Nokea
A client has been diagnosed with lung cancer and requires lobectomy. How much of the lung is removed?
- A. One entire lung.
- B. A lobe of the lung.
- C. A small, localized area near the surface of the lung.
- D. One entire lung.
Correct Answer: B
Rationale: The correct answer is B: A lobe of the lung. During a lobectomy, a lobe of the lung is surgically removed, typically to treat lung cancer while preserving the remaining lung tissue. Removing one entire lung (choices A and D) is not necessary for a lobectomy and would be a more extensive procedure. Choice C, removing a small localized area near the surface of the lung, does not accurately reflect the extent of tissue removal required for a lobectomy. Therefore, the correct choice is B as it specifically addresses the removal of a lobe during the surgical procedure.
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A male client abruptly sits up in bed, reports having difficulty breathing and has an arterial oxygen saturation of 88%. Which mode of oxygen delivery would most likely reverse the manifestations?
- A. Simple mask
- B. Non-rebreather mask
- C. Face tent
- D. Nasal cannula
Correct Answer: B
Rationale: The correct answer is B: Non-rebreather mask. This device provides the highest concentration of oxygen among the choices, around 80-100%. In a client with difficulty breathing and low oxygen saturation, a high concentration of oxygen is crucial to quickly reverse hypoxemia. The non-rebreather mask ensures that the client is receiving the maximum amount of oxygen with each breath, improving oxygenation rapidly.
A: Simple mask delivers a lower concentration of oxygen and would not be sufficient for a client in distress.
C: Face tent does not provide a high concentration of oxygen and may not be effective in quickly reversing hypoxemia.
D: Nasal cannula delivers a lower concentration of oxygen compared to the non-rebreather mask and may not be enough to reverse manifestations in a client with significant difficulty breathing and low oxygen saturation.
A client seen in the emergency department reports fever,fatigue and dry cough but no other upper respiratory symptoms. A chest x-ray reveals mediastinal widening. What action by the nurse is best?
- A. Collect a sputum sample for culture by deep suctioning.
- B. Inform the client that oral antibiotics will be needed for 60 days.
- C. Place the client on Airborne Precautions immediately.
- D. Tell the client that directly observed therapy is needed.
Correct Answer: B
Rationale: The correct answer is B: Inform the client that oral antibiotics will be needed for 60 days. This is the best action because the client is showing symptoms consistent with tuberculosis, such as fever, fatigue, dry cough, and mediastinal widening on chest x-ray. Treatment for tuberculosis typically involves a combination of oral antibiotics for a prolonged period, usually 6-9 months. Collecting a sputum sample for culture by deep suctioning (A) may be necessary to confirm the diagnosis but is not the priority at this moment. Placing the client on Airborne Precautions immediately (C) is important once the diagnosis is confirmed, not the initial action. Directly observed therapy (D) is a method to ensure adherence to medication but is not the immediate next step.
Which of the following methods of speech following laryngectomy involves a throat vibrator held against the neck that projects sound into the mouth causing words to be formed with the mouth?
- A. Tracheoesophageal puncture (TEP)
- B. Esophageal speech
- C. Artificial (electric) larynx
- D. Speech therapy
Correct Answer: C
Rationale: The correct answer is C. The artificial (electric) larynx uses a throat vibrator to produce sound, enabling speech. A (TEP) involves a surgically created opening for speech. B (esophageal speech) relies on air swallowed into the esophagus. D (speech therapy) is a broader term encompassing various techniques.
Damage to the phrenic nerves would
- A. increase respiratory rate
- B. increase the tidal volume
- C. force reliance on costal breathing
- D. result in greater pressure differences between the lungs and the outside air
Correct Answer: C
Rationale: Damage to the phrenic nerves would result in the inability to fully expand the diaphragm, leading to reliance on costal breathing. This is because the phrenic nerves innervate the diaphragm, the main muscle of respiration. Without proper diaphragmatic function, the individual would have difficulty engaging in effective diaphragmatic breathing. Therefore, choice C is correct.
Choices A, B, and D are incorrect because damage to the phrenic nerves would not directly impact the respiratory rate, tidal volume, or pressure differences between the lungs and the outside air. These functions are more related to overall respiratory control and lung mechanics, which are not solely dependent on the phrenic nerves.
After using a nasal cannula delivery system at 3 L/min, a patient with chronic airflow
limitation (CAL) changes to a simple face mask. The nasal equipment oxygen was set at 3
L/min. How should the nurse adjust the oxygen flow for the new delivery system?
- A. Decrease it to 2 L.
- B. Keep it the same.
- C. Increase it to 4 L.
- D. Increase it to 6 L.
Correct Answer: D
Rationale: To determine the correct oxygen flow for a simple face mask, you should increase it from the previous nasal cannula rate. As simple face masks deliver oxygen less efficiently, a higher flow rate is needed to maintain the same oxygen concentration. Moving from 3 L/min nasal cannula to a simple face mask, you should increase the flow to 6 L/min to ensure adequate oxygen delivery to the patient with chronic airflow limitation. Choices A and B are incorrect as decreasing or keeping the flow the same would not provide sufficient oxygen. Choice C is also incorrect as increasing it to 4 L/min may not be enough to compensate for the decreased efficiency of the simple face mask.