NUR 334 Exam 3 Review Questions and
Correct Answers
Blood pH ✅• Neither blood buffer systems nor the respiratory control mechanisms for
carbon dioxide elimination can eliminate H+ from the body - this is accomplished by the
kidneys
• The ability of the kidneys to excrete large amounts of H+ in the urine is accomplished
by combining the excess ions with buffers in the urine
o The three major urine buffers are bicarbonate (HCO3 -), phosphate (HPO42 -), and
ammonia (NH3)
• An important aspect of this buffer system is that the deamination process increases
whenever the body's hydrogen ion concentration remains elevated for 1 to 2 days
Type H Alveolar Cell ✅• The alveolar epithelium is composed of two types of cells:
type I and type II alveolar cells
o Type I alveolar cells are extremely thin squamous cells with a thin cytoplasm and
flattened nucleus that occupy about 95% of the surface area of the alveoli
• Type I alveolar cells are not capable of regeneration
o Type II alveolar cells, which are found interspersed between the type I alveolar cells,
are secretory cells that produce the surface active agent called surfactant
• Type II alveolar cells are the progenitor cells for type I cells - following lung injury they
proliferate and restore both type I and type II alveolar cells
Surfactant ✅• The surfactant molecules produced by the type II alveolar cells reduce
the surface tension at the air-epithelium interface, and they modulate the immune
functions of the lung.
• Recent research has identified four types of surfactant, each with a different molecular
structure: surfactant proteins A, B, C, and D
o Surfactants B and C serve to reduce the surface tension at the air-epithelium interface
and increase lung compliance and ease of lung inflation,
o Surfactants A and D do not reduce surface tension, but contribute to innate immune
defenses that protect against pathogens that have entered the lung.
• They bind to pathogens, damage microbial membranes, regulate microbial
phagocytosis, and activate or deactivate the inflammatory response
Mucolytics ✅• Mucolytic agents such as guaifenesin may be used to thin secretions in
the treatment of rhinosinusitis
Decongestants ✅• The topical α-adrenergic decongestants may be used on a short-
term (3 days) basis in older children and adults to promote adequate drainage by
reducing nasal congestion in the treatment of rhinosinusitis
Spirometer ✅• Instrument used to measure lung volumes
,o The person is first asked to breathe normally into the spirometer, during which the
tidal volume is measured, and then to inhale and exhale maximally, during which the
IRV and ERV are measured
o The RV cannot be measured with a spirometer because the air cannot be expressed
from the lungs - it is measured from indirect methods, such as the helium dilution
methods, the nitrogen washout methods, or body plethysmography
o The spirometer is also used to determine dynamic lung volumes; these test are often
used in assessing pulmonary function
Lung Volume ✅• Lung volumes, or the amount of air exchanged, can be subdivided
into three components: tidal volume, the inspiratory reserve volume, and the expiratory
reserve volume
o The tidal volume (TV is the amount of air that moves into and out of the lungs during a
normal breath
• About 500 mL at rest
o The inspiratory reserve volume (IRV) is the amount of air that can be inspired in
excess of the normal TV
• About 3000 mL
o The expiratory reserve volume (ERV) is the maximum amount that can be exhaled in
excess of the normal TV
• About 1100 mL
o Approximately 1200 mL of air remains in the lungs after forced expiration; this air is
the residual volume (RV)
• About 1200 mL
• The RV increases with age because there is more trapping of air in the lungs at the
end of expiration
Lung Capacity ✅• Lung capacities include two or more lung volumes
o The vital capacity (VC) equals the IRV plus the TV and the ERV and is the amount of
air that can be exhaled from the point of maximal inspiration
• About 2300 mL
o The inspiratory capacity (IC) equals the TV plus the IRV. It is the amount of air a
person can breath in beginning at the normal expiratory level
• About 4600 mL
o The functions residual capacity (FRC) is the sum of the RV and the ERV; it is the
volume of air that remains in the lungs at the end of normal expiration
• About 5800 mL
Anemia ✅• Anemia tends to develop early in the course of CKD, often interfering with
the quality of life.
• The anemia of CKD is due to several factors, including chronic blood loss, hemolysis,
bone marrow suppression due to retained uremic factors, and decreased red cell
production due to impaired production erythropoietin and iron deficiency.
Folate ✅• It can treat certain types of anemia. It's also given to women who are
pregnant or who plan to become pregnant
, Myoglobin ✅• Myoglobin is an oxygen carrying protein similar to hemoglobin,
expressed in cardiac and skeletal muscle
Epiglottis ✅• The epiglottis, which is located above the vocal cords, is a large, leaf-
shaped piece of cartilage that is covered with epithelium
• During swallowing, the free edges of the epiglottis move downward to cover the larynx,
thus routing liquids and foods into the esophagus
• Part of the laryngotracheal airways
Mucociliary blanket ✅• The mucus produced by the epithelial cells in the conducting
airways forms a layer called the mucociliary blanket that protects the respiratory tract by
entrapping dust, bacteria, and other foreign particles that enter the airways.
• The cilia, which constantly are in motion, propel the mucociliary blanket with its
entrapped particles in an escalator-like fashion toward the oropharynx, from which it is
expectorated or swallowed.
Pleurisy ✅• Pleuritis (also called pleurisy) refers to inflammation of the parietal pleura
that typically results in characteristic pleural pain
• Since the visceral pleura does not contain pain receptors, pleural pain results from
somatic pain fibers that innervate the parietal pleura
o The pain is usually unilateral and abrupt in onset, and is usually made worse by chest
movements, such as deep breathing and coughing that exaggerate pressure changes in
the pleural cavity and increase movement of the inflamed or injured pleural surfaces
o Because deep breathing is painful, tidal volumes usually are kept small, and breathing
becomes more rapid to maintain the minute ventilation
o Reflex splinting of the chest muscles may occur, causing a lesser respiratory
expansion on the affected side
• In young, healthy individuals, it is commonly caused by viral infections or pneumonia
Pneumothorax ✅• Pneumothorax refers to the presence of air in the pleural space.
• Pneumothorax causes partial or complete collapse of the affected lung
• Pneumothorax can occur without any obvious cause or injury (spontaneous
pneumothorax) or as a result of direct injury to the chest or major airways (traumatic
pneumothorax)
o Spontaneous pneumothorax is hypothesized to occur due the rupture of an air-filled
bleb, or blister, on the surface of the lung. Rupture of these blebs allows atmospheric air
from the airways to enter the pleural cavity
• Because alveolar pressure is normally greater than pleural pressure, air flows form the
alveoli into the pleural space, causing the involved portion of the lung to collapse as a
result of its own recoil
• Tension pneumothorax describes a life-threatening condition in which increased
pressure within the pleural cavity impairs both respiratory and cardiac function
o Occurs when injury to the chest or respiratory structures allows air to enter but nor
leave the pleural space
