A nurse cares for a client who had a bronchoscopy 2 hours ago. The client asks for a drink of water. Which action should the nurse take next?

Correct Answer: C

Rationale: Correct Answer: C Rationale: 1. Assessing the client's gag reflex is crucial after a bronchoscopy to prevent aspiration. 2. Gag reflex helps protect the airway from foreign substances entering the lungs. 3. Providing food or water without assessing the gag reflex can lead to aspiration pneumonia. 4. It is essential to ensure the client's safety before allowing any intake post-bronchoscopy. Summary: A: Calling the physician for a prescription is not necessary at this immediate stage. B: Ice chips may still pose a risk if the client cannot protect their airway. D: Allowing a sip without assessing gag reflex may lead to aspiration.

Correct Answer: D

Rationale: The correct answer is D: Hemoglobin. Carbonic anhydrase is an enzyme found in red blood cells that rapidly catalyzes the conversion of carbon dioxide into bicarbonate ions. Hemoglobin plays a crucial role in transporting carbon dioxide in the blood. The high concentration of hemoglobin in red blood cells allows for efficient binding and transport of carbon dioxide, leading to the need for a rapid enzyme like carbonic anhydrase to facilitate its conversion. Plasma (choice A) does not directly influence the concentration of carbonic anhydrase. Carbon dioxide (choice B) is the substrate for carbonic anhydrase, not the reason for its concentration. Sodium ions (choice C) do not directly affect the action of carbonic anhydrase in red blood cells.

Correct Answer: A

Rationale: The correct answer is A, presence of a cough and gag reflex. After a bronchoscopy, it is crucial for the nurse to ensure the patient has a cough and gag reflex before allowing them to drink fluids to prevent aspiration. Cough reflex helps clear secretions, and gag reflex prevents fluids from entering the airway. Choices B, C, and D are incorrect as they do not directly relate to the safety of the patient's ability to swallow post-bronchoscopy.

Correct Answer: B

Rationale: The correct answer is B: Decreased diffusion capacity for oxygen. With age, respiratory dead space increases, leading to a mismatch between ventilation and perfusion in the lungs. This results in a decrease in the ability of the lungs to effectively transfer oxygen into the bloodstream, reducing the diffusion capacity for oxygen. This physiological change can lead to decreased oxygenation of tissues and organs. Summary: A: Increased diffusion of gases - Incorrect. Increased dead space does not enhance gas diffusion; instead, it impairs gas exchange. C: Decreased shunting of blood - Incorrect. Shunting refers to blood bypassing oxygenation in the lungs, which is not directly affected by dead space. D: Increased ventilation - Incorrect. While dead space may lead to increased ventilation efforts, it does not directly improve oxygen diffusion capacity.

Correct Answer: D

Rationale: The correct answer is D: Bronchioles. Bronchioles are the smallest airways in the lungs and play a crucial role in determining pulmonary resistance. They have smooth muscle surrounding them, which can contract or relax to regulate airflow and resistance. Constriction of bronchioles increases resistance, while dilation decreases it. Visceral and parietal pleura (A) are membranes that cover the lungs and chest wall, not directly involved in determining pulmonary resistance. The trachea (B) and bronchi (C) are larger airways that mainly serve as conduits for air passage and do not have as significant an impact on resistance as the bronchioles do.