NUR 529 EXAM 2 QUESTIONS WITH
LATEST CORRECT ANSWERS
cardiac cachexia ✅✅ANSW-a condition of malnutrition and tissue wasting that occurs in people
with end-stage heart failure
What changes occur in cardiogenic shock regardless of the cause? ✅✅ANSW--decrease in stroke
volume and cardiac output, which results in insufficient perfusion to meet cellular demands for
oxygen;
-poor cardiac output due to decreased myocardial contractility, increased afterload, and excessive
preload (increased left ventricular end-systolic volume);
-mediators and neurotransmitters (norepi) produce increase in systemic vascular resistance, which
increases afterload and ultimately contributes to deterioration of cardiac dysfunction;
-activation of RAAS worsens both preload and afterload
how does hemoglobin correspond to oxygen transport in the body ✅✅ANSW-myocardial oxygen
supply is related to coronary arteries, capillary inflow, and ability of hemoglobin to transport and
deliver O2 to the heart muscle;
the fraction of inspired oxygen in the blood and the number of RBC with normally functioning hgb is
important;
even with adequate coronary blood flow, myocardial ischemia can occur in situations of hypoxia
(low O2), anemia (low hgb), and carbon monoxide poisoning (high CO2)
What is nasal flaring? ✅✅ANSW-nasal flaring (sign of increased work of breathing) is a method
infants use to take in more air by increasing size of the nares and decrease resistance of small
airways
why are infants and children more susceptible to choking? ✅✅ANSW-the airways of the infant
and small child are much smaller than adults and resistance to airflow is inversely related to the 4th
power of the radius causing relatively small amounts of mucus secretions, edema, or airway
constriction to produce marked changes in airway resistance and airflow
specific sequence of upper airway nerve and muscle activity that occurs before and early in
inspiration of infants ✅✅ANSW-the tongue moves forward to prevent airway obstruction; vocal
cords abduct, reducing airway resistance
,diaphragm in an infant vs in an adult ✅✅ANSW-diaphragm in an infant inserts more horizontally
than in an adult; as a result the contraction of the diaphragm draws the lower ribs inward (especially
if in horizontal position); in an adult the intercostal muscles function to lift the ribs during
inspiration; in an infant, the intercostal muscles are not fully developed so they function to stabilize
the chest rather than lift the chest wall; during crying, intercostal muscles and diaphragm function
together to splint the chest wall and prevent collapse
high compliance of infants chest wall and decreased activity of intercostal muscles during sleep
✅✅ANSW-causes paradoxical inward movement of upper chest during inspiration (especially
during sleep)
high compliance of lungs during infancy ✅✅ANSW-benefits: only takes small amount of pressure
to inflate a compliant lung;
during respiratory disease, the diaphragm must generate more pressure causing the compliant chest
wall to be sucked inward (retractions which indicate airway obstruction or atelectasis)
why are infants obligatory nose breathers (up to 2-3 months)? ✅✅ANSW-
in the infant, the functional residual capacity (air left in lungs after expiration) occurs at a higher lung
volume than older child or adults due to increased respiration rate aids with ✅✅ANSW-1. holds
the airways open throughout all phases of respiration
2. favors reabsorption of intrapulmonary fluids
3. maintains more uniform lung expansion and enhances gas exchange
Epiglottitis ✅✅ANSW-life-threatening emergency characterized by sudden inflammatory edema
of supraglottic area including the epiglottis and pharyngeal structures (upper airway)
characteristics of Epiglottitis ✅✅ANSW-child appears: pale, toxic, lethargic, assumes distinctive
position (sitting up with mouth open and chin thrust forward), difficulty swallowing, muffled voice,
drooling, fever, extreme anxiety, inspiratory and sometimes expiratory stridor, nasal flaring,
inspiratory retractions of suprasternal notch and supraclavicular and intercostal spaces
bronchiolitis ✅✅ANSW-acute bronchiolitis is a viral infection of the lower airways, most
commonly caused by RSV, producing inflammatory obstruction of small airways and necrosis of cells
lining the lower airways; usually occurs during first 2 years of life with peak incidence between 3-6
months old; most have hx of mild upper respiratory tract infection; most critical phase first 48-72 hrs
, characteristics of bronchiolitis ✅✅ANSW-fever, diminished appetite, gradual development of
respiratory distress characterized by wheezy cough, dyspnea, and irritability; infant able to take in
sufficient air but has trouble exhaling it; typical appearance marked by breathlessness with rapid
respirations, distressing cough, and retractions of lower ribs and sternum exaggerated by crying and
feeding
indication of impending respiratory failure in infant with bronchiolitis ✅✅ANSW-cyanosis, pallor,
listlessness, and sudden diminution or absence of breath sounds
Diagnosis of community acquired pneumonia ✅✅ANSW-infection that begins outside the
hospital or is diagnosed within 48 hours after admission in person who has not resided in long-term
care facility for 14 days or more before admission;
in people < 65 y/o without coexisting disease, diagnosis based on H&P, chest radiograph, and
knowledge of microorganisms currently causing infection in community
Sputum specimen for staining procedures and culture
admission to the hospital is needed if patient is sick enough that blood cultures need to be drawn
most common cause of community acquired pneumonia ✅✅ANSW-S. pneumoniae
(pneumococcus)
treatment of community acquired pneumonia ✅✅ANSW-use of appropriate antibiotic therapy,
oxygen, hydration, supportive therapy, nutrition
hospital acquired pneumonia ✅✅ANSW-lower respiratory tract infection not present or
incubating on admission (48 hr or more after admission)
hypoxemic respiratory failure ✅✅ANSW-due to failure of gas exchange function of the lung
(movement of gases across the alveolar-capillary membrane)
ex: COPD, interstitial (restrictive) lung disease, severe pneumonia, atelectasis
LATEST CORRECT ANSWERS
cardiac cachexia ✅✅ANSW-a condition of malnutrition and tissue wasting that occurs in people
with end-stage heart failure
What changes occur in cardiogenic shock regardless of the cause? ✅✅ANSW--decrease in stroke
volume and cardiac output, which results in insufficient perfusion to meet cellular demands for
oxygen;
-poor cardiac output due to decreased myocardial contractility, increased afterload, and excessive
preload (increased left ventricular end-systolic volume);
-mediators and neurotransmitters (norepi) produce increase in systemic vascular resistance, which
increases afterload and ultimately contributes to deterioration of cardiac dysfunction;
-activation of RAAS worsens both preload and afterload
how does hemoglobin correspond to oxygen transport in the body ✅✅ANSW-myocardial oxygen
supply is related to coronary arteries, capillary inflow, and ability of hemoglobin to transport and
deliver O2 to the heart muscle;
the fraction of inspired oxygen in the blood and the number of RBC with normally functioning hgb is
important;
even with adequate coronary blood flow, myocardial ischemia can occur in situations of hypoxia
(low O2), anemia (low hgb), and carbon monoxide poisoning (high CO2)
What is nasal flaring? ✅✅ANSW-nasal flaring (sign of increased work of breathing) is a method
infants use to take in more air by increasing size of the nares and decrease resistance of small
airways
why are infants and children more susceptible to choking? ✅✅ANSW-the airways of the infant
and small child are much smaller than adults and resistance to airflow is inversely related to the 4th
power of the radius causing relatively small amounts of mucus secretions, edema, or airway
constriction to produce marked changes in airway resistance and airflow
specific sequence of upper airway nerve and muscle activity that occurs before and early in
inspiration of infants ✅✅ANSW-the tongue moves forward to prevent airway obstruction; vocal
cords abduct, reducing airway resistance
,diaphragm in an infant vs in an adult ✅✅ANSW-diaphragm in an infant inserts more horizontally
than in an adult; as a result the contraction of the diaphragm draws the lower ribs inward (especially
if in horizontal position); in an adult the intercostal muscles function to lift the ribs during
inspiration; in an infant, the intercostal muscles are not fully developed so they function to stabilize
the chest rather than lift the chest wall; during crying, intercostal muscles and diaphragm function
together to splint the chest wall and prevent collapse
high compliance of infants chest wall and decreased activity of intercostal muscles during sleep
✅✅ANSW-causes paradoxical inward movement of upper chest during inspiration (especially
during sleep)
high compliance of lungs during infancy ✅✅ANSW-benefits: only takes small amount of pressure
to inflate a compliant lung;
during respiratory disease, the diaphragm must generate more pressure causing the compliant chest
wall to be sucked inward (retractions which indicate airway obstruction or atelectasis)
why are infants obligatory nose breathers (up to 2-3 months)? ✅✅ANSW-
in the infant, the functional residual capacity (air left in lungs after expiration) occurs at a higher lung
volume than older child or adults due to increased respiration rate aids with ✅✅ANSW-1. holds
the airways open throughout all phases of respiration
2. favors reabsorption of intrapulmonary fluids
3. maintains more uniform lung expansion and enhances gas exchange
Epiglottitis ✅✅ANSW-life-threatening emergency characterized by sudden inflammatory edema
of supraglottic area including the epiglottis and pharyngeal structures (upper airway)
characteristics of Epiglottitis ✅✅ANSW-child appears: pale, toxic, lethargic, assumes distinctive
position (sitting up with mouth open and chin thrust forward), difficulty swallowing, muffled voice,
drooling, fever, extreme anxiety, inspiratory and sometimes expiratory stridor, nasal flaring,
inspiratory retractions of suprasternal notch and supraclavicular and intercostal spaces
bronchiolitis ✅✅ANSW-acute bronchiolitis is a viral infection of the lower airways, most
commonly caused by RSV, producing inflammatory obstruction of small airways and necrosis of cells
lining the lower airways; usually occurs during first 2 years of life with peak incidence between 3-6
months old; most have hx of mild upper respiratory tract infection; most critical phase first 48-72 hrs
, characteristics of bronchiolitis ✅✅ANSW-fever, diminished appetite, gradual development of
respiratory distress characterized by wheezy cough, dyspnea, and irritability; infant able to take in
sufficient air but has trouble exhaling it; typical appearance marked by breathlessness with rapid
respirations, distressing cough, and retractions of lower ribs and sternum exaggerated by crying and
feeding
indication of impending respiratory failure in infant with bronchiolitis ✅✅ANSW-cyanosis, pallor,
listlessness, and sudden diminution or absence of breath sounds
Diagnosis of community acquired pneumonia ✅✅ANSW-infection that begins outside the
hospital or is diagnosed within 48 hours after admission in person who has not resided in long-term
care facility for 14 days or more before admission;
in people < 65 y/o without coexisting disease, diagnosis based on H&P, chest radiograph, and
knowledge of microorganisms currently causing infection in community
Sputum specimen for staining procedures and culture
admission to the hospital is needed if patient is sick enough that blood cultures need to be drawn
most common cause of community acquired pneumonia ✅✅ANSW-S. pneumoniae
(pneumococcus)
treatment of community acquired pneumonia ✅✅ANSW-use of appropriate antibiotic therapy,
oxygen, hydration, supportive therapy, nutrition
hospital acquired pneumonia ✅✅ANSW-lower respiratory tract infection not present or
incubating on admission (48 hr or more after admission)
hypoxemic respiratory failure ✅✅ANSW-due to failure of gas exchange function of the lung
(movement of gases across the alveolar-capillary membrane)
ex: COPD, interstitial (restrictive) lung disease, severe pneumonia, atelectasis
