Question 1

In the absence of surgery or trauma, what does the presence of blood in the pleural fluid most likely signify?

Accepted Answer

The presence of blood in the pleural fluid, known as a hemothorax, in the absence of surgery or trauma, most likely signifies a malignant disease. This can occur when cancer cells invade the pleural space, causing bleeding.

Question 2

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

Accepted Answer

Transudative pleural effusions are characterized by thin, watery fluid with low protein content and few blood cells, indicating a systemic cause like heart failure or cirrhosis, rather than local inflammation or infection.

Question 3

An adult patient with a large pleural effusion requires placement of a thoracostomy tube. Which of the following statements are true regarding thoracostomy tube placement?
1) The tube is placed in the second to third intercostal space.
2) The tube is placed in the fourth to fifth intercostal space.
3) The tube is placed in the midclavicular line.
4) The tube is placed in the midaxillary line.

Accepted Answer

For a large pleural effusion, the thoracostomy tube is typically placed in the fourth to fifth intercostal space at the midaxillary line to ensure optimal drainage and avoid injury to underlying structures.

Question 4

A respiratory therapist is assisting a physician who is performing a thoracentesis. It is suspected that the patient has a chylothorax. How would the pleural effusion be described?

Accepted Answer

The answer of A respiratory therapist is assisting a physician...

Question 5

Treatment of an empyema typically includes:

Accepted Answer

Thoracostomy tube insertion is a common treatment for empyema, which involves draining the infected fluid from the pleural space. Other options like pleurodesis, lobectomy, and pneumonectomy are not standard treatments for empyema.

Question 6

Pulmonary function testing on a patient with atelectasis associated with pleural effusion would likely reveal:
1) increased VC.
2) decreased ERV.
3) decreased FRC.
4) normal RV/TLC ratio.

Accepted Answer

The answer of Pulmonary function testing on a patient with...

Question 7

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

Accepted Answer

The answer of A patient has malignant mesothelioma related to...

Question 8

A 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, which of the following tests should be performed?
1) Specific gravity
2) Biochemical makeup
3) Cytologic examination
4) Bacterial culture

Accepted Answer

To identify the cause of a pleural effusion, analyzing the biochemical makeup (to check for substances like proteins, lactate dehydrogenase), performing a cytologic examination (to look for cancer cells or other abnormal cells), and conducting a bacterial culture (to identify any bacterial infection) are essential. Specific gravity alone is less informative without these other tests.

Question 9

During a chest assessment on a patient with a large pleural effusion, which of the following would be expected?
1) Increased tactile and vocal fremitus
2) Hyperresonant percussion note
3) Diminished breath sounds
4) Tracheal shift

Accepted Answer

Pleural effusion typically leads to diminished breath sounds due to fluid accumulation in the pleural space, and tracheal shift if the effusion is large enough to exert pressure on the mediastinum. Increased tactile and vocal fremitus and hyperresonant percussion notes are not characteristic of pleural effusion; instead, fremitus is usually decreased, and percussion notes are dull.

Question 10

The major pathologic and structural changes associated with a significant pleural effusion include which of the following?
1) Diaphragm elevation
2) Atelectasis
3) Compression of the great vessels
4) Lung compression

Accepted Answer

A significant pleural effusion can lead to atelectasis, compression of the great vessels, and lung compression due to the accumulation of fluid in the pleural space.

Question 11

What percentage of patients with bacterial pneumonia are likely to develop pleural effusion?

Accepted Answer

The answer of What percentage of patients with bacterial pneumonia...

Question 12

While reviewing an upright chest radiograph of a patient with a pleural effusion, the respiratory therapist observes a fluid density in the right lung area that extends upward around the anterior, lateral, and posterior thoracic walls. What is this characteristic sign called?

Accepted Answer

The Meniscus sign is characteristic of pleural effusion on an upright chest radiograph, where the fluid density is seen extending upward around the thoracic walls, creating a curved upper margin.

Question 13

The anatomic alteration caused by a pleural effusion is:

Accepted Answer

Pleural effusion is the accumulation of fluid in the pleural space, which naturally separates the visceral and parietal pleura. This condition does not cause fibrosis, adhesion, or edema directly but rather increases the space between the pleurae due to fluid accumulation.

Question 14

Which of the following are chest radiograph findings associated with a large pleural effusion?
1) Blunting of the costophrenic angle
2) Fluid level on the affected side
3) Mediastinal shift toward the unaffected side
4) Elevated hemidiaphragm on the affected side

Accepted Answer

Chest radiographs of a large pleural effusion often show blunting of the costophrenic angle due to fluid accumulation, a visible fluid level on the affected side, and mediastinal shift toward the unaffected side as the fluid volume increases and pushes against the lung and mediastinum.

Question 15

What is the most common cause of a chylothorax?

Accepted Answer

The most common cause of a chylothorax is thoracic duct trauma, which can occur due to surgical procedures, accidents, or malignancies that disrupt the integrity of the thoracic duct, leading to the accumulation of lymphatic fluid in the pleural space.

Quiz 24: Pleural Effusion and Empyema

In the absence of surgery or trauma, what does the presence of blood in the pleural fluid most likely signify?

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 respiratory therapist is assisting a physician who is performing a thoracentesis. It is suspected that the patient has a chylothorax. How would the pleural effusion be described?

Treatment of an empyema typically includes:

Pulmonary function testing on a patient with atelectasis associated with pleural effusion would likely reveal: 1) increased VC. 2) decreased ERV. 3) decreased FRC. 4) normal RV/TLC ratio.

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

A 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, which of the following tests should be performed? 1) Specific gravity 2) Biochemical makeup 3) Cytologic examination 4) Bacterial culture

During a chest assessment on a patient with a large pleural effusion, which of the following would be expected? 1) Increased tactile and vocal fremitus 2) Hyperresonant percussion note 3) Diminished breath sounds 4) Tracheal shift

The major pathologic and structural changes associated with a significant pleural effusion include which of the following? 1) Diaphragm elevation 2) Atelectasis 3) Compression of the great vessels 4) Lung compression

What percentage of patients with bacterial pneumonia are likely to develop pleural effusion?

While reviewing an upright chest radiograph of a patient with a pleural effusion, the respiratory therapist observes a fluid density in the right lung area that extends upward around the anterior, lateral, and posterior thoracic walls. What is this characteristic sign called?

The anatomic alteration caused by a pleural effusion is:

Which of the following are chest radiograph findings associated with a large pleural effusion? 1) Blunting of the costophrenic angle 2) Fluid level on the affected side 3) Mediastinal shift toward the unaffected side 4) Elevated hemidiaphragm on the affected side

What is the most common cause of a chylothorax?