A nurse in the postanesthesia care unit is assessing a patient who has an endotracheal tube in place and observes the absence of left-sided chest wall expansion upon respiration.
Which of the following complications should the nurse suspect?

Passage of the ET tube into the esophagus.

Movement of the ET tube into the right main bronchus.

Infection of the vocal cords.

Blockage of the ET tube by the patient's tongue.

Answer and Explanation

The Correct Answer is B

Choice A rationale

If the endotracheal tube were in the esophagus, there would be no chest wall expansion on either side, and breath sounds would be absent. Instead, abdominal distention would be observed as air enters the stomach. The absence of chest wall expansion on only one side indicates a problem within the respiratory tract, not an esophageal intubation.

Choice B rationale

The right main bronchus is wider, shorter, and more vertical than the left, making it more likely for an endotracheal tube to be advanced too far and enter this bronchus. When the tube is lodged in the right main bronchus, the left lung is not ventilated, leading to the absence of breath sounds and chest wall expansion on the left side, as observed.

Choice C rationale

Vocal cord infection would cause symptoms such as hoarseness, pain, and potentially swelling. It does not typically lead to the absence of unilateral chest wall expansion. The absence of left-sided chest wall expansion is a mechanical ventilation issue related to the tube's position, not an infectious process of the larynx.

Choice D rationale

A blockage of the endotracheal tube by the patient's tongue is anatomically impossible. The endotracheal tube is designed to bypass the oral cavity and extend past the tongue into the trachea. While the tube could become occluded by secretions or kinking, the tongue is not a source of obstruction for an properly placed endotracheal tube.

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Free Nursing Study Resources

Correct Answer is ["150"]

Explanation

Step 1 is: 600 mg of Clindamycin in 50 mL is to run over 20 minutes.

Step 2 is: To find mL/hr, convert the minutes to hours by dividing 60 min by 20 min. 60 min ÷ 20 min = 3.

Step 3 is: Multiply the total volume of 50 mL by the conversion factor of 3. 50 mL × 3 = 150 mL. Final calculated answer is 150 mL/hr. *.

A. Metoprolol (Lopressor). B. Epoprostenol (Flolan). C. Nifedipine (Procardia). D. Warfarin (Coumadin)

Correct Answer is A

Explanation

Choice A rationale

Beta-blockers, such as metoprolol, are generally contraindicated in patients with pulmonary hypertension. These medications can worsen the condition by further constricting pulmonary arteries and decreasing cardiac output. This negative effect is due to their blockade of beta-2 adrenergic receptors, which can lead to bronchospasm and pulmonary vasoconstriction.

Choice B rationale

Epoprostenol is a potent vasodilator and is a first-line treatment for severe pulmonary hypertension. It works by mimicking prostacyclin, a naturally occurring substance that relaxes smooth muscles in the pulmonary arteries, thereby reducing pulmonary artery pressure and improving blood flow.

Choice C rationale

Calcium channel blockers, like nifedipine, are used in a small subset of patients with pulmonary hypertension who are "vasoreactive.”. These drugs relax vascular smooth muscle, reducing pulmonary vascular resistance. They are a common therapeutic option for managing this condition in appropriate patients.

Choice D rationale

Warfarin, an anticoagulant, is often prescribed for patients with pulmonary hypertension to prevent the formation of blood clots (thrombi) in the small pulmonary arteries. These clots can further impede blood flow and worsen the disease, so anticoagulation is a standard part of the treatment regimen. *.

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A nurse in the postanesthesia care unit is assessing a patient who has an endotracheal tube in place and observes the absence of left-sided chest wall expansion upon respiration. Which of the following complications should the nurse suspect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The patient has an order for clindamycin 600 mg IV every 12 hours. Clindamycin from the pharmacy comes as 600 mg in 50 ml. It is to run over 20 minutes. The nurse should set the pump to deliver how many ml/hr?

Correct Answer is ["150"]

Explanation

The nurse is reviewing medication orders for a patient with pulmonary hypertension. Which medication order would the nurse querry

Correct Answer is A

Explanation

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A nurse in the postanesthesia care unit is assessing a patient who has an endotracheal tube in place and observes the absence of left-sided chest wall expansion upon respiration.
Which of the following complications should the nurse suspect?