NURS 5315 Pulmonary, Respiratory Advanced
Patho Exam with Verified Answers 2026
Which of the following best describes respiration?
A) The mechanical process of moving air in and out of the lungs
B) The exchange of gases between the environment and the cells of the body
C) The contraction and relaxation of the diaphragm
D) The movement of oxygen into the lungs through the trachea
B) The exchange of gases between the environment and the cells of the body
Rationale: Respiration is a biochemical process that involves gas exchange at the
cellular level, including both external and internal respiration.
What is the primary driver of ventilation?
A) Diffusion of gases across the alveoli
B) Contraction and relaxation of the diaphragm and intercostal muscles
C) Hemoglobin saturation levels
D) Carbonic anhydrase activity in red blood cells
B) Contraction and relaxation of the diaphragm and intercostal muscles
Rationale: Ventilation refers to the mechanical process of air movement, which is
primarily controlled by muscle contraction and relaxation.
Which of the following is an example of external respiration?
A) The diffusion of oxygen from the alveoli into the bloodstream
B) The uptake of oxygen by mitochondria for ATP production
C) The conversion of carbon dioxide into bicarbonate in red blood cells
D) The transportation of oxygen via hemoglobin
A) The diffusion of oxygen from the alveoli into the bloodstream
Rationale: External respiration is the exchange of gases between the lungs and the
environment, primarily occurring at the alveolar-capillary membrane.
Where does gas exchange primarily occur in the lungs?
A) Trachea
B) Bronchioles
C) Alveoli
D) Pharynx
C) Alveoli
Rationale: The alveoli are the primary site for gas exchange due to their thin walls and
extensive capillary network.
Which law explains the diffusion of gases across the alveolar-capillary membrane?
A) Boyle's Law
B) Henry's Law
C) Fick's Law
D) Dalton's Law
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C) Fick's Law
Rationale: Fick's Law states that gas diffusion depends on surface area, membrane
thickness, and partial pressure gradients.
What determines the direction of oxygen diffusion in the lungs?
A) The volume of air in the lungs
B) The concentration gradient between alveolar air and blood
C) The presence of surfactant in the alveoli
D) The amount of hemoglobin in red blood cells
B) The concentration gradient between alveolar air and blood
Rationale: Oxygen moves from high partial pressure in the alveoli to the lower partial
pressure in the pulmonary capillaries.
How is most oxygen transported in the blood?
A) Dissolved in plasma
B) Bound to hemoglobin
C) Converted to bicarbonate
D) As carbonic acid
B) Bound to hemoglobin
Rationale: About 98.5% of oxygen is bound to hemoglobin in red blood cells.
What percentage of carbon dioxide is transported as bicarbonate?
A) 10%
B) 23%
C) 70%
D) 98.5%
C) 70%
Rationale: The majority of CO₂ (about 70%) is converted into bicarbonate in red blood
cells for transport.
Which factor shifts the oxygen-hemoglobin dissociation curve to the right, facilitating
oxygen release?
A) Decreased temperature
B) Increased pH
C) Increased CO₂ levels
D) Decreased 2,3-BPG levels
C) Increased CO₂ levels
Rationale: Increased CO₂ levels lower pH (Bohr effect), shifting the curve right and
promoting oxygen unloading.
Which structure is considered extra-thoracic?
A) Trachea
B) Pharynx
C) Bronchioles
D) Alveoli
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B) Pharynx
Rationale: The pharynx is outside the thoracic cavity and is classified as an extra-
thoracic airway.
What is the primary function of the conducting airways?
A) Gas exchange
B) Filtering, warming, and humidifying air
C) Oxygen transport via hemoglobin
D) Carbon dioxide diffusion into plasma
B) Filtering, warming, and humidifying air
Rationale: Conducting airways prepare air for entry into the respiratory zone by filtering
and humidifying it.
What type of epithelial cells primarily line the alveoli?
A) Stratified squamous
B) Simple columnar
C) Cuboidal
D) Simple squamous
D) Simple squamous
Rationale: Simple squamous epithelium facilitates efficient gas exchange due to its
thinness.
Which nervous system promotes bronchodilation?
A) Parasympathetic
B) Sympathetic
C) Enteric
D) Somatic
B) Sympathetic
Rationale: The sympathetic nervous system releases epinephrine, activating beta-2
receptors to cause bronchodilation.
Which mediator causes bronchoconstriction in asthma?
A) Epinephrine
B) Acetylcholine
C) Leukotrienes
D) Dopamine
C) Leukotrienes
Rationale: Leukotrienes are inflammatory mediators that promote bronchoconstriction in
asthma.
What effect does histamine have on bronchioles?
A) Bronchodilation
B) Increased mucus production
C) Bronchoconstriction
D) Decreased airway resistance
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C) Bronchoconstriction
Rationale: Histamine binds to H1 receptors, leading to bronchoconstriction and
increased airway resistance.
During inspiration, pleural pressure becomes:
A) More positive
B) More negative
C) Equal to alveolar pressure
D) Greater than atmospheric pressure
B) More negative
Rationale: Pleural pressure becomes more negative to allow lung expansion during
inspiration.
What happens to alveolar pressure during expiration?
A) It becomes negative
B) It remains the same as atmospheric pressure
C) It becomes positive
D) It decreases below pleural pressure
C) It becomes positive
Rationale: Alveolar pressure rises above atmospheric pressure, forcing air out of the
lungs.
Which factor primarily prevents alveolar collapse?
A) Carbonic anhydrase
B) Surfactant
C) Hemoglobin
D) Alveolar macrophages
B) Surfactant
Rationale: Surfactant reduces surface tension, preventing alveolar collapse.
Which of the following best describes the changes in alveolar structure due to aging?
A. Increase in alveolar size with loss of elastic fibers
B. Thickening of alveolar walls with increased gas exchange efficiency
C. Increase in the number of alveoli with improved oxygen diffusion
D. Enhanced elastic recoil of the alveoli
A. Increase in alveolar size with loss of elastic fibers
Rationale: Aging leads to alveolar enlargement due to loss of elastic fibers, reducing
surface area for gas exchange.
What is a major consequence of decreased elastic recoil in aging lungs?
A. Increased ability to exhale efficiently
B. Air trapping and difficulty expelling air
C. Decreased airway resistance
D. Increased surface area for gas exchange
B. Air trapping and difficulty expelling air
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