Nokea
Respiratory mechanism is controlled by
- A. Central nervous system
- B. Sympathetic nervous system
- C. Parasympathetic nervous system
- D. Autonomic nervous system
Correct Answer: A
Rationale: The correct answer is A: Central nervous system. The respiratory mechanism is controlled by the brainstem, specifically the medulla oblongata and pons. These areas of the central nervous system regulate breathing by monitoring levels of carbon dioxide and oxygen in the blood. The medulla sets the basic rhythm of breathing, while the pons helps fine-tune the breathing rate. Choices B, C, and D are incorrect because while the sympathetic and parasympathetic nervous systems are involved in regulating various bodily functions, they do not directly control the respiratory mechanism. The autonomic nervous system, which includes both the sympathetic and parasympathetic divisions, plays a role in involuntary functions like heart rate and digestion, but it is not the primary controller of breathing.
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The nurse is assessing a patient with chronic obstructive pulmonary disease (COPD). Which assessment finding indicates a potential complication and requires the nurse's immediate attention?
- A. Distended neck veins
- B. Left lower quadrant tenderness
- C. Urinary output of 40 mL/hr
- D. Excessive coughing
Correct Answer: A
Rationale: The correct answer is A: Distended neck veins. This finding indicates potential right-sided heart failure, a complication of COPD called cor pulmonale. The nurse should address this immediately to prevent further deterioration. Distended neck veins suggest increased central venous pressure and impaired right heart function. Left lower quadrant tenderness (B) is unrelated to COPD. Urinary output of 40 mL/hr (C) is within normal range. Excessive coughing (D) is a common symptom of COPD but does not indicate an immediate complication.
Pinnaglobin is a brown coloured blood pigment present in the plasma of the mollusk Pinna. It contains
- A. Iron
- B. Copper
- C. Manganese
- D. Vanadium
Correct Answer: B
Rationale: The correct answer is B: Copper. Pinnaglobin is a copper-containing blood pigment found in the plasma of the mollusk Pinna. Copper ions are essential for the formation of this pigment. Iron (Choice A), Manganese (Choice C), and Vanadium (Choice D) are not typically found in Pinnaglobin. Iron is commonly associated with hemoglobin in vertebrates, while manganese and vanadium do not play a significant role in mollusk blood pigments. Therefore, the presence of copper in Pinnaglobin makes Choice B the correct answer.
The client with COPD has a nursing diagnosis of Ineffective Breathing Pattern. Which action is appropriate to delegate to the experienced LPN/LVN under your supervision?
- A. Observe how well the client performs pursed-lip breathing.
- B. Plan a nursing care regimen that gradually increases activity tolerance.
- C. Assist the client with basic activities of daily living (ADLs).
- D. Consult with physical therapy about reconditioning exercises.
Correct Answer: C
Rationale: The correct answer is C. Assisting with ADLs is a routine task suitable for an LPN/LVN. Observing pursed-lip breathing (A) and planning care regimens (B) are more advanced tasks. Consulting physical therapy (D) requires RN-level decision-making.
When CO2 diffuses into blood in systemic capillaries most of it:
- A. Remains in solution as CO2
- B. Converts to carbamino compounds
- C. Converts to bicarbonate ions in RBC
- D. Combines with Hb directly
Correct Answer: C
Rationale: The correct answer is C because the majority of CO2 diffusing into blood combines with water inside red blood cells (RBC) to form carbonic acid, which then dissociates into bicarbonate ions and hydrogen ions. This reaction is facilitated by the enzyme carbonic anhydrase. This process allows for efficient transport of CO2 in the bloodstream. Choices A and B are incorrect as CO2 primarily undergoes conversion to bicarbonate ions, not remaining in solution as CO2 or forming carbamino compounds. Option D is incorrect as CO2 does not directly combine with hemoglobin.
The nurse is assessing a newly admitted medical patient and notes there is a depression in the lower portion of the patient's sternum. This patient's health record should note the presence of what chest deformity?
- A. A barrel chest
- B. A funnel chest
- C. A pigeon chest
- D. Kyphoscoliosis
Correct Answer: B
Rationale: The correct answer is B: A funnel chest. A funnel chest, also known as pectus excavatum, is characterized by a depression in the lower portion of the sternum. This deformity causes the chest to appear sunken or caved in. The other choices are incorrect because: A) A barrel chest is associated with COPD and is characterized by an increased anterior-posterior diameter of the chest. C) A pigeon chest, also known as pectus carinatum, is characterized by a protrusion of the sternum and ribs. D) Kyphoscoliosis is a combination of kyphosis and scoliosis, involving both a curvature of the spine and rotation of the vertebrae.