Chapter 23 Management of Patients With Chest and Lower Respiratory Tract Disorders Review Book Exam 2

No exposure; no infection

Class 0

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

The nurse is assessing a patient who has been admitted with possible acute respiratory distress syndrome (ARDS). What findings would distinguish ARDS from cardiogenic pulmonary edema?

Elevated B-type natriuretic peptide (BNP) levels

Define the etiology of cor pulmonale.

Enlargement of the right ventricle of the heart because of diseases affecting the structure or functions of the lung

The nurse is conducting a community program about prevention of respiratory illness. What illness does the nurse recognize is the most common cause of death in the United States?

Pneumonia

The nurse is caring for a patient with pleurisy. What symptoms does the nurse recognize are significant for this patient's diagnosis?

Stabbing pain during respiratory movement

When a nonfunctioning nasogastric tube allows the gastric contents to accumulate in the stomach, a condition known as silent _________ may result.

aspiration

Three severe complications of pneumonia are _______

hypotension, shock, respiratory failure

A patient taking isoniazid (INH) therapy for tuberculosis demonstrates understanding when making which statement?

"It is all right if I have a grilled cheese sandwich with American cheese"

A patient who wears contact lenses is to be placed on rifampin for tuberculosis therapy. What information should the nurse provide to the patient?

"You should switch to wearing your glasses while taking this medication"

The nurse is planning the care for a patient at risk of developing pulmonary embolism. What nursing interventions should be included in the care plan? (Select all that apply.)

- Encouraging a liberal fluid intake - Assisting the patient to do leg elevations above the level of the heart - Using elastic stockings, especially when decreased mobility would promote venous stasis - Applying a sequential compression device

The nurse is developing a plan of care for a patient with acute tracheobronchitis. What nursing interventions should be included in the plan of care? (Select all that apply.)

- Increasing fluid intake to remove secretions -. Encouraging the patient to remain in bed - Using cool-vapor therapy to relieve laryngeal and tracheal irritation

The nurse is administering anticoagulant therapy with heparin. What international normalized ratio (INR) would the nurse know is within therapeutic range?

2.0 to 2.5

Hospital-acquired pneumonia develops ________ or more after admission and does not appear to be incubating at the time of admission.

48 hours

The nurse is educating a patient who will be started on an antituberculosis medication regimen. The patient asks the nurse, "How long will I have to be on these medications?" What should the nurse tell the patient?

6 to 12 months

The nurse is collecting a sputum culture to identify the causative organism for a patient with acute tracheobronchitis. What causative fungal organism does the nurse suspect?

Aspergillus

A patient with pulmonary hypertension has a positive vasoreactivity test. What medication does the nurse anticipate administering to this patient?

Calcium channel blockers

Exposure; no evidence of infection

Class 1

Latent infection; no disease (e.g., positive PPD)

Class 2

Disease; not clinically active

Class 3

Disease; clinically active

Class 4

Suspected disease; diagnosis pending

Class 5

The nurse is having an information session with a women's group at the YMCA about lung cancer. What frequent and commonly experienced symptom should the nurse be sure to include in the session?

Coughing

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

Dyspnea

The nurse is caring for a patient with suspected acute respiratory distress syndrome (ARDS) with a PO2 of 53. The patient is placed on oxygen via face mask and the PO2 remains the same. What does the nurse recognize as a key characteristic of ARDS?

Unresponsive arterial hypoxemia

A(n) _______ is an accumulation of thick, purulent fluid within the pleural space, often with fibrin development and a loculated area where infection is located

empyema

superinfection

is suspected when a subsequent infection occurs with another bacterium during antibiotic therapy.

In current tuberculosis (TB) treatment, four first-line medications are used:

rifampin, pyrazinamide, ethambutol, isoniazid

A patient arrives in the emergency department after being involved in a motor vehicle crash. The nurse observes paradoxical chest movement when removing the patient's shirt. What does the nurse know that this finding indicates?

Flail chest

Describe the characteristic and diagnostic feature of ARDS.

Hypoxemia that does not respond to supplemental oxygen

A patient who had a colon resection 3 days ago reports discomfort in the left calf. How should the nurse assess Homan sign to determine if the patient may have a thrombus formation in the leg?

Dorsiflex the foot while the leg is elevated to check for calf pain

Name seven possible clinical manifestations of atelectasis.

Dyspnea, cough, sputum production, tachycardia, tachypnea, pleural pain, and central cyanosis

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 recognize is the most common organism that causes community- acquired pneumonia?

Streptococcus pneumoniae

Three common pathogens that cause aspiration pneumonia are __________

Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus

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

Identify eight nursing measures that can be used to prevent atelectasis.

Frequent turning, early mobilization, deep breathing maneuvers, assistance with the use of spirometry, suctioning, postural drainage, aerosol nebulizer treatments, and chest percussion

The nurse assesses a patient for a possible pulmonary embolism. What frequent sign of pulmonary embolus does the nurse anticipate finding on assessment?

Tachypnea

_______________________ are hallmarks of the severity of atelectasis.

Tachypnea, dyspnea, mild to moderate hypoxemia