Question 1

The nurse establishes the presence of a tension pneumothorax when assessment findings reveal which of the following results?

Accepted Answer

A tension pneumothorax occurs when air enters the pleural space and cannot escape, causing increasing pressure on the affected lung and mediastinal structures. This can lead to decreased breath sounds on the affected side due to compression of lung tissue, but lung sounds may still be heard. Inability to auscultate tracheal breath sounds would suggest obstruction of the airway, which is not a characteristic finding of tension pneumothorax. A sucking sound with each breath would suggest an open chest wound, which is a potential cause of tension pneumothorax but not a definitive finding. A shift of the point of maximal impulse to the left, with bounding pulses, is a classic finding in cardiac tamponade, not tension pneumothorax.

Question 2

In relation to lung cancer and gender,which of the following statements is true?

Accepted Answer

Women develop lung cancer after fewer years of smoking than men do. Although men were historically more likely to smoke, women are now smoking at rates similar to men, and studies have shown that they develop lung cancer after smoking for fewer years than men.

Question 3

When developing a teaching plan for a patient with a 42-pack-year history of cigarette smoking,it will be most important for the nurse to include information about which of the following?

Accepted Answer

Options for smoking cessation will be the most important information to include in the teaching plan for a patient with a 42-pack-year history of cigarette smoking. It is critical to help the patient quit smoking to decrease future health risks, such as lung cancer and chronic obstructive pulmonary disease (COPD). While annual sputum cytology testing and computed tomography screening for lung cancer are important, they will not be as effective in reducing the patient's risk as quitting smoking. Erlotinib therapy is used for the treatment of non-small-cell lung cancer, but it is not used for prevention.

Question 4

A 52-year-old patient has a 40-pack-year history of smoking and has been diagnosed with cancer of the lung.He tells the nurse that he did not know that anything was wrong until he had a routine chest X-ray.The nurse explains that symptoms of lung cancer occur late in the disease.What is the first thing people usually notice?

Accepted Answer

A persistent cough is often the first noticeable symptom of lung cancer, but it may only occur when the tumor is large or has spread to other areas. Fatigue, chest pain, and shortness of breath may occur later in the disease.

Question 5

A 68-year-old man has a long history of chronic obstructive pulmonary disease and is admitted to the hospital with cor pulmonale.Which clinical manifestation noted by the nurse is would indicate that the patient with a diagnosis of cor pulmonale also has heart failure?

Accepted Answer

Peripheral edema is a classic sign of heart failure, which can occur secondary to cor pulmonale. Audible crackles at both lung bases may indicate fluid in the lungs, which can also occur in heart failure but is not specific for it. A loud murmur at the mitral area may be indicative of mitral regurgitation, which can be a complication of heart failure but does not necessarily indicate its presence. High systemic blood pressure may be indicative of hypertension, which can lead to heart failure but is not specific for it.

Question 6

The nurse identifies a nursing diagnosis of ineffective airway clearance for a patient who has incisional pain,a poor cough effort,and expiratory wheezing after having a pneumonectomy.To promote airway clearance,what is the nurse's initial action?

Accepted Answer

Medicating the patient with the ordered morphine addresses the incisional pain, which is a significant barrier to effective coughing and deep breathing. By managing the pain, the patient will be better able to participate in activities like using an incentive spirometer, coughing effectively, and sitting up, which all promote airway clearance.

Question 7

A patient who was admitted the previous day with pneumonia complains of a sharp pain whenever he takes a deep breath.Which action will the nurse take next?

Accepted Answer

A sharp pain with deep breaths is suggestive of pleurisy or pleuritic chest pain, which can occur in patients with pneumonia. Listening to the patient's lungs can help assess for any changes in breath sounds or the presence of pleural friction rubs that would support the diagnosis of pleurisy. Checking oxygen saturation (B) and having the patient cough forcefully (C) may provide additional information but are not the most appropriate next steps. The nurse should notify the healthcare provider (D) if the patient's condition worsens or if there are any concerns, but listening to the lungs is the next immediate action to assess the patient's respiratory status.

Question 8

After discharge teaching has been completed for a patient who has had a lung transplant,the nurse will evaluate that the teaching has been effective if the patient states which of the following?

Accepted Answer

Writing down medications and spirometry readings in a journal is an effective way for the patient to keep track of their medication regimen and lung function. It promotes self-management and adherence to treatment, which are important factors in maintaining the health of a lung transplant recipient. Checking in with the doctor annually and using sterile technique with a central line are also important, but not as directly related to the patient's daily management of their health following a lung transplant. Limiting home oxygen to 2 L/min is not necessarily applicable to all lung transplant recipients and may not be an appropriate statement for the patient to make.

Question 9

A patient with primary pulmonary hypertension (PPH)is on diuretic therapy.The nurse will evaluate that the treatment is effective in which of the following situations?

Accepted Answer

Diuretic therapy helps in relieving the symptoms of PPH by reducing the fluid volume overload in the body. Therefore, the best way to evaluate the effectiveness of the treatment is to assess for the relief of symptoms, such as exertional dyspnea. Options B, C, and D are not directly related to the effectiveness of diuretic therapy in treating PPH.

Question 10

Which of the following is an extrapulmonary cause of restrictive lung disease?

Accepted Answer

Kyphoscoliosis is a skeletal disorder that affects the shape of the chest and spine, and can lead to restrictive lung disease. Atelectasis, interstitial lung disease, and tuberculosis are all pulmonary causes of restrictive lung disease.

Question 11

A lobectomy is scheduled for a patient with squamous cell carcinoma of the lung.The patient tells the nurse,"I would rather have radiation than surgery." What is the most appropriate response?

Accepted Answer

Asking the patient to share their knowledge on different treatment options will help the nurse to understand the patient's perspective and concerns. This will help the nurse to provide appropriate education and support to the patient.

Question 12

A patient is scheduled for a thoracentesis to obtain pleural fluid for diagnosis of a large pleural effusion.Before the procedure,the nurse will anticipate which of the following?

Accepted Answer

Positioning the patient sitting upright on the edge of the bed and leaning forward helps to maximize lung expansion and make it easier to access the pleural space during the procedure. Incentive spirometer use and sedative drugs are not routinely given prior to a thoracentesis. While fasting may be necessary depending on the specific procedure and the patient's medical history, it is not typically required for a thoracentesis.

Question 13

A patient has a chest tube following a thoracotomy.Continuous bubbling in the suction-control chamber of the collection device would alert the nurse to which of the following facts?

Accepted Answer

Continuous bubbling in the suction-control chamber of a chest tube collection device indicates that the unit is functioning normally, as it is designed to regulate the amount of suction applied.

Question 14

The nurse is performing TB screening in a clinic that has many patients who have immigrated to Canada.Before doing a TB skin test on a patient,which question is most important for the nurse to ask?

Accepted Answer

Knowing if the patient has received the BCG vaccine for TB is important because it may cause a false-positive reaction on the TB skin test. It is unrelated to how long the patient has lived in Canada, family history of TB, or over-the-counter medications.

Question 15

A patient experiences a flail chest as a result of an automobile accident.During the respiratory assessment,what would the nurse expect to find?

Accepted Answer

Flail chest occurs when multiple ribs are fractured in more than one place, causing a segment of the chest wall to become unstable and move paradoxically during respiration. This means that during inspiration, the affected area moves inward instead of outward, and during expiration, it moves outward instead of inward. Therefore, the nurse would expect to find paradoxical chest movement during the respiratory assessment. Options A, B, and C are not specifically associated with flail chest.

Question 16

A young man is admitted to the emergency department with a stab wound to the right chest.He has moderate bleeding from the site,and his vital signs show symptoms of shock.Air can be heard entering his chest with each inspiration.To decrease the possibility of a tension pneumothorax in the patient,what should the nurse do?

Accepted Answer

Applying a nonporous dressing taped on three sides to the chest wound creates a one-way valve that allows air and blood to escape from the chest cavity but prevents air from entering. This helps prevent a tension pneumothorax, which can be life-threatening. Positioning the patient on his injured side or administering high-flow oxygen using a nonrebreathing mask are not effective interventions for a tension pneumothorax. Covering a sucking chest wound with a petrolatum gauze dressing would be appropriate, but it is not the best choice for preventing a tension pneumothorax.

Question 17

When caring for a patient who is hospitalized with active TB,the nurse observes a family member who is visiting the patient.The nurse will need to intervene if the family member does which of the following?

Accepted Answer

Surgical face masks are not sufficient to protect against TB transmission. A more protective mask, such as an N95 respirator, is required when entering the room of a patient with active TB to prevent inhalation of airborne particles.

Question 18

When providing preoperative instruction for a patient scheduled for a left pneumonectomy for cancer of the lung,the nurse informs the patient that postoperatively he can expect which of the following interventions?

Accepted Answer

The answer of When providing preoperative instruction for a patient...

Question 19

The physician inserts two chest tubes connected with a Y-connecter in a patient with a hemopneumothorax.When monitoring the patient after the chest tube placement,the nurse will be concerned about which of the following?

Accepted Answer

The answer of The physician inserts two chest tubes connected...

Question 20

The occupational nurse at a manufacturing plant where there is high worker exposure to beryllium dust will monitor workers for which of the following?

Accepted Answer

Beryllium dust exposure can lead to chronic beryllium disease, which can cause symptoms such as shortness of breath, cough, and chest tightness. The other options are not specifically associated with beryllium exposure.

Quiz 30: Nursing Management: Lower Respiratory Problems