Nokea
In human beings, rib case and sternum move upwardly and outwardly during
- A. Exercise
- B. Sudden back injury
- C. Expiration
- D. Inspiration
Correct Answer: D
Rationale: During inspiration, the diaphragm contracts and moves downward, while the intercostal muscles contract to lift the rib cage and sternum upward and outward to increase lung volume for air intake. This creates a negative pressure in the lungs, allowing air to be drawn in. In contrast, expiration involves relaxation of the diaphragm and intercostal muscles, leading to the rib cage and sternum moving downward and inward to expel air. Therefore, the correct answer is D: Inspiration. Choices A, B, and C are incorrect as they do not specifically involve the physiological process of rib cage and sternum movement related to breathing.
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The ________ circulation picks up oxygen for cellular use and drops off carbon dioxide for removal from the body.
- A. pulmonary
- B. interlobular
- C. respiratory
- D. bronchial
Correct Answer: A
Rationale: The correct answer is A: pulmonary. The pulmonary circulation involves the flow of blood between the heart and the lungs. In this circulation, deoxygenated blood from the body is pumped to the lungs to pick up oxygen and release carbon dioxide. The oxygenated blood is then returned to the heart to be pumped to the rest of the body. The other choices (B: interlobular, C: respiratory, D: bronchial) are incorrect because they do not specifically refer to the circulation responsible for oxygenating blood and removing carbon dioxide in the lungs. Instead, they relate to other structures or functions within the respiratory system.
The nurse on the intermediate care unit received a change-of-shift report on four patients with hypertension. Which patient should the nurse assess first?
- A. 48-yr-old with a blood pressure of 160/92 mm Hg who reports chest pain
- B. 52-yr-old with a blood pressure of 198/90 mm Hg who has leg cramping
- C. 50-yr-old with a blood pressure of 190/104 mm Hg who has a creatinine of 1.1 mg/dL
- D. 43-yr-old with a blood pressure of 172/98 mm Hg whose urine shows microalbuminuria.
Correct Answer: A
Rationale: The correct answer is A. The nurse should assess the 48-yr-old with a blood pressure of 160/92 mm Hg who reports chest pain first because chest pain can be a sign of a cardiac issue, which could be life-threatening. Assessing this patient first is crucial to rule out any acute cardiac events. Leg cramping (choice B) is a common symptom in hypertensive patients but is not as urgent as chest pain. High creatinine levels (choice C) may indicate kidney issues but do not require immediate assessment compared to chest pain. Microalbuminuria (choice D) is a sign of kidney damage in hypertension but does not pose an immediate threat like chest pain.
The nurse is caring for a first-day postoperative thoracotomy patient. The nurse assesses that
the level of drainage has not increased over the last 3 hours. After assessing the patient’s
respiratory status, what should the nurse do next?
- A. Raise the system above the patient's heart.
- B. Check the tubing for kinks.
- C. Reposition the patient.
- D. Notify the physician.
Correct Answer: B
Rationale: The correct answer is B: Check the tubing for kinks. This is the best next step because stagnant drainage could be caused by a kink in the tubing, obstructing proper drainage. By checking for kinks, the nurse ensures proper functioning of the drainage system, preventing potential complications such as fluid buildup or infection.
Raising the system above the patient's heart (A) may not address the underlying issue of kinked tubing. Repositioning the patient (C) may not be necessary if the drainage is not related to patient positioning. Notifying the physician (D) should be done after checking the tubing for kinks, as it is important to troubleshoot and address the issue promptly.
Which assessment findings aren't consistent with a client diagnosis of right-sided heart failure?
- A. Collapsed neck veins
- B. Distended abdomen
- C. Dependent edema
- D. Decreased appetite
Correct Answer: A
Rationale: The correct answer is A because collapsed neck veins are not consistent with right-sided heart failure. In right-sided heart failure, venous congestion leads to jugular venous distention, not collapse. Distended abdomen (choice B) occurs due to fluid accumulation in the abdomen, a common finding in right-sided heart failure. Dependent edema (choice C) results from fluid retention in the lower extremities, also seen in right-sided heart failure. Decreased appetite (choice D) can be present due to abdominal discomfort from fluid accumulation. Therefore, the presence of collapsed neck veins is the only assessment finding that is not indicative of right-sided heart failure.
Which of the following should the nurse include in the teaching plan of a client with acute bronchitis?
- A. Not coughing frequently
- B. Consuming adequate calories
- C. Washing the hands frequently
- D. Encouraging a semi-Fowler’s position
Correct Answer: C
Rationale: The correct answer is C. Frequent handwashing prevents the spread of infection, which is crucial in managing acute bronchitis. A (not coughing frequently) is impractical and counterproductive. B (consuming adequate calories) supports general health but is not specific. D (semi-Fowler’s position) may aid breathing but is not a primary teaching point.