A nurse auscultates a harsh hollow sound over a client's trachea and larynx. Which action should the nurse take first?

Correct Answer: A

Rationale: The correct answer is A: Document the findings. The nurse should first document the assessment findings to establish a baseline and communicate the abnormal sound to the healthcare team for further evaluation. This is crucial for accurate diagnosis and treatment planning. Administering oxygen therapy (B) may be needed depending on the client's oxygen saturation but is not the priority in this situation. Positioning the client in high-Fowlers position (C) may help with breathing but does not address the underlying cause of the abnormal sound. Administering albuterol (D) may be indicated for bronchospasm but should not be done without understanding the cause of the harsh hollow sound first.

Correct Answer: A

Rationale: Step-by-step rationale for choice A being correct: 1. Myoglobin is composed of a single polypeptide chain with 153 amino acids, making it monomeric. 2. Being monomeric, myoglobin does not exhibit cooperative binding, leading to a hyperbolic oxygen dissociation curve. 3. The lack of multiple subunits in myoglobin results in non-cooperative binding and a hyperbolic curve. 4. The monomeric nature allows myoglobin to have a simple structure, enhancing its affinity for oxygen. Summary of why other choices are incorrect: B: High concentration in the muscle does not directly explain the hyperbolic curve. C: Being a muscle protein does not inherently determine the hyperbolic nature of the oxygen dissociation curve. D: Quaternary structure would involve multiple subunits, leading to cooperative binding and a sigmoidal oxygen dissociation curve.

Correct Answer: B

Rationale: The correct answer is B because turning the patient to enable assessment of all the lung fields is the best approach to assess lung sounds comprehensively. By turning the patient, the nurse can listen to breath sounds on both the anterior and posterior chest walls, ensuring a thorough assessment. Option A is incorrect as it assumes the need for a chest x-ray without first performing a physical assessment. Option C is incorrect as it limits assessment to only the anterior chest wall, potentially missing abnormalities in the posterior lung fields. Option D is incorrect as obtaining a pulse oximetry reading and repositioning the patient should not replace the need for a physical assessment of lung sounds.

Correct Answer: C

Rationale: The continuous wheezes heard on auscultation during both inspiration and expiration in a teenage girl with acute shortness of breath are highly suggestive of asthma. Asthma is characterized by airway inflammation and bronchoconstriction, leading to wheezing on both inspiration and expiration. Other choices like pleurisy typically present with sharp chest pain worsened by breathing, emphysema with decreased breath sounds and barrel chest, and pneumonia with crackles and possibly fever.

Correct Answer: D

Rationale: The correct answer is D: decreased amounts of BPG. BPG binds to hemoglobin, reducing its affinity for oxygen. Without BPG, hemoglobin holds onto oxygen tightly, decreasing its release to tissues. Increased temperature (choice A) and decreased pH (choice B) actually enhance oxygen release by hemoglobin through the Bohr effect. Decreased tissue PO2 (choice C) triggers hemoglobin to release more oxygen due to the oxygen-hemoglobin dissociation curve.