A nurse is performing pulmonary hygiene for a client who has pneumonia and positions the client on his left side in Trendelenburg position. From which of the following lung segments should the nurse expect secretions to be mobilized with the client in this position?

Lateral segment of the right lower lobe

Lateral segment of the left lower lobe

Posterior segment of the right middle lobe

Posterior segment of the right lower lobe

Answer and Explanation

The Correct Answer is A

A. Lateral segment of the right lower lobe is the correct answer because placing the client on the left side in Trendelenburg position promotes drainage from the right lower lobe’s lateral segment by using gravity to mobilize secretions.
B. Lateral segment of the left lower lobe would require the client to be positioned on the right side rather than the left.
C. Posterior segment of the right middle lobe would require the client to be positioned in a different way, typically supine with a slight Trendelenburg tilt.
D. Posterior segment of the right lower lobe would require a prone position in Trendelenburg, not left-side lying.

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Correct Answer is B

Explanation

A. The visibility of the eyelets on the chest tube is not a critical indicator for immediate notification unless other issues are present.
B. Movement of the trachea toward the unaffected side can indicate tension pneumothorax or other significant issues requiring immediate intervention.
C. Crepitus around the insertion site can indicate subcutaneous emphysema, which may be a complication but not an immediate emergency.
D. Bubbling in the water seal chamber during exhalation is a normal finding, as it indicates that the chest tube is functioning to allow air to escape.

A. pH 7.25, HCO₃- 19 mEq/L, PaCO₂ 30 mm Hg B. pH 7.30, HCO₃- 26 mEq/L, PaCO₂ 50 mm Hg C. pH 7.50, HCO₃- 20 mEq/L, PaCO₂ 32 mm Hg D. pH 7.55, HCO₃- 30 mEq/L, PaCO₂ 31 mm Hg

Correct Answer is A

Explanation

A. pH 7.25, HCO₃- 19 mEq/L, PaCO₂ 30 mm Hg indicates metabolic acidosis with partial respiratory compensation. This is a common finding in chronic kidney disease due to the kidneys' reduced ability to excrete hydrogen ions and reabsorb bicarbonate.

B. pH 7.30, HCO₃- 26 mEq/L, PaCO₂ 50 mm Hg suggests respiratory acidosis with a normal bicarbonate level, which is not typical for chronic kidney disease.

C. pH 7.50, HCO₃- 20 mEq/L, PaCO₂ 32 mm Hg indicates respiratory alkalosis, which is not characteristic of chronic kidney disease.

D. pH 7.55, HCO₃- 30 mEq/L, PaCO₂ 31 mm Hg indicates metabolic alkalosis, which is also not typical for chronic kidney disease.

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A nurse is performing pulmonary hygiene for a client who has pneumonia and positions the client on his left side in Trendelenburg position. From which of the following lung segments should the nurse expect secretions to be mobilized with the client in this position?

Nursing Test Bank

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