A female patient suffers acute respiratory distress syndrome as a consequence of shock. The patient's condition deteriorates rapidly, and endotracheal intubation and mechanical ventilation are initiated. When the high-pressure alarm on the mechanical ventilator, alarm sounds, the nurse starts to check for the cause. Which condition triggers the high-pressure alarm?

Correct Answer: A

Rationale: The correct answer is A: Kinking of the ventilator tubing. This condition can cause a blockage in the airflow, leading to increased pressure in the ventilator circuit, triggering the high-pressure alarm. Kinking restricts the flow of air, causing a buildup of pressure in the system. This situation can lead to inadequate ventilation and potential harm to the patient. Choice B, a disconnected ventilator tube, would trigger a low-pressure alarm rather than a high-pressure alarm because the disconnection would result in a loss of pressure. Choice C, an endotracheal cuff leak, would not directly cause an increase in pressure within the ventilator circuit. Choice D, a change in oxygen concentration without resetting the alarm, would not trigger the high-pressure alarm but rather an oxygen alarm if the concentration falls outside the set range. In summary, kinking of the ventilator tubing is the correct answer as it directly leads to increased pressure in the ventilator circuit, triggering the high-pressure alarm.

Correct Answer: B

Rationale: The correct answer is B: Sputum culture. This test confirms the diagnosis of tuberculosis by identifying the presence of Mycobacterium tuberculosis in the sputum sample. It is the gold standard for diagnosing active tuberculosis. Bronchoscopy (A) is invasive and used to visualize the airways, not for confirming TB diagnosis. Chest x-ray (C) may show characteristic findings of TB, but it does not confirm the diagnosis. Tuberculin skin test (D) only indicates exposure to TB bacteria, not active infection.

Correct Answer: D

Rationale: The correct answer is D: Increased red blood cells. In chronic bronchitis, the body compensates for chronic hypoxia by increasing red blood cell production (erythropoiesis) to improve oxygen delivery. This is known as polycythemia. Decreased platelets (A) and white blood cells (B) are not typical features of chronic bronchitis. Increased eosinophils (C) are more commonly associated with allergic conditions or parasitic infections, not chronic bronchitis. In summary, the increased red blood cells in chronic bronchitis help enhance oxygen-carrying capacity, distinguishing it from the other options.

Correct Answer: B

Rationale: The correct answer is B because pleurisy is inflammation of the pleural membrane, causing pain during breathing due to friction between the inflamed layers. Choice A is incorrect as alveoli are not directly affected in pleurisy. Choice C is incorrect as pleurisy does not cause cramps in the diaphragm. Choice D is incorrect as the vagus nerve irritation is not a characteristic feature of pleurisy.

Correct Answer: D

Rationale: The correct answer is D because hemoglobin releases oxygen more readily in highly active tissues due to increased metabolic demand for oxygen. This is known as the Bohr effect. Choice A is incorrect as hemoglobin binds oxygen in the lungs where oxygen partial pressure is high. Choice B is incorrect as hemoglobin actually releases oxygen in acidic conditions to increase oxygen delivery to tissues. Choice C is incorrect as hemoglobin releases oxygen in warmer areas to facilitate oxygen delivery to metabolically active tissues.