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Test Bank For High Acuity Nursing 6th Edition By Kathleen Dorman Wagner

  • ISBN-10: 0133026922
  • ISBN-13: 9780133026924
  • Author : by Kathleen Dorman Wagner

$30.00

SKU:TB0001472

Test Bank For High Acuity Nursing 6th Edition By Kathleen Dorman Wagner

Chapter 11
Question 1
Type: MCSA
A patient is being admitted for treatment of pneumothorax. The nurse would anticipate providing care for a patient with which pathophysiology?
1. Prolonged expiratory time
2. Increased lung compliance
3. Reduced tidal volume
4. Hyper-inflated lungs
Correct Answer: 3
Rationale 1: Expiratory time is dependent upon airflow with remains normal in the patient with a restrictive lung disorder such as pneumothorax.
Rationale 2: With restrictive lung disorders such as pneumothorax the air cannot move into the alveoli because of decreased lung compliance.
Rationale 3: Restrictive disorders such as pneumothorax are problems of volume rather than airflow. The patient’s tidal volume will be reduced.
Rationale 4: Restrictive lung disorders such as pneumothorax result in decrease in the air capacity of the lungs.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 11-1

Question 2
Type: MCSA
A patient is diagnosed with cystic fibrosis. The nurse will anticipate providing care for a patient with which change in lung function?
1. Decreased total lung capacity
2. Progressive respiratory alkalosis
3. Increased PaCO2
4. Increased forced expiratory volume (FEV)
Correct Answer: 3
Rationale 1: The air trapping associated with obstructive lung disorders such as cystic fibrosis results in increase in total lung capacity.
Rationale 2: Obstructive pulmonary disorders such as cystic fibrosis tends to produce progressive respiratory acidosis.
Rationale 3: In obstructive lung disorders such as cystic fibrosis PaCO2 levels increase as a result of air trapping.
Rationale 4: Obstructive disorders such as cystic fibrosis cause inability to exhale trapped air. This results in a decreased FEV.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 11-1

Question 3
Type: MCSA
A patient tells the nurse that when he is exposed to cigarette smoke he begins to get short of breath, starts coughing, and gets a “high pitched noise” in his lungs when he breathes. The nurse would ask additional assessment questions about which pulmonary disorder?
1. COPD
2. Asthma
3. Emphysema
4. Pneumonia
Correct Answer: 2
Rationale 1: COPD also is an obstructive disorder but does not typically become exacerbated with a trigger to cause the onset of symptoms.
Rationale 2: The classic triad of asthma symptoms includes paroxysmal episodes of dyspnea, wheeze, and cough triggered by a stimulus. The stimulus, or trigger, for the patient is cigarette smoke. This patient most likely is describing the symptoms of asthma.
Rationale 3: Emphysema also is an obstructive disorder but does not typically become exacerbated with a trigger to cause the onset of symptoms.
Rationale 4: Pneumonia will not “suddenly appear” after exposure to cigarette smoke to cause the onset of the patient’s symptoms.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 11-1

Question 4
Type: MCSA
The nurse is caring for a patient with obstructive pulmonary disease who had tachycardia, tachypnea, and restlessness. The patient has become very lethargic, but has a normal respiratory rate. The nurse should evaluate this change as indicating which condition?
1. The patient is now able to rest and sleep.
2. The patient’s condition has significantly deteriorated.
3. The patient’s condition shows some slight improvement.
4. The patient’s condition has stabilized significantly.
Correct Answer: 2
Rationale 1: These findings do not indicate that the patient is resting and now able to sleep.
Rationale 2: The patient’s condition has deteriorated as evidenced by lethargy and decreased respiratory rate. The elevated carbon dioxide levels have affected the central nervous system causing lethargy, which may progress to coma. The patient has become exhausted and is unable to maintain the compensatory mechanisms needed to maintain acid–base balance.
Rationale 3: These findings do not indicate that the patient’s condition is improving.
Rationale 4: These findings do not indicate significant stabilization of the patient’s condition.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 11-2

Question 5
Type: MCMA
A patient with pneumonia is restless and confused with increased blood pressure and respiratory rate. PaO2 is less than 60 mm Hg with a normal PaCO2. What conclusion can the nurse draw regarding this patient?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. The patient has ventilation failure.
2. Without treatment the patient’s oxygen saturation is likely to drop rapidly.
3. The patient has decreased airflow.
4. The patient is at risk for respiratory muscle fatigue.
5. Acute respiratory failure is present.
Correct Answer: 2,4
Rationale 1: Ventilation failure is reflected by an increased PaCO2.
Rationale 2: Once the PaO2 drops below 60 mm Hg oxygen’s affinity to hemoglobin drops.
Rationale 3: When the patient has ventilatory failure (decreased airflow) carbon dioxide levels increase. This patient has a normal PaCO2.
Rationale 4: As respiratory rate increases the risk of respiratory muscle fatigue also increases.
Rationale 5: Currently the patient does not have acute respiratory failure because the PaCO2 is normal.
Global Rationale:

Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 11-2

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