can result in symptoms such as coughing, wheezing, and shortness of breath. Ventilation-perfusion mismatch refers to an imbalance between the amount of air reaching the alveoli and the blood flow to the lungs, which is not directly related to the closure of the airway. Hyperventilation and thinning smooth muscle in the bronchioles are not typically associated with chronic bronchitis.

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  • 34. 

    A 25-year-old male presents with chronic bronchitis of 5 months’ duration. When obtaining the patient’s history, which of the following findings is most likely to cause this condition? 

    • Chronic asthma

    • Air pollution

    • Cigarette smoke

    • Recurrent pneumonias

    Correct Answer
    A. Cigarette smoke
    Explanation
    Cigarette smoke is the most likely cause of chronic bronchitis in this case. Chronic bronchitis is a condition characterized by inflammation and irritation of the bronchial tubes, which results in a persistent cough, mucus production, and difficulty breathing. Cigarette smoke contains harmful chemicals and irritants that can damage the lining of the bronchial tubes and lead to chronic bronchitis. The patient's history of chronic bronchitis for 5 months suggests a chronic exposure to a respiratory irritant, and cigarette smoke is a common cause of this condition.

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  • 35. 

    A 25-year-old male presents with chronic bronchitis of 5 months’ duration. Which of the following is the most significant concern for the nurse to monitor in this patient? 

    • Left heart failure

    • Pulmonary embolus

    • Immunosuppression

    • Recurrent pulmonary infections

    Correct Answer
    A. Recurrent pulmonary infections
    Explanation
    The most significant concern for the nurse to monitor in this patient with chronic bronchitis is recurrent pulmonary infections. Chronic bronchitis is characterized by inflammation and narrowing of the airways, leading to increased mucus production and cough. This chronic inflammation weakens the immune system and impairs the ability to fight off infections, making the patient more prone to recurrent pulmonary infections. Monitoring for signs and symptoms of infection, such as fever, increased sputum production, and worsening cough, is important in order to promptly treat and manage these infections.

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  • 36. 

    A 53-year-old male with a 20-year history of smoking is diagnosed with emphysema. When a staff member asks why the patient’s airways are obstructed, how should the nurse respond? The airways are obstructed because of: 

    • Excessive mucus production

    • Loss of elastic recoil

    • Infection and inflammation

    • Airway edema

    Correct Answer
    A. Loss of elastic recoil
    Explanation
    The airways are obstructed in emphysema due to the loss of elastic recoil. In emphysema, the walls of the air sacs in the lungs become damaged, causing them to lose their elasticity. This loss of elasticity leads to the collapse of the airways during exhalation, trapping air in the lungs and making it difficult for the patient to breathe. This obstruction of the airways is a key characteristic of emphysema and contributes to the symptoms experienced by the patient.

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  • 37. 

    A 53-year-old male with a 20-year history of smoking is diagnosed with emphysema. When the nurse is asked what causes this, what is the nurse’s best response? Changes in his lungs are caused by: 

    • Viral infections

    • Destruction of alveolar macrophages

    • Alpha-1-antitrypsin deficiency

    • Fibrotic lung disease

    Correct Answer
    A. Alpha-1-antitrypsin deficiency
    Explanation
    The nurse's best response would be "Alpha-1-antitrypsin deficiency." Emphysema is a type of chronic obstructive pulmonary disease (COPD) that is often caused by smoking. However, in some cases, it can also be caused by a genetic condition called alpha-1-antitrypsin deficiency. This condition leads to a deficiency of a protein called alpha-1-antitrypsin, which helps protect the lungs from damage. Without enough of this protein, the lungs are more susceptible to damage from the enzymes released by immune cells, leading to the development of emphysema.

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  • 38. 

    Individuals with a recent diagnosis of emphysema should be assessed for which most common presenting factor? 

    • A productive cough

    • Cyanosis

    • Dyspnea

    • Cor pulmonale

    Correct Answer
    A. Dyspnea
    Explanation
    Individuals with a recent diagnosis of emphysema should be assessed for dyspnea, which refers to shortness of breath or difficulty in breathing. Emphysema is a chronic lung condition characterized by damage to the air sacs in the lungs, leading to reduced lung function and impaired oxygen exchange. Dyspnea is a common symptom of emphysema, as the damaged air sacs make it harder for air to flow in and out of the lungs. Assessing for dyspnea in individuals with a recent diagnosis of emphysema is important to determine the severity of the condition and develop an appropriate treatment plan.

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  • 39. 

    A 60-year-old female with a 25-year history of smoking is diagnosed with emphysema. She has an increased anterior-posterior chest diameter. The nurse attributes this finding to:

    • Air trapping

    • Decreased inspiratory reserve volumes

    • Increased flow rates

    • Alveolar destruction

    Correct Answer
    A. Air trapping
    Explanation
    The increased anterior-posterior chest diameter in a patient with emphysema is due to air trapping. Emphysema is a condition characterized by the destruction of the alveoli in the lungs, leading to decreased elasticity and increased air trapping. This causes the lungs to become hyperinflated, resulting in an increased chest diameter, particularly in the anterior-posterior direction. Decreased inspiratory reserve volumes and increased flow rates are not directly related to the increased chest diameter in emphysema. Alveolar destruction is a characteristic feature of emphysema, but it does not directly cause the increased chest diameter.

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  • 40. 

    A patient asks what causes pneumonia. How should the nurse reply? Pneumonia is caused by: 

    • Use of anesthetic agents in surgery

    • Atelectasis

    • Chronic lung changes seen with aging

    • Viral or bacterial infections

    Correct Answer
    A. Viral or bacterial infections
    Explanation
    Pneumonia is caused by viral or bacterial infections. These infections can lead to inflammation and infection in the lungs, resulting in pneumonia. Other factors such as the use of anesthetic agents in surgery, atelectasis, and chronic lung changes seen with aging can contribute to the development of pneumonia, but the primary cause is viral or bacterial infections.

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  • 41. 

    When the nurse observes a diagnosis of nosocomial pneumonia, the patient generally acquires this pneumonia:

    • At day care centers

    • On airplanes

    • During hospitalization

    • In the winter season

    Correct Answer
    A. During hospitalization
    Explanation
    Nosocomial pneumonia refers to pneumonia that is acquired in a hospital setting. This means that the patient develops pneumonia while they are already hospitalized for another reason. Nosocomial pneumonia is often caused by bacteria that can be present in healthcare facilities, and it typically occurs in patients who are already sick or have weakened immune systems. Therefore, the correct answer is during hospitalization.

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  • 42. 

    A 30-year-old male prison inmate contracted tuberculosis during an outbreak. When the nurse reviews the lab results, the organism that caused this condition is a:

    • Bacterium

    • Fungus

    • Virus

    • Parasite

    Correct Answer
    A. Bacterium
    Explanation
    The correct answer is Bacterium. Tuberculosis is caused by the bacterium Mycobacterium tuberculosis. It is a contagious infection that primarily affects the lungs but can also spread to other parts of the body. The bacteria are transmitted through the air when an infected person coughs or sneezes. Treatment for tuberculosis typically involves a combination of antibiotics taken over a long period of time.

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  • 43. 

    A 30-year-old male prison inmate contracted tuberculosis during an outbreak. While planning interactions, the nurse realizes the patient can transmit this disease through:

    • Skin contact

    • Fecal-oral contact

    • Airborne droplets

    • Blood transfusions

    Correct Answer
    A. Airborne droplets
    Explanation
    The correct answer is airborne droplets. Tuberculosis is primarily transmitted through the air when an infected person coughs, sneezes, or talks and releases tiny droplets containing the bacteria. These droplets can be inhaled by others, leading to the spread of the disease. Skin contact, fecal-oral contact, and blood transfusions are not common modes of transmission for tuberculosis.

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  • 44. 

    A 70-year-old female is in the hospital for pelvic fracture. She develops pulmonary thromboembolism. The nurse realizes this embolus is composed of:

    • Fat

    • Air

    • Tissue fragment

    • Blood clot

    Correct Answer
    A. Blood clot
    Explanation
    The correct answer is blood clot. Pulmonary thromboembolism refers to the obstruction of the pulmonary artery or its branches by a blood clot that has traveled from elsewhere in the body, typically the legs. In this case, the embolus causing the pulmonary thromboembolism is composed of a blood clot.

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  • 45. 

    Which of the following patients is at highest risk for developing pulmonary embolism (PE)?

    • 21-year-old male with a hemophilia bleeding disorder

    • 28-year-old woman who had a baby 6 months earlier

    • 36-year-old woman with a history of alcohol abuse who is recovering from a gastric ulcer

    • 72-year-old male who is recovering from hip replacement surgery in the hospital

    Correct Answer
    A. 72-year-old male who is recovering from hip replacement surgery in the hospital
    Explanation
    The 72-year-old male who is recovering from hip replacement surgery in the hospital is at the highest risk for developing pulmonary embolism (PE). Surgery, especially orthopedic surgery such as hip replacement, increases the risk of blood clots. Immobility during the recovery period further increases the risk. Additionally, advanced age is a risk factor for PE.

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  • 46. 

    An 80-year-old female is in the hospital for a bone fracture. While there she develops a large, nonlethal pulmonary embolus. Which of the following is a direct result of the obstruction to pulmonary blood flow? 

    • Pulmonary hypertension

    • Systemic hypertension

    • Pulmonary edema

    • Risk of cerebral emboli

    Correct Answer
    A. Pulmonary hypertension
    Explanation
    The obstruction to pulmonary blood flow caused by the large, nonlethal pulmonary embolus leads to an increase in pressure in the pulmonary arteries, resulting in pulmonary hypertension. This occurs because the embolus blocks blood flow to a portion of the lungs, causing the unaffected areas to compensate by increasing their resistance to blood flow. This increased resistance leads to elevated pressure in the pulmonary arteries, which is known as pulmonary hypertension.

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  • 47. 

    When a patient has a massive pulmonary embolism (PE), what complications will the nurse monitor for?

    • Damage to the lung microcapillaries

    • Chronic obstructive pulmonary disease (COPD)

    • Disseminated intravascular coagulation (DIC)

    • Shock and death

    Correct Answer
    A. Shock and death
    Explanation
    In a patient with a massive pulmonary embolism (PE), the nurse will monitor for complications such as shock and death. A massive PE can obstruct blood flow to the lungs, leading to a sudden drop in blood pressure and inadequate oxygenation of tissues, resulting in shock. If not promptly treated, the lack of oxygen can cause severe damage to vital organs and potentially lead to death. Therefore, it is crucial for the nurse to closely monitor the patient's vital signs and intervene promptly if any signs of shock or deterioration occur.

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  • 48. 

    A 50-year-old male is diagnosed with pulmonary embolism (PE). Which of the following symptoms most likely occurred before treatment?

    • Dry cough and inspiratory crackles

    • Shallow respirations and wheezing

    • Chest pain and shortness of breath

    • Kussmaul respirations and back pain

    Correct Answer
    A. Chest pain and shortness of breath
    Explanation
    Chest pain and shortness of breath are common symptoms of pulmonary embolism. This occurs when a blood clot blocks one or more of the arteries in the lungs. The clot restricts blood flow, leading to chest pain and difficulty breathing. These symptoms typically occur before treatment because the clot is still present and causing obstruction. It is important to seek medical attention promptly if experiencing these symptoms to prevent further complications.

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  • 49. 

    A 60-year-old male undergoes surgery for a bone fracture. Which of the following nursing measures would be most effective for preventing pulmonary embolism (PE) in this patient?

    • Ensure that patient uses supplemental oxygen

    • Prevent deep vein thrombosis formation

    • Check hematocrit and hemoglobin levels frequently during the postoperative period

    • Promote aggressive fluid intake

    Correct Answer
    A. Prevent deep vein thrombosis formation
    Explanation
    Preventing deep vein thrombosis (DVT) formation would be the most effective nursing measure for preventing pulmonary embolism (PE) in this patient. DVT is a common risk factor for PE, as blood clots can form in the deep veins of the legs and travel to the lungs, causing a potentially life-threatening PE. By implementing measures to prevent DVT formation, such as early mobilization, leg exercises, compression stockings, and anticoagulant medications, the risk of PE can be significantly reduced.

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Quiz Review Timeline (Updated): Mar 20, 2023 +

Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

  • Current Version
  • Mar 20, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Oct 28, 2017
    Quiz Created by
    Karitch98

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