Question 1.                

Which of the following patients are NOT displaying known risk factors for the development of pulmonary emboli?

A patient who is immobilized following orthopedic surgery

A patient who has impaired Cl– and Na+ regulation

A patient who is taking amiodarone for the treatment of a cardiac arrhythmia

A patient who is a smoker and takes oral contraceptives

A patient who is undergoing radiation therapy for the treatment of breast cancer


Question 2.                

A 71-year-old woman is dependent on oxygen therapy and bronchodilators due to her diagnosis of emphysema. Which of the following processes would her care team be most justified in ruling out?

Decreased elastic recoil due to alveolar damage

Decreased residual lung volume due to impaired alveolar ventilation

Increased anatomic dead space due to reduced tidal volume

Increased alveolar dead space due to incorrect intrapleural pressure


Question 3.                

As a consequence of long-standing lung disease, a patient is in a chronic state of hypoxia. Which of the following phenomena would the patient’s nurse practitioner be most justified in anticipating? Select all that apply:

Metabolic alkalosis

Increased erythropoietin production

Pulmonary vasodilation


A shift to the right of the oxygen-hemoglobin dissociation curve

Personality changes


Question 4.                

A nurse practitioner is doing the admission assessment on a patient who has been transferred to the floor after being diagnosed by the emergency room physician with bilateral pleural effusion. Which of the following findings from the nurse practitioner’s initial assessment of the patient is incongruent with the patient’s diagnosis, and would require further investigation?


The patient complains of sharp pain exacerbated by deep inspiration.

The patient’s breath sounds are diminished on auscultation.

Pulse oximetry indicates that the patient is hypoxemic.

The patient complains of dyspnea and increased work of breathing.


Question 5.                

Which of the following phenomena is most likely occurring during a child’s alveolar stage of lung development?


Terminal alveolar sacs are developing and surfactant production is beginning.

A single-capillary network exists and the lungs are capable of respiration.

The conducting airways are formed, but respiration is not yet possible.

Primitive alveoli are formed and the bronchi and bronchioles become much larger.

Question 6.                

A 21-year-old male patient has suffered a head injury during a crash on his motorcycle, and a deficit that assessments have revealed is an impaired swallowing mechanism. He has also developed aspiration pneumonia. Which of the following statements most accurately capture an aspect of his condition?

His oropharynx is obstructed.

His epiglottis is covering his larynx

His vocal folds have been compromised.

His tracheobronchial tree is intermittently obstructed.


Question 7.                

A short, nonsmoking middle-aged man presents to the emergency department with left-sided chest pain and a cough. He says that the pain started abruptly, just after lunch, and that breathing and coughing make it worse. He denies recent injury. He is breathing shallowly and rapidly and expresses fear that he may be having a heart attack. Breath sounds are normal, and he is not cyanotic. Which condition is most likely causing his symptoms?

Myocardial infarction

Spontaneous pneumothorax

Pleuritis related to infection

Obstructive atelectasis



Question 8.                

About 3 weeks after razing an old chicken house, a 71-year-old retired farmer has developed a fever, nausea, and vomiting. After ruling out more common health problems, his care provider eventually makes a diagnosis of histoplasmosis. Which of the following processes is most likely taking place?

Toxin production by Histoplasma capsulatum is triggering an immune response.

Antibody production against the offending fungi is delayed by the patient’s age and the virulence of the organism.

Spore inhalation initiates an autoimmune response that produces the associated symptoms.

Macrophages are able to remove the offending fungi from the bloodstream but can’t destroy them.


Question 9.                

Which of the following clinical findings would be most closely associated with a patient who has interstitial lung disease rather than COPD?

Audible wheezing on expiration

Diminished expiratory flow rates

Increased respiratory rate with decreased tidal volume

Normal compliance of alveolar tissue



Question 10.              

As a result of dehydration, a patient’s epithelial cells are producing insufficient amounts of mucus. Consequently, the patient’s mucociliary blanket is compromised. Which of the following changes would a care provider most reasonably anticipate as a direct result of this change?

Impaired function of the patient’s cilia

Decreased levels of oxygen saturation

Increased amounts of bacteria in the lungs

Increased carbon dioxide levels


Question 11.              

Following a winter power outage, a patient who had been using a home gasoline generator began to experience dizziness and headaches and was diagnosed with carbon monoxide poisoning. What is the goal of hyperbaric oxygen treatment for carbon monoxide poisoning?


To increase the amount of oxygen dissolved in plasma

To increase the production of unbound hemoglobin

To stimulate the release of oxygen at the capillaries

To remove bound CO from hemoglobin


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