Nokea
A male patient has a sucking stab wound to the chest. Which action should the nurse take first?
- A. Drawing blood for a hematocrit and hemoglobin level.
- B. Applying a dressing over the wound and taping it on three sides.
- C. Preparing a chest tube insertion tray.
- D. Preparing to start an I.V. line.
Correct Answer: B
Rationale: The correct answer is B. Applying a dressing over the wound and taping it on three sides should be done first to prevent air from entering the wound and causing a tension pneumothorax. This action helps stabilize the wound and minimizes the risk of further complications. Drawing blood for hematocrit and hemoglobin (A) is not the priority in this situation. Chest tube insertion (C) and starting an IV line (D) can be necessary interventions but are not the immediate priority in managing a sucking chest wound.
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Which metal ion is often present in the active site of carbonic anhydrase enzymes?
- A. Iron (Fe)
- B. Calcium (Ca)
- C. Zinc (Zn)
- D. Magnesium (Mg)
Correct Answer: C
Rationale: The correct answer is C: Zinc (Zn). Zinc is often present in the active site of carbonic anhydrase enzymes because it plays a crucial role in catalyzing the conversion of carbon dioxide to bicarbonate and protons. Zinc ions have the appropriate coordination geometry and charge to facilitate this reaction efficiently. Iron (Fe) is not typically found in the active site of carbonic anhydrase enzymes. Calcium (Ca) and Magnesium (Mg) do not have the appropriate properties to serve as the catalytic metal ion in this enzyme. Therefore, zinc (Zn) is the correct answer due to its specific role and properties in the catalytic mechanism of carbonic anhydrase enzymes.
A nurse has educated a client on isoniazid. What statement by the client indicates that teaching has been effective?
- A. I need to take extra vitamin C while on isoniazid.
- B. I should take this medicine with milk or juice.
- C. I will take this medication on an empty stomach.
- D. My contact lenses will be permanently stained.
Correct Answer: C
Rationale: The correct answer is C: "I will take this medication on an empty stomach." This indicates effective teaching because isoniazid should be taken on an empty stomach to maximize absorption. Taking it with food can reduce absorption.
A: Taking extra vitamin C is not necessary for isoniazid.
B: Taking isoniazid with milk or juice can reduce its effectiveness.
D: Contact lenses are not affected by isoniazid, so they will not be permanently stained.
When CO2 diffuses into blood in systemic capillaries most of it:
- A. Remains in solution as CO2
- B. Converts to carbamino compounds
- C. Converts to bicarbonate ions in RBC
- D. Combines with Hb directly
Correct Answer: C
Rationale: The correct answer is C because the majority of CO2 diffusing into blood combines with water inside red blood cells (RBC) to form carbonic acid, which then dissociates into bicarbonate ions and hydrogen ions. This reaction is facilitated by the enzyme carbonic anhydrase. This process allows for efficient transport of CO2 in the bloodstream. Choices A and B are incorrect as CO2 primarily undergoes conversion to bicarbonate ions, not remaining in solution as CO2 or forming carbamino compounds. Option D is incorrect as CO2 does not directly combine with hemoglobin.
The client with COPD has a nursing diagnosis of Ineffective Breathing Pattern. Which action is appropriate to delegate to the experienced LPN/LVN under your supervision?
- A. Observe how well the client performs pursed-lip breathing.
- B. Plan a nursing care regimen that gradually increases activity tolerance.
- C. Assist the client with basic activities of daily living (ADLs).
- D. Consult with physical therapy about reconditioning exercises.
Correct Answer: C
Rationale: The correct answer is C. Assisting with ADLs is a routine task suitable for an LPN/LVN. Observing pursed-lip breathing (A) and planning care regimens (B) are more advanced tasks. Consulting physical therapy (D) requires RN-level decision-making.
Carbon monoxide
- A. has a very low affinity or attraction to hemoglobin.
- B. is unlikely to be transported by the circulatory system.
- C. is not the cause of death of people who breathe excessive amounts of automobile exhausts.
- D. can arise from cigarette smoke
Correct Answer: D
Rationale: The correct answer is D because carbon monoxide can indeed arise from cigarette smoke due to incomplete combustion of tobacco. This is supported by scientific evidence. Carbon monoxide has a high affinity for hemoglobin, so choice A is incorrect. It can be transported by the circulatory system, making choice B incorrect. Breathing excessive amounts of automobile exhaust containing carbon monoxide can lead to death, making choice C incorrect.