,NSG3850/NSG 3850 Exam 2 | Advanced Pathophysiology |
Galen College | Q & A | 2026/2027 Edition (PDF)
1. Which of the following is indicative of a left tension pneumothorax?
A) Coarse crackles throughout the left chest
B) Tracheal deviation to the left
C) Absent breath sounds on the left
D) Respiratory acidosis
Correct Answer: Absent breath sounds on the left
Expert Rationale: In a tension pneumothorax, air accumulates in the pleural space, causing lung collapse
and mediastinal shift. Breath sounds are absent on the affected side due to lung compression. Tracheal
deviation occurs away from the affected side, not toward it, and crackles are not characteristic of this
condition.
2. A patient with a productive cough and parenchymal infiltrates on chest x-ray is demonstrating
symptomology of which condition?
A) Bacterial pneumonia
B) Viral pneumonia
C) Tuberculosis
D) Acute respiratory distress syndrome
Correct Answer: Bacterial pneumonia
Expert Rationale: Bacterial pneumonia typically presents with a productive cough and parenchymal
infiltrates visible on imaging. Viral pneumonia often presents with a non-productive cough, tuberculosis
has a more insidious onset with systemic symptoms, and ARDS is characterized by diffuse infiltrates and
severe hypoxemia.
3. Which disease is caused by the inhalation of organic substances such as moldy hay or bird droppings?
A) Diffuse interstitial lung disease
,B) Hypersensitivity pneumonitis
C) Sarcoidosis
D) Acute respiratory distress syndrome
Correct Answer: Hypersensitivity pneumonitis
Expert Rationale: Hypersensitivity pneumonitis is an inflammatory lung disease caused by inhalation of
organic antigens such as moldy hay, bird droppings, or fungal spores. Diffuse interstitial lung disease,
sarcoidosis, and ARDS have different etiologies and pathogeneses.
4. Empyema is defined as which of the following?
A) Exudative bronchitis
B) Infection in the pleural space
C) Infection localized in the lung
D) Infection in the blood
Correct Answer: Infection in the pleural space
Expert Rationale: Empyema refers to a collection of pus in the pleural space, often as a complication of
pneumonia or lung abscess. This is distinct from bronchitis (airway infection), lung infection
(pneumonia), or bacteremia (bloodstream infection).
5. A patient with flail chest will demonstrate which characteristic finding?
A) Absence of chest movement with breaths
B) No inspiratory breath sounds
C) Outward chest movement on expiration
D) Fluttering chest movements on expiration
Correct Answer: Outward chest movement on expiration
, Expert Rationale: Flail chest results from multiple rib fractures, causing a segment of the chest wall to
move paradoxically. During inspiration, the flail segment moves inward; during expiration, it moves
outward. This paradoxical movement is a key clinical feature.
6. Obstructive sleep apnea would most likely be found in a patient diagnosed with which condition?
A) Myasthenia gravis
B) Poliomyelitis
C) Pickwickian syndrome
D) Pneumonia
Correct Answer: Pickwickian syndrome
Expert Rationale: Pickwickian syndrome, or obesity-hypoventilation syndrome, is strongly associated
with obstructive sleep apnea due to obesity-related airway compression. Myasthenia gravis and
poliomyelitis cause neuromuscular respiratory weakness, while pneumonia is an acute infection.
7. Pneumocystis pneumonia is a term that refers to which condition?
A) Fungal pneumonia secondary to HIV
B) Viral pneumonia found in transplant recipients
C) Non-infectious inflammation in the lung
D) Acute respiratory distress syndrome
Correct Answer: Fungal pneumonia secondary to HIV
Expert Rationale: Pneumocystis pneumonia (PCP) is an opportunistic fungal infection caused by
*Pneumocystis jirovecii*, most commonly seen in immunocompromised patients, particularly those with
HIV/AIDS. It is not viral, non-infectious, or ARDS.
8. Emphysema results from destruction of alveolar walls and capillaries, which is caused primarily by
which mechanism?
A) Release of proteolytic enzymes from immune cells
Galen College | Q & A | 2026/2027 Edition (PDF)
1. Which of the following is indicative of a left tension pneumothorax?
A) Coarse crackles throughout the left chest
B) Tracheal deviation to the left
C) Absent breath sounds on the left
D) Respiratory acidosis
Correct Answer: Absent breath sounds on the left
Expert Rationale: In a tension pneumothorax, air accumulates in the pleural space, causing lung collapse
and mediastinal shift. Breath sounds are absent on the affected side due to lung compression. Tracheal
deviation occurs away from the affected side, not toward it, and crackles are not characteristic of this
condition.
2. A patient with a productive cough and parenchymal infiltrates on chest x-ray is demonstrating
symptomology of which condition?
A) Bacterial pneumonia
B) Viral pneumonia
C) Tuberculosis
D) Acute respiratory distress syndrome
Correct Answer: Bacterial pneumonia
Expert Rationale: Bacterial pneumonia typically presents with a productive cough and parenchymal
infiltrates visible on imaging. Viral pneumonia often presents with a non-productive cough, tuberculosis
has a more insidious onset with systemic symptoms, and ARDS is characterized by diffuse infiltrates and
severe hypoxemia.
3. Which disease is caused by the inhalation of organic substances such as moldy hay or bird droppings?
A) Diffuse interstitial lung disease
,B) Hypersensitivity pneumonitis
C) Sarcoidosis
D) Acute respiratory distress syndrome
Correct Answer: Hypersensitivity pneumonitis
Expert Rationale: Hypersensitivity pneumonitis is an inflammatory lung disease caused by inhalation of
organic antigens such as moldy hay, bird droppings, or fungal spores. Diffuse interstitial lung disease,
sarcoidosis, and ARDS have different etiologies and pathogeneses.
4. Empyema is defined as which of the following?
A) Exudative bronchitis
B) Infection in the pleural space
C) Infection localized in the lung
D) Infection in the blood
Correct Answer: Infection in the pleural space
Expert Rationale: Empyema refers to a collection of pus in the pleural space, often as a complication of
pneumonia or lung abscess. This is distinct from bronchitis (airway infection), lung infection
(pneumonia), or bacteremia (bloodstream infection).
5. A patient with flail chest will demonstrate which characteristic finding?
A) Absence of chest movement with breaths
B) No inspiratory breath sounds
C) Outward chest movement on expiration
D) Fluttering chest movements on expiration
Correct Answer: Outward chest movement on expiration
, Expert Rationale: Flail chest results from multiple rib fractures, causing a segment of the chest wall to
move paradoxically. During inspiration, the flail segment moves inward; during expiration, it moves
outward. This paradoxical movement is a key clinical feature.
6. Obstructive sleep apnea would most likely be found in a patient diagnosed with which condition?
A) Myasthenia gravis
B) Poliomyelitis
C) Pickwickian syndrome
D) Pneumonia
Correct Answer: Pickwickian syndrome
Expert Rationale: Pickwickian syndrome, or obesity-hypoventilation syndrome, is strongly associated
with obstructive sleep apnea due to obesity-related airway compression. Myasthenia gravis and
poliomyelitis cause neuromuscular respiratory weakness, while pneumonia is an acute infection.
7. Pneumocystis pneumonia is a term that refers to which condition?
A) Fungal pneumonia secondary to HIV
B) Viral pneumonia found in transplant recipients
C) Non-infectious inflammation in the lung
D) Acute respiratory distress syndrome
Correct Answer: Fungal pneumonia secondary to HIV
Expert Rationale: Pneumocystis pneumonia (PCP) is an opportunistic fungal infection caused by
*Pneumocystis jirovecii*, most commonly seen in immunocompromised patients, particularly those with
HIV/AIDS. It is not viral, non-infectious, or ARDS.
8. Emphysema results from destruction of alveolar walls and capillaries, which is caused primarily by
which mechanism?
A) Release of proteolytic enzymes from immune cells
