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NURS EXAM TB QUIZ WITH QUESTIONS AND VERIFIED ANSWERS A GRADED

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DEWIT 2e Chapter 15: Care of Patients with Disorders of the Lower Respiratory System Chapter 15: Care of Patients with Disorders of the Lower Respiratory System MULTIPLE CHOICE 14. When caring for a patient who is on a closed-chest drainage system with chest tubes, the nurse can confirm that the system is intact and working when: a. the water level in the water-seal chamber fluctuates. b. the level of fluid in the collection chamber rises. c. there are constant bubbles in the water-seal chamber. d. the suction has been attached. ANS: A If the level of the water in the water-seal chamber rises and falls with the patient’s respiration, the system is intact. Constant bubbles in the water-seal chamber indicate a leak in the system. The fluid in the collection container drains by gravity whether the closed-chest drainage system is intact or not. Suction is not significant with respect to whether the system is intact. DIF: Cognitive Level: Analysis REF: 316-317 OBJ: 6 (theory) TOP: Closed-Chest Drainage KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance 15. When the nurse assesses that the level of drainage has not increased over the last 3 hours on a first-day postoperative thoracotomy patient, the nurse should initially: a. inform the charge nurse. b. rearrange tubing to correct dependent loops. c. splint the patient with a pillow and coach to cough. d. gently massage the tube toward the collection bottle. ANS: B Dependent loops can capture drainage and plug the tube, not allowing any more drainage to leave the chest. Massaging (milking) the tube can be implemented after the dependent loops have been corrected. It would not be necessary to notify the charge nurse unless there is a problem, and having the patient cough would not correct the drainage problem. DIF: Cognitive Level: Application REF: 316-317 OBJ: 6 (theory) TOP: Closed-Chest Drainage KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Basic Care and Comfort 16. The nurse schedules the postural drainage treatments to be done before breakfast because: a. fluids that have accumulated overnight can be expelled. b. bronchial openings are still more fully open after a night’s rest. c. appetite will be stimulated for a meal after fluid is expelled. d. the empty stomach reduces gagging. ANS: A Morning postural drainage can expel the fluids collected overnight. After a postural drainage, the patient is tired and may not want to eat at all. The empty stomach prevents excessive vomiting but not gagging. DIF: Cognitive Level: Application REF: 321 OBJ: 2 (theory) TOP: Postural Drainage KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity: Basic Care and Comfort 17. The patient with sleep apnea is fitted with a continuous positive airway pressure (CPAP) mask and asks the nurse h w this device will help. The nurse correctly responds with which statement? “The device delivers constant positive pressure to keep your airway a. open.” b. “The device will require you to be intubated to open your airway.” c. “The device delivers oxygen only when you are apneic.” d. “The device delivers negative pressure to stimulate your respirations.” ANS: A The CPAP mask delivers a constant positive pressure to keep the airway open. CPAP does not require intubation and does not deliver negative pressure. DIF: Cognitive Level: Application REF: 326 OBJ: 6 (theory) TOP: Continuous Positive Airway Pressure Mask KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Basic Care and Comfort Chapter 16: The Hematologic System MULTIPLE CHOICE 1. The stem cells in the marrow are stimulated to make blood cells by the erythropoietin- stimulating factor in the: a. brain.

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