NURS 5315 University Of Texas -
Arlington -UTA Nurs 5315 Mod 6
Pulm & Shock Questions With
Complete Solutions
Course
NURS 5315
Question 1
A patient with a pulmonary embolism suddenly develops severe dyspnea and hypoxemia. Which
pathophysiologic mechanism primarily explains the impaired gas exchange?
A. Increased pulmonary compliance
B. Ventilation without perfusion (dead-space ventilation)
C. Perfusion without ventilation (shunt)
D. Decreased surfactant production
Correct Answer: B. Ventilation without perfusion (dead-space ventilation)
Rationale
A pulmonary embolus obstructs pulmonary blood flow while ventilation remains intact,
producing a high ventilation/perfusion (V/Q) ratio and increased physiologic dead space.
Question 2
Which pulmonary disorder is characterized by decreased lung compliance?
A. Emphysema
B. COPD
C. Pulmonary fibrosis
D. Chronic bronchitis
Correct Answer: C. Pulmonary fibrosis
Rationale
Pulmonary fibrosis causes excessive collagen deposition, making lung tissue stiff and difficult to
expand, thereby decreasing compliance.
,Question 3
A patient has the following ABG values:
pH = 7.28
PaCO₂ = 60 mmHg
HCO₃⁻ = 27 mEq/L
What acid-base disorder is present?
A. Metabolic acidosis
B. Respiratory alkalosis
C. Respiratory acidosis
D. Metabolic alkalosis
Correct Answer: C. Respiratory acidosis
Rationale
The elevated PaCO₂ indicates carbon dioxide retention due to hypoventilation, causing
respiratory acidosis.
Question 4
Which characteristic best differentiates Acute Respiratory Distress Syndrome (ARDS) from
cardiogenic pulmonary edema?
A. Increased pulmonary capillary permeability
B. Elevated left ventricular filling pressure
C. Reduced alveolar permeability
D. Increased cardiac output
Correct Answer: A. Increased pulmonary capillary permeability
Rationale
ARDS results from diffuse inflammatory injury to the alveolar-capillary membrane, allowing
protein-rich fluid to enter the alveoli despite normal cardiac function.
Question 5
, A patient with septic shock remains hypotensive despite aggressive fluid resuscitation. What is
the primary mechanism responsible?
A. Left ventricular infarction
B. Systemic vasodilation caused by inflammatory mediators
C. Pulmonary artery obstruction
D. Decreased blood volume from hemorrhage
Correct Answer: B. Systemic vasodilation caused by inflammatory mediators
Rationale
Nitric oxide and inflammatory cytokines produce profound vasodilation, reducing systemic
vascular resistance and causing refractory hypotension.
Question 6
Which finding is most characteristic of cardiogenic shock?
A. Warm flushed skin
B. Elevated cardiac output
C. Decreased cardiac output with elevated preload
D. Low pulmonary capillary wedge pressure
Correct Answer: C. Decreased cardiac output with elevated preload
Rationale
Cardiogenic shock results from pump failure. Blood backs up into the heart, increasing preload
while cardiac output declines.
Question 7
A patient experiences severe blood loss following trauma. Which compensatory response occurs
first?
A. Aldosterone secretion
B. ADH release
C. Sympathetic nervous system activation
Arlington -UTA Nurs 5315 Mod 6
Pulm & Shock Questions With
Complete Solutions
Course
NURS 5315
Question 1
A patient with a pulmonary embolism suddenly develops severe dyspnea and hypoxemia. Which
pathophysiologic mechanism primarily explains the impaired gas exchange?
A. Increased pulmonary compliance
B. Ventilation without perfusion (dead-space ventilation)
C. Perfusion without ventilation (shunt)
D. Decreased surfactant production
Correct Answer: B. Ventilation without perfusion (dead-space ventilation)
Rationale
A pulmonary embolus obstructs pulmonary blood flow while ventilation remains intact,
producing a high ventilation/perfusion (V/Q) ratio and increased physiologic dead space.
Question 2
Which pulmonary disorder is characterized by decreased lung compliance?
A. Emphysema
B. COPD
C. Pulmonary fibrosis
D. Chronic bronchitis
Correct Answer: C. Pulmonary fibrosis
Rationale
Pulmonary fibrosis causes excessive collagen deposition, making lung tissue stiff and difficult to
expand, thereby decreasing compliance.
,Question 3
A patient has the following ABG values:
pH = 7.28
PaCO₂ = 60 mmHg
HCO₃⁻ = 27 mEq/L
What acid-base disorder is present?
A. Metabolic acidosis
B. Respiratory alkalosis
C. Respiratory acidosis
D. Metabolic alkalosis
Correct Answer: C. Respiratory acidosis
Rationale
The elevated PaCO₂ indicates carbon dioxide retention due to hypoventilation, causing
respiratory acidosis.
Question 4
Which characteristic best differentiates Acute Respiratory Distress Syndrome (ARDS) from
cardiogenic pulmonary edema?
A. Increased pulmonary capillary permeability
B. Elevated left ventricular filling pressure
C. Reduced alveolar permeability
D. Increased cardiac output
Correct Answer: A. Increased pulmonary capillary permeability
Rationale
ARDS results from diffuse inflammatory injury to the alveolar-capillary membrane, allowing
protein-rich fluid to enter the alveoli despite normal cardiac function.
Question 5
, A patient with septic shock remains hypotensive despite aggressive fluid resuscitation. What is
the primary mechanism responsible?
A. Left ventricular infarction
B. Systemic vasodilation caused by inflammatory mediators
C. Pulmonary artery obstruction
D. Decreased blood volume from hemorrhage
Correct Answer: B. Systemic vasodilation caused by inflammatory mediators
Rationale
Nitric oxide and inflammatory cytokines produce profound vasodilation, reducing systemic
vascular resistance and causing refractory hypotension.
Question 6
Which finding is most characteristic of cardiogenic shock?
A. Warm flushed skin
B. Elevated cardiac output
C. Decreased cardiac output with elevated preload
D. Low pulmonary capillary wedge pressure
Correct Answer: C. Decreased cardiac output with elevated preload
Rationale
Cardiogenic shock results from pump failure. Blood backs up into the heart, increasing preload
while cardiac output declines.
Question 7
A patient experiences severe blood loss following trauma. Which compensatory response occurs
first?
A. Aldosterone secretion
B. ADH release
C. Sympathetic nervous system activation
