Nokea
The nurse assesses wheezes in a patient with asthma and realizes that these breath sounds result from:
- A. Increased thickness of respiratory secretions.
- B. Use of accessory muscles of respiration.
- C. Tachypnea and tachycardia.
- D. Movement of air through narrowed airways.
Correct Answer: D
Rationale: The correct answer is D because wheezes in asthma are caused by the movement of air through narrowed airways due to bronchoconstriction and inflammation. This narrowing leads to turbulent airflow, resulting in the characteristic high-pitched musical sound of wheezes. Increased thickness of respiratory secretions (A) may cause crackles, not wheezes. Use of accessory muscles (B) indicates respiratory distress but does not directly cause wheezes. Tachypnea and tachycardia (C) are common in asthma but do not directly cause wheezes. Thus, D is the most directly related to the pathophysiology of wheezes in asthma.
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Double Bohr effect (Oxygen curves for maternal and foetal Hb move apart in opposite directions) occurs in
- A. Foetal circulation
- B. Maternal circulation
- C. In the Placenta operating in both maternal and foetal circulations
- D. In the uterine wall
Correct Answer: C
Rationale: Rationale:
1. In the placenta, maternal and fetal blood circulations are in close proximity.
2. Maternal Hb releases oxygen to fetal Hb due to the lower affinity of fetal Hb for oxygen.
3. This double Bohr effect causes the oxygen dissociation curves of maternal and fetal Hb to move apart.
4. This occurs specifically in the placenta where both maternal and fetal circulations operate.
Summary:
A. Incorrect. Double Bohr effect doesn't occur solely in fetal circulation.
B. Incorrect. Double Bohr effect doesn't occur solely in maternal circulation.
C. Correct. Placenta facilitates the exchange between maternal and fetal blood causing the double Bohr effect.
D. Incorrect. Double Bohr effect is not related to the uterine wall.
which of the following is a chronic respiratory disorder caused by smoking?
- A. asthma
- B. emphysema
- C. respiratory alkalosis
- D. Acidosis
Correct Answer: B
Rationale: Emphysema is the correct answer because it is a chronic respiratory disorder specifically caused by smoking. Smoking damages the air sacs in the lungs, leading to shortness of breath and difficulty breathing. Asthma is a separate condition involving airway inflammation. Respiratory alkalosis and acidosis refer to imbalances in blood pH levels, not directly caused by smoking.
A nurse cares for a client who had a partial laryngectomy 10 days ago. The client states that all food tastes bland. How would the nurse respond?
- A. I will consult the speech therapist to ensure you are swallowing properly.
- B. This is normal after surgery. What types of food do you like to eat?
- C. I will ask the dietitian to change the consistency of the food in your diet.
- D. Replacement of protein, calories, and water is very important after surgery.
Correct Answer: B
Rationale: Step 1: Acknowledge client's concern about bland taste.
Step 2: Validate normalcy post-laryngectomy.
Step 3: Assess client's food preferences for individualized care.
Step 4: Encourage open communication for effective care plan.
Step 5: Addressing the issue holistically promotes client-centered care.
Summary:
- A: Focuses on swallowing, not taste.
- C: Addresses food consistency, not taste.
- D: Important but not directly related to client's concern.
Client history and assessment reveals all of these findings. Which finding supports the diagnosis of PE?
- A. Client was recently in a motor vehicle accident.
- B. Client participated in an aerobic exercise program for 6 months.
- C. Client gave birth to youngest child 1 year ago.
- D. Client was on bedrest 6 hours after diagnostic procedure.
Correct Answer: A
Rationale: The correct answer is A. Recent trauma or immobility due to a motor vehicle accident increases the risk of PE. Aerobic exercise (B), childbirth over a year ago (C), and brief bedrest (D) are less likely risk factors.
Which of the following should the nurse include in the teaching plan of a client with acute bronchitis?
- A. Not coughing frequently
- B. Consuming adequate calories
- C. Washing the hands frequently
- D. Encouraging a semi-Fowler’s position
Correct Answer: C
Rationale: The correct answer is C. Frequent handwashing prevents the spread of infection, which is crucial in managing acute bronchitis. A (not coughing frequently) is impractical and counterproductive. B (consuming adequate calories) supports general health but is not specific. D (semi-Fowler’s position) may aid breathing but is not a primary teaching point.