A patient with chronic obstructive pulmonary disease (COPD) has the following arterial blood gas (ABG) results: a blood pH of 7.29, a partial pressure of carbon dioxide (PaCO2) level of 49 mm Hg, and a bicarbonate ion (HCO3) level of 25 mEq/L. Which condition would the nurse have in mind when developing the patient's plan of care?

Metabolic acidosis.

Metabolic alkalosis.

Respiratory acidosis.

Respiratory alkalosis.

Answer and Explanation

The Correct Answer is C

Choice A rationale:

Metabolic acidosis is characterized by low blood pH and low bicarbonate ion levels. In this case, the patient has a high bicarbonate ion level (25 mEq/L), indicating a compensatory response to respiratory acidosis. Metabolic alkalosis, on the other hand, would present with high pH and high bicarbonate ion levels.

Choice B rationale:

Metabolic alkalosis is characterized by high blood pH and high bicarbonate ion levels. The patient's bicarbonate ion level (25 mEq/L) is within the normal range, and the low pH and high PaCO2 (49 mm Hg) indicate respiratory acidosis, not metabolic alkalosis.

Choice C rationale:

Respiratory acidosis is characterized by low blood pH and high partial pressure of carbon dioxide (PaCO2) levels. In this case, the patient has a low pH (7.29) and elevated PaCO2 (49 mm Hg), indicating respiratory acidosis. The elevated bicarbonate ion level (25 mEq/L) is a compensatory response. Respiratory alkalosis would present with high pH and low PaCO2 levels.

Choice D rationale:

Respiratory alkalosis is characterized by high blood pH and low PaCO2 levels. The patient's PaCO2 level is elevated (49 mm Hg), indicating respiratory acidosis, not alkalosis. The low pH (7.29) further supports the diagnosis of respiratory acidosis.

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Correct Answer is A

Explanation

Choice A rationale:

The patient's symptoms of leg pain that worsens at night and occurs when the legs are elevated but improves when they are dangled are indicative of peripheral arterial disease (PAD) PAD is a condition caused by the narrowing of arteries in the legs due to atherosclerosis. This narrowing restricts blood flow to the muscles, causing pain, especially during activities or positions that demand increased blood flow like walking or elevating the legs.

Choice B rationale:

Lymphatic obstruction typically does not cause pain in the same manner described by the patient. Lymphatic obstruction may cause swelling and discomfort, but it usually does not lead to pain that worsens with elevation and improves with dangling.

Choice C rationale:

Chronic venous insufficiency can cause leg pain and swelling, especially when standing for extended periods. However, the characteristic of pain worsening at night and with leg elevation points more towards arterial issues like PAD rather than venous insufficiency.

Choice D rationale:

Musculoskeletal abnormalities could cause localized pain, but the pattern described by the patient (worsening at night, relief with dangling) is not typical of musculoskeletal issues. PAD, on the other hand, often presents with these specific symptoms due to compromised blood flow to the muscles in the legs.

A. "I will take a walk daily.” B. "I will try to lose at least 20 pounds.” C. "I will put on my stockings after I get out of bed each day.” D. "I will not wear knee-high socks that are tight around my calf.”

Correct Answer is D

Explanation

Choice A rationale:

Taking a daily walk is a beneficial activity for patients with venous leg ulcers. Walking promotes blood circulation, which can aid in wound healing. This statement indicates that the patient understands the importance of physical activity for their condition.

Choice B rationale:

Trying to lose weight is another positive step for a patient with venous leg ulcers, especially if the patient is overweight. Excess body weight can put additional pressure on the veins in the legs, worsening venous insufficiency. Losing weight can alleviate this pressure and improve venous circulation, supporting the healing process of leg ulcers.

Choice C rationale:

Wearing stockings after getting out of bed is a proper technique for managing venous leg ulcers. Compression stockings help improve blood flow in the legs and reduce swelling, which is beneficial for patients with venous insufficiency and leg ulcers. This statement indicates that the patient understands the importance of wearing compression stockings consistently.

Choice D rationale:

Not wearing knee-high socks that are tight around the calf is essential advice for patients with venous leg ulcers. Tight clothing, including socks or stockings, can impede blood circulation in the legs, worsening venous insufficiency and delaying wound healing. This statement indicates the need for further education because the patient should avoid any tight clothing around the affected area to promote optimal blood flow and wound healing.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient reports leg pain that awakens the patient at night.The patient reports that the same pain develops in the legs when they are elevated and disappears when the legs are dangled.Which condition would the nurse suspect?

Correct Answer is A

Explanation

The nurse provides discharge teaching to a patient with venous leg ulcers.Which statement made by the patient indicates the need for further education?

Correct Answer is D

Explanation

The nurse provides education to a patient about the symptoms of uncontrolled hypertension.Which symptom would the nurse include? Select all that apply.One, some, or all responses may be correct.

Which goal is a primary objective for a patient who has chronic heart failure (HF)?

A patient is diagnosed with primary hypertension and asks the nurse what caused the condition.Which response would the nurse give?

The blood pressure (BP) of a 71-year-old patient admitted with pneumonia is 160/70 mm Hg. Which age-related change contributes to this finding?

A patient who smokes reports chest pain while at rest.Which condition would the nurse suspect the patient is experiencing?

Which finding would the nurse expect to see in a patient with a hemoglobin level of 8 g/dL? Select all that apply.One, some, or all responses may be correct.

The nurse suspects that a patient has polycythemia vera based on which finding in the patient's laboratory reports? Select all that apply. One, some, or all responses may be correct.

Which arterial blood gas (ABG) data corresponds with a patient's clinical manifestations of respiratory alkalosis?