Nokea
A patient reports sudden difficulty breathing with tachypnea and tachycardia and localized chest pain. The physician suspects a pulmonary embolism. What test would you expect the physician to order?
- A. Helical CT scan.
- B. EKG.
- C. ECC.
- D. Vital capacity.
Correct Answer: A
Rationale: The correct answer is A. A helical CT scan is the most appropriate test to diagnose pulmonary embolism due to its high sensitivity and specificity. EKG (B) and ECC (C) assess cardiac function but do not confirm PE. Vital capacity (D) measures lung function, which is irrelevant here.
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A nurse assesses a client after a thoracentesis. Which assessment finding warrants immediate action?
- A. The client rates pain as a 5/10 at the site of the procedure.
- B. A small amount of drainage from the site is noted.
- C. Pulse oximetry is 93% on 2 liters of oxygen.
- D. The trachea is deviated toward the opposite side of the neck.
Correct Answer: D
Rationale: The correct answer is D because tracheal deviation indicates a potential pneumothorax, a life-threatening complication of thoracentesis. Trachea should be midline. A, B, and C are incorrect because mild pain, small drainage, and slightly decreased oxygen saturation are expected findings post-thoracentesis and do not necessitate immediate action.
The partial pressure of carbon dioxide is greatest in
- A. venous blood
- B. alveolar air
- C. expired air
- D. inspired air
Correct Answer: A
Rationale: The correct answer is A: venous blood. In the body, carbon dioxide is carried in the blood, primarily in the form of bicarbonate ions. Venous blood, returning from tissues to the heart, has higher levels of carbon dioxide compared to arterial blood. This results in a higher partial pressure of carbon dioxide in venous blood. Alveolar air (B) has a lower partial pressure of carbon dioxide due to gas exchange in the lungs, while expired air (C) has even lower levels as carbon dioxide is exhaled. Inspired air (D) has the lowest partial pressure of carbon dioxide as it has not yet entered the body.
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 mm Hg
- D. 40 and 95 mm hg
Correct Answer: A
Rationale: The correct answer is A (158 and 116 mm Hg) because in inspired air, the partial pressure of oxygen is around 158 mm Hg, which corresponds to the atmospheric oxygen level. During expiration, some oxygen is exchanged for carbon dioxide, leading to a decrease in oxygen partial pressure to around 116 mm Hg.
Choice B is incorrect because the partial pressure of oxygen in expired air is not as high as 40 mm Hg, which is too low for the oxygen content in the air we breathe.
Choice C is incorrect because the partial pressure of oxygen in inspired air is not exactly 100 mm Hg, and the partial pressure in expired air is not as close to 95 mm Hg.
Choice D is incorrect because the partial pressure of oxygen in inspired air is not as low as 40 mm Hg, and the partial pressure in expired air is not as high as 95 mm Hg.
The nursing assistant tells you that the client on oxygen at a flow rate of 6 L/min by nasal cannula is complaining of nasal passage discomfort. What intervention should you suggest to improve the client's comfort for this problem?
- A. Suggest that the client's oxygen be humidified.
- B. Suggest that the client be placed on a simple face mask.
- C. Suggest that the client be provided an extra pillow.
- D. Suggest that the client sit up in a chair at the bedside.
Correct Answer: A
Rationale: The correct answer is A. Humidifying oxygen reduces nasal dryness and irritation caused by high-flow oxygen through a nasal cannula. Using a face mask (B) might help but is less practical for long-term use. Providing an extra pillow (C) or sitting up in a chair (D) does not address the nasal discomfort directly.
The nurse is caring for a patient who has a pleural effusion and who underwent a thoracoscopic procedure earlier in the morning. The nurse should prioritize assessment for which of the following?
- A. Sputum production
- B. Shortness of breath
- C. Throat discomfort
- D. Epistaxis
Correct Answer: B
Rationale: The correct answer is B: Shortness of breath. Following a thoracoscopic procedure for a pleural effusion, shortness of breath is a priority assessment as it could indicate complications such as pneumothorax or respiratory distress. Sputum production (A) may be important but is secondary to respiratory distress. Throat discomfort (C) and epistaxis (D) are not directly related to the procedure or potential complications and would not be the priority assessment in this scenario.