Nokea
Most of the carbon dioxide in the blood is transported as
- A. solute dissolved in the plasma
- B. carbaminohemoglobin
- C. bicarbonate ions
- D. solute dissolved in the cytoplasm of red blood cells
Correct Answer: C
Rationale: The correct answer is C: bicarbonate ions. Carbon dioxide in the blood mainly combines with water to form carbonic acid, which dissociates into bicarbonate ions and hydrogen ions. The majority of carbon dioxide is transported in the blood as bicarbonate ions. This process occurs in red blood cells via the enzyme carbonic anhydrase. Choices A and D are incorrect as carbon dioxide mainly combines with water and does not remain as a solute in plasma or cytoplasm. Choice B, carbaminohemoglobin, is a minor way carbon dioxide is transported, where a small amount binds to hemoglobin, but the majority is transported as bicarbonate ions.
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You are supervising a nursing student who is providing care for a thoracotomy client with a chest tube. What finding will you clearly instruct the nursing student to notify you about immediately?
- A. Chest tube drainage of 10-15 mL per hour
- B. Continuous bubbling in the water seal chamber
- C. Complaints of pain at the chest tube site
- D. Chest tube dressing dated yesterday.
Correct Answer: B
Rationale: The correct answer is B. Continuous bubbling in the water seal chamber indicates an air leak and potential complications. Drainage of 10-15 mL/hour (A) is normal. Pain complaints (C) and outdated dressing (D) are less urgent.
A nurse assesses clients on the medical-surgical unit. Which client is at greatest risk for development of obstructive sleep apnea?
- A. A 26-year-old woman who is 8 months pregnant.
- B. A 42-year-old man with gastroesophageal reflux disease.
- C. A 55-year-old woman who is 50 lb (23 kg) overweight.
- D. A 73-year-old man with type 2 diabetes mellitus.
Correct Answer: C
Rationale: The correct answer is C, a 55-year-old woman who is 50 lb overweight. Obesity is a major risk factor for obstructive sleep apnea (OSA) due to excess fat in the neck area that can obstruct the airway during sleep. This increases the likelihood of experiencing breathing pauses. Pregnancy (choice A) may cause temporary OSA due to hormonal changes, but it's not the greatest risk factor among the options provided. Gastroesophageal reflux disease (choice B) and type 2 diabetes mellitus (choice D) are associated with sleep disturbances, but they are not as directly linked to OSA as obesity.
A client has been diagnosed with lung cancer and requires lobectomy. How much of the lung is removed?
- A. One entire lung.
- B. A lobe of the lung.
- C. A small, localized area near the surface of the lung.
- D. One entire lung.
Correct Answer: B
Rationale: The correct answer is B: A lobe of the lung. During a lobectomy, a lobe of the lung is surgically removed, typically to treat lung cancer while preserving the remaining lung tissue. Removing one entire lung (choices A and D) is not necessary for a lobectomy and would be a more extensive procedure. Choice C, removing a small localized area near the surface of the lung, does not accurately reflect the extent of tissue removal required for a lobectomy. Therefore, the correct choice is B as it specifically addresses the removal of a lobe during the surgical procedure.
If the thoracic wall but not lungs is punctured
- A. The lungs get inflated
- B. The man dies as lungs get collapsed
- C. The breathing rate decrease
- D. The breathing rate increase
Correct Answer: B
Rationale: The correct answer is B because if the thoracic wall is punctured but not the lungs, air will enter the pleural cavity causing a pneumothorax. This leads to lung collapse and can result in death due to impaired gas exchange. Choices A and C are incorrect as the lungs do not get inflated and breathing rate does not decrease. Choice D is incorrect as the breathing rate actually increases in response to the decreased lung function.
A medical nurse has admitted a patient to the unit with a diagnosis of failure to thrive. The patient has developed a fever and cough, so a sputum specimen has been obtained. The nurse notes that the sputum is greenish and that there is a large quantity of it. The nurse notifies the patient's physician because these symptoms are suggestive of what?
- A. Pneumothorax
- B. Lung tumors
- C. Infection
- D. Pulmonary edema
Correct Answer: C
Rationale: The correct answer is C: Infection. The greenish color and large quantity of sputum suggest an infection in the lungs, typically caused by bacteria. Greenish sputum is often a sign of bacterial pneumonia. Fever and cough are common symptoms of a lung infection, along with increased sputum production. Pneumothorax (A) is characterized by a collapsed lung and does not typically present with greenish sputum. Lung tumors (B) may cause cough and sputum production, but the color of the sputum is not specific to tumors. Pulmonary edema (D) is a condition where fluid accumulates in the lungs, leading to shortness of breath and pink, frothy sputum, not greenish sputum.