Download NSG-530 QUIZ 2 2024-2025 QUESTIONS AND DETAILED ANSWERS WITH RATIONALES| NSG 530 STUDYGUID and more Exams Nursing in PDF only on Docsity!
NSG-530 QUIZ 2 2024 - 2025 QUESTIONS
AND DETAILED ANSWERS WITH
RATIONALES| NSG 530 STUDYGUIDE
alveoli epithelial cells Correct Answer Type I alveolar cells (alveolar structure) Type II alveolar cells (surfactant production) 1.Which of the following is TRUE regarding the pulmonary system? A.Each lobe is divided into bronchi. B.The left lobe is divided into three lobes. C.The mediastinum contains the lungs and heart. D.The larynx connects the upper and lower airways. Correct Answer Correct Answer: D The larynx connects the upper and lower airways. The mediastinum is located between the lungs and contains the heart, great vessels, andesophagus. The right lung has three lobes, and the left lung has two. Each lobe is divided into segments and lobules Neurochemical control: Respiratory center Correct Answer •Dorsal and ventral respiratory groups •Pneumotaxic and apneustic centers Neurochemical control: Lung receptors Correct Answer •Irritant receptors •Stretch receptors
Neurochemical control: Chemoreceptors: Correct Answer Central chemoreceptors Peripheral chemoreceptors Muscles of Breathing: Major muscles of inspiration Correct Answer Diaphragm External intercostals Muscles of Breathing: Accessory muscles of inspiration Correct Answer ØSternocleidomastoid muscle ØScalene muscles Mechanics of Breathing: Gas Transport Correct Answer Four steps ØVentilation of the lungs ØDiffusion of oxygen from the alveoli into the capillary blood ØPerfusion of systemic capillaries with oxygenated blood ØDiffusion of oxygen from systemic capillaries into the cells Diffusion of CO2 occurs in reverse order 1.A patient has bulbous enlargement of the distal segments of the fingers. Which disease is associated with this condition? A.Cystic fibrosis B.Acute pneumonia C.Sickle cell disease D.Acute myocardial infarction Correct Answer A This condition describes clubbing, in which there is enlargement of the distal segment of the finger. It is associated with conditions of decreased oxygenation such as bronchiectasis, cystic fibrosis, pulmonary fibrosis, lung abscess, and congenital heart disease. Open pneumothorax Correct Answer An open wound to the chest that allows air to enter the pleural space and cause lung collapse
B.It can cause severe pulmonary edema. C.It is most commonly caused by exposure to inhaled irritants. D.Macrophages are not involved in response. Correct Answer Correct Answer: B Acute respiratory distress syndrome (ARDS) is characterized by damage that is done to the alveolar capillary membrane and causes severe pulmonary edema. The most common cause of ARDS is either sepsis or multiple trauma. Macrophages, neutrophils, complement, and endotoxins are all important mediators. Asthma Correct Answer ØChronic inflammation of the airways ØCauses bronchial hyperresponsiveness, constriction of airways, and reversible airflow obstruction ØPulsus paradoxus, status asthmaticus ØSymptoms include expiratory wheezing, dyspnea, and tachypnea ØPeak flow meters, corticosteroids, beta agonist inhalers, and anti-inflammatories used to treat Obstructive Lung Diseases: Emphysema Correct Answer ØAbnormal permanent enlargement of the gas-exchange airways accompanied by destruction of alveolar walls without obvious fibrosis ØInherited deficit of α1-antitrypsin ØLoss of elastic recoil ØAir trapping 3.Which of the following is TRUE regarding the pathophysiology of asthma? A.IgA is the major factor. B.There is decreased vascular permeability. C.Inflammation results in hyperresponsiveness.
D.The inflammatory process is caused by the loss of bronchial smooth muscle spasm. Correct Answer Correct Answer: C Asthma is caused by increased bronchial smooth muscle spasm and increased vascular permeability. IgE is the major factor. There is increased capillary permeability. Inflammatory mediators cause vasodilation, increased capillary permeability, mucosal edema, bronchial smooth muscle contraction (bronchospasm), and mucus secretion from mucosal goblet cells with narrowing of the airways and obstruction to airflow. Acute bronchitis Correct Answer ØAcute infection or inflammation of the airways or bronchi ØCommonly follows a viral illness ØAcute bronchitis causes symptoms similar tothose of pneumonia but does not demonstrate pulmonary consolidation and chest infiltrates Pneumonia Correct Answer ØLower respiratory tract infection ØCaused by bacteria, viruses, fungi, protozoa, or parasites ØTypes: •Community acquired (CAP) Streptococcus pneumoniae Influenza •Healthcare acquired (HCAP) •Ventilator-associated (VAP) Lung cancer Correct Answer ØNearly 80% caused by cigarette smoking •Smokers with COPD have even greater risk ØEnvironmental, occupational, and genetic risk factors are also associated ØTypes: •Non-small cell cancer: Squamous cell carcinoma
airways and alveoli caused by viruses and bacteria. Aspiration pneumonia is caused by a foreign substance entering the lung and causing inflammation. IgE antibodies Correct Answer response to environmental antigens, allergies Seasonal allergic rhinitis - watery itchy eyes, runny nose, congestion active immunity Correct Answer immunization or exposure to antigen Vaccine types: inactive antigen, killed organism, requires booster attenuated antigen, reducing the virulence (causes disease) of a pathogen, but still keeping it viable or "alive" Humoral Immunity Correct Answer body produces a special kind of antibodies, called immunoglobulin E (IgE), to the antigen Immediate hypersensitivity, example, hay fever or allergic rhinitis, bee sting cell-mediated immunity Correct Answer type of immunity produced by T cells that attack infected or abnormal body cells
- immune response not involving antibodies
- involves the activation of phagocytes, antigen-specific cytotoxic T-lymphocytes, & release of various cytokines responding to an antigen
- Delayed hypersensitivity example, allergic contact dermatitis, may take hours or days before obvious poison ivy from touching contaminated person or thing Deficiencies in Immunity Primary caused by genetic defect Correct Answer DiGeorge Syndrome - velocardiofacial syndrome, 22q11. 2 deletion syndrome Color blindness most frequently in males on X chromosome!
Deficiencies in Immunity Secondary or acquired immune deficiency Correct Answer Caused by another condition Cancer, AIDS, infection, Diabetes, LupusErythematosis Autoimmune Diseases Correct Answer Elevated antinuclear antibody may indicate autoimmune disease systemic lupus erythematosus (SLE) Correct Answer autoimmune disease in which immune system attacks connective tissue throughout body such as in joints and skin. Ankylosing Spondylitis (AS) Correct Answer a form of rheumatoid arthritis that primarily causes inflammation of the joints between the vertebrae Multiple Sclerosis (MS) Correct Answer disease of the central nervous system characterized by the demyelination (deterioration of the myelin sheath) of nerve fibers, with episodes of neurologic dysfunction (exacerbation) followed by recovery (remission) myasthenia gravis Correct Answer autoimmune neuromuscular disorder characterized by weakness of voluntary muscles rheumatoid arthritis (RA) Correct Answer chronic joint condition with inflammation and pain; caused by an autoimmune reaction against joint tissue, particularly the synovial membrane Sarcoidosis Correct Answer autoimmune disease with fibrous lesions forming in lymph nodes, liver, skin, lungs, spleen, eyes, and small bones of hands and feet celiac disease Correct Answer malabsorption syndrome caused by an immune reaction to gluten
Clinical Manifestations of Cancer Correct Answer - Pain - obstruction, pressure, tissue destruction
- Fatigue - malnutrition, anemia
- Cachexia - severe malnutrition
- Anemia - blood forming cells affected, malnutrition
- Leukopenia - direct tumor invasion to the bone marrow Vascular Disease: Veins Correct Answer 1. Venous insufficiency - valves don't work examples and signs
- varicose - bulging, tortuous, venous stasis ulcers, skin hyperpigmentation & edema
- thrombus & vena cava syndrome (emergent)
- Lower leg pain with swelling and redness - think thrombus! Vascular Disease: Arteries Correct Answer Primary HBP, essential or idiopathic HBP, secondary HBP and complicated HBP Vascular Disease: Diseases of the arteries and veins Correct Answer - Orthostatic (postural) hypotension - light headed or fainting
- Aneurysm - abdominal most common
- Thrombus and embolism Vascular Disease: Peripheral Artery Disease Correct Answer Burgers or Raynaud's syndrome Vascular Disease: Arteriosclerosis Correct Answer thickening, loss of compliance most common cause of myocardial ischemia (MI) coronary artery disease Correct Answer 1. atherosclerosis of the coronary arteries that reduces the blood supply to the heart muscle
- Myocardial ischemia most common cause atherosclerosis
uMyocardial infarction (MI)
- Cellular injury, cellular death, structural and functional changes and repair
- Atherosclerotic changes with vessel obstruction
- Symptoms: sudden severe chest pain, radiates, nausea, vomiting, diaphoresis & dyspnea
- Diagnosing history, physical exam, ECG, serial cardiac troponin elevations
- Cardiac troponin I (cTnI) most specific indicator of MI
- cTnI detected 2-4 hrs after onset of symptoms Disorders of Endocardium (thin, smooth membrane lines inside chambers forms surface of the valves) Correct Answer 1. Valvular Dysfunction - regurgitation A. Aortic regurgitation/insufficiency aortic valve's/leaflets do not close completely
- heard best - patient sits up & forward stethoscope on left (Erb's point, at the 3rd intercostal space ) at end expiration
- Symptoms, widened pulse pressure, prominent carotid pulsations and bounding or throbbing peripheral pulses (Corrigan pulse) B. Mitral valve prolapse - one or both of cusps do not close completely
- heard best - at the apex & sounds like mid-systolic click, followed by a late systolic murmur
- most common valve disease & most frequently in woman
- Rheumatic Heart Disease
- Acute infection with group A B-hemolytic streptococcus infection
- Vegetations on mitral valve
- Can start with untreated strept throat Left ventricular failure called Congestive Failure Correct Answer - Reduced ejection fraction called systolic failure - heart looses pumping ability
- Heart failure with preserved ejection fraction called diastolic failure - heart walls stiffen, unable to relax
renin-angiotensin-aldosterone system (RAAS) Correct Answer a coordinated system of hormones that regulate the body's blood pressure and water balance. https://www.youtube.com/watch?v=M0vpn6YVwiI systolic pressure Correct Answer 1. left ventricle ejects blood into the aorta & aortic pressure rises and reaches maximal aortic pressure
- Aorta compliance (stretch or stiffness) effects systolic pressure
- Aneurism stretched aorta causes falling BP
- Rigidity, stiffness causes increased BP Diastolic pressure Correct Answer - The lowest pressure in the aorta, occurs just before the ventricle ejects blood into the aorta pulse pressure Correct Answer - Difference between systolic & diastolic pressures
- Typically ranges between 40 and 50 mmHg Congenital heart disease (CHD Correct Answer 1. Left right shunt such as atrial (ASD) or ventricle septal defects (VSD)
- Patent ductus arteriosus (PDA) artery connect aorta & pulmonary artery allowing left to right shunt
- Atrial and ventricle septal defects opening in septal wall
- VSD most common cardiac congenital defect
- Tetralogy of Fallot most common cyanotic, hypoxic heart defect
- Obstructive defects
- Coarcation of the aorta - weak or absent femoral pulses
- Aortic stenosis - narrowing or stricture of the outlet of the left ventricle
- Pulmonic stenosis- narrowing or stricture of pulmonary valve
- CHD and genetic factors occur in trisomy (13,18,21),Turner, Down and cri du chat syndrome
- Down Syndrome and Trisomy 21 may have - AVSD: atrioventricular septal defect; VSD: ventricular septal defect. ARDS (acute respiratory distress syndrome) Correct Answer 1. ARDS - swelling of lungs causing tiny blood vessels to leak fluid & alveoli collapse or fill with fluid, preventing the lungs from working
- Alvelolocapillary membrane injury cause inflammatory response
- Signs and symptoms: •Severe SOB •labored breathing •tachypnea •low BP •confusion & exhaustion •Causes direct injuries: pneumonia, aspiration, chest injury. Indirect injuries include: sepsis, severe injury causing low BP, pancreatitis. Cystic Fibrosis Correct Answer 1. complicated multisystem disorder: lungs, digestive enzymes, missing vas deferens (95% males)
- Autosomal-recessive disease
- Diagnostic lab includes the Sweat test - excess sodium chloride
- Transmembrane conductance regulator (CFTR) protein is either not made or incorrectly made --Chloride channel transports across membrane of cells producing: mucus, sweat, saliva, tears, and digestive enzymes. u Emphysema Correct Answer 1. Emphysema risk factors
- Smoking causes emphysema --the most preventable cause
