Nokea
If the thoracic wall but not lungs is punctured
- A. The lungs get inflated
- B. The man dies as lungs get collapsed
- C. The breathing rate decrease
- D. The breathing rate increase
Correct Answer: B
Rationale: The correct answer is B because if the thoracic wall is punctured but not the lungs, air will enter the pleural cavity causing a pneumothorax. This leads to lung collapse and can result in death due to impaired gas exchange. Choices A and C are incorrect as the lungs do not get inflated and breathing rate does not decrease. Choice D is incorrect as the breathing rate actually increases in response to the decreased lung function.
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Identify the inconsistent value in these measurements on a mixed venous blood sample obtained in a healthy person from IVC at sea level
- A. pO2 = 40mmHg
- B. pCO2 = 48mmHg
- C. PN2 = 620mmHg
- D. O2 content = 150ml/L blood
Correct Answer: C
Rationale: The correct answer is C: PN2 = 620mmHg. This is the inconsistent value because the normal partial pressure of nitrogen in venous blood is around 40 mmHg, not 620 mmHg. This discrepancy indicates an abnormal measurement. The other choices (A, B, D) are within expected ranges for a mixed venous blood sample in a healthy person at sea level. Choice A (pO2 = 40mmHg) is typical for venous blood, choice B (pCO2 = 48mmHg) falls within the normal range, and choice D (O2 content = 150ml/L blood) is a reasonable value for mixed venous blood.
A client seen in the emergency department reports fever,fatigue and dry cough but no other upper respiratory symptoms. A chest x-ray reveals mediastinal widening. What action by the nurse is best?
- A. Collect a sputum sample for culture by deep suctioning.
- B. Inform the client that oral antibiotics will be needed for 60 days.
- C. Place the client on Airborne Precautions immediately.
- D. Tell the client that directly observed therapy is needed.
Correct Answer: B
Rationale: The correct answer is B: Inform the client that oral antibiotics will be needed for 60 days. This is the best action because the client is showing symptoms consistent with tuberculosis, such as fever, fatigue, dry cough, and mediastinal widening on chest x-ray. Treatment for tuberculosis typically involves a combination of oral antibiotics for a prolonged period, usually 6-9 months. Collecting a sputum sample for culture by deep suctioning (A) may be necessary to confirm the diagnosis but is not the priority at this moment. Placing the client on Airborne Precautions immediately (C) is important once the diagnosis is confirmed, not the initial action. Directly observed therapy (D) is a method to ensure adherence to medication but is not the immediate next step.
Damage to the phrenic nerves would
- A. increase respiratory rate
- B. increase the tidal volume
- C. force reliance on costal breathing
- D. result in greater pressure differences between the lungs and the outside air
Correct Answer: C
Rationale: Damage to the phrenic nerves would result in the inability to fully expand the diaphragm, leading to reliance on costal breathing. This is because the phrenic nerves innervate the diaphragm, the main muscle of respiration. Without proper diaphragmatic function, the individual would have difficulty engaging in effective diaphragmatic breathing. Therefore, choice C is correct.
Choices A, B, and D are incorrect because damage to the phrenic nerves would not directly impact the respiratory rate, tidal volume, or pressure differences between the lungs and the outside air. These functions are more related to overall respiratory control and lung mechanics, which are not solely dependent on the phrenic nerves.
A medical nurse has admitted a patient to the unit with a diagnosis of failure to thrive. The patient has developed a fever and cough, so a sputum specimen has been obtained. The nurse notes that the sputum is greenish and that there is a large quantity of it. The nurse notifies the patient's physician because these symptoms are suggestive of what?
- A. Pneumothorax
- B. Lung tumors
- C. Infection
- D. Pulmonary edema
Correct Answer: C
Rationale: The correct answer is C: Infection. The greenish color and large quantity of sputum suggest an infection in the lungs, typically caused by bacteria. Greenish sputum is often a sign of bacterial pneumonia. Fever and cough are common symptoms of a lung infection, along with increased sputum production. Pneumothorax (A) is characterized by a collapsed lung and does not typically present with greenish sputum. Lung tumors (B) may cause cough and sputum production, but the color of the sputum is not specific to tumors. Pulmonary edema (D) is a condition where fluid accumulates in the lungs, leading to shortness of breath and pink, frothy sputum, not greenish sputum.
A client who has chronic heart failure is admitted to the emergency department with severe dyspnea and a dry hacking cough. Which action should the nurse take first?
- A. Auscultate the abdomen
- B. Check the capillary refill
- C. Auscultate the breath sounds
- D. Ask about the patient's allergies
Correct Answer: C
Rationale: The correct action for the nurse to take first is to auscultate the breath sounds (Choice C) because the client is presenting with severe dyspnea and a dry hacking cough, which are indicative of respiratory distress in a patient with chronic heart failure. Auscultating the breath sounds will help the nurse assess the presence of crackles, wheezing, or decreased air entry, providing crucial information about the client's respiratory status and guiding immediate interventions. Checking the capillary refill (Choice B) is important but not the priority in this situation. Auscultating the abdomen (Choice A) is not relevant to the presenting symptoms. Asking about the patient's allergies (Choice D) is important but can be addressed after addressing the immediate respiratory distress.