Nokea
A 54-year-old man has just been diagnosed with small cell lung cancer. The patient asks the nurse why the doctor is not offering surgery as a treatment for his cancer. What fact about lung cancer treatment should inform the nurses response?
- A. The cells in small cell cancer of the lung are not large enough to visualize in surgery
- B. Small cell lung cancer is self-limiting in many patients and surgery should be delayed
- C. Patients with small cell lung cancer are not normally stable enough to survive surgery
- D. Small cell cancer of the lung grows rapidly and metastasizes early and extensively
Correct Answer: D
Rationale: Surgery is primarily used for NSCLCs, because small cell cancer of the lung grows rapidly and metastasizes early and extensively. Difficult visualization and a patients medical instability are not the limiting factors. Lung cancer is not a self-limiting disease.
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An adult patient has tested positive for tuberculosis (TB). While providing patient teaching, what information should the nurse prioritize?
- A. The importance of adhering closely to the prescribed medication regimen
- B. The fact that the disease is a lifelong, chronic condition that will affect ADLs
- C. The fact that TB is self-limiting, but can take up to 2 years to resolve
- D. The need to work closely with the occupational and physical therapists
Correct Answer: A
Rationale: Successful treatment of TB is highly dependent on careful adherence to the medication regimen. The disease is not self-limiting; occupational and physical therapy are not necessarily indicated. TB is curable.
The nurse is caring for an 82-year-old patient with a diagnosis of tracheobronchitis. The patient begins complaining of right-sided chest pain that gets worse when he coughs or breathes deeply. Vital signs are within normal limits. What would you suspect this patient is experiencing?
- A. Traumatic pneumothorax
- B. Empyema
- C. Pleuritic pain
- D. Myocardial infarction
Correct Answer: C
Rationale: The key characteristic of pleuritic pain is its relationship to respiratory movement. Taking a deep breath, coughing, or sneezing worsens the pain. Pleuritic pain is limited in distribution rather than diffuse; it usually occurs only on one side. The pain may become minimal or absent when the breath is held. It may be localized or radiate to the shoulder or abdomen. Later, as pleural fluid develops, the pain decreases. The scenario does not indicate any trauma to the patient, so a traumatic pneumothorax is implausible. Empyema is unlikely as there is no fever indicative of infection. Myocardial infarction would affect the patients vital signs profoundly.
The nurse is caring for a 46-year-old patient recently diagnosed with the early stages of lung cancer. The nurse is aware that the preferred method of treating patients with nonsmall cell tumors is what?
- A. Chemotherapy
- B. Radiation
- C. Surgical resection
- D. Bronchoscopic opening of the airway
Correct Answer: C
Rationale: Surgical resection is the preferred method of treating patients with localized nonsmall cell tumors with no evidence of metastatic spread and adequate cardiopulmonary function. The other listed treatment options may be considered, but surgery is preferred.
A patient has just been diagnosed with lung cancer. After the physician discusses treatment options and leaves the room, the patient asks the nurse how the treatment is decided upon. What would be the nurses best response?
- A. The type of treatment depends on the patients age and health status
- B. The type of treatment depends on what the patient wants when given the options
- C. The type of treatment depends on the cell type of the cancer, the stage of the cancer, and the patients health status
- D. The type of treatment depends on the discussion between the patient and the physician of which treatment is best
Correct Answer: C
Rationale: Treatment of lung cancer depends on the cell type, the stage of the disease, and the patients physiologic status (particularly cardiac and pulmonary status). Treatment does not depend solely on the patients age or the patients preference between the different treatment modes. The decision about treatment does not primarily depend on a discussion between the patient and the physician of which treatment is best, though this discussion will take place.
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
- C. Smoking causes atrophy of the alveoli
- D. Smoking damages the ciliary cleansing mechanism
Correct Answer: D
Rationale: 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.