Nokea
O2 dissociation curve shift to R) by all of the following except
- A. Increase [H+]
- B. pCO2
- C. Increase temperature
- D. Carbon monoxide
Correct Answer: D
Rationale: The correct answer is D: Carbon monoxide. Carbon monoxide does not shift the O2 dissociation curve to the right (R) because it binds to hemoglobin with a higher affinity than oxygen, causing a leftward shift (L). Increased [H+], pCO2, and temperature all shift the curve to the right by decreasing hemoglobin's affinity for oxygen.
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The covering of the lung is called
- A. Pericardium
- B. Perichondrium
- C. Pleural membrane/ pleura
- D. Peritoneum
Correct Answer: C
Rationale: The correct answer is C: Pleural membrane/pleura. The pleural membrane is a double-layered serous membrane that covers the lungs. The visceral pleura is attached to the lung surface, while the parietal pleura lines the chest cavity. This arrangement helps reduce friction and allows the lungs to expand during breathing.
A: Pericardium covers the heart, not the lungs.
B: Perichondrium covers cartilage, not the lungs.
D: Peritoneum covers abdominal organs, not the lungs.
Therefore, the correct choice is C because it specifically refers to the covering of the lungs.
Nurse Maureen has assisted a physician with the insertion of a chest tube. The nurse monitors the client and notes fluctuation of the fluid level in the water seal chamber after the tube is inserted. Based on this assessment, which action would be appropriate?
- A. Inform the physician.
- B. Continue to monitor the client.
- C. Reinforce the occlusive dressing.
- D. Encourage the client to deep breathe.
Correct Answer: B
Rationale: The correct answer is B: Continue to monitor the client. Fluctuation of fluid level in the water seal chamber post chest tube insertion indicates proper functioning of the chest tube system. This signifies that the tube is effectively draining fluid or air from the pleural space. It is essential to continue monitoring the client to ensure ongoing proper functioning of the chest tube. Informing the physician (Choice A) is not necessary at this point unless there are other concerning symptoms. Reinforcing the occlusive dressing (Choice C) is not indicated unless there is a leak or issue with the dressing. Encouraging the client to deep breathe (Choice D) is unrelated to the assessment of the chest tube system.
Under quiet conditions, blood returning to the heart retains about ________ of its oxygen content.
- A. 25 percent
- B. 50 percent
- C. 75 percent
- D. 90 percent
Correct Answer: C
Rationale: The correct answer is C (75 percent) because under quiet conditions, the venous blood returning to the heart still contains a significant amount of oxygen due to the efficient extraction of oxygen by tissues. This oxygen extraction process typically leaves around 25 percent of oxygen in the venous blood, which is then returned to the heart. Choices A (25 percent), B (50 percent), and D (90 percent) are incorrect because they do not accurately reflect the amount of oxygen retained in the blood under quiet conditions. Option A (25 percent) is the amount typically extracted by tissues, so it cannot be the correct answer. Option B (50 percent) is too high, as more oxygen is extracted by tissues. Option D (90 percent) is also too high, as it overestimates the amount of oxygen retained in venous blood.
While assessing an acutely ill patient's respiratory rate, the nurse assesses four normal breaths followed by an episode of apnea lasting 20 seconds. How should the nurse document this finding?
- A. Eupnea
- B. Apnea
- C. Biot's respiration
- D. Cheyne-Stokes
Correct Answer: C
Rationale: The correct answer is C: Biot's respiration. Biot's respiration is characterized by regular breathing interrupted by periods of apnea. In this scenario, the nurse observed normal breaths followed by a 20-second episode of apnea, which aligns with Biot's respiration. It is crucial to document this finding accurately to ensure appropriate care.
Incorrect answers:
A: Eupnea refers to normal breathing without any interruptions or irregularities. The presence of apnea in the scenario rules out eupnea.
B: Apnea would be an incomplete assessment as it does not capture the alternating pattern of normal breaths and apnea observed in Biot's respiration.
D: Cheyne-Stokes breathing involves a cyclical pattern of gradually increasing and decreasing breathing rates, which is not evident in the scenario described.
The nurse assesses wheezes in a patient with asthma and realizes that these breath sounds result from:
- A. Increased thickness of respiratory secretions.
- B. Use of accessory muscles of respiration.
- C. Tachypnea and tachycardia.
- D. Movement of air through narrowed airways.
Correct Answer: D
Rationale: The correct answer is D because wheezes in asthma are caused by the movement of air through narrowed airways due to bronchoconstriction and inflammation. This narrowing leads to turbulent airflow, resulting in the characteristic high-pitched musical sound of wheezes. Increased thickness of respiratory secretions (A) may cause crackles, not wheezes. Use of accessory muscles (B) indicates respiratory distress but does not directly cause wheezes. Tachypnea and tachycardia (C) are common in asthma but do not directly cause wheezes. Thus, D is the most directly related to the pathophysiology of wheezes in asthma.