Nokea
In an older client, the alveolar walls become thinner and contain fewer capillaries. What does this condition lead to?
- A. Loss of elasticity in the lungs
- B. Decreased gas exchange
- C. Increased stiffness in lungs
- D. Decreased numbers of alveoli
Correct Answer: B
Rationale: The correct answer is B (Decreased gas exchange). Thinning alveolar walls and reduced capillary density directly impair the diffusion of gases across the alveolar-capillary membrane, leading to decreased gas exchange. While A (loss of elasticity) might occur with aging, it is not the primary consequence here. C (increased stiffness) is incorrect because stiffness typically results from fibrosis or other conditions, not thinning walls. D (decreased numbers of alveoli) could happen but is unrelated to the specific scenario described.
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A nurse cares for a client who has packing inserted for posterior nasal bleeding. What action would the nurse take first?
- A. Assess the client's pain level.
- B. Keep the client's head elevated.
- C. Teach the client about the causes of nasal bleeding.
- D. Assess the client's airway.
Correct Answer: D
Rationale: The correct answer is D: Assess the client's airway. This is the priority action as airway patency is always the top priority in any emergency situation. In this case, posterior nasal bleeding can lead to blood flow into the throat, potentially obstructing the airway. Ensuring the client's airway is clear and maintaining adequate oxygenation is crucial for their safety.
Choice A (Assess the client's pain level) is not the priority when there is a potential risk to the airway. Choice B (Keep the client's head elevated) may be done after confirming airway patency. Choice C (Teach the client about the causes of nasal bleeding) is important but not the immediate priority in this situation.
As the nurse responsible for this client's care, you anticipate which physician's orders?
- A. Endotracheal intubation and mechanical ventilation
- B. Immediate application of CPAP to client's nose and mouth
- C. Intravenous furosemide (Lasix) 100 mg IV push stat
- D. Call a CODE for respiratory arrest.
Correct Answer: A
Rationale: The correct answer is A. Poor oxygenation despite non-rebreather mask suggests impending respiratory failure, necessitating intubation and mechanical ventilation. CPAP (B) and Lasix (C) may be considered but are secondary. Calling a CODE (D) is only if respiratory arrest occurs.
In the lungs
- A. PCO2 in the alveoli is the same as that in the capillaries
- B. PO2 in the alveoli is the same as that in the capillaries
- C. PCO2 in the alveoli is higher than that in the capillaries
- D. PCO2 in the alveoli is lower than that in the capillaries
Correct Answer: D
Rationale: The correct answer is D because in the lungs, during gas exchange, carbon dioxide (CO2) is removed from the blood and exhaled. This leads to a lower PCO2 in the alveoli compared to the capillaries. The concentration gradient drives the diffusion of CO2 from the capillaries to the alveoli. Options A and B are incorrect because the partial pressure of CO2 (PCO2) and oxygen (PO2) differ between the alveoli and capillaries due to gas exchange. Option C is also incorrect as PCO2 is lower in the alveoli to facilitate the removal of CO2 from the blood.
Which area represents the work to overcome airway resistance?
- A. ABCEA
- B. ABCFA
- C. AECFA
- D. ABCDOA
Correct Answer: C
Rationale: The correct answer is C: AECFA. This sequence represents the flow of air through the respiratory system. Airway resistance is primarily overcome by the contraction and relaxation of the smooth muscles in the airways. The correct sequence includes the airway segments that actively participate in regulating airway resistance - the trachea (A), bronchi (E), and bronchioles (C and F). The other choices do not include the correct segments that are involved in overcoming airway resistance.
The impulse for voluntary muscles for forced breathing starts in
- A. Medulla ( pons )
- B. Vagus nerve
- C. Cerebral hemispheres
- D. Spinal cord
Correct Answer: A
Rationale: The correct answer is A: Medulla (pons). The medulla, located in the brainstem, controls involuntary functions like breathing. Specifically, the medulla contains the respiratory center, which regulates breathing rhythm and depth. During forced breathing, the medulla sends impulses to the voluntary muscles involved in breathing, such as the diaphragm and intercostal muscles. The pons, which is closely connected to the medulla, assists in regulating breathing patterns. The vagus nerve (B) is responsible for parasympathetic functions, not voluntary breathing. The cerebral hemispheres (C) are primarily involved in higher brain functions, not breathing regulation. The spinal cord (D) plays a role in transmitting signals between the brain and muscles but does not initiate voluntary breathing impulses.