Nokea
The patient with angina is admitted to the hospital. The patient states "I might as well have died because now I won't be able to do anything." Your best response is
- A. What do you mean about not being able to do anything?
- B. Don't worry about it. Everything will be alright.
- C. You should not be thinking about that because you are doing so well now.
- D. Take life one day at a time. We will be taking excellent care of you.
Correct Answer: A
Rationale: The correct answer is A because it demonstrates active listening and empathy, allowing the patient to express their feelings. By asking for clarification, it shows interest in the patient's concerns and opens up a dialogue for further exploration. This approach can help the patient feel heard and supported, leading to better understanding and communication.
Choices B, C, and D are incorrect because they do not directly address the patient's statement or feelings. B dismisses the patient's concerns, C invalidates their emotions, and D offers a general statement without acknowledging the patient's specific worries. These responses may lead to the patient feeling unheard or misunderstood, hindering effective communication and rapport building.
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The physician orders a PFT. The patient asks you how the test is performed. The best response is:
- A. A tube is inserted into lungs while the patient is asleep to expand his/her lungs to their full capacity.
- B. The patient breathes through a mouthpiece into a spirometer until all air in lungs is expelled. Then the patient will take a deep breath through the mouthpiece. This is done three times and a computer calculates the capacity of lungs.
- C. The patient breathes into a spirometer to measure lung capacity.
- D. A computer is used to measure volume and vital capacity.
Correct Answer: B
Rationale: The correct answer is B. Pulmonary function tests involve breathing into a spirometer to measure lung volumes and capacities. A is incorrect as no tube is inserted. C is incomplete. D focuses only on the computer aspect without explaining the procedure.
The most important factor in determining the percent of oxygen saturation of hemoglobin
- A. The partial pressure of o2
- B. acidity
- C. the partial of co2
Correct Answer: A
Rationale: The correct answer is A: The partial pressure of O2. Oxygen saturation of hemoglobin is directly related to the partial pressure of oxygen in the blood. As the partial pressure of O2 increases, more oxygen binds to hemoglobin, leading to higher oxygen saturation. Acidity (choice B) and the partial pressure of CO2 (choice C) can influence the oxygen-hemoglobin dissociation curve, but they are not the primary factors determining oxygen saturation. Choice D is incomplete and not relevant to the question.
Hemoglobin affinity for Oxygen is to the P50 (O2 tension that produces 50% saturation of Hb)
- A. Directly related
- B. Inversely related
- C. Not related
- D. Related
Correct Answer: B
Rationale: The correct answer is B. Hemoglobin affinity for oxygen is inversely related to P50. When P50 is lower, hemoglobin has higher affinity for oxygen, meaning it binds oxygen more readily at lower oxygen tensions. Conversely, when P50 is higher, hemoglobin has lower affinity for oxygen. This relationship is crucial for the efficient loading and unloading of oxygen in tissues. Choices A, C, and D are incorrect because hemoglobin affinity for oxygen is not directly related, unrelated, or simply related to P50.
Which of the following decreases respiratory efficiency?
- A. decreased blood flow
- B. increased surface area
- C. increased partial pressure gradients
- D. increased gas solubility
Correct Answer: A
Rationale: Step 1: Blood flow supplies oxygen and removes carbon dioxide in the lungs, essential for efficient gas exchange.
Step 2: Decreased blood flow means less oxygen delivery and carbon dioxide removal, leading to decreased respiratory efficiency.
Step 3: Choice A is correct as it directly impacts the gas exchange process.
Summary:
- Choice B (increased surface area) would enhance gas exchange efficiency.
- Choice C (increased partial pressure gradients) would improve gas exchange efficiency.
- Choice D (increased gas solubility) would not directly affect respiratory efficiency.
A 17-year-old male is admitted following an automobile accident. He is very anxious, dyspneic, and in severe pain. The left chest wall moves in during inspiration and balloons out when he exhales. The nurse understands these symptoms are most suggestive of?
- A. Hemothorax
- B. Flail chest
- C. Atelectasis
- D. Pleural effusion
Correct Answer: B
Rationale: The correct answer is B: Flail chest. Flail chest is characterized by paradoxical movement of a segment of the chest wall due to multiple rib fractures. In this case, the left chest wall moving in during inspiration and out during expiration indicates this paradoxical movement. This leads to ineffective breathing, causing dyspnea and anxiety. Hemothorax (A) is accumulation of blood in the pleural cavity, not associated with chest wall movement. Atelectasis (C) is collapse of lung tissue, not associated with chest wall movement. Pleural effusion (D) is accumulation of fluid in the pleural space, also not associated with paradoxical chest wall movement.