NR 283 Exam 2: Respiratory and Cardiovascular Assessment

1. Nocturnal Respiratory Distress

Question:
A nurse finds a patient awake in the middle of the night, struggling to breathe, and needing to sit or stand to relieve symptoms. Which condition is this?

Options:
A) Subjective Dyspnea
B) Orthopnea
C) Paroxysmal Nocturnal Dyspnea
D) Dyspnea on Exertion

2. PaCO₂ Imbalance

Question:
What term describes a patient having elevated PaCO₂ levels due to inadequate expiration?

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

3. Breathing Patterns During Intense Exercise

Question:
Which breathing pattern is observed during intense exercise, characterized by increased respiratory rate and larger tidal volumes?

Options:
A) Labored Breathing
B) Cheyne-Stokes Respirations
C) Normal Breathing
D) Kussmaul Respirations

4. Hypoxemia

Question:
Hypoxemia refers to a deficiency of oxygen in the tissues.

Answer: True

Question:
Which factors can contribute to hypoxemia? (Select all that apply)

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

5. Pleural Space Disorders

Question:
The accumulation of air in the pleural space creating a “one-way valve” effect is termed:

Options:
A) Spontaneous Pneumothorax
B) Flail Chest
C) Tension Pneumothorax
D) Atelectasis

Question:
An accumulation of pus, cellular debris, and microorganisms in the pleural space is called:

Options:
A) Pulmonary Edema
B) Transudative Pleural Effusion
C) Pneumonia
D) Empyema

6. Acute Respiratory Distress Syndrome (ARDS)

Question:
A common cause of ARDS is:

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

Question:
What leads to hypoxemia in ARDS?

Answer:
In ARDS, injury to the alveolocapillary membrane allows blood, cells, and debris to enter alveoli, causing alveolar collapse or fluid accumulation. This prevents effective gas exchange, reducing oxygen delivery to the blood.

7. Emphysema

Question:
During education on emphysema, which statement is correct?

Options:
A) Excessive mucus obstructs small airways
B) Allergen inhalation triggers bronchospasm and mucus production
C) Airway obstruction and air trapping result from tissue destruction rather than mucus
D) Caused by community-acquired or nosocomial bacteria

Question:
Emphysema can be caused by: (Select all that apply)

Options:
A) Cigarette smoke
B) Air pollutants
C) Increased mucus glands
D) Enzyme deficiency

8. Tuberculosis Risk Factors

Question:
A patient presents with fatigue, weight loss, anorexia, night sweats, and general anxiety and has been homeless for the past year. Which disease is suspected?

Options:
A) Chronic Bronchitis
B) Asthma
C) Pulmonary Edema
D) Tuberculosis

9. Pulmonary Embolism

Question:
A pulmonary embolism typically originates from:

Options:
A) Pulmonary Vein
B) Deep Vein in the Arm
C) Deep Vein in the Thigh
D) Pulmonary Artery

10. Cor Pulmonale

Question:
Which statement best defines cor pulmonale?

Options:
A) Characterized by high pulmonary vessel pressure
B) Increases left heart workload
C) Known as pulmonary heart disease
D) Early symptoms include productive cough and wheezing

11. Oxygen Transport

Question:
Oxygenated blood flows through which structure?

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

12. Cardiac Output

Question:
What is the formula for cardiac output (CO)?

Answer: CO = Heart Rate (HR) × Stroke Volume (SV)

Question:
What does cardiac output indicate?

Answer: It reflects the efficiency of the heart’s pumping ability.

Question:
Which factors influence cardiac output?

Answer:

• Preload

• Afterload

• Contractility

• Heart Rate

13. Venous Disorders

Question:
Chronic venous insufficiency can lead to varicose veins.

Answer: True

Question:
Which factors are part of Virchow’s Triad? (Select all that apply)

Options:
A) Immobility—causing venous stasis
B) Use of birth control—contributing to hypercoagulability
C) Damage to venous valves—endothelial injury
D) History of varicose veins

14. Hypertension

Question:
Which factor does not increase due to primary hypertension?

Options:
A) Peripheral Resistance
B) Circulating Volume
C) Salt and Water Excretion
D) Arterial Vasoconstriction

Question:
Malignant hypertension is a rapidly progressive form causing organ damage.

Answer: True

15. Aneurysms

Question:
Which statement is true regarding aneurysms?

Options:
A) Infection is the most common cause
B) Symptoms are always present
C) Saccular aneurysms create outpouchings on both sides
D) False aneurysms can result from hematoma formation

16. Atherosclerosis

Question:
Reducing cholesterol can significantly reduce the risk of atherosclerosis.

Answer: True

Question:
Which factors increase the risk of atherosclerosis? (Select all that apply)

Options:
A) Obesity
B) Smoking
C) Hypertension
D) High HDL levels

Question:
What is the term for clot formation within a blood vessel?

Options:
A) Thrombosis
B) Hemorrhage
C) Embolism
D) Aneurysm

17. Stroke Assessment

Question:
A patient presents with facial droop, arm weakness, and speech difficulties. Which type of stroke is likely?

Options:
A) Ischemic Stroke
B) Hemorrhagic Stroke
C) Transient Ischemic Attack (TIA)
D) Subarachnoid Hemorrhage

Question:
Right-sided hemiplegia indicates damage to which brain hemisphere?

Options:
A) Left Hemisphere
B) Right Hemisphere
C) Cerebellum
D) Brainstem

Question:
A patient presents with a sudden, severe “thunderclap” headache and history of hypertension. Which condition is suspected?

Options:
A) TIA
B) Stroke
C) Subarachnoid Hemorrhage
D) Migraine

18. Heart Failure

Question:
Which finding in a patient with heart failure is most concerning?

Options:
A) Increased Heart Rate
B) Decreased Urine Output
C) Sudden Weight Gain
D) Mild Peripheral Edema

Question:
Which type of heart failure most likely causes pulmonary congestion?

Options:
A) Right-Sided Heart Failure
B) Left-Sided Heart Failure
C) Isolated Heart Failure
D) Compensated Heart Failure

Question:
Left-sided heart failure typically presents with:

Options:
A) Peripheral Edema
B) Jugular Venous Distension
C) Pulmonary Congestion
D) Hepatomegaly

Question:
In chronic heart failure, “decompensation” refers to:

Options:
A) Heart fails to pump sufficiently to meet the body’s needs
B) Improvement in symptoms
C) Compensatory mechanisms increase cardiac output
D) Reduced cardiac workload

Question:
A patient with heart failure and low ejection fraction is likely to experience:

Options:
A) Increased oxygen demand
B) Increased blood volume in the heart
C) Impaired contractility
D) Decreased venous return

Question:
Which medication is typically prescribed to reduce preload in heart failure?

Options:
A) Diuretics
B) Beta-Blockers
C) ACE Inhibitors
D) Digoxin

Question:
Complications associated with heart failure include: (Select all that apply)

Options:
A) Thromboembolism
B) Renal Failure
C) Liver Dysfunction
D) Pulmonary Edema

NR 283 Exam 2