NUR 242 MED SURG EXAM 3
QUESTIONS AND CORRECT
DETAILED ANSWERS | ALREADY
GRADED A+||GALEN COLLEGE OF
NURSING
What is ventilation? - Answer-✅the movement of air into and out of the lungs
What is perfusion? - Answer-✅the circulation of blood through the lungs
What are central chemoreceptors responsive to? - Answer-✅increased H+ in the brain
ECF;
increased PaCO2;
"hypercarbic drive"
What are peripheral chemoreceptors responsive to? - Answer-✅decreased pH;
increased PaCO2;
decreased PaO2;
"hypoxic drive"
What are elastic forces? - Answer-✅lungs recoil due to elastin, collagen, fibrin
What are surface forces? - Answer-✅surface tension due to water-air interface
What is airway resistance? - Answer-✅opposition to flow caused by the forces of
friction; primarily determined by airway radius
What is the distensibility of the lungs? - Answer-✅ease with which the lungs can be
inflated
What is lung distensibility increased in? - Answer-✅neonates and children;
emphysema
What is lung distensibility decreased in? - Answer-✅elderly;
pneumonia, pulmonary edema, ARDS, atelectasis, fibrosis
,What is surfactant? - Answer-✅complex substance lining the alveoli and smallest
bronchioles containing phospholipids and a number of apoproteins which reduces
surface tension throughout the lungs, thereby contributing to its general compliance;
stabilizes the alveoli and keeps them dry
What produces surfactant? - Answer-✅produced by the Type II alveolar cells
What is Ohm's law? - Answer-✅velocity = driving force/resistance
What is Poiseuille law? - Answer-✅resistance = (8 x viscosity x length) / (pi x radius^4)
What happens if the radius in the lungs goes down? - Answer-✅the resistance goes up
How is the ventilation distributed in the lungs? - Answer-✅the top of the lungs are more
distended and less compliant whereas the lower lung is small and highly compliant
What factors affect lung perfusion? - Answer-✅lung capacitance;
low resistance system;
flow influenced by gravity;
resistance primarily determined by vessel radius
What does hypoxia lead to? - Answer-✅vasoconstriction of pulmonary vessels
What does prolonged hypoxia lead to? - Answer-✅pulmonary hypertension
What factors affect alveolar-capillary diffusion? - Answer-✅capillary permeability;
surface area available for diffusion;
concentration gradient for the gas;
distance for diffusion
What causes right shifts (decreased affinity) in Hemoglobin-O2 affinity? - Answer-
✅acidemia;
hyperthermia;
hypercarbia
What causes left shifts (increased affinity) in Hemoglobin-O2 affinity? - Answer-
✅alkalemia;
hypothermia;
hypocarbia
What is hypoxemia? - Answer-✅deficient blood oxygen;
low PaO2;
low O2 saturation
,What is hypoxia? - Answer-✅decreased tissue oxygen
What is hypoxic hypoxia? - Answer-✅decreased tissue oxygen caused by decreased
respirations
What is anemic hypoxia? - Answer-✅decreased tissue oxygen caused by decreased
hemoglobin
What is circulatory hypoxia? - Answer-✅decreased tissue oxygen caused by decreased
blood flow
What is histotoxic hypoxia? - Answer-✅decreased tissue oxygen caused by increased
toxic substance
What is ischemia? - Answer-✅greatly reduced or interrupted flow through the arterial
system, producing significant tissue hypoxia
What is hypercapnia? - Answer-✅increased level of CO2 in the blood
What are S&S of acute hypoxia? - Answer-✅dyspnea; restlessness; palpitations;
agitation; headache; tremors; diaphoresis; respiratory distress; cyanosis; tachypnea;
tachycardia; dysrhythmias; hypertension; lethargy; confusion to coma
What are some effects of hypercapnia? - Answer-✅respiratory acidosis (decreased pH
from increase in CO2); lethargy and confusion; increased HR and BP; flushed skin;
arrhythmias; seizures; coma; death
What is dyspnea? - Answer-✅subjective feeling of being SOB
What does dyspnea lead to? - Answer-✅decreased sense of wellness which may
cause psychological and social consequences
What is the leading cause of cancer death? - Answer-✅lung cancer
What is lung cancer most likely caused by? - Answer-✅cigarette smoking;
asbestos;
familial predisposition
What are the manifestations of lung cancer? - Answer-✅cough, hemoptysis (blood in
cough sputum);
hoarseness;
chest pain;
often disseminated (spread widely) at time of diagnosis
, What are the types of bronchogenic carcinomas? - Answer-✅squamous cell lung
carcinoma (25-40%);
adenocarcinoma (20-40%);
small cell carcinoma (20-25%);
large cell carcinoma (10-15%)
What is acute airway obstruction caused by? - Answer-✅foreign body aspiration;
laryngospasm (spontaneous spasm of the vocal cords);
trauma
What is complete acute airway obstruction? - Answer-✅inspiratory chest movements
but no air movement;
tachycardia, cyanosis, rapid progression to unconsciousness
What is partial acute airway obstruction? - Answer-✅stridor (harsh vibrating noise),
wheezing, dyspnea, tachypnea, tachycardia, retractions (chest moving inward)
What are some respiratory disorders in children? - Answer-✅upper airway infections:
viral croup, spasmodic croup, and epiglotitis;
lower airway infections: acute bronchiolitis
What is croup (laryngotracheobronchitis)? - Answer-✅inflammation of the larynx with a
sudden onset;
barking cough with stridor
What are the manifestations of viral croup? - Answer-✅febrile;
upper respiratory infection precedes
What are the manifestations of spasmodic croup? - Answer-✅afebrile;
may be allergic
What is epiglotitis? - Answer-✅bacterial infection of supraglottic structures;
high mortality without treatment
What are the clinical manifestations of epiglottitis? - Answer-✅fever; dyspnea;
dysphagia; drooling; refusal to eat; orthopnea; protruding tongue; wheezing; stridor
What is bronchiolitis? - Answer-✅viral infection of the lower airways often caused by
respiratory syncytial virus (RSV);
may lead to respiratory failure
What are the clinical manifestations of bronchiolitis? - Answer-✅breathlessness; rapid
and shallow breathing; wheezing; retractions; cyanosis; pallor
QUESTIONS AND CORRECT
DETAILED ANSWERS | ALREADY
GRADED A+||GALEN COLLEGE OF
NURSING
What is ventilation? - Answer-✅the movement of air into and out of the lungs
What is perfusion? - Answer-✅the circulation of blood through the lungs
What are central chemoreceptors responsive to? - Answer-✅increased H+ in the brain
ECF;
increased PaCO2;
"hypercarbic drive"
What are peripheral chemoreceptors responsive to? - Answer-✅decreased pH;
increased PaCO2;
decreased PaO2;
"hypoxic drive"
What are elastic forces? - Answer-✅lungs recoil due to elastin, collagen, fibrin
What are surface forces? - Answer-✅surface tension due to water-air interface
What is airway resistance? - Answer-✅opposition to flow caused by the forces of
friction; primarily determined by airway radius
What is the distensibility of the lungs? - Answer-✅ease with which the lungs can be
inflated
What is lung distensibility increased in? - Answer-✅neonates and children;
emphysema
What is lung distensibility decreased in? - Answer-✅elderly;
pneumonia, pulmonary edema, ARDS, atelectasis, fibrosis
,What is surfactant? - Answer-✅complex substance lining the alveoli and smallest
bronchioles containing phospholipids and a number of apoproteins which reduces
surface tension throughout the lungs, thereby contributing to its general compliance;
stabilizes the alveoli and keeps them dry
What produces surfactant? - Answer-✅produced by the Type II alveolar cells
What is Ohm's law? - Answer-✅velocity = driving force/resistance
What is Poiseuille law? - Answer-✅resistance = (8 x viscosity x length) / (pi x radius^4)
What happens if the radius in the lungs goes down? - Answer-✅the resistance goes up
How is the ventilation distributed in the lungs? - Answer-✅the top of the lungs are more
distended and less compliant whereas the lower lung is small and highly compliant
What factors affect lung perfusion? - Answer-✅lung capacitance;
low resistance system;
flow influenced by gravity;
resistance primarily determined by vessel radius
What does hypoxia lead to? - Answer-✅vasoconstriction of pulmonary vessels
What does prolonged hypoxia lead to? - Answer-✅pulmonary hypertension
What factors affect alveolar-capillary diffusion? - Answer-✅capillary permeability;
surface area available for diffusion;
concentration gradient for the gas;
distance for diffusion
What causes right shifts (decreased affinity) in Hemoglobin-O2 affinity? - Answer-
✅acidemia;
hyperthermia;
hypercarbia
What causes left shifts (increased affinity) in Hemoglobin-O2 affinity? - Answer-
✅alkalemia;
hypothermia;
hypocarbia
What is hypoxemia? - Answer-✅deficient blood oxygen;
low PaO2;
low O2 saturation
,What is hypoxia? - Answer-✅decreased tissue oxygen
What is hypoxic hypoxia? - Answer-✅decreased tissue oxygen caused by decreased
respirations
What is anemic hypoxia? - Answer-✅decreased tissue oxygen caused by decreased
hemoglobin
What is circulatory hypoxia? - Answer-✅decreased tissue oxygen caused by decreased
blood flow
What is histotoxic hypoxia? - Answer-✅decreased tissue oxygen caused by increased
toxic substance
What is ischemia? - Answer-✅greatly reduced or interrupted flow through the arterial
system, producing significant tissue hypoxia
What is hypercapnia? - Answer-✅increased level of CO2 in the blood
What are S&S of acute hypoxia? - Answer-✅dyspnea; restlessness; palpitations;
agitation; headache; tremors; diaphoresis; respiratory distress; cyanosis; tachypnea;
tachycardia; dysrhythmias; hypertension; lethargy; confusion to coma
What are some effects of hypercapnia? - Answer-✅respiratory acidosis (decreased pH
from increase in CO2); lethargy and confusion; increased HR and BP; flushed skin;
arrhythmias; seizures; coma; death
What is dyspnea? - Answer-✅subjective feeling of being SOB
What does dyspnea lead to? - Answer-✅decreased sense of wellness which may
cause psychological and social consequences
What is the leading cause of cancer death? - Answer-✅lung cancer
What is lung cancer most likely caused by? - Answer-✅cigarette smoking;
asbestos;
familial predisposition
What are the manifestations of lung cancer? - Answer-✅cough, hemoptysis (blood in
cough sputum);
hoarseness;
chest pain;
often disseminated (spread widely) at time of diagnosis
, What are the types of bronchogenic carcinomas? - Answer-✅squamous cell lung
carcinoma (25-40%);
adenocarcinoma (20-40%);
small cell carcinoma (20-25%);
large cell carcinoma (10-15%)
What is acute airway obstruction caused by? - Answer-✅foreign body aspiration;
laryngospasm (spontaneous spasm of the vocal cords);
trauma
What is complete acute airway obstruction? - Answer-✅inspiratory chest movements
but no air movement;
tachycardia, cyanosis, rapid progression to unconsciousness
What is partial acute airway obstruction? - Answer-✅stridor (harsh vibrating noise),
wheezing, dyspnea, tachypnea, tachycardia, retractions (chest moving inward)
What are some respiratory disorders in children? - Answer-✅upper airway infections:
viral croup, spasmodic croup, and epiglotitis;
lower airway infections: acute bronchiolitis
What is croup (laryngotracheobronchitis)? - Answer-✅inflammation of the larynx with a
sudden onset;
barking cough with stridor
What are the manifestations of viral croup? - Answer-✅febrile;
upper respiratory infection precedes
What are the manifestations of spasmodic croup? - Answer-✅afebrile;
may be allergic
What is epiglotitis? - Answer-✅bacterial infection of supraglottic structures;
high mortality without treatment
What are the clinical manifestations of epiglottitis? - Answer-✅fever; dyspnea;
dysphagia; drooling; refusal to eat; orthopnea; protruding tongue; wheezing; stridor
What is bronchiolitis? - Answer-✅viral infection of the lower airways often caused by
respiratory syncytial virus (RSV);
may lead to respiratory failure
What are the clinical manifestations of bronchiolitis? - Answer-✅breathlessness; rapid
and shallow breathing; wheezing; retractions; cyanosis; pallor
