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Patho Exam 3 Questions And Answers
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A client who presented with shortness of breath and difficulty climbing stairs has been diagnosed with pulmonary fibrosis, a disease characterized by scarring of the alveoli. Upon assessment of the lungs, what clinical manifestations should the nurse expect? a. Rapid, deep breaths. b. Wheezing throughout lung fields. c. Short, shallow breaths. d. Pursed-lip breaths with slow, steady breaths. - well answered Short, shallow breaths. The nurse is performing a health history for a male client who is having a series of diagnostic tests to determine the presence of squamous cell carcinoma. What question would be most beneficial for the nurse to ask that would correlate with this suspicion? a. "Have you been around any chemicals that may have been inhaled?" b. "Do you have a history of smoking, and if so, how much?" c. "Do you work in construction and have you been digging soil?" d. "Do you have a history of cancer in your family?" - well answered "Do you have a history of smoking, and if so, how much?" Select the clinical situation that would result in increased diffusion of gases from the arterial blood into the alveoli. a. A client who is receiving 100% oxygen via oxygen mask b. A client who has a pulmonary disorder that increases the thickness of the alveolar-capillary membrane c. A client who is diagnosed with pneumonia d. A client who has an oxygen saturation measured at 95% - well answered A client who is receiving 100% oxygen via oxygen mask Which client who presented to a walk-in medical clinic is most likely to be diagnosed with rhinosinusitis rather than a common cold?
a. A man complaining of general fatigue, a headache, and facial pain with a temperature of 100.9°F (38.2°C) b. A woman presenting with malaise, lethargy, and copious nasal secretions c. A man with a dry, stuffy nasopharynx, a sore throat, and temperature of 98.9°F (37.1°C) d. A woman complaining of generalized aches and who has a hoarse voice and reddened, painful upper airways - well answered A man complaining of general fatigue, a headache, and facial pain with a temperature of 100.9°F (38.2°C) A client with a history of asthma comes to the clinic complaining of wheezing and difficulty in breathing when harvesting the field. The assessment findings include use of accessory neck muscles, prolonged expiration, intercostal retractions, decreased breath sounds, and expiratory wheezes. Based on these findings, the nurse determines which anatomical receptors in the lungs have been stimulated? a. Irritant receptors b. Surfactant receptors c. Juxtacapillary receptors d. Cough receptors - well answered Irritant receptors The nurse teaches a client scheduled for surgery about pulmonary function testing (PFT). Which statement, if made by the client, indicates teaching was effective? a. "These tests results will be used to assess any risk I could have due to the anesthesia." b. "These tests will prevent me from developing pneumonia after surgery." c. "I have to have these tests because I have a thoracic aneurysm." d. "These tests will measure how well my blood is oxygenated." - well answered "These tests results will be used to assess any risk I could have due to the anesthesia." An older adult client admitted to the hospital with tuberculosis becomes cyanotic, tachycardic, and develops a fever and cough. Chest x-ray reveals pus in the pleural space. What is the most likely diagnosis? a. Tuberculous empyema due to primary progressive tuberculosis b. Pneumococcal pneumonia with pulmonary edema c. Legionnaire disease d. Fungal infection - well answered Tuberculous empyema due to primary progressive tuberculosis
Which client is showing signs of chronic hypoxemia? A client who is: a. lying in bed talking on the phone using complete sentences. b. diaphoretic and breathless after walking in the hall. c. restless, has clubbed fingers, and frequently drops items. d. sitting up in bed with blue lips expressing sudden feelings of doom. - well answered restless, has clubbed fingers, and frequently drops items. With acute respiratory distress syndrome (ARDS), a client progressively increases his work of breathing. The physiologic principle behind this respiratory distress is related to: a. increases in left atrial pressure causing thickening of the lining of the pulmonary arteries. b. the elevation of pulmonary venous pressure. c. structural abnormalities of pulmonary vessels with proliferation of the vessel intima. d. the stiffening of the lung, making it more difficult to inflate. - well answered the stiffening of the lung, making it more difficult to inflate. A male, lifetime smoker has died as a result of chronic obstructive pulmonary disease. Which phenomenon regarding his alveoli would his care team have expected in the weeks prior to his death? a. Proliferation of natural killer (NK) cells in the alveolar lumen b. Large numbers of alveolar macrophages in septal connective tissue c. The presence of tubercles in the interalveolar spaces d. Compensatory regeneration of type I alveolar cells - well answered Large numbers of alveolar macrophages in septal connective tissue A nurse on an acute medical unit is providing care for a number of clients with a variety of diagnoses. Which client most likely exhibits risk factors for impaired coughing? A client with: a. an injury to her cerebellum. b. a nasogastric (NG) tube attached to suction. c. a diagnosis of viral pneumonia. d. diagnosis of diabetes mellitus and morbidly obese. - well answered a nasogastric (NG) tube attached to suction.
When a client with a history of asthma takes a walk outside on a windy day with high pollen counts, she may experience an asthma attack, resulting in an increase in respiration rate and wheezing. The body's response is likely related to which pathophysiologic principle? a. Parasympathetic nervous system stimulation resulting in airway constriction b. Release of catecholamines causing blood vessel constriction c. Influx of macrophages to wall of the pollen, thereby stopping the attack d. Inhibition of glandular secretions, which causes build up of mucus in the lungs - well answered Release of catecholamines causing blood vessel constriction A client comes to an urgent care center. The nurse notes that the client has a fever of 103.2°F (39.5°C), pleuritic pain with each breath, and enlarged lymph nodes in the neck and axilla area. The client also has a productive cough. The nurse should consider tuberculosis if the client's history includes: a. noncompliance in finishing antibiotics when prescribed. b. intravenous drug abuse and living on the streets. c. working on a farm picking vegetables that may have been sprayed with pesticides. d. frequently going to food kitchens to supply meals for family. - well answered intravenous drug abuse and living on the streets. A client recently diagnosed with bronchiectasis asks what may have caused the condition. Which response by the nurse is accurate? a. "Your habit of cigarette smoking is the primary causative factor." b. "It may have developed after you had a severe inflammation caused by aspiration pneumonia." c. "Bronchiectasis occurred due to poor control of your asthma." d. "Obesity causes bronchiectasis by placing a strain on your heart and lungs." - well answered "It may have developed after you had a severe inflammation caused by aspiration pneumonia." A 44-year-old woman has developed calf pain during a transatlantic flight. She is extremely short of breath upon arrival at her destination. She was subsequently diagnosed with a pulmonary embolism (PE) that resolved with anticoagulant therapy. Which statement best characterizes the underlying problem of her PE? a. Ventilation was occurring but perfusion was inadequate, causing shortness of breath. b. The combination of normal perfusion but compromised ventilation caused hypoxia.
- Splinting of the chest
- Decreased tidal volume The provider would interpret these manifestations as: a. Pleuritis b. Pulmonary embolism c. Pulmonary hypertension d. Pleural effusion - well answered Pleuritis Which situation would be most deserving of a pediatrician's attention? a. The mother of an infant 2 days postpartum notes that her baby has intermittent periods of hyperventilation followed by slow respirations or even brief periods of apnea. b. A volunteer in the nursery notes that one of the infants, aged 2 weeks, appears unable to breathe through his mouth, even when his nose is congested. c. A neonate is visibly flaring her nostrils on inspiration. d. A midwife notes that a newborn infant's chest is retracting on inspiration and that the child is grunting. - well answered A midwife notes that a newborn infant's chest is retracting on inspiration and that the child is grunting. A 66-year-old man presents in the emergency room accompanied by his wife, who claims that he has been acting confused. The man reports a sudden onset of severe weakness and malaise and has a dry cough and diarrhea. His temperature is 39.3°C, and his blood work indicates his sodium level is at 126 mEq/L (126 mmol/L). The normal level is 135-145 mEq/L (135 to 145 mmol/L). What will be the assessing physician's most likely suspicion? a. Bronchopneumonia b. Mycoplasma pneumonia c. Legionnaire disease d. Pneumococcal pneumonia - well answered Legionnaire disease Which individual is experiencing an immunologic lung disorder affecting ventilation that has caused the formation of a granuloma on chest x-ray? a. A 30-year-old male who has been diagnosed with sarcoidosis b. An infant whose routine screening is suggestive of cystic fibrosis
c. An older adult, lifelong smoker who has been admitted to hospital with emphysema exacerbation d. A 16-year-old female who must limit her activity to prevent the onset of acute asthmatic attacks - well answered A 30-year-old male who has been diagnosed with sarcoidosis A nurse caring for a client with asthma monitors respiratory function. Which data indicate the client has severe persistent asthma? a. PEF 450 mL in AM, 300 mL at noon, symptoms occur daily b. PEF 400 mL in AM, 390 mL at noon, symptoms occur twice a week c. PEF 350 mL in AM, 200 mL at noon, symptoms occur continuously d. PEF 500 mL in AM, 427 mL at noon, symptoms occur 2-3 times a week - well answered PEF 350 mL in AM, 200 mL at noon, symptoms occur continuously A female client is requiring supplementary oxygen by face mask due to her reduced lung compliance. Which pathophysiologic process is most likely to be a contributor to her low lung compliance? a. The woman's lungs have more recoil than a healthy person's. b. Her type II alveolar cells are producing a slight excess of surfactant. c. Turbulent airflow is taking place in the client's large airways. d. Her thoracic cage is less flexible than when she was healthy. - well answered Her thoracic cage is less flexible than when she was healthy. A 40-year-old male presents to the emergency department reporting chest pain and shortness of breath. The health care provider suspects a pulmonary embolism and orders several diagnostic tests. Select the test that would require further follow-up. a. Positive D-dimer b. Decreased white blood cells c. Elevated CPK-MB d. Abnormal EKG - well answered Positive D-dimer In the early morning, a parent brings the 5-year-old child to the emergency room. The child is wheezing, short of breath, and has a dry cough. The parent states that the child has always been very healthy. The child went to bed with only a slight cold and a runny nose but woke up coughing shortly after 4 a.m. The symptoms worsened so dramatically that parent brought the child to the hospital. The care team would most likely suspect that the child has:
A 41-year-old male client has presented to the emergency department with an acute onset of increased respiratory rate and difficulty breathing. STAT chest X-ray indicates diffuse bilateral infiltrates of his lung tissue and ECG displays no cardiac dysfunction. What is this client's most likely diagnosis? a. Cor pulmonale b. Acute lung injury c. Pulmonary hypertension d. Sarcoidosis - well answered Acute lung injury COPD clients live with persistently elevated PCO2 levels. Therefore, which assessment finding would likely initiate a stimulus for ventilation in this client population? a. PCO2 level of 65 mm Hg b. PO2 level of 50 mm Hg c. Arterial blood gas pH of 7. d. Pulse oximeter reading of 96% saturation - well answered PO2 level of 50 mm Hg A mother rushes her toddler into the emergency department stating, "My baby can't breathe." Initial assessment reveals the child is struggling to breathe in an upright position. He has both inspiratory and expiratory stridor and is using his chest muscles to breathe. The nurse suspects the child has which acute respiratory infection? a. Croup b. Asthma c. Epiglottitis d. Bronchiolitis - well answered Epiglottitis A short, nonsmoking 44-year-old male presents to the emergency room with left-sided chest pain and a cough. He states the pain started abruptly and worsens with deep breathing and coughing. He denies recent injury. Assessment includes shallow respirations with a rate of 36, normal breath sounds, no cyanosis. Which condition is most likely causing his symptoms? a. Myocardial infarction b. Spontaneous pneumothorax c. Pleuritis related to infection d. Obstructive atelectasis - well answered Pleuritis related to infection
A client admitted to the hospital with heart failure tells the nurse he has developed a condition that interferes with movement of blood through sections of the lungs. The nurse recognizes this as: a. Physiologic shunting b. Anatomic shunting c. Abdominal peritoneal shunting d. Ventricular peritoneal shunting - well answered Physiologic shunting A child is diagnosed with a restrictive lung disease and is assessed by the nurse to have a rapid and shallow respiratory effort, and the nurse hears an audible expiratory grunt. What does the nurse understand the grunt signifies in this child? a. The child is trying to raise the functional residual capacity by closing the glottis at the end of expiration. b. The child is trying to increase the tidal volume of inspired air. c. The child is demonstrating improvement in the respiratory status. d. The child is demonstrating an occlusion in the intrathoracic airways. - well answered The child is trying to raise the functional residual capacity by closing the glottis at the end of expiration. A 62-year-old female smoker is distraught at her recent diagnosis of small cell lung cancer (SCLC). How can her physician most appropriately respond to her? a. "I'm sure this is very hard news to hear, but be aware that with aggressive treatment your chances of beating this are quite good." b. "This is very difficult to hear, I'm sure, and we have to observe to see if it spreads because that often happens." c. "I'm very sorry to have to give you this news; I'd like to talk to you about surgical options, however." d. "This is a difficult diagnosis to receive, but there is a chance that the cancer may go into remission." - well answered "This is very difficult to hear, I'm sure, and we have to observe to see if it spreads because that often happens." A nurse caring for a client with asthma monitors respiratory function. Which data indicate the client has mild intermittent asthma? a. PEF 450 mL in AM, 300 mL at noon, symptoms occur daily b. PEF 400 mL in AM, 390 mL at noon, symptoms occur twice a week
d. An 88-year-old female who experiences acute shortness of breath and airway constriction when exposed to tobacco smoke. - well answered An 81-year-old male who has a productive cough and recurrent respiratory infections. A 36-year-old woman with a history of endometriosis and ectopic pregnancies is admitted to the hospital with severe dyspnea and abnormal lung sounds on the right side. What is the most likely diagnosis? a. Catamenial pneumothorax b. Traumatic pneumothorax c. Tension pneumothorax d. Spontaneous pneumothorax - well answered Catamenial pneumothorax A family physician is performing client teaching about the influenza virus with each client who has come to the clinic to receive that year's vaccine. Which statement by the client best reflects an accurate understanding of the flu virus? a. "I could come down with viral or bacterial pneumonia as a result of a bad flu bug." b. "I know my vaccination is especially important since there aren't any drugs that can treat the flu once I get sick with it." c. "The emphasis on bundling up, staying warm, and drinking lots of fluids is outdated and actually ineffective." d. "Like all vaccines, it is ideal if everyone in a population gets immunized against the flu." - well answered "I could come down with viral or bacterial pneumonia as a result of a bad flu bug." A 77-year-old lifetime smoker has been diagnosed with a tumor in his lung at the site of an old tubercule scarring site, located in a peripheral area of his bronchiolar tissue. What is this client's most likely diagnosis? a. Squamous cell carcinoma b. Small cell lung cancer c. Large cell carcinoma d. Adenocarcinoma - well answered Adenocarcinoma
An older male client has fallen at home and sustained a bruised left hip. Assessment reveals shortness of breath and shallow respirations with a respiratory rate of 40 breaths/min. If the client develops a tension pneumothorax, what additional assessment finding would the nurse observe? a. Presence of a mediastinal shift b. Increased blood pressure c. Asymmetry of chest during inspiration d. Auscultation of pleural friction rub - well answered Presence of a mediastinal shift A client with advanced chronic obstructive pulmonary disease (COPD) has been taught methods to maintain maximum functioning. Which client statement indicates accurate understanding of the instructions? a. "I will skip church during flu season and wear a scarf when out in the cold." b. "I will spend more time standing to increase my endurance." c. "I will use my albuterol daily to reduce symptoms." d. "I will eat smaller, more frequent meals and reduce fluids in the evening." - well answered "I will skip church during flu season and wear a scarf when out in the cold." A client has suffered a head injury during a motorcycle accident resulting in impaired swallowing and aspiration pneumonia. Which statement most accurately captures an aspect of his condition? a. His vocal folds of the larynx are not performing their normal function. b. His epiglottis is covering his larynx c. His trachea has been compromised. d. His tracheobronchial tree is intermittently obstructed. - well answered His vocal folds of the larynx are not performing their normal function. A parent brings his child to the emergency department stating that the child became sick very quickly. The nurse observes the child having to sit upright with the mouth open, drooling, lethargic, with inspiratory and expiratory stridor. What action should the nurse perform at this time? a. Have the child lie flat. b. Inspect the child's throat for edema. c. Perform venipuncture for a complete blood count. d. Keep the child calm and decrease anxiety. - well answered Keep the child calm and decrease anxiety.
d. Bronchitis, increased mucus and painful cough, PEF 390 mL out of best PEF 475 mL. - well answered Refractory asthma, PEF 210 mL out of best PEF 450 mL, diminished wheezing.
