Bio 103 Chapter 23 Testbank uestions

TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017) 454



Chapter23:ManagementofPatientswithChestandLowerRespiratory
TractDisorders


1. Aperioperativenurseiscaringforapostoperativepatient.Thepatienthasashallowrespiratorypattern
andisreluctanttocoughortobeginmobilizing.Thenurseshouldaddressthepatientsincreasedriskfor
whatcomplication?


A) Acuterespiratorydistresssyndrome(ARDS)


B) Atelectasis


C) Aspiration


D) Pulmonaryembolism


Ans: B


Feedback:


Ashallow,monotonousrespiratorypatterncoupledwithimmobilityplacesthepatientatanincreased
riskofdevelopingatelectasis.Thesespecificfactorsarelesslikelytoresultinpulmonaryembolismor
aspiration.ARDSinvolvesanexaggeratedinflammatoryresponseanddoesnotnormallyresultfrom
factorssuchasimmobilityandshallowbreathing.


2. Acritical-carenurseiscaringforapatientdiagnosedwithpneumoniaasasurgicalcomplication.The
nursesassessmentrevealsthatthepatienthasanincreasedworkofbreathingduetocopious
tracheobronchialsecretions.Whatshouldthenurseencouragethepatienttodo?


A) Increaseoralfluidsunlesscontraindicated.


B) Callthenursefororalsuctioning,asneeded.


C) LieinalowFowlersorsupineposition.


D) Increaseactivity.


Ans: A


Feedback:


Thenurseshouldencouragehydrationbecauseadequatehydrationthinsandloosenspulmonary
secretions.Oralsuctioningisnotsufficientlydeeptoremovetracheobronchialsecretions.Thepatient
shouldhavetheheadofthebedraised,andrestshouldbepromotedtoavoidexacerbationofsymptoms.

,TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017) 455


3. ThepublichealthnurseisadministeringMantouxteststochildrenwhoarebeingregisteredfor
kindergarteninthecommunity.Howshouldthenurseadministerthistest?


A) Administerintradermalinjectionsintothechildrensinnerforearms.


B) Administerintramuscularinjectionsintoeachchildsvastuslateralis.


C) Administerasubcutaneousinjectionintoeachchildsumbilicalarea.


D) Administerasubcutaneousinjectionata45-degreeangleintoeachchildsdeltoid.


Ans: A


Feedback:


Thepurifiedproteinderivative(PPD)isalwaysinjectedintotheintradermallayeroftheinneraspectof
theforearm.Thesubcutaneousandintramuscularroutesarenotutilized.


4. Thenurseiscaringforapatientwhohasbeeninamotorvehicleaccidentandthecareteamsuspects
thatthepatienthasdevelopedpleurisy.Whichofthenursesassessmentfindingswouldbestcorroborate
thisdiagnosis?


A) Thepatientisexperiencingpainlesshemoptysis.


B) Thepatientsarterialbloodgases(ABGs)arenormal,buthedemonstratesincreasedworkof
breathing.


C) Thepatientsoxygensaturationlevelisbelow88%,buthedeniesshortnessofbreath.


D) Thepatientspainintensifieswhenhecoughsortakesadeepbreath.


Ans: D


Feedback:


Thekeycharacteristicofpleuriticpainisitsrelationshiptorespiratorymovement.Takingadeepbreath,
coughing,orsneezingworsensthepain.ThepatientsABGswouldmostlikelybeabnormaland
shortnessofbreathwouldbeexpected.


5. Thenursecaringforapatientrecentlydiagnosedwithlungdiseaseencouragesthepatientnottosmoke.
Whatistheprimaryrationalebehindthisnursingaction?


A) Smokingdecreasestheamountofmucusproduction.


B) Smokeparticlescompeteforbindingsitesonhemoglobin.

, TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017) 456




C) Smokingcausesatrophyofthealveoli.


D) Smokingdamagestheciliarycleansingmechanism.


Ans: D


Feedback:


Inadditiontoirritatingthemucouscellsofthebronchiandinhibitingthefunctionofalveolar
macrophage(scavenger)cells,smokingdamagestheciliarycleansingmechanismoftherespiratory
tract.Smokingalsoincreasestheamountofmucusproductionanddistendsthealveoliinthelungs.It
reducestheoxygen-carryingcapacityofhemoglobin,butnotbydirectlycompetingforbindingsites.


6. ApatienthasbeenbroughttotheEDbytheparamedics.ThepatientissuspectedofhavingARDS.What
interventionshouldthenursefirstanticipate?


A) Preparingtoassistwithintubatingthepatient


B) Settingupoxygenat5L/minutebynasalcannula


C) Performingdeepsuctioning


D) Settingupanebulizertoadministercorticosteroids


Ans: A


Feedback:


ApatientwhohasARDSusuallyrequiresintubationandmechanicalventilation.Oxygenbynasal
cannulawouldlikelybeinsufficient.Deepsuctioningandnebulizersmaybeindicated,butthepriorityis
tosecuretheairway.


7. Thenurseiscaringforapatientwhoisscheduledforalobectomyforadiagnosisoflungcancer.While
assistingwithasubclavianveincentrallineinsertion,thenursenotestheclientsoxygensaturation
rapidlydropping.Thepatientcomplainsofshortnessofbreathandbecomestachypneic.Thenurse
suspectsapneumothoraxhasdeveloped.Furtherassessmentfindingssupportingthepresenceofa
pneumothoraxincludewhat?


A) Diminishedorabsentbreathsoundsontheaffectedside


B) Paradoxicalchestwallmovementwithrespirations


C) Suddenlossofconsciousness


D) Muffledheartsounds