Chapter 23- Anatomy and Physiology of the Respiratory System My Nursing Test Banks

 

1.

A patient in the ICU experiences difficulty breathing in during exercise following trauma to his sternum. Which muscle involved in respiration was likely injured in this patient, leading to this condition?

A)

Diaphragm

B)

Sternocleidomastoid

C)

External intercostal

D)

Scalene

2.

The nurse is explaining to a young patient with asthma how air is conducted from his nose through his airways to the alveoli in his lungs. Which of the following represents the correct order of airways?

A)

Nasopharynx, oropharynx, trachea, bronchi, bronchioles

B)

Trachea, nasopharynx, oropharynx, bronchi, bronchioles

C)

Trachea, bronchi, bronchioles, nasopharynx, oropharynx

D)

Oropharynx, nasopharynx, trachea, bronchioles, bronchi

3.

The nurse is explaining to a patient in the ICU who has experienced a pneumothorax the role of the alveoli in respiration. The nurse should mention that which of the following are present in the alveoli? Select all that apply.

A)

Macrophages

B)

Surfactant

C)

Epiglottis

D)

Bronchus

4.

A premature infant is experiencing infant respiratory distress syndrome in the NICU. The nurse recognizes that this condition is most likely caused by which of the following?

A)

Defective type I alveolar cells

B)

An obstruction at the right bronchus

C)

Negative intrapleural pressure

D)

Immature type II alveolar cells

5.

A patient is experiencing poor perfusion in his right thorax as a result of suspected partially occluded arteries. Occlusion in which artery or arteries would cause this? Select all that apply.

A)

Aorta

B)

Internal mammary

C)

Subclavian

D)

Intercostal

6.

A patient in the ICU with chronic obstructive pulmonary disease has mucous secretions throughout her respiratory system. Her breathing is highly labored. What is the primary cause of her labored breathing?

A)

Decreased airway resistance due to increased airway diameter

B)

Excessive surfactant

C)

Increased airway resistance due to decreased airway diameter

D)

Increased lung compliance

7.

A patient with pulmonary edema is experiencing respiratory distress. The nurse recognizes that which factor affecting gas exchange is most likely responsible for the patients dyspnea?

A)

Surface area available for diffusion

B)

Thickness of the alveolar-capillary membrane

C)

Partial pressure of alveolar gas

D)

Solubility and molecular weight of the gas

8.

A patient is recovering from severe altitude sickness after a failed attempt to climb Mount Everest. Which factor affecting gas exchange was most likely responsible for the patients illness?

A)

Surface area available for diffusion

B)

Thickness of the alveolar-capillary membrane

C)

Partial pressure of alveolar gas

D)

Solubility and molecular weight of the gas

9.

A patient in the ICU with pneumothorax is experiencing a ventilation-perfusion imbalance. Which type of imbalance is the patient most likely experiencing?

A)

Physiological shunt

B)

Anatomical shunt

C)

Alveolar dead space

D)

Silent unit

10.

A patient in the ICU experiences an asthma attack after a guest brings her a flower arrangement. Stimulation of which receptors is most associated with the patients asthma attack?

A)

Stretch receptors

B)

Peripheral chemoreceptors

C)

Irritant receptors

D)

Juxtacapillary receptors

11.

The patient has experienced a mediastinal shift to the left. Several structures or functions will be compromised by this condition. What is the most significant effect?

A)

Right lung will be compressed.

B)

Cardiac output will be diminished.

C)

Point of maximal impulse will be displaced.

D)

Jugular venous distention will occur.

12.

The patient has experienced a mechanical obstruction of the lower trachea from a mucous plug. What is the priority nursing action?

A)

Obtain arterial blood gas results.

B)

Deep suction the patient.

C)

Turn onto left side and elevate head.

D)

Increase tidal volume on ventilator.

13.

The patient has experienced a toxic inhalation injury that has significantly damaged his type II alveolar cells. The nurse should expect to find which of the following?

A)

Impaired gas exchange and atelectasis

B)

Bronchospasm and wheezing

C)

Laryngospasm and stridor

D)

Eupnea and bradycardia

14.

The patient has experienced an acute embolus in the thorax. An embolus in which artery is most likely to significantly compromise gas exchange?

A)

Left main bronchial artery

B)

Right peripheral bronchial arteriole

C)

Left peripheral pulmonary arteriole

D)

Right main pulmonary artery

15.

The patient has suffered a stab wound to the chest, interrupting the integrity of the pleura with loss of negative pleural pressure and interruption of the contact between the visceral and parietal pleural surfaces. What is the most significant effect of this trauma?

A)

Pleuritic chest pain

B)

Displaced diaphragm

C)

Crepitus over ribs

D)

Compromised gas exchange

16.

The patient is recovering from acute pulmonary disease. The nurse is comparing his current assessment findings with older ones. What currently increased assessment finding would indicate achievement of therapeutic goals?

A)

Pulmonary compliance

B)

Effort of breathing

C)

Pressure support

D)

Airway resistance

17.

The patient is exhibiting poor gas exchange. Four factors influence gas exchange across the alveolar membrane. What condition related to the four factors could be interfering with gas exchange?

A)

Oxygen at 100%

B)

35% of the alveoli are filled with fluid.

C)

Oxygen delivered under pressure

D)

Alveolar membranes are 0.3 microns thick.

18.

The patient is experiencing a ventilationperfusion mismatch and compromised gas exchange. Correcting ventilationperfusion mismatch entails what actions?

A)

Decreasing anatomic dead space with intubation

B)

Decreasing alveolar dead space with positive-pressure ventilation

C)

Increasing alveolar perfusion with platelet therapy

D)

Increasing apex ventilation with high tidal volumes

19.

The patient is in severe metabolic acidosis from diabetic ketoacidosis. Based on the oxyhemoglobin dissociation curve, what change in the plan of care does the nurse expect?

A)

Reduction of inhaled oxygen as hemoglobin is fully saturated

B)

Use of positive-pressure ventilation to improve alveolar expansion

C)

Increase in inhaled oxygen as hemoglobin saturation is low

D)

Increase in ventilation rate to help excrete carbon dioxide

20.

After a drug overdose, a patient has very slow and shallow respirations. What stimulation of chemoreceptors or lung receptors will result in an increase in respiratory rate?

A)

Decreased carbon dioxide levels at central chemoreceptors

B)

PaO2 less than 60 at peripheral chemoreceptors

C)

Normal airway resistance perceived by stretch receptors

D)

Lack of stimulation of irritant receptors

Answer Key

1.

B

2.

A

3.

A, B

4.

D

5.

B, C, D

6.

C

7.

B

8.

C

9.

D

10.

C

11.

B

12.

B

13.

A

14.

D

15.

D

16.

A

17.

B

18.

B

19.

C

20.

B

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