The nurse is caring for an elderly patient in the PACU. The patient has had a bronchoscopy, and the nurse is monitoring for complications related to the administration of lidocaine. For what complication related to the administration of large doses of lidocaine in the elderly should the nurse assess?

Correct Answer: C

Rationale: The correct answer is C: Confusion and lethargy. Lidocaine toxicity in the elderly can lead to central nervous system symptoms like confusion and lethargy due to impaired metabolism and clearance of the drug. The liver and kidney function decline with age, affecting lidocaine clearance. This can result in an accumulation of lidocaine leading to CNS symptoms. Choices A, B, and D are incorrect as they do not directly relate to lidocaine toxicity in the elderly. Decreased urine output and hypertension may be seen with other conditions like renal failure. Headache and vision changes are not typical symptoms of lidocaine toxicity. Jaundice and elevated liver enzymes may indicate liver dysfunction but are not specific to lidocaine toxicity.

Correct Answer: C

Rationale: Step 1: The movement labeled '2' is inhalation. Step 2: During inhalation, the diaphragm contracts and moves downward. Step 3: This creates more space in the thoracic cavity, allowing the lungs to expand and fill with air. Step 4: Therefore, the correct answer is C: diaphragm contracts produces the movement labeled '2'. Summary: Choice A and B are incorrect because the rectus abdominis is not directly involved in inhalation. Choice D is incorrect because the diaphragm needs to contract to create the necessary space for inhalation.

Correct Answer: D

Rationale: The correct answer is D because a higher PO2 gradient between alveoli and blood promotes greater oxygen binding to hemoglobin in the lungs. A high PCO2 (choice A) would actually decrease oxygen binding, while a slightly acidic pH (choice B) can affect oxygen dissociation but not loading. Having a PO2 of about 70 mm Hg (choice C) is not optimal for maximum loading as it is lower than what is typically found in the alveoli during normal breathing.

Correct Answer: C

Rationale: The correct answer is C because the Dorsal Respiratory Group (DRG) is involved in both inspiration and expiration, not just forced breathing. During quiet breathing, the DRG primarily controls inspiration, while the Ventral Respiratory Group (VRG) primarily controls expiration. In forced breathing, both the DRG and VRG are activated to increase respiratory effort. Choice A and B are both true statements as the DRG controls inspiration and the VRG controls expiration. Choice D is incorrect as the VRG is involved in both quiet and forced breathing, not just forced breathing.

Correct Answer: A

Rationale: The correct answer is A: visceral and parietal pleurae. The visceral pleura covers the surface of the lungs, while the parietal pleura lines the thoracic cavity. They form a double-layered membrane that helps reduce friction during breathing. Choices B and C are incorrect because the mediastinum is a central compartment in the thoracic cavity, not a layer of the pleura. Choice D is incorrect as it does not provide a valid alternative.