Nokea
The nurse is caring for a client with hypoxemia of unknown cause. Which oxygen transport consideration(s) does the nurse identify as crucial to circulate oxygen in the body system? Select all that apply.
- A. Oxygen is dissolved.
- B. High blood pressure disrupts oxygen transport.
- C. Oxyhemoglobin circulates to the body tissue.
- D. All systemic oxygen is available for diffusion.
- E. Adequate red blood cells are needed for oxygen transport.
Correct Answer: A,C,E
Rationale: Oxygen transport occurs by dissolving oxygen in the water in the plasma and combining oxygen with red blood cells (oxyhemoglobin). Normal red blood cell count is needed for oxygen transport. High blood pressure does not disrupt transport unless there is disruption in perfusion via a bleeding or occlusion. Dissolved oxygen is the only form which can diffuse across cell membranes.
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The nurse is in the radiology unit of the hospital. The nurse is caring for a client who is scheduled for a lung scan. The nurse knows that lung scans need the use of radioisotopes and a scanning machine. Before the perfusion scan, what must the client be assessed for?
- A. Bleeding
- B. Iodine allergy
- C. Dysrhythmias
- D. Inflammation
Correct Answer: B
Rationale: During lung scans, a radioactive contrast medium is administered intravenously for the perfusion scan. Before the perfusion scan, nurses must assess the client to check for allergies to iodine. Laryngoscopy determines inflammation. Dysrhythmias and bleeding are possible complications of mediastinoscopy.
The client is returning from the operating room following a bronchoscopy. Which action, performed by the nursing assistant, would the nurse stop if began prior to nursing assessment?
- A. The nursing assistant is assisting the client to a semi-Fowler's position.
- B. The nursing assistant is assisting the client to the side of the bed to use a urinal.
- C. The nursing assistant is pouring a glass of water to wet the client's mouth.
- D. The nursing assistant is asking a question requiring a verbal response.
Correct Answer: C
Rationale: When completing a procedure which sends a scope down the throat, the gag reflex is anesthetized to reduce discomfort. Upon returning to the nursing unit, the gag reflex must be assessed before providing any food or fluids to the client. The client may need assistance following the procedure for activity and ambulation but this is not restricted in the post-procedure period.
The nurse is caring for a client with a decrease in airway diameter causing airway resistance. The client experiences coughing and mucus production. On lung assessment, which adventitious breath sounds are anticipated?
- A. Crackles
- B. Sonorous wheezes
- C. Rubs
- D. Sibilant wheezes
Correct Answer: D
Rationale: A decrease in airway diameter, such as in asthma, produces breath sounds of wheezes. Wheezes may be sibilant (hissing or whistling) or sonorous (full and deep). Sibilant wheezes (formerly called wheezes) are continuous musical sounds that can be heard during inspiration and expiration. They result from air passing through narrowed or partially obstructed air passages and are heard in clients with increased secretions. Sonorous wheezes (formerly called rhonchi) are lower pitched and are heard in the trachea and bronchi. Sonorous wheezes are coarse, rattling sounds similar to snoring usually caused by secretion in the bronchial tree. Crackles, also called rales, are crackling or rattling sounds signifying fluid or exudate in the lung fields. Rubs are secretions that can be heard in the large airway.
Including clients with a history of respiratory issues, for which diagnostic stud(ies) would the nurse screen the client for an allergy to contrast medium prior to testing?
- A. Lung scan
- B. Chest x-ray
- C. Pulmonary angiography
- D. Bronchoscopy
- E. Pulmonary function test
- F. Sputum culture
Correct Answer: A,C
Rationale: The nurse must be well educated in screening clients before diagnostic procedures, which include contrast medium for an allergy to iodine. A lung scan and pulmonary angiography both require contrast medium. A chest x-ray, bronchoscopy, sputum culture test, and pulmonary functions test do not require contrast medium.
The student nurse is learning breath sounds while listening to a client in the physician's office. An experienced nurse is assisting and notes air movement over the trachea to the upper lungs. The air movement is noted equally on inspiration and expiration. Which breath sounds would the nurse document?
- A. Abnormal vesicular sounds
- B. Normal bronchial sounds
- C. Normal bronchovesicular sounds
- D. Abnormal bronchial sounds
Correct Answer: C
Rationale: Air movement over the trachea and upper lungs is a normal finding for bronchovesicular sounds. The air movement is noted equally on inspiration and expiration. The other choices do not match the description.