All of the following shift the oxygen dissociation curve to the right EXCEPT
- A. Decreased pH
- B. Increased temperature
- C. Carbon monoxide
- D. Increased 2.3 DPG
Correct Answer: C
Rationale: The correct answer is C: Carbon monoxide. Carbon monoxide binds to hemoglobin with a higher affinity than oxygen, shifting the oxygen dissociation curve to the left, not the right. Decreased pH, increased temperature, and increased 2,3 DPG all shift the curve to the right by decreasing hemoglobin's affinity for oxygen. This results in easier unloading of oxygen to tissues.
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Dead air is not involved in respiration because
- A. It is very low quantity
- B. It is trapped in nasal passage
- C. It contains less Oxygen
- D. It is present deep in the lungs
Correct Answer: D
Rationale: The correct answer is D because dead air is the air present in the alveoli that does not participate in gas exchange. It is located deep in the lungs, beyond the respiratory bronchioles where gas exchange occurs. Dead air does not reach the alveoli to participate in respiration. Choices A, B, and C are incorrect because the quantity of dead air or its oxygen content are not the primary reasons why it is not involved in respiration.
A nurse is assessing a client who has a tracheostomy. The nurse notes that the tracheostomy tube is pulsing with the heartbeat as the client's pulse is being taken. No other abnormal findings are noted. What action by the nurse is most appropriate?
- A. Call the operating room to inform them of a pending emergency case.
- B. No action is needed at this time; this is a normal finding in some clients.
- C. Remove the tracheostomy tube; ventilate the client with a bag-valve-mask.
- D. Stay with the client and have someone else call the primary health care provider immediately.
Correct Answer: D
Rationale: The correct answer is D.
1. Pulsation of the tracheostomy tube with the heartbeat indicates a possible vascular anomaly or the tube being in contact with a major vessel.
2. Staying with the client ensures immediate monitoring and intervention if needed.
3. Having someone else call the primary health care provider promptly allows for timely assessment and intervention.
4. Options A, B, and C are incorrect. Option A is premature without assessing the client further. Option B is incorrect as pulsation is not a normal finding in tracheostomy tubes. Option C is unsafe and can lead to airway compromise.
Most oxygen in the blood is transported
- A. as gas dissolved in plasma
- B. as oxyhemoglobin
- C. as carboxyhemoglobin
- D. as bicarbonate
Correct Answer: B
Rationale: The correct answer is B: as oxyhemoglobin. Oxygen is primarily carried in the blood by binding to hemoglobin in red blood cells to form oxyhemoglobin. This allows for efficient transport of oxygen to tissues. Choice A is incorrect because only a small amount of oxygen is dissolved in plasma. Choice C is incorrect as carboxyhemoglobin refers to carbon monoxide binding to hemoglobin, not oxygen. Choice D is incorrect as the majority of carbon dioxide is transported as bicarbonate, not oxygen.
You are evaluating and assessing a client diagnosed with chronic emphysema. The client is on oxygen at a flow rate of 5 L/min by nasal cannula. Which finding concerns you immediately?
- A. The client has fine bibasilar crackles.
- B. The client's respiratory rate is 8 breaths/minute.
- C. The client sits up and leans over the nightstand.
- D. The client has a large barrel chest.
Correct Answer: B
Rationale: The correct answer is B. A respiratory rate of 8 breaths/minute is abnormally low and indicates potential hypoventilation or respiratory depression, which is concerning in a client with chronic emphysema. Fine crackles (A) and barrel chest (D) are common findings but not immediately alarming. Sitting up and leaning forward (C) is a compensatory mechanism for easier breathing.
A 25-year-old nonsmoker who is normally in good health reports having a bad cough for the past 3 weeks. He has crackles and rhonchi, and shows the physician a small clear plastic container that has discolored, blood-tinged sputum that he produced this morning. What would the physician want to rule out?
- A. Lung cancer.
- B. The flu.
- C. Pneumonia.
- D. Asthma.
Correct Answer: C
Rationale: The correct answer is C (Pneumonia). The symptoms described—persistent cough, crackles, rhonchi, and blood-tinged sputum—are indicative of pneumonia. Lung cancer (A) is less likely in a young nonsmoker. The flu (B) typically does not cause blood-tinged sputum. Asthma (D) does not usually present with these specific findings.