A client with a pulmonary embolus has the following arterial blood gas (ABG) values: pH. 7.49: partial pressure of arterial oxygen (PaO2), 60 mm Hg partial pressure of arterial carbon dioxide (PaCO2), 30 mm Hg: bicarbonate (HCO3-1 25 mEq/L. What should the nurse do first?

Increase fluid intake.

Administer oxygen therapy.

Administer sodium bicarbonate.

Prepare the client for mechanical ventilation.

Answer and Explanation

The Correct Answer is B

Rationale:
A. Increasing fluid intake does not address the immediate problem of impaired oxygenation.
B. The ABG shows respiratory alkalosis (pH 7.49, PaCO₂ 30) with hypoxemia (PaO₂ 60). The priority intervention is to administer oxygen therapy to correct hypoxemia caused by the pulmonary embolus.
C. Sodium bicarbonate is used for metabolic acidosis, not respiratory alkalosis.
D. Mechanical ventilation may be required if oxygen therapy fails, but it is not the first action.

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Correct Answer is C

Explanation

Rationale:
A. Metabolic alkalosis is characterized by a high pH (>7.45) and elevated bicarbonate, which is not seen here.
B. Respiratory alkalosis presents with high pH (>7.45) and low PaCO₂ (<35 mm Hg). In this case, PaCO₂ is elevated, and pH is low, so this is incorrect.
C. Respiratory acidosis is indicated by a low pH (<7.35) and elevated PaCO₂ (>45 mm Hg). The client’s pH is 7.22, and PaCO₂ is 68 mm Hg, consistent with respiratory acidosis. The low respiratory rate (7/min) confirms hypoventilation as the underlying cause.
D. Metabolic acidosis shows low pH and low bicarbonate, but the bicarbonate here is normal (26 mEq/L), so this is incorrect.

A. Applying a cold compress to the patient's chest B. Encouraging the patient to lie flat to rest C. Administering bronchodilators as prescribed D. Increasing the patient's fluid intake to 500 mL daily

Correct Answer is C

Explanation

Rationale:
A. Applying a cold compress to the chest does not relieve dyspnea or help mobilize secretions.
B. Lying flat worsens breathing by reducing lung expansion; COPD patients should be positioned upright to ease ventilation.
C. Administering bronchodilators as prescribed is the most appropriate intervention because bronchodilators relax airway smooth muscle, reduce bronchospasm, and improve airflow, helping the patient clear secretions more effectively.
D. Fluid intake should be increased to 2,000–2,500 mL/day (unless contraindicated) to thin secretions; reducing to 500 mL daily would worsen secretion clearance.

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A client with a pulmonary embolus has the following arterial blood gas (ABG) values: pH. 7.49: partial pressure of arterial oxygen (PaO2), 60 mm Hg partial pressure of arterial carbon dioxide (PaCO2), 30 mm Hg: bicarbonate (HCO3-1 25 mEq/L. What should the nurse do first?

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Naxlex Comprehensive Predictor Exams

A client is admitted to the emergency room with a respiratory rate of 7/min. Arterial blood gases (ABG) reveal the following values. Which of the following is an appropriate analysis of the ABGs? pH 7.22 PaCO2, 68 mm Hg PaO2, 78 mm Hg Saturation 80% Bicarbonate 26 mEq/L

Correct Answer is C

Explanation

Which of the following interventions is most appropriate for a patient with Chronic Obstructive Pulmonary Disease (COPD) experiencing difficulty breathing due to increased secretions?

Correct Answer is C

Explanation

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