Nokea
A gerontologic nurse is analyzing the data from a patient's focused respiratory assessment. The nurse is aware that the amount of respiratory dead space increases with age. What is the effect of this physiological change?
- A. Increased diffusion of gases
- B. Decreased diffusion capacity for oxygen
- C. Decreased shunting of blood
- D. Increased ventilation
Correct Answer: B
Rationale: The correct answer is B: Decreased diffusion capacity for oxygen. With age, respiratory dead space increases, leading to a mismatch between ventilation and perfusion in the lungs. This results in a decrease in the ability of the lungs to effectively transfer oxygen into the bloodstream, reducing the diffusion capacity for oxygen. This physiological change can lead to decreased oxygenation of tissues and organs.
Summary:
A: Increased diffusion of gases - Incorrect. Increased dead space does not enhance gas diffusion; instead, it impairs gas exchange.
C: Decreased shunting of blood - Incorrect. Shunting refers to blood bypassing oxygenation in the lungs, which is not directly affected by dead space.
D: Increased ventilation - Incorrect. While dead space may lead to increased ventilation efforts, it does not directly improve oxygen diffusion capacity.
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Carbonic anhydrase in the RBC is the fastest enzyme and it decomposes in one second for fast action. Its concentration in the blood is due to the presence of
- A. Plasma
- B. Carbon dioxide
- C. Sodium ions
- D. Hemoglobin
Correct Answer: D
Rationale: The correct answer is D: Hemoglobin. Carbonic anhydrase is an enzyme found in red blood cells that rapidly catalyzes the conversion of carbon dioxide into bicarbonate ions. Hemoglobin plays a crucial role in transporting carbon dioxide in the blood. The high concentration of hemoglobin in red blood cells allows for efficient binding and transport of carbon dioxide, leading to the need for a rapid enzyme like carbonic anhydrase to facilitate its conversion. Plasma (choice A) does not directly influence the concentration of carbonic anhydrase. Carbon dioxide (choice B) is the substrate for carbonic anhydrase, not the reason for its concentration. Sodium ions (choice C) do not directly affect the action of carbonic anhydrase in red blood cells.
The nurse is caring for a patient who has returned to the unit following a bronchoscopy. The patient is asking for something to drink. Which criterion will determine when the nurse should allow the patient to drink fluids?
- A. Presence of a cough and gag reflex
- B. Absence of nausea
- C. Ability to demonstrate deep inspiration
- D. Oxygen saturation of ≥92%
Correct Answer: A
Rationale: The correct answer is A, presence of a cough and gag reflex. After a bronchoscopy, it is crucial for the nurse to ensure the patient has a cough and gag reflex before allowing them to drink fluids to prevent aspiration. Cough reflex helps clear secretions, and gag reflex prevents fluids from entering the airway. Choices B, C, and D are incorrect as they do not directly relate to the safety of the patient's ability to swallow post-bronchoscopy.
The charge nurse on a medical unit is preparing to admit several "clients" who have possible pandemic flu during a preparedness drill. What action by the nurse is best?
- A. Admit the "clients" on Contact Precautions.
- B. Inquire as to recent travel outside the United States.
- C. Do not allow pregnant caregivers to care for these "clients."
- D. Place the "clients" on enhanced Droplet Precautions.
Correct Answer: B
Rationale: The correct answer is B because in a pandemic flu scenario, it is crucial to inquire about recent travel history to identify potential exposure risks. This information can help determine if the "clients" have been in high-risk areas or in contact with infected individuals. This step is essential for implementing appropriate infection control measures and preventing the spread of the virus.
Choice A is incorrect because Contact Precautions are not typically used for airborne infections like the flu. Choice C is incorrect as it discriminates against pregnant caregivers without any evidence-based rationale. Choice D is incorrect because enhanced Droplet Precautions are more suitable for diseases spread through respiratory droplets, not necessarily for pandemic flu with potential airborne transmission.
How many lobes does each lung have, and which lung has a cardiac notch?
- A. right lung has 2 lobes, the left lung has 3 lobes; the right lung has a cardiac notch
- B. right lung has 3 lobes, the left lung has 2 lobes; the right lung has a cardiac notch
- C. right lung has 2 lobes, the left lung has 3 lobes; the left lung has a cardiac notch
- D. right lung has 3 lobes, the left lung has 2 lobes; the left lung has a cardiac notch
Correct Answer: D
Rationale: Step 1: Identifying lobes - The right lung has 3 lobes (upper, middle, lower) while the left lung has 2 lobes (upper, lower).
Step 2: Cardiac notch - The cardiac notch is a concave space on the left lung where the heart lies. Therefore, the left lung has a cardiac notch.
Step 3: Correct choice - Option D states that the right lung has 3 lobes, the left lung has 2 lobes, and the left lung has a cardiac notch, which aligns with the anatomical features of the lungs.
Step 4: Incorrect choices - Choices A, B, and C have incorrect combinations of lobes and the presence of a cardiac notch, making them incorrect.
A nurse is preparing to obtain a sputum specimen from a male client. Which of the following nursing actions will facilitate obtaining the specimen?
- A. Limiting fluid.
- B. Having the client take deep breaths.
- C. Asking the client to spit into the collection container.
- D. Asking the client to obtain the specimen after eating.
Correct Answer: B
Rationale: The correct answer is B: Having the client take deep breaths. This action facilitates obtaining a sputum specimen by helping the client to cough and expectorate sputum effectively. Deep breaths help to mobilize secretions, making it easier for the client to produce a quality specimen. Limiting fluid intake (choice A) can lead to dehydration and thickening of secretions, making it harder to obtain a specimen. Asking the client to spit into the container (choice C) may result in contamination with saliva. Asking the client to obtain the specimen after eating (choice D) can introduce food particles into the specimen, affecting the accuracy of the test.