Chapter 15: Pulmonary Disorders

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Type II acute respiratory failure is characterized by:

a.	hypoxemic normocapnia.
b.	hypoxemic hypocapnia.
c.	hypoxemic hypercapnia.
d.	hypoxemia.

 

ANS:   C

Acute respiratory failure can be classified as hypoxemic normocapnic respiratory failure (type I) or hypoxemic hypercapnic respiratory failure (type II), depending on the patient’s arterial blood gas levels.

 

DIF:    Cognitive Level: Comprehension       REF:    283

OBJ:    Nursing Process: Analysis      TOP:    Pulmonary Disorders

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

2. A common cause of hospital-acquired pneumonia is:

a.	direct exposure to other patients who are infected.
b.	poor hand-washing technique by personnel.
c.	aspiration of sputum and saliva.
d.	accumulation of secretions in the lungs of immobilized patients.

 

ANS:   B

Personnel- and procedure-related factors include cross-contamination by hands, exposure to infected personnel, antibiotic therapy, and use of histamine blockers and antacids.

 

DIF:    Cognitive Level: Comprehension       REF:    294

OBJ:    Nursing Process: Analysis      TOP:    Pulmonary Disorders

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

3. Which of the following causes of hypoxemia is the result of blood passing through unventilated portions of the lungs?

a.	Alveolar hypoventilation
b.	Dead space ventilation
c.	Intrapulmonary shunting
d.	Ventilation/perfusion mismatching

 

ANS:   C

Hypoxemia is the result of impaired gas exchange and is the hallmark of acute respiratory failure. Hypercapnia may be present, depending on the underlying cause of the problem. The main causes of hypoxemia are alveolar hypoventilation, ventilation/perfusion (V/Q) mismatching, and intrapulmonary shunting. Intrapulmonary shunting occurs when blood passes through a portion of a lung that is not ventilated.

 

DIF:    Cognitive Level: Comprehension       REF:    285

OBJ:    Nursing Process: Assessment TOP:    Pulmonary Disorders

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

4. Which of the following medications are used to facilitate dilatation of the airways in the patient with acute respiratory failure?

a.	Aminophylline or theophylline
b.	Acetylcysteine or iodinated glycerol
c.	Guaifenesin or dextromethorphan
d.	Ipratropium or albuterol

 

ANS:   D

Medications to facilitate dilatation of the airways may also be of benefit in the treatment of the patient with acute respiratory failure. Bronchodilators, such as b₂ agonists and anticholinergic agents, aid in smooth muscle relaxation and are of particular benefit to patients with airflow limitations.

 

DIF:    Cognitive Level: Application REF:    286

OBJ:    Nursing Process: Implementation       TOP:    Pulmonary Disorders

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

5. Sedation and analgesia have failed to decrease agitation in a patient who is mechanically ventilated. The next intervention would be:

a.	neuromuscular paralysis.
b.	switching modes of mechanical ventilation.
c.	continuous infusion of opioid medication.
d.	deep sedation or general anesthesia.

 

ANS:   A

In some patients, sedation does not decrease spontaneous respiratory efforts enough to allow adequate ventilation. Neuromuscular paralysis may be necessary to facilitate optimal ventilation. Paralysis also may be necessary to decrease oxygen consumption in the severely compromised patient.

 

DIF:    Cognitive Level: Application REF:    286

OBJ:    Nursing Process: Implementation       TOP:    Pulmonary Disorders

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies