Answer each of the
following questions (there is only one correct answer to each question).
1
Beyond the bronchioles there is a phospholipid film
which lowers surface tension and lines the
A. Epithelium
B. Septal tissue
C. Surfactant
D. Macrophages
2
Adjacent lobules are connected by alveolar pores called:
A. Pores of Kohn
B. Fibrous pores
C. Alveolar ducts
D. Terminal sacs
3
Chronic bronchitis is characterized by:
A. Overinflation
B. A cough lasting a minimum of 3 months per
year for two consecutive years
C. Allergic reactions
D. Three-tiered mucus
4
Patients with alpha-1 antitrypsin deficiency display:
A. Centrilobular emphysema
B. Paracicatricial emphysema
C. Valves and bullae
D. Panlobular emphysema
5
Bronchiectasis includes the following classifications:
A. Saccular
B. Cystic
C. Tubular
D. All the above
6
The #1 etiology for emphysema is:
A. Smoking
B. Allergies
C. Occupational exposure
D. Recurrent infection
7
What is the control center for respiratory rhythmicity?
A. Pons
B. Medulla oblongata
C. Cortex
D. Spinal column
8
The pneumotaxic center is located where?
A. Cortex
B. Medulla
C. Pons
D. Muscle spindles
9
The chemosensitive areas are located in:
A. Peripheral chemoreceptors
B. The medulla
C. Respiratory muscles
D. None of the above
10
Elevated PaCO2 is called:
A. Hypoxia
B. Hypercapnia
C. Venous admixture
D. Shunt
11
Severe arterial hypoxemia caused increased production
of erythropoietin resulting in:
A. Erythrocytosis
B. Increased hemoglobin
C. Increased blood volume
D. All the above
12
Adventitious breath sounds include:
A. Vesicular
B. Rales
C. Bronchiolar
D. Bronchovesicular
13
A V/Q Scan checks:
A. Hypoxia
B. Arterial gradient
C. Ventilation and perfusion
D. Transpulmonary pressure
14
Severe COPDers will have low
A. PaCO2
B. PaO2
C. Serum bicarbonate
D. All of the above
15
Hyperresonant chest is caused by:
A. Increased AP (anterior-posterior) diameter
B. Vesicular breath sounds
C. Gastric reflux
D. Decreased respiration
16
Deteriorating ABGs cause:
A. Decreased mental acuity
B. Headache
C. Insomnia
D. All the above
17
Which of the following symptoms are present in COPD:
A. Easily fatigued
B. Headache
C. Insomnia
D. All the above
18
Bronchiectasis is only confirmed by:
A. Bronchogram
B. X-ray
C. No improvement despite treatments
D. Allergies
19
Can COPDers have normal chest X-rays?
A. Yes, essentially
B. No
C. Never
D. Only at apneusis
20
Fluoroscopy is helpful in detecting:
A. Ventricular failure
B. COPD
C. Clots
D. Ventricular enlargement
21
The EKG of a severe COPDer with CHF & cor pulmonale
will most likely show:
A. Right ventricular failure
B. P pulmonale
C. Atrial fib or flutter
D. No significant change
22
Pulse oximetry is:
A. Invasive
B. Non-invasive
C. Expensive
D. Difficult to obtain
23
The nurse would not teach the COPD/CHF client about
the following:
A. Symptoms of heart failure
B. Signs of infection
C. Added salt diet
D. Symptoms of ulcers
24
The client asks you if he should relocate to Arizona
to help his breathing ... what would you advise?
A. Low pollution
B. Low elevation
C. A & B above
D. None of the above
25
Which of the following is an experimental drug for COPD?
A. RU 484
B. OM -85 BV
C. Prednisone
D. Intal
The
following section deals with critical thinking in clinical situations.
26
You are working as a telephonic nurse and a client calls
to tell you he is 18 years old, has asthma and has noticed some increased
difficulty breathing since he returned from a school field trip to a
wildflower center earlier in the day. You might suspect:
A. Narrowing of the airways due to exposure to
plant pollen
B. Progression of his disease to emphysema
C. Previously undiagnosed Kartagener's syndrome
D. Congestive heart failure
27
Today was your day to screen incoming calls to your
Family Practice office. Cheri, a 28-year-old smoker, calls to report
thick green sputum for 2 days. You locate her chart and discover she
has been complaining about a "smoker's cough" for 3 years. You schedule
an appointment and suspect:
A. Chronic bronchitis
B. Asthma
C. Emphysema
D. Bronchiectasis
28
Claire has been feature twirler at high school for 3
years and has had 5 admissions with pneumonia. She has lost weight and
complains of a constant sinus infection. Her sputum is frothy green
and she jokes that it looks like tiered Jell-O. You would suspect:
A. Asthma
B. Bronchitis
C. Bronchiectasis
D. Emphysema
29
A mom recently had a liver transplant for a blood enzyme
deficiency and they asked her to be genetically tested. She works as
a detective and has been experiencing extreme shortness of breath on
exertion. She calls you to schedule an appointment and said her doctor
said the test was necessary because her condition could affect her lungs,
liver, or GI tract. What would you suspect?
A. Alpha-1 antitrypsin deficiency
B. Panlobular emphysema
C. Bronchiectasis
D. A & B
30
A patient arrives to your floor from ER and has a SaO2
of 80%. You have a standard order for 2-6 L O2
PRN. The transporter places him on 6 liters oxygen and takes him to
X-ray stat. He comes back from X-ray and appears lethargic, agitated,
and somewhat tired and confused. While he was in X-ray you were faxed
a baseline arterial blood gas with a PaO2 of 55.
When he first arrived his respirations were 44; now, after the X-ray,
he is diaphoretic with a rate of 12. You should:2
to 2-3 L
A. II, I, III, IV
B. III, II, I, IV
C. II
D. IV, I
Evaluation Thank you for
choosing the National Center!
