NR 603 Week 2 Case Discussion: Pulmonary
(Part One)_ Questions and answers solutions
with Rationales
1. Which of the following is the primary pathophysiologic change in emphysema?
A. Bronchial inflammation
B. Destruction of alveolar walls
C. Airway hyperresponsiveness
D. Pulmonary edema
Answer: B. Destruction of alveolar walls
Solution/Rationale: Emphysema involves permanent destruction of alveolar walls, leading to
decreased elastic recoil and airflow limitation (GOLD Guidelines 2023).
2. A patient with COPD has an FEV₁/FVC ratio of 0.65. What does this indicate?
A. Restrictive lung disease
B. Obstructive lung disease
C. Normal lung function
D. Pulmonary hypertension
Answer: B. Obstructive lung disease
Solution: An FEV₁/FVC ratio <0.70 confirms obstructive lung disease, typical in COPD.
3. Which of the following is considered a long-term complication of chronic hypoxemia?
A. Pulmonary hypertension
B. Pneumothorax
C. Pulmonary embolism
D. Acute bronchitis
, Answer: A. Pulmonary hypertension
Solution: Chronic hypoxemia causes vasoconstriction of pulmonary arteries, leading to
pulmonary hypertension and right-sided heart strain (cor pulmonale).
4. What is the most common trigger for an asthma exacerbation in adults?
A. Viral respiratory infection
B. Pulmonary embolism
C. High altitude
D. Bronchiectasis
Answer: A. Viral respiratory infection
Solution: Viral infections are the most frequent triggers for asthma exacerbations, provoking
airway inflammation and bronchospasm.
5. In ARDS, which of the following is a hallmark finding on chest imaging?
A. Hyperinflation of lungs
B. Bilateral pulmonary infiltrates
C. Cavitary lesions
D. Pleural effusion
Answer: B. Bilateral pulmonary infiltrates
Solution: ARDS presents with diffuse alveolar damage, leading to bilateral infiltrates and
severe hypoxemia.
6. Which arterial blood gas (ABG) finding is typical in early COPD exacerbation?
A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic acidosis
D. Metabolic alkalosis
Answer: A. Respiratory alkalosis
Solution: Early COPD exacerbation often causes tachypnea, leading to CO₂ washout and
respiratory alkalosis. Later stages may progress to chronic CO₂ retention and acidosis.
7. A patient presents with sudden dyspnea, chest pain, and hemoptysis. Which pulmonary
condition should be suspected first?
A. Pneumothorax
B. Pulmonary embolism
(Part One)_ Questions and answers solutions
with Rationales
1. Which of the following is the primary pathophysiologic change in emphysema?
A. Bronchial inflammation
B. Destruction of alveolar walls
C. Airway hyperresponsiveness
D. Pulmonary edema
Answer: B. Destruction of alveolar walls
Solution/Rationale: Emphysema involves permanent destruction of alveolar walls, leading to
decreased elastic recoil and airflow limitation (GOLD Guidelines 2023).
2. A patient with COPD has an FEV₁/FVC ratio of 0.65. What does this indicate?
A. Restrictive lung disease
B. Obstructive lung disease
C. Normal lung function
D. Pulmonary hypertension
Answer: B. Obstructive lung disease
Solution: An FEV₁/FVC ratio <0.70 confirms obstructive lung disease, typical in COPD.
3. Which of the following is considered a long-term complication of chronic hypoxemia?
A. Pulmonary hypertension
B. Pneumothorax
C. Pulmonary embolism
D. Acute bronchitis
, Answer: A. Pulmonary hypertension
Solution: Chronic hypoxemia causes vasoconstriction of pulmonary arteries, leading to
pulmonary hypertension and right-sided heart strain (cor pulmonale).
4. What is the most common trigger for an asthma exacerbation in adults?
A. Viral respiratory infection
B. Pulmonary embolism
C. High altitude
D. Bronchiectasis
Answer: A. Viral respiratory infection
Solution: Viral infections are the most frequent triggers for asthma exacerbations, provoking
airway inflammation and bronchospasm.
5. In ARDS, which of the following is a hallmark finding on chest imaging?
A. Hyperinflation of lungs
B. Bilateral pulmonary infiltrates
C. Cavitary lesions
D. Pleural effusion
Answer: B. Bilateral pulmonary infiltrates
Solution: ARDS presents with diffuse alveolar damage, leading to bilateral infiltrates and
severe hypoxemia.
6. Which arterial blood gas (ABG) finding is typical in early COPD exacerbation?
A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic acidosis
D. Metabolic alkalosis
Answer: A. Respiratory alkalosis
Solution: Early COPD exacerbation often causes tachypnea, leading to CO₂ washout and
respiratory alkalosis. Later stages may progress to chronic CO₂ retention and acidosis.
7. A patient presents with sudden dyspnea, chest pain, and hemoptysis. Which pulmonary
condition should be suspected first?
A. Pneumothorax
B. Pulmonary embolism
