NUR 242 MED SURG EXAM 3 LATEST ACTUAL EXAM 180 QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES|ALREADY GRADED A+||GALEN COLLEGE OF NURSING
What is ventilation? - ANSWER-the movement of air into and out of the lungs
What is perfusion? - ANSWER-the circulation of blood through the lungs
What are central chemoreceptors responsive to? - ANSWER-increased H+ in the brain ECF;
increased PaCO2;
"hypercarbic drive"
What are peripheral chemoreceptors responsive to? - ANSWER-decreased pH;
increased PaCO2;
decreased PaO2;
"hypoxic drive"
What are elastic forces? - ANSWER-lungs recoil due to elastin, collagen, fibrin
What are surface forces? - ANSWER-surface tension due to water-air interface
What is airway resistance? - ANSWER-opposition to flow caused by the forces of friction;
primarily determined by airway radius
What is the distensibility of the lungs? - ANSWER-ease with which the lungs can be inflated
What is lung distensibility increased in? - ANSWER-neonates and children;
emphysema
What is lung distensibility decreased in? - ANSWER-elderly;
pneumonia, pulmonary edema, ARDS, atelectasis, fibrosis
What is surfactant? - ANSWER-complex substance lining the alveoli and smallest bronchioles
containing phospholipids and a number of apoproteins which reduces surface tension
throughout the lungs, thereby contributing to its general compliance;
stabilizes the alveoli and keeps them dry
What produces surfactant? - ANSWER-produced by the Type II alveolar cells
,What is Ohm's law? - ANSWER-velocity = driving force/resistance
What is Poiseuille law? - ANSWER-resistance = (8 x viscosity x length) / (pi x radius^4)
What happens if the radius in the lungs goes down? - ANSWER-the resistance goes up
How is the ventilation distributed in the lungs? - ANSWER-the top of the lungs are more
distended and less compliant whereas the lower lung is small and highly compliant
What factors affect lung perfusion? - ANSWER-lung capacitance;
low resistance system;
flow influenced by gravity;
resistance primarily determined by vessel radius
What does hypoxia lead to? - ANSWER-vasoconstriction of pulmonary vessels
What does prolonged hypoxia lead to? - ANSWER-pulmonary hypertension
What factors affect alveolar-capillary diffusion? - ANSWER-capillary permeability;
surface area available for diffusion;
concentration gradient for the gas;
distance for diffusion
What causes right shifts (decreased affinity) in Hemoglobin-O2 affinity? - ANSWER-acidemia;
hyperthermia;
hypercarbia
What causes left shifts (increased affinity) in Hemoglobin-O2 affinity? - ANSWER-alkalemia;
hypothermia;
hypocarbia
What is hypoxemia? - ANSWER-deficient blood oxygen;
low PaO2;
low O2 saturation
What is hypoxia? - ANSWER-decreased tissue oxygen
What is hypoxic hypoxia? - ANSWER-decreased tissue oxygen caused by decreased respirations
,What is anemic hypoxia? - ANSWER-decreased tissue oxygen caused by decreased hemoglobin
What is circulatory hypoxia? - ANSWER-decreased tissue oxygen caused by decreased blood
flow
What is histotoxic hypoxia? - ANSWER-decreased tissue oxygen caused by increased toxic
substance
What is ischemia? - ANSWER-greatly reduced or interrupted flow through the arterial system,
producing significant tissue hypoxia
What is hypercapnia? - ANSWER-increased level of CO2 in the blood
What are S&S of acute hypoxia? - ANSWER-dyspnea; restlessness; palpitations; agitation;
headache; tremors; diaphoresis; respiratory distress; cyanosis; tachypnea; tachycardia;
dysrhythmias; hypertension; lethargy; confusion to coma
What are some effects of hypercapnia? - ANSWER-respiratory acidosis (decreased pH from
increase in CO2); lethargy and confusion; increased HR and BP; flushed skin; arrhythmias;
seizures; coma; death
What is dyspnea? - ANSWER-subjective feeling of being SOB
What does dyspnea lead to? - ANSWER-decreased sense of wellness which may cause
psychological and social consequences
What is the leading cause of cancer death? - ANSWER-lung cancer
What is lung cancer most likely caused by? - ANSWER-cigarette smoking;
asbestos;
familial predisposition
What are the manifestations of lung cancer? - ANSWER-cough, hemoptysis (blood in cough
sputum);
hoarseness;
chest pain;
often disseminated (spread widely) at time of diagnosis
What are the types of bronchogenic carcinomas? - ANSWER-squamous cell lung carcinoma (25-
40%);
adenocarcinoma (20-40%);
, small cell carcinoma (20-25%);
large cell carcinoma (10-15%)
What is acute airway obstruction caused by? - ANSWER-foreign body aspiration;
laryngospasm (spontaneous spasm of the vocal cords);
trauma
What is complete acute airway obstruction? - ANSWER-inspiratory chest movements but no air
movement;
tachycardia, cyanosis, rapid progression to unconsciousness
What is partial acute airway obstruction? - ANSWER-stridor (harsh vibrating noise), wheezing,
dyspnea, tachypnea, tachycardia, retractions (chest moving inward)
What are some respiratory disorders in children? - ANSWER-upper airway infections: viral croup,
spasmodic croup, and epiglotitis;
lower airway infections: acute bronchiolitis
What is croup (laryngotracheobronchitis)? - ANSWER-inflammation of the larynx with a sudden
onset;
barking cough with stridor
What are the manifestations of viral croup? - ANSWER-febrile;
upper respiratory infection precedes
What are the manifestations of spasmodic croup? - ANSWER-afebrile;
may be allergic
What is epiglotitis? - ANSWER-bacterial infection of supraglottic structures;
high mortality without treatment
What are the clinical manifestations of epiglottitis? - ANSWER-fever; dyspnea; dysphagia;
drooling; refusal to eat; orthopnea; protruding tongue; wheezing; stridor
What is bronchiolitis? - ANSWER-viral infection of the lower airways often caused by respiratory
syncytial virus (RSV);
may lead to respiratory failure
ANSWERS WITH RATIONALES|ALREADY GRADED A+||GALEN COLLEGE OF NURSING
What is ventilation? - ANSWER-the movement of air into and out of the lungs
What is perfusion? - ANSWER-the circulation of blood through the lungs
What are central chemoreceptors responsive to? - ANSWER-increased H+ in the brain ECF;
increased PaCO2;
"hypercarbic drive"
What are peripheral chemoreceptors responsive to? - ANSWER-decreased pH;
increased PaCO2;
decreased PaO2;
"hypoxic drive"
What are elastic forces? - ANSWER-lungs recoil due to elastin, collagen, fibrin
What are surface forces? - ANSWER-surface tension due to water-air interface
What is airway resistance? - ANSWER-opposition to flow caused by the forces of friction;
primarily determined by airway radius
What is the distensibility of the lungs? - ANSWER-ease with which the lungs can be inflated
What is lung distensibility increased in? - ANSWER-neonates and children;
emphysema
What is lung distensibility decreased in? - ANSWER-elderly;
pneumonia, pulmonary edema, ARDS, atelectasis, fibrosis
What is surfactant? - ANSWER-complex substance lining the alveoli and smallest bronchioles
containing phospholipids and a number of apoproteins which reduces surface tension
throughout the lungs, thereby contributing to its general compliance;
stabilizes the alveoli and keeps them dry
What produces surfactant? - ANSWER-produced by the Type II alveolar cells
,What is Ohm's law? - ANSWER-velocity = driving force/resistance
What is Poiseuille law? - ANSWER-resistance = (8 x viscosity x length) / (pi x radius^4)
What happens if the radius in the lungs goes down? - ANSWER-the resistance goes up
How is the ventilation distributed in the lungs? - ANSWER-the top of the lungs are more
distended and less compliant whereas the lower lung is small and highly compliant
What factors affect lung perfusion? - ANSWER-lung capacitance;
low resistance system;
flow influenced by gravity;
resistance primarily determined by vessel radius
What does hypoxia lead to? - ANSWER-vasoconstriction of pulmonary vessels
What does prolonged hypoxia lead to? - ANSWER-pulmonary hypertension
What factors affect alveolar-capillary diffusion? - ANSWER-capillary permeability;
surface area available for diffusion;
concentration gradient for the gas;
distance for diffusion
What causes right shifts (decreased affinity) in Hemoglobin-O2 affinity? - ANSWER-acidemia;
hyperthermia;
hypercarbia
What causes left shifts (increased affinity) in Hemoglobin-O2 affinity? - ANSWER-alkalemia;
hypothermia;
hypocarbia
What is hypoxemia? - ANSWER-deficient blood oxygen;
low PaO2;
low O2 saturation
What is hypoxia? - ANSWER-decreased tissue oxygen
What is hypoxic hypoxia? - ANSWER-decreased tissue oxygen caused by decreased respirations
,What is anemic hypoxia? - ANSWER-decreased tissue oxygen caused by decreased hemoglobin
What is circulatory hypoxia? - ANSWER-decreased tissue oxygen caused by decreased blood
flow
What is histotoxic hypoxia? - ANSWER-decreased tissue oxygen caused by increased toxic
substance
What is ischemia? - ANSWER-greatly reduced or interrupted flow through the arterial system,
producing significant tissue hypoxia
What is hypercapnia? - ANSWER-increased level of CO2 in the blood
What are S&S of acute hypoxia? - ANSWER-dyspnea; restlessness; palpitations; agitation;
headache; tremors; diaphoresis; respiratory distress; cyanosis; tachypnea; tachycardia;
dysrhythmias; hypertension; lethargy; confusion to coma
What are some effects of hypercapnia? - ANSWER-respiratory acidosis (decreased pH from
increase in CO2); lethargy and confusion; increased HR and BP; flushed skin; arrhythmias;
seizures; coma; death
What is dyspnea? - ANSWER-subjective feeling of being SOB
What does dyspnea lead to? - ANSWER-decreased sense of wellness which may cause
psychological and social consequences
What is the leading cause of cancer death? - ANSWER-lung cancer
What is lung cancer most likely caused by? - ANSWER-cigarette smoking;
asbestos;
familial predisposition
What are the manifestations of lung cancer? - ANSWER-cough, hemoptysis (blood in cough
sputum);
hoarseness;
chest pain;
often disseminated (spread widely) at time of diagnosis
What are the types of bronchogenic carcinomas? - ANSWER-squamous cell lung carcinoma (25-
40%);
adenocarcinoma (20-40%);
, small cell carcinoma (20-25%);
large cell carcinoma (10-15%)
What is acute airway obstruction caused by? - ANSWER-foreign body aspiration;
laryngospasm (spontaneous spasm of the vocal cords);
trauma
What is complete acute airway obstruction? - ANSWER-inspiratory chest movements but no air
movement;
tachycardia, cyanosis, rapid progression to unconsciousness
What is partial acute airway obstruction? - ANSWER-stridor (harsh vibrating noise), wheezing,
dyspnea, tachypnea, tachycardia, retractions (chest moving inward)
What are some respiratory disorders in children? - ANSWER-upper airway infections: viral croup,
spasmodic croup, and epiglotitis;
lower airway infections: acute bronchiolitis
What is croup (laryngotracheobronchitis)? - ANSWER-inflammation of the larynx with a sudden
onset;
barking cough with stridor
What are the manifestations of viral croup? - ANSWER-febrile;
upper respiratory infection precedes
What are the manifestations of spasmodic croup? - ANSWER-afebrile;
may be allergic
What is epiglotitis? - ANSWER-bacterial infection of supraglottic structures;
high mortality without treatment
What are the clinical manifestations of epiglottitis? - ANSWER-fever; dyspnea; dysphagia;
drooling; refusal to eat; orthopnea; protruding tongue; wheezing; stridor
What is bronchiolitis? - ANSWER-viral infection of the lower airways often caused by respiratory
syncytial virus (RSV);
may lead to respiratory failure
