Nokea
During inspiration, air passes into lungs due to
- A. Increase in volume of thoracic cavity and fall in lung pressure
- B. Fall in pressure inside the lungs
- C. Increased volume of thoracic cavity
- D. Muscular expansion of lungs
Correct Answer: A
Rationale: Correct Answer: A - Increase in volume of thoracic cavity and fall in lung pressure
Rationale:
1. During inspiration, the diaphragm contracts and moves downward, increasing the volume of the thoracic cavity.
2. The external intercostal muscles also contract, lifting the ribcage and further expanding the thoracic cavity.
3. As thoracic cavity volume increases, lung pressure decreases, creating a pressure gradient that allows air to flow into the lungs.
Summary:
B: Fall in pressure inside the lungs - This is a consequence of the increase in thoracic cavity volume, not the cause of air entering the lungs.
C: Increased volume of thoracic cavity - This is correct but does not explain how air enters the lungs.
D: Muscular expansion of lungs - Lungs do not expand on their own; it is the thoracic cavity that expands to create the pressure gradient for air entry.
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Partial pressure of carbon dioxide in the inspired and expired air respectively
- A. 0.3 and 40 mm Hg
- B. 0.3 and 32 mm Hg
- C. 40 and 46 mm Hg
- D. 40 and 0.3 mm Hg
Correct Answer: A
Rationale: The partial pressure of carbon dioxide in inspired air is around 0.3 mm Hg as it is very low in atmospheric air. During expiration, the partial pressure of carbon dioxide increases to around 40 mm Hg due to its exchange in the lungs. This makes option A the correct answer. Option B is incorrect because the partial pressure of CO2 in expired air is not 32 mm Hg. Option C is incorrect as 40 mm Hg is the partial pressure in expired air, not inspired air. Option D is incorrect because 0.3 mm Hg is the partial pressure in inspired air, not expired air.
The lungs are covered by a two-layer membrane called the:
- A. pleura.
- B. diaphragm.
- C. respiratory membrane.
- D. intercostal muscles.
Correct Answer: A
Rationale: The correct answer is A: pleura. The pleura is a two-layered membrane that covers the lungs. The outer layer is called the parietal pleura, which lines the chest wall, and the inner layer is called the visceral pleura, which covers the lungs themselves. This double-layered structure helps to protect and cushion the lungs during breathing movements.
Summary of incorrect choices:
B: The diaphragm is a dome-shaped muscle located below the lungs that plays a role in breathing but does not cover the lungs.
C: The respiratory membrane refers to the interface where gas exchange occurs in the alveoli, not the covering of the lungs.
D: The intercostal muscles are located between the ribs and assist in breathing but do not cover the lungs.
In an older client, the alveolar walls become thinner and contain fewer capillaries. What does this condition lead to?
- A. Loss of elasticity in the lungs
- B. Decreased gas exchange
- C. Increased stiffness in lungs
- D. Decreased numbers of alveoli
Correct Answer: B
Rationale: The correct answer is B (Decreased gas exchange). Thinning alveolar walls and reduced capillary density directly impair the diffusion of gases across the alveolar-capillary membrane, leading to decreased gas exchange. While A (loss of elasticity) might occur with aging, it is not the primary consequence here. C (increased stiffness) is incorrect because stiffness typically results from fibrosis or other conditions, not thinning walls. D (decreased numbers of alveoli) could happen but is unrelated to the specific scenario described.
In assessing for major sources of infection in a COPD patient, the nurse focuses on:
- A. Stasis of respiratory secretions.
- B. Low body weight.
- C. Episodes of postural hypotension.
- D. Delayed antigen-antibody response.
Correct Answer: A
Rationale: The correct answer is A: Stasis of respiratory secretions. In COPD patients, stasis of respiratory secretions can lead to bacterial growth and increase the risk of infections like pneumonia. This is a common issue in COPD due to impaired mucociliary clearance. Choices B, C, and D are not directly related to sources of infection in COPD patients. Low body weight is more associated with malnutrition, postural hypotension with cardiovascular issues, and delayed antigen-antibody response with immune system deficiencies.
For a male client with an endotracheal (ET) tube, which nursing action is most essential?
- A. Auscultating the lungs for bilateral breath sounds.
- B. Turning the client from side to side every 2 hours.
- C. Monitoring serial blood gas values every 4 hours.
- D. Providing frequent oral hygiene.
Correct Answer: A
Rationale: The correct answer is A: Auscultating the lungs for bilateral breath sounds. This is the most essential nursing action for a male client with an endotracheal tube because it ensures proper placement of the tube and adequate ventilation. By auscultating the lungs, the nurse can assess for any potential complications such as tube displacement, pneumothorax, or mucus plugging. This action helps in early detection of respiratory issues and prompt intervention if needed.
Summary:
- Choice B (Turning the client from side to side every 2 hours) is important for preventing pressure ulcers but not as critical as assessing breath sounds.
- Choice C (Monitoring serial blood gas values every 4 hours) is important for evaluating respiratory status but does not provide immediate information on tube placement.
- Choice D (Providing frequent oral hygiene) is important for preventing infections but does not directly assess the client's respiratory status with an ET tube.