Nokea
Which of the following statements about the chloride shift is false?
- A. It involves a movement of chloride ion into RBCs
- B. It depends on the chloride-bicarbonate countertransporter
- C. It causes RBCs to swell
- D. It is driven by a rise in PCO2
Correct Answer: C
Rationale: The correct answer is C because the chloride shift actually causes RBCs to shrink, not swell. During the chloride shift, chloride ions move out of RBCs in exchange for bicarbonate ions to maintain electrochemical equilibrium. This process helps maintain pH balance in blood. Choices A and B are correct as they accurately describe aspects of the chloride shift. Choice D is incorrect because the chloride shift is primarily driven by a decrease in PCO2, not a rise.
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While assessing a patient who has pneumonia, the nurse has the patient repeat the letter E while the nurse auscultates. The nurse notes that the patient's voice sounds are distorted and that the letter A is audible instead of the letter E. How should this finding be documented?
- A. Bronchophony
- B. Egophony
- C. Whispered pectoriloquy
- D. Sonorous wheezes
Correct Answer: B
Rationale: The correct answer is B: Egophony. Egophony is a lung sound in which the spoken "E" sound changes to a loud, nasal "A" sound when auscultated, indicating consolidation in the lungs, such as in pneumonia. This finding should be documented as egophony because it specifically describes the distortion of voice sounds during auscultation related to lung pathology.
A: Bronchophony refers to increased clarity and loudness of spoken sounds during auscultation and is not specific to the distortion of the voice sounds as in the given scenario.
C: Whispered pectoriloquy describes whispered sounds being heard clearly during auscultation, which is different from the scenario presented.
D: Sonorous wheezes are continuous low-pitched wheezing sounds heard with inspiration or expiration, not related to the distortion of voice sounds as in egophony.
Which blood pressure (BP) finding by the nurse indicates that no changes in therapy are needed for a 78-yr-old patient with newly diagnosed hypertension?
- A. 98/56 mm Hg
- B. 118/76 mm Hg
- C. 128/92 mm Hg
- D. 142/78 mm Hg
Correct Answer: B
Rationale: The correct answer is B (118/76 mm Hg) because it falls within the recommended range for a 78-year-old patient with hypertension. The systolic BP should ideally be below 140 mm Hg and the diastolic BP below 90 mm Hg for this age group. Option A is too low for systolic BP, indicating hypotension. Option C has elevated diastolic BP, suggesting uncontrolled hypertension. Option D has high systolic BP, indicating a need for therapy adjustment. Thus, only option B aligns with the guidelines, making it the correct choice.
While assessing a client who has facial trauma the nurse auscultates stridor. The client is anxious and restless. What action would the nurse take first?
- A. Contact the primary health care provider and prepare for intubation.
- B. Administer prescribed albuterol nebulizer therapy.
- C. Place the client in high-Fowler position.
- D. Ask the client to perform deep-breathing exercises.
Correct Answer: A
Rationale: Rationale: Stridor indicates upper airway obstruction, which can quickly progress to respiratory distress. As the client is anxious and restless, immediate intervention is crucial. Contacting the primary health care provider and preparing for intubation is the priority to secure the airway and ensure adequate oxygenation. Administering albuterol, positioning in high-Fowler, or deep-breathing exercises are not appropriate as they do not address the acute airway compromise.
A nurse caring for a client removes the client's oxygen as prescribed. The client is now breathing what percentage of oxygen in the room air?
- A. 14%
- B. 21%
- C. 28%
- D. 31%
Correct Answer: B
Rationale: The correct answer is B (21%). Room air contains approximately 21% oxygen. By removing the supplemental oxygen, the client is now breathing the oxygen content present in the surrounding air. Choices A, C, and D are incorrect as they do not reflect the standard oxygen concentration in room air. Oxygen concentration in room air is typically around 21%, making choice B the most accurate option.
In an adult patient with bronchiectasis, what is a nursing assessment likely to reveal?
- A. Chest trauma
- B. Childhood asthma
- C. Smoking or oral tobacco use
- D. Recurrent lower respiratory tract infections
Correct Answer: D
Rationale: In an adult patient with bronchiectasis, a nursing assessment is likely to reveal recurrent lower respiratory tract infections due to the damaged and widened airways in the lungs.