Chapter 22: Thoracic Surgery

Chapter 22: Thoracic Surgery

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. The thoracic outlet is a junction bound anteriorly by the manubrium, anterolaterally by the first ribs, and posteriorly by the first thoracic vertebrae and posterior angles of the first ribs of the space. The great vessels of the head, neck, and arm pass through this space. What syndrome is caused by the compression of these structures?

ANS:  C

Compression of these structures causes thoracic outlet syndrome.

REF:   Page 936

2. The nerves of the lungs are a part of the autonomic nervous system. What structures are constricted and relaxed by their influence?

ANS:  A

The nerves of the lungs are a part of the autonomic nervous system. They regulate constriction and relaxation of the bronchi and the blood vessels within the lungs.

REF:   Pages 936-937

3. Inspiration normally takes place when the intrathoracic pressure is slightly below atmospheric pressure and when a partial vacuum exists between the parietal and visceral pleural (intrathoracic) surfaces. As the muscles of inspiration contract to enlarge the chest cage, what action by the lungs occurs to facilitate air intake?

ANS:  B

As the muscles of inspiration contract to enlarge the chest cage, the lungs passively follow the diaphragm and chest wall because of decreased intrathoracic pressure. The acts of inspiration and expiration are the result of air moving in and out of the lung, causing pressure to equalize with that of the atmosphere at the end of expiration.

REF:   Page 938

4. Assessment of the skin and the patient’s general condition is important in preventing perioperative complications. The nurse should assess the patient’s smoking history (including the use of cigars, pipes, tobacco, or controlled substances) and any exposure to secondhand smoke within the home and/or workplace and reinforce the need to abstain following surgery. Patients might be sensitive about smoking history because of the assumed relationship between smoking and lung disease. Select the statement that best reflects an appropriate strategy that the nurse could use in assessing the patient’s smoking history.

ANS:  D

The nurse should phrase questions in a way that will not result in guilt about smoking habits or assumptions that the diagnosed condition is associated with smoking. The nurse should also assess the patient’s pain tolerance to determine necessary teaching or tools that will assist in achieving positive postoperative outcomes.

REF:   Page 940

5. After reviewing the laboratory results and assessing the patient, the perioperative nurse determines that the patient’s nursing diagnosis is Impaired Gas Exchange related to surgical intervention. Select the appropriate nursing intervention that is related to assisting the patient to experience adequate gas exchange during the surgical procedure.

ANS:  B

The nurse should collaborate in positioning the patient to provide access to the endotracheal tube, enable efficient ventilatory function, and prevent injury. Verify that a double-lumen endotracheal tube with a soft, inflatable cuff is available for the anesthesia provider. The nurse should collaborate in obtaining equipment and monitoring arterial blood gases (ABGs); document results. Obtain equipment and assist with patient preparation for hemodynamic monitoring: electrocardiogram (ECG), CO₂ analyzer, pulse oximeter, arterial pressure line, and central venous pressure line; the nurse should collaborate with the anesthesia provider in evaluating results provided by these monitoring devices during the procedure.