QUESTIONS WITH CORRECT DETAILED ANSWERS
Question 1
The nurse is caring for a patient who is 24 hours post-operative following
abdominal surgery. The patient is febrile and has crackles in the lung bases.
The nurse suspects atelectasis. Which pathophysiological process best
explains this finding?
A) Destruction of alveolar walls and loss of elastic recoil
B) Complete or partial collapse of lung alveoli due to hypoventilation and
retained secretions
C) Blockage of a pulmonary artery by a blood clot
D) Reversible airway obstruction due to bronchoconstriction
Correct Answer: B) Complete or partial collapse of lung alveoli due to
hypoventilation and retained secretions
Rationale: Atelectasis is the complete or partial collapse of lung alveoli, most
common after surgery due to anesthesia-induced hypoventilation, retained
secretions, and reduced surfactant. Post-operative patients are at high risk
because they take shallow breaths, do not cough effectively, and have
impaired mobilization of secretions. The alveoli deflate or become poorly
filled with fluid, leading to impaired gas exchange .
,Question 2
A patient presents with sudden onset of shortness of breath, pleuritic chest
pain, and hemoptysis. The nurse notes tachycardia, tachypnea, and hypoxia.
Which condition should the nurse suspect?
A) Atelectasis
B) Pulmonary embolism
C) Asthma exacerbation
D) Chronic bronchitis
Correct Answer: B) Pulmonary embolism
Rationale: Pulmonary embolism (PE) involves blockage of a pulmonary artery
by a blood clot, often from a deep vein thrombosis (DVT). Classic
manifestations include sudden onset of shortness of breath (SOB), hypoxia,
hemoptysis, pleuritic chest pain, and elevated respiratory rate. Risk factors
include DVT, immobilization, surgery, and cancer. Treatment includes
thrombolytics for massive PE and anticoagulation with heparin or warfarin
for stable patients. Diagnosis is confirmed by CT angiogram or V/Q scan .
Question 3
Which statement best describes the pathophysiology of emphysema?
A) Chronic inflammation and mucus hypersecretion in the airways
B) Destruction of alveolar walls with loss of elastic recoil and air trapping
C) Reversible airway obstruction due to bronchoconstriction
D) Genetic deficiency of alpha-1 antitrypsin causing airway inflammation
Correct Answer: B) Destruction of alveolar walls with loss of elastic
recoil and air trapping
Rationale: Emphysema is a type of COPD characterized by destruction of
alveolar walls, leading to loss of elastic recoil, air trapping, and
hyperinflation. This results in a barrel chest, pursed-lip breathing, and
, dyspnea on exertion. The destruction is caused by an imbalance between
proteases (neutrophil elastase) and antiproteases (alpha-1 antitrypsin).
Primary emphysema is caused by alpha-1 antitrypsin deficiency, while
secondary emphysema results from inhaled irritants such as cigarette smoke .
Question 4
A patient with chronic bronchitis has a history of a productive cough for at
least three months over two consecutive years. Which pathophysiological
change is characteristic of this condition?
A) Destruction of alveolar walls
B) Hypertrophy of mucous glands and mucus hypersecretion
C) Loss of elastic lung fibers
D) Bronchoconstriction due to mast cell degranulation
Correct Answer: B) Hypertrophy of mucous glands and mucus
hypersecretion
Rationale: Chronic bronchitis is defined by chronic inflammation and mucus
hypersecretion in the airways, leading to hypertrophy of mucous glands and
increased goblet cells. The diagnosis requires a history of chronic cough
lasting at least three months for two consecutive years. This condition leads
to chronic productive cough, airflow obstruction, and hypoxemia ("blue
bloaters") .
Question 5
The nurse is teaching a patient with asthma about the pathophysiology of
the disease. Which statement by the patient indicates understanding?
A) "Asthma is caused by permanent damage to my airways."
B) "My airways become narrow due to inflammation, bronchospasm, and