Porth's Pathophysiology, Concepts of Altered Health States 9th Edition by Sheila Grossman-Carol Mattson Porth
Porth's Pathophysiology, Concepts of Altered Health States 9th Edition by Sheila Grossman-Carol Mattson Porth
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Chapter 37- Disorders of Ventilation and Gas Exchange
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
| 1. | As a consequence of a long-standing lung disease, a client is in a chronic state of hypoxia. Which of the following phenomena would the client’s care team be most justified in anticipating?
Select all that apply. |
|
| A) | Metabolic alkalosis | |
| B) | Increased erythropoietin production | |
| C) | Pulmonary vasodilation | |
| D) | Hyperventilation | |
| E) | Personality changes | |
| Ans: | B, D, E | |
| Feedback: | ||
| Increased production of erythropoietin, hyperventilation, and cognitive and personality changes are all associated with hypoxemia. Acidosis, not alkalosis, and vasoconstriction rather than vasodilation are likely to occur. | ||
| 2. | A patient who has been on a high-protein diet comes to the emergency department with respiratory symptoms. Upon analysis of arterial blood gases (ABGs), the patient is diagnosed with hypercapnia. The nurse will note the ABG results that confirm this diagnosis include: Select all that apply. | |
| A) | pH 7.31 (normal 7.35 to 7.45). | |
| B) | PO2 of 97%. | |
| C) | PCO2 of 58 mm Hg (normal 38 to 42). | |
| D) | Serum HCO3of –33 mEq/L (normal 22 to 28). | |
| E) | Serum K+ (potassium)of 3.6 mmol/L (normal 3.5 to 5.0). | |
| Ans: | A, C, D | |
| Feedback: | ||
| Hypercapnia affects a number of body functions, including acid–base balance and renal, neurological, and CV functions. Elevated levels of PCO2 (38 to 42) produce a decrease in pH (7.35 to 7.45) and respiratory acidosis. Compensatory mechanisms result in an increase in serum HCO3 (22 to 28). In this example, the PO2 level is within normal range. Serum K+ is not part of the ABG analysis. | ||
| 3. | A nurse is providing care for a patient who has been admitted with a newly diagnosed bilateral pleural effusion. Which of the following findings from the nurse’s initial assessment of the patient is incongruent with the patient’s diagnosis and would require further investigation? | |
| A) | The client complains of sharp pain exacerbated by deep inspiration. | |
| B) | The client’s breath sounds are diminished on auscultation. | |
| C) | Pulse oximetry indicates that the client is hypoxemic. | |
| D) | The client complains of dyspnea and increased work of breathing. | |
| Ans: | A | |
| Feedback: | ||
| Pleural effusion is not normally associated with pain, and intense pain that is worsened by deep breathing would necessitate further investigation. Diminished breath sounds, hypoxemia, and dyspnea are common findings associated with pleural effusion. | ||
| 4. | A patient arrives in the ED after an automobile accident. Which of the following clinical manifestations lead the nurse to suspect a pneumothorax? Select all that apply. | |
| A) | Respiratory rate 34 | |
| B) | Asymmetrical chest movements, especially on inspiration | |
| C) | Diminished breath sounds over the painful chest area | |
| D) | Pulse oximetry 98% | |
| E) | ABG pH level of 7.38 | |
| Ans: | A, B, C | |
| Feedback: | ||
| Manifestations of pneumothorax include increase in respiratory rate, dyspnea, asymmetrical movements of the chest wall, especially during inspiration, hyperresonant sound on percussion, and decreased or absent breath sounds over the area of pneumothorax. The pulse oximetry reading is normal. ABG pH level of 7.38 is a normal finding. | ||
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