Nokea
Which of these does not affect diffusion rate?
- A. Surface area for diffusion
- B. Concentration gradient
- C. Solubility of gas
- D. Molecular weight of gas
Correct Answer: D
Rationale: The correct answer is D: Molecular weight of gas. Diffusion rate is inversely proportional to the square root of the molecular weight of the gas. This means that as the molecular weight increases, the diffusion rate decreases. This is because heavier molecules move more slowly and have a harder time diffusing through a medium. Surface area for diffusion, concentration gradient, and solubility of gas all directly affect diffusion rate. Increasing the surface area for diffusion allows for more space for molecules to diffuse, a steeper concentration gradient increases the rate of diffusion, and higher solubility of gas in a medium enhances the diffusion rate.
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What does a nurse assess postoperatively in a client with a nasal fracture?
- A. Allergic reaction
- B. Airway obstruction
- C. Extreme sense of smell
- D. Stridor
Correct Answer: B
Rationale: The correct answer is B. Airway obstruction is a critical concern after a nasal fracture due to potential swelling or displacement of bone fragments. A (allergic reaction) is unrelated. C (extreme sense of smell) is not a concern postoperatively. D (stridor) indicates severe airway compromise but is less common in nasal fractures.
With respect to regional gas exchange in the upright lung
- A. Ventilation is greater at the top of the lungs
- B. Perfusion is much greater at the top of the lungs compared with the bases
- C. Ventilation/perfusion ratio is abnormally high at the top of the lungs
- D. PO2 is highest at the bases of the lungs
Correct Answer: C
Rationale: The correct answer is C because in the upright lung, the ventilation-perfusion ratio is higher at the top due to gravity causing increased perfusion at the bases. This results in a mismatch between ventilation and perfusion, leading to a higher V/Q ratio at the top. Choices A and B are incorrect because ventilation is actually greater at the bases due to the effect of gravity, leading to higher ventilation there. Choice D is incorrect because PO2 is higher at the apex of the lung due to decreased perfusion but not at the bases.
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.
A 64-year-old female is admitted to the hospital. She has smoked two packs per day for 30 years. While providing her history, she becomes dyspneic and appears very anxious. She has a cough with thick white sputum production. Her chest is barrel shaped. Based on these data, the nurse will need to develop a plan of care for a client with?
- A. Pneumonia.
- B. Chronic obstructive pulmonary disease.
- C. Tuberculosis.
- D. Asthma.
Correct Answer: B
Rationale: The correct answer is B: Chronic obstructive pulmonary disease (COPD). The patient's smoking history, dyspnea, anxiety, chronic cough with sputum production, and barrel-shaped chest are indicative of COPD. Smoking is the primary cause of COPD, leading to airway inflammation and airflow limitation. The dyspnea, cough, and sputum production are common symptoms of COPD due to air trapping and mucus hypersecretion. The barrel-shaped chest is a sign of hyperinflation of the lungs seen in COPD patients. Pneumonia (A) typically presents with symptoms like fever and productive cough, not necessarily dyspnea and barrel chest. Tuberculosis (C) commonly presents with weight loss, night sweats, and hemoptysis, not the symptoms described. Asthma (D) often presents with wheezing, chest tightness, and reversible airflow obstruction, not the chronic symptoms described in this case.
Rate and depth of respiration shall increase when
- A. Oxygen concentration increases
- B. CO2 concentration increases
- C. Bicarbonate concentration increases
- D. Bicarbonate concentration decrease
Correct Answer: B
Rationale: The correct answer is B: CO2 concentration increases. When CO2 levels rise in the blood, it leads to an increase in the acidity of the blood, triggering the respiratory centers in the brain to increase the rate and depth of respiration in order to expel excess CO2 and restore the pH balance.
Explanation for other choices:
A: Oxygen concentration increases - An increase in oxygen concentration does not directly stimulate an increase in respiration rate or depth. The respiratory drive is primarily regulated by CO2 levels.
C: Bicarbonate concentration increases - While bicarbonate is involved in the acid-base balance in the body, it does not directly influence the rate and depth of respiration.
D: Bicarbonate concentration decreases - A decrease in bicarbonate concentration may affect acid-base balance, but it does not have a direct effect on respiratory rate and depth.