NUR 406 Exam 18 - patient has later-stage COPD? a. pH 7.32, PaCO2...

NUR 406 Exam 18

• The nurse reviews the arterial blood gases of a patient. Which result would indicate the

patient has later-stage COPD?

• pH 7.32, PaCO2 58 mm Hg, PaO2 60 mm Hg, HCO3 30 mEq/L
• pH 7.30, PaCO2 45 mm Hg, PaO2 55 mm Hg, HCO3 18 mEq/L
• pH 7.40, PaCO2 40 mm Hg, PaO2 70 mm Hg, HCO3 25 mEq/L
• pH 7.52, PaCO2 30 mm Hg, PaO2 80 mm Hg, HCO3 35 mEq/L

Answer

• pH 7.32,

PaCO2 58 mm Hg, PaO2 60 mm Hg, HCO3 30 mEq/L

• A patient's ABG results include

pH 7.31 PaCO2 50 mm Hg PaO2 51 mm Hg HCO3 24 mEq/L Oxygen is administered at 2 L/min, and the patient is placed in high-Fowler's position. An hour later the ABGs are repeated with a results of pH 7.36 PaCO2 40 mm Hg PaO2 60 mm Hg HCO3 24 mEq/L What is most important for the nurse to do?

• Increase the oxygen flow rate to 4 L/min
• Document the findings in the patient's record
• Reposition the patient in a semi-Fowler's position
• Prepare the patient for endotracheal intubation and mechanical ventilation-

Answer

• Increase the oxygen flow rate to 4 L/min

• Which patient is at highest risk for hypoxemic respiratory failure?
• A patient who has respiratory muscle paralysis
• A patient who has fractured ribs and a flail chest
• A patient who has a massive pulmonary embolism 1 / 3

• A patient who has slow breathing from a drug overdose

Answer

• A patient who has a massive pulmonary embolism

• A patient's ABG results include pH 7.32

PaCO3 50 mmHg PaO2 51 mmHg HCO3 24 mEq/L Oxygen is administered at 2 L/min, and the patient is placed in high-fowler's position. An hour later, the ABGs are repeated with results of pH 7.36 PaCO2 40 mmHg

PaO2 60 mmHg HCO3 24 mEq/L What is most important for the nurse to do?

• increase the oxygen flow rate to 4 L/min
• document the findings in the patient's record
• reposition the patient in a semi-Fowler's position
• prepare the patient for endotracheal intubation and mechanical ventilation-

Answer

• increase the oxygen flow rate to 4 L/min

• When assessing a patient with sepsis, which finding would alert the nurse to the onset of

acute respiratory distress syndrome (ARDS)?

• SpO2 of 80%
• use of accessory muscles of respiration
• fine, scattered crackles on auscultation of the chest

• ABGs of oH 7.33, PaCO2 49 mmHg, PaO2 80 mmHg

Answer

• fine, scattered crackles on auscultation of the chest

• A patient with severe chronic lung disease is hospitalized with respiratory distress. Which

finding would suggest to the nurse that the patient has devel- oped rapid decompensation?

• an SpO2 of 86%
• a blood pH of 7.33 2 / 3

• agitation of confusion

• PaCO2 increases from 48 to 55 mmHg

Answer

• agitation of confusion

• A patient with a history of alcoholism is admitted to the ICU with hemor- rhage from

esophageal varices. Admission VS are BP 84/58 mmHg, HR 105, RR 32. The nurse recognizes the onset of systemic inflammatory response syndrome (SIRS) upon finding

• pulmonary edema
• cardiac dysrhythmias
• absent bowel sounds

• decreasing blood pressure

Answer

• pulmonary edema

• A patient admitted to the hospital from a long-term care facility appears to be in the late

stage of shock with systemic inflammatory response syndrome (SIRS). Which order implemented by the nurse has the highest priority?

• insert an indwelling urinary catheter
• insert two large-bore intravenous catheters
• administer 0.9% normal saline at 100 mL/hr

• administer 100% oxygen by non-rebreather mask

Answer

• insert two large-bore intravenous catheters

• Isoniazid

Answer an antitubercular given to patient's with TB infection

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