Nokea
The client with which of the following types of lung cancer metastasizes quickly?
- A. Adenocarcinoma
- B. Oat cell
- C. Squamous cell
- D. Bronchial carcinoids
Correct Answer: B
Rationale: The correct answer is B: Oat cell. Oat cell (small cell) lung cancer metastasizes quickly due to its aggressive nature, high growth rate, and early dissemination to distant sites. This type of cancer is known for its rapid spread to other organs, leading to poor prognosis. Adenocarcinoma, squamous cell, and bronchial carcinoids have a slower metastatic rate compared to oat cell lung cancer. Adenocarcinoma tends to metastasize to the lymph nodes and other organs over time, while squamous cell typically spreads locally within the lung tissue. Bronchial carcinoids are slow-growing tumors with a lower propensity for rapid metastasis compared to oat cell lung cancer.
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Palpation is the assessment technique used to find which abnormal assessment findings?
- A. Stridor
- B. Finger clubbing
- C. Tracheal deviation
- D. Limited chest expansion
Correct Answer: D
Rationale: The correct answer is D because limited chest expansion is one of the abnormal assessment findings that can be identified through palpation techniques.
Which of the following structures is not part of the bronchial tree?
- A. alveoli
- B. bronchi
- C. terminal bronchioles
- D. respiratory bronchioles
Correct Answer: A
Rationale: The correct answer is A: alveoli. The alveoli are not part of the bronchial tree; they are the tiny air sacs at the end of the bronchial tree where gas exchange occurs. The bronchial tree consists of the bronchi, terminal bronchioles, and respiratory bronchioles, which are responsible for conducting air into the lungs. Alveoli are located at the end of the respiratory bronchioles and are where oxygen is absorbed into the bloodstream and carbon dioxide is released. Therefore, alveoli are not considered part of the bronchial tree.
The medical nurse who works on a pulmonology unit is aware that several respiratory conditions can affect lung tissue compliance. The presence of what condition would lead to an increase in lung compliance?
- A. Emphysema
- B. Pulmonary fibrosis
- C. Pleural effusion
- D. Acute respiratory distress syndrome (ARDS)
Correct Answer: A
Rationale: The correct answer is A: Emphysema. Emphysema leads to an increase in lung compliance due to the destruction of alveolar walls, resulting in decreased elastic recoil. This decreased recoil makes it easier for the lungs to expand and increases overall lung compliance.
Incorrect choices:
B: Pulmonary fibrosis - Pulmonary fibrosis causes lung tissue scarring and stiffening, resulting in decreased lung compliance.
C: Pleural effusion - Pleural effusion is an accumulation of fluid in the pleural space, which can restrict lung expansion and decrease lung compliance.
D: Acute respiratory distress syndrome (ARDS) - ARDS causes inflammation and fluid buildup in the lungs, leading to decreased lung compliance due to increased stiffness and reduced ability to expand.
For a patient with advanced chronic obstructive pulmonary disease (COPD), which nursing action best promotes adequate gas exchange?
- A. Encouraging the patient to drink three glasses of fluid daily.
- B. Keeping the patient in semi-Fowler's position.
- C. Using a high-flow venturi mask to deliver oxygen as prescribed.
- D. Administering a sedative, as prescribed.
Correct Answer: C
Rationale: The correct answer is C: Using a high-flow venturi mask to deliver oxygen as prescribed. This is the best option as it directly addresses the issue of promoting adequate gas exchange in a patient with advanced COPD. The high-flow venturi mask delivers oxygen at a precise concentration, ensuring optimal oxygenation.
Encouraging the patient to drink fluids (A) is important for overall health but does not directly address gas exchange. Keeping the patient in semi-Fowler's position (B) can help with breathing but is not as effective as providing supplemental oxygen. Administering a sedative (D) can further depress the respiratory system and worsen gas exchange, making it an inappropriate choice.
A nurse is instructing a hospitalized client with a diagnosis of emphysema about measures that will enhance the effectiveness of breathing during dyspneic periods. Which of the following positions will the nurse instruct the client to assume?
- A. Side-lying in bed.
- B. Sitting in a recliner chair.
- C. Sitting up in bed.
- D. Sitting on the side of the bed and leaning on an overbed table.
Correct Answer: D
Rationale: The correct answer is D, sitting on the side of the bed and leaning on an overbed table. This position promotes maximum expansion of the thorax, allowing for improved lung ventilation. Leaning forward helps reduce the work of breathing and facilitates better airflow. Options A and C do not provide the same level of thoracic expansion and may not be as effective. Option B may not provide the necessary support for the client to lean forward and optimize breathing.