Deck 23: Effusion and Empyema

Question 1

Which of the following are major causes of an exudative pleural effusion?
1) Empyema
2) Chylothorax
3) Pancreatitis
4) Peritoneal dialysis

A)1, 4
B)2, 3
C)1, 2, 3
D)1, 2, 3, 4

Answer 1

1, 2, 3

Question 2

Your patient has a large pleural effusion. It will act as a/an:

A) restrictive lung disorder.
B)obstructive lung disorder.
C)obstructive > restrictive lung disorder.
D)restrictive > obstructive lung disorder.

Answer 2

restrictive lung disorder.

Question 3

Your patient has a pleural effusion from an unknown cause. A fluid sample has been taken for analysis. To help identify the cause of the effusion, all of the following tests should be performed EXCEPT:

A) specific gravity.
B)biochemical makeup.
C)cytologic examination.
D)check for bacteria.

Answer 3

specific gravity.

Question 4

While reviewing the upright chest radiograph of your patient, you see a fluid density in the right lung area that extends upward around the anterior, lateral, and posterior thoracic walls. What is this sign of a pleural effusion called?

A) Meniscus sign
B)Scarf sign
C)Transudate sign
D)Kerley B lines

Question 5

Your are assisting the physician who is performing a thoracentesis. It is suspected that the patient has a hemothorax. If that is the case, how would the pleural effusion fluid appear?

A) White color
B)Light yellow color
C)Red color
D)Green color

Question 6

Usual chest radiograph findings on a patient with a large pleural effusion include:
1) blunting of the costophrenic angle.
2) fluid level on the affected side.
3) mediastinal shift to the unaffected side.
4) mediastinal shift to the affected side.

A)1, 3
B)2, 4
C)1, 2, 4
D)1, 2, 3

Question 7

The causes of a transudative pleural effusion include:
1) congestive heart failure.
2) fungal pneumonia.
3) pulmonary embolism.
4) hemothorax.

A)1, 3
B)2, 4
C)1, 3, 4
D)1, 2, 3, 4

Question 8

Which of the following are associated with a transudative pleural effusion?
1) Thin and watery fluid
2) Fluid has a lot of cellular debris
3) Fluid has high protein count
4) Few blood cells

A)2, 3
B)1, 4
C)1, 2, 3
D)1, 3, 4

Question 9

The major pathologic and structural changes associated with a significant pleural effusion include all of the following EXCEPT:

A) diaphragm elevation.
B)atelectasis.
C)compression of the great vessels.
D)lung compression.

Question 10

Your patient with a large pleural effusion will have a chest tube inserted. Which of the following statements are true of this procedure?
1) Tube placement in the 2nd to 3rd intercostal space
2) Tube placement in the 4th to 5th intercostal space
3) Tube placement in the midclavicular line
4) Tube placement in the midaxillary line

A)1, 4
B)2, 3
C)1, 3
D)2, 4

Question 11

Treatment of an empyema usually includes:
1) antibiotics for bacterial infection.
2) thoracentesis.
3) lung removal (pneumonectomy).
4) lung transplant.

A)1
B)2
C)2, 3
D)1, 2

Question 12

Your patient with pneumonia of the left lung and related empyema has a distinctive breath sound heard over the affected area. What is the name of this characteristic breath sound?

A) Bronchial breath sound
B)Pleural friction rub
C)Empyema rhonchi
D)Pleural crackles

Question 13

The anatomic alteration caused by a pleural effusion is:

A) pulmonary fibrosis.
B)separation of the visceral and parietal pleura.
C)adhesion of the visceral and parietal pleura.
D)pulmonary edema.

Question 14

A large pleural effusion commonly demonstrates which of the following findings during a chest assessment?
1) Increased tactile and vocal fremitus
2) Hyperresonant percussion note
3) Diminished breath sounds
4) Tracheal shift

A)1
B)2, 3
C)3, 4
D)1, 3, 4

Question 15

Your patient has cancer related to his chronic asbestos exposure. What is his pleural effusion fluid likely to show on laboratory analysis?
1) Erythrocytes
2) Lymphocytes
3) Normal mesothelial cells
4) Malignant mesothelial cells

A)1, 4
B)2, 3
C)2, 3, 4
D)1, 2, 3, 4