Nokea
What does the nurse include when planning for postural drainage for the patient with COPD?
- A. Schedules the procedure 1 hour before and after meals
- B. Has the patient cough before positioning to clear the lungs
- C. Assesses the patient’s tolerance for dependent (head-down) positions
- D. Ensures that percussion and vibration are performed before positioning the patient
Correct Answer: C
Rationale: When planning for postural drainage for a patient with COPD, assessing the patient's tolerance for dependent positions is crucial as it helps ensure the safety and effectiveness of the procedure. Positioning the patient appropriately is key in promoting drainage and improving respiratory function.
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The client with which of the following types of lung cancer metastasizes quickly?
- A. Adenocarcinoma
- B. Oat cell
- C. Squamous cell
- D. Bronchial carcinoids
Correct Answer: B
Rationale: The correct answer is B: Oat cell. Oat cell (small cell) lung cancer metastasizes quickly due to its aggressive nature, high growth rate, and early dissemination to distant sites. This type of cancer is known for its rapid spread to other organs, leading to poor prognosis. Adenocarcinoma, squamous cell, and bronchial carcinoids have a slower metastatic rate compared to oat cell lung cancer. Adenocarcinoma tends to metastasize to the lymph nodes and other organs over time, while squamous cell typically spreads locally within the lung tissue. Bronchial carcinoids are slow-growing tumors with a lower propensity for rapid metastasis compared to oat cell lung cancer.
Residual volume of the lung is
- A. 1200 ml
- B. 1500 ml
- C. 4500 ml
- D. 500 ml
Correct Answer: A
Rationale: The correct answer is A: 1200 ml. Residual volume is the amount of air left in the lungs after maximum expiration. It is around 1200 ml because it cannot be exhaled due to lung elasticity. Choice B (1500 ml) is incorrect as it is higher than the normal range. Choice C (4500 ml) is incorrect as it is too high for residual volume. Choice D (500 ml) is incorrect as it is too low for residual volume.
The client with COPD tells the nursing assistant that she did not get her annual flu shot this year and has not had a pneumonia vaccination. You will be sure to instruct the nursing assistant to report which of the following?
- A. Blood pressure 152/84
- B. Respiratory rate 27/minute
- C. Heart rate 92/minute
- D. Oral temperature 101.2°F
Correct Answer: D
Rationale: The correct answer is D. A fever of 101.2°F is significant and warrants immediate reporting. Blood pressure (A), respiratory rate (B), and heart rate (C) are within normal limits for someone with COPD.
A nurse teaches a client who had a supraglottic laryngectomy. Which technique would the nurse teach the client to prevent aspiration?
- A. Tilt the head back as far as possible when swallowing.
- B. Swallow twice while bearing down.
- C. Breathe slowly and deeply while swallowing.
- D. Keep the head very still and straight while swallowing.
Correct Answer: B
Rationale: The correct answer is B: Swallow twice while bearing down. This technique helps close the trachea during swallowing to prevent aspiration. Swallowing twice initiates a double swallow, which helps clear the throat and reduce the risk of food or liquid entering the airway. Tilt the head back (A), breathing slowly and deeply (C), and keeping the head still and straight (D) do not directly address the risk of aspiration in a client with a supraglottic laryngectomy.
Most of the oxygen transported by the blood is
- A. dissolved in plasma
- B. bound to hemoglobin
- C. in ionic form as solute in the plasma
- D. bound to the same protein as carbon dioxide
Correct Answer: B
Rationale: The correct answer is B: bound to hemoglobin. This is because hemoglobin is the protein in red blood cells that carries oxygen from the lungs to tissues throughout the body. Oxygen binds to the iron atoms in hemoglobin, forming oxyhemoglobin. This accounts for the majority of oxygen transport in the blood.
A: Dissolved in plasma is incorrect as only a small fraction of oxygen is carried this way.
C: In ionic form as a solute in plasma is incorrect as oxygen is not typically found in ionic form in the blood.
D: Bound to the same protein as carbon dioxide is incorrect as oxygen binds to hemoglobin, while carbon dioxide primarily binds to different proteins such as carbonic anhydrase.