NR 283 Exam 2

Student Name

Chamberlain University

NR-283: Pathophysiology

Prof. Name

Date

NR 283 Exam 2

A nurse finds her patient up in the middle of the night gasping for air and needing to sit or stand to catch their breath. What does this patient have?

A) Subjective Dyspnea
B) Orthopnea
C) Paroxysmal Nocturnal Dyspnea
D) Dyspnea on exertion

What is it called when a patient has a PaCO₂ greater than normal because they are not expiring enough?

A) Hypercapnia
B) Hyperventilation
C) Hypocapnia
D) Clubbing

What breathing pattern is related to strenuous exercise and presents as an increased respiratory rate with large tidal volumes?

A) Labored breathing
B) Cheyne-Stokes Respirations
C) Normal breathing
D) Kussmaul Respirations

Hypoxemia is a lack of oxygen in the tissues. True or False?

False – Hypoxemia is a lack of oxygen in the blood; hypoxia refers to tissues.

Which of the following can be a cause of hypoxemia? (select all that apply)

A) Damage to the alveolocapillary membrane
B) Atelectasis
C) Pulmonary embolus
D) Pneumonia

The presence of an excess amount of air in the pleural space causing a “one-way valve” to develop would be known as what?

A) Spontaneous Pneumothorax
B) Flail chest
C) Tension Pneumothorax
D) Atelectasis

An increased amount of pus, cellular debris, and microorganisms in the pleural space would be known as what?

A) Pulmonary edema
B) Transudative pleural effusion
C) Pneumonia
D) Empyema

A common cause of acute respiratory distress syndrome (ARDS) is:

A) Cardiac Disease
B) Renal Disease
C) Sepsis
D) Compromised Chest Wall

Why does ARDS lead to hypoxemia?

Because the alveolocapillary membrane gets injured and blood, cells, and debris enter the alveoli, causing some alveoli to collapse. These filled or collapsed alveoli cannot participate in gas exchange, so oxygen cannot reach the blood.

A nurse is educating colleagues on the pathology of emphysema. Which statement is accurate?

A) Excessive mucus production obstructs the small airways
B) Inhalation of an allergen causes bronchospasm and mucus production
C) Obstruction and air trapping results from tissue changes rather than mucus production
D) Caused by a community-acquired or nosocomial bacteria

Emphysema can be caused by which of the following? (select all that apply)

A) Cigarette smoke
B) Air pollutants
C) Increased mucus glands
D) Deficiency of an enzyme

A patient presents with fatigue, weight loss, anorexia, night sweats, and general anxiety. They have been homeless most of the last year. Which disease process is suspected?

A) Chronic Bronchitis
B) Asthma
C) Pulmonary edema
D) Tuberculosis

A pulmonary embolus commonly arises from what?

A) Pulmonary vein
B) Deep vein in the arm
C) Deep vein in the thigh
D) Pulmonary artery

Which one best describes cor pulmonale?

A) It is high pressures in the vessels of the lung
B) It will cause the left side of the heart to work harder than normal
C) It is known as pulmonary heart disease
D) Early signs include productive cough and wheezing

Oxygenated blood flows through the what?

A) Superior Vena Cava
B) Pulmonary Veins
C) Pulmonary Arteries
D) Coronary Veins

What is the equation for CO?

CO = HR × SV

What is CO telling us?
How well the heart is performing (cardiac performance).

What affects cardiac output?

• Preload
• Afterload
• Contractility
• Heart rate

Chronic venous insufficiency can progress to varicose veins. True or False?

False – It’s the opposite.

Which of the following would be part of Virchow’s Triad? (select all that apply)

A) Immobility – causes venous stasis
B) Use of birth control pills – causes hypercoagulability
C) Damage to the valves in a vein – endothelial damage

Which of the following will not increase as a result of primary hypertension?

A) Peripheral resistance
B) Circulating Volume
C) Salt and water excretion
D) Arterial vasoconstriction

NR 283 Exam 2

Malignant hypertension is a chronic form of hypertension with organ damage. True or False?

False – Malignant hypertension is the rapidly progressing form; complicated hypertension is chronic.

Which is true regarding aneurysms?

A) Most common cause is infection
B) A patient will always have symptoms with an aneurysm
C) A saccular aneurysm produces outpouching on both sides of the vessel wall
D) False aneurysms can occur related to hematoma formation

Decreasing a patient’s cholesterol can cause regression of atherosclerotic lesions and improve vessel function. True or False?

True

What is the progression of cell and plaque formation seen in atherosclerosis?

1. Macrophages move to injured vessel site
2. Eat cholesterol and become foam cells
3. Fatty streak – first plaque, group of foam cells (reversible)
4. Fibrous plaque – smooth muscle cells covering the fatty streak
5. Complicated plaque – ruptured plaque

Coronary artery disease can diminish myocardial blood supply enough to cause:

A) Infarction
B) Ischemia
C) Acute coronary syndrome
D) Inflammation

_____ angina occurs because of vasospasms of one or more coronary arteries.

A) Unstable
B) Stable
C) Silent
D) Prinzmetal

Which of these is a sign of impending cardiac death?

A) Prinzmetal angina
B) Silent ischemia
C) Unstable Angina
D) Stable Angina

Constrictive Pericarditis results in what?

A) Damage to the myocardium
B) Inflammation of the pericardium
C) Calcification of the pericardium
D) Thinning of pericardial sac

What are we most concerned about with a patient who has a pericardial effusion?

A) Increased blood pressure
B) Development of an aneurysm
C) Development of tamponade
D) Infection

Which cardiomyopathy results in increased ventricular size?

A) Hypertrophic cardiomyopathy
B) Restrictive cardiomyopathy
C) Dilated cardiomyopathy
D) Obstructive cardiomyopathy

Which disease will result in left atrial hypertrophy?

A) Aortic stenosis
B) Tricuspid Regurgitation
C) Mitral Stenosis
D) Aortic regurgitation

Which of the following results in blood returning to the left ventricle?

A) Mitral valve prolapse
B) Aortic valve stenosis
C) Mitral Valve regurgitation
D) Aortic valve regurgitation

Which of the following produces valve vegetations that can lead to emboli formation?

A) Endocarditis
B) Pericarditis
C) Myocarditis
D) Rheumatic Fever

With heart failure, left ventricular preload is:

A) Decreased
B) Increased
C) Stays the same
D) Increased, then decreased

NR 283 Exam 2

Left-sided heart failure will result in what kind of manifestations? Why?

Manifestations in the lungs – dyspnea, DOE, orthopnea, cough with frothy sputum, pulmonary edema, crackles.
Reason – The left ventricle fails, fluid backs up into the left atrium, pulmonary veins, and eventually the lungs.