A nurse assesses a client who is admitted with an acid-base imbalance. The client's arterial blood gas values are pH 7.32. PaO2 85 mm Hg, PaCO2 34 mm Hg. and HCO3⁻16 mEq/L. What action should the nurse take next?

Encourage deep breathing exercises.

Administer sodium bicarbonate intravenously.

Place the client on a ventilator.

Increase the client's oxygen flow rate.

Answer and Explanation

The Correct Answer is B

Rationale:
A. Deep breathing exercises would help correct respiratory acidosis by eliminating CO₂, but this client has metabolic acidosis.
B. The ABG shows metabolic acidosis (low pH 7.32, low HCO₃⁻ 16, low PaCO₂ as partial compensation). The priority treatment may include IV sodium bicarbonate in severe cases to buffer excess acid.
C. Mechanical ventilation is indicated for respiratory failure, not metabolic acidosis.
D. Oxygen therapy is unnecessary since the PaO₂ is normal (85 mm Hg).

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Correct Answer is A

Explanation

Rationale:
A. Confusion is a common manifestation of pneumonia in older adults due to hypoxia and systemic infection, even if typical respiratory symptoms are mild or absent.
B. Hypertension is not a typical finding; pneumonia may actually cause hypotension in severe cases due to sepsis.
C. Unequal pupils are unrelated to pneumonia and may indicate neurological issues.
D. Tympany upon chest percussion indicates air in the pleural space (e.g., pneumothorax), not consolidation from pneumonia.

A. Short-acting inhalers should be used before exercise to prevent long-term asthma symptoms. B. Long-acting inhalers can replace the need for short-acting inhalers entirely. C. Short-acting inhalers should be taken daily to prevent asthma attacks. D. Long-acting inhalers should be used regularly to maintain control of asthma symptoms.

Correct Answer is D

Explanation

Rationale:
A. Short-acting inhalers (rescue inhalers, e.g., albuterol) can be used before exercise to prevent exercise-induced bronchospasm, but they are not meant for long-term control.
B. Long-acting inhalers (e.g., salmeterol, formoterol) do not replace short-acting inhalers; patients still need rescue inhalers for acute symptoms.
C. Short-acting inhalers are not taken daily; they are used only as needed for quick relief of acute symptoms.
D. Long-acting inhalers are taken regularly as maintenance therapy to provide ongoing control of asthma symptoms and prevent exacerbations.

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A nurse assesses a client who is admitted with an acid-base imbalance. The client's arterial blood gas values are pH 7.32. PaO2 85 mm Hg, PaCO2 34 mm Hg. and HCO3⁻16 mEq/L. What action should the nurse take next?

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Naxlex Comprehensive Predictor Exams

A nurse in the emergency department is assessing an older adult client who has community-acquired pneumonia. Which of the following findings should the nurse expect?

Correct Answer is A

Explanation

Which of the following statements is true regarding the use of long-acting and short-acting inhalers for asthma management?

Correct Answer is D

Explanation

Which of the following are the most common manifestations of COPD? (Select all that apply.)

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The nurse is caring for a client who has heart failure and a history of asthma. The nurse reviews the provider's orders and recognizes that clarification is needed for which of the following medications?

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Which of the following is a common characteristic of nonallergic asthma that a nurse might find when assessing an adult client?