Nokea
For which client(s) would you assign the nursing care to the new RN under your supervision? (Choose all that apply.)
- A. A 38-year-old client with moderate persistent asthma awaiting discharge
- B. A 63-year-old client with tracheostomy needing trach care every shift
- C. A 56-year-old client with lung cancer just returned from left lower lobectomy
- D. A 49-year-old new admission client with new diagnosis of esophageal cancer
Correct Answer: D
Rationale: The correct answer includes A and D. Assigning care for clients with moderate persistent asthma (A) and a new diagnosis of esophageal cancer (D) is appropriate for a new RN under supervision. Clients requiring tracheostomy care (B) or post-lobectomy recovery (C) involve complex care unsuitable for a new RN.
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The most important factor in determining the percent of oxygen saturation of hemoglobin
- A. The partial pressure of o2
- B. acidity
- C. the partial of co2
Correct Answer: A
Rationale: The correct answer is A: The partial pressure of O2. Oxygen saturation of hemoglobin is directly related to the partial pressure of oxygen in the blood. As the partial pressure of O2 increases, more oxygen binds to hemoglobin, leading to higher oxygen saturation. Acidity (choice B) and the partial pressure of CO2 (choice C) can influence the oxygen-hemoglobin dissociation curve, but they are not the primary factors determining oxygen saturation. Choice D is incomplete and not relevant to the question.
A 17-year-old male is admitted following an automobile accident. He is very anxious, dyspneic, and in severe pain. The left chest wall moves in during inspiration and balloons out when he exhales. The nurse understands these symptoms are most suggestive of?
- A. Hemothorax
- B. Flail chest
- C. Atelectasis
- D. Pleural effusion
Correct Answer: B
Rationale: The correct answer is B: Flail chest. Flail chest is characterized by paradoxical movement of a segment of the chest wall due to multiple rib fractures. In this case, the left chest wall moving in during inspiration and out during expiration indicates this paradoxical movement. This leads to ineffective breathing, causing dyspnea and anxiety. Hemothorax (A) is accumulation of blood in the pleural cavity, not associated with chest wall movement. Atelectasis (C) is collapse of lung tissue, not associated with chest wall movement. Pleural effusion (D) is accumulation of fluid in the pleural space, also not associated with paradoxical chest wall movement.
Alveolar ventilation in a male with a respiratory rate of 10/min and tidal volume of 600 ml is
- A. 1000ml
- B. 1750 ml
- C. 3000ml
- D. 4500ml
Correct Answer: D
Rationale: The correct answer is D: 4500ml. Alveolar ventilation is calculated by multiplying tidal volume by respiratory rate. In this case, 600ml (tidal volume) x 10/min (respiratory rate) = 6000ml/min. However, we need to consider dead space ventilation, which is about 150ml. Therefore, the final alveolar ventilation is 6000ml/min - 150ml = 5850ml/min. Since the question asks for alveolar ventilation per minute, the correct answer is the closest option, which is D: 4500ml.
Choices A, B, and C are incorrect because they do not accurately reflect the calculation of alveolar ventilation based on the provided respiratory rate, tidal volume, and dead space ventilation.
Hemoglobin affinity for Oxygen is to the P50 (O2 tension that produces 50% saturation of Hb)
- A. Directly related
- B. Inversely related
- C. Not related
- D. Related
Correct Answer: B
Rationale: The correct answer is B. Hemoglobin affinity for oxygen is inversely related to P50. When P50 is lower, hemoglobin has higher affinity for oxygen, meaning it binds oxygen more readily at lower oxygen tensions. Conversely, when P50 is higher, hemoglobin has lower affinity for oxygen. This relationship is crucial for the efficient loading and unloading of oxygen in tissues. Choices A, C, and D are incorrect because hemoglobin affinity for oxygen is not directly related, unrelated, or simply related to P50.
Why may an ice collar be ordered for a client who is undergoing drainage of a peritonsillar abscess?
- A. To reduce swelling and pain
- B. To help the client drink fluids
- C. To prevent respiratory obstruction
- D. To prevent excessive bleeding
Correct Answer: A
Rationale: The correct answer is A. An ice collar reduces swelling and pain by constricting blood vessels and numbing the area. B (helping the client drink fluids) is unrelated. C (preventing respiratory obstruction) is not the primary purpose of an ice collar. D (preventing excessive bleeding) is managed differently, usually with direct pressure or medication.