Nokea
Hemoglobin's affinity for oxygen when the BPG level is high is
- A. greater than hemoglobin's affinity for oxygen when the BPG level is low
- B. less than hemoglobin's affinity for oxygen when the BPG level is low
- C. equal to hemoglobin's affinity for oxygen when the BPG level is low
- D. equal to hemoglobin's affinity for oxygen when pH is low
Correct Answer: B
Rationale: The correct answer is B: less than hemoglobin's affinity for oxygen when the BPG level is low. When the 2,3-bisphosphoglycerate (BPG) level is high, it binds to hemoglobin and decreases its affinity for oxygen. This results in easier unloading of oxygen to tissues. In contrast, when the BPG level is low, hemoglobin's affinity for oxygen is higher, making it harder to release oxygen to tissues. Choices A and C are incorrect because high BPG levels decrease hemoglobin's affinity for oxygen, making it less than when BPG levels are low. Choice D is incorrect because pH levels do not directly affect hemoglobin's affinity for oxygen in the context of this question.
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diaphragm relaxes and decrease thoracic space in which phase of respiration.
- A. inspiration
- B. expiration
- C. Pause
- D. both a and b
Correct Answer: B
Rationale: During expiration, the diaphragm relaxes, causing it to move upwards, which decreases the thoracic space. This leads to the expulsion of air from the lungs. In contrast, during inspiration, the diaphragm contracts and moves downwards, increasing the thoracic space to allow air to enter the lungs. Option C, Pause, does not involve any specific respiratory phase. Option D, both a and b, is incorrect because during inspiration, the diaphragm contracts and increases thoracic space. Therefore, the correct answer is B, expiration, as this phase specifically involves the relaxation of the diaphragm and the decrease in thoracic space.
A patient with active TB continues to have positive sputum cultures after 6 months of treatment. She says she cannot remember to take the medication all the time. What is the best action for the nurse to take?
- A. Schedule the patient to come to the clinic every day to take the medication.
- B. Have a patient who has recovered from TB tell the patient about his successful treatment.
- C. Schedule more teaching sessions so the patient will understand the risks of noncompliance.
- D. Arrange for directly observed therapy by a responsible family member or a public health nurse.
Correct Answer: D
Rationale: Directly observed therapy by a responsible family member or a public health nurse is the best action to ensure adherence to TB treatment and prevent further drug resistance.
How is a client positioned for a thoracentesis?
- A. The client sits at the side of the bed.
- B. The client lies on the affected side.
- C. The client lies flat on the back.
- D. The client lies down with the head raised.
Correct Answer: A
Rationale: The correct answer is A. For thoracentesis, the client typically sits at the edge of the bed, leaning forward with arms supported on a table or over their knees to spread out the intercostal spaces and stabilize the chest wall. B is incorrect because lying on the affected side would compress the area being accessed. C is wrong as lying flat reduces access to the pleural space. D is incorrect because raising the head is not standard positioning for this procedure.
What is the primary principle involved in the various airway clearance devices used for mobilizing secretions?
- A. Vibration
- B. Inhalation therapy
- C. Chest physiotherapy
- D. Positive expiratory pressure
Correct Answer: D
Rationale: The primary principle involved in airway clearance devices used for mobilizing secretions is positive expiratory pressure, which helps in loosening and moving mucus from the airways.
A client has a tracheostomy tube in place. When the nurse suctions the client food particles are noted. What action by the nurse is best?
- A. Elevate the head of the client's bed.
- B. Measure and compare cuff pressures.
- C. Place the client on NPO status.
- D. Request that the client have a swallow study.
Correct Answer: B
Rationale: The correct answer is B: Measure and compare cuff pressures. When food particles are noted during suctioning, it indicates a potential issue with the tracheostomy tube cuff. By measuring and comparing cuff pressures, the nurse can ensure the cuff is properly inflated to prevent aspiration of food particles into the lungs. Elevating the head of the bed (choice A) is a standard practice for preventing aspiration but does not address the specific issue of cuff pressure. Placing the client on NPO status (choice C) is not necessary if the cuff pressure is the main concern. Requesting a swallow study (choice D) may be needed eventually but is not the immediate priority when food particles are already present.