NCLEX-RN Daily Ten Question Practical Exercise 13

6. A 67-year-old client develops acute shortness of breath and progressive hypoxia requiring right femur. The hypoxia was probably caused by which of the following conditions?

Correct Answer: D

Answer Explanation:

Long bone fractures are correlated with fat emboli, which cause shortness of breath and hypoxia.

Option A: Asthma attacks do not develop following a femoral fracture.
Option B: He could develop atelectasis but it typically doesn’t produce progressive hypoxia.
Option C: It’s unlikely the client has developed bronchitis without a previous history.

7. A client with shortness of breath has decreased to absent breath sounds on the right side, from the apex to the base. Which of the following conditions would best explain this?

Correct Answer: D

Answer Explanation:

A spontaneous pneumothorax occurs when the client’s lung collapses, causing an acute decrease in the amount of functional lung used in oxygenation. The sudden collapse was the cause of his chest pain and shortness of breath.

Option A: An asthma attack would show wheezing breath sounds.
Option B: Bronchitis would have rhonchi.
Option C: Pneumonia would have bronchial breath sounds over the area of consolidation.

8. A 62-year-old male client was in a motor vehicle accident as an unrestrained driver. He’s now in the emergency department complaining of difficulty of breathing and chest pain. On auscultation of his lung field, no breath sounds are present in the upper lobe. This client may have which of the following conditions?

Correct Answer: C

Answer Explanation:

Pneumothorax is defined as the presence of air or gas in the pleural cavity, which can impair oxygenation and/or ventilation.

Option A: Rhonchi is heard with bronchitis.
Option B: From the trauma the client experienced, it’s unlikely he has pneumonia. Pneumonia may produce crackling, bubbling, and rumbling sounds when inhaling upon auscultation.
Option D: Bronchial breath sounds with TB would be heard.

9. If a client requires a pneumonectomy, what fills the area of the thoracic cavity?

Correct Answer: C

Answer Explanation:

Serous fluid fills the space and eventually consolidates, preventing extensive mediastinal shift of the heart and remaining lung.

Option A: Air can’t be left in space. Air in the chest cavity is called a pneumothorax, and it may cause the lungs to collapse.
Option B: There’s no gel that can be placed in the pleural space. The pleural cavity is the space that lies between the pleura, the two thin membranes that line and surround the lungs. It contains a small amount of liquid known as pleural fluid.
Option D: The tissue from the other lung can’t cross the mediastinum, although a temporary mediastinal shift exists until space is filled.

10. Hemoptysis may be present in the client with a pulmonary embolism because of which of the following reasons?

Correct Answer: A

Answer Explanation:

The infarcted area produces alveolar damage that can lead to the production of bloody sputum, sometimes in massive amounts.

Option B: Clot formation usually occurs in the legs. This is called deep vein thrombosis, which occurs in one or more of the deep veins in the legs.
Option C: Loss of lung parenchyma is not found with hemoptysis in pulmonary embolism. The lung parenchyma comprises a large number of thin-walled alveoli, forming an enormous surface area, which serves to maintain proper gas exchange.
Option D: A regional loss of surfactant is one of the consequences in pulmonary embolism.


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