Nokea
What happens to the diaphragm during inspiration?
- A. It relaxes and raises.
- B. It contracts and flattens.
- C. It relaxes and flattens.
- D. It contracts and raises.
Correct Answer: B
Rationale: During inspiration, the diaphragm contracts and flattens, which expands the thoracic cage and increases the thoracic cavity.
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The nurse is caring for a client in the immediate post-thoracentesis period. In which position is the client placed?
- A. In the supine position
- B. Lying on the unaffected side
- C. In the high Fowler's position
- D. Prone with a pillow under the head
Correct Answer: B
Rationale: Following a thoracentesis, the client remains on bed rest and typically lies on the unaffected side for at least 1 hour to promote expansion of the lung on the affected side. Lying flat in a supine position or prone does not promote expansion of the lung.
The nurse receives an order to obtain a sputum sample from a client with hemoptysis. When advising the client of the physician's order, the client states not being able to produce sputum. Which suggestion, offered by the nurse, is helpful in producing the sputum sample?
- A. Tickle the back of the throat to produce the gag reflex.
- B. Drink 8 oz of water to thin the secretions for expectoration.
- C. Use the secretions present in the oral cavity.
- D. Take deep breaths and cough forcefully.
Correct Answer: D
Rationale: Taking deep breaths moves air around the sputum and coughing forcefully moves the sputum up the respiratory tract. Once in the pharynx, the sputum can be expectorated into a specimen container. Producing a gag reflex elicits stomach contents and not respiratory sputum. Dilute and thinned secretions are not helpful in aiding expectoration. A sputum culture is not a component of oral secretions.
Perfusion refers to blood supply to the lungs, through which the lungs receive nutrients and oxygen. What are the two methods of perfusion?
- A. The two methods of perfusion are the bronchial and alveolar circulation.
- B. The two methods of perfusion are the bronchial and capillary circulation.
- C. The two methods of perfusion are the bronchial and pulmonary circulation.
- D. The two methods of perfusion are the alveolar and pulmonary circulation.
Correct Answer: C
Rationale: The two methods of perfusion are the bronchial and pulmonary circulation. There is no alveolar circulation. Capillaries are the vessels that perform the perfusion regardless of which area of the lung they are in.
Including clients with a history of respiratory issues, for which diagnostic stud(ies) would the nurse screen the client for an allergy to contrast medium prior to testing?
- A. Lung scan
- B. Chest x-ray
- C. Pulmonary angiography
- D. Bronchoscopy
- E. Pulmonary function test
- F. Sputum culture
Correct Answer: A,C
Rationale: The nurse must be well educated in screening clients before diagnostic procedures, which include contrast medium for an allergy to iodine. A lung scan and pulmonary angiography both require contrast medium. A chest x-ray, bronchoscopy, sputum culture test, and pulmonary functions test do not require contrast medium.
A client arrived in the emergency department with a sharp object penetrating the diaphragm. When planning nursing care, which client need would the nurse identify as a priority?
- A. Acute pain
- B. Infection risk
- C. Impaired gas exchange
- D. Ineffective airway clearance
Correct Answer: C
Rationale: The diaphragm separates the thoracic and abdominal cavities. On inspiration, the diaphragm contracts and moves downward, creating a partial vacuum. Without this vacuum, air is not as efficiently drawn into the thoracic cavity. Hypoxia or hypoxemia may occur from the poor availability of oxygen. Although the nursing diagnosis of acute pain is probable, gas exchange is a higher priority. Ineffective airway clearance is not the greatest concern because the problem is with ventilation. Infection risk is present but is not the highest-priority client need.