A nurse is reviewing the arterial blood gas (ABG) result for a client diagnosed with progressive chronic obstructive pulmonary disease (COPD). The nurse should expect which of the following ABG findings for a client diagnosed with progressive COPD?
pH 7.55, PaCO2 30 mm Hg, PaO2 80 mm Hg, HCO3 24 mEq/L
pH 7.30, PaCO2 60 mm Hg, PaO2 70 mm Hg, HCO3 30 mEq/L
pH 7.40, PaCO2 40 mm Hg, PaO2 94 mm Hg, HCO3 22 mEq/L
pH 7.38, PaCO2 45 mm Hg, PaO2 88 mm Hg, HCO3 26 mEq/L
The Correct Answer is B
A. pH 7.55, PaCO2 30 mm Hg, PaO2 80 mm Hg, HCO3 24 mEq/L: This ABG finding indicates respiratory alkalosis, as evidenced by the elevated pH and decreased PaCO2. In progressive COPD, clients typically retain carbon dioxide rather than blow it off, so this finding would not be expected in a patient with chronic respiratory issues.
B. pH 7.30, PaCO2 60 mm Hg, PaO2 70 mm Hg, HCO3 30 mEq/L: This is the most consistent finding for a client with progressive COPD. The low pH indicates acidosis, and the elevated PaCO2 suggests respiratory acidosis due to carbon dioxide retention, a common problem in COPD. The elevated HCO3 indicates a compensatory metabolic response, as the body attempts to retain bicarbonate to buffer the acidosis.
C. pH 7.40, PaCO2 40 mm Hg, PaO2 94 mm Hg, HCO3 22 mEq/L: These values indicate a normal ABG, which would not be expected in a client with progressive COPD. Patients with chronic lung disease typically present with acid-base imbalances due to respiratory failure, so this finding suggests the client is not exhibiting the expected complications of COPD.
D. pH 7.38, PaCO2 45 mm Hg, PaO2 88 mm Hg, HCO3 26 mEq/L: Although these findings show mild acidosis, the PaCO2 is within normal limits, indicating that this patient may not be experiencing significant respiratory failure. In advanced COPD, one would expect to see a higher PaCO2 and more pronounced acidosis, making this option less characteristic of a patient with progressive COPD compared to option B.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. When asked about your strengths and weaknesses, focus primarily on your strengths. While highlighting strengths is important, interviewers also value self-awareness and the ability to recognize areas for improvement. Providing a well-balanced answer that includes a genuine weakness and how you are working to improve it demonstrates professionalism and a growth mindset.
B. Ask questions about the salary. While salary is an important consideration, bringing it up too early in the interview may give the impression that financial compensation is the primary concern. It is generally best to wait until the employer brings up salary or discuss it once a job offer has been extended.
C. Place your portfolio containing your resume on the interviewer's desk. Offering a resume or portfolio when asked is appropriate, but placing it on the interviewer’s desk without being invited to do so may come across as overly assertive. A more professional approach is to hand over documents when requested or when relevant to the discussion.
D. Ask questions about the position and the facility. Asking thoughtful questions about the role, work environment, team structure, and opportunities for growth shows genuine interest in the position. It also helps the candidate assess whether the job aligns with their professional goals. Engaging in meaningful dialogue makes a positive impression on the interviewer.
Correct Answer is B
Explanation
A. Poorly coordinated care and nosocomial infections are examples of errors: While poorly coordinated care can lead to adverse events, nosocomial infections are typically classified as healthcare-associated infections rather than errors. Errors generally refer to mistakes made in clinical practice that can lead to harm, whereas nosocomial infections are outcomes that arise from the healthcare environment.
B. As many as 90% of medication errors are preventable: This statement is true and highlights the significant opportunity for improvement in patient safety. Recognizing that a large percentage of medication errors can be prevented underscores the importance of implementing safety protocols, effective communication, and education to reduce the likelihood of errors occurring in clinical practice.
C. Errors of execution are usually intentional and occur because of time or resource constraints: This statement is misleading, as errors of execution typically refer to mistakes made during the performance of a task rather than intentional actions. These errors often occur due to lack of knowledge, skill, or attention rather than being intentional, and they are not solely attributed to time or resource constraints.
D. Medication errors are adverse events: While medication errors can lead to adverse events, not all medication errors result in harm. An adverse event is defined as an injury caused by medical management rather than the underlying condition of the patient, so this statement is not entirely accurate. Medication errors can be classified as near misses or adverse events, depending on whether they resulted in harm to the patient.
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