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1500 exam 3 review (5,18,19,21,22,4)

Total questions: 50

Worksheet time: 37mins

Name
Class
Date
1.

What effect do disorders of the pleura have on the lungs?

a)

Increase lung compliance

b)

Increase airway resistance

c)

Decrease lung compliance

d)

Decrease airway resistance

2.

A patient has experienced chest wall trauma and is in the emergency room for evaluation. The chest wall is auscultated and there are decreased breath sounds on the left side. Observation reveals that there is also limited movement of the chest wall on the left. The trachea is shifted to the right chest. What is the probable disorder happening?

a)

Right-sided pneumothorax

b)

Right-sided hemothorax

c)

Left-sided pneumothorax

d)

Left-sided pneumonia

3.

A patient has a chest wound and has developed an open pneumothorax. The air in the pleural space is from the:

a)

Lungs

b)

Stomach

c)

Atmosphere

4.

Paradoxical chest movement is associated with which of the following?

a)

Pneumothorax

b)

Flail chest

c)

Pleural effusion

d)

Pleurisy

5.

Cardiac tamponade can cause which of the following?

a)

Pulmonary emboli

b)

Pulsus alternans

c)

Bradycardia

d)

hypotension

6.

Severe chest trauma patients which are bedfast and require extensive medical treatments are prone to developing which of the following conditions? Select all that apply

a)

pulmonary embolism

b)

ARDS

c)

asthma

d)

all the above

7.

Initial evaluation of a trauma victim should include which of the following? Select all that apply

a)

breathing effort

b)

chest symmetry

c)

lung scan

d)

CXR

8.

A patient is suspected of having a tension pneumothorax. What should the physician do first?

a)

Obtain a chest radiograph

b)

Obtain CT of chest

c)

Placement of chest tube

d)

Perform needle decompression of the chest

9.

What is the definition of shock?

a)

State of hypothermia

b)

State of organ hypoperfusion

c)

Reactive state to sudden change

10.

A patient that was involved in a motor vehicle accident is this patient likely to suffer from what type of shock?

a)

Hypovolemic

b)

Cardiogenic

c)

Neurogenic

d)

Distributive

11.

Chest trauma that causes aortic rupture typically results in?

a)

Prolonged coma

b)

Quick death

c)

Progressive neuromuscular degeneration

d)

Little effect on the patient

12.

A patient is seen in the emergency department. His skin is cool and clammy and his extremities are mottled in appearance. He is placed on a monitor and his heart rate is 113 beats/min. His BP is reading 80/60 mm Hg. He is experiencing altered mental status. Previously he was complaining of shortness of breath and feeling faint. Auscultation reveals crackles in both bases. What type of shock do you suspect the patient is experiencing?

a)

Anaphylactic

b)

Neurogenic

c)

Hypovolemic

d)

Cardiogenic

13.

Hypovolemic shock is caused by:

a)

Decreased tissue perfusion due to decreased intravascular circulating volume

b)

Decreased tissue perfusion due to decreased cardiac output

c)

Inflammatory response, which is complicated by a persistent drop in blood pressure

d)

Disruption of sympathetic tone that reduces vascular resistance, dropping systemic blood pressure and reducing oxygen delivery to body tissues and organs

14.

Which of the following guidelines meets the criteria for diagnosis of an ARDS patient?

a)

PCWP of 26 cm H20

b)

PaO2/Fio2 150

c)

unilateral RLL consolidation

d)

All of the above

15.

Which of the following are associated with ARDS patients?

a)

Widening A-a gradient

b)

decreasing spontaneous Vt

c)

increasing FiO2 level requirements

d)

All of the above

16.

Which of the following are true statements about ARDS? Select all that apply

a)

most pts have no prior respiratory disease

b)

can be caused by trauma

c)

rarely causes hypoxemia

d)

typically causes fibrosis and poor lung cL

17.

Which of the following is the first and most common problem with ARDS?

a)

Ventilation

b)

Oxygenation

c)

Perfusion

d)

HbCO levels

18.

Which of the following are changes in the lungs that occur with ARDS? Select all that apply.

a)

increased capillary permeability

b)

decreased alveolar surface tension

c)

inflammation

d)

pulmonary vasodilation

19.

The main focus of management of ARDS is which of the following?

a)

Alveolar recruitment

b)

Pulmonary hygiene

c)

Retain muscle strength

d)

Normalize CO₂

20.

Which of the following may be present in an ARDS patient's CXR? Select all that apply

a)

Kerly B lines

b)

honeycomb or ground glass pattern

c)

butterfly/batwing appearance

d)

fluffy infiltrates

21.

True or False: Interstitial lung disease consists of disorders associated with the interstitium, alveolar structure and diffusion impairment

a)

true

b)

false

22.

PFTs for an ILD patient will show? Select all that apply

a)

Increased compliance

b)

Restrictive defect

c)

Decreased DLCO

d)

Increased DLCO

23.

A patient has worked for the U.S. Navy in shipyards his whole career with the armed forces. He has been complaining of a nonproductive cough and shortness of breath. Asbestosis is suspected. Which of the following procedures is recommended to help confirm a diagnosis?

a)

Bronchial alveolar lavage

b)

CT scan

c)

CBC with differential

d)

Pulmonary angiography

24.

Medical treatment of ILD is dependent on the classification. One common drug classification that is prescribed is?

a)

Corticosteroids and immunosuppressive

b)

Corticosteroids and bronchodilators

c)

Immunosuppressive and bronchodilators

d)

Chemotherapy and statins

25.

The only option for ongoing survival for some ILD patients is?

a)

Oxygen

b)

Steroids

c)

Lung transplant

d)

Exercise training

26.

Nodules seen in high-resolution CT is consistent with which ILD?

a)

Sarcoidosis

b)

Langerhans cell histiocytosis

c)

Asbestosis

d)

IPF

27.

True or False: A patient has had recent heart surgery to replace a faulty mitral valve. The patient has an irregular heartbeat and has been placed on amiodarone. This patient is at risk of developing ILD.

a)

True

b)

False

28.

True or False: A strict chronological timeline of a patient's employment is necessary when investigating ILD.

a)

True

b)

False

29.

How do postoperative pulmonary complications affect hospital length of stay?

a)

They increase hospital length of stay

b)

They decrease hospital length of stay

c)

They have no effect on hospital length of stay

30.

Which of the following surgeries will be at a higher risk for postoperative pulmonary complications?

a)

Long bone fracture

b)

Abdominal surgery

c)

Hip replacement

d)

Surgery that lasts 2 hours

31.

A male patient has a history of asthma. He takes a long-acting bronchodilator and inhaled corticosteroids. He has not used his rescue inhaler in over 3 weeks. What is the risk of postoperative pulmonary complications compared to a normal healthy adult?

a)

Increased

b)

Decreased

c)

The same

32.

True or False: Common postoperative pulmonary complications include pneumonia, chemical pneumonitis and a pleural effusion

a)

true

b)

false

33.

A patient is recovering from surgery and is still in the PACU. The patient is hypoxemic. The most likely cause is?

a)

Atelectasis

b)

Hypoventilation

c)

Pneumonia

d)

Pneumothorax

34.

Ventilator-associated pneumonia (VAP) is a result of which of the following?

a)

Atelectasis

b)

Pleural effusion

c)

Aspiration

d)

Wound infection

35.

When is the best time to teach lung expansion maneuvers, such as: coughing, incentive spirometry, voluntary deep breaths and inspiratory muscle training?

a)

before surgery

b)

after surgery

36.

What part of the brain controls automatic breathing system in the body?

a)

Parietal cortex and cerebral cortex

b)

Pons and medulla

c)

Cerebellum and pons

d)

Cerebral cortex and medulla

37.

What muscles are used for inspiration?

a)

diaphgragm

b)

internal intercostal muscles

c)

sternocleidomastoids

d)

scalene

e)

all the above

38.

Weakness of lower extremities and paresthesia of fingers and toes are the initial symptoms of Guillain-Barre.

a)

True

b)

False

39.

What is a critical factor to monitor in a patient with neuromuscular disease?

a)

Muscle strength

b)

6-minute walk distance

c)

Cough reflex

d)

Infection rate

40.

How do drugs like opiates affect the nervous system?

a)

They stimulate the central nervous system.

b)

They depress the central nervous system.

c)

They stimulate the peripheral nervous system.

d)

They depress the peripheral nervous system.

41.

Which of the following statements about ALS is true?

a)

It is a genetic recessive disorder

b)

More women than men are diagnosed

c)

It is from a bacterial infection

d)

It usually appears between ages 50 and 70

42.

What diagnostic test is used to confirm the presence of Guillian-Barre?

a)

Tensilon test

b)

CSF protein levels

c)

Edrophonium

d)

Sweat chloride test

43.

To diagnose ALS it is required that patients show which of the following?

a)

evidence of lower motor neuron degeneration on clinical, electrophysiologic, or neuropathologic exam

b)

evidence of upper neuron degeneration on clinical exam

c)

progression of motor syndrome within a region or to other regions as determined by history or exam

d)

all the above

44.

A patient has presented to the ER following a motor vehicle accident. The patient is gasping for breath and appears to be in distress. The patient has no feeling or movement in her arms or legs. Where should the healthcare team suspect the spine impairment to be?

a)

C1–C3

b)

C3–C4

c)

C6–C8

d)

T1–T4

45.

At what point in cervical injuries is the diaphragm function intact?

a)

C4

b)

C5

c)

C6

d)

C8

46.

True or False: treatment of Guillian-Barre includes plasma exchange, DVT prophylaxis and airway management if necessary

a)

true

b)

false

47.

How does muscle weakness progress in Myasthenia Gravis?

a)

it starts in the feet and moves up

b)

It starts in the head and moves down

c)

it starts in no particular area

d)

it starts in the central region and moves outwards

48.

True or False: The phrenic nerve innervates the diaphragm

a)

true

b)

false

49.

What is the primary respiratory complication in patients with a neuromuscular disease?

a)

hypoventilation and respiratory muscle weakness

b)

airway hyperresponsiveness

c)

excessive mucus production

d)

pulmonary fibrosis

50.

What is most likely to be required during the acute phase of Guillain-Barre?

a)

CPT

b)

bronchodilator therapy

c)

CPAP therapy

d)

mechanical ventilation due to muscle paralysis