Nokea
Regarding oxygen transport
- A. The predominant way oxygen is transported in the blood is as dissolved oxygen
- B. 1 gram of pure Hb can combine with 1.34 - 1.39 ml of oxygen
- C. An anaemic patient has a lowered arterial pO2 because the Hb is low
- D. CO2 is 200 times more soluble than oxygen
Correct Answer: B
Rationale: The correct answer is B: 1 gram of pure Hb can combine with 1.34 - 1.39 ml of oxygen. This is correct because each gram of hemoglobin can bind with approximately 1.34 - 1.39 ml of oxygen, facilitating efficient oxygen transport in the blood.
A is incorrect because while a small amount of oxygen is transported as dissolved oxygen, the majority is transported bound to hemoglobin.
C is incorrect because arterial pO2 reflects the oxygen content in the blood, not just the hemoglobin levels.
D is incorrect because CO2 is actually 20 times more soluble than oxygen, not 200 times.
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Which of the following structures is not part of the bronchial tree?
- A. alveoli
- B. bronchi
- C. terminal bronchioles
- D. respiratory bronchioles
Correct Answer: A
Rationale: The correct answer is A: alveoli. The alveoli are not part of the bronchial tree; they are the tiny air sacs at the end of the bronchial tree where gas exchange occurs. The bronchial tree consists of the bronchi, terminal bronchioles, and respiratory bronchioles, which are responsible for conducting air into the lungs. Alveoli are located at the end of the respiratory bronchioles and are where oxygen is absorbed into the bloodstream and carbon dioxide is released. Therefore, alveoli are not considered part of the bronchial tree.
A client who has chronic heart failure tells the nurse 'I was fine when I went to bed but I woke up in the middle of the night feeling like I was suffocating!' How should the nurse document this finding?
- A. Orthopnea
- B. Pulsus alternans
- C. Paroxysmal nocturnal dyspnea
- D. Acute bilateral pleural effusion
Correct Answer: C
Rationale: The correct answer is C: Paroxysmal nocturnal dyspnea. This finding describes the sudden onset of severe shortness of breath at night, commonly seen in patients with chronic heart failure due to fluid redistribution when lying down. Orthopnea (A) is difficulty breathing when lying flat, not specifically at night. Pulsus alternans (B) is a regular rhythm with alternating strong and weak pulses, not related to this patient's symptom. Acute bilateral pleural effusion (D) is a buildup of fluid in the lungs, not a sudden onset symptom like in this case.
Which pressure remains negative throughout the respiratory cycle?
- A. intrapulmonary
- B. intrapleural
- C. intra-alveolar
- D. atmospheric
Correct Answer: B
Rationale: The correct answer is B: intrapleural pressure. Intrapleural pressure remains negative throughout the respiratory cycle due to the opposing forces of the elastic recoil of the lungs and the chest wall. This negative pressure keeps the lungs inflated and facilitates breathing. In contrast, intrapulmonary (A) and intra-alveolar (C) pressures fluctuate during inhalation and exhalation, becoming positive and negative, respectively. Atmospheric pressure (D) remains relatively constant and serves as the reference point for pressure changes in the respiratory system.
A client has been taking isoniazid for tuberculosis for 3 weeks. What laboratory results need to be reported to the primary health care provider immediately?
- A. Albumin: 5.1 g/dL (7.4 mcmol/L)
- B. Alanine aminotransferase (ALT): 180 U/L
- C. Red blood cell (RBC) count: 5.2/million/µL (5.2  1012/L)
- D. White blood cell (WBC) count: 12,500/mm3 (12.5 ï‚´ 109/L)
Correct Answer: B
Rationale: The correct answer is B: Alanine aminotransferase (ALT): 180 U/L. Elevated ALT levels indicate liver damage, a potential side effect of isoniazid. This is crucial to report immediately to the primary health care provider to assess liver function and adjust medication if needed.
A: Albumin levels may fluctuate due to various factors but are not typically urgent in this context.
C: RBC count within normal range, not directly related to isoniazid therapy.
D: WBC count slightly elevated but not a priority unless there are other concerning symptoms.
What is the least successful treatment for laryngeal cancer?
- A. Surgical treatment
- B. Radical neck dissection
- C. Radiation therapy with surgery
- D. Chemotherapy
Correct Answer: D
Rationale: The correct answer is D. Chemotherapy alone is generally less effective for laryngeal cancer compared to surgical treatment, radiation therapy, or combinations thereof. A (surgical treatment) and C (radiation therapy with surgery) are more successful. B (radical neck dissection) is a specific surgical approach but still more effective than chemotherapy alone.