Nokea
A nurse is assisting a physician with the removal of a chest tube. The nurse should instruct the client to:
- A. Exhale slowly
- B. Stay very still
- C. Inhale and exhale quickly
- D. Perform the Valsalva maneuver
Correct Answer: D
Rationale: The correct answer is D: Perform the Valsalva maneuver. The Valsalva maneuver involves holding the breath and bearing down, which helps prevent air from entering the pleural space during chest tube removal, reducing the risk of a pneumothorax. Exhaling slowly (A) or inhaling and exhaling quickly (C) can increase the risk of air entering the pleural space. Staying very still (B) is important to minimize movement during the procedure, but performing the Valsalva maneuver is crucial to prevent complications.
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How does the pressure 'P4' at label '4' compare to the pressure 'P5' at label '5'?
- A. P4 is higher than P5 during inhalation and then lower during exhalation
- B. P4 is always higher than P5
- C. P4 is always lower than P5
- D. P4 always equals P5
Correct Answer: C
Rationale: The correct answer is C because pressure decreases as air moves from a region of higher pressure to lower pressure. At label '4', the air pressure is higher due to inhalation, and at label '5', the pressure is lower as air exits during exhalation. Therefore, P4 is always lower than P5. Choices A and B are incorrect because pressure dynamics change during inhalation and exhalation. Choice D is incorrect as pressure imbalances exist during breathing.
Partial pressure of Oxygen in the inspired and expired air is respectively
- A. 158 and 116 mm Hg
- B. 158 and 40 mm Hg
- C. 100 and 95 nn Hg
- D. 40 and 95 mm Hg
Correct Answer: B
Rationale: The correct answer is B (158 and 40 mm Hg) because the partial pressure of oxygen in inspired air is approximately 158 mm Hg, while in expired air it decreases to around 40 mm Hg due to oxygen being taken up by the body tissues for metabolism. Choice A (158 and 116 mm Hg) is incorrect because expired air has a lower partial pressure of oxygen than inspired air. Choice C (100 and 95 mm Hg) is incorrect as it does not reflect the significant decrease in oxygen partial pressure from inspired to expired air. Choice D (40 and 95 mm Hg) is incorrect as it has the values reversed, with expired air having a higher partial pressure of oxygen than inspired air, which is not physiologically accurate.
Expiration involves
- A. Relaxation of diaphragm and intercostals muscles
- B. Contraction of diaphragm and intercostals muscles
- C. Contraction of diaphragm muscles
- D. Contraction of inter costal muscles
Correct Answer: A
Rationale: The correct answer is A because expiration involves the relaxation of the diaphragm and intercostal muscles. During expiration, the diaphragm moves up and the intercostal muscles relax, causing the thoracic cavity to decrease in volume. This increase in pressure forces air out of the lungs. Choice B is incorrect as it describes the process of inspiration, not expiration. Choice C is incorrect because expiration involves both the diaphragm and intercostal muscles, not just the diaphragm muscles. Choice D is incorrect as the intercostal muscles also relax during expiration, rather than contracting.
The patient with sleep apnea is fitted with a continuous positive airway pressure (CPAP) mask and asks the nurse how this device will help. How should the nurse respond?
- A. The device delivers constant positive pressure to keep your airway open.
- B. The device will require you to be intubated to open your airway.
- C. The device delivers oxygen only when you are apneic.
- D. The device delivers negative pressure to stimulate your respirations.
Correct Answer: A
Rationale: The correct answer is A because a CPAP mask delivers a constant positive pressure to keep the airway open during sleep, preventing airway collapse and interruptions in breathing. This helps improve oxygenation and reduce the frequency of apnea episodes. Choice B is incorrect as intubation is not required with CPAP. Choice C is incorrect as CPAP does not deliver oxygen, it only provides pressurized air. Choice D is incorrect as CPAP delivers positive pressure, not negative pressure, to support breathing.
Foetal hemoglobin has a Sigmoid dissociation curve which is shifted to left relative to adult Hb because
- A. Foetal Hb has higher P50
- B. Foetal HB has lower P50 (18-20 mm Hg) than Adult Hb (26.6 mm.Hg)
- C. Foetal Hb readily accept Oxygen
- D. Foetal Hb easily remove Carbon dioxide
Correct Answer: B
Rationale: The correct answer is B because foetal Hb has a lower P50 (18-20 mm Hg) than adult Hb (26.6 mm Hg). A lower P50 indicates higher oxygen affinity, allowing foetal Hb to bind oxygen more readily at lower partial pressures. This shift to the left of the dissociation curve ensures efficient oxygen transfer from the maternal bloodstream to the foetus. Choices A, C, and D are incorrect because foetal Hb having a higher P50 (A), readily accepting oxygen (C), or easily removing carbon dioxide (D) would not explain the left shift in the dissociation curve.