A nurse is reviewing arterial blood gas results for a client diagnosed with chronic obstructive pulmonary disease (COPD). The nurse should expect which abnormal finding?

Increased arterial oxygen

Increased pH

Increased carbon dioxide

Decreased alveolar function

Answer and Explanation

The Correct Answer is C

A. Increased arterial oxygen: Clients with COPD typically experience chronic hypoxemia due to alveolar destruction, airway inflammation, and mucus production, which impair gas exchange. Rather than increased oxygen levels, they often have a decreased PaO₂, requiring supplemental oxygen therapy. However, excessive oxygen administration can suppress their respiratory drive, worsening CO₂ retention.
B. Increased pH: COPD is associated with respiratory acidosis due to chronic CO₂ retention from inadequate alveolar ventilation. While the kidneys compensate by increasing bicarbonate retention, the pH usually remains low or near normal in chronic cases rather than becoming elevated. A higher pH would indicate alkalosis, which is not typical in COPD unless there is an additional metabolic disturbance.
C. Increased carbon dioxide: COPD causes airway obstruction and reduced alveolar ventilation, leading to CO₂ retention (hypercapnia). As CO₂ accumulates in the blood, it lowers the pH, resulting in respiratory acidosis. Chronic hypercapnia is a hallmark of advanced COPD, and in response, the kidneys retain bicarbonate to partially compensate, stabilizing the pH over time but leaving PaCO₂ elevated.
D. Decreased alveolar function: While COPD does lead to progressive alveolar damage and reduced gas exchange, this is a structural and functional change rather than a specific abnormality seen in arterial blood gases. The primary ABG finding in COPD is hypercapnia, which reflects inadequate ventilation and CO₂ retention rather than just decreased alveolar function alone.

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Correct Answer is D

Explanation

A. Develop a quality improvement program for nurses involved in medication administration errors. While quality improvement programs are essential, implementing a targeted program without first analyzing the root causes of errors may not effectively address the underlying issues. A broader review of system-wide factors contributing to medication errors is necessary before designing an intervention.
B. Require staff nurses to demonstrate competency by passing a medication administration examination. Competency assessments may help identify knowledge gaps, but they do not address system-based errors such as workload issues, unclear protocols, or distractions during medication administration. A root cause analysis should be conducted first to ensure that interventions target the actual sources of errors.
C. Provide an inservice on medication administration to all the nurses. Educational sessions can reinforce safe practices, but without identifying the specific factors contributing to errors, they may not be effective. Training should be tailored to address the findings from an initial review of the medication errors.
D. Review the events leading up to each medication administration error. The first step in continuous quality improvement is conducting a thorough analysis of the errors, identifying patterns, and determining root causes. This helps in designing targeted interventions, whether they involve process changes, additional training, or improved safety protocols.

A. The importance of adhering closely to the prescribed medication regimen. B. The client must remain in respiratory isolation until medication treatment ends. C. The fact that the disease is self-limiting, but can take up to two years to resolve. D. The importance of participating in physical therapy to re-establish functional abilities.

Correct Answer is A

Explanation

A. The importance of adhering closely to the prescribed medication regimen. Tuberculosis requires strict adherence to a long-term antibiotic regimen, typically lasting 6 to 9 months, to prevent drug resistance, treatment failure, and disease relapse. Noncompliance can lead to multidrug-resistant TB (MDR-TB), which is more difficult to treat. Directly observed therapy (DOT) is often recommended to ensure adherence.
B. The client must remain in respiratory isolation until medication treatment ends. While respiratory isolation is essential for active TB, it is not required until the full course of treatment is completed. Isolation is typically maintained until the client has received at least two weeks of effective therapy, symptoms improve, and three consecutive sputum smears are negative for acid-fast bacilli (AFB).
C. The fact that the disease is self-limiting, but can take up to two years to resolve. TB is not self-limiting; without proper treatment, it can persist indefinitely, worsen, and become fatal. Standard treatment with first-line drugs such as isoniazid, rifampin, ethambutol, and pyrazinamide effectively eradicates the infection within 6 to 9 months in most cases.
D. The importance of participating in physical therapy to re-establish functional abilities. While TB can cause fatigue and weakness, physical therapy is not a primary focus of treatment. The priority is to eradicate the infection through strict medication adherence, as untreated TB can progress to severe pulmonary damage, systemic involvement, and complications.

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A nurse is reviewing arterial blood gas results for a client diagnosed with chronic obstructive pulmonary disease (COPD). The nurse should expect which abnormal finding?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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