questions and answers/ NURS242 Exam 3 med surg exam latest 2024,2025
actual exam final with correct questions and answers
What are the S&S of secondary pulmonary hypertension? - CORRECT ANSWER-
dyspnea and profound fatigue;
peripheral edema;
ascites;
signs of right heart failure (for pulmonale)
How does a pulmonary embolism develop? - CORRECT ANSWER-a blood-borne
substance lodges in a branch of the pulmonary artery and obstructs the flow
What are the types of pulmonary embolism? - CORRECT ANSWER-thrombus-
venous blood clot;
fat- mobilized from the bone marrow after a fracture;
amniotic fluid- enters the maternal circulation after rupture of the membranes
at the time of delivery;
air
What are the manifestations of pulmonary embolism? - CORRECT ANSWER-
sudden onset of dyspnea and tachypnea;
sudden onset of anxiety;
sudden onset of flank or side pain;
cough;
hemoptysis (blood tinged sputum);
cyanosis
,What is pulmonary edema? - CORRECT ANSWER-accumulation of fluid in the
interstitium and alveoli of the lungs;
most commonly caused by left heart failure
What does fluid in alveoli cause? - CORRECT ANSWER-lung stiffness;
difficult expansion;
impaired gas exchange
What are the S&S of pulmonary edema? - CORRECT ANSWER-severe dyspnea
and air hunger (gasping for air);
cough productivity of frothy, blood tinged sputum;
tachypnea and tachycardia;
cold, clammy skin;
cyanosis;
extreme apprehension;
confusion, stupor
What is acute respiratory distress syndrome? - CORRECT ANSWER-disorder
caused by disseminated pulmonary inflammation and leads to profound
hypoxemia and increased work of breathing
What is the cause of acute respiratory distress syndrome (ARDS)? - CORRECT
ANSWER-shock;
major trauma (with or without fat emboli);
sepsis secondary to pulmonary or nonpulmonary infections;
,acute pancreatitis;
hematologic disorders;
aspiration;
reactions to drugs and toxins;
inhalation of toxins
What is the pathology of ARDS? - CORRECT ANSWER-diffuse epithelial cell
injury;
increased permeability of alveolar- capillary membrane;
fluid collects in interstitium and alveoli;
surfactant (helps inflate the alveoli) inactivation (caused by increased fluid);
hyaline membrane formation (collection of sloughed off cells and tissue);
increased work of breathing;
intrapulmonary shunting of blood (constriction of vessels in damaged parts of
the lungs to create more oxygen to the healthy part of the lungs);
impaired gas exchange
What are the manifestations of ARDS? - CORRECT ANSWER-profound hypoxia-
PO2 may be in 30s or 40s;
tachypnea;
severe dyspnea;
hypotension- has to do with shunting of the blood;
hypercapnia;
acidosis- can't get rid of CO2;
multiple organ failure;
, mortality- 30-60%
What is acute respiratory failure? - CORRECT ANSWER-state of disturbed gas
exchange;
PaO2 < 60 mmHg and PaCO2 > 50 mmHg;
may involve hypoxemia, hypercapnia;
high mortality rate- 30-50%
What is ventilation? - CORRECT ANSWER-the movement of air into and out of
the lungs
What is perfusion? - CORRECT ANSWER-the circulation of blood through the
lungs
What are central chemoreceptors responsive to? - CORRECT ANSWER-increased
H+ in the brain ECF;
increased PaCO2;
"hypercarbic drive"
What are peripheral chemoreceptors responsive to? - CORRECT ANSWER-
decreased pH;
increased PaCO2;
decreased PaO2;
"hypoxic drive"