C HAPTER 14: P ULMONARY D ISORDERS
Urden: Priorities in Critical Care Nursing, 8th Edition
MULTIPLE CHOICE
1. A patient has been admitted with severe shortness of breath and p leuritic
chest pain. The practitioner suspects the patient may have a pulmonary
embolism (PE). Which finding would confirm this diagnosis?
a. Low-probabilit y V/Q scan
b. Negative pulmonary angiogram
c. High-probabilit y V/Q scan
d. Absence of vascular markings on the c hest radiograph
ANS: C
A definitive diagnosis of a pulmonary embolism requires confirmation
by a high probabilit y V/Q scan, an abnormal pulmonary angiogram or
computed tomography scan, or strong clinical suspicion coupled with
abnormal findings on lower ext remit y deep venous thrombosis studies.
PTS: 1 DIF: Cognitive Level: Anal yzing OBJ: Nursing
Process Step: Assessment TOP: Pulmonary Disorders
MSC: NC LEX: Physiological Integrit y: Reduction of Risk
Potential
2. A patient was admitted after a left pneumo nectom y. The patient is
receiving 40% ox ygen via a simple face mask. The morning chest
radiography study reveals right lower lobe pneumonia. After eating
, breakfast, the patient suddenl y vomits and aspirates. What action should
the nurse take next?
a. Lavage the airway with normal saline
b. Place the patient supine in a semi -Fowler position
c. Manuall y ventilate the patient
d. Suction the airway
ANS: D
When aspiration is witnessed, emergency treatment should be instituted
to secure the airway and minimize pulmonary dama ge. The patient’s
head should be turned to the side, and the oral cavit y and upper airway
should be suctioned immediatel y to remove the gastric contents.
PTS: 1 DIF: Cognitive Level: Appl ying OBJ: Nursing
Process Step: Implementation TOP: Pulmonary
Disorders MSC: NC LEX: Physiological Integrit y:
Physiological Adaptation
3. A patient was admitted in acute lung failure. The patient is receiving
40% ox ygen via a simple face mask. The morning chest radiography
study reveals right lower lobe pneumonia. Which test would the nurse
expect the practitioner to order to identify the infectious pathogen?
a. CBC with differential
b. Wound culture of surgical site
c. Sputum gram stain and culture
d. Urine specimen
ANS: C
, A sputum gram stain and culture are done to facilitate the
identification of the infectious pathogen. In 50% of cases, though, a
causative agent is not identified. A diagnostic bronchoscopy may be
needed, particularl y if the diagnosis is unclear or current therapy is not
working. In addition, a complete blood count with differential,
chemistry panel, blood cultures, and arterial blood gas anal ysis is
obtained.
PTS: 1 DIF: Cognitive Level: Appl ying OBJ: Nursing
Process Step: Planning TOP: Pulmonary Disorders
MSC: NC LEX: Physiological Integrit y: Reduction of Ri sk
Potential
4. A patient was admitted with acute lung failure secondary to pneumonia.
What is the single most important measure to prevent the spread of
infection between staff and patients?
a. Place the patient in respiratory isolation.
b. Ensure everyone is using proper hand hygiene.
c. Use personal protective equipment when touching the patient.
d. Initiate prompt administration of antibiotics.
ANS: B
Proper hand hygiene is the single most important measure available to
prevent the spread of bacteria from person to person.
PTS: 1 DIF: Cognitive Level: Appl ying OBJ: Nursing
Process Step: Implementation TOP: Pulmonary
Disorders MSC: NC LEX: Physiological Integrit y:
Physiological Adaptation
Urden: Priorities in Critical Care Nursing, 8th Edition
MULTIPLE CHOICE
1. A patient has been admitted with severe shortness of breath and p leuritic
chest pain. The practitioner suspects the patient may have a pulmonary
embolism (PE). Which finding would confirm this diagnosis?
a. Low-probabilit y V/Q scan
b. Negative pulmonary angiogram
c. High-probabilit y V/Q scan
d. Absence of vascular markings on the c hest radiograph
ANS: C
A definitive diagnosis of a pulmonary embolism requires confirmation
by a high probabilit y V/Q scan, an abnormal pulmonary angiogram or
computed tomography scan, or strong clinical suspicion coupled with
abnormal findings on lower ext remit y deep venous thrombosis studies.
PTS: 1 DIF: Cognitive Level: Anal yzing OBJ: Nursing
Process Step: Assessment TOP: Pulmonary Disorders
MSC: NC LEX: Physiological Integrit y: Reduction of Risk
Potential
2. A patient was admitted after a left pneumo nectom y. The patient is
receiving 40% ox ygen via a simple face mask. The morning chest
radiography study reveals right lower lobe pneumonia. After eating
, breakfast, the patient suddenl y vomits and aspirates. What action should
the nurse take next?
a. Lavage the airway with normal saline
b. Place the patient supine in a semi -Fowler position
c. Manuall y ventilate the patient
d. Suction the airway
ANS: D
When aspiration is witnessed, emergency treatment should be instituted
to secure the airway and minimize pulmonary dama ge. The patient’s
head should be turned to the side, and the oral cavit y and upper airway
should be suctioned immediatel y to remove the gastric contents.
PTS: 1 DIF: Cognitive Level: Appl ying OBJ: Nursing
Process Step: Implementation TOP: Pulmonary
Disorders MSC: NC LEX: Physiological Integrit y:
Physiological Adaptation
3. A patient was admitted in acute lung failure. The patient is receiving
40% ox ygen via a simple face mask. The morning chest radiography
study reveals right lower lobe pneumonia. Which test would the nurse
expect the practitioner to order to identify the infectious pathogen?
a. CBC with differential
b. Wound culture of surgical site
c. Sputum gram stain and culture
d. Urine specimen
ANS: C
, A sputum gram stain and culture are done to facilitate the
identification of the infectious pathogen. In 50% of cases, though, a
causative agent is not identified. A diagnostic bronchoscopy may be
needed, particularl y if the diagnosis is unclear or current therapy is not
working. In addition, a complete blood count with differential,
chemistry panel, blood cultures, and arterial blood gas anal ysis is
obtained.
PTS: 1 DIF: Cognitive Level: Appl ying OBJ: Nursing
Process Step: Planning TOP: Pulmonary Disorders
MSC: NC LEX: Physiological Integrit y: Reduction of Ri sk
Potential
4. A patient was admitted with acute lung failure secondary to pneumonia.
What is the single most important measure to prevent the spread of
infection between staff and patients?
a. Place the patient in respiratory isolation.
b. Ensure everyone is using proper hand hygiene.
c. Use personal protective equipment when touching the patient.
d. Initiate prompt administration of antibiotics.
ANS: B
Proper hand hygiene is the single most important measure available to
prevent the spread of bacteria from person to person.
PTS: 1 DIF: Cognitive Level: Appl ying OBJ: Nursing
Process Step: Implementation TOP: Pulmonary
Disorders MSC: NC LEX: Physiological Integrit y:
Physiological Adaptation
