Nokea
The nurse is caring for a patient with lung metastases who just underwent a mediastinotomy. What should be the focus of the nurse's postprocedure care?
- A. Assisting with pulmonary function testing (PFT)
- B. Maintaining the patient's chest tube
- C. Administering oral suction as needed
- D. Performing chest physiotherapy
Correct Answer: B
Rationale: The correct answer is B: Maintaining the patient's chest tube. After a mediastinotomy, the focus of postprocedure care is to ensure proper drainage and prevent pneumothorax. Chest tube maintenance is crucial for monitoring drainage, preventing complications, and promoting lung expansion. Assisting with PFT (A) is not a priority immediately post mediastinotomy. Administering oral suction (C) can disrupt the chest tube and increase infection risk. Performing chest physiotherapy (D) may be indicated later but is not the immediate priority.
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The partial pressure of oxygen in atmospheric air at sea level is
- A. greater than the partial pressure of oxygen in atmospheric air at the top of Mt. Everest
- B. less than the partial pressure of oxygen in atmospheric air at the top of Mt. Everest
- C. equal to the partial pressure of oxygen in atmospheric air at the top of Mt. Everest
- D. equal to the sum of partial pressures from carbon dioxide and nitrogen
Correct Answer: A
Rationale: The correct answer is A because the partial pressure of oxygen decreases with increasing altitude due to the decrease in atmospheric pressure. At sea level, the atmospheric pressure is higher, resulting in a higher partial pressure of oxygen compared to the top of Mt. Everest. Choice B is incorrect because the partial pressure of oxygen is not higher at higher altitudes. Choice C is incorrect because the partial pressure of oxygen is not equal at sea level and Mt. Everest. Choice D is incorrect because the question specifically asks about the partial pressure of oxygen only, not the sum of partial pressures from other gases.
Which teaching point is most important for the client with a peritonsillar abscess?
- A. Gargle with warm salt water.
- B. Take all antibiotics as directed.
- C. Let us know if you want liquid medications.
- D. Wash hands frequently.
Correct Answer: B
Rationale: The correct answer is B: Take all antibiotics as directed. This is the most important teaching point for a client with a peritonsillar abscess because antibiotics are crucial in treating the infection and preventing complications. Here's the rationale:
1. Antibiotics target the bacteria causing the abscess, helping to clear the infection.
2. Incomplete antibiotic course can lead to antibiotic resistance and recurrence of infection.
3. Not following antibiotic instructions can result in treatment failure and worsening of the abscess.
4. Gargling with warm salt water (choice A) may provide temporary relief but does not address the underlying infection. Liquid medications (choice C) and handwashing (choice D) are important but not as vital as completing the antibiotic course.
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.
What is the primary function of carbonic anhydrase in the human body?
- A. Breakdown of carbohydrates
- B. Regulation of blood sugar levels
- C. Facilitation of gas exchange in the lungs
- D. Catalyzing the conversion of carbon dioxide and water to bicarbonate and hydrogen ions
Correct Answer: D
Rationale: The correct answer is D: Catalyzing the conversion of carbon dioxide and water to bicarbonate and hydrogen ions. Carbonic anhydrase helps maintain acid-base balance in the body by catalyzing the reversible reaction between carbon dioxide and water to form bicarbonate and hydrogen ions. This process is crucial in regulating pH levels in various bodily fluids.
A: Breakdown of carbohydrates - This is not the primary function of carbonic anhydrase. Carbohydrate breakdown is primarily carried out by enzymes like amylase and sucrase.
B: Regulation of blood sugar levels - Carbonic anhydrase does not play a direct role in regulating blood sugar levels, which is mainly controlled by insulin and glucagon.
C: Facilitation of gas exchange in the lungs - While carbonic anhydrase indirectly affects gas exchange by regulating blood pH, its primary function is not to facilitate gas exchange in the lungs.
Oxygen moves from alveoli to the bloodstream
- A. because the concentration of oxygen is greater in alveoli than in the blood.
- B. mainly due to the activity of carbonic anhydrase in the red blood cells.
- C. by using the assistance of carbaminohemoglobin
- D. through active transport.
Correct Answer: A
Rationale: The correct answer is A because oxygen moves from alveoli to the bloodstream by simple diffusion. This is due to the concentration gradient of oxygen being higher in the alveoli (where oxygen is inhaled) compared to the blood vessels surrounding the alveoli. Oxygen molecules move from an area of high concentration (alveoli) to an area of low concentration (bloodstream) to reach equilibrium. Choices B, C, and D are incorrect because the movement of oxygen in this context is primarily driven by passive diffusion, not by the activity of carbonic anhydrase, carbaminohemoglobin, or active transport.