Nokea
Nurse Reese is caring for a client hospitalized with acute exacerbation of chronic obstructive pulmonary disease. Which of the following would the nurse expect to note on assessment of this client?
- A. Hypocapnia
- B. A hyperinflated chest noted on the chest x-ray.
- C. Increased oxygen saturation with exercise.
- D. A widened diaphragm noted on the chest x-ray.
Correct Answer: B
Rationale: The correct answer is B: A hyperinflated chest noted on the chest x-ray. In COPD, air trapping leads to hyperinflation of the lungs, causing the chest to appear hyperinflated on x-ray. This is due to the increased residual volume and decreased expiratory flow rates in COPD.
Incorrect choices:
A: Hypocapnia is unlikely in COPD as patients typically retain carbon dioxide due to impaired gas exchange.
C: Increased oxygen saturation with exercise is unlikely in COPD as these patients often have decreased oxygen saturation due to impaired gas exchange.
D: A widened diaphragm would not be a typical finding on chest x-ray in COPD; hyperinflated lungs are more characteristic.
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How much does the inspired O2 concentration have to be raised to abolish the hypoxaemia?
- A. 5%
- B. 7%
- C. 10%
- D. 15%
Correct Answer: B
Rationale: The correct answer is B (7%). To abolish hypoxemia, inspired O2 concentration needs to be increased sufficiently to raise arterial oxygen levels. A 7% increase is generally effective in achieving this without causing oxygen toxicity. Choices A, C, and D are incorrect because a 5% increase may not be enough to abolish hypoxemia, a 10% increase can lead to oxygen toxicity, and a 15% increase is excessive and unnecessary for treating hypoxemia. Therefore, option B is the most appropriate and balanced choice for addressing hypoxemia effectively.
Which of the following describes a correct order of structures in the respiratory passageways?
- A. pharynx, trachea, larynx, bronchi, bronchioles
- B. larynx, pharynx, trachea, bronchioles, bronchi
- C. trachea, pharynx, larynx, bronchi, bronchioles
- D. pharynx, larynx, trachea, bronchi, bronchioles
Correct Answer: D
Rationale: The correct order of structures in the respiratory passageways is D: pharynx, larynx, trachea, bronchi, bronchioles. This is the correct order because air enters the body through the pharynx, then passes through the larynx (voice box), followed by the trachea (windpipe), which branches into the bronchi, and then further divides into bronchioles. The other choices are incorrect because they do not follow the natural flow of air through the respiratory system. Choice A has the incorrect order starting with the pharynx, followed by the trachea, larynx, bronchi, and bronchioles. Choice B starts with the larynx, then pharynx, trachea, bronchioles, and bronchi, which is out of sequence. Choice C begins with the trachea, then pharynx, larynx, bronchi, and bronchioles, which is also incorrect
Which of the following is a risk factor for developing heart failure?
- A. Regular exercise
- B. Low blood cholesterol levels
- C. Smoking
- D. Adequate sleep
Correct Answer: C
Rationale: The correct answer is C: Smoking. Smoking is a risk factor for developing heart failure because it damages the blood vessels, increases blood pressure, and reduces oxygen delivery to the heart. Regular exercise (A) is actually beneficial for heart health. Low blood cholesterol levels (B) are generally considered a positive factor for heart health. Adequate sleep (D) is important for overall well-being but is not a direct risk factor for heart failure. In conclusion, smoking (C) stands out as the correct answer due to its harmful effects on the cardiovascular system.
The nurse is teaching a client with obstructive sleep apnea (OSA) about the prescribed CPAP. What information does the nurse NOT include?
- A. Insurance will cover the cost if you wear it at least 4 hours a day.
- B. Once the delivery mask is adjusted, do not loosen the straps.
- C. The CPAP provides pressure that holds your upper airways open.
- D. You need to clean the mask at least once a week to prevent infection.
Correct Answer: A
Rationale: The correct answer is A because insurance coverage for CPAP machines is generally not based on the number of hours it is worn per day but rather on medical necessity. The nurse would not include this information as it could lead to misunderstanding and incorrect assumptions. Choice B is incorrect because adjusting the mask may be necessary for comfort. Choice C is correct as CPAP does provide pressure to keep airways open. Choice D is also correct as cleaning the mask regularly is essential to prevent infections.
The nurse is performing an occupational history as part of the respiratory assessment. Which occupation(s) place the patient isn't at increased risk for an occupational lung disorder?
- A. A firefighter
- B. A cotton gin worker
- C. A construction contractor
- D. A bartender
Correct Answer: D
Rationale: The correct answer is D: A bartender. Bartenders are not typically exposed to occupational lung hazards like smoke, dust, or chemicals. Firefighters (A), cotton gin workers (B), and construction contractors (C) are all at increased risk due to exposure to smoke, cotton dust, and construction materials, respectively. As a result, the bartender is the least likely to develop an occupational lung disorder compared to the other professions listed.