Which factors are considered to be direct causes of lung cancer? Select all that apply.
Smoking
Chewing tobacco
Genetic mutation
Bronchial asthma
Coal dust inhalation
High levels of pollution
Rationale
Coal dust, smoking, and high levels of pollution contribute to lung cancer. These carcinogens cause the
development of mutations that alter the epithelial cells. Chewing tobacco is a precursor to oral cancer,
not lung cancer. Bronchial asthma is a medical condition not associated with lung cancer, and genetic
mutations are a predisposition for cancer overall, not specifically lung cancer.
p. 514
After assessing a patient with non-small cell lung cancer, the nurse finds that the patient has airway
stenting. What outcome does the nurse expect for the patient after this treatment?
The patient will have a clear airway due to destruction of tumor.
The patient will have a decreased incidence of cerebral metastasis.
The patient will have a delay in extension of the tumor in the airway lumen.
The patient will have a reduced production of the kinase protein produced by the anaplastic
lymphoma kinase (ALK) gene.
Rationale :Airway stenting helps protect the airway wall against collapse or external compression,
thereby delaying the extension of tumor into the airway lumen. The targeted therapy with crizotinib, a
,kinase inhibitor, helps reduce production of kinase protein produced by the ALK gene. Bronchoscopic
laser therapy destroys tumor cells and causes thermal necrosis and shrinkage, which will clear the
airway. Prophylactic radiation is a radiation therapy, which reduces the risk of cerebral metastasis in
patients with lung cancer after receiving chemotherapy.p. 517
The nurse is caring for a patient with respiratory failure. What information should the nurse include
when explaining the disease condition to the family members? Select all that apply.
Respiratory failure is inevitable after cardiac failure.
Respiratory failure is categorized as hypoxemic or hypercapnic.
Respiratory failure is insufficient oxygen transfer into the blood.
Respiratory failure is inadequate carbon dioxide removal from the lungs.
Respiratory failure is a disease that presents with various respiratory symptoms.
Rationale Respiratory failure is classified as hypoxemic or hypercapnic. Respiratory failure results when
gas exchanging functions are inadequate, i.e., insufficient oxygen is transferred to the blood or
inadequate carbon dioxide is removed from the lungs. Although respiratory failure may be secondary to
cardiac failure, not all cases of respiratory failure are secondary to cardiac failure. Respiratory failure is
not a disease but a symptom of an underlying pathologic condition affecting lung function, oxygen
delivery, cardiac output, or the baseline metabolic state.p. 1609
The nurse is caring for a patient who is being mechanically ventilated due to respiratory failure. For
what complications should the nurse closely monitor? Select all that apply.
Barotrauma
Volutrauma
Hypoxemia
Renal failure
Ventilator-associated pneumonia (VAP)
,Rationale Mechanical ventilation can result in alveolar injuries due to the overdistension of the lungs,
which can result in barotrauma. Volutrauma is a complication caused by a mechanical ventilator set on
large tidal volumes. Ventilator-associated pneumonia occurs in patients who receive mechanical
ventilation for a prolonged period of time. Hypoxemia is caused by acute respiratory distress syndrome (
ARDS). Renal failure is a renal complication that occurs from decreased renal tissue oxygenation.pp.
1622-1623
A patient sustains a direct lung injury. What does the nurse recognize as the common direct causes of
acute respiratory distress syndrome (ARDS) in this patient? Select all that apply.
Sepsis
Acute pancreatitis
Bacterial pneumonia
Severe massive trauma
Aspiration of gastric contents
Rationale Sepsis is an initial manifestation of multisystem organ failure that leads to acute respiratory
distress syndrome (ARDS). Patients with lung infections such as bacterial or viral pneumonia also are at
risk. Aspiration of gastric content into lungs causes infections leading to ARDS or other lung problems.
Indirect injury to the lung results in acute pancreatitis and severe massive trauma. Acute pancreatitis
causes lung complications leading to ARDS. Trauma caused by any severe head injury indirectly causes
ARDS.p. 1620
When taking care of a patient diagnosed with respiratory failure on a mechanical ventilator, the nurse
hears the apnea alarm beeping. What assessment data should be gathered to determine the cause of the
alarm?
Pain or anxiety
Partial ventilator disconnect
Secretions, coughing, or gagging
Oversedation with opioid analgesics
, Rationale The apnea alarm on mechanical ventilation may be caused by respiratory arrest, oversedation,
change in patient condition, or loss of airway (total or partial extubation). The high-pressure limit alarm
is caused by secretions, coughing, or gagging. The low tidal volume alarm can be caused by partial
ventilator disconnect. The high tidal volume alarm can be caused by pain or anxiety.p. 1575
The nurse is caring for a patient with a shunt due to acute respiratory distress syndrome (ARDS). Which
nursing intervention is associated with better symptomatic relief for this patient?
Mechanical ventilation only
Mechanical ventilation and high FIO 2
Bronchodilators along with corticosteroids
High fraction of inspired oxygen (FIO 2) only
Rationale
Patients with ARDS having a shunt disorder are usually more hypoxemic than patients with ventilation-
perfusion (V/Q) mismatch. They often require mechanical ventilation and a high FIO 2 in combination to
improve gas exchange. Bronchodilators and corticosteroids are not helpful for immediate relief because
the patient does not have bronchospasm and inflammation.p. 1616
A patient with obstructive sleep apnea (OSA) is prescribed a continuous positive airway pressure
(CPAP) mask to be worn while sleeping. What benefits of CPAP compliance for a patient with OSA can
the nurse list to encourage adherence? Select all that apply.
Less nasal stuffiness
Less daytime sleepiness
Easy transition to daily usage
Improved concentration and memory
Decreased risk of cardiovascular disorders
Rationale
Smoking
Chewing tobacco
Genetic mutation
Bronchial asthma
Coal dust inhalation
High levels of pollution
Rationale
Coal dust, smoking, and high levels of pollution contribute to lung cancer. These carcinogens cause the
development of mutations that alter the epithelial cells. Chewing tobacco is a precursor to oral cancer,
not lung cancer. Bronchial asthma is a medical condition not associated with lung cancer, and genetic
mutations are a predisposition for cancer overall, not specifically lung cancer.
p. 514
After assessing a patient with non-small cell lung cancer, the nurse finds that the patient has airway
stenting. What outcome does the nurse expect for the patient after this treatment?
The patient will have a clear airway due to destruction of tumor.
The patient will have a decreased incidence of cerebral metastasis.
The patient will have a delay in extension of the tumor in the airway lumen.
The patient will have a reduced production of the kinase protein produced by the anaplastic
lymphoma kinase (ALK) gene.
Rationale :Airway stenting helps protect the airway wall against collapse or external compression,
thereby delaying the extension of tumor into the airway lumen. The targeted therapy with crizotinib, a
,kinase inhibitor, helps reduce production of kinase protein produced by the ALK gene. Bronchoscopic
laser therapy destroys tumor cells and causes thermal necrosis and shrinkage, which will clear the
airway. Prophylactic radiation is a radiation therapy, which reduces the risk of cerebral metastasis in
patients with lung cancer after receiving chemotherapy.p. 517
The nurse is caring for a patient with respiratory failure. What information should the nurse include
when explaining the disease condition to the family members? Select all that apply.
Respiratory failure is inevitable after cardiac failure.
Respiratory failure is categorized as hypoxemic or hypercapnic.
Respiratory failure is insufficient oxygen transfer into the blood.
Respiratory failure is inadequate carbon dioxide removal from the lungs.
Respiratory failure is a disease that presents with various respiratory symptoms.
Rationale Respiratory failure is classified as hypoxemic or hypercapnic. Respiratory failure results when
gas exchanging functions are inadequate, i.e., insufficient oxygen is transferred to the blood or
inadequate carbon dioxide is removed from the lungs. Although respiratory failure may be secondary to
cardiac failure, not all cases of respiratory failure are secondary to cardiac failure. Respiratory failure is
not a disease but a symptom of an underlying pathologic condition affecting lung function, oxygen
delivery, cardiac output, or the baseline metabolic state.p. 1609
The nurse is caring for a patient who is being mechanically ventilated due to respiratory failure. For
what complications should the nurse closely monitor? Select all that apply.
Barotrauma
Volutrauma
Hypoxemia
Renal failure
Ventilator-associated pneumonia (VAP)
,Rationale Mechanical ventilation can result in alveolar injuries due to the overdistension of the lungs,
which can result in barotrauma. Volutrauma is a complication caused by a mechanical ventilator set on
large tidal volumes. Ventilator-associated pneumonia occurs in patients who receive mechanical
ventilation for a prolonged period of time. Hypoxemia is caused by acute respiratory distress syndrome (
ARDS). Renal failure is a renal complication that occurs from decreased renal tissue oxygenation.pp.
1622-1623
A patient sustains a direct lung injury. What does the nurse recognize as the common direct causes of
acute respiratory distress syndrome (ARDS) in this patient? Select all that apply.
Sepsis
Acute pancreatitis
Bacterial pneumonia
Severe massive trauma
Aspiration of gastric contents
Rationale Sepsis is an initial manifestation of multisystem organ failure that leads to acute respiratory
distress syndrome (ARDS). Patients with lung infections such as bacterial or viral pneumonia also are at
risk. Aspiration of gastric content into lungs causes infections leading to ARDS or other lung problems.
Indirect injury to the lung results in acute pancreatitis and severe massive trauma. Acute pancreatitis
causes lung complications leading to ARDS. Trauma caused by any severe head injury indirectly causes
ARDS.p. 1620
When taking care of a patient diagnosed with respiratory failure on a mechanical ventilator, the nurse
hears the apnea alarm beeping. What assessment data should be gathered to determine the cause of the
alarm?
Pain or anxiety
Partial ventilator disconnect
Secretions, coughing, or gagging
Oversedation with opioid analgesics
, Rationale The apnea alarm on mechanical ventilation may be caused by respiratory arrest, oversedation,
change in patient condition, or loss of airway (total or partial extubation). The high-pressure limit alarm
is caused by secretions, coughing, or gagging. The low tidal volume alarm can be caused by partial
ventilator disconnect. The high tidal volume alarm can be caused by pain or anxiety.p. 1575
The nurse is caring for a patient with a shunt due to acute respiratory distress syndrome (ARDS). Which
nursing intervention is associated with better symptomatic relief for this patient?
Mechanical ventilation only
Mechanical ventilation and high FIO 2
Bronchodilators along with corticosteroids
High fraction of inspired oxygen (FIO 2) only
Rationale
Patients with ARDS having a shunt disorder are usually more hypoxemic than patients with ventilation-
perfusion (V/Q) mismatch. They often require mechanical ventilation and a high FIO 2 in combination to
improve gas exchange. Bronchodilators and corticosteroids are not helpful for immediate relief because
the patient does not have bronchospasm and inflammation.p. 1616
A patient with obstructive sleep apnea (OSA) is prescribed a continuous positive airway pressure
(CPAP) mask to be worn while sleeping. What benefits of CPAP compliance for a patient with OSA can
the nurse list to encourage adherence? Select all that apply.
Less nasal stuffiness
Less daytime sleepiness
Easy transition to daily usage
Improved concentration and memory
Decreased risk of cardiovascular disorders
Rationale
