Complications of lung abscesses include all of the following except:

A) Fistula

B) Tuberculosis

C) Empyema

D) Hematogenous spreading

Which of the following is an indication of a pneumothorax?

A) Blood in the pleural spacing

B) Crackles of the lungs

C) Trachea deviation towards affected side

D) Air in the pleural spacing

A) underweight, male, smoker, 32 yrs old
B) broken ribs
C) spontaneous, 20-40 yrs old, male

Pneumothorax occurs in which of the following (select all that apply):

A) underweight, 32 year old male smoker

B) a female patient with broken ribs following MVA

C) spontaneously in 20-40 year old males

D) a female who ran 5 miles

E) a 16-year old male tackled during football practice and complaining of palpitations

F) all the above

Which of the following conditions is not commonly seen following a chest injury?

A) 18-year old with a tension pneumothorax following a MVA

B) 24-year old male with gunshot wound to the chest, complaining of dyspnea

C) 21-year old with chylothorax following a fall down the stairs

D) 40-year-old male with broken ribs, O2 sats of 85%, and reporting dyspnea following a motorcycle accident

A charge nurse is supervising a new nurse provide care to a patient following an MVA with a diagnosis of flail chest. Which of the following nursing interventions would indicate the charge nurse needs to intervene?

A) Removing the chest tube to roll the patient during an assessment

B) The nurse gives a non-opioid analgesic to the patient with a pain level of 3/10

C) Nurse marks the chest tube drainage system and documents it in the patients chart

D) The nurse performs oral care for the patient with a chest tube, who is currently NPO status

Which of the following is indicated as a nurse's responsbility with caring for a patient with a chest tube?

A) Remove the chest tube when the drainage stops

B) Position the patient on the side with the chest tube, to help drain more fluid

C) Refill the water seal chamber with tap water when it falls below the line

D) Apply petroleum gauze dressing around the site after providing skin care

Steady, gentle bubbling in __________ chamber is normal with chest tube draining systems, while bubbling in __________ chamber indicates a need for the nurse to intervene.

A) left, right

B) suction control, water seal

C) water seal, suction control

D) right, left

False:

Fluctations or tidaling is common in the water seal chamber. Bubbles in the water seal chamber indicate a leak.

True/False

Slight fluctuations in the water seal chamber is an emergency that requires the nurse to reassess the chest tube and drainage system, indicating a leak in the water seal chamber.

When a patient is getting ready to have the chest tube removed, which of the following statements will help the removal process and decrease the pain for the patient?

A)  "This shouldn't hurt at all. Mine didn't hurt when I had the tube removed last year after my car wreck"
B) "After the tube is out, you can go back to playing sports right away."
C) "I'll give you so pain meds after the tube is removed. They can't remove the chest tube if I get it to you before."
D) "Make sure when the tube is being removed, you bear down to help prevent air from entering the incision site."

A) Turn, cough, and deep breath every 1-2 hours to prevent complaications, like pneumonia

One-day post-op from chest surgery, the nurse should encourage the patient to do what?

A) Turn, cough, and deep breath every 1-2 hours to prevent complaications, like pneumonia

B) Take shallow breaths if there is pain with breathing, so it won't hurt as much

C) Only use the call light when you need pain medicine, otherwise I can't take care of other patients

D) The patient needs to get out of bed every two hours and walk around the room two times, to prevent muscle deterioration

All of the following are restrictive respiratory disorders, except:

A) Pleural effusion

B) Atelectasis

C) Pleurisy

D) Lung cancer

C) pain worsening on expirations

-pain worsens with inspiration

A patient with pleurisy will have the following clinical manifestations except:

A) friction rub on auscultation

B) sharp, sudden pain at a level of 8/10

C) pain worsening on expirations

D) shallow respriations are a rate of 30 breaths/min

_________ is the purulent fluid in the pleural space.

A) Empyema

B) Pleurisy

C) Exudate

D) Chylothorax

The nurse is performing patient teaching for atelectasis prevention for post-op patients. Which of the following patient teachings is incorrect?

A) Turn, cough, deep breath every 2 hours

B) Use the incentive spirometry to help view your progress

C) Remain in bed for at least 1 week to prevent atelectasis

D) Change positions frequently to avoid decubitus ulcers

Pulmonary edema is most common caused by what?

A) Right sided heart failure

B) Untreated hypertension

C) Surgery

D) Left sided heart failure

Which patient does not have a medical emergency?

A) Tension pneumothorax

B) Lung cancer

C) Pulmonary edema

D)  Pulmonary embolism

A patient receiving treatment for pulmonary embolism (PE) and has an aPTT of 45. The doctor has ordered Heparin 1,500 units to be given. What is the nurses action?

A) Withhold the Heparin and notify the doctor of patient's aPTT level

B) Do nothing, since this patient does not need Heparin for a PE

C) Question the doctor's orders, as this patient does not need Heparin

D) Administer the medication, as aPTT levels are within normal range

Which of the following patients is at a higher risk of having a pulmonary embolism?

A) 72-year old male with a history of hypertension and GERD

B) 18-year-old female who is 3-weeks post-op from wisdom teeth removal

C) 25-year old female who gave birth 6 months ago via c-section

D) 64-year-old female who is 2-days post-op from surgery for a femur fracture

What are clinical manifestations of pulmonary edema?

A) dyspnea, hypertension, diminshed lung sounds

B) cough with blood-tinged sputum, fever, chest pain

C) orthopnea, confusion, pink-frothy sputum

D) hemoptysis, hypotension, headache

Which patient would you suspect of having a massive emboli?

A) 18-year old with hypertension, dyspnea, and nausea

B) 91-year old with constipation, O2 sat of 93%, and COPD

C) 33-year old with tachycardia, hypoxemia, and right ventricular failure

D) 54-year old with right-sided HF, tachycardia, crackles in the lungs

Pulmonary hypertension is clinically manifestated with which of the following:

A) headache, tinnitus, dizziness

B) dyspnea, fatigue, chest pain

C) syncope, hypotension, light-headedness

D) shock, severe dyspnea, tachycardia

True/False:

Primary pulmonary hypertension can lead to cor pulmonale and has no cure.

False:

Secondary pulmonary hypertension is related to co-morbidities and treatment is aimed at the underlying diseases

True/False:

Primary pulmonary hypertension treatment consists of treating the underlying diseases rather than the hypertension.

Cor pulmonale is ______________:

A) enlargement of the left ventricle

B) enlargement of the left atrium

C) enlargement of the right atrium

D) enlargement of the right ventricle

A patient with a diagnosis of cor pulmonale displays all of the following except:

A) weight loss

B) ascites

C) distended neck veins

D) hepatomegaly

Treatment for cor pulmonale includes all of the following except:

A) diuretics

B) low-flow oxygen

C) bronchodilators

D) vasoconstrictors

A patient reports to the ED with tachypnea with irregular breathing pattern, is diaphoretic, has difficulty speaking, and is using accessory muscles. The nurse should expect to see which of the following diagnosis?

A) Pulmonary edema

B) Status asthmaticus

C) Cor pulmonale

D) Pleurisy

Which of the following is a late sign of a patient with hypoxia?

A) altered LOC

B) bradycardia

C) tachycardia

D) dipahoresis

False:

HF is NOT a disease--it is a "syndrome"

True/False:

Heart failure is a disease characterized by ventricular dysfunction and is the most common reason for hospitalization in adults >65-years old

The leading cause (and most preventable risk factor) of heart failure is:

A) diabetes

B) high cholesterol

C) hypertension

D) tobacco use

C) decrease in the left ventricular ejection fraction

A patient with systolic heart failure has which of the following findings?

A) decrease in the right ventricular ejection fraction

B) increase in the left ventricular ejection fraction

C) decrease in the left ventricular ejection fraction

D) increase in the right ventricular ejection fraction

Diastolic heart failure is related to:

A) the inability of ventricles to relax and fill during diastole

B) increase in the ejection fracture

C) the inability of the atria to contract and pump blood through the heart

D) increase of stroke volume and CO

C) jugular venous distenion

*seen in right-sided HF

Manifestations of left-sided HF include all of the following except:

A) edema

B) crackles in the lungs

C) jugular venous distenion

D) increased respirations

Right-sided HF is a result of:

A) backup of blood into the left atrium and pulmonary veins

B) backup of blood into the ventricles

C) backup of blood into the right atrium and the lungs

D) backup of blood into the right atrium and venous circulation

B) 40-year old who reports having to use three pillows at night and has cyanosis of the lips

Which of the following patients would the nurse suspect to have acte decompensated heart failure (ADHF)?

A) 18-year old with report of dyspnea, who has a family history of hypertension

B) 40-year old who reports having to use three pillows at night and has cyanosis of the lips

C) 24-year old who reports weight loss of 3 lbs in 2 days and feeling light-headedness

D) 88-year old who reports changes in bowel functions and is bradycardic

Which of the following patient statements is an indicator for heart failure?

A) "Lately, my shoes have been a little snug when putting them on."
B) "I have been coughing up yellow phlem for the last week."
C) "I work 12-hour shifts every day and feel so tired after I get home."
D) "I sometimes take nitro tabs for chest pain, but it the pain goes away after that."

Which of the following are signs and symptoms of chronic HF?

A) dyspnea, blood-tinged sputum, and hypertension

B) fatigue, constipation, neck pain

C) increased agitation, bradycardia, clammy skin

D) peripheral edema with no hair growth, confusion, nocturia

A) atrial fibrillation

B) friction rub on auscultation

D) fatal dysrhythmias

F) renal failure

Complications of HF include which of the following (select all that apply):

A) atrial fibrillation

B) friction rub on auscultation

C) urinary incontinence

D) fatal dysrhythmias

E) empyema

F) renal failure

Which of the following patient statements indicates an understanding of HF education?

A) "These water pills will let me continue my usual diet so I don't have to change anything."
B) "I will need to go to the emergency department if I start feeling light-headed when standing up because of my medications."
C) "If my shoes feel tighter than usual, it may be sign that my HF is getting worse."

D) "I don't need any pills for my HF. It will get better over time with rest."