CMSRN – Pulmonary Exam Questions And Correct Answers
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Course
CMSRN
Institution
CMSRN
CMSRN – Pulmonary Exam Questions And
Correct Answers
Common causes of aspiration - answerIntubation. vomiting, tube feedings, conditions that
supress cough/gag reflex, oversedation, CNS disorders
Symptoms of aspiration - answerCoughing when eating/drinking, feeding tube not in place, O2
sats...
CMSRN – Pulmonary Exam Questions And
Correct Answers
Common causes of aspiration - answer✔Intubation. vomiting, tube feedings, conditions that
supress cough/gag reflex, oversedation, CNS disorders
Symptoms of aspiration - answer✔Coughing when eating/drinking, feeding tube not in place, O2
sats decreased, c/o SOB
Diagnostic tests for aspiration - answer✔CXR, ABG, CT chest
What is pneumanitis - answer✔Typically an inflammatory response to aspiration
How do we treat pneumonitis - answer✔Supportive care, can profess to pneumonia - in which
case we need abx therapy tailored to sputum cultures
How to prevent pneumonitis/aspiration - answer✔Keep HOB 30-45 degrees (especially if pt on
tube feeds). Verify position of NG tube
How to verify NG placement - answer✔Chest x-ray is the only way to verify 100%. Auscultation
and pH testing can help indicate correct placement.
Alveolar Cells Type 1 - answer✔Make up the squamous epithelium. Where gas exchange occurs.
Semi-permeable membrane allows for gas exchange according to pressure gradients.
Alveolar Cells Type 2 - answer✔secrete pulmonary surfactant and reabsorb sodium and water,
preventing fluid buildup. This decreases work of breathing by allowing alveoli to stay open at
low distending pressures.
Minute Ventilation - answer✔Amount of air exchanged in 1 minute. Calculated by Tidal Volume
x Respiratory Rate. 6L is the normal resting minute ventilation in adults.
Tidal Volume - answer✔Amount of air that moves in and out of the lungs during a normal breath
Alveolar Ventilation - answer✔The volume of air that reaches the alveoli. Normal CO2 indicates
adequate alveolar ventilation.
COPD - answer✔Common term for chronic bronchitis and emphysema. Most patients have a
combination of both diseases
COPD etiology - answer✔group of conditions associated with obstruction of airflow entering or
leaving the lungs, due to genetic and environmental causes
asthma- chronic disease with episodic attacks of breathlessness
emphysema- overinflation of alveoli, resulting in destruction of alveolar walls
chronic bronchitis- inflammation of bronchi with productive cough
cystic fibrosis- hereditary dysfunction of exocrine glands, causing production of abnormally
thick mucous secretions
Chronic Bronchitis - answer✔inflammation of the bronchi persisting over at least 3 months per
year x 2 years. Results from mucous gland and goblet cell hyperplasia. Causes decreased cilia,
increasing risk for infection. Hypoxemia is common as well as cyanosis. "Blue bloaters"
V/Q mismatch - answer✔An imbalance in the amount of oxygen received in the alveoli and the
amount of blood flowing through the alveolar capillaries
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