Chapter 30: Lung cancer and other noninfectious lower resp

Which statement indicates a need for further learning about dietary management in a patient who developed esophagitis while undergoing radiation therapy?

"I will eat high-fiber foods."

Which ectopic hormone is involved in Cushing syndrome and may cause small cell lung cancer?

Adrenocorticotropic hormone

What is a late manifestation of lung cancer?

Dysphagia

A patient with small cell lung cancer (SCLC) has gynecomastia. This is most likely due to paraneoplastic syndrome caused by the tumor cells secreting which hormone?

Follicle-stimulating hormone

A patient with pulmonary arterial hypertension is worried about developing lung cancer. Which statement made by the student nurse indicates ineffective learning about the risk of lung cancer?

"People who are exposed to air pollutants are not at risk."

Which statement indicates ineffective learning by a student nurse about the placement of a chest tube and proper care for a thoracostomy?

"The collection device should be placed above the chest."

Which statement made by a student nurse indicates ineffective learning about the management of chest tube drainage systems?

"The drainage system should be higher than the level of the patient's chest."

Which statement made by a student nurse indicates ineffective learning about dyspnea management?

"The patient should be resting in supine position."

Which statements comparing the side effects of radiation therapy and chemotherapy for lung cancer are correct? Select all that apply.

- Chemotherapy can cause mucositis; esophagitis is a potential problem with radiation. - Chemotherapy can cause nausea and vomiting; nausea is a potential problem with radiation. - Chemotherapy side effects are related to the systemic nature of the therapy; radiation side effects are local/regional.

Which physical signs are expected in a patient diagnosed with lung cancer? Select all that apply.

- Clubbing of the fingers - Compression of the heart - Cyanosis of the lips and fingertips

Which interventions will the nurse include in the plan of care for a patient with chronic obstructive pulmonary disease (COPD) who is experiencing anxiety during acute dyspneic episodes? Select all that apply.

- Exploring the use of biofeedback - Using diaphragmatic breathing techniques - Helping the patient write a plan to use for symptom flare-ups

Which patient who has been treated for lung cancer does the nurse expect to experience ongoing fatigue?

A patient who received radiation therapy

A patient has just been admitted to the intensive care unit (ICU) after having a left lower lobectomy with a video-assisted thoracoscopic surgery (VATS). Which of these requests should the nurse implement first?

Adjust oxygen flow rate to keep O 2 saturation at 93% to 100%.

When assessing a patient suspected of having lung cancer, the nurse feels increased vibrations on the chest wall. What could be the reason for the vibrations?

Airspaces of the lung replaced with tumor

The nurse assesses a patient's chest tube and notices continuous bubbling in the water seal chamber in a patient who underwent a lobectomy 12 hours ago. What is the probable reason for this finding?

An air leak in the chest tube

The nurse is assessing a patient with suspected lung cancer. While auscultating lung sounds, the nurse hears an increased loudness of the patient's voice. What does this finding indicate?

An increased density of the lung tissue

Which patient condition may be treated by oxygen therapy?

Anxiety

The nurse who is assessing a patient with a chest tube following a right-sided lobectomy observes 2 cm of water in chamber two of the three-chamber chest tube drainage system and also notes that the water has stopped bubbling. What is the correct action by the nurse?

Auscultate the lung sounds and assess respiratory status.

While the nurse is talking with the postoperative thoracic surgery patient, the patient coughs and the chest tube collection water seal chamber bubbles. What does the nurse do?

Calmly continues talking

A patient scheduled for a lobectomy to treat stage II cancer is anxious about the surgical procedure. Which preoperative teaching points may help decrease the patient's anxiety about the surgery? Select all that apply.

Chest tube and drainage system Probable location for surgical incision Shoulder exercises to increase comfort

What is the greatest risk factor for lung cancer?

Cigarette smoking

Which is an example of a primary lung cancer prevention measure that the nurse can implement?

Educating about the risks associated with smoking

What is the side effect of chemotherapy that leads to infection?

Immunosuppression with neutropenia

The nurse is teaching a patient who has been newly diagnosed with cancer. Which side effect specific to radiation does the nurse teach prevention techniques?

Increased risk for sunburn

What is indicated if the laboratory report of a patient with suspected lung cancer shows purulent and copious sputum?

Necrosis

What is the most important reason a patient with lung cancer should be handled carefully while the nurse repositions and ambulates him or her?

Low bone density

Which is the leading cause of cancer-related deaths in North America?

Lung cancer

Which pulmonary diseases are caused by cigarette smoking? Select all that apply.

Lung cancer Chronic bronchitis

What is the most important intervention the nurse should provide to the patient with lung cancer who underwent lobectomy?

Maintain patent airway.

Which action should be avoided in the chest tube drainage system while caring for a patient with lung cancer?

Manipulating the chest tube

The nurse finds a blood clot in the drainage tube from the chest tube of a patient who underwent a thoracotomy 8 hours ago. Which nursing intervention would be done to prevent complications?

Move the clot down the tube gently using both hands to help prevent obstruction of the system.

The patient is 1 day postoperative after an open thoracotomy and has a chest tube in place with a water seal drainage system. The nurse notes that when the patient coughs, there is bubbling in the water seal chamber. What is the nurse's action?

No action is required because bubbling is normal under these circumstances.

What is an effective treatment for a patient with lung cancer whose clinical and laboratory reports show hemoptysis, obstruction of the bronchi, and superior vena cava syndrome?

Radiation therapy

A patient has had chest tubes placed during a lobectomy for lung cancer. The nurse notices the tube is dislodged and lying on the floor. What should be the nurse's priority action?

Place a gauze dressing over the chest tube site.

What is a possible reason for the development of bronchopleural fistula in a patient with lung cancer?

Pneumonectomy

What is the most efficient diagnostic test to determine metastasis in lung cancer?

Positron emission tomography

What is a possible reason for the physician to instruct the nurse to administer erlotinib to a patient?

To treat non-small cell lung cancer