Module 12 Alterations of Pulmonary Function exam 1. Cheyne-Stokes respirations are characterized by: A) audible wheezing or stridor.

B) a slightly increased ventilatory rate, large tidal volumes, and no expiratory pause. C) rapid respirations alternating with periods of apnea. D) very slow inhalations and rapid expirations. 2. Hypertrophy of the nailbeds due to chronic hypoxemia is called: A) hemoptysis. B) clubbing. C) cyanosis. D) a bulla. 3. Hypoventilation results in: A) hypercapnia. B) respiratory alkalosis. C) increased minute ventilation. D) decreased PaCO2. 4. Respiratory acidosis can result from: A) increased minute ventilation. B) decreased PaCO2. C) tissue hypoxia. D) reduced tidal volumes. 5. Which of the following conditions causes a decreased drive to breathe that results in hypoxemia and hypercapnia? A) Emphysema B) Asthma

C) Central nervous system disorders D) Neuromuscular disorders 6. A decrease in tidal volume results in a decrease in: A) PaCO2. B) the respiratory rate. C) minute ventilation. D) acidity. 7. Which of the following diseases will result in a ventilation/perfusion (V/Q) mismatch? A) Asthma B) Pulmonary edema C) Emphysema D) All of the above 8. The collapse of a previously inflated area of lung tissue is called: A) aspiration. B) bronchiectasis. C) bronchiolitis. D) atelectasis. 9. Coal miners or individuals exposed to asbestos often develop a chronic respiratory condition called: A) bronchiolitis. B) pneumoconiosis. C) empyema. D) allergic alveolitis. 10. In acute respiratory distress syndrome (ARDS), alveolar damage and impaired surfactant secretion lead to each of the following problems except: A) pulmonary edema. B) atelectasis.

C) air trapping. D) pulmonary thrombus formation. 11. Why does airway obstruction in chronic lung disease cause hypercapnia? A) Airway obstruction causes pulmonary edema. B) Airway obstruction causes alveolar destruction. C) Airway obstruction causes prolonged inspiration and rapid expirations. D) Airway obstruction causes air trapping. 12. When exposed to inhaled allergens, a child with asthma produces large quantities of: A) IgG. B) IgE. C) IgA. D) IgM. 13. In individuals with asthma, exposure to an allergen leads to which of the following pathophysiological events? A) Loss of elastin and increased airway compliance B) Pulmonary edema and increased alveolar compliance C) Type II alveolar cell injury and decreased surfactant D) Bronchoconstriction and airway edema 14. When conducting a physical assessment of an individual during an acute asthma episode, you would expect to observe all of the following except: A) the use of accessory breathing muscles. B) expiratory wheezing. C) the absence of pulsus paradoxus. D) coughing. 15. The loss of alpha1-antitrypsin in emphysema results in: A) chronic mucous secretion and airway fibrosis.

B) the destruction of alveolar septa and the loss of elastic recoil. C) pulmonary edema and increased alveolar compliance. D) bronchoconstriction and airway edema. 16. A frequent complication of chronic bronchitis related to the hypersecretion of mucus is: A) recurrent infections. B) destruction of the alveolar septa. C) suppression of the inflammatory response. D) epithelial desquamation. 17. Pneumonia leads to hypoxemia due to: A) cardiogenic pulmonary edema. B) upper airway obstruction. C) the accumulation of exudates and fibrin deposition. D) the decreased fraction of inspired oxygen. 18. All of the following physical and laboratory findings are indicative of a bacterial pneumonia except: A) fever. B) infiltrates on the chest X-ray film. C) an increased white blood cell count. D) a dry cough. 19. Staff at an inner-city homeless shelter send 46-year-old Henry Ship by ambulance to a local hospital after he begins coughing up blood. On arrival at the emergency room, he is feverish and says that he has felt very fatigued for several weeks. He also reports experiencing night sweats. Mr. Ships symptoms are most likely caused by: A) viral pneumonia. B) a pulmonary embolus. C) tuberculosis. D) aspiration pneumonia. 20. Risk factors for tuberculosis (TB) include:

A) age. B) immunosuppression. C) gender. D) excessive use of antibiotics. 21. Severe acute respiratory distress syndrome (SARS) is transmitted via which of the following mechanisms? A) Skin contact B) Sexual contact C) Droplet inhalation D) All of the above 22. What is the World Health Organizations major concern regarding the avian flu, which is caused by the H5N1 virus? A) The virus may develop the ability to cause disease in humans. B) The virus may cause another outbreak of the bubonic plague. C) The virus may mutate to a form that can be easily transmitted from person to person. D) The virus may cause infectious emphysema. 23. Which of the following patients is at highest risk for developing a pulmonary embolism? A) A 25-year-old male with asthma B) A 28-year-old female in the first trimester of pregnancy C) A 42-year-old female with a broken arm D) A 67-year-old male hospitalized with a deep vein thrombosis in the femoral vein 24. Chronic pulmonary hypertension can eventually cause which of the following complications? A) Pulmonary emboli B) Congestive heart failure C) Chronic obstructive pulmonary disease D) Cor pulmonale

25. Common sites of metastasis for lung cancer include all of the following except: A) the liver. B) the kidneys. C) bone. D) the brain. 26. Metaplastic changes to bronchial epithelial tissues are frequently caused by: A) genetic mutations. B) chronic obstructive pulmonary disease. C) cigarette smoking. D) endocrine disorders. 27. Signs and symptoms of dyspnea include: A) decreased work of breathing. B) feeling short of breath. C) a failure to use accessory breathing muscles. D) an improvement of symptoms with exercise. 28. A high ventilation/perfusion (V/Q) ratio can be caused by: A) increased dead space. B) alveolar collapse. C) obstruction to pulmonary blood flow. D) bronchoconstriction. 29. Respiratory failure is defined by which one of the following laboratory alterations? A) High PaO2 B) High PaCO2 C) Low hematocrit D) High blood pH

30. Lung injury that results in diffuse pulmonary inflammation and infiltrates and that is followed by development of a hyaline membrane at the alveolocapillary interface is a condition known as: A) sarcoidosis. B) emphysema. C) chronic obstructive pulmonary disease (COPD). D) acute respiratory distress syndrome (ARDS). 31. Non-cardiogenic pulmonary edema most often is caused by: A) congestive heart failure. B) systemic infection (sepsis). C) dehydration. D) anemia. 32. Pulmonary edema and pneumothorax are examples of ______ pulmonary disease. A) malignant B) restrictive C) obstructive D) pleuritic 33. Air that enters the pleural space during inspiration and is unable to exit during expiration creates a condition called: A) tension pneumothorax. B) open pneumothorax. C) pleural effusion. D) empyema. 34. Which of the following characteristics is not typical of asthma? A) Asthma is a chronic inflammatory disorder. B) Asthma is caused by bronchial hyperresponsiveness. C) Asthma causes alveolar collapse.

D) Genetic susceptibility plays a role in the development of asthma. 35. A life-threatening complication of asthma is: A) exercise-induced asthma. B) chronic obstructive pulmonary disease. C) status asthmaticus. D) bronchiectasis. 36. Airway obstruction in chronic bronchitis is generally the result of: A) thick mucous secretions and smooth muscle hypertrophy. B) loss of alveolar elastin. C) the accumulation of pulmonary edema. D) hyperplasia of bronchial cartilage. 37. Individuals who have recently developed chronic bronchitis most often present with: A) productive cough. B) wheezing. C) a barrel chest. D) severe dyspnea. 38. The increased anterior-posterior chest diameter associated with obstructive lung disease is caused by: A) increased pulmonary blood flow. B) increased expiratory flow rates. C) increased residual lung volumes. D) decreased chest wall compliance. 39. Which of the following measures is most effective for preventing pulmonary emboli in patients who are recovering from a major surgery? A) Ambulate patients frequently to prevent blood clot formation. B) Ensure that patients use supplemental oxygen.

C) Prevent the development of anemia. D) Promote aggressive fluid intake. 40. Primary pulmonary hypertension usually is caused by: A) chronic pulmonary disease. B) right-sided heart failure. C) hereditary traits. D) pulmonary emboli. 41. _____ is a term that signifies right-sided heart failure secondary to pulmonary hypertension. A) Congestive heart failure B) High output failure C) Coronary disease D) Cor pulmonale 42. ______ atelectasis is the collapse of lung tissue caused by external pressure exerted by a tumor, fluid, or air. A) Absorption B) Perfusion C) Fibrotic D) Compression 43. Inflammation of the pleura that causes pain on inspiration is called: A) an abscess. B) pleurisy. C) flail chest. D) pleural effusion.