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Med-Surg Respiratory..

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Postoperatively there is an increased risk for atelectasis from anesthesia as well as restricted breathing from pain. Without deep breathing to stretch the alveoli, surfactant secretion to hold the alveoli open is not promoted. Pneumonia will occur later after surgery. Pleural effusion occurs because of blockage of lymphatic drainage or an imbalance between intravascular and oncotic fluid pressures, which is not expected in this case The patient is hospitalized with pneumonia. Which diagnostic test should be used to measure the efficiency of gas transfer in the lung and tissue oxygenation? A. Thoracentesis B. Bronchoscopy C. Arterial blood gases D. Pulmonary function tests C. Arterial blood gases Arterial blood gases are used to assess the efficiency of gas transfer in the lung and tissue oxygenation as is pulse oximetry. Thoracentesis is used to obtain specimens for diagnostic evaluation, remove pleural fluid, or instill medication into the pleural space. Bronchoscopy is used for diagnostic purposes, to obtain biopsy specimens, and to assess changes resulting from treatment. Pulmonary function tests measure lung volumes and airflow to diagnose pulmonary disease, monitor disease progression, evaluate disability, and evaluate response to bronchodilators The nurse is interpreting a tuberculin skin test (TST) for a 58-year-old female patient with end-stage kidney disease secondary to diabetes mellitus. Which finding would indicate a positive reaction? A. Acid-fast bacilli cultured at the injection site B. 15-mm area of redness at the TST injection site C. 11-mm area of induration at the TST injection site D. Wheal formed immediately after intradermal injection

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Respiratory Exam Med-Surg


The nurse is caring for a patient with chronic obstructive pulmonary disorder (COPD) and pneumonia
who has an order for arterial blood gases to be drawn. What is the minimum length of time the nurse
should plan to hold pressure on the puncture site?



A. 2 minutes

B. 5 minutes

C. 10 minutes

D. 15 minutes

B. 5 minutes



After obtaining blood for an arterial blood gas measurement, the nurse should hold pressure on the
puncture site for 5 minutes by the clock to be sure that bleeding has stopped. An artery is an elastic
vessel under much higher pressure than veins, and significant blood loss or hematoma formation could
occur if the time is insufficient.



A patient with a recent history of a dry cough has had a chest x-ray that revealed the presence of
nodules. In an effort to determine whether the nodules are malignant or benign, what is the primary
care provider likely to order?



A. Thoracentesis

B. Pulmonary angiogram

C. CT scan of the patient's chest

D. Positron emission tomography (PET)

D. Positron emission tomography (PET)



PET is used to distinguish benign and malignant pulmonary nodules. Because malignant lung cells have
an increased uptake of glucose, the PET scan (which uses an IV radioactive glucose preparation) can
demonstrate increased uptake of glucose in malignant lung cells. This differentiation cannot be made
using CT, a pulmonary angiogram, or thoracentesis.

, After assisting at the bedside with a thoracentesis, the nurse should continue to assess the patient for
signs and symptoms of what?



A. Bronchospasm

B. Pneumothorax

C. Pulmonary edema

D. Respiratory acidosis

B. Pneumothorax



Because thoracentesis involves the introduction of a catheter into the pleural space, there is a risk of
pneumothorax. Thoracentesis does not carry a significant potential for causing bronchospasm,
pulmonary edema, or respiratory acidosis.



The patient had abdominal surgery yesterday. Today the lung sounds in the lower lobes have decreased.
The nurse knows this could be due to what occurring?



A. Pain

B. Atelectasis

C. Pneumonia

D. Pleural effusion

B. Atelectasis



Postoperatively there is an increased risk for atelectasis from anesthesia as well as restricted breathing
from pain. Without deep breathing to stretch the alveoli, surfactant secretion to hold the alveoli open is
not promoted. Pneumonia will occur later after surgery. Pleural effusion occurs because of blockage of
lymphatic drainage or an imbalance between intravascular and oncotic fluid pressures, which is not
expected in this case



The patient is hospitalized with pneumonia. Which diagnostic test should be used to measure the
efficiency of gas transfer in the lung and tissue oxygenation?



A. Thoracentesis

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