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The nurse is teaching a male client with chronic bronchitis about breathing exercises. Which of the following should the nurse include in the teaching?
- A. Make inhalation longer than exhalation.
- B. Exhale through an open mouth.
- C. Use diaphragmatic breathing.
- D. Use chest breathing.
Correct Answer: C
Rationale: The correct answer is C: Use diaphragmatic breathing. Diaphragmatic breathing involves using the diaphragm to breathe deeply, allowing more air to enter the lungs and improving oxygenation. This is beneficial for clients with chronic bronchitis as it helps improve lung function and efficiency. Making inhalation longer than exhalation (Choice A) may lead to hyperventilation. Exhaling through an open mouth (Choice B) can lead to loss of carbon dioxide. Using chest breathing (Choice D) is less efficient and can exacerbate breathing difficulties in clients with chronic bronchitis. Diaphragmatic breathing is the most effective technique for improving breathing and should be emphasized in teaching.
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A nurse in a medical unit is caring for a client with heart failure. The client suddenly develops extreme dyspnea,tachycardia and lung crackles. The nurse immediately asks another nurse to contact the primary health care provider and prepares to implement ALL priority interventions EXCEPT?
- A. Administer oxygen
- B. Administer furosemide (diuretic)
- C. Transport to coronary care unit
- D. Obtain stat Hepatic Panel
Correct Answer: C
Rationale: Rationale: Option C, transporting the client to the coronary care unit, is not the priority intervention because the client is presenting with acute pulmonary edema, a sign of worsening heart failure. Administering oxygen (Option A) is crucial to improve oxygenation. Administering furosemide (Option B) helps reduce fluid overload. Obtaining a stat Hepatic Panel (Option D) may be necessary to assess liver function due to medication side effects. However, immediate actions to address respiratory distress and tachycardia take precedence over moving the client to another unit.
The client with COPD has a nursing diagnosis of Ineffective Breathing Pattern. Which action is appropriate to delegate to the experienced LPN/LVN under your supervision?
- A. Observe how well the client performs pursed-lip breathing.
- B. Plan a nursing care regimen that gradually increases activity tolerance.
- C. Assist the client with basic activities of daily living (ADLs).
- D. Consult with physical therapy about reconditioning exercises.
Correct Answer: C
Rationale: The correct answer is C. Assisting with ADLs is a routine task suitable for an LPN/LVN. Observing pursed-lip breathing (A) and planning care regimens (B) are more advanced tasks. Consulting physical therapy (D) requires RN-level decision-making.
The nurse recognizes that additional teaching is needed when the patient with asthma says
- A. a. I should exercise every day if my symptoms are controlled.
- B. b. I may use over-the-counter bronchodilator drugs occasionally if I develop chest tightness.
- C. c. I should inform my spouse about my medications and how to get help if I have a severe asthma attack.
- D. A diary to record my medication use, symptoms, peak expiratory flow rates, and activity levels will help in adjusting my therapy.
Correct Answer: D
Rationale: Additional teaching is needed when the patient mentions using over-the-counter bronchodilator drugs occasionally. This is not recommended as it can mask underlying issues and delay proper treatment.
At a PO2 of 70 mm Hg and normal temperature and pH, hemoglobin is ________ percent saturated with oxygen.
- A. 10
- B. 25
- C. 50
- D. more than 90
Correct Answer: D
Rationale: The correct answer is D (more than 90). At a PO2 of 70 mm Hg, hemoglobin is more than 90% saturated with oxygen due to the high oxygen affinity of hemoglobin at this partial pressure. Hemoglobin exhibits near-maximal saturation at this level, promoting efficient oxygen binding and transport. Choices A, B, and C are incorrect as they do not accurately reflect the high oxygen saturation levels associated with a PO2 of 70 mm Hg.
Which metal ion is often present in the active site of carbonic anhydrase enzymes?
- A. Iron (Fe)
- B. Calcium (Ca)
- C. Zinc (Zn)
- D. Magnesium (Mg)
Correct Answer: C
Rationale: The correct answer is C: Zinc (Zn). Zinc is often present in the active site of carbonic anhydrase enzymes because it plays a crucial role in catalyzing the conversion of carbon dioxide to bicarbonate and protons. Zinc ions have the appropriate coordination geometry and charge to facilitate this reaction efficiently. Iron (Fe) is not typically found in the active site of carbonic anhydrase enzymes. Calcium (Ca) and Magnesium (Mg) do not have the appropriate properties to serve as the catalytic metal ion in this enzyme. Therefore, zinc (Zn) is the correct answer due to its specific role and properties in the catalytic mechanism of carbonic anhydrase enzymes.