Nokea
For a patient with advanced chronic obstructive pulmonary disease (COPD), which nursing action best promotes adequate gas exchange?
- A. Encouraging the patient to drink three glasses of fluid daily.
- B. Keeping the patient in semi-Fowler's position.
- C. Using a high-flow venturi mask to deliver oxygen as prescribed.
- D. Administering a sedative, as prescribed.
Correct Answer: C
Rationale: The correct answer is C: Using a high-flow venturi mask to deliver oxygen as prescribed. This is the best option as it directly addresses the issue of promoting adequate gas exchange in a patient with advanced COPD. The high-flow venturi mask delivers oxygen at a precise concentration, ensuring optimal oxygenation.
Encouraging the patient to drink fluids (A) is important for overall health but does not directly address gas exchange. Keeping the patient in semi-Fowler's position (B) can help with breathing but is not as effective as providing supplemental oxygen. Administering a sedative (D) can further depress the respiratory system and worsen gas exchange, making it an inappropriate choice.
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Cloacal respiration is found in
- A. Snake
- B. Turtle and Tortoise
- C. Crocodile
- D. Frog
Correct Answer: B
Rationale: Cloacal respiration is found in turtles and tortoises. These reptiles can absorb oxygen through their cloaca, a multi-functional opening used for excretion and reproduction. Turtles and tortoises lack specialized respiratory organs like lungs, and thus utilize cloacal respiration as an additional means of obtaining oxygen. Snakes (Option A) primarily rely on lung respiration. Crocodiles (Option C) have well-developed lungs for breathing. Frogs (Option D) respire through their skin and lungs but do not utilize cloacal respiration like turtles and tortoises. Therefore, the correct answer is B, as it is the only species listed that exhibits cloacal respiration.
Most of the oxygen transported by the blood is
- A. dissolved in plasma
- B. bound to hemoglobin
- C. in ionic form as solute in the plasma
- D. bound to the same protein as carbon dioxide
Correct Answer: B
Rationale: The correct answer is B: bound to hemoglobin. This is because hemoglobin is the protein in red blood cells that carries oxygen from the lungs to tissues throughout the body. Oxygen binds to the iron atoms in hemoglobin, forming oxyhemoglobin. This accounts for the majority of oxygen transport in the blood.
A: Dissolved in plasma is incorrect as only a small fraction of oxygen is carried this way.
C: In ionic form as a solute in plasma is incorrect as oxygen is not typically found in ionic form in the blood.
D: Bound to the same protein as carbon dioxide is incorrect as oxygen binds to hemoglobin, while carbon dioxide primarily binds to different proteins such as carbonic anhydrase.
Foetal hemoglobin has great affinity than adult hemoglobin because
- A. It binds 2,3 DPG less avidity by Gamma polypeptide chain than HbA
- B. Its concentration is very high
- C. Foetal blood gets oxygen from the mother
- D. Its polypetide chains bind very fast with Oxygen
Correct Answer: A
Rationale: The correct answer is A because 2,3 DPG binds less avidly to the Gamma polypeptide chain in foetal hemoglobin, resulting in a higher affinity for oxygen. This is due to structural differences between foetal and adult hemoglobin. Choice B is incorrect as high concentration alone does not determine affinity. Choice C is incorrect as the source of oxygen does not affect hemoglobin's affinity. Choice D is incorrect as the speed of oxygen binding does not necessarily correlate with affinity.
Identify the inconsistent value at sea level
- A. Alveolar pCO2 = 40mmHg
- B. Alveolar pO2 = 100mmHg
- C. Alveolar PH2O = 47mmHg
- D. pO2 of inspired air = 130mmHg
Correct Answer: D
Rationale: The correct answer is D because at sea level, the pO2 of inspired air is around 159mmHg, not 130mmHg. This is due to the partial pressure of oxygen being higher at sea level. Alveolar pCO2, pO2, and PH2O values are consistent with normal values at sea level. Therefore, D is the inconsistent value.
What is the least successful treatment for laryngeal cancer?
- A. Surgical treatment
- B. Radical neck dissection
- C. Radiation therapy with surgery
- D. Chemotherapy
Correct Answer: D
Rationale: The correct answer is D. Chemotherapy alone is generally less effective for laryngeal cancer compared to surgical treatment, radiation therapy, or combinations thereof. A (surgical treatment) and C (radiation therapy with surgery) are more successful. B (radical neck dissection) is a specific surgical approach but still more effective than chemotherapy alone.