Med Surg Final Exam: Key Questions & Answers Review

Thoracentesis

Question: What position should a patient be placed in for a thoracentesis?
Answer: Upright, leaning over a table to increase lung expansion.

 Metabolic Acidosis

Question: What type of respirations are seen in metabolic acidosis?
Answer: Kussmaul respirations (deep, rapid breathing).

 Wheezing

Question: How is wheezing characterized?
Answer: Short, high-pitched sounds made during expiration.

 Abnormal Breath Sounds

Question: How are bronchial or bronchovesicular sounds in peripheral lung fields described?
Answer: As abnormal breath sounds.

 Adventitious Breath Sounds

Question: What are adventitious breath sounds?
Answer: Extra, abnormal breath sounds that should not be present.

Bronchoscopy

Question: What is the most important nursing action after a bronchoscopy?
Answer: Keep the patient NPO until the gag reflex returns.

 Hypoxemia

Question: A patient has PaO2 at 55% and SpO2 at 88%. What does this indicate?
Answer: Hypoxemia (low oxygen levels in the blood).

 Pulmonary Embolism

Question: What is the best diagnostic test for a pulmonary embolism?
Answer: CT Scan.

 Oxygen-Hemoglobin Dissociation

Question: A patient with SaO2 of 85% and PaO2 of 50 mm Hg has what condition?
Answer: A shift to the left in the oxygen-hemoglobin dissociation curve, which may be caused by hypothermia.

 Normal Arterial Blood Gas (ABG) Values

Question: What are the normal ABG values?
Answer:

• pH: 7.35 - 7.45

• PaO2: 80 - 100 mm Hg

• SaO2: > 95%

• PaCO2: 32 - 48 mm Hg

• HCO3-: 22 - 26 mEq/L

Tracheostomy Swallowing Assessment

Question: How can a nurse assess swallowing ability in a patient with a tracheostomy?
Answer: Deflate the cuff and have the patient drink a small amount of blue-colored water, observing for coughing or colored secretions.

Oral Cancer Assessment

Question: What symptoms might a patient with oral cancer report?
Answer: Persistent mouth sores, difficulty swallowing, or pain.