PN 150 Ch 21 PrepU

A patient taking isoniazid (INH) therapy for tuberculosis demonstrates understanding when making which statement? "I am going to have a tuna fish sandwich for lunch." "It is all right if I drink a glass of red wine with my dinner." "It is all right if I have a grilled cheese sandwich with American cheese." "It is fine if I eat sushi with a little bit of soy sauce."

"It is all right if I have a grilled cheese sandwich with American cheese." Ratioinal: Patients taking INH should avoid foods that contain tyramine and histamine (tuna, aged cheese, red wine, soy sauce, yeast extracts), because eating them while taking INH may result in headache, flushing, hypotension, lightheadedness, palpitations, and diaphoresis. Patients should also avoid alcohol because of the high potential for hepatotoxic effects

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 to 4 mm 5 to 6 mm 7 to 8 mm 9 mm

0 to 4 mm

A nurse is assessing the injection site of a client who has received a purified protein derivative test. Which finding indicates a need for further evaluation? 5-mm induration Reddened area 15-mm induration A blister

15-mm induration rational: A 10-mm induration strongly suggests a positive response in this tuberculosis screening test

After diagnosing a client with pulmonary tuberculosis, the physician tells family members that they must receive isoniazid (INH [Laniazid]) as prophylaxis against tuberculosis. The client's daughter asks the nurse how long the drug must be taken. What is the usual duration of prophylactic isoniazid therapy? 3 to 5 days 1 to 3 weeks 2 to 4 months 6 to 12 months

6 to 12 months

When caring for a client with acute respiratory failure, the nurse should expect to focus on resolving which set of problems? Hypotension, hyperoxemia, and hypercapnia Hyperventilation, hypertension, and hypocapnia Hyperoxemia, hypocapnia, and hyperventilation Hypercapnia, hypoventilation, and hypoxemia

Hypercapnia, hypoventilation, and hypoxemia

A client who works construction and has been demolishing an older building is diagnosed with pneumoconiosis. This lung inflammation is most likely caused by exposure to: asbestos. silica. coal dust. pollen.

asbestos

The nurse is auscultating the patient's lung sounds to determine the presence of pulmonary edema. What adventitious lung sounds are significant for pulmonary edema? Crackles in the lung bases Low-pitched rhonchi during expiration Pleural friction rub Sibilant wheezes

crackles in the lung base

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

dyspnea Rational: Dyspnea, the main symptom of PH, occurs at first with exertion and eventually at rest

Which interventions does a nurse implement for clients with empyema? Institute droplet precautions Place suspected clients together Encourage breathing exercises Do not allow visitors with respiratory infection

encourage breathing exercises

The nursing instructor is teaching students about types of lung cancer. Which type of lung cancer is characterized as fast growing and can arise peripherally? Large cell carcinoma Bronchoalveolar carcinoma Adenocarcinoma Squamous cell carcinoma

large cell carcinoma

Class 1 with regard to TB indicates no exposure and no infection. exposure and no evidence of infection. latent infection with no disease. disease that is not clinically active.

no exposure and no infection

A nurse assesses arterial blood gas results for a patient in acute respiratory failure (ARF). Which results are consistent with this disorder? pH 7.28, PaO2 50 mm Hg pH 7.46, PaO2 80 mm Hg pH 7.36, PaCO2 32 mm Hg pH 7.35, PaCO2 48 mm Hg

pH 7.28, PaO2 50 mm Hg Rational: pH 7.28, PaO2 50 mm Hg

A physician stated to the nurse that the client has fluid in the pleural space and will need a thoracentesis. The nurse expects the physician to document this fluid as pleural effusion. pneumothorax. hemothorax. consolidation.

pleural effusion

The nurse is assessing an adult client following a motor vehicle accident. The nurse observes that the client has an increased use of accessory muscles and is reporting chest pain and shortness of breath. The nurse should recognize the possibility of what condition? Pneumothorax Cardiac ischemia Acute bronchitis Aspiration

pneumothorax rational: If the pneumothorax is large and the lung collapses totally, acute respiratory distress occurs. The client is anxious, has dyspnea and air hunger, has increased use of the accessory muscles, and may develop central cyanosis from severe hypoxemia. These symptoms are not definitive of pneumothorax, but because of the client's recent trauma they are inconsistent with cardiac ischemia, bronchitis, or aspiration

What does a positive Mantoux test indicate active immunity to tuberculosis production of an immune response developent of full-blown tuberculosis an active case of tuberculosis

production of an immune response

A client in the ICU is status post embolectomy after a pulmonary embolus. What assessment parameter should the nurse monitor most closely on a client who is postoperative following an embolectomy? Lung function testing Pressure in the vena cava White blood cell differential Pulmonary arterial pressure

pulmonary arterial pressure

While assessing the patient, the nurse observes constant bubbling in the water-seal chamber of a closed chest drainage system. What should the nurse conclude? The system is functioning normally. The patient has a pneumothorax. The system has an air leak. The chest tube is obstructed.

the system has an air leak

The nurse caring for a client with tuberculosis anticipates administering which vitamin with isoniazid (INH) to prevent INH-associated peripheral neuropathy? Vitamin B6 Vitamin C Vitamin D Vitamin E

vitamin B6

A client is brought to the ED after aspirating large amounts of water and nearly drowning. This client is at risk for which complication as a result of this recent trauma? acute respiratory distress syndrome (ARDS) empyema pulmonary tuberculosis bronchiectasis

ARDS

A client diagnosed with acute respiratory distress syndrome (ARDS) is restless and has a low oxygen saturation level. If the client's condition does not improve and the oxygen saturation level continues to decrease, what procedure will the nurse expect to assist with in order to help the client breathe more easily? Intubate the client and control breathing with mechanical ventilation Increase oxygen administration Administer a large dose of furosemide (Lasix) IVP stat Schedule the client for pulmonary surgery

Intubate the client and control breathing with mechanical ventilation

A water seal system for chest drainage has been inserted into a patient who suffered chest trauma during a motor vehicle accident. At the beginning of the night shift, the nurse has entered the patient's room to assess the system and the patient's condition. Which of the following assessment findings suggests that the system is operating correctly and the patient is maintaining oxygenation? There is constant bubbling in the water seal chamber. The water level in the water seal chamber increases when the patient inhales. The level in the water seal chamber stays constant throughout the ventilation cycle. The water level reaches the top of the water seal chamber with each breath.

The water level in the water seal chamber increases when the patient inhales

The nurse is caring for a patient with pleurisy. What symptoms does the nurse recognize are significant for this patient's diagnosis? Dullness or flatness on percussion over areas of collected fluid Dyspnea and coughing Fever and chills Stabbing pain during respiratory movement

stabbing pain during respiratory movement rational: When the inflamed pleural membranes rub together during respiration (intensified on inspiration), the result is severe, sharp, knifelike pain. The key characteristic of pleuritic pain is its relationship to respiratory movement. Taking a deep breath, coughing, or sneezing worsens the pain. Pleuritic pain is limited in distribution rather than diffuse; it usually occurs only on one side. The pain may become minimal or absent when the breath is held. It may be localized or radiate to the shoulder or abdomen

A patient comes to the clinic with fever, cough, and chest discomfort. The nurse auscultates crackles in the left lower base of the lung and suspects that the patient may have pneumonia. What does the nurse know is the most common organism that causes community-acquired pneumonia? Staphylococcus aureus Mycobacterium tuberculosis Pseudomonas aeruginosa Streptococcus pneumoniae

streptococcus pneumoniae

When giving oxygen to a hypoxic patient, the nurse must remember that oxygen transport is also dependent on the arterial oxygen content. Which of the following is a blood gas analysis that would indicate the presence of hypoxemia? PaO2 < 60 mm Hg PaO2 = 65 mm Hg PaO2 = 70 mm Hg PaO2 = 75 mm Hg

PaO2 < 60 mm Hg Rational: Hypoxemia is defined as a PaO2 of less than 60 mm Hb and/or a POX of less than 90%.

A client presents to the walk-in clinic reporting a dry, irritating cough and production of a small amount of mucus-like sputum. The client also reports soreness in her chest in the sternal area. The nurse should suspect that the primary care provider will assess the client for what health problem? Pleural effusion Pulmonary embolism Tracheobronchitis Tuberculosis

tracheobronchitis rational: Initially, the client with tracheobronchitis has a dry, irritating cough and expectorates a scant amount of mucoid sputum. The client may report sternal soreness from coughing and have fever or chills, night sweats, headache, and general malaise