Nokea
The impulse for voluntary muscles for forceful breathing starts in
- A. Medulla (Pons)
- B. Vagus nerve
- C. Cerebral hemispheres
- D. Spinal cord
Correct Answer: C
Rationale: The correct answer is C: Cerebral hemispheres. The impulse for voluntary muscles for forceful breathing originates in the cerebral hemispheres where conscious control over breathing is regulated. The cerebral cortex sends signals to the respiratory muscles to increase or decrease breathing effort based on the body's needs. The other choices are incorrect because:
A: Medulla (Pons) - This region of the brainstem is responsible for automatic breathing control, not voluntary forceful breathing.
B: Vagus nerve - The vagus nerve is not directly involved in initiating voluntary breathing movements.
D: Spinal cord - While the spinal cord plays a role in coordinating some aspects of breathing, it is not the primary center for voluntary forceful breathing control.
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Which chamber of the heart is most commonly affected in heart failure?
- A. Left atrium
- B. Right atrium
- C. Left ventricle
- D. Right ventricle
Correct Answer: C
Rationale: The correct answer is C: Left ventricle. The left ventricle is the chamber responsible for pumping oxygenated blood to the rest of the body, making it the most commonly affected in heart failure. When the left ventricle weakens or becomes stiff, it can lead to inefficient pumping, causing fluid buildup and symptoms of heart failure. The other choices, A: Left atrium, B: Right atrium, and D: Right ventricle, are less commonly affected in heart failure as they have different functions in the heart's circulation.
A nurse assesses a client's respiratory status. Which information is of highest priority for the nurse to obtain?
- A. Average daily fluid intake
- B. Neck circumference
- C. Height and weight
- D. Occupation and hobbies
Correct Answer: D
Rationale: The correct answer is D: Occupation and hobbies. This is the highest priority information for the nurse to obtain because it can provide crucial insights into potential respiratory risks or exposures (e.g., smoking, exposure to fumes or pollutants). Understanding the client's occupation and hobbies helps the nurse assess the impact on respiratory health and tailor interventions accordingly.
A: Average daily fluid intake is important for overall health but not directly related to respiratory status.
B: Neck circumference may be relevant for assessing airway patency in certain conditions, but occupation and hobbies are more pertinent.
C: Height and weight are important for general health assessment but do not directly impact respiratory status as much as occupation and hobbies.
A patient with a history of smoking two packs of cigarettes a day for the past 20 years says that he is not alarmed by his cough. He says, "I get this cough and spit up mucus every winter." The nurse recognizes these symptoms as being suggestive of:
- A. Chronic bronchitis.
- B. Emphysema.
- C. Sarcoidosis.
- D. Diffuse interstitial fibrosis.
Correct Answer: A
Rationale: The correct answer is A: Chronic bronchitis. The patient's history of smoking for 20 years and persistent cough with mucus production every winter are indicative of chronic bronchitis. Chronic bronchitis is characterized by inflammation of the bronchial tubes due to irritants like smoking, leading to excessive mucus production and persistent cough. Emphysema is characterized by destruction of lung tissue, not necessarily accompanied by mucus production. Sarcoidosis is a systemic inflammatory disease affecting multiple organs, not specifically related to the symptoms described. Diffuse interstitial fibrosis involves scarring of lung tissue, typically presenting with a dry, non-productive cough.
An emergency room nurse is assessing a male client who has sustained a blunt injury to the chest wall. Which of these signs would indicate the presence of a pneumothorax in this client?
- A. A low respiratory rate.
- B. Diminished breath sounds.
- C. The presence of a barrel chest.
- D. A sucking sound at the site of injury.
Correct Answer: B
Rationale: The correct answer is B: Diminished breath sounds. In the case of a pneumothorax, air leaks into the pleural space, causing the lung to collapse partially. This results in diminished or absent breath sounds on the affected side. A low respiratory rate (A) is a general sign of respiratory distress but not specific to pneumothorax. The presence of a barrel chest (C) is associated with conditions like chronic obstructive pulmonary disease (COPD) but not indicative of a pneumothorax. A sucking sound at the site of injury (D) is characteristic of an open pneumothorax, not necessarily present in all cases of pneumothorax.
Hemoglobin's affinity for oxygen when the BPG level is high is
- A. greater than hemoglobin's affinity for oxygen when the BPG level is low
- B. less than hemoglobin's affinity for oxygen when the BPG level is low
- C. equal to hemoglobin's affinity for oxygen when the BPG level is low
- D. equal to hemoglobin's affinity for oxygen when pH is low
Correct Answer: B
Rationale: The correct answer is B: less than hemoglobin's affinity for oxygen when the BPG level is low. When the 2,3-bisphosphoglycerate (BPG) level is high, it binds to hemoglobin and decreases its affinity for oxygen. This results in easier unloading of oxygen to tissues. In contrast, when the BPG level is low, hemoglobin's affinity for oxygen is higher, making it harder to release oxygen to tissues. Choices A and C are incorrect because high BPG levels decrease hemoglobin's affinity for oxygen, making it less than when BPG levels are low. Choice D is incorrect because pH levels do not directly affect hemoglobin's affinity for oxygen in the context of this question.