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Worksheets1500 exam 3 review (5,18,19,21,22,4)
Total questions: 50
Worksheet time: 37mins
What effect do disorders of the pleura have on the lungs?
Increase lung compliance
Increase airway resistance
Decrease lung compliance
Decrease airway resistance
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?
Right-sided pneumothorax
Right-sided hemothorax
Left-sided pneumothorax
Left-sided pneumonia
A patient has a chest wound and has developed an open pneumothorax. The air in the pleural space is from the:
Lungs
Stomach
Atmosphere
Paradoxical chest movement is associated with which of the following?
Pneumothorax
Flail chest
Pleural effusion
Pleurisy
Cardiac tamponade can cause which of the following?
Pulmonary emboli
Pulsus alternans
Bradycardia
hypotension
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
pulmonary embolism
ARDS
asthma
all the above
Initial evaluation of a trauma victim should include which of the following? Select all that apply
breathing effort
chest symmetry
lung scan
CXR
A patient is suspected of having a tension pneumothorax. What should the physician do first?
Obtain a chest radiograph
Obtain CT of chest
Placement of chest tube
Perform needle decompression of the chest
What is the definition of shock?
State of hypothermia
State of organ hypoperfusion
Reactive state to sudden change
A patient that was involved in a motor vehicle accident is this patient likely to suffer from what type of shock?
Hypovolemic
Cardiogenic
Neurogenic
Distributive
Chest trauma that causes aortic rupture typically results in?
Prolonged coma
Quick death
Progressive neuromuscular degeneration
Little effect on the patient
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?
Anaphylactic
Neurogenic
Hypovolemic
Cardiogenic
Hypovolemic shock is caused by:
Decreased tissue perfusion due to decreased intravascular circulating volume
Decreased tissue perfusion due to decreased cardiac output
Inflammatory response, which is complicated by a persistent drop in blood pressure
Disruption of sympathetic tone that reduces vascular resistance, dropping systemic blood pressure and reducing oxygen delivery to body tissues and organs
Which of the following guidelines meets the criteria for diagnosis of an ARDS patient?
PCWP of 26 cm H20
PaO2/Fio2 150
unilateral RLL consolidation
All of the above
Which of the following are associated with ARDS patients?
Widening A-a gradient
decreasing spontaneous Vt
increasing FiO2 level requirements
All of the above
Which of the following are true statements about ARDS? Select all that apply
most pts have no prior respiratory disease
can be caused by trauma
rarely causes hypoxemia
typically causes fibrosis and poor lung cL
Which of the following is the first and most common problem with ARDS?
Ventilation
Oxygenation
Perfusion
HbCO levels
Which of the following are changes in the lungs that occur with ARDS? Select all that apply.
increased capillary permeability
decreased alveolar surface tension
inflammation
pulmonary vasodilation
The main focus of management of ARDS is which of the following?
Alveolar recruitment
Pulmonary hygiene
Retain muscle strength
Normalize CO₂
Which of the following may be present in an ARDS patient's CXR? Select all that apply
Kerly B lines
honeycomb or ground glass pattern
butterfly/batwing appearance
fluffy infiltrates
True or False: Interstitial lung disease consists of disorders associated with the interstitium, alveolar structure and diffusion impairment
true
false
PFTs for an ILD patient will show? Select all that apply
Increased compliance
Restrictive defect
Decreased DLCO
Increased DLCO
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?
Bronchial alveolar lavage
CT scan
CBC with differential
Pulmonary angiography
Medical treatment of ILD is dependent on the classification. One common drug classification that is prescribed is?
Corticosteroids and immunosuppressive
Corticosteroids and bronchodilators
Immunosuppressive and bronchodilators
Chemotherapy and statins
The only option for ongoing survival for some ILD patients is?
Oxygen
Steroids
Lung transplant
Exercise training
Nodules seen in high-resolution CT is consistent with which ILD?
Sarcoidosis
Langerhans cell histiocytosis
Asbestosis
IPF
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.
True
False
True or False: A strict chronological timeline of a patient's employment is necessary when investigating ILD.
True
False
How do postoperative pulmonary complications affect hospital length of stay?
They increase hospital length of stay
They decrease hospital length of stay
They have no effect on hospital length of stay
Which of the following surgeries will be at a higher risk for postoperative pulmonary complications?
Long bone fracture
Abdominal surgery
Hip replacement
Surgery that lasts 2 hours
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?
Increased
Decreased
The same
True or False: Common postoperative pulmonary complications include pneumonia, chemical pneumonitis and a pleural effusion
true
false
A patient is recovering from surgery and is still in the PACU. The patient is hypoxemic. The most likely cause is?
Atelectasis
Hypoventilation
Pneumonia
Pneumothorax
Ventilator-associated pneumonia (VAP) is a result of which of the following?
Atelectasis
Pleural effusion
Aspiration
Wound infection
When is the best time to teach lung expansion maneuvers, such as: coughing, incentive spirometry, voluntary deep breaths and inspiratory muscle training?
before surgery
after surgery
What part of the brain controls automatic breathing system in the body?
Parietal cortex and cerebral cortex
Pons and medulla
Cerebellum and pons
Cerebral cortex and medulla
What muscles are used for inspiration?
diaphgragm
internal intercostal muscles
sternocleidomastoids
scalene
all the above
Weakness of lower extremities and paresthesia of fingers and toes are the initial symptoms of Guillain-Barre.
True
False
What is a critical factor to monitor in a patient with neuromuscular disease?
Muscle strength
6-minute walk distance
Cough reflex
Infection rate
How do drugs like opiates affect the nervous system?
They stimulate the central nervous system.
They depress the central nervous system.
They stimulate the peripheral nervous system.
They depress the peripheral nervous system.
Which of the following statements about ALS is true?
It is a genetic recessive disorder
More women than men are diagnosed
It is from a bacterial infection
It usually appears between ages 50 and 70
What diagnostic test is used to confirm the presence of Guillian-Barre?
Tensilon test
CSF protein levels
Edrophonium
Sweat chloride test
To diagnose ALS it is required that patients show which of the following?
evidence of lower motor neuron degeneration on clinical, electrophysiologic, or neuropathologic exam
evidence of upper neuron degeneration on clinical exam
progression of motor syndrome within a region or to other regions as determined by history or exam
all the above
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?
C1–C3
C3–C4
C6–C8
T1–T4
At what point in cervical injuries is the diaphragm function intact?
C4
C5
C6
C8
True or False: treatment of Guillian-Barre includes plasma exchange, DVT prophylaxis and airway management if necessary
true
false
How does muscle weakness progress in Myasthenia Gravis?
it starts in the feet and moves up
It starts in the head and moves down
it starts in no particular area
it starts in the central region and moves outwards
True or False: The phrenic nerve innervates the diaphragm
true
false
What is the primary respiratory complication in patients with a neuromuscular disease?
hypoventilation and respiratory muscle weakness
airway hyperresponsiveness
excessive mucus production
pulmonary fibrosis
What is most likely to be required during the acute phase of Guillain-Barre?
CPT
bronchodilator therapy
CPAP therapy
mechanical ventilation due to muscle paralysis
