Nokea
When CO2 diffuses into blood in systemic capillaries most of it:
- A. Remains in solution as CO2
- B. Converts to carbamino compounds
- C. Converts to bicarbonate ions in RBC
- D. Combines with Hb directly
Correct Answer: C
Rationale: The correct answer is C because the majority of CO2 diffusing into blood combines with water inside red blood cells (RBC) to form carbonic acid, which then dissociates into bicarbonate ions and hydrogen ions. This reaction is facilitated by the enzyme carbonic anhydrase. This process allows for efficient transport of CO2 in the bloodstream. Choices A and B are incorrect as CO2 primarily undergoes conversion to bicarbonate ions, not remaining in solution as CO2 or forming carbamino compounds. Option D is incorrect as CO2 does not directly combine with hemoglobin.
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A client with suspected tuberculosis will most likely relate which clinical manifestations?
- A. Fatigue, weight loss, low grade fevers, night sweats.
- B. Dyspnea, chest pain, cough.
- C. Rapid shallow breathing, prolonged labored expiration, stridor.
- D. Dyspnea, hypoxemia, decreased pulmonary compliance.
Correct Answer: A
Rationale: The correct answer is A. A client with suspected tuberculosis is likely to experience fatigue, weight loss, low-grade fevers, and night sweats due to the chronic infection affecting the body. Fatigue and weight loss are common symptoms of active tuberculosis due to the systemic impact of the infection. Low-grade fevers and night sweats are characteristic of tuberculosis due to the body's immune response. These symptoms are key indicators of tuberculosis infection.
Choices B, C, and D are incorrect because they describe symptoms that are not typically associated with tuberculosis. Dyspnea, chest pain, and cough (Choice B) are more commonly seen in respiratory conditions such as pneumonia or bronchitis. Rapid shallow breathing, prolonged labored expiration, and stridor (Choice C) are indicative of airway obstruction rather than tuberculosis. Dyspnea, hypoxemia, and decreased pulmonary compliance (Choice D) are more characteristic of conditions such as chronic obstructive pulmonary disease (COPD) rather than tuberculosis.
A nurse in a medical unit is caring for a client with heart failure. The client suddenly develops extreme dyspnea,tachycardia and lung crackles. The nurse immediately asks another nurse to contact the primary health care provider and prepares to implement ALL priority interventions EXCEPT?
- A. Administer oxygen
- B. Administer furosemide (diuretic)
- C. Transport to coronary care unit
- D. Obtain stat Hepatic Panel
Correct Answer: C
Rationale: Rationale: Option C, transporting the client to the coronary care unit, is not the priority intervention because the client is presenting with acute pulmonary edema, a sign of worsening heart failure. Administering oxygen (Option A) is crucial to improve oxygenation. Administering furosemide (Option B) helps reduce fluid overload. Obtaining a stat Hepatic Panel (Option D) may be necessary to assess liver function due to medication side effects. However, immediate actions to address respiratory distress and tachycardia take precedence over moving the client to another unit.
Lungs are held tightly to the wall of the thorax due to
- A. the diaphragm and intercostal muscle contractions
- B. tight junctions between the lungs and the thorax
- C. surface tension of the pleural fluid and negative pressure in the cavity
- D. atmospheric pressure pushing on the lungs
Correct Answer: C
Rationale: The correct answer is C because the surface tension of the pleural fluid creates a cohesive force that keeps the lungs adhered to the thoracic wall. This, combined with the negative pressure in the pleural cavity, creates a vacuum effect that maintains the lungs' position.
A) The diaphragm and intercostal muscle contractions help with breathing but do not directly secure the lungs to the thorax.
B) Tight junctions between the lungs and thorax do not play a significant role in holding the lungs in place.
D) Atmospheric pressure does not hold the lungs against the thoracic wall; rather, it helps with breathing by aiding in lung expansion and contraction.
A medical patient rings her call bell and expresses alarm to the nurse, stating, 'I've just coughed up this blood. That can't be good, can it?' How can the nurse best determine whether the source of the blood was the patient's lungs?
- A. Obtain a sample and test the pH of the blood, if possible.
- B. Try to see if the blood is frothy or mixed with mucus.
- C. Perform oral suctioning to see if blood is obtained.
- D. Swab the back of the patient's throat to see if blood is present.
Correct Answer: B
Rationale: The correct answer is B: Try to see if the blood is frothy or mixed with mucus. By observing if the blood is frothy or mixed with mucus, the nurse can determine if the source is more likely to be from the lungs, as blood from the lungs is often frothy due to air mixing with it during coughing. This observation helps differentiate between blood coming from the respiratory tract versus other sources in the body.
Incorrect choices:
A: Testing the pH of the blood does not directly indicate the source of the blood in this context.
C: Performing oral suctioning may not provide accurate information about the source of the blood.
D: Swabbing the back of the throat may not help determine if the blood is coming from the lungs as it could be from other sources in the upper respiratory tract.
At a PO2 of 70 mm Hg and normal temperature and pH, hemoglobin is ________ percent saturated with oxygen.
- A. 10
- B. 25
- C. 50
- D. more than 90
Correct Answer: D
Rationale: The correct answer is D (more than 90). At a PO2 of 70 mm Hg, hemoglobin is more than 90% saturated with oxygen due to the high oxygen affinity of hemoglobin at this partial pressure. Hemoglobin exhibits near-maximal saturation at this level, promoting efficient oxygen binding and transport. Choices A, B, and C are incorrect as they do not accurately reflect the high oxygen saturation levels associated with a PO2 of 70 mm Hg.