A client's arterial blood gas (ABG) results show a pH of 7.30, PaCO2 of 40 mmHg, HCO3- of 20 mEq/L. These findings indicate which of the following conditions?

Respiratory acidosis

Respiratory alkalosis

Metabolic acidosis, uncompensated

Metabolic alkalosis, uncompensated

Answer and Explanation

The Correct Answer is C

A. Respiratory acidosis: Respiratory acidosis is characterized by a high PaCO2 level due to hypoventilation or impaired lung function, which is not reflected in this ABG result. The pH of 7.30 indicates acidosis, but the normal PaCO2 of 40 mmHg suggests it is not respiratory in nature.
B. Respiratory alkalosis: Respiratory alkalosis involves a decrease in PaCO2, which is not present here. The PaCO2 of 40 mmHg is within normal range, ruling out this possibility.
C. Metabolic acidosis, uncompensated: The low HCO3- of 20 mEq/L and the pH of 7.30 indicate metabolic acidosis. Since there is no compensation by the lungs (i.e., PaCO2 is not lowered), this is considered uncompensated metabolic acidosis.
D. Metabolic alkalosis, uncompensated: Metabolic alkalosis would involve an elevated HCO3- level and a higher pH, which is not seen in this case. The HCO3- is low, supporting metabolic acidosis, not alkalosis.

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Correct Answer is D

Explanation

A. Only the flail segment pulling inward during expiration: During expiration, the pressure inside the chest decreases, and typically the chest wall recoils outward. A flail segment moves abnormally in the opposite direction during inspiration, not expiration.
B. The entire chest pulling inward during expiration: Inward movement of the entire chest during expiration is not characteristic of flail chest. This could suggest severe respiratory distress or chest wall weakness, but not the hallmark sign of flail chest.
C. The entire chest pushing outward during inspiration: This is a normal movement during inspiration and not specific to flail chest. In flail chest, the abnormality is seen in the flail segment, not the entire chest.
D. Only the flail segment pulling inward during inspiration: This is the classic finding in flail chest. Due to the broken ribs losing continuity with the rest of the rib cage, the flail segment moves paradoxically—inward during inspiration and outward during expiration—opposite to the normal chest wall motion.

A. There are no audible sounds in an open pneumothorax. B. Air moves in and out of a wound in the chest wall. C. Air cannot pass freely into the thoracic cavity through a chest wound D. The air is trapped when it enters the cavity.

Correct Answer is B

Explanation

A. "There are no audible sounds in an open pneumothorax": An open pneumothorax typically involves audible sounds as air moves through the chest wound during inhalation and exhalation. It is not a silent condition.
B. "Air moves in and out of a wound in the chest wall": In an open pneumothorax, air can freely enter and exit through the wound, leading to a "sucking" wound. This causes a loss of pressure in the pleural space, potentially leading to collapsed lung tissue.
C. "Air cannot pass freely into the thoracic cavity through a chest wound": This statement is incorrect for an open pneumothorax. In fact, air passes freely through the chest wound in this condition, which distinguishes it from a closed pneumothorax.
D. "The air is trapped when it enters the cavity": This describes a tension pneumothorax, where air is trapped in the pleural space and cannot escape, causing pressure buildup. In an open pneumothorax, the air moves in and out of the wound.

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A client's arterial blood gas (ABG) results show a pH of 7.30, PaCO2 of 40 mmHg, HCO3- of 20 mEq/L. These findings indicate which of the following conditions?

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Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has flail chest. Which of the following findings should the nurse expect?

Correct Answer is D

Explanation

Which of the following is true regarding the physiology of an open pneumothorax?

Correct Answer is B

Explanation

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