Question 1

Hyaline membrane disease of an infant is due to deficiency of surfactant and the source of pulmonary surfactant is?

Accepted Answer

Answer reason: In neonatal respiratory distress (hyaline membrane disease), insufficient surfactant increases surface tension, causing alveolar collapse (atelectasis), decreased lung compliance, and impaired gas exchange. Type I pneumocytes primarily provide the thin diffusion barrier for oxygen and carbon dioxide and do not produce surfactant. Alveolar macrophages and capillary endothelium have immune and vascular roles, respectively, rather than surfactant production.

Question 2

Cough is a symptom of?

Accepted Answer

Answer reason: Pulmonary tuberculosis commonly presents with a persistent cough that may be productive and can be associated with systemic symptoms such as fever, night sweats, and weight loss. In contrast, diabetes, anemia, and hypertension do not primarily produce cough as a typical presenting symptom. While some medications (e.g., ACE inhibitors) can cause cough, that is not the condition asked among these options.

Question 3

Which finding would be the most characteristic of an acute episode of reactive airway disease?

Accepted Answer

Answer reason: This produces turbulent airflow during expiration, heard clinically as expiratory wheezing. Stridor is an inspiratory, upper-airway sound suggesting laryngeal/tracheal obstruction rather than bronchospasm. Gurgling more often reflects pooled secretions in larger airways, and dry cough can occur in asthma but is less specific than expiratory wheeze for an acute bronchospastic episode.

Question 4

A 2 year-old child has just been diagnosed with cystic fibrosis. The child's father asks the nurse "What is our major concern now, and what will we have to deal with in the future?" Which of the following is the best response?

Accepted Answer

Answer reason: The core problem in cystic fibrosis is defective chloride transport leading to dehydrated, thick mucus that obstructs airways and predisposes to chronic infection and progressive lung damage. This makes ongoing pulmonary hygiene and management of retained secretions the central long-term challenge and the major driver of morbidity. Nutritional issues are important but are secondary to the fundamental pathophysiology and are often manageable with enzyme replacement and high-calorie diets. The other choices are either too vague, overly reassuring, or focus on support resources rather than answering the father’s question about the main future health concern.

Question 5

A 38 year-old female client is admitted to the hospital with an acute exacerbation of asthma. This is her third admission for asthma in 7 months. She describes how she doesn't really like having to use her medications all the time. Which explanation by the nurse best describes the long-term consequence of uncontrolled airway inflammation?

Accepted Answer

Answer reason: This leads to fixed airflow limitation and a progressive decline in pulmonary function, especially when controller therapy is underused and exacerbations recur. Alveolar degeneration is more characteristic of emphysema rather than asthma’s primary pathology. Bronchoconstriction is a key acute feature, but the long-term consequence being tested is irreversible airway remodeling from chronic inflammation.

Question 6

Deficiency of Oxygen into Blood is called?

Accepted Answer

Answer reason: This is distinct from hypoxia, which is inadequate oxygen at the tissue level and can occur even with normal PaO2 (e.g., anemia or cyanide poisoning). The stem specifically points to oxygen deficiency “into blood,” aligning with impaired oxygenation of arterial blood. The other options relate to different abnormalities (low hemoglobin/“anemia” concept and low body temperature) and do not describe low blood oxygen.

Question 7

Asthma What are the symptoms of asthma?

Accepted Answer

Answer reason: Airflow limitation causes musical expiratory sounds due to narrowed airways and can also create a sense of chest constriction from increased work of breathing and air trapping. Sneezing is more typical of allergic rhinitis/upper-airway irritation and is not a hallmark symptom used to define asthma episodes. Therefore, the combination of chest tightness and wheezing best matches typical asthma symptomatology.

Question 8

Lungs have large number of narrow tubes called ________

Accepted Answer

Answer reason: The conducting airways branch repeatedly from bronchi into progressively smaller tubes that distribute air throughout the lungs. These small-caliber passages are bronchioles, which lack cartilage and regulate airflow via smooth muscle tone. Alveoli are microscopic air sacs for gas exchange, not tubes. The trachea and bronchi are larger airways and are not present in the lungs in the same large, numerous, narrow-tube network as bronchioles.

Question 9

You are caring for a patient who is in diabetic ketoacidosis. You observe the patient in Kussmaul respiration. What are Kussmaul respirations?

Accepted Answer

Answer reason: It is characterized by deep (increased tidal volume), rapid-to-increased rate, and typically regular respirations reflecting a sustained drive to “blow off” CO2. The description that captures depth, regularity, and increased ventilatory effort best matches this mechanism. Slow regular respirations suggest bradypnea, and periods of apnea are more consistent with Cheyne-Stokes/central dysregulation rather than metabolic acidosis compensation.

Question 10

Which of following allows air to pass into the lungs..?

Accepted Answer

Answer reason: The structure that provides this direct passage is the trachea, a cartilaginous tube that bifurcates into the right and left main bronchi. The esophagus transports food to the stomach, not air. The aorta and heart are cardiovascular structures involved in blood flow rather than ventilation.

Question 11

Which of the following forms of hypoxemia is not corrected by O2 administration?

Accepted Answer

Answer reason: In a right-to-left shunt, a portion of venous blood reaches the arterial circulation without contacting alveolar gas, creating refractory hypoxemia. This makes hypoxemia from true shunt relatively unresponsive to increased FiO2 compared with other mechanisms. By contrast, hypoventilation, diffusion limitation, and V/Q mismatch in poorly ventilated regions typically improve when alveolar PO2 is increased with oxygen therapy.

Question 12

A pediatric patient has been diagnosed with right lower lobe pneumonia. Upon auscultation of this lung field, the healthcare provider should expect to hear which breath sounds?

Accepted Answer

Answer reason: This produces discontinuous, fine “popping” sounds that are typically localized over the affected lobe. Rhonchi are more consistent with larger-airway secretions and may clear with coughing, making them less specific for lobar alveolar consolidation. Stridor indicates upper-airway obstruction, and wheezes more often reflect bronchospasm or narrowed bronchioles rather than alveolar infection.

Question 13

Treatment of choice for tension pneumothorax in immediate condition?

Accepted Answer

Answer reason: The urgent priority is rapid decompression to relieve pressure before definitive tube thoracostomy can be placed. Needle decompression (needle drainage) provides the fastest bedside method to convert a tension pneumothorax into a simple pneumothorax and restore cardiopulmonary stability. An intercostal chest drain is definitive management but is typically performed after immediate decompression rather than as the first time-critical step. Airway suctioning and postural drainage do not address pleural air under pressure and therefore do not treat the underlying emergency.

Question 14

Most common and dangerous complication associated with influenza?

Accepted Answer

Answer reason: This complication is a major driver of ICU admission and mortality, especially in older adults, pregnant patients, and those with cardiopulmonary comorbidities. Otitis media is a frequent complication mainly in children but is typically not life-threatening. Reye syndrome and Guillain-Barré syndrome are rare post-infectious complications compared with the burden and lethality of influenza-associated pneumonia.

Question 15

Exchange of gases takes place in which of the following organ?

Accepted Answer

Answer reason: This process relies on ventilation, perfusion, and partial pressure gradients, which are core functions of the respiratory organs. The kidney, liver, and heart have critical roles in filtration/metabolism and circulation, but none provide an alveolar-capillary surface for diffusion. Therefore the organ responsible for physiologic gas exchange is the respiratory organ containing alveoli.

Question 16

A nurse is caring for a client who is experiencing an anxiety attack. The client presents with hyperventilation, tachypnea, breath, and dizziness. Which of the following conditions is expected?

Accepted Answer

Answer reason: Anxiety/panic attacks commonly trigger tachypnea leading to hypocapnia, cerebral vasoconstriction, and symptoms such as dizziness and lightheadedness. Respiratory acidosis would require CO2 retention from hypoventilation, which is the opposite of the presentation. Metabolic causes are not the primary disturbance when the initiating problem is rapid breathing with CO2 loss.

Question 17

Most common problem in preterm baby is ....?

Accepted Answer

Answer reason: This predisposes them to respiratory distress syndrome and apnea of prematurity, making breathing issues the most frequent and immediate clinical problem after birth. While prematurity is also associated with cardiac issues (e.g., PDA) and eye complications (e.g., ROP), these are generally less universally present than early respiratory compromise. Renal immaturity can affect fluid and electrolyte handling, but it is typically not the most common presenting problem compared with respiratory instability. Therefore the best answer is the option focused on breathing difficulty.

Question 18

A home health nurse visits a patient with chronic obstructive pulmonary disease (COPD) using home oxygen at 2 liters per minute. The patient reports periods of shortness of breath and inquires about increasing the oxygen to 4 liters/minute. The nurse explains that increasing the supplemental oxygen will?

Accepted Answer

Answer reason: Increasing supplemental oxygen can raise PaO2 enough to reduce this hypoxic ventilatory stimulus, leading to decreased respiratory drive and hypoventilation. This can worsen hypercapnia and respiratory acidosis (oxygen-induced hypercapnia), which is the key safety concern when increasing flow without assessment or prescription. Options suggesting symptom relief or infection prevention are not reliable physiologic effects and may obscure the risk of CO2 narcosis and ventilatory failure.

Question 19

Lack of oxygen in newborn may cause?

Accepted Answer

Answer reason: The term for severe oxygen deprivation with resultant impaired respiration is asphyxia, commonly discussed as perinatal/neonatal asphyxia. Dysphagia refers to swallowing difficulty and is not a direct consequence term for low blood oxygen. Dyspepsia is indigestion, and acyanosis means absence of cyanosis (the opposite of what hypoxia tends to produce), so they do not fit the physiology of oxygen lack.

Question 20

An acute, severe prolonged asthmatic attack that is not responsive to usual treatment is referred to as which of the following?

Accepted Answer

Answer reason: The key differentiator is refractoriness to usual treatment with ongoing airflow obstruction, air trapping, and increasing work of breathing. In contrast, “mild intermittent,” “moderate persistent,” and “severe persistent” are chronic severity classifications based on symptom frequency and baseline lung function, not an acute, treatment-resistant crisis. Because it signals impending ventilatory failure, it warrants aggressive emergency management and close monitoring.

Question 21

The exchange of oxygen and carbon dioxide in the lungs occurs in the ______?

Accepted Answer

Answer reason: The alveoli provide a very large surface area and have type I pneumocytes with an adjacent capillary endothelium, allowing rapid diffusion of O2 into blood and CO2 out of blood down partial pressure gradients. Conducting airways such as the trachea, bronchi, and pharynx mainly move, warm, and humidify air and do not have the specialized surface for diffusion. Therefore, the site of oxygen–carbon dioxide exchange is the alveolar sacs.

Question 22

Hypoxia means low...?

Accepted Answer

Answer reason: The term is built from “hypo-” (low) and “-oxia” (oxygen), so the definition directly targets oxygen rather than electrolytes or nutrients. Low glucose would be hypoglycemia, and low salt or calcium are hyponatremia and hypocalcemia respectively—distinct conditions with different physiology and clinical management. Recognizing this terminology is essential because hypoxia can rapidly lead to organ dysfunction and requires prompt assessment of airway, breathing, and circulation.

Question 23

A 65-year-old male patient with emphysema and acute upper respiratory infection is admitted. Oxygen is ordered at 2 L/min. The reason for low-flow oxygen is to?

Accepted Answer

Answer reason: Giving high concentrations of oxygen may blunt this hypoxic stimulus, leading to hypoventilation, rising PaCO2, and respiratory acidosis (CO2 narcosis). Therefore, oxygen is started at low flow (e.g., 1–2 L/min via nasal cannula) and then titrated to a safe target saturation while monitoring clinical status and ABGs. Other options describe general oxygen effects or humidification issues but do not explain the key COPD-specific rationale for cautious oxygen administration.

Question 24

The most common complication in low birth weight infant is?

Accepted Answer

Answer reason: This makes respiratory distress syndrome/respiratory distress the most frequent and clinically prominent early complication in this population. In contrast, complications like intracranial hemorrhage or brain injury can occur but are not as universally common as respiratory compromise driven by lung immaturity. “Mucus damage” is not a standard, primary complication category for low birth weight infants. Prompt recognition focuses on tachypnea, retractions, grunting, and need for oxygen/CPAP or surfactant support.

Question 25

Exchange of gases between the blood and lungs is known as-?

Accepted Answer

Answer reason: It depends on diffusion down partial-pressure gradients, with oxygen moving into blood and carbon dioxide moving into the alveoli for exhalation. Internal respiration instead refers to gas exchange between systemic capillaries and body tissues. “Oxygenation” is a nonspecific term and does not precisely name the physiologic process, while excretion refers to waste elimination rather than alveolar-capillary gas exchange.

Question 26

When evaluating the arterial blood gases (ABGs) of a patient with a 20year history of chronic bronchitis, which of these would the healthcare provider expect?

Accepted Answer

Answer reason: With a 20-year history, the kidneys have time to compensate by retaining bicarbonate and excreting hydrogen ions, raising HCO3− and partially normalizing pH. This pattern fits a chronic, compensated respiratory acidosis rather than an uncompensated process. A common distractor is respiratory alkalosis, which would be expected with sustained hyperventilation, not chronic CO2 retention.

Question 27

What is the primary purpose of a tracheostomy?

Accepted Answer

Answer reason: This enables reliable ventilation (spontaneous or mechanical) and facilitates airway clearance through suctioning, which supports oxygenation and CO2 removal. Administering medications is not the primary goal because inhaled therapies can be delivered without a tracheostomy and drug delivery is not the indication for the procedure. Swallowing often becomes more difficult initially due to altered laryngeal elevation and cuff effects, so it is not a primary purpose.

Question 28

Which blood gas abnormality is initially most suggestive of pulmonary edema?

Accepted Answer

Answer reason: This initial hyperventilation blows off CO2, producing a low PaCO2 on arterial blood gases. As edema worsens and respiratory fatigue/ventilation failure develops, PaCO2 may later rise, making hypercapnia a later finding. “Anoxia” is not a typical initial ABG pattern descriptor, and “hyperoxygenation” is inconsistent with diffusion impairment.

Question 29

Which finding should a nurse expect on a typical X-ray of a child with asthma?

Accepted Answer

Answer reason: Chest X-ray in asthma is often normal or shows hyperinflation, but when an abnormality is seen, subsegmental atelectasis from mucus plugging is a common, expected finding. Infiltrates more strongly suggest pneumonia rather than uncomplicated asthma. Hemothorax and pneumothoraces are not typical baseline findings and would imply trauma or a complication such as severe barotrauma/air leak rather than routine asthma.

Question 30

A client describes knifelike chest pain that increases in intensity with inspiration to the nurse. The nurse is aware that the most likely origin of pain is?

Accepted Answer

Answer reason: Pleuritic chest pain is characteristically sharp/knifelike and worsens with inspiration because pleural surfaces move and become more inflamed or irritated during breathing. This pattern points to a respiratory/pleural source such as pleurisy, pulmonary embolism, or pneumothorax rather than myocardial ischemia. Cardiac ischemic pain is typically pressure-like and not consistently exacerbated by deep breathing. Musculoskeletal pain can be reproducible with palpation or movement, but the classic inspiratory “pleuritic” worsening most strongly supports a pulmonary origin.

Question 31

A client develops pneumonia. The nurse can expect which pathophysiological mechanism to develop as a secondary response to the pneumonia?

Accepted Answer

Answer reason: This ventilation impairment commonly leads to alveolar collapse, producing atelectasis as a frequent secondary physiologic change and contributor to hypoxemia. Pleural effusion can occur with pneumonia but is a complication in the pleural space rather than the typical intrapulmonary secondary mechanism expected from secretion plugging and poor aeration. Bronchiectasis is usually a chronic structural change from recurrent infections/inflammation, not an expected secondary response in an acute episode.

Question 32

Which organism is the most common causative agent for bacterial pneumonia?

Accepted Answer

Answer reason: This pathogen commonly produces lobar consolidation and is a primary target of pneumococcal vaccination and empiric antibiotic coverage when bacterial pneumonia is suspected. The other listed organisms are viruses (parainfluenza, RSV) and therefore do not represent bacterial pneumonia causes in this context. Mycoplasma is a bacterium but is a more common cause of atypical pneumonia and is not the most common overall bacterial agent.

Question 33

The nurse is assessing the client with chronic bronchitis. Which finding should the nurse expect?

Accepted Answer

Answer reason: Hyperinflation increases the anteroposterior diameter of the chest, producing a barrel-shaped chest as a common COPD-associated physical finding. Copious pink frothy sputum is more consistent with pulmonary edema/left-sided heart failure rather than chronic bronchitis. Stridor indicates upper airway obstruction (typically inspiratory) and is not an expected COPD assessment finding, and “minimal sputum” contradicts the chronic productive cough typical of chronic bronchitis.

Question 34

The nurse hears a physician refer to a client as a “blue bloater.” The nurse is aware that this term refers to?

Accepted Answer

Answer reason: The “blue bloater” phenotype classically describes chronic bronchitis–predominant COPD, where chronic airway inflammation and mucus hypersecretion cause significant ventilation–perfusion mismatch. This leads to hypoxemia with cyanosis (“blue”) and often CO2 retention; patients may also have edema and weight gain from pulmonary hypertension and right-sided heart strain (“bloater”). Emphysema is more associated with the “pink puffer” description due to dyspnea with less early cyanosis. ARDS and asthma are acute/episodic processes and are not the traditional COPD phenotype being referenced.

Question 35

The nurse is teaching a client about lung cancer. The nurse determines teaching was effective when the client states the primary cause of lung cancer is?

Accepted Answer

Answer reason: Cigarette smoking is the dominant, most preventable risk factor for lung cancer and accounts for the majority of cases through chronic exposure to inhaled carcinogens that cause DNA damage and malignant transformation. This makes it the best single “primary cause” when teaching overall population risk. Occupational exposures (e.g., asbestos, radon) and genetics increase risk but contribute a smaller proportion of cases compared with cigarette smoking. Pipe smoking also increases risk, but cigarettes are far more strongly associated and far more prevalent, driving the overall primary cause.

Question 36

A nurse is performing an assessment on a newborn with a possible diagnosis of cystic fibrosis. Which of the following is an early sign of the disease?

Accepted Answer

Answer reason: In newborns, this commonly presents early as intestinal obstruction from inspissated meconium, producing meconium ileus (failure to pass meconium, abdominal distention, vomiting). This finding is a classic early clue to CF even before recurrent pulmonary infections become prominent. Constipation can occur later but is less specific and not as hallmark an early neonatal presentation as meconium ileus. Hyperalbuminemia is not characteristic of CF; malabsorption would more typically contribute to poor growth and low protein states rather than elevated albumin.

Question 37

The nurse asks the client to say “EEE” and hears “AYE” over an area of consolidation. Which term is used to describe this phenomenon?

Accepted Answer

Answer reason: Sound transmission changes when lung tissue becomes more dense (e.g., with consolidation), causing higher-frequency components of the voice to be transmitted more clearly and altering the perceived sound quality. Hearing an “E” sound as “A” (“EEE” to “AYE”) is the classic description of egophony on auscultation and is commonly associated with pneumonia or compressed lung near pleural effusion. Percussion is a separate exam technique assessing resonance/dullness rather than voice sound conversion. Whispered pectoriloquy refers to abnormally clear whispered sounds, and tactile fremitus refers to palpable vibrations, not this specific E-to-A change.

Question 38

A nurse is admitting a client to the medical unit. The client tells the nurse that the doctor diagnosed him with a centrally located lung tumor. Upon assessment of the client, the nurse anticipates the client to exhibit?

Accepted Answer

Answer reason: Centrally located lung tumors commonly arise near major bronchi and can erode or irritate bronchial mucosa and adjacent vessels, leading to bleeding into the airway. This makes blood-tinged sputum a classic expected finding with central lesions, especially squamous cell carcinomas. Pleuritic pain is more associated with peripheral tumors that involve the pleura, because the lung parenchyma itself has limited pain fibers. Shoulder pain is more typical of apical (Pancoast) tumors invading the brachial plexus rather than central airway lesions.

Question 39

A client with pulmonary embolism has developed hemoptysis. The nurse determines that this is most likely related to?

Accepted Answer

Answer reason: Hemoptysis in pulmonary embolism most commonly results from pulmonary infarction causing bleeding into the alveoli and small airways. An embolus can obstruct a pulmonary artery branch, leading to ischemic necrosis of distal lung tissue and disruption of the alveolar-capillary membrane. This capillary leak allows blood to enter the alveolar spaces and be coughed up. Bleeding is typically not from the large systemic vessel where the thrombus originated, but from damaged pulmonary microvasculature at the infarct site. Descriptions like generalized “loss of tissue/parenchyma” are less specific for the mechanism that directly produces coughing up blood.

Question 40

The nurse is caring for a client with a pleural effusion. The client asks, “What is a pleural effusion?” What is the most appropriate response from the nurse?

Accepted Answer

Answer reason: ” A pleural effusion is defined by fluid collecting in the pleural space between the visceral and parietal pleura, which can restrict lung expansion and cause dyspnea. This option precisely describes the anatomic location and mechanism of the condition in patient-friendly language. In contrast, collapse of alveoli describes atelectasis, and fluid in the alveoli describes pulmonary edema or pneumonia-related consolidation rather than a pleural process. A bronchiole “collapse” is not the standard definition of pleural effusion and would not explain the pleural-space fluid finding.

Question 41

The nurse is teaching the parents of a child with pneumonia about the condition. Which description is correct?

Accepted Answer

Answer reason: This description matches the core pathology being taught to parents—disease in the lung tissue rather than just the conducting airways. Inflammation of the large airways describes bronchitis, which primarily affects the trachea and bronchi and typically presents with prominent cough without alveolar consolidation. Severe infection of the bronchioles and a viral process maximal at the bronchiolar level more specifically describe bronchiolitis, common in infants and characterized by small-airway edema and wheeze.

Question 42

The nurse is caring for an 8-year-old child admitted with pneumonia. Based on the child’s age, which type of pneumonia would the nurse suspect?

Accepted Answer

Answer reason: Mycoplasma pneumoniae classically causes “walking pneumonia” in children and adolescents, often with a more gradual onset and prominent cough compared with typical bacterial pneumonia. Chlamydophila pneumonia can occur in older children but is less classically tied to the 5–15 year age group than Mycoplasma in standard pediatric teaching. Enteric bacilli and staphylococcal pneumonia are more associated with specific risk factors or severe/complicated disease rather than being the most likely organism solely based on an 8-year-old’s age.

Question 43

The child is diagnosed with CF. Which fact about CF should the nurse consider when developing the plan of care for the child?

Accepted Answer

Answer reason: Cystic fibrosis causes defective chloride transport (CFTR), leading to dehydrated, viscous mucus in the airways that is difficult to clear and predisposes to obstruction and recurrent infections. This core pathophysiology directly drives key care priorities such as airway clearance therapies, hydration, and monitoring for respiratory complications. Constipation can occur, but the more characteristic GI issues are pancreatic insufficiency, steatorrhea, and risk of distal intestinal obstruction rather than a defining universal feature. CF is autosomal recessive (not dominant), and it is associated with CF-related diabetes mellitus rather than diabetes insipidus.

Question 44

The nurse is reviewing the chart of a 58-year-old male client with community-acquired pneumonia and determines that which of the following is the most likely causative organism?

Accepted Answer

Answer reason: This organism classically produces lobar pneumonia and is a primary empiric target in outpatient and inpatient CAP regimens. While Haemophilus influenzae is also a CAP cause, it is more strongly associated with COPD and smoking-related bronchitis. Staphylococcus aureus and Klebsiella pneumoniae are more characteristic of post-influenza pneumonia and severe aspiration/alcohol use or healthcare-associated settings, respectively, making them less likely as the “most likely” organism here.

Question 45

A client asks the nurse how lung maturity is determined in the neonate. What is the best response by the nurse?

Accepted Answer

Answer reason: As gestation advances, lecithin (surfactant component) rises while sphingomyelin remains relatively stable, so a ratio above 2:1 indicates adequate surfactant and lower risk of neonatal respiratory distress syndrome. Meconium in fluid reflects fetal stress or post-term status rather than surfactant sufficiency. Lack of phosphatidylglycerol suggests immaturity (it is typically present when lungs are mature), and steroid administration may accelerate maturity but is not how maturity is determined.

Question 46

Neonatal chronic lung disease (bronchopulmonary dysplasia) can be classified into four categories. Which characteristic is noted during the early or first stage of the disease?

Accepted Answer

Answer reason: In the first stage, findings are dominated by diffuse atelectasis, decreased lung compliance, and worsening oxygen needs, which makes it look like persistent or recurrent RDS. Features such as emphysematous changes and hyperinflation develop later as airway injury leads to air trapping. Interstitial fibrosis is also a later, chronic change reflecting longer-term remodeling rather than the initial stage.

Question 47

The nurse reviews the arterial blood gas results of a client with asthma. The nurse is aware that the client’s partial pressure of arterial oxygen (PaO2) result will provide information about which of the following?

Accepted Answer

Answer reason: In asthma, ventilation–perfusion mismatch can reduce arterial oxygenation even when the client is still moving air, so PaO2 is a direct indicator of oxygenation/gas exchange performance. The degree of dyspnea is subjective and does not reliably correlate with oxygenation. Effectiveness of ventilation is better assessed by PaCO2, which reflects alveolar ventilation and CO2 elimination.

Question 48

A nurse is explaining bronchiolitis to the parents of an infant admitted with the condition. Which explanation by the nurse would be the most accurate?

Accepted Answer

Answer reason: This mechanism explains classic findings such as wheeze, crackles, tachypnea, and air trapping. Aspiration of a solid object causes sudden focal obstruction rather than a diffuse inflammatory bronchiolar process. Inflammation of the pulmonary parenchyma describes pneumonia, while a croup-like syndrome reflects upper-airway laryngotracheal inflammation with inspiratory stridor and barking cough.

Question 49

In most cases, bronchiolitis is caused by a viral agent, most commonly respiratory syncytial virus (RSV). The nurse should keep in mind which statement regarding RSV infection?

Accepted Answer

Answer reason: RSV primarily infects the epithelial cells of the respiratory tract, leading to inflammation, edema, and increased mucus production that contribute to bronchiolitis and airway obstruction in infants and young children. This mechanism directly aligns with the statement that it attacks the respiratory tract mucosa. A common distractor is seasonality: RSV typically peaks in late fall through winter/early spring rather than summer. It is also highly contagious via droplets and direct contact/fomites, and severe disease is most common in children under 2 years, not older than 5.

Question 50

A nurse reinforces the teaching plan for a client who has recently been diagnosed with squamous cell carcinoma of the left lung. The most appropriate information for the nurse to give the client would be?

Accepted Answer

Answer reason:  Squamous cell carcinoma of the lung is typically a centrally located non–small cell lung cancer that tends to grow more slowly than small cell carcinoma and is less aggressive in terms of early distant spread. Patient teaching should emphasize the general biologic behavior of this histologic type without making unsupported, specific survival predictions. Statements implying extremely rapid growth or that metastasis is generally present at diagnosis more closely fit small cell lung cancer patterns rather than squamous cell. Predicting “only a few months to live” is inappropriate and not evidence-based without staging and individualized prognostic evaluation.

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