Nokea
The nurse advises the parents of a child who is in status asthmaticus that if not corrected, the result could be:
- A. Pneumothorax, severe hypoxemia, and respiratory arrest.
- B. Hypertension, CVA, and cardiac arrest.
- C. Respiratory alkalosis, pneumonia, and death.
- D. Lung abscess, cor pulmonale, and respiratory failure.
Correct Answer: A
Rationale: The correct answer is A because status asthmaticus can lead to pneumothorax due to increased air trapping, severe hypoxemia from impaired gas exchange, and respiratory arrest from respiratory muscle fatigue. Pneumothorax can occur due to increased intrathoracic pressure during an asthma attack. Hypertension, CVA, and cardiac arrest (choice B) are not typical complications of status asthmaticus. Respiratory alkalosis, pneumonia, and death (choice C) are less likely outcomes compared to the severe complications mentioned in choice A. Lung abscess, cor pulmonale, and respiratory failure (choice D) are not directly associated with the pathophysiology of status asthmaticus.
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Which action should the nurse take first when a client develops epistaxis?
- A. Pack the affected nostril tightly with an epistaxis balloon.
- B. Apply squeezing pressure to the nostrils for 10 minutes.
- C. Obtain silver nitrate that may be needed for cauterization.
- D. Instill a vasoconstrictor medication into the affected nostril.
Correct Answer: B
Rationale: The correct action is to apply squeezing pressure to the nostrils for 10 minutes. This helps control the bleeding by promoting clot formation. It is the initial intervention to stop the bleeding before considering other options. Packing the nostril with a balloon (Choice A) may worsen the bleeding. Obtaining silver nitrate (Choice C) for cauterization is not the first-line approach. Instilling vasoconstrictor medication (Choice D) should be considered after applying pressure if bleeding persists.
Foetal hemoglobin has a Sigmoid dissociation curve which is shifted to left relative to adult Hb because
- A. Foetal Hb has higher P50
- B. Foetal HB has lower P50 (18-20 mm Hg) than Adult Hb (26.6 mm.Hg)
- C. Foetal Hb readily accept Oxygen
- D. Foetal Hb easily remove Carbon dioxide
Correct Answer: B
Rationale: The correct answer is B because foetal Hb has a lower P50 (18-20 mm Hg) than adult Hb (26.6 mm Hg). A lower P50 indicates higher oxygen affinity, allowing foetal Hb to bind oxygen more readily at lower partial pressures. This shift to the left of the dissociation curve ensures efficient oxygen transfer from the maternal bloodstream to the foetus. Choices A, C, and D are incorrect because foetal Hb having a higher P50 (A), readily accepting oxygen (C), or easily removing carbon dioxide (D) would not explain the left shift in the dissociation curve.
Which of the following would be the most appropriate nursing intervention when caring for a client with a fractured rib?
- A. Apply immobilization device after examination by physician
- B. Discourage taking deep breaths if breathing is painful
- C. Advice against using analgesics and regional nerve blocks
- D. Encourage increased fluid intake if pulmonary contusion exists
Correct Answer: A
Rationale: The correct answer is A. Applying an immobilization device after physician evaluation helps stabilize the rib and reduce pain. B (discouraging deep breaths) is harmful as it can lead to atelectasis. C (advising against analgesics) is incorrect because pain management is essential. D (increasing fluid intake) is secondary and depends on the presence of pulmonary complications.
Which of the following processes does atmospheric pressure play a role in?
- A. pulmonary ventilation
- B. production of pulmonary surfactant
- C. resistance
- D. surface tension
Correct Answer: A
Rationale: The correct answer is A: pulmonary ventilation. Atmospheric pressure plays a crucial role in pulmonary ventilation by creating a pressure gradient that allows air to flow into and out of the lungs during inhalation and exhalation. When the atmospheric pressure is higher than the pressure inside the lungs, air moves in (inhalation); when the pressure inside the lungs is higher, air moves out (exhalation).
Summary of why the other choices are incorrect:
B: Production of pulmonary surfactant is not directly influenced by atmospheric pressure. Pulmonary surfactant reduces surface tension in the alveoli to prevent collapse.
C: Resistance in the respiratory system is mainly influenced by airway diameter and elasticity of the lungs, not atmospheric pressure.
D: Surface tension in the alveoli is affected by pulmonary surfactant, not atmospheric pressure.
The classic pathway of complement activation begins when the protein C1 binds to:
- A. the cell wall of bacteria.
- B. the plasma membrane of bacteria.
- C. two antibodies attached to an antigen.
- D. a cell surface antigen.
Correct Answer: C
Rationale: The correct answer is C because in the classic pathway of complement activation, C1 binds to two antibodies attached to an antigen, forming an immune complex. This binding triggers a cascade of reactions leading to the activation of complement proteins. Choice A is incorrect as C1 does not bind directly to the cell wall of bacteria. Choice B is incorrect as C1 does not bind to the plasma membrane of bacteria. Choice D is incorrect as C1 does not bind directly to a cell surface antigen. The key step in the classic pathway is the recognition of immune complexes by C1, initiating the complement activation cascade.