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Study Questions
Chapter 15: Thorax and Lungs
1.
Which of the following is not a risk factor for tuberculosis?
(a) close contact with others who have TB
(b) poor sanitation
(c) travel to Western Europe
(d) immunosuppressed status
Answer: c
Rationale: Travel to Haiti or Southeast Asia presents a danger, because TB is more prevalent
there, but Western Europe is not particularly dangerous.
2.
You have a patient who receives intermittent tube feedings via a nasogastric tube. Which
of the following procedures help to improve safety of its use (choose two)?
(a) Have the patient lie supine during feedings.
(b) Have the patient sit upright during feedings.
(c) Don’t delay the feeding if the patient has retained a significant amount of residual
liquid in his stomach.
(d) Listen for proper placement of the tube prior to starting the feeding.
Answer: b, d
Rationale: Having the patient upright rather than supine lets gravity assist the digestive process.
Delay the feeding if a significant amount of residual remains. Auscultating for proper placement
is necessary to lessen the chance of aspiration.
3.
If a patient is having difficulty breathing, all of the following measures may provide
some relief, except which one?
(a) Help him sit upright or prop him up with pillows.
(b) Open the windows or turn on a fan to provide fresh air.
(c) Help him lie flat.
(d) Help him into a tripod position.
Answer: c
Rationale: Dyspnea may be aggravated by lying flat.
4.
A patient with silicosis may well have the following occupation:
(a) mining
(b) welding
(c) glass making
(d) woodworking
Answer: c
Rationale: Silicosis may result from exposure to glass making.
5.
You may note use of accessory muscles of respiration during these conditions (choose
two):
(a) sleep
(b) chronic obstructive pulmonary disease
(c) exercise
(d) sitting quietly
Answer: b, c
Rationale: Accessory muscles may be used when a person is in a state of hypoxemia or
hypermetabolism.
6.
The following statements are true of sleep apnea (choose two):
(a) In central sleep apnea, the respiratory drive is altered.
(b) In obstructive sleep apnea, the respiratory drive is altered.
(c) In central sleep apnea, a physical blockage leads to periods of respiratory cessation.
(d) In obstructive sleep apnea, a physical blockage leads to periods of respiratory
cessation.
Answer: a, d
Rationale: Sleep apnea can be either central, referring to the nervous system, or obstructive,
referring to a blockage in the airway.
7.
Diabetic ketoacidosis may result in this type of respiratory pattern:
(a) Biot’s respirations
(b) Cheyne-Stokes respirations
(c) Kussmaul’s respirations
(d) apneustic respirations
Answer: c
Rationale: Kussmaul’s respirations, characterized by extreme depth and rate, are the body’s
attempt to lower its PaCO2 level to try to correct acidosis.
8.
Your patient has pink, frothy sputum. This is characteristic of:
(a) bacterial infection
(b) black lung disease
(c) asthma
(d) pulmonary edema
Answer: d
Rationale: This is classic for pulmonary edema.
9.
Your patient has a tracheostomy tube. Assessment of the patient and correct procedures
when working with it include all of the following except:
(a) Suction the oropharynx after deflation of the cuff.
(b) Note whether there is a cuff and if it is inflated.
(c) Make sure that ties hold it securely in place.
(d) Note the size of the tube.
Answer: a
Rationale: Suctioning the oropharynx should be done prior to deflation of the tube to help prevent
aspiration. This can be done with clean technique, whereas suctioning the tracheostomy itself
requires aseptic technique.
10.
When assessing a patient on a mechanical ventilator, it is important to note all but which
one of the following:
(a) the FiO2 setting.
(b) the rate and tidal volume.
(c) that the alarms are set.
(d) what the patient says about his situation.
Answer: d
Rationale: Patients cannot speak while on mechanical ventilators due to the endotracheal tube or
tracheostomy.
11.
The following are true statements about crepitus, also referred to as subcutaneous
emphysema (choose two):
(a) It is sometimes a normal finding.
(b) It is usually felt earliest in the clavicular region.
(c) It can be due to aortic dissection.
(d) The air is slowly absorbed by the body.
Answer: b, d
Rationale: It is always an abnormal finding, and it is due to conditions that interrupt the integrity
of the pleura or lungs.
12.
Gerontological variations of the respiratory system may include:
(a) easier respiratory effort.
(b) decreased alveolar gas exchange.
(c) increased sensitivity to changes in carbon dioxide and oxygen levels.
(d) increased ciliary activity to allow easier clearing of the lungs.
Answer: b
Rationale: Respiratory effort becomes more difficult with calcification of cartilage and atrophy of
muscles. Sensitivity to gas levels is decreased, as is ciliary activity.
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