WCU Advanced Med Surg Exam
1 Questions with 100% Correct
Answers
post bronchoscopy - Answer- monitor VS and resp. status, LOC, bleeding, gag reflex,
ability to swallow prior to resuming oral intake (usually takes about 2 hours to return)
post bronchoscopy oral care - Answer- gargling with salt and water relieves soreness
complications of a bronchoscopy - Answer- laryngospams, pneumothorax, aspiration
thoracentesis - Answer- surgical perforation into the pleural to remove fluid (effusion) or
air for therapeutic relief.
Thoracentesis indication - Answer- pneumonia, cirrhosis
pre thoracentesis - Answer- informed consent, cxr, position upright, arms and shoulders
supported on pillows. Patient education: remain still, no coughing or talking
intra thoracentesis - Answer- monitor VS and skin color. Measure and record amount of
fluid. (remove < 1L of fluid to prevent cardiovascular collapse), spend specimens to lab
post thoracentesis - Answer- Apply dressing to site, cxr to ensure success of drainage.
auscultate lungs, deep breathing exercises
thoracentesis complications - Answer- pneumothorax, bleeding infection
mediastinal shift interventions - Answer- monitor VS, auscultate for absent/decreased
breath sounds
pneumothorax - Answer- collapsed lung injury
pneumothorax s/s - Answer- decreased breath sounds on one side, deviated trachea,
pain on affected side that worses w/exhalation, affected side doesn't move in/out upon
inhalation/exhalation, tachycardia, rapid shallow respirations, nagging cough, air hunger
pulmonary embolism - Answer- blockage of pulmonary arteries by thrombus, fat, or air.
medical emergency.
most common embolism - Answer- dvt accounts for 90%
, pulmonary embolism risk factors - Answer- immobility, afib, oral
contraceptives/estrogen, pregnancy tobacco, obesity, surgery(orthopedic of lower
extremity), hypercoagulability(elevated platelet count), central venous catheters, elderly,
long bone fractures
pulmonary embolism subjective clinical manifestation - Answer- anxiety, impending
doom, chest [\pressure, pain w/inspiration, chest wall tenderness, air hunger
pulmonary embolism objective clinical manifestaions - Answer- pleurisy(sharp pain from
inspiration), pleural friction rub(squeaking door sound in lungs), tachycardia,
hypotension, dyspnea, tachypnea, crackles/cough, diaphoresis, decreased 02 sat,
petichiaie, pleural effusion
pulmonary embolism diagnositc procedures - Answer- ABGs, CBC D-dimer, cxr, ct, v/q
scan, pulmonary angiography
Pulomary embolism interventions - Answer- high fowlers, monitor vs, loc, emotional
support, meds, rt, radiology, cardiology
blunt trauma - Answer- chest strikes or is struck by an object
penetrating trauma - Answer- open injury with foreign body impaling through body
tissues=
s/s of chest trauma affecting lungs - Answer- dyspnea, cough, bloody sputum, cyanosis,
tracheal deviation, audible air escaping from chest wound, decreaed breath sounds on
affected side, decreased 02 sat, tachycardia, dec bp, asymmetric bp values in arms,
distended neck veins, cp, dysrhythmias, bruising, abrasions, asymmeytrical chest
movement
chest trauma affecting airways interventions - Answer- patent airway, 02 iv access, fluid
resuscitation, remove clothing, cover sucking wound w/dressing taped on 3 sides,
stablize impaled object (DO NOT REMOVE),
tension pneumothorax - Answer- incvreased pressure on heart and lungs. compresses
blood vessels and limits venous return, decreased CO, death, mediastinal shift. Air can't
escape
spontaneous pneumothorax - Answer- pneumothorax that is not caused by trauma
hemothorax - Answer- blood in pleural spaces
flail chest - Answer- multiple rib fractures, instability of chest walls, limit chest wall
expansion
1 Questions with 100% Correct
Answers
post bronchoscopy - Answer- monitor VS and resp. status, LOC, bleeding, gag reflex,
ability to swallow prior to resuming oral intake (usually takes about 2 hours to return)
post bronchoscopy oral care - Answer- gargling with salt and water relieves soreness
complications of a bronchoscopy - Answer- laryngospams, pneumothorax, aspiration
thoracentesis - Answer- surgical perforation into the pleural to remove fluid (effusion) or
air for therapeutic relief.
Thoracentesis indication - Answer- pneumonia, cirrhosis
pre thoracentesis - Answer- informed consent, cxr, position upright, arms and shoulders
supported on pillows. Patient education: remain still, no coughing or talking
intra thoracentesis - Answer- monitor VS and skin color. Measure and record amount of
fluid. (remove < 1L of fluid to prevent cardiovascular collapse), spend specimens to lab
post thoracentesis - Answer- Apply dressing to site, cxr to ensure success of drainage.
auscultate lungs, deep breathing exercises
thoracentesis complications - Answer- pneumothorax, bleeding infection
mediastinal shift interventions - Answer- monitor VS, auscultate for absent/decreased
breath sounds
pneumothorax - Answer- collapsed lung injury
pneumothorax s/s - Answer- decreased breath sounds on one side, deviated trachea,
pain on affected side that worses w/exhalation, affected side doesn't move in/out upon
inhalation/exhalation, tachycardia, rapid shallow respirations, nagging cough, air hunger
pulmonary embolism - Answer- blockage of pulmonary arteries by thrombus, fat, or air.
medical emergency.
most common embolism - Answer- dvt accounts for 90%
, pulmonary embolism risk factors - Answer- immobility, afib, oral
contraceptives/estrogen, pregnancy tobacco, obesity, surgery(orthopedic of lower
extremity), hypercoagulability(elevated platelet count), central venous catheters, elderly,
long bone fractures
pulmonary embolism subjective clinical manifestation - Answer- anxiety, impending
doom, chest [\pressure, pain w/inspiration, chest wall tenderness, air hunger
pulmonary embolism objective clinical manifestaions - Answer- pleurisy(sharp pain from
inspiration), pleural friction rub(squeaking door sound in lungs), tachycardia,
hypotension, dyspnea, tachypnea, crackles/cough, diaphoresis, decreased 02 sat,
petichiaie, pleural effusion
pulmonary embolism diagnositc procedures - Answer- ABGs, CBC D-dimer, cxr, ct, v/q
scan, pulmonary angiography
Pulomary embolism interventions - Answer- high fowlers, monitor vs, loc, emotional
support, meds, rt, radiology, cardiology
blunt trauma - Answer- chest strikes or is struck by an object
penetrating trauma - Answer- open injury with foreign body impaling through body
tissues=
s/s of chest trauma affecting lungs - Answer- dyspnea, cough, bloody sputum, cyanosis,
tracheal deviation, audible air escaping from chest wound, decreaed breath sounds on
affected side, decreased 02 sat, tachycardia, dec bp, asymmetric bp values in arms,
distended neck veins, cp, dysrhythmias, bruising, abrasions, asymmeytrical chest
movement
chest trauma affecting airways interventions - Answer- patent airway, 02 iv access, fluid
resuscitation, remove clothing, cover sucking wound w/dressing taped on 3 sides,
stablize impaled object (DO NOT REMOVE),
tension pneumothorax - Answer- incvreased pressure on heart and lungs. compresses
blood vessels and limits venous return, decreased CO, death, mediastinal shift. Air can't
escape
spontaneous pneumothorax - Answer- pneumothorax that is not caused by trauma
hemothorax - Answer- blood in pleural spaces
flail chest - Answer- multiple rib fractures, instability of chest walls, limit chest wall
expansion
