Med Surg Unit 3 PRACTICE Questions With Complete
Solutions
1. A patient is having her tonsils removed. The patient asks the
nurse what function the tonsils serve. Which of the following
would be the most accurate response?
A) "The tonsils aid digestion."
B) "The tonsils help to guard the body from invasion of
organisms."
C) "The tonsils contain nerves that provoke sneezing."
D) "The tonsils regulate the airflow to the bronchi." Correct
Answers Ans: B
Page and Header: 488, Anatomic and Physiologic Overview
Feedback: The tonsils, the adenoids, and other lymphoid tissue
encircle the throat. These structures are important links in the
chain of lymph nodes guarding the body from invasion of
organisms entering the nose and throat. The tonsils do not aid
digestion, do not contain nerves that provoke sneezing, nor do
they regulate airflow to the bronchi.
10. The patient is positioned in a recumbent position. Which
approach should the nurse take to assess the patient's lung fields
for a patient in this position?
A) Inform that physician that the patient is in a recumbent
position and anticipate an order for a portable chest x-ray
B) Turn the patient to assess all lung fields so that dependent
areas can be assessed for breath sounds
C) Avoid turning the patient, and assess the accessible breath
sounds from the anterior chest wall
,D) Obtain a pulse oximetry reading, and, if the reading is low,
reposition the patient and auscultate breath sounds Correct
Answers Ans: B
Page and Header: 506, Assessment
Feedback: Assessment of the anterior and posterior lung fields is
part of the nurse's routine evaluation. If the patient is recumbent,
it is essential to turn the patient to assess all lung fields so that
dependent areas can be assessed for breath sounds, including the
presence of normal breath sounds and adventitious sounds.
Failure to examine the dependent areas of the lungs can result in
missing significant findings.
11. You suspect your patient has a pleural effusion. Which of
the following respiratory findings would you expect to find upon
assessment of your patient?
A) Increased tactile fremitus, egophony, and a dull sound upon
percussion of the chest wall
B) Decreased tactile fremitus, wheezing, and a hyperresonant
sound upon percussion of the chest wall
C) Lung fields dull to percussion, absent breath sounds, and a
pleural friction rub
D) Normal tactile fremitus, decreased breath sounds, and a
resonant sound upon percussion of the chest wall Correct
Answers Ans: C
Page and Header: 506, Assessment
Feedback: Assessment findings consistent with a pleural
effusion include affected lung fields being dull to percussion and
absence of breath sounds. A pleural friction rub may also be
present.
,12. You are doing rounds at the beginning of your shift when
you notice a sputum specimen sitting on the bedside table in a
patient's room. You ask the patient when he produced the
sputum specimen. You learn the specimen is about 4 hours old.
Knowing this information, what action would you take?
A) Immediately take the sputum specimen to the laboratory
B) Discard the specimen and assist the patient in obtaining
another specimen
C) Refrigerate the sputum specimen
D) Wait an additional 2 hours before sending the specimen to
the laboratory Correct Answers Ans: B
Page and Header: 509, Diagnostic Evaluation
Feedback: A sputum specimen should be delivered to the
laboratory within 2 hours of collection. Allowing the specimen
to stand for several hours in a warm room results in the
overgrowth of contaminated organisms and may make it
difficult to identify the pathogenic organisms. Refrigeration of
the sputum specimen is not an appropriate action.
13. You are admitting a patient with a heart murmur. You note
there is a depression in the lower portion of the sternum. What is
this type of chest deformity called?
A) A barrel chest
B) A funnel chest
C) A pigeon chest
D) Kyphoscoliosis Correct Answers Ans: B
Page and Header: 500, Assessment
, Feedback: A funnel chest occurs when there is a depression in
the lower portion of the sternum, and this may lead to
compression of the heart and great vessels, resulting in
murmurs. A barrel chest is characterized by an increase in the
anteroposterior diameter of the thorax and is a result of
overinflation of the lungs. A pigeon chest occurs as a result of
displacement of the sternum and includes an increase in the
anteroposterior diameter. Kyphoscoliosis is characterized by
elevation of the scapula and a corresponding S-shaped spine and
limits lung expansion within the thorax.
14. You are the nurse working on the respiratory intensive care
unit. You are aware that several respiratory conditions can affect
the compliance of the lung tissue. Which condition leads to an
increase in lung compliance?
A) Emphysema
B) Pulmonary fibrosis
C) Pleural effusion
D) Acute respiratory distress syndrome Correct Answers Ans:
A
Page and Header: 490, Anatomic and Physiologic Overview
Feedback: High or increased compliance occurs if the lungs
have lost their elasticity and the thorax is overdistended, in
conditions such as emphysema. Conditions associated with
decreased compliance include pneumothorax, hemothorax,
pleural effusion, pulmonary edema, atelectasis, pulmonary
fibrosis, and acute respiratory distress syndrome.
15. A nurse admits a patient to her unit with a presumptive
diagnosis of pneumonia. When a sputum specimen is obtained,
Solutions
1. A patient is having her tonsils removed. The patient asks the
nurse what function the tonsils serve. Which of the following
would be the most accurate response?
A) "The tonsils aid digestion."
B) "The tonsils help to guard the body from invasion of
organisms."
C) "The tonsils contain nerves that provoke sneezing."
D) "The tonsils regulate the airflow to the bronchi." Correct
Answers Ans: B
Page and Header: 488, Anatomic and Physiologic Overview
Feedback: The tonsils, the adenoids, and other lymphoid tissue
encircle the throat. These structures are important links in the
chain of lymph nodes guarding the body from invasion of
organisms entering the nose and throat. The tonsils do not aid
digestion, do not contain nerves that provoke sneezing, nor do
they regulate airflow to the bronchi.
10. The patient is positioned in a recumbent position. Which
approach should the nurse take to assess the patient's lung fields
for a patient in this position?
A) Inform that physician that the patient is in a recumbent
position and anticipate an order for a portable chest x-ray
B) Turn the patient to assess all lung fields so that dependent
areas can be assessed for breath sounds
C) Avoid turning the patient, and assess the accessible breath
sounds from the anterior chest wall
,D) Obtain a pulse oximetry reading, and, if the reading is low,
reposition the patient and auscultate breath sounds Correct
Answers Ans: B
Page and Header: 506, Assessment
Feedback: Assessment of the anterior and posterior lung fields is
part of the nurse's routine evaluation. If the patient is recumbent,
it is essential to turn the patient to assess all lung fields so that
dependent areas can be assessed for breath sounds, including the
presence of normal breath sounds and adventitious sounds.
Failure to examine the dependent areas of the lungs can result in
missing significant findings.
11. You suspect your patient has a pleural effusion. Which of
the following respiratory findings would you expect to find upon
assessment of your patient?
A) Increased tactile fremitus, egophony, and a dull sound upon
percussion of the chest wall
B) Decreased tactile fremitus, wheezing, and a hyperresonant
sound upon percussion of the chest wall
C) Lung fields dull to percussion, absent breath sounds, and a
pleural friction rub
D) Normal tactile fremitus, decreased breath sounds, and a
resonant sound upon percussion of the chest wall Correct
Answers Ans: C
Page and Header: 506, Assessment
Feedback: Assessment findings consistent with a pleural
effusion include affected lung fields being dull to percussion and
absence of breath sounds. A pleural friction rub may also be
present.
,12. You are doing rounds at the beginning of your shift when
you notice a sputum specimen sitting on the bedside table in a
patient's room. You ask the patient when he produced the
sputum specimen. You learn the specimen is about 4 hours old.
Knowing this information, what action would you take?
A) Immediately take the sputum specimen to the laboratory
B) Discard the specimen and assist the patient in obtaining
another specimen
C) Refrigerate the sputum specimen
D) Wait an additional 2 hours before sending the specimen to
the laboratory Correct Answers Ans: B
Page and Header: 509, Diagnostic Evaluation
Feedback: A sputum specimen should be delivered to the
laboratory within 2 hours of collection. Allowing the specimen
to stand for several hours in a warm room results in the
overgrowth of contaminated organisms and may make it
difficult to identify the pathogenic organisms. Refrigeration of
the sputum specimen is not an appropriate action.
13. You are admitting a patient with a heart murmur. You note
there is a depression in the lower portion of the sternum. What is
this type of chest deformity called?
A) A barrel chest
B) A funnel chest
C) A pigeon chest
D) Kyphoscoliosis Correct Answers Ans: B
Page and Header: 500, Assessment
, Feedback: A funnel chest occurs when there is a depression in
the lower portion of the sternum, and this may lead to
compression of the heart and great vessels, resulting in
murmurs. A barrel chest is characterized by an increase in the
anteroposterior diameter of the thorax and is a result of
overinflation of the lungs. A pigeon chest occurs as a result of
displacement of the sternum and includes an increase in the
anteroposterior diameter. Kyphoscoliosis is characterized by
elevation of the scapula and a corresponding S-shaped spine and
limits lung expansion within the thorax.
14. You are the nurse working on the respiratory intensive care
unit. You are aware that several respiratory conditions can affect
the compliance of the lung tissue. Which condition leads to an
increase in lung compliance?
A) Emphysema
B) Pulmonary fibrosis
C) Pleural effusion
D) Acute respiratory distress syndrome Correct Answers Ans:
A
Page and Header: 490, Anatomic and Physiologic Overview
Feedback: High or increased compliance occurs if the lungs
have lost their elasticity and the thorax is overdistended, in
conditions such as emphysema. Conditions associated with
decreased compliance include pneumothorax, hemothorax,
pleural effusion, pulmonary edema, atelectasis, pulmonary
fibrosis, and acute respiratory distress syndrome.
15. A nurse admits a patient to her unit with a presumptive
diagnosis of pneumonia. When a sputum specimen is obtained,
