critical care exam 2 - practice
questions well answered
A client in the ICU experiences difficulty breathing in during exercise following trauma to the
sternum. Which muscle injury is causing the client to be short of breath?
a) Diaphragm
b) Sternocleidomastoid
c) external intercostal
d) scalene - correct answer ✔✔b) Sternocleidomastoid
-the accessory muscles of inspiration include the scalene and sternocleidomastoid muscles; the
scalene muscles elevate the first two ribs, and the sternocleidomastoid muscles raise the
sternum; during normal breathing, these muscles are not used, but during exercise, these
muscles contract to aid in inspiration; injury to the diaphragm would affect both inspiration and
expiration, whether at rest or in exercise; although expiration is a largely passive process during
normal breathing, it can become an active process during exercise; the abdominal and
intercostal muscles can increase expiratory effort
The nurse is explaining to a young client w/ asthma how air is conducted from the nose through
the airways to the alveoli in the lungs. Which represents the correct order of airways?
a) Nasopharynx, oropharynx, trachea, bronci, bronchioles
b) Trachea, nasopharynx, oropharynx, bronchi, bronchioles
c) Trachea, bronchi, bronchioles, nasopharynx, oropharynx
d) Oropharynx, nasopharynx, trachea, bronchioles, bronchi - correct answer ✔✔a)
Nasopharynx, oropharynx, trachea, bronci, bronchioles
-air enters through the nose and flows through the nasopharynx, then the oropharynx, trachea
(windpipe), left and right bronchi, and then the bronchioles
,The nurse is explaining to a client in the ICU unit who has experienced a pneumothorax the role
of the alveoli in respiration. The nurse should mention that which structure(s) are present in the
alveoli? Select all that apply.
a) Macrophages
b) Surfactant
c) Epiglottis
d) Bronchus - correct answer ✔✔a) Macrophages
b) Surfactant
-the alveoli are thin-walled, cup-shaped structures where gas exchange occurs in the lungs; the
alveoli contains macrophages that perform phagocytic role, along w/ surfactant, a lipoprotein
that decreases surface tension in the alveoli; the epiglottis is a small structure that covers the
larynx to allow food and liquid to pass into the esophagus; the bronchus is a tube that serves as
the passageway for gases into and out of the lungs
The nurse is assessing the client's anterior thorax. The nurse anticipates locating the base of the
lung at which location?
a) Sixth rib at midclavicular line
b) Eighth rib at midclavicular line
c) Ninth rib at midaxillary line
d) Seventh rib at midclavicular line - correct answer ✔✔a) Sixth rib at midclavicular line
-the base of each lung rests anteriorly at the level of the sixth rib at the midclavicular line and at
the eighth rib at the midaxillary line
A client is experiencing poor perfusion in the right thorax as a result of suspected partially
occluded arteries. Which arteries will cause occlusion? Select all that apply
a) Aorta
,b) Internal mammary
c) Subclavian
d) Intercostal - correct answer ✔✔b) Internal mammary
c) Subclavian
d) Intercostal
-the bronchial arteries that perfuse the left side of the thorax arise from the aorta, and the
arteries that perfuse the right side of the thorax branch from the internal mammary, subclavian,
and intercostal arteries
A client in the ICU w/ COPD has mucous secretions throughout the respiratory system. The
client's breathing is highly labored. What is the primary cause of the labored breathing?
a) Decreased airway resistance d/t increased airway diameter
b) Excessive surfactant
c) Increased airway resistance d/t decreased airway diameter
d) Increased lung compliance - correct answer ✔✔c) Increased airway resistance d/t decreased
airway diameter
-in conditions that decrease airway diameter, such as those caused by pulmonary secretions or
bronchospasm, marked increases in airway resistance occur; to maintain the same rate of
airflow as before the onset of increased airway resistance, clients w/ these conditions must
increase the driving pressure (or respiratory effort) to move air; lack of surfactant. not excessive
surfactant, would contribute to labored breathing; increased lung compliance would make
breathing easier, not labored
A client w/ pulmonary edema is experiencing respiratory distress. The nurse recognizes that
which factor affecting gas exchange is likely responsible for the client's dyspnea?
a) Surface area available for diffusion
b) Thickness of the alveolar-capillary membrane
, c) Partial pressure of alveolar gas
d) Solubility and molecular weight of the gas - correct answer ✔✔b) Thickness of the alveolar-
capillary membrane
-fick law states that the rate of transfer of gas through a semipermeable membrane is
proportional to the tissue surface area to the difference in gas pressures between the two sides
and is inversely proportional to the tissue thickness; therefore, the thicker the alveolar-capillary
membrane, the slower the rate of gas transfer and the more labored the client's breathing;
conditions such as pneumonia, interstitial lung disease, and pulmonary edema increase
membrane thickness; the other factors are not as pertinent
A client is recovering from severe altitude sickness after a failed attempt to climb mount
everest; which factor affecting gas exchange was most likely responsible for the client's illness?
a) Surface area available for diffusion
b) Thickness of the alveolar-capillary membrane
c) Partial pressure of alveolar gas
d) Solubility and molecular weight of the gas - correct answer ✔✔c) Partial pressure of alveolar
gas
-ascent to high altitudes can lead to altitude sickness d/t a decrease in partial pressure of
oxygen, which impairs gas exchange in the alveoli; the other factors are less likely to be
pertinent in this situation
A client is the ICU w/ pneumothorax is experiencing a ventilation-perfusion imbalance; which
type of imbalance is the client most likely experiencing?
a) Physiologic shunt
b) Anatomic shunt
c) Alveolar dead space
d) Silent unit - correct answer ✔✔d) Silent unit
questions well answered
A client in the ICU experiences difficulty breathing in during exercise following trauma to the
sternum. Which muscle injury is causing the client to be short of breath?
a) Diaphragm
b) Sternocleidomastoid
c) external intercostal
d) scalene - correct answer ✔✔b) Sternocleidomastoid
-the accessory muscles of inspiration include the scalene and sternocleidomastoid muscles; the
scalene muscles elevate the first two ribs, and the sternocleidomastoid muscles raise the
sternum; during normal breathing, these muscles are not used, but during exercise, these
muscles contract to aid in inspiration; injury to the diaphragm would affect both inspiration and
expiration, whether at rest or in exercise; although expiration is a largely passive process during
normal breathing, it can become an active process during exercise; the abdominal and
intercostal muscles can increase expiratory effort
The nurse is explaining to a young client w/ asthma how air is conducted from the nose through
the airways to the alveoli in the lungs. Which represents the correct order of airways?
a) Nasopharynx, oropharynx, trachea, bronci, bronchioles
b) Trachea, nasopharynx, oropharynx, bronchi, bronchioles
c) Trachea, bronchi, bronchioles, nasopharynx, oropharynx
d) Oropharynx, nasopharynx, trachea, bronchioles, bronchi - correct answer ✔✔a)
Nasopharynx, oropharynx, trachea, bronci, bronchioles
-air enters through the nose and flows through the nasopharynx, then the oropharynx, trachea
(windpipe), left and right bronchi, and then the bronchioles
,The nurse is explaining to a client in the ICU unit who has experienced a pneumothorax the role
of the alveoli in respiration. The nurse should mention that which structure(s) are present in the
alveoli? Select all that apply.
a) Macrophages
b) Surfactant
c) Epiglottis
d) Bronchus - correct answer ✔✔a) Macrophages
b) Surfactant
-the alveoli are thin-walled, cup-shaped structures where gas exchange occurs in the lungs; the
alveoli contains macrophages that perform phagocytic role, along w/ surfactant, a lipoprotein
that decreases surface tension in the alveoli; the epiglottis is a small structure that covers the
larynx to allow food and liquid to pass into the esophagus; the bronchus is a tube that serves as
the passageway for gases into and out of the lungs
The nurse is assessing the client's anterior thorax. The nurse anticipates locating the base of the
lung at which location?
a) Sixth rib at midclavicular line
b) Eighth rib at midclavicular line
c) Ninth rib at midaxillary line
d) Seventh rib at midclavicular line - correct answer ✔✔a) Sixth rib at midclavicular line
-the base of each lung rests anteriorly at the level of the sixth rib at the midclavicular line and at
the eighth rib at the midaxillary line
A client is experiencing poor perfusion in the right thorax as a result of suspected partially
occluded arteries. Which arteries will cause occlusion? Select all that apply
a) Aorta
,b) Internal mammary
c) Subclavian
d) Intercostal - correct answer ✔✔b) Internal mammary
c) Subclavian
d) Intercostal
-the bronchial arteries that perfuse the left side of the thorax arise from the aorta, and the
arteries that perfuse the right side of the thorax branch from the internal mammary, subclavian,
and intercostal arteries
A client in the ICU w/ COPD has mucous secretions throughout the respiratory system. The
client's breathing is highly labored. What is the primary cause of the labored breathing?
a) Decreased airway resistance d/t increased airway diameter
b) Excessive surfactant
c) Increased airway resistance d/t decreased airway diameter
d) Increased lung compliance - correct answer ✔✔c) Increased airway resistance d/t decreased
airway diameter
-in conditions that decrease airway diameter, such as those caused by pulmonary secretions or
bronchospasm, marked increases in airway resistance occur; to maintain the same rate of
airflow as before the onset of increased airway resistance, clients w/ these conditions must
increase the driving pressure (or respiratory effort) to move air; lack of surfactant. not excessive
surfactant, would contribute to labored breathing; increased lung compliance would make
breathing easier, not labored
A client w/ pulmonary edema is experiencing respiratory distress. The nurse recognizes that
which factor affecting gas exchange is likely responsible for the client's dyspnea?
a) Surface area available for diffusion
b) Thickness of the alveolar-capillary membrane
, c) Partial pressure of alveolar gas
d) Solubility and molecular weight of the gas - correct answer ✔✔b) Thickness of the alveolar-
capillary membrane
-fick law states that the rate of transfer of gas through a semipermeable membrane is
proportional to the tissue surface area to the difference in gas pressures between the two sides
and is inversely proportional to the tissue thickness; therefore, the thicker the alveolar-capillary
membrane, the slower the rate of gas transfer and the more labored the client's breathing;
conditions such as pneumonia, interstitial lung disease, and pulmonary edema increase
membrane thickness; the other factors are not as pertinent
A client is recovering from severe altitude sickness after a failed attempt to climb mount
everest; which factor affecting gas exchange was most likely responsible for the client's illness?
a) Surface area available for diffusion
b) Thickness of the alveolar-capillary membrane
c) Partial pressure of alveolar gas
d) Solubility and molecular weight of the gas - correct answer ✔✔c) Partial pressure of alveolar
gas
-ascent to high altitudes can lead to altitude sickness d/t a decrease in partial pressure of
oxygen, which impairs gas exchange in the alveoli; the other factors are less likely to be
pertinent in this situation
A client is the ICU w/ pneumothorax is experiencing a ventilation-perfusion imbalance; which
type of imbalance is the client most likely experiencing?
a) Physiologic shunt
b) Anatomic shunt
c) Alveolar dead space
d) Silent unit - correct answer ✔✔d) Silent unit
