Chs 22, 23 (Respiratory) Flashcards

1
Q

A 23-year-old woman goes to the drug store to buy a medication to ease the symptoms of her cold. Her friends have told her to buy a medication with an antihistamine in it to help dry up her runny nose and make it easier to breath. The woman talks with the pharmacist, who has known her many years. The pharmacist recommends that this young woman not buy a cold medication with a decongestant in it. Why would he do that?

a. Client has history of hyperthyroidism
b. Client has history of hypotension
c. Client has history of type I diabetes mellitus
d. Client has history of juvenile rheumatoid arthritis.

A

a. Client has history of hyperthyroidism

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2
Q

The early stages of influenza pass by as if the infection were any other viral infection. What is the distinguishing feature of an influenza viral infection that makes it different from other viral infections?

a. Slow onset of upper respiratory symptoms
b. Rapid onset of profound malaise
c. Slow onset of fever and chills
d. Rapid onset of productive cough

A

b. Rapid onset of profound malaise

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3
Q

Influenza A subtype H5N1 has been documented in poultry in both East and Southeast Asian Countries. This form of Avian flu (bird flu) is highly contagious from bird to bird, but rarely is passed from human to human. There is a large amount of concern that the H5N1 strain might mutate, making it easier to be passed from human to human, carrying with it a high mortality rate. What is the main concern if the H5N1 strain does mutate?

a. An epidemic in Southeast Asia
b. Inability to develop a vaccine for the newly infected poultry
c. Initiation of a pandemic
d. Several small pockets of infection so widespread it will be difficult to control them

A

c. Initiation of a pandemic

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4
Q

Community-acquired pneumonia can be categorized according to several indexes. What are these indexes? (Mark all that apply.)

a. Radiologic findings
b. Serologic findings
c. Age
d. Presence of coexisting disease
e. Need for hosptalization in long-term care facility

A

a, c, d (Radiologic findings, age, presence of coexisting disease)

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5
Q

An immunocompromised host is open to pneumonia from all types of organisms. There is, however, a correlation between specific types of immunologic deficits and specific invading organisms. What organism is most likely to cause pneumonia in an immunocompromised host with neutropenia and impaired granulocyte function?

a. B-Hemolytic streptococcus
b. Gram-positive bacilli
c. Eosinophilic bacillus subtilis
d. Haemophilus influenza
e. Staphylococcus aureus

A

e. Staphylococcus aureus

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6
Q

Elderly people are very susceptible to pneumonia in all its varieties. The symptoms the elderly exhibit can be very different than those of other age groups who have pneumonia. What signs and symptoms are elderly people with pneumonia less likely to experience than people with pneumonia in other age groups?

a. Marked elevation in temperature
b. Loss of appetite
c. Deterioration in mental status
d. Pleuritic pain

A

a. Marked elevation in temperature

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7
Q

Tuberculosis is a highly destructive disease because the tubercle bacillus activates a tissue hypersensitivity to the tubercular antigens. What does the destructive nature of tuberculosis cause in a previously unexposed immunocompetent person?

a. Cavitation and rapidly progressing pulmonary lesions
b. Caseating necrosis and cavitation
c. Rapidly progressing lesions and purulent necrosis
d. Caseating necrosis and purulent pulmonary lesions

A

b. Caseating necrosis and cavitation

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8
Q

Coccidiodomycosis is a pulmonary fungal infection resembling tuberculosis. Less severe forms of the infection are treated with oral antifungal medications. For persons with progressive disease, what is the drug of choice?

a. IV fluconazole
b. IV BCG
c. IV amphotericin B
d. IV rifampin

A

c. IV amphotericin B

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9
Q

Non-small cell lung cancerls (NSCLCs) mimic Small cell lung cancers (SCLCs) through their abilities to do what?

a. Synthesize bioactive products and produce pan-neoplastic syndromes
b. Neutralize bioactive products, which produce paraneoplastic syndromes
c. Produce paraneoplastic syndromes and synthesize adrendocorticotropic hormone (ACTH)
d. Synthesize bioactive products and produce paraneoplastic syndromes

A

d. Synthesize bioactive products and produce paraneoplastic syndromes

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10
Q

Premature infants who are treated with mechanical ventilation, mostly for respiratory distress syndrome, are at risk for developing bronchopulmonary dysplasia (BPD), a chronic lung disease. What are the signs and symptoms of BPD?

a. Rapid and shallow breathing and chest retractions
b. Weight loss and a barrel chest
c. Tachycardia and slow shallow breathing
d. A barrel chest and rapid weight gain

A

a. Rapid and shallow breathing and chest retractions

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11
Q
For each of the following conditions, identify where it occurs in the respiratory tract of children: upper airway or lower airway.
Epiglottitis
Acute bronchiolitis
Asthma
Spasmodic croup
Laryngotracheobronchitis
A
Epiglottitis - upper airway
Acute bronchiolitis - lower airway
Asthma - lower airway
Spasmodic croup - upper airway
Laryngotracheobronchitis - upper airway
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12
Q

What is the underlying cause of respiratory failure in a child with bronchiolitis?

a. Obstructive process
b. Impaired gas exchange
c. Hypoxemia and hypercapnia
d. Metabolic acidosis

A

b. Impaired gas exchange

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13
Q

There can be many reasons for a patient to present with hypoxemia. For a client’s PO2 to fall, a respiratory disease is usually involved. Often, patient have involvement from more than one mechanism. Match the mechanism involved with the end result (hypoxemia or decreased levels of PO2).
Decreased oxygen in air
Inadequate circulation through pulmonary capillaries
Hypoventilation
Disease in respiratory system
Mismatched ventilation and perfusion
Dysfunction of neurologic system

A

Decreased oxygen in air - hypoxemia
Inadequate circulation through pulmonary capillaries - decreased PO2
Hypoventilation - decreased PO2
Disease in respiratory system - hypoxemia
Mismatched ventilation and perfusion - decreased PO2
Dysfunction of neurologic system - hypoxemia

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14
Q

When CO2 levels in the blood rise, a state of hypercapnia occurs n the body. What factors contribute to hypercapnia? (Mark all that apply.)

a. Alteration in carbon dioxide production
b. Abnormalities in respiratory system
c. Disturbance in gas exchange function
d. Decrease in carbon dioxide production
e. Changes in neural control of respiration

A

a, b, c, e (Alteration in carbon dioxide production, abnormailities in respiratory function, disturbance in gas exchange function, changes in neural control of respiration)

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15
Q

The complications of a hemothorax can impact the total body. Left untreated, what can a moderate or large hemothorax cause?

a. Calcification of the lung tissue
b. Fibrothorax
c. Pleuritis
d. Atelectasis

A

b. Fibrothorax

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16
Q

Talc lung can occur from injected or inhaled talc powder that has been mixed with heroin, methamphetamine, or codeine as a filler. What are people with talc lung very susceptible to?

a. Hemothorax
b. Chylothorax
c. Fibrothorax
d. Pneumothorax

A

c. Pneumothorax

17
Q

Pleuritis, an inflammatory process of the pleura, is a common in infectious processes that spread to the pleura. Which are the drugs of choice for treating pleural pain?

a. Indomethacin
b. Aspirin
c. Acetaminophen
d. Inderal

A

a. Indomethacin

18
Q

Atelectasis is the term used to designate an incomplete expansion of a portion of the lung. Depending on the size of the collapsed area and the type of atelectasis occurring, you may see a shift of the mediastinum and trachea. Which way does the mediastinum and trachea shift in compression atelectasis?

a. Toward the affected lung
b. Toward the mediastinum
c. Away from the affected lung
d. Away from the trachea

A

c. Away from the affected lung

19
Q

Infants and small children have asthma and need to be medicated, just as adults do. There are special systems manufactured for the delivery of inhaled medications to children. At what age is it recommended that children may begin using an metered-dose inhaler (MDI) with a spacer?

a. 3 to 5 years
b. 4 to 6 years
c. 2 to 4 years
d. 5 to 7 years

A

a. 3 to 5 years

20
Q

Chronic obstructive pulmonary disease (COPD) is a combination of disease processes. What disease processes have been identified as being part of COPD?

a. Emphysema and asthma
b. Chronic obstructive bronchitis and emphysema
c. Chronic obstructive bronchitis and asthma
d. Chronic bronchitis and emphysema

A

b. Chronic obstructive bronchitis and emphysema

21
Q

Bronchiectasis is considered a secondary COPD and, with the advent of antibiotics, it is not a common disease entity. In the past, bronchiectasis often followed specific diseases. Which disease did it not follow?

a. Necrotizing bacterial pneumonia
b. Complicated measles
c. Chickenpox
d. Influenza

A

c. Chickenpox

22
Q

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. Pseudomonas aeruginosa and Escherichia coli
b. Staphylococcus aureus and Hepatitis C
c. Haemohilus influenzae and Influenza A
d. Pseudoonas aeruginosa and S. aureus

A

d. Pseudomnas aeruginosa and S. aureus

23
Q

What etiologic determinants are important in the development of the pneumoconioses? (Mark all that apply.)

a. Chemical nature of the dust particle
b. Size of the dust particle
c. Density of dust particle
d. Biologic nature of the dust particle
e. Ability of particle to incite lung destruction

A

a, b, e (Chemical nature of the dust particle, size of dust particle, ability of particle to incite lung destruction)

24
Q

There are cytotoxic drugs used in the treatment of cancer that cause pulmonary damage because of their direct toxicity and because they stimulate an influx of inflammatory cells into the alveoli. Which cardiac drug is known for its toxic effect in the lungs?

a. Amiodarone
b. Inderal
c. Methotrexate
d. Busulfan

A

a. Amiodarone

25
Q

A pulmonary embolism occurs when there is an obstruction in the pulmonary artery blood flow. Classic signs and symptoms of a pulmonary embolism include dyspnea, chest pain, and increased respiratory rate. What is a classic sign of pulmonary infarction?

a. Mediastinal shift to the left
b. Pleuritic pain
c. Tracheal shift to the right
d. Pericardial pain

A

b. Pleuritic pain

26
Q

Pulmonary hypertension is usually caused by long-term exposure to hypoxemia. When pulmonary vessels are exposed to hypoxemia, what is their response?

a. Pulmonary vessels dilate
b. Pulmonary vessels constrict
c. Pulmonary vessels spasm
d. Pulmonary vessels infarct

A

b. Pulmonary vessels constrict

27
Q

The management of cor pulmonale is directed at the underlying lung disease and heart failure. Why is low-flow oxygen therapy a part of the management of cor pulmonale?

a. Stimulates a body to breathe on its own
b. Inhibits the respiratory center of the brain from initiating tachypnea
c. Reduces pulmonary hypertension and polycythemia associated with chronic lung disease
d. Reduces pulmonary hypertension and formation of pulmonary embolism

A

c. Reduces pulmonary hypertension and polycythemia associated with chronic lung disease

28
Q

Acute lung injury/acute respiratory distress syndrome (ALI/ARDS) are distinguishable between the two by the extent of hypoxemia involved. What is the clinical presentation of ARDS? (Mark all that apply.)

a. Diffuse bilateral infiltrates of lung tissue without cardiac dysfunction
b. Rapid onset
c. Signs of respiratory distress
d. Increase in respiratory rate
e. Hypoxemia refractory to treatment

A

b, d, e (Rapid onset, increase in respiratory rate, hypoxemia refractory to treatment)

29
Q

Acute respiratory failure is commonly signaled by varying degrees of hypoxemia and hypercapnia. Respiratory acidosis develops manifested by what?

a. Decrease in cerebral blood flow
b. Arterial vasoconstriction
c. Increase in cardiac contractility
d. Increased cerebral spinal fluid pressure

A

d. Increased cerebral spinal fluid pressure