Student Review Questions, Chapter 21, Assessment of Respiratory Function
1.
Which of the following terms is used to describe the inability to breathe easily except in an upright position?
Dyspnea
*Orthopnea
Hemoptysis
Hypoxemia
Patients with orthopnea are placed in a highFowler's position to facilitate breathing. Dyspnea refers to labored breathing or shortness of breath. Hemoptysis refers to expectoration of blood from the respiratory tract. Hypoxemia refers to low oxygen levels in the blood.
2.
In relation to the structure of the larynx, the cricoid cartilage is
*the only complete cartilaginous ring in the larynx.
used in vocal cord movement with the thyroid cartilage.
the largest of the cartilage structures.
the valve flap of cartilage that covers the opening to the larynx during swallowing.
The cricoid cartilage is located below the thyroid cartilage. The arytenoid cartilages are used in vocal cord movement with the thyroid cartilage. The thyroid cartilage is the largest of the cartilage structures and part of it forms the Adam's apple. The epiglottis is the valve flap of cartilage that covers the opening to the larynx during swallowing.
3.
Which respiratory volume is the maximum volume of air that can be inhaled after maximal expiration?
Tidal volume
Expiratory reserve volume
Residual volume
*Inspiratory reserve volume
Inspiratory reserve volume is normally 3000 mL. Tidal volume is the volume of air inhaled and exhaled with each breath. Expiratory reserve volume is the maximum volume of air that can be exhaled forcibly after a normal exhalation. Residual volume is the volume of air remaining in the lungs after a maximum exhalation.
4.
While conducting the physical examination during assessment of the respiratory system, which of the following conditions does a nurse assess by inspecting and palpating the trachea?
Evidence of exudate
Color of the mucous membranes
*Deviation from the midline
Evidence of muscle weakness
During the physical examination, the nurse must inspect and gently palpate the trachea to assess for placement and deviation from the midline. The nurse examines the posterior pharynx and tonsils with a tongue blade and light, and notes any evidence of swelling, inflammation, or exudate, as well as changes in color of the mucous membranes. The nurse also examines the anterior, posterior, and lateral chest walls for any evidence of muscle weakness.
5.
Which of the following clinical manifestations should a nurse monitor for during a pulmonary angiography that indicates an allergic reaction to the contrast medium?
Hematoma
Absent distal pulses
Urge to cough
*Difficulty in breathing
Nurses must determine if the patient has any allergies, particularly to iodine, shellfish, or contrast dye. During the procedure, the nurse should check for signs and symptoms of allergic reactions to the contrast medium, such as itching, hives, or difficulty in breathing.
The nurses inspects for hematoma, absent distal pulses, after the procedure. When the contrast medium is infused, patients often experience an urge to cough.
6.
A thoracentesis is performed to obtain a sample of pleural fluid or a biopsy specimen from the pleural wall for diagnostic purposes. What does serous fluid indicate?
Trauma
Infection
*Cancer
Emphysema
A thoracentesis may be performed to obtain a sample of pleural fluid or to biopsy a specimen from the pleural wall for diagnostic purposes. Serous fluid may be associated with cancer, inflammatory conditions, or heart failure. Blood fluid typically suggests trauma. Purulent fluid is diagnostic for infection. Complications that may follow a thoracentesis include pneumothorax and subcutaneous emphysema.
7.
It is important for a nurse to provide required information and appropriate explanations of diagnostic procedures to patients with respiratory disorders to
ensure adequate rest periods.
manage respiratory distress.
aid the caregivers of the patient.
*manage decreased energy levels.
In addition to the nursing management of individual tests, patients with respiratory disorders require informative and appropriate explanations of any diagnostic procedures they will experience. Nurses must remember that for many of these patients, breathing may in some way be compromised and energy levels may be decreased. For that reason, explanations should be brief, yet complete, and may need to be repeated later after a rest period. The nurse must also ensure adequate rest periods before and after the procedures. After invasive procedures, the nurse must carefully assess for signs of respiratory distress.
8.
Which of the following results in decreased gas exchange in older adults?
The alveolar walls become thicker.
*The alveolar walls contain fewer capillaries.
The elasticity of the lungs increases with age.
The number of alveoli decreases with age.
Although the number of alveoli remains stable with age, the alveolar walls become thinner and contain fewer capillaries, resulting in decreased gas exchange. The lungs also lose elasticity and become stiffer. Elasticity of lungs does not increase with age, and number of alveoli does not decrease with age.
9.
Which ventilation-perfusion ratio is exhibited by a pulmonary emboli?
Low ventilation-perfusion ratio
*Dead space
Silent unit
Normal ratio of perfusion to ventilation
When ventilation exceeds perfusion a dead space exists. An example of a dead space is pulmonary emboli. A low ventilation-perfusion ratio exists in pneumonia or with a mucus plug. A silent unit occurs in pneumothorax or ARDS.
10.
The term for the volume of air inhaled and exhaled with each breath is
residual volume.
*tidal volume.
vital capacity.
expiratory reserve volume.
Tidal volume is the volume of air inhaled and exhaled with each breath. Residual volume is the volume of air remaining in the lungs after a maximum expiration. Vital capacity is the maximum volume of air exhaled from the point of maximum inspiration. Expiratory reserve volume is the maximum volume of air that can be exhaled after a normal inhalation.
11.
High or increased compliance occurs in which disease process?
*Emphysema
Pneumothorax
Pleural effusion
ARDS
High or increased compliance occurs if the lungs have lost their elasticity and the thorax is overdistended as in emphysema. Conditions associated with decreased compliance include pneumothorax, pleural effusion, and acute respiratory distress syndrome (ARDS).
12.
In which position should the patient be placed for a thoracentesis?
Prone
*Sitting on the edge of the bed
Supine
Lateral recumbent
If possible place the patient upright or sitting on the edge of the bed with the feet supported and arms and head on a padded over-the-bed table. Other positions in which the patient could be placed include straddling a chair with arms and head resting on the back of the chair, or lying on the unaffected side with the head of the bed elevated 30 to 45 degrees if unable to assume a sitting position.
13. Which of the following is a true statement regarding air pressure variances?
Air is drawn through the trachea and bronchi into the alveoli during inspiration.
Air flows from a region of lower pressure to a region of higher pressure during inspiration.
The diaphragm contracts during inspiration.
The thoracic cavity becomes smaller during inspiration.
Air flows from a region of higher pressure to a region of lower pressure. During inspiration, movement of the diaphragm and other muscles of respiration enlarge the thoracic cavity and thereby lower the pressure inside the thorax to a level below that of atmospheric pressure.
14.
Normally, approximately what percentage of the blood pumped by the right ventricle does not perfuse the alveolar capillaries?
*2
4
6
8
Normally about 2% of the blood pumped by the right ventricle does not perfuse the alveolar capillaries. This shunted blood drains into the left side of the heart without participating in alveolar gas exchange. The other options are inaccurate.
15.
Which of the following is an age-related change associated with the respiratory system?
Increased chest muscle mass
Decreased thickening of alveolar membranes
*Decreased size of the airway
Increased elasticity of alveolar sacs
Age-related changes that occur in the respiratory system are a decrease in the size of the airway, decreased chest muscle mass, increased thickening of the alveolar membranes, and decreased elasticity of the alveolar sacs.
16.
Pink frothy sputum may be an indication of
a lung abscess.
*pulmonary edema.
an infection.
bronchiectasis.
Profuse, frothy pink material, often welling up into the throat, may indicate pulmonary edema. Foul-smelling sputum and bad breath may indicate a lung abscess, bronchiectasis, or an infection caused by fusospirochetal or other anaerobic organisms.
17.
Which of the following is a deformity of the chest that occurs as a result of overinflation of the lungs?
Funnel chest
Pigeon chest
*Barrel chest
Kyphoscoliosis
A barrel chest occurs as a result of overinflation of the lungs. There is an increase in the anteroposterior diameter of the thorax. Funnel chest occurs when there is a depression in the lower portion of the sternum, which may result in murmurs. Pigeon chest occurs as a result of displacement of the sternum resulting in an increase in the anteroposterior diameter. Kyphoscoliosis is characterized by elevation of the scapula and a corresponding S-shaped spine.This deformity limits lung expansion within the thorax.
18.
Bradypnea is associated with which of the following conditions?
*Increased intracranial pressure
Pneumonia
Metabolic acidosis
Pulmonary edema
Bradypnea is associated with increased intracranial pressure. Tachypnea is commonly seen in patients with pneumonia, pulmonary edema, and metabolic acidosis.
19.
Which diagnostic is more accurate in detecting malignancies than a CT scan?
*PET scan
Gallium scan
MRI
Pulmonary angiography
A PET scan is more accurate in detecting malignancies than a CT scan, and it has equivalent accuracy in detecting malignant nodules when compared with invasive procedures such as thorascopy. The gallium scan is used to stage bronchogenic cancer and document tumor regression after chemotherapy or radiation. An MRI is used to characterize pulmonary nodules, to help stage bronchogenic carcinoma, and to evaluate inflammatory activity in interstitial lung disease. Pulmonary angiography is used to investigate thromboembolic disease of the lungs.