Respiratory Disorders

Chest/ Lung Trauma

100

True or False Chest tubes are inserted to maintain positive pressure for Lung expansion

false- Chest Tubes Restore negative Pressure

200

A nurse performing an assessment notices 30 cc of output in the chest tube drainage compartment over 2 hours, the nurse recognizes this as a normal or abnormal finding?

30 ml would be a normal amount of drainage. >100 ml/hr would be abnormal.

300

What is the progressive build-up of air within the pleural space, usually due to a lung laceration which allows air to escape into the pleural space but not to return.

What is a Tension Pheumothorax

400

Symptoms of this include chest pain that usually has a sudden onset. The pain is sharp and may lead to feelings of tightness in the chest. Shortness of breath, rapid heart rate, rapid breathing, cough, and fatigue The skin may develop a bluish color due to decreases in blood oxygen levels.

What is a pneumothorax

500

What is the immediate care is a chest tube becomes dislodged?

Placement of an occlusive dressing over the site, taped on 3 sides to allow for air to escape on expiration, thus preventing a tension Pneumothorax

Lung and Laryngeal CA

100

The nurse is caring for a patient whose recent unexplained weight loss and history of smoking have prompted diagnostic testing for cancer. What symptom is most closely associated with the early stages of laryngeal cancer? 88% A) Hoarseness B) Dyspnea C) Dysphagia D) Frequent nosebleeds

Explanation: Hoarseness is an early symptom of laryngeal cancer. Dyspnea, dysphagia, and lumps are later signs of laryngeal cancer. Alopecia is not associated with a diagnosis of laryngeal cancer

200

What is the most common type of lung cancer ?

non-small cell lung cancer

300

Which information about the prevention of lung disease should the nurse include for a patient with a 42 pack-year history of cigarette smoking?

a. Resources for support in smoking cessation

b. Reasons for annual sputum cytology testing

c. Erlotinib (Tarceva) therapy to prevent tumor risk

d. Computed tomography (CT) screening for cancer

A. Because smoking is the major cause of lung cancer, the most important role for the nurse is teaching patients about the benefits of and means of smoking cessation.

400

What interventions should be implemented to reduce the anxiety of a patient who has undergone a total laryngectomy?

Assess frequently, place call bell within reach, provide alternative forms of communication.

500

A patient presents with a chronic persistent non productive cough for 4 months the patient should be evaluated for

Lung CA

ARDs/TB/Pulmonary Hypertension

100

True/ False People who have latent TB don't feel good.

False

200

A client admitted with multiple traumatic injuries receives massive fluid resuscitation. Later, the physician suspects that the client has aspirated stomach contents. The nurse knows that this client is at highest risk for A) chronic obstructive pulmonary disease (COPD). B) bronchial asthma. C) acute respiratory distress syndrome (ARDS). D) renal failure.

Explanation: A client who receives massive fluid resuscitation or blood transfusions or who aspirates stomach contents is at highest risk for ARDS, which is associated with catastrophic events, such as multiple trauma, bacteremia, pneumonia, near drowning, and smoke inhalation. COPD refers to a group of chronic diseases, including bronchial asthma, characterized by recurring airflow obstruction in the lungs. Although renal failure may occur in a client with multiple trauma (depending on the organs involved), this client's history points to an assault on the respiratory system secondary to aspiration of stomach contents and massive fluid resuscitation

300

A patient is admitted to the hospital with a diagnosis of respiratory acidosis secondary to overdose of barbiturates. What signs and symptoms would the nurse anticipate?

What is slow shallow respirations and headache.

400

Fatigue, dyspnea, Retrosternal Chest Pain

What are manifestations of Pulmonary Hypertension?

500

"The Ventilator Bundle" Position the patient with the HOB at least >45 degrees, Frequent and meticulous oral care with suctioning of the oropharynx, Proper nutrition

What are interventions for Ventilator Associated Pneumonia?

Acid Base

100

ABGs of: pH 7.31 CO2 60 PaO2 45 HCO3 25

What is Respiratory Acidosis?

200

A patient is admitted to the hospital with numerous episodes of muscle weakness and twitching. ABGs are: pH 7.44, PCO2 49, HCO3 30. How would the nurse interpret these findings?

What is compensated metabolic alkalosis

300

The nurse would assess for what signs and symptoms in a patient who has metabolic acidosis?

What is rapid deep respirations and drowsiness.

400

The nurse is interpreting blood gases for a patient with acute respiratory distress syndrome (ARDS). Which set of blood gas values indicates respiratory acidosis? A) pH 7.87, PaCO2 38, HCO3 28 B) pH 7.47, PaCO2 28, HCO3 30 C) pH 7.49, PaCO2 34, HCO3 25 D) pH 7.25, PaCO2 48, HCO3 24

Explanation: pH 7.25, PaCO2 48, HCO3 24 = respiratory acidosis pH 7.87, PaCO2 38, HCO3 28 = metabolic alkalosis pH 7.47, PaCO2 28, HCO3 30 = respiratory alkalosis pH 7.49, PaCO2 34, HCO3 25 = respiratory alkalosis

500

The nurse anticipates which of the following responses in a patient who develops metabolic acidosis? A. HR will increase B. UO will increase C. RR will increase D. Temp will increase

C: RR will increase in an attempt to compensate for the acidosis. Increases in HR and Temp are metabolic responses that are not directly associated with maintaining acid-base balance. Initial compensation with metabolic acidosis will be via the lungs not kidneys.

Medications

100

A nurse is reinforcing discharge teaching with a client who has COPD and has a new prescription for albuterol (Proventil). Which of the following statements made by the client indicates an understanding of the teaching? 

A. “This medication can increase my blood sugar levels.” 

B. “This medication can decrease my immune response.” 

C. “I can have an increase in my heart rate while taking this medication.” 

D. “I can have mouth sores while taking this medication.”    

C. “I can have an increase in my heart rate while taking this medication.”  

200

A client is to begin a 6-month course of therapy with isoniazid (INH). A nurse plans to teach the client to: 

A. Drink alcohol in small amounts only 

B. Report yellow eyes or skin immediately 

C. Increase intake of Swiss or aged cheese 

D. Avoid vitamin supplements during therapy  

B. Report yellow eyes or skin immediately  

300

A client has a prescription for long-term use of oral prednisone for treatment of chronic asthma. The nurse should instruct the client to watch for which of the following? 

A. Weight gain and fluid retention 

B. Nervousness and insomnia 

C. Chest pain and tachycardia 

D. Dry mouth and constipation

A. Weight gain and fluid retention

400

A nurse is providing instructions to a client who has been prescribed albuterol (Proventil) and beclomethasone (QVAR) inhalers for the control of asthma. Which of the following instructions should the nurse include? 

A. Alternate which inhaler is used so that both are not taken the same time of day. 

B. Use the albuterol inhaler prior to using the beclomethasone inhaler. 

C. Only use beclomethasone if experiencing an acute episode. 

D. Use the beclomethasone inhaler first and immediately follow with the albuterol inhaler.  

B. Use the albuterol inhaler prior to using the beclomethasone inhaler.  

500

A client with tuberculosis is being started on antituberculosis therapy with isoniazid (INH). Before giving the client the first dose, a nurse ensures that which of the following baseline students has been completed? 

A. Electrolyte levels 

B. Coagulation times 

C. Liver enzymes levels 

D. Serum creatinine level  

C. Liver enzymes levels