NURS620 Respiratory Revision
Questions and Correct Detailed Answers
Approximately 50% of children with viral croup
show a tapered symmetric subglottic narrowing or "steeple" sign on the anteroposterior
view on an x-ray.
The x-rays do not correlate with the level of disease.
Primary spontaneous pneumothorax?
Usually occurs in healthy individuals without preexisting lung disease. It occurs more commonly
in young, tall, asthenic men and is an accumulation of air in the normally airless pleural space
between the lung and chest wall.
Stridor can be heard on auscultation when a client has
Stridor, a high-pitched inspiratory crowing sound, can be heard on auscultation when a
client has acute epiglottitis or croup.
Persistent fine crackles can be heard with atelectasis,
expiratory wheezes with asthma, and
persistent peristaltic sounds with diminished breath sounds on the same side with a
diaphragmatic hernia.
Of all the adults who smoke, what percentage who quit are successful in their efforts?
,8%
Nearly 17 million Americans try to quit smoking each year. Only about 1.3 million Americans
are able to remain smoke free. Only 8% or so of smokers who quit smoking are successful in
their efforts. Although the overall success rate of smoking cessation is disappointing, smoking
cessation programs have been extremely helpful. Motivation is the key to a successful effort,
along with making every clinical encounter an opportunity to discuss the topic. At the very
least, every client should be asked about his or her smoking history. Clinicians should advise
smokers to quit, assist them in setting a quitting date, provide self-help materials, and evaluate
them for nicotine replacement therapy (patches, nasal spray, or gum) or pharmacological
therapies.
Which underlying lung diseases are the most common cause of a secondary spontaneous
pneumothorax?
emphysematous COPD or HIV-associated Pneumocystis jiroveci pneumonia (PCP)
Other predisposing conditions include lung abscess, cystic fibrosis, and tuberculosis.
Harvey has severe obstructive sleep apnea and has just been ordered a continuous
positive airway pressure (CPAP) machine. What do you tell him about it?
CPAP administered through a nasal mask has become the most common treatment for obstructive
sleep apnea (OSA). Depending on the patient ' s mode of breathing, a larger mask encompassing
the mouth may also be used. CPAP dramatically eliminates apneas and hypopneas, improves sleep
architecture, and reduces daytime sleepiness, even for those with mild sleep apnea. In order to be
effective, the machine must be used all night long, every night.
Minor adverse effects of CPAP include feelings of suffocation, nasal drying or rhinitis, ear
pain, difficulty in exhaling, mask and mouth leaks, chest and back pain, and conjunctivitis.
Most of these can be alleviated.
The well-established risk factor(s) for a nosocomial pneumonia caused by a
multidrugresistant organism is (are)
,Treatment of nosocomial pneumonia is complicated by the frequent involvement of multidrug-
resistant organisms.
Prior exposure to antibiotics and a hospital stay of more than 1 week are well-established
risk factors for infection with these organisms.
The two most predominant organisms constituting the normal flora of the oropharynx are
-Streptococci (especially Streptococcus viridans )
-Staphylococci (especially Staphylococcus aureus )
They are followed by Streptococcus pyogenes, Streptococcus pneumoniae, Moraxella
catarrhalis, Neisseria species, and Lactobacilli .
The most common reason for a chronic cough in children is
postinfection most common
The other reasons, in order of frequency, are asthma, a postnasal drip, and irritants.
Uncommon causes include other respiratory infections, pertussis, a foreign body, cystic
fibrosis, congenital abnormalities, and psychogenic reasons.
Hyperresonance on percussion of the chest occurs
when too much air is present, such as occurs with emphysema or a pneumothorax.
A dull sound on percussion indicates an abnormal density in the
lungs, such as occurs with pneumonia, pleural effusion, a lung tumor, or atelectasis.
Susie, age 10, has a cough that characteristically occurs all day long but never during
sleep. You suspect
If a cough characteristically occurs all day long but never during sleep, suspect that it is
a psychogenic cough (or habit).
, Allergic rhinitis results in a cough that is seasonal,
pertussis in a cough that is followed by a " whoop,"
a postnasal drip results in a throat-clearing cough.
A pulmonary function test, such as spirometry, is helpful in the diagnosis of
restrictive lung disease
and
obstructive lung disease, including
chronic bronchitis and asthma.
Clients with postinfectious or cough-variant asthma may show mild obstruction, but they
often have normal spirometry.
A chest x-ray confirms the diagnosis of pneumonia.
While spirometry may show a decrease in lung capacity with advanced lung cancer, it is not
diagnostic.
In trying to differentiate between chronic bronchitis and emphysema, you know that chronic
bronchitis
Chronic bronchitis
-adventitious sounds, wheezing and rhonchi, and a normal percussion note.
-usually occurs after age 35,
-with recurrent respiratory infections.
-usually a persistent, productive cough of copious mucopurulent sputum,
-pulmonary function studies show normal or decreased total lung capacity with a moderately
increased residual volume.
Questions and Correct Detailed Answers
Approximately 50% of children with viral croup
show a tapered symmetric subglottic narrowing or "steeple" sign on the anteroposterior
view on an x-ray.
The x-rays do not correlate with the level of disease.
Primary spontaneous pneumothorax?
Usually occurs in healthy individuals without preexisting lung disease. It occurs more commonly
in young, tall, asthenic men and is an accumulation of air in the normally airless pleural space
between the lung and chest wall.
Stridor can be heard on auscultation when a client has
Stridor, a high-pitched inspiratory crowing sound, can be heard on auscultation when a
client has acute epiglottitis or croup.
Persistent fine crackles can be heard with atelectasis,
expiratory wheezes with asthma, and
persistent peristaltic sounds with diminished breath sounds on the same side with a
diaphragmatic hernia.
Of all the adults who smoke, what percentage who quit are successful in their efforts?
,8%
Nearly 17 million Americans try to quit smoking each year. Only about 1.3 million Americans
are able to remain smoke free. Only 8% or so of smokers who quit smoking are successful in
their efforts. Although the overall success rate of smoking cessation is disappointing, smoking
cessation programs have been extremely helpful. Motivation is the key to a successful effort,
along with making every clinical encounter an opportunity to discuss the topic. At the very
least, every client should be asked about his or her smoking history. Clinicians should advise
smokers to quit, assist them in setting a quitting date, provide self-help materials, and evaluate
them for nicotine replacement therapy (patches, nasal spray, or gum) or pharmacological
therapies.
Which underlying lung diseases are the most common cause of a secondary spontaneous
pneumothorax?
emphysematous COPD or HIV-associated Pneumocystis jiroveci pneumonia (PCP)
Other predisposing conditions include lung abscess, cystic fibrosis, and tuberculosis.
Harvey has severe obstructive sleep apnea and has just been ordered a continuous
positive airway pressure (CPAP) machine. What do you tell him about it?
CPAP administered through a nasal mask has become the most common treatment for obstructive
sleep apnea (OSA). Depending on the patient ' s mode of breathing, a larger mask encompassing
the mouth may also be used. CPAP dramatically eliminates apneas and hypopneas, improves sleep
architecture, and reduces daytime sleepiness, even for those with mild sleep apnea. In order to be
effective, the machine must be used all night long, every night.
Minor adverse effects of CPAP include feelings of suffocation, nasal drying or rhinitis, ear
pain, difficulty in exhaling, mask and mouth leaks, chest and back pain, and conjunctivitis.
Most of these can be alleviated.
The well-established risk factor(s) for a nosocomial pneumonia caused by a
multidrugresistant organism is (are)
,Treatment of nosocomial pneumonia is complicated by the frequent involvement of multidrug-
resistant organisms.
Prior exposure to antibiotics and a hospital stay of more than 1 week are well-established
risk factors for infection with these organisms.
The two most predominant organisms constituting the normal flora of the oropharynx are
-Streptococci (especially Streptococcus viridans )
-Staphylococci (especially Staphylococcus aureus )
They are followed by Streptococcus pyogenes, Streptococcus pneumoniae, Moraxella
catarrhalis, Neisseria species, and Lactobacilli .
The most common reason for a chronic cough in children is
postinfection most common
The other reasons, in order of frequency, are asthma, a postnasal drip, and irritants.
Uncommon causes include other respiratory infections, pertussis, a foreign body, cystic
fibrosis, congenital abnormalities, and psychogenic reasons.
Hyperresonance on percussion of the chest occurs
when too much air is present, such as occurs with emphysema or a pneumothorax.
A dull sound on percussion indicates an abnormal density in the
lungs, such as occurs with pneumonia, pleural effusion, a lung tumor, or atelectasis.
Susie, age 10, has a cough that characteristically occurs all day long but never during
sleep. You suspect
If a cough characteristically occurs all day long but never during sleep, suspect that it is
a psychogenic cough (or habit).
, Allergic rhinitis results in a cough that is seasonal,
pertussis in a cough that is followed by a " whoop,"
a postnasal drip results in a throat-clearing cough.
A pulmonary function test, such as spirometry, is helpful in the diagnosis of
restrictive lung disease
and
obstructive lung disease, including
chronic bronchitis and asthma.
Clients with postinfectious or cough-variant asthma may show mild obstruction, but they
often have normal spirometry.
A chest x-ray confirms the diagnosis of pneumonia.
While spirometry may show a decrease in lung capacity with advanced lung cancer, it is not
diagnostic.
In trying to differentiate between chronic bronchitis and emphysema, you know that chronic
bronchitis
Chronic bronchitis
-adventitious sounds, wheezing and rhonchi, and a normal percussion note.
-usually occurs after age 35,
-with recurrent respiratory infections.
-usually a persistent, productive cough of copious mucopurulent sputum,
-pulmonary function studies show normal or decreased total lung capacity with a moderately
increased residual volume.
