Nokea
A charge nurse is rounding on several older clients on ventilators in the Intensive Care Unit whom the nurse identifies as being at high risk for ventilator-associated pneumonia. To reduce this risk what activity would the nurse delegate to the assistive personnel (AP)?
- A. Encourage between-meal snacks.
- B. Monitor temperature every 4 hours.
- C. Provide oral care every 4 hours.
- D. Report any new onset of cough.
Correct Answer: C
Rationale: The correct answer is C: Provide oral care every 4 hours. Oral care helps prevent ventilator-associated pneumonia by reducing the risk of oral bacteria being aspirated into the lungs. The AP can assist with oral care under the nurse's supervision.
A: Encouraging between-meal snacks does not directly address pneumonia risk.
B: Monitoring temperature is important but not specific to ventilator-associated pneumonia prevention.
D: Reporting new cough onset is important but does not directly reduce the risk of ventilator-associated pneumonia.
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Chloride shift occurs from the plasma to the RBC and is meant for
- A. Formation of Hemoglobinic acid
- B. Formation of Bicarbonates
- C. To keep electrostatic neutrality of RBC membrane
- D. To transport CO2
Correct Answer: C
Rationale: The correct answer is C: To keep electrostatic neutrality of RBC membrane. Chloride shift helps maintain the balance of charges inside and outside red blood cells (RBCs) to prevent excessive positive or negative charges, ensuring the electrostatic neutrality of the RBC membrane. This process involves the exchange of chloride ions between the plasma and RBCs, with chloride moving into the RBCs to balance the outflow of bicarbonate ions during the transport of CO2. Choices A, B, and D are incorrect as they do not directly relate to the primary function of chloride shift, which is to maintain the electrostatic neutrality of the RBC membrane. Hemoglobinic acid formation, bicarbonate formation, and CO2 transport are secondary outcomes of the chloride shift process, but the main purpose is to regulate the charge balance within the RBCs.
Life-long nonsmokers live an average of how much longer than those who, in their mid-twenties, smoked two packs of cigarettes a day?
- A. 6 months
- B. 1-2 years
- C. over 12 years
- D. 7-9 years
Correct Answer: C
Rationale: The correct answer is C: over 12 years. Life-long nonsmokers live significantly longer than those who smoke heavily in their mid-twenties. Smoking two packs of cigarettes a day significantly increases the risk of various health conditions leading to premature death. On average, smoking can reduce life expectancy by over 10 years. Therefore, the correct answer is over 12 years. Choices A, B, and D are incorrect as they underestimate the impact of smoking on life expectancy and do not adequately reflect the significant difference in longevity between smokers and life-long nonsmokers.
The pneumotaxic center of the pons
- A. sets the at-rest respiratory pattern
- B. prolongs inspiration
- C. modifies the rate and depth of breathing
- D. suppresses the expiratory center in the medulla
Correct Answer: C
Rationale: The correct answer is C because the pneumotaxic center in the pons modifies the rate and depth of breathing by sending inhibitory signals to the dorsal respiratory group in the medulla, which controls inspiration and expiration. It does not set the at-rest respiratory pattern like option A, prolong inspiration like option B, or suppress the expiratory center in the medulla like option D. This center plays a crucial role in fine-tuning breathing patterns to maintain appropriate oxygen levels in the body.
Rate and depth of respiration shall increase when
- A. Oxygen concentration increases
- B. CO2 concentration increases
- C. Bicarbonate concentration increases
- D. Bicarbonate concentration decrease
Correct Answer: B
Rationale: The correct answer is B: CO2 concentration increases. When CO2 levels rise in the blood, it leads to an increase in the acidity of the blood, triggering the respiratory centers in the brain to increase the rate and depth of respiration in order to expel excess CO2 and restore the pH balance.
Explanation for other choices:
A: Oxygen concentration increases - An increase in oxygen concentration does not directly stimulate an increase in respiration rate or depth. The respiratory drive is primarily regulated by CO2 levels.
C: Bicarbonate concentration increases - While bicarbonate is involved in the acid-base balance in the body, it does not directly influence the rate and depth of respiration.
D: Bicarbonate concentration decreases - A decrease in bicarbonate concentration may affect acid-base balance, but it does not have a direct effect on respiratory rate and depth.
Mammalian RBC respire anaerobically because
- A. It has stroma inside
- B. It has Haemoglobin
- C. It lacks Mitochondria
- D. It has bicarbonate ions inside
Correct Answer: C
Rationale: The correct answer is C because mammalian RBCs lack mitochondria, which are responsible for aerobic respiration. Without mitochondria, RBCs are unable to perform oxidative phosphorylation to generate ATP aerobically. Stroma (A) is found in chloroplasts, not RBCs. Hemoglobin (B) is responsible for oxygen transport, not cellular respiration. Bicarbonate ions (D) are involved in the buffering system of blood, not in cellular respiration. Therefore, the lack of mitochondria is the key reason for RBCs to respire anaerobically.