Question 1

A patient is diagnosed with histoplasmosis. Which of the following elements of this patient's history would help explain the reason for the disease?

Accepted Answer

Histoplasmosis is a fungal infection that can be acquired by inhaling spores from bird or bat droppings. Working with fresh poultry can increase the risk of exposure to these spores. The other choices are not directly related to histoplasmosis.

Question 2

A patient who is in the hospital is diagnosed with sudden acute respiratory syndrome (SARS). The best nursing intervention for this patient is to implement which of the following?

Accepted Answer

Sudden Acute Respiratory Syndrome (SARS) is a viral respiratory illness caused by a coronavirus, which can be spread through airborne particles, direct contact, and droplets. Therefore, the best nursing intervention is to implement standard, contact, and airborne precautions to prevent the spread of the virus.

Question 3

The nurse is providing care to a patient with pulmonary tuberculosis. Which of the following should the nurse do to ensure personal protection while caring for this patient?

Accepted Answer

Wearing a gown and a High-Efficiency Particulate Air (HEPA) mask, also known as an N95 respirator, is essential for personal protection when caring for a patient with pulmonary tuberculosis. This type of mask is specifically designed to filter out very fine particles, including bacteria like Mycobacterium tuberculosis.

Question 4

A patient with a lung abscess is being discharged from the hospital. Appropriate discharge instructions for this patient should include which of the following?

Accepted Answer

It is important for the patient to complete the entire prescription of antibiotics to ensure complete eradication of the infection and prevent recurrence.

Answer: D 
 Lung abscesses can have complications such as sepsis, empyema, or bronchopleural fistula, even after treatment. It is important for the patient to be aware of this and seek medical attention if any new symptoms develop.

Therefore, the appropriate discharge instructions for the patient with a lung abscess should include: A) complete the entire prescription of antibiotics and D) lung abscesses can have complications, so seek medical attention if any new symptoms develop.

Question 5

A patient tells the nurse he had the bacilli Calmette-Guérin (BCG) vaccination as a child because his mother had tuberculosis. This patient will be screened for tuberculosis by doing which of the following?

Accepted Answer

The BCG vaccine can cause a false positive result on skin tests for TB (such as the tine and Mantoux tests), so a chest x-ray is a more reliable screening method for someone with a history of BCG vaccination.

Question 6

A 20-year-old patient who is asking questions about smoking cessation tells the nurse about an upcoming class on scuba diving. The nurse identifies that this patient might be at risk for developing which of the following?

Accepted Answer

Scuba diving involves changes in pressure that can lead to the development of a pneumothorax, which is the accumulation of air in the pleural space that can cause lung collapse. Smoking further increases the risk of developing a pneumothorax due to its damaging effects on lung tissue. Pleural effusion, pleurisy, and hemothorax are not typically associated with scuba diving or smoking.

Question 7

A patient with lung cancer is demonstrating signs of complete tumor response after two courses of chemotherapy. The nurse concludes that this response is which of the following?

Accepted Answer

A complete tumor response after chemotherapy is a good sign for long-term survival from the disease. It does not necessarily indicate the need for radiation therapy or surgery, and further chemotherapy may still be recommended.

Question 8

A patient who was admitted with symptoms of hypoxia is changed from a face mask to a nasal cannula for oxygen delivery. The nurse realizes that this patient's condition is

Accepted Answer

A nasal cannula delivers a lower concentration of oxygen than a face mask, but it is more comfortable and allows the patient to eat and talk. If the patient was changed from the face mask to the nasal cannula, it indicates that their condition is improving and they need less oxygen support.

Question 9

A patient who is on isoniazid (INH) for pulmonary tuberculosis tells the nurse he doesn't like taking the medication because it makes his "fingers burn." The nurse concludes that the patient is experiencing which of the following?

Accepted Answer

The patient is experiencing peripheral neuropathy, a common side effect of isoniazid (INH). Pyridoxine (vitamin B6) can be given to treat this side effect.

Question 10

A patient states, "I've been sick for days and all the doctor does is take a chest x-ray, hand me prescriptions, and tell me I have bronchitis." The nurse realizes that this patient's treatment

Accepted Answer

Bronchitis is typically diagnosed based on clinical symptoms, such as cough, chest discomfort, and shortness of breath. Chest x-rays may be taken to rule out other conditions but are not always necessary to diagnose bronchitis. Treatment generally includes rest, hydration, and medication to manage symptoms, such as cough suppressants and/or antibiotics if the bronchitis is bacterial. Therefore, the patient's treatment is appropriate for the diagnosis.

Question 11

During the assessment of a patient's respiratory status, the nurse notes paradoxical lung movements. This finding is consistent with which of the following?

Accepted Answer

Paradoxical lung movements occur when a segment of the chest wall moves in the opposite direction to the rest of the chest during respiration. This usually occurs with flail chest, which is a condition where several adjacent ribs are fractured in multiple places, resulting in a segment of the chest wall moving independently during inhalation and exhalation.

Question 12

A patient who is receiving radiation therapy for lung cancer complains of ongoing fatigue. Appropriate teaching for this patient includes that

Accepted Answer

Frequent rest periods and good nutrition can help with the fatigue caused by radiation therapy. It is important to prioritize self-care during radiation therapy to alleviate symptoms and promote overall well-being. Restricting caloric intake would not be helpful in managing fatigue. Option A is incorrect as fatigue may improve after radiation therapy. Option B is incorrect as there are interventions that can help manage fatigue.

Question 13

A patient who is taking rifampin (Rifadin) as part of his treatment for tuberculosis asks about making an appointment for a urologist because his urine is "bright orange." The nurse realizes that this patient is experiencing which of the following?

Accepted Answer

The orange-red discoloration of bodily fluids, including urine, is a well-known and harmless side effect of rifampin therapy. It is important to educate the patient about this common occurrence to alleviate any concerns they may have. However, if the patient experiences other symptoms such as pain or difficulty urinating, further evaluation may be necessary to rule out other conditions.

Question 14

The nurse is providing care to a patient with a differential diagnosis of carbon monoxide poisoning. Which of the following would be consistent with this diagnosis?  Select all that apply.

Accepted Answer

Cherry-red mucous membranes, nausea, and dizziness are all common symptoms of carbon monoxide poisoning. Circumoral pallor and diarrhea would not typically be seen in a patient with carbon monoxide poisoning.

Question 15

The nurse observes air bubbles in a patient's chest tube water seal chamber. The nurse interprets this finding as which of the following?

Accepted Answer

Air bubbles in the chest tube water seal chamber are a normal finding as long as they occur intermittently and not continuously. This indicates that air is being evacuated from the pleural space. However, if air bubbles are continuous and increasing in frequency, it may indicate a worsening of the pneumothorax or an air leak.

Question 16

A patient who had a Mantoux test for tuberculosis two days ago has a 2 mm area of erythema at the site of the test. The nurse concludes that this patient's response

Accepted Answer

A Mantoux test is considered negative if the area of erythema at the test site measures 0-4 mm after 48-72 hours. The patient's 2 mm area of erythema falls within this range and therefore suggests a negative response.

Question 17

A patient is diagnosed with a tension pneumothorax. Which of the following would be consistent with this diagnosis?  Select all that apply.

Accepted Answer

A tension pneumothorax is a life-threatening condition that occurs when air accumulates in the pleural space, causing the lung to collapse and putting pressure on the heart and great vessels. This can lead to a variety of clinical findings, including distended neck veins due to impaired venous return, absent breath sounds on the affected side due to lung collapse, and tracheal deviation toward the unaffected side due to pressure on the mediastinum. Hypertension is not typically associated with a tension pneumothorax, and bradycardia is an uncommon finding that may occur in severe cases.

Question 18

The young child has been diagnosed with pneumonia and has been prescribed erythromycin, 45 mg per day for every 1 kilogram of body weight. The patient weighs 46 pounds. The physician asks that the patient receive the medication in three equal doses throughout the day. Calculate how much medication the patient should receive per each dose. Round the final answer to a whole number. ____ mg

Accepted Answer

The answer of The young child has been diagnosed with...

Question 19

A patient is diagnosed with pleurisy. The nurse instructs the patient to alleviate the associated chest pain by which of the following?

Accepted Answer

Splinting the affected area when coughing can help reduce pain by providing support to the affected area and reducing movement. Taking the prescribed analgesic as directed by the healthcare provider may also be helpful, but waiting until the pain is severe may not provide adequate pain relief. Bed rest is generally recommended for pleurisy, but it may not directly alleviate chest pain. A fever is a common symptom of pleurisy and does not directly relate to pain relief.

Question 20

A patient who is diagnosed with primary atypical pneumonia tells the nurse that he "doesn't feel too sick." The nurse's best response is which of the following?

Accepted Answer

The best response is to provide accurate information about the nature of the illness. Primary atypical pneumonia is typically mild in its effects, so the nurse can reassure the patient that this is likely the reason why he doesn't feel very sick. Option A is dismissive and Option B isn't helpful. Option C makes an assumption about the patient's condition and is not entirely accurate.

Quiz 36: Nursing Care of Patients with Ventilation Disorders