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1. A patient with chronic obstructive pulmonary disease (COPD) is admitted to
the hospital with acute respiratory distress. The nurse assesses the patient's
arterial blood gas (ABG) results and finds the following: pH 7.28, PaCO2 60
mmHg, PaO2 50 mmHg, HCO3 28 mEq/L. Based on these results, the nurse
should conclude that the patient has:
a) Respiratory acidosis with partial compensation
b) Respiratory alkalosis with partial compensation
c) Metabolic acidosis with partial compensation
d) Metabolic alkalosis with partial compensation
*Answer: a) Respiratory acidosis with partial compensation
Rationale: Respiratory acidosis occurs when the lungs cannot eliminate enough
carbon dioxide, resulting in a low pH and a high PaCO2. The kidneys try to
compensate by retaining bicarbonate (HCO3), which is a base, to balance the
acid. Partial compensation means that the pH is still abnormal, but the HCO3
is within or close to the normal range (22-26 mEq/L).*
2. A patient with type 1 diabetes mellitus is scheduled for a hemoglobin A1c
(HbA1c) test to monitor his blood glucose control over the past three months.
The nurse knows that the normal range for HbA1c is:
a) 4-6%
b) 6-8%
c) 8-10%
d) 10-12%
*Answer: a) 4-6%
Rationale: HbA1c is a measure of how much glucose is attached to the
hemoglobin molecules in the red blood cells. The higher the blood glucose
level, the more glucose attaches to hemoglobin, and the higher the HbA1c
level. A normal HbA1c level indicates good blood glucose control and a lower
risk of diabetes complications. A HbA1c level above 6.5% is diagnostic of
diabetes.*
3. A patient with hypertension is prescribed a beta-blocker medication to lower
his blood pressure. The nurse understands that beta-blockers work by:
a) Blocking the action of angiotensin II on the blood vessels
b) Blocking the action of aldosterone on the kidneys
c) Blocking the action of epinephrine and norepinephrine on the heart
d) Blocking the action of renin on angiotensinogen
*Answer: c) Blocking the action of epinephrine and norepinephrine on the
heart
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