Nokea
What is the effect of carbonic anhydrase inhibition on the excretion of bicarbonate in the urine?
- A. Increased excretion
- B. Decreased excretion
- C. No effect on excretion
- D. Increased reabsorption
Correct Answer: A
Rationale: Carbonic anhydrase catalyzes the conversion of carbon dioxide and water to bicarbonate and hydrogen ions in the kidney. Inhibiting carbonic anhydrase reduces bicarbonate reabsorption, leading to increased excretion of bicarbonate in the urine. Therefore, the correct answer is A.
Incorrect choices:
B: Inhibiting carbonic anhydrase would decrease bicarbonate reabsorption, resulting in increased excretion, not decreased.
C: Inhibition of carbonic anhydrase does have an effect on bicarbonate excretion.
D: Inhibiting carbonic anhydrase would not increase reabsorption but rather decrease it, leading to increased excretion.
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A nurse is assessing a client who is recovering from a lung biopsy. The client's breath sounds are absent. While another nurse calls the Rapid Response Team
- A. what action by the nurse takes is most important?
- B. Take a full set of vital signs.
- C. Obtain pulse oximetry reading.
- D. Ask the patient about hemoptysis.
Correct Answer: B
Rationale: The correct answer is B, taking a full set of vital signs, as it is crucial in assessing the client's overall condition and detecting any signs of deterioration. Vital signs include blood pressure, heart rate, respiratory rate, and temperature, which provide valuable information about the client's cardiovascular and respiratory status. In this scenario, absent breath sounds indicate potential respiratory compromise, making it essential to monitor vital signs for any signs of respiratory distress or instability.
Choice A is incorrect because calling the Rapid Response Team is important, but assessing the client's vital signs should take priority to provide immediate information on the client's condition. Choice C, obtaining pulse oximetry reading, is also important but may not provide a comprehensive assessment of the client's overall condition compared to a full set of vital signs. Choice D, asking about hemoptysis, is not the most urgent action to take in this situation as assessing vital signs would provide more immediate and critical information for the client's management.
What keeps alveoli from collapsing?
- A. Carina
- B. Surfactant
- C. Empyema
- D. Thoracic cage
Correct Answer: B
Rationale: Surfactant is a substance that prevents the collapse of alveoli by reducing surface tension, allowing them to remain open and functional during the breathing process.
A nurse is teaching a client about possible complications and hazards of home oxygen therapy. About which complications doesn't the nurse plan to teach the client?
- A. Absorptive atelectasis
- B. Combustion
- C. Dried mucous membranes
- D. Alveolar recruitment
Correct Answer: D
Rationale: The correct answer is D - Alveolar recruitment. This is because alveolar recruitment is actually a benefit of home oxygen therapy, not a complication. It helps improve oxygenation by opening up collapsed alveoli.
A - Absorptive atelectasis is a potential complication where nitrogen is absorbed from the alveoli leading to collapse. B - Combustion is a hazard due to oxygen's flammability. C - Dried mucous membranes is a common complication of oxygen therapy due to the drying effect of oxygen.
An increase in the level of carbon dioxide in the blood will result in a(n):
- A. decrease in the rate of breathing.
- B. increase of the respiratory rate.
- C. decrease of pulmonary ventilation.
- D. decrease of the alveolar ventilation rate.
Correct Answer: B
Rationale: The correct answer is B: an increase of the respiratory rate. When carbon dioxide levels rise in the blood, it triggers the body to increase the rate of breathing to eliminate excess carbon dioxide through exhalation. This is known as the respiratory drive, controlled by the respiratory centers in the brainstem. Increasing the respiratory rate helps to restore the balance of gases in the blood.
Incorrect Choices:
A: Decrease in the rate of breathing - This is incorrect because high levels of carbon dioxide would stimulate an increase in breathing rate, not a decrease.
C: Decrease of pulmonary ventilation - This is incorrect as an increase in carbon dioxide would typically lead to an increase, not a decrease, in pulmonary ventilation.
D: Decrease of the alveolar ventilation rate - This is incorrect because an increase in carbon dioxide would prompt an increase in alveolar ventilation to remove excess carbon dioxide from the blood.
After undergoing a left pneumonectomy, a female patient has a chest tube in place for drainage. When caring for this patient, the nurse must:
- A. Monitor fluctuations in the water-seal chamber.
- B. Clamp the chest tube once every shift.
- C. Encourage coughing and deep breathing.
- D. Milk the chest tube every 2 hours.
Correct Answer: C
Rationale: Step-by-step rationale for why "Encourage coughing and deep breathing" (Choice C) is the correct answer:
1. After pneumonectomy, patient is at risk for lung complications.
2. Encouraging coughing and deep breathing helps prevent atelectasis and pneumonia.
3. It promotes lung expansion and clears secretions.
4. This intervention supports respiratory function and aids in recovery.
Summary of why the other choices are incorrect:
A. Monitoring fluctuations in the water-seal chamber (Choice A) is important for assessing the status of the chest tube drainage, but not the immediate priority for patient care post-pneumonectomy.
B. Clamping the chest tube once every shift (Choice B) is not recommended as it can lead to complications like tension pneumothorax.
D. Milking the chest tube every 2 hours (Choice D) is unnecessary and can cause trauma to the lung tissue and increase the risk of infection.