Nokea
Your client with pneumonia is being discharged today. Which of the following physical findings would lead the nurse to believe the client is appropriate for discharge. Select all that apply.
- A. Decreased tactile fremitus in left base
- B. Increased fatigue when walking
- C. SpO2 98% at rest
- D. Respiratory rate 30 breaths/minute
Correct Answer: C
Rationale: The correct answer is C: SpO2 98% at rest. This indicates adequate oxygenation, a crucial aspect of recovery from pneumonia. A: Decreased tactile fremitus suggests consolidation, indicating ongoing infection. B: Increased fatigue suggests continued weakness. D: A respiratory rate of 30 breaths/minute is elevated and indicates respiratory distress, not readiness for discharge.
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Factors affecting the release of oxygen from hemoglobin can be visualized by using a
- A. spirograph
- B. pulmonary volume chart
- C. respiratory cycle chart
- D. oxygen-hemoglobin saturation curve
Correct Answer: D
Rationale: The correct answer is D: oxygen-hemoglobin saturation curve. This is because the oxygen-hemoglobin saturation curve graphically depicts the relationship between the saturation of hemoglobin with oxygen and the partial pressure of oxygen. This curve helps visualize factors affecting oxygen release, such as pH, temperature, and carbon dioxide levels.
A: Spirograph is a tool used for drawing geometric shapes and has no relevance to hemoglobin oxygen release.
B: Pulmonary volume chart is used to measure lung volumes and capacities, not specifically related to hemoglobin oxygen release.
C: Respiratory cycle chart may show breathing patterns but does not directly visualize factors affecting oxygen release from hemoglobin.
In summary, the oxygen-hemoglobin saturation curve is the most appropriate tool for visualizing factors influencing oxygen release from hemoglobin, making it the correct choice over the other options.
The nurse is caring for a patient with advanced emphysema. Which sign isn't manifestations of this disorder?
- A. Productive cough
- B. Dyspnea
- C. Barrel chest
- D. Wheezing
Correct Answer: D
Rationale: The correct answer is D: Wheezing. Emphysema is characterized by destruction of lung tissue, leading to air trapping and decreased airflow. Wheezing is typically associated with asthma or bronchitis, not emphysema. A: Productive cough is common in emphysema due to increased mucus production. B: Dyspnea (shortness of breath) is a hallmark symptom of emphysema due to impaired gas exchange. C: Barrel chest is a physical finding in emphysema caused by hyperinflation of the lungs.
Which information from a client helps the nurse confirm the previous diagnosis of chronic stable angina?
- A. The pain wakes me up at night.
- B. The pain is level 3 to 5 (0 to 10 scale).
- C. The pain has gotten worse over the last week.
- D. The pain goes away after I stop jogging.
Correct Answer: D
Rationale: The correct answer is D because chronic stable angina is characterized by chest pain or discomfort that is triggered by physical exertion or emotional stress and relieved by rest or medication. Therefore, the fact that the pain goes away after stopping jogging aligns with the typical pattern of chronic stable angina.
A: The pain waking the client up at night is more indicative of unstable angina or a heart attack.
B: The level of pain on a scale does not provide conclusive evidence of chronic stable angina.
C: Pain worsening over time may suggest unstable angina or a heart attack rather than chronic stable angina.
An oxygen delivery system is prescribed for a male client with chronic obstructive pulmonary disease to deliver a precise oxygen concentration. Which of the following types of oxygen delivery systems would the nurse anticipate to be prescribed?
- A. Face tent
- B. Venturi mask
- C. Aerosol mask
- D. Tracheostomy collar
Correct Answer: B
Rationale: The correct answer is B: Venturi mask. This type of oxygen delivery system allows for precise oxygen concentration delivery by adjusting the oxygen flow rate and selecting the appropriate color-coded adaptor. Venturi masks are commonly used in clients with COPD to ensure accurate oxygen delivery and prevent oxygen toxicity.
A: Face tent provides high humidity but does not allow for precise oxygen concentration delivery.
C: Aerosol mask is used for humidification and medication delivery, not for precise oxygen concentration.
D: Tracheostomy collar is used for clients with a tracheostomy, not for precise oxygen concentration in COPD.
Which form of epithelial tissue may be found in the upper respiratory system (URS)?
- A. pseudostratified ciliated columnar epithelium.
- B. moist cuboidal epithelium.
- C. simple squamous epithelium.
- D. stratified squamous epithelium.
Correct Answer: A
Rationale: Step 1: The upper respiratory system requires protection and mucus secretion.
Step 2: Pseudostratified epithelium provides protection and has cilia for moving mucus.
Step 3: Ciliated columnar cells help sweep mucus and debris out of the respiratory tract.
Step 4: Therefore, pseudostratified ciliated columnar epithelium is the correct choice.
Summary:
B: Moist cuboidal epithelium lacks cilia and isn't specialized for mucus clearance.
C: Simple squamous epithelium is too thin and fragile for protection.
D: Stratified squamous epithelium is more suited for areas with high mechanical stress.