NCLEX Book questions Lung Cancer

The nurse in the perioperative area is preparing a client for surgery and notices that the client looks sad. The client says, "I am scared of having cancer. It is so horrible, and I brought it on myself. I should have quit smoking years ago." What would be the nurse's best response to the client 1. "It is okay to be scared. What is it about cancer that you are afraid of?" 2. "It is normal to be scared. I would be, too. We will help you through it." 3. "Do not be so hard on yourself. You do not know if your smoking caused the cancer." 4. "Do you feel guilty because you smoked?"

1. "It is okay to be scared. What is it about cancer that you are afraid of?"

109. When teaching a client to deep breathe effectively after a lobectomy, what should the nurse instruct the client to do? 1. Contract the abdominal muscles; take a slow, deep breath through the nose; hold it for 3 to seconds; and then exhale. 2. Contract the abdominal muscles, take a deep breath through the mouth, and exhale slowly as if trying to blow out a candle. 3. Relax the abdominal muscles; take a slow, deep breath through the nose; and hold it for 3 to 5 seconds 4. Relax abdominal muscles, take a deep breath through the mouth, and exhale slowly over 10 seconds.

1. Contract the abdominal muscles; take a slow, deep breath through the nose; hold it for 3 to 5 seconds; and then exhale.

101. A female client diagnosed with lung cancer is to have a left lower lobectomy. What increases the client's risk of developing postoperative pulmonary complications? 1. Height is 5 feet, 7 inches (170.2 cm) and weight is 110 lb (49.9 kg). 2. The client tends to keep her real feelings to herself. 3. She ambulates and can climb one flight of stairs withat dyspnea. 4. A 4. The client is 58 years of age.

1. Height is 5 feet, 7 inches (170.2 cm) and weight is 110 lb (49.9 kg).

114. A client who underwent a lobectomy and has a water seal chest drainage system is breathing with a little more effort and at a faster rate than 1 hour ago. The client's pulse rate is also increased. The nurse should: 1. check the tubing to ensure that the client is not lying on it or kinking it. 2. increase the suction 3. Lower the drainage bottles 2-3 feet (61-91.4 cm) below the level of clients chest 4. ensure that the chest tube has two clamps on it to prevent.air leaks

1. check the tubing to ensure that the client is not lying on it or kinking it.

112. A client has a chest tube attached to a water seal drainage system, and the nurse notes that the fluid in the chest tube and in the water seal column has stopped fluctuating. The nurse should determine that: 1. the lung has fully expanded. 2. the lung has collapsed. 3. The chest tube is in the pleural space. 4. the mediastinal space has decreased.

1. the lung has fully expanded.

104. Which factor is a priority to evaluate when completing discharge planning for a client who has had a lobectomy for treatment of lung cancer? 1. the support available to assist the client at home 2. the distance the client lives from the hospital 3. the client's ability to do home blood pressure monitoring 4. the client's knowledge of the causes of lung cancer

1. the support available to assist the client at home

113. The nurse observes a constant gentle bubbling in the water seal column of a water seal chest drainage system. The nurse should: 1. Continue monitoring as usual; this is expected 2. check the connectors between the chest and drainage tubes and where the drainage tube enters chset drainage system. 3. Decrease the suction and continue observing the system for chnages in bubbling during the next several hours 4. Notify the healthcare provider (HCP)

2. Check the connectors between the chest and drainage tubes and where the drainage tube enters chest drainage system.

105. What is an instruction the nurse can give to help people prevent lung cancer? 1. Encourage cigarette smokers to have yearly chest radiographs. 2. Instruct people about techniques for smoking cessation. 3. Recommend that people have their houses and apartments checked for asbestos leakage. 4. Encourage people to install central air filters in their homes.

2. Instruct people about techniques for smoking cessation.

100. A recently extubated client has shortness of breath. The nurse reports the client's discomfort and the results of the recently prescribed arterial blood gas analysis to the healthcare provider (HCP). After reviewing the report of the complete blood count (see report), the nurse should also report which results to the HCP? 1. PT 2. hemoglobin and hematocrit 3. monocytes 4. platelets

2. hemoglobin and hematocrit

117. The nurse is preparing to assist with the removal of a chest tube. Which dressing is appropriate at the site from which the chest tube is removed? 1. adhesive strips 2. petrolatum gauze 3. dry 4 x 4 Gauze 4. No dressing is necessary

2. petrolatum gauze

107. Following a thoracotomy, the client has pain of 9 on a 10-point scale. Thirty minutes after administering the highest dose of the prescribed pain medication, the nurse should: 1. reposition the client. 2. reassess the client. 3. reassure the client. 4. readjust the pain medication dosage as needed.

2. reassess the client.

108. While assessing a thoracotomy incisional area from which a chest tube exits, the nurse feels à crackling sensation under the fingertips along the entire incision. What should the nurse do next? 1. Lower the head of the bed, and call the healthcare provider (HCP). 2. Prepare an aspiration tray. 3. Mark the area with a skin pencil at the outer periphery of the crackling. 4. Turn off the suction of the chest drainage system.

3. Mark the area with a skin pencil at the outer periphery of the crackling.

110. Which instruction should the nurse give the client who has undergone chest surgery to prevent shoulder ankylosis? 1. Turn from side to side. 2. Raise and lower the head. 3. Raise the arm on the affected side over the head. 4. Flex and extend the elbow on the affected şide.

3. Raise the arm on the affected side over the head.

116. What should be readily available at the bedside of a client with a chest tube in place? 1. a tracheostomy tray 2. another sterile chest tube 3. a bottle of sterile water 4. a spirometer

3. a bottle of sterile water

115. The nurse is assessing a client who has a chest tube connected to a water seal chest tube drainage system. According to the illustration shown, what should the nurse do? 1. Clamp the chest tube near the insertion site to prevent air from entering the pleural cavity. 2. Notify the healthcare provider (HCP) of amount of chest tube drainage. 3. Add water to maintain the water seal. 4. Lower the drainage system to maintain gravity flow.

4. Lower the drainage system to maintain gravity flow.

106. After a thoracotomy, the nurse instructs the client to perform deep-breathing exercises. What is an expected outcome of these exercises? 1. The elevated diaphragm enlarges the thorax and increases the lung surface available for gas exchange. 2. There is increased blood flow to the lungs to allow them to recover from the trauma of surgery. 3. The rate of airflow to the remaining lobe is controlled so that it will not become hyperinflated. 4. The alveoli expand and increase the lung surface available for ventilatilation

4. The alveoli expand and increase the lung surface available for ventilation

111. When caring for a client with a chest tube and water seal drainage system, the nurse should: 1. verify that the air vent on the water seal drainage system is capped when the suction is off. 2. strip the chest drainage tubes at least every 4 hours if excessive bleeding occurs. 3. Ensure that the chest tube is clamped when moving the client out of bed 4. make sure that the drainage apparatus always below the client's chest level.

4. make sure that the drainage apparatus is always below the client's chest level.

103. A client who underwent a left lower lobectomy has been out of surgery for 48 hours. The client is receiving morphine sulfate via a patient-controlled analgesia (PCA) system and reports having pain in the left thorax that worsens when coughing. After checking the PCA system, the nurse should next: 1. let the client rest, so that the client is not stimulated to cough. 2. encourage the client to take deep breaths to help control the pain. 3. reassure the client that the machine is working and will administer medication to relieve the pain. 4. obtain a more detailed assessment of the client's pain using a pain scale.

4. obtain a more detailed assessment of the client's pain using a pain scale.