Nokea
Haldane effect refers to
- A. Increased CO2 uptake to minimize CO2 tension
- B. Increased O2 tension
- C. Decreased CO2 tension
- D. Decreases O2 tension
Correct Answer: A
Rationale: The correct answer is A: Increased CO2 uptake to minimize CO2 tension. The Haldane effect describes how the blood's ability to carry CO2 increases as oxygen levels decrease. When oxygen binds to hemoglobin, it displaces CO2, allowing more CO2 to be carried by the blood. This phenomenon is crucial in the exchange of gases in the lungs and tissues.
Choice B is incorrect as the Haldane effect is related to CO2, not O2 tension. Choice C is incorrect as the Haldane effect leads to increased CO2 uptake, not decreased. Choice D is incorrect as it states decreases O2 tension, which is not directly related to the Haldane effect.
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A male client who weighs 175 lb (79.4 kg) is receiving aminophylline (Aminophylline) (400 mg in 500 ml) at 50 ml/hour. The theophylline level is reported as 6 mcg/ml. The nurse calls the physician who instructs the nurse to change the dosage to 0.45 mg/kg/hour. The nurse should:
- A. Question the order because it's too low.
- B. Question the order because it's too high.
- C. Set the pump at 45 ml/hour.
- D. Stop the infusion and have the laboratory repeat the theophylline measurement.
Correct Answer: A
Rationale: The correct answer is A: Question the order because it's too low. To determine the correct dosage, calculate the current dosage the client is receiving (400 mg in 500 ml at 50 ml/hour). Then calculate the new dosage using the client's weight (79.4 kg). Comparing the two dosages, if the new order is significantly lower than the current dosage, it may not be appropriate for the client's condition. Therefore, the nurse should question the physician's order to ensure the client is receiving an adequate dose. Choices B, C, and D are incorrect because they do not address the discrepancy in dosage and the need to verify the appropriateness of the new order based on the client's weight and current medication regimen.
The nurse reading a tuberculin skin test (TST) on a new employee who lives in the Midwest,
is 20-years-old, and has no known history of contact with any people with tuberculosis (TB).
The nurse should interpret the reading as positive if the area around the injection site has an
induration of how many millimeters?
- A. 0 mm
- B. 5 mm
- C. 10 mm
- D. 15 mm
Correct Answer: D
Rationale: The correct answer is D (15 mm) because for a low-risk individual like the new employee, a TST is considered positive if the induration is 15 mm or greater. This is based on the guidelines from the Centers for Disease Control and Prevention (CDC) for interpreting TST results in individuals without known risk factors. Choices A, B, and C are incorrect because an induration of 0 mm, 5 mm, or 10 mm, respectively, would not meet the criteria for a positive TST in this low-risk individual. It is important to consider the individual's risk factors and follow established guidelines to accurately interpret TST results.
Which intervention for airway management should you delegate to the nursing assistant?
- A. Assist client to sit up on side of bed.
- B. Instruct client to cough effectively.
- C. Teach client to use incentive spirometry.
- D. Auscultate breath sounds every 4 hours.
Correct Answer: A
Rationale: The correct answer is A. Assisting the client to sit up is a basic intervention suitable for a nursing assistant. Instructing effective coughing (B) and teaching incentive spirometry (C) require more skill. Auscultating breath sounds (D) is outside the scope of practice for a nursing assistant.
A 68-year-old male is being admitted to the hospital for an exacerbation of his COPD. The nurse is developing his plan of care. The nurse can expect that this client will?
- A. Be placed on 10 L of oxygen per nasal cannula.
- B. Be placed in respiratory isolation.
- C. Require frequent rest periods throughout the day.
- D. Be placed on fluid restriction.
Correct Answer: C
Rationale: The correct answer is C: Require frequent rest periods throughout the day. This is because patients with COPD often experience shortness of breath and fatigue, necessitating frequent rest periods to conserve energy and manage symptoms. Oxygen therapy is typically started at a lower flow rate (2-4 L/min) to avoid suppressing the patient's respiratory drive, so option A is not appropriate. Respiratory isolation is unnecessary for COPD exacerbation, as it is not a contagious condition, making option B incorrect. Fluid restriction is not typically indicated for COPD exacerbation unless the patient has comorbid conditions like heart failure, so option D is not the priority.
Which of these statements is false regarding Pulmonary Resistance?
- A. Increase in pulmonary arterial pressure generally cause a fall in pulmonary resistance
- B. Pulmonary resistance is only 1/10 of systemic circulation resistance
- C. Increase of lung volume results in increase of resistance in extra alveolar vessels
- D. Acetylcholine has a good bronchiole smooth muscle relaxation effect
Correct Answer: C
Rationale: Rationale for Correct Answer (C):
- Increase of lung volume results in decrease, not increase, in resistance in extra alveolar vessels due to increased recruitment of capillaries.
- This is known as distension recruitment, which helps reduce resistance in extra alveolar vessels.
- Increased lung volume also helps to distribute blood flow more evenly in the lungs, reducing resistance.
- Therefore, statement C is false.
Summary of Incorrect Choices:
A: True - increase in pulmonary arterial pressure generally causes a fall in pulmonary resistance due to vessel dilation.
B: True - pulmonary resistance is indeed lower than systemic circulation resistance due to shorter pulmonary vascular bed.
D: True - acetylcholine causes bronchiole smooth muscle contraction, not relaxation.