After evaluation, a child’s asthma is characterized as “extrinsic.” This means that the asthma is

PATH370 Pathophysiology

Week 4 Understanding Assignment

Question 1After evaluation, a child’s asthma is characterized as “extrinsic.” This means that the asthma is

   of unknown pathogenesis.

 

 associated with specific allergic triggers.

 

 associated with respiratory infections.

 

 induced by psychological factors (stress).

 

 Question 2Croup is characterized by

 

a productive cough.

 

 a barking cough.

 

 an inability to cough.

 

drooling, sore throat, and difficulty swallowing.

 

Question 3Empyema is defined as an

 

   exudative bronchitis.

 

 infection in the pleural space.

 

 infection localized in the lung.

 

 infection in the blood.

 

Question 4Obstructive sleep apnea would most likely be found in a patient diagnosed with

 

  myasthenia gravis.

 

 poliomyelitis.

 

 Pickwickian syndrome.

 

 pneumonia.

 

Question 5A major risk factor for the development of active pulmonary tuberculosis (TB) disease is

 

contaminated water.

 

immunosuppression.

 

 being a male.

 

overuse of antibiotics.

 

 Question 6Osmoreceptors located in the hypothalamus control the release of

 

angiotensin.

 

 atrial natriuretic peptide.

 

 aldosterone.

 

 vasopressin (antidiuretic hormone, ADH).

 

 Question 7Emphysema results from destruction of alveolar walls and capillaries, which is because of

 

release of proteolytic enzymes from immune cells.

 

 air trapping with resultant excessive alveolar pressure.

 

 excessive α1-antitrypsin.

 

   autoantibodies against pulmonary basement membrane.

 

 Question 8An increase in the resting membrane potential (hyperpolarized) is associated with

 

hypokalemia.

 

 hyperkalemia.

 

 hypocalcemia.

 

  hypercalcemia.

 

Question 9To best prevent emphysema, a patient is instructed to stop smoking since cigarette smoke

 

impairs α1-antitrypsin, allowing elastase to predominate.

 

paralyzes the cilia, causing impaired mucociliary clearance.

 

 predisposes to respiratory infections.

 

 introduces carcinogens into the lungs.

 

 Question 10Airway obstruction in chronic bronchitis is because of

 

thick mucus, fibrosis, and smooth muscle hypertrophy.

 

 loss of alveolar elastin.

 

 pulmonary edema.

 

 hyperplasia and deformation of bronchial cartilage.

 

 Question 11Accumulation of fluid in the pleural space is called

 

   an abscess.

 

 pleurisy.

 

 flail chest.

 

 pleural effusion.

 

Question 12The hypersecretion of mucus resulting for chronic bronchitis is the result of

 

recurrent infection.

 

 destruction of alveolar septa.

 

 reduced inflammation.

 

 barrel chest.

 

Question 13 patient with a productive cough and parenchymal infiltrates on x-ray is demonstrating symptomology of

 

bacterial pneumonia.

 

 viral pneumonia.

 

 tuberculosis.

 

 acute respiratory distress syndrome.

 

 Question 14All obstructive pulmonary disorders are characterized by

 

resistance to airflow.

 

 hyperresponsiveness.

 

 decreased residual volumes.

 

 decreased lung compliance.

 

 Question 15Viral pneumonia is characterized by

 

   a productive cough.

 

 a dry cough.

 

 exudative consolidation.

 

 significant ventilation-perfusion imbalance.

 

 Question 16A restrictive respiratory disorder is characterized by

 

increased total lung capacity.

 

 decreased residual volume.

 

 inspiratory wheezing.

 

 expiratory wheezing.

 

 Question 17When a parent of a toddler recently diagnosed with pneumococcal pneumonia asks why their child is so much sicker than a classmate was when they were diagnosed with pneumonia, the nurse replies

 

 “It sounds as if the classmate was just lucky and less exposed at daycare.”

 

 “It sounds like your child has a case of bacterial pneumonia, while the classmate had viral pneumonia.”

 

 “It sounds as if your child is having a severe reaction to bacterial pneumonia. It hits some children harder than others.”

 

 “It sounds as if your child has a case of viral pneumonia, while the classmate had bacterial pneumonia.”

 

 Question 18Asthma is categorized as a(n)

 

restrictive pulmonary disorder.

 

 infective pulmonary disorder.

 

 obstructive pulmonary disorder.

 

 type of acute tracheobronchial obstruction.

 

 Question 19Which complication of asthma is life threatening?

 

   Exercise-induced asthma

 

 Late phase response

 

 Status asthmaticus

 

 Mast cell degranulation

 

 Question 20Chronic bronchitis often leads to cor pulmonale because of

 

ventricular hypoxia.

 

 increased pulmonary vascular resistance.

 

 left ventricular strain.

 

 hypervolemia.

 

 Question 21Excessive antidiuretic hormone (ADH) secretion can cause _____ concentration.

 

increased serum sodium

 

 decreased serum sodium

 

 increased serum potassium

 

 decreased serum potassium

 

 Question 22Which alterations can lead to edema?

 

Decreased capillary hydrostatic pressure

 

 Increased capillary colloid osmotic pressure

 

 Decreased lymphatic flow

 

 Decreased capillary membrane permeability

 

 Question 23A person who overuses magnesium-aluminum antacids for a long period of time is likely to develop

 

hypokalemia.

 

 hyperkalemia.

 

 hypophosphatemia.

 

 hyperphosphatemia.

 

Question 24What form of oral rehydration, bottled water or salty broth, is best suited for a patient who is demonstrating signs of clinical dehydration?

 

  

 

Bottled water, because he is so weak that he might choke on the fluid when he swallows, and water would be less damaging to the lungs than salty soup

 

 Bottled water, because it will rehydrate his cells

 

 Salty soup, because he needs nutrition as well as fluid

 

 Salty soup, because it will provide some sodium to help hold the fluid in his blood vessels and interstitial fluid

 

Question 25The inward-pulling force of particles in the vascular fluid is called _____ pressure.

 

capillary hydrostatic

 

 interstitial osmotic

 

 capillary osmotic

 

 interstitial hydrostatic

 

Question 26Effects of hypernatremia on the central nervous system typically include

 

confusion.

 

excitation.

 

 insomnia.

 

 hallucinations.

 

 Question 27The process responsible for distribution of fluid between the interstitial and intracellular compartments is

 

   filtration.

 

 osmosis.

 

 active transport.

 

 diffusion.

 

Question 28How is a patient hospitalized with a malignant tumor that secretes parathyroid hormone–related peptide monitored for the resulting electrolyte imbalance?

 

Serum calcium, Chvostek and Trousseau signs

 

Serum calcium, bowel function, level of consciousness

 

 Serum potassium, Chvostek and Trousseau signs

 

 Serum potassium, bowel function, level of consciousness

 

 Question 29The imbalance that occurs with oliguric renal failure is

 

metabolic alkalosis.

 

 hyperkalemia.

 

 hypokalemia.

 

 hypophosphatemia.

 

 Question 30The body compensates for metabolic alkalosis by

 

hypoventilation.

 

 decreasing arterial carbon dioxide.

 

 increasing bicarbonate ion excretion.

 

 hyperventilation.

 

 Question 31Hypernatremia may be caused by

 

   decreased aldosterone secretion.

 

 decreased antidiuretic hormone secretion.

 

 compulsive water drinking.

 

excessive dietary potassium.

 

 Question 32Signs and symptoms of extracellular fluid volume excess include

 

tachycardia.

 

 increased serum sodium concentration.

 

 bounding pulse.

 

 increased hematocrit.

 

 Question 33Causes of metabolic acidosis include

 

   hyperventilation.

 

 massive blood transfusion.

 

 tissue anoxia.

 

 hypoventilation.

 

blood into bicarbonate. Hypoventilation causes CO2 retention and respiratory acidosis.

 

 Question 34A person with acute hypoxemia may hyperventilate and develop

 

   respiratory acidosis.

 

 respiratory alkalosis.

 

    metabolic alkalosis.

 

metabolic acidosis.

 

 

 

 

 

Question 35Total body water in older adults is

 

   increased because of decreased adipose tissue and decreased bone mass.

 

 increased because of decreased renal function and hormonal fluctuations.

 

 decreased because of increased adipose tissue and decreased muscle mass.

 

 decreased because of renal changes that cause diuresis with sodium excretion.

 

 Question 36A patient diagnosed with chronic compensated heart failure reports that, “My feet swell if I eat salt but I don’t understand why” The nurse’s best response is

 

 “Salt holds water in your blood and makes more pressure against your blood vessels, so fluid leaks out into your tissues and makes them swell.”

 

 “Gravity makes more pressure down by your feet than up at the top of your body, so more fluid leaks into your tissues at your feet and they swell.”

 

 “Salt makes your blood vessels relax and the blood does not flow as fast, so some of it leaks into your tissues and makes swelling.”

 

 “Salt binds to the proteins in your blood and changes the osmotic pressure so more fluid can leak out and stay in the tissues, causing swelling.”

 

 Salt holds water in the ECV, thus increasing capillary hydrostatic pressure. Gravity leads to feet swelling, but it does not explain what the patient is asking. Salt does not cause vasodilation, nor does it bind to blood proteins and change osmotic pressure.

 

 Question 37Respiratory acidosis is associated with

 

increased carbonic acid.

 

 hypokalemia.

 

 increased neuromuscular excitability.

 

 increased pH.

 

 Question 38Clinical manifestations of extracellular fluid volume deficit include

 

weak pulse, low blood pressure, and increased heart rate.

 

 thirst, dry mucous membranes, and diarrhea.

 

 confusion, lethargy, coma, and perhaps seizures.

 

 cardiac dysrhythmias, paresthesias, and muscle weakness.

 

 Question 39What age group has a larger volume of extracellular fluid than intracellular fluid?

 

Infants

 

 Adolescents

 

 Young adults

 

 Older adults

 

 Question 40How do clinical conditions that increase vascular permeability cause edema?

 

   Through altering the negative charge on the capillary basement membrane, which enables excessive fluid to accumulate in the interstitial compartment

 

 By causing movement of fluid from the vascular compartment into the intracellular compartment, which leads to cell swelling

 

 Through leakage of vascular fluid into the interstitial fluid, which increases interstitial fluid hydrostatic pressure

 

 By allowing plasma proteins to leak into the interstitial fluid, which draws in excess fluid by increasing the interstitial fluid osmotic pressure

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