QUESTION: 21

Which of the following signs and symptoms indicates a tension pneumothorax as compared to an open pneumothorax?

Ventilation-perfusion (V./Q.) mismatch
Hypoxemia and respiratory acidosis
Mediastinal tissue and organ shifting
Decreased tidal volume and tachypnea

Answer(s): C

Explanation:

(A, B, D) These occur in both tension pneumothorax and open pneumothorax. (C) The tension pneumothorax acts like a one- way valve so that the pneumothorax increases with each breath. Eventually, it occupies enough space to shift mediastinal tissue toward the unaffected side away from the midline. Tracheal deviation, movement of point of maximum impulse, and decreased cardiac output will occur. The other three options will occur in both types of pneumothorax.

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QUESTION: 21

Which of the following signs and symptoms indicates a tension pneumothorax as compared to an open pneumothorax?

Ventilation-perfusion (V./Q.) mismatch
Hypoxemia and respiratory acidosis
Mediastinal tissue and organ shifting
Decreased tidal volume and tachypnea

Answer(s): C

Explanation:

(A, B, D) These occur in both tension pneumothorax and open pneumothorax. (C) The tension pneumothorax acts like a one- way valve so that the pneumothorax increases with each breath. Eventually, it occupies enough space to shift mediastinal tissue toward the unaffected side away from the midline. Tracheal deviation, movement of point of maximum impulse, and decreased cardiac output will occur. The other three options will occur in both types of pneumothorax.

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QUESTION: 22

In assessing cardiovascular clients with progression of aortic stenosis, the nurse should be aware that there is typically:

Decreased pulmonary blood flow and cyanosis
Increased pressure in the pulmonary veins and pulmonary edema
Systemic venous engorgement
Increased left ventricular systolic pressures and hypertrophy

Answer(s): D

Explanation:

(A) These signs are seen in pulmonic stenosis or in response to pulmonary congestion and edema and mitral stenosis. (B) These signs are seen primarily in mitral stenosis or as a late sign in aortic stenosis after left ventricular failure. (C) These signs are seen primarily in right-sided heart valve dysfunction. (D) Left ventricular hypertrophy occurs to increase muscle mass and overcome the stenosis; left ventricular pressures increase as left ventricular volume increases owing to insufficient emptying.

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QUESTION: 22

In assessing cardiovascular clients with progression of aortic stenosis, the nurse should be aware that there is typically:

Decreased pulmonary blood flow and cyanosis
Increased pressure in the pulmonary veins and pulmonary edema
Systemic venous engorgement
Increased left ventricular systolic pressures and hypertrophy

Answer(s): D

Explanation:

(A) These signs are seen in pulmonic stenosis or in response to pulmonary congestion and edema and mitral stenosis. (B) These signs are seen primarily in mitral stenosis or as a late sign in aortic stenosis after left ventricular failure. (C) These signs are seen primarily in right-sided heart valve dysfunction. (D) Left ventricular hypertrophy occurs to increase muscle mass and overcome the stenosis; left ventricular pressures increase as left ventricular volume increases owing to insufficient emptying.

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QUESTION: 21

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QUESTION: 22

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