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A patient who was involved in a workplace accident suffered a penetrating wound of the chest that led to acute respiratory failure. What goal of treatment should the care team prioritize when planning this patients care?
- A. Facilitation of long-term intubation
- B. Restoration of adequate gas exchange
- C. Attainment of effective coping
- D. Self-management of oxygen therapy
Correct Answer: B
Rationale: The objectives of treatment are to correct the underlying cause of respiratory failure and to restore adequate gas exchange in the lung. This is priority over coping and self-care. Long-term ventilation may or may not be indicated.
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The nurse is caring for a patient at risk for atelectasis. The nurse implements a first-line measure to prevent atelectasis development in the patient. What is an example of a first-line measure to minimize atelectasis?
- A. Incentive spirometry
- B. Intermittent positive-pressure breathing (IPPB)
- C. Positive end-expiratory pressure (PEEP)
- D. Bronchoscopy
Correct Answer: A
Rationale: Strategies to prevent atelectasis, which include frequent turning, early ambulation, lung-volume expansion maneuvers (deep breathing exercises, incentive spirometry), and coughing, serve as the first-line measures to minimize or treat atelectasis by improving ventilation. In patients who do not respond to first-line measures or who cannot perform deep-breathing exercises, other treatments such as positive end-expiratory pressure (PEEP), continuous or intermittent positive-pressure breathing (IPPB), or bronchoscopy may be used.
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.
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.
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 is caring for a patient in the ICU admitted with ARDS after exposure to toxic fumes from a hazardous spill at work. The patient has become hypotensive. What is the cause of this complication to the ARDS treatment?
- A. Pulmonary hypotension due to decreased cardiac output
- B. Severe and progressive pulmonary hypertension
- C. Hypovolemia secondary to leakage of fluid into the interstitial spaces
- D. Increased cardiac output from high levels of PEEP therapy
Correct Answer: C
Rationale: Systemic hypotension may occur in ARDS as a result of hypovolemia secondary to leakage of fluid into the interstitial spaces and depressed cardiac output from high levels of PEEP therapy. Pulmonary hypertension, not pulmonary hypotension, sometimes is a complication of ARDS, but it is not the cause of the patient becoming hypotensive.