Nokea
A nurse is caring for a client with acute respiratory distress syndrome. Which of the following would the nurse expect to note in the client?
- A. Decreased respiratory rate.
- B. Pallor.
- C. Low arterial PaO2.
- D. An elevated arterial PaO2.
Correct Answer: C
Rationale: The correct answer is C: Low arterial PaO2. In acute respiratory distress syndrome (ARDS), there is impaired gas exchange leading to hypoxemia. Low arterial PaO2 indicates poor oxygenation in the blood, a hallmark of ARDS. Decreased respiratory rate (A) is unlikely as the body compensates by increasing respiratory effort. Pallor (B) is a general sign of reduced blood flow and not specific to ARDS. An elevated arterial PaO2 (D) would not be expected in ARDS, as it signifies adequate oxygenation.
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Stimulation of the apneustic center would result in
- A. increased respiratory rate
- B. more intense inhalation
- C. a shorter respiratory cycle
- D. less activity in the DRG center
Correct Answer: B
Rationale: The correct answer is B: more intense inhalation. The apneustic center is responsible for prolonging inhalation by stimulating the inspiratory neurons in the medulla oblongata. When the apneustic center is stimulated, it disrupts the normal breathing pattern, causing a prolonged and more intense inhalation. This results in deeper and more forceful breaths.
Incorrect choices:
A: increased respiratory rate - Stimulation of the apneustic center would not lead to an increased respiratory rate, but rather to changes in the depth and intensity of inhalation.
C: a shorter respiratory cycle - The apneustic center's stimulation does not lead to a shorter respiratory cycle, but rather to a prolonged inhalation phase.
D: less activity in the DRG center - The dorsal respiratory group (DRG) is responsible for initiating inspiration, and the apneustic center does not affect its activity.
The nurse is caring for a patient immediately postoperative after a left pneumonectomy. How should the nurse position the patient?
- A. In high Fowler position
- B. In semi-Fowler position
- C. In a right side-lying position
- D. In a left side-lying position
Correct Answer: D
Rationale: Step-by-step rationale for why choice D is correct:
1. Post-pneumonectomy, positioning the patient on the left side allows the remaining lung to expand fully.
2. This position promotes better ventilation and perfusion, aiding in oxygenation.
3. Placing the patient on the left side also helps prevent pressure on the surgical site.
4. The left side-lying position also facilitates drainage and prevents pooling of secretions in the surgical area.
Summary of why other choices are incorrect:
A. High Fowler position may cause increased pressure on the surgical site and impede lung expansion.
B. Semi-Fowler position may not optimize lung expansion and could lead to decreased oxygenation.
C. Right side-lying position is not ideal as it does not facilitate full expansion of the remaining lung and may cause pooling of secretions.
What is an advantage of a tracheostomy over an endotracheal (ET) tube for long-term management of an upper airway obstruction?
- A. A tracheostomy is safer to perform in an emergency.
- B. An ET tube has a higher risk of tracheal pressure necrosis.
- C. A tracheostomy tube allows for more comfort and mobility.
- D. An ET tube is more likely to lead to lower respiratory tract infection.
Correct Answer: C
Rationale: A tracheostomy tube allows for more comfort and mobility compared to an endotracheal tube, making it preferable for long-term management of an upper airway obstruction. The ability to speak, eat, and move more freely with a tracheostomy tube can significantly improve the quality of life for the patient.
Plastron is the air bubble carrying respiratory air in the abdomen of
- A. Belostoma
- B. Nepa (Water boat man)
- C. Chironomous
- D. Mosquito
Correct Answer: B
Rationale: The correct answer is B: Nepa (Water boat man). Plastron is an air bubble that aquatic insects such as Nepa carry to respire underwater. Belostoma and Chironomous do not have plastrons. Mosquitoes breathe through a siphon, not a plastron. Therefore, the correct answer is B.
A client has been hospitalized with tuberculosis (TB). The client's spouse is fearful of entering the room where the client is in isolation and refuses to visit. What action by the nurse is best?
- A. Ask the spouse to explain the fear of visiting in further detail.
- B. Inform the spouse that the precautions are meant to keep other clients safe.
- C. Show the spouse how to follow the Isolation Precautions to avoid illness.
- D. Tell the spouse that he or she has already been exposed, so it's safe to visit.
Correct Answer: A
Rationale: The correct answer is A: Ask the spouse to explain the fear of visiting in further detail. By asking the spouse to explain their fear, the nurse can address and alleviate specific concerns, providing tailored support. This approach promotes open communication and understanding, which may help the spouse feel more comfortable visiting.
B: Informing the spouse about precautions may not address the underlying fear and could come across as dismissive.
C: Showing how to follow precautions does not directly address the spouse's fear and may not be sufficient to alleviate concerns.
D: Telling the spouse they have already been exposed may not address their fear and could potentially increase anxiety.