Nokea
Foetal hemoglobin has a Sigmoid dissociation curve which is shifted to left relative to adult Hb because
- A. Foetal Hb has higher P50
- B. Foetal HB has lower P50 (18-20 mm Hg) than Adult Hb (26.6 mm.Hg)
- C. Foetal Hb readily accept Oxygen
- D. Foetal Hb easily remove Carbon dioxide
Correct Answer: B
Rationale: The correct answer is B because foetal Hb has a lower P50 (18-20 mm Hg) than adult Hb (26.6 mm Hg). A lower P50 indicates higher oxygen affinity, allowing foetal Hb to bind oxygen more readily at lower partial pressures. This shift to the left of the dissociation curve ensures efficient oxygen transfer from the maternal bloodstream to the foetus. Choices A, C, and D are incorrect because foetal Hb having a higher P50 (A), readily accepting oxygen (C), or easily removing carbon dioxide (D) would not explain the left shift in the dissociation curve.
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How does the pressure 'P4' at label '4' compare to the pressure 'P5' at label '5'?
- A. P4 is higher than P5 during inhalation and then lower during exhalation
- B. P4 is always higher than P5
- C. P4 is always lower than P5
- D. P4 always equals P5
Correct Answer: C
Rationale: The correct answer is C because pressure decreases as air moves from a region of higher pressure to lower pressure. At label '4', the air pressure is higher due to inhalation, and at label '5', the pressure is lower as air exits during exhalation. Therefore, P4 is always lower than P5. Choices A and B are incorrect because pressure dynamics change during inhalation and exhalation. Choice D is incorrect as pressure imbalances exist during breathing.
Which blood pressure (BP) finding by the nurse indicates that no changes in therapy are needed for a 78-yr-old patient with newly diagnosed hypertension?
- A. 98/56 mm Hg
- B. 118/76 mm Hg
- C. 128/92 mm Hg
- D. 142/78 mm Hg
Correct Answer: B
Rationale: The correct answer is B (118/76 mm Hg) because it falls within the recommended range for a 78-year-old patient with hypertension. The systolic BP should ideally be below 140 mm Hg and the diastolic BP below 90 mm Hg for this age group. Option A is too low for systolic BP, indicating hypotension. Option C has elevated diastolic BP, suggesting uncontrolled hypertension. Option D has high systolic BP, indicating a need for therapy adjustment. Thus, only option B aligns with the guidelines, making it the correct choice.
The nurse advises the parents of a child who is in status asthmaticus that if not corrected, the result could be:
- A. Pneumothorax, severe hypoxemia, and respiratory arrest.
- B. Hypertension, CVA, and cardiac arrest.
- C. Respiratory alkalosis, pneumonia, and death.
- D. Lung abscess, cor pulmonale, and respiratory failure.
Correct Answer: A
Rationale: The correct answer is A because status asthmaticus can lead to pneumothorax due to increased air trapping, severe hypoxemia from impaired gas exchange, and respiratory arrest from respiratory muscle fatigue. Pneumothorax can occur due to increased intrathoracic pressure during an asthma attack. Hypertension, CVA, and cardiac arrest (choice B) are not typical complications of status asthmaticus. Respiratory alkalosis, pneumonia, and death (choice C) are less likely outcomes compared to the severe complications mentioned in choice A. Lung abscess, cor pulmonale, and respiratory failure (choice D) are not directly associated with the pathophysiology of status asthmaticus.
What instructions will you give the nursing assistant who will assist the client with ADLs? (Choose all that apply.)
- A. Use a lift sheet when moving and positioning the client in bed.
- B. Use an electric razor when shaving the client each day.
- C. Use a soft-bristled toothbrush or tooth sponge for oral care.
- D. Use a rectal thermometer to attain a more accurate body temperature.
Correct Answer: D
Rationale: The correct answer includes A, B, and C. Using a lift sheet (A), electric razor (B), and soft-bristled toothbrush (C) are safe practices during anticoagulation therapy. Using a rectal thermometer (D) is contraindicated due to bleeding risk.
While assessing a patient who has pneumonia, the nurse has the patient repeat the letter E while the nurse auscultates. The nurse notes that the patient's voice sounds are distorted and that the letter A is audible instead of the letter E. How should this finding be documented?
- A. Bronchophony
- B. Egophony
- C. Whispered pectoriloquy
- D. Sonorous wheezes
Correct Answer: B
Rationale: The correct answer is B: Egophony. Egophony is a lung sound in which the spoken "E" sound changes to a loud, nasal "A" sound when auscultated, indicating consolidation in the lungs, such as in pneumonia. This finding should be documented as egophony because it specifically describes the distortion of voice sounds during auscultation related to lung pathology.
A: Bronchophony refers to increased clarity and loudness of spoken sounds during auscultation and is not specific to the distortion of the voice sounds as in the given scenario.
C: Whispered pectoriloquy describes whispered sounds being heard clearly during auscultation, which is different from the scenario presented.
D: Sonorous wheezes are continuous low-pitched wheezing sounds heard with inspiration or expiration, not related to the distortion of voice sounds as in egophony.