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The experienced LPN/LVN is providing nursing care for a client with a respiratory problem. Which of the following actions are appropriate to the scope of practice for an experienced LPN/LVN? (Choose all that apply.)
- A. Auscultate breath sounds.
- B. Administer MDI (multidose inhaler) medications.
- C. Check oxygen saturation using pulse oximetry.
- D. Evaluate client's technique for using MDIs.
Correct Answer: D
Rationale: The correct answer includes A, B, and C. Auscultating breath sounds, administering MDI medications, and checking oxygen saturation are within the scope of practice for an LPN/LVN. Evaluating the client's technique (D) may require more advanced assessment skills typically performed by RNs.
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The nurse recognizes that a rising PaCO2 level in a COPD patient means that:
- A. There is more arterial oxygen available than is needed.
- B. The ventilation-perfusion ratio is becoming balanced.
- C. Respiratory acidosis has begun.
- D. The anticholinergics are effective.
Correct Answer: C
Rationale: Step-by-step rationale for why answer C is correct:
1. In COPD, impaired lung function leads to inadequate ventilation and CO2 retention.
2. Rising PaCO2 indicates inadequate CO2 removal, leading to respiratory acidosis.
3. Respiratory acidosis is characterized by low pH and high PaCO2 levels.
4. This condition can worsen COPD symptoms and lead to respiratory failure.
Summary: Option A is incorrect as rising PaCO2 indicates hypoxemia. Option B is incorrect as ventilation-perfusion imbalance worsens in COPD. Option D is incorrect as anticholinergics do not directly affect PaCO2 levels in COPD.
One way to improve respiratory performance with age is to
- A. eat smaller meals
- B. stop smoking
- C. sleep longer
- D. maintain normal glucose levels
Correct Answer: B
Rationale: The correct answer is B: stop smoking. Smoking can damage the lungs and reduce respiratory function. By quitting smoking, lung health can improve, leading to better respiratory performance with age. Eating smaller meals, sleeping longer, and maintaining normal glucose levels do not directly impact respiratory performance. Smoking cessation is the most effective way to improve lung function and overall respiratory health.
During internal and external respiration, gases move by
- A. osmosis
- B. active transport
- C. diffusion
- D. endocytosis
Correct Answer: C
Rationale: The correct answer is C: diffusion. During internal and external respiration, gases move from areas of high concentration to low concentration through passive diffusion. This process is driven by the concentration gradient, allowing gases like oxygen and carbon dioxide to exchange in the lungs and tissues. Osmosis (A) is the movement of water across a semipermeable membrane, not gases. Active transport (B) requires energy and moves substances against their concentration gradient, which is not how gases move during respiration. Endocytosis (D) is a process where cells engulf substances by forming vesicles, not how gases are exchanged in respiration.
In describing the parts of the respiratory system, the word 'septum' designates a partition in the
- A. larynx.
- B. nasal cavities.
- C. pharynx.
- D. glottis.
Correct Answer: B
Rationale: The correct answer is B: nasal cavities. The term "septum" refers to a partition or dividing wall that separates two cavities. In the context of the respiratory system, the nasal septum divides the nasal cavities into left and right sides. This separation helps to regulate airflow and also provides structural support for the nasal passages.
Other choices are incorrect because:
A: The larynx is not typically associated with a septum. It is primarily responsible for vocalization and protecting the airway.
C: The pharynx is a passageway for air and food, but it does not contain a septum dividing it into distinct sections.
D: The glottis is the space between the vocal cords in the larynx and does not have a septum separating it into parts.
Which nursing activity is most important to include in the client's care?
- A. Perform postural drainage and chest physiotherapy every 4 hours.
- B. Discuss client's feelings about the need for a living will.
- C. Place in private room to decrease the risk of further infection.
- D. Plan activities to allow at least 8 hours of uninterrupted sleep.
Correct Answer: A
Rationale: The correct answer is A. Postural drainage and chest physiotherapy are critical for clearing secretions and improving lung function in cystic fibrosis. Discussing a living will (B), isolation (C), and sleep planning (D) are less urgent.