Nokea
Which of the following conditions is evident by persistent hoarseness?
- A. Bacterial infection
- B. Laryngeal cancer
- C. Aphonia
- D. Peritonsillar abscess
Correct Answer: B
Rationale: The correct answer is B. Persistent hoarseness is a hallmark symptom of laryngeal cancer. A (bacterial infection) may cause temporary hoarseness but not persistent. C (aphonia) refers to complete loss of voice, not hoarseness. D (peritonsillar abscess) affects the throat but does not typically cause persistent hoarseness.
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A client has been admitted for suspected inhalation anthrax infection. What question by the nurse is most important?
- A. Are any family members also ill?
- B. Have you traveled recently?
- C. How long have you been ill?
- D. What is your occupation?
Correct Answer: D
Rationale: The correct answer is D: What is your occupation? This is the most important question because inhalation anthrax is commonly associated with certain occupations, like handling animal products or working in agricultural settings. Knowing the client's occupation can help identify potential sources of exposure.
A: Are any family members also ill? - While important for assessing potential spread of infection, this question does not directly help in determining the cause of the anthrax infection.
B: Have you traveled recently? - Travel history is relevant for certain infectious diseases, but for inhalation anthrax, occupational exposure is a more crucial factor to consider.
C: How long have you been ill? - Timing of symptoms is important for diagnosis and treatment, but knowing the client's occupation provides more specific information in the case of suspected inhalation anthrax.
A nurse observes that a client's anteroposterior (AP) chest diameter is the same as the lateral chest diameter. Which question would the nurse ask the client in response to this finding?
- A. Are you taking any medications or herbal supplements?
- B. Do you have any chronic breathing problems?
- C. How often do you perform aerobic exercise?
- D. What is your occupation and what are your hobbies?
Correct Answer: B
Rationale: The correct answer is B: Do you have any chronic breathing problems? This question is appropriate because equal AP and lateral chest diameters could indicate barrel chest, which is often associated with chronic obstructive pulmonary disease (COPD) or other chronic breathing problems. Asking about chronic breathing problems can help the nurse further assess the client's respiratory health.
Incorrect answers:
A: Are you taking any medications or herbal supplements? This question is not directly related to the observed chest diameter findings.
C: How often do you perform aerobic exercise? This question is not relevant to the physical assessment findings and does not address the potential respiratory issue.
D: What is your occupation and what are your hobbies? This question does not directly address the equal AP and lateral chest diameters and does not help in assessing the respiratory status of the client.
When Bohr effect occurs due to increased CO2 tension, Oxygen affinity of Hb decreases. The reason for increased CO2 tension is
- A. Increase in P50
- B. Decrease in P50
- C. High CO2 content
- D. High O2 content
Correct Answer: A
Rationale: The correct answer is A because an increase in P50 indicates a decrease in oxygen affinity of hemoglobin (Hb), as seen in the Bohr effect. When CO2 tension rises, it forms carbonic acid in the blood, leading to a decrease in pH. This decrease in pH causes a right shift in the oxygen-hemoglobin dissociation curve, resulting in lower oxygen affinity of Hb. Decreasing P50 reflects this reduced affinity. Choices B, C, and D are incorrect because a decrease in P50, high CO2 content, and high O2 content would not lead to a decrease in oxygen affinity as observed in the Bohr effect.
Which type of acid-base imbalance can result from the inhibition of carbonic anhydrase?
- A. Metabolic acidosis
- B. Respiratory acidosis
- C. Metabolic alkalosis
- D. Respiratory alkalosis
Correct Answer: C
Rationale: Carbonic anhydrase catalyzes the conversion of carbon dioxide and water into carbonic acid, which then dissociates into bicarbonate and hydrogen ions. Inhibition of carbonic anhydrase leads to decreased bicarbonate levels, causing metabolic alkalosis. Without adequate bicarbonate, the body accumulates excess base, resulting in alkalosis. Metabolic acidosis (A) is incorrect because inhibition of carbonic anhydrase would lead to excess base, not acid. Respiratory acidosis (B) and respiratory alkalosis (D) are incorrect as they are caused by respiratory, not metabolic, disturbances.
The 75-year-old patient presents to the emergency department with shortness of breath,
fatigue, and a dry cough. When information leads the nurse to suspect that this patient should
undergo workup for histoplasmosis?
- A. The patient reports drinking pond water
- B. The patient lives on a farm and raises chickens.
- C. The patient recently went hunting in a wooded area.
- D. The patient owns a landscaping company.
Correct Answer: B
Rationale: The correct answer is B because living on a farm and raising chickens increases the risk of exposure to histoplasmosis, a fungal infection commonly found in soil contaminated with bird droppings. Raising chickens can lead to exposure to bird feces, which may contain the histoplasma fungus. The other choices (A, C, D) do not directly involve exposure to environments where the fungus is commonly found, making them less likely to lead to histoplasmosis workup.