Nokea
The client with which of the following types of lung cancer metastasizes quickly?
- A. Adenocarcinoma
- B. Oat cell
- C. Squamous cell
- D. Bronchial carcinoids
Correct Answer: B
Rationale: The correct answer is B: Oat cell. Oat cell (small cell) lung cancer metastasizes quickly due to its aggressive nature, high growth rate, and early dissemination to distant sites. This type of cancer is known for its rapid spread to other organs, leading to poor prognosis. Adenocarcinoma, squamous cell, and bronchial carcinoids have a slower metastatic rate compared to oat cell lung cancer. Adenocarcinoma tends to metastasize to the lymph nodes and other organs over time, while squamous cell typically spreads locally within the lung tissue. Bronchial carcinoids are slow-growing tumors with a lower propensity for rapid metastasis compared to oat cell lung cancer.
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Blocking afferent action potentials from the chemoreceptors in the carotid and aortic bodies would interfere with the brain's ability to regulate breathing in response to
- A. changes in PCO2
- B. changes in PCO2
- C. changes in pH
- D. changes in blood pressure
Correct Answer: B
Rationale: The correct answer is B: changes in PCO2. Chemoreceptors in the carotid and aortic bodies detect levels of oxygen, carbon dioxide, and pH in the blood. Blocking afferent action potentials from these chemoreceptors would specifically interfere with detecting changes in PCO2, as these receptors primarily respond to alterations in CO2 levels. This interference would disrupt the brain's ability to regulate breathing in response to changes in PCO2, leading to potential respiratory problems. Choices A and C are incorrect because chemoreceptors primarily respond to CO2 levels, not O2 or pH. Choice D is incorrect because changes in blood pressure are primarily detected by baroreceptors, not chemoreceptors in the carotid and aortic bodies.
Identify the inconsistent value at sea level
- A. Alveolar pCO2 = 40mmHg
- B. Alveolar pO2 = 100mmHg
- C. Alveolar PH2O = 47mmHg
- D. pO2 of inspired air = 130mmHg
Correct Answer: D
Rationale: The correct answer is D because at sea level, the pO2 of inspired air is around 159mmHg, not 130mmHg. This is due to the partial pressure of oxygen being higher at sea level. Alveolar pCO2, pO2, and PH2O values are consistent with normal values at sea level. Therefore, D is the inconsistent value.
A nurse is instructing a hospitalized client with a diagnosis of emphysema about measures that will enhance the effectiveness of breathing during dyspneic periods. Which of the following positions will the nurse instruct the client to assume?
- A. Side-lying in bed.
- B. Sitting in a recliner chair.
- C. Sitting up in bed.
- D. Sitting on the side of the bed and leaning on an overbed table.
Correct Answer: D
Rationale: The correct answer is D, sitting on the side of the bed and leaning on an overbed table. This position promotes maximum expansion of the thorax, allowing for improved lung ventilation. Leaning forward helps reduce the work of breathing and facilitates better airflow. Options A and C do not provide the same level of thoracic expansion and may not be as effective. Option B may not provide the necessary support for the client to lean forward and optimize breathing.
The patient with asthma is prescribed a leukotriene modifier drug, montelukast (Singulair).
Which statement describes an advantage of this medication?
- A. Limited gastrointestinal (GI) side effects
- B. Bronchodilation and anti-inflammatory effects
- C. Stringent control of acute episodes of asthma
- D. Ability to replace all other asthma remedies
Correct Answer: B
Rationale: The correct answer is B because montelukast is a leukotriene modifier that works by reducing inflammation and promoting bronchodilation in asthma patients. This helps in managing asthma symptoms and improving lung function.
A is incorrect because montelukast can cause mild GI side effects such as nausea and diarrhea. C is incorrect because while montelukast helps in controlling asthma symptoms, it does not provide immediate relief during acute episodes. D is incorrect because montelukast is typically used as an add-on therapy and not as a replacement for all other asthma medications.
Carina is the point where ...... divided
- A. Trachea
- B. bronchi
- C. larynx
- D. none of them
Correct Answer: A
Rationale: The correct answer is A: Trachea. Carina is the point where the trachea is divided into the left and right primary bronchi. This anatomical landmark is located at the lower end of the trachea where it bifurcates into the bronchi. The other choices, B: bronchi and C: larynx, are incorrect because the trachea is the structure that is divided at the carina, not the bronchi or larynx. Choice D: none of them is also incorrect because the trachea is indeed divided at the carina. Therefore, the correct answer is A as it accurately describes the anatomical location where the trachea divides.