Nokea
The nurse recognizes that a rising PaCO2 level in a COPD patient means that:
- A. There is more arterial oxygen available than is needed.
- B. The ventilation-perfusion ratio is becoming balanced.
- C. Respiratory acidosis has begun.
- D. The anticholinergics are effective.
Correct Answer: C
Rationale: Step-by-step rationale for why answer C is correct:
1. In COPD, impaired lung function leads to inadequate ventilation and CO2 retention.
2. Rising PaCO2 indicates inadequate CO2 removal, leading to respiratory acidosis.
3. Respiratory acidosis is characterized by low pH and high PaCO2 levels.
4. This condition can worsen COPD symptoms and lead to respiratory failure.
Summary: Option A is incorrect as rising PaCO2 indicates hypoxemia. Option B is incorrect as ventilation-perfusion imbalance worsens in COPD. Option D is incorrect as anticholinergics do not directly affect PaCO2 levels in COPD.
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A client who is human immunodeficiency virus-positive has had a Mantoux skin test. The nurse notes a 7-mm area of induration at the site of the skin test. The nurse interprets the results as:
- A. Positive
- B. Negative
- C. Inconclusive
- D. Indicating the need for repeat testing.
Correct Answer: A
Rationale: The correct answer is A: Positive. In individuals with HIV, a positive Mantoux test is considered when the induration is 5 mm or greater. A 7-mm area of induration indicates a positive result, suggesting an immune response to the tuberculin antigen, potentially due to latent tuberculosis infection. The other choices are incorrect because a 7-mm induration in an HIV-positive client is not considered negative, inconclusive, or indicative of the need for repeat testing based on current guidelines.
The nurse is assessing a patient who frequently coughs after eating or drinking. How should the nurse best follow up this assessment finding?
- A. Obtain a sputum sample.
- B. Perform a swallowing assessment.
- C. Inspect the patient's tongue and mouth.
- D. Assess the patient's nutritional status.
Correct Answer: B
Rationale: The correct answer is B: Perform a swallowing assessment. This is the best follow-up because coughing after eating or drinking can be a sign of dysphagia, a swallowing disorder. By performing a swallowing assessment, the nurse can identify any issues with the patient's ability to swallow safely, which can lead to aspiration and respiratory complications. Obtaining a sputum sample (A) may not provide relevant information in this context. Inspecting the patient's tongue and mouth (C) may not directly address the coughing after eating. Assessing the patient's nutritional status (D) is important but may not address the immediate issue of coughing after eating or drinking.
The common drugs used against TB is
- A. Para amino salicylic acid (PAS)
- B. Ethambutol
- C. Steptomycin
- D. All these
Correct Answer: D
Rationale: The correct answer is D, "All these." PAS, Ethambutol, and Streptomycin are all common drugs used against TB. PAS inhibits bacterial folic acid synthesis, Ethambutol inhibits cell wall synthesis, and Streptomycin inhibits protein synthesis. Using a combination of these drugs helps to target different aspects of TB bacteria, reducing the likelihood of resistance development. Therefore, all of these drugs are essential in the treatment of TB, making choice D the correct answer.
Diaphragm is supplied with Phrenic nerve and is involved in
- A. Inspiration
- B. Parturition
- C. Micturition and Defecation
- D. All these
Correct Answer: D
Rationale: The correct answer is D: All these. The phrenic nerve innervates the diaphragm, which is responsible for inspiration (A). During parturition (B), the diaphragm plays a role in the pushing phase of labor. While the diaphragm is not directly involved in micturition and defecation (C), it indirectly affects these processes by helping to create intra-abdominal pressure. Therefore, the correct answer is D as the diaphragm is involved in inspiration, parturition, and indirectly affects micturition and defecation.
A nurse is caring for a client using oxygen while in the hospital. What assessment finding indicates that outcomes for client safety with oxygen therapy are being met?
- A. 100% of meals being eaten by the client
- B. Intact skin behind the ears
- C. The client understanding the need for oxygen
- D. Unchanged weight for the past 3 days
Correct Answer: B
Rationale: The correct answer is B. Intact skin behind the ears indicates that the oxygen delivery device is fitted properly and not causing skin breakdown, ensuring client safety. A (meals being eaten) is not directly related to oxygen therapy outcomes. C (client understanding) is important but doesn't directly assess client safety with oxygen therapy. D (unchanged weight) is not a specific indicator of client safety with oxygen therapy.