Nokea
A nurse is caring for a client with acute respiratory distress syndrome. Which of the following would the nurse expect to note in the client?
- A. Decreased respiratory rate.
- B. Pallor.
- C. Low arterial PaO2.
- D. An elevated arterial PaO2.
Correct Answer: C
Rationale: The correct answer is C: Low arterial PaO2. In acute respiratory distress syndrome (ARDS), there is impaired gas exchange leading to hypoxemia. Low arterial PaO2 indicates poor oxygenation in the blood, a hallmark of ARDS. Decreased respiratory rate (A) is unlikely as the body compensates by increasing respiratory effort. Pallor (B) is a general sign of reduced blood flow and not specific to ARDS. An elevated arterial PaO2 (D) would not be expected in ARDS, as it signifies adequate oxygenation.
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After inspiration commences the:
- A. Intrapleural pressure and intrapulmonary P both fall
- B. Intrapleural pressure falls and intrapulmonary P rises
- C. Intrapleural pressure falls and venous return decreases
- D. Intrapulmonary pressure rises and volume of the alveoli is momentarily unchanged
Correct Answer: A
Rationale: After inspiration commences, the diaphragm contracts and the thoracic cavity expands. This leads to a decrease in intrapleural pressure, allowing the lungs to expand. Simultaneously, intrapulmonary pressure decreases, creating a pressure gradient for air to flow into the lungs. Choice A is correct because both intrapleural pressure and intrapulmonary pressure fall during inspiration.
Choice B is incorrect because intrapulmonary pressure actually decreases during inspiration, not rises. Choice C is incorrect because intrapleural pressure falling does not directly correlate with a decrease in venous return. Choice D is incorrect because during inspiration, the volume of the alveoli increases as the lungs expand, causing intrapulmonary pressure to decrease.
2,3 DPG causes shifting of Oxygen dissociation curve in Adult Hb to Right because
- A. It increases Oxygen affinity for Hemoglobin
- B. It binds to Beta chain of Hb
- C. Its concentration is high in adults
- D. It lacks Hb binding sites
Correct Answer: B
Rationale: The correct answer is B because 2,3 DPG binds to the Beta chain of Hemoglobin, reducing its oxygen affinity, causing a right shift in the Oxygen dissociation curve. This change allows for easier oxygen unloading in tissues. Choice A is incorrect as 2,3 DPG decreases, not increases, oxygen affinity. Choice C is irrelevant as its concentration is not a factor in the shifting of the curve. Choice D is incorrect as 2,3 DPG does bind to Hemoglobin, specifically to the Beta chain.
The maximum amount of air that can be taken into the lungs in a single deep breath is the
- A. vital capacity.
- B. tidal volume
- C. pleural volume.
- D. alveolar volume.
Correct Answer: A
Rationale: The correct answer is A: vital capacity. Vital capacity is the maximum amount of air a person can exhale after taking the deepest breath possible. It is calculated by adding tidal volume, inspiratory reserve volume, and expiratory reserve volume together. This measurement reflects the maximum lung capacity and is important in assessing lung function. Tidal volume (B) is the amount of air inhaled and exhaled during normal breathing cycles. Pleural volume (C) refers to the space between the lungs and the chest wall. Alveolar volume (D) is the amount of air in the alveoli available for gas exchange. These choices are incorrect as they do not represent the maximum air intake capacity of the lungs.
A client is admitted with chronic obstructive pulmonary disease (COPD). Which of the following signs and symptoms aren't characteristic of COPD?
- A. Fever
- B. Dyspnea on exertion.
- C. Barrel chest.
- D. Clubbed fingers and toes.
Correct Answer: A
Rationale: The correct answer is A: Fever. Fever is not a characteristic sign or symptom of COPD. The rationale is that COPD is a chronic respiratory condition that primarily affects the lungs and airways, leading to symptoms such as shortness of breath (dyspnea on exertion), barrel chest due to air trapping, and clubbed fingers and toes due to chronic hypoxia. Fever is not a typical presentation of COPD, as it is usually associated with infections or inflammatory conditions rather than COPD itself. In summary, choices B, C, and D are characteristic of COPD, while choice A is not typically associated with this condition.
After change of shift, you are assigned to care for the following clients. Which client should you assess first?
- A. A 68-year-old client on ventilator who needs a sterile sputum specimen sent to the laboratory
- B. A 57-year-old client with COPD and pulse oximetry reading from previous shift of 90% saturation
- C. A 72-year-old client with pneumonia who needs to be started on intravenous antibiotics
- D. A 51-year-old client with asthma complaining of shortness of breath (SOB) after using a bronchodilator inhaler
Correct Answer: D
Rationale: The correct answer is D. A client with acute SOB after using a bronchodilator requires immediate attention. Clients on ventilators (A), with stable but low oxygen saturation (B), or needing antibiotics (C) are important but less urgent.