ACNP Pulmonary- Questions & Answers
HCAP Correct Ans-Includes any patient who was hospitalized in an acute care hospital for 2
or more days within 90 days of infection; resided in a nursing home or long-term care facility;
recevied recent IV anbx therapy, chemotherapy, or wound care within the past 30 days of teh
current infection; or attended a hospital or hemodialysis clinic
-Organisms in HCAP are more similar to those of HAP than CAP
Pneumothorax Correct Ans-Gas in the pleural space that raises pleural pressures and can
impair respiration, resulting in "collapsed lung"
S/S Pneumothorax Correct Ans-1. Chest pain, dyspnea or cough
2. Hyperresonance on affected side
3. Diminished breath sounds and diminshed fremitus on affected side
4. Mediastinal shift toward the unaffected side (tension)
5. Hypotension
Labs and diagnositcs of Pneumothorax Correct Ans-Chest x-ray is diagnostic
ABG may be indicated
Management of Pneumothorax Correct Ans-<20% PTX in asymptomatic patient requires no
intervention
Chest tube is used first if available; in emergency, needle thoracostomy (2nd ICS, MCL)
, Chest tube placement : 4th or 5th ICS, MAL
Pulmonary Embolus Correct Ans-diagnosed based on clinical suspicion (history is very
important) and the results of specific diagnostic studies. Predisposing risk factors are often in the
history: the leading cause of in-hospital death
Death is from failure of R ventricle due to forces of pulmonary artery
Risk factors for PE Correct Ans-Prolonged bed rest/immobility
Oral contraceptives
Surgery to LONG bones
Venous stasis
Hypercoagulable states
Cardiac thrombi
S/S PE Correct Ans-Usually occur abruptly
Unexplained dyspnea and tachycardia are most common
Chest pain (retrosternal or lateralized and pleuritic)
Hemoptysis
Low grade fever may occur
Hypotension
Cyanosis
HCAP Correct Ans-Includes any patient who was hospitalized in an acute care hospital for 2
or more days within 90 days of infection; resided in a nursing home or long-term care facility;
recevied recent IV anbx therapy, chemotherapy, or wound care within the past 30 days of teh
current infection; or attended a hospital or hemodialysis clinic
-Organisms in HCAP are more similar to those of HAP than CAP
Pneumothorax Correct Ans-Gas in the pleural space that raises pleural pressures and can
impair respiration, resulting in "collapsed lung"
S/S Pneumothorax Correct Ans-1. Chest pain, dyspnea or cough
2. Hyperresonance on affected side
3. Diminished breath sounds and diminshed fremitus on affected side
4. Mediastinal shift toward the unaffected side (tension)
5. Hypotension
Labs and diagnositcs of Pneumothorax Correct Ans-Chest x-ray is diagnostic
ABG may be indicated
Management of Pneumothorax Correct Ans-<20% PTX in asymptomatic patient requires no
intervention
Chest tube is used first if available; in emergency, needle thoracostomy (2nd ICS, MCL)
, Chest tube placement : 4th or 5th ICS, MAL
Pulmonary Embolus Correct Ans-diagnosed based on clinical suspicion (history is very
important) and the results of specific diagnostic studies. Predisposing risk factors are often in the
history: the leading cause of in-hospital death
Death is from failure of R ventricle due to forces of pulmonary artery
Risk factors for PE Correct Ans-Prolonged bed rest/immobility
Oral contraceptives
Surgery to LONG bones
Venous stasis
Hypercoagulable states
Cardiac thrombi
S/S PE Correct Ans-Usually occur abruptly
Unexplained dyspnea and tachycardia are most common
Chest pain (retrosternal or lateralized and pleuritic)
Hemoptysis
Low grade fever may occur
Hypotension
Cyanosis
