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A male adult client is suspected of having a pulmonary embolism. A nurse assesses the client, knowing that which of the following is a common clinical manifestation of pulmonary embolism?
- A. Dyspnea
- B. Bradypnea
- C. Bradycardia
- D. Decreased respirations
Correct Answer: A
Rationale: The correct answer is A: Dyspnea. Pulmonary embolism causes a blockage in the pulmonary arteries, leading to decreased oxygenation and subsequent shortness of breath. To assess for pulmonary embolism, a nurse would look for symptoms such as sudden onset dyspnea. Bradypnea (B) refers to abnormally slow breathing rate, which is not typically seen in pulmonary embolism. Bradycardia (C) is a slow heart rate, which may occur in some cases but is not a common clinical manifestation of pulmonary embolism. Decreased respirations (D) is too vague and does not specifically indicate the difficulty in breathing associated with pulmonary embolism.
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Which statement is false about anatomical dead space?
- A. Anatomical dead space varies with age
- B. Can be estimated by the Fowlers method
- C. Significantly large in shallow breathing
- D. Measured by plotting N2 concentration against expired volume as in Bohr’s method
Correct Answer: D
Rationale: The correct answer is D because Bohr's method measures physiological dead space, not anatomical dead space. Anatomical dead space is constant and not affected by N2 concentration. A: Anatomical dead space does vary with age due to changes in lung dimensions. B: Fowlers method estimates anatomical dead space by measuring tidal volume and respiratory rate. C: Anatomical dead space is not significantly large in shallow breathing as it mainly involves the conducting airways, not the alveoli.
Asphyxia occurs due to
- A. Rise in level of CO2
- B. Fall in level of CO2
- C. Rise of O2 level
- D. Fall in O2 level
Correct Answer: A
Rationale: The correct answer is A: Rise in level of CO2. Asphyxia occurs when there is a buildup of carbon dioxide (CO2) in the body, leading to a lack of oxygen supply to tissues. When CO2 levels rise, it can displace oxygen in the bloodstream, causing respiratory distress and potential suffocation. Choices B, C, and D are incorrect because a fall in CO2 levels, a rise in O2 levels, or a fall in O2 levels do not directly cause asphyxia. This highlights the importance of understanding the physiological processes involved in respiration to identify the correct answer.
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.
A nurse observes that a client's anteroposterior (AP) chest diameter is the same as the lateral chest diameter. Which question would the nurse ask the client in response to this finding?
- A. Are you taking any medications or herbal supplements?
- B. Do you have any chronic breathing problems?
- C. How often do you perform aerobic exercise?
- D. What is your occupation and what are your hobbies?
Correct Answer: B
Rationale: The correct answer is B: Do you have any chronic breathing problems? This question is appropriate because equal AP and lateral chest diameters could indicate barrel chest, which is often associated with chronic obstructive pulmonary disease (COPD) or other chronic breathing problems. Asking about chronic breathing problems can help the nurse further assess the client's respiratory health.
Incorrect answers:
A: Are you taking any medications or herbal supplements? This question is not directly related to the observed chest diameter findings.
C: How often do you perform aerobic exercise? This question is not relevant to the physical assessment findings and does not address the potential respiratory issue.
D: What is your occupation and what are your hobbies? This question does not directly address the equal AP and lateral chest diameters and does not help in assessing the respiratory status of the client.
A patient with a decreased level of consciousness is in a recumbent position. How should the nurse best assess the lung fields for a patient in this position?
- A. Inform that physician that the patient is in a recumbent position and anticipate an order for a portable chest x-ray.
- B. Turn the patient to enable assessment of all the patient's lung fields.
- C. Avoid turning the patient, and assess the accessible breath sounds from the anterior chest wall.
- D. Obtain a pulse oximetry reading, and, if the reading is low, reposition the patient and auscultate breath sounds.
Correct Answer: B
Rationale: The correct answer is B because turning the patient to enable assessment of all the lung fields is the best approach to assess lung sounds comprehensively. By turning the patient, the nurse can listen to breath sounds on both the anterior and posterior chest walls, ensuring a thorough assessment. Option A is incorrect as it assumes the need for a chest x-ray without first performing a physical assessment. Option C is incorrect as it limits assessment to only the anterior chest wall, potentially missing abnormalities in the posterior lung fields. Option D is incorrect as obtaining a pulse oximetry reading and repositioning the patient should not replace the need for a physical assessment of lung sounds.