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Chapter 25 - Structure and Function of The Pulmonary System - Nursing Test Banks
Chapter 25 - Structure and Function of The Pulmonary System - Nursing Test Banks
Test Bank
MULTIPLE CHOICE
1. The nasopharynx is lined with a ciliated mucosal membrane with a highly vascular blood supply. The
nurse is discussing the functions of this membrane. Which information should be included? One function of
the membrane is to:
a. Absorb air
b. Humidify air
c. Cool air
d. Exchange gases
ANS: B
These structures are lined with a ciliated mucosa that warms and humidifies inspired air and removes
foreign particles from it.
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REF: p. 659
2. The nurse is describing the slit-shaped space between the true vocal cords. What term should the nurse
use?
a. Glottis
b. Epiglottis
c. Larynx
d. Carina
ANS: A
The slit-shaped space between the true vocal cords forms the glottis.
The slit-shaped space between the true vocal cords forms the glottis, not the epiglottis.
The slit-shaped space between the true vocal cords forms the glottis, not the larynx.
The slit-shaped space between the true vocal cords forms the glottis, not the carina.
REF: p. 659
3. After entering a room of chemical fog, a 20-year-old male cannot stop sneezing. Which of the following
structures is primarily responsible for his sneezing?
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ANS: C
The irritant receptors in the nostrils are responsible for sneezing, not the upper respiratory tract mucosa.
The irritant receptors in the nostrils are responsible for sneezing, not those in the trachea.
The irritant receptors in the nostrils are responsible for sneezing, not the turbinates.
REF: p. 660
4. A newborn is in respiratory distress and requires ventilation. Tests reveal that he does not produce
surfactant due to the absence of:
a. Mucus-producing cells
c. Alveolar macrophages
d. Goblet cells
ANS: B
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REF: p. 663
5. The nurse is describing the movement of blood into and out of the capillary beds of the lungs to the body
organs and tissues. What term should the nurse use to describe this process?
a. Perfusion
b. Ventilation
c. Diffusion
d. Circulation
ANS: A
Perfusion is the movement of blood into and out of the capillary beds of the lungs to body organs and
tissues.
Diffusion is the movement of gases between air spaces in the lungs and the bloodstream.
REF: p. 659
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6. Which principle should the nurse remember while planning care for a patient with respiratory problems?
Diffusion of respiratory gases takes place at the:
a. Alveolocapillary membrane
b. Visceral pleurae
c. Parietal pleurae
d. Respiratory center
ANS: B
The visceral pleurae are the linings of the lung; gas exchange does not occur here.
The parietal pleurae are the linings of the lung; gas exchange does not occur here.
The respiratory center is where impulses to the respiratory muscles are generated.
REF: p. 672
7. Students in a histology class are assigned to identify regions of the lung. The slide shows a basement
membrane, capillary lumen, and macrophages. The students are looking at the:
a. Trachea
b. Bronchioles
c. Alveoli
d. Bronchus
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ANS: C
REF: p. 662
a. Mucous
b. Serous
c. Synovial
d. Peritoneal
ANS: B
The pleural membranes are serous membranes, not mucous membranes, which are found in the mouth.
The pleural membranes are serous membranes, not synovial, which are found in joints.
The pleural membranes are serous membranes, not peritoneal, which are found in the bowel.
REF: p. 663
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9. A nurse is teaching about the functions of the pulmonary system. Which information should the nurse
include? One of the functions of the pulmonary system is the:
a. Expelling of bacteria
ANS: B
The pulmonary system promotes exchange of gases between the environment and the blood.
One of the functions of the pulmonary system is exchange of gases, not the expelling of bacteria.
One of the functions of the pulmonary system is exchange of gases, not the movement of blood into and out
of the capillaries.
One of the functions of the pulmonary system is exchange of gases, not cooling the heart.
REF: p. 660
10. A 42-year-old male was involved in a motor vehicle accident during which he suffered a severe head
injury. He died shortly after the accident from loss of respiration. The nurse suspects the area of the brain
most likely involved is the:
a. Cerebral cortex
b. Thalamus
c. Basal ganglia
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d. Brainstem
ANS: D
The respiratory center in the brainstem controls respiration by transmitting impulses to the respiratory
muscles, causing them to contract and relax.
REF: p. 665
11. The pulmonologist talks about the receptors that respond to increased pulmonary capillary pressure.
What term will indicate the nurse understands? They are called:
a. Irritant receptors
b. Chemoreceptors
c. Stretch receptors
d. J receptors
ANS: D
J-receptors (juxtapulmonary capillary receptors) are located near the capillaries in the alveolar septa. They
are sensitive to increased pulmonary capillary pressure, which stimulates them to initiate rapid, shallow
breathing, hypotension, and bradycardia.
REF: p. 665
12. While reviewing the results of the pulmonary functions test, the nurse is aware that the maximum
amount of gas that can be displaced (expired) from the lung is called:
c. Functional capacity
d. Residual volume
ANS: A
VC is the amount of air that can be forcibly expired after a maximal inspiration.
VC is the amount of air that can be forcibly expired after a maximal inspiration. Total lung capacity is the
volume of lung capacity at full inhalation.
VC is the amount of air that can be forcibly expired after a maximal inspiration. Functional capacity is not a
term used to describe function tests.
VC is the amount of air that can be forcibly expired after a maximal inspiration. Residual volume is the
amount of air remaining after exhalation.
REF: p. 669
13. The nurse is describing the receptors in the lung that decrease ventilatory rate and volume when
stimulated. Which receptors is the nurse discussing?
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b. Baroreceptors
c. Stretch receptors
d. Chemoreceptors
ANS: C
Stretch receptors, not carbon dioxide receptors, decrease ventilatory rate and volume when stimulated.
Stretch receptors decrease ventilatory rate and volume when stimulated; baroreceptors regulate blood
pressure.
Stretch receptors decrease ventilatory rate and volume when stimulated; chemoreceptors increase the rate
and depth of respiration.
REF: p. 666
14. The pulmonologist is presenting a workshop over the lungs. Which information should be included?
The lung receives parasympathetic innervation by the _____ nerve.
a. Vagus
b. Phrenic
c. Brachial
d. Pectoral
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ANS: A
Parasympathetic innervations for the lung are via the vagus nerve.
Parasympathetic innervations for the lung are via the vagus nerve, not the phrenic.
Parasympathetic innervations for the lung are via the vagus nerve, not the brachial.
Parasympathetic innervations for the lung are via the vagus nerve, not the pectoral.
REF: p. 666
15. While planning care for a patient with respiratory difficulty and retaining too much carbon dioxide,
which principle should the nurse recall? _______ would be stimulated in an attempt to maintain a normal
homeostatic state.
a. Irritant receptors
b. Stretch receptors
c. Peripheral chemoreceptors
d. Central chemoreceptors
ANS: D
Chemoreceptors monitor arterial blood indirectly by sensing changes in the pH of cerebrospinal fluid
(CSF). The central chemoreceptors are sensitive to very small changes in the pH of CSF and can maintain a
normal PaCO2.
Chemoreceptors monitor arterial blood indirectly by sensing changes in the pH of CSF. The central
chemoreceptors are sensitive to very small changes in the pH of CSF and can maintain a normal PaCO2.
Irritant receptors sense the need to expel unwanted substances.
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Chemoreceptors monitor arterial blood indirectly by sensing changes in the pH of CSF. The central
chemoreceptors are sensitive to very small changes in the pH of CSF and can maintain a normal PaCO2.
Stretch receptors decrease ventilatory rate and volume when stimulated.
Chemoreceptors monitor arterial blood indirectly by sensing changes in the pH of cerebrospinal fluid
(CSF). The central chemoreceptors are sensitive to very small changes in the pH of CSF and can maintain a
normal PaCO2. The peripheral chemoreceptors become the major stimulus to ventilation when the central
chemoreceptors are reset.
REF: p. 666
16. If an individual with respiratory difficulty were retaining too much carbon dioxide, which of the
following compensatory responses would the nurse expect to be initiated?
ANS: A
To rid the body of excess carbon dioxide, the rate and depth of respiration are increased.
Vasodilation of the pulmonary arterioles will not rid the body of carbon dioxide.
REF: p. 666
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17. During inspiration, muscular contraction of the diaphragm causes air to move into the lung. The
mechanisms that drive air movement during inspiration are a(n):
ANS: C
Inspiration occurs due to an increase in the size of the thorax and a decrease in intrapleural pressure.
REF: p. 667
18. A nurse remembers the majority of total airway resistance occurs in the:
a. Bronchi
b. Nose
c. Oral pharynx
d. Diaphragm
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ANS: B
One-half to two-thirds of total airway resistance occurs in the nose, not the bronchi.
One-half to two-thirds of total airway resistance occurs in the nose, not the oral pharynx.
One-half to two-thirds of total airway resistance occurs in the nose, not the diaphragm.
REF: p. 668
a. Wall thickness
b. Surface tension
c. Minute volume
d. Alveolar radius
ANS: D
The radius of the alveoli is inversely related to the pressure required to inflate it.
It is the radius that is related to the pressure, not the wall thickness.
It is the radius that is related to the pressure, not the surface tension.
It is the radius that is related to the pressure, not the minute volume.
REF: p. 667
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20. An aide asks a nurse how surfactant works. How should the nurse respond? Surfactant facilitates
alveolar distention and ventilation by:
ANS: C
REF: p. 667
21. Which principle should the nurse remember while planning care for a patient with a respiratory
problem? Under most circumstances, increased work of breathing results in:
c. Decreased PaCO2
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ANS: B
An increase in the work of breathing can result in a marked increase in oxygen consumption.
An increase in the work of breathing can result in a marked increase in oxygen consumption, not in partial
pressure.
An increase in the work of breathing can result in a marked increase in oxygen consumption; it may not
lower CO2.
An increase in the work of breathing can result in a marked increase in oxygen consumption; it would not
alter alveolar perfusion.
REF: p. 669
22. Which of the following terms should the nurse use when there is a balance between outward recoil of
the chest wall and inward recoil of lungs at rest?
ANS: A
Balance between the outward recoil of the chest wall and inward recoil of the lungs occurs at the resting
level, the end of expiration, where the FRC is reached.
VC is the amount of air that can be forcibly expired after a maximal inspiration.
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REF: p. 668
23. What is the partial pressure of oxygen in the lung given the following conditions?
a. 111 mm Hg
b. 124 mm Hg
c. 131 mm Hg
d. 140 mm Hg
ANS: D
The partial pressure of oxygen is equal to the percentage of oxygen in the air, 20, times the total pressure
(700 mm Hg), or 140 mm Hg (700 ´ 0.20 = 140).
The partial pressure of oxygen is equal to the percentage of oxygen in the air, 20, times the total pressure
(700 mm Hg), or 140 mm Hg (700 ´ 0.20 = 140).
The partial pressure of oxygen is equal to the percentage of oxygen in the air, 20, times the total pressure
(700 mm Hg), or 140 mm Hg (700 ´ 0.20 = 140).
The partial pressure of oxygen is equal to the percentage of oxygen in the air, 20, times the total pressure
(700 mm Hg), or 140 mm Hg (700 ´ 0.20 = 140).
REF: p. 670
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24. A pulmonologist is discussing the base of the lungs with staff. Which information should be included?
At the base of the lungs:
b. Arterial perfusion pressure and alveolar gas pressure are less than at the apex.
ANS: C
In the base of the lungs, both arterial and venous pressures are greater than alveolar pressure, and blood
flow is not affected by alveolar pressure.
In the base of the lungs, both arterial and venous pressures are greater than alveolar pressure, and blood
flow is not affected by alveolar pressure. It is in the apex that alveolar pressure exceeds pulmonary arterial
and venous pressures.
In the base of the lungs, both arterial and venous pressures are greater than alveolar pressure, and blood
flow is not affected by alveolar pressure. It is in the apex that alveolar pressure exceeds pulmonary arterial
and venous pressures.
In the base of the lungs, both arterial and venous pressures are greater than alveolar pressure, and blood
flow is not affected by alveolar pressure. In zone II, also part of the apex, alveolar pressure is greater than
venous pressure, but not arterial pressure.
REF: p. 671
25. While auscultating a patient’s lungs, a nurse recalls the alveoli in the apexes of the lungs are _____ than
alveoli in the bases.
a. Larger
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b. More numerous
c. More compliant
d. Less perfused
ANS: A
The alveoli in the upper portions, or apexes, of the lungs contain a greater residual volume of gas and are
larger and less numerous than those in the lower portions.
The alveoli in the upper portions, or apexes, of the lungs contain a greater residual volume of gas and are
larger and less numerous, not more, than those in the lower portions.
The alveoli in the upper portions, or apexes, of the lungs contain a greater residual volume of gas and are
larger and less numerous than those in the lower portions. The apexes are less compliant.
REF: p. 671
26. A patient asks how oxygen is transported in the body. What is the nurse’s best response? Most of the
oxygen (O2) is transported:
b. Bound to hemoglobin
d. As a free-floating molecule
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ANS: B
REF: p. 672
27. If a patient’s hemoglobin concentration (Hb) is 14 g/100 ml and arterial oxygen saturation (SaO2) is
98%, what would be his arterial oxygen content? Remember that 1.34 ml O2 is the maximum amount of
oxygen that can be transported per gram of hemoglobin.
ANS: C
REF: p. 672
28. In a patient with acidosis or a fever, the nurse would expect the oxyhemoglobin dissociation curve to
shift:
ANS: A
The oxyhemoglobin dissociation curve is shifted to the right by acidosis (low pH) and hypercapnia
(increased PaCO2).
The oxyhemoglobin dissociation curve is shifted to the right, not the left, by acidosis (low pH) and
hypercapnia (increased PaCO2); more, not less, O2 is released to cells.
The oxyhemoglobin dissociation curve is shifted to the right, not downward, by acidosis (low pH) and
hypercapnia (increased PaCO2).
The oxyhemoglobin dissociation curve is shifted to the right, not upward, by acidosis (low pH) and
hypercapnia (increased PaCO2).
REF: p. 673
29. A patient wants to know how carbon dioxide is transported in the body. How should the nurse respond?
Carbon dioxide (CO2) is mainly transported in the blood:
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ANS: D
CO2 is carried in the blood as bicarbonate, not dissolved in red blood cells.
REF: p. 673
a. Reactive vasodilation
b. Local bronchoconstriction
ANS: D
A consequence of alveolar hypoxia is pulmonary artery vasoconstriction, not a decreased respiratory rate.
REF: p. 675
31. An 80-year-old male presents to his primary care provider reporting difficulty breathing. Pulmonary
function tests reveal that he has increased residual volume. A nurse suspects the most likely cause of this
disorder is _____ in lung compliance.
a. An increase
b. A decrease
c. No change
d. An absence
ANS: A
The patient is experiencing an increase in lung compliance. Increased compliance indicates that the lungs or
chest wall is abnormally easy to inflate and has lost some elastic recoil.
REF: p. 675
MULTIPLE RESPONSE
1. A nurse is teaching staff about the respiratory bronchi. Which information should the nurse include?
__________ may be found in the walls of the respiratory bronchi? (Select all that apply,)
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a. Smooth muscle
b. Surfactant-producing glands
c. Goblet cells
d. Ciliated cells
e. Epithelial lining
ANS: A, C, D, E
The bronchial walls have three layers: an epithelial lining, a smooth muscle layer, and a connective tissue
layer. The epithelial lining of the bronchi contains single-celled exocrine glands—the mucus-secreting
goblet cells—and ciliated cells. Surfactant-producing glands are found in the alveoli.
REF: p. 600
COMPLETION
1. _____ seconds is required for oxygen (O2) concentration to equilibrate (equalize) across the
alveolocapillary membrane.
ANS: .25
REF: p. 672
ANS: 97
REF: p. 672
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3. A pulmonologist, while presenting a seminar on partial pressures of oxygen, would include which
statement? At sea level, the partial pressure of oxygen is approximately ___% (round to the nearest whole
number).
ANS:
21
REF: p. 670
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc.
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