ATI LPN
Exam Questions on Respiratory System Questions
Question 1 of 5
The nurse is planning to teach a client with COPD how to cough effectively. Which of the following instructions should be included?
Correct Answer: A
Rationale: Effective coughing in COPD conserves energy, clears secretions, and prevents airway collapse. Option A three deep abdominal breaths, bending forward, coughing with 'who' (huff cough) enhances expiration by increasing airway pressure, keeping passages open, and mobilizing mucus. Sitting upright with feet grounded optimizes lung expansion; pursed-lip breathing aids control. Lying flat (B) restricts expansion, splinting limits force. Rapid, shallow breaths and forceful coughing (C) tire the client and collapse airways, trapping secretions. Side-lying with arm overhead (D) doesn't maximize chest mechanics. The huff technique, repeated 3-4 times, leverages diaphragm strength, critical for COPD patients with weakened respiratory muscles, improving secretion clearance and reducing infection risk.
Question 2 of 5
A 48-year-old man has gradually increasing dyspnea and 4-kg weight loss over the past 2 years. He has smoked two packs of cigarettes per day for 20 years, but not for the past year. Physical examination shows an increase in the anteroposterior diameter of the chest. Auscultation of the chest shows decreased breath sounds. A chest radiograph shows bilateral hyperlucent lungs; the lucency is especially marked in the upper lobes. Pulmonary function tests show that FEV1 is markedly decreased, FVC is normal, and the FEV1/FVC ratio is decreased. Which of the following is most likely to contribute to the pathogenesis of his disease?
Correct Answer: D
Rationale: Release of elastase from neutrophils (D) drives this smoker's centriacinar emphysema . Smoking (40 pack-years) recruits neutrophils, releasing elastase that degrades alveolar walls (300 million to 150 million), causing air trapping (FEV1/FVC <70%). Hyperlucency and barrel chest reflect loss of elastic recoil . Chloride transport (A) is cystic fibrosis bronchiectasis, not emphysema. Ciliary defects (B) cause bronchiectasis in Kartagener's. AAT deficiency (C) yields panacinar emphysema, less common, not upper-lobe dominant. D's unchecked elastase smoking boosts it 10-fold contrasts A's mucus issue or C's genetic rarity, per pathology texts.
Question 3 of 5
A 33-year-old man has had increasing dyspnea for the past 8 years. He does not smoke. On examination, there are decreased breath sounds over lower lung fields. A chest radiograph shows flattened diaphragms; his CT scan is shown in the figure. Pulmonary function tests show decreased DLCO, decreased FEV1, and increased FVC. Arterial blood gas analysis shows Po2, 65 mm Hg; Pco2, 60 mm Hg; HCO3-, 32 mEq/L; and pH, 7.35. A sibling is similarly affected. What is the most likely mechanism for his pulmonary disease?
Correct Answer: D
Rationale: Reduced antielastase activity (D) from AAT deficiency causes panacinar emphysema . Nonsmoker, familial pattern (PiZZ genotype), and lower-lobe damage drop DLCO and FEV1. Atopy (A) is asthma. CFTR (B) yields bronchiectasis. Neutrophils (C) fit smoking. D's elastase excess 50% alveolar loss contrasts A's reversibility, per document.
Question 4 of 5
a 76 year old man came with dry cough and wheezing, he's been taking aspirin for 4 months as a prophylactic treatment. Which of the following is the most probable diagnosis for him?
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 5 of 5
which one of the following is not type of emphysema?
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.