Chp. 23 PrepU Questions: Chest and Lower Respiratory Tract Disorders (Exam 1)

What is flail chest?

A life-threatening medical condition where a segment of the rib cage breaks and becomes detached from the rest of the chest wall due to trauma

Which statements indicates a client understands teaching about the purified protein derivative (PPD) test for TB?

Because I had a previous reaction to the test, this time I need to get a chest X-ray. (p. 588)

A patient is admitted to the hospital with pulmonary arterial hypertension. What assessment finding by the nurse is significant for this patient?

Dyspnea (p. 599)

A client is admitted to the health care facility with active TB. The nurse should include which intervention in the care plan?

Putting on an individually fitted mask when entering the client's room (p. 591)

Which action should the nurse take first in caring for a client during an acute asthma attack?

administer bronchodilator as ordered (p. 638)

What manifestiaotn correlates with a moderate pulmonary contusion?

blood-tinged sputum (p. 613)

You are a clinic nurse caring for a client with acute tracheobrocnchitis. This client asks what may have caused the infection. Which response is most accurate?

chemical irritation (p. 573)

What adventitious lung sound is associated with pulmonary edema?

crackles in the lung bases (p. 570)

Primary Drug Resistance

resistance to one the first-line TB agents in people who have NEVER had previous treatment (p. 589)

Providing discharge teaching for pulmonary sarcoidosis. What is an early sign of exacerbation in this patient?

shortness of breath (p. 604)

After 48 hours, a Mantoux test is evaluated. At the site, there is a 10 mm induration. This finding would be considered...

significant (p. 588)

670year-old pt. being discharged postop following pelvic surgery. To prevent pulmonary embolus what shoudl the pt be instructed to do?

tense and relax lower extremity muscles (p. 601)

Pt. with a chest tube is being transported to x-ray. Which complication may occur if the chest tube is clamped during transportation?

tension pneumothorax (p. 614)

What is the reasoning for a chest tube insertion in treating a pneumothorax?

the tube will drain the air from the space around the lung (p. 614)

A patient has a Mantoux skin test prior to being placed on an immunosuppressant for the treatment of Crohn's disease. What results would the nurse determine is not significant for holding the medication?

0-4 mm (p. 588)

Following thoracic surgery, the care plan for a client at risk for impaired gas exchange would include which of the following?

1. Elevate head of bed 10-40 degree as tolerated 2. Monitor vital signs frequently 3. Reinforce preoperative breathing exercises (p. 528-530)

A client admitted with pneumonia has a history of lung cancer and heart failure. A nurse caring for this client recognizes that he should maintain adequate fluid intake to keep secretions thin for ease in expectoration. What is the amount of fluid this patient should maintain?

1.4 L (P. 582)

How long will a pt. be on TB medications?

6-12 months

An ICU nurse caring for a 2-year olf near drowning victim monitors fro what possible complication?

Acute respiratory distress syndrome (p. 596)

You are an ICE nurse caring for a client who was admitted with a diagnosis of smoke inhalation. You know that this client is at increased risk fro which of the following?

Acute respiratory distress syndrome (p. 596)

A client with pulmonary embolus has the following arterial blood gas (ABG) values: pH 7.49, partial pressure of arterial oxygen 60 mm Hg, partial pressure of arterial carbon dioxide 30 mm Hg, and bicarbonate 25 mEq/L. What should the nurse do first?

Administer oxygen by nasal cannula as ordered (p. 601-602)

The nursing instructor is discussing pulmonary arterial hypertension with the nursing students. What would the instructor describe as the patho of secondary pulmonary arterial hypertension?

Alveolar destruction causes increased resistance and pressure in the pulmonary vascular bed (p. 598-599)

A 65-year-old client who works construction, and has been demolishing older buildings is diagnosed with pneumoconiosis. The nurse is aware that his lung inflammation is most likely caused by exposure to which of the following?

Asbestos (p. 605)

The nurse is collaborating with a community group to develop plans to reduce the incidence of lung cancer in the community. Which of the following would be most effective?

Classes at community centers to reach about smoking cessation strategies (p. 605-606)

Which intervention does a nurse implement for a patient with empyema?

Encourage breathing exercises

A nurse is caring for a patient diagnosed with empyema. Which of the following interventions does a nurse implement for patients with empyema?

Encourage breathing exercises (p. 595)

A client hospitalized with pneumonia has thick, tenacious secretions. Which intervention should the nurse include when planning this client's care?

Encouraging increased fluid intake (p. 528)

You are an occupational health nurse in a large ceramic manufacturing company. How would you intervene to prevent occupational lung disease in the employees of the company?

Fit all employees with protective masks (p. 605)

A pt arrive at the Er after a motor vehicle accident. The nurse observes paradoxical chest movement when removing the patient's shirt. What does the nurse know that this finding indicates?

Flail chest (p. 612)

When caring for a client with acute respiratory failure, the nurse should expect to focus on resolving which set of problems?

Hypercapnia, hypoventilation, and hypoxemia (p. 595)

The nurse is caring for a patient with chest trauma. Which nursing diagnosis takes the highest priority?

Impaired gas exchange (airway) P. 610

After INH teaching, the pt. demonstrates understanding when the say?

It is all right if I have a grilled cheese with American cheese (p. 590)

A nurse is reading a chart notes that the patient had a Mantoux skin test result with no induration and a 1 mm area of ecchymosis. How would you interpret the result?

Negative (p. 588)

A physician stated to the nurse that the patient has fluid noted in the pleural space and will need a thoracentesis. the nurse would expect that the physician will document this fluid as which of the following?

Pleural effusion (p. 593)

Resistance to one of the first-line anti-tuberculotic agents in people who have not had previous treatment is:

Primary drug resistance

What are the signs and symptoms of chronic respiratory failure?

Progressive loss of lung function associated with chronic disease (p. 595)

Which of the following should a nurse encourage in patients who are at risk of pneumococcal and influenza infections?

Receiving vaccination (p. 574)

What dietary recommendations should the nurse provide a patient with a lung abscess?

Rich in protein (p. 591)

You are caring for a client status post lung resection. When assessing your client you find that the bubbling in the water-seal chamber for the chest tubes is more than you expected. What should you check when bubbling in hte water-seal chamber is excessive?

See if there are leaks in the system (p. 526)

The nursing instructor is talking with the junior class of nursing students about lung cancer. What would be the best rationale the instructor could give for the difficulty of early diagnosis of lung cancer?

Symptoms often do not appear until the disease is well established (p. 607)

the nurse is caring for a patient with TB and anticipates administering which vitamin with INH to prevent INH-associated peripheral neuropathy?

Vitamin B6 (p. 586)

You are caring for a client who has been diagnosed with viral pneumonia. You are making a plan of care for this client. What nursing intervention would you put into the plan of care for a client with pneumonia?

encourage fluid intake (p. 583)

What might be revealed by a chest radiography for a client with occupational lung disease?

fibrotic changes in lungs (p. 606)

A client who sustained a pulmonary contusion in a motor accident develops a pulmonary embolism. Which nursing diagnosis takes priority with this client?

inefective breathing pattern related to tissue trauma (p. 601)

A client is suspected severe acute resp. syndrome (SARS) comes to the ER. Which physician order should the nurse implement first?

institute isolation precautions (p. 586)

What blood gas results are consistent with acute respiratory failure (ARF)?

pH 7.28, PaO2 50 mm Hg (p. 595)

You are assessing a client's potential for pulmonary emboli. What finding indicates possible DVT?

pain in calf (p. 600)

Client is brought to the Er following a motor vehicle accident. What assessment finding is associated with flail chest?

paradoxical chest movement (p. 612)