Questions 1 & 2 below refer to the following situation:
A 55-year-old man with emphysema (a type of chronic lung disease) who has smoked 2 packs of
cigarettes per day for 40 years is hospitalized for acute onset of cou
...
Questions 1 & 2 below refer to the following situation:
A 55-year-old man with emphysema (a type of chronic lung disease) who has smoked 2 packs of
cigarettes per day for 40 years is hospitalized for acute onset of cough productive of bloody
sputum (sputum=secretions from deep in the lungs). After a few days of testing and treatment,
the patient’s nurse reads a physician’s note on the chart: “I have told the patient that the
etiologies of his hemoptysis are: 1) exacerbation of his chronic emphysema and 2) the new
diagnosis of lung cancer. The onsets of both were contributed to by his longstanding smoking.”
1. The patient asks the nurse for more information. Which of the following explanations to
the patient best indicates a full understanding of the patient’s situation?
a. “You have a disease process that was iatrogenically caused by cigarette smoking.”
Incorrect: “iatrogenically” means caused by a medical person.
b. “You have a sudden onset of a chronic lung disease that was brought on by lung
cancer.” Incorrect: the chronic lung disease was part of the medical history of the
patient; the term “chronic” means a long-standing disease, not a “sudden onset.”
c. “The coughing up of blood is caused by a worsening of a disease you’ve had for a
long time plus a new problem-- lung cancer.”
d. “These diseases have been creeping up on you for probably 20 years; it just goes to
show that you should never have taken up smoking.” Incorrect: no evidence in the
scenario to support this sentence. (Besides, it sounds very judgmental.)
2. Based on all the information you have on the patient, which statement is most likely
correct?
a. The patient has a poor prognosis because of the comorbidities of lung cancer and
cigarette smoking. Incorrect: Smoking is a risk factor not a disease that would fit
the term “comorbidity.”
b. Lung cancer was a sequela of the bloody sputum. Incorrect: the bloody sputum
was part of the S&S of cancer; this answer implies the bloody sputum caused the
cancer.
c. A precipitating factor for the acute hospitalization was overexertion when the patient
started an exercise class. Incorrect: no evidence in the scenario to support this
sentence.
d. Heavy cigarette smoking was a risk factor in the patient’s developing emphysema
and lung cancer.
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