Nokea
A patient with active TB continues to have positive sputum cultures after 6 months of treatment. She says she cannot remember to take the medication all the time. What is the best action for the nurse to take?
- A. Schedule the patient to come to the clinic every day to take the medication.
- B. Have a patient who has recovered from TB tell the patient about his successful treatment.
- C. Schedule more teaching sessions so the patient will understand the risks of noncompliance.
- D. Arrange for directly observed therapy by a responsible family member or a public health nurse.
Correct Answer: D
Rationale: Directly observed therapy by a responsible family member or a public health nurse is the best action to ensure adherence to TB treatment and prevent further drug resistance.
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During swallowing, the glottis is covered by
- A. false vocal cord
- B. true vocal cord
- C. epiglottis
- D. Adam's apple
Correct Answer: C
Rationale: The epiglottis covers the glottis during swallowing to prevent food or liquid from entering the airway. This helps protect the lungs from aspiration. False vocal cords (A) are not directly involved in this process. True vocal cords (B) are responsible for producing sound and are located below the glottis. Adam's apple (D) is the laryngeal prominence formed by the thyroid cartilage and does not cover the glottis during swallowing. Therefore, the correct answer is C (epiglottis).
Hemoglobin's affinity for oxygen when the BPG level is high is
- A. greater than hemoglobin's affinity for oxygen when the BPG level is low
- B. less than hemoglobin's affinity for oxygen when the BPG level is low
- C. equal to hemoglobin's affinity for oxygen when the BPG level is low
- D. equal to hemoglobin's affinity for oxygen when pH is low
Correct Answer: B
Rationale: The correct answer is B: less than hemoglobin's affinity for oxygen when the BPG level is low. When the 2,3-bisphosphoglycerate (BPG) level is high, it binds to hemoglobin and decreases its affinity for oxygen. This results in easier unloading of oxygen to tissues. In contrast, when the BPG level is low, hemoglobin's affinity for oxygen is higher, making it harder to release oxygen to tissues. Choices A and C are incorrect because high BPG levels decrease hemoglobin's affinity for oxygen, making it less than when BPG levels are low. Choice D is incorrect because pH levels do not directly affect hemoglobin's affinity for oxygen in the context of this question.
The impulse for voluntary muscles for forceful breathing starts in
- A. Medulla (Pons)
- B. Vagus nerve
- C. Cerebral hemispheres
- D. Spinal cord
Correct Answer: C
Rationale: The correct answer is C: Cerebral hemispheres. The impulse for voluntary muscles for forceful breathing originates in the cerebral hemispheres where conscious control over breathing is regulated. The cerebral cortex sends signals to the respiratory muscles to increase or decrease breathing effort based on the body's needs. The other choices are incorrect because:
A: Medulla (Pons) - This region of the brainstem is responsible for automatic breathing control, not voluntary forceful breathing.
B: Vagus nerve - The vagus nerve is not directly involved in initiating voluntary breathing movements.
D: Spinal cord - While the spinal cord plays a role in coordinating some aspects of breathing, it is not the primary center for voluntary forceful breathing control.
How is a client positioned for a thoracentesis?
- A. The client sits at the side of the bed.
- B. The client lies on the affected side.
- C. The client lies flat on the back.
- D. The client lies down with the head raised.
Correct Answer: A
Rationale: The correct answer is A. For thoracentesis, the client typically sits at the edge of the bed, leaning forward with arms supported on a table or over their knees to spread out the intercostal spaces and stabilize the chest wall. B is incorrect because lying on the affected side would compress the area being accessed. C is wrong as lying flat reduces access to the pleural space. D is incorrect because raising the head is not standard positioning for this procedure.
Reduction in respiratory surface of the lungs due to break down of partition in the alveoli is known as
- A. Asphyxia
- B. Bronchitis
- C. Asthma
- D. Emphysema
Correct Answer: D
Rationale: Emphysema is the correct answer because it is a condition where the alveoli walls break down, reducing the surface area for gas exchange in the lungs. This leads to difficulty in breathing. Asphyxia is suffocation due to lack of oxygen, not related to alveoli breakdown. Bronchitis is inflammation of the bronchial tubes, not alveoli damage. Asthma is a chronic condition affecting the airways, not specifically related to alveoli destruction. Therefore, emphysema is the most appropriate term for reduction in respiratory surface due to alveolar breakdown.