Nokea
You are the team leader RN working with a student nurse. The student nurse is to teach the client how to use a multidose inhaler without a spacer. Put the steps that the student nurse should teach the client in correct order.
- A. Remove the inhaler cap and shake the inhaler.
- B. Tilt your head back and breathe out fully.
- C. Press down firmly on the canister and breathe deeply through your mouth.
- D. Wait at least 1 minute between puffs.
Correct Answer: D
Rationale: The correct order is: A (remove cap and shake), B (tilt head back and breathe out), C (press down and breathe in), D (wait between puffs). This sequence ensures proper inhaler technique.
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Carbon dioxide and water combine to form
- A. hydrochloric acid
- B. oxygen
- C. carbonic acid
- D. carbaminohemoglobin
Correct Answer: C
Rationale: The correct answer is C: carbonic acid. When carbon dioxide and water combine, they form carbonic acid through a chemical reaction known as hydration. This process is essential for the transportation of carbon dioxide in the blood and plays a crucial role in maintaining the body's pH balance. Hydrochloric acid (A) is formed by the reaction of hydrogen chloride gas with water. Oxygen (B) is not a product of the reaction between carbon dioxide and water. Carbaminohemoglobin (D) is a compound formed by the binding of carbon dioxide to hemoglobin in red blood cells, not a direct product of the reaction between carbon dioxide and water.
A charge nurse is rounding on several older clients on ventilators in the Intensive Care Unit whom the nurse identifies as being at high risk for ventilator-associated pneumonia. To reduce this risk what activity would the nurse delegate to the assistive personnel (AP)?
- A. Encourage between-meal snacks.
- B. Monitor temperature every 4 hours.
- C. Provide oral care every 4 hours.
- D. Report any new onset of cough.
Correct Answer: C
Rationale: The correct answer is C: Provide oral care every 4 hours. Oral care helps prevent ventilator-associated pneumonia by reducing the risk of oral bacteria being aspirated into the lungs. The AP can assist with oral care under the nurse's supervision.
A: Encouraging between-meal snacks does not directly address pneumonia risk.
B: Monitoring temperature is important but not specific to ventilator-associated pneumonia prevention.
D: Reporting new cough onset is important but does not directly reduce the risk of ventilator-associated pneumonia.
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.
The concentration of carbon dioxide in the earth's atmosphere is
- A. 0.004 percent.
- B. 0.04 percent.
- C. 0.4 percent
- D. 4.0 percent.
Correct Answer: B
Rationale: The correct answer is B (0.04 percent) because the concentration of carbon dioxide in the Earth's atmosphere is around 400 parts per million (ppm), which is equivalent to 0.04 percent. This concentration is widely accepted by scientific research and measurements. Choice A (0.004 percent) is too low and doesn't accurately reflect the actual concentration. Choice C (0.4 percent) and choice D (4.0 percent) are both too high, which are significantly above the current levels of carbon dioxide in the atmosphere. Therefore, B is the correct choice as it aligns with the established scientific data on carbon dioxide concentration in the atmosphere.
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.