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A client with acute asthma showing inspiratory and expiratory wheezes and a decreased forced expiratory volume should be treated with which of the following classes of medication right away?
- A. Beta-adrenergic blockers.
- B. Bronchodilators.
- C. Inhaled steroids.
- D. Oral steroids.
Correct Answer: B
Rationale: The correct answer is B: Bronchodilators. In acute asthma, bronchodilators are the first-line treatment to quickly relieve bronchoconstriction and improve airflow. Inspiratory and expiratory wheezes indicate airway obstruction, and decreased forced expiratory volume suggests reduced airflow. Beta-adrenergic blockers (A) can worsen asthma symptoms by blocking beta-2 receptors, leading to bronchoconstriction. Inhaled steroids (C) are used for long-term asthma control and not for acute exacerbations. Oral steroids (D) are typically used in severe asthma exacerbations requiring systemic anti-inflammatory effects and are not the immediate first-line treatment for acute asthma.
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While assisting a patient with intermittent asthma to identify specific triggers of asthma, what should the nurse explain?
- A. a. Food and drug allergies do not manifest in respiratory symptoms.
- B. b. Exercise-induced asthma is seen only in individuals with sensitivity to cold air.
- C. c. Asthma attacks are psychogenic in origin and can be controlled with relaxation techniques.
- D. d. Viral upper respiratory infections are a common precipitating factor in acute asthma attacks.
Correct Answer: d
Rationale: The correct answer is D because viral upper respiratory infections are a common precipitating factor in acute asthma attacks. This is important information for the patient to understand in order to help identify triggers and manage their asthma effectively. Viral infections can exacerbate asthma symptoms, so recognizing this connection can aid in prevention and treatment.
Prolonged inspirations can result from stimulating the ________ center.
- A. apneustic
- B. pneumotaxic
- C. expiratory
- D. baroreceptor
Correct Answer: A
Rationale: The correct answer is A: apneustic. Stimulation of the apneustic center in the brainstem prolongs inspiration by sending signals to the respiratory muscles to maintain inspiration. The apneustic center plays a role in regulating the depth and duration of breathing.
Explanation for why other choices are incorrect:
B: Pneumotaxic center helps regulate the respiratory rate by inhibiting inspiration, not prolonging it.
C: Expiratory center is responsible for controlling expiration, not inspiration.
D: Baroreceptor center is involved in regulating blood pressure, not respiratory functions.
Which statement by a patient with newly diagnosed heart failure indicates to the nurse that the teaching was effective?
- A. I will call the clinic if my weight goes up 3 pounds in a week.
- B. I will take furosemide (Lasix) every day just before bedtime.
- C. I will use the nitroglycerin patch whenever I have chest pain.
- D. I will weigh myself every week with the same scale.
Correct Answer: A
Rationale: The correct answer is A because it demonstrates understanding of monitoring for fluid retention, a common issue in heart failure. Calling the clinic if weight increases by 3 pounds in a week allows for early intervention. Choice B is incorrect because taking furosemide at bedtime may disrupt sleep and increase nighttime urination. Choice C is incorrect as nitroglycerin is for acute chest pain, not a preventative measure. Choice D is incorrect because weighing weekly may not catch sudden weight changes that indicate worsening heart failure.
At high altitudes all of the following things occur in an effort to acclimatise EXCEPT
- A. Hypoventilation
- B. Polycythaemia
- C. Increased numbers of capillaries per unit volume in peripheral tissues
- D. O2 dissociation curve shifts to right
Correct Answer: A
Rationale: The correct answer is A: Hypoventilation. At high altitudes, the body adapts to the decreased oxygen availability by increasing red blood cell production (polycythaemia) to enhance oxygen-carrying capacity. This is supported by the shift of the oxygen dissociation curve to the right, facilitating oxygen unloading in tissues. Additionally, increased capillaries in peripheral tissues improve oxygen delivery. However, hypoventilation, or decreased breathing rate, is not a typical response to high altitudes. In fact, the body usually compensates by increasing ventilation to maintain adequate oxygen levels.
Which of the following anatomical structures is not part of the conducting zone?
- A. pharynx
- B. nasal cavity
- C. alveoli
- D. bronchi
Correct Answer: C
Rationale: The correct answer is C: alveoli. The conducting zone of the respiratory system includes structures that transport air to and from the gas exchange sites. Alveoli are the primary sites of gas exchange, not part of the conducting zone. Pharynx (A), nasal cavity (B), and bronchi (D) are all part of the conducting zone as they help in air transportation but do not directly participate in gas exchange like alveoli do. Therefore, alveoli is the correct answer as it does not belong to the conducting zone.