Nokea
The most important chemical regulator of respiration is
- A. oxygen
- B. carbon dioxide
- C. bicarbonate ion
- D. sodium ion
Correct Answer: B
Rationale: The correct answer is B: carbon dioxide. Carbon dioxide is the most important chemical regulator of respiration as it directly affects the respiratory rate and depth. An increase in carbon dioxide levels in the blood triggers the body to increase respiration to expel the excess carbon dioxide. Conversely, a decrease in carbon dioxide levels signals the body to decrease respiration. Oxygen (choice A) is important for cellular respiration but does not directly regulate breathing. Bicarbonate ion (choice C) and sodium ion (choice D) do not play a direct role in regulating respiration.
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You are evaluating and assessing a client diagnosed with chronic emphysema. The client is on oxygen at a flow rate of 5 L/min by nasal cannula. Which finding concerns you immediately?
- A. The client has fine bibasilar crackles.
- B. The client's respiratory rate is 8 breaths/minute.
- C. The client sits up and leans over the nightstand.
- D. The client has a large barrel chest.
Correct Answer: B
Rationale: The correct answer is B. A respiratory rate of 8 breaths/minute is abnormally low and indicates potential hypoventilation or respiratory depression, which is concerning in a client with chronic emphysema. Fine crackles (A) and barrel chest (D) are common findings but not immediately alarming. Sitting up and leaning forward (C) is a compensatory mechanism for easier breathing.
A nurse instructs a female client to use the pursed-lip method of breathing and the client asks the nurse about the purpose of this type of breathing. The nurse responds, knowing that the primary purpose of pursed-lip breathing is to:
- A. Promote oxygen intake.
- B. Strengthen the diaphragm.
- C. Strengthen the intercostal muscles.
- D. Promote carbon dioxide elimination.
Correct Answer: D
Rationale: The correct answer is D: Promote carbon dioxide elimination. Pursed-lip breathing is a technique used to slow down breathing and help control shortness of breath. By exhaling through pursed lips, it creates back-pressure in the airways, allowing more time for the lungs to empty and facilitating better removal of carbon dioxide. This helps improve oxygenation by optimizing the gas exchange process. Choices A, B, and C are incorrect because pursed-lip breathing primarily focuses on improving ventilation and gas exchange, not specifically on increasing oxygen intake or strengthening specific respiratory muscles.
The ED nurse is assessing a patient complaining of dyspnea. The nurse auscultates the patient's chest and hears wheezing throughout the lung fields. What might this indicate?
- A. The patient has a narrowed airway.
- B. The patient has pneumonia.
- C. The patient needs physiotherapy.
- D. The patient has a hemothorax.
Correct Answer: A
Rationale: The correct answer is A: The patient has a narrowed airway. Wheezing throughout the lung fields indicates the presence of narrowed airways, often due to conditions like asthma or chronic obstructive pulmonary disease (COPD). Wheezing is caused by turbulent airflow through narrowed airways, leading to a high-pitched whistling sound during expiration. This is a characteristic finding in patients with obstructive airway diseases.
Summary of other choices:
B: The patient having pneumonia would typically present with symptoms like fever, cough, and consolidation on auscultation, not wheezing.
C: The patient needing physiotherapy may have respiratory muscle weakness or secretion clearance issues but would not typically present with wheezing throughout lung fields.
D: The presence of a hemothorax (blood in the pleural space) would manifest as decreased breath sounds and signs of respiratory distress but not wheezing.
A nurse reviews the arterial blood gas results of a client and notes the following: pH 7.45, PCO2 30, HCO3 20. The nurse analyzes these results as indicating which condition?
- A. Metabolic acidosis, compensated
- B. Respiratory alkalosis, fully compensated
- C. Metabolic alkalosis, uncompensated
- D. Respiratory acidosis, uncompensated
Correct Answer: B
Rationale: The correct answer is B: Respiratory alkalosis, fully compensated. The pH is elevated (alkalosis) at 7.45. The low PCO2 of 30 indicates respiratory alkalosis. The HCO3 level of 20 is slightly below normal, indicating metabolic compensation. The body has compensated for the respiratory alkalosis by reducing the HCO3 level. Choices A, C, and D are incorrect because they do not align with the given ABG results. A (Metabolic acidosis, compensated) would have low pH and HCO3 levels. C (Metabolic alkalosis, uncompensated) would have high pH and HCO3 levels. D (Respiratory acidosis, uncompensated) would have high PCO2 and low pH.
In human beings the number of lobes in right and left lungs is
- A. 2 and 3
- B. 2 and 2
- C. 3 and 2
- D. 4 and 2
Correct Answer: C
Rationale: The correct answer is C: 3 and 2. The right lung has 3 lobes (upper, middle, lower), while the left lung has 2 lobes (upper and lower). This is due to the presence of the heart on the left side, occupying space that limits the left lung to 2 lobes. Option A is incorrect as the left lung has only 2 lobes. Option B is incorrect as both lungs have different numbers of lobes. Option D is incorrect as the right lung typically has 3 lobes, not 4.