Nokea
A nurse is suctioning fluids from a male client via a tracheostomy tube. When suctioning, the nurse must limit the suctioning time to a maximum of:
- A. 1 minute
- B. 5 seconds
- C. 10 seconds
- D. 30 second
Correct Answer: C
Rationale: The correct answer is C: 10 seconds. Suctioning time for a tracheostomy tube should be limited to 10 seconds to prevent hypoxia and tissue damage. Prolonged suctioning can lead to decreased oxygenation and potential trauma to the airway. Choice A (1 minute) is too long and can cause harm. Choice B (5 seconds) is too short to effectively clear secretions. Choice D (30 seconds) exceeds the recommended time limit and can lead to complications. Therefore, limiting suctioning time to 10 seconds is the safest and most effective approach.
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The nurse assesses the client using the device pictured below to deliver 50% O2: The nurse finds that the mask fits snugly the skin under the mask and straps is intact and the flow rate of the oxygen is 3 L/min. What action by the nurse is best?
- A. Assess the client's oxygen saturation.
- B. Document these findings in the chart.
- C. Immediately increase the flow rate.
- D. Turn the flow rate down to 2 L/min.
Correct Answer: C
Rationale: The correct answer is C: Immediately increase the flow rate. A flow rate of 3 L/min is inadequate to deliver 50% O2 through a mask. Increasing the flow rate will ensure the client receives the prescribed oxygen concentration.
Incorrect choices:
A: Assess the client's oxygen saturation - This is not the priority as the oxygen delivery is suboptimal.
B: Document these findings in the chart - Documentation is important but addressing the oxygen delivery issue is more critical.
D: Turn the flow rate down to 2 L/min - This would further reduce the oxygen concentration, which is not appropriate in this case.
The patient has just had an MRI ordered because a routine chest x-ray showed suspicious areas in the right lung. The physician suspects bronchogenic carcinoma. An MRI would most likely be ordered to assess for what in this patient?
- A. Alveolar dysfunction
- B. Forced vital capacity
- C. Tidal volume
- D. Chest wall invasion
Correct Answer: D
Rationale: The correct answer is D: Chest wall invasion. An MRI would be ordered to assess for any potential invasion of the chest wall by the suspected bronchogenic carcinoma. MRI provides detailed imaging of soft tissues and can help determine the extent of tumor invasion beyond the lungs.
Explanation:
A: Alveolar dysfunction - Alveolar dysfunction is typically assessed using pulmonary function tests or imaging techniques like CT scans, not MRI.
B: Forced vital capacity - Forced vital capacity is a measure of lung function and is not typically assessed using MRI.
C: Tidal volume - Tidal volume is a measure of the volume of air moved in and out of the lungs during normal breathing and is not assessed using MRI in this context.
Total alveolar surface area is reduced in
- A. lung cancer
- B. atelectasis
- C. emphysema
- D. pneumothorax
Correct Answer: C
Rationale: The correct answer is C: emphysema. Emphysema is a condition characterized by the destruction of alveolar walls, leading to a decrease in alveolar surface area for gas exchange. This reduction in surface area impairs the exchange of oxygen and carbon dioxide in the lungs. In contrast, lung cancer (A) primarily affects lung tissue but may not directly reduce alveolar surface area. Atelectasis (B) refers to the collapse of lung tissue, which can impact ventilation but not necessarily alveolar surface area. Pneumothorax (D) is the presence of air in the pleural space and does not directly affect alveolar surface area.
Regarding control of ventilation
- A. The apneustic centre lies in the medulla
- B. The central chemoreceptors respond to changes in oxygen concentrations
- C. The chemoreceptors in the aortic bodies respond to a fall in arterial pH
- D. Peripheral chemoreceptors respond to decreases in arterial pO2
Correct Answer: D
Rationale: The correct answer is D: Peripheral chemoreceptors respond to decreases in arterial pO2. These chemoreceptors located in the carotid bodies and aortic bodies detect changes in arterial pO2 levels, triggering an increase in ventilation to compensate for low oxygen levels. The apneustic center (A) is located in the pons, not the medulla. Central chemoreceptors (B) primarily respond to changes in arterial CO2 levels, not oxygen concentrations. The chemoreceptors in the aortic bodies (C) primarily respond to changes in arterial pCO2, not pH. Overall, choice D is correct due to the specific role of peripheral chemoreceptors in detecting decreases in arterial pO2 levels and regulating ventilation accordingly.
In which organ is carbonic anhydrase crucial for maintaining acid-base balance?
- A. Liver
- B. Kidneys
- C. Heart
- D. Pancreas
Correct Answer: B
Rationale: Carbonic anhydrase is crucial for acid-base balance by catalyzing the interconversion of carbon dioxide and bicarbonate ions in the blood. The kidneys regulate blood pH by reabsorbing bicarbonate and excreting hydrogen ions. Therefore, carbonic anhydrase in the kidneys plays a vital role in maintaining acid-base balance. The liver is not directly involved in this process but helps in detoxification and metabolism. The heart and pancreas do not have a primary role in acid-base balance regulation. Thus, the correct answer is B: Kidneys.