Nokea
The percent of oxygen saturation of hemoglobin when the temperature is 38 degrees centigrade is
- A. greater than the percent of oxygen saturation of hemoglobin when the temperature is 43 degrees centigrade
- B. less than the percent of oxygen saturation of hemoglobin when the temperature is 43 degrees centigrade
- C. equal to the percent of oxygen saturation of hemoglobin when the temperature is 43 degrees centigrade
- D. equal to the percent of oxygen saturation of hemoglobin when the temperature is 20 degrees centigrade
Correct Answer: A
Rationale: The correct answer is A because at higher temperatures, oxygen dissociation from hemoglobin increases, leading to lower oxygen saturation. This is due to the Bohr effect, where increased temperature shifts the hemoglobin-oxygen dissociation curve to the right. Therefore, the percent of oxygen saturation is greater at 38 degrees Celsius compared to 43 degrees Celsius.
Choice B is incorrect because higher temperatures decrease oxygen saturation. Choice C is incorrect as the saturation is not equal at different temperatures due to the Bohr effect. Choice D is incorrect because the saturation at 20 degrees Celsius would be higher than at 38 degrees Celsius.
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The impulse for voluntary muscles for forced breathing starts in
- A. Medulla ( pons )
- B. Vagus nerve
- C. Cerebral hemispheres
- D. Spinal cord
Correct Answer: A
Rationale: The correct answer is A: Medulla (pons). The medulla, located in the brainstem, controls involuntary functions like breathing. Specifically, the medulla contains the respiratory center, which regulates breathing rhythm and depth. During forced breathing, the medulla sends impulses to the voluntary muscles involved in breathing, such as the diaphragm and intercostal muscles. The pons, which is closely connected to the medulla, assists in regulating breathing patterns. The vagus nerve (B) is responsible for parasympathetic functions, not voluntary breathing. The cerebral hemispheres (C) are primarily involved in higher brain functions, not breathing regulation. The spinal cord (D) plays a role in transmitting signals between the brain and muscles but does not initiate voluntary breathing impulses.
As the nurse responsible for this client's care, you anticipate which physician's orders?
- A. Endotracheal intubation and mechanical ventilation
- B. Immediate application of CPAP to client's nose and mouth
- C. Intravenous furosemide (Lasix) 100 mg IV push stat
- D. Call a CODE for respiratory arrest.
Correct Answer: A
Rationale: The correct answer is A. Poor oxygenation despite non-rebreather mask suggests impending respiratory failure, necessitating intubation and mechanical ventilation. CPAP (B) and Lasix (C) may be considered but are secondary. Calling a CODE (D) is only if respiratory arrest occurs.
While changing the tapes on a tracheostomy tube, the male client coughs and the tube is dislodged. The initial nursing action is to:
- A. Call the physician to reinsert the tube.
- B. Grasp the retention sutures to spread the opening.
- C. Call the respiratory therapy department to reinsert the tracheotomy.
- D. Cover the tracheostomy site with a sterile dressing to prevent infection.
Correct Answer: B
Rationale: The correct initial nursing action is to choose option B: Grasp the retention sutures to spread the opening. This is because spreading the opening using the retention sutures can help maintain the airway patency until the tube is reinserted. Calling the physician (option A) or respiratory therapy department (option C) may cause delays in addressing the immediate airway obstruction. Covering the tracheostomy site with a sterile dressing (option D) does not address the primary concern of maintaining the airway. Therefore, option B is the most appropriate and effective action to take in this situation.
Which area represents the work to overcome airway resistance?
- A. ABCEA
- B. ABCFA
- C. AECFA
- D. ABCDOA
Correct Answer: C
Rationale: The correct answer is C: AECFA. This sequence represents the flow of air through the respiratory system. Airway resistance is primarily overcome by the contraction and relaxation of the smooth muscles in the airways. The correct sequence includes the airway segments that actively participate in regulating airway resistance - the trachea (A), bronchi (E), and bronchioles (C and F). The other choices do not include the correct segments that are involved in overcoming airway resistance.
A nurse cares for a client who has packing inserted for posterior nasal bleeding. What action would the nurse take first?
- A. Assess the client's pain level.
- B. Keep the client's head elevated.
- C. Teach the client about the causes of nasal bleeding.
- D. Assess the client's airway.
Correct Answer: D
Rationale: The correct answer is D: Assess the client's airway. This is the priority action as airway patency is always the top priority in any emergency situation. In this case, posterior nasal bleeding can lead to blood flow into the throat, potentially obstructing the airway. Ensuring the client's airway is clear and maintaining adequate oxygenation is crucial for their safety.
Choice A (Assess the client's pain level) is not the priority when there is a potential risk to the airway. Choice B (Keep the client's head elevated) may be done after confirming airway patency. Choice C (Teach the client about the causes of nasal bleeding) is important but not the immediate priority in this situation.