Nokea
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.
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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.
Delegation Decision: The nurse is caring for a patient with COPD. Which intervention could be delegated to unlicensed assistive personnel (UAP)?
- A. Assist the patient to get out of bed.
- B. Auscultate breath sounds every 4 hours.
- C. Plan patient activities to minimize exertion.
- D. Teach the patient pursed lip breathing technique.
Correct Answer: A
Rationale: Assisting the patient to get out of bed can be safely delegated to unlicensed assistive personnel (UAP) as it does not require specialized nursing knowledge or skills. It is a basic activity of daily living that can be delegated to support staff while allowing nurses to focus on more complex patient care tasks.
Which of the following factors would increase the amount of oxygen discharged by hemoglobin to peripheral tissues?
- A. decreased temperature
- B. decreased pH
- C. increased tissue PO2
- D. decreased amounts of BPG
Correct Answer: B
Rationale: The correct answer is B: decreased pH. A decrease in pH (increased acidity) causes a rightward shift in the oxygen-hemoglobin dissociation curve, facilitating the release of oxygen from hemoglobin to peripheral tissues. This occurs due to the Bohr effect, where a decrease in pH weakens the bond between hemoglobin and oxygen, allowing for easier oxygen release.
Incorrect answers:
A: Decreased temperature would actually shift the dissociation curve to the left, making it more difficult for oxygen to be released from hemoglobin.
C: Increased tissue PO2 would lead to less oxygen being released from hemoglobin as the gradient for oxygen release decreases.
D: Decreased amounts of BPG would result in less oxygen being released as BPG helps facilitate oxygen unloading from hemoglobin in tissues.
Which of the following nursing interventions regarding nutrition is used until the suture line heals, usually 10 to 14 days postoperatively?
- A. Enteral feedings
- B. Meticulous mouth care every 4 hours
- C. Gradual advancement of the diet
- D. Reassurance that the sense of taste will return
Correct Answer: A
Rationale: The correct answer is A. Enteral feedings bypass the oral route, allowing the suture line to heal without strain. B (meticulous mouth care) is important but not directly related to nutrition. C (gradual advancement of the diet) occurs later. D (reassurance) addresses psychological concerns but not nutritional needs.
For a female patient with chronic obstructive pulmonary disease, which nursing intervention would help maintain a patent airway?
- A. Restricting fluid intake to 1,000 ml per day.
- B. Enforcing absolute bed rest.
- C. Teaching the patient how to perform controlled coughing.
- D. Administering prescribed sedatives regularly and in large amounts.
Correct Answer: C
Rationale: The correct answer is C: Teaching the patient how to perform controlled coughing. This intervention helps to clear mucus and secretions from the airways, maintaining a patent airway. Controlled coughing also prevents airway obstruction and promotes effective breathing. Restricting fluid intake (A) can lead to dehydration and thickening of secretions, worsening airway clearance. Enforcing bed rest (B) can cause decreased lung expansion and retention of secretions. Administering sedatives (D) can depress respiratory drive and worsen respiratory function.