The nurse is caring for a client at risk for a respiratory infection.
Which of the following natural respiratory defense mechanisms help defend against infection? (Select all that apply).
Cilia lining the respiratory tract sweep debris upward in mucus to be swallowed.
The respiratory tract cools and dries the air being inhaled.
Cells in the respiratory tract secrete lysozymes that can destroy certain bacteria.
Macrophages engulf and destroy bacteria found in the alveoli.
High concentration of oxygen and carbon dioxide aid the defense mechanisms.
Correct Answer : A,C,D
These are natural respiratory defense mechanisms that help defend against infection.
Choice A is correct because cilia lining the respiratory tract sweep debris upward in mucus to be swallowed.
This prevents pathogens and particles from reaching the lungs.
Choice B is wrong because the respiratory tract does not cool and dry the air being inhaled. In fact, the respiratory tract warms and humidifies the air to facilitate gas exchange.
Choice C is correct because cells in the respiratory tract secrete lysozymes that can destroy certain bacteria.
Lysozymes are enzymes that break down the cell walls of bacteria.
Choice D is correct because macrophages engulf and destroy bacteria found in the alveoli. Macrophages are a type of white blood cell that act as scavengers of foreign invaders.
Choice E is wrong because high concentrations of oxygen and carbon dioxide do not aid the defense mechanisms.
On the contrary, high levels of these gases can impair gas exchange and cause acid-base imbalance.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
This is because it shows a normal pH, pCO2, HCO3 and pO2, indicating that the treatment has been effective in restoring normal gas exchange and acid- base balance.
Choice A is wrong because it shows a low pH, high pCO2 and high HCO3, indicating a mixed respiratory and metabolic acidosis.
Choice B is wrong because it shows a low pH, high pCO2 and low HCO3, indicating a combined respiratory and metabolic acidosis.
Choice D is wrong because it shows a high pH, low pCO2 and low HCO3, indicating a mixed respiratory and metabolic alkalosis.
The normal ranges for arterial blood gas (ABG) are:
- pH: 7.35 – 7.45
- pO2: 10 – 14 kPa or 75 – 105 mmHg
- pCO2: 4.5 – 6 kPa or 34 – 45 mmHg
Correct Answer is ["B","C","D"]
Explanation
The nurse should acknowledge the need for intimacy and value themselves in sexual relationships, ask if sexual experiences cause any kind of physical or emotional discomfort, and discuss any changes in sexual experience or satisfaction since beginning new treatments ordered by care providers.
These actions show respect, empathy, and professionalism towards the client’s sexuality.
Choice A is wrong because waiting for the client to volunteer information about any sexual problems they are having may imply that the nurse is uncomfortable or uninterested in addressing sexuality.
The nurse should initiate the conversation and create a safe and supportive environment for the client to express their concerns.
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