NRS 315 - Exam 1 Questions with Verified Solutions Latest Update 2025
endotracheal tube - Answers meant for SHORT term use; can go through the nose or mouth;
passes THROUGH the vocal cords; patient CANNOT speak or eat
Problems r/t endotracheal tubes - Answers risk for patient taking it out; can damage teeth and
vocal cords; can choke on teeth or scope when inserting; occlusion from biting; skin breakdown
(tape and tube)
Trachs - Answers used for LONG term use; BELOW vocal cords; use an obturator to insert; has
potential to eat
Types of Trachs - Answers cuffed/uncuffed; can come with inner cannula or not;
disposable/non-disposable; fenestrated (weaning)
cuffed trach - Answers cuff prevents air leaks around the tube
Bivona Fome Cuff - Answers air fills balloon when it is uncapped; air has to be removed with a
syringe
Silver Jackson tracheostomy tube - Answers long term patients (rare); WILL NOT attach to
ventilator w/out adaptor
What is a laryngectomy? - Answers surgical removal of the larynx; total neck breather; do NOT
attempt intubation
problems r/t trachs - Answers bleeding; accidental expulsion; ulceration and necrosis
how do we prevent trach ulceration and necrosis? - Answers check cuff pressure; use pressure
easy valves
ways to communicate with a trach patient - Answers pencil and paper; sign language; lip reading;
placing a finger over trach (cuff has to be deflated); passy-muir valve; artificial larynx
Passy Muir Valve - Answers air goes in through trach and out through vocal cords
how to care for trachs - Answers nondisposable: use brush and pipe cleaners ;
disposable: replace inner cannula; leave old ties on until the new one is in
true or false: trach care can be delegated to UAPs - Answers False: they can only do oral care;
LPNs can do trach care
Yankauer Suction - Answers hard plastic catheter (like at the dentist)
oral swab and toothbrush - Answers used to suction and clean around gums; softer
Types of suctioning - Answers oropharyngeal nasopharyngeal
, nasotracheal
What is a pneumothorax? - Answers air in the pleural space; can be caused by a puncture wound,
thoracentesis, blowout r/t pressure, and rupture of a bleb
Nursing Assessment for pneumothorax - Answers sharp/sudden chest pain; dyspnea; dry, hacky
cough; asymmetric chest movement; decreased breath sounds; crackles; crepitations (rattling
sound); HYPERRESONANT
What is a hemothorax? - Answers blood in the pleural space
Nursing Assessment for hemothorax - Answers chest pain; dyspnea; asymmetric chest
movement; decreased breath sounds; blood loss --> hypotension, tachycardia, diaphoresis,
pallor; DULLNESS
What is pleural effusion? - Answers fluid in the pleural space
What is thoracentesis? - Answers The pleural space is entered by puncture & fluid is drained by
gravity into bottles-allows the lungs to re-expand
Nursing Assessment for rib fractures - Answers pain w/deep breaths; bruises; dyspnea; shallow
breathing; low saturations; grating sound; atelectasis or pneumonia r/t shallow breathing
What is flail chest? - Answers Free floating ribs disconnected in 2 places, moveable and can
cause injury to soft tissue
what do we NOT use on a patient with flail chest? - Answers rib binders
non-small cell lung cancer - Answers
squamous cell (epidermoid) - Answers better cure rate r/t slower growth and metastasis
adenocarcinoma - Answers slower growth with intermediate metastasis
large cell lung cancer - Answers less than 20% 5 year cure rate
small cell (oat cell) - Answers rapid growth and metastasis
mesothelioma - Answers rare and linked to asbestos
clinical manifestations of lung cancer - Answers Persistent cough
Wheezing
Pain
Hemoptysis (blood in sputum)
dyspnea
endotracheal tube - Answers meant for SHORT term use; can go through the nose or mouth;
passes THROUGH the vocal cords; patient CANNOT speak or eat
Problems r/t endotracheal tubes - Answers risk for patient taking it out; can damage teeth and
vocal cords; can choke on teeth or scope when inserting; occlusion from biting; skin breakdown
(tape and tube)
Trachs - Answers used for LONG term use; BELOW vocal cords; use an obturator to insert; has
potential to eat
Types of Trachs - Answers cuffed/uncuffed; can come with inner cannula or not;
disposable/non-disposable; fenestrated (weaning)
cuffed trach - Answers cuff prevents air leaks around the tube
Bivona Fome Cuff - Answers air fills balloon when it is uncapped; air has to be removed with a
syringe
Silver Jackson tracheostomy tube - Answers long term patients (rare); WILL NOT attach to
ventilator w/out adaptor
What is a laryngectomy? - Answers surgical removal of the larynx; total neck breather; do NOT
attempt intubation
problems r/t trachs - Answers bleeding; accidental expulsion; ulceration and necrosis
how do we prevent trach ulceration and necrosis? - Answers check cuff pressure; use pressure
easy valves
ways to communicate with a trach patient - Answers pencil and paper; sign language; lip reading;
placing a finger over trach (cuff has to be deflated); passy-muir valve; artificial larynx
Passy Muir Valve - Answers air goes in through trach and out through vocal cords
how to care for trachs - Answers nondisposable: use brush and pipe cleaners ;
disposable: replace inner cannula; leave old ties on until the new one is in
true or false: trach care can be delegated to UAPs - Answers False: they can only do oral care;
LPNs can do trach care
Yankauer Suction - Answers hard plastic catheter (like at the dentist)
oral swab and toothbrush - Answers used to suction and clean around gums; softer
Types of suctioning - Answers oropharyngeal nasopharyngeal
, nasotracheal
What is a pneumothorax? - Answers air in the pleural space; can be caused by a puncture wound,
thoracentesis, blowout r/t pressure, and rupture of a bleb
Nursing Assessment for pneumothorax - Answers sharp/sudden chest pain; dyspnea; dry, hacky
cough; asymmetric chest movement; decreased breath sounds; crackles; crepitations (rattling
sound); HYPERRESONANT
What is a hemothorax? - Answers blood in the pleural space
Nursing Assessment for hemothorax - Answers chest pain; dyspnea; asymmetric chest
movement; decreased breath sounds; blood loss --> hypotension, tachycardia, diaphoresis,
pallor; DULLNESS
What is pleural effusion? - Answers fluid in the pleural space
What is thoracentesis? - Answers The pleural space is entered by puncture & fluid is drained by
gravity into bottles-allows the lungs to re-expand
Nursing Assessment for rib fractures - Answers pain w/deep breaths; bruises; dyspnea; shallow
breathing; low saturations; grating sound; atelectasis or pneumonia r/t shallow breathing
What is flail chest? - Answers Free floating ribs disconnected in 2 places, moveable and can
cause injury to soft tissue
what do we NOT use on a patient with flail chest? - Answers rib binders
non-small cell lung cancer - Answers
squamous cell (epidermoid) - Answers better cure rate r/t slower growth and metastasis
adenocarcinoma - Answers slower growth with intermediate metastasis
large cell lung cancer - Answers less than 20% 5 year cure rate
small cell (oat cell) - Answers rapid growth and metastasis
mesothelioma - Answers rare and linked to asbestos
clinical manifestations of lung cancer - Answers Persistent cough
Wheezing
Pain
Hemoptysis (blood in sputum)
dyspnea
