NURS 640 EXAM 1 FINAL PAPER 2026 EXAM
QUESTIONS AND SOLUTIONS 100 PERCENT
CORRECT
◉ o Obstruction grades by FEV1 severity. Answer: § I 80-100
§ II 50-80
§ III 30-50
§ IV 0-30
◉ Tracheal stenosis. Answer: s/t previous tracheotomy or
endotracheal intubation.
Physical findings may absent until the tracheal diameter is reduced
50% or more → wheezing, a palpable tracheal thrill and harsh
breath sounds may be detected.
Dx test → plain films or CT of the trachea
Complications - recurrent pulmonary infection and life threatening
respiratory failure.
Management - ensuring adequate ventilation and oxygenation,
avoiding manipulative procedures that may increase edema of the
tracheal mucosa. Surgical reconstruction, endotracheal stent
placement, or laser photoresection may be required.
,◉ Bronchial obstruction. Answer: Caused by retained pulmonary
secretion, aspiration, foreign bodies, bronchomalacia, bronchogenic
carcinoma, compression by extrinsic masses and tumors metastatic
to the airway.
Clinical and radiographic findings vary depending on the location of
the obstruction and the degree of airway narrowing.
Symptoms - dyspnea, cough, wheezing, and if infection present, fever
and chills.
Hx of recurrent pneumonia in the same lobe or segment or slow
resolution (more than 3 months) of pneumonia on successive
radiographs suggests the possibility of bronchial obstruction and the
need for bronchoscopy.
◉ Atelectasis. Answer: local parenchymal collapse, postobstructive
infiltrates, and air trapping caused by unidirectional expiratory
obstruction.
Bronchoscopy is the definite diagnostic study particularly if tumor
or foreign body aspiration is noted.
The findings of bronchial breath sounds on physical examination or
an air bronchogram on chest radiograph in an area of atelectasis
rules out complete airway obstruction.
Bronchoscopy is unlikely to be therapeutic benefit in this situation.
◉ Obstructive Lung Disease. Answer: its characteristic narrowing of
pulmonary airways hinder a person's ability to completely expel air
,from the lungs. The practical result is that by the end of every
breath, quite a bit of air remains in the lungs.
◉ Bronchiectasis. Answer: Congenital or acquires disorder of the
large bronchi characterized by permanent, abnormal dilation and
destruction of the bronchial walls
◉ Bronchiolitis. Answer: Generic term applied to varied
inflammatory processes that affect the bronchioles (examples
include acute, constrictive, proliferative, cryptogenic organizing
pneumonitis, follicular, respiratory, and diffuse bronchiolitis
◉ Cystic Fibrosis. Answer: Autosomal-recessive disorder caused by
abnormalities in a membrane chloride channel (CFTR protein) that
results in altered chloride transport and water flux across the apical
surface of epithelial cells. Almost all exocrine glands produce an
abnormal mucus that obstructs glands and ducts and leads to tissue
damage. In the respiratory tract, inadequate hydration of the
tracheobronchial epithelium impairs mucociliary function. High
concentration of extracellular DNA in airway secretions (due to
chronic airway inflammation and autolysis of neutrophils) increases
sputum viscosity
◉ Restrictive Lung Disease. Answer: People suffering from
restrictive lung disease have a hard time fully expanding their lungs
when they inhale. That is, it's more difficult to fill lungs with air. This
is a result of the lungs being restricted from fully expanding. This
, can occur when tissue in the chest wall becomes stiffened, or due to
weakened muscles or damaged nerves. Any of these factors can
restrict the expansion of the lungs. Some of the conditions classified
as restrictive lung disease include
◉ Interstitial lung disease. Answer: umbrella term used to
categorize over 100 different types of pulmonary disorders that
affect the absorption of oxygen into the lungs. It includes a diverse
collection of illnesses with a variety of causes, treatments and
prognoses. Individuals who suffer from interstitial lung disease
often have difficulty breathing and moving from place to place due to
a consistent feeling of shortness of breath. Disorders classified
under interstitial lung disease are often characterized by scarring of
the lung's delicate tissues and a dry, pestering cough.
There are a variety of causes of interstitial lung disease that range in
diversity.
However, interstitial lung disease may also develop without a known
cause, and in that case it is known as idiopathic. The most common
form of idiopathic interstitial lung disease is pulmonary fibrosis.
◉ Sarcoidosis. Answer: Systemic diseases of unknown etiology
characterized in about 90% of patients by granulomatous
inflammation of the lungs. Incidence highest in North American
blacks (women more than men), onset of disease in usually in third
or fourth decade (p 293)
Neuromuscular disease, such as amyotrophic lateral sclerosis (ALS)
Pulmonary fibrosis
QUESTIONS AND SOLUTIONS 100 PERCENT
CORRECT
◉ o Obstruction grades by FEV1 severity. Answer: § I 80-100
§ II 50-80
§ III 30-50
§ IV 0-30
◉ Tracheal stenosis. Answer: s/t previous tracheotomy or
endotracheal intubation.
Physical findings may absent until the tracheal diameter is reduced
50% or more → wheezing, a palpable tracheal thrill and harsh
breath sounds may be detected.
Dx test → plain films or CT of the trachea
Complications - recurrent pulmonary infection and life threatening
respiratory failure.
Management - ensuring adequate ventilation and oxygenation,
avoiding manipulative procedures that may increase edema of the
tracheal mucosa. Surgical reconstruction, endotracheal stent
placement, or laser photoresection may be required.
,◉ Bronchial obstruction. Answer: Caused by retained pulmonary
secretion, aspiration, foreign bodies, bronchomalacia, bronchogenic
carcinoma, compression by extrinsic masses and tumors metastatic
to the airway.
Clinical and radiographic findings vary depending on the location of
the obstruction and the degree of airway narrowing.
Symptoms - dyspnea, cough, wheezing, and if infection present, fever
and chills.
Hx of recurrent pneumonia in the same lobe or segment or slow
resolution (more than 3 months) of pneumonia on successive
radiographs suggests the possibility of bronchial obstruction and the
need for bronchoscopy.
◉ Atelectasis. Answer: local parenchymal collapse, postobstructive
infiltrates, and air trapping caused by unidirectional expiratory
obstruction.
Bronchoscopy is the definite diagnostic study particularly if tumor
or foreign body aspiration is noted.
The findings of bronchial breath sounds on physical examination or
an air bronchogram on chest radiograph in an area of atelectasis
rules out complete airway obstruction.
Bronchoscopy is unlikely to be therapeutic benefit in this situation.
◉ Obstructive Lung Disease. Answer: its characteristic narrowing of
pulmonary airways hinder a person's ability to completely expel air
,from the lungs. The practical result is that by the end of every
breath, quite a bit of air remains in the lungs.
◉ Bronchiectasis. Answer: Congenital or acquires disorder of the
large bronchi characterized by permanent, abnormal dilation and
destruction of the bronchial walls
◉ Bronchiolitis. Answer: Generic term applied to varied
inflammatory processes that affect the bronchioles (examples
include acute, constrictive, proliferative, cryptogenic organizing
pneumonitis, follicular, respiratory, and diffuse bronchiolitis
◉ Cystic Fibrosis. Answer: Autosomal-recessive disorder caused by
abnormalities in a membrane chloride channel (CFTR protein) that
results in altered chloride transport and water flux across the apical
surface of epithelial cells. Almost all exocrine glands produce an
abnormal mucus that obstructs glands and ducts and leads to tissue
damage. In the respiratory tract, inadequate hydration of the
tracheobronchial epithelium impairs mucociliary function. High
concentration of extracellular DNA in airway secretions (due to
chronic airway inflammation and autolysis of neutrophils) increases
sputum viscosity
◉ Restrictive Lung Disease. Answer: People suffering from
restrictive lung disease have a hard time fully expanding their lungs
when they inhale. That is, it's more difficult to fill lungs with air. This
is a result of the lungs being restricted from fully expanding. This
, can occur when tissue in the chest wall becomes stiffened, or due to
weakened muscles or damaged nerves. Any of these factors can
restrict the expansion of the lungs. Some of the conditions classified
as restrictive lung disease include
◉ Interstitial lung disease. Answer: umbrella term used to
categorize over 100 different types of pulmonary disorders that
affect the absorption of oxygen into the lungs. It includes a diverse
collection of illnesses with a variety of causes, treatments and
prognoses. Individuals who suffer from interstitial lung disease
often have difficulty breathing and moving from place to place due to
a consistent feeling of shortness of breath. Disorders classified
under interstitial lung disease are often characterized by scarring of
the lung's delicate tissues and a dry, pestering cough.
There are a variety of causes of interstitial lung disease that range in
diversity.
However, interstitial lung disease may also develop without a known
cause, and in that case it is known as idiopathic. The most common
form of idiopathic interstitial lung disease is pulmonary fibrosis.
◉ Sarcoidosis. Answer: Systemic diseases of unknown etiology
characterized in about 90% of patients by granulomatous
inflammation of the lungs. Incidence highest in North American
blacks (women more than men), onset of disease in usually in third
or fourth decade (p 293)
Neuromuscular disease, such as amyotrophic lateral sclerosis (ALS)
Pulmonary fibrosis
