Bronchoscopy and biopsy of lung cancer quiz

1. The nurse is preparing to suction a client via a trache- ostomy tube. The nurse should plan to limit the suc- tioning time to a maximum of which time period?

1.5seconds.

10 seconds.

30 seconds.

60 seconds.

Hypoxemia can be caused by prolonged suctioning, which stimulates the pacemaker cells in the heart. Avasovagal response may occur, causing bradycardia. The nurse must pre- oxygenate the client before suctioning and limit the suctioning pass to 10 seconds.

Explanation

Hypoxemia can be caused by prolonged suctioning, which stimulates the pacemaker cells in the heart. Avasovagal response may occur, causing bradycardia. The nurse must pre- oxygenate the client before suctioning and limit the suctioning pass to 10 seconds.

2. A client is to begin a 6-month course of therapy with isoniazid. The nurse should plan to teach the client to take which action?

Use alcohol in small amounts only.  

Report yellow eyes or skin immediately. 

Increase intake of Swiss or aged cheeses. 

Avoid vitamin supplements during therapy.

Isoniazid is hepatotoxic, and therefore the client is taught to report signs and symptoms of hepatitis immediately, which include yellow skin and sclera. For the same reason, alcohol should be avoided during therapy. The client should avoid intake of Swiss cheese, fish such as tuna, and foods con- taining tyramine because they may cause a reaction character- ized by redness and itching of the skin, flushing, sweating, tachycardia, headache, or lightheadedness. The client can avoid developing peripheral neuritis by increasing the intake of pyridoxine (vitamin B6) during the course of isoniazid therapy

Explanation

Isoniazid is hepatotoxic, and therefore the client is taught to report signs and symptoms of hepatitis immediately, which include yellow skin and sclera. For the same reason, alcohol should be avoided during therapy. The client should avoid intake of Swiss cheese, fish such as tuna, and foods con- taining tyramine because they may cause a reaction character- ized by redness and itching of the skin, flushing, sweating, tachycardia, headache, or lightheadedness. The client can avoid developing peripheral neuritis by increasing the intake of pyridoxine (vitamin B6) during the course of isoniazid therapy

3. A client is diagnosed with a disorder involving the inner ear. Which is the most common client complaint associated with a disorder involving this part of the ear?

Pruritus .

Tinnitus .

Hearing loss.

Burning in the ear.

Tinnitus is the most common complaint of clients with otological disorders, especially disorders involving the inner ear. Symptoms of tinnitus range from mild ringing in the ear, which can go unnoticed during the day, to a loud roaring in the ear, which can interfere with the client’s thinking pro- cess and attention span. Options 1, 3, and 4 are not associated specifically with disorders of the inner ear.

Explanation

Tinnitus is the most common complaint of clients with otological disorders, especially disorders involving the inner ear. Symptoms of tinnitus range from mild ringing in the ear, which can go unnoticed during the day, to a loud roaring in the ear, which can interfere with the client’s thinking pro- cess and attention span. Options 1, 3, and 4 are not associated specifically with disorders of the inner ear.

4. The nurse is performing an assessment on a client with a suspected diagnosis of cataract. Which clinical manifestation should the nurse expect to note in the early stages of cataract formation?

Diplopia. 

Eye pain. 

Floating spots

Blurred vision.

A gradual, painless blurring of central vision is the chief clinical manifestation of a cataract. Early symptoms include slightly blurred vision and a decrease in color perception. Options 1, 2, and 3 are not characteristics of a cataract.

Explanation

A gradual, painless blurring of central vision is the chief clinical manifestation of a cataract. Early symptoms include slightly blurred vision and a decrease in color perception. Options 1, 2, and 3 are not characteristics of a cataract.

5. The nurse is preparing to administer a dose of nal- oxone intravenously to a client with an opioid overdose. Which supportive medical equipment should the nurse plan to have at the client's bedside if needed?

Nasogastric tube.  

Paracentesis tray.  

Resuscitation equipment.

Central line insertion tray.

The nurse administering naloxone for suspected opioid overdose should have resuscitation equipment readily available to support naloxone therapy if it is needed. Other adjuncts that may be needed include oxygen, a mechanical ventilator, and vasopressors.

Explanation

The nurse administering naloxone for suspected opioid overdose should have resuscitation equipment readily available to support naloxone therapy if it is needed. Other adjuncts that may be needed include oxygen, a mechanical ventilator, and vasopressors.

6. The nurse should evaluate that defibrillation of a client was most successful if which observation was made?

Arousable, sinus rhythm, blood pressure (BP)  116/72 mm Hg.

Nonarousable, sinus rhythm, BP 88/60 mm Hg.

Arousable, marked bradycardia, BP 86/  54 mm Hg.

Nonarousable, supraventricular tachycardia, BP 122/60 mm Hg.

After defibrillation, the client requires continuous monitoring of electrocardiographic rhythm, hemodynamic status, and neurological status. Respiratory and metabolic acidosis develop during ventricular fibrillation because of lack of respiration and cardiac output. These can cause cerebral and cardiopulmonary complications. Arousable status, ade- quate BP, and a sinus rhythm indicate successful response to defibrillation.

Explanation

After defibrillation, the client requires continuous monitoring of electrocardiographic rhythm, hemodynamic status, and neurological status. Respiratory and metabolic acidosis develop during ventricular fibrillation because of lack of respiration and cardiac output. These can cause cerebral and cardiopulmonary complications. Arousable status, ade- quate BP, and a sinus rhythm indicate successful response to defibrillation.

7. The nurse is caring for a client after a bronchoscopy and biopsy. Which finding, if noted in the client, should be reported immediately to the health care provider?

Drycough .

Hematuria. 

Bronchospasm .

Blood-streaked sputum.

If a biopsy was performed during a bronchoscopy, blood-streaked sputum is expected for several hours. Frank blood indicates hemorrhage. A dry cough may be expected. The client should be assessed for signs of complications, which would include cyanosis, dyspnea, stridor, bronchospasm, hemoptysis, hypotension, tachycardia, and dysrhythmias. Hematuria is unrelated to this procedure

Explanation

If a biopsy was performed during a bronchoscopy, blood-streaked sputum is expected for several hours. Frank blood indicates hemorrhage. A dry cough may be expected. The client should be assessed for signs of complications, which would include cyanosis, dyspnea, stridor, bronchospasm, hemoptysis, hypotension, tachycardia, and dysrhythmias. Hematuria is unrelated to this procedure

8. A client with a urinary tract infection is receiving ciprofloxacin by the intravenous (IV) route. The nurse appropriately administers the medication by performing which action?

Infusing slowly over 60 minutes.

Infusing in a light-protective bag.    

Infusing only through a central line.

Infusing rapidly as a direct IV push medication.

Ciprofloxacin is prescribed for treatment of mild, moderate, severe, and complicated infections of the urinary tract, lower respiratory tract, and skin and skin structure. A single dose is administered slowly over 60 minutes to minimize discomfort and vein irritation. Ciprofloxacin is not light sensitive, may be infused through a peripheral IV access, and is not given by IV push method.

Explanation

Ciprofloxacin is prescribed for treatment of mild, moderate, severe, and complicated infections of the urinary tract, lower respiratory tract, and skin and skin structure. A single dose is administered slowly over 60 minutes to minimize discomfort and vein irritation. Ciprofloxacin is not light sensitive, may be infused through a peripheral IV access, and is not given by IV push method.

9. A client arrives in the emergency department following an automobile crash . The client's fore head hit the steering wheel and a hyphema is diagnosed. The nurse should place the client in which position?

Flat in bed. 

Asemi-Fowler’sposition. 

Lateral on the affected side. 

Lateral on the unaffected side.

Ahyphema is the presence of blood in the anterior chamber. Hyphema is produced when a force is sufficient to break the integrity of the blood vessels in the eye and can be caused by direct injury, such as a penetrating injury from a BB or pellet, or indirectly, such as from striking the forehead on a steering wheel during an accident. The client is treated by bed rest in a semi-Fowler’s position to assist gravity in keeping the hyphema away from the optical center of the cornea

Explanation

Ahyphema is the presence of blood in the anterior chamber. Hyphema is produced when a force is sufficient to break the integrity of the blood vessels in the eye and can be caused by direct injury, such as a penetrating injury from a BB or pellet, or indirectly, such as from striking the forehead on a steering wheel during an accident. The client is treated by bed rest in a semi-Fowler’s position to assist gravity in keeping the hyphema away from the optical center of the cornea

10. The client newly diagnosed with chronic kidney disease recently has begun hemodialysis. Knowing that the client is at risk for disequilibrium syn- drome, the nurse should assess the client during dialysis for which associated manifestations?

Hypertension, tachycardia, and fever. 

Hypotension, bradycardia, and hypothermia. 

Restlessness,irritability,and generalized weakness.

Headache, deteriorating level of consciousness, and twitching.

Disequilibrium syndrome is characterized by head- ache, mental confusion, decreasing level of consciousness, nausea, vomiting, twitching, and possible seizure activity. Dis- equilibrium syndrome is caused by rapid removal of solutes from the body during hemodialysis. At the same time, the blood-brain barrier interferes with the efficient removal of wastes from brain tissue. As a result, water goes into cerebral cells because of the osmotic gradient, causing increased intra- cranial pressure and onset of symptoms. The syndrome most often occurs in clients who are new to dialysis and is prevented by dialyzing for shorter times or at reduced blood flow rates. Tachycardia and fever are associated with infection. General- ized weakness is associated with low blood pressure and anemia. Restlessness and irritability are not associated with disequilibrium syndrome.

Explanation

Disequilibrium syndrome is characterized by head- ache, mental confusion, decreasing level of consciousness, nausea, vomiting, twitching, and possible seizure activity. Dis- equilibrium syndrome is caused by rapid removal of solutes from the body during hemodialysis. At the same time, the blood-brain barrier interferes with the efficient removal of wastes from brain tissue. As a result, water goes into cerebral cells because of the osmotic gradient, causing increased intra- cranial pressure and onset of symptoms. The syndrome most often occurs in clients who are new to dialysis and is prevented by dialyzing for shorter times or at reduced blood flow rates. Tachycardia and fever are associated with infection. General- ized weakness is associated with low blood pressure and anemia. Restlessness and irritability are not associated with disequilibrium syndrome.

Bronchoscopy And Biopsy Of Lung Cancer Quiz