Nokea
A nurse assesses clients on the medical-surgical unit. Which client is at greatest risk for development of obstructive sleep apnea?
- A. A 26-year-old woman who is 8 months pregnant.
- B. A 42-year-old man with gastroesophageal reflux disease.
- C. A 55-year-old woman who is 50 lb (23 kg) overweight.
- D. A 73-year-old man with type 2 diabetes mellitus.
Correct Answer: C
Rationale: The correct answer is C, a 55-year-old woman who is 50 lb overweight. Obesity is a major risk factor for obstructive sleep apnea (OSA) due to excess fat in the neck area that can obstruct the airway during sleep. This increases the likelihood of experiencing breathing pauses. Pregnancy (choice A) may cause temporary OSA due to hormonal changes, but it's not the greatest risk factor among the options provided. Gastroesophageal reflux disease (choice B) and type 2 diabetes mellitus (choice D) are associated with sleep disturbances, but they are not as directly linked to OSA as obesity.
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A client has been diagnosed with lung cancer and requires lobectomy. How much of the lung is removed?
- A. One entire lung.
- B. A lobe of the lung.
- C. A small, localized area near the surface of the lung.
- D. One entire lung.
Correct Answer: B
Rationale: The correct answer is B: A lobe of the lung. During a lobectomy, a lobe of the lung is surgically removed, typically to treat lung cancer while preserving the remaining lung tissue. Removing one entire lung (choices A and D) is not necessary for a lobectomy and would be a more extensive procedure. Choice C, removing a small localized area near the surface of the lung, does not accurately reflect the extent of tissue removal required for a lobectomy. Therefore, the correct choice is B as it specifically addresses the removal of a lobe during the surgical procedure.
A patient on the medical unit has told the nurse that he is experiencing significant
dyspnea, despite that he has not recently performed any physical activity. What
assessment question should the nurse ask the patient while preparing to perform a
physical assessment?
- A. On a scale from 1 to 10, how bad would rate your shortness of breath?
- B. When was the last time you ate or drank anything?
- C. Are you feeling any nausea along with your shortness of breath?
- D. Do you think that some medication might help you catch your breath?
Correct Answer: A
Rationale: Rationale for Correct Answer (A):
1. Assessing the severity of dyspnea is crucial for determining the urgency of intervention.
2. By asking for a rating on a scale from 1 to 10, the nurse can quantify the level of distress the patient is experiencing.
3. This allows for a more objective assessment and helps in determining appropriate interventions.
4. Monitoring changes in the severity of dyspnea over time can also guide treatment effectiveness.
Summary of Incorrect Choices:
B. Asking about the last time the patient ate or drank is important for assessing possible contributing factors to dyspnea, but it does not directly address the immediate severity of the symptom.
C. Inquiring about nausea is relevant for a more comprehensive assessment, but it does not directly address the severity of dyspnea.
D. Asking about the potential need for medication is important, but it does not directly address the current level of dyspnea and may not be the immediate priority.
During inhalation,
- A. the pressure in the thoracic cavity is greater than the pressure within the lungs.
- B. the pressure in the thoracic cavity is less than the pressure within the lungs.
- C. the diaphragm moves upward and becomes more curved.
- D. the chest cavity volume decreases.
Correct Answer: B
Rationale: During inhalation, the diaphragm contracts and moves downward, increasing the volume of the thoracic cavity. This decrease in pressure within the thoracic cavity creates a pressure gradient, causing air to flow into the lungs where the pressure is now higher. Choice B is correct because the pressure in the thoracic cavity is indeed less than the pressure within the lungs during inhalation. Choices A, C, and D are incorrect because during inhalation, the pressure in the thoracic cavity decreases, the diaphragm moves downward and flattens, and the chest cavity volume increases to allow for air intake.
Rectal respiration is seen in
- A. Cockroach
- B. Spider
- C. Niads of Dragon fly
- D. Water flea
Correct Answer: C
Rationale: Rectal respiration in insects involves the exchange of gases through the anus. The correct answer is C, Niads of Dragonfly, as they have specialized structures called rectal gills for respiration. Cockroach (A), Spider (B), and Water flea (D) do not possess rectal gills or exhibit rectal respiration. Cockroaches have spiracles for respiration, spiders have book lungs or tracheal systems, and water fleas have gills located elsewhere on their bodies. Thus, only Niads of Dragonfly demonstrate rectal respiration, making it the correct choice.
The greatest quantity of air that can be expired after a maximum inspiratory effort is its
- A. Residual volume
- B. Tidal volume
- C. Vital capacity
- D. Lung volume
Correct Answer: C
Rationale: The correct answer is C: Vital capacity. Vital capacity is the maximum amount of air a person can expel from the lungs after a maximum inhalation. It is the sum of tidal volume, inspiratory reserve volume, and expiratory reserve volume. Residual volume (A) is the air left in the lungs after maximum exhalation. Tidal volume (B) is the amount of air inhaled and exhaled during normal breathing. Lung volume (D) is a general term and not a specific measure of air quantity. Thus, vital capacity is the best choice as it accounts for the maximum air that can be expired after a deep inhalation.