IGNOU Post B. SC. Nursing entrance-2019
Medical & Surgical Nursing
Medium
All of the following are causes of Type I (hypoxaemic) respiratory failure, except?
Appeared in: IGNOU Post B. SC. Nursing entrance-2019
Explanation
- Drug overdose, particularly with opioids or sedatives, suppresses the respiratory center in the central nervous system.
- This suppression leads to alveolar hypoventilation, a state of reduced overall breathing, which impairs the body's ability to eliminate carbon dioxide.
- The resulting buildup of carbon dioxide in the blood (hypercapnia, PaCO₂ greater than 50 mmHg) is the defining characteristic of Type II respiratory failure, not Type I.
Why Other Options Were Wrong
- Option A: Asthma causes widespread bronchoconstriction and airway inflammation, leading to a severe ventilation/perfusion (V/Q) mismatch. This impairs oxygen transfer and is a classic cause of Type I (hypoxemic) respiratory failure.
- Option B: In pulmonary oedema, fluid fills the alveoli, preventing gas exchange. This creates an intrapulmonary shunt where blood passes through the lungs without being oxygenated, leading to profound hypoxemia, which is characteristic of Type I respiratory failure.
- Option D: Granulomatous lung diseases, such as sarcoidosis or tuberculosis, cause inflammation and fibrosis of the lung interstitium. This thickens the alveolar-capillary membrane, impairing the diffusion of oxygen from the alveoli into the blood, resulting in Type I (hypoxemic) respiratory failure.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Classification and causes of respiratory failure (Type I vs. Type II) as background academic context rather than a clinical decision trigger.
- Differentiating between Type I and Type II respiratory failure is crucial for nurses as the management strategies differ significantly. Type I failure is managed by increasing inspired oxygen (FiO₂), while Type II failure often requires mechanical ventilation to support breathing and reduce CO₂ levels.
- In a patient with a suspected drug overdose and respiratory depression, the priority nursing actions are to maintain a patent airway, provide ventilatory support (e.g., with a bag-valve-mask), and prepare for the administration of reversal agents like naloxone for opioid overdose.
- What if? If a patient with severe asthma initially presents with Type I failure (low O₂, low/normal CO₂) but then becomes drowsy and their PaCO₂ starts to rise, they are progressing to Type II failure. This is an ominous sign of respiratory muscle fatigue and impending respiratory arrest, requiring immediate escalation for intubation and mechanical ventilation.
How to Approach the Question
- First, recognize the negative framing of the question with the word 'except'. This means you are looking for the option that is NOT a cause of Type I respiratory failure.
- Recall the core definitions: Type I (Hypoxemic) failure is an 'oxygenation' problem (low PaO₂). Type II (Hypercapnic) failure is a 'ventilation' problem (high PaCO₂).
- Analyze the pathophysiology of each option. Ask yourself: 'Does this condition primarily affect the lung's ability to get oxygen into the blood, or does it affect the overall act of breathing?'
- Asthma, pulmonary edema, and granulomatous diseases all create problems within the lung (V/Q mismatch, shunt, diffusion block), impairing oxygenation. These are causes of Type I failure.
- Drug overdose affects the brain's control over breathing, leading to slow or shallow breaths (hypoventilation). This is a cause of Type II failure.
- Since the question asks for the exception to Type I causes, the correct answer is the one that causes Type II failure.
Concept Tested & Keywords
- Concept Tested: Classification and causes of respiratory failure (Type I vs. Type II)
- Stem keywords: Type I respiratory failure, hypoxaemic, causes
- Lead-in keywords: except
- Negative lead-in flag: Question asks for the exception
Question ID
QgO6wTOPZRsZM3xehV8CSJ
Reference Book
E6 Medicine Harrison 22e Part 2 p. 199-201
E6 Medicine Davidson Principles Practice 24e p. 585-587
E6 Nursing Brunner Adult Health 3SA Vol 1 Part 2 p. 4-6
Practise the full IGNOU Post B. SC. Nursing entrance-2019
Attempt every question from this paper in a timed mock, then review the full solution for each one.
More Gas Exchange and Respiratory Function Questions
- Which is the most relevant knowledge about oxygen administration to a client with COPD?
- Patient in emergency department diagnosed to have fluid and air present in lung. What is the above-mentioned condition known as?
- Patient is suffering from dyspnea. Which position will you provide for patient to relieve?
- Identify the following instrument which is used in diagnostic procedures:
- Identify the instrument shown in the following image:
- Identify the tube in the following image:
- Which of the following method is used for high flow oxygen administration:
- The following conditions can be diagnosed using chest X-ray; EXCEPT:
- The X-ray finding in a patient with pleural effusion reveals that fluid starts to build up as a result of gravity in:
- Surgical procedure used to correct a deviated nasal septum is:
More IGNOU Post B. SC. Nursing entrance-2019 Questions
- Midbrain (brain stem) contains the center for?
- The process to attend and react to a stimulus is known as?
- External auditory canal can be straightened most appropriately in adults by pulling the pinna?
- All of the following organs have involuntary muscles except?
- The body system that collects, processes, and responds to information using electrical signals?
- The most dilated portion of the digestive system is?
- One of the following bacteria has the capability to form spores:
- One of the following scientists demonstrated the transmission of malarial parasites by the bite of an Anopheles mosquito:
- Psychosocial theory of development was proposed by?
- Identity Vs. Role confusion as a psychosocial crisis is in which stage of development?