Q: A patient with pulmonary hypertension undergoes right heart catheterization. Which hemodynamic finding confirms the diagnosis?

$$\text{Mean pulmonary artery pressure} \u003e 20\ \text{mm Hg}$$ and $$\text{wedge pressure} \leq 15\ \text{mm Hg}$$

Question 1

Which of the following best describes the pathophysiology of pulmonary tuberculosis (TB)?

Accepted Answer

Mycobacteria are inhaled, reach the alveoli, multiply, and trigger an immune response leading to granuloma formation.

Question 2

A patient presents with fever, night sweats, weight loss, and a chronic cough. Which diagnostic test is most definitive for confirming active tuberculosis?

Accepted Answer

Sputum culture for acid-fast bacilli (AFB)

Question 3

Which of the following is a key nursing intervention to prevent transmission of tuberculosis in a hospital setting?

Accepted Answer

Educate the patient on proper cough etiquette and ensure use of airborne precautions.

Question 4

A 70-year-old patient in a long-term care facility develops anorexia, weight loss, and altered mental status. Which disease should be considered due to atypical presentation in older adults?

Accepted Answer

Tuberculosis

Question 5

Which of the following medications is most likely to cause hepatotoxicity and requires monitoring of liver function tests during TB treatment?

Accepted Answer

Isoniazid

Question 6

A patient with a history of aspiration develops a productive cough with foul-smelling sputum and fever. Chest x-ray reveals a cavity with an air-fluid level. What is the most likely diagnosis?

Accepted Answer

Lung abscess

Question 7

Which of the following is the primary treatment for a lung abscess caused by anaerobic bacteria?

Accepted Answer

IV antimicrobial therapy based on sputum culture results

Question 8

A patient with sarcoidosis is started on prednisone. What is the primary reason for this therapy?

Accepted Answer

To control respiratory impairment and relieve symptoms

Question 9

Which of the following findings is most characteristic of pleural effusion on physical examination?

Accepted Answer

Decreased breath sounds and dullness to percussion over the affected area

Question 10

A patient with pulmonary hypertension undergoes right heart catheterization. Which hemodynamic finding confirms the diagnosis?

Accepted Answer

$$	ext{Mean pulmonary artery pressure} \u003e 20\ 	ext{mm Hg}$$ and $$	ext{wedge pressure} \leq 15\ 	ext{mm Hg}$$

Question 11

Which of the following is a major risk factor for developing pneumoconiosis?

Accepted Answer

Prolonged occupational exposure to mineral dusts

Question 12

A patient with a history of asbestosis presents with progressive dyspnea and restrictive lung disease. What is the most important nursing intervention?

Accepted Answer

Assess for occupational exposure history and educate on preventive measures

Question 13

Which of the following statements about the Mantoux tuberculin skin test is correct?

Accepted Answer

A significant reaction indicates past exposure or vaccination, but not necessarily active disease.

Question 14

A patient with pleurisy reports severe, sharp pain that worsens with inspiration. Which intervention is most appropriate to enhance comfort?

Accepted Answer

Turn frequently onto the affected side and use a pillow to splint the rib cage while coughing.

Question 15

Which of the following is a common clinical manifestation of pulmonary hypertension in its late stages?

Accepted Answer

Peripheral edema and ascites

Question 16

A patient with a history of deep vein thrombosis (DVT) suddenly develops dyspnea and chest pain. What is the most likely diagnosis?

Accepted Answer

Pulmonary embolism

Question 17

Which of the following is a recommended strategy for preventing occupational lung disease in at-risk workers?

Accepted Answer

Use of protective devices such as facemasks and industrial respirators

Question 18

A patient with empyema is being discharged with a pleural drainage system. Which instruction is most important for the nurse to provide?

Accepted Answer

Monitor for signs of infection and know when to contact the primary provider.

Question 19

Which of the following is a distinguishing feature of sarcoidosis on biopsy?

Accepted Answer

Noncaseating granulomas

Question 20

A patient with pulmonary hypertension is started on bosentan. What is the most important laboratory test to monitor during therapy?

Accepted Answer

Liver function tests

Chapter 20: Management of Patients With Nonacute Disorders of the Chest and Lower Respiratory Tract and Disorders of the Pulmonary Vasculature

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