Nokea
Hering Breuer Reflex serves as a protective mechanism to prevent
- A. Tracheal collapsing
- B. Excess lung inflation
- C. Excess oxygenation
- D. All these
Correct Answer: B
Rationale: The correct answer is B: Excess lung inflation. The Hering Breuer Reflex is triggered by stretch receptors in the lungs, which send signals to the brain to inhibit further inhalation and prevent overinflation of the lungs. This mechanism helps regulate breathing and prevents lung damage from excessive stretching. Choices A, C, and D are incorrect because the reflex specifically focuses on preventing overinflation of the lungs, not tracheal collapsing or excess oxygenation. Therefore, the correct answer is B as it aligns with the protective function of the Hering Breuer Reflex.
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The nurse is assessing the respiratory status of a patient who is experiencing an exacerbation of her emphysema symptoms. When preparing to auscultate, what breath sounds should the nurse anticipate?
- A. Absence of breath sounds
- B. Wheezing with discontinuous breath sounds
- C. Faint breath sounds with prolonged expiration
- D. Faint breath sounds with fine crackles
Correct Answer: C
Rationale: The correct answer is C: Faint breath sounds with prolonged expiration. In emphysema, the alveoli lose elasticity, leading to air trapping and difficulty in expiration. This results in faint breath sounds with prolonged expiration due to the decreased airflow. Absence of breath sounds (A) would indicate a serious issue like pneumothorax. Wheezing with discontinuous breath sounds (B) is more characteristic of asthma. Faint breath sounds with fine crackles (D) are typically heard in conditions like pneumonia or pulmonary fibrosis, not in emphysema.
The patient is apprehensive about undergoing bronchoscopy. He cannot imagine having anything inserted into his throat. What is the best response?
- A. The physician performs this procedure hundreds of times a week.
- B. The physician had it performed 3 years ago and he/she was fine.
- C. The thought of this procedure seems to be disturbing the patient. He/she will be asleep during this procedure. The physician should visit the patient again and answer any questions that he/she has regarding the procedure.
- D. The patient would not feel a thing. He/she will be fine.
Correct Answer: C
Rationale: The correct answer is C. Acknowledging the patient's anxiety and providing reassurance while addressing concerns is the best approach. A and B are inappropriate as they dismiss the patient's feelings. D oversimplifies the procedure.
The theophylline blood level is 13 mcg/mL. Which intervention is the most appropriate in light of this finding?
- A. Give the next dose of theophylline as ordered.
- B. Skip the next dose, and then resume.
- C. Call the charge nurse or physician.
- D. Take the patient's blood pressure immediately.
Correct Answer: A
Rationale: The correct answer is A because the theophylline blood level of 13 mcg/mL is within the therapeutic range (10-20 mcg/mL). Therefore, the next dose should be administered as ordered to maintain therapeutic levels. Choice B is incorrect as skipping doses can lead to subtherapeutic levels. Choice C is unnecessary as the level is within range. Choice D is irrelevant to the theophylline level.
In human beings, CO2 concentration in the inspired and expired air is respectively
- A. 0.03 % and 5.3 %
- B. 0.4 % and 5.0 %
- C. 0.04 % and 3.0 %
- D. 0.03 % and 4.0 %
Correct Answer: D
Rationale: The correct answer is D (0.03% and 4.0%). The inspired air contains approximately 0.03% CO2, as the atmosphere has a low CO2 concentration. During expiration, the CO2 concentration in the air increases due to the removal of oxygen and the addition of CO2 from cellular respiration, resulting in an average of around 4.0% CO2 in expired air. Choices A, B, and C are incorrect because they do not accurately reflect the typical CO2 concentrations in inspired and expired air in human beings.
Nurse Joy is caring for a client after a bronchoscopy and biopsy. Which of the following signs, if noticed in the client, should be reported immediately to the physician?
- A. Dry cough
- B. Hematuria
- C. Bronchospasm
- D. Blood-streaked sputum
Correct Answer: C
Rationale: The correct answer is C: Bronchospasm. Bronchospasm is a serious complication after a bronchoscopy that can lead to respiratory distress. It requires immediate medical attention to prevent further complications. A dry cough (A) may be expected post-procedure. Hematuria (B) is unrelated to a bronchoscopy. Blood-streaked sputum (D) is common after a biopsy and may not require immediate attention unless it becomes excessive. Reporting bronchospasm promptly is crucial in preventing respiratory compromise.