Question

Which type of sleep apnea is characterized by lack of airflow due to pharyngeal occlusion?

Answer 1

Correct Answers:

Obstructive

Rationale :

🫁OSA is caused by pharyngeal (upper-airway) collapse/occlusion during sleep, which blocks airflow despite continued respiratory effort.

🫁The hallmark is recurrent apneic episodes with snoring, witnessed apneas, and daytime sleepiness due to fragmented sleep.

🫁Pathophysiology centers on loss of upper-airway tone in sleep, especially in the oropharynx and soft palate, narrowing the airway.

🫁Obesity, craniofacial crowding, and enlarged tonsils increase tissue load in the pharynx, further promoting occlusion.

🫁CPAP (positive airway pressure) splints the airway open, directly addressing the mechanical obstruction.

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Answer 2

Correct Answers:

Redness and induration.

Rationale :

💉A Mantoux (PPD) reaction is identified by palpable induration at the injection site, which reflects cell-mediated (delayed-type) hypersensitivity to TB antigens.

💉Induration (measured in millimeters) is the diagnostic criterion; erythema may accompany but is not measured—the presence of a firm, raised area is what matters.

💉The size threshold for positivity varies by risk group (e.g., ≥5 mm, ≥10 mm, or ≥15 mm), but the core feature is induration.

💉Proper technique includes intradermal placement on the forearm and reading at 48–72 hours to capture the peak reaction.

💉Documentation should include site, arm, and exact induration size in mm, not simply “positive” or “negative.”

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Answer 3

Correct Answers:

Barrel-shaped chest

Rationale :

🌬️In advanced emphysema, air trapping and hyperinflation increase the anteroposterior (AP) chest diameter, producing a barrel-shaped chest.

🌬️Destruction of alveolar walls reduces elastic recoil, so air is retained during exhalation, expanding thoracic volume.

🌬️Patients often adopt pursed-lip breathing to maintain airway pressure and improve expiratory flow from hyperinflated lungs.

🌬️Physical findings can include decreased breath sounds, hyperresonance to percussion, and use of accessory muscles.

🌬️Imaging typically shows flattened diaphragms and increased retrosternal airspace, consistent with hyperinflation.

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Answer 4

Correct Answers:

Hemoptysis

Rationale :

🩸Hemoptysis is coughing up blood from the lower respiratory tract and commonly presents with TB, bronchiectasis, or severe bronchitis.

🩸The client’s recent travel to Southeast Asia plus weeks of malaise heightens suspicion for pulmonary tuberculosis.

🩸In TB, cavitary lesions can erode blood vessels, leading to blood-tinged sputum or frank hemoptysis.

🩸Assessment should include TB screening/NAAT, chest imaging, and airborne precautions if TB is suspected.

🩸Stabilization prioritizes airway, breathing, and circulation, with quantification of blood loss and monitoring for hypoxemia.

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Answer 5

Correct Answers:

Epistaxis

Rationale :

👃Epistaxis refers to acute nasal bleeding, most commonly from Kiesselbach’s plexus in the anterior nasal septum.

👃Initial management includes upright positioning, forward head tilt, and firm pressure on the soft part of the nose for 10–15 minutes.

👃Topical vasoconstrictors (e.g., oxymetazoline) and cautery may be used if direct pressure fails.

👃Identify triggers such as nasal trauma, dry air, anticoagulants, or hypertension and address modifiable risks.

👃Avoid posterior head tilt, which increases the risk of blood aspiration and nausea.

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Answer 6

Correct Answers:

acute respiratory distress syndrome (ARDS).

Rationale :

🚨Aspiration of gastric contents causes chemical pneumonitis that can trigger diffuse alveolar damage and non-cardiogenic pulmonary edema, the hallmark of ARDS.

🚨Large-volume resuscitation can worsen capillary leak and fluid shifts, compounding hypoxemia.

🚨ARDS is characterized by refractory hypoxemia, bilateral infiltrates on imaging, and reduced lung compliance in the absence of left-sided heart failure.

🚨Management centers on lung-protective ventilation (low tidal volumes, appropriate PEEP), prone positioning, and meticulous fluid management.

🚨Early recognition is critical to prevent ventilator-induced lung injury and improve outcomes.

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Answer 7

Correct Answers:

Chest pain and dyspnea

Rationale :

⚠️Pulmonary embolism (PE) typically presents with sudden dyspnea and pleuritic chest pain, often with tachycardia and hypoxemia.

⚠️The pathophysiology involves embolus-induced obstruction of pulmonary arteries, increasing dead space and ventilation–perfusion (V/Q) mismatch.

⚠️Additional findings can include hemoptysis, anxiety, and syncope in large emboli.

⚠️Risk factors include DVT, recent immobilization or surgery, malignancy, and estrogen therapy.

⚠️Workup includes Wells/Geneva scoring, D-dimer, and CT pulmonary angiography; start prompt anticoagulation if not contraindicated.

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Answer 8

Correct Answers:

Wheezes

Rationale :

🔊Wheezes are continuous, high-pitched, musical sounds most prominent during expiration due to airflow through narrowed bronchi.

🔊In asthma, bronchospasm, mucosal edema, and mucus plugging constrict airways, producing expiratory wheezes.

🔊The severity of wheezing does not always correlate with disease severity; silent chest may indicate severe airflow limitation.

🔊Treatment targets bronchial smooth muscle (e.g., short-acting beta-agonists) and airway inflammation (e.g., corticosteroids).

🔊Peak flow monitoring and response to bronchodilator therapy help assess reversibility.

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Answer 9

Correct Answers:

chronic bronchitis

Rationale :

🫁A chronic productive cough lasting at least 3 months (classically in 2 consecutive years) is the clinical definition of chronic bronchitis.

🫁Repeated wintertime cough with sputum production in long-term care residents strongly suggests chronic airway inflammation.

🫁Pathology features hypertrophy of mucus glands and goblet-cell hyperplasia, causing excess mucus and impaired ciliary clearance.

🫁Patients often exhibit coarse crackles/rhonchi, hypoxemia, and frequent infective exacerbations.

🫁Management includes smoking cessation (if applicable), bronchodilators, inhaled corticosteroids for frequent exacerbations, and vaccinations.

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Answer 10

Correct Answers:

Apply ice and tell the patient to keep his head elevated

Rationale :

❄️For a suspected nasal fracture, ice reduces edema and pain, while head elevation limits bleeding and swelling.

❄️Early measures also facilitate evaluation for septal hematoma, which requires urgent drainage to prevent cartilage necrosis.

❄️Avoid warm compresses, which increase vasodilation and worsen swelling.

❄️Assess for clear rhinorrhea (possible CSF leak), malocclusion, and ocular injury, and provide analgesia as ordered.

❄️Arrange timely ENT or maxillofacial follow-up for alignment and to minimize cosmetic/functional complications.

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NURS230 EXAM 1

No.

1 :
Which type of sleep apnea is characterized by lack of airflow due to pharyngeal occlusion?

2 :
When interpreting the results of a Mantoux test, the nurse explains to the client that a reaction occurs when the intradermal injection site shows:

3 :
Which assessment finding would be most consistent with advanced emphysema?

5 :
The nurse assesses a client who is bleeding profusely from the nose. The nurse documents this finding as which condition?

6 :
A client admitted with multiple traumatic injuries receives massive fluid resuscitation. Later, the physician suspects that the client has aspirated stomach contents. The nurse knows that this client is at highest risk for:

7 :
A nurse caring for a client with deep vein thrombosis must be especially alert for complications such as pulmonary embolism. Which findings suggest pulmonary embolism?

8 :
While auscultating the lungs of a client with asthma, the nurse hears a continuous, high-pitched whistling sound on expiration. The nurse will document this sound as which of the following?

9 :
A resident in the long-term care facility has been experiencing a chronic, productive cough for the last 3 months. The client tells the nurse "this is just my winter cough." This client most likely has which condition?

10 :
A 13-year-old boy has been brought to the emergency department by his mother after he took a powerful blow to his nose during a volleyball game. Preliminary examination suggests a nasal fracture, which should prompt the nurse to:

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NURS230 EXAM 1

No.

1 : Which type of sleep apnea is characterized by lack of airflow due to pharyngeal occlusion?

2 : When interpreting the results of a Mantoux test, the nurse explains to the client that a reaction occurs when the intradermal injection site shows:

3 : Which assessment finding would be most consistent with advanced emphysema?

5 : The nurse assesses a client who is bleeding profusely from the nose. The nurse documents this finding as which condition?

6 : A client admitted with multiple traumatic injuries receives massive fluid resuscitation. Later, the physician suspects that the client has aspirated stomach contents. The nurse knows that this client is at highest risk for:

7 : A nurse caring for a client with deep vein thrombosis must be especially alert for complications such as pulmonary embolism. Which findings suggest pulmonary embolism?

8 : While auscultating the lungs of a client with asthma, the nurse hears a continuous, high-pitched whistling sound on expiration. The nurse will document this sound as which of the following?

9 : A resident in the long-term care facility has been experiencing a chronic, productive cough for the last 3 months. The client tells the nurse "this is just my winter cough." This client most likely has which condition?

10 : A 13-year-old boy has been brought to the emergency department by his mother after he took a powerful blow to his nose during a volleyball game. Preliminary examination suggests a nasal fracture, which should prompt the nurse to:

1 :
Which type of sleep apnea is characterized by lack of airflow due to pharyngeal occlusion?

2 :
When interpreting the results of a Mantoux test, the nurse explains to the client that a reaction occurs when the intradermal injection site shows:

3 :
Which assessment finding would be most consistent with advanced emphysema?

5 :
The nurse assesses a client who is bleeding profusely from the nose. The nurse documents this finding as which condition?

6 :
A client admitted with multiple traumatic injuries receives massive fluid resuscitation. Later, the physician suspects that the client has aspirated stomach contents. The nurse knows that this client is at highest risk for:

7 :
A nurse caring for a client with deep vein thrombosis must be especially alert for complications such as pulmonary embolism. Which findings suggest pulmonary embolism?

8 :
While auscultating the lungs of a client with asthma, the nurse hears a continuous, high-pitched whistling sound on expiration. The nurse will document this sound as which of the following?

9 :
A resident in the long-term care facility has been experiencing a chronic, productive cough for the last 3 months. The client tells the nurse "this is just my winter cough." This client most likely has which condition?

10 :
A 13-year-old boy has been brought to the emergency department by his mother after he took a powerful blow to his nose during a volleyball game. Preliminary examination suggests a nasal fracture, which should prompt the nurse to: