Chapter 11 High Acuity Nursing 6th Edition by Kathleen Dorman Wagner

Chapter 11 High Acuity Nursing 6th Edition by Kathleen Dorman Wagner

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

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