Deck 32: Disorders of the Pleura

Question 1

Which of the following conditions is considered a complication of a thoracentesis?

A)Increased intracranial pressure
B)Pneumothorax
C)Pneumonia
D)Consolidation

Answer 1

B
Complications of thoracentesis include pneumothorax,hemorrhage,and infection.

Question 2

In which of the following body positions are radiographs generally taken to reveal the presence of excess fluid in the pleural space?

A)Anteroposterior (AP)recumbent
B)Posteroanterior (PA)recumbent
C)Fowler
D)Lateral decubitus

Answer 2

D
In healthy individuals the chest radiograph seldom demonstrates any pleural fluid.An estimated 4% of normal adults may have minor radiographic evidence of pleural fluid if the films are taken in the decubitus or Trendelenburg position.

Question 3

Which of the following clinical symptoms is associated with a pleural effusion?

A)Chest pain
B)Productive cough
C)Dyspnea
D)Dysphagia

Answer 3

A
The patient may experience few symptoms from a small pleural effusion but usually has symptoms of respiratory distress with larger accumulations.Chest pain,chest wall tenderness,dyspnea,and pain with coughing or deep breathing are often associated with pleural effusions.

Question 4

Which of the following clinical conditions causes fluid to accumulate in the pleural space?

A)Congestive heart failure
B)Asthma
C)Cor pulmonale
D)Chronic obstructive pulmonary disease

Question 5

What procedure should the therapist suggest to relieve a tension pneumothorax while awaiting more definitive treatment?

A)Insertion of thoracostomy tubes
B)Thoracotomy
C)Thoracentesis with a large-bore needle
D)Needle thoracostomy

Question 6

What type of auscultatory and percussion findings often reveal evidence of a pleural effusion?

A)Wheezing;hyperresonance
B)Crackles;bronchovesicular
C)Crackles;dull
D)Diminished;dull

Question 7

Which of the following factors determines the amount of fluid present in the pleural space?

A)Intracapillary hydrostatic pressure
B)Subatmospheric pressure in the pleural space
C)Pleural pressure
D)Intra-alveolar pressure

Question 8

Which of the following mechanisms explains the accumulation of fluid in the pleural space of patients with ARDS?

A)Increased capillary permeability
B)Decreased osmotic pressure
C)Increased hydrostatic pressure
D)Obstructed lymphatic drainage

Question 9

Fluid drained from a thoracentesis has the appearance of pus.Which of the following microorganisms should the therapist typically suspect in children with empyema?

A)Staphylococcus aureus
B)Streptococcus pneumoniae
C)Klebsiella pneumoniae
D)Mycoplasma pneumoniae

Question 10

The therapist is assessing a water seal and a collection chamber and observes bubbling in the water seal chamber.What should the therapist do at this time?

A)Nothing because bubbling indicates normal function
B)Increase the suction pressure
C)Reassess the patient because bubbling indicates presence of air leak
D)Remove the chest tube

Question 11

Which of the following laboratory analyses would the respiratory therapist possibly conduct,using a sample of pleural fluid?

A)Determination of the causative microorganism
B)pH determination
C)Determination that the effusion is an exudate or a transudate
D)Composition testing

Question 12

Excessive amounts of pleural fluid may require drainage through a chest tube.What is the normal amount of fluid present in the pleural space?

A)1 L
B)5 to 10 L
C)10 to 50 mL
D)1 to 5 mL

Question 13

Which of the following are the most common symptoms associated with pneumothorax?

A)Cough and headache
B)Shortness of breath and chest pain
C)Hemoptysis and chest pain
D)Dry cough and dyspnea

Question 14

What is the most common cause of pleural effusion in the pediatric population?

A)Empyema
B)Congestive heart failure
C)Parapneumonic effusion
D)Adenobacterial effusion