Nokea
A patient, age 69, has emphysema. On assessment, the nurse notes the presence of a 'barrel chest.' Which pathology causes this to occur?
- A. An increase in the lateromedial area from hypertrophy of mucous glands in the bronchi
- B. An increased anteroposterior diameter caused by overinflation of the alveoli
- C. A decrease in anteroposterior diameter caused by chronic dilation of the bronchi
- D. A widening of the sternocostal area secondary to chronic constriction of smooth muscles in the airways leading to bronchospasms
Correct Answer: B
Rationale: The patient will eventually appear barrel chested (an increased anteroposterior diameter caused by overinflation).
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The ___ are the structures of the lung in which gas exchange occurs.
Correct Answer: alveoli
Rationale: The end structures of the bronchial tree are called alveoli. It is in these terminal structures of the bronchial tree that gas exchange takes place.
A problem for the patient with a new laryngectomy would be feelings of isolation due to being unable to communicate verbally. Which nursing intervention is appropriate?
- A. Complete care quickly.
- B. Provide a pad and pencil or magic slate.
- C. Refrain from conversations with the patient to reduce stress level.
- D. Offer books or jigsaw puzzles for entertainment.
Correct Answer: B
Rationale: Provide patient with implements for communication. Rapidly completing care and provision of solitary activities does not reduce social isolation.
Which intervention should the nurse use to keep the chest tubes from becoming occluded?
- A. Irrigate tubes as needed.
- B. Prevent the patient from lying on it.
- C. Loop the tube over the bed rail.
- D. Milk' the tube frequently.
Correct Answer: B
Rationale: To keep the tubes patent, the patient should not lie on the tubing. These tubes are not irrigated and should not be milked frequently.
A patient is on postoperative day 2 after undergoing a total hip replacement. The patient suddenly complains of chest pain and is coughing up blood-tinged sputum. Which action should be the nurse's initial intervention?
- A. Report signs to the charge nurse.
- B. Elevate head of bed and administer oxygen.
- C. Prevent patient from excessive coughing.
- D. Increase IV flow rate.
Correct Answer: B
Rationale: When a pulmonary embolus is suspected, the head of the bed should be elevated to facilitate respiration and oxygen is administered. The charge nurse and the health care provider should be notified, but only after the patient is positioned and oxygenated.
Which nursing intervention is for a patient, age 40, who is diagnosed with active tuberculosis?
- A. Place the patient in drainage and secretion precautions.
- B. Place the patient in acid-fast bacillus (AFB) Isolation Precautions.
- C. Maintain the patient in enteric isolation.
- D. Place the patient in any Isolation Precautions.
Correct Answer: B
Rationale: If TB is suspected, place the patient in acid-fast bacillus (AFB) Isolation Precautions immediately.