Question 1

The nurse would explain that the client's diagnosis of interstitial pneumonia means

Accepted Answer

Interstitial pneumonia occurs when the parenchymal tissue surrounding the air space is inflamed.

Question 2

A client is hospitalized for an exacerbation of sarcoidosis. The nurse anticipates an order to administer

Accepted Answer

Sarcoidosis consists of an immune response at the site of involvement. Corticosteroids are used to blunt this response. Antibiotics and antipyretics are usually not a major part of the treatment plan. Rifampin is for TB.

Question 3

A spinal cord-injured client complains of severe dyspnea in the side-lying position. The nurse anticipates diagnostic testing to reveal

Accepted Answer

The most common causes of bilateral diaphragmatic paralysis include spinal cord injury, thoracic trauma, multiple sclerosis, nerve compression from tumors, anterior horn disease, and muscular dystrophy. Classic manifestations include dyspnea and hypoxemia in the side-lying position. There is generally no treatment for this condition unless the phrenic nerve is still intact, in which case a phrenic nerve pacemaker can be implanted.

Question 4

A client is being discharged after treatment for a bronchopleural fistula. Important self-care measures the nurse should teach include

Accepted Answer

Because these fistulas are slow to heal, clients may be sent home with closed-chest drainage systems. Teaching the client how to manage the chest tubes and drainage apparatus and what to report are important self-care measures.

Question 5

A client with HIV infection has a history of close exposure to someone with active pulmonary tuberculosis and has developed a cough and low-grade fever. The client's Mantoux is negative but the client has been admitted to the hospital for further testing. The most appropriate action by the nurse is to (Select all that apply)

Accepted Answer

The client should understand that a negative test result does not always mean that TB is absent, particularly in HIV-positive clients, who are immunosuppressed. Until TB has been ruled out, the client needs to be in respiratory isolation in a negative airflow room. These rooms should send room air directly to the outside and have at least six air exchanges per hour. Putting the client in a private room is not enough. The client should not have a roommate. The location of the room is less important than having negative airflow capability. Definitive testing for tuberculosis includes chest x-ray, AFB smears from sputum, and culture.

Question 6

A client has an interstitial lung disease (ILD) and has questions related to the disease process. The best explanation by the nurse is that ILD

Accepted Answer

In ILD the interstitium of the alveolar walls thickens and becomes fibrotic because of an accumulation of inflammatory cells. The thickened alveoli become nonfunctional.

Question 7

A client is admitted with flu-like symptoms that developed after hunting rabbits. The nurse anticipates which of the following initial orders for this client?

Accepted Answer

Pneumonic plague, which is a type of bubonic plague, can develop after exposure to infected rodents, rabbits, and fleas. Clinical manifestations start with flu-like symptoms, then progress to rapidly developing pneumonia with shortness of breath, cough, and blood or watery sputum. Clients need immediate respiratory isolation and caregivers need to wear tight-fitting, disposable surgical masks.

Question 8

Nurses caring for clients being treated for active pulmonary tuberculosis in the hospital are required to have (Select all that apply)

Accepted Answer

Personal protective equipment called a particulate respirator is required for all health care providers who enter the room of a client with active TB. Skin testing should be performed annually for all health care workers.

Question 9

A client is being evaluated for a lung transplant. The nurse assists the client to understand that the psychological assessment includes which of the following? (Select all that apply.)

Accepted Answer

Options a, b, and c all relate to the extensive psychosocial assessment done before listing a client for transplantation.

Question 10

A client has undergone a pleurodesis. The priority nursing action after the procedure is to assess the client's

Accepted Answer

Pleural space obliteration creates permanent changes and can create compromised respiratory function. Therefore the priority assessment in this case is of respiratory status.

Question 11

After the physician tells a client that pneumonia has caused the client's bilateral lobar atelectasis, the client anxiously asks the nurse, "Does that mean my lungs have collapsed?" The most informative response by the nurse would be the following:

Accepted Answer

Atelectasis can occur throughout the lung or in portions of it (lobar). The lung reinflates after the condition that caused the obstruction has been treated.

Question 12

A client comes to the clinic complaining of shortness of breath with activity that has gradually gotten worse over several years. An important finding from the nursing history would be the client's

Accepted Answer

Pneumoconioses ("dust diseases") are an occupational hazard for people who are coal miners, construction workers, sandblasters, potters, or who work in foundries and rock quarries. Manifestations develop gradually over a period of years and the decreased lung capacity is due to diffuse pulmonary fibrosis.

Question 13

A client has been diagnosed with histoplasmosis lung infection. The nurse would anticipate treatment to include

Accepted Answer

Amphotericin B or itraconazole are the treatments of choice for fungal lung infections.

Question 14

A nurse is planning care for a client who has an intrapulmonary restrictive lung disorder. The nurse chooses interventions with the understanding that treatment for this disease

Accepted Answer

Intrapulmonary restrictive disorders are not reversible. Management of the client revolves around maintaining a functional status and good quality of life as long as possible. Disorders that are extrapulmonary, for instance caused by obesity, can be helped by treating the underlying cause.

Quiz 62: Management of Clients with Parenchymal and Pleural Disorders