A client receiving mechanical ventilation has a pH of 7.26, PaCO2 of 88 mm Hg, and a PaO2 of 92 mm Hg. Which intervention should the nurse implement?

Reference Range:

Arterial Blood Gas (ABG)

pH Adult/child: 7.35 to 7.45]

PaCO2 [Adult/child: 35 to 45 mm Hg]

HCO-[Adult/child: 21 to 28 mEq/L (21 to 28 mmol/L)]

Increase ventilator tidal volume.

Decrease expiratory flow time.

Decrease expiratory pressure.

Increase rate of ventilation.

Answer and Explanation

The Correct Answer is D

A. Increasing the ventilator tidal volume could improve the client's ventilation but may not adequately address the severe hypercapnia indicated by the elevated PaCO2.

B. Decreasing expiratory flow time is not a priority and may not improve ventilation effectively.

C. Decreasing expiratory pressure does not directly address the underlying problem of carbon dioxide retention.

D. Increasing the rate of ventilation is the most appropriate intervention to improve carbon dioxide elimination and correct the acid-base imbalance indicated by the low pH and high PaCO2.

Nursing Test Bank

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Free Nursing Study Resources

Correct Answer is ["A","B","D"]

Explanation

A. Obtaining a portable chest x-ray is the gold standard for confirming ETT placement, ensuring the tube is positioned correctly in the trachea and not in the esophagus.

B. Assessing for symmetrical chest movement is important; asymmetry may indicate improper tube placement or lung involvement.

C. Monitoring ETT markings can provide some information about placement, but it is not a definitive method for verifying correct placement since individual anatomy can vary.

D. Auscultating for bilateral breath sounds confirms that air is reaching both lungs, indicating proper ETT placement.

E. Checking capillary refill does not assess ETT placement and is not relevant in this context; the focus should be on respiratory status and tube positioning.

A. Explain that the client may need medication therapy. B. Encourage the client to reduce consumption of fatty foods. C. Confirm that this value is helpful in reducing cardiac risk. D. Ask the client about hereditary cardiac risk factors.

Correct Answer is C

Explanation

A. A high HDL level typically indicates a lower risk for heart disease, and medication therapy is generally not indicated for high HDL.

B. Reducing fatty food intake is not necessary since a high HDL level is associated with lower cardiovascular risk.

C. Confirming that a high HDL level is beneficial for reducing cardiac risk is important, as it reflects a protective factor against heart disease.

D. While asking about hereditary cardiac risk factors is relevant in a comprehensive assessment, it is not immediately necessary in response to a high HDL level.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A young adult is brought to the emergency department after taking a handful of drugs. The client is unresponsive, so an endotracheal tube (ETT) is inserted. How should the nurse determine if the ETT is correctly placed? Select all that apply.

Correct Answer is ["A","B","D"]

Explanation

A older adult client tells the nurse that of having a high-density lipoprotein (HDL) level of 85 mg/dL (2.2 mmol/L). Which action should the nurse take? Reference Range: High Density Lipoproteins (HDL) [greater than 45 mg/dL (greater than 0.75 mmol/L)]

Correct Answer is C

Explanation

Which assessment technique provides the most useful data when the nurse is concerned about possible urinary retention?

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