Nokea
Pain with chronic stable angina is due to:
- A. Rubbing of epicardium against the pericardial sac.
- B. Insufficient blood flow due to narrowing of the coronary arteries
- C. Irritation of cardiac nerve endings in the chest wall
- D. Dilation of the coronary arteries to increase blood flow
Correct Answer: B
Rationale: The correct answer is B because chronic stable angina is caused by insufficient blood flow due to narrowing of the coronary arteries, leading to inadequate oxygen supply to the heart muscle during exertion. This results in chest pain.
A is incorrect as there is no rubbing of epicardium against the pericardial sac in chronic stable angina.
C is incorrect as the pain is not due to irritation of cardiac nerve endings in the chest wall.
D is incorrect as dilation of the coronary arteries does not cause pain in chronic stable angina; it is actually a compensatory mechanism to increase blood flow in response to decreased oxygen supply.
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Following a motor vehicle accident, the nurse assesses the driver for which distinctive sign of flail chest?
- A. Severe hypotension
- B. Chest pain over ribs
- C. Absence of breath sounds
- D. Paradoxical chest movement
Correct Answer: D
Rationale: Flail chest is characterized by paradoxical chest movement, where a segment of the chest wall moves in the opposite direction during breathing. This can lead to respiratory compromise and requires careful monitoring and management.
A 10 percent increase in the level of carbon dioxide in the blood will
- A. decrease the rate of breathing
- B. double the respiratory rate
- C. decrease pulmonary ventilation
- D. decrease the alveolar ventilation rate
Correct Answer: B
Rationale: A 10% increase in CO2 levels triggers chemoreceptors to signal the brainstem, increasing the respiratory rate to eliminate excess CO2. This is known as hypercapnia-induced hyperventilation. Option A is incorrect because an increase in CO2 levels would not decrease the rate of breathing. Option C is incorrect because an increase in CO2 would actually stimulate an increase in pulmonary ventilation to remove the excess CO2. Option D is incorrect because alveolar ventilation (gas exchange in the lungs) would increase, not decrease, to maintain proper oxygen and CO2 levels in the body.
In pleurisy,
- A. some of the alveoli fill with fluid.
- B. the pleural membrane becomes inflamed and swollen and causes painful breathing.
- C. the diaphragm develops muscular cramps.
- D. the vagus nerve is irritated
Correct Answer: B
Rationale: The correct answer is B because pleurisy is inflammation of the pleural membrane, causing pain during breathing due to friction between the inflamed layers. Choice A is incorrect as alveoli are not directly affected in pleurisy. Choice C is incorrect as pleurisy does not cause cramps in the diaphragm. Choice D is incorrect as the vagus nerve irritation is not a characteristic feature of pleurisy.
A nurse performs an admission assessment on a client with a diagnosis of tuberculosis. The nurse reviews the results of which diagnostic test that will confirm this diagnosis?
- A. Bronchoscopy.
- B. Sputum culture.
- C. Chest x-ray.
- D. Tuberculin skin test.
Correct Answer: B
Rationale: The correct answer is B: Sputum culture. This test confirms the diagnosis of tuberculosis by identifying the presence of Mycobacterium tuberculosis in the sputum sample. It is the gold standard for diagnosing active tuberculosis. Bronchoscopy (A) is invasive and used to visualize the airways, not for confirming TB diagnosis. Chest x-ray (C) may show characteristic findings of TB, but it does not confirm the diagnosis. Tuberculin skin test (D) only indicates exposure to TB bacteria, not active infection.
A patient reports sudden difficulty breathing with tachypnea and tachycardia and localized chest pain. The physician suspects a pulmonary embolism. What test would you expect the physician to order?
- A. Helical CT scan.
- B. EKG.
- C. ECC.
- D. Vital capacity.
Correct Answer: A
Rationale: The correct answer is A. A helical CT scan is the most appropriate test to diagnose pulmonary embolism due to its high sensitivity and specificity. EKG (B) and ECC (C) assess cardiac function but do not confirm PE. Vital capacity (D) measures lung function, which is irrelevant here.