Pulmonary, Shock, Sepsis, Neurology | Q&A | Grade A | 100%
Correct (Verified Answers)
Subject: Advanced Pathophysiology and Pharmacology - Pulmonary, Shock, Sepsis, and
Neurology
Source: NR572 Mid-Term Exam Weeks 1-4 - Latest 2026/2027 Blueprint
Format: Q&A Guide with Clinical Rationale | Evidence-Based Practice | Verified
Accurate Solutions
Instructions: Each question includes the verified correct answer covering
pneumothorax, pleural effusions, shock states, sepsis, neuromuscular disorders, and ABG
interpretation.
1: What is the treatment for pneumothorax in non-urgent situations?
Correct Answer: A chest tube is usually inserted for symptomatic clients with >20%
involvement to expand the lung. When evidence of tension pneumothorax exists, emergency
intervention by needle decompression should be performed followed by chest tube
insertion.
1. Small pneumothoraces (<20%) in asymptomatic patients may resolve spontaneously
with observation.
2. Chest tube placement (tube thoracostomy) is indicated for larger pneumothoraces or
symptomatic patients.
3. Tension pneumothorax is a life-threatening emergency requiring immediate needle
decompression (2nd ICS, midclavicular line) followed by chest tube.
2: Where is a chest tube typically inserted?
Correct Answer: 4th or 5th intercostal space at the midclavicular line (anterior chest).
1. The "triangle of safety" is bounded by the latissimus dorsi, pectoralis major, and
horizontal line at nipple level.
2. Insertion at this location avoids major vessels, nerves, and the diaphragm.
3. Alternative site: 5th-6th intercostal space, midaxillary line (lateral approach).
, 3: What is a hallmark sign/symptom of pneumothorax recalled by the acronym P-
THORAX?
Correct Answer: P: Pleuritic Pain, T: Tracheal Deviation to Opposite Side (late sign), H:
Hyperresonance on affected side, O: Onset Sudden, R: Reduced Breath Sounds & Dyspnea,
A: Absent Fremitus, X: X-ray Findings. Additional findings: fatigue, tachycardia,
tachypnea, dry cough.
1. Tracheal deviation is a late finding indicating mediastinal shift in tension
pneumothorax.
2. Hyperresonance to percussion is due to air accumulation in pleural space.
3. Absent or decreased breath sounds are key auscultatory findings.
4: Which characteristics suggest an exudative pleural effusion?
A. Pleural/serum protein ratio greater than 0.5
B. Pleural pH of 7.40
C. Pleural/serum LDH ratio less than 0.1
D. White blood count (WBC) content of 6000
Correct Answer: A. Pleural/serum protein ratio greater than 0.5
1. Light's criteria for exudative effusion: pleural/serum protein >0.5, pleural/serum LDH
>0.6, pleural LDH >2/3 upper limit of normal serum LDH.
2. Exudative effusions are caused by inflammation, malignancy, or infection.
3. Transudative effusions (protein <0.5) are caused by heart failure, cirrhosis, or
nephrotic syndrome.
5: Which is a late finding in a client with tension pneumothorax?
A. Increased heart rate
B. Hypertension
C. Tracheal deviation
D. Decreased breath sounds
Correct Answer: C. Tracheal deviation
1. Tracheal deviation indicates mediastinal shift due to progressive air accumulation
under tension.
2. Early signs include tachycardia, hypotension, hypoxia, and respiratory distress.
3. Tracheal deviation is a late, ominous sign requiring immediate decompression.