Lung Cancer
Q: What is the most common cause of lung cancer?
A: Cigarette smoking.
Rationale: Smoking accounts for 85–90% of lung cancer cases because carcinogens damage bronchial cell DNA, leading to mutations.
Q: What is a pleural effusion?
A: Accumulation of fluid in the pleural space.
Rationale: Fluid buildup compresses the lung, impairing gas exchange.
Q: What genetic pattern does cystic fibrosis follow?
A: Autosomal recessive.
Rationale: Child must inherit two defective CFTR genes, one from each parent.
Q: What imaging test is most commonly used to detect lung abnormalities?
A: Chest X-ray.
Rationale: Shows opacities, masses, or effusions.
A: Chest X-ray.
Rationale: Shows opacities, masses, or effusions.
Q: What is the priority nursing diagnosis for a patient with lung cancer?
A: Impaired gas exchange.
Rationale: Tumor growth decreases ventilation and oxygenation.
Q: What are early warning signs of lung cancer?
A: Persistent cough, hemoptysis, shortness of breath, unexplained weight loss.
Rationale: These occur as tumors obstruct airways or invade surrounding tissue.
Q: What breath sounds are expected with pleural effusion?
A: Diminished or absent breath sounds over affected area.
Rationale: Fluid prevents sound transmission.
Q: What system is primarily affected in cystic fibrosis?
A: Respiratory system.
Rationale: Thick mucus obstructs airways, leading to infections and lung damage.
Q: What diagnostic test identifies cellular changes in sputum?
A: Sputum cytology.
Rationale: Detects malignant cells from bronchial secretions.
What position promotes optimal breathing in respiratory distress?
A: High Fowler’s position.
Rationale: Maximizes chest expansion and eases work of breathing.
Q: Which diagnostic test confirms lung cancer?
A: Biopsy (bronchoscopic or needle).
Rationale: Imaging shows suspicious lesions, but only tissue biopsy can confirm malignancy.
Q: What procedure removes fluid from pleural space for relief and analysis?
A: Thoracentesis.
Rationale: Needle aspiration both diagnoses cause and improves breathing.
Q: What is the gold standard diagnostic test for cystic fibrosis?
A: Sweat chloride test.
Rationale: CF causes excessive chloride in sweat; a result >60 mEq/L confirms diagnosis.
Q: What is the purpose of pulmonary function tests (PFTs)?
A: To measure lung volume, capacity, and airflow.
Rationale: Evaluates severity of disease and treatment effectiveness.
Q: What infection control precaution is vital for cystic fibrosis patients?
A: Contact precautions.
Rationale: Prevents cross-infection with resistant bacteria.
A: Chronic hypoxia.
Rationale: Long-term oxygen deprivation stimulates soft tissue growth at fingertips.
A: Chronic hypoxia.
Rationale: Long-term oxygen deprivation stimulates soft tissue growth at fingertips.
Q: What is a nursing action before thoracentesis?
A: Position patient sitting upright leaning forward over a bedside table.
Rationale: Maximizes lung expansion and access to pleural space.
Q: What type of diet is recommended for a patient with cystic fibrosis?
A: High-calorie, high-protein, high-fat diet with pancreatic enzymes.
Rationale: Malabsorption requires extra nutrients and enzyme replacement.
Q: What is the purpose of a bronchoscopy?
A: Visual examination of the airways and collection of tissue samples.
Rationale: Used for diagnosis, biopsy, or removal of foreign bodies.
What is an important nursing intervention after thoracentesis?
A: Monitor for respiratory distress and unequal breath sounds.
Rationale: Detects pneumothorax or lung collapse early.
Q: What is the nurse’s priority intervention for a client with lung cancer and new onset of confusion and restlessness?
A: Assess oxygen saturation and apply supplemental oxygen as ordered.
Rationale: Brain hypoxia or metastasis can cause neurological changes; oxygenation must be evaluated first.
Q: What is a potential complication after thoracentesis?
A: Pneumothorax.
Rationale: Accidental puncture can collapse the lung; monitor for absent breath sounds or distress.
Q: Why is chest physiotherapy (CPT) important in cystic fibrosis care?
A: It helps mobilize and clear thick mucus from the lungs.
Rationale: Airway clearance improves ventilation and prevents infection.
Q: Why is chemotherapy used in lung cancer?
A: To kill rapidly dividing cancer cells and shrink tumors.
Rationale: Systemic therapy targets metastasized cells.
Q: How should oxygen be administered to a patient with chronic CO₂ retention (like COPD)?
A: Low-flow oxygen (1–2 L/min via nasal cannula).
Rationale: High oxygen can suppress hypoxic drive and lead to respiratory failure.
Q: A patient with small-cell lung cancer develops SIADH. What lab results would the nurse expect?
A: Low serum sodium, low serum osmolality, concentrated urine.
Rationale: SIADH causes water retention and dilutional hyponatremia
Q: How can pleural effusion cause tracheal deviation?
A: Large effusions push mediastinal structures to opposite side.
Rationale: Increased intrathoracic pressure displaces the trachea.
Q: What finding indicates cystic fibrosis treatment is effective?
A: Decreased sputum production and improved oxygenation.
Rationale: Indicates airway clearance and reduced infection.
Q: What is pleurodesis, and why is it performed?
A: Chemical adhesion of pleural layers to prevent fluid reaccumulation.
Rationale: Used for recurrent malignant pleural effusions.
Q: A patient with lung cancer is anxious before a bronchoscopy. What should the nurse do?
A: Explain the procedure, ensure consent, and provide reassurance.
Rationale: Reduces anxiety and promotes cooperation through education.