Pleural Disorders Practice Exam PDF

Pleural Disorders Practice Exam: **1. What is the primary function of the pleural space?** - A. To promote gas exchange - B. To protect the lungs from infection - C. To reduce friction between the lungs and chest wall during respiration - D. To maintain a positive pressure for lung...

Pleural Disorders Practice Exam: **1. What is the primary function of the pleural space?** - A. To promote gas exchange - B. To protect the lungs from infection - C. To reduce friction between the lungs and chest wall during respiration - D. To maintain a positive pressure for lung expansion **Correct Answer:** C\ **Rationale:** The pleural space contains a small amount of fluid that reduces friction, facilitating smooth movement of the lungs during respiration. **2. Which of the following is a hallmark sign of a tension pneumothorax?** - A. Symmetrical chest expansion - B. Hyperresonance on percussion - C. Tracheal deviation away from the affected side - D. Increased fremitus on the affected side **Correct Answer:** C\ **Rationale:** Tracheal deviation occurs as air builds up in the pleural space, causing a mediastinal shift in tension pneumothorax. **3. What is the most likely cause of a transudative pleural effusion?** - A. Tuberculosis - B. Congestive heart failure - C. Lung cancer - D. Pneumonia **Correct Answer:** B\ **Rationale:** Transudative pleural effusions are typically caused by systemic factors such as fluid imbalances seen in congestive heart failure. **4. What is the first priority intervention for a patient with a tension pneumothorax?** - A. Administer high-flow oxygen - B. Prepare for needle decompression - C. Obtain a chest X-ray - D. Start intravenous antibiotics **Correct Answer:** B\ **Rationale:** Needle decompression is the priority to relieve the life-threatening buildup of air and pressure in the pleural cavity. **5. Which patient is most at risk for developing a primary spontaneous pneumothorax (PSP)?** - A. A 50-year-old female with COPD - B. A 25-year-old tall, thin male who smokes - C. A 70-year-old male with lung cancer - D. A 40-year-old female following thoracic surgery **Correct Answer:** B\ **Rationale:** PSP commonly occurs in tall, thin males who smoke and have no pre-existing lung pathology. **6. What is the expected percussion finding in a patient with a pneumothorax?** - A. Dullness - B. Tympany - C. Resonance - D. Hyperresonance **Correct Answer:** D\ **Rationale:** Hyperresonance occurs due to the accumulation of air in the pleural space. **7. What is the primary purpose of a chest tube in pleural disorders?** - A. To drain excess blood - B. To restore negative pressure in the pleural space - C. To prevent infection - D. To stabilize the rib cage **Correct Answer:** B\ **Rationale:** Chest tubes restore negative pressure, which allows the lung to re-expand and prevents air or fluid from reaccumulating. **8. Which of the following findings indicates a chest tube complication?** - A. Gentle bubbling in the suction control chamber - B. Continuous bubbling in the water seal chamber - C. No fluctuation of fluid in the tubing during respiration - D. Less than 50 mL of serosanguineous drainage per hour **Correct Answer:** B\ **Rationale:** Continuous bubbling in the water seal chamber may indicate an air leak. **9. What is a priority nursing action after a thoracotomy?** - A. Encourage ambulation immediately - B. Maintain strict NPO status - C. Manage pain effectively - D. Keep the patient in a supine position **Correct Answer:** C\ **Rationale:** Pain management is critical to allow effective breathing and lung expansion post-thoracotomy. **10. Which type of pleural effusion is associated with local inflammation?** - A. Transudative - B. Exudative - C. Spontaneous - D. Traumatic **Correct Answer:** B\ **Rationale:** Exudative effusions result from local inflammation, as seen in infections or cancer. **11. A patient with pleurisy is most likely to report which symptom?** - A. Persistent cough - B. Sharp, stabbing chest pain worsened by deep breaths - C. Hemoptysis - D. Bilateral lower extremity edema **Correct Answer:** B\ **Rationale:** Pleurisy is characterized by pleuritic chest pain that worsens with deep inspiration. **12. What diagnostic test confirms the presence of a pleural effusion?** - A. Arterial blood gas - B. Chest X-ray - C. Electrocardiogram - D. Pulmonary function test **Correct Answer:** B\ **Rationale:** A chest X-ray can visualize fluid in the pleural space, confirming a pleural effusion. **13. Which condition can lead to empyema?** - A. Viral infection - B. Pulmonary embolism - C. Bacterial pneumonia - D. Asthma **Correct Answer:** C\ **Rationale:** Empyema is commonly caused by bacterial infections, such as pneumonia. **14. What intervention is indicated for a patient with a hemothorax and unstable vital signs?** - A. Thoracentesis - B. Chest tube placement - C. Administration of anticoagulants - D. Needle decompression **Correct Answer:** B\ **Rationale:** A chest tube is required to drain blood and restore normal intrapleural pressure in hemothorax. **15. What clinical sign is expected in a patient with a tension pneumothorax?** - A. Bilateral crackles - B. Dullness on percussion - C. Sudden onset of hypotension - D. Elevated SpO2 **Correct Answer:** C\ **Rationale:** Hypotension occurs due to decreased cardiac output from increased intrathoracic pressure. **16. A patient presents with absent fremitus and diminished breath sounds on one side. What condition is most likely?** - A. Pleural effusion - B. Pulmonary embolism - C. Acute bronchitis - D. Pneumonia **Correct Answer:** A\ **Rationale:** Pleural effusion often presents with absent fremitus and diminished or absent breath sounds due to fluid accumulation in the pleural space. **17. What is the primary nursing consideration for a patient undergoing thoracentesis?** - A. Ensure the patient lies supine during the procedure - B. Monitor for signs of pneumothorax post-procedure - C. Administer anticoagulants before the procedure - D. Encourage deep breathing during needle insertion **Correct Answer:** B\ **Rationale:** Thoracentesis carries a risk of pneumothorax; therefore, post-procedure monitoring for symptoms like dyspnea and chest pain is critical. **18. Which of the following is a key assessment finding in pleurisy?** - A. Wheezing - B. Friction rub on auscultation - C. Barrel-shaped chest - D. Hyperresonance on percussion **Correct Answer:** B\ **Rationale:** A friction rub is caused by the inflamed pleural layers rubbing together during respiration, a hallmark sign of pleurisy. **19. A patient with a spontaneous pneumothorax asks why air is removed from the pleural space. What is the nurse's best response?** - A. \"To prevent lung infections.\" - B. \"To restore negative pressure and allow your lung to re-expand.\" - C. \"To prevent the other lung from collapsing.\" - D. \"To decrease oxygen needs of the lung.\" **Correct Answer:** B\ **Rationale:** Removing air from the pleural space restores negative pressure, which is necessary for lung re-expansion. **20. Which intervention is most appropriate for managing a patient with pleural pain from pleurisy?** - A. Administer opioids only when severe pain occurs - B. Limit respiratory effort to reduce pleural irritation - C. Administer anti-inflammatory medications and encourage splinting during coughing - D. Withhold medications until a diagnosis is confirmed **Correct Answer:** C\ **Rationale:** Anti-inflammatory medications reduce pleural inflammation, and splinting during coughing minimizes pain while maintaining respiratory function. **21. A patient is suspected of having a hemothorax. Which diagnostic test would most likely confirm the condition?** - A. Pulmonary function test - B. Arterial blood gas analysis - C. Chest X-ray - D. CT scan of the abdomen **Correct Answer:** C\ **Rationale:** A chest X-ray is a quick and effective way to visualize blood in the pleural cavity. **22. What is the primary clinical manifestation of a tension pneumothorax?** - A. Cyanosis and productive cough - B. Increased breath sounds on the affected side - C. Rapid respiratory distress and hypotension - D. Generalized weakness and fatigue **Correct Answer:** C\ **Rationale:** Tension pneumothorax causes rapid respiratory distress and hypotension due to the increased intrathoracic pressure and reduced venous return. **23. Which of the following findings indicates successful chest tube therapy for a patient with a pneumothorax?** - A. Continuous bubbling in the water seal chamber - B. Clear breath sounds and symmetrical chest expansion - C. Increased fluid output in the collection chamber - D. Persistent chest pain and dyspnea **Correct Answer:** B\ **Rationale:** Clear breath sounds and symmetrical chest expansion suggest lung re-expansion and resolution of the pneumothorax. **24. A nurse observes bubbling in the water seal chamber of a chest tube system. What is the most appropriate action?** - A. Clamp the chest tube immediately - B. Check for air leaks in the system - C. Notify the healthcare provider immediately - D. Remove the chest tube **Correct Answer:** B\ **Rationale:** Bubbling in the water seal chamber may indicate an air leak. The nurse should investigate and resolve the issue. **25. A patient with an empyema reports worsening dyspnea. What complication should the nurse suspect?** - A. Pulmonary embolism - B. Pleural thickening - C. Tension pneumothorax - D. Respiratory alkalosis **Correct Answer:** B\ **Rationale:** Empyema can lead to pleural thickening, causing decreased lung compliance and worsening dyspnea. **26. Which condition is most likely to cause exudative pleural effusion?** - A. Congestive heart failure - B. Liver cirrhosis - C. Pulmonary tuberculosis - D. Chronic kidney disease **Correct Answer:** C\ **Rationale:** Exudative pleural effusions are caused by local inflammation, such as in pulmonary tuberculosis. **27. A patient with a chest tube accidentally disconnects the system. What is the immediate nursing action?** - A. Call the healthcare provider - B. Clamp the tube near the insertion site - C. Immerse the tube in sterile water - D. Remove the chest tube **Correct Answer:** C\ **Rationale:** Immersing the chest tube in sterile water creates a water seal to prevent air from entering the pleural space. **28. Which nursing action is appropriate during patient transport with a chest tube?** - A. Keep the collection device above chest level - B. Clamp the chest tube during transport - C. Ensure the collection device remains upright and below chest level - D. Disconnect the suction system for transport **Correct Answer:** C\ **Rationale:** The collection device should remain upright and below chest level to prevent backflow and maintain drainage. **29. Which symptom is most concerning in a patient with a pneumothorax?** - A. Subcutaneous emphysema - B. Decreased SpO2 and hypotension - C. Pleural pain with deep breathing - D. Mild tachycardia **Correct Answer:** B\ **Rationale:** Decreased oxygen saturation and hypotension indicate respiratory distress and potentially life-threatening complications. **30. What is the primary nursing goal for a patient with a chest tube?** - A. Prevent infection at the insertion site - B. Maintain adequate fluid intake - C. Promote lung re-expansion and monitor drainage - D. Encourage bed rest and limit movement **Correct Answer:** C\ **Rationale:** The primary goal is to promote lung re-expansion and monitor for complications, such as excessive or inadequate drainage.