Q: Which of the following is a risk factor for infection with Pseudomonas aeruginosa in pneumonia, as listed in Chart 19-3?

Recent antibiotic therapy (\textgreater 7 days in the past month)

Question 1

Which of the following best describes the primary mechanism by which obstructive atelectasis develops?

Accepted Answer

Blockage impedes air passage, causing gas reabsorption and alveolar collapse.

Question 2

A patient is recovering from upper abdominal surgery and is at risk for atelectasis. Which nursing intervention is most effective in preventing this complication?

Accepted Answer

Frequent turning and use of incentive spirometry every 2 hours.

Question 3

A patient with pneumonia has a PaO$$_2 of 55 mm Hg $$and a PaCO$$_2 of 60 mm Hg $$with a pH of 7.30. According to Chart 19-9, which of the following is indicated?

Accepted Answer

Begin mechanical ventilation due to respiratory failure.

Question 4

Which of the following is a key element of the ventilator-associated pneumonia (VAP) prevention bundle according to Chart 19-4?

Accepted Answer

Daily sedation interruption and assessment of readiness to extubate.

Question 5

A patient with a history of chronic obstructive pulmonary disease (COPD) is admitted with pneumonia. Which type of pneumonia is this patient most at risk for developing?

Accepted Answer

Health care–associated pneumonia (HCAP)

Question 6

Which of the following clinical findings is most indicative of severe ARDS?

Accepted Answer

PaO$$_2/$$FiO$$_2$$ ratio $$\leq 100 mm Hg$$

Question 7

A patient with a chest tube for pneumothorax suddenly develops severe respiratory distress, tracheal deviation to the left, and absent breath sounds on the right. What is the most likely diagnosis?

Accepted Answer

Tension pneumothorax

Question 8

Which of the following is a recommended clinical practice to prevent aspiration in patients receiving enteral tube feedings, according to Chart 19-6?

Accepted Answer

Maintain head-of-bed elevation at 30 to 45 degrees unless contraindicated.

Question 9

A 70-year-old patient with pneumonia presents with confusion, tachycardia, and no fever. What is the most appropriate next step?

Accepted Answer

Order a chest x-ray to evaluate for pneumonia.

Question 10

Which of the following is a risk factor for infection with Pseudomonas aeruginosa in pneumonia, as listed in Chart 19-3?

Accepted Answer

Recent antibiotic therapy (	extgreater 7 days in the past month)

Question 11

A patient with a flail chest exhibits paradoxical chest wall movement. Which of the following best explains the pathophysiology?

Accepted Answer

The flail segment moves inward during inspiration, reducing air intake.

Question 12

Which of the following is the most appropriate initial management for a patient with acute respiratory failure and a PaO$$_2 of 50 mm Hg$$?

Accepted Answer

Initiate supplemental oxygen and prepare for possible intubation.

Question 13

A patient with an endotracheal tube is at risk for aspiration. According to best practices, what is the recommended cuff pressure to minimize this risk?

Accepted Answer

$$20 to$$ $$25 mm Hg$$

Question 14

Which of the following is a primary goal in the management of ARDS?

Accepted Answer

Identify and treat the underlying condition while providing aggressive supportive care.

Question 15

A patient with pneumonia is switched from IV to oral antibiotics. Which of the following criteria indicate clinical stability for this transition?

Accepted Answer

Temperature 	extless 37.8$$^\circC$$, heart rate 	extless 100 bpm, respiratory rate 	extless 24/min, oxygen saturation 	extgreater 90\%.

Question 16

Which of the following is a recommended strategy to improve airway clearance in a patient with pneumonia?

Accepted Answer

Encourage hydration of 2–3 L/day unless contraindicated.

Question 17

A patient with a history of stroke is receiving enteral feedings. Which intervention best reduces the risk of aspiration pneumonia?

Accepted Answer

Maintain head-of-bed elevation at 30–45 degrees during and after feeding.

Question 18

Which of the following is a common early sign of acute respiratory failure?

Accepted Answer

Restlessness and dyspnea

Question 19

A patient with pneumonia is experiencing increased respiratory rate and insensible fluid loss. What is the recommended nursing intervention?

Accepted Answer

Encourage increased fluid intake unless contraindicated.

Question 20

Which of the following is a key component of the ABCDEF bundle for critically ill patients?

Accepted Answer

Early mobility and family engagement

Chapter 19: Management of Patients with Acute Disorders of the Chest and Lower Respiratory Tract

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