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NSG 533 Pulmonary (2025) Actual Exam Questions and Answers A+ Graded.pdf, Exams of Nursing

NSG 533 Pulmonary (2025) Actual Exam Questions and Answers A+ Graded.pdf

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NSG 533 Pulmonary (2025) Actual Exam
Questions and Answers A+ Graded
Blood .Gas .values .- .CORRECT .ANSWER-pH: .7.35-7.45
PaO2: .80-100
PaCO2: .35-45
Ventilation .- .CORRECT .ANSWER-The .movement .of .air .in .and .out .of .lungs .- .a
.function .of .tidal .volume .and .respiratory .rate. .Analyze .PaCO2.
-Inversely .related .to .PaCO2 .-- .if .a .person .is .breathing .slowly .and .shallowly,
.PaCO2 .will .be .high.
Oxygenation .- .CORRECT .ANSWER-The .process .of .delivering .oxygen .to .the
.blood .by .diffusion .from .the .alveoli .following .inhalation .into .the .lungs.
- .Three .measures .to .analyze: .SaO2 .(95-100%), .PaO2 .(80-100), .and .hemoglobin
.(~ .15)
PaO2 .is .oxygen .available .to .tissues.
Work .of .breathing .- .Resistance .- .CORRECT .ANSWER-How .much .pressure .we
.need .to .generate .to .get .the .flow .in. .
- .If .we .clear .secretions, .maybe .don't .need .a .ventilator.
Work .of .breathing .- .Compliance .- .CORRECT .ANSWER-How .much .volume .do .we
.need .to .bring .in .to .inflate .the .alveoli.
-If .we .decrease .fluid .and .fix .pulmonary .edema, .maybe .we .don't .need .a
.ventilator.
-Compliance .is .the .opposite .of .elasticity. .A .thick .rubber .band .is .very .elastic .but
.has .low .compliance .(requires .more .pressure .to .inflate). .
-A .skinny .rubber .band .is .not .elastic .but .has .high .compliance .(easy .to .inflate).
Low .compliance .- .CORRECT .ANSWER-Stiff .lung .(high .elastic .recoil): .thick
.balloon, .often .seen .in .fibrosis.
High .compliance .- .CORRECT .ANSWER-Pliable .lung .(low .elastic .recoil): .grocery
.bag, .often .seen .in .emphysema.
A-a .gradient .- .CORRECT .ANSWER-Measures .the .difference .between .the .oxygen
.concentration .in .the .alveoli .and .arterial .system.
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NSG 533 Pulmonary (2025) Actual Exam

Questions and Answers A+ Graded

Blood .Gas .values .- .CORRECT .ANSWER-pH: .7.35-7. PaO2:. 80 - 100 PaCO2:. 35 - 45 Ventilation .- .CORRECT .ANSWER-The .movement .of .air .in .and .out .of .lungs .- .a .function .of .tidal .volume .and .respiratory .rate. .Analyze .PaCO2.

  • Inversely .related .to .PaCO2 .-- .if .a .person .is .breathing .slowly .and .shallowly, .PaCO2 .will .be .high. Oxygenation .- .CORRECT .ANSWER-The .process .of .delivering .oxygen .to .the .blood .by .diffusion .from .the .alveoli .following .inhalation .into .the .lungs.
  • .Three .measures .to .analyze: .SaO2 .(95-100%), .PaO2 .(80-100), .and .hemoglobin .(~ .15) PaO2 .is .oxygen .available .to .tissues. Work .of .breathing .- .Resistance .- .CORRECT .ANSWER-How .much .pressure .we .need .to .generate .to .get .the .flow .in..
  • .If .we .clear .secretions, .maybe .don't .need .a .ventilator. Work .of .breathing .- .Compliance .- .CORRECT .ANSWER-How .much .volume .do .we .need .to .bring .in .to .inflate .the .alveoli.
  • If .we .decrease .fluid .and .fix .pulmonary .edema, .maybe .we .don't .need .a .ventilator.
  • Compliance .is .the .opposite .of .elasticity. .A .thick .rubber .band .is .very .elastic .but .has .low .compliance .(requires .more .pressure .to .inflate)..
  • A .skinny .rubber .band .is .not .elastic .but .has .high .compliance .(easy .to .inflate). Low .compliance .- .CORRECT .ANSWER-Stiff .lung .(high .elastic .recoil): .thick .balloon, .often .seen .in .fibrosis. High .compliance .- .CORRECT .ANSWER-Pliable .lung .(low .elastic .recoil): .grocery .bag, .often .seen .in .emphysema. A-a .gradient .- .CORRECT .ANSWER-Measures .the .difference .between .the .oxygen .concentration .in .the .alveoli .and .arterial .system.
  • Normal .is. 12 - 15 A=alveolar .oxygen a=arterial .oxygen Causes .of .hypoxemia .- .CORRECT .ANSWER-Right-to-left .shunt, .hypoventilation, .low .inspired .O2 .tension, .diffusion .defect, .V/Q .mismatch Normal .A-a .O2 .gradient .- .CORRECT .ANSWER-*Low .PIO2 .(low .inhaled .O .concentration)
  • high .elevation .or .house .fires
  • incidence .where .another .gas .takes .over .oxygen .in .air .(MRI .story) *Alveolar .hypoventilation
  • Overdose Increased .A-a .O2 .gradient .(wide) .- .CORRECT .ANSWER-*V/Q .mismatch
  • in .case .of .mucus .plug
  • Opposite .end .of .shunt .is .dead .space, .where .there's .no .blood .flow .to .pulmonary .capillary .despite .lots .of .ventilation. *Shunt .(low .ventilation .to .perfusion .ratio; .and .extreme .form .of .low .V/Q .mismatch)
  • In .cases .of .pneumonia, .ARDs, .pulmonary .edema
  • .Diffusion .defect .(thickening .of .alveolar .capillary .membrane)
  • In .cases .of .fibrosis .(thickening .of .alveolar/capillary .liner .from .interstitial .lung .disease; .diffusion .of .O2) .or .increased .distance .between .the .walls .(milder .pulmonary .edema, .d/t .fluid; .diffusion .of .O2) .-- .measure .with .DLCO. V/Q .- .CORRECT .ANSWER-Ventilation .is .about .4L .of .air .per .minute .and .Perfusion .is .about .%L .of .blood .per .minute.
  • Normal .V/Q .is .4/5=0.
  • Both .shunting .and .dead .space .can .lead .to .hypoxemia. .Both .asthma .and .pulmonary .edema .can .lead .to .hypoxemia .by .shunting.. Perfusion .without .ventilation .(Shunt) .V/Q= Ventilation .without .perfusion .(dead .space) .V/Q=infinity DLCO .- .CORRECT .ANSWER-Diffusion .capacity .of .the .lung .for .carbon .monoxide.
  • how .easy .it .is .for .O2 .to .diffuse .from .the .air .to .the .bloodstream; .since .O2 .is .difficult .to .measure, .do .it .with .a .small .amount .of .carbon .monoxide .instead..
  • Measure .the .exact .amount .given .and .how .much .is .exhaled .and .subtract .the .two. --If .there .is .a .big .difference, .able .to .diffuse .a .lot. Variables .affecting .DLCO .- .CORRECT .ANSWER-Hb, .COHb, .Altitude, .PAO2, .Body .position, .pulmonary .capillary .blood .volume, .Asthma, .Obesity.
  • .Destruction .of .alveoli .through .breakdown .of .elastin .within .septa .caused .by .an .imbalance .between .proteases .and .antiproteases, .oxidative .stress, .and .apoptosis .of .lung .cells. Emphysema .patho .- .CORRECT .ANSWER-Cigarette .smoke .stimulates .polymorphonuclear .leucocytes .to .release .serine .elastase. .The .smoke .also .inactivates .the .elastase .inhibitor .alpha1-antitrypsin. .This .lets .serine .elastase .destroy .elastic .tissues .of .lung, .producing .emphysema. Fibrotic .lung .disease .(Restrictive) .- .CORRECT .ANSWER-Thickened .alveolar .membrane .slows .gas .exchange. .Loss .of .lung .compliance .may .decrease .alveolar .ventilation.
  • Excessive .amount .of .fibrous .or .connective .tissue .in .the .lung .(scar .after .pulmonary .disease, .autoimmune .disorders, .or .by .inhalation .of .harmful .substances).
  • Chronic .inflammation .leads .to .fibrosis .and .alveolar .epithelization. ** .Lungs .become .stiff .and .difficult .to .ventilate. Pulmonary .fibrosis .(Restrictive) .- .CORRECT .ANSWER-An .excessive .amount .of .connective .tissue .in .the .lung. .It .diminishes .lung .compliance .and .may .be .idiopathic .or .caused .by .disease; .it .results .in .decreased .oxygen .diffusion .and .hypoxemia. Obstructive .lung .disease .- .CORRECT .ANSWER-Airway .obstruction .that .is .worse .with .expiration.
  • takes .more .force .or .more .time .to .expire .a .given .volume .of .air.
  • can .be .acute .or .chronic .(asthma, .chronic .bronchitis, .and .emphysema) Restrictive .lung .disease .- .CORRECT .ANSWER-Decreased .lung .compliance .(usually .alveoli).
  • Alveoli .stiff, .collapse, .hard .to .re-inflate.
  • Takes .more .effort .to .expand .the .lungs .and .chest .wall .during .inspiration..
  • Reduced .vital .capacity Restrictive .lung .disorders .- .CORRECT .ANSWER-1. .Difficult .to .inflate .space .(lesions, .effusions, .pneumonia, .ARDS, .pulmonary .edema .or .tumor)
  1. .Loss .of .lung .volume .(atelectasis, .lobectomy)
  2. .Decreased .compliance .(fibrotic .disease)
  3. .Deformity .of .chest .wall .(kyphoscoliosis)
  4. .Weakness .of .muscle .(neuromuscular)
  5. .Extra-thoracic .restriction .(obesity, .ascites, .pregnancy) Obstructive .lung .disorders .- .CORRECT .ANSWER-Asthma, .COPD, .bronchiectasis, .cystic .fibrosis. Mechanisms .responsible .for .airway .obstruction .in .COPD .- .CORRECT .ANSWER- *Inflammation .and .fibrosis .of .bronchial .wall .-> .Bronchial .edema.

Hypertrophied .mucous .glands .--> .excess .mucus .Obstructed .airflow, .hypersecretion .of .mucus. Loss .of .alveolar .tissue .-> .Decreased .surface .area .for .gas .exchange, .bacterial .colonization .of .airways, .destruction .of .alveolar .septa .Loss .of .elastic .lung .fibers .->Airway .collapse, .obstructed .exhalation, .air .trapping, .and .loss .of .elastic .recoil .of .bronchial .walls. FEV1/FVC .in .Obstructive .- .CORRECT .ANSWER-FEV1 .is .reduced .due .to .narrowed .airways..

  • FVC .is .usually .normal .or .nearly .normal, .so .FEV1/FVC .ratio .is .reduced. FEV1/FVC .in .Restrictive .- .CORRECT .ANSWER-FEV1 .is .reduced .but .so .is .FVC.
  • FEV1/FVC .ratios .is .not .decreased, .may .be .increased. Intrapulmonary .shunt .- .CORRECT .ANSWER-When .alveoli .are .perfused .with .blood .as .normal, .but .ventilation .fails .to .supply .the .perfused .region..
  • The .ventilation/perfusion .ratio .is .zero
  • A .pulmonary .shunt .often .occurs .when .the .alveoli .fill .with .fluid, .causing .parts .of .the .lung .to .be .unventilated